Mental health of nursing professionals during the COVID-19 pandemic: a cross-sectional study.

OBJECTIVE: To identify the prevalence of and factors associated with: (1) major depressive episodes; (2) minor psychiatric disorders (MPDs); and (3) suicidal ideation among nursing professionals from a municipality in southern Brazil. METHODS: Using a cross-sectional design, we recruited 890 nursing professionals linked to 50 Primary Care units, 2 walk-in clinics, 2 hospital services, 1 emergency room service, 1 mobile emergency care service, and 1 teleconsultation service, in addition to the municipal epidemiological surveillance service and the vacancy regulation center between June and July 2020. We used the Patient Health Questionnaire-9 and the Self-Reporting Questionnaire to evaluate the studied outcomes. Associations between the outcomes and variables related to sociodemographic profile, work, health conditions, and daily life were explored using Poisson regression models with robust variance estimators. RESULTS: The observed prevalence of depression, MPDs, and suicidal ideation were 36.6%, 44%, and 7.4%, respectively. MPDs were associated with the assessment of support received by the service as 'regular' (PR: 1.48; 95% CI: 1.19-1.85) or 'poor' (PR: 1.54; 95% CI: 1.23-1.94), with a reported moderate (PR: 1.63; 95% CI: 1.29-2.07), or heavy (PR: 2.54; 95% CI: 2.05-3.15) workload, and with suspected COVID-19 infection (PR: 1.44; 95% CI: 1.25-1.66). Major depressive episodes were associated with a reported lack of personal protective equipment (PR: 1.20; 95% CI: 1.01-1.42), whereas suicidal ideation was inversely related to per capita income > 3 minimum monthly wages (PR: 0.28; 95% CI: 0.11-0.68), and positively related to the use of psychotropic drugs (PR: 3.14; 95% CI: 1.87-5.26). CONCLUSION: Our results suggest that nursing professionals' working conditions are associated with their mental health status. The need to improve working conditions through adequate dimensioning, support and proper biosafety measures is only heightened in the context of the COVID-19 pandemic.

CuO nanoparticles decorated on hydroxyapatite/ferrite magnetic support: photocatalysis, cytotoxicity, and antimicrobial response.

Photocatalysts supported in magnetic nanocomposites for application in environmental remediation processes have been evaluated for removing contaminants due to easy recovery and low toxicity to the ecosystem. In this work, copper oxide (CuO) nanoparticles with photocatalytic properties were decorated on magnetic support constituted by hydroxyapatite (HAP) and ferrite to achieve efficiency in contaminated water remediation under visible light irradiation. First, nanomaterials were obtained by precipitation route, allowing fast and straightforward synthesis. Then, CuO nanoparticles with 6 nm diameter were efficiently decorated on magnetic support (25 nm), showing a high ability to absorb visible light irradiation (bandgap) to promote electronic transition and charge separation. Under visible irradiation, CuO promotes the H2O2 reduction in the conduction band (BC) to form hydroxyl radicals (•OH), which are responsible for rhodamine B (RhB) dye degradation (> 90% in 60 min). Magnetic hysteresis assays confirmed the magnetic properties of HAP/ferrite support, which enabled the recovery and reuse of the magnetic photocatalyst efficiently up to 3 cycles. Due to low Cu2+ leaching after the photocatalytic application stage, cytotoxicity assay for the Allium cepa seeds did not exhibit abnormal cells other than those commonly found. Furthermore, the CuO-decorated nanoparticles showed bactericidal activity against S. aureus (Gram-positive) and E. coli (Gram-negative) microorganisms, being more significant for the first one. Thus, the developed nanocomposite of CuO nanoparticles decorated on the magnetic support surface showed to be a complete system for water remediation, acting in contaminant degradation under visible light irradiation and bactericidal control with environmentally friendly characteristics.Graphical abstract CuO nanoparticles decorated on hydroxyapatite/ferrite magnetic support acting as a photocatalytic and bactericidal system.

Online mental health care during the COVID-19 pandemic / Atendimento on-line em saúde mental durante a pandemia da COVID-19

ABSTRACT Objective: Identify users, services, and reasons for seeking online mental health care during the COVID-19 pandemic. Methods: A descriptive, retrospective study, with documentary analysis of medical records of users served between April and July 2020. Results: Of the 258 accesses, 159 were complete, and 99 were offline messages. Although there were 61 (38.36%) consultations in May, in April, there were 49 (30.82%) in 18 days of reception. More than 89% of accesses were women between 40 and 59 years. Among the motivations in the search for care, anxiety, fear, depression, sadness, crying, stress, and suicidal ideation stand out. Final considerations: Chat is a quick, early and short-wait intervention opportunity for people in need of mental health care. Therefore, the study emphasizes the importance of investing in the training of nursing professionals to act in mental health.

RESUMEN Objetivo: Caracterizar usuarios, atenciones y motivaciones para búsqueda de atención online en salud mental durante la pandemia de COVID-19. Métodos: Estudio descriptivo, retrospectivo, con análisis documental de prontuarios de usuarios atendidos entre abril y julio de 2020. Resultados: De los 258 accesos, 159 fueron efectuados, y 99 fueron mensajes desconectadas. Aunque el mes de mayo presentó 61 (38,36%) atenciones, en abril ocurrieron 49 (30,82%) en 18 días de recepción. Más de 89% de los accesos fueron de mujeres, entre 40 y 59 años. De las motivaciones en la búsqueda por atención, destacan la ansiedad, miedo, depresión, tristeza, lloro, estrés e ideación suicida. Consideraciones finales: El chat es una oportunidad de intervención rápida, precoz y con corto tiempo de espera para las personas que necesitan de cuidado en salud mental. Así, se resalta la importancia de invertir en la formación de profesionales de enfermería para la actuación en la salud mental.

RESUMO Objetivo: Caracterizar os usuários, os atendimentos e as motivações para busca de atendimento online em saúde mental durante a pandemia da COVID-19. Métodos: Estudo descritivo, retrospectivo, com análise documental de prontuários de usuários atendidos entre abril e julho de 2020. Resultados: Dos 258 acessos, 159 foram efetivados, e 99 foram mensagens off-line. Apesarde o mês de maio apresentar 61 (38,36%) atendimentos, em abril ocorreram 49 (30,82%) em 18 dias de acolhimento. Mais de 89% dos acessos foram de mulheres, entre 40 e 59 anos. Dasmotivações na busca por atendimento, destacam-se a ansiedade, medo, depressão, tristeza, choro, estresse e ideação suicida. Considerações finais: O chat é uma oportunidade de intervenção rápida, precoce e com curto tempo de espera para as pessoas que necessitam de cuidado em saúde mental. Portanto, ressalta-se a importância de se investir na formação de profissionais de enfermagem para a atuação na saúde mental.

Mental health of nursing professionals during the COVID-19 pandemic: a cross-sectional study

ABSTRACT OBJECTIVE To identify the prevalence of and factors associated with: (1) major depressive episodes; (2) minor psychiatric disorders (MPDs); and (3) suicidal ideation among nursing professionals from a municipality in southern Brazil. METHODS Using a cross-sectional design, we recruited 890 nursing professionals linked to 50 Primary Care units, 2 walk-in clinics, 2 hospital services, 1 emergency room service, 1 mobile emergency care service, and 1 teleconsultation service, in addition to the municipal epidemiological surveillance service and the vacancy regulation center between June and July 2020. We used the Patient Health Questionnaire-9 and the Self-Reporting Questionnaire to evaluate the studied outcomes. Associations between the outcomes and variables related to sociodemographic profile, work, health conditions, and daily life were explored using Poisson regression models with robust variance estimators. RESULTS The observed prevalence of depression, MPDs, and suicidal ideation were 36.6%, 44%, and 7.4%, respectively. MPDs were associated with the assessment of support received by the service as 'regular' (PR: 1.48; 95% CI: 1.19-1.85) or 'poor' (PR: 1.54; 95% CI: 1.23-1.94), with a reported moderate (PR: 1.63; 95% CI: 1.29-2.07), or heavy (PR: 2.54; 95% CI: 2.05-3.15) workload, and with suspected COVID-19 infection (PR: 1.44; 95% CI: 1.25-1.66). Major depressive episodes were associated with a reported lack of personal protective equipment (PR: 1.20; 95% CI: 1.01-1.42), whereas suicidal ideation was inversely related to per capita income > 3 minimum monthly wages (PR: 0.28; 95% CI: 0.11-0.68), and positively related to the use of psychotropic drugs (PR: 3.14; 95% CI: 1.87-5.26). CONCLUSION Our results suggest that nursing professionals' working conditions are associated with their mental health status. The need to improve working conditions through adequate dimensioning, support and proper biosafety measures is only heightened in the context of the COVID-19 pandemic.

Potencialidades de um website para um centro de atenção psicossocial infantojuvenil / Potentials of a website for a child and youth psychosocial care center / Potencialidades de un sitio web para un centro de atención psicosocial para niños y adolescentes

Objetivo: evidenciar, a partir do feedback dos usuários, familiares, coordenadores e profissionais do Centro de Atenção Psicossocial Infanto Juvenil (CAPSi), a potencialidade do e-Mental Health na promoção do acesso através de um website.Método: pesquisa com abordagem metodológica qualitativa através de um estudo exploratório, do tipo pesquisa-ação utilizando o Knowledge Translation e a Metodologia da Dinâmica do Espelhamento Digital. A coleta de dados ocorreu entre os meses de agosto e setembro de 2018 no CAPSi da cidade de Pelotas, RS, Brasil. Resultados: o website iCanguru demonstrou ser capaz de melhorar o acesso, atuar na prevenção e promoção em saúde mental infanto-juvenil, aproximar a população rural e dar suporte cidades desassistidas. Conclusão: o website iCanguru pode ser uma excelente estratégia para superar algumas das barreiras de acesso e ser uma porta de entrada para o CAPSi. Descritores: e-Saúde; Serviços comunitários de saúde mental; Intervenção baseada em internet; Acesso a tecnologias em saúde; Avaliação das tecnologias de Saúde. (AU)

Objective: To demonstrate, based on the feedback from users, family members, coordinators, and professionals of the Center for Psychosocial Care for Children and Youths, the potential of e-Mental Health in promoting access through a website. Methods: Qualitative research approach through an exploratory study - action research, using Knowledge Translation and the Methodology of Digital Mirroring Dynamic. Data collection occurred between August and September 2018 at Center for Psychosocial Care for Children and Youths in the city of Pelotas, RS, Brazil. Results: The iCanguru website demonstrated to be able to improve access, prevention, and mental health promotion for children and youths, approaching the rural population and unsupported cities. Conclusion: The iCanguru website can be an excellent strategy to overcome some of the barriers to access and be a gateway to Center for Psychosocial Care for Children and Youths. (AU)

Objetivo: Destacar, a partir de la retroalimentación de los usuarios, familias, coordinadores y profesionales del Centro de Atención Psicosocial a la Infancia y la Adolescencia, el potencial de la e-Salud Mental para promover el acceso a través de un sitio web. Métodos: Investigación con enfoque metodológico cualitativo a través de un estudio exploratorio, del tipo de investigación acción utilizando la Traducción del Conocimiento y la Metodología de la Dinámica del Mirroring Digital. La recolección de datos se llevó a cabo entre agosto y septiembre de 2018 en Centro de Atención Psicosocial a la Infancia y la Adolescencia en la ciudad de Pelotas, RS, Brasil. Resultados: El sitio web iCanguru demostró ser capaz de mejorar el acceso, actuar en la prevención y promoción de la salud mental de niños y adolescentes, acercar a la población rural y apoyar a las ciudades no asistidas. Conclusión: El sitio web de iCanguru puede ser una excelente estrategia para superar algunas de las barreras de acceso y ser una puerta de entrada a Centro de Atención Psicosocial a la Infancia y la Adolescencia. (AU)

Online mental health care during the COVID-19 pandemic.

OBJECTIVE: Identify users, services, and reasons for seeking online mental health care during the COVID-19 pandemic. METHODS: A descriptive, retrospective study, with documentary analysis of medical records of users served between April and July 2020. RESULTS: Of the 258 accesses, 159 were complete, and 99 were offline messages. Although there were 61 (38.36%) consultations in May, in April, there were 49 (30.82%) in 18 days of reception. More than 89% of accesses were women between 40 and 59 years. Among the motivations in the search for care, anxiety, fear, depression, sadness, crying, stress, and suicidal ideation stand out. FINAL CONSIDERATIONS: Chat is a quick, early and short-wait intervention opportunity for people in need of mental health care. Therefore, the study emphasizes the importance of investing in the training of nursing professionals to act in mental health.

Atenção psicossocial infantojuvenil: interfaces com a rede de saúde pelo sistema de referência e contrarreferência / Atención psicosocial infantojuvenil: interfaces con la red de salud del sistema de referencia y contra-referencia / Psychosocial attention of children and adolescents: interfaces with the health network by the referral and counter-referral system

RESUMO Objetivo: descrever as características da articulação entre os serviços que compõem a rede de saúde mental infantojuvenil, através do sistema de referência e contrarreferência. Método: estudo descritivo desenvolvido em 25 serviços, a partir de informações obtidas em questionários autoaplicados aos coordenadores, através do sistema eletrônico do Ministério da Saúde. A organização e análise descritiva dos dados foram realizadas no programa estatístico Stata versão 12.0. Resultados: evidenciou-se a existência de sistemas de referência e contrarreferência entre a atenção básica e os centros de atenção psicossocial infantojuvenil e uma parceria com os outros serviços de saúde mental e ampliação do cuidado. No entanto, o hospital psiquiátrico ainda é utilizado como referência no tratamento, dentre outras limitações, como dificuldades em lidar com as demandas de saúde mental, devido a encaminhamentos recorrentes e inexperiência neste tipo de acolhimento/tratamento. Conclusão: a emergência para o cuidado em saúde mental infantojuvenil que atenda os pressupostos do paradigma psicossocial suscita novas práticas que possam contribuir para o fortalecimento das ações neste cenário. Estas ações devem ser pautadas num sistema de referência que demonstre efetividade na rede de saúde, de modo a promover um cuidado amplo, contínuo, tendo em vista o fortalecimento da rede de atenção psicossocial.

RESUMEN Objetivo: describir las características de la articulación entre los servicios que componen la red de salud mental infanto-juvenil, a través del sistema de referencia y contra-referencia. Método: estudio descriptivo desarrollado en 25 servicios, a partir de informaciones obtenidas en cuestionarios auto-administrados a los coordinadores, a través del sistema electrónico del Ministerio de la salud. La organización y análisis descriptivo de los datos se realizaron utilizando Stata versión 12.0. Resultados: se evidenció la existencia de sistemas de referencia y contra-referencia entre los centros de atención psicosocial infantojuveniles y la asociación con otros servicios de salud mental y la atención primaria en expansión. Sin embargo, el hospital psiquiátrico todavía se utiliza como referencia en el tratamiento, entre otras limitaciones, tales como dificultades para hacer frente a las exigencias de la salud mental debido a la falta de experiencia y referencias recurrentes en este tipo de atención/tratamiento. Conclusión: la emergencia para el cuidado en salud mental infanto-juvenil que cumpla con las condiciones del paradigma psicosocial, suscita nuevas prácticas que pueden contribuir al fortalecimiento de las acciones en este escenario. Estas acciones deben guiarse en un sistema de referencia para demostrar la eficacia del sistema de salud, con el fin de promover una atención integral, continua con el fin de fortalecer la red de atención psicosocial.

ABSTRACT Objective: describing the characteristics of the articulation between the services that compose the mental health network of children and adolescents, through the referral and counter-referral system. Method: descriptive study developed in 25 services, based on information obtained from self-administered questionnaires applied to coordinators through the Ministry of Health electronic system. Data organization and descriptive analysis were performed in the Stata statistical program version 12.0. Results: the existence of referral and counter-referral systems are evidenced between the basic healthcare and psychosocial healthcare centers for children and adolescents, and a partnership with other mental-health services and expanded care. However, psychiatric hospitals are still used as a reference for treatment, among other limitations, such as difficulties in dealing with mental health demands due to recurrent referrals and inexperience in this type of care/treatment. Conclusion: emergency services for children and adolescent mental healthcare which meet the expectations of the psychosocial paradigm need new practices that may contribute to strengthening actions in this scenario. Such actions should be based on a referral system that can demonstrate effectiveness among the healthcare network in order to promote comprehensive and continuous care focused on strengthening the psychosocial care network.

A intersetorialidade na atenção psicossocial infantojuvenil / La intersectorialidad en la atención psicosocial infantil-juvenil / The intersectoriality in the psychosocial attention of children and adolescent

Objective: To describe the capacity of articulation of the Centers of Psychosocial Attention of Children and Adolescent (CPACA) of the States of the South of Brazil with the sectors of Basic Health Network, School, Education Secretary, EJA, Guardianship Council, Social Assistance (CRAS/CREAS) and Justice. Method: Census and descriptive character, is a cut from the Research CAPSUL (2011), conducted with 25 CPACA, being 16 in the state of Rio Grande do Sul; 5 in Santa Catarina and 4 in Paraná, in the period of June 2011 to November 2012. In the analysis the basic statistic of descriptive analysis was used. Results: The CPACA needs attention and investment by public politics, to promote these actions of improvement are very important to the development of children and adolescents, once in this age they begin the social formation and the psychological maturity. Conclusion: To establish partnerships with the responsible bodies, to build an intersectoral network of mutual assistance.

Objetivo: Descrever a capacidade de articulação dos Centros de Atenção Psicossocial Infantojuvenil (CAPSi) dos Estados do Sul do Brasil com os setores da Rede Básica de Saúde, Escola, Secretaria de Educação, EJA, Conselho Tutelar, Assistência Social (CRAS/CREAS) e Justiça. Método: De caráter censitário e descritivo é um recorte da Pesquisa CAPSUL(2011), realizada com 25 CAPSi, 16 no estado do Rio Grande do Sul; 5 em Santa Catarina e 4 no Paraná, no período de junho de 2011 a novembro de 2012. Na análise, utilizou-se a estatística básica de análise descritiva. Resultados: Os CAPSi precisam de atenção e investimento por parte das políticas públicas, promover essas ações de melhoria são de suma importância para o desenvolvimento das crianças e jovens, já que nesta faixa etária começa a formação social e amadurecimento psicológico. Conclusão: Estabelecer parcerias com os órgãos responsáveis, para que se possa construir uma rede intersetorial de assistência mútua.

Objetivo: Describir la capacidad de articulación de los Centros de Atención Psicosocial Infantil-Juvenil (CAPSi) de los Estados del Sur de Brasil con los sectores de la Red Básica de Salud, Escuela, Secretaria de Educación, EJA, Consejo Tutelar, Asistencia Social (CRAS/CREAS) y Justicia. Método: De carácter de censo y descriptivo, es un recorte de la Investigación CAPSUL (2011), realizada con 25 CAPSi, siendo 16 en el estado de Rio Grande do Sul; 5 en Santa Catarina y 4 en Paraná, en el período de junio de 2011 a noviembre de 2012. En el análisis se utilizó la estadística básica de análisis descriptiva. Resultados: Los CAPSi necesitan de atención e inversión por parte de las políticas públicas, promover esas acciones de mejoría es importante para el desarrollo de estos niños y jóvenes ya que en esta faja de edad comienza la formación social y maduración psicológica. Conclusión: Establecer asociaciones con los órganos responsables, para que se pueda construir una red intersectorial de asistencia mutua.