Instrumentos de avaliação e autoavaliação da fala em público: uma revisão integrativa da literatura / Public speaking assessment and self-assessment instruments: an integrative literature review

RESUMO Objetivo revisar e descrever os estudos que utilizaram instrumentos para avaliar e autoavaliar a fala em público de indivíduos adultos, no período de 2011 a 2020. Estratégia de pesquisa trata-se de uma revisão integrativa da literatura. A busca dos estudos ocorreu nas bases de dados SciELO, PubMed e Biblioteca Virtual em Saúde, que abrange as bases de dados MEDLINE e LILACS. A questão norteadora desta revisão foi: "Quais os tipos, aspectos avaliados e categorias de resposta dos instrumentos que avaliaram a fala em público de indivíduos adultos nos últimos dez anos?". Critérios de seleção Foram selecionados artigos originais, disponíveis na íntegra, publicados nos últimos dez anos, nos idiomas português, inglês ou espanhol, que apresentassem instrumentos de avaliação da fala em público, em adultos. Foram excluídos da revisão teses, dissertações, monografias, anais de congressos, estudos com análise do discurso e artigos de revisão de literatura. Resultados foram localizados 2539 artigos, dos quais 21 foram incluídos nesta revisão. A maioria dos estudos foi desenvolvida no Brasil, realizada com universitários e utilizou instrumentos de autoavaliação para investigar a fala em público. Conclusão os instrumentos de investigação para avaliação da fala em público são distintos e não há padronização conceitual dos aspectos avaliativos e das categorias de respostas. Nos instrumentos de autoavaliação, os aspectos mais avaliados são ansiedade ao falar em público, voz, velocidade de fala, competência comunicativa, pitch, articulação e loudness. Nos instrumentos de avaliação, os aspectos avaliativos mais abordados são voz, velocidade de fala, articulação, pausas, loudness, pitch e gestos.

ABSTRACT Purpose To review and describe studies that used assessment and selfassessment instruments, investigating public speaking by adults from 2011 to 2020. Research strategy: This was an integrative literature review. Studies were searched on SciELO, PubMed and Virtual Health Library databases, which included databases from MEDLINE and LILACS. This study proposed to answer the following question: What kind of instruments assessed public speaking by adults over the last 10 years? Selection criteria Original articles that presented instruments for assessing public speaking by adults were selected. The articles were available in full format and published over the last 10 years in English, Portuguese, or Spanish. Theses, dissertations, monographs, conference proceedings, studies with discourse analysis and literature review articles were excluded from the review. Results A total of 2,539 articles were found, of which 21 were included in this review. Most of the studies were from Brazil carried out by college students. Studies included self-assessment instruments to investigate public speaking. Conclusion The investigation instruments used to assess public speaking were all different (from each other) and there was no assessment or conceptual response category standardization. The most self-assessed aspects were public speaking anxiety, voice, speech rate, communicative competence, pitch, articulation, and loudness. The most addressed aspects in the assessment instruments were voice, speech rate, articulation, pauses, loudness, pitch, and gestures.

Binge Drinking Among Public Sector Food Service Workers in Brazil: Physical and Psychosocial Demands on Focus.

OBJECTIVE: To investigate occupational risk factors associated with binge drinking (BD) among public sector food service workers in a Brazilian capital. METHODS: All workers from the Government-backed Economy Restaurant Program (GbERP) in Belo Horizonte city were evaluated. BD was defined as consumption of five or more doses (male) or four or more doses (female) of alcoholic beverages on a single occasion within 30 days. Occupational psychosocial and physical stressors were the main exposure variables; sociodemographic, health, and lifestyle variables were inserted as potential confounding factors. We performed logistic regression. RESULTS: A total of 214 people participated in the study and 30.7% reported BD. Psychosocial (violence and high demands) and ergonomic aspects were associated with the outcome. CONCLUSION: There was a high prevalence of BD among GbERP workers. Actions are necessary to reduce violence and high strain and consequently BD.

Burden and Protection: Heterogeneous Effects of Occupational and Operational Stressors on Burnout Dimensions Among Firefighters.

OBJECTIVE: To investigate the association between occupational stressors and Burnout dimensions among Brazilian firefighters. METHOD: A cross-sectional study about firefighters (n = 237) was developed in Fortaleza, Northeast of Brazil. Logistic regression analysis was applied to investigate the association between high strain (high demand and low job control), low social support, high operational exposure, and Burnout dimensions (emotional exhaustion, depersonalization, and low personal accomplishment). RESULTS: High strain was associated to emotional exhaustion (odds ratio [OR] = 11.65; 95% confidence interval [CI]: 3.92 to 34.60) and depersonalization (OR = 5.43; 95% CI: 2.03 to 14.58). Low social support was associated to emotional exhaustion (OR = 2.86; 95% CI: 1.24 to 6.60) and low personal accomplishment (OR = 2.59; 95% CI: 1.36 to 4.93). High operational exposure did not increase the odds of emotional exhaustion and depersonalization and decreased the odds of low personal accomplishment (OR = 0.31; 95% CI: 0.10 to 0.94). CONCLUSION: The study highlights the heterogeneous effects that operational and organisational stressors have on each dimension of Burnout.

Work-related factors in the etiology of symptoms of post-traumatic stress among first responders: the Brazilian Firefighters Longitudinal Health Study (FLoHS).

Two important aspects must be accounted for when discussing the mental health of first responders and, in particular, their report of post-traumatic stress symptoms (PTSS). The first concerns the provision of quantitative data from longitudinal study designs, the second concerns the sophistication of the work-related model used to frame such studies. This is a report on the development of a model for Brazilian firefighters who also work as first responders, from the establishment of a longitudinal panel design study, the Brazilian Firefighter Longitudinal Health Study (FLoHS). The first objective was to compare trainee and active firefighters based on their follow-up data with a nationwide sample of similarly aged Brazilians. The second was to test the effect that operational and organizational experiences had on firefighters' PTSS level during follow up. At baseline, trainee firefighters came from higher socioeconomic backgrounds, were healthier and less exposed to trauma compared to a similarly aged national sample. At follow up, they reported higher prevalence of smoking, sleep problems, anhedonia and were more likely to be overweight. PTSS was predicted by operational and organizational stressors, even when controlled for health status at baseline. The results present not only the differences in the predictive status of operational and organizational events in relation to PTSS, but also how the effects of such events might interact. The data suggest the need for evidence-based interventions, support provided and changes at work environments to improve report rates for mental health in general and for PTSS in particular.

Work-related factors in the etiology of symptoms of post-traumatic stress among first responders: the Brazilian Firefighters Longitudinal Health Study (FLoHS) / Fatores relacionados ao trabalho na etiologia de sintomas de estresse pós-traumático entre socorristas: o Estudo Longitudinal de Saúde em Bombeiros Brasileiros (FLoHS) / Factores laborales relacionados con la etiología de síntomas de estrés postraumático entre trabajadores de primeros auxilios: el Estudio Longitudinal de Salud en Bomberos Brasileños (FLoHS)

Abstract: Two important aspects must be accounted for when discussing the mental health of first responders and, in particular, their report of post-traumatic stress symptoms (PTSS). The first concerns the provision of quantitative data from longitudinal study designs, the second concerns the sophistication of the work-related model used to frame such studies. This is a report on the development of a model for Brazilian firefighters who also work as first responders, from the establishment of a longitudinal panel design study, the Brazilian Firefighter Longitudinal Health Study (FLoHS). The first objective was to compare trainee and active firefighters based on their follow-up data with a nationwide sample of similarly aged Brazilians. The second was to test the effect that operational and organizational experiences had on firefighters' PTSS level during follow up. At baseline, trainee firefighters came from higher socioeconomic backgrounds, were healthier and less exposed to trauma compared to a similarly aged national sample. At follow up, they reported higher prevalence of smoking, sleep problems, anhedonia and were more likely to be overweight. PTSS was predicted by operational and organizational stressors, even when controlled for health status at baseline. The results present not only the differences in the predictive status of operational and organizational events in relation to PTSS, but also how the effects of such events might interact. The data suggest the need for evidence-based interventions, support provided and changes at work environments to improve report rates for mental health in general and for PTSS in particular.

Resumo: Há duas questões subjacentes importantes na saúde mental dos socorristas, e particularmente em seu relato de sintomas de transtorno de estresse pós-traumático (TEPT). A primeira diz respeito à produção de dados quantitativos a partir do delineamento de estudos longitudinais, e a segunda está relacionada à sofisticação do modelo relacionado ao trabalho para contextualizar tais estudos. O artigo aborda o desenvolvimento de um modelo para bombeiros brasileiros, que também são socorristas, através do estabelecimento de um estudo com delineamento de painel longitudinal, chamado Estudo Longitudinal de Saúde em Bombeiros Brasileiros (FLoHS). O primeiro objetivo foi a comparação de bombeiros estagiários versus efetivados com base em dados de seguimento com uma amostra nacional de brasileiros com idades semelhantes. O segundo objetivo foi testar o efeito das experiências operacionais e organizacionais sobre os níveis de sintomas de TEPT nos bombeiros durante o seguimento. Na linha de base, os bombeiros estagiários vinham de origens socioeconômicas mais favoráveis e eram mais saudáveis e menos expostos a trauma, em comparação com uma amostra nacional da população com idade semelhante. No seguimento, os estagiários relatavam maior prevalência de tabagismo, problemas de sono, anedonia e maior sobrepeso. Os sintomas de TEPT eram previstos por estressores operacionais e organizacionais, mesmo despois de controlar para o estado de saúde na linha de base. Os resultados apontaram não apenas para diferenças no estado preditivo dos eventos operacionais e organizacionais em relação aos sintomas de TEPT, como também, para a maneira pela qual esses eventos podem interagir em termos de efeitos. Assim, os dados sugerem intervenções baseadas em evidências, apoio através do trabalho e organização do trabalho que possam melhorar as taxas de notificação para saúde mental em geral e sintomas de TEPT em particular.

Resumen: Existen dos importantes temas subyacentes a la salud mental de los trabajadores de primeros auxilios y, uno en particular, es la manifestación de síntomas de estrés postraumático (PTSS). El primero está relacionado con la provisión de datos cuantitativos, procedentes de estudios de diseños longitudinales, y, el segundo, con la sofisticación según el modelo de trabajo usado para enmarcar tales estudios. Este trabajo informó del desarrollo de un modelo para los bomberos brasileños, que también son trabajadores de primeros auxilios, mediante el establecimiento de un estudio de diseño longitudinal: el Estudio Longitudinal de Salud en Bomberos Brasileños (FloHS). El primer objetivo fue comparar bomberos entrenados y activos, basándonos en sus datos de seguimiento, con una muestra nacional de brasileños en edades similares. El segundo objetivo fue probar el efecto que las experiencias operacionales y organizativas tuvieron en el nivel de PTSS entre los bomberos durante el seguimiento. En la base de referencia, los bomberos entrenados contaban con antecedentes socioeconómicos más altos, estaban más sanos y menos expuestos al trauma, cuando se comparan con una muestra nacional de población en edad similar. Durante el seguimiento, informaron de una prevalencia más alta de fumadores, problemas de sueño, anhedonia y tenían más probabilidad de tener sobrepeso. Los PTSS se predijeron mediante estresores operacionales y organizativos, incluso controlando el estatus de salud en la base de referencia. Los resultados apuntaron no solo las diferencias en el estatus predictivo de eventos operacionales y organizativos, en relación con PTSS, sino también la forma en la que tal vez tales eventos interactúan en sus efectos. De este modo, los datos animan intervenciones basadas en la evidencia, además de apoyo mediante el trabajo y diseño de intervenciones, que tal vez mejore las tasas de informes para la salud mental en general y para los PTSS en particular.

Crescimento pós-traumático em profissionais de emergências: uma revisão sistemática de estudos observacionais / Posttraumatic growth among emergency workers: a systematic review of observational studies / Crecimiento post-traumático en profesionales de servicios de urgencia: una revisión sistemática de estudios observacionales

A exposição a eventos traumáticos pode gerar Crescimento Pós-Traumático (CPT). O objetivo do presente estudo foi realizar uma revisão sistemática das publicações sobre prevalência de CPT e sua associação com estressores ocupacionais entre profissionais de emergências. A revisão foi baseada no método PRISMA e previamente registrada no PROSPERO. A busca foi realizada nas bases de dados Medical Literature Analysis and Retrieval System Online (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (ScIELO). Dentre os resultados, não foi possível identificar a prevalência de CPT. Estressores operacionais foram associados ao CPT. Estressores organizacionais foram raramente investigados. Concluiu-se que o CPT é um dos focos em estudos sobre reações pós-traumáticas entre profissionais de emergências e está associado a estressores ocupacionais. Por isso, trata-se de um construto importante para compreender a saúde mental desses profissionais, dada a organização e a natureza de suas tarefas no trabalho. (AU)

Exposure to traumatic events can lead to Posttraumatic Growth (PTG). The present study aimed to was to conduct a systematic review of publications on the prevalence of PTG and its association with occupational stressors among emergency professionals. The review was based on the PRISMA method and previously registered in PROSPERO. The search was conducted in following eletronic databases: Medical Literature Analysis and Retrieval System Online (Mediline), Latin American and Caribbean Literature in Health Sciences (Lilacs), and Scientific Electronic Library Online (Scielo). It was not possible to identify the prevalence of The prevalence of PTG was not identified among emergency professionals. Operational stressors were associated with to PTG. Organizational stressors were rarely investigated. We concluded that PTG is one of the focuses in studies on post-traumatic reactions among emergency professionals and it is associated with occupational stressors. Therefore, it is an important construct to understand the mental health of these professionals given the organization and the nature of their occupational tasks. (AU)

La exposición a eventos traumáticos puede generar Crecimiento Post-Traumático (CPT). El objetivo del presente estudio fue realizar una revisión sistemática de las publicaciones sobre predominio del CPT y su asociación con estresores ocupacionales entre profesionales de servicios de urgencia. La revisión fue basada en el método PRISMA y previamente registrada en el PROSPERO. La búsqueda se llevó a cabo en las bases de datos de Medical Literature Analysis and Retrieval System Online (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (Scielo). Entre los resultados, no fue posible identificar el predominio del CPT. Estresores operativos se asociaron con el CPT y estresores organizacionales fueron raramente investigados. Se concluyó que el CPT es el foco principal en los estudios sobre reacciones postraumáticas entre los profesionales de servicios de urgencia y está asociado a estresores ocupacionales. Por eso, se trata de un constructo importante para comprender la salud mental de esos profesionales dada la organización y la naturaleza de sus tareas en el trabajo. (AU)

Baixas na linha de frente: absenteísmo entre bombeiros durante o combate à pandemia da COVID-19 / Frontline losses: absenteeism among firefighters during the fight against the COVID-19 pandemic

Resumo Objetivos: descrever o absenteísmo relacionado a casos suspeitos (com infecção respiratória aguda) e confirmados da COVID-19 e a outros diagnósticos entre bombeiros de Minas Gerais, Brasil. Métodos: foram analisados os registros oficiais sobre afastamento do trabalho por problemas de saúde (licença-saúde). A análise foi organizada em: 1) gráficos estratificados por grupo de diagnóstico; 2) análises descritivas da proporção de licenças-saúde e do percentual de dias de trabalho perdidos por infecção respiratória aguda; 3) comparação (qui-quadrado) da proporção de licenças-saúde e do percentual de dias de trabalho perdidos por infecção respiratória aguda e por outros diagnósticos entre 2019 e 2020. Resultados: a análise gráfica mostrou um padrão regular de licenças-saúde antes do início da pandemia, um pico de licenças-saúde por infecção respiratória aguda após o início da pandemia e um novo padrão de licenças-saúde após o período de pico. A proporção de licenças-saúde e o percentual de dias de trabalho perdidos por infecção respiratória aguda aumentaram, respectivamente, 312% e 580% em 2020. Em contraste, o percentual de dias de trabalho perdidos por outros diagnósticos diminuiu 16%. Conclusão: a mudança no perfil de absenteísmo entre bombeiros reflete o vínculo formal de emprego, as políticas institucionais e a percepção de risco sobre a COVID-19.

Abstract Objectives: to describe absenteeism related to suspected (acute respiratory infection cases) and confirmed cases of COVID-19 and other diagnoses among firefighters in Minas Gerais, Brazil. Methods: we analyzed official records of sick leave due to health problems. The analysis was organized into: 1) graphs stratified by diagnostic group; 2) descriptive analyses of proportion of sick leave and percentage of working days lost due to acute respiratory infection; Chi-squared comparison of proportion of sick leave and percentage of working days lost due to acute respiratory infection, and other diagnoses, between 2019 and 2020. Results: the graphical analysis showed a regular sick leave pattern before the onset of the pandemic, a peak in sick leave due to acute respiratory infection after the onset of the pandemic, and a new sick leave pattern after the peak period. The proportion of sick leave and the percentage of working days lost due to acute respiratory infection increased by 312% and 580% in 2020, respectively. In contrast, the percentage of working days lost due to other diagnoses decreased by 16%. Conclusion: the change in the absenteeism profile among firefighters reflects formal employment contract, institutional policies and risk perception about COVID-19.

Prevalence and factors associated with fear of public speaking. / Prevalência e fatores associados ao medo de falar público.

PURPOSE: To identify the prevalence of fear of public speaking and verify its association with sociodemographic variables, self-perception of voice, speech, and oral communication skills in public. METHODS: A cross-sectional and analytical study with 1,124 university students was carried out. An online questionnaire addressed was performed, considering factors as sociodemographic characteristics; fear of speaking; Scale for Self-Assessment When Speaking in Public (SSPS), self-perception of the voice, the ability to grasp, and keep the listener's attention and influence another. RESULTS: The fear of public speaking was prevalent in undergraduate students. There was an association of the fear of speaking with the vocal self-perception, with the ability to capture and keep the listener's attention and to influence another with their communication. Individuals who have the ability to capture and maintain the attention of the interlocutor are more likely to be afraid of public speaking than the undergraduate students who perceive themselves as having the ability to influence the listener with their communication. CONCLUSION: The more communicative skills and more persuasive the individual perceives his or her self, the less likely he or she is to be affected by the fear of speaking.

OBJETIVO: identificar a prevalência do medo de falar em público e verificar sua associação com as variáveis sociodemográficas, autopercepção da voz, fala e habilidades de comunicação oral em público. MÉTODO: estudo transversal analítico com 1124 universitários. Um questionário online abordou características sociodemográficas, medo de falar, autoavaliação da fala em público por meio da Escala para Autoavaliação ao Falar em Público (SSPS), autopercepção da voz, da capacidade de captar e manter a atenção do ouvinte e de influenciar o outro. RESULTADOS: o medo de falar em público foi muito prevalente nos universitários. Houve associação do medo de falar com a autopercepção vocal, com a capacidade de captar e manter a atenção do ouvinte e influenciar o outro com a sua comunicação. Indivíduos que autorrelataram capacidade de captar e manter a atenção do interlocutor apresentaram maior chance de manifestar medo de falar em público em relação aos universitários que se autoperceberam como capazes de influenciar o ouvinte com a sua comunicação. CONCLUSÃO: quanto mais habilidades comunicativas e mais persuasivo o indivíduo se percebe, menores as chances de ele ser acometido pelo medo de falar em público.

Translation and cross-cultural adaptation of the International Trauma Questionnaire for use in Brazilian Portuguese.

BACKGROUND: The most recent editions of diagnostic manuals have proposed important modifications in posttraumatic stress disorder (PTSD) criteria. The International Trauma Questionnaire (ITQ) is the gold-standard measurement for assessing PTSD and complex PTSD in accordance with the model of the 11th International Classification of Diseases (ICD-11). OBJECTIVE: The aim of this study was to adapt the ITQ for the Brazilian context. DESIGN AND SETTING: The translation and cross-cultural adaptation of the ITQ for use in Brazilian Portuguese was performed in trauma research facilities in Porto Alegre, Rio de Janeiro and Belo Horizonte, Brazil. METHODS: The adaptation followed five steps: (1) translation; (2) committee synthesis; (3) experts' evaluation through the content validity index (CVI) and assessment of interrater agreement though kappa statistics; (4) comprehension test with clinical and community samples (n = 35); and (5) final back-translation and authors' evaluation. RESULTS: Two independent translations were conducted. While working on a synthesis of these translations, the committee proposed changes in six items to adapt idiomatic expressions or to achieve a more accurate technical fit. Both the expert judges' evaluation (CVI > 0.7; k > 0.55) and the pretest in the target population (mean comprehension > 3) indicated that the adapted items were adequate and comprehensible. The final back-translation was approved by the authors of the original instrument. CONCLUSION: ITQ in its Brazilian Portuguese version achieved satisfactory content validity, thus providing a tool for Brazilian research based on PTSD models of the ICD-11.

[Overview of Occupational Surveys in Brazil (2005-2015): a systematic review of the literature]. / Panorama dos Inquéritos Ocupacionais no Brasil (2005-2015):uma revisão sistemática da literatura.

Occupational Surveys are methods of collecting data from the cross-sectional studies, which are indispensable for the elaboration of public policies oriented to workers' health. The objective of this study was to perform a systematic review on articles that featured results of Occupational Surveys conducted in Brazil from 2005 to 2015. Based on the Prisma recommendation, this review selected articles indexed in Medline, Lilacs and Scielo databases. Analysis of the data consisted of the description of the Occupational Surveys according to: large regions in which the research was carried out; techniques and instruments used; topics covered; sectors of the economy in which health-work relations were investigated; and methodological criteria. Differences in the distribution of Occupational Surveys were observed regionally and by sector. The structure of the investigations, for the most part, was concerned with identifying sickness in workers. A lack of consensus regarding the methods used was revealed, which consequently prejudiced the comparison of results and monitoring of health and working conditions. Efforts are needed to build consensus and foster research in sectors and regions that are as yet scantly explored.

Inquéritos Ocupacionais são métodos de coleta de dados dos estudos transversais indispensáveis à elaboração de políticas públicas voltadas à saúde do trabalhador. O objetivo deste estudo foi realizar uma revisão sistemática sobre artigos que retratavam resultados de Inquéritos Ocupacionais conduzidos no Brasil, no período de 2005 a 2015. Baseada na recomendação Prisma, esta revisão selecionou artigos indexados em base de dados Medline, Lilacs e SciELO. A análise dos dados consistiu na descrição dos Inquéritos Ocupacionais de acordo com: grandes regiões nas quais as pesquisas foram realizadas, técnicas e instrumentos utilizados, temas abordados, setores da economia nos quais as relações saúde-trabalho foram investigadas e critérios metodológicos. Observou-se diferenças na distribuição dos Inquéritos Ocupacionais regional e setorialmente. A estrutura das investigações, em sua maioria, se interessava em identificar adoecimento em trabalhadores. Ausência de consenso no tocante aos métodos utilizados foi observada com prejuízos para a comparação de resultados e monitoramento da saúde e condições de trabalho. Esforços são necessários para a elaboração de consensos e fomento à pesquisa em setores e regiões ainda pouco exploradas.

Panorama dos Inquéritos Ocupacionais no Brasil (2005-2015): uma revisão sistemática da literatura / Overview of Occupational Surveys in Brazil (2005-2015): a systematic review of the literature

Resumo Inquéritos Ocupacionais são métodos de coleta de dados dos estudos transversais indispensáveis à elaboração de políticas públicas voltadas à saúde do trabalhador. O objetivo deste estudo foi realizar uma revisão sistemática sobre artigos que retratavam resultados de Inquéritos Ocupacionais conduzidos no Brasil, no período de 2005 a 2015. Baseada na recomendação Prisma, esta revisão selecionou artigos indexados em base de dados Medline, Lilacs e SciELO. A análise dos dados consistiu na descrição dos Inquéritos Ocupacionais de acordo com: grandes regiões nas quais as pesquisas foram realizadas, técnicas e instrumentos utilizados, temas abordados, setores da economia nos quais as relações saúde-trabalho foram investigadas e critérios metodológicos. Observou-se diferenças na distribuição dos Inquéritos Ocupacionais regional e setorialmente. A estrutura das investigações, em sua maioria, se interessava em identificar adoecimento em trabalhadores. Ausência de consenso no tocante aos métodos utilizados foi observada com prejuízos para a comparação de resultados e monitoramento da saúde e condições de trabalho. Esforços são necessários para a elaboração de consensos e fomento à pesquisa em setores e regiões ainda pouco exploradas.

Abstract Occupational Surveys are methods of collecting data from the cross-sectional studies, which are indispensable for the elaboration of public policies oriented to workers' health. The objective of this study was to perform a systematic review on articles that featured results of Occupational Surveys conducted in Brazil from 2005 to 2015. Based on the Prisma recommendation, this review selected articles indexed in Medline, Lilacs and Scielo databases. Analysis of the data consisted of the description of the Occupational Surveys according to: large regions in which the research was carried out; techniques and instruments used; topics covered; sectors of the economy in which health-work relations were investigated; and methodological criteria. Differences in the distribution of Occupational Surveys were observed regionally and by sector. The structure of the investigations, for the most part, was concerned with identifying sickness in workers. A lack of consensus regarding the methods used was revealed, which consequently prejudiced the comparison of results and monitoring of health and working conditions. Efforts are needed to build consensus and foster research in sectors and regions that are as yet scantly explored.

Translation and cross-cultural adaptation of the International Trauma Questionnaire for use in Brazilian Portuguese

ABSTRACT BACKGROUND: The most recent editions of diagnostic manuals have proposed important modifications in posttraumatic stress disorder (PTSD) criteria. The International Trauma Questionnaire (ITQ) is the gold-standard measurement for assessing PTSD and complex PTSD in accordance with the model of the 11th International Classification of Diseases (ICD-11). OBJECTIVE: The aim of this study was to adapt the ITQ for the Brazilian context. DESIGN AND SETTING: The translation and cross-cultural adaptation of the ITQ for use in Brazilian Portuguese was performed in trauma research facilities in Porto Alegre, Rio de Janeiro and Belo Horizonte, Brazil. METHODS: The adaptation followed five steps: (1) translation; (2) committee synthesis; (3) experts' evaluation through the content validity index (CVI) and assessment of interrater agreement though kappa statistics; (4) comprehension test with clinical and community samples (n = 35); and (5) final back-translation and authors' evaluation. RESULTS: Two independent translations were conducted. While working on a synthesis of these translations, the committee proposed changes in six items to adapt idiomatic expressions or to achieve a more accurate technical fit. Both the expert judges' evaluation (CVI > 0.7; k > 0.55) and the pretest in the target population (mean comprehension > 3) indicated that the adapted items were adequate and comprehensible. The final back-translation was approved by the authors of the original instrument. CONCLUSION: ITQ in its Brazilian Portuguese version achieved satisfactory content validity, thus providing a tool for Brazilian research based on PTSD models of the ICD-11.

Factors associated with the use of anxiolytic drugs among military firefighters. / Fatores associados ao uso de medicamentos ansiolíticos entre bombeiros militares.

INTRODUCTION: Use of anxiolytic drugs is an option for treating psychological symptoms. However, even if their use is controlled, there are risks of dependence, intoxication and cognitive alterations. Uncontrolled use among workers worsens these problems. OBJECTIVES: Identify the prevalence of anxiolytic use and to know the factors associated with consumption in military firefighters. METHOD: Cross-sectional survey of 711 firefighters from Belo Horizonte, Minas Gerais, Brazil, was conducted through self-reporting. Multinomial logistic regression was used to investigate associations between sociodemographic characteristics, living, working and health conditions and anxiolytic consumption in a controlled or uncontrolled manner. RESULTS: Prevalence of anxiolytic use was 9.9%. For 7.5% of firefighters the consumption occurred without indication and/or specialized therapeutic control. Controlled use was only associated with symptoms compatible with Common Mental Disorder (OR = 23.6; 95%CI 6.54 - 85.11). Uncontrolled use was associated with length of service (OR = 2.57; 95%CI 1.03 - 6.40), smoking (OR = 3.22; 95%CI 1.50 - 6.91) and symptomatology compatible with Common Mental Disorder (OR = 4.02; 95%CI 2.17 - 7.45). CONCLUSION: The high prevalence of consumption indicates alert to occupational health programs.

INTRODUÇÃO: O uso de ansiolíticos é uma opção no tratamento de sintomas psíquicos. Contudo, ainda que o uso seja controlado há riscos de dependência, intoxicação e alterações cognitivas. O uso não controlado entre trabalhadores agrava tais problemas. OBJETIVOS: Identificar a prevalência do uso de ansiolíticos e conhecer os fatores associados ao consumo em bombeiros militares. MÉTODO: Pesquisa transversal de base censitária investigou 711 bombeiros de Belo Horizonte, Minas Gerais, por meio de autorrelato. Regressão logística multinomial foi utilizada para verificar associação entre características sociodemográficas, condições de vida, trabalho e saúde e consumo de ansiolíticos de modo controlado ou não. RESULTADOS: A prevalência do uso de ansiolíticos foi 9,9%. Para 7,5% dos bombeiros o consumo ocorreu sem indicação e/ou controle terapêutico especializado. O uso controlado foi associado ao relato compatível com Transtorno Mental Comum (OR = 23,6; IC95% 6,54 - 85,11). O uso não controlado foi associado ao tempo de serviço (OR = 2,57; IC95% 1,03 - 6,40), ao tabagismo (OR = 3,22; IC95% 1,50 - 6,91) e ao Transtorno Mental Comum (OR = 4,02; IC95% 2,17 - 7,45). CONCLUSÃO: A alta prevalência de consumo indica alerta para as ações dos programas de saúde ocupacional.

Prevalência e fatores associados ao medo de falar público / Prevalence and factors associated with fear of public speaking

RESUMO Objetivo identificar a prevalência do medo de falar em público e verificar sua associação com as variáveis sociodemográficas, autopercepção da voz, fala e habilidades de comunicação oral em público. Método estudo transversal analítico com 1124 universitários. Um questionário online abordou características sociodemográficas, medo de falar, autoavaliação da fala em público por meio da Escala para Autoavaliação ao Falar em Público (SSPS), autopercepção da voz, da capacidade de captar e manter a atenção do ouvinte e de influenciar o outro. Resultados o medo de falar em público foi muito prevalente nos universitários. Houve associação do medo de falar com a autopercepção vocal, com a capacidade de captar e manter a atenção do ouvinte e influenciar o outro com a sua comunicação. Indivíduos que autorrelataram capacidade de captar e manter a atenção do interlocutor apresentaram maior chance de manifestar medo de falar em público em relação aos universitários que se autoperceberam como capazes de influenciar o ouvinte com a sua comunicação. Conclusão quanto mais habilidades comunicativas e mais persuasivo o indivíduo se percebe, menores as chances de ele ser acometido pelo medo de falar em público.

ABSTRACT Purpose To identify the prevalence of fear of public speaking and verify its association with sociodemographic variables, self-perception of voice, speech, and oral communication skills in public. Methods A cross-sectional and analytical study with 1,124 university students was carried out. An online questionnaire addressed was performed, considering factors as sociodemographic characteristics; fear of speaking; Scale for Self-Assessment When Speaking in Public (SSPS), self-perception of the voice, the ability to grasp, and keep the listener's attention and influence another. Results The fear of public speaking was prevalent in undergraduate students. There was an association of the fear of speaking with the vocal self-perception, with the ability to capture and keep the listener's attention and to influence another with their communication. Individuals who have the ability to capture and maintain the attention of the interlocutor are more likely to be afraid of public speaking than the undergraduate students who perceive themselves as having the ability to influence the listener with their communication. Conclusion The more communicative skills and more persuasive the individual perceives his or her self, the less likely he or she is to be affected by the fear of speaking.

Fatores associados ao uso de medicamentos ansiolíticos entre bombeiros militares / Factors associated with the use of anxiolytic drugs among military firefighters

RESUMO: Introdução: O uso de ansiolíticos é uma opção no tratamento de sintomas psíquicos. Contudo, ainda que o uso seja controlado há riscos de dependência, intoxicação e alterações cognitivas. O uso não controlado entre trabalhadores agrava tais problemas. Objetivos: Identificar a prevalência do uso de ansiolíticos e conhecer os fatores associados ao consumo em bombeiros militares. Método: Pesquisa transversal de base censitária investigou 711 bombeiros de Belo Horizonte, Minas Gerais, por meio de autorrelato. Regressão logística multinomial foi utilizada para verificar associação entre características sociodemográficas, condições de vida, trabalho e saúde e consumo de ansiolíticos de modo controlado ou não. Resultados: A prevalência do uso de ansiolíticos foi 9,9%. Para 7,5% dos bombeiros o consumo ocorreu sem indicação e/ou controle terapêutico especializado. O uso controlado foi associado ao relato compatível com Transtorno Mental Comum (OR = 23,6; IC95% 6,54 - 85,11). O uso não controlado foi associado ao tempo de serviço (OR = 2,57; IC95% 1,03 - 6,40), ao tabagismo (OR = 3,22; IC95% 1,50 - 6,91) e ao Transtorno Mental Comum (OR = 4,02; IC95% 2,17 - 7,45). Conclusão: A alta prevalência de consumo indica alerta para as ações dos programas de saúde ocupacional.

ABSTRACT: Introduction: Use of anxiolytic drugs is an option for treating psychological symptoms. However, even if their use is controlled, there are risks of dependence, intoxication and cognitive alterations. Uncontrolled use among workers worsens these problems. Objectives: Identify the prevalence of anxiolytic use and to know the factors associated with consumption in military firefighters. Method: Cross-sectional survey of 711 firefighters from Belo Horizonte, Minas Gerais, Brazil, was conducted through self-reporting. Multinomial logistic regression was used to investigate associations between sociodemographic characteristics, living, working and health conditions and anxiolytic consumption in a controlled or uncontrolled manner. Results: Prevalence of anxiolytic use was 9.9%. For 7.5% of firefighters the consumption occurred without indication and/or specialized therapeutic control. Controlled use was only associated with symptoms compatible with Common Mental Disorder (OR = 23.6; 95%CI 6.54 - 85.11). Uncontrolled use was associated with length of service (OR = 2.57; 95%CI 1.03 - 6.40), smoking (OR = 3.22; 95%CI 1.50 - 6.91) and symptomatology compatible with Common Mental Disorder (OR = 4.02; 95%CI 2.17 - 7.45). Conclusion: The high prevalence of consumption indicates alert to occupational health programs.

Homelessness and incarceration among psychiatric patients in Brazil.

Psychiatric patients are at increased risk of adverse life events, such as being incarcerated and homelessness in their life course. Using data from a cross-sectional multicenter study of 2,475 patients selected from 26 mental health services in Brazil, we examined the association of sociodemographic, clinical, behavioral, and adverse life characteristics with history of homelessness, incarceration or their co-occurrence during lifetime. Odds ratios were obtained by multinomial logistic regression models. The prevalence of homelessness, incarceration and co-occurrence of these two conditions were 8.6%, 16.4%, and 9.4%, respectively. Lower income, living in unstable condition, intellectual disability, and cigarette smoking were associated with homelessness. Being male, lower schooling, sex under effect of alcohol or drugs, and multiple sex partners were associated with incarceration. Psychiatric hospitalizations, substance use, and history of sexually transmitted diseases, and sexual, physical, or verbal violence were associated with co-occurrence of both conditions. Our findings suggest that incarceration and homelessness are very prevalent and correlated in psychiatric patients in Brazil. Many of the associated factors are potentially modifiable, and may act synergistically requiring integrated care.

Homelessness and incarceration among psychiatric patients in Brazil / Pacientes psiquiátricos em situação de rua e encarceramento no Brasil

Abstract Psychiatric patients are at increased risk of adverse life events, such as being incarcerated and homelessness in their life course. Using data from a cross-sectional multicenter study of 2,475 patients selected from 26 mental health services in Brazil, we examined the association of sociodemographic, clinical, behavioral, and adverse life characteristics with history of homelessness, incarceration or their co-occurrence during lifetime. Odds ratios were obtained by multinomial logistic regression models. The prevalence of homelessness, incarceration and co-occurrence of these two conditions were 8.6%, 16.4%, and 9.4%, respectively. Lower income, living in unstable condition, intellectual disability, and cigarette smoking were associated with homelessness. Being male, lower schooling, sex under effect of alcohol or drugs, and multiple sex partners were associated with incarceration. Psychiatric hospitalizations, substance use, and history of sexually transmitted diseases, and sexual, physical, or verbal violence were associated with co-occurrence of both conditions. Our findings suggest that incarceration and homelessness are very prevalent and correlated in psychiatric patients in Brazil. Many of the associated factors are potentially modifiable, and may act synergistically requiring integrated care.

Resumo Os pacientes psiquiátricos estão em risco aumentado de eventos adversos da vida, como ser preso e morar na rua. Investigamos a associação de características sociodemográficas, clínicas, comportamentais e eventos adversos de vida com o histórico de morar na rua, encarceramento e a coocorrência dessas duas condições ao longo da vida em um estudo multicêntrico de corte transversal de 2.475 usuários de 26 serviços de saúde mental no Brasil. "Odds ratios" foram obtidos por modelos de regressão logística multinomial. A prevalência de morar na rua, encarceramento e coocorrência dessas condições foi de 8,6%, 16,4% e 9,4%, respectivamente. Menor renda, viver em habitações instáveis, deficiência mental e tabagismo foram associados a morar na rua. Ser do sexo masculino, ter menor escolaridade, histórico de sexo sob efeito de álcool ou drogas e múltiplos parceiros sexuais foram associados ao encarceramento. Internações psiquiátricas, uso de substâncias, histórico de doenças sexualmente transmissíveis e violência sexual, física ou verbal foram associados à coocorrência das duas condições. Encarceramento e morar na rua são eventos muito prevalentes e correlacionados em pacientes psiquiátricos. Muitos dos fatores associados são modificáveis e podem agir sinergicamente exigindo cuidados integrados.

[Mental disorders and participation in the labor market: a multicenter national study in Brazil]. / Transtornos mentais e inserção no mercado de trabalho no Brasil: um estudo multicêntrico nacional.

The objective was to explore the relationship between labor market participation and patient characteristics in a representative sample of 2,475 adults admitted to 26 Brazilian mental health institutions (15 Centers for Psychosocial Care and 11 hospitals). Socio-demographic, clinical, and behavioral characteristics were obtained with structured interviews. Multinomial regression was used. Increased likelihood of temporary absence from the work market was associated with female gender, single, divorced, or widowed conjugal status, lack of stable housing, and history of first admission or treatment before the age of 18. Increased likelihood of permanent absence from the labor market was associated with older age. Temporary or permanent leave from work was directly associated with low schooling, lifetime hospitalizations, and diagnosis of severe mental disorder and inversely associated with alcohol and drug use. The occupational vulnerabilities identified in the study raise the debate on specific policies for the mental health sector.

Transtornos mentais e inserção no mercado de trabalho no Brasil: um estudo multicêntrico nacional / Mental disorders and participation in the labor market: a multicenter national study in Brazil / Trastornos mentales e inserción en el mercado de trabajo: un estudio multicéntrico nacional en Brasil

Resumo: Objetivou-se explorar a relação entre inserção no mercado de trabalho e as características de pacientes da amostra representativa de 2.475 adultos internados em 26 instituições brasileiras de saúde mental (15 Centros de Atendimento Psicossocial e 11 hospitais). Características sociodemográficas, clínicas e comportamentais foram obtidas de entrevistas estruturadas. Regressão multinomial foi utilizada. Maior probabilidade de afastamento temporário do mercado de trabalho foi observada em pacientes do sexo feminino, solteiros, divorciados ou viúvos, sem moradia estável e internados ou tratados pela primeira vez antes dos 18 anos de idade. Maior probabilidade de afastamento definitivo do mercado de trabalho foi observada entre os mais velhos. Afastamento temporário ou definitivo foi diretamente associado à baixa escolaridade, ao número de internações ao longo da vida e ao diagnóstico de transtorno mental grave; e inversamente associado ao uso de álcool e drogas. As vulnerabilidades ocupacionais identificadas suscitam o debate sobre a formulação de políticas setoriais.

Abstract: The objective was to explore the relationship between labor market participation and patient characteristics in a representative sample of 2,475 adults admitted to 26 Brazilian mental health institutions (15 Centers for Psychosocial Care and 11 hospitals). Socio-demographic, clinical, and behavioral characteristics were obtained with structured interviews. Multinomial regression was used. Increased likelihood of temporary absence from the work market was associated with female gender, single, divorced, or widowed conjugal status, lack of stable housing, and history of first admission or treatment before the age of 18. Increased likelihood of permanent absence from the labor market was associated with older age. Temporary or permanent leave from work was directly associated with low schooling, lifetime hospitalizations, and diagnosis of severe mental disorder and inversely associated with alcohol and drug use. The occupational vulnerabilities identified in the study raise the debate on specific policies for the mental health sector.

Resumen: El objetivo fue investigar la relación entre la inserción en el mercado laboral y las características de los pacientes de una muestra representativa de 2.475 adultos, internados en 26 instituciones brasileñas de salud mental (15 Centros de Atención Psicosocial y 11 hospitales). Las características sociodemográficas, clínicas y comportamentales se obtuvieron de entrevistas estructuradas. Se utilizó la regresión multinomial en el estudio. Una mayor probabilidad de apartarse temporalmente del mercado de trabajo se observó en pacientes del sexo femenino, solteros, divorciados o viudos, sin vivienda estable e internados o tratados por primera vez antes de los 18 años de edad. Una mayor probabilidad de abandonar definitivamente del mercado laboral se observó entre los más viejos. El abandono temporal o definitivo del mercado laboral se asoció directamente a la baja escolaridad, al número de internamientos a lo largo de la vida y al diagnóstico de trastorno mental grave; e inversamente asociado al uso de alcohol y drogas. Las vulnerabilidades ocupacionales identificadas suscitan el debate sobre la formulación de políticas sectoriales.