Changes in the diagnosis of depression among nursing professionals during the COVID-19 pandemic: A longitudinal study.

AIMS: To identify changes in mental health status among nursing professionals in a Brazilian municipality during the COVID-19 pandemic. DESIGN: An observational and longitudinal study. METHODS: Using the Patient Health Questionnaire-9, the presence of depressive symptoms was evaluated among 690 nursing professionals in the city of Pelotas, Brazil, at two moments: June/July 2020 and June/July 2021. RESULTS: 13.0% incidence of depressive symptoms was identified; as well as 12.2% remission; 24.1% persistence and 50.7% absence. Among the factors associated with the worst prognoses we can mention female gender, greater workload, feeling of overload, illness of family members or friends due to COVID-19 and use of psychotropic drugs CONCLUSIONS: There was significant mobility in the diagnosis of depression among the professionals studied during the period analysed, with incidence of new cases of significant depression and greater than the number of remissions. In addition to sociodemographic aspects, traumatic experiences and exposure to continuous overload were associated with persistence and incidence of new cases. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: With the advent of the COVID-19 pandemic, several studies have shown an increase in depressive symptoms among nursing professionals; however, understanding the long-term effects of this scenario is still a challenge. IMPACT: What problem did the study address? This study investigates changes in the mental health status of nursing professionals working at different care levels, taking the prevalence of screening for depression as a proxy, during a period of a year during the COVID-19 pandemic. What were the main findings? Between both data collection moments, 2020 e 2021, there was a significant percentage of professionals with persistent depression, in addition to a significant proportion of incident cases that slightly exceeded the number of remissions and the factors associated with the worst prognoses were sociodemographic aspects such as gender and emotional stressors like illness of family members or close friends due to COVID-19, in addition to those related to the organisation and support provided by the services, such as workload and feeling of overload. Where and on whom will the research have an impact? This study will impact the nursing professionals and in role of the health services in order to establishing actions that contribute to minimising the deleterious effects of the pandemic on the mental health of their Nursing teams. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Intention to leave Nursing during the COVID-19 pandemic. / Intenção em deixar a Enfermagem durante a pandemia de COVID-19.

OBJECTIVE: to investigate the percentage of professionals with an intention to leave Nursing during the COVID-10 pandemic, as well as the factors associated with this outcome. METHOD: a cross-sectional study conducted by applying questionnaires to 890 Nursing professionals from the municipality of Pelotas (RS). The outcome was identified by means of self-reports obtained from the question itself. Relative Risks, as well as their Confidence Intervals (95%), were calculated for the independent variables by means of unadjusted and adjusted Poisson regression. RESULTS: the percentage of professionals who stated their intention to leave Nursing was 24.6% (n=219). There was a positive association between the outcome and higher schooling levels, negative evaluation of institutional support, moderate or intense overload, and skin lesions. A negative association was also observed between the outcome and individuals aged 51 years old or more. CONCLUSION: except for skin lesions, aspects such as lack of support and overload, although they may have been intensified during the pandemic, do not represent a new fact in the health services. In this sense, the associations found in the study reflect the need for cross-sectional actions to promote retention of professionals.

Prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic.

OBJECTIVE: to identify the prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic. METHOD: a cross-sectional study, conducted in June and July 2020, with 890 nursing professionals. To screen the outcome, question 3 of the Self-Reporting Questionnaire was used, assessing poor sleep quality 30 days preceding the application of the questionnaire. Associations between variables of interest were tested using Poisson regression models. RESULTS: the prevalence of poor sleep quality was 68%. Associated factors were moderate or heavy workload, poor assessment of working conditions, suspected infection with COVID-19, more than two thirds of the workload for pandemic and the use of psychotropic drugs. CONCLUSION: the study pointed out a high prevalence of poor sleep quality among nursing workers with an important relationship with working conditions.

Mental health of nursing professionals during the COVID-19 pandemic: a cross-sectional study.

OBJECTIVE: To identify the prevalence of and factors associated with: (1) major depressive episodes; (2) minor psychiatric disorders (MPDs); and (3) suicidal ideation among nursing professionals from a municipality in southern Brazil. METHODS: Using a cross-sectional design, we recruited 890 nursing professionals linked to 50 Primary Care units, 2 walk-in clinics, 2 hospital services, 1 emergency room service, 1 mobile emergency care service, and 1 teleconsultation service, in addition to the municipal epidemiological surveillance service and the vacancy regulation center between June and July 2020. We used the Patient Health Questionnaire-9 and the Self-Reporting Questionnaire to evaluate the studied outcomes. Associations between the outcomes and variables related to sociodemographic profile, work, health conditions, and daily life were explored using Poisson regression models with robust variance estimators. RESULTS: The observed prevalence of depression, MPDs, and suicidal ideation were 36.6%, 44%, and 7.4%, respectively. MPDs were associated with the assessment of support received by the service as 'regular' (PR: 1.48; 95% CI: 1.19-1.85) or 'poor' (PR: 1.54; 95% CI: 1.23-1.94), with a reported moderate (PR: 1.63; 95% CI: 1.29-2.07), or heavy (PR: 2.54; 95% CI: 2.05-3.15) workload, and with suspected COVID-19 infection (PR: 1.44; 95% CI: 1.25-1.66). Major depressive episodes were associated with a reported lack of personal protective equipment (PR: 1.20; 95% CI: 1.01-1.42), whereas suicidal ideation was inversely related to per capita income > 3 minimum monthly wages (PR: 0.28; 95% CI: 0.11-0.68), and positively related to the use of psychotropic drugs (PR: 3.14; 95% CI: 1.87-5.26). CONCLUSION: Our results suggest that nursing professionals' working conditions are associated with their mental health status. The need to improve working conditions through adequate dimensioning, support and proper biosafety measures is only heightened in the context of the COVID-19 pandemic.

Intenção em deixar a Enfermagem durante a pandemia de COVID-19 / Intention to leave Nursing during the COVID-19 pandemic / Intención de abandonar la profesión de Enfermería durante la pandemia del COVID-19

Resumo Objetivo: investigar a proporção de profissionais com intenção em deixar a Enfermagem durante a pandemia de COVID-19, bem como os fatores associados a esse desfecho. Método: estudo transversal realizado por meio da aplicação de questionários a 890 profissionais de Enfermagem do município de Pelotas (RS). O desfecho foi identificado por meio do autorrelato obtido a partir de questão própria. Riscos Relativos, bem como seus Intervalos de Confiança (95%), foram calculados para as variáveis independentes por meio de regressão de Poisson bruta e ajustada. Resultados: a proporção de profissionais que manifestaram intenção em deixar a Enfermagem foi de 24,6% (n=219). Houve associação positiva entre o desfecho e maior escolaridade, avaliação negativa do suporte institucional, sobrecarga moderada ou pesada e lesões de pele. Foi observada ainda associação negativa entre o desfecho e idade igual ou superior a 51 anos. Conclusão: exceto pelas lesões de pele, aspectos como a falta de suporte e a sobrecarga, embora possam ter sido exacerbadas na pandemia, não caracterizam fato novo nos serviços de saúde. Nesse sentido, as associações encontradas pelo estudo refletem a necessidade de ações transversais para promover a retenção de profissionais.

Abstract Objective: to investigate the percentage of professionals with an intention to leave Nursing during the COVID-10 pandemic, as well as the factors associated with this outcome. Method: a cross-sectional study conducted by applying questionnaires to 890 Nursing professionals from the municipality of Pelotas (RS). The outcome was identified by means of self-reports obtained from the question itself. Relative Risks, as well as their Confidence Intervals (95%), were calculated for the independent variables by means of unadjusted and adjusted Poisson regression. Results: the percentage of professionals who stated their intention to leave Nursing was 24.6% (n=219). There was a positive association between the outcome and higher schooling levels, negative evaluation of institutional support, moderate or intense overload, and skin lesions. A negative association was also observed between the outcome and individuals aged 51 years old or more. Conclusion: except for skin lesions, aspects such as lack of support and overload, although they may have been intensified during the pandemic, do not represent a new fact in the health services. In this sense, the associations found in the study reflect the need for cross-sectional actions to promote retention of professionals.

Resumen Objetivo: investigar el porcentaje de profesionales con intención de abandonar la profesión de Enfermería durante la pandemia del COVID-19, así como los factores asociados con este desenlace. Método: estudio transversal realizado por medio de cuestionarios aplicados a 890 profesionales de Enfermería del municipio de Pelotas (RS). El desenlace se identificó por medio de autoinformes obtenidos a partir de la pregunta en sí. Por medio de regresión de Poisson ajustada y no ajustada, se calculó el Riesgo Relativo, al igual que sus Intervalos de Confianza (95%), para las variables independientes. Resultados: el porcentaje de profesionales que manifestaron su intención de abandonar la profesión de Enfermería fue del 24,6% (n=219). Se registró una asociación positiva entre el desenlace y nivel de estudios más elevado, evaluación negativa del apoyo institucional, sobrecarga moderada o intensa y lesiones en la piel. También se observó una asociación negativa entre el desenlace y personas de al menos 51 años de edad. Conclusión: salvo por las lesiones en la piel, aspectos como la falta de apoyo y la sobrecarga, aunque pudieran haberse visto intensificados durante la pandemia, no representan un hecho novedoso en los servicios de salud. En este sentido, las asociaciones que se encontraron en el estudio reflejan la necesidad de implementar acciones transversales para promover retención de profesionales.

Prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic / Prevalência e fatores associados à má qualidade do sono entre profissionais de enfermagem durante a pandemia de COVID-19 / Prevalencia y factores asociados a la mala calidad del sueño entre profesionales de enfermería durante la pandemia de COVID-19

ABSTRACT Objective: to identify the prevalence and factors associated with poor sleep quality among nursing professionals during the COVID-19 pandemic. Method: a cross-sectional study, conducted in June and July 2020, with 890 nursing professionals. To screen the outcome, question 3 of the Self-Reporting Questionnaire was used, assessing poor sleep quality 30 days preceding the application of the questionnaire. Associations between variables of interest were tested using Poisson regression models. Results: the prevalence of poor sleep quality was 68%. Associated factors were moderate or heavy workload, poor assessment of working conditions, suspected infection with COVID-19, more than two thirds of the workload for pandemic and the use of psychotropic drugs. Conclusion: the study pointed out a high prevalence of poor sleep quality among nursing workers with an important relationship with working conditions.

RESUMO Objetivo: identificar a prevalência e os fatores associados à má qualidade do sono entre profissionais de enfermagem durante a pandemia de COVID-19. Método: estudo transversal, realizado nos meses de junho e julho de 2020, com 890 profissionais de enfermagem. Para triagem do desfecho, foi utilizada a questão 3 do Self-Reporting Questionnaire, avaliando a má qualidade do sono 30 dias anteriores à aplicação do questionário. As associações entre as variáveis de interesse foram testadas por meio de modelos de regressão de Poisson. Resultados: a prevalência de má qualidade do sono foi de 68%. Os fatores associados foram carga horária moderada ou pesada, má avaliação das condições de trabalho, suspeita de infecção por COVID-19, mais de dois terços da carga horária por pandemia e uso de psicofármacos. Conclusão: o estudo apontou alta prevalência de má qualidade do sono entre trabalhadores de enfermagem com importante relação com as condições de trabalho.

RESUMEN Objetivo: identificar la prevalencia y los factores asociados a la mala calidad del sueño entre los profesionales de enfermería durante la pandemia de COVID-19. Método: estudio transversal, realizado en junio y julio de 2020, con 890 profesionales de enfermería. Para cribar el desenlace se utilizó la pregunta 3 del Cuestionario de Autoinforme, que evalúa la mala calidad del sueño en los 30 días anteriores a la aplicación del cuestionario. Las asociaciones entre variables de interés se probaron utilizando modelos de regresión de Poisson. Resultados: la prevalencia de mala calidad del sueño fue del 68%. Los factores asociados fueron carga de trabajo moderada o alta, mala evaluación de las condiciones de trabajo, sospecha de infección por COVID-19, más de dos tercios de la carga de trabajo por pandemia y uso de psicofármacos. Conclusión: el estudio señaló una alta prevalencia de mala calidad del sueño entre los trabajadores de enfermería con una importante relación con las condiciones de trabajo.

Mental health of nursing professionals during the COVID-19 pandemic: a cross-sectional study

ABSTRACT OBJECTIVE To identify the prevalence of and factors associated with: (1) major depressive episodes; (2) minor psychiatric disorders (MPDs); and (3) suicidal ideation among nursing professionals from a municipality in southern Brazil. METHODS Using a cross-sectional design, we recruited 890 nursing professionals linked to 50 Primary Care units, 2 walk-in clinics, 2 hospital services, 1 emergency room service, 1 mobile emergency care service, and 1 teleconsultation service, in addition to the municipal epidemiological surveillance service and the vacancy regulation center between June and July 2020. We used the Patient Health Questionnaire-9 and the Self-Reporting Questionnaire to evaluate the studied outcomes. Associations between the outcomes and variables related to sociodemographic profile, work, health conditions, and daily life were explored using Poisson regression models with robust variance estimators. RESULTS The observed prevalence of depression, MPDs, and suicidal ideation were 36.6%, 44%, and 7.4%, respectively. MPDs were associated with the assessment of support received by the service as 'regular' (PR: 1.48; 95% CI: 1.19-1.85) or 'poor' (PR: 1.54; 95% CI: 1.23-1.94), with a reported moderate (PR: 1.63; 95% CI: 1.29-2.07), or heavy (PR: 2.54; 95% CI: 2.05-3.15) workload, and with suspected COVID-19 infection (PR: 1.44; 95% CI: 1.25-1.66). Major depressive episodes were associated with a reported lack of personal protective equipment (PR: 1.20; 95% CI: 1.01-1.42), whereas suicidal ideation was inversely related to per capita income > 3 minimum monthly wages (PR: 0.28; 95% CI: 0.11-0.68), and positively related to the use of psychotropic drugs (PR: 3.14; 95% CI: 1.87-5.26). CONCLUSION Our results suggest that nursing professionals' working conditions are associated with their mental health status. The need to improve working conditions through adequate dimensioning, support and proper biosafety measures is only heightened in the context of the COVID-19 pandemic.

Prevalence of psychotropic drug use and conformity of therapeutic dose among mental health users.

OBJECTIVES: to identify the prevalence of psychotropic drug use according to their Anatomical Therapeutic Chemical classification among Psychosocial Care Center users and assess their prescription compliance based on the recommended therapeutic dose. METHODS: this is an analytical study, based on documents, from the study of 389 records between September 2017 and May 2018. Associations between the presence of underdose or overdose and participants' characteristics were assessed using the chi-square test, adopting a significant value of p <0.05. RESULTS: the most used drugs were antipsychotics (74.7%), 16.0% of users with at least one medication with a dose below the therapeutic level and another 3.6% above the recommended therapeutic dose. CONCLUSIONS: greater nonconformities in the prescribed dose were related to antihistamines, antipsychotics and antidepressants, with underdosage associated with females and overdose with the report of hearing voices.

Prevalence of psychotropic drug use and conformity of therapeutic dose among mental health users / Prevalencia del uso de psicotrópicos y cumplimiento de la dosis terapéutica entre los usuarios de salud mental / Prevalência do uso de psicotrópicos e conformidade da dose terapêutica entre usuários de saúde mental

ABSTRACT Objectives: to identify the prevalence of psychotropic drug use according to their Anatomical Therapeutic Chemical classification among Psychosocial Care Center users and assess their prescription compliance based on the recommended therapeutic dose. Methods: this is an analytical study, based on documents, from the study of 389 records between September 2017 and May 2018. Associations between the presence of underdose or overdose and participants' characteristics were assessed using the chi-square test, adopting a significant value of p <0.05. Results: the most used drugs were antipsychotics (74.7%), 16.0% of users with at least one medication with a dose below the therapeutic level and another 3.6% above the recommended therapeutic dose. Conclusions: greater nonconformities in the prescribed dose were related to antihistamines, antipsychotics and antidepressants, with underdosage associated with females and overdose with the report of hearing voices.

RESUMEN Objetivos: identificar la prevalencia del uso de psicofármacos según su clasificación Anatómica Terapéutica Química entre los usuarios de un Centro de Atención Psicosocial y evaluar el cumplimiento de su prescripción en base a la dosis terapéutica recomendada. Métodos: estudio analítico, basado en documentos, basado en el estudio de 389 historias clínicas entre septiembre de 2017 y mayo de 2018. Las asociaciones entre la presencia de subdosis o sobredosis y las características de los participantes se evaluaron mediante la prueba de chi-cuadrado valor significativo p<0,05. Resultados: los fármacos más utilizados fueron los antipsicóticos (74,7%), el 16,0% de los usuarios con al menos un medicamento con dosis por debajo del nivel terapéutico y otro 3,6% por encima de la dosis terapéutica recomendada. Conclusiones: las principales no conformidades en la dosis prescrita se relacionaron con antihistamínicos, antipsicóticos y antidepresivos, con infradosificación asociada a mujeres y sobredosis con el reporte de escuchar vocês.

RESUMO Objetivos: identificar a prevalência do uso de psicotrópicos conforme sua classificação Anatômico Terapêutico Químico entre usuários de um Centro de Atenção Psicossocial e avaliar a conformidade da prescrição dos mesmos com base na dose terapêutica recomendada. Métodos: estudo analítico, de base documental, a partir do estudo de 389 prontuários entre setembro de 2017 e maio de 2018. Associações entre a presença de subdose ou sobredose e as características dos participantes foram avaliadas por meio do teste qui-quadrado, adotando como valor significativo p <0.05. Resultados: os medicamentos mais utilizados foram os antipsicóticos (74,7%), 16,0% de usuários com pelo menos uma medicação com dose abaixo da terapêutica e outros 3,6% acima da dose terapêutica recomendada. Conclusões: maiores inconformidades na dose prescrita se relacionaram aos anti-histamínicos, os antipsicóticos e antidepressivos, com subdosagem associada ao sexo feminino e sobredose com o relato de audição de vozes.

Suspected infection, absenteeism at work and testing for COVID-19 among nursing professionals / Sospecha de infección, ausentismo laboral y pruebas de detección de COVID-19 entre profesionais de enfermería / Suspeita de infecção, abstenção no trabalho e testagem para COVID-19 entre profissionais de enfermagem

ABSTRACT Objective: to identify the occurrence of the factors associated with: (1) suspected infection by the virus that causes COVID-19; (2) absenteeism at work due to suspected infection or diagnosis of infection by the virus that causes COVID-19; and (3) performance of tests for the screening of infection by the virus that causes COVID-19 among Nursing professionals. Method: a cross-sectional study conducted with 890 nurses in June and July 2020. The associations between the outcomes and the other variables were explored using Poisson regression models with robust variance estimators. Results: occurrence of the outcomes was (1) 35.5%, (2) 16.2% and (3) 38.2%, respectively. For suspected infection, associations were observed with assessment of the working conditions as deficient (RR: 1.55; 95% CI: 1.21-1.99) and with lack of Personal Protective Equipment (RR: 1.27; 95% CI: 1.06-1.51). Absenteeism at work was associated with the adoption of moderate social distancing (RR: 1.49; 95% CI: 1.00-2.21). To perform the screening tests, the associations with links to outpatient (RR: 2.47; 95% CI: 1.52-4.01) and hospital (RR: 2.49; 95% CI: 1.60-3.89) services stood out, in addition to direct contact with patients with confirmed COVID-19 diagnoses (RR: 1.65; 95% CI: 1.33-2.05). Conclusion: despite the high occurrence of suspected infection and a considerable incidence of absenteeism at work among professionals from the various services under study, disparity in access to the screening tests was evidenced, especially with regard to the professionals who work in Primary Care.

RESUMEN Objetivo: identificar la incidencia y los factores asociados con: (1) sospecha de infección por el virus que causa COVID-19; (2) ausencia laboral debido a sospecha o diagnóstico de infección por el virus que causa COVID-19; y (3) pruebas para detectar la infección por el virus que causa COVID-19 entre profesionales de Enfermería. Método: estudio transversal realizado con 890 profesionales de Enfermería durante los meses de junio y julio de 2020. Las asociaciones entre los resultados y las demás variables se estudiaron por medio de modelos de regresión de Poisson con estimadores robustos de varianza. Resultados: la incidencia de los resultados fue: (1) 35,5%, (2) 16,2% y (3) 38,2%. Para la sospecha de infección, se observaron asociaciones con condiciones de trabajo evaluadas como deficientes (RR: 1,55; IC 95%: 1,21-1,99) y con la falta de Equipos de Protección Personal (RR: 1,27; IC 95%: 1,06-1,51). La ausencia laboral se asoció con la adopción de distanciamiento social moderado (RR: 1,49; IC 95%: 1,00-2,21). Para llevar adelante las pruebas de detección, se destacaron las asociaciones con la vinculación a servicios ambulatorios (RR: 2,47; IC 95%: 1,52-4,01) y hospitalarios (RR: 2,49; IC 95%: 1,60-3,89), además del contacto directo con pacientes con diagnósticos confirmados da COVID-19 (RR: 1,65; IC 95%: 1,33-2,05). Conclusión: pese a la elevada incidencia de sospechas de infección y una considerable cantidad de ausencias laborales entre profesionales de los diversos servicios estudiados, se evidenció cierta disparidad en el acceso a las pruebas de detección, especialmente en lo que se refiere a los profesionales de Atención Primaria.

RESUMO Objetivo: identificar a ocorrência e os fatores associados a: (1) suspeita de infecção pelo vírus causador da COVID-19; (2) abstenção no trabalho devido a suspeita ou ao diagnóstico de infecção pelo vírus causador da COVID-19 e (3) realização de testes para o rastreio de infecção pelo vírus causador da COVID-19 entre profissionais de Enfermagem. Método: estudo transversal realizado com 890 enfermeiros entre os meses de junho e julho de 2020. As associações entre os desfechos e as demais variáveis foram exploradas com a utilização de modelos de regressão de Poisson com estimadores robustos de variância. Resultados: a ocorrência dos desfechos foi de (1) 35,5%, (2) 16,2% e (3) 38,2%. Para a suspeita de infecção, foram observadas associações com a avaliação das condições de trabalho como ruins (RR: 1,55; IC 95%: 1,21-1,99) e a falta de equipamentos de proteção individual (RR: 1,27; IC 95%: 1,06-1,51). A abstenção do trabalho esteve associada com a adoção de distanciamento social moderado (RR: 1,49; IC 95%: 1,00-2,21). Para a realização de testes de rastreio, destacam-se as associações com a vinculação a serviços ambulatoriais (RR: 2,47; IC 95%: 1,52-4,01) e hospitalares (RR: 2,49; IC 95%: 1,60-3,89), além do contato direto com pacientes confirmadamente acometidos pela COVID-19 (RR: 1,65; IC 95%: 1,33-2,05). Conclusão: apesar da elevada ocorrência de suspeitas de infecção e um número considerável de abstenção do trabalho entre profissionais dos diversos serviços estudados, foi evidenciada uma disparidade no acesso aos testes de rastreio, especialmente no que se refere aos profissionais da Atenção Primária.

Gender differences in the manifestation of burden among family caregivers of people with mental disorders.

This is a cross-sectional study conducted with 537 family caregivers of people with mental disorders. The objective was to quantify the degree of burden experienced by men and women, and identify the most affected dimensions of their lives and the factors associated with burden manifestation by gender. The Zarit Burden Interview (ZBI) scale was used to assess burden. Mean burden was 22.8 points (SD = 6.3) for men and 27.8 points (SD = 17.8) for women. The most affected dimensions among the two groups were the same; however, among the 22 items on the scale, 11 presented significantly higher means among women. The factors associated with the manifestation of burden in both groups were as follows: low income; use of psychotropic drugs; greater degree of dependence of the service user; not receiving family support; and dissatisfaction with family relationships. For men, manifestation of burden was also associated with age. For women, there were further associations of the outcome with the presence of health problems, not having someone to share care with, and caring for the assisted person for >10 years. Our findings suggest that the degree of burden of family members caring for those with mental disorders is associated with gender, and this should be considered by services responsible for planning care shared by professionals and relatives. Guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE Statement) were adhered to in this study.

Craving in crack cocaine users according to individual and behavioral characteristics. / Craving em usuários de crack segundo características individuais e comportamentais.

OBJECTIVE: to analyze variation in craving levels according to individual and behavioral characteristics of crack cocaine users at two public treatment services in Pelotas, Rio Grande do Sul, Brazil. METHODS: this was a cross sectional study with a sample of 133 participants; the Cocaine Craving Questionnaire scale was used to verify craving levels. RESULTS: 86% of interviewees had moderate and severe craving levels; regarding individual factors, a higher level of severe craving was found in women (45%), those with brown skin color/"mestizos" (60%), low schooling (46%) and minor psychiatric disorders (59%); regarding behavioral factors, the level of severe craving was higher in users who divorced the last year (44%), those who had problems with the Law (61%), those who practiced violence acts (57%), those using more than four psychoactive substances (67%), and those with heavy crack consumption (57%). CONCLUSION: almost all crack users were found to have high craving levels; these were proportionally higher in some individual and behavioral variables.

Being autonomous: what do mental health services indicate? / Ser autônomo: o que os serviços de saúde mental indicam?

OBJECTIVE: To build qualitative outcome indicators in psychosocial care regarding autonomy from the perspective of users and their families. METHODOLOGY: This is an evaluative case study based on the dialectical hermeneutics theoretical framework, conducted at a mental health community service, in the state of Rio Grande do Sul, Brazil. The first stage of data collection occurred between February and July 2014, and consisted of constructing indicators based on qualitative data analysis of the two evaluative studies conducted at this same service. The second stage, between August and September 2014, consisted of validating the indicators constructed through the focus groups with nine users and nine family members. RESULTS: The users and relatives stated three qualitative indicators related to their autonomy resulting from their insertion in the service. The indicators were better self-management of income, improved everyday activities, and greater bargaining power. CONCLUSION: The methodology proved appropriate to create qualitative indicators, from the perspective of the participants, and revealed that the service helps users achieve autonomy.

Prevalência da dependência de álcool em usuários de substâncias psicoativas / Prevalence of alcohol dependence in psychoactive substances users

Objetivo: analisar a prevalência da dependência de álcool em usuários de substâncias psicoativas do município de Pelotas-Rio Grande do Sul. Metodologia: pesquisa transversal, exploratória de abordagem quantitativa, recorte da pesquisa intitulada “Perfil dos Usuários de Crack e Padrões de Uso”. A coleta dedados foi realizada entre outubro de 2011 e outubro de 2012, durante o trabalho de campo da equipe de Estratégia de Redução de Danos e no Centro de Atenção Psicossocial Álcool e Drogas no município de Pelotas.Resultados: Nos dados encontrados foi possível observar semelhança entre a prevalência segundo avaliação da dependência do álcool entre o grupo dos homens e o das mulheres, 33,4% e 31,7%, respectivamente. A idade apresentou significância estatística, sendo o grupo etário entre 30 e 49 anos, o grupo com maior prevalência(33,1%). Se observou um nível alto de dependência de álcool em 32,2% da população estudada, assim, é possível verificar que mais de um terço da população estudada faz uso frequente de álcool. Conclusão: A partir dos dados obtidos com a realização deste estudo, espera-se que seja possível contribuir para o desenvolvimento de políticas e do cuidado com os usuários de substâncias psicoativas.

Objective: to analyze the prevalence of alcohol addiction of psychoactive substance users in the city of Pelotas-Rio Grande do Sul. Methodology: transversal, exploratory research with quantitative approach, whichis also part of the research titled “Profile of Crack users and Use Patterns”. Data collection was carried out from October 2011 to October 2012, during the fieldwork of the Strategy of Harm Reduction and the Psychosocial Care Center for Alcohol and Other Drugs at Pelotas. Results: at the presented data it was possible to observe similarity among the prevalence according to the evaluation of alcohol dependence between the group of men and women, 33,4% and 31,7%, respectively. Age presented meaningful statistics results, with the age group from 30 to 49 years old the most prevalent (33,1%). It was observed a high level of alcohol addiction in 32.2% of the studied population, so it is possible to verify that more than a third of the population use alcohol. Conclusion: from the obtained study data, we hope to contribute to the development of policies and the care of psychoactive substances users.

Transtornos psiquiátricos menores em usuários de substâncias psicoativas / Minor psychiatric disorders in users of psychoactive substances / Trastornos psiquiátricos en usuarios de sustancias psicoativas

OBJETIVO: verificar a prevalência de Transtornos Psiquiátricos Menores de acordo com o perfil demográfico e socioeconômico, com o tipo de droga utilizada e com as condições de saúde dos usuários de crack, álcool e outras drogas. METODOLOGIA: estudo transversal, com amostra de 505 usuários. Utilizou-se o Self-Reporting Questionnaire para verificação da prevalência dos transtornos. RESULTADOS: a prevalência encontrada foi de 28,7%, sendo superior entre usuários de crack, mulheres, negros, divorciados ou viúvos, desempregados, entrevistados com problema de saúde, autoavaliação de saúde ruim e que estão insatisfeitos com relacionamentos familiares. CONCLUSÃO: constatou-se que a presença dos Transtornos Psiquiátricos Menores pode estar relacionada com alguns fatores que incluem não apenas as características individuas, mas também questões sociais, culturais, econômicas, entre outras.

OBJECTIVE: To verify the prevalence of Minor Psychiatric Disorders according to the demographic and socioeconomic profile, type of drug used and the health conditions of users of crack, alcohol and other drugs. METHODOLOGY: Cross-sectional study, with a sample of 505 users. The Self-Reporting Questionnaire was used to verify the prevalence of disorders. RESULTS: The prevalence found was 28.7%, higher among crack users, women, blacks, divorcees or widowers, unemployed, users with health problems, poor self-assessment of health and who are dissatisfied with family relationships. CONCLUSIONS: The presence of Minor Psychiatric Disorders may be related to some factors that include not only individual characteristics, but also social, cultural and economic issues, among others.

OBJETIVO: verificar la prevalencia de Trastornos Psiquiátricos Menores de acuerdo con el perfil demográfico y socioeconómico, con el tipo de droga utilizada y con las condiciones de salud de los usuarios de crack, alcohol, y otras drogas. METODOLOGÍA: estudio transversal, con amuestra de 505 usuarios. Se utilizó el Self-Reporting Questionnaire para verificación de prevalencia de los trastornos. RESULTADOS: la prevalencia encontrada fue de 28,7%, siendo superior entre usuarios de crack, mujeres, negros, divorciados o viudos, desempleados, entrevistados con problemas de salud, mala autoevaluación de salud, y que están insatisfechos con relacionamientos familiares. CONCLUSIÓN: constatado que la presencia de los trastornos psiquiátricos menores puede estar relacionada con algunos factores que incluyen no solamente las características individuales, pero también cuestiones sociales, culturales, económicas, entre otras.

Ser autônomo: o que os serviços de saúde mental indicam? / Ser autónomo: ¿qué indican los servicios de salud mental? / Being autonomous: what do mental health services indicate?

Resumo OBJETIVO Construir indicadores qualitativos de resultado na Atenção Psicossocial relacionados à autonomia na perspectiva dos usuários e familiares. MÉTODO Estudo de caso avaliativo, com referencial teórico hermenêutico-dialético em um Centro de Atenção Psicossocial no Rio Grande do Sul, Brasil. A primeira etapa da coleta de dados, fevereiro-julho/2014, consistiu na construção de indicadores a partir da análise dos dados qualitativos de duas pesquisas avaliativas neste mesmo serviço. A segunda etapa, agosto-setembro/2014, validou os indicadores construídos por meio de grupos focais com nove usuários e nove familiares. RESULTADO Os participantes apontaram três indicadores qualitativos relacionados à sua autonomia como resultado da inserção no serviço, sendo eles, melhora na autogestão da renda, melhor desenvolvimento das atividades do cotidiano e maior poder de negociação. CONCLUSÃO A metodologia utilizada mostrou-se adequada para criação de indicadores qualitativos na perspectiva de usuários e familiares, bem como apontou que o serviço auxilia no processo de conquista da autonomia.

Resumen OBJETIVO Construir indicador cualitativo de resultado en la Atención Psicosocial relacionado con la autonomía desde la perspectiva de los usuarios y familias. METODOLOGÍA Estudio de caso evaluativo, realizado en un Centro de Atención Psicosocial del Rio Grande do Sul, Brasil. La primera etapa de recopilación de datos, febrero-julio/2014, consistió en la construcción de indicadores a partir del análisis de los datos cualitativos a partir de dos investigaciones de evaluación en este mismo servicio. La segunda etapa, agosto-septiembre/2014, validó los indicadores construidos a través de grupos focales con nueve miembros y nueve familiares. RESULTADOS Los usuarios y familias mostraron tres indicadores cualitativos relacionados con su autonomía como consecuencia de la entrada en lo servicio: mejora de la auto-gestión de los ingresos, mejor desarrollo de las actividades diarias y aumento de la capacidad de negociación. CONCLUSIÓN Lo servicio ayuda en el proceso de desarrollo de la autonomía.

Abstract OBJECTIVE To build qualitative outcome indicators in psychosocial care regarding autonomy from the perspective of users and their families. METHODOLOGY This is an evaluative case study based on the dialectical hermeneutics theoretical framework, conducted at a mental health community service, in the state of Rio Grande do Sul, Brazil. The first stage of data collection occurred between February and July 2014, and consisted of constructing indicators based on qualitative data analysis of the two evaluative studies conducted at this same service. The second stage, between August and September 2014, consisted of validating the indicators constructed through the focus groups with nine users and nine family members. RESULTS The users and relatives stated three qualitative indicators related to their autonomy resulting from their insertion in the service. The indicators were better self-management of income, improved everyday activities, and greater bargaining power. CONCLUSION The methodology proved appropriate to create qualitative indicators, from the perspective of the participants, and revealed that the service helps users achieve autonomy.

Fatores associados a uma pior avaliação da qualidade de vida entre familiares cuidadores de usuários de Centros de Atenção Psicossocial / Factors associated with worst quality of life assessment among family caregivers of users from Psychosocial Care Centers

Resumo Introdução A identificação dos fatores associados a uma pior avaliação da qualidade de vida dos familiares cuidadores em saúde mental pode constituir uma estratégia importante para o estabelecimento de ações de acompanhamento e de suporte desses sujeitos. Objetivo Este estudo buscou identificar quais os fatores associados a uma pior avaliação da qualidade de vida entre 1.242 familiares cuidadores de usuários de 40 Centros de Atenção Psicossocial (CAPS) localizados no Sul do Brasil. Métodos Para análise, munindo-se de um modelo teórico hierarquizado, utilizou-se a regressão logística com o cálculo das razões de odds ajustadas. Resultados Os fatores associados a uma pior avaliação da qualidade de vida foram: escolaridade, facilidade de acesso aos CAPS, eficácia dos CAPS, apoio dos CAPS na sobrecarga, divisão das atividades do cuidado, problema de saúde, relação com a família e sentimento de sobrecarga. Conclusão Ao considerar a gama de aspectos relacionados ao serviço que estiveram associados ao desfecho, este estudo entende que os CAPS exercem um papel importante na vida dos familiares cuidadores a eles vinculados, influenciando significativamente em sua qualidade de vida.

Abstract Introduction The identification of the factors associated with a worse assessment of the quality of life among family caregivers in mental health can be an important strategy for establishing follow-up and support actions to the subjects. Objective This study aims to identify the factors associated with worse assessment of quality of life among 1242 family caregivers of users from 40 Psychosocial Care Centers located in southern Brazil. Methods We used a logistic regression analysis based in a hierarchical theoretical model to calculate the adjusted odds ratios. Results Factors associated with worse assessment of quality of life were: education; access the Psychosocial Care Center; effectiveness of Psychosocial Care Center; Psychosocial Care Center support in cases of burden; share of care activities; health problem; family relationship and feeling of burden. Conclusion Considering the range of issues related to service that were associated with the outcome, this study highlight the prospect that the Psychosocial Care Centers play an important role in the lives of family caregivers, significantly influencing their quality of life.

Avaliação da aceitabilidade do usuário/família sobre a estratégia saúde da família / Evaluation of family health strategy acceptability by the user/family

O objetivo deste estudo foi avaliar a aceitabilidade do usuário/família sobre a Estratégia Saúde da Família (ESF). Realizou-se um estudo avaliativo de abordagem quantitativa em uma Unidade de Saúde da Família onde foram entrevistados 217 usuários, durante o mês de novembro de 2007. Para análise dos resultados utilizou-se o SPSS® for Windows, Versão 11.0. Identificou-se uma população adulta com idade média de 41 anos, com baixa escolaridade e com maior proporção de mulheres. A maioria dos usuários está satisfeita com a informação recebida sobre a doença, o tratamento, a forma de obter a ficha, o tempo dedicado à consulta e de espera para o atendimento. Todos profissionais da equipe receberam nota maior que sete. Identificou-se que a maioria dos usuários aceita a ESF, sugerindo que esta estratégia apresenta potencialidades para qualificar a atenção primária à saúde. Entretanto, os problemas estruturais da unidade foram os mais apontados pelos participantes.

The objective of this study was to evaluate the acceptability of the Family Health Strategy (FHS) by the user/family. We did an evaluative study with a quantitative approach at a Family Health Unit, where 217 users were interviewed during the month of November 2007. SPSS® for Windows, Version 11.0, was used to analyze the results. We identified an adult population with a mean age of 41 years, with low education levels, and with a higher proportion of women. Most users are satisfied with the information they have received about: disease, treatment, how to get an appointment, the time spent during consultations and in waiting to be seen. All the professional staff received grades higher than seven. It was found that most users accept the FHS, suggesting that this strategy has the potential to qualify the health care service in primary care. However, the unit's structural problems were those most often mentioned by the participants.

Indicadores qualitativos de satisfação em saúde mental / Qualitative indicators of satisfaction in mental health

RESUMO Este artigo objetivou construir indicadores qualitativos de resultado relacionados com a satisfação na perspectiva dos usuários e familiares. Estudo de caso avaliativo, participativo, hermenêutico-dialético, realizado em um Centro de Atenção Psicossocial no Rio Grande do Sul, com usuários e familiares em grupos focais para discussão, negociação e validação de indicadores qualitativos em 2014. Identificaram-se dois indicadores qualitativos de satisfação, sendo estes: a não internação psiquiátrica ou menor necessidade desta; sentimento ou sensação de bem-estar. Conclui-se que usuários e familiares apresentam-se satisfeitos com a práxis do Centro de Atenção Psicossocial estudado.

ABSTRACT This article aimed to build outcome qualitative indicators related to satisfaction from the perspective of users and relatives. Evaluative case study, participatory, hermeneutic-dialectical, performed in a Psychosocial Care Center, in Rio Grande do Sul, with users and relatives in focal groups for discussion, negotiation and validation of qualitative indicators in 2014. We identified two qualitative indicators of satisfaction: non-psychiatric hospitalization or less need of it; the feeling or sense of well being. It was concluded that users and relatives presented satisfaction with the praxis from the Psychosocial Care Center studied.

Fatores associados à fissura em usuários de crack: revisão sistemática / Factors associated with craving in crack users: systematic review / Los factores asociados con la ansia en los consumidores de crack: revisión sistemática

OBJETIVO: identificar publicações relacionadas à influência dos fatores associados à variação dos níveis de fissura em usuários de crack. METODOLOGIA: revisão de literatura sistemática, em que se rastreou estudos publicados no Brasil e exterior. As bases de dados utilizadas foram Publisher Medline, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scientific Electronic Library. RESULTADOS: foram selecionados nove artigos, após a utilização dos critérios de inclusão e exclusão. Os fatores associados observados estão relacionados ao padrão de uso do crack, relações familiares, atividade profissional, utilização de outras substâncias, estratégias de redução de danos e ansiedade. CONCLUSÃO: acredita-se que a fissura pode interferir no consumo abusivo de crack e, assim, ocasionar diversos problemas tanto de ordem social como de saúde.

OBJECTIVE: to identify publications related to the influence of the factors associated with the variation in the levels of craving in crack users. METHOD: systematic literature review in which studies published in Brazil and abroad were screened. The databases used were Publisher Medline, Literatura Latino-Americana e do Caribe em Ciências da Saúde and Scientific Electronic Library Online. RESULTS: nine articles were selected, after the use of the inclusion and exclusion criteria. The associated factors observed are related to the pattern of crack use, family relationships, professional activity, use of other substances, damage reduction strategies and anxiety. CONCLUSION: craving can interfere in crack abuse and thus cause different social and health problems.

Objetivo: Identificar publicaciones relacionadas con la influencia de los factores asociados con la variación de los niveles de ansia en los consumidores de crack. Métodos: Una revisión sistemática de la literatura que rastreó los estudios publicados en Brasil y en el extranjero. Las bases de datos utilizadas fueron Publisher Medline, América Latina y el Caribe en Ciencias de la Salud y Scientific Electronic Library. Resultados: Se seleccionaron nueve artículos después del uso de los criterios de inclusión y exclusión. Los factores asociados observados en los estudios se relacionan a lo comportamiento de lo consumo de crack, las relaciones familiares, la ocupación, el uso de otras sustancias, estrategias de reducción de daños y la ansiedad. Conclusión: La ansia puede causar el consumo excesivo de crack y por lo tanto causar muchos problemas tanto sociales cuanto de salud.