Common mental disorders in hematopoietic stem cell transplant patients: a scoping review / Trastornos mentales comunes en pacientes con trasplante de células madre hematopoyéticas: revisión del alcance / Transtornos mentais comuns em pacientes transplantados com células-tronco hematopoéticas: revisão de escopo

ABSTRACT Objective: to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation. Methods: this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included. Results: the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia. Conclusions: the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients' evolution.

RESUMEN Objetivo: mapear los trastornos mentales recurrentes comunes en pacientes sometidos a trasplante de células madre hematopoyéticas. Métodos: se trata de una revisión de alcance realizada en enero de 2022 en bases de datos electrónicas y repositorios de disertaciones y tesis. Se incluyeron publicaciones que respondieron a la pregunta de investigación, cumplieron con el objetivo del estudio y estaban disponibles en su totalidad en formato electrónico, en cualquier idioma. Resultados: la muestra estuvo compuesta por 28 estudios, 14 de los cuales fueron publicados en los Estados Unidos de América. Los trastornos mentales comunes encontrados fueron depresión, ansiedad, estrés postraumático y trastornos del estado de ánimo. Se mencionaron 20 síntomas, entre los más prevalentes se encuentran fatiga y trastornos del sueño/insomnio. Conclusiones: se destacó la dificultad e importancia de realizar el diagnóstico diferencial de estos trastornos, ya que sus síntomas pueden confundirse con otros problemas de salud y tienen un fuerte potencial de interferir en la evolución del paciente.

RESUMO Objetivo: mapear os transtornos mentais comuns recorrentes em pacientes submetidos ao transplante de células-tronco hematopoéticas. Métodos: trata-se de revisão de escopo realizada em janeiro de 2022 em bases de dados eletrônicas e repositórios de dissertações e tese. Foram incluídas publicações que respondessem à questão de pesquisa, atendessem ao objetivo do estudo e que estivessem disponíveis na íntegra em meio eletrônico, em qualquer idioma. Resultados: a amostra foi composta por 28 estudos, dos quais 14 foram publicados nos Estados Unidos da América. Os transtornos mentais comuns encontrados foram os transtornos depressivos, de ansiedade, estresse pós-traumático e de humor. Foram citados 20 sintomas, entre os mais prevalentes estão a fadiga e distúrbios do sono/insônia. Conclusões: evidenciaram-se a dificuldade e a importância de realizar o diagnóstico diferencial desses transtornos, uma vez que seus sintomas podem ser confundidos com outros problemas de saúde e têm forte potencial para interferir na evolução do paciente.

Common mental disorders in hematopoietic stem cell transplant patients: a scoping review.

OBJECTIVE: to map common recurrent mental disorders in patients undergoing hematopoietic stem cell transplantation. METHODS: this is a scoping review carried out in January 2022 in electronic databases and repositories of dissertations and thesis. Studies that answered the research question, met the objective of the study and were available in full electronically, in any language, were included. RESULTS: the sample consisted of 28 studies, 14 of which were published in the United States of America. The common mental disorders found were depressive, anxiety, post-traumatic stress and mood disorders. Twenty symptoms were mentioned, among the most prevalent are fatigue and sleep disorders/insomnia. CONCLUSIONS: the difficulty and importance of carrying out the differential diagnosis of these disorders were highlighted, since their symptoms can be confused with other health problems and have a strong potential to interfere with patients' evolution.

Experiences of mothers with early weaning: a grounded theory.

OBJECTIVE: To understand the experiences of mothers with early weaning. METHOD: Qualitative research with a theoretical-methodological contribution from Grounded Theory (Straussian perspective), carried out in the context of primary health care in a medium-sized municipality in the northeast of Brazil. 19 collaborators participated by theoretical sampling. Data collection took place between April and September 2018, with in-depth interviews, and was analyzed in three stages: open and axial coding, and integration. RESULTS: The central category "Women experiencing guilt and overload due to early weaning" was supported by three categories: a) conditions: "Showing the factors that limit breastfeeding"; b) actions/interactions: "Trying to balance motherhood and work during breastfeeding" and "Insufficient social support to keep exclusive breastfeeding"; and c) consequences: "Introducing formula and complementary foods before six months" and "Blaming oneself for the early weaning". FINAL CONSIDERATIONS: The theoretical model can give support to managers and health professionals to advocate for longer maternity leaves and confront gender disparities and inequities, professional performance with conflicts of interest, and abusive marketing regarding the use of formula.

Experiences of mothers with early weaning: a grounded theory / Experiencias de madres en el destete temprano: teoría fundamentada em los datos / Vivências de mães no desmame precoce: uma teoria fundamentada nos dados

ABSTRACT Objective: To understand the experiences of mothers with early weaning. Method: Qualitative research with a theoretical-methodological contribution from Grounded Theory (Straussian perspective), carried out in the context of primary health care in a medium-sized municipality in the northeast of Brazil. 19 collaborators participated by theoretical sampling. Data collection took place between April and September 2018, with in-depth interviews, and was analyzed in three stages: open and axial coding, and integration. Results: The central category "Women experiencing guilt and overload due to early weaning" was supported by three categories: a) conditions: "Showing the factors that limit breastfeeding"; b) actions/interactions: "Trying to balance motherhood and work during breastfeeding" and "Insufficient social support to keep exclusive breastfeeding"; and c) consequences: "Introducing formula and complementary foods before six months" and "Blaming oneself for the early weaning". Final considerations: The theoretical model can give support to managers and health professionals to advocate for longer maternity leaves and confront gender disparities and inequities, professional performance with conflicts of interest, and abusive marketing regarding the use of formula.

RESUMEN Objetivo: Comprenderlas experiencias de las madres enel destete precoz. Método: Teoría fundamentada em losdatos. La muestra teórica estuvo compuesta por 19 participantes: madres, familiares y profesionales de la salud de una Unidad Básica de Salud de la región Nordeste de Brasil. La recolección de datos ocurrió de abril a septiembre de 2018, con entrevistas enprofundidad, analizadas a través de codificación abierta, axial y de integración. Resultados: Emergió la categoría central "La mujer experimentando culpa y sobrecarga por el destete precoz", sustentada entres categorías: a) condicionantes: "revelando las limitaciones para lalactancia materna"; b) acciones/interacciones: "intentar conciliar la lactancia materna con la práctica profesional" y "recibir apoyo social insuficiente para mantener la lactancia materna exclusiva"; y c) consecuencias: "introducir fórmulas infantiles y alimentación complementaria antes de los seis meses de edad y culpabilizarse por el destete precoz". Consideraciones finales: Las madres experimentaron la falta de una red de apoyo, la insuficiencia del tiempo de licencia por maternidad y el sentimiento de culpa.

RESUMO Objetivo: Compreender vivências de mães no desmame precoce. Método: Estudo qualitativo orientado pelo referencial metodológico da teoria fundamentada nos dados. A amostragem teórica foi composta por 19 participantes: mães, familiares e profissionais da saúde de uma Unidade Básica de Saúde, todos da Região Nordeste, Brasil. A coleta de dados ocorreu de abril a setembro de 2018, com entrevistas individuais em profundidade, analisadas por meio da codificação aberta, axial e de integração. Resultados: Emergiu o fenômeno "A mulher vivenciando a culpa e a sobrecarga pelo desmame precoce", sustentado por cinco categorias inter-relacionadas. Considerações finais: As mães vivenciaram a carência da rede de apoio, a insuficiência do tempo da licença-maternidade e o sentimento de culpa.

Representações sociais da maternidade para mulheres em privação de liberdade no sistema prisional feminino / Social representations of motherhood for women deprived of liberty in the female prison system

Resumo Neste artigo, objetivou-se analisar as representações sociais da maternidade de mulheres gestantes, lactantes e que vivenciaram a gestação em privação de liberdade no sistema prisional. Trata-se de estudo qualitativo, ancorado nos pressupostos do Paradigma Teórico das Representações Sociais, realizado com 42 mulheres. As participantes eram, em maioria, jovens entre 18 e 39 anos de idade (90,5%; n=38) e se encontravam solteiras (50,0%; n=21); 61,9% (n=26) relataram duas ou mais gestações e 47,6% (n=20) referiram um ou mais abortamentos. A possível representação do ser mãe na prisão se cristalizou, em termos semânticos, principalmente pelos termos "separação" (f=27; OME: 2,9), "tristeza" (f=18; OME: 2,3), "horrível" (f=16; OME: 2,1) e "dor" (f=12; OME: 2,8). Na zona de substituição e de descontextualização, as representações foram objetivadas pelos termos "separação" (f=18; OME: 3), "tristeza" (f=13; OME: 2,5), "medo" (f=11; OME: 2,2) e "horrível" (f=10; OME: 1,5). Evidenciou-se que a centralidade das representações sociais para as participantes do estudo reflete o sofrimento vivenciado pela separação da díade mãe-filho.

Abstract This paper aimed to analyze the social representations of motherhood of pregnant women, breastfeeding women, and those who experienced pregnancy in deprivation of liberty in the prison system. This qualitative study was conducted with 42 women and is grounded on the assumptions of the Theoretical Paradigm of Social Representations. Most participants were young women aged 18-39 (90.5%; n=38) and single (50.0%; n=21); 61.9% (n=26) reported two or more pregnancies and 47.6% (n=20) reported one or more miscarriages. The possible representation of being a mother in prison was crystallized, in semantic terms, mainly by the terms "separation" (f=27; OME: 2.9), "sadness" (f=18; OME: 2.3), "horrible" (f=16; OME: 2.1) and "pain" (f=12; OME: 2.8). In the substitution and decontextualization zone, representations were objectified by the terms "separation" (f=18; OME: 3), "sadness" (f=13; OME: 2.5), "fear" (f=11; OME: 2.2) and "horrible" (f=10; OME: 1.5). It was evident that the centrality of social representations for the study participants reflects the suffering experienced by the separation of the mother-child dyad.

Biographical ruptures by the COVID-19 pandemic on adolescent and young trans men and transmasculine people: demands for nursing.

OBJECTIVE: to understand the biographical ruptures caused by the COVID-19 pandemic on adolescent and young trans men and transmasculine people in the Brazilian context. METHOD: qualitative study - multicenter, online survey. A total of 97 self-identified trans men and 22 transmasculine people participated and completed a semi-structured form in two stages. The data was subjected to Reflective Thematic Content Analysis. The interpretation was made on a sociological basis, based on the concept of biographical rupture. RESULTS: five categories were derived: interruption of hormonization, surgeries and specialized follow-up; discomforts caused by the rupture of masculine characteristics, self-image, self-perception, and identity; vulnerability from the losses of family members and significant people, employment, and weakening of support networks; emergence of psycho-emotional problems, such as loss of meaning in life; demands for nursing care and valuing the life of transmasculine adolescents and young men in post-pandemic times. CONCLUSION: the biographical ruptures caused by the pandemic threatened the identities of trans and transmasculine people of adolescents and youth, degraded and interrupted biographies, leading them to the loss of meaning in life. Nursing professionals can be strategic and essential in overcoming threats by intervening early. KEYPOINTS: (1) Shows biographical ruptures in transmasculinities during the pandemic. (2) Elucidates threats to achieving the desired trans identity. (3) Reveals barriers in services that hinder hormone transition. (4) Presents the discourse of suicide and new stressors in mental health. (5) Raises calls for nursing practice/care in adolescent health.

Nurses and health care for gay adolescents.

OBJECTIVE: to analyze nurses' statements about health care for gay adolescents. METHOD: qualitative study, anchored on the Thematic Analysis of Clarke and Braun, with adoption of Symbolic Interactionism as a theoretical framework, since it favors the understanding of the relationship between behaviors, interactions, and social meanings. Twelve nurses recruited using the snowball sampling technique were remotely interviewed via the Google Meet® video-conferencing app. RESULTS: four themes were elaborated throughout the comprehensive-interpretative process: "Gay adolescents, agendas, and relation with health;" "The gay adolescent's family and care;" "Relationship with gay adolescents in care," and "Limits to nursing care for gay adolescents." CONCLUSION: the statements denounce stigmas and symbols derived from cisheteronormativity as intervening in the relationship and indicate the urgency of investing in the intersubjective encounter with gay adolescents and their families in a horizontal, affective, and empathic relationship, with chances of favoring public defense of the right to health. There are comments on the nurses' attitude and qualification of care for this population. KEYPOINTS: (1) Tendency towards "de-subjectifying" objectification in health practices. (2) Hegemony of cisheteronormative logic as a limitation to care. (3) Sex and sexually transmitted infections (STIs) as stigmas attached to gay adolescents. (4) Family and health care for homosexual adolescents: opportunities and obstacles. (5) The limits and powers of nursing to enable equity in care for gay adolescents.

Social representations of motherhood for women deprived of liberty in the female prison system. / Representações sociais da maternidade para mulheres em privação de liberdade no sistema prisional feminino.

This paper aimed to analyze the social representations of motherhood of pregnant women, breastfeeding women, and those who experienced pregnancy in deprivation of liberty in the prison system. This qualitative study was conducted with 42 women and is grounded on the assumptions of the Theoretical Paradigm of Social Representations. Most participants were young women aged 18-39 (90.5%; n=38) and single (50.0%; n=21); 61.9% (n=26) reported two or more pregnancies and 47.6% (n=20) reported one or more miscarriages. The possible representation of being a mother in prison was crystallized, in semantic terms, mainly by the terms "separation" (f=27; OME: 2.9), "sadness" (f=18; OME: 2.3), "horrible" (f=16; OME: 2.1) and "pain" (f=12; OME: 2.8). In the substitution and decontextualization zone, representations were objectified by the terms "separation" (f=18; OME: 3), "sadness" (f=13; OME: 2.5), "fear" (f=11; OME: 2.2) and "horrible" (f=10; OME: 1.5). It was evident that the centrality of social representations for the study participants reflects the suffering experienced by the separation of the mother-child dyad.

Neste artigo, objetivou-se analisar as representações sociais da maternidade de mulheres gestantes, lactantes e que vivenciaram a gestação em privação de liberdade no sistema prisional. Trata-se de estudo qualitativo, ancorado nos pressupostos do Paradigma Teórico das Representações Sociais, realizado com 42 mulheres. As participantes eram, em maioria, jovens entre 18 e 39 anos de idade (90,5%; n=38) e se encontravam solteiras (50,0%; n=21); 61,9% (n=26) relataram duas ou mais gestações e 47,6% (n=20) referiram um ou mais abortamentos. A possível representação do ser mãe na prisão se cristalizou, em termos semânticos, principalmente pelos termos "separação" (f=27; OME: 2,9), "tristeza" (f=18; OME: 2,3), "horrível" (f=16; OME: 2,1) e "dor" (f=12; OME: 2,8). Na zona de substituição e de descontextualização, as representações foram objetivadas pelos termos "separação" (f=18; OME: 3), "tristeza" (f=13; OME: 2,5), "medo" (f=11; OME: 2,2) e "horrível" (f=10; OME: 1,5). Evidenciou-se que a centralidade das representações sociais para as participantes do estudo reflete o sofrimento vivenciado pela separação da díade mãe-filho.

Aspectos psicossociais do suicídio em mulheres do sertão do Rio Grande do Norte, Brasil / Psychosocial aspects of suicide in women from the backwoods of Rio Grande do Norte, Brazil

Resumo Introdução O suicídio é um grave problema de saúde pública mundial. No que tange aos estudos de suicídio em mulheres, há ainda que se avançar no conhecimento desse fenômeno, especialmente em municípios distantes das capitais brasileiras. Obejtivo Identificar os aspectos psicossociais do suicídio de mulheres no sertão do Rio Grande do Norte. Método Trata-se de pesquisa qualitativa com o método de autópsia psicossocial. A coleta dos dados ocorreu entre março e junho de 2018 por meio de um roteiro de entrevista semiestruturada. Foram entrevistados familiares de cinco mulheres que morreram por suicídio. O material coletado foi analisado por meio de análise temática de conteúdo. Resultados Emergiram três categorias analíticas: "comportamento suicida feminino", "transtornos mentais e relações com suicídio" e "violência de gênero e conflitos familiares". Ao longo da vida das mulheres que morreram por suicídio, constataram-se enunciação suicida, sinais depressivos, esquizofrenia, violência de gênero e cerceamento do modo de vida feminino. Conclusão No decorrer da vida dessas mulheres, observou-se o desejo de morrer vinculado a fatores emocionais, transtornos mentais, conflitos familiares e violência de gênero.

Abstract Background Suicide is a public health problem worldwide. Regarding the studies of suicide in women, it is still necessary to advance the knowledge of this phenomenon, especially in cities far from Brazilian capitals. Objective This study aimed to identify the psychosocial aspects of suicides of women in the country town of Rio Grande do Norte, Brazil. Method This is qualitative research using the psychosocial autopsy method. Data collection took place between March and June 2018 and a semi-structured interview script was used. Seven relatives of five women who died by suicide were interviewed. The collected material was analyzed through thematic content analysis. Results Three analytical categories emerged: "female suicidal behavior", "mental disorders and relationships with suicide" and "gender violence and family conflicts". Suicidal enunciation was found throughout the life of women who died from suicide, depressive signs, schizophrenia, gender violence, and curbing the female way of life. Conclusion Throughout the life of these women, there was a desire to die linked with emotional factors, mental disorders, family conflicts, and gender violence.

Violence against children and adolescents: nurse's actions in primary health care.

OBJECTIVES: to analyze the role of nurses in suspected or confirmed cases of violence against children and adolescents in Primary Health Care. METHODS: an analytical research, with a qualitative approach. Thirty nurses participated in the study, and data were collected by means of an individual form and a semi-structured interview. The data received lexicographic analysis by the software IRaMuTeQ (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) organized by Bardin's content analysis. RESULTS: five categories emerged, in which it was possible to consider that the nurses' approach in cases of violence was based on the identification of violence through physical examination during nursing consultations, health promotion actions in the school environment, request for support from the multi-professional team, and transfer of responsibilities. FINAL CONSIDERATIONS: it is inferred that the fragility in the professional training of nurses to address situations of violence against children and adolescents produces deficits in comprehensive care for victims.

Mental health, art, and deinstitutionalization: an aesthetic-poetic-theatrical account of the city's occupation. / Saúde mental, arte e desinstitucionalização: um relato estético-poético-teatral de uma ocupação da cidade.

This study aimed to report the experience of an aesthetic, poetic, and theatrical production of the city's occupation from a device of the Psychosocial Care Network to offer space for sociability, production, and cultural intervention. This is an account of an experience from the Social and Cultural Center (CECCO) in Natal, Rio Grande do Norte, Brazil, within madness and mental health deinstitutionalization. The intervention "The Little Prince occupies the Ribeira" was inspired by the work of author Saint-Exupéry. The artistic and creative acts reported occurred in December 2019. We experienced in this intervention the reach of an aesthetic clinic that, when opened to the street and art, expanded and weaved in the territory, instrumentalized by theater, dance, poetry, percussion, crafts, and city's occupation. The movement led the community to "step down from the stage" to the streets and is connected with the twist of the asylum model and the production of the affection clinic that we seek to sustain in the daily service.

Objetivou-se relatar a experiência de uma produção estética, poética e teatral de ocupação da cidade a partir de um dispositivo da Rede de Atenção Psicossocial, com vistas a oferecer espaço de sociabilidade, produção e intervenção cultural. Trata-se de um relato de experiência a partir do Centro de Convivência e Cultura (CECCO) de Natal, Rio Grande do Norte, Brasil, dentro do campo da desinstitucionalização da loucura e da saúde mental. A intervenção urbana "O Pequeno Príncipe ocupa a Ribeira" foi inspirada na obra do escritor Saint-Exupéry. Os atos artísticos e criativos relatados aconteceram em dezembro de 2019. Experimentamos nessa intervenção os alcances de uma clínica-estética que, ao se abrir para a rua e para a arte, se amplia e se tece no território, instrumentalizado pelo teatro, dança, poesia, percussão, artesanato e ocupação da cidade. O movimento gerou no coletivo um "descer do palco" em direção à rua e se conecta com a desconstrução do modelo manicomial e produção da clínica dos afetos que buscamos sustentar no cotidiano do serviço.

Saúde mental, arte e desinstitucionalização: um relato estético-poético-teatral de uma ocupação da cidade / Mental health, art, and deinstitutionalization: an aesthetic-poetic-theatrical account of the city's occupation

Resumo Objetivou-se relatar a experiência de uma produção estética, poética e teatral de ocupação da cidade a partir de um dispositivo da Rede de Atenção Psicossocial, com vistas a oferecer espaço de sociabilidade, produção e intervenção cultural. Trata-se de um relato de experiência a partir do Centro de Convivência e Cultura (CECCO) de Natal, Rio Grande do Norte, Brasil, dentro do campo da desinstitucionalização da loucura e da saúde mental. A intervenção urbana "O Pequeno Príncipe ocupa a Ribeira" foi inspirada na obra do escritor Saint-Exupéry. Os atos artísticos e criativos relatados aconteceram em dezembro de 2019. Experimentamos nessa intervenção os alcances de uma clínica-estética que, ao se abrir para a rua e para a arte, se amplia e se tece no território, instrumentalizado pelo teatro, dança, poesia, percussão, artesanato e ocupação da cidade. O movimento gerou no coletivo um "descer do palco" em direção à rua e se conecta com a desconstrução do modelo manicomial e produção da clínica dos afetos que buscamos sustentar no cotidiano do serviço.

Abstract This study aimed to report the experience of an aesthetic, poetic, and theatrical production of the city's occupation from a device of the Psychosocial Care Network to offer space for sociability, production, and cultural intervention. This is an account of an experience from the Social and Cultural Center (CECCO) in Natal, Rio Grande do Norte, Brazil, within madness and mental health deinstitutionalization. The intervention "The Little Prince occupies the Ribeira" was inspired by the work of author Saint-Exupéry. The artistic and creative acts reported occurred in December 2019. We experienced in this intervention the reach of an aesthetic clinic that, when opened to the street and art, expanded and weaved in the territory, instrumentalized by theater, dance, poetry, percussion, crafts, and city's occupation. The movement led the community to "step down from the stage" to the streets and is connected with the twist of the asylum model and the production of the affection clinic that we seek to sustain in the daily service.

Violence against children and adolescents: nurse's actions in primary health care / Violencia contra el niño y el adolescente: actuación del enfermero en la atención primaria de salud / Violência contra criança e adolescente: atuação do enfermeiro na atenção primária à saúde

ABSTRACT Objectives: to analyze the role of nurses in suspected or confirmed cases of violence against children and adolescents in Primary Health Care. Methods: an analytical research, with a qualitative approach. Thirty nurses participated in the study, and data were collected by means of an individual form and a semi-structured interview. The data received lexicographic analysis by the software IRaMuTeQ (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) organized by Bardin's content analysis. Results: five categories emerged, in which it was possible to consider that the nurses' approach in cases of violence was based on the identification of violence through physical examination during nursing consultations, health promotion actions in the school environment, request for support from the multi-professional team, and transfer of responsibilities. Final Considerations: it is inferred that the fragility in the professional training of nurses to address situations of violence against children and adolescents produces deficits in comprehensive care for victims.

RESUMEN Objetivos: analizar actuación de enfermeros en casos sospechosos o confirmados de violencia contra niños y adolescentes en la Atención Primaria de Salud. Métodos: investigación analítica, con abordaje cualitativo. Participaron del estudio 30 enfermeros, siendo recolectados los datos por medio de formulario individual y entrevista semiestructurada. Los datos recibieron análisis lexicográfico del software IraMuTeQ (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) organizado por el análisis de contenido de Bardin. Resultados: emergieron cinco categorías, en las cuales fue posible considerar que el abordaje de los enfermeros en casos de violencia se pautó en la identificación de la violencia por el examen físico en las consultas de enfermería, acciones de promoción de la salud en el ambiente escolar, requisición de soporte de la equipe multiprofesional y transferencia de responsabilidades. Consideraciones Finales: se infiere que la fragilidad en la formación profesional del enfermero para abordaje de situaciones de violencia contra niños y adolescentes produce déficits de atención integral a las víctimas.

RESUMO Objetivos: analisar a atuação dos enfermeiros em casos suspeitos ou confirmados de violência contra crianças e adolescentes na Atenção Primária à Saúde. Métodos: pesquisa analítica, com abordagem qualitativa. Participaram do estudo 30 enfermeiros, sendo coletados os dados por meio de formulário individual e entrevista semiestruturada. Os dados receberam análise lexicográfica do software IRaMuTeQ (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) organizada pela análise de conteúdo de Bardin. Resultados: emergiram cinco categorias, nas quais foi possível considerar que a abordagem dos enfermeiros em casos de violência se pautou na identificação da violência pelo exame físico nas consultas de enfermagem, ações de promoção da saúde no ambiente escolar, requisição de suporte da equipe multiprofissional e transferência de responsabilidades. Considerações Finais: infere-se que a fragilidade na formação profissional do enfermeiro para abordagem de situações de violência contra crianças e adolescentes produz déficits de atenção integral às vítimas.

Biographical ruptures by the COVID-19 pandemic on adolescent and young trans men and transmasculine people: demands for nursing / Rupturas biográficas pela pandemia da COVID-19 sobre adolescentes e jovens homens trans e transmasculinos: demandas para a enfermagem / Rupturas biográficas por la pandemia del COVID-19 en adolescentes y jóvenes hombres trans y transmasculinos: demandas para la enfermería

Abstract Objective: to understand the biographical ruptures caused by the COVID-19 pandemic on adolescent and young trans men and transmasculine people in the Brazilian context. Method: qualitative study - multicenter, online survey. A total of 97 self-identified trans men and 22 transmasculine people participated and completed a semi-structured form in two stages. The data was subjected to Reflective Thematic Content Analysis. The interpretation was made on a sociological basis, based on the concept of biographical rupture. Results: five categories were derived: interruption of hormonization, surgeries and specialized follow-up; discomforts caused by the rupture of masculine characteristics, self-image, self-perception, and identity; vulnerability from the losses of family members and significant people, employment, and weakening of support networks; emergence of psycho-emotional problems, such as loss of meaning in life; demands for nursing care and valuing the life of transmasculine adolescents and young men in post-pandemic times. Conclusion: the biographical ruptures caused by the pandemic threatened the identities of trans and transmasculine people of adolescents and youth, degraded and interrupted biographies, leading them to the loss of meaning in life. Nursing professionals can be strategic and essential in overcoming threats by intervening early.

Resumo Objetivo: compreender as rupturas biográficas causadas pela pandemia da COVID-19 sobre adolescentes e jovens homens trans e pessoas transmasculinas no contexto do Brasil. Método: estudo qualitativo - survey on-line, multicêntrico. Participaram 97 homens trans e 22 pessoas transmasculinas, autoidentificados, que responderam formulário semiestruturado em duas etapas. Os dados foram submetidos à Análise de Conteúdo Temática Reflexiva. Realizou-se a interpretação com base sociológica, a partir do conceito de ruptura biográfica. Resultados: derivadas cinco categorias: interrupção da hormonização, cirurgias e acompanhamento especializado; desconfortos precipitados pela ruptura das características masculinas, autoimagem, autopercepção e identidade; vulnerabilidade a partir das perdas de familiares e pessoas significativas, emprego e fragilização das redes de apoio; emergência de problemas psicoemocionais, como perda do sentido da vida; demandas para o cuidado de enfermagem e valorização da vida de adolescentes e jovens transmasculinos no pós-pandemia. Conclusão: as rupturas biográficas provocadas pela pandemia ameaçaram as identidades de homens trans e pessoas transmasculinas de adolescentes e jovens, produziram degradação e descontinuidade das biografias, conduzindo-os à perda de sentido da vida. Profissionais de enfermagem podem ser estratégicos e essenciais na superação das ameaças, intervindo antecipadamente.

Resumen Objetivo: comprender las rupturas biográficas provocadas por la pandemia del COVID-19 en adolescentes y jóvenes hombres trans y personas transmasculinas en el contexto de Brasil. Método: estudio cualitativo - encuesta en línea - multicéntrico. Participaron 97 hombres trans y 22 personas transmasculinas autoidentificadas, que respondieron un formulario semiestructurado en dos etapas. Los datos se sometieron al Análisis de Contenido Temático Reflexivo. La interpretación se realizó sobre una base sociológica a partir del concepto de ruptura biográfica. Resultados: surgieron cinco categorías: interrupción de la terapia hormonal, cirugías y seguimiento especializado; malestares precipitados por la interrupción de las características masculinas, autoimagen, autopercepción e identidad; vulnerabilidad por la pérdida de familiares y seres queridos, empleo y debilitamiento de las redes de apoyo; aparición de problemas psicoemocionales, como la pérdida del sentido de la vida; demandas de atención de enfermería y valoración de la vida de adolescentes y jóvenes transexuales en el pospandemia. Conclusión: las rupturas biográficas provocadas por la pandemia amenazaron las identidades de los hombres trans y personas transmasculinas adolescentes y jóvenes, produjeron degradación y discontinuidad de las biografías, llevándolas a perder el sentido de la vida. Los profesionales de enfermería pueden ser estratégicos e imprescindibles en la superación de estas amenazas al promover una intervención anticipada.

Nurses and health care for gay adolescents / Enfermeiros diante do cuidado à saúde de adolescentes gays / Los enfermeros frente al cuidado de la salud de los adolescentes gays

Abstract Objective: to analyze nurses' statements about health care for gay adolescents. Method: qualitative study, anchored on the Thematic Analysis of Clarke and Braun, with adoption of Symbolic Interactionism as a theoretical framework, since it favors the understanding of the relationship between behaviors, interactions, and social meanings. Twelve nurses recruited using the snowball sampling technique were remotely interviewed via the Google Meet® video-conferencing app. Results: four themes were elaborated throughout the comprehensive-interpretative process: "Gay adolescents, agendas, and relation with health;" "The gay adolescent's family and care;" "Relationship with gay adolescents in care," and "Limits to nursing care for gay adolescents." Conclusion: the statements denounce stigmas and symbols derived from cisheteronormativity as intervening in the relationship and indicate the urgency of investing in the intersubjective encounter with gay adolescents and their families in a horizontal, affective, and empathic relationship, with chances of favoring public defense of the right to health. There are comments on the nurses' attitude and qualification of care for this population.

Resumo Objetivo: analisar narrativas de enfermeiros sobre o cuidado à saúde de adolescentes gays. Método: estudo qualitativo, ancorado na Análise Temática de Clarke e Braun, adotando como referencial teórico o Interacionismo Simbólico, uma vez que ele favorece a apreensão da relação de comportamentos, interações e significados sociais. Foram entrevistados remotamente 12 enfermeiros, recrutados a partir da técnica de bola de neve, por meio da plataforma de vídeo Google Meet ® . Resultados: ao longo do processo compreensivo-interpretativo, foram elaborados quatro temas: "Adolescente gay, pautas e relação com a saúde"; "A família do adolescente gay e o cuidado"; "Relação com adolescente gay no cuidado" e "Limites para o cuidar de enfermagem ao adolescente gay". Conclusão: as narrativas denunciam estigmas e símbolos derivados da cisheteronormatividade como intervenientes da relação e indicam premência de apostas no encontro intersubjetivo com os adolescentes gays e seus familiares em relação horizontal, afetiva e empática, com chances de favorecer defesa pública do direito à saúde. Há apontamentos para a atitude dos enfermeiros e qualificação do cuidado a essa população.

Resumen Objetivo: analizar los relatos de los enfermeros sobre el cuidado de la salud de los adolescentes gays. Método: estudio cualitativo, anclado en el Análisis Temático de Clarke y Braun, adoptando el Interaccionismo Simbólico como marco teórico, ya que favorece la aprehensión de la relación de comportamientos, interacciones y significados sociales. Fueron entrevistados remotamente 12 enfermeros, reclutados a partir de la técnica de bola de nieve, por medio de la plataforma de video Google Meet ® . Resultados: a lo largo del proceso comprensivo-interpretativo, se elaboraron cuatro temas: "Adolescente gay, pautas y relación con la salud"; "La familia del adolescente gay y el cuidado"; "Relación con adolescente gay en el cuidado" y "Límites para el cuidado de enfermería al adolescente gay". Conclusión: las narrativas denuncian los estigmas y símbolos derivados de la cisheteronormatividad como intervinientes de la relación e indican la urgencia de apuestas en el encuentro intersubjetivo con los adolescentes gays y sus familiares en relación horizontal, afectiva y empática, con posibilidades de favorecer la defensa pública del derecho a la salud. Hay apuntes para la actitud de los enfermeros y calificación del cuidado a esa población.

Estimates of suicide mortality in women residents in northeast brazilian states from 1996 to 2018.

The objective of this study was to analyze the temporal trend of suicide mortality in women in the states of Northeastern Brazil. This is an ecological study of a time series stratified by states in Northeast Brazil from 1996 to 2018, with data extracted from the Mortality Information System (SIM). The temporal trend was evaluated by negative binomial regression (p values≤0.05). There was a higher proportion of deaths in black and brown women (73.9%), single (57.3%), with the place of death occurring in the home (53.4%). Hanging and strangulation stood out as the perpetration means (47.6%). Most states showed an upward temporal trend, except for Pernambuco, Rio Grande do Norte, Sergipe and Maranhão, which showed a steady trend (p>0.05). An upward temporal trend was identified in the analysis of deaths by suicide in women in five states in northeastern Brazil between 1996 and 2018. The information presented can support planning and decision-making for the prevention of suicide among women in northeastern Brazil.

Factors associated with suicidal ideation among travestis and transsexuals receiving assistance from transgender organizations. / Fatores associados à ideação suicida entre travestis e transexuais assistidas por organizações não governamentais.

The aim of this study was to determine the prevalence of suicidal ideation and explore associated factors among travestis and transsexuals. A cross-sectional study was conducted between 2015 and 2016 with 22 travestis and 36 transsexuals who were members of the four transgender organizations operating in the state of Rio Grande do Norte, Brazil. Associations between suicidal ideation and the categorical variables were measured using the chi-squared test, Fisher's exact test, and likelihood ratios. Multivariate analysis was performed using robust Poisson regression. The suicidal ideation prevalence rate was 41.4% (95%CI 41.3-54.51%): 13.79% among travestis (95%CI 4.91-22.66%) and 27.61% in transsexuals (95%CI 16.08-39.08%). The prevalence of suicidal ideation was higher among respondents who reported suffering violence at school (PR = 2.05; 95%CI 1.08-3.87) and those experiencing moderate/severe depression (PR = 3.86; 95%CI 1.51-9.83). The findings suggest that unfavorable school contexts and the presence of depression compromise mental health and contribute to suicidal ideation among travestis and transsexuals.

Objetivou-se analisar a prevalência e os fatores associados à ideação suicida em travestis e transexuais. Estudo transversal, realizado entre 2015 e 2016 com travestis (n = 22) e transexuais (n = 36) associadas a quatro organizações civis do Rio Grande do Norte. Avaliou-se a diferença entre as categorias por meio dos testes qui-quadrado, exato de Fisher e de razão de verossimilhança. Realizou-se a análise múltipla por meio da regressão de Poisson com variância robusta. A prevalência de ideação suicida foi de 41,4% (IC 95%: 41,3-54,51%), sendo de 13,79% entre travestis (IC 95%: 4,91-22,66%) e 27,61% entre transexuais (IC 95%: 16,08-39,08%). Observou-se que apresentaram maior prevalência de ideação suicida os participantes com histórico de violência na escola (RP = 2,05; IC 95%: 1,08-3,87) e classificados com níveis depressivos moderado/grave (RP = 3,86; IC 95%: 1,51-9,83). Contexto escolar desfavorável e presença de sintomatologia depressiva parecem prejudicar a saúde mental e colaborar com a ideação suicida de pessoas transexuais e travestis.

Estimates of suicide mortality in women residents in northeast brazilian states from 1996 to 2018 / Estimativas de mortalidade por suicídio em mulheres residentes nos estados do nordeste brasileiro de 1996 a 2018

Abstract The objective of this study was to analyze the temporal trend of suicide mortality in women in the states of Northeastern Brazil. This is an ecological study of a time series stratified by states in Northeast Brazil from 1996 to 2018, with data extracted from the Mortality Information System (SIM). The temporal trend was evaluated by negative binomial regression (p values≤0.05). There was a higher proportion of deaths in black and brown women (73.9%), single (57.3%), with the place of death occurring in the home (53.4%). Hanging and strangulation stood out as the perpetration means (47.6%). Most states showed an upward temporal trend, except for Pernambuco, Rio Grande do Norte, Sergipe and Maranhão, which showed a steady trend (p>0.05). An upward temporal trend was identified in the analysis of deaths by suicide in women in five states in northeastern Brazil between 1996 and 2018. The information presented can support planning and decision-making for the prevention of suicide among women in northeastern Brazil.

Resumo O objetivo deste estudo foi analisar a tendência temporal da mortalidade por suicídio em mulheres nos estados do Nordeste do Brasil. Trata-se de um estudo ecológico de uma série temporal estratificada por estados do Nordeste do Brasil de 1996 a 2018, com dados extraídos do Sistema de Informações sobre Mortalidade (SIM). A tendência temporal foi avaliada por regressão binomial negativa (valores de p≤0,05). Houve uma proporção maior de mortes em mulheres negras e pardas (73,9%), solteiras (57,3%), com o local da morte ocorrendo em casa (53,4%). Suspensão e estrangulamento se destacaram como o meio de perpetração (47,5%). A maioria dos estados apresentou tendência temporal ascendente, com exceção de Pernambuco, Rio Grande do Norte, Sergipe e Maranhão, que apresentaram tendência estável (p>0,05). Uma tendência temporal ascendente foi identificada na análise dos óbitos por suicídio em mulheres em cinco estados do Nordeste brasileiro entre 1996 e 2018. Assim, as informações apresentados podem apoiar no planejamento e nas tomadas de decisões para prevenção do suicídio entre mulheres no Nordeste brasileiro.

Fatores associados à ideação suicida entre travestis e transexuais assistidas por organizações não governamentais / Factors associated with suicidal ideation among travestis and transsexuals receiving assistance from transgender organizations

Resumo Objetivou-se analisar a prevalência e os fatores associados à ideação suicida em travestis e transexuais. Estudo transversal, realizado entre 2015 e 2016 com travestis (n = 22) e transexuais (n = 36) associadas a quatro organizações civis do Rio Grande do Norte. Avaliou-se a diferença entre as categorias por meio dos testes qui-quadrado, exato de Fisher e de razão de verossimilhança. Realizou-se a análise múltipla por meio da regressão de Poisson com variância robusta. A prevalência de ideação suicida foi de 41,4% (IC 95%: 41,3-54,51%), sendo de 13,79% entre travestis (IC 95%: 4,91-22,66%) e 27,61% entre transexuais (IC 95%: 16,08-39,08%). Observou-se que apresentaram maior prevalência de ideação suicida os participantes com histórico de violência na escola (RP = 2,05; IC 95%: 1,08-3,87) e classificados com níveis depressivos moderado/grave (RP = 3,86; IC 95%: 1,51-9,83). Contexto escolar desfavorável e presença de sintomatologia depressiva parecem prejudicar a saúde mental e colaborar com a ideação suicida de pessoas transexuais e travestis.

Abstract The aim of this study was to determine the prevalence of suicidal ideation and explore associated factors among travestis and transsexuals. A cross-sectional study was conducted between 2015 and 2016 with 22 travestis and 36 transsexuals who were members of the four transgender organizations operating in the state of Rio Grande do Norte, Brazil. Associations between suicidal ideation and the categorical variables were measured using the chi-squared test, Fisher's exact test, and likelihood ratios. Multivariate analysis was performed using robust Poisson regression. The suicidal ideation prevalence rate was 41.4% (95%CI 41.3-54.51%): 13.79% among travestis (95%CI 4.91-22.66%) and 27.61% in transsexuals (95%CI 16.08-39.08%). The prevalence of suicidal ideation was higher among respondents who reported suffering violence at school (PR = 2.05; 95%CI 1.08-3.87) and those experiencing moderate/severe depression (PR = 3.86; 95%CI 1.51-9.83). The findings suggest that unfavorable school contexts and the presence of depression compromise mental health and contribute to suicidal ideation among travestis and transsexuals.

Mortality due to breast cancer in a region of high socioeconomic vulnerability in Brazil: Analysis of the effect of age-period and cohort.

INTRODUCTION: Breast cancer is an important public health problem worldwide, with important disparities in incidence, mortality, and survival rates between developed and developing countries due to inequalities regarding access to measures for the prevention and treatment of the disease. In Brazil, there are higher rates of incidence and a downward trend in mortality in regions of greater socioeconomic development. OBJECTIVE: To evaluate the effect of age, period, and birth cohort on breast cancer mortality in women aged 20 years and older in the states of the Northeast Region of Brazil, an area of high socioeconomic vulnerability, from 1980 to 2019. METHODS: The death records were extracted from the DATASUS Mortality Information System website (Department of National Health Informatics) from the Ministry of Health of Brazil. Estimable functions were used to estimate the age-period and cohort models (APC) using the Epi library from the R statistical software version 6.4.1. RESULTS: The average breast cancer mortality rate for the period was 20.45 deaths per 100,000 women. The highest coefficients per 100,000 women were observed in the states of Pernambuco (21.09 deaths) and Ceará (20.85 deaths), and the lowest in Maranhão (13.58 deaths) and Piauí (15.43 deaths). In all of the locations, there was a progressive increase in mortality rates in individuals over 40 years of age, with higher rates in the last five-year period (2015-2019). There was an increase in the risk of death for the five-year period of the 2000s in relation to the reference period (1995-1999) in the Northeast region and in the states of Alagoas, Bahia, Maranhão, Paraíba, and Piauí. In addition, there was an increased risk of death for women born after the 1950s in all locations. CONCLUSION: The highest mortality rates in all five-year periods analyzed were observed in states with greater socioeconomic development, with an increase in mortality rates in the 2000s, and a higher risk of death in the younger cohorts.