Perceptions of quality of life by female sex workers from the rural area of the Sertão Produtivo Baiano, Brazil: a phenomenological study.

INTRODUCTION: Paid sexual services performed by women are surrounded by stigma and associated prejudice and shame results in vulnerability, making it very difficult for these women to achieve a good quality of life. Such an environment is exacerbated by intersectionalities that mark the trajectory of women who have the ability and desire to obtain income in sexual practice. They experience inequities in gender, race and class and, above all, bear marks of struggle and survival, being residents of a poor, rural region of Brazil, far from urban centers. The objective of this study was to understand the meanings that female sex workers living in rural areas attribute to quality of life using Sartre's phenomenological perspective. METHODS: This was a qualitative study from a larger project. For this study, we interviewed 30 female sex workers living in a rural area of the Sertão Produtivo da Bahia region, Brazil. The in-depth interview comprised two guiding questions: (1) 'Tell me what you mean by quality of life, as a sex worker'; and (2) 'Tell me how you experience well-being and quality of life when you are a sex worker and a rural resident'. The narratives resulting from the interviews were organized, categorized and operationalized from the hermeneutics dialectic. The interpretations were anchored in theoretical reference to Sartre's phenomenology. RESULTS: Some meanings were congruent in the women's narratives of their daily lives (described or observed), giving rise to three categories of analysis: the sex workers' concept of quality of life; whether they believed they have good quality of life or not; and what is required to achieve good quality of life. Three categories emerged, organized in a framework, the themes of which refer to the experience of sex workers as poor women living in the countryside: (1) quality of life as a synonym for health, food, and healthy life; (2) difficulties in achieving good quality of life; and (3) without money, there is no quality of life. CONCLUSION: The fact that these female sex workers come from a poor region of Brazil and live in a rural area far from urban centers leads to unique difficulties for them. They suffer from marginalization and restricted social services as a result of their circumstances, and highly value the freedom to face the difficulties of day-to-day life that their income from sex work provides. Good quality of life for these women is achieved by striving for physical health, food, and well-being (goals made attainable by that income), but can be hindered by violence.

Quality of life from women's perspective in the exercise of sex work: a study of social representations.

OBJECTIVES: to analyze the social representations elaborated by sex workers from Alto Sertão Produtivo Baiano about quality of life. METHODS: a qualitative study, based on the Social Representation Theory, carried out in the region of Alto Sertão Produtivo Baiano, with 30 sex workers. Individual in-depth interview was carried out, with speeches organized in a corpus and treated in IRAMUTEQ, enabling lexical analysis for Descending Hierarchical Classification. RESULTS: four thematic classes emerged, in which social representations of quality of life pervade: money earned to supply needs; association with healthy living and obtaining health (physical and mental); balance of emotions (although there are some negative sensations such as fear and anxiety); and faith in a deity. FINAL CONSIDERATIONS: the social representations elaborated by sex workers about quality of life are anchored in concepts, subjective and practical, punctuated by the World Health Organization.

Saúde mental de trabalhadoras sexuais na pandemia da COVID-19: agentes estressores e estratégias de coping / Mental health of female sex workers in the COVID-19 pandemic: stressors and coping strategies

Resumo Objetivou-se analisar as estratégias de coping adotadas por trabalhadoras sexuais frente aos agentes estressores decorrentes da pandemia da COVID-19. Estudo qualitativo, apoiado nas teorias do Sistemas e Coping. Realizou-se entrevista em profundidade com 30 trabalhadoras sexuais, do Alto Sertão Produtivo Baiano, entre os meses de setembro e outubro de 2020. As narrativas foram submetidas aos recursos da hermenêutica-dialética para organização das categorias. Quatro categorias remetem aos agentes estressores do sistema: sentimentos negativos de medo, ansiedade e dificuldades de dormir com as incertezas diante da pandemia; preocupação com o sustento dos familiares; irritabilidade diante de conflitos; angústias e inseguranças com as condições de trabalho. Cinco categorias fazem alusão ao coping: focam no problema (pandemia); ressignificação e regulação de emoções; espiritualidade e religiosidade; redes de apoio e suporte social; uso de substâncias e medicamentos. Os estressores surgem em decorrência das vivências do serviço sexual aliadas a situação pandêmica com redução de clientes e renda, desenvolvendo sentimentos e emoções negativas. Todavia, as estratégias de coping são diversas e tentativas de lidar com os problemas e equilibrar a saúde mental.

Abstract The objective was to analyze the coping strategies adopted by female sex workers in the face of stressors resulting from the COVID-19 pandemic. Qualitative study supported by Systems and Coping theories. An in-depth interview was carried out with 30 sex workers from the Alto Sertão Produtivo Baiano between September and October 2020. The narratives were submitted to the resources of hermeneutics-dialectic to organize the categories. Four categories make reference to the system's stressors: negative feelings of fear, anxiety and difficulties in sleeping with the uncertainties in the face of the pandemic; concern about personal and family support; irritability in the face of conflicts; anxieties and insecurities with working conditions. Five categories allude to coping: strategies focused on the problem (pandemic); reframing and regulation of emotions; spirituality and religiosity; support networks and social support; use of medications. Stressors arise as a result of sexual service experiences combined with the pandemic situation with reduced customers and income, leading to the development of negative feelings and emotions. However, coping strategies are diverse and they women made effort to deal with problems and to balance their mental health.

Mental health of female sex workers in the COVID-19 pandemic: stressors and coping strategies. / Saúde mental de trabalhadoras sexuais na pandemia da COVID-19: agentes estressores e estratégias de coping.

The objective was to analyze the coping strategies adopted by female sex workers in the face of stressors resulting from the COVID-19 pandemic. Qualitative study supported by Systems and Coping theories. An in-depth interview was carried out with 30 sex workers from the Alto Sertão Produtivo Baiano between September and October 2020. The narratives were submitted to the resources of hermeneutics-dialectic to organize the categories. Four categories make reference to the system's stressors: negative feelings of fear, anxiety and difficulties in sleeping with the uncertainties in the face of the pandemic; concern about personal and family support; irritability in the face of conflicts; anxieties and insecurities with working conditions. Five categories allude to coping: strategies focused on the problem (pandemic); reframing and regulation of emotions; spirituality and religiosity; support networks and social support; use of medications. Stressors arise as a result of sexual service experiences combined with the pandemic situation with reduced customers and income, leading to the development of negative feelings and emotions. However, coping strategies are diverse and they women made effort to deal with problems and to balance their mental health.

Objetivou-se analisar as estratégias de coping adotadas por trabalhadoras sexuais frente aos agentes estressores decorrentes da pandemia da COVID-19. Estudo qualitativo, apoiado nas teorias do Sistemas e Coping. Realizou-se entrevista em profundidade com 30 trabalhadoras sexuais, do Alto Sertão Produtivo Baiano, entre os meses de setembro e outubro de 2020. As narrativas foram submetidas aos recursos da hermenêutica-dialética para organização das categorias. Quatro categorias remetem aos agentes estressores do sistema: sentimentos negativos de medo, ansiedade e dificuldades de dormir com as incertezas diante da pandemia; preocupação com o sustento dos familiares; irritabilidade diante de conflitos; angústias e inseguranças com as condições de trabalho. Cinco categorias fazem alusão ao coping: focam no problema (pandemia); ressignificação e regulação de emoções; espiritualidade e religiosidade; redes de apoio e suporte social; uso de substâncias e medicamentos. Os estressores surgem em decorrência das vivências do serviço sexual aliadas a situação pandêmica com redução de clientes e renda, desenvolvendo sentimentos e emoções negativas. Todavia, as estratégias de coping são diversas e tentativas de lidar com os problemas e equilibrar a saúde mental.

Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study.

BACKGROUND: Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness. OBJECTIVE: Estimate the prevalence of Metabolic Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil. METHOD: Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described. RESULTS: MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35-2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05-1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18-1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13-2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48-4.46) were associated with MS. CONCLUSION: The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.

Repercussions of the COVID-19 pandemic on health professionals in the state of Rio de Janeiro / Brazil.

Brazil has been severely affected by the COVID-19 pandemic. The high numbers of confirmed cases and deaths have continued unabated since the first reported case, with no flattening or downward turn in the curve. In this context, healthcare workers have been exposed uninterruptedly to stress factors throughout a year of the pandemic. The study´s aim was to identify and analyze healthcare workers´ perceptions of their feelings and concerns that have surfaced in responding to the pandemic. METHOD: This was a cross-sectional online qualitative survey study of 554 healthcare personnel working in the state of Rio de Janeiro during the COVID-19 pandemic. Recruitment occurred from July 20 to September 30, 2020, using an online survey, preceded byfree informed consent term. Data were analyzed with the Iramuteq software. RESULTS: Through a dendrogram, the words with the highest chi-square were highlighted and grouped into four classes: healthcare workers´ fear of falling ill to COVID-19 and infecting their family members; work/labor issues; feelings of powerlessness and need for public policies for government action; and fatigue and burnout in the pandemic. Each word class was also illustrated by a similarity tree. CONCLUSION: The study revealed healthcare workers´ exacerbated fear of infection and transmission of COVID-19 to their family members, besides financial losses and feelings of powerlessness and abandonment.

Pacientes com Câncer e suas Representações Sociais sobre a Doença: Impactos e Enfrentamentos do Diagnóstico / Cancer Patients and their Social Representations about the Disease: Impacts and Confrontations of the Diagnosis / Pacientes con Cáncer y sus Representaciones Sociales sobre la Enfermedad: Impactos y Confrontaciones del Diagnóstico

Introdução: O diagnóstico de câncer atinge diversos aspectos, como emocionais, de relacionamento, espirituais e financeiros, tornando-o um importante problema de saúde pública mundialmente. Objetivo: Analisar a estrutura das representações sociais do câncer para pacientes oncológicos hospitalizados adultos e apontar sua relação com aspectos do cotidiano de enfrentamento do diagnóstico e do adoecimento por essa patologia. Método: De natureza qualitativa, descritiva e exploratória, embasado na Teoria das Representações Sociais. O cenário foi um hospital federal de câncer, no município do Rio de Janeiro, com 111 participantes vivendo o adoecimento oncológico. Foram coletadas as evocações livres ao termo indutor "câncer" e aplicado o questionário para caracterização dos pacientes. A análise se deu por intermédio do software EVOC 2005. Resultados: Participantes, majoritariamente homens (69,3%), com ensino fundamental (57,6%). Apresentaram-se como provável núcleo central: doença, tristeza e morte. O conhecimento reificado do câncer ocorreu por meio da palavra "doençaË®. Reconhece-se o predomínio de elementos negativos, ainda que hajam alguns positivos como tratamento, cura e Deus na representação do grupo. A doença em voga carreia estigma, tornando o enfrentamento um processo doloroso e triste. Conclusão: É possível observar o pesar de estar com câncer na visão dos pacientes, ao passo que a esperança existe e os move em direção à cura. Identifica-se a necessidade de o profissional enfermeiro dar enfoque no que diz respeito à dimensão espiritual e religiosa em seu cuidado, entendendo o indivíduo como um ser único e complexo que demanda cuidados individuais.

Introduction: The diagnosis of cancer affects several aspects, whether emotional, relationships, spiritual and financial, making it an important public health problem worldwide. Objective: To analyze the structure of social representations of cancer for adult hospitalized cancer patients and reveal its relations with daily aspects of coping with the diagnosis and sickening by this pathology. Method: Qualitative, descriptive and exploratory based in the Theory of Social Representations. The scenario was a federal cancer hospital in the city of Rio de Janeiro, with 111 participants living the oncological sickening. Free evocations related to the inducing term "cancer" were collected and a questionnaire was applied to characterize the patients. The EVOC 2005 software was utilized for the analyses. Results: Mostly male participants (69.3%), with elementary education (57.6%) appeared as probable core nucleus: disease, sadness and death. The reified knowledge of cancer is given through the word "diseaseË®. The predominance of negative elements is recognized, although there are some positive ones such as treatment, cure and God in the representation of the group. The current disease carries stigma, making coping a painful and sad process. Conclusion: It is possible to detect the regret the patients express for being with cancer, while hope exists and moves them towards the cure. It is identified the need for the nurse to focus on the spiritual and religious dimensions during the caring process, understanding the individual as a unique and complex being that demands centered care

Introducción: El diagnóstico de cáncer incide en diversos aspectos, ya sean emocionales, relacionales, espirituales y económicos, convirtiéndolo en un importante problema de salud pública a nivel mundial. Objetivo: Analizar la estructura de las representaciones sociales del cáncer en pacientes adultos con cáncer hospitalizados y señalar su relación con aspectos cotidianos del afrontamiento del diagnóstico y la enfermedad por esta patología. Método: Cualitativo, descriptivo y exploratorio, basado en la Teoría de las Representaciones Sociales. El escenario fue un hospital federal de cáncer, en la ciudad de Río de Janeiro, 111 participantes viviendo enfermarse de cáncer. Se recogieron evocaciones gratuitas del término inductor "cáncer" y se aplicó un cuestionario para caracterizar a los pacientes. El análisis se realizó mediante el software EVOC 2005. Resultados: Mayoritariamente varones (69,3%), con educación básica (57,6%). Aparecen como un probable núcleo central: enfermedad, tristeza y muerte. El conocimiento cosificado del cáncer se da a través de la palabra "enfermedadË®. Se reconoce el predominio de elementos negativos, aunque existen algunos positivos como el tratamiento, la cura y Dios en la representación del grupo. La enfermedad actual conlleva un estigma, lo que hace que el afrontamiento sea un proceso doloroso y triste. Conclusión: Es posible observar el arrepentimiento de estar con cáncer en la mirada de los pacientes, mientras existe la esperanza y los mueve hacia la cura. Identifica la necesidad del profesional de enfermería de centrarse en la dimensión espiritual y religiosa en su cuidado, entendiendo al individuo como un ser único y complejo que demanda cuidados individuales

Assistance strategies for women victims of genderbased violence during the COVID-19 pandemic / Estratégias assistenciais às mulheres vítimas de violência de gênero durante a pandemia da COVID-19

The objective was to analyze the scientific evidence on assistance strategies provided to women, victims of gender violence, in several countries, in the COVID-19 pandemic. It is a narrative review of the literature, by searching PubMed, Scopus and Virtual Health Library databases, using the keywords "COVID-19" and "women" and "violence". Seventy-six publications were initially found. After the selection, based on the inclusion criteria and the answers to the guiding question, 25 articles were used, submitted to the analysis of semantic content. There were five categories of analysis: Internet accessibility, telehealth and digital exclusion; Emergency telephone lines for reporting violence during the pandemic; Readjustment/expansion of services to combat COVID-19 to assist women victims of violence; Health education and intersectoral actions - interface with media programs; State actions and society responses. It is concluded that the main evidenced actions are anchored in the support and intersectoral actions proposed by the governments. It will help the State to develop strategies, enabling health professionals to rethink their practice, in a contextualized way to the current reality, from welcoming women to notification of suspicion, as well as health education for the empowerment of victims.

Objetivou-se analisar as evidências científicas sobre estratégias assistenciais dispensadas às mulheres, vítimas de violência de gênero, em diversos países, na pandemia da COVID-19. Trata-se de uma revisão narrativa de literatura, por meio da busca em bases de dados PubMed, Scopus e Biblioteca Virtual em Saúde, usando os descritores de busca "COVID-19" and "women" and "violence". Foram encontradas inicialmente 76 publicações. Após a seleção, baseada nos critérios de inclusão e nas respostas à pergunta norteadora, foram aproveitados 25 artigos, submetidos à análise de conteúdo semântica. Evidenciou-se cinco categorias de análise: Acessibilidade à internet, telesaúde e exclusão digital; Linhas telefônicas de emergência para denúncia da violência durante a Pandemia; Readequação/ampliação dos serviços de combate à COVID-19 ao atendimento às mulheres vítimas de violência; Educação em saúde e ações intersetoriais - interface com programas midiáticos; Ações do Estado e respostas da sociedade. Conclui-se que as principais ações evidenciadas estão ancoradas no apoio e ações intersetoriais propostas pelos governos. Contribuirá para que o Estado desenvolva estratégias, possibilitando que profissionais de saúde repensem sua práxis, de forma contextualizada à realidade atual, desde o acolhimento à mulher até a notificação da suspeita, bem como educação em saúde para empoderamento das vítimas.

The Prevalence of Abdominal Adiposity among Primary Health Care Physicians in Bahia, Brazil: An Epidemiological Study.

BACKGROUND: Labor activities are demanding for workers and can induce occupational stress. Primary health care (PHC) workers have faced problems that can lead to the development of stress and abdominal obesity. The aim of this study was to estimate the prevalence of abdominal adiposity among primary health care physicians in the metropolitan mesoregion of Salvador, Bahia. METHODS: This is a cross-sectional study conducted with physicians from the family health units (FHUs) of the metropolitan mesoregion of Salvador, Bahia, Brazil. The number of FHUs corresponded to 41 teams (52 physicians). Anamnesis was performed and a questionnaire was applied. The clinical examination consisted of measuring waist circumference (WC), blood pressure levels (BP), and body mass index (BMI), as well as examining for acanthosis nigricans. Blood samples were collected for biochemical dosages. The data obtained were analyzed by SPSS version 22.0. RESULTS: The sample included 41 physicians (response rate: 78.8%), of which 18 were women (44.0%). The percentage of overweight participants represented by BMI was 31.7%. The hypertriglyceridemia prevalence was 29.2%. HDL-c was low in 48.7% of the participants. The waist circumference measurement revealed a prevalence of abdominal adiposity of 38.8% (women) and 34.8% (men). CONCLUSIONS: Medical professionals in PHC are more susceptible to having higher abdominal adiposity, especially female physicians.

Utilização do software IRAMUTEQ em pesquisa de abordagem qualitativa: relato de experiência / Uso del software IRAMUTEQ en investigación cualitativa: informe de experiencia / Use of IRAMUTEQ software in qualitative research: an experience report

Objetivo: relatar a experiência de utilização do software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) como ferramenta informatizada de apoio à análise de dados textuais em uma pesquisa qualitativa em saúde. Método: tratou-se do relato de experiência acontecida entre março e junho de 2019, a partir de uma pesquisa qualitativa desenvolvida por meio do Método Criativo-Sensível e com o uso do IRAMUTEQ. Participaram puérperas e familiares de recém-nascidos de uma instituição hospitalar pública localizada na cidade de Rio das Ostras no Estado do Rio de Janeiro, Brasil. Resultados: foi possível constatar que as diferentes técnicas de análise lexical disponíveis no IRAMUTEQ permitiram discriminar, claramente, os conteúdos semânticos referentes às pretensões dos cuidadores sobre os cuidados a serem desempenhados com o recém-nascido em casa. Conclusão: essa ferramenta informatizada mostrou-se útil, adequada e fidedigna, qualificando o processo de análise textual.

Objective: to report the experience of using the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) as a computerized tool to support the analysis of textual data in qualitative research in health. Method: this was an experience report that took place between March and June 2019, based on qualitative research developed through the Creative-Sensitive Method and using IRAMUTEQ. Newborns and family members of newborns from a public hospital located in the city of Rio das Ostras in the state of Rio de Janeiro, Brazil, participated in the study. Results: it was possible to verify that the different lexical analysis techniques available in IRAMUTEQ allowed to discriminate the semantic contents referring to the caregivers' claims about the care to be performed with the newborn at home. Conclusion: this computerized tool proved to be useful, adequate, and reliable, qualifying the textual analysis process.

Objetivo: reportar la experiencia del uso del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ) como una herramienta computarizada para apoyar el análisis de datos textuales en una investigación cualitativa en salud. Método: se trata de un relato de experiencia que se llevó a cabo entre marzo y junio de 2019, con base en una investigación cualitativa desarrollada a través del Método Creativo-Sensible y utilizando IRAMUTEQ. Participaron recién nacidos y familiares de recién nacidos de un hospital público ubicado en la ciudad de Rio das Ostras en el estado de Rio de Janeiro, Brasil. Resultados: se pudo constatar que las diferentes técnicas de análisis léxico disponibles en IRAMUTEQ permitieron discriminar claramente los contenidos semánticos referidos a las afirmaciones de los cuidadores sobre el cuidado a realizar con el recién nacido en el domicilio. Conclusión: esta herramienta computarizada resultó ser útil, adecuada y confiable, calificando el proceso de análisis textual.

A presença do genitor no pré-natal: um estudo de representações sociais com gestantes / Fathers' presence in prenatal care: study of social representations among pregnant women / La presencia del progenitor en el prenatal: un estudio de representaciones sociales con embarazadas

Objetivo: analisar as representações sociais da presença do genitor no pré-natal para as mulheres gestantes. Método: estudo descritivo e qualitativo, fundamentado na Teoria da Representações Sociais. Contribuíram com o estudo 28 gestantes que realizavam as consultas do pré-natal e responderam a um roteiro de entrevista em profundidade contendo três questões abertas, cujas respostas foram submetidas à Análise de Conteúdo Lexical, possibilitada pelo software IRAMUTEQ. Resultados: a análise aponta a palavra 'não" como a mais latente no sistema cognitivo das gestantes, sendo percebida a alta frequência no Dendograma de Classes, presença no eixo de intersecção entre as ordenadas e abscissas no Mapa Fatorial de Correspondência, além de ser central e fazer as maiores forças de conexidade com as demais palavras na árvore máxima de similitude. Conclusão: as representações sociais das gestantes sobre a presença do genitor durante as consultas de pré-natal foram elaboradas a partir da negação, evidenciadas nos discursos do grupo no termo "não".

Objective: to examine social representations held by pregnant women of the fathers' presence in prenatal care. Method: this qualitative, descriptive study, based on Social Representations Theory, involved 28 pregnant women undergoing prenatal consultations, who answered an in-depth, scripted interview containing three open questions. Their responses were analyzed using Lexical Content Analysis, made possible by IRAMUTEQ software. Results: the analysis pointed to the word "no" as the most latent in the pregnant women's cognitive system: it was found at high frequency in the Dendrogram of Classes, was present at the axis of intersection between ordinates and abscissas on the Factorial Correspondence Map, besides being central and showing strongest connectedness with the other words in the similarity tree. Conclusion: the pregnant women's social representations of the fathers' presence at prenatal appointments were elaborated on the basis of denial, evidenced in the group's discourse in the term "no".

Objetivo: analizar las representaciones sociales que tienen las mujeres embarazadas sobre la presencia del padre en la atención prenatal. Método: este estudio cualitativo, descriptivo, basado en la Teoría de las Representaciones Sociales, involucró a 28 gestantes en consulta prenatal, quienes respondieron una entrevista en profundidad y guionizada que contenía tres preguntas abiertas. Sus respuestas se analizaron mediante el análisis de contenido léxico, posible gracias al software IRAMUTEQ. Resultados: el análisis apuntó a la palabra "no" como la más latente en el sistema cognitivo de la gestante: se encontró con alta frecuencia en el Dendrograma de Clases, estuvo presente en el eje de intersección entre ordenadas y abscisas en el Mapa de Correspondencia Factorial , además de ser central y mostrar una conexión más fuerte con las otras palabras en el árbol de similitudes. Conclusión: las representaciones sociales de las mujeres embarazadas sobre la presencia de los padres en las citas prenatales se elaboraron sobre la base de la negación, evidenciada en el discurso del grupo en el término "no".

A enfermagem frente ao processo de morte e morrer: uma reflexão em tempos de Coronavírus / Enfermería frente al proceso de muerte y morir: una reflexión en tiempos del Coronavirus / Nursing in front of the death and dying process: a reflection in times of Coronavirus

Objetivo: refletir sobre os desafios da enfermagem diante do processo de morte e morrer em face a pandemia por Coronavírus. Método: estudo de análise reflexiva baseada na leitura, análise e interpretação de artigos e relatórios do Ministério da Saúde e do Conselho Federal de Enfermagem. Resultados: a mudança cotidiana no enfrentamento do Coronavírus, conduz a uma maior vulnerabilidade do profissional de enfermagem, sejam elas fruto da restrita formação sobre a morte e o morrer ou da experiência prática em tempos de pandemia. Conclusão: o espaço acadêmico tem sido apresentado como um possível local de discussão e desenvolvimento de habilidades e competências para o cuidado ao paciente que está morrendo. No entanto, os profissionais de enfermagem não vêm sendo preparados adequadamente para lidar com a morte, já que esta pode ser sinônimo de sofrimento psíquico e estresse, assim como a morte do paciente passou a ser um sinônimo de fracasso profissional.(AU)

Objective: to reflect on the challenges of Nursing in the face of the process of death and dying in the face of the Coronavirus pandemic. Method: reflective analysis study based on reading, analyzing and interpreting articles and reports from the Ministry of Health and the Federal Nursing Council. Results: the daily change in the confrontation of the Coronavirus, leads to a greater vulnerability of the nursing professional, whether they are the result of the restricted training on death and dying or of the practical experience in times of pandemic. Conclusion: the academic space has been presented as a possible place for discussion and development of skills and competences for the care of dying patients. However, nursing professionals have not been adequately prepared to deal with death, as death can be synonym with psychological suffering and stress, just as it has become a synonym for professional failure.(AU)

Objetivo: reflexionar sobre los desafíos de la Enfermería frente al proceso de muerte y muerte ante la pandemia de Coronavirus. Método: estudio de análisis reflexivo basado en la lectura, análisis e interpretación de artículos e informes del Ministerio de Salud y el Consejo Federal de Enfermería. Resultados: el cambio diario en la confrontación del Coronavirus, conduce a una mayor vulnerabilidad del profesional de enfermería, ya sea como resultado de la capacitación restringida sobre muerte y morir o de la experiencia práctica en tiempos de pandemia. Conclusión: el espacio académico se ha presentado como un posible lugar para la discusión y el desarrollo de habilidades y competencias para el cuidado de pacientes moribundos. Sin embargo, los profesionales de enfermería no se han preparado adecuadamente para enfrentar la muerte, ya que esa puede ser sinónimo de sufrimiento psicológico y estrés, al igual que se ha convertido en sinónimo de fracaso profesional.(AU)

Prevalence and Factors Associated with Burnout Syndrome among Primary Health Care Nursing Professionals: A Cross-Sectional Study.

The objective of the study was to evaluate the prevalence and factors associated with Burnout Syndrome (BS) in Primary Health Care (PHC) nursing professionals from the state of Bahia, Brazil. A multicentre, cross-sectional population-based study was conducted in a cluster sample among 1125 PHC Nursing professionals during the years 2017 and 2018. We used a questionnaire that included sociodemographic, labor and lifestyle variables and the Maslach Burnout Inventory scale to identify BS. The associations were evaluated using a robust Poisson regression with the hierarchical selection of the independent variables. The prevalence of BS was 18.3% and the associated factors were ethnicity (prevalence ratio (PR) = 0.62, confidence interval (CI) 95% = 0.47-0.83), residence (PR = 2.35, CI 95% = 1.79-3.09), economic situation (PR = 1.40, CI 95% = 1.06-1.86), satisfaction with current occupation (PR = 1.75, CI 95% = 1.31-2.33), (PR = 1.60, CI 95% = 1.23-2.08), rest (PR = 1.83, 95% CI = 1.41-2.37), technical resources and equipment (PR = 1.37, CI 95% = 1.06-1.77), night shift (PR = 1.49, CI 95% = 1.14-1.96), physical activity practice (PR = 1.72; CI 95% = 1.28-2.31), smoking (PR = 1.82, CI 95% = 1.35-2.45), and satisfaction with physical form (PR = 1.34, CI 95% = 1.01-179). Strategies are needed to prevent BS, with an emphasis on implementing worker health programs in the context of PHC.

Espiritualidade e religiosidade no cuidado em saúde: revisão integrativa / Espiritualidad y religiosidad en la atención de salud: revisión integrativa / Spirituality and religiosity in health care: an integrative review

RESUMO Objetivo descrever como a saúde, espiritualidade e religiosidade são abordadas nas publicações científicas nacionais. Método revisão integrativa de literatura no período entre 2011 e 2016, realizada na Biblioteca Virtual em Saúde em novembro de 2017, utilizando os descritores: "Saúde", "Espiritualidade", "Religiosidade". Resultados para a análise, segundo os critérios de inclusão estabelecidos, foram selecionados 30 artigos e identificadas quatro categorias: Conceitos e concepções de religiosidade e espiritualidade; Religiosidade e espiritualidade como estratégias de enfrentamento da doença; Necessidade de suporte espiritual; e Falta de preparo profissional. Verificou-se a relevância da dimensão espiritual na assistência e a necessidade de integralizar todas as dimensões do ser humano: biopsíquica, espiritual e social. Conclusão foram encontrados estudos que sugerem que algumas práticas religiosas são capazes de proporcionar tanto aspectos positivos quanto negativos na saúde física e mental dos seus praticantes.

RESUMEN Objetivo Describir de qué manera la salud, la espiritualidad y la religiosidad son abordadas en las publicaciones científicas nacionales. Método Revisión integrativa de literatura abarcando período de 2011 a 2016, realizada en la Biblioteca Virtual en Salud en noviembre de 2017, utilizando los descriptores "Saúde", "Espiritualidade" y "Religiosidade". Resultados Para el análisis, conforme los criterios establecidos, fueron seleccionados 30 artículos, y se identificaron cuatro categorías: Conceptos y concepciones de religiosidad y espiritualidad; Religiosidad y espiritualidad como estrategias para el enfrentamiento de la enfermedad; Necesidad de apoyo espiritual; y Falta de preparación profesional. Se verificó la relevancia de la dimensión espiritual en la atención y la necesidad de integrar todas las dimensiones del ser humano: biopsíquica, espiritual y social. Conclusión Fueron encontrados estudios que sugieren que algunas prácticas religiosas tienen la capacidad de brindar tanto aspectos positivos como negativos para la salud física y mental de quienes las practican.

ABSTRACT Objective describe how health, spirituality and religiosity are discussed in Brazilian scientific publications. Method integrative literature review of the period between 2011 and 2016, developed in the Virtual Health Library in November 2017, using the descriptors: "Health", "Spirituality", "Religiosity". Results for the analysis, according to the established inclusion criteria, 30 articles were selected and four categories were identified: Concepts and conceptions of religiosity and spirituality; Religiosity and spirituality as strategies to cope with disease; Need for spiritual support; and Lack of professional preparation. The relevance of the spiritual dimension in care was verified, as well as the need to comprehensively consider all dimensions of the human being: biopsychic, spiritual and social. Conclusion studies were found that suggest that some religious practices are capable of offering both positive and negative aspects in the physical and mental health of their practitioners.

As representações sociais da espiritualidade para pessoas que vivem com HIV/Aids / The social representations of spirituality for people living with HIV/AIDS

O presente estudo tem como objetivo analisar as representações sociais da espiritualidade para pessoas que vivem com HIV/Aids de diferentes grupos religiosos. Trata-se de um estudo qualitativo, descritivo e exploratório, orientado pela Teoria das Representações Sociais em sua abordagem processual e estrutural e foi desenvolvido em duas fases: a primeira incluiu 166 pessoas que vivem com HIV/Aids em atendimento ambulatorial de um Hospital Universitário do Município do Rio de Janeiro, com as quais foram coletadas evocações livres ao termo indutor espiritualidade, e a segunda, 32 pessoas com o mesmo perfil e no mesmo hospital, sendo que, neste momento foram realizadas entrevistas semi-estruturadas a partir de um roteiro temático com quatro eixos organizadores. A análise dos dados utilizou o quadro de quatro casas com o apoio do software EVOC 2005 e a análise de similitude para os dados oriundos das evocações livres e a análise lexical pelo software IRAMUTEQ para aqueles das entrevistas. Com relação à estrutura da representação, destaca-se que o Núcleo Central foi composto por ter-fé, Deus e religião, que se organizam ao redor das dimensões prática, imagética e institucional. Na primeira periferia, destaca-se a presença de elementos relativos às dimensões afetivas como amor e paz ligados ao transcendente. A zona de contraste revela a existência de elementos que expressam um caráter de enfrentamento como força, vida, tudo, crença e a figura imagética de Jesus. A partir da análise de similitude foi possível perceber uma maior tendência à centralidade ter-fé, Deus e amor, sendo que este último estava na primeira periferia do quadro de quatro casas. No que tange à análise lexical, foram definidas cinco classes: As definições de espiritualidade e suas influências no cotidiano da vivência e do enfrentamento da síndrome; A família, o trabalho e os relacionamentos afetivo-sexuais: as diferentes formas da rede social de apoio; Da morte à cronicidade: a aids vista a partir das memórias sociais; O enfrentamento de situações limites, o processo de autocuidado e sua relação com a espiritualidade; E o antirretroviral e a cotidianidade da pessoa que vive com HIV/Aids: aspectos positivos, desafios diários e dimensões da religiosidade. Destaca-se a organização da representação social da espiritualidade se deu ao redor de duas dimensões, a conceitual e a prática. A conceitual possui como eixo central a relação com o Divino, que, para católicos, evangélicos e sem religião, é centrado na figura de Deus, enquanto para os espíritas, no conjunto de seres que compõem o mundo espiritual. Na dimensão prática, a espiritualidade possui relação com aumento da autoestima e menor isolamento entre os católicos, maior sensação de bem-estar e paz entre os evangélicos, maior aceitação da síndrome e menor sofrimento entre os espíritas e maior isolamento entre os sem-religião, dentre outros aspectos. Conclui-se que há influência da espiritualidade no enfrentamento da síndrome e na vivência cotidiana com a aids, gerando, dentre outras coisas, uma ressignificação da vida em busca da superação do medo, do estigma, do preconceito e da própria morte.

This study aims to analyze the social representations of spirituality for people living with HIV/AIDS from different religious groups. It is a qualitative, descriptive and exploratory study, oriented by the theory of social representations in its procedural and structural approach. This investigation was developed in two phases: the first one included 166 people who living with HIV/AIDS in outpatient care in a University Hospital of the City of Rio de Janeiro, with whom were collected free evocations to the inductor term spirituality, and the second phase included 32 people with the same profile and in the same hospital, but it was collected a semi-structured interview from a script with four thematic axes. The analysis of the data from free evocations used the board of four houses with the support of EVOC 2005 software and the similitude analysis. For the interviews, the lexical analysis was performed with support of software IRAMUTEQ. Considering the structure of representation, it is worth to highlighting that the central core is composed of faith, God and religion, which are organized around the practical, imaginary and institutional dimensions. In the first periphery, the presence of elements related to affective dimensions such as love and peace are linked to the transcendent. The contrast zone reveals the existence of elements that express a character of coping related to force, life, everything, belief and the image of Jesus. Concerning the analysis of similitude, it was possible to perceive a greater tendency to the centrality of faith, God and love, being the latter in the first periphery of the frame of four houses. With regard to lexical analysis, five classes were defined: The definitions of spirituality and its influences in the everyday life of the experience and confrontation of the syndrome; Family, work and affective-sexual relationships: the different forms of the social support network; From death to chronicity: AIDS seen from social memories; The confrontation of limiting situations, the process of self-care and its relation with spirituality; and the antiretroviral and daily life of people living with HIV/AIDS: positive aspects, daily challenges and dimensions of religiosity. It is noted that the organization of the social representation of spirituality was centered around two dimensions, conceptual and practical. The conceptual has a central axis in the relationship with the Divine, that, for Catholics, Evangelicals and people without religion, is centered in the God's figure, while for the Spiritists, is centered in the set of beings that composes the spiritual world. In the practical dimension, spirituality is related to an increase in self-esteem and less isolation among Catholics, greater sense of well-being and peace between Evangelicals, a greater acceptance of the syndrome and less suffering among Spiritists, and higher isolation among people without religion, beyond other aspects. In conclusion, there are influence from spirituality in the confrontation of syndrome and in the daily life with AIDS, generating resignification of life in search of overcoming the fear, the stigma, the prejudice ant the death itself.

Representações sociais da espiritualidade de quem vive com Aids: um estudo a partir da abordagem estrutural / Social representations about spirituality of people who lives with aids: un study according to structural approach

O objetivo do estudo é analisar os conteúdos que integram a representação social da espiritualidade entre pessoas que vivem com HIV/Aids assistidas no serviço de atendimento especializado de um hospital universitário no Rio de Janeiro. É um estudo descritivo, de natureza qualitativa, apoiado na teoria do núcleo central das representações sociais, realizado no período de março a setembro de 2015 com 166 pacientes assistidos no Serviço de Atendimento Especializado em aids do referido hospital. Utilizou-se a técnica de evocação livre de palavras ao termo indutor espiritualidade na coleta de dados e o questionário sociodemográfico para caracterização dos participantes. Os dados do questionário foram organizados no software excel e os conteúdos das evocações foram tratados pela técnica do quadro de quatro casas e analisados à luz dos pressupostos da teoria do núcleo central. Os resultados evidenciaram que houve predomínio de pessoas do sexo masculino com idade entre 41 a 60 anos. Declararam-se, por ordem de frequência, católicos, espíritas e evangélicos, sendo que 30 indivíduos afirmaram não professar nenhuma religião. Os elementos que compõem o núcleo central da representação são ter fé, Deus e religião, sendo que ter fé e Deus são os possíveis elementos centrais pelos fortes laços que estabelecem com os demais termos presentes na representação. Conclui-se que a representação da espiritualidade está organizada em dois polos, o divino e o humano, que têm uma relação direta ou é mediado pela religião. (AU)

the objective of the study is to analyze the contents that integrate the social representation of spirituality among people living with HIV/AIDS assisted in the specialized attention service of a university hospital in Rio de Janeiro. It is a descriptive and qualitative study based on the central core theory of social representations, carried out in the period from March to September 2015 with 166 patients assisted in the Specialized Attention Service in AIDS of the referred hospital. For data collection, it was used the sociodemographic questionnaire and the technique of words evocation to the term inducer spirituality in the data collection. The data of questionnaire were organized in excel software and the contents of the evocations were treated by the four-frame technique and analyzed considering the assumptions of the central core theory. The results showed a predominance of males aged between 41 and 60 years. They were declared, in order of frequency, Catholics, Spiritists and Evangelicals, and 30 individuals stated that they did not profess any religion. The elements that make up the central nucleus of representation are faith, God and religion, and to have faith and God are the possible central elements because of the strong ties they establish with the other terms present in the representation. It was concluded that the representation of spirituality is organized in two poles, the divine and the human, that have a direct relationship or is mediated by religion. (AU)