Conhecimento sobre asma de pediatras de hospitais públicos do Rio de Janeiro
Asthma knowledge among pediatricians at public hospitals in Rio de Janeiro, Brazil
Nelson Guilherme Bastos Cordeiro; Antônio José Ledo Alves da Cunha; Fabio Chigres Kuschnir
Resumo
Objetivo: Avaliar o conhecimento, atitudes e práticas sobre asma de pediatras que atuavam em serviços públicos hospitalares. Métodos: Estudo descritivo transversal envolvendo 76 pediatras de quatro hospitais públicos de emergência do município do Rio de Janeiro (RJ). Foram avaliados o conhecimento global (CGA) e específico sobre asma, além de atitudes e práticas, como frequência de prescrição de ß2-agonistas através de aerossol dosimetrado (AD), encaminhamento ao especialista, uso de espaçadores e do medidor do pico de fluxo expiratório (PFE). Resultados: Em relação ao CGA, 73,7% (55/76) da amostra total obteve conceito final insuficiente. Classificação e tratamento da asma alcançaram os percentuais mais baixos de acertos, 23,7% e 14,5% respectivamente. Somente 13,2% dos participantes utilizaram o PFE frequentemente, e a prescrição de ß2-agonistas através de AD foi indicada por apenas 21,9% da amostra, porém esta prática associou-se de modo significativo com o uso frequente de espaçadores (RP = 8,75; IC 95%: 1,07-71,06; p = 0,028) e do PFE (RP = 10,80; IC 95%: 2,31-50,45; p = 0,003). Houve forte associação entre ser alergista/pneumologista pediátrico e CGA suficiente (RP = 8,28; IC 95%: 1,46-46,8; p = 0,015) e uso frequente do PFE (RP = 6,64; IC 95%: 1,22-35,95; p = 0,044). Conclusões: O nível de conhecimento sobre asma dos pediatras que atuavam nos hospitais de emergência avaliados foi insatisfatório. Houve baixa utilização do PFE e subutilização de ß2-agonistas através de AD. A especialização melhorou a compreensão global da doença. Estes resultados reforçam a necessidade de estratégias na educação médica continuada, voltada para asma infantil, nos hospitais públicos do Município do RJ.
Palavras-chave
Abstract
Objective: To evaluate asthma knowledge, attitudes and practices among pediatricians working at public hospital services in Rio de Janeiro, Brazil. Methods: This cross-sectional study involved 76 pediatricians working at four publicly funded municipal emergency hospitals in Rio de Janeiro. Global knowledge on asthma (GKA) as well as specific knowledge, attitudes and practices such as frequency of prescription of inhaled ß2-agonists (in aerosol formulation), when to refer patients to specialists, use of spacers and peak expiratory flow (PEF) meters, were evaluated. Results: Regarding GKA, 73.7% of the sample (55/76) showed an insufficient final score. Asthma classification and treatment reached the lowest percentages of correct answers, with 23.7% and 14.5%, respectively. Only 13.2% of the participants used PEF meters regularly, and only 21.9% prescribed inhaled ß2-agonists; however, the latter practice was significantly associated with the use of spacers (PR = 8.75, 95%CI 1.07-71.06; p = 0.028) and PEF meters (RP = 10.80, 95%CI 2.31-50.45; p = 0.003). There was a strong association between being a pediatric allergist/ pulmonologist and having sufficient GKA knowledge (PR = 8.28, 95%CI 1.46-46.8; p = 0.015) and using a PEF meter frequently (PR = 6.64, 95%CI 1.22-35.95; p = 0.044). Conclusions: The level of asthma knowledge among pediatricians working at the emergency hospitals evaluated was unsatisfactory. There was a low frequency of use of PEF meters and also underuse of inhaled ß2-agonists. Being a specialist improved the global understanding of the illness. These results reinforce the need for continued medical education strategies focused on childhood asthma at public emergency hospitals in the city of Rio de Janeiro.
Keywords
Referências
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Submetido em:
14/08/2017
Aceito em:
29/09/2017
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