Association between childhood trauma and postpartum depression among Brazilian puerperal women.

OBJECTIVE: to evaluate the association between different forms of childhood trauma and postpartum depression in Brazilian puerperal women. METHOD: this cross-sectional survey included 253 puerperal women who were evaluated using the Edinburgh Postnatal Depression Scale and the Childhood Trauma Questionnaire. Multivariate logistic regression analyses were performed to verify the association of different types of trauma and the co-occurrence of forms of abuse and neglect with postpartum depression. RESULTS: postpartum depression was identified in 93 women (36.8%; 95% Confidence Interval: 30.8-42.7). All forms of childhood trauma assessed (emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse) were independently associated with postpartum depression after adjusting for confounding variables. Emotional abuse remained associated with postpartum depression when the co-occurrence of all forms of childhood trauma was analyzed. CONCLUSION: the results suggest an association between the different forms of childhood trauma and postpartum depression. In this sense, childhood trauma is an indicator for Nursing professionals to screen for risk factors of postpartum depression during obstetric_follow-up.

Stress during the covid-19 pandemic: unusual challenges for university professors / Estresse durante a pandemia de covid-19: desafios incomuns para professores universitários

Objective: Investigate the factors related to the stress levels triggered during the COVID-19 pandemic and the quality of life (QOL) of university professors. Methods: This is a cross-sectional study with 318 professors from private and public higher education institutions in Maranhão, Brazil. Data collection included a sociodemographic questionnaire, the Brazilian versions of the Perceived Stress Scale (PSS), and the Abbreviated World Health Organ-ization QOL Assessment Instrument (WHOQOL-bref). Statistical analyses were performed with Student's T-test and Analysis of Variance with Duncan's post-hoc. Results: according to the results of the professor score assessment, perceived stress levels were classified as normal (n = 166, 52.2%), moderate (n = 126, 39.6%), and high (n = 26, 8, 2%), with an average of 26.6 (± 10.5). QOL had an overall average of 56.4 (± 13.0). Among the QOL domains, the physical had the highest mean with 66.1 (± 17.7), while the lowest mean was in the social domain with 55.8 (± 14.8). Conclusion: The factors that influenced the stress levels were being female with age between 31 and 40 years old, those who had a child, and those who did not perform a frequent religious practice (AU).

Objetivo: Investigar os fatores relacionados aos níveis de estresse desencadeados durante a pandemia de COVID-19 e à qualidade de vida (QV) em professores universitários. Método: Trata-se de um estudo transversal com 318 docentes de instituições de ensino superior públicas e privadas do Maranhão, Brasil. A coleta de dados incluiu um questionário so-ciodemográfico, as versões brasileiras da Escala de Estresse Percebido (PSS) e o Instrumento Abreviado de Avaliação da QV da Organização Mundial da Saúde (WHOQOL-bref). As análises estatísticas foram realizadas com testes T de Student e Análise de Variância com post-hoc de Duncan. Resultados: de acordo com os resultados da avaliação da pontuação dos professores, os níveis de estresse percebido foram classificados como normal (n = 166, 52,2%), moderado (n = 126, 39,6%) e alto (n = 26, 8, 2%), com uma média de 26,6 (± 10,5). A QV teve uma média geral de 56,4 (± 13,0). Entre os domínios da QV, o físico apresentou a maior média com 66,1 (± 17,7), enquanto a menor média foi no domínio social com 55,8 (± 14,8). Conclusão: Os fatores que influenciaram os níveis de estresse no grupo participante foram o sexo feminino com idade entre 31 e 40 anos, ter filho e não exercer prática religiosa frequente (AU).

Mindfulness Practice Reduces Hair Cortisol, Anxiety and Perceived Stress in University Workers: Randomized Clinical Trial.

BACKGROUND: Anxiety and stress are common mental health conditions reported by university workers. Practices of mindfulness represent one promising approach as an effective and feasible means to reduce stress, improve mental health and promote well-being; however, there are no clinical trials that have combined long-term stress biomarkers (hair cortisol) and psychometric assessments in a sample of university workers. OBJECTIVE: This study investigated the effectiveness of a mindfulness-based program on long-term stress, by measuring hair cortisol concentration and perceived stress and anxiety among workers who were undergoing high levels of stress. METHOD: We conducted a randomized clinical trial at work among the employees of a public university. We compared a group that received the eight-week mindfulness intervention with the wait list group who received no intervention. RESULTS: A total of 30 participants were included in the study, with n = 15 subjects in the intervention group and n = 15 in the control group. Hair cortisol, perceived stress and anxiety significantly reduced after the intervention compared to the control group, which had no appreciable decline in the measured variables. CONCLUSION: This clinical trial showed the effectiveness of a mindfulness program on mental health psychometric measures (perceived stress and anxiety) and on a long-term stress biomarker (hair cortisol). It can be concluded that an eight-week mindfulness program could be implemented as an effective strategy to reduce stress biomarkers (hair cortisol) as well as perceived stress and anxiety, improving the mental health of university workers.

Risk factors for the population's mental health amidst the COVID-19 pandemic.

OBJECTIVE: To identify risk factors for mental health in the population in times of COVID-19 through the analysis of levels of socio-cognitive mindfulness and perception of stress in individuals. METHOD: This is a cross-sectional observational study with a quantitative approach, carried out through online data collection using the Perceived Stress Scale and the Langer Mindfulness Scale in a sample of 955 individuals from different regions of Brazil. RESULTS: Women, younger people and individuals with low socioeconomic conditions had higher levels of perceived stress; on the other hand, older men and individuals with high socioeconomic status had higher levels of mindfulness. CONCLUSION: Socio-cognitive mindfulness was not a protective factor for perceived stress in the context of the COVID-19 pandemic.

Echoes of early-life stress on suicidal behavior in individuals with substance use disorder / Ecos del estrés en la vida temprana en el comportamiento suicida en personas con trastorno por uso de sustancias

Introduction: Psychoactive substances abuse is considered a problematic social factor due its likelihood to cause harmful, self-destructive behaviors to the subjects and the overall society. Stress in an individual's early life may also be a contributing factor to substance abuse as well as suicide attempts. There is a lack of studies examining these factors in people with substance-use disorder. Aim: to identify the relationship between early-life stress and suicide attempts in drug-dependent adults. Methods: This is a predictive correlational study with a cross-sectional approach. The convenience sample consisted of 105 individuals treated at an outpatient unit for addiction treatment. The participants were assessed using the Mini-international Neuropsychiatric Interview, a Childhood Trauma Questionnaire to measure the severity of the different types of early life stress; the Beck Scale for Suicide Ideation was also used. The data were analyzed using descriptive and inferential statistics through univariate and multivariate logistic regression. Results: The analyzed sample included 33 (31.4%) individuals who attempted suicide and were significantly more likely to suffer from emotional, physical, or sexual abuse than those who had never attempted suicide (p <0,05). Conclusions: Different forms of early-life stress are related to attempted suicide in people with substance-use disorder. Further studies are needed to understand the effects of early-life stress on suicide attempts in drug-dependent people.

Introducción: El abuso de sustancias psicoactivas se considera un factor social problemático cuando se producen conductas autodestructivas perjudiciales para el sujeto y la sociedad. El estrés en la vida temprana de una persona también puede ser un factor que contribuya a las situaciones de abuso de sustancias, así como a los intentos de suicidio. Hay una falta de estudios que examinen estos factores en personas con trastorno por uso de sustancias. Objetivo: Identificar la relación entre estrés en la vida temprana y los intentos de suicidio en personas adultas con trastorno por uso de sustancias. Métodos: Estudio correlacional, predictivo, transversal. La muestra de conveniencia consistió en 105 personas tratadas en una unidad ambulatoria para el tratamiento de adicciones. Las personas se evaluaron por medio de la Mini-Entrevista Neuropsiquiátrica Internacional, el Cuestionario de Trauma Infantil para medir la gravedad de los diferentes tipos de estrés en la vida temprana y la Escala de Beck para Ideación Suicida. Los datos se analizaron mediante estadística descriptiva e inferencial mediante regresión logística univariante y multivariante. Resultados: De la muestra analizada, 33 (31,4%) habían intentado suicidarse y tenían una exposición significativamente mayor al abuso emocional, físico y sexual (p<0,05) en comparación con las personas que nunca habían intentado suicidarse. Conclusiones: Diferentes formas de estrés en la vida temprana están relacionadas con el intento de suicidio en personas con trastorno por consumo de sustancias. Se necesitan más estudios para comprender los efectos del estrés en la vida temprana sobre los intentos de suicidio en una persona con dependencia.

Introdução: O uso abusivo de substâncias psicoativas é considerado um fator social problemático quando ocorrem comportamentos autodestrutivos prejudiciais ao sujeito e à sociedade. O estresse no início da vida de um indivíduo também pode ser um fator que contribui para situações de abuso de substâncias, bem como tentativas de suicídio. Há uma falta de estudos examinando esses fatores em pessoas com transtorno por uso de substâncias. Objetivo: Identificar a relação entre o estresse no início da vida e as tentativas de suicídio em adultos com transtorno de uso de substâncias. Métodos: Estudo correlacional preditivo com abordagem transversal. A amostra por conveniência foi composta por 105 indivíduos atendidos em uma unidade ambulatorial para tratamento de dependências e foi avaliada por meio do Mini-International Neuropsychiatric Interview, do Childhood Trauma Questionnaire para medir a gravidade de diferentes tipos de estresse precoce e da Escala de Beck para Ideação Suicida. Os dados foram analisados por meio de estatística descritiva e inferencial por meio de regressão logística univariada e multivariada. Resultados: Da amostra analisada, 33 (31,4%) já haviam tentado suicídio e tiveram exposição significativamente maior a abusos emocionais, físicos e sexuais (p <0,05) em comparação com os participantes que nunca tentaram suicídio. Conclusões: Diferentes formas de estresse no início da vida estão relacionadas à tentativa de suicídio em indivíduos com transtorno por uso de substâncias . Mais estudos são necessários para compreender os efeitos do estresse precoce nas tentativas de suicídio de uma pessoa com dependência.

The Impact of an Online Mindfulness-Based Practice Program on the Mental Health of Brazilian Nurses during the COVID-19 Pandemic.

This quantitative, before-after study was developed to evaluate the usefulness of an online mindfulness practices program to help nursing professionals deal with stress in the challenging context of the COVID-19 pandemic through the assessment of perceived stress, anxiety and depression, levels of mindfulness, and participants' satisfaction with the program. Eligible participants were assessed at baseline to receive the online mindfulness training program for eight weeks and were appraised again at the end of the program. Standardized measures of perceived stress, depression, anxiety, and one-dimensional and multidimensional mindfulness were performed. Participant satisfaction was also studied. Adherence to treatment was 70.12%. The perceived stress, depression, and anxiety scores were significantly lower after the intervention. The mindfulness measure increased significantly, as well as the sense of well-being and satisfaction with life, study, and/or work. The participants showed high satisfaction with the program and would recommend it to other professionals. Our results indicate that mindfulness-based interventions represent an effective strategy for nurses in the face of the need for self-care with mental health and mechanisms that guarantee the sustainability of their capacities to continue exercising health care.

Relationship between early-life stress and trait mindfulness in adulthood: a correlational study.

BACKGROUND: To investigate the relationship between early-life stress (ELS) and the trait mindfulness level in workers. METHOD: This study is quantitative cross-sectional and correlational research with a sample of 929 workers from a Brazilian public university. ELS and mindfulness assessment was performed using the Childhood Trauma Questionnaire (CTQ) and the Five-Facet Mindfulness Questionnaire-BR (FFMQ-BR), respectively. The data were submitted to correlation tests adopting a significance level of .05 and a multivariate linear regression analysis. RESULTS: 50.0% of the participants obtained a score indicative of ELS exposure in at least one subtype among the five proposed by the CTQ, with emotional neglect predominating (63.0%). The group not exposed to emotional abuse had higher scores in the "describe-positive formulation" and "non-reactivity to inner experience" facets. Those that scored for physical abuse had higher values in "acting with awareness-autopilot". However, the group exposed to sexual abuse obtained the highest score in the "acting with awareness-autopilot" and "acting with awareness-distraction" facets. The correlation between FFMQ-BR and CTQ overall scores showed a weak correlation with statistical significance. The multiple linear revealed that the facets of mindfulness were significantly associated by at least one type of early stress; however, no significant association was found between CTQ and FFMQ-BR overall results. CONCLUSION: The results showed that emotional regulation might have effectively occurred in this specific population, even with the presence of some childhood trauma.

Visceral leishmaniasis and HIV coinfection in Brazil: epidemiological profile and spatial patterns.

BACKGROUND: Geographical overlap of human visceral leishmaniasis (HVL) and HIV infection favors occurrences of HVL/HIV coinfection. The increasing numbers of cases of HVL/HIV coinfection are a worldwide concern and knowledge of the factors involved can help in developing preventive measures. METHODS: We aimed to identify spatial patterns and describe the epidemiological profile of HVL/HIV coinfection in Brazil from 2007 to 2015. This was an ecological study, in which thematic maps were created through geoprocessing tools, based on secondary data obtained from open-access platforms, to identify priority areas for interventions for controlling HLV/HIV coinfection, using the TerraView 4.2.2 software. RESULTS: We found spatial autocorrelations between the HVL/HIV rates of neighboring municipalities according to the global Moran index (0.10; p<0.01). The highest HVL/HIV rate was in the central-western region. Among the epidemiological characteristics according to the regions, an increasing trend in the annual variation rate was observed, with positive values over the years and statistical significance (p<0.05) in the North with 1.62 (95% CI 0.57 to 2.69; p=0.02) and Northeast with 6.41 (95% CI 2.60 to 10.37; p=0.006). Similarly, increasing trends were observed in the states of Maranhão with 21.34 (95% CI 13.99 to 9.16; p<0.001) and Sergipe with 5.44 (95% CI 0.61 to 10.50; p=0.04). CONCLUSIONS: Our results showed spatial overlap between occurrences of HVL and HIV with spatial patterns of HVL/HIV coinfection, thus revealing that the numbers of cases reported are increasing. Identifying areas with higher coinfection indices contributes to applying interventions and control measures among targeted populations, to prevent new cases.

The development of interprofessional education and collaborative practice in Latin America and the Caribbean: preliminary observations.

The Pan-American Health Organization (PAHO) and World Health Organization have encouraged countries across Latin America and the Caribbean (LAC) to incorporate interprofessional education and collaborative practice (IPECP) into policies on the health workforce, and support policymakers in expanding its use. PAHO recommend countries to promote the development of interprofessional teams in integrated health services networks using IPECP. The creation of the Regional Network for Interprofessional Education in the Americas, the mobilization of a series of IPECP regional meetings, and the development of national IPECP action plans are the most promising results achieved thus far. This report describes the process of implementing IPECP in LAC countries as an innovative initiative in interprofessional health policy.

Risk factors for the population's mental health amidst the COVID-19 pandemic / Factores de riesgo para la salud mental de la población en medio de la pandemia de COVID-19 / Fatores de risco para a saúde mental da população em meio a pandemia de COVID-19

ABSTRACT Objective: To identify risk factors for mental health in the population in times of COVID-19 through the analysis of levels of socio-cognitive mindfulness and perception of stress in individuals. Method: This is a cross-sectional observational study with a quantitative approach, carried out through online data collection using the Perceived Stress Scale and the Langer Mindfulness Scale in a sample of 955 individuals from different regions of Brazil. Results: Women, younger people and individuals with low socioeconomic conditions had higher levels of perceived stress; on the other hand, older men and individuals with high socioeconomic status had higher levels of mindfulness. Conclusion: Socio-cognitive mindfulness was not a protective factor for perceived stress in the context of the COVID-19 pandemic.

RESUMEN Objetivo: Identificar factores de riesgo para la salud mental en la población en tiempos de COVID-19 a través del análisis de los niveles de mindfulness sociocognitivo y percepción de estrés en los individuos. Método: Se trata de un estudio observacional transversal con enfoque cuantitativo, realizado a través de la recolección de datos en línea utilizando la Escala de Estrés Percibido y la Escala de Mindfulness de Langer en una muestra de 955 individuos de diferentes regiones de Brasil. Resultados: Las mujeres, los jóvenes y las personas con condiciones socioeconómicas bajas presentaron mayores niveles de estrés percibido. Por el contrario, los hombres mayores y las personas con un nivel socioeconómico alto tenían niveles más altos de atención plena. Conclusión: El mindfulness sociocognitivo no fue un factor protector para el estrés percibido en el contexto de la pandemia de COVID-19.

RESUMO Objetivo: Identificar fatores de risco para a saúde mental na população em tempos de COVID-19 por meio da análise dos níveis atenção plena sociocognitiva e de percepção ao estresse nos indivíduos. Método: Trata-se de um estudo observacional do tipo transversal com abordagem quantitativa, realizado por meio de coleta de dados online utilizando a Escala de Estresse Percebido e a Escala de Atenção Plena de Langer em uma amostra de 955 indivíduos de diversas regiões do Brasil. Resultados: Mulheres, pessoas mais jovens e indivíduos com baixas condições socioeconômicas apresentaram maiores níveis de estresse percebido. Em contrapartida, os homens mais velhos e indivíduos com altas condições socioeconômicas apresentaram maiores níveis de atenção plena. Conclusão: A atenção plena sociocognitiva não se constituiu fator de proteção ao estresse percebido no contexto pandêmico da COVID-19.

Perceived Stress Associated Factors in Workers at a Public University.

OBJECTIVE: To describe the predictors of perceived stress in a broad sample of workers at a Brazilian public university. METHOD: Cross-sectional study carried out with a convenience sample of workers at a public university in Brazil. To be included in the present study, the worker had to be an administrative technician. From March to August, 2017, workers were surveyed, and 929 participants answered the questionnaires of sociodemographic characterization, work and health conditions, perceived stress (Perceived Stress Scale), depression (Beck Depression Inventory), and anxiety (Beck Anxiety Inventory). RESULTS: The multiple linear regression showed that higher perceived stress was associated with being younger and male, occupying a higher or technical position, and presenting higher levels of depression and anxiety. CONCLUSION: These findings have implications for occupational health nurses and other health professionals to identify workers at risk for chronic and mental illness through predictors of perceived stress and to guide institutions in planning practical actions for stress management interventions.

Repercussões do estresse precoce nas manifestações de impulsividade em usuários de drogas / Repercussions of early stress on manifestations of impulsiveness in drug users

Objetivo: Analisar a relação entre estresse e impulsividade em indivíduos com transtornos mentais relacionados ao uso e abuso de substâncias. Método: Pesquisa transversal e analítica. Avaliações foram realizadas pelo Childhood Trauma Questionnaire e pela Escala de Impulsividade de Barrat. Resultados: A regressão linear demonstrou uma significativa previsibilidade do escore total de Impulsividade explicada pelo Childhood Trauma Questionnaire total, abuso emocional e abuso físico (p<0,05). Impulsividade motora foi significativamente prevista pelo Childhood Trauma Questionnaire total, abuso emocional, abuso físico e abuso sexual (p<0,05). Foram identificadas correlações positivas entre abuso emocional e físico com o escore de impulsividade. Nos modelos de regressão linear os abusos emocional e físico foram as principais variáveis influenciadoras da impulsividade. Conclusão: O abuso emocional e físico em usuários de drogas influencia as manifestações de impulsividade, por isso é pertinente criar estratégias que visem diminuir os impactos da impulsividade e dos fatores subjacentes.

Objective: To analyze the relationship between stress and impulsive behavior in individuals with mental disorders related to substance use and abuse. Method: Cross-sectional analytical study. Assessments were performed using the Childhood Trauma Questionnaire and the Barratt Impulsiveness Scale. Results: Linear regression demonstrated a significant predictability of the total impulsiveness score explained by the total Childhood Trauma Questionnaire, emotional abuse and physical abuse (p<0.05). Motor impulsiveness was significantly predicted by total Childhood Trauma Questionnaire, emotional abuse, physical abuse and sexual abuse (p<0.05). Positive correlations between emotional and physical abuse and the impulsiveness score were identified. In linear regression models, emotional and physical abuse were the main variables influencing impulsiveness. Conclusion:Emotional and physical abuse in drug users influences the manifestations of impulsiveness, so it is pertinent to create strategies aimed at reducing the impacts of impulsiveness and underlying factors.

Sentimentos de enfermeiros frente ao paciente em unidade de terapia intensiva / Nurses' feeling facing patient in an intensive care unit / Sentimientos de las enfermeras hacia el paciente en la unidad de cuidado intensive

Objetivo: Identificar os sentimentos dos enfermeiros frente ao paciente sem possibilidades de cura, suas maiores dificuldades e discutir aspectos relevantes ao preparo dos enfermeiros no processo morte/morrer em Unidades de Terapia Intensiva. Método: Pesquisa descritiva, qualitativa em três hospitais públicos e privados no interior do Maranhão com 33 enfermeiros atuantes em Unidades de Terapia Intensiva. Dados coletados entre agosto e setembro de 2015 com entrevista semiestruturada tendo como base a análise temática. Resultados: Organizados em três categorias temáticas: Sentimentos que envolvem enfermeiros frente ao óbito do paciente; A morte na rotina de trabalho que influencia na vida pessoal dos enfermeiros e Preparo do enfermeiro da graduação para lidar com o processo de morte. Conclusão: O enfrentamento da morte é um desafio para os enfermeiros visto que nem todas às instituições de ensino oferecem abordagem aprofundada relacionada ao processo de morte/morrer

Objective: To identify the nurses' feelings towards the palliative patients under their care, their greater difficulties and to discuss aspects relevant to the nurses' preparation in the death/dying process in Intensive Care Units. Method: Descriptive and qualitative research carried out in three public and private hospitals at a town in Maranhão state including 33 nurses working in the Intensive Care Units. Data collected between August and September 2015 through a semi-structured interview and analyzed through thematic analysis. Results: Organized in three main thematic categories: Feelings that involve nurses facing patients' death; Death in the work routine that affects nurses personally and Nursing undergraduate training to deal with the death process. Conclusion: Coping with death is a challenge for nurses since not all educational institutions offer an in-depth approach to the death/dying process

Objetivo: Identificar los sentimientos de las enfermeras hacia los pacientes sin posibilidad de cura, sus mayores dificultades y discutir aspectos relevantes para la preparación de las enfermeras en el proceso de muerte/morir en las unidades de cuidados intensivos. Método: Investigación descriptiva y cualitativa en tres hospitales públicos y privados en el interior de Maranhão con 33 enfermeras que trabajan en unidades de cuidados intensivos. Datos recopilados entre agosto y septiembre de 2015 com entrevista semiestructurada y analizados mediante análisis temático. Resultados: Organizados en tres categorías temáticas principales: sentimientos que involucran a las enfermeras con respecto a la muerte del paciente; La muerte en la rutina laboral que influye en la vida personal de las enfermeras y la preparación de enfermeras de pregrado para hacer frente al proceso de muerte. Conclusión: Enfrentarse a la muerte es un desafío para las enfermeras, ya que no todas las instituciones educativas ofrecen un enfoque profundo relacionado con el proceso de muerte/murir

Perceived Stress Associated Factors in Workers at a Public University / Fatores associados ao estresse percebido em trabalhadores de uma universidade pública / Factores asociados al estrés percibido en trabajadores de una universidad pública

ABSTRACT Objective: To describe the predictors of perceived stress in a broad sample of workers at a Brazilian public university. Method: Cross-sectional study carried out with a convenience sample of workers at a public university in Brazil. To be included in the present study, the worker had to be an administrative technician. From March to August, 2017, workers were surveyed, and 929 participants answered the questionnaires of sociodemographic characterization, work and health conditions, perceived stress (Perceived Stress Scale), depression (Beck Depression Inventory), and anxiety (Beck Anxiety Inventory). Results: The multiple linear regression showed that higher perceived stress was associated with being younger and male, occupying a higher or technical position, and presenting higher levels of depression and anxiety. Conclusion: These findings have implications for occupational health nurses and other health professionals to identify workers at risk for chronic and mental illness through predictors of perceived stress and to guide institutions in planning practical actions for stress management interventions.

RESUMO Objetivo: descrever os preditores de estresse percebido em uma ampla amostra de trabalhadores de uma universidade pública brasileira. Método: Estudo transversal realizado com amostra de conveniência de trabalhadores de uma universidade pública no Brasil. Para ser incluído no presente estudo, o trabalhador deveria ser técnico-administrativo. Entre março e agosto de 2017, os trabalhadores foram pesquisados, e 929 participantes no total responderam aos questionários de caracterização sociodemográfica, condições de trabalho e saúde, estresse percebido (Escala de Estresse Percebido), depressão (Inventário de Depressão de Beck) e ansiedade (Inventário de Ansiedade de Beck). Resultados: A regressão linear múltipla mostrou que maior estresse percebido estava associado a ser mais jovem e do sexo masculino, ocupar cargo de nível superior ou técnico e apresentar níveis mais elevados de depressão e ansiedade. Conclusão: Esses achados têm implicações para enfermeiros de saúde ocupacional e outros profissionais de saúde identificarem trabalhadores em risco de doenças crônicas e mentais por meio de preditores de estresse percebido e orientar instituições no planejamento de ações práticas para intervenções de manejo do estresse.

RESUMEN Objetivo: describir los predictores del estrés percibido en una amplia muestra de trabajadores de una universidad pública brasileña. Método: Estudio transversal realizado con muestreo de conveniencia de trabajadores de una universidad pública de Brasil. Para ser incluido en el presente estudio, el trabajador debí a ser técnico-administrativo. Entre marzo y agosto de 2017, se encuestó a los trabajadores y 929 participantes en total respondieron los cuestionarios de caracterización sociodemográfica, condiciones de trabajo y de salud, estrés percibido (Escala de Estrés Percibido), depresión (Inventario de Depresión de Beck) y ansiedad (Inventario de Ansiedad de Beck). Resultados: La regresión lineal múltiple mostró que un mayor estrés percibido se asoció con ser más joven y de sexo masculino, ocupar una posición superior o de nivel técnico y presentar niveles más elevados de depresión y ansiedad. Conclusión: Estos hallazgos tienen implicaciones para que los enfermeros de salud ocupacional y otros profesionales de la salud identifiquen a los trabajadores en riesgo de enfermedades crónicas y mentales a través de predictores del estrés percibido y guíen a las instituciones en la planificación de acciones prácticas para las intervenciones de manejo del estrés.

[Skill mix of nurses and primary health care professionals: a systematic review]. / Combinação de tarefas do enfermeiro e de outros profissionais na atenção primária em saúde: uma revisão sistemática.

OBJECTIVE: To evaluate the effectiveness of the strategy of skill mix of nurses and other health care professionals in primary health care. METHODS: Systematic review of the literature aligned with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), including observational and intervention studies. No restrictions were established for period or country of publication; studies published in Spanish, English and Portuguese were included. The search was carried out in MEDLINE, CINAHL, LILACS, EMBASE and Web of Science electronic databases. RESULTS: Eighteen studies were analyzed, including 6 from the United States; 3 from the Netherlands; 2 from the United Kingdom; 1 each from Australia, South Africa, South Korea, Scotland, Haiti and Japan; and 1 study with a prospective observational design from 8 countries. The studies reported that the skill mix among health professionals enables a better use of material resources; optimizes time spent on care; improves adhesion to treatment, quality of care and commitment and satisfaction with the work; and reduces the level of psychological distress in nursing professionals. CONCLUSIONS: The expansion of tasks of nurses and other health care professionals, and the skill mix as well as the development of interprofessional teams, are strategies that help to face a scarcity and poor distribution of human resources in urban and non-urban areas with improvement of the health care of the population and satisfaction of professionals and clients.

Combinação de tarefas do enfermeiro e de outros profissionais na atenção primária em saúde: uma revisão sistemática

[RESUMO]. Objetivo. Avaliar a efetividade da estratégia de combinação de tarefas dos profissionais de saúde, e do enfermeiro na Atenção Primária de Saúde. Método. Revisão sistemática da literatura alinhada com as recomendações do protocolo dos Principais Itens para Relatar Revisões Sistemáticas e Metanálises, incluindo estudos observacionais e de intervenções, sem estabelecimento de período de publicação, independentemente do país de origem e publicados nos idiomas espanhol, inglês e português. As buscas ocorreram nas bases de dados eletrônicas da MEDLINE, CINAHL, LILACS, EMBASE e Web of Science. Resultados. Incluídos 18 estudos, dos quais 6 foram desenvolvidos nos Estados Unidos; 3 na Holanda; 2 no Reino Unido; um na África do Sul, Austrália, Coreia do Sul, Escócia, Haiti e Japão; e um estudo com desenho observacional prospectivo em 8 países. Os estudos relataram que, a combinação de tarefas entre os profissionais de saúde, possibilita melhor aproveitamento de recursos materiais, otimização do tempo gasto no atendimento, retenção do paciente no tratamento, melhora na qualidade do trabalho com diminuição dos níveis de sofrimento psicológico do enfermeiro e comprometimento e satisfação com o trabalho. Conclusão. A expansão de tarefas do enfermeiro, assim como de outras categorias de profissionais da saúde, a combinação de tarefas, bem como o desenvolvimento de equipes interprofissionais, são estratégias que podem ser empregadas em situações de escassez de recursos humanos e de má distribuição em áreas urbanas e não urbanas com resultados positivos na melhoria da atenção em saúde da população e satisfação dos profissionais e clientes.

[ABSTRACT]. Objective. To evaluate the effectiveness of the strategy of skill mix of nurses and other health care professionals in primary health care. Methods. Systematic review of the literature aligned with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), including observational and intervention studies. No restrictions were established for period or country of publication; studies published in Spanish, English and Portuguese were included. The search was carried out in MEDLINE, CINAHL, LILACS, EMBASE and Web of Science electronic databases. Results. Eighteen studies were analyzed, including 6 from the United States; 3 from the Netherlands; 2 from the United Kingdom; 1 each from Australia, South Africa, South Korea, Scotland, Haiti and Japan; and 1 study with a prospective observational design from 8 countries. The studies reported that the skill mix among health professionals enables a better use of material resources; optimizes time spent on care; improves adhesion to treatment, quality of care and commitment and satisfaction with the work; and reduces the level of psychological distress in nursing professionals. Conclusions. The expansion of tasks of nurses and other health care professionals, and the skill mix as well as the development of interprofessional teams, are strategies that help to face a scarcity and poor distribution of human resources in urban and non-urban areas with improvement of the health care of the population and satisfaction of professionals and clients.

Combinação de tarefas do enfermeiro e de outros profissionais na atenção primária em saúde: uma revisão sistemática / Combination of tasks of the nurse and others primary health care professionals: a systematic review

Objetivo. Avaliar a efetividade da estratégia de combinação de tarefas dos profissionais de saúde, e do enfermeiro na Atenção Primária de Saúde. Método. Revisão sistemática da literatura alinhada com as recomendações do protocolo dos Principais Itens para Relatar Revisões Sistemáticas e Metanálises, incluindo estudos observacionais e de intervenções, sem estabelecimento de período de publicação, independentemente do país de origem e publicados nos idiomas espanhol, inglês e português. As buscas ocorreram nas bases de dados eletrônicas da MEDLINE, CINAHL, LILACS, EMBASE e Web of Science. Resultados. Incluídos 18 estudos, dos quais 6 foram desenvolvidos nos Estados Unidos; 3 na Holanda; 2 no Reino Unido; um na África do Sul, Austrália, Coreia do Sul, Escócia, Haiti e Japão; e um estudo com desenho observacional prospectivo em 8 países. Os estudos relataram que, a combinação de tarefas entre os profissionais de saúde, possibilita melhor aproveitamento de recursos materiais, otimização do tempo gasto no atendimento, retenção do paciente no tratamento, melhora na qualidade do trabalho com diminuição dos níveis de sofrimento psicológico do enfermeiro e comprometimento e satisfação com o trabalho. Conclusão. A expansão de tarefas do enfermeiro, assim como de outras categorias de profissionais da saúde, a combinação de tarefas, bem como o desenvolvimento de equipes interprofissionais, são estratégias que podem ser empregadas em situações de escassez de recursos humanos e de má distribuição em áreas urbanas e não urbanas com resultados positivos na melhoria da atenção em saúde da população e satisfação dos profissionais e clientes.(AU)

Mindfulness: reflexão sobre limites e potencialidades para a assistência de enfermagem / Mindfulness: critical thinking on limits and potentialities for nursing assistance / Mindfulness: reflexión sobre límites y potencialidades para la asistencia de enfermería

Objetivo: refletir sobre os limites e as potencialidades de mindfulness para a assistência de enfermagem, explorando as evidências científicas disponíveis, o uso na assistência à saúde e na assistência de enfermagem. Método: a reflexão pautou-se nos tópicos: Mindfulness e evidências científicas, Mindfulness na assistência à saúde, e Mindfulness na assistência de enfermagem. Resultados: o potencial das práticas de mindfulness foi evidenciado para tratar e prevenir problemas relacionados com o estresse e promover estratégias de enfrentamento consideradas mais assertivas, tanto para os clientes como para os próprios profissionais de enfermagem. As limitações envolveram a insipiência da temática no âmbito da enfermagem brasileira e no delineamento dos estudos, pois as intervenções baseadas em mindfulness requerem protocolos mais longos que exigem capacitação e engajamento na prática. Considerações finais: evidências apontam diversas potencialidades de intervenções baseadas em mindfulness para o autocuidado e atenção aos usuários e familiares, promovendo assistência integral e prescrevendo uma perspectiva inovadora para o cuidado.

Aim: to think critically about the limits and potentialities of mindfulness for nursing care, exploring available scientific evidence, its use in health care and nursing care. Method: the critical thinking based itself on the topics: Mindfulness and scientific evidence, Mindfulness in health care, and Mindfulness in nursing care. Results: the potential of mindfulness interventions was evidenced to treat and prevent stressrelated problems and to promote coping strategies considered more assertive, both for clients and for the nursing professionals themselves. The limitations involved the insipidity of the subject in the scope of Brazilian nursing and in the design of the studies, since interventions based on mindfulness require longer protocols that require training and engagement in the practice. Final considerations: evidence syndicate several potentialities of mindfulness based interventions for self-care and attention to users and families, promoting comprehensive care and prescribing an innovative perspective for care.

Objetivo: reflexionar sobre los límites y las potencialidades del mindfulness para la asistencia de enfermería, explorando las evidencias científicas disponibles, el uso en la asistencia a la salud y en la asistencia de enfermería. Método: la reflexión se basó en los temas: Mindfulness y las evidencias científicas, Mindfulness en la asistencia a la salud, y Mindfulness en la asistencia de enfermería. Resultados: el potencial de la práctica de mindfulness fue evidenciado para tratar y prevenir problemas relacionados alestrés y para promover estrategias de enfrentamiento consideradas más asertivas, tanto para los clientes cuanto para los propios profesionales de enfermería. Las limitaciones se relacionaron a la insipiencia de la temática en el ámbito de la enfermería brasileña y en el delineamiento de los estudios, pues las intervenciones basadas en mindfulness requieren protocolos más largos que exigen capacitación y compromiso en la práctica. Consideraciones finales: evidencias revelan diversas potencialidades de las intervenciones basadas en mindfulness para el autocuidado y atención a los usuarios y familiares, promoviendo asistencia integral y prescribiendo una perspectiva innovadora para el cuidado.

Leadership in nursing: why should we discuss it?

The Nursing Now campaign, which will end in 2020, involves a collaborative partnership of the United Kingdom’s Burdett Trust for Nursing, the World Health Organization (WHO), and the International Council of Nurses. The campaign aims to improve health around the world by raising the profile and status of nurses globally, influencing policymakers, and supporting nurses to lead, learn, and build a worldwide movement. The campaign advocates for more nurses in positions of leadership and for enhancing their influence on national and international policies to address the current social issues that affect health care systems. Nurses have direct interaction and build trust with the general public. They are involved in all levels of health care delivery and can serve as instrumental leaders in transforming the health care system.