Primary Health Care and Tuberculosis Detection during the COVID-19 Pandemic: Crucial Actions for Intensifying Efforts.

BACKGROUND: Tuberculosis has been considered a global emergency since 1993, and controlling it has become even more challenging since 2020 due to the health and social crisis resulting from the COVID-19 pandemic. This study aimed to identify the impact of the COVID-19 pandemic on tuberculosis case detection activities within primary health Care in the largest city in Brazil. METHODS: This is a cross-sectional and analytical study on the provision of tuberculosis detection actions in primary healthcare units during the pandemic period. A descriptive analysis was performed for characterization, and Generalized Mixed Models were used for evaluating associations, with a Bonferroni post hoc test applied. RESULTS: The study sample comprised 80 health units in the municipality. There was a moderate alteration level in the provision of consultations for individuals with signs and symptoms of tuberculosis in 2020 (13.8%) and in 2021 (15.1%). Statistical significance (p < 0.05) was found between the pandemic period and detection actions, with a lower alteration level in 2022. CONCLUSIONS: Tuberculosis detection activities underwent changes due to the COVID-19 pandemic, mainly in 2020, which was associated with alterations in consultation and case notification provision.

Nursing rights in comics: educational technological innovation report.

OBJECTIVES: to report an educational technology construction on nursing professionals' rights. METHODS: an experience report on educational technology construction during the crediting of university extension hours in an undergraduate nursing course at a Brazilian public university, between March and June 2023. The Deming cycle was used as a procedural method. RESULTS: four meetings were held between students and extension workers. Eight comic books were produced based on the Code of Ethics for Nurses, addressing professional autonomy, fair remuneration, risk-free work, denial of exposure in the media and others. The Deming cycle proved to be an important strategy for constructing products. CONCLUSIONS: nursing professionals' rights must be discussed and improved. Educational technologies, such as comic books, provide playful and reflective learning.

Non-violent communication as a technology in interpersonal relationships in health work: a scoping review.

BACKGROUND: Working in healthcare environments is highly stressful for most professionals and can trigger problems in interpersonal relationships that can result in horizontal violence. In order to prevent violence and improve the working environment, some strategies can be implemented to provide well-being for all those involved, whether directly or indirectly in health care, such as non-violent communication. The aim of this study was to map and synthesize the available scientific evidence on the use of Nonviolent Communication as a technology for a culture of peace in interpersonal relationships in healthcare. METHODS: This is a scoping review carried out in the National Library of Medicine (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Excerpa Medica DataBASE (Embase), PsycINFO - APA/ PsycNET (American Psychological Association) and Latin American and Caribbean Health Sciences Literature (LILACS) databases between March and August 2023. The eligibility criteria used were studies that addressed the topic of NVC in the area of health, published in Portuguese, Spanish or English, with no time restrictions. RESULTS: 53 studies were found in the databases. Two additional studies were extracted from of primary research. In the first exclusion phase, 16 texts were removed due to being duplicated. 39 articles were potentially relevant, and full-texts were reviewed for eligibility along with the inclusion and exclusion criteria Thus, seven studies were included in this review, published in English (five) and Portuguese (two), two of which were carried out in Brazil, one in the United States of America, one in South Korea, one in France, one in Canada and one in Thailand. In terms of the type of study/publication, two studies were reflections, one was a review, one was a mixed study, one was an experience report and two were experimental. The studies were predominantly of high and moderate methodological quality (85.7%). The total number of participants in the studies was 185. The studies showed that NVC is a technology that has made it possible to improve interpersonal relationships between health professionals. Training programs or educational intervention projects on the subject are useful for familiarizing professionals with the subject and demonstrating situations in which the technique can be included. CONCLUSION: The global scientific literature indicates that Nonviolent Communication is a significant resource for improving interpersonal relationships in healthcare work. This approach can be adopted as a strategy by managers and decision-makers, both to resolve conflicts and to prevent aggressive situations between health professionals, especially when it comes to moral or psychological aspects.

Violência contra mulher parda e preta durante a pandemia: revisão de escopo / Violencia contra mujeres pardas y negras durante la pandemia: revisión de alcance / Violence against brown and black women during the pandemic: a scoping review

Resumo Objetivo Mapear e sumarizar as principais evidências disponíveis sobre a violência por parceiro íntimo contra a mulher parda e preta durante a pandemia COVID-19. Métodos Trata-se de uma revisão de escopo nas bases de dados National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO - APA PsycNET e Literatura Latino-Americana e do Caribe em Ciências da Saúde. Os critérios de inclusão foram estudos sobre violência interpessoal contra a mulher parda e preta após o decreto de pandemia COVID-19, perpetrada por parceiro íntimo, publicados a partir de 2020, nos idiomas português, espanhol ou inglês. Excluíram-se editoriais, cartas resposta, retratações e estudos voltados à violência autoprovocada. Foi realizada análise descritiva. Resultados Foram obtidos 26 estudos e após a seleção obteve-se a amostra de oito artigos, publicados entre 2020 e 2022. Os resultados evidenciaram estudos majoritariamente norte-americanos, contudo apontaram para a violência por parceiro íntimo contra a mulher parda e preta como um fenômeno global durante a pandemia. As vítimas apresentavam múltiplas condições de vulnerabilidade e encontraram várias barreiras de acesso aos serviços de saúde e segurança pública, incluindo o racismo. Medidas de prevenção e controle foram escassas e geraram consequências à saúde integral da mulher. Conclusão O fenômeno foi caracterizado como um agravo global durante a pandemia COVID-19. Estratégias de enfrentamento individuais, coletivas e políticas foram criadas pelas vítimas. Políticas públicas de prevenção e controle da violência por parceiro íntimo não foram adequadamente aplicadas em muitos países durante a pandemia.

Resumen Objetivo Mapear y resumir las principales evidencias disponibles sobre la violencia contra mujeres pardas y negras por parte de la pareja íntima durante la pandemia de COVID-19. Métodos Se trata de una revisión de alcance en las bases de datos National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO - APA PsycNET y Literatura Latinoamericana y del Caribe en Ciencias de la Salud. Los criterios de inclusión fueron estudios sobre violencia interpersonal contra mujeres pardas y negras después del decreto de pandemia de COVID-19, ejercida por su pareja íntima, publicados a partir de 2020, en idioma portugués, español o inglés. Se excluyeron editoriales, cartas de respuesta, retractaciones y estudios sobre violencia autoprovocada. Se realizó análisis descriptivo. Resultados Se obtuvieron 26 estudios y, después de la selección, se obtuvo una muestra de ocho artículos, publicados entre 2020 y 2022. Los resultados evidenciaron estudios mayormente norteamericanos, pero señalaron que la violencia contra mujeres pardas y negras por parte de su pareja íntima fue un fenómeno global durante la pandemia. Las víctimas presentaron múltiples condiciones de vulnerabilidad y encontraron varias barreras de acceso a los servicios de salud y seguridad pública, inclusive racismo. Las medidas de prevención y control fueron escasas y generaron consecuencias en la salud integral de las mujeres. Conclusión El fenómeno fue caracterizado como un agravio global durante la pandemia de COVID-19. Las estrategias de enfrentamiento individuales, colectivas y políticas fueron creadas por las víctimas. Las políticas públicas de prevención y control de la violencia por parte de pareja íntima no fueron aplicadas adecuadamente en muchos países durante la pandemia. Open Science Framework: https://osf.io/bdsf7/

Abstract Objective To map and summarize the main available evidence on intimate partner violence against brown and black women during the COVID-19 pandemic. Methods This is a scoping review carried out in the National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO - APA PsycNET and Latin American and Caribbean Literature in Health Sciences databases. Studies on interpersonal violence against brown and black women after the COVID-19 pandemic decree, perpetrated by an intimate partner, published from 2020 onwards in Portuguese, Spanish or English, were included. Editorials, response letters, retractions and studies focused on self-inflicted violence were excluded. Descriptive analysis was carried out. Results A total of 26 studies were obtained, and after selection, a sample of eight articles was obtained, published between 2020 and 2022. The results showed mostly North American studies, however, they pointed to intimate partner violence against brown and black women as a global phenomenon during the pandemic. The victims presented multiple conditions of vulnerability and encountered several barriers to accessing health and public safety services, including racism. Prevention and control measures were scarce and had consequences for women's overall health. Conclusion The phenomenon was characterized as a global problem during the COVID-19 pandemic. Individual, collective and political coping strategies were created by the victims. Public policies to prevent and control intimate partner violence were not adequately implemented in many countries during the pandemic. Open Science Framework: https://osf.io/bdsf7/

Nursing rights in comics: educational technological innovation report / Los derechos de enfermería en el cómic: informe de innovación tecnológica educativa / Direitos da enfermagem em quadrinhos: relato de inovação tecnológica educacional

ABSTRACT Objectives: to report an educational technology construction on nursing professionals' rights. Methods: an experience report on educational technology construction during the crediting of university extension hours in an undergraduate nursing course at a Brazilian public university, between March and June 2023. The Deming cycle was used as a procedural method. Results: four meetings were held between students and extension workers. Eight comic books were produced based on the Code of Ethics for Nurses, addressing professional autonomy, fair remuneration, risk-free work, denial of exposure in the media and others. The Deming cycle proved to be an important strategy for constructing products. Conclusions: nursing professionals' rights must be discussed and improved. Educational technologies, such as comic books, provide playful and reflective learning.

RESUMEN Objetivos: informar la construcción de una tecnología educativa sobre los derechos de los profesionales de enfermería. Métodos: relato de experiencia sobre la construcción de tecnología educativa durante la acreditación de horas de extensión universitaria en una carrera de pregrado en enfermería en una universidad pública brasileña, entre marzo y junio de 2023. Se utilizó el ciclo de Deming como método procesal. Resultados: se realizaron cuatro reuniones entre estudiantes y extensionistas. Se produjeron ocho historietas basadas en el Código de Ética para los Profesionales de Enfermería, abordando la autonomía profesional, la remuneración justa, el trabajo libre de riesgos, la negación de la exposición en los medios de comunicación y otros. El ciclo de Deming demostró ser una estrategia importante para la construcción de productos. Conclusiones: los derechos de los profesionales de enfermería deben ser discutidos y mejorados. Las tecnologías educativas, como los cómics, proporcionan un aprendizaje lúdico y reflexivo.

RESUMO Objetivos: relatar a construção de uma tecnologia educacional sobre os direitos dos profissionais de enfermagem. Métodos: relato de experiência sobre a construção de tecnologia educacional durante a creditação de horas de extensão universitária em uma disciplina da graduação em enfermagem de uma universidade pública brasileira, entre março e junho de 2023. Utilizou-se o ciclo de Deming como método processual. Resultados: foram realizados quatro encontros entre estudantes e extensionistas. Oito histórias em quadrinhos foram produzidas pautadas no Código de Ética dos Profissionais de Enfermagem abordando autonomia profissional, remuneração justa, trabalho sem riscos, negação à exposição em mídias e outros. O ciclo de Deming mostrou-se importante estratégia para construção dos produtos. Conclusões: os direitos dos profissionais de enfermagem devem ser discutidos e aprimorados. Tecnologias educacionais, como histórias em quadrinhos, proporcionam aprendizagem lúdica e reflexiva.

Profile and characteristics of violence against older adults during the COVID-19 pandemic / Perfil e características da violência contra a pessoa idosa durante a pandemia COVID-19 / Perfil y características de la violencia contra los adultos mayores durante la pandemia de COVID-19

Abstract Objective: to identify the sociodemographic profile and the characteristics of interpersonal violence against older adults during the first year of the COVID-19 pandemic in a capital city from the Brazilian Southeast region. Method: a descriptive and exploratory research study with a cross-sectional design based on the notifications of suspected or confirmed cases of violence against older adults between March 2020 and March 2021. A univariate statistical analysis and Fisher's exact test (p<0.05) were performed. Results: a total of 2,681 notifications were recorded during the period. The main victims were individuals aged between 60 and 64 years old, female, white-skinned and with low schooling levels. The instances of violence were more frequent in the victims' homes. Physical and psychological violence predominated, through physical force/beatings and threats, respectively. Most of the aggressors were male, younger than the victims and generally their children or intimate partners. The aggressions were perpetrated more than once and were driven by generational conflicts. There was low referral to entities for the protection of older adults. Conclusion: the sociodemographic profile found evidences vulnerable victims, subjected to many types of violence, and at a potential risk against their overall health.

Resumo Objetivo: identificar o perfil sociodemográfico e as características da violência interpessoal contra a pessoa idosa no primeiro ano da pandemia COVID-19 em uma capital da região sudeste do Brasil. Método: pesquisa descritiva, exploratória, com delineamento transversal a partir da análise das notificações de casos suspeitos ou confirmados de violência contra a pessoa idosa, ocorridas entre março de 2020 e março de 2021. Foi realizada a análise estatística univariada e teste exato de Fisher (p<0,05). Resultados: houve 2681 notificações no período. As principais vítimas foram pessoas com idade entre 60 e 64 anos, do sexo feminino, brancas e com baixa escolaridade. As ocorrências tiveram maior frequência nos domicílios. As violências físicas e psicológicas foram as mais comuns, com uso de força física/espancamento e ameaça, respectivamente. O agressor era, em sua maioria, do sexo masculino, mais jovem do que a vítima, geralmente filho ou parceiro íntimo. As agressões ocorreram mais de uma vez e foram motivadas por conflitos geracionais. Houve baixo encaminhamento para órgãos de proteção a pessoa idosa. Conclusão: o perfil sociodemográfico encontrado evidencia vítimas vulneráveis, sujeitas a muitas formas de violência e com potenciais riscos à integralidade de sua saúde.

Resumen Objetivo: identificar el perfil sociodemográfico y las características de la violencia interpersonal contra los adultos mayores en el primer año de la pandemia de COVID-19 en una ciudad capital de la región sureste de Brasil. Método: investigación descriptiva, exploratoria con diseño transversal a partir del análisis de las notificaciones de casos sospechosos o confirmados de violencia contra el adulto mayor, ocurridos entre marzo de 2020 y marzo de 2021. Se realizó un análisis estadístico univariado y la prueba exacta de Fisher (p< 0,05). Resultados: hubo 2681 notificaciones en el período. Las principales víctimas fueron personas entre 60 y 64 años, de sexo femenino, blancas y con baja escolaridad. La mayoría de los casos se registró en el hogar. La violencia física y psicológica fueron las más comunes, con uso de fuerza física/golpes y amenaza, respectivamente. El agresor era generalmente del sexo masculino, más joven que la víctima, hijo o pareja. Las agresiones se produjeron más de una vez y fueron motivadas por conflictos generacionales. Hubo baja derivación a organismos de protección de adultos mayores. Conclusión: el perfil sociodemográfico obtenido revela que son víctimas vulnerables, sujetas a múltiples formas de violencia y que la integridad de su salud está en riesgo potencial.

King's Parkinson's Disease Pain Questionnaire: reliability and convergent construct validity.

OBJECTIVES: to assess the evidence of reliability and convergent construct validity of the King's Parkinson's Disease Pain Questionnaire. METHODS: psychometric study of 75 older adults with Parkinson's disease. The instrument was applied by two researchers separately and reapplied by one researcher 15 days later. In terms of reliability, internal consistency was assessed using the Cronbach's alpha test and stability using the intraclass correlation coefficient. Scores of the King's Parkinson's Disease Pain Questionnaire were compared to those of the Geriatric Pain Measure in the assessment of construct validity. RESULTS: the mean Cronbach's alpha obtained between the three assessments was above 0.60, the intraclass correlation between the three assessments was above 0.90, and there was a weak but significant correlation between the two applied scales. CONCLUSIONS: the instrument showed adequate evidence of convergent construct validity and reliability, and can be used in clinical practice.

Fatores relacionados à sobrecarga e ao autocuidado para hipertensão em cuidadores familiares / Factors related to burden and self-care for hypertension in family caregivers / Factores relacionados con la carga y el autocuidado de la hipertensión en cuidadores familiares

RESUMO Objetivo: identificar os fatores relacionados à sobrecarga e ao autocuidado para hipertensão em cuidadores familiares. Método: pesquisa online e transversal, com 68 cuidadores familiares de pessoas idosas, realizada entre dezembro de 2021 e fevereiro de 2022, no Brasil. Foram aplicados questionários sobre atividade de cuidador, Questionário de Avaliação da Sobrecarga do Cuidador Informal e Escala Autocuidado de Hipertensão. Foram realizadas análises descritivas e analíticas. Resultados: cuidadores que residiam com idoso (p=0,0006) e sem dia de descanso (p=0,0097) apresentaram maior sobrecarga. Quanto maior o tempo como cuidador (p=0,0411), menor o escore do domínio medidas de manejo do autocuidado durante a descompensação pressórica. Cuidadores que recebiam auxílio de outra pessoa (p=0,0379) apresentaram maior escore no domínio grau de confiança do paciente para o autocuidado relacionado à hipertensão. Conclusão: este estudo contribui para maior compreensão das variáveis referentes à atividade de cuidador relacionada à sobrecarga e ao autocuidado para hipertensão de cuidadores de pessoas idosas.

ABSTRACT Objective: To identify factors related to burden and self-care for hypertension in family caregivers. Method: an online, cross-sectional survey of 68 family caregivers of elderly people, carried out between December 2021 and February 2022 in Brazil. Questionnaires on caregiver activity, the Informal Caregiver Burden Assessment Questionnaire and the Hypertension Self-Care Scale were applied. Descriptive and analytical analyses were carried out. Results: caregivers who lived with the elderly (p=0.0006) and had no rest day (p=0.0097) showed greater burden. The longer the time as a caregiver (p=0.0411), the lower the score in the domain of self-care management measures during blood pressure decompensation. Caregivers who received help from someone else (p=0.0379) had a higher score in the domain of the patient's degree of confidence in self-care related to hypertension. Conclusion: This study contributes to a better understanding of the variables relating to caregiver activity related to burden and self-care for hypertension among caregivers of elderly people.

RESUMEN Objetivo: identificar los factores relacionados con la carga y el autocuidado de la hipertensión en cuidadores familiares. Material y método: encuesta transversal online a 68 cuidadores familiares de ancianos, realizada entre diciembre de 2021 y febrero de 2022 en Brasil. Se aplicaron cuestionarios sobre la actividad del cuidador, el Cuestionario de Evaluación de la Carga del Cuidador Informal y la Escala de Autocuidado de la Hipertensión. Se realizaron análisis descriptivos y analíticos. Resultados: los cuidadores que vivían con el anciano (p=0,0006) y no tenían día de descanso (p=0,0097) mostraron mayor carga. Cuanto mayor era el tiempo como cuidador (p=0,0411), menor era la puntuación en el dominio de las medidas de gestión del autocuidado durante la descompensación por presión. Los cuidadores que recibían ayuda de otra persona (p=0,0379) tenían una puntuación más alta en el dominio del grado de confianza del paciente en el autocuidado relacionado con la hipertensión. Conclusión: Este estudio contribuye a una mayor comprensión de las variables relativas a la actividad del cuidador relacionadas con la carga y el autocuidado de la hipertensión de los cuidadores de personas mayores.

Profile and characteristics of violence against older adults during the COVID-19 pandemic.

OBJECTIVE: to identify the sociodemographic profile and the characteristics of interpersonal violence against older adults during the first year of the COVID-19 pandemic in a capital city from the Brazilian Southeast region. METHOD: a descriptive and exploratory research study with a cross-sectional design based on the notifications of suspected or confirmed cases of violence against older adults between March 2020 and March 2021. A univariate statistical analysis and Fisher's exact test (p<0.05) were performed. RESULTS: a total of 2,681 notifications were recorded during the period. The main victims were individuals aged between 60 and 64 years old, female, white-skinned and with low schooling levels. The instances of violence were more frequent in the victims' homes. Physical and psychological violence predominated, through physical force/beatings and threats, respectively. Most of the aggressors were male, younger than the victims and generally their children or intimate partners. The aggressions were perpetrated more than once and were driven by generational conflicts. There was low referral to entities for the protection of older adults. CONCLUSION: the sociodemographic profile found evidences vulnerable victims, subjected to many types of violence, and at a potential risk against their overall health.

Fatores associados ao autocuidado das pessoas com diabetes mellitus na pandemia de COVID-19 / Associated factors with the self-care of people with diabetes mellitus in the COVID-19 pandemic

RESUMO Objetivo analisar os fatores associados ao autocuidado em pessoas com diabetes durante a pandemia de COVID-19. Métodos estudo transversal analítico e exploratório online com 70 participantes, utilizando o Questionário de Atividades de Autocuidado com o Diabetes. O perfil clínico e sociodemográfico foi retratado com uma análise descritiva. Já para a associação entre as variáveis, aplicaram-se o teste exato de Fisher, o teste Qui-quadrado e regressão de Poisson com variância robusta. Resultados após a regressão, os itens Atividade física, Uso de medicação e Alimentação geral do Questionário de Atividades de Autocuidado com o Diabetes apresentaram, respectivamente, associação significativa com as variáveis exercício físico (p<0,001), ocupação (p=0,005) e idade (p=0,01). Conclusão os itens de exercício físico, uso de medicação e alimentação geral do questionário de autocuidado se relacionaram com as variáveis de idade, ocupação e prática de exercício físico, respectivamente. Contribuições para a prática os serviços de saúde devem intensificar a investigação dos fatores associados às dificuldades das pessoas com diabetes, para oferecer uma melhor qualidade de vida e uma promoção de saúde adequada para essa população.

ABSTRACT Objective to analyze the factors associated with self-care in people with diabetes during the COVID-19 pandemic. Methods cross-sectional analytical and exploratory online study with 70 participants, using the Summary Diabetes Self-Care Activities Questionnaire. The clinical and sociodemographic profile was portrayed with a descriptive analysis. Fisher's exact test, the Chi-square test and Poisson regression with robust variance were used to determine the association between the variables. Results after regression, the items Physical Activity, Use of Medication and General Diet from the Summary Diabetes Self-Care Activities Questionnaire showed, respectively, a significant association with the variables Physical Exercise (p<0.001), Occupation (p=0.005) and Age (p=0.01). Conclusion the physical exercise, medication use and general diet items on the self-care questionnaire were related to the variables of age, occupation, and physical exercise, respectively. Contributions to practice health services should intensify the investigation of factors associated with the difficulties of people with diabetes, to offer a better quality of life and adequate health promotion for this population.

Qualidade do sono e burnout em docentes do ensino superior / Sleep quality and burnout in higher education teachers

RESUMO Objetivo avaliar a associação da qualidade do sono e presença da síndrome de burnout com o perfil epidemiológico de docentes do ensino superior. Métodos estudo observacional, analítico, do tipo transversal, realizado com 140 docentes, por meio do Índice de Qualidade do Sono de Pittsburgh e Maslach Burnout Inventory. Resultados na amostra, a maioria era do sexo feminino (54,3%), com idades entre 26 e 40 anos (58,6%). Houve predomínio de docentes com título de especialista (48,6%), com faixa salarial de até R$ 5.000,00 (85,7%), com dois ou mais vínculos empregatícios (52,1%). Constatou-se que docentes que recebiam mais de R$ 5.000,00 (p=0,003), com dois ou mais empregos, classificaram a eficiência habitual do sono como ruim/muito ruim (p=0,027). Todavia, aqueles com qualidade subjetiva do sono boa apresentaram menores escores nos domínios Exaustão emocional (p=0,005) e Despersonalização em relação à referida síndrome (p=0,023). Conclusão diversos fatores colaboram para o desenvolvimento de distúrbios relacionados ao sono na classe docente, tornando-a mais suscetível à manifestação do burnout. Contribuições para a prática os resultados podem subsidiar medidas preventivas para a saúde dos docentes e manutenção da qualidade de suas atividades laborais, visando diminuir o efeito-mediação das variáveis que favorecem o esgotamento psicológico.

ABSTRACT Objective to evaluate the association of sleep quality and the presence of burnout syndrome with the epidemiological profile of higher education teachers. Methods an observational, analytical, cross-sectional study of 140 teachers, using the Pittsburgh Sleep Quality Index and the Maslach Burnout Inventory. Results in the sample, the majority was female (54.3%), aged between 26 and 40 years (58.6%). There was a predominance of teachers with a specialist title (48.6%), with a salary range of up to R$ 5,000.00 (85.7%), with two or more employment relationships (52.1%). It was found that teachers who received more than R$ 5,000.00 (p=0.003), with two or more jobs, classified the usual sleep efficiency as poor/feeble (p=0.027). However, those with good subjective sleep quality had lower scores in the Emotional exhaustion (p=0.005) and Depersonalization domains in relation to the syndrome (p=0.023). Conclusion several factors contribute to the development of sleep-related disorders in teachers, making them more susceptible to the manifestation of burnout. Contributions to practice the results can support preventive measures for the health of teachers and maintain the quality of their work activities, aiming to reduce the mediation effect of the variables that favor psychological exhaustion.

Uma revisão de escopo do uso excessivo de mamografia de rastreamento / Una revisión de alcance del uso excesivo de mamografía de tamizaje / A scoping review of excessive use of mammography screening

Resumo Objetivos Identificar como os estudiosos definem o rastreamento excessivo para mulheres sem risco de desenvolver câncer de mama, examinar os determinantes (barreiras e facilitadores) do uso excessivo da mamografia de rastreamento e descrever as taxas de observação do uso excessivo da mamografia de rastreamento. Métodos Revisão de escopo baseada em busca realizada em maio de 2022 em seis bancos de dados e bibliotecas eletrônicas de saúde. Artigos revisados por pares em qualquer idioma e ano de publicação foram incluídos. Resultados Na amostra de 18 artigos publicados a partir de 1991, a maioria deles dos Estados Unidos, o uso excessivo de mamografia foi definido como a intenção ou realização de mamografia fora da faixa etária ou intervalo recomendado, entre mulheres com expectativa de vida limitada, em programas, organizados e oportunísticos, coexistentes. As taxas de observação do uso excessivo de mamografia de rastreamento nos estudos selecionados variaram de 1,4% a 87,2%. Os facilitadores da mamografia excessiva são preocupações relacionadas ao câncer; a recomendação médica, especialmente de especialistas; e ao maior acesso a exames. As mais expostas ao rastreamento excessivo são as mulheres com maior escolaridade e renda. As barreiras para o excesso de mamografia incluíram orientações nas consultas sobre os malefícios da mamografia e a expectativa de vida, por médicos generalistas, principalmente os da atenção primária. Conclusão Nosso estudo identificou que o uso excessivo da mamografia de rastreamento tem alta prevalência quando realizado como rastreamento e é permeado por fatores multiníveis. Nossa lista de determinantes pode fornecer algumas orientações para estudos futuros com o objetivo de desimplementar o cuidado de baixo valor do uso excessivo da mamografia de rastreamento.

Resumen Objetivos Identificar cómo los académicos definen el tamizaje excesivo en mujeres sin riesgo de presentar cáncer de mama, examinar los determinantes (barreras y facilitadores) del uso excesivo de mamografía de tamizaje y describir los índices de observación del uso excesivo de mamografía de tamizaje. Métodos Revisión de alcance basada en una búsqueda realizada en mayo de 2022 en seis bases de datos y bibliotecas electrónicas de salud. Se incluyeron artículos revisados por pares en cualquier idioma o año de publicación. Resultados En la muestra de 18 artículos publicados a partir de 1991, la mayoría de Estados Unidos, el uso excesivo de mamografía fue definido como la intención o realización de mamografía fuera del grupo de edad o intervalo recomendado, en mujeres con expectativa de vida limitada, en programas coexistentes, organizados y oportunistas. Los índices de observación del uso excesivo de mamografía de tamizaje en los estudios seleccionados varían de 1,4 % a 87,2 %. Los facilitadores de la mamografía excesiva son las preocupaciones relacionadas con el cáncer, las recomendaciones médicas, especialmente de especialistas, y el mayor acceso al examen. Las personas más expuestas al tamizaje excesivo son las mujeres con mayor escolaridad e ingresos. Las barreras para el exceso de mamografías incluyeron orientaciones en consultas sobre los maleficios de la mamografía y expectativa de vida, por parte de médicos generales, principalmente los de atención primaria. Conclusión El estudio identificó que el uso excesivo de mamografía de tamizaje tiene alta prevalencia cuando se realiza como tamizaje y está impregnado de factores multinivel. La lista de determinantes puede ofrecer algunas orientaciones para estudios futuros con el objetivo de dejar de implementar esta atención de escaso valor que es el uso excesivo de mamografía de tamizaje.

Abstract Objectives To identify how scholars define excessive screening for women without risk of developing breast cancer, examine the determinants (barriers and facilitators) of excessive use of mammography screening, and describe the rates of observations of excessive use mammography screening. Methods Scoping review based on a search in May 2022 in six electronic health databases and libraries. Articles included were peer-reviewed articles, in any language and year of publication. Results In a sample of 18 articles, published from 1991 onwards, most of them from the United States, the excessive use of mammography were defined as the intention or performance of mammography outside the recommended age or interval range, among women with limited life expectancy, in coexisting, organized and opportunistic programs. The rates of observations of excessive use of mammography screening in the selected studies ranged from 1.4% to 87,2%. Facilitators for excessive mammography are related concerns of getting cancer; to the medical advice, especially from specialists; and to the increased access to tests. The most exposed to excessive screening are women with higher levels of education and income. Barriers for excessive mammography included guidance in consultations about the harm of mammography and life expectancy by general practitioners, particularly those in primary care. Conclusion Our study identified that the excessive use of mammography screening has a high prevalence when done as screening and is permeated by multi-level factors. Our list of determinants can provide some guidance for future studies aiming to de-implement the low-value care of excessive mammography screening.

Associação da espiritualidade, qualidade de vida e depressão em familiares de idosos com demências / Relación entre la espiritualidad, calidad de vida y depresión en familiares de adultos mayores con demencias / Association of spirituality, quality of life and depression in family members of older adults with dementia

Resumo Objetivo Associar a espiritualidade com a qualidade de vida e a depressão de cuidadores familiares e compreender a dinâmica familiar quando há um integrante com demência no domicílio. Métodos Estudo misto, com estratégia sequencial exploratória. Na etapa quantitativa, foram usados os instrumentos questionário sóciocontextual, World Health Organization Quality of Life - BREF, Inventário de Depressão de Beck e World Health Organization Quality of Life - spirituality, religiousness and personal beliefs. Na etapa qualitativa, 35 participantes responderam a uma entrevista semiestruturada. As duas etapas foram on-line na plataforma Google Forms e Meet. Resultados A amostra foi composta de 100 participantes, dos quais 83% eram do sexo feminino com idade entre 18 e 76 anos. Na correlação entre WHOQOL-BREF, WHOQOL-SRPB e BDI os resultados evidenciaram que quanto menor o escore de depressão, maiores os escores de espiritualidade e qualidade de vida. Dos resultados das entrevistas emergiram três categorias: Reorganização familiar na promoção do cuidado à pessoa com demência; Espiritualidade e suas implicações no enfrentamento da demência; Espiritualidade e rede de apoio como fator de proteção à saúde do cuidador familiar. Conclusão A espiritualidade configurou-se como importante fator de enfrentamento para os cuidadores familiares de idosos com demência, bem como um fator redutor do risco de depressão e de melhora da qualidade de vida.

Resumen Objetivo Relacionar la espiritualidad con la calidad de vida y la depresión de cuidadores familiares y comprender la dinámica familiar cuando hay un integrante con demencia en el domicilio. Métodos Estudio mixto, con estrategia secuencial exploratoria. En la etapa cuantitativa, se usaron los siguientes instrumentos: cuestionario socio-contextual, World Health Organization Quality of Life - BREF, Inventario de Depresión de Beck y World Health Organization Quality of Life - spirituality, religiousness and personal beliefs. En la etapa cualitativa, 35 participantes respondieron a una entrevista semiestructurada. Las dos etapas fueron virtuales en la plataforma Google Forms y Meet. Resultados La muestra fue compuesta por 100 participantes, de los cuales el 83 % era de sexo femenino, de entre 18 y 76 años. En la correlación entre WHOQOL-BREF, WHOQOL-SRPB y BDI, los resultados demostraron que cuanto menor era la puntuación de depresión, mayor era la puntuación de espiritualidad y calidad de vida. A partir de los resultados de las entrevistas, surgieron tres categorías: Reorganización familiar en la promoción del cuidado a personas con demencia, Espiritualidad y sus consecuencias en el afrontamiento a la demencia, Espiritualidad y red de apoyo como factor de protección de la salud del cuidador familiar. Conclusión La espiritualidad se configuró como un importante factor de afrontamiento para los cuidadores familiares de adultos mayores con demencia, así como un factor reductor del riesgo de depresión y de mejora de la calidad de vida.

Abstract Objective To associate spirituality with the quality of life and depression of family caregivers and understand the family dynamics when there is a member with dementia at home. Methods Mixed method study with a sequential exploratory strategy. The following instruments were used in the quantitative phase: the socio-contextual questionnaire, World Health Organization Quality of Life - BREF, Beck Depression Inventory and World Health Organization Quality of Life - spirituality, religiousness and personal beliefs. In the qualitative phase, 35 participants responded to a semi-structured interview. The two phases were performed online by means of the Google Forms and Meet platform. Results The sample consisted of 100 participants, of which 83% were female aged between 18 and 76 years. In the correlation between WHOQOL-BREF, WHOQOL-SRPB and BDI, the results showed that the lower the depression score, the higher the spirituality and quality of life scores. Three categories emerged from results of the interviews: Family reorganization in the care for the person with dementia; Spirituality and its implications for coping with dementia; Spirituality and support network as a health protection factor for the family caregiver. Conclusion Spirituality was as an important coping factor for family caregivers of older adults with dementia, and a factor that reduces the risk of depression and improves quality of life.

King's Parkinson's Disease Pain Questionnaire: reliability and convergent construct validity / King's Parkinson's Disease Pain Questionnaire: fiabilidad y validez de constructo convergente / King's Parkinson's Disease Pain Questionnaire: confiabilidade e validade de construto convergente

ABSTRACT Objectives: to assess the evidence of reliability and convergent construct validity of the King's Parkinson's Disease Pain Questionnaire. Methods: psychometric study of 75 older adults with Parkinson's disease. The instrument was applied by two researchers separately and reapplied by one researcher 15 days later. In terms of reliability, internal consistency was assessed using the Cronbach's alpha test and stability using the intraclass correlation coefficient. Scores of the King's Parkinson's Disease Pain Questionnaire were compared to those of the Geriatric Pain Measure in the assessment of construct validity. Results: the mean Cronbach's alpha obtained between the three assessments was above 0.60, the intraclass correlation between the three assessments was above 0.90, and there was a weak but significant correlation between the two applied scales. Conclusions: the instrument showed adequate evidence of convergent construct validity and reliability, and can be used in clinical practice.

RESUMEN Objetivos: evaluar las evidencias de confiabilidad y validez convergente de constructo del King's Parkinson's Disease Pain Questionnaire. Métodos: estudio psicométrico con 75 adultos mayores con enfermedad de Parkinson. El instrumento fue aplicado por dos investigadores por separado y vuelto a aplicar por uno investigador después de 15 días. En cuanto a la confiabilidad, se evaluó la consistencia interna mediante la prueba alfa de Cronbach y la estabilidad mediante el coeficiente de correlación intraclase. Al evaluar la validez del constructo, las puntuaciones del King's Parkinson's Disease Pain Questionnaire se compararon con las de la Geriatric Pain Measure. Resultados: se obtuvo un alfa de Cronbach promedio entre las tres evaluaciones por encima de 0,60 y correlación intraclase por encima de 0,90, y una correlación débil pero significativa entre las dos escalas aplicadas. Conclusiones: el instrumento mostró evidencia adecuada de validez convergente de constructo y confiabilidad, y puede ser utilizado en la práctica clínica.

RESUMO Objetivos: avaliar as evidências de confiabilidade e de validade de construto convergente do King's Parkinson's Disease Pain Questionnaire. Métodos: estudo psicométrico com 75 idosos com doença Parkinson. O instrumento foi aplicado por dois pesquisadores separadamente e reaplicado por um dos pesquisadores após 15 dias. Na confiabilidade, a consistência interna foi avaliada pelo teste de alfa de Cronbach e a estabilidade pelo coeficiente de correlação intraclasse. Na avaliação da validade de construto, os escores do King's Parkinson's Disease Pain Questionnaire foram comparados ao escore da Geriatric Pain Measure. Resultados: foi obtido um alfa de Cronbach médio entre as três avaliações acima de 0,60 e correlação intraclasse entre as três avaliações acima de 0,90, bem como uma correlação fraca, mas significativa entre as duas escalas aplicadas. Conclusões: o instrumento apresentou adequadas evidências de validade de construto convergente e de confiabilidade, podendo ser utilizado na prática clínica.

Self-inflicted violence and suicide in people living with HIV/AIDS: a systematic review.

OBJECTIVES: to analyze intellectual productions on self-inflicted violence and suicide in people living with HIV/AIDS. METHODS: a systematic review, carried out between March and April 2021, in the PubMed®/MEDLINE®, Web of Science and LILACS databases, subsidized in the Strengthening the Reporting of Observational Studies in Epidemiology. The period outlined was from 2011 to 2020. RESULTS: a total of 199 studies were identified, and 16 composed the final sample, grouped into the categories: Sociodemographic characteristics of victims of self-inflicted violence/suicide and their intervening factors (pointing to young adults, especially homosexuals, with low social support and a history of mental illness or substance abuse as usual victims); Successful measures for suicide prevention/control in people living with HIV/AIDS (suggesting more frequent psychosocial and clinical follow-up of those starting antiretroviral and immunocompromised treatment). CONCLUSIONS: biopsychosocial follow-up, analysis of sociodemographic profile and intervening factors should be frequent in this population for disease prevention/control.

Factors associated with risk, perception and knowledge of falls in elderly people.

OBJECTIVE: To verify the factors associated with risk, perception, and knowledge of falls; and pain among older adults. METHOD: A cross-sectional study carried out in the Emergency Service of a teaching hospital in the city of São Paulo between September 2019 and March 2020. We selected 197 older adults aged 65 and over, who were not disoriented or confused, of both genders. The instruments Awareness Questionnaire on the Risk of Falls, Morse Fall Scale and Numerical Pain Scales were applied. Mann-Whitney and Kruskal-Wallis tests were used. RESULTS: Interviewees with a high risk of falls in older adults (p = 0.0041); those with a support network had a lower perception and knowledge about the risk of falls (p = 0.0025) and lower percentage of severe pain (p = 0.0033). CONCLUSION: Factors associated with risk, perception and knowledge of falls and pain among older adults were age, family income, number of dependents, caregiver, support network, hypertension, impaired walking, antihypertensive medication, lipid-lowering medication, level of education, comorbidities and religion.

Association of the Charlson index with risk classification, clinical aspects, and emergency outcomes.

OBJECTIVE: To exam the association of the age-adjusted Charlson comorbidity index with the categories of risk classification, the clinical aspects, and the patient outcomes in the emergency department. METHOD: Cross-sectional, analytical study that analyzed the medical records of 3,624 patients seen in the emergency department. Charlson index scores greater than 2 showed a high rate of comorbidity (mortality risk). T-test and analysis of variance were applied in the analyses. RESULTS: There was a significant difference between the Charlson comorbidity index and the risk classification, with higher scores found in patients classified in the white (2.57) and red (2.06) categories. Patients with vascular, endocrine, neurological, cardiologic, or device problems, and those who underwent a head tomography had a high rate of comorbidity. In addition, those admitted, transferred, or who died in the emergency room had significantly higher index scores compared to those who were discharged from the hospital. CONCLUSION: The high rate of comorbidity was associated with the categories of risk classification, main and nonspecific complaints, performance of a head tomography, and patient outcomes in the emergency room.

Vulnerability and quality of life of older persons in the community in different situations of family care / Vulnerabilidad y calidad de vida de los mayores em la comunidade em diferentes situaciones de cuidado familiar / Vulnerabilidade e qualidade de vida de pessoas idosas em diferentes situações de atenção familiar

ABSTRACT Objective: to correlate socio-contextual aspects, physical vulnerability and quality of life of older persons in the community in different situations of family care. Methods: epidemiological, a cross-sectional and analytical study, with elderly people in the community (n=769), with application of the instruments: Vulnerable Elders Survey-13 (VES-13), World Health Organization Quality of Life for Older Persons (WHOQOL-OLD) and the World Health Organization Quality of Life (WHOQOL-BREF); and socio-contextual data questionnaire. Results: the population assessed presented an average of regular quality of life in both the WHOQOL-BREF and the WHOQOL-OLD. Older non-vulnerable persons (62.2%) and those with close family contact (82.6%) have a better quality of life than the vulnerable (p<0.0001). Conclusion: lower quality of life scores and more distant families are related to vulnerable elderly people; thus, the assessment of family proximity and physical vulnerability of older persons is shown to be an important factor in improving quality of life.

RESUMEN Objetivo: correlacionar aspectos socio-contextuales, vulnerabilidad física y calidad de vida de las personas mayores de la comunidad en diferentes situaciones de cuidado familiar. Métodos: estudio epidemiológico, transversal y analítico, con personas mayores de la comunidad (n=769), con aplicación de los instrumentos: Vulnerable Elders Survey-13 (VES-13), World Health Organization Quality of Life for Older Persons (WHOQOL-OLD) y World Health Organization Quality of Life (WHOQOL-BREF); y cuestionario de datos socio-contextuales. Resultados: la población evaluada presentó un promedio de calidad de vida regular tanto en WHOQOL-BREF como en WHOQOL-OLD. Los ancianos no vulnerables (62,2%) y aquellos con contacto familiar cercano (82,6%) tienen una mejor calidad de vida que los vulnerables (p<0,0001). Conclusión: los puntajes de calidad de vida más bajos y las familias más distantes se relacionan con las personas mayores vulnerables; así, la evaluación de la proximidad familiar y la vulnerabilidad física del anciano se muestra como un factor importante en la mejora de la calidad de vida.

RESUMO Objetivo: correlacionar aspectos sociocontextuais, vulnerabilidade física e a qualidade de vida de pessoas idosas na comunidade em diferentes situações de atenção familiar. Métodos: estudo epidemiológico, transversal e analítico, com pessoas idosas na comunidade (n=769), com aplicação dos instrumentos: Vulnerable Elders Survey-13 (VES-13), World Health Organization Quality of Life for Older Persons (WHOQOL-OLD) e o World Health Organization Quality of Life (WHOQOL-BREF); e questionário de dados sóciocontextual. Resultados: a população avaliada apresentou média de regular qualidade de vida tanto no WHOQOL-BREF quanto no WHOQOL-OLD. Pessoas idosas não vulneráveis (62,2%) e com contato familiar próximo (82,6%) apresentam melhor qualidade de vida do que os vulneráveis (p<0,0001). Conclusão: menores escores de qualidade de vida e famílias mais distantes estão relacionados a pessoas idosas vulneráveis; assim, a avaliação da proximidade familiar e vulnerabilidade física da pessoa idosa se mostra como um fator importante de melhora na qualidade de vida.

Self-inflicted violence and suicide in people living with HIV/AIDS: a systematic review / Violencia autoinfligida y suicidio en personas que viven con VIH/SIDA: una revisión sistemática / Violência autoprovocada e suicídio em pessoas que vivem com HIV/AIDS: revisão sistemática

ABSTRACT Objectives: to analyze intellectual productions on self-inflicted violence and suicide in people living with HIV/AIDS. Methods: a systematic review, carried out between March and April 2021, in the PubMed®/MEDLINE®, Web of Science and LILACS databases, subsidized in the Strengthening the Reporting of Observational Studies in Epidemiology. The period outlined was from 2011 to 2020. Results: a total of 199 studies were identified, and 16 composed the final sample, grouped into the categories: Sociodemographic characteristics of victims of self-inflicted violence/suicide and their intervening factors (pointing to young adults, especially homosexuals, with low social support and a history of mental illness or substance abuse as usual victims); Successful measures for suicide prevention/control in people living with HIV/AIDS (suggesting more frequent psychosocial and clinical follow-up of those starting antiretroviral and immunocompromised treatment). Conclusions: biopsychosocial follow-up, analysis of sociodemographic profile and intervening factors should be frequent in this population for disease prevention/control.

RESUMEN Objetivos: analizar las producciones intelectuales sobre la violencia autoinfligida y el suicidio en personas viviendo con VIH/SIDA. Métodos: revisión sistemática, realizada entre marzo y abril de 2021, utilizando las bases de datos PubMed®/MEDLINE®, Web of Science y LILACS, apoyada en el instrumento Strengthening the Reporting of Observational Studies in Epidemiology. El período planteado fue del 2011 al 2020. Resultados: se identificaron 199 estudios, de los cuales 16 conformaron la muestra final, siendo agrupados en las categorías: Características sociodemográficas de las víctimas de violencia autoinfligida/suicidio y sus factores intervinientes (señalando adultos jóvenes, especialmente homosexuales, con bajo apoyo social y antecedentes de enfermedad mental o abuso de sustancias como víctimas habituales); Medidas exitosas para la prevención/control del suicidio en personas que viven con VIH/SIDA (lo que sugiere un seguimiento psicosocial y clínico más frecuente para quienes comienzan el tratamiento antirretroviral y las personas inmunodeprimidas). Conclusiones: el seguimiento biopsicosocial, el análisis del perfil sociodemográfico y los factores intervinientes deben ser frecuentes en esta población, para la prevención/control de la enfermedad.

RESUMO Objetivos: analisar as produções intelectuais sobre a violência autoprovocada e suicídio em pessoas que vivem com HIV/AIDS. Métodos: revisão sistemática, realizada entre março e abril de 2021, nas bases PubMed®/MEDLINE®, Web of Science e LILACS, subsidiada no instrumento Strengthening the Reporting of Observational Studies in Epidemiology. O período delineado foi de 2011 a 2020. Resultados: identificaram-se 199 estudos, e 16 compuseram a amostra final, sendo agrupados nas categorias: Características sociodemográficas das vítimas de violência autoprovocada/suicídio e seus fatores intervenientes (apontando adultos jovens, especialmente homossexuais, com baixo suporte social e histórico de doenças mentais ou abuso de substâncias como as vítimas usuais); Medidas exitosas para prevenção/controle de suicídio em pessoas vivendo com HIV/AIDS (sugerindo acompanhamento psicossocial e clínico mais frequente daqueles em início de tratamento antirretroviral e imunodeprimidos). Conclusões: acompanhamento biopsicossocial, análise do perfil sociodemográfico e dos fatores intervenientes devem ser frequentes nesta população, para prevenção/controle do agravo.