Determinants of socioeconomic factors for quality of life and depressive symptoms in community-dwelling older people: A cross-sectional study in Brazil and Portugal.

Our aim was to analyze the association between socioeconomic status and quality of life (QoL) among older people with depressive symptoms treated through the Primary Health Care (PHC) system in Brazil and Portugal. This was a comparative cross-sectional study with a nonprobability sample of older people in the PHC in Brazil and Portugal conducted between 2017 and 2018. To evaluate the variables of interest, the socioeconomic data questionnaire, the Geriatric Depression Scale and the Medical Outcomes Short-Form Health Survey were used. Descriptive and multivariate analyses were performed to test the study hypothesis. The sample consisted of n = 150 participants (Brazil n = 100 and Portugal n = 50). There was a predominance of woman (76.0%, p = 0.224) and individuals between 65 and 80 years (88.0%, p = 0.594). The multivariate association analysis showed that in the presence of depressive symptoms, the QoL mental health domain was most associated with the socioeconomic variables. Among the prominent variables, woman group (p = 0.027), age group 65-80 years (p = 0.042), marital status "without a partner" (p = 0.029), education up to 5 years (p = 0.011) and earning up to 1 minimum wage (p = 0.037) exhibited higher scores among brazilian participants. The portuguese participants showed an association between the general health status domain and woman group (p = 0.042) and education up to 5 years (p = 0.045). The physical functioning domain was associated with income of up to 1 minimum wage (p = 0.037). In these domains, the portuguese participants exhibited higher scores than the brazilian participants. We verified the association between socioeconomic profile and QoL in the presence of depressive symptoms, which occurred mainly among woman, participants with low levels of education and low income, with QoL aspects related to mental, physical and social health and self-perceived health. The group from Brazil had higher QoL scores than the group from Portugal.

Quality of Life in Community-Dwelling Older People with Functional and Nutritional Impairment and Depressive Symptoms: A Comparative Cross-Sectional Study in Brazil and Portugal.

BACKGROUND: The interaction of quality of life (QoL) with functionality, nutrition and depression has been studied, but few studies have compared different realities. Our objective was to compare the associations of QoL with impaired functionality, nutritional status and depressive symptoms among older people patients treated in primary health care (PHC) in Brazil and Portugal. METHODS: Cross-sectional, comparative study was conducted with primary data from PHC services in Brazil and Portugal with users over 65 years old. Participants' scores were classified as "impaired" and "preserved" for QoL, functional decline, nutrition and depression. We used Pearson's chi-square test, Fisher's exact test and the Mann-Whitney U test. RESULTS: Our sample had a total of 150 PHC users. We found lower QoL scores in Brazil, which were associated with the risk of functional decline for the domains Physical Functioning, General Health Perceptions, Mental Health dimensions and Physical Health. Nutritional impairment in the group from Portugal included the domains of Vitality and Social Role Functioning. For depressive impairment, Portugal showed an association with the domains Mental Health, Vitality and Social Role Functioning. CONCLUSIONS: QoL was associated with functional and nutritional impairment and depressive symptoms, highlighting physical, mental and social characteristics related to the perception of well-being.

Depression and quality of life in Brazilian and Portuguese older people communities: Analysis of association.

ABSTRACT: We aimed to compare the association of depression with aspects of quality of life (QoL) among older people users of primary health care (PHC) living in Brazil and Portugal.We carried out an observational, cross-sectional and comparative study with a quantitative approach in the PHC scope in Brazil and Portugal, where we obtained a nonrandom sample of 150 participants aged 65 years or older (100 Brazilians and 50 Portuguese). We used the socioeconomic and health data questionnaire, the Medical Outcomes Short-Form Health Survey QoL (SF-36) questionnaire and the Beck Inventory.Among the socioeconomic profiles, most were females aged between 65 and 80 years in both countries. There was a significant difference between groups in the income variable, with 100.0% of Portuguese people earning up to 1 minimum wage (P value <.001), and the presence of chronic diseases in 92.0% of respondents in Portugal (P value = .033). In the association analysis, most aspects of QoL had a higher median score (>50.0) within the categorical variables of "absent" and "mild" depression. The Emotional role functioning, Physical role functioning, Physical functioning, Mental health, Total score domains and the Mental health and Physical health summary measures stood out with this behavior in Brazil and in Portugal, where these latter 2 presented moderate to strong correlation values (ρ > 0.400) in Portugal. Greater associations of depression on QoL were revealed in Portugal than in Brazil. Among their most expressive associations, the Physical role functioning (odds ratio [OR] = 4.776; 95.0% confidence interval [CI]: 2.41-9.43), Physical functioning (OR = 3.037; 95.0% CI: 3.037), Vitality (OR = 6.000; 95.0% CI: 1.56-23.07) and Total score (OR = 3.727; 95.0% CI: 2.24-6.17) domains and the Mental health summary measure (OR = 3.870; 95.0% CI: 2.13-7.02) stood out.Aspects related to the emotional, physical, functional and mental health components stood out. The association and correlation with depression were more expressive in Portugal compared to Brazil. However, similar results were obtained in Brazil but with less relevance.

Tuberculosis control actions: analysis based on the access and primary health care quality improvement program / Acciones de control de la tuberculosis: análisis a partir del programa de mejoría del acceso y de la calidad de la atención básica / Ações de controle da tuberculose: análise a partir do programa de melhoria do acesso e da qualidade da atenção básica

ABSTRACT The study's aim was to analyze primary health care delivered to people with tuberculosis on a national level, based on the information collected by an external assessment implemented by the Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. This cross-sectional study with a quantitative approach used data from the 2nd cycle external assessment of the Programa de Melhoria do Acesso e da Qualidade da Atenção Básica conducted in 2014. The Statistical Package for Social Sciences was used to establish frequencies and check for associations using the Chi-square test. The percentage of Family Health Strategy units recording the annual number of confirmed tuberculosis cases and respiratory symptoms was high for the entire country (81.1%). In contrast, the recording of follow-up of tuberculosis cases was performed by only 48.3% of the facilities, while only 48% of the health basic unites units implemented directly observed treatment. The findings reveal barriers in the structure of health basic unites units regarding the operationalization and sustainability of care provided to individuals with tuberculosis, including directly observed treatment.

RESUMEN El estudio tuvo como objetivo analizar las acciones de salud a la persona con tuberculosis en la Atención Básica, a nivel nacional, desde la Evaluación Externa del Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. Se trata de un estudio transversal con abordaje cuantitativo, basados en los datos de la evaluación externa del 2º ciclo del Programa de Melhoria do Acesso e da Qualidade da Atenção Básica realizado en el año de 2014. Se utilizó el programa software Statistical Package for Social Sciences para la realización de frecuencias y tentativas de asociaciones por medio del teste estadístico Qui-Cuadrado. Se encontró que el porcentual de registro de la estimativa anual del número de casos confirmados de tuberculosis y sintomáticos respiratorios en las ESF atingió 81,1%, en todo Brasil; en contrapartida el porcentual de registros de acompañamiento de los casos de Tuberculosis alcanzó, solamente, 48,3% y el Tratamiento Directamente Observado en el 48% de las unidades básicas de salud. Los datos indicaron la presencia de barreras en la estructuración de las unidades básicas de salud cuanto a la operacionalización y sustentabilidad de la asistencia al portador de tuberculosis, incluyendo la estrategia Tratamiento Directamente Observado.

RESUMO O estudo objetivou analisar as ações de saúde à pessoa com tuberculose na atenção básica à saúde, em nível nacional, a partir da avaliação externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. Trata-se de um estudo transversal de abordagem quantitativa, com base nos dados da avaliação externa do 2º ciclo do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica realizado em 2014. Utilizou-se o software Statistical Package for Social Sciences para realização de frequências e associações por meio do teste estatístico qui-quadrado. Constatou-se que o percentual de registro da estimativa anual do número de casos confirmados de tuberculose e sintomáticos respiratórios na Estratégias Saúde da Família atingiu 81,1%, em todo Brasil; em contrapartida, o percentual de registros de acompanhamento dos casos de tuberculose alcançou, somente, 48,3% e tratamento diretamente observado 48% das unidades básicas de saúde. Os achados indicaram a presença de barreiras na estruturação das unidades básicas de saúde quanto à operacionalização e sustentabilidade da assistência ao portador de tuberculose, incluindo a estratégia do tratamento diretamente observado.

[Nurses' social representations of work-related stress in an emergency room]. / Representações sociais de enfermeiros acerca do estresse laboral em um serviço de urgência.

The aim of this study was to understand the social representations of nurses in the emergency room and their relationship to stress. This descriptive, exploratory study was performed using a qualitative approach, with Social Representations Theory being the prime focus. Research was conducted at a benchmark public hospital for emergency services in the municipality of Natal/RN. The sample consisted of 10 nurses. A content analysis approach was used for data analysis. The results indicate that the relationship between nurses' social representations of work and stress is a complex and multi-faceted phenomenon that contributes to the development of physical, emotional and mental illnesses, and exhaustion.

[Fragments of history in psychiatric care Rio Grande do Norte, Brazil]. / Fragmentos históricos da assistência psiquiátrica no Rio Grande do Norte, Brasil.

This article aims to rescue aspects of the performing therapeutic of the Day Hospital (HD) Dr Elger Nunes, Natal, Rio Grande do Norte, Brazil, during its term, and analyze the results regarding to the number of patients assisted from 1996 to 2004. This is an empirical, descriptive and exploratory study, ex post facto with a quantitative approach, carried out through the analysis of the records of 910 people attended in the hospital. The data was submitted to the informational resource software Microsoft Excel and converted into diagrams. The results show a greater accessibility to this treatment modality, decreasing in hospitalization-time length and improving hospital discharge conditions for users, with reduction in number of patients who interrupted treatment. It focus on the importance of the Day Hospital in the process of psychiatric reform, with care grounded on the use of the humanized therapeutic practices, and still not losing the bond with family and society.

[Social representations and the therapeutic role of nursing students]. / Representações sociais e o papel terapêutico dos acadêmicos de enfermagem.

This study with a qualitative approach aims to apprehend the social representation and disciplinary practices in Mental Health subject regarding the therapeutic role of the nursing students in the attention of adult into the Context of Enlarged Clinic held in the Day-Hospital Dr. Elger Nunes, Natal/RN. A total of 42 case studies were analyzed and formatted in corpus and based on the ALCESTE software. It was inferred for this group of students that the social representation is established acquiring knowledge to be therapeutic as student and professional. This competence makes them skilled to deal with mental disorders from the perspective of this service, as well as the official model of health care.

[Mental health, work and retirement: a focus on mental allienation]. / Saúde mental, trabalho e aposentadoria: focalizando a alienação mental.

It is an exploratory-descriptive study that aimed to analyze the disability retirement of employees of the UFRN for mental and behavioral disorders in the period 2000-2005. The sample was obtained from records of the DAS/PRH/UFRN. Of 43 retirees, 58% were men, 41% retire between 41-50 years and 35% between 51-60 years, 44% occupied position/function for the high school level and 28% for the elementary level. The mood disorders lead to 61% of the retirements by mental alienation, followed by thought disorders (19%), organic mental disorders and personality disorder (4%). We found that they lived with intense psychological distress creating an indirect burden on their lives and on their family's life facing lost opportunities of life and to the adjusted years of disability affecting their work.

[Perceptions of mental patients' sexuality by nurses]. / Percepções da sexualidade do doente mental pelo enfermeiro.

This research aimed at identifying the social representations of nursing professionals expressed in situations in which the sexuality of mentally-ill people constitutes a visible fact in psychiatric institutions. The technical and methodological resource for data collection, based on projective procedures, was denominated Investigation Technique in Daily Situations--ITDS. This instrument consisted of sixteen boards with graphic reproductions of these professionals' daily actions, from which six were selected for the analysis of the mentally-ill person's sexuality. Seventeen nurses working in psychiatric hospitals in Ribeirão Preto composed the sample. Their discoursive manifestation showed their denials of the mentally-ill person's sexuality, which restrained it as a deviation, misbehavior and disease. By doing so, they take a distant position with repressive or defensive attitudes. This position reveals the strategy adopted in relation to such knowledge and power, following the determinations of their professional code by meeting institutional and social expectations.