Determinantes Psicossociais da Infecção Respiratória Aguda em lactentes no terceiro mês de vida

Abstract

This thesis involves two related studies. In the first, was conducted a cross-cultural adaptation for the Brazilian portuguese of the instrument Sense of Community Index (SCI). The second manuscript aimed to evaluate the psychosocial determinants, represented by the sense of community, social support, social networking and maternal depression, of acute respiratory infection (ARI). In appreciation of the cross-cultural adaptation, were considered semantic and measurement equivalences. The results point to moderate reliability. Factor analysis of the Sense of Community Index version resulted in a different dimensionality as proposed in the development of the original instrument. In a cross-sectional study, scales for analysis of psychosocial determinants of acute respiratory infection were applied to mothers of infants users of primary health care units of Rio de Janeiro. Data were collected between 2005 and 2009. Information regarding ARI were obtained by the description of mothers about the presence of cough and fever or difficulty breathing. The associations between exposure and outcome were verified by odds ratio estimates and their 95% confidence intervals. ARI was present in 121 infants (28.8%). Severe acute respiratory infection, considered as the accumulation of symptoms investigated, involved 22 children (5.2%). In the final model ARI was associated with an agglomeration at home (P = 0.02), inadequate garbage disposal (P ≤ 0.01) and living with a partner (P = 0.05). Severe ARI was associated only with prematurity (P = 0.03) and age (P = 0.03). Although the psychosocial determinants of health were not associated with ARI in the studied population, this is a theme poorly elucidated in the literature and should be considered in future studies. To prevent ARI among lactants there is a need for establishing partnerships in search for innovative and sustainable technologies that favours the recognition of other strategies that could be used in primary health care