Avaliação de conhecimentos e práticas dos profissionais da atenção primária à saúde sobre sono

Abstract

Introduction: Problems with the sleep/wake cycle and sleep disorders are considered public health problems, which can harm an individual's quality of life and well-being. However, there is little in the scientific literature what health professionals in the context of PHC in Brazil know about sleep and what professional practices are related to assisting the population with sleep changes and disorders. Objective: To evaluate knowledge about the sleep/wake cycle and sleep disorders and the application of this knowledge in the field of work among primary health care professionals in the context of the 5th Regional Public Health Unit (URSAP). Methods: 83 professionals with completed higher education, of both sexes, were included in the sample, of which 13 (with more than 1 year of experience in PHC) participated in the interviews. Sociodemographic information and knowledge about sleep were collected through the “A Saúde e o Sono” questionnaires and the translated version of the “Assessment of Sleep Knowledge in Medical Education” (ASKME). The Chi-square test was used to evaluate the sample distribution according to sociodemographic variables; sources of obtaining information; way of applying knowledge; percentage of correct answers and errors per knowledge question and the average percentage of correct answers for the questionnaire as a whole and for each domain/category. Working time and self-perception of knowledge about sleep were described as mean and standard deviation. Regarding qualitative data, word clouds, similarity analysis, Descending Hierarchical Classification (CHD) and content analysis were performed. Results: Most participants were aged 30 to 39 years (49.4%), female (72.3%), brown (50.6%), with postgraduate degrees (61.1%), average length of work of 3.7 ± 4.5 years, 68 non-medical professionals and 15 physicians, with an average knowledge of 5.7 ± 1.9 on the Likert scale. The most sought-after source of information about sleep was digital media (60.2%), followed by undergraduate degrees (48.2%). Regarding knowledge about sleep hygiene, 35% answered “more or less” and reported using the information for their daily routine and to guide PHC users. Furthermore, 73% were not aware of the PHC notebooks from the Ministry of Health that provide guidance on the importance of asking patients about sleep. Regarding knowledge about sleep (health and sleep), the statements about “Consequences of Sleep Deprivation” were those that obtained the highest percentage of correct answers (93.07%). Overall, the categories had 71.05% of correct answers. In ASKME, the highest percentages of correct answers were for the statements about “Insomnia” (62.25%) and “Principles of Circadian Rhythm” (62.95%). The frequency of correct answers in the total questionnaire was 44.97%. Regarding qualitative data, many professionals reported asking about patients’ sleep, however, they reported that there was never any action in the workplace. Despite this, they attest to the possibility of carrying out interventions on the subject. Regarding guidance on sleep during consultations, it was noted that most professionals felt insecure about talking about what was passed on to patients. Finally, the content analysis generated 2 thematic categories: “Work process of health professionals in their workplaces” and “Approach to sleep in the workplace: absence and possibilities of integration into the professional routine”. Final considerations: There are significant gaps in terms of detailed knowledge about CSV, sleep disorders and sleep hygiene practices based on scientific evidence. In addition, some professionals summarize their guidance in talking about sleep hygiene, disregarding individual differences in bedtime and wake-up times and the need for sleep hours of individuals.