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塞尔希培州公立和私立卫生网络中 STEMI 患者院内营养咨询质量:VICTIM 登记。

Quality of Intra-Hospital Nutritional Counseling in Patients with STEMI in the Public and Private Health Networks of Sergipe: The VICTIM Register.

机构信息

Universidade Federal de Sergipe - Programa de Pós-Graduação em Ciências da Saúde, São Cristóvão, SE - Brazil.

Universidade Federal de Sergipe - Departamento de Nutrição, São Cristóvão, SE - Brazil.

出版信息

Arq Bras Cardiol. 2019 Jul 18;113(2):260-269. doi: 10.5935/abc.20190124.

Abstract

BACKGROUND

Having appropriate dietary habits is part of the recommendations after ST-Elevation Myocardial Infarction (STEMI), however, the quality of intra-hospital nutritional counselling in the different health services has been minimally explored.

OBJECTIVE

To evaluate the quality of intra-hospital nutritional counselling among patients with STEMI in the public and private health systems in Sergipe.

METHODS

A cross-sectional, with data from the Via Crucis for the Treatment of Myocardial Infarction (VICTIM) Register, conducted from April to November of 2017, with individuals aged ≥ 18 years diagnosed with STEMI, in one public health service hospital and three private hospitals. The occurrence and quality of nutritional counselling were analyzed based on current guidelines and the administration of questionnaires. A significance level of 0.05 was adopted.

RESULTS

A total of 188 patients were analyzed; 80.3% were from the public health service facility. Among the interviewees, 57.6% of the public health service, and 70.3% of the private hospital patients received intra-hospital nutritional counselling (p = 0.191). The documentation of this practice, in medical records, was lower in the public service (2.6% vs. 37.8%, p < 0.001). A predominance of restrictive orientations was found in the public and private sectors, mainly regarding salt and fat, 52.3% and 70.3% respectively (p = 0.064). Patients from the private service were more counselling to introduce of cardioprotective foods, mainly fruit, vegetable/legume consumption (48.6% vs. 13.2%, p < 0.001). Among those who received counselling, nutritional knowledge was higher in the private sector (68.2% vs. 26.3%, p < 0.001).

CONCLUSION

The intra-hospital nutritional counselling provided to patients with STEMI, in Sergipe, still presents poor quality in both services, especially in the public health system.

摘要

背景

养成适当的饮食习惯是 ST 段抬高型心肌梗死(STEMI)后的建议之一,然而,不同医疗服务机构内部的住院期营养咨询质量仅得到了初步探索。

目的

评估塞尔希培州公立和私立医疗系统中 STEMI 患者的住院期营养咨询质量。

方法

本研究为 2017 年 4 月至 11 月进行的一项横断面研究,数据来自 Via Crucis 心肌梗死治疗登记处(VICTIM),研究对象为年龄≥18 岁的 STEMI 确诊患者,他们分别来自一家公立医院和三家私立医院。根据现行指南和问卷调查结果分析营养咨询的发生情况和质量。采用 0.05 为检验水准。

结果

共分析了 188 例患者;80.3%的患者来自公立医院。在受访者中,57.6%的公立医院患者和 70.3%的私立医院患者接受了住院期营养咨询(p=0.191)。公立医院患者的医疗记录中记录该操作的比例较低(2.6%比 37.8%,p<0.001)。在公立和私立部门中,均以限制饮食为主导,主要涉及盐和脂肪,分别为 52.3%和 70.3%(p=0.064)。私立医院的患者更倾向于建议摄入具有心脏保护作用的食物,主要是水果和蔬菜/豆类(48.6%比 13.2%,p<0.001)。在接受咨询的患者中,私立部门的营养知识更高(68.2%比 26.3%,p<0.001)。

结论

在塞尔希培州,无论是在公立医院还是私立医院,STEMI 患者的住院期营养咨询质量都较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/767d/6777890/7f6dbbbcc1c6/abc-113-02-0260-g01.jpg

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