RESUMO
OBJECTIVE: to identify spatial clusters of suicide and its epidemiological characteristics in the Chapecó (SC) micro-region from 1996 to 2018. METHODS: this was an exploratory ecological study, using data from the Mortality Information System; specific suicide rates and relative risks (RR) were calculated with a 95% confidence interval (95%CI); the scan statistic was used for spatial analysis. RESULTS: there were 1,034 suicides (13.7/100,000 inhabitants), with a male/female ratio of 3.79; the ≥ 60 age group was at higher risk for both sexes; a high risk cluster was found in the southwest region (RR = 1.57) and a low risk cluster in the southeast region, including Chapecó itself (RR = 0.68); risk of suicide among widowed (RR = 3.05; 95%CI 1.99;4.67), separated (RR = 2.48; 95%CI 1.44;4.27), and married (RR = 1.97; 95%CI 1.54;2.51) people was higher than among single people. The main methods were hanging (81.2%) and firearms (9.7%). CONCLUSION: there was a higher risk of suicide in the elderly, male and widowed people. Hanging was the most frequent method and risk clustering was found in the southwest.
Assuntos
Armas de Fogo , Suicídio , Humanos , Masculino , Feminino , Idoso , Brasil/epidemiologia , Análise Espacial , Análise por ConglomeradosRESUMO
In Brazil, the provision of mental health care in primary care centers has gained strategic importance, as it ensures that users will be able to attend these services within their communities, and empathy is a key aspect in the development of the doctor-patient relationship. The aim of this study was to identify characteristics related to empathy in physicians who work in primary care centers and who provide care to individuals with mental disorders. Qualitative research was carried out in 2016, based on semi-structured interviews with eight general and family physicians. Material from the interviews was analyzed using content analysis techniques and three categories emerged: empathy in the active listening of the physician, strategies that allow for better patient care, and the mobilization of emotions. The use of empathy is intrinsically linked to the resolutive capacity of care, and the characteristics identified were active listening, resource management, and the development of methods to overcome the structural obstacles of daily routines.
En Brasil, el cuidado en salud mental en los centros de atención primaria se tornó estratégico, dado que garantiza que el usuario asista en su territorio, y la empatía es de gran importancia en el desarrollo de la relación médico-paciente. El objetivo de este estudio fue identificar características relacionadas con la empatía en médicas y médicos que trabajan en el primer nivel y atienden a personas con sufrimiento mental. Se realizó una investigación cualitativa, en 2016, con entrevistas semiestructuradas a ocho médicas y médicos generalistas y de familia. Los relatos se analizaron con la técnica de análisis de contenido y se identificaron tres categorías: empatía en la escucha activa del médico, estrategias que permitan una mejor atención del paciente y movilización de sentimientos. El uso de la empatía está intrínsecamente relacionado con la resolutividad de la atención y las características encontradas fueron la utilización de la escucha activa, el manejo de recursos y el desarrollo de métodos para superar trabas estructurales del cotidiano.
Assuntos
Empatia , Médicos de Atenção Primária , Brasil , Comunicação , Humanos , Saúde Mental , Relações Médico-Paciente , Pesquisa QualitativaRESUMO
Objective: to identify spatial clusters of suicide and its epidemiological characteristics in the Chapecó (SC) micro-region from 1996 to 2018. Methods: this was an exploratory ecological study, using data from the Mortality Information System; specific suicide rates and relative risks (RR) were calculated with a 95% confidence interval (95%CI); the scan statistic was used for spatial analysis. Results: there were 1,034 suicides (13.7/100,000 inhabitants), with a male/female ratio of 3.79; the ≥ 60 age group was at higher risk for both sexes; a high risk cluster was found in the southwest region (RR = 1.57) and a low risk cluster in the southeast region, including Chapecó itself (RR = 0.68); risk of suicide among widowed (RR = 3.05; 95%CI 1.99;4.67), separated (RR = 2.48; 95%CI 1.44;4.27), and married (RR = 1.97; 95%CI 1.54;2.51) people was higher than among single people. The main methods were hanging (81.2%) and firearms (9.7%). Conclusion: there was a higher risk of suicide in the elderly, male and widowed people. Hanging was the most frequent method and risk clustering was found in the southwest.
Objetivo: identificar agregados espaciales de suicidio y el perfil epidemiológico en la microrregión de Chapecó (SC), 1996-2018. Métodos: estudio ecológico exploratorio, con datos del Sistema de Información de Mortalidad. Fueron calculadas tasas específicas de suicidio y riesgos relativos (RR) con intervalo de confianza 95% (IC95%). Para el análisis espacial se utilizó la estadística scan. Resultados: hubo 1.034 suicidios (13,7/100.000 habitantes), razón sexo masculino/femenino de 3,79. El grupo de ≥ 60 años presentó mayor riesgo para ambos sexos. Se observó un agregado de alto riesgo en la región suroeste (RR = 1,57) y un agregado de menor riesgo en el sureste (RR = 0,68). El riesgo de suicidio entre viudos (RR = 3.05; IC95% 1,99;4,67), separados (RR = 2.48; IC95% 1,44;4,27) y casados (RR = 1.97; IC95% 1,54;2,51) fueron mayores que entre solteros. El principal medio fue el ahorcamiento (81,2%), seguido de las armas de fuego (9,7%). Conclusión: hubo mayor riesgo de suicidio en ancianos, sexo masculino y viudos. Ahorcamiento fue el método más frecuente y se observó agrupación de riesgos hacia el Suroeste.
Objetivo: identificar conglomerados espaciais do suicídio e características epidemiológicas na microrregião de Chapecó, SC, Brasil, 1996-2018. Métodos: estudo ecológico exploratório, com dados do Sistema de Informações sobre Mortalidade; foram calculadas taxas específicas de suicídio, e riscos relativos (RR) com intervalo de confiança de 95% (IC95%); na análise espacial, utilizou-se estatística scan. Resultados: 1.034 suicídios (13,7/100 mil habitantes), a razão sexo masculino/feminino de 3,79; a idade ≥ 60 anos apresentou maior risco para ambos os sexos; observou-se um conglomerado de alto risco na região sudoeste (RR = 1,57) e um de menor risco a sudeste, incluindo Chapecó (RR = 0,68); risco de suicídio entre viúvos (RR = 3,05; IC95% 1,99;4,67), separados (RR = 2,48; IC95% 1,44;4,27) e casados (RR = 1,97; IC95% 1,54;2,51) maior que entre solteiros; principal método, enforcamento (81,2%), seguido por uso de arma de fogo (9,7%). Conclusão: maior risco de suicídio para idosos, sexo masculino e viúvos; enforcamento foi mais frequente; conglomerado de risco a sudoeste.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Suicídio/estatística & dados numéricos , Mortalidade , Suicídio Consumado/estatística & dados numéricos , Brasil/epidemiologia , Análise por Conglomerados , Monitoramento Epidemiológico , Análise Espaço-TemporalRESUMO
RESUMEN En Brasil, el cuidado en salud mental en los centros de atención primaria se tornó estratégico, dado que garantiza que el usuario asista en su territorio, y la empatía es de gran importancia en el desarrollo de la relación médico-paciente. El objetivo de este estudio fue identificar características relacionadas con la empatía en médicas y médicos que trabajan en el primer nivel y atienden a personas con sufrimiento mental. Se realizó una investigación cualitativa, en 2016, con entrevistas semiestructuradas a ocho médicas y médicos generalistas y de familia. Los relatos se analizaron con la técnica de análisis de contenido y se identificaron tres categorías: empatía en la escucha activa del médico, estrategias que permitan una mejor atención del paciente y movilización de sentimientos. El uso de la empatía está intrínsecamente relacionado con la resolutividad de la atención y las características encontradas fueron la utilización de la escucha activa, el manejo de recursos y el desarrollo de métodos para superar trabas estructurales del cotidiano.
ABSTRACT In Brazil, the provision of mental health care in primary care centers has gained strategic importance, as it ensures that users will be able to attend these services within their communities, and empathy is a key aspect in the development of the doctor-patient relationship. The aim of this study was to identify characteristics related to empathy in physicians who work in primary care centers and who provide care to individuals with mental disorders. Qualitative research was carried out in 2016, based on semi-structured interviews with eight general and family physicians. Material from the interviews was analyzed using content analysis techniques and three categories emerged: empathy in the active listening of the physician, strategies that allow for better patient care, and the mobilization of emotions. The use of empathy is intrinsically linked to the resolutive capacity of care, and the characteristics identified were active listening, resource management, and the development of methods to overcome the structural obstacles of daily routines.