https://repositorio.ufpb.br/jspui/handle/tede/5442 PPGMDS Fri, 09 Oct 2026 11:57:11 GMT 2026-10-09T11:57:11Z https://repositorio.ufpb.br/jspui/handle/123456789/39231 Título: Fadiga, sofrimento psicológico, resiliência e uso de cigarro, álcool e outras substâncias psicoativas por fisioterapeutas brasileiros durante a pandemia de COVID-19 Autor(es): Pereira Júnior, Basílio Henrique Orientador: Ribeiro, Katia Suely Queiroz Silva Abstract: Objective: To analyze fatigue, psychological distress, resilience, and the use of cigarettes, alcohol, and other psychoactive substances among Brazilian physiotherapists during the COVID-19 pandemic. Methods: This cross-sectional, descriptive, and exploratory study involved 670 physiotherapists active during the pandemic across Brazil’s five macroregions. An online questionnaire was administered between October and December 2020. The study adhered to the STROBE and CHERRIES guidelines, ensuring standardization in electronic research. Psychological distress was assessed using the General Health Questionnaire (QSG-12); substantial fatigue, by the Dutch Fatigue Scale; resilience, by the Brief Resilient Coping Scale (EBCR); and substance use, by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST – WHO). Exploratory and confirmatory factor analyses were conducted for the QSG-12, Fatigue Scale, and EBCR. A canonical correlation analysis was performed between the QSG-12 and the Fatigue Scale. ASSIST outcomes were modeled via machine learning for three abuse endpoints (tobacco products, alcohol, and psychoactive substances). Tobacco abuse was modeled with a multilayer perceptron artificial neural network, while alcohol and psychoactive substance abuse were modeled with eXtreme Gradient Boosting (XGBoost). Results: The presence of psychological distress, substantial fatigue, and low resilience was detected among participants. Canonical correlation analysis revealed a strong association between the depression factor and substantial fatigue. Tobacco product abuse was linked to younger age (mean = 22 years), gender, single marital status, and non-religiosity. Excessive alcohol consumption correlated with non-practice of religion, higher frequency of use, and concurrent psychoactive substance use. Psychoactive substance abuse was associated with low resilience, larger household size, longer professional tenure, higher fatigue, greater psychological distress, and more frequent alcohol intake. Conclusion: All instruments demonstrated high statistical reliability, and the machine learning models exhibited excellent performance and predictive power. Findings underscore the physical and emotional vulnerability of physiotherapists during the pandemic and support the implementation of targeted intervention and support strategies to improve working conditions, as well as the development of public policies aimed at enhancing professionals’ quality of life. Moreover, these results provide a robust foundation for learning and readiness in future health emergencies. Editor: Universidade Federal da Paraíba Tipo: Tese Tue, 25 Feb 2025 00:00:00 GMT https://repositorio.ufpb.br/jspui/handle/123456789/39231 2025-02-25T00:00:00Z https://repositorio.ufpb.br/jspui/handle/123456789/39228 Título: Characteristics of long COVID: a survey-based study in Brazilian primary health care Autor(es): Ferreira, Assel Muratovna Shigayeva Orientador: Pernambuco, Leandro de Araújo Abstract: In Brazil, the knowledge regarding Long COVID prevalence, its specific clinical outcomes and overall impact on population health is severely limited. To address these existing gaps, the PhD study aimed to describe the prevalence, risk factors and clinical outcomes of Long COVID, and its impact on health-related quality of life among adults diagnosed with mild to moderate during the 2021 COVID-19 pandemic in Brazilian primary care. A retrospective cross-sectional survey was conducted in six Family Health Care Units in João Pessoa, Paraiba, from May 2023 to July 2024, using two instruments: 1) a standardized questionnaire containing 18 validated clinical outcomes, and 2) a generic EQ-5D-5L instrument for measuring health-related quality of life (HRQOL). To define Long COVID, the study adopted the definition outlined by the WHO (2021). Descriptive statistical analyses were used to describe the sociodemographic characteristics of the study population, COVID-19 vaccination status, symptoms, and the presence of comorbidities. The overall prevalence of Long COVID along with symptom-specific prevalence adjusted for sex and age, was estimated and compared between adults with and without Long COVID. EQ-5D-5L health index values and visual analogue scale (VAS) scores were analyzed to compare health-related quality of life between the two groups. Binary logistic regression models were used to examine the associations between Long COVID and clinical outcomes, risk factors, and health states. Of 226 respondents, 69.0% met the definition of Long COVID and had at least one persistent symptom following SARS-CoV-2 infection. A total of 16 clinical outcomes were significantly associated with Long COVID. The largest adjusted odds ratios (aORs) were observed for short-term memory loss, anxiety, and impaired attention. The risk factors for Long COVID included five or more symptoms, female sex, age 40–49 years, and age 70 years or older. Individuals with Long COVID continued to experience significantly poorer health-related quality of life two years or more after mild-to-moderate infection compared with those without persistent illness, regardless of sex, age, ethnicity, educational level, or comorbidities. Adults with this condition are at higher risk of experiencing health issues related to anxiety or depression, pain or discomfort, and deterioration in usual activities. This thesis highlights the need to target multidisciplinary services in primary care for COVID-19 survivors experiencing long-term health issues after infection. Furthermore, understanding the long-lasting health effects of SARS-CoV-2 infection and identifying adults at higher risk for enduring health issues can help health professionals, caregivers, and policymakers better address aspects of patients’ lives that lack quality and develop a multidisciplinary approach in primary care for managing this condition. Editor: Universidade Federal da Paraíba Tipo: Tese Fri, 06 Mar 2026 00:00:00 GMT https://repositorio.ufpb.br/jspui/handle/123456789/39228 2026-03-06T00:00:00Z https://repositorio.ufpb.br/jspui/handle/123456789/38957 Título: Impacto da Atenção Primária à Saúde sobre as internações por condições sensíveis no estado da Paraíba Autor(es): Nunes, Janaina Cristine Pereira Orientador: Leite, José Carlos de Lacerda Abstract: In Brazil’s Unified Health System (Sistema Único de Saúde – SUS), Primary Health Care (PHC) constitutes the first level of care and is responsible for coordinating patient care and organizing actions and services within the health care network. Over the years, PHC has undergone successive transformations, making it essential to assess the effectiveness of these changes. To this end, the number of Hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) is used as an indicator, referring to hospital admissions that could be avoided through effective, accessible, and high-quality PHC. The objective of this study was to analyze the profile and determinants of ACSC in the state of Paraíba in 2023, investigating the correlation between health care performance and socioeconomic and demographic indicators. An ecological and retrospective study was conducted across the 223 municipalities of Paraíba, using data from the Hospital Information System of the Unified Health System (SIH/SUS), e-Gestor AB, and the Brazilian Institute of Geography and Statistics (IBGE). Data systematization was performed using the csapAIH package in the R environment. For association analysis, Beta regression with a complementary log-log link function was applied. A total of 67,229 ACSC hospitalizations were recorded, with urinary tract infections, cerebrovascular diseases, and pneumonia being the most prevalent causes, predominantly affecting females. Although regional health hubs concentrated the highest absolute volumes of hospitalizations, the highest rates were observed in small municipalities, with an atypical persistent pattern identified in Uiraúna. The model (R² = 0.2774) indicated that the number of Family Health Strategy (FHS) teams exerts a robust protective effect. However, the positive association between the volume of registered individuals and ACSC suggests that nominal expansion of coverage, without corresponding clinical resolutiveness, may increase hospital demand. Notably, Gross Domestic Product (GDP) and the Municipal Human Development Index (MHDI) were not statistically significant, indicating that health system organization outweighs isolated economic determinants in explaining avoidable hospitalizations. It is concluded that the consolidation of the health care network depends on overcoming the hospital-centered model and strengthening longitudinal clinical management within PHC. Editor: Universidade Federal da Paraíba Tipo: Dissertação Fri, 27 Feb 2026 00:00:00 GMT https://repositorio.ufpb.br/jspui/handle/123456789/38957 2026-02-27T00:00:00Z https://repositorio.ufpb.br/jspui/handle/123456789/38661 Título: Efficacy of voice therapy associated with photobiomodulation in individuals with behavioral dysphonia: a randomized triple-blind clinical trial Autor(es): Santana, Émile Rocha Orientador: Lopes, Leonardo Wanderley Abstract: OBJECTIVE: To compare the efficacy of vocal therapy associated with photobiomodulation with isolated voice therapy in patients with behavioral dysphonia. METHODS: This was a randomized, prospective, triple-blind clinical trial, with random allocation of participants in two intervention groups: VT-LLLT (Vocal Therapy Associated with Low-Level Laser Therapy), VT-PLT (Vocal Therapy Associated with Placebo Laser Therapy). VT-LLLT received low-level laser therapy (10mW power, 808nm infrared, point, 30J) associated with the Comprehensive Vocal Rehabilitation Program (CVRP) for 8 sessions; VT-PLT received laser placebo before performing the CVRP for 8 sessions. 39 women with behavioral dysphonia between the ages of 18 and 60 years attended the Speech Therapy Clinic at the Federal University of Paraíba (UFPB) and the State University of Bahia to participate. The subjects who agreed to participate in the study signed a Free and Informed Consent Form (ICF). Videolaringostroboscopy were assessed using the Laryngeal Vibration and Structural Assessment Form (LVSAF); vocal self-assessment tools were also applied [The Voice Symptom Scale (VoiSS), Voice Handicap Index (VHI-10) and Voice Severity Rating Scale (VSRS)]; computerized acoustic assessment of the voice samples was performed with extraction of Jitter, Shimmer, Cepstral Peak Prominence Smoothed (CPPS), difference between the amplitude of the first and second harmonics (H1-H2), Harmonic-to-Noise Ratio (HNR), Glottal-to-Noise Excitation Ratio (GNE), Acoustic Voice Quality Index (AVQI), Acoustic Breathness Index (ABI), using the PRAAT and Voxplot softwares; Overall Severity of dysphonia (OS) was extracted through Visual Analog Scale (VAS) using the software VOXMore after choosing the most reliable judge. All evaluations were performed before and after intervention in subjects of all groups. The intervention lasted 8 weeks with weekly monitoring by the researcher and team in the proposed procedures. Statistical analysis to compare all evaluation outcomes before and after intervention, as well as the group differences that occurred, applying parametric and non-parametric tests with Statistical Package Software for Social Sciences (SPSS) 29.0.2.0 and R Studio 2025.09.1 programs, considering a confidence level of 95%. Machine Learning classifier results were generated using Weka 3.8.6 to recognize voice parameter patterns in the acoustic and self-assessment post-intervention data and classify the groups. RESULTS: ENT and self-assessment variables did not show statistical difference between the groups, only related to the time factor; CPPS (p=0.049), and AVQI (p=0.014) demonstrated a group factor statistically significant with better values on the VT-LLLT group after intervention; OS also showed a statistically significant effect related to the group factor with a better progress in the VT-LLLT group (p=0.002). Hybrid machine learning classifiers showed good accuracy (84,62%) on recognizing patterns and classifying both groups, but the VT-LLLT stood up. CONCLUSION: The results suggest that the LLLT combined with vocal therapy is more effective than isolated vocal therapy on BD treatment. Editor: Universidade Federal da Paraíba Tipo: Tese Fri, 19 Dec 2025 00:00:00 GMT https://repositorio.ufpb.br/jspui/handle/123456789/38661 2025-12-19T00:00:00Z