Efeitos da educação em saúde na aprendizagem, mudança de atitude e desenvolvimento cognitivo de crianças de área endêmica para helmintoses

Abstract

This study aimed to evaluate the effects of two methods of Health Education in learning, attitude change and cognitive development of healthy and infected children, previously treated for helminths. This is a longitudinal quasi-experimental study (lasting eight months), conducted in a rural area of NE Minas Gerais state, Brazil, where helminth infection is endemic. Ninety-eight children of both genders participated in this study and were randomly distributed in three groups: the first group received Non-Directive Pedagogy (NDP), based on the works of John Dewey; the second group received Directive Pedagogy (DP), based on traditional educational methods; and the third group (Control group) received activities unrelated to Pedagogy. For the Non-Directive Pedagogy group (NDP) and the Directive Pedagogy group (DP), themes such as helminth infections and transmission, hygiene, health-care and the environment were approached. Three methods were used to collect data pre- and post- intervention: (1) a structured questionnaire, (2) a semi-structured questionnaire, and (3) a cognitive test battery, including the Raven, Wisc-III and DFH III psychological tests. These tests were applied before and after the educational intervention took place to evaluate changes in learning, attitude, and the cognitive development of children, respectively. Before starting the study, children were tested for helminth infection through a parasites exam and, if results came positive, they were treated, and an egg-negative study was then initiated. For intragroup comparison, of results concerning questionnaires and psychological tests, data was analyzed by comparing the mean percentage before and after the tests (Paired-Samples T Test); to compare intergroup performance, ANOVA and Turkey Tests were utilized. For a comparison between the healthy group and the infected group in pre-intervention, and within the Education group (children from NDP and DP Groups) and the Control group, the Mann Whitney test was used. In relation to the general knowledge on helminthiasis, the three groups presented statistically significant development. However, despite the higher proportional gain of the NDP group, there was no statistically relevant difference between the advances of those groups (p > 0.005). Concerning specific knowledge of each helminth, the results showed equally significant advances in the NDP and DP groups (p: 0.001 and p: 0.001, respectively). The results obtained from the semi-structured questionnaire showed that there was no change in health attitude following the educational intervention. In relation to the psychological tests, results showed small improvements in cognitive development; however, they were statistically insignificant in as much as allowing changes in the classification level of cognition of the test subjects. Therefore, even though educational intervention was efficient in promoting learning in regard to helminthiasis, there was not enough time to attain improvement in the cognitive function of the subjects. As for the relation among learning, cognitive development and infection, it was verified that infected children who were subjected to educational methods (Education group) showed some improvement if compared to the ones in the Control group. The fact that two educational methods have produced equally important results regarding learning can be explained considering that the fluid time-space of DP is incompatible with the need to consolidate knowledge and attitude, indicated in health education.