Effects of a stigma reduction intervention on help-seeking behaviors in university students: A 2019-2021 randomized controlled trial.

INTRODUCTION: Stigma is one of the most frequently identified help-seeking barriers, but there is a lack of research on the effects of stigma reduction interventions on actual mental health help-seeking behaviors during crucial academic years. This research explores the effects of stigma on university students' mental health care help-seeking behaviors before and during the pandemic. METHODS: A randomized control trial spanned from 2019 to 2021 at the University of Porto, along five evaluation moments, with students into one control group and two intervention groups-the interventions aimed to reduce depression stigma. RESULTS: Among the 702 participants (mean age 18.87, 59.4 % female), the intervention groups significantly increased help-seeking behaviors. In 2020, the intervention groups, having reduced stigma, continued to demonstrate to be more prompt to seek mental health help. In 2021, 22 months, the effects of the intervention on help-seeking were no longer significant; however, participants in the intervention groups showed less severe symptomatology. CONCLUSION: Stigma reduction interventions have a pronounced effect on enhancing help-seeking behaviors among university students, even during times of crisis. This study advocates for prioritizing stigma reduction in academic settings, highlighting its value in promoting mental health access during crucial academic and life challenges.

Prevenção quaternária na saúde na percepção de profissionais de saúde / Quaternary prevention in health in the perception of health professionals / Prevención cuaternaria en salud en la percepción de los profesionales de la salud

Objetivo: compreender as percepções de profissionais de saúde atuantes em um hospital acerca da prevenção quaternária. Método: foi conduzido um estudo exploratório de cunho qualitativo, cuja fundamentação teórica baseou-se no interacionismo simbólico e na análise de conteúdo como referencial metodológico. A população foi composta por onze profissionais de saúde. Os dados foram obtidos por meio de entrevistas com roteiro semiestruturado. Resultados: A análise dos discursos determinou a construção das unidades temáticas agrupadas em três categorias temáticas para discussão: significado da prevenção quaternária para profissionais de saúde, experiências com a prevenção quaternária no contexto clínico-assistencial e interações sociais. À luz do interacionismo simbólico, identificaram-se experiências positivas e negativas com destaque às dificuldades dos profissionais e instituições para atuarem com a prevenção quaternária. Conclusão: Para concretização dessa proposta é necessário que uma reorientação da prática clínica dos profissionais seja almejada por meio de condutas técnicas e éticas desejáveis

Objective: to understand the perceptions of health professionals who work in a hospital about quaternary prevention. Method:an exploratory qualitative study was conducted, whose theoretical basis was based on symbolic interactionism and content analysis as a methodological reference. The population consisted of thirteen health professionals. The data were obtained through interviews with a semi-structured script. Results: The analysis of the discourses determined the construction of thematic units grouped into three thematic categories for discussion: meaning of quaternary prevention for health professionals, experiences with quaternary prevention in the clinical-care context and social interactions. In the light of symbolic interactionism, positive and negative experiences were identified, highlighting the difficulties of professionals and institutions to work with quaternary prevention. Conclusion: To implement this proposal, it is necessary that a reorientation of the clinical practice of professionals is desired through desirable technical and ethical conducts

Objetivo: comprender las percepciones de los profesionales de la salud que trabajan en un hospital sobre la prevención cuaternaria. Método: se realizó un estudio cualitativo exploratorio, cuya base teórica se basó en el interaccionismo simbólico y el análisis de contenido como referencia metodológica. La población estaba formada por trece profesionales de la salud. Los datos se obtuvieron a través de entrevistas con un guión semiestructurado. Resultados: El análisis de los discursos determinó la construcción de unidades temáticas agrupadas en tres categorías temáticas para la discusión: significado de la prevención cuaternaria para los profesionales de la salud, experiencias con la prevención cuaternaria en el contexto clínico-asistencial e interacciones sociales. A la luz del interaccionismo simbólico, se identificaron experiencias positivas y negativas, destacando las dificultades de los profesionales e instituciones para trabajar con la prevención cuaternaria. Conclusión: Para implementar esta propuesta, es necesario que se desee una reorientación de la práctica clínica de los profesionales a través de conductas técnicas y éticas deseables

Atuação do enfermeiro em saúde mental na estratégia de saúde da família / The role of mental health nurses in the family health strategy

Objetivos: conhecer a atuação do enfermeiro e os cuidados desempenhados em saúde mental na Estratégia de Saúde da Família. Método: estudo descritivo e qualitativo, tendo como cenário um polo de matriciamento em saúde mental. A coleta de dados foi realizada por meio de entrevista individual, com questionário semiestruturado. Resultados: os resultados obtidos foram agrupados e discutidos por meio das seguintes categorias: ações de enfermagem no campo da saúde mental desenvolvidas na Estratégia de Saúde da Família e apoio matricial em Saúde Mental como elemento facilitador da prática de enfermagem. Conclusão: os enfermeiros têm desenvolvido ações de enfermagem no campo da saúde mental na Estratégia de Saúde da Família, e o apoio matricial atua como principal elemento facilitador da prática de enfermagem, reafirmando a Reforma Psiquiátrica Brasileira. Em contrapartida, a sobrecarga de ações e a restrita formação em saúde mental são elementos que dificultam o trabalho desse profissional.

Objectives: to know the role of nurses and the care performed in mental health in the Family Health Strategy. Method: a descriptive, exploratory, and qualitative study, with a scenario of matrix support in mental health. Data collection was carried out through individual interviews and with a semi-structured questionnaire. Results: the results obtained were grouped and discussed through the following categories: Nursing actions mental health field developed in the Family Health Strategy, and Matrix Support in Mental Health as a facilitating element of nursing practice. Conclusion: nurses have developed nursing actions mental health field in the Family Health Strategy and matrix support acts as the main facilitator of nursing practice, reaffirming the Brazilian Psychiatric Reform. On the other hand, the overload of actions and the limited training in mental health are elements that hinder the work of these professionals.

Psychometric properties of the Depression Stigma Scale in the Portuguese population and its association with gender and depressive symptomatology.

BACKGROUND: Stigma is one of the most significant constraints on people living with depression. There is a lack of validated scales in Portugal to measure depression stigma; therefore, the Depression Stigma Scale (DSS) is essential to the depression stigma research in Portugal. METHODS: We developed the adaptation process with the ITC Guidelines for Translation and Adapting Tests taken into consideration. We collected the sample as part of the OSPI program-Optimizing suicide prevention programs and their implementation in Europe, specifically within the application in Portugal, and included 1693 participants. Floor-ceiling effects and response ranges were analyzed, and we calculated Cronbach alphas, and Confirmatory Analysis. Validity evidence was tested with two well-documented hypotheses, using data on gender and depression symptoms. RESULTS: The sample was well comparable with the general Portuguese population, indicating its representativeness. We identified a three-factor structure in each subscale (personal and perceived stigma): weak-not-sick, discrimination, and dangerous/unpredictable, with good model fit results. The Cronbach's alphas were satisfactory, and validity was confirmed. CONCLUSIONS: This study established the validity and demonstrated good psychometric properties of the DSS in the Portuguese population. The validation of the DSS can be beneficial in exploring stigma predictors and evaluating the effectiveness of stigma reduction interventions.

The association between stigmatizing attitudes towards depression and help seeking attitudes in college students.

Depression stigma has been considered a significant barrier to treatment and rehabilitation. This study aimed to understand the effects of gender, previous mental health care, and symptomatology on depression stigma and analyze the impact of depression stigma on help-seeking attitudes. A total of 969 students with a mean age of 18.87 (SD = 1.49) were included in this study and completed the Depression Stigma Scale, the Attitude Toward Seeking Professional Psychological Help, the Patient Health Questionnaire-4 questionnaire, and a socio-demographic questionnaire. We analyzed data using SPSS 24.0, with a 95% confidence interval. Participants came from all University schools, and 64.6% were women. Personal stigma and help-seeking attitudes were affected by gender (ß(male) = 5.65, CI = 4.07, 7.25) and previous access to mental healthcare services (ß(previous help) = -4.35, CI = -5.89, -2.82). Perceived depression stigma was affected gender (ß(male) = -2.67, CI = -5.00, -0.34) and symptomatology (ß(no symptomatology) = -3.29, CI = -6.09, -0.49). Personal (r = -0.42, p<0.01) and perceived (r = 0.10, p<0.01) depression stigma correlated with help-seeking attitudes, but we detected no direct symptomatology effect on help-seeking attitudes. Personal depression stigma significantly affected help-seeking attitudes (ß = -0.15, CI = -0.17, -0.12). Promoting literacy may decrease personal depression stigma and increase professional help-seeking attitudes and behaviors.

The effects of a video-based randomized controlled trial intervention on depression stigma and help-seeking attitudes in university students.

University students are a risk group for developing mental illness, but they do not receive the care they need because of hampered help-seeking induced by stigma. This study evaluates the effects of a video-based stigma reduction intervention and help-seeking attitudes promotion in university students. We randomly distributed a sample of university students among one control group (CG, n = 188) and two intervention groups (IG-1, n = 222 and IG-2, n = 216): IG-1 watched a contact-based video and IG-2 the same video plus a psychoeducational video. The study followed an experimental single-blind randomized control trial design with a pre-test before the intervention (M0), a post-test, and a follow-up test. We evaluated participants using a sociodemographic questionnaire, the Attitudes Toward Seeking Professional Psychological Help Questionnaire, the Depression Stigma Scale, the 9-item Patient Health Questionnaire, and the 7-item Generalized Anxiety Disorder. A total of 626 participants with a mean age of 19.85 (SD=1.48) responded to all evaluation moments. At M0, there were no differences between groups on stigma or help-seeking attitudes. Immediately after the intervention, stigma levels significantly decreased, and help-seeking attitudes significantly improved. These effects persisted for the next five months. Video-based depression stigma reduction intervention can be an essential tool to reduce depression stigma and improve help-seeking attitudes.

The Association Between Changes in the University Educational Setting and Peer Relationships: Effects in Students' Depressive Symptoms During the COVID-19 Pandemic.

Objective: Abrupt life changes imposed by the lockdown measures, with a direct impact on teaching methodology and social interactions, as well as sleeping patterns, harmed university students' mental health. This study aimed to analyze the relationship between satisfaction with online teaching, social interaction with depression, anxiety symptomatology, and to analyze the effects of the pandemic and the lockdown in mental care access. Methods: The online survey collected demographic data, satisfaction with online teaching, and social interaction. We evaluated the depression and anxiety symptomatology using the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder, respectively. For the PHQ-9, we used the cut-off 15 for moderately severe depressive symptoms, whereas for GAD-7, we recurred to the cut-off 10 for moderately severe anxiety symptoms. This study used three data points: October 2019, June 2020, and March 2021. Findings: The study included n = 366 participants from all university study fields, with a mean age of 21.71 (SD = 1.42) in the last survey, and 71.3% were women. Depressive symptoms increased significantly from October 2019 to June 2020, and the mean scores grew until March 2021. Anxiety symptoms also significantly increased from October 2019 to June 2020; however, from June 2020 to March 2021, there was a non-significant decrease in the proportion. Mean scores for satisfaction with online teaching were 38.23% in June 2020 and 34.25% in March 2021, a non-significant difference. Satisfaction with social interaction significantly decreased from 37.35% in 2020 to 24.41% in 2021. Participants with scores above the cut-off of moderately severe and severe depressive and anxiety symptoms showed significantly lower satisfaction with online teaching than students with lower depression and anxiety scores. Despite the significant increase in clinical symptomatology, help-seeking behaviors did not change accordingly, and more than 50% of the students with mild or severe depressive and anxiety symptomatology did not get treatment during the pandemic. Conclusion: The findings of this study suggest that most students are dissatisfied with online teaching and the type of social interaction they were forced to adopt because of the pandemic. The severity of depressive and anxiety symptomatology significantly increased between October 2019 and March 2021, but help-seeking behaviors did not increase accordingly.

Caracterização clínica e epidemiológica de idosos de uma instituição de longa permanência / Clinical and epidemiological characterization of the elderly in a long-term institution / Caracterización clínico-epidemiológica del anciano en una institución de larga duración

Objetivo: Caracterizar clínica e epidemiologicamente os idosos residentes em uma instituição de longa permanência para idosos no Norte de Minas Gerais, Brasil. Método: Estudo descritivo e transversal realizado com a população idosa residente em uma instituição de longa permanência. Foi realizada entrevista individual com a aplicação de um instrumento de caracterização sociodemográfica, a Escala Katz e Teste do Relógio, no período entre 2018 e 2019. Os dados foram submetidos à análise estatística descritiva. Resultados: Participaram do estudo 116 idosos com média de idade de 78,240 (±9,21) anos, a maioria do sexo masculino (n=70; 60,3%), raça parda (n=74; 63,8%) e solteiros (n=77; 66,4%). Quanto aos resultados da Escala de Katz e Teste do Relógio, os participantes foram classificados como mais funcionais (n=39; 33,6%) e com inabilidade (n=90; 77,6%) respectivamente. Conclusões: A caracterização do perfil e o levantamento de problemas reais e potenciais contribuíram para o cuidado com os idosos que precisam ser apropriados e direcionados para que os idosos alcancem a máxima qualidade de vida, independência e funcionalidade. (AU)

Objective: Characterizing clinically and epidemiologically the elderly residents in a long-term care facility for the elderly in Northern Minas Gerais, Brazil. Methods: A descriptive and transversal character study conducted with the elderly population residing in a long-term institution. An individual interview was conducted with the application of a sociodemographic characterization instrument, the Katz Scale and Clock Test, in the period between 2018 and 2019. The data were subjected to descriptive statistical analysis. Results: Participated in the study 116 elderly people with an average age of 78.240 (± 9.21) years old, mostly male (NO = 70; 60.3%), mixed race (NO = 74; 63.8%) and single (NO = 77; 66.4%). Regarding the results of the Katz Scale and Clock Test, the participants were classified as more functional (NO = 39; 33.6%) and with disability (NO = 90; 77.6%) respectively. Conclusion: The characterization of the profile and the survey of real and potential problems contributed to the care for the elderly, which need to be appropriate and directed so that the elderly achieve the maximum quality of life, independence and functionality. (AU)

Objetivo: Caracterizar clínica y epidemiológicamente a los ancianos residentes en un centro de atención a largo plazo para ancianos en el Norte de Minas Gerais, Brasil. Métodos: Un estudio descriptivo y transversal realizado con población anciana residente en una institución de larga duración. Se realizó una entrevista individual con la aplicación de un instrumento de caracterización sociodemográfica, la Escala de Katz y Test de Reloj, en el período comprendido entre 2018 y 2019. Los datos fueron sometidos al análisis estadístico descriptivo. Resultados: Participaron del estudio 116 ancianos con una edad media de 78.240 (± 9,21) años, en su mayoría varones (n = 70; 60,3%), mestizos (n = 74; 63,8%) y solteros (n = 77; 66,4%). En cuanto a los resultados de la Escala de Katz y la Prueba del Reloj, los participantes fueron clasificados como más funcionales (n = 39; 33,6%) y con discapacidad (n = 90; 77,6%) respectivamente. Conclusion: La caracterización del perfil y el relevamiento de problemas reales y potenciales contribuyeron al cuidado del anciano, que debe ser adecuado y dirigido para que el anciano alcance la máxima calidad de vida, independencia y funcionalidad. (AU)

Percepção dos usuários de um centro de atenção psicossocial sobre o cuidado em saúde mental / Perception of users of a psychosocial care center on mental health care / Percepción de los usuarios de un centro de atención psicosocial sobre el cuidado en salud mental

A Reforma Psiquiátrica Brasileira teve seu início na década de 70, ganhando força a partir da constituição de 1988, onde cria-se o SUS e suas diretrizes. O movimento de reforma ocorreu de forma complexa e progressiva, sendo marcada por diversas conquistas, principalmente no que diz respeito à leis e decretos que põe fim ao modelo hospitalocêntrico e inaugura uma nova rede de cuidado. Levando em consideração esse processo histórico, este estudo tem por objetivo compreender a percepção dos usuários de um Centro de Atenção Psicossocial (CAPS) sobre o cuidado em saúde mental a partir do novo modelo assistencial instituído pela Reforma Psiquiátrica. Trata-se de um estudo qualitativo descritivo, tendo como instrumento de coleta de dados a entrevista semiestruturada com pacientes egressos de hospitais psiquiátricos e que no momento da pesquisa eram atendidos pelo CAPS II da cidade de Montes Claros-MG, utilizou-se a técnica de Análise de Conteúdo para análise dos dados. Os resultados levaram a três categorias: O cuidado em saúde mental sob o olhar dos usuários; A clínica no contexto de mudança do modelo de atenção em saúde mental; O cenário da reabilitação psicossocial entre o vivido e o ideal. Foi possível concluir que os pacientes perceberam mudanças relacionadas a um modo mais humanizado de cuidar.

The Brazilian Psychiatric Reform began in the 70s, gained strength from the 1988 constitution, where SUS and its guidelines were created. The reform movement took place in a complex and progressive way, marked by several achievements, mainly with regard to laws and decrees, which not only puts an end to the hospital-centered model, but also inaugurates a new care network. Taking this historical process into account, this study aims to understand the perception of users of a Psychosocial Care Center (CAPS) about mental health care in the city of Montes Claros-MG from the new model of care established by the Psychiatric Reform . This is a qualitative descriptive study, using the semi-structured interview with CAPS II patients from the city of Montes Claros-MG as a research tool, for data analysis using the Content Analysis technique. The results led to three categories: Mental health care under the eyes of users; The clinic in the context of changing the mental health care model; The psychosocial rehabilitation scenario between the lived and the ideal. It was possible to conclude that the patients noticed changes related to a more humanized way of caring.

La Reforma Psiquiátrica Brasileña se inició en los años 70, se fortaleció a partir de la constitución de 1988, donde se creó el SUS y sus directrices. El movimiento de reforma se desarrolló de manera compleja y progresiva, marcada por varios logros, principalmente en lo que respecta a leyes y decretos, que no solo pone fin al modelo centrado en el hospital, sino que también inaugura una nueva red asistencial. Teniendo en cuenta este proceso histórico, este estudio tiene como objetivo comprender la percepción de los usuarios de un Centro de Atención Psicosocial (CAPS) sobre la atención en salud mental en la ciudad de Montes Claros-MG a partir del nuevo modelo de atención establecido por la Reforma Psiquiátrica. . Se trata de un estudio descriptivo cualitativo, utilizando como herramienta de investigación la entrevista semiestructurada a pacientes CAPS II de la ciudad de Montes Claros-MG, para el análisis de datos mediante la técnica de Análisis de Contenido. Los resultados llevaron a tres categorías: atención de la salud mental bajo la mirada de los usuarios; La clínica en el contexto del cambio de modelo de atención en salud mental; El escenario de rehabilitación psicosocial entre lo vivido y lo ideal. Se pudo concluir que los pacientes notaron cambios relacionados con una forma de cuidar más humanizada.

Depressão em pacientes atendidos em serviço de saúde mental: fatores associados e diagnósticos de enfermagem / Depression in patients served in mental health service: prevalence and associated factors / Depresión en pacientes atendidos en servicio de salud mental: prevalencia y factores associados

OBJETIVO: estimar a prevalência de depressão em pacientes atendidos em Centro de Atenção Psicossocial, identificar os fatores sociodemográficos e diagnósticos de Enfermagem associados ao desfecho. MÉTODO: estudo transversal, realizado entre janeiro a junho de 2018, em 370 prontuários de pacientes atendidos, no período de 2002 a 2016, em Centro de Atenção Psicossocial de um município do norte de Minas Gerais, Brasil. Com o auxílio de um instrumento, foram coletados dados clínicos, sociodemográficos e diagnósticos de Enfermagem. Os diagnósticos de Enfermagem foram validados por especialistas com suporte no raciocínio diagnóstico de Risner. Realizaram-se análises descritiva, bivariada e regressão logística. RESULTADOS: dos 370 pacientes, 57 (15,4%) apresentaram depressão. A maioria (53,2%) era composta por indivíduos do sexo feminino e a média de idade foi de 36 anos. Os diagnósticos de Enfermagem prioritários entre os pacientes com depressão foram: humor deprimido (100%), crise (68,4%), insônia (45,6%) e risco de suicídio (49,1%). As variáveis independentes que impactaram, de forma significativa, o desfecho depressão foram: sexo feminino (p=0,012), insônia (p=0,006) e risco de suicídio (p<0,001). CONCLUSÃO: identificar precocemente possíveis fatores e diagnósticos de Enfermagem associados à pessoa com depressão poderá auxiliar na implementação de cuidados acurados a pacientes com esse problema atendidos em Centro de Atenção Psicossocial.

OBJECTIVE: estimate the prevalence of depression in patients seen in a psychosocial care center, identify the sociodemographic factors and nursing diagnoses associated with the outcome. METHOD: cross-sectional study, carried out between January and June 2018, in 370 medical records of patients treated, from 2002 to 2016, in a psychosocial care center in a municipality in the north of Minas Gerais, Brazil. With the aid of an instrument, clinical, sociodemographic and nursing diagnoses data were collected. Nursing diagnoses were validated by specialists with support for Risner's diagnostic reasoning. Descriptive, bivariate analysis and logistic regression were performed. RESULTS: of the 370 patients, 57 (15.4%) had depression. The majority (53.2%) were female and the average age was 36 years. The priority nursing diagnoses among patients with depression were: depressed mood (100%), crisis (68,4%), insomnia (45,6%) and risk of suicide (49,1%). The independent variables that significantly impacted the depression outcome were: female gender (p=0,012), insomnia (p=0,006) and risk of suicide (p<0,001). CONCLUSION: early identification of possible nursing factors and diagnoses associated with a person with depression may help in the implementation of accurate care for patients with this problem treated at a psychosocial care center.

OBJETIVO: estimar la prevalencia de depresión en pacientes atendidos en un centro de atención psicosocial, identificar los factores sociodemográficos y diagnósticos de enfermería asociados al resultado. MÉTODO: estudio transversal, realizado entre enero y junio de 2018, en 370 historias clínicas de pacientes atendidos, de 2002 a 2016, en un centro de atención psicosocial de un municipio del norte de Minas Gerais, Brasil. Con la ayuda de un instrumento se recolectaron datos de diagnósticos clínicos, sociodemográficos y de enfermería. Los diagnósticos de enfermería fueron validados por especialistas con apoyo del razonamiento diagnóstico de Risner. Se realizó análisis descriptivo, bivariado y regresión logística. RESULTADOS: de los 370 pacientes, 57 (15,4%) tenían depresión. La mayoría (53,2%) eran mujeres y la edad media era de 36 años. Los diagnósticos de enfermería prioritarios entre los pacientes con depresión fueron: estado de ánimo deprimido (100%), crisis (68,4%), insomnio (45,6%) y riesgo de suicidio (49,1%). Las variables independientes que impactaron significativamente el resultado de la depresión fueron: sexo femenino (p=0,012), insomnio (p=0,006) y riesgo de suicidio (p<0,001). CONCLUSIÓN: la identificación temprana de posibles factores de enfermería y diagnósticos asociados a una persona con depresión puede ayudar en la implementación de una atención adecuada a los pacientes con este problema atendidos en un centro de atención psicosocial.

Suicide time-series structural change analysis in Portugal (1913-2018): Impact of register bias on suicide trends.

BACKGROUND: Suicide is a potentially preventable cause of death. Epidemiology might help to identify death determinants and to monitor prevention strategies. Few studies address secular trends in suicide deaths, and even fewer describe trend-changes in relation to data collection/registration bias. Moreover, suicide is admittedly underreported. It is crucial to validate results in the context of other external causes of death trends, such as unintentional and undetermined intent deaths. We aimed to explore trends in suicide and other external causes of death in Portugal from the inception of registries until 2018, considering breaks in series. METHODS: We collected data from all available official primary sources. We calculated cause-specific age-standardized death rates (SDR) by sex for ages equal or higher than 15 years with reference to the European Standard Population. We considered suicide (S), undetermined intent deaths (UnD), accidents (Accs), and all causes of death (ttMty). A time-series structural analysis was executed. RESULTS: Suicide and other external causes of death rates were consistently higher in males than females. A global decline of deaths by suicide, undetermined intention and unintentional is observable. Breakpoints in years 1930, 1954, 1982, 2000-2001 were associated with major changes in deaths registration procedures or methodology. CONCLUSIONS: The epidemiology of suicide in Portugal has changed over 106 years. However, adjusted data and consideration of bias reduce trends fluctuation. Trend changes are akin to specific changes in methodology of death registry. Suicide surveillance will improve with more reliable and stable procedures.

Specialized nursing terminology for the care of people with COVID-19.

OBJECTIVE: To create specialized nursing terminology for the care of people with COVID-19. METHODS: Methodological study, carried out based on the identification of concepts related to the care of the person with the infection, present in the official guidelines of the Brazilian Ministry of Health; the concepts were validated by three specialist nurses; and a cross-mapping of the extracted concepts was done with CIPE® 2019 primitive concepts. RESULTS: Out of 436 unique concepts, being 399 of these validated; of these, 70.9% were in the Classification and referred to the nursing care of people with COVID-19. In the Axis, the concepts related to Focus, Action, and Environment stood out. As for the non-validated concepts, 78.4% were not included in the 2019 version of CIPE®. CONCLUSION: We were able to structure a specialized CIPE® terminology, with the potential to generate nursing care indicators for people with COVID-19.

A Naturalistic, European Multi-Center Clinical Study of Electrodermal Reactivity and Suicide Risk Among Patients With Depression.

Background: Electrodermal hyporeactivity has been proposed as a marker of suicidal risk. The EUDOR-A study investigated the prevalence of electrodermal hyporeactivity among patients with depression and its association with attempted and completed suicide. Methods: Between August 2014 and March 2016, 1,573 in- and outpatients with a primary diagnosis of depression (active or remission phase) were recruited at 15 European psychiatric centers. Each patient was followed-up for 1 year. Electrodermal activity was assessed at baseline with the ElectroDermal Orienting Reactivity Test. Data on the sociodemographic characteristics, clinical diagnoses, and treatment of the subjects were also collected. The severity of the depressive symptoms was assessed through the Montgomery-Asberg Depression Rating Scale. Information regarding number, time, and method of suicide attempts was gathered at baseline and at the end of the 1-year follow-up. The same data were collected in case of completed suicide. Results: Hyporeactive patients were shown to be significantly more at risk of suicide attempt compared to reactive patients, both at baseline and follow-up. A sensitivity of 29.86% and a positive predictive value (PPV) of 46.77% were found for attempted suicide at baseline, while a sensitivity of 35.36% and a PPV of 8.92% were found for attempted suicide at follow-up. The sensitivity and PPV for completed suicide were 25.00 and 0.61%, respectively. However, when controlled for suicide attempt at baseline, the association between hyporeactivity and follow-up suicide attempt was no longer significant. The low number of completed suicides did not allow any analysis.

A systematic review of older adults' request for or attitude toward euthanasia or assisted-suicide.

OBJECTIVES: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have increased among older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical health, psychological, social, quality of life, religious, or existential) associated with attitudes toward, wishes and requests for, as well as death by EUT/PAS among individuals aged 60 years and over. METHOD: The search for quantitative studies in PsycINFO and MEDLINE databases was conducted three times from February 2016 until April 2018. Articles of probable relevance (n = 327) were assessed for eligibility. Studies that only presented descriptive data (n = 306) were excluded. RESULTS: This review identified 21 studies with predictive analyses, but in only 4 did older adults face actual end-of-life decisions. Most studies (17) investigated attitudes toward EUT/PAS (9 through hypothetical scenarios). Younger age, lower religiosity, higher education, and higher socio-economic status were the most consistent predictors of endorsement of EUT/PAS. Findings were heterogeneous with regard to physical health, psychological, and social factors. Findings were difficult to compare across studies because of the variety of sample characteristics and outcomes measures. CONCLUSION: Future studies should adopt common and explicit definitions of EUT/PAS, as well as research designs (e.g. mixed longitudinal) that allow for better consideration of personal, social, and cultural factors, and their interplay, on EUT/PAS decisions.

Diagnósticos de enfermagem da taxonomia NANDA-I para idosos em instituição de longa permanência / Diagnósticos de enfermería de la taxonomía NANDA-I para ancianos en una institución a largo plazo / Nursing diagnoses of NANDA-I taxonomy for the elderly in a long-term institution

Resumo Objetivo identificar diagnósticos de enfermagem da Taxonomia da NANDA-I em idosos institucionalizados. Método estudo descritivo, conduzido com 116 idosos de uma instituição de longa permanência, realizado a partir da identificação de diagnósticos de enfermagem da Taxonomia da NANDA-I em um instrumento fundamentado no modelo teórico das Necessidades Humanas Básicas e validação por especialistas com suporte no raciocínio diagnóstico de Risner. Resultados identificou-se 1.555 títulos de diagnósticos de enfermagem para os 116 idosos, com uma média de 13,4 diagnósticos por idoso. Após exclusão de repetições foram obtidos 39 títulos distintos de diagnósticos. Entre eles, 26 (66,7%) são títulos de diagnósticos reais, 13 (33,3%) títulos de diagnósticos de risco e estão classificados em 8 dos 13 domínios da taxonomia da NANDA-I. Os diagnósticos de enfermagem mais frequentes foram: risco de quedas (94,8%); síndrome do idoso frágil (91,3%) e processos familiares disfuncionais (90,5%). Conclusão e implicações para a prática o perfil de diagnósticos de enfermagem identificado pode contribuir para o incremento de indicadores sensíveis à prática de enfermagem, com o planejamento e implementação de medidas assistenciais direcionadas as reais necessidades dos idosos institucionalizados impactando na autonomia, independência e consequentemente na qualidade de vida.

Resumen Objetivo identificar diagnósticos de enfermería de la taxonomía NANDA-I en ancianos institucionalizados. Método estudio descriptivo, realizado con 116 personas mayores de una residencia gerontológica, a partir de la identificación de diagnósticos de enfermería de la taxonomía NANDA-I en un instrumento basado en el modelo teórico de Necesidades Humanas Básicas y validado por especialistas con apoyo en razonamiento Diagnóstico de Risner. Resultados se indicaron 1.555 títulos de diagnóstico de enfermería para los 116 p edad adultos mayores, con un promedio de 13.4 diagnósticos por adulto mayor. Excluidas las repeticiones, se obtuvieron 39 títulos de diagnóstico diferentes. Entre ellos, 26 (66.7%) son títulos de diagnósticos reales, 13 (33.3%) son títulos de diagnósticos de riesgo, y se clasifican en 8 de los 13 dominios de la taxonomía NANDA-I. Los diagnósticos de enfermería más frecuentes fueron: riesgo de caídas (94,8%); síndrome de fragilidad del anciano (91.3%) y procesos familiares disfuncionales (90.5%). Conclusión e implicaciones para la práctica el perfil de los diagnósticos de enfermería identificados puede contribuir al aumento de indicadores sensibles a la práctica de enfermería, con la planificación e implementación de medidas de atención dirigidas a las necesidades reales de los ancianos institucionalizados, que impactan en la autonomía, independencia y consecuentemente calidad de vida.

Abstract Objective To identify nursing diagnoses of the NANDA-I Taxonomy in institutionalized older adults. Method A descriptive study, conducted with 116 older adults from a long-term institution, carried out based on the identification of nursing diagnoses of the NANDA-I Taxonomy in an instrument based on the theoretical model of Basic Human Needs and validation by experts with support in Risner's diagnosis reasoning. Results 1,555 nursing diagnosis titles were indicated for the 116 older adults, with a mean of 13.4 diagnoses per individual. After excluding repetitions, 39 different diagnosis titles were obtained. Among them, 26 (66.7%) are titles of real diagnoses, 13 (33.3%) are titles of risk diagnoses and are classified in 8 of the 13 domains of the NANDA-I taxonomy. The most frequent nursing diagnoses were the following: risk for falls (94.8%); frail elderly syndrome (91.3%), and dysfunctional family processes (90.5%). Conclusion and implications for the practice The profile of the nursing diagnoses identified can contribute to the increase of sensitive indicators to the nursing practice, with the planning and implementation of care measures directed to the real needs of institutionalized older adults, impacting on autonomy, independence and, consequently, on quality of life.

Violência no trabalho contra os trabalhadores de enfermagem e seus imbricamentos com a saúde mental / Violencia en el trabajo contra los trabajadores de enfermería y sus imbricaciones con la salud mental / Violence at work against nursing workers and their imbrications with mental health

Objetivo: Conhecer a percepção da violência experienciada por trabalhadores de enfermagem no ambiente de trabalho e seus imbricamentos com a saúde mental. Método: Foi conduzido um estudo de cunho qualitativo, tendo como suporte técnico conceitual os preceitos da teoria do Interacionismo Simbólico, em um hospital público de grande porte. A coleta de dados foi realizada, por meio de entrevista semiestruturada, a partir do referencial de Minayo, no qual utilizou-se a Análise de Conteúdo. Resultados: Observa-se, com base nas falas dos profissionais, que a violência é um fenômeno presente no trabalho, o que gera revolta e sofrimento. Como consequência, emergem sentimentos de culpa, preocupação, tensão, estresse, desespero, raiva, sendo diversas as repercussões no trabalho. Conclusões: A violência, no ambiente de trabalho dos profissionais de enfermagem, produz sofrimento e riscos à saúde mental do trabalhador, assim, surge a preocupação em relação à saúde mental dos trabalhadores da enfermagem e a necessidade de ações articuladas e focadas na saúde do trabalhador e na prevenção da violência(AU)

Objective: To acquaint with the perception of violence experienced by nursing workers in the work environment and their consequences on mental health. Method: A qualitative study was conducted in a large public hospital, using the precepts of the theory of Symbolic Interactionism as technical-conceptual support. Data collection was performed through semi-structured interviews based on Minayo's reference, followed by content analysis. Results: The professionals' testimonials evidence that violence is a phenomenon present at work, which generates indignation and suffering. As a consequence, feelings of guilt, concern, tension, stress, despair, and anger emerge, as well as several repercussions at work. Conclusions: Violence in the nursing environment causes suffering and risks to the mental health of workers, thus, it arises to concern about the mental health of nursing workers and the need for coordinated actions focused on workers' health and violence prevention.(AU)

Objetivo: Conocer la percepción de violencia que experimentan los trabajadores de enfermería en el entorno laboral y sus imbricaciones con la salud mental. Método: Se realizó un estudio cualitativo con el apoyo técnico-conceptual de los preceptos de la teoría del interaccionismo simbólico en un gran hospital público. La recopilación de datos se realizó a través de entrevistas semiestructuradas basadas en la referencia de Minayo, en las que se utilizó el análisis de contenido. Resultados: De los discursos de los profesionales se observa que la violencia es un fenómeno presente en el trabajo, que genera revuelta y sufrimiento. Como consecuencia, surgen sentimientos de culpa, preocupación, tensión, estrés, desesperación e ira, siendo varias las repercusiones en el trabajo. Conclusiones: La violencia en el entorno laboral de los profesionales de enfermería produce sufrimiento y riesgos para la salud mental de estos, por lo tanto, surge la preocupación por la salud mental de los trabajadores de enfermería y la necesidad de acciones articuladas centradas en la salud de los trabajadores y la prevención de la violencia(AU)

Sentimentos e emoções de mães de prematuros de uma unidade de terapia intensiva neonatal / Sentimientos y emociones de madres de hijos prematuros de una unidad de cuidados intensivos neonatales / Feelings and emotions of mothers of preterm babies at a neonatal intensive care unit

Objetivo: Desvelar os sentimentos e emoções das mães que se deparam com filho prematuro internado na Unidade de Terapia Intensiva Neonatal, para compreender o sentido dessa vivência. Método: Estudo qualitativo sob a perspectiva fenomenológica fundamentada em Heidegger. Os sujeitos do estudo foram sete mães que experenciaram o ser mãe de uma criança hospitalizada, em Unidade de Terapia Intensiva Neonatal. Resultados: Os discursos foram analisados, por meio de três categorias analíticas: sonho de ser mãe em risco e o sentimento de frustração e culpa, sentimentos ambivalentes no pós-parto e a vivência de sofrimento pela condição de fragilidade do filho e a ressignificação da experiência e o sentimento de esperança e fé. Conclusão: Houve ambivalência afetiva de sentimentos e emoções das mães. O vivido das mães foram marcados por experiências, cujo sentido se expressaram pelo sonho de ser mãe em risco até à ressignificação desse sofrimento construído pelas expectativas em torno da recuperação(AU)

Purpose: To unveil the feelings and emotions of mothers of a premature child admitted to the Neonatal Intensive Care Unit to understand the meaning of this experience. Method: A qualitative study under Heidegger's phenomenological perspective. The study subjects were seven women who experienced being a mother of a child hospitalized in a Neonatal Intensive Care Unit. Results: Their speeches were analyzed through three analytical categories: dream of being a mother at risk and the feeling of frustration and guilt; ambivalent feelings in the postpartum period and the experience of suffering due to the fragile condition of the child; and the redefinition of the experience and the feeling of hope and faith. Conclusion: There was an affective ambivalence of mothers' feelings and emotions. The mothers' experiences were marked by the dream of being a mother at risk as well as the re-signification of this suffering built by expectations around recovery(AU)

Objetivo: Revelar los sentimientos y emociones de las madres que se enfrentan a un niño prematuro ingresado en la Unidad de Cuidados Intensivos Neonatales para comprender el significado de esta experiencia. Método: Estudio cualitativo bajo la perspectiva fenomenológica basado en Heidegger. Los sujetos del estudio fueron siete madres que vivieron la experiencia de ser madres de un niño hospitalizado en una Unidad de Cuidados Intensivos Neonatales. Resultados: Los discursos se analizaron a través de tres categorías analíticas: el sueño de ser madre en riesgo y el sentimiento de frustración y culpa, los sentimientos ambivalentes en el posparto y la vivencia del sufrimiento por la frágil condición del niño y la redefinición de la experiencia y el sentimiento de esperanza y fe. Conclusión: Hubo ambivalencia afectiva de los sentimientos y emociones de las madres. La vida de las madres estuvo marcada por experiencias cuyo significado fue expresado por el sueño de ser madre en riesgo hasta la resignificación de este sufrimiento construido por expectativas en torno a la recuperación(AU)

Acolhimento na atenção primária à saúde na percepção da equipe multiprofissional / Welcoming in primary health care in the perception of the multidisciplinary team / Acogiendo en la atención primaria de salud en la percepción del equipo multidisciplinario

Objetivo: compreender o acolhimento na unidade básica de saúde na percepção da equipe multiprofissional. Métodos: estudo descritivo e qualitativo conduzido com uma equipe de Saúde da Família por meio da técnica de grupo focal. A análise dos dados foi realizada por meio Análise de Conteúdo na modalidade Análise Temática. Resultados: verificou-se que as ações concebidas pela equipe como acolhimento eram realizadas em turno e horário específicos, por uma categoria profissional, consideradas como triagem de queixas agudas que determinariam atendimento médico. Conclusão: a maioria dos profissionais possuíam pouco entendimento ou desconheciam as diretrizes da Política Nacional de Humanização e a concepção ampliada do acolhimento, gerando processos de trabalho incompatíveis com a política, resultando-se em vários desafios a serem enfrentados pela equipe

Objective: to understand the reception in the basic health unit in the perception of the multidisciplinary team. Methods: descriptive and qualitative study conducted with a Family Health team using the focus group technique. Data analysis was performed through Content Analysis according in the Thematic Analysis modality. Results: it was verified that the actions conceived by the team as welcoming were performed in specific shift and time, by a professional category, considered as screening of acute complaints that would determine medical care. Conclusion:most professionals had little understanding or lacked the guidelines of the National Humanization Policy and the expanded conception of welcoming, generating work processes incompatible with the policy, resulting in several challenges to be faced by the team

Objetivo: entender la recepción en la unidad básica de salud en la percepción del equipo multidisciplinar. Métodos:estudio descriptivo y cualitativo realizado con un equipo de Salud Familiar utilizando la técnica del grupo de enfoque. El análisis de datos se realizó a través del Análisis de Contenido en la modalidad Análisis Temático. Resultados: se verificó que las acciones concebidas por el equipo como bienvenida se realizaron en un turno y tiempo específicos, por una categoría profesional, considerada como cribado de quejas agudas que determinarían la atención médica. Conclusión:la mayoría de los profesionales tenían poca comprensión o careceden de las directrices de la Política Nacional de Humanización y la concepción ampliada de la acogida, generando procesos de trabajo incompatibles con la política, lo que resultó en varios desafíos que enfrentar el equipo