Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis.

Patient therapeutic adherence lies at the core of mental health care. Health Care professionals and organizations play a major role in promoting adherence among people with mental disorders. However, defining therapeutic adherence remains complex. We used Rodgers' evolutionary concept analysis to explore the concept of therapeutic adherence in the context of mental health. We conducted a systematic literature search on Medline/PubMed and CINAHL for works published between January 2012 and December 2022. The concept analysis showed that major attributes of therapeutic adherence include patient, microsystem and meso/exosystem-level factors. Antecedents are those related to patients, such as their background, beliefs and attitudes, and acceptance of mental illness-and those related to patient-HCP therapeutic engagement. Lastly, three different consequences of the concept emerged: an improvement in clinical and social outcomes, commitment to treatment, and the quality of healthcare delivery. We discuss an operational definition that emerged from the concept analysis approach. However, considering the concept has undergone evolutionary changes, further research related to patient adherence experiences in an ecological stance is needed.

"Looking beyond Mental Health Stigma": An Online Focus Group Study among Senior Undergraduate Nursing Students.

Evidence highlights the need for professionals to be aware of their stigmatizing attitudes and discriminatory practices in order to minimize the negative impact on the people they take care of. However, nursing students' perceptions of these issues have been poorly studied. This study explores the perspective of senior undergraduate nursing students on mental health and the stigma around it, by considering a simulated case vignette of a person with a mental health problem. A descriptive qualitative approach was chosen and involved three online focus group discussions. The findings show various manifestations of stigma, both at an individual and collective level, which indicates that it is an obstacle to the wellbeing of people with mental illness. Individual manifestations of stigma concern its effect on the person with mental illness, while at the collective level they concern the family or society in general. Stigma is a multifactorial, multidimensional, and complex concept, in terms of identifying and fighting it. Thus, the strategies identified involve multiple approaches at the individual level, aimed at the patient and family, namely through education/training, communication, and relationship strategies. At the collective level, to intervene with the general population and specific groups, such as groups of young people, strategies suggested include education/training, use of the media, and contact with people with mental disorders as ways to fight stigma.

Intervention Programs for First-Episode Psychosis: A Scoping Review Protocol.

Early intervention programs for first-episode psychosis aim to intervene in the early stages of the disease. They are essential to prevent and delay the progression of the illness to a more advanced stage, but information about their characteristics is not systematized. The scoping review considered all studies of first-episode psychosis intervention programs, regardless of their context (hospital or community), and explored their characteristics. The scoping review was developed according to the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. The PCC mnemonic (population, concept, and context) addressed research questions, the inclusion and exclusion criteria, and the search strategy. The scoping review sought to identify the literature that meets the predefined inclusion criteria. The research was conducted in the following databases: Web of Science Core Collection, MEDLINE, CINAHL Complete and PsycINFO, Scopus, Cochrane Library, and JBI Evidence Synthesis. The search for unpublished studies included OpenGrey (a European repository) and MedNar. It used sources in English, Portuguese, Spanish, and French. It included quantitative, qualitative, and multi-method/mixed methods studies. It also considered gray or unpublished literature. After removing duplicates, two independent reviewers extracted the relevant information after selecting the articles. If there were disagreements, a third reviewer was used. The researchers have developed a tool based on the JBI model that will allow them to extract the relevant information for the review. The results are presented schematically in narratives and tables. This scoping review maps first-episode psychosis intervention programs by identifying their characteristics, participants, and specific implementation contexts and allows researchers to create multicomponent programs tailored to different contexts.

Psychoeducational interventions to promote adolescents' mental health literacy in schools: Identifying theory for the development of a complex intervention.

TOPIC: The concept of mental health literacy (MHL) was defined as the knowledge and beliefs about mental disorders that help in their recognition, management, or prevention. The complexity of interventions to promote adolescents' MHL requires that they be investigated through a process of development, feasibility/piloting, evaluation, and implementation, according to Medical Research Council (MRC) Framework. PURPOSE: This article aimed to identify the theory that supports the development of a psychoeducational intervention to promote adolescents' MHL in schools, possibly to be developed by mental health and psychiatric nurses. SOURCES USED: Journal articles, books, reports, and regulations. CONCLUSIONS: This theory allows us to design a psychoeducational intervention to promote adolescents' MHL in schools and supports the subsequent phases of the MRC Framework.

Positive Mental Health Literacy: A Concept Analysis.

Background: The positive component of Mental Health Literacy (PMeHL) refers to a person's awareness of how to achieve and maintain good mental health. Although explored recently, the term still lacks a clear definition among healthcare practitioners. Aim: To identify the attributes and characteristics of PMeHL, as well as its theoretical and practical applications. Methods: Literature search (using the Medline and CINAHL databases) and review, covering the last 21 years, followed by concept analysis according to the steps described by Walker and Avant approach. Results: Positive component of Mental Health Literacy is considered one component of MHL, integrating positive mental health. The concept's attributes include: (a) competence in problem-solving and self-actualization; (b) personal satisfaction; (c) autonomy; (d) relatedness and interpersonal relationship skills; (e) self-control; and (f) prosocial attitude. Four case scenarios (model, borderline, related and contrary cases) were used to clarify the antecedents (individual factors and social/contextual factors) and consequences (individual sphere; relational/social sphere; contextual/organizational sphere) of PMeHL. Conclusion: Positive component of Mental Health Literacy is considered a component of MHL, which deserves attention throughout the lifespan, in different contexts and intervention levels. Considering PMeHL as a multi-faceted and dynamic construct will help understand the mechanisms that improve mental health and promote healthy behaviors. Priority should be given to robust primary research focused on nursing interventions that enhance and sustain PMeHL in people and families.

Mapping Complex Interventions in Portuguese Healthcare Research: A Scoping Review Protocol.

Along with the worldwide recognition of the importance of the methodological guidance to the validity and rigour of complex health interventions, this scoping review aims to identify and characterise the scientific evidence on complex health interventions in Portuguese healthcare research. The Joanna Briggs Institute (JBI) guidance for scoping reviews will be followed. The population (P) concept (C) context (C) mnemonic will scaffold the research questions, inclusion and exclusion criteria, and searching strategy. MEDLINE, CINAHL, LILACS, and Open Access Scientific Repository of Portugal (RCAAP) will be searched. Scientific evidence reporting complex health interventions in the Portuguese healthcare context, in Portuguese and English and published from 2008 and onwards will be considered for inclusion. Literature pertaining to complex health interventions outside the Portuguese healthcare context will be excluded. The literature will be screened for eligibility by two independent reviewers first by title and abstract and subsequently by full-text. A data matrix will be used for data-extraction of the included literature. The charted data will be thematically analysed and presented graphically with a narrative description of the literature characteristics. The results from this literature review are expected to provide an overview of the knowledge concerning the characteristics and methodological guidance of Portuguese complex health interventions.

The Effectiveness of Psychoeducational Interventions in Adolescents' Anxiety: A Systematic Review Protocol.

The COVID-19 pandemic had a strong impact on increasing anxiety in adolescents. This systematic review aims to identify the most effective psychoeducational interventions for reducing anxiety in adolescents following the guidelines of the Joanna Briggs Institute (JBI). The inclusion and exclusion criteria have been defined, and the search strategy has been planned. The search strategy will aim to locate both published and unpublished studies using, among other databases: CINAHL Plus with Full Text; PubMed; the Cochrane Central Register of Controlled Trials; and the JBI Database of Systematic Reviews. Following the search, all identified citations will be collated and uploaded into Endnote, and duplicates removed. Titles and abstracts will then be screened by two independent reviewers and by a third reviewer if a disagreement occurs. The results of the search will be reported in full in the final systematic review and presented in the PRISMA flow diagram. Eligible studies will be critically appraised for methodological quality using standardized critical appraisal instruments from the JBI. Data will be extracted from the studies included using the standardized JBI data extraction tool. For data synthesis, studies will be pooled using JBI SUMARI. The GRADE approach for grading the certainty of evidence will be followed, and a summary of findings will be created using GRADEPro GDT software. The results from this systematic review are expected to provide an overview of the most effective psychoeducational interventions for reducing anxiety in adolescents, allowing researchers to design and propose a new multicomponent psychoeducational intervention that will be validated and tested in the future. PROSPERO protocol registration number: CRD42020204356.

Acceptability and Feasibility of the ProLiSMental Psychoeducational Intervention to Promote Adolescents' Mental Health Literacy on Anxiety in a School Context.

The ProLiSMental psychoeducational intervention intends to promote adolescents' mental health literacy on anxiety, facilitating their access, understanding, evaluation, and use of effective mental health information. This study aimed to assess the acceptability and feasibility of that intervention in a school context and improve its content, structure, and procedure. A convenience sample of seventeen participants has been recruited: eleven students (mean age = 14.09 years, SD = 0,30) and six education and health professionals (mean age = 53.00 years, SD = 4,05). High levels of acceptability and feasibility of the ProLiSMental psychoeducational intervention were observed and important improvements were made.

Adolescents' Empowerment for Mental Health Literacy in School: A Pilot Study on ProLiSMental Psychoeducational Intervention.

Adolescence is a critical life phase for mental health and anxiety an emerging challenge for adolescents. Psychoeducational interventions to promote mental health literacy (MHL) on anxiety in adolescents are needed. This study aimed to test the primary outcome of a future full-scale trial: improvement of adolescents' anxiety MHL components on recognition, prevention strategies, and self-help strategies. A sample of 38 adolescents, 24 (63.2%) females and 14 (36.8%) males, with an average age of 14.50 years (SD = 0.89) participated in this study. Each class was allocated to the intervention group (IG, n = 21) or the waiting list control group (WLCG, n = 17) with single-blinded randomization. MHL was assessed using the QuALiSMental. The ProLiSMental psychoeducational intervention consists of four or eight weekly sessions of 90 or 45 min for adolescents, using different active pedagogical methods and techniques. There also are initial and final sessions with adolescents, legal guardians, and teachers. There was a significant improvement with a small to relatively strong effect size in many dimensions of anxiety MHL components. This study suggests the progression to the full-scale trial and values the important role of mental health and psychiatric nurses in the adolescents' empowerment for MHL in schools.

Intervenção psicoeducacional promotora da literacia em saúde mental de adolescentes na escola: estudo com grupos focais / Psychoeducational intervention to promote mental health literacy among adolescents at school: a focus groups study / Intervención psicoeducativa para promover la alfabetización en salud mental de los adolescentes en la escuela: estudio con grupos focales

Resumo Enquadramento: Estudos nacionais e internacionais evidenciam reduzida literacia em saúde mental (LSM) dos adolescentes sobre a ansiedade e a necessidade de serem desenvolvidas intervenções psicoeducacionais em contexto escolar. Objetivo: Identificar as componentes de uma intervenção psicoeducacional de promoção da LSM sobre a ansiedade para adolescentes em contexto escolar. Metodologia: Realizou-se um estudo exploratório, descritivo e de natureza qualitativa, recorrendo a 2 grupos focais e à análise de conteúdo. No primeiro grupo focal, participaram 6 profissionais de saúde ou da educação e, no segundo, 6 adolescentes do 9º ano de escolaridade. Resultados: Foram identificadas as componentes de uma intervenção psicoeducacional de promoção da LSM sobre a ansiedade para adolescentes em contexto escolar, que contribuíram para o seu desenho preliminar, integrando 4 sessões de 90 minutos, com diferentes métodos e técnicas pedagógicas. Conclusão: Este estudo contribuiu para o desenho preliminar da intervenção psicoeducacional "ProLiSMental", que pretende capacitar os adolescentes para o acesso, a compreensão e a utilização de informação útil que os ajude na prevenção, no reconhecimento e na gestão da ansiedade.

Abstract Background: National and international studies have revealed low mental health literacy (MHL) on anxiety among adolescents and the need to develop psychoeducational interventions at schools. Objective: To identify the components of a psychoeducational intervention to promote MHL on anxiety among adolescents in the school context. Methodology: An exploratory, descriptive, and qualitative study was conducted using 2 focus groups and the content analysis technique. Six health or education professionals participated in the first focus group, and 6 9th-grade adolescents participated in the second focus group. Results: The components of a psychoeducational intervention to promote MHL on anxiety among adolescents in the school context were identified, contributing to its preliminary design. The intervention consists of 4 90-minute sessions using different pedagogical methods and techniques. Conclusion: This study contributed to the preliminary design of the "ProLiSMental" psychoeducational intervention, which aims to enable adolescents to access, understand, and use relevant information that helps them to prevent, recognize, and manage anxiety.

Resumen Marco contextual: Estudios nacionales e internacionales muestran la escasa alfabetización en salud mental de los adolescentes respecto a la ansiedad y la necesidad de desarrollar intervenciones psicoeducativas en entornos escolares. Objetivo: Identificar los componentes de una intervención psicoeducativa para promover la alfabetización en salud mental (LSM en portugués) sobre la ansiedad de los adolescentes en el contexto escolar. Metodología: Se llevó a cabo un estudio exploratorio, descriptivo y de naturaleza cualitativa mediante 2 grupos focales y un análisis de contenido. En el primer grupo focal, participaron 6 profesionales de la salud o de la educación y, en el segundo, 6 adolescentes del 9.º grado de escolaridad. Resultados: Se identificaron los componentes de una intervención psicoeducativa de promoción de la LSM sobre la ansiedad en adolescentes en el contexto escolar, que contribuyeron a su diseño preliminar e incluyeron 4 sesiones de 90 minutos, con diferentes métodos y técnicas pedagógicas. Conclusión: Este estudio contribuyó al diseño preliminar de la intervención psicoeducativa "ProLiSMental", cuyo objetivo es capacitar a los adolescentes para acceder, comprender y utilizar información útil que les ayude a prevenir, reconocer y gestionar la ansiedad.

Intervenção psicoeducacional “ProLiSMental” para adolescentes em contexto escolar: Validade de conteúdo através de e-Delphi modificado / “ProLiSMental” psychoeducational intervention for adolescents in school context: Content validity through modified e-Delphi / Intervención psicoeducativa “ProLiSMental” para adolescentes en contexto escolar: Validez de contenido a través de e-Delphi modificado

CONTEXTO: A literacia para a saúde mental foi definida como o conhecimento e as crenças sobre as perturbações mentais que ajudam no seu reconhecimento, gestão ou prevenção. Estudos nacionais e internacionais evidenciam reduzida literacia em saúde mental dos adolescentes e a necessidade de serem desenvolvidas intervenções psicoeducacionais sobre a ansiedade em contexto escolar. OBJETIVO: Avaliar a validade de conteúdo da intervenção psicoeducacional promotora da literacia em saúde mental sobre a ansiedade dos adolescentes em contexto escolar: “ProLiSMental”. MÉTODOS: Intervenções complexas segundo a Medical Research Council Framework. O desenho da intervenção psicoeducacional “ProLiSMental” foi submetido à avaliação da validade de conteúdo através de um e-Delphi modificado com peritos. Foram definidos os critérios de seleção dos peritos, os critérios de consenso e as questões orientadoras. Foram garantidas as considerações éticas. RESULTADOS: Participaram 25 peritos nacionais e internacionais com elevado nível de perícia e obtiveram-se os critérios de consenso na 1ª ronda, registando concordância nas respostas a todas questões (100%) e concordância elevada nas respostas a 8 questões (57,1%). CONCLUSÕES: Validou-se o conteúdo da intervenção psicoeducacional “ProLiSMental”, constituída por 4 sessões de 90 minutos, com recurso a diferentes métodos e técnicas pedagógicas. Espera-se que esta intervenção psicoeducacional promova a capacitação dos adolescentes para aceder, compreender e usar informação sobre a saúde mental que os ajude na prevenção, no reconhecimento e na gestão da ansiedade.

BACKGROUND: Mental health literacy was defined as knowledge and beliefs about mental disorders that help in their recognition, management or prevention. National and international studies show low mental health in adolescents' mental health and the need to develop psychoeducational interventions on anxiety in the school context. AIM: To evaluate the content validity of the psychoeducational intervention to promote mental health literacy on anxiety of adolescents in a school context: “ProLiSMental”. METHODS: Complex interventions according to the Medical Research Council Framework. The design of the “ProLiSMental” psychoeducational intervention was submitted to content validity assessment through a modified e-Delphi with experts. Criteria for selecting experts, consensus criteria and guiding questions were defined. Ethical considerations were guaranteed. RESULTS: 25 national and international experts with a high level of expertise participated and consensus criteria were obtained in the 1st round, registering agreement on the answers to all questions (100%) and high agreement on the answers to 8 questions (57,1%). CONCLUSIONS: The content of the “ProLiSMental” psychoeducational intervention was validated, consisting of 4 sessions of 90 minutes, using different teaching methods and techniques. It is expected that this psychoeducational intervention will promote the empowerment of adolescents to access, understand and use information about mental health that will help them to prevent, recognize and manage anxiety.

CONTEXTO: La alfabetización en salud mental se definió como el conocimiento y las creencias sobre los trastornos mentales que ayudan en su reconocimiento, manejo o prevención. Estudios nacionales e internacionales muestran un bajo nivel de alfabetización en la salud mental de los adolescentes y la necesidad de desarrollar intervenciones psicoeducativas sobre la ansiedad en el contexto escolar. OBJETIVO: Evaluar la validez de contenido de la intervención psicoeducativa promotora de la alfabetización en salud sobre la ansiedad de los adolescentes en el contexto escolar: “ProLiSMental”. METODOLOGÍA: Intervenciones complejas de acuerdo a Medical Research Council Framework. El diseño de la intervención psicoeducativa “ProLiSMental” fue sometido a evaluación de validez de contenido a través de un e-Delphi modificado con expertos. Se definieron criterios de selección de expertos, criterios de consenso y preguntas orientadoras. Se garantizaron las consideraciones éticas. RESULTADOS: Participaron 25 expertos nacionales e internacionales con alto nivel de especialización y se obtuvieron criterios de consenso en la 1a ronda, registrándose acuerdo en las respuestas a todas las preguntas (100%) y alto acuerdo en las respuestas a 8 preguntas (57,1%) . CONCLUSIONES: Se validó el contenido de la intervención psicoeducativa “ProLiSMental”, que consta de 4 sesiones de 90 minutos, utilizando diferentes métodos y técnicas de enseñanza. Se espera que esta intervención psicoeducativa promueva la formación de los adolescentes para que accedan, comprendan y utilicen información sobre salud mental que les ayude a prevenir, reconocer y manejar la ansiedad.

Relações pedagógicas na sala de aula de informática educativa - um novo olhar ao ambiente tecnológico

O interesse em estudar as relações pedagógicas na sala de informática educativa nasceu da experiência de trabalho com computadores como ferramenta pedagógica, observações e depoimentos de alunos e colegas sobre experiências na sala de informática. Para esse estudo, busquei, na sala de Informática Educativa, indicadores de relações pedagógicas prazerosas e eficazes, do ponto de vista dos professores e alunos. O pressuposto é que relações pedagógicas de boa qualidade são fundamentais para a aprendizagem do aluno. Como sujeitos da pesquisa, foram selecionados alunos e professores, do Ensino Fundamental de 5ª a 8ª série, de uma escola particular de classe média, situada na Zona Oeste, da cidade de São Paulo. A pesquisa parte de um período de Observação Participante, registros de situações vividas no laboratório de Informática Educativa. Na segunda parte da pesquisa, foi proposta e aplicada uma redação, junto aos alunos de 5ª a 8ª série e, junto aos seus professores, um questionário. A fundamentação teórica da pesquisa teve o aporte de Henri Wallon e Thomas Gordon. Os indicadores de relações pedagógicas prazerosas e eficazes, encontrados em relação à sala de Informática Educativa, têm pontos em comum, na perspectiva de professores e alunos. Alguns deles são: preocupação com planejamento ou aulas bem dadas, metodologias diversificadas, respeito mútuo e afeto. Com relação aos indicadores encontrados apenas nas falas dos professores, nos deparamos com: o envolvimento com a capacitação, manejo da disciplina e satisfação com o apoio especializado para a sala de Informática Educativa. Os alunos apresentam um indicador de destaque: o gosto pelo ambiente tecnológico. A sala de informática, além de uma motivadora ferramenta tecnológica, é percebida, outrossim, como um ambiente propício às relações pedagógicas/interpessoais que também beneficiam a aprendizagem e cujas qualidades e possibilidades podem ser transferidas ou ampliadas para a sala de aula. Para potencializar tais resultados, faz-se necessário que professores e alunos estejam abertos para investir num trabalho integrado, permeado pela afetividade e habilidade na comunicação (AU)