ABC | Volume 113, Nº2, August 2019

Original Article Quality of Intra-Hospital Nutritional Counseling in Patients with STEMI in the Public and Private Health Networks of Sergipe: The VICTIM Register Ticiane Clair Remacre Munareto Lima, 1 Danielle Góes da Silva, 2 Ikaro Daniel de Carvalho Barreto, 3 Jussiely Cunha Oliveira, 4, 5 Laís Costa Souza Oliveira, 1, 6 L arissa Andreline Maia Arcelino, 1 J eferson Cunha Oliveira, 1, 6 Antônio Carlos Sobral Sousa, 1,7, 8 J osé Augusto Soares Barreto Filho 1,7, 8 Universidade Federal de Sergipe – Programa de Pós-Graduação em Ciências da Saúde, 1 São Cristóvão, SE – Brazil Universidade Federal de Sergipe – Departamento de Nutrição, 2 São Cristóvão, SE – Brazil Universidade Federal Rural de Pernambuco – Núcleo de Pós-graduação em Biometria e Estatística Aplicada, 3 Recife, PE – Brazil Universidade Federal de Sergipe – Programa de Pós-Graduação em Enfermagem, 4 São Cristóvão, SE – Brazil Universidade Tiradentes, 5 Aracaju, SE – Brazil Hospital Primavera, 6 Aracaju, SE – Brazil Universidade Federal de Sergipe – Departamento de Medicina, 7 São Cristóvão, SE – Brazil Fundação São Lucas – Centro de Ensino e Pesquisa, 8 Aracaju, SE – Brazil Mailing Address: Ticiane Clair Remacre Munareto Lima • Universidade Federal de Sergipe – Programa de Pós-Graduação em Ciências da Saúde Rua Cláudio Batista, s/n. Postal Code 49060-108, Cidade Nova, Aracaju, Sergipe - Brazil E-mail: ticiane.nutricionista@gmail.com Manuscript received June 25, 2018, revised manuscript October 08, 2018, accepted October 24, 2018 DOI: 10.5935/abc.20190124 Abstract Background: Having appropriate dietary habits is part of the recommendations after ST-ElevationMyocardial Infarction (STEMI), however, the quality of intra-hospital nutritional counseling in the different health services has been minimally explored. Objective: To evaluate the quality of intra-hospital nutritional counseling 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 counseling 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 counseling (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 counseling to introduce of cardioprotective foods, mainly fruit, vegetable/legume consumption (48.6% vs. 13.2%, p < 0.001). Among those who received counseling, nutritional knowledge was higher in the private sector (68.2% vs. 26.3%, p < 0.001). Conclusion: The intra-hospital nutritional counseling provided to patients with STEMI, in Sergipe, still presents poor quality in both services, especially in the public health system. (Arq Bras Cardiol. 2019; 113(2):260-269) Keywords: ST Elevation Myocardial Infarction; Health Education/methods; Healthy Diet; Risk Reduction Behavior; Healthcare Disparities; Nutritional Support; Hospitals,Public; Hospitals, Private. Introduction Cardiovascular diseases (CVD) are the leading causes of death in the world, with a higher prevalence in low- and middle‑income countries. They are responsible for approximately 30%of deaths in Brazil annually, and the ischemic heart diseases are the main causes of this high mortality, with an emphasis on acute myocardial infarction (AMI), due to its magnitude and the severity of its clinical prognosis. 1-5 After the acute coronary event, actions are necessary for secondary prevention of the disease, which should consist of adherence to prescribed medication therapy and lifestyle changes, with an emphasis on the practice of programmed physical activity, adoption of healthy eating habits, and smoking cessation. 6-10 Changes in dietary patterns were highlighted in the prevention and treatment of CVD in epidemiological studies. These studies reinforced that a free of trans-fatty acid diet, restriction of saturated fat, salt, alcoholic beverages, and increase in dietary fibre with a predominance of whole grains, fruits, vegetables and legumes, brought cardioprotective 260