Satisfaction with care in a Brazilian psychiatric inpatient unit: differences in perceptions among patients according to type of health insurance.

INTRODUCTION: User satisfaction assessment in mental health services is an important indicator of treatment quality. The objective of this study was to evaluate treatment satisfaction in a sample of inpatients with mental disorders and the associations between levels of satisfaction and clinical/sociodemographic variables. METHODS: This exploratory study investigated 227 psychiatric inpatients who answered the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and the Perception of Change Scale (EMP). SATIS scores were analyzed according to associations with clinical and sociodemographic data. Pearson correlations were used to correlate SATIS scores with other variables. RESULTS: We found a high degree of satisfaction with care at the psychiatric inpatient unit assessed. In general, patients rated maximum satisfaction for most items. The highest satisfaction scores were associated with patients receiving treatment through the Brazilian Unified Health System (SUS) and with less education. SATIS showed a moderate positive correlation with EMP. The worst evaluated dimension was physical facilities and comfort of the ward. CONCLUSION: Patients treated via SUS may be more satisfied than patients with private health insurance when treated in the same facility. The evaluation of treatment satisfaction can be used to reorganize services at psychiatric inpatient units.

Satisfaction with care in a Brazilian psychiatric inpatient unit: differences in perceptions among patients according to type of health insurance / Satisfação com o cuidado em uma unidade de internação psiquiátrica brasileira: diferenças nas percepções dos pacientes segundo tipo de plano de saúde

Abstract Introduction User satisfaction assessment in mental health services is an important indicator of treatment quality. The objective of this study was to evaluate treatment satisfaction in a sample of inpatients with mental disorders and the associations between levels of satisfaction and clinical/sociodemographic variables. Methods This exploratory study investigated 227 psychiatric inpatients who answered the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and the Perception of Change Scale (EMP). SATIS scores were analyzed according to associations with clinical and sociodemographic data. Pearson correlations were used to correlate SATIS scores with other variables. Results We found a high degree of satisfaction with care at the psychiatric inpatient unit assessed. In general, patients rated maximum satisfaction for most items. The highest satisfaction scores were associated with patients receiving treatment through the Brazilian Unified Health System (SUS) and with less education. SATIS showed a moderate positive correlation with EMP. The worst evaluated dimension was physical facilities and comfort of the ward. Conclusion Patients treated via SUS may be more satisfied than patients with private health insurance when treated in the same facility. The evaluation of treatment satisfaction can be used to reorganize services at psychiatric inpatient units.

Resumo Introdução A avaliação da satisfação do usuário nos serviços de saúde mental é um importante indicador da qualidade do tratamento. O objetivo deste estudo foi avaliar a satisfação com o tratamento em uma amostra de pacientes internados com transtornos mentais e as associações entre os níveis de satisfação e variáveis clínicas/sociodemográficas. Métodos Este estudo exploratório investigou 227 pacientes psiquiátricos internados que responderam a Escala de Satisfação do Paciente com os Serviços de Saúde Mental (SATIS-BR) e a Escala de Percepção da Mudança (EMP). Os escores SATIS-BR foram analisados segundo associações com dados clínicos e sociodemográficos. Correlações de Pearson foram usadas para correlacionar escores SATIS com outras variáveis. Resultados Encontramos alto grau de satisfação com o atendimento na unidade de internação psiquiátrica avaliada. Em geral, os pacientes atribuíram satisfação máxima para a maioria dos itens. Os maiores escores de satisfação foram associados a pacientes em tratamento pelo Sistema Único de Saúde (SUS) e com menor escolaridade. A SATIS mostrou uma correlação positiva moderada com EMP. A pior dimensão avaliada foi associada às instalações físicas e conforto da enfermaria. Conclusão Pacientes com cobertura pelo SUS podem estar mais satisfeitos do que pacientes com planos privados de saúde quando tratados na mesma unidade. A avaliação da satisfação com o tratamento pode ser usada para reorganizar serviços em unidades de internação psiquiátrica.

Is there a correlation between physicians' clinical impressions and patients' perceptions of change? Use of the Perceived Change Scale with inpatients with mental disorders / Existe correlação entre a mudança percebida pelo médico e a mudança percebida pelo paciente? Uso da Escala de Mudança Percebida em pacientes com transtornos mentais internados

Abstract Introduction: Assessment of the results of treatment for mental disorders becomes more complete when the patient's perspective is incorporated. Here, we aimed to evaluate the psychometric properties and application of the Perceived Change Scale - Patient version (PCS-P) in a sample of inpatients with mental disorders. Methods: One hundred and ninety-one psychiatric inpatients answered the PCS-P and the Patients' Satisfaction with Mental Health Services Scale (SATIS) and were evaluated in terms of clinical and sociodemographic data. An exploratory factor analysis (EFA) was performed and internal consistency was calculated. The clinical impressions of the patient, family, and physician were correlated with the patient's perception of change. Results: The EFA indicated a psychometrically suitable four-factor solution. The PCS-P exhibited a coherent relationship with SATIS and had a Cronbach's alpha value of 0.856. No correlations were found between the physician's clinical global impression of improvement and the patient's perception of change, although a moderate positive correlation was found between the patients' clinical global impression of improvement and the change perceived by the patient. Conclusions: The PCS-P exhibited adequate psychometric proprieties in a sample of inpatients with mental disorders. The patient's perception of change is an important dimension for evaluation of outcomes in the treatment of mental disorders and differs from the physician's clinical impression of improvement. Evaluation of positive and negative perceptions of the various dimensions of the patient's life enables more precise consideration of the patient's priorities and interests.

Resumo Introdução: A avaliação dos resultados do tratamento para transtornos mentais torna-se mais completa quando a perspectiva do paciente é incluída. O objetivo deste trabalho foi avaliar as propriedades psicométricas e a aplicação da Escala de Mudança Percebida - Versão do Paciente (EMP-P) em uma amostra de pacientes internados com transtornos mentais. Métodos: Um total de 191 pacientes psiquiátricos internados responderam a EMP-P e a Escala de Avaliação da Satisfação dos Usuários com os Serviços de Saúde Mental (SATIS), além de serem avaliados quanto a dados clínicos e sociodemográficos. Foi realizada análise fatorial exploratória (AFE) e calculada a consistência interna. As impressões clínicas do paciente, da família e do médico foram correlacionadas com a mudança percebida pelo paciente. Resultados: A AFE indicou uma solução de quatro fatores psicometricamente adequada. A EMP-P apresentou uma relação coerente com a SATIS e um alfa de Cronbach de 0,856. Não foi encontrada correlação entre impressão clínica global de melhora pelo médico e mudança percebida pelo paciente, embora uma correlação positiva moderada tenha sido observada entre impressão clínica global de melhora pelo paciente e mudança percebida pelo paciente. Conclusão: A EMP-P exibiu propriedades psicométricas adequadas em uma amostra de pacientes com transtornos mentais internados. A percepção de mudança pelo paciente é uma importante dimensão para a avaliação de resultados no tratamento de transtornos mentais e difere da impressão clínica de melhora do médico. A avaliação das percepções positivas e negativas das diversas dimensões da vida dos pacientes permite uma análise mais precisa de suas prioridades e interesses.

Is there a correlation between physicians' clinical impressions and patients' perceptions of change? Use of the Perceived Change Scale with inpatients with mental disorders.

INTRODUCTION:: Assessment of the results of treatment for mental disorders becomes more complete when the patient's perspective is incorporated. Here, we aimed to evaluate the psychometric properties and application of the Perceived Change Scale - Patient version (PCS-P) in a sample of inpatients with mental disorders. METHODS:: One hundred and ninety-one psychiatric inpatients answered the PCS-P and the Patients' Satisfaction with Mental Health Services Scale (SATIS) and were evaluated in terms of clinical and sociodemographic data. An exploratory factor analysis (EFA) was performed and internal consistency was calculated. The clinical impressions of the patient, family, and physician were correlated with the patient's perception of change. RESULTS:: The EFA indicated a psychometrically suitable four-factor solution. The PCS-P exhibited a coherent relationship with SATIS and had a Cronbach's alpha value of 0.856. No correlations were found between the physician's clinical global impression of improvement and the patient's perception of change, although a moderate positive correlation was found between the patients' clinical global impression of improvement and the change perceived by the patient. CONCLUSIONS:: The PCS-P exhibited adequate psychometric proprieties in a sample of inpatients with mental disorders. The patient's perception of change is an important dimension for evaluation of outcomes in the treatment of mental disorders and differs from the physician's clinical impression of improvement. Evaluation of positive and negative perceptions of the various dimensions of the patient's life enables more precise consideration of the patient's priorities and interests.

Factors related to positive and negative outcomes in psychiatric inpatients in a general hospital psychiatric unit: a proposal for an outcomes index

Background General Hospital Psychiatric Units have a fundamental importance in the mental health care systems. However, there is a lack of studies regarding the level of improvement of patients in this type of facility. Objective To assess factors related to good and poor outcomes in psychiatric inpatients using an index composed by clinical parameters easily measured. Methods Length of stay (LOS), Global Assessment of Functioning (variation and at discharge) and Clinical Global Impression (severity and improvement) were used to build a ten-point improvement index (I-Index). Records of psychiatric inpatients of a general hospital during an 18-month period were analyzed. Three groups (poor, intermediate and good outcomes) were compared by univariate and multivariate models according to clinical and sociodemographic variables. Results Two hundred and fifty patients were included, with a percentage in the groups with poor, regular and good outcomes of 16.4%, 59,6% and 24.0% respectively. Poor outcome at the discharge was associated mainly with lower education, transient disability, antipsychotics use, chief complaint “behavioral change/aggressiveness” and psychotic features. Multivariate analysis found a higher OR for diagnoses of “psychotic disorders” and “personality disorders” and others variables in relation to protective categories in the poor outcome group compared to the good outcome group. Discussion Our I-Index proved to be an indicator of that allows an easy and more comprehensive evaluation to assess outcomes of inpatients than just LOS. Different interventions addressed to conditions such as psychotic disorders and disruptive chief complaints are necessary.

Autopercepção de dificuldades escolares em alunos do ensino fundamental e médio em município do Rio Grande do Sul / Self-perception of learning difficulties in students of elementary and high school in a city in Rio Grande do Sul

Este estudo teve como objetivo investigar a autopercepção de áreas do desenvolvimento infantil que são relevantes no desempenho escolar e podem levar a dificuldades escolares em alunos do ensino fundamental e médio de um município do Rio Grande do Sul, bem como sua associação com repetência, sexo e nível de escolaridade dos pais. Foi realizado um estudo transversal de base populacional com 1070 escolares. Os dados foram analisados através de estatística descritiva. Os resultados indicaram maior autopercepção de dificuldades escolares no sexo feminino. Também foi observada significância estatística nas correlações entre repetência, nível de escolaridade dos pais dos alunos e sexo. A partir dos resultados foi possível constatar que a autopercepção negativa pode ser determinante no desempenho dos alunos. Investigações sobre o tema são relevantes para o planejamento de intervenções no âmbito escolar.(AU)

This study aimed to investigate the self-perception of learning difficulties in students of elementary and high school in a city in Rio Grande do Sul, as well as its association with repetition, gender and level of parental education. Cross-sectional population-based study comprising 1070 students. Data were analyzed through descriptive statistics. The results indicated a higher perception of learning difficulties in women. Significance was also observed in correlations between repetition, parents education level and students gender. From the results it can be concluded that research on this issue are relevant for planning interventions in the school setting. Negative self-perception can be determinant in student performance.(AU)

Automedicação e comportamento entre adolescentes em uma cidade do Rio Grande do Sul / Self-medication and behavior in adolescents from a city in Rio Grande do Sul

OBJETIVO: Estudar o consumo de medicamentos e associações com variáveis sociodemográficas e comportamentais, bem como, os fármacos mais utilizados. MÉTODOS: Estudo transversal com escolares a partir da 5ª série. Os dados foram coletados através de um questionário com variáveis sociodemográficos e comportamentais, e a análise realizada utilizando-se o teste do qui-quadrado. RESULTADOS: 11,9% utilizavam regularmente medicamentos. 35,9% utilizaram medicação na semana anterior à aplicação do questionário, nos dois grupos tinha predomínio de meninas e consumo maior de álcool, seguido de drogas ilícitas e tabaco. CONCLUSÕES: A automedicação mostrou-se prevalente nas meninas maiores de 16 anos. Observou-se relação familiar quanto à indicação da mesma. Existem relações significativas quando se associa automedicação com álcool e drogas. O grupo de uso regular apresenta nível de escolaridade superior dos alunos e dos pais. Anti-histamínicos e medicações para doenças respiratórias foram mais utilizados regularmente, enquanto analgésicos, anti-inflamatórios e antitérmicos foram mais utilizados no recordatório da última semana.(AU)

OBJECTIVE: To study the consumption of drugs and associations with socio-demographic and behavioral variables, as well as, the most frequently used drugs. METHODS: Cross-sectional study with students from the 5th grade. Data were collected through a questionnaire with demographic and behavioral variables, the analysis was done by SPSS 18.0 and Chi - square test. RESULTS: 11.9 % used drugs regularly. 35.9 % used medication in the previous week to the questionaire in both groups had a predominance of girls and higher alcohol consumption, followed by illicit drugs and tobacco. CONCLUSIONS: Self-medication was found to be prevalent among girls with 16 years old. In observed family relationship as the indication of the same. There are significant positive associations with self-medication with alcohol and drugs abuse. Students and their families with regular use has higher education in comparison with the other group. Antihistamines and drugs for respiratory diseases were used more regularly, but analgesic, antiinflammatory and antipyretic were more prevalente in the last week recordatory.(AU)