Tratamento do sobrepeso e obesidade: indicadores e medidas para acompanhamento das ações na atenção primária a saúde do município do Rio de Janeiro

• Autor(a) principal: Santos, Evelyn Kowalczyk dos
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/7293
• topic: Obesity; Indicators; Nutrition; Nutrição; Obesidade; Indicadores; CNPQ::CIENCIAS DA SAUDE::NUTRICAO::ANALISE NUTRICIONAL DE POPULACAO

Objective: a literature review was conducted to identify potential indicators, measures and tools in the management of overweight and obesity in adults. This set of measures were discussed by experts academic professionals and researchers in obesity treatment, looking for identifying potential indicators to be used in the primary health network, based on feasibility of data collection against limited public resources in Brazil. Methodology: The search was carried out in the following databases: Medline, Lilacs and SUMSearch to find articles and guidelines published from 1985 until april of 2016. A combination of MeSH terms and key-words related to obesity (such as body mass index; obesity; body weight; overweight) and health indicators (delivery of health care, continuity of patient care, needs assessment, patient care management, patient care planning, comprehensive health care, treatment outcome e health status indicator) were used to identify potential indicators, measures and tools. The indicators, measures and tools were then subdivided according the following dimensions: anthropometry and physical exam; biochemistry and blood circulation; dietary profile; socioeconomic, family and cultural issues; Psychological and emotional factors and lifestyle and health conditions. Six experts academic professionals and researchers held a meeting to discuss and reduce to a smaller contextualized subset the found indicators, measures and tools. Results: eighty one papers or guidelines were included, comprising a total of 181 different indicators, measures and tools: 43% related to psychological and emotional factors, of which 29,3% directly related to eating disorders; 20% to lifestyle and health conditions; 12% to biochemistry and hemodynamics; 9% to dietary profile; 9% to socioeconomic,family and cultural issues; and 9% to anthropometry. However, body mass index was the most mentioned indicator, found in 80% articles or guidelines, followed by waist circunference (27%), lipid profile (21%), weight loss(17%) and glicemia (17%). The discussion with experts academic professionals and researchers resulted in a subset of 19 indicators, measures and tools. Conclusions: Although there are many indicators, measures and tools, in the practice context, the research focus remains on the parameters of anthropometry, biochemistry and psychological and emotional factors, with a lack of feasibility on primary health network, specially for psychological and some biochemistry and hemodynamics factors. Since each location has a specific context, where some indicators may have greater potential for monitoring the health situation according to the resources available and needed for obtain it, thus, each scenario needs to be carefully evaluated for the elaboration of care lines with tangible goals and integral attention to the individuals