Anxiety Sensitivity and Panic Disorder: Evaluation of the Impact of Cognitive-Behavioral Group Therapy.

Anxiety sensitivity (AS) is a multidimensional construct associated with the etiology and maintenance of panic disorder (PD) symptoms. However, only a few studies have evaluated whether cognitive-behavioral group therapy (CBGT) can modify the condition. The objective of this study was to evaluate the impact of CBGT on AS in patients with PD and to analyze AS and its dimensions as predictors of response to CBGT. In the present clinical trial, an intervention group (n = 37) attended 12 CBGT sessions, while a control group (n = 52) did not receive any intervention. The severity of symptoms and of AS were evaluated before and after CBGT in the intervention group and once in the control group. Significant improvement occurred in all specific PD symptoms and in general anxiety and depressive symptoms. Furthermore, AS scores reduced significantly after intervention. This study confirmed that AS is higher in patients with more severe PD. The effectiveness of CBGT for reducing the physical, cognitive, and social dimensions of AS was also observed, supporting the hypothesis of a positive impact of therapy.

Cross-cultural adaptation and translation into Brazilian Portuguese of the instruments Sick Control One Stone Fat Food Questionnaire (SCOFF), Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment Questionnaire (CIA).

INTRODUCTION: Eating disorders (EDs) affect up to 13% of young people and are associated with significant morbidity and mortality. Nevertheless, important, internationally recognized instruments for brief ED screening (Sick Control One Stone Fat Food Questionnaire [SCOFF]), symptom severity assessment and diagnosis (Eating Disorder Examination Questionnaire [EDE-Q]) and assessment of ED-associated psychosocial impairment (Clinical Impairment Assessment Questionnaire [CIA]) were not yet available in Brazilian Portuguese. Our objective was to perform the cross-cultural adaptation and translation into Brazilian Portuguese of the instruments SCOFF, EDE-Q and CIA. METHOD: The process involved a series of standardized steps, as well as discussions with experts. First, the relevance and adequacy of the scales' items to our culture and population were extensively discussed. Then, two independent groups translated the original documents, creating versions that were compared. With the participation of external ED experts (i.e., who did not take part in the translation process), synthesized versions were produced. The syntheses were then applied to a focal group of patients with ED (n = 8). After that step, a preliminary version of the three scales in Brazilian Portuguese was produced and sent for back-translation by two English native speakers, who worked independently. A synthesis of the back-translations, along with the preliminary versions in Brazilian Portuguese, were sent to the original authors. RESULTS: The Brazilian Portuguese versions of SCOFF, EDE-Q and CIA were approved by the original authors and are now available for use. CONCLUSION: This study provides important tools for the ED research field in Brazil.

Cross-cultural adaptation and translation into Brazilian Portuguese of the instruments Sick Control One Stone Fat Food Questionnaire (SCOFF), Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment Questionnaire (CIA)

Abstract Introduction Eating disorders (EDs) affect up to 13% of young people and are associated with significant morbidity and mortality. Nevertheless, important, internationally recognized instruments for brief ED screening (Sick Control One Stone Fat Food Questionnaire [SCOFF]), symptom severity assessment and diagnosis (Eating Disorder Examination Questionnaire [EDE-Q]) and assessment of ED-associated psychosocial impairment (Clinical Impairment Assessment Questionnaire [CIA]) were not yet available in Brazilian Portuguese. Our objective was to perform the cross-cultural adaptation and translation into Brazilian Portuguese of the instruments SCOFF, EDE-Q and CIA. Method The process involved a series of standardized steps, as well as discussions with experts. First, the relevance and adequacy of the scales' items to our culture and population were extensively discussed. Then, two independent groups translated the original documents, creating versions that were compared. With the participation of external ED experts (i.e., who did not take part in the translation process), synthesized versions were produced. The syntheses were then applied to a focal group of patients with ED (n = 8). After that step, a preliminary version of the three scales in Brazilian Portuguese was produced and sent for back-translation by two English native speakers, who worked independently. A synthesis of the back-translations, along with the preliminary versions in Brazilian Portuguese, were sent to the original authors. Results The Brazilian Portuguese versions of SCOFF, EDE-Q and CIA were approved by the original authors and are now available for use. Conclusion This study provides important tools for the ED research field in Brazil.

Results of the Nursing Outcomes Classification/NOC for patients with obsessive-compulsive disorder.

OBJECTIVE: To analyze the application of nursing outcomes and indicators selected from the Nursing Outcomes Classification (NOC) to evaluate patients with obsessive-compulsive disorder (OCD) in outpatient follow-up. METHOD: Outcome-based research. First, a consensus was achieved between nurses specialized in mental health (MH) and in the nursing process to select NOC-related outcomes and indicators, followed by the elaboration of their conceptual and operational definitions. Then, an instrument was created with these, which was tested in a pilot group of six patients treated at a MH outpatient clinic. The instrument was applied to patients with OCD undergoing Group Cognitive Behavioral Therapy (GCBT). The study was approved by the Research Ethics Committee of the institution. RESULTS: Four NOC outcomes and 17 indicators were selected. There was a significant change in the scores of nine indicators after CBGT. CONCLUSION: The study showed feasibility for evaluating symptoms of patients with OCD through NOC outcomes and indicators in an outpatient situation.

Results of the Nursing Outcomes Classification/NOC for patients with obsessive-compulsive disorder / Resultados de la Nursing Outcomes Classification/NOC para pacientes con trastorno obsesivo-compulsivo / Resultados da Nursing Outcomes Classification/NOC para pacientes com transtorno obsessivo-compulsivo

ABSTRACT Objective: To analyze the application of nursing outcomes and indicators selected from the Nursing Outcomes Classification (NOC) to evaluate patients with obsessive-compulsive disorder (OCD) in outpatient follow-up. Method: Outcome-based research. First, a consensus was achieved between nurses specialized in mental health (MH) and in the nursing process to select NOC-related outcomes and indicators, followed by the elaboration of their conceptual and operational definitions. Then, an instrument was created with these, which was tested in a pilot group of six patients treated at a MH outpatient clinic. The instrument was applied to patients with OCD undergoing Group Cognitive Behavioral Therapy (GCBT). The study was approved by the Research Ethics Committee of the institution. Results: Four NOC outcomes and 17 indicators were selected. There was a significant change in the scores of nine indicators after CBGT. Conclusion: The study showed feasibility for evaluating symptoms of patients with OCD through NOC outcomes and indicators in an outpatient situation.

RESUMEN Objetivo: Evaluar la aplicación de resultados e indicadores de enfermería seleccionados en la Nursing Outcomes Classification (NOC) para examinar a los pacientes con Trastorno Obsesivo-Compulsivo (TOC) en seguimiento ambulatorio. Método: Investigación de resultados. Primeramente, se realizó un acuerdo entre enfermeros expertos en salud mental (SM) y en proceso de enfermería para seleccionar los resultados e indicadores de la NOC, seguido de la elaboración de sus definiciones conceptuales y operativas. Después, se construyó un instrumento con las informaciones recolectadas, y lo aplicaron a un grupo piloto con seis pacientes, que recibían atención en el ambulatorio de SM. Se aplicó el instrumento a los pacientes con TOC, sometidos a Terapia Cognitivo-Conductual en Grupo (TCCG). Estudio aprobado por el Comité de Ética en Investigación de la institución. Resultados: Se seleccionaron cuatro resultados y 17 indicadores NOC. Se observó una modificación significativa de los puntajes de nueve indicadores después de la TCCG. Conclusión: El estudio apuntó la viabilidad de evaluación de los síntomas de pacientes con TOC por medio de los resultados e indicadores de la NOC en el ámbito ambulatorio.

RESUMO Objetivo: Analisar a aplicação de resultados e indicadores de enfermagem selecionados na Nursing Outcomes Classification (NOC) para avaliar pacientes com Transtorno Obsessivo-Compulsivo (TOC) em acompanhamento ambulatorial. Método: Pesquisa de resultados. Primeiro, realizou-se consenso entre enfermeiros especialistas em saúde mental (SM) e em processo de enfermagem para seleção de resultados e indicadores da NOC, seguido da elaboração das suas definições conceituais e operacionais. Depois, construiu-se um instrumento com estes, que foi testado em grupo piloto de seis pacientes atendidos em ambulatório de SM. O instrumento foi aplicado aos pacientes com TOC submetidos a Terapia Cognitivo-Comportamental em Grupo (TCCG). Estudo aprovado pelo Comitê de Ética em Pesquisa da instituição. Resultados: Foram selecionados quatro resultados e 17 indicadores NOC. Observou-se modificação significativa dos escores de nove indicadores após a TCCG. Conclusão: O estudo apontou viabilidade de avaliação dos sintomas de pacientes com TOC através dos resultados e indicadores da NOC em cenário ambulatorial.

Resilience and coping strategies in cognitive behavioral group therapy for patients with panic disorder.

BACKGROUND: Although resilience and coping are important factors associated with mental health, they are rarely investigated in the treatment of patients with panic disorder (PD). OBJECTIVE: To evaluate the response to four resilience and coping strategy sessions added to the standard cognitive behavioral group therapy (CBGT) protocol for PD. DESIGN: Controlled clinical trial. METHODS: The control group (n = 50) attended 12 CBGT sessions, while the intervention group (n = 50) received four additional resilience and coping strategy sessions, i.e., 16 in total. Symptom severity, resilience, coping strategies, and quality of life were assessed at baseline and post-CBGT. RESULTS: Symptom severity and maladaptive coping strategies decreased significantly in both groups. However, the intervention group had increased resilience and improvement in the environment domain of quality of life. CONCLUSIONS: Additional sessions have potential benefits for coping skills and resilience in PD patients, but these benefits should be evaluated in further long-term studies.

Respiratory subtype of panic disorder: Can serum phosphate levels be a possible outcome to group cognitive-behavior therapy?

OBJECTIVE: Panic disorder (PD) respiratory subtype (RS) was described in order to cluster patients according to their symptoms. These patients are characterized by experiencing a relatively high number of noticeable respiratory symptoms during a panic attack (PA) and a higher reactivity to CO2. In this study, we aimed to evaluate the clinical relevance of this diagnostic category, evaluating if there are different responses to cognitive-behavioral therapy in patients with panic disorder RS as compared to those with the non-respiratory subtype (NRS), using serum phosphate as a biological marker. METHODS: Patients were assessed by a clinical interview followed by a structured diagnostic interview (M.I.N.I) and classified as RS or NRS based on symptoms. The severity of PD was evaluated throughout the PDSS, CGI, HAM-A, STAI and the BDI rating scales. All patients underwent 12 structured sessions of group-CBT for PD and had their blood collected at baseline and after treatment to assess phosphate levels. RESULTS: One hundred and thirty-eight patients have been assessed, and 102 were included in this trial. Sixty-nine patients completed the treatment protocol, 42 were classified as RS and 27 as NRS. Both RS and NRS patients improved in all clinical scales (p < 0.001). The mean phosphate levels increased from 2.44 mg/dl ±â€¯0.49 at baseline to 3.38 mg/dl ±â€¯0.52 (p < 0.01) in the RS group as well as from 2.46 mg/dl ±â€¯0.64 at baseline to 3.46 mg/dl ±â€¯0.61 (p < 0.01) in the NSR group. LIMITATIONS: Small sample size and the lack of assessment of other clinical and physiological parameters, such as respiratory variables. CONCLUSION: Our findings suggest that both RS and NRS benefit from group CBT and that there was a change in phosphate levels after effective treatment in both groups. Our data support the idea that there is a reversal of the conditions that promote hypophosphatemia as chronic hyperventilation after CBT treatment, whereas it is in disagreement to the presence of two different PD subtypes based on phosphate levels once their rates did not differ at baseline and had a similar increase after effective treatment.

Sensibilidade à ansiedade e transtorno de pânico: avaliação do impacto da terapia cognitivo-comportamental em grupo / Anxiety sensitivity and panic disorder: assessment of the impact of group cognitive behavioral therapy

O transtorno de pânico (TP) é caracterizado pela presença de ataques súbitos de ansiedade e sensação de medo intenso. Embora haja tratamento efetivo com medicações e terapia cognitivo-comportamental (TCC), muitos pacientes tratados apresentam resposta parcial e tendem à cronicidade. A sensibilidade à ansiedade (SA) é um constructo multidimensional que expressa preocupações físicas, sociais e cognitivas da ansiedade, considerada uma tendência específica a reagir com medo aos sintomas de ansiedade. A SA tem sido associada à gênese e à manutenção dos sintomas do TP, porém ainda são escassos estudos que avaliam se a TCC em grupo (TCCG) modifica tal condição. Os objetivos deste estudo foram: 1) avaliar o impacto da TCCG na SA em pacientes com TP; 2) verificar a associação entre as características sociodemográficas e clínicas (comorbidades, uso de medicação, gravidade do TP) relacionadas à SA; 3) verificar as variáveis clínicas relacionadas à mudança da SA após a TCCG; 4) analisar a SA e suas dimensões como preditor de resposta à TCCG. Trata-se de um ensaio clínico controlado para avaliação da SA em pacientes com TP que realizaram 12 sessões de TCCG comparados ao grupo controle sem a intervenção. A gravidade dos sintomas foi avaliada antes e depois da TCCG no grupo intervenção e uma vez no grupo controle. Utilizou-se a Escala de gravidade do TP (PDSS), a Impressão Clínica Global (CGI), a Hamilton Ansiedade (HAM-A), o Inventário de Ansiedade de Beck (BAI) e o Inventário de Depressão de Beck (BDI). Para avaliar a SA, foi utilizada a Escala de Sensibilidade à Ansiedade-Revisada (ESA-R) com quatro fatores: fator 1 − medo de sintomas respiratórios e cardiovasculares; fator 2 − medo de descontrole cognitivo; fator 3 − medo de que as reações à ansiedade sejam observadas publicamente; fator 4 − medo de sintomas gastrintestinais. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Hospital de Clínicas de Porto Alegre (nº 14-0379). Os pacientes assinaram o termo de consentimento livre e esclarecido (TCLE). A amostra foi composta por 89 sujeitos, com média de idade de 37,9 (DP=10,6) anos. Observou-se associação significativa entre a SA mais elevada em pacientes com comorbidade com agorafobia e sintomas mais elevados de ansiedade e de depressão. Um total de 37 (42%) pacientes participou do grupo intervenção e 52 (58%) pacientes do grupo controle. Houve melhora significativa em todos os sintomas específicos do TP, da ansiedade geral e dos sintomas depressivos. A SA também sofreu redução significativa em todos os fatores após a intervenção quando comparada aos escores iniciais, com tamanho de efeito (TE) de moderado a grande. Quando comparada a SA do grupo controle e do grupo intervenção após a TCCG, os escores da ESA-R diminuíram significativamente em todos os fatores e no total. Ou seja, a SA modifica-se com a TCCG tanto em termos de intragrupo intervenção quanto em termos de escores do grupo controle. Os resultados deste estudo confirmaram que a relação entre a SA é maior em pacientes com TP mais graves. Também foi evidenciada a eficácia da TCCG na redução das dimensões física, cognitiva e social da SA, confirmando a hipótese do impacto positivo da TCCG para a modificação desse quadro.

Panic disorder (PD) is characterized by the presence of sudden attacks of anxiety and intense fear sensation. Although there are effective treatments with medications and cognitivebehavioral therapy (CBT), many treated patients present partial response and tend to chronicity. Anxiety sensitivity (AS) is a multidimensional construct that expresses physical, social and cognitive anxiety concerns, considered a specific tendency to react with fear to the symptoms of anxiety. AS has been associated with the genesis and maintenance of PD symptoms, but there are still few studies evaluating whether CBT in group (CBT-G) modifies such condition. The objectives of this study were: 1) to evaluate the impact of CBT-G on AS in patients with PD; 2) to verify the association between sociodemographic and clinical characteristics (comorbidities, medication use, severity of PD) related to AS; 3) to verify the clinical variables related to the change in AS after CBT-G; 4) to analyze AS and its dimensions as a predictor of response to CBT-G. This is a controlled clinical trial for the evaluation of AS in patients with PD who performed 12 sessions of CBT-G compared to the control group without the intervention. The severity of the symptoms was evaluated before and after the CBT-G in the intervention group and once in the control group. We used the PD Severity Scale (PDSS), Clinical Global Impression (CGI), Hamilton Anxiety (HAM-A), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). In order to evaluate the AS, the Anxiety Sensitivity Index-Revised (ASI-R) was used with four factors: factor 1 - fear of respiratory and cardiovascular symptoms; factor 2 - fear of cognitive uncontrol; factor 3 - fear that reactions to anxiety could be publicly observed; factor 4 - fear of gastrointestinal symptoms. The study was approved by the Research Ethics Committee of the Hospital de Clínicas of Porto Alegre (nº 14-0379). Patients signed the informed consent form (TCLE). The sample consisted of 89 subjects, with a mean age of 37.9 (SD = 10.6) years. A significant association was observed between the highest AS in patients with comorbidity with agoraphobia and higher anxiety and depression symptoms. A total of 37 (42%) patients participated in the intervention group and 52 (58%) patients in the control group. There was a significant improvement in all the specific symptoms of PD, general anxiety and depressive symptoms. AS also had a significant reduction in all factors after the intervention when compared to the initial scores, with moderate to large effect size (ES). When compared to AS of the control group and the intervention group after the CBT-G, ASI-R scores decreased significantly in all factors and in the total. That is to say, AS is modified with CBT-G both in terms of intragroup intervention and in terms of scores of the control group. The results of this study confirmed that the relationship between AS is higher in patients with more severe PD. The effectiveness of CBT-G in reducing the physical, cognitive and social dimensions of AS was also evidenced, confirming the hypothesis of the positive impact of CBT-G for the modification of this condition.

Contribution of Group Therapeutic Factors to the Outcome of Cognitive-Behavioral Therapy for Patients with Panic Disorder.

BACKGROUND: Investigating the contribution of therapeutic factors arising from the collective nature or group therapy to treat mental disorders may help therapists maximize the outcome of therapy. Studies about the role of therapeutic factors in cognitive-behavioral group therapy (CBGT) for panic disorder (PD) patients are still scarce. OBJECTIVES: To identify the therapeutic factors rated as the most useful by patients during CBGT. Also, we aimed to investigate the relationship between patient rating of therapeutic factors and specific stages of CBGT. DESIGN: Non-controlled clinical trial. METHODS: A 12-session CBGT protocol was set up, covering psychoeducation, techniques for anxiety coping, cognitive restructuring, interoceptive and naturalistic exposure, and live exposure to avoidant behavior. PD symptom severity was assessed before and after the CBGT protocol. Yalom's Curative Factors Questionnaire was self-administered at the end of each session to evaluate the 12 therapeutic factors. RESULTS: The sample consisted of 16 patients, who produced 192 assessments of therapeutic factors. Severity of symptoms improved at the end of CBGT, with a large effect size (>1.0). Different ratings were attributed to therapeutic factors at different phases of CBGT. Seven factors were rated as significantly helpful: altruism, interpersonal learning/input, guidance, identification, family reenactment, self-understanding, and existential factors. CONCLUSIONS: Therapeutic factors are dynamic and interdependent. Therefore, recognizing the impact of these factors during CBGT may potentially contribute to a better understanding of the therapeutic process.

Patient Rating of Therapeutic Factors and Response to Cognitive-Behavioral Group Therapy in Patients with Obsessive-Compulsive Disorder.

Group therapy involves complex mechanisms that rely on certain therapeutic factors to promote improvement. The objective of this study was to assess patient rating of therapeutic factors during cognitive-behavioral group therapy (CBGT) and to investigate the correlation between patient rating and outcome of CBGT for the treatment of obsessive-compulsive disorder (OCD). In the present clinical trial, 15 patients participated in a 12-session CBGT protocol. Severity of symptoms was assessed before and after CBGT with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Clinical Global Impression (CGI), Hamilton Anxiety Scale (HAM-A), and Beck Depression Inventory (BDI). Yalom's Curative Factors Questionnaire was administered at the end of each session for patient rating of the usefulness of 12 therapeutic factors to treat OCD. There was a significant interaction between improvement in obsessive-compulsive symptoms and patient rating of altruism, universality, interpersonal learning input and output, family re-enactment, self-understanding, and existential factors over time. The results show that group therapeutic factors positively influence the response to CBGT in OCD patients.

Avaliação dos fatores terapêuticos de grupo e a resposta à terapia cognitivo-comportamental para transtorno de pânico e transtorno obsessivo compulsivo / Group therapeutic factors assessment and response to cognitive behavioral assessment therapy for panic disorder and obsessive compulsive disorder

Estudos evidenciam a eficácia da terapia cognitivo-comportamental em grupo (TCCG) para pacientes com transtorno de pânico (TP) e para pacientes com transtorno obsessivo-compulsivo (TOC). O processo das terapias em grupo é complexo e apresentam fatores considerados terapêuticos por facilitarem novas aprendizagens. Entretanto, estudos sobre o processo terapêutico de TCCG ainda são escassos. Os objetivos deste estudo foram: avaliar o efeito dos fatores terapêuticos na resposta à TCCG para pacientes com TP e para pacientes com TOC; identificar e relacionar os fatores terapêuticos que ocorrem na TCCG com a fase e as técnicas cognitivo-comportamentais. Trata-se de um ensaio clínico de 12 sessões de TCCG para TP e para TOC. A gravidade dos sintomas foi avaliada antes e depois da TCCG. Em pacientes com TP, utilizou-se a Escala de gravidade do TP (PDSS), a Impressão Clínica Global (CGI), a Hamilton Ansiedade (HAM-A) e o Inventário de Depressão de Beck (BDI). Em pacientes com TOC, a gravidade específica foi avaliada pela Escala Obsessivo-Compulsivo de Yale-Brown (Y-BOCS) e pela CGI, bem como pela HAM-A e pelo BDI. O Questionário de Fatores Terapêuticos de Yalom foi aplicado no final de cada sessão para avaliar os 12 fatores: altruísmo, coesão, universalidade, aprendizagem interpessoal-input, aprendizagem interpessoal-output, orientação, catarse, identificação, redefinição familiar, autocompreensão, instilação de esperança e fatores existenciais. O estudo foi aprovado pelo CEP/HCPA (nº 130400). Todos os pacientes assinaram o termo de consentimento livre e esclarecido. A amostra foi composta por 31 pacientes, sendo 16 no grupo do TP com idade média de 36,2(DP=9,98) anos e 15 pacientes no grupo do TOC com idade média de 37,4(DP=11,10) anos. Os fatores terapêuticos totalizaram 192 observações no grupo do TP e 180 no grupo do TOC...

Houve melhora significativa da gravidade dos sintomas de ansiedade, depressivos e específicos comparados com a avaliação inicial em ambos os grupos (p<0,001). Oito fatores foram considerados de utilidade significativa para os pacientes ao longo das sessões do grupo do TP. Observou-se interação significativa no grupo dos pacientes com TP entre o efeito do fator reedição familiar na melhora dos sintomas de ansiedade e depressivos. Os fatores existenciais foram significativos com a melhora dos sintomas depressivos e com os específicos do TP verificado pela PDSS. Quanto à CGI no TP, não se verificou interação significativa com nenhum fator terapêutico. No grupo de pacientes com TOC, os fatores considerados mais úteis foram dois. Constatou-se interação significativa no grupo do TOC entre o efeito de nove fatores e a melhora dos sintomas de ansiedade, porém nenhuma interção com sintomas depressivos. Também houve interação significativa entre a melhora dos sintomas obsessivo-compulsivos verificado pela YBOCS com altruísmo, universalidade, aprendizagem interpessoal-input e output, reedição familiar, autocompreensão e fatores existenciais. Quanto à CGI no TOC, houve interação significativa com os fatores aprendizagem interpessoal-input, autocompreensão e fatores existenciais. Os resultados demonstram que fatores terapêuticos de grupo influenciam positivamente a resposta da TCCG para ambos os grupos. Contudo, existem diferenças de efeito a serem consideradas para que haja melhor compreensão do processo terapêutico e aprimoramento da terapia de grupo...

Applicability of the NANDA-I and Nursing Interventions Classification taxonomies to mental health nursing practice.

PURPOSE: To assess the applicability of the systematization of nursing care (NCS) to outpatient nursing appointments using the NANDA-I and Nursing Interventions Classification (NIC) taxonomies. METHODS: Data were collected from 40 patients who had appointments with a nurse who specialized in mental health. Nursing diagnoses (NDs) and interventions were classified using the NANDA-I and NIC taxonomies, respectively. FINDINGS: A total of 14 different NDs were detected (minimum of one and maximum of three per appointment). The most frequently made diagnoses were impaired social interaction (00052), anxiety (00146), and ineffective self-health management (00078). A total of 23 nursing interventions were prescribed (approximately two per appointment), of which the most frequent were socialization enhancement (5100), self-care assistance (1800), and exercise promotion (0200). Significant associations were found between the most frequently detected NDs and the most commonly prescribed interventions (p > .05). CONCLUSIONS: The NCS through the use of classification systems allows mental health nurses to better identify and assist poorly adjusted patients. IMPLICATIONS FOR NURSING PRACTICE: The assessment of the applicability of the NCS to different areas of health care and types of medical assistance contributes significantly to the quality of nursing care.

Erros de medicação realizados pelo técnico de enfermagem na UTI: contextualização da problemática

Pesquisa qualitativa, exploratória, cujos objetivos foram descrever os tipos de erros ocorridos na administração de medicamentos pelos técnicos de enfermagem que trabalham em UTI geral e identificar a(s) justificativa(s) para a ocorrência de tais falhas. Após aprovação do Comitê de Ética e Pesquisa, a coleta de dados efetivou-se por entrevista semiestruturada com técnicos de enfermagem. Os resultados indicam que os erros mais relatados estão relacionados à preparação dos medicamentos, e as justificativas para a ocorrência de erros evidenciam a sobrecarga de trabalho e a falta de atenção, articuladas à inexperiência de alguns profissionais e às falhas na estrutura. Conclui-se que é premente otimizar estratégias preventivas para evitar ou minimizar erros com medicamentos...

That is an exploratory research with a qualitative focus, whose aim was to describe the types of errors that occur in the administration of medicines by the nursing technicians that work in the general Intensive Therapy Unit and identify the justification(s) for the occurences of such failures. After the approval of the Ethics and Research Committee of the institution hosting the study, the collected data was obtained by means of semi-structured interviews with nursing technicians. The results indicate that the most reported errors are related to the preparation of the medicines, and the justifications to the occurences of the errors highlight the work overload and the lack of attention, linked with the inexperience of some professionals and structure failures. It is concluded that is urgent the adoption of preventive strategies to avoid or to minimize errors with medicines...

Se trata de una investigación cualitativa, exploratória, cuyos objetivos fueron: describir los tipos de errores en la administración medicamentos por parte de personal de enfermería que trabajan en una unidad de cuidados intensivos general y para identificar a la persona (s) de la justificación (s) para la ocurrencia de dichos fallos. Tras la aprobación por el Comité de Ética e Investigación, recopilación de datos se realizó mediante entrevistas semi-estructuradas con el personal de enfermería. Los resultados indican que la mayoría de los errores reportados están relacionados con la preparación de medicamentos, y los motivos de los errores que ocurren destacan la sobrecarga de trabajo y la falta de atención, articulados a la inexperiencia de algunos profesionales y fallas en la estructura. Se concluye que existe una necesidad apremiante estrategias de optimización de prevención para evitar o reducir al mínimo los errores de la droga...

A família frente ao processo de tratamento e reinternação do portador de esquizofrenia

A esquizofrenia é uma doença complexa pois, além de ser orgânica, sofre interferências ambientais que potencializam o indivíduo predisposto a vir a desenvolvê-la. O objetivo deste estudo foi conhecer a compreensão das famílias sobre o processo de tratamento e a reinternação do familiar com esquizofrenia. É um estudo exploratório-descritivo com abordagem qualitativa. Os sujeitos foram oito familiares de pacientes do sexo masculino, em internação psiquiátrica pela segunda vez, ou mais, que aceitaram participar da pesquisa. Foi usada a entrevista semiestruturada e, a seguir, a análise do conteúdo que permitiu identificar as categorias: Falhas do serviço sob a perspectiva familiar; Compreensão da família em relação à esquizofrenia; Não adesão ao tratamento; Comorbidade: uso de drogas associado à esquizofrenia; e A doença avançada. Conclui-se que as famílias têm necessidade de compreender a esquizofrenia e as formas de tratamento e o enfermeiro está habilitado para orientá-las bem como no controle da doença, remissão dos sintomas e agravamento...

Schizophrenia is a complex disease, because besides being organic, suffers interference that empowers the individual to come predisposed to develop it. The aim of this study was the understanding families about the process of treatment and hospital readmission of the family member with schizophrenia. It is an exploratory descriptive study with qualitative approach. The subjects were eight relatives of male patients in psychiatric hospital for the second time or more, who agreed to participate. It was used semi-structured interview and then content analysis that allowed to identify the following categories: Service failures in the family perspective, understanding the family in relation to schizophrenia, not adherence to treatment, co-morbidity: drug use associated with schizophrenia, and advanced disease. It is concluded that families need to understand schizophrenia and forms of treatment and the nurse is able to guide the families and control the disease, remission of symptoms and aggravation...

La esquizofrenia es una enfermedad compleja, además de ser orgánica, sufre interferencias que permiten a las personas a venir con predisposición a desarrollarla. El objetivo de este estudio fue la comprensión de las familias en el proceso de tratamiento y la readmisión de la familia con esquizofrenia. Se trata de un estudio exploratorio descriptivo con enfoque cualitativo. Los sujetos fueron ocho los familiares de pacientes del sexo masculino en un hospital psiquiátrico por segunda vez o más, que aceptaron participar de la investigación. Se utilizó la entrevista semiestructurada y el análisis de contenido identificó las categorías de fallas en el servicio en la perspectiva de la familia, la comprensión de la familia en relación con la esquizofrenia; la no adherencia al tratamiento, co-morbilidad del consumo de drogas asociado con la esquizofrenia y la enfermedad avanzada. Se concluye que las familias necesitan entender la esquizofrenia y las formas de tratamiento y la enfermera es capaz de guiar a ellos, así como control de la enfermedad y remisión de los síntomas y molestias...