Addressing Mental Health Needs in Low- and Middle-Income Countries: The case of São Caetano do Sul, Brazil.

São Caetano do Sul, a city in southeastern Brazil, boasts exemplary social indicators and healthcare services, with a population of 162,763 and a density of 9,736.03 inhabitants/km². Allocating 25% of its budget to healthcare, the city's mental healthcare services adhere to the National Mental Health Policy. Structured services include a CAPS-II, CAPS-AD, outpatient teams, and teams in various locations. Initiatives since 2000 include inaugurating a CAPS-AD in 2006, a psychiatric emergency service in 2010, and a CAPS-II in 2016, relocating CAPS-AD in 2019, and establishing the Cuca Legal Project in 2022. São Caetano do Sul has a Mental Health Risk Classification Protocol to aid clinical decision-making. Developing care lines for various groups, it offers programs like smoking prevention, school psychology, and obesity support. Collaborating with community centers, these facilities serve as teaching environments. The mental health care network focuses on five axes: Communication, Care, Prevention, Management, and Education, with specific proposed actions and competencies. Despite progress, challenges remain. Expanding access, reducing stigma, and implementing robust monitoring are crucial. São Caetano do Sul's experience offers valuable insights for similar urban settings in LMICs developing mental health programs.

Adolescent Victimization during COVID-19 Lockdowns and Its Influence on Mental Health Problems in Seven Countries: The Mediation Effect of Resilience.

The objective of this study was to test the differences between the mean scores of victimization, an indicator of depression, stress, and anxiety (DASS), across seven countries (Australia, Chile, India, Indonesia, Mexico, Poland, and the Russian Federation) during the COVID-19 lockdowns. In addition, this study sought to analyze the mediator role of resilience in these relationships in the different countries. To this end, a structural equation model (SEM) was tested and differences across countries were considered through a multigroup analysis. Data for adolescent students from seven countries (n = 7241) collected by the Global Research Alliance showed that levels of anxiety, depression, and stress among adolescents were different in the countries assessed; all of them presented values above the mean of the indicator, with Chile and Russia having the highest values. Regarding the prevalence of exposure to violence, the mean across all countries studied was 34%, with the highest prevalence in Russia and India. At the global level, an adequate adjustment was observed in the SEM mediation model considering all countries. However, a mediator effect of resilience was only observed in the relationship between victimization and the indicator of DASS in Chile, Indonesia, and Russia. The results are discussed, analyzing the relevance of resilience as a protective factor for mental health during COVID-19 lockdowns.

What is needed to promote physical activity in a secondary school? a qualitative study / O que é necessário para promover a atividade física em uma escola de ensino médio? um estudo qualitativo / ¿qué se necesita para promover la actividad física en una escuela secundaria? un estudio cualitativo

Interventions are required to modify physical activity behaviours in adolescents, and in this regard, education-based actions seem to be effective. The aim of this study was to explore the beliefs and perceptions of the context stakeholders with respect to adolescents' health behaviours, as well as intervention programmes to gain insight into the setting where the implementation of an intervention is required. Three focus groups were created with twenty-two participants (nine adolescents, four parents, six teachers, and three local politicians). The educational context, in collaboration with the community, was perceived as a setting with high a potential for physical activity promotion. Engagement and coordination of all stakeholders were considered necessary for a tailored intervention, in addition to programme institutionalization to ensure sustainability. Multilevel intervention with a whole-school and community approach is key to increasing physical activity levels among adolescents. (AU)

São necessárias intervenções para modificar os comportamentos de atividade física dos adolescentes e, nesse sentido, as ações baseadas na educação nas escolas parecem ser eficazes. O objetivo deste estudo foi explorar as crenças e percepções das partes interessadas do contexto em relação aos comportamentos de saúde dos adolescentes, bem como aos programas de intervenção para obter uma visão do ambiente em que uma intervenção deseja ser implementada. Foram criados três grupos focais com vinte e dois participantes (nove adolescentes, quatro pais, seis professores e três políticos locais). O contexto educativo, em colaboração com a comunidade, foi percebido como um ambiente com um alto potencial para a promoção da atividade física. O compromisso e a coordenação de todas as partes interessadas foram considerados necessários para uma intervenção personalizada, bem como a institucionalização do programa para garantir a sustentabilidade. A intervenção multinível com uma abordagem de toda a escola e da comunidade é fundamental para aumentar os níveis de atividade física entre os adolescentes. (AU)

Se necesitan intervenciones para modificar los comportamientos de actividad física en adolescentes y, en este sentido, las iniciativas desde la educación parecen ser efectivas. El objetivo de este estudio fue explorar las creencias y percepciones de las partes interesadas del contexto en relación con los comportamientos de salud de los adolescentes y los programas de intervención para conocer mejor el entorno en el que se quiere aplicar una intervención. Se crearon tres grupos focales con veintidós participantes (nueve adolescentes, cuatro padres, seis docentes y tres políticos locales). El contexto educativo, en colaboración con la comunidad, fue percibido como un ambiente con un alto potencial para la promoción de la actividad física. Se consideró necesario el compromiso y la coordinación de todas las partes interesadas para una intervención personalizada, así como la institucionalización del programa para garantizar la sostenibilidad. La intervención multinivel con un enfoque de toda la escuela y la comunidad es clave para aumentar los niveles de actividad física entre los adolescentes. (AU)

Influencia de factores psicosociales en el clima y estrés laboral del personal de un hospital ecuatoriano / Influence of psychosocial factors on work climate and stress in Ecuadorian hospital personnel

RESUMEN Introducción: actualmente, el estudio de las relaciones del individuo con las condiciones de su trabajo resulta de gran interés. Objetivo: analizar la influencia de factores psicosociales de riesgo en el clima y estrés laboral de los trabajadores de un hospital básico en la ciudad de Ambato, en Ecuador. Materiales y métodos: estudio no experimental, transversal y prospectivo. A cincuenta trabajadores se le aplicaron tres encuestas: CoPsoq-istas21 (versión 2), cuestionario de clima laboral FOCUS-93 y el cuestionario para la evaluación del estrés (versión 3) de la Pontificia Universidad Javeriana. Se utilizaron la prueba de Chi-cuadrado de Pearson, con un nivel de significancia del 0,05, para descartar la hipótesis nula, y la regresión lineal curvilínea para determinar la influencia de los factores en las dos variables dependientes. Resultados: la estima (100 % de desfavorabilidad), las exigencias psicológicas (94 %) y la doble presencia (90 %) fueron los factores psicosociales peor calificados por los informantes. Solo el 40,5 % de los participantes consideraron su clima laboral como satisfactorio; y se registró en el 80 % de la población la presencia de síntomas fisiológicos y psicoemocionales provocados por el estrés. La inseguridad sobre el futuro y el apoyo social/calidad de liderazgo, fueron las subvariables que mayor número de inferencias estadísticas tuvieron con el estrés y el clima laboral. Conclusiones: los factores de riesgo psicosociales influyeron en la percepción negativa del clima laboral y en el incremento de la sintomatología del estrés.

ABSTRACT Introduction: currently, the study of the relationships between people and their work conditions are of great interest. Objective: to analyze the influence of risk psychosocial factors in the labor climate and stress of the workers of a basic hospital in the city of Ambato, Ecuador. Materials and methods: non-experimental, cross-sectional and prospective study. Three surveys were applied to 50 workers: the CoPsoQ-ista21 (version 2), the FOCUS-93 labor climate questionnaire, and the stress evaluation inventory of the Pontificia Universidad Javeriana (version 3). Pearson's Chi-square test, with a significance level of 0.05, was used to discard the null hypothesis, and curvilinear linear regression was used to determine the influence of the factors on the two dependent variables. Results: esteem (100 % unfavorableness), psychological demands (94 %) and double presence (90 %) were the psychosocial factors the informers rated worst. Only 40.5 % of the participants considered their work climate as satisfactory; and the presence of physiological and psycho-emotional symptoms caused by stress was recorded in 80 % of the population. Conclusions: psychosocial risk factors influenced the negative perception of the labor environment and the increase of stress symptoms.

Psycho-social impact of positive human papillomavirus testing in Jujuy, Argentina results from the Psycho-Estampa study.

Human papillomavirus (HPV) testing can have a negative impact on women's lives which might also result in abandoning the follow-up and treatment process. This study measured the psycho-social impact of HPV-positivity among HPV-tested women from Jujuy, Argentina, a middle-low income setting. In this cross-sectional study (2015-2016), the psycho-social impact of HPV-positivity was measured using the Psycho-Estampa Scale, specifically designed and validated to be used in screening contexts. We measured mean scores for each of the five scale domains, and the Overall Impact score (Values from 1: No impact to 4: Heavy impact). We compared scores according to cytology triage diagnosis using ordinal logistic regression. A total of 163 HPV-positive women were recruited at the Centro Carlos Alvarado hospital and included in the study sample; of these, 124 (76.1%) had normal triage cytologies. The overall Impact score was between low and moderate (mean:2.56, SD:0.65). The highest psycho-social impact was measured in the Worries about cancer and treatment domain (mean score:3.60, SD:0.60), followed by Sexuality domain (mean:2.50; SD:1.00). The Uncertainty about information provided by health providers domain had the lowest mean score (mean:2.14, SD:0.73). Compared to women with normal cytologies (n = 124), women with abnormal cytologies (n = 39) had a higher likelihood of greater overall Psycho-social Impact (OR: 2.91; p = 0.0036). No statistically significant differences were found in scores of specific domains according to cytology results. It is important to devise specific counseling interventions to reduce the psycho-social impact of HPV-Testing as primary screening and its potential effect on completion of the diagnosis/ treatment process.

Predictores de sintomatología postraumática aguda y crecimiento post-estrés tras un accidente laboral reciente / Predictors of Acute Posttraumatic Symptoms and Post- Stress Growth After a Recent Work Accident

Resumen El propósito de este estudio fue evaluar un modelo predictivo de sintomatología postraumática aguda (SPT) y de crecimiento post-estrés (CPE) en trabajadores que sufrieron un accidente laboral reciente. Se encuestaron 246 trabajadores (23.2% mujeres) entre los 18 y los 73 años. Se encontró que los principales predictores de la SPT son: severidad subjetiva del evento, afrontamiento religioso negativo, reinterpretación positiva y rumiación de tipos intrusiva, negativa y deliberada. A su vez, los principales predictores de CPE fueron: rumiación deliberada y afrontamiento religioso positivo. Se realizó un análisis de sendero para evaluar un modelo en el cual la rumiación intrusiva y la deliberada cumplen una función mediadora, obteniendo adecuados índices de ajuste. Se plantea la necesidad de contar con un método de evaluación temprana de las respuestas psicológicas tras un accidente.

Abstract The aim of this study is to evaluate a predictive model of acute posttraumatic symptomatology (PTS) and post-stress growth (PSG) in workers who suffered a recent work accident. To this end, 246 workers (23.2% women) were surveyed, aged between 18 and 73 years. The main predictors of PTS were subjective severity of event, negative religious coping, positive reinterpretation, and intrusive, brooding and deliberate rumination. At the same time, the main predictors of PSG were deliberate rumination and positive religious coping. A path analysis was performed to evaluate a model in which intrusive and deliberate rumination fulfill a mediating function, obtaining adequate goodness-of-fix indices. The need to have a method of early evaluation of psychological responses after an accident is proposed.

La evaluación psicosocial de un donante vivo de riñón / Psycho-Social Evaluation of a Living Kidney Donor

resumen La decisión de convertirse en donante vivo de riñón suele ser conflictiva. Generalmente se cree que el candidato conoce sus motivos, que es consciente de ellos, que ha pensado largamente su decisión y hasta ha consultado sobre ella. Sorprende corroborar que -en muchos casos- solo tiene una conciencia vaga, más bien oscura, de sus razones y de la validez de ellas. Otras veces ha tomado una decisión impulsiva, guiado por sus afectos, y se ha confiado a su suerte y/o a su fe. Y, otras más, viene indeciso, presionado por diversas circunstancias. La evaluación de salud mental debe ayudarle a poner sus motivos en claro, es decir, a hacerlos conscientes, a verbalizarlos. Debe permitirle analizarlos y afirmarse en su decisión o arrepentirse de ella. Es decir, debe ser una experiencia positiva, que enriquezca la decisión, la madure o la descarte. Y debe dejar al candidato la sensación interior de haber recibido ayuda para tomar la mejor decisión posible en su caso. La evaluación psicosocial debería ser la primera de varias valoraciones a las que debe someterse un candidato, porque una decisión bien tomada es requisito para realizar un proceso adecuado. El autor revisa las condiciones en que debe desarrollarse la entrevista, los requisitos que debe cumplir la decisión y las técnicas apropiadas para obtener la información indispensable.

abstract The decision to become a living kidney donor is full of conflicts. It is generally believed that the candidates are aware of their reasons, that they have thought long about it, and have even asked questions about it. Thus it is surprising that, in many cases, they are only vaguely aware of their reasons and their validity. Sometimes, it is an impulsive decision guided by their emotions and entrusted to their luck or faith. Sometimes, they are undecided and put under pressure due to various circumstances. The mental health assessment should help to clarify their reasons, and to put them into words. It should be a positive experience, enriching their decision. It should give the candidate the inner feeling of having received help for taking the best decision. The psychosocial evaluation should be the first of multiple assessment ratings that the living kidney donor must face. A well-taken decision is a requirement to start the process properly. The author reviews the conditions in which that interview should be developed, the requirements to be met by the decision, and the proper techniques to obtain accurate information.

Proceso de trabajo y salud docente. Un abordaje socio-antropológico de las relaciones entre los riesgos organizacionales y psicosociales del trabajo en contextos de pobreza urbana de Rosario (Argentina) / Work process and teacher's health. A socio-anthropological approach to the relationship between the organizational and psychosocial workplace risk factors in the context of urban poverty in Rosario (Argentina)

El presente escrito aborda las relaciones entre el proceso de trabajo y los procesos de salud-enfermedad de docentes de Nivel Medio de la ciudad de Rosario (Argentina), en el contexto de las reformas educativas de la denominada posconvertibilidad. El objetivo específico de este artículo es analizar los riesgos organizacionales y psicosociales presentes en una escuela secundaria ubicada en un contexto barrial de creciente fragmentación, diferenciación socioeconómica y pobreza. El estudio se realiza a partir de un enfoque propio de la Antropología del Trabajo y retoma asimismo los aportes de la Medicina Social. En este sentido, entendemos los procesos productivos a partir de su condición sociohistórica y a los procesos de salud-enfermedad a estos asociados como expresión del conflicto entre capital y trabajo (Grimberg, 1991). Se privilegió el desarrollo del denominado enfoque etnográfico, el cual implicó optar por estrategias intensivas de construcción de la información, tales como la observación participante y las entrevistas semiestructuradas. A partir de un referente empírico acotado se identificaron riesgos psicosociales vinculados con la condición social de los alumnos y sus familias, los cuales forman parte de la dinámica escolar en el contexto específico. Asimismo, se profundizó la identificación y análisis de los riesgos organizacionales vinculados a las formas de contratación; tiempo de trabajo, salario y exigencias de capacitación. El enfoque propuesto que vincula analíticamente los riesgos psicosociales y organizacionales es plausible de ser retomado para abordar la relación trabajo-salud de docentes en otros contextos escolares similares(AU)

In this article, we analyze the relationships between the work process, psychosocial risk factors and the health-disease processes of secondary level school teachers in Rosario (Argentina), in the context of the so-called "postconvertibility educational reforms". The main objective was to analyze organizational and psychosocial risk factors, based on a case study of a school located in an urban area affected by increasing fragmentation, socioeconomic differentiation and poverty. We used an approach based on the anthropology of work, with some contributions from the field of social medicine. In this sense, we understand productive processes as based on their socio-historical condition, and the associated health-disease processes as the expression of the conflict between capital and work. We prioritized the implementation of the ethnographic approach, which led us to select intensive strategies to construct the information, such as participant observation and semi-structured surveys. Based on a limited empirical reference, we were able to identify psychological risks attached to the students and the social conditions of their family. These risks reflect the different dimensions of school dynamics within this general context. Moreover, we went further by identifying and analyzing the organizational risks connected to hiring, working time, wages and training demands. We consider that this approach, which connects psychological and the organizational risk factors, has been scarcely researched in studies in this area. Thus, it is plausible that it can be used to further investigate relationships between work and health among teachers in similar school contexts(AU)

Prevalence of Burnout Syndrome in staff of juvenile facilities: Differences according to their socio-labour context / Prevalência da síndrome de Burnout em pessoal de centros de menores: diferenças segundo seu contexto socioprofissional / Prevalência del síndrome de Burnout en personal de centros de menores: diferencias según su contexto sociolaboral

Abstract This study is aimed at determining the prevalence of burnout and its three components (emotional exhaustion, depersonalisation and lack of self-fulfilment) in the staff of juvenile facilities in Spain, and to analyze the predictive capacity of various epidemiological and occupational factors regarding the likelihood of suffering the aforementioned syndrome. For this end, a quantitative cross-sectional research was carried out with a sample of 160 professionals by means of an ad hoc questionnaire and the Maslach Burnout Inventory. The burnout results in juvenile facilities show an average impact of emotional exhaustion (40%) and self-fulfilment (41.2%) and a low depersonalisation (55.6%). Likewise, it is confirmed that the location and the age of the centre are significant sources of variation in emotional exhaustion, as well as gender is in depersonalisation, and profession in self-fulfilment. In conclusion, the greatest predisposition to suffer Burnout occurs in unmarried women aged between 34 and 43, with little work experience, permanent contract and working as social educators or social workers in alternate shifts (morning or afternoon) in urban centres.

Resumo O objetivo deste estudo foi determinar a prevalência da síndrome de burnout e de seus três componentes (esgotamento emocional, despersonalização e falta de realização pessoal) no pessoal de alguns centros de menores na Espanha e analisar a capacidade preditiva de diversos fatores epidemiológicos e profissionais sobre a probabilidade de padecer dessa síndrome. Para isso, realizou-se uma pesquisa quantitativa de corte transversal numa amostra de 160 profissionais mediante a aplicação de um questionário elaborado ad hoc e do Maslach Burnout Inventory. Os resultados obtidos mostram uma incidência média em esgotamento emocional (40%) e realização pessoal (41,2%), e uma baixa despersonalização (55,6%) no burnout de profissionais de centros de menores. Além disso, confirma-se que a localização do centro e a antiguidade são fontes significativas de variação no esgotamento emocional, bem como o sexo na despersonalização, e a profissão na realização pessoal. Em conclusão, a maior pré-disposição a sofrer burnout é produzida em mulheres solteiras, com idade entre 34 e 43 anos, com pouca experiência profissional, contrato fixo e que trabalham como educadoras ou trabalhadoras sociais em períodos alternados (manhã ou tarde) dos centros localizados em centros urbanos.

Resumen El objetivo del estudio fue determinar la prevalencia del síndrome de burnout y de sus tres componentes (agotamiento emocional, despersonalización y falta de realización personal) en el personal de algunos centros de menores en España y analizar la capacidad predictiva de diversos factores epidemiológicos y laborales sobre la probabilidad de padecer dicho síndrome. Para ello, se llevó a cabo una investigación cuantitativa de corte transversal en una muestra de 160 profesionales mediante la aplicación de un cuestionario elaborado ad hoc y el Maslach Burnout Inventory. Los resultados obtenidos muestran una incidencia media en agotamiento emocional (40 %) y realización personal (41.2 %), y una baja despersonalización (55.6 %) en el burnout de profesionales de centros de menores. Asimismo, se confirma que la ubicación del centro y la antigüedad son fuentes significativas de variación en el agotamiento emocional, así como el sexo en la despersonalización, y la profesión en la realización personal. En conclusión, la mayor predisposición a sufrir burnout se produce en mujeres solteras y con edades entre los 34 y 43 años, con poca experiencia laboral, contrato fijo, y que trabajan como educadoras o trabajadoras sociales en turnos alternos (mañana o tarde) de los centros ubicados en cascos urbanos.

Atendimento psicossocial a crianças e adolescentes em situação de violência: o psicólogo e a rede de atenção / Psychosocial care for children and adolescents in situation of violence: the psychologist and the attention network / Atención psicosocial para niños y adolescentes en situación de violencia: el psicólogo y la red de atención

Este estudo de caso discute o atendimento psicossocial oferecido a crianças e adolescentes em situação de violência, em um centro de extensão universitário voltado a essa clientela, no município de Goiânia (GO). Tratou-se de uma família que enfrentava situação de vulnerabilidade social e de violência física, encaminhada para instituição especializada no atendimento a situações de violação de direitos. Além do atendimento psicológico, foram necessárias ações para garantir os direitos desses sujeitos, o que exigiu da psicóloga um posicionamento estratégico para dialogar com outros profissionais e instituições. Entre os impasses para a eficácia dessas ações, destacaram-se a escassa e demorada articulação entre os profissionais da rede e a falta de capacitação no sentido de superar formas tradicionais de atendimento, correndo-se o risco de perpetuar práticas retrógradas e estigmatizantes em detrimento da doutrina da proteção integral.

This case study discusses the psychosocial care offered to children and adolescents in a situation of violence, in a university extension center addressed to this clientele, in the city of Goiânia (GO). It was a family that faced a situation of social vulnerability and physical violence, referred to an institution specialized in dealing with situations of violation of rights. In addition to psychological care, actions were required to guarantee the rights of these subjects, which required the Psychologist a strategic position to dialogue with other professionals and institutions. Among the impasses for the effectiveness of these actions were the scarce and time-consuming articulation between the network professionals and the lack of training in order to overcome traditional forms of care, running the risk of perpetuating retrograde and stigmatizing practices to the detriment of the doctrine of integral protection.

Este estudio de caso discute la atención psicosocial que se ofreció a niños y adolescentes en situación de violencia, en un centro de extensión universitario dirigido a esta clientela, en la ciudad de Goiânia (GO). Fue una familia que se enfrentó a una situación de vulnerabilidad social y violencia física, referida a una institución especializada en atender situaciones de violación de derechos. Además de la atención psicológica, se requerían acciones para garantizar los derechos de estos sujetos, lo que exigía de la psicóloga una posición estratégica para dialogar con otros profesionales e instituciones. Entre los impases para la efectividad de estas acciones estaban la escasa y demorada articulación entre los profesionales de la red y la falta de formación para superar las formas tradicionales de atención, corriendo el riesgo de perpetuar las prácticas retrógradas y estigmatizadoras en detrimento de la doctrina de protección integral.

Posturas en la atención psicosocial a víctimas del conflicto armado en Colombia / Postures in the psychosocial care to victims of the armed conflict in Colombia

El artículo presenta una revisión de la producción académica nacional relacionada con el tema de la atención psicosocial a víctimas del conflicto armado. La revisión se realizó a partirdel año 2000, con el objetivo de situar las principales consideraciones sobre los procesos de acompañamiento psicosocial a la población víctima de la violencia por el conflicto armadoen la historia reciente de Colombia. El análisis se hizo a partir de cuatro categorías: 1) Iniciativas estatales para la atención psicosocial a víctimas del conflicto armado; 2) Reflexiones investigativas sobre procesos de atención a víctimas; 3) Recomendaciones para las instituciones y profesionales que adelantan procesos de atención y reparación integrala víctimas; y 4) La reivindicación del sujeto en los procesos de atención. Los resultados de este trabajo presentan un panorama sobre las principales posturas asumidas en los escenarios de atención psicosocial a víctimas del conflicto en Colombia...

The article presents a review of the national academic production related to the subject of psycho-social care to armed conflict victims. The review was conducted from the year 2000,in order to locate main considerations about the processes of psycho-social accompaniment to the victims of violence by the armed conflict in the recent history of Colombia. The analysiswas made from four categories: 1) State initiatives for psycho-social care to victims of the armed conflict; (2) research reflections on processes of care to victims; (3) recommendationsfor the institutions and professionals carried out processes of care and full reparation to victims; and (4) the claim of the subject in the care processes. The results of this work present an overview of the main positions assumed in the scenarios of psycho-social care to victims of the conflict in Colombia...

Psychosocial and quality of life impact on patients with failed back surgery syndrome / Impacto psicossocial e na qualidade de vida de pacientes com síndrome dolorosa após laminectomia

BACKGROUND AND OBJECTIVES: Triggering and chronicity of failed back surgery syndrome should consider psychosocial and emotional factors which impair quality of life. This study aimed at identifying such factors and at evaluating quality of life of failed back surgery syndrome patients. METHODS: This is a descriptive, exploratory, comparative, cross-sectional study with quantitative approach. Sample was made up of a test group (I) diagnosed with failed back surgery syndrome (n=16) and a control group (II) undergoing inter-consultation in the Pain Clinic (n=15). Tools were the visual analog scale and Fischer dolorimeter. WHOQOL-Bref questionnaire was used to evaluate quality of life and Beck Anxiety Inventory and Depression Inventory were used to evaluate emotional factors anxiety and depression. RESULTS: There has been predominance of females on both groups, mean age was 42.3±5.8 (group I), most were married and mean education was 8.4±3.0 years. Mean pain duration was 0.7±0.3 months after surgery in group I with lower pain threshold. Physical dimensions and social relations were the most affected on quality of life, as well as anxiety and depression levels. CONCLUSION: Our results have shown worse pain, quality of life, anxiety and depression in group I, suggesting a better knowledge of potential postoperative complications aiming at preventing the establishment of an abnormal functionality pattern. .

JUSTIFICATIVA E OBJETIVOS: O desencadeamento e a cronificação da síndrome dolorosa pós-laminectomia deve considerar fatores psicossociais e emocionais, que comprometem a qualidade de vida. O objetivo deste estudo foi identificar esses fatores e avaliar a qualidade de vida de pacientes com síndrome dolorosa pós-laminectomia. MÉTODOS: Trata-se de um estudo descritivo, exploratório, comparativo, de corte transversal e abordagem quantitativa, com amostra de um grupo teste (I), com diagnóstico de síndrome dolorosa pós-laminectomia (n=16) e um grupo controle (II) submetido a interconsulta na Clínica da Dor (n=15). Os instrumentos foram a escala analógica visual e o dolorímetro de Fischer. Para avaliar a qualidade de vida, foi utilizado questionário WHOQOL-Bref e para os fatores emocionais ansiedade e depressão, o Inventario Beck de Ansiedade e de Depressão. RESULTADOS: Na amostra dos dois grupos houve predomínio do gênero feminino, média de idade de 42,3±5,8 anos (grupo I), maioria casada e média de escolaridade de 8,4±3,0 anos. O tempo médio de dor foi de 0,7±0,3 meses após a cirurgia no grupo I com limiar de dor mais baixo. As dimensões físicas e relações sociais foram as mais comprometidas na qualidade de vida, assim como os níveis de ansiedade e depressão. CONCLUSÃO: Esses resultados mostraram pior dor, qualidade de vida, ansiedade e depressão no grupo I, sugerindo maior conhecimento de possíveis complicações pós-operatórias buscando não permitir que se estabeleça um padrão anormal de funcionalidade. .

Evaluación de los riesgos psicosociales con el instrumento CTCPS-MAC -batería para el estudio de la condiciones de trabajo de carácter psicosocial- en el Departamento de Obras Públicas de un ayuntamiento del sur de Jalisco (México) / Evaluation of the psycho-social risks with the instrument "CTCPS-MAC" -support for the study of the conditions of the psycho-social work- in the Department of Public Works of the city hall of the South of Jalisco (México)

Objetivo: Describir las condiciones de trabajo de carácter psicosocial percibidas por el personal del Departamento de Obras Públicas de un ayuntamiento del sur de Jalisco (México). Materiales y métodos: El estudio fue descriptivo y se realizó en una muestra de 53 empleados de diferentes áreas de la organización compuesta por 115 trabajadores. Se utilizó el CTCPS-MAC: Batería para el estudio de las condiciones de trabajo de carácter psicosocial. Resultados: Se obtuvieron datos sociodemográficos de los participantes, así como de las dimensiones y los factores de riesgo que componen cada una de ellas. Se encontró que si bien hay una percepción de que las condiciones de trabajo de carácter psicosocial se encuentran en niveles de "bueno" y "muy bueno", sin embargo, se presentan puntuaciones de regular a nocivo para algunos casos. Conclusión: La dimensión contenido de trabajo es percibida por el 41.5 % como regular también en tres de sus cuatro factores, con 41.5 % ambientes laborales, con 45.3 % equipo y agentes físicos y con 32.1 % concepción de las tareas del puesto de trabajo, y se registró además casos en nivel nocivo, que también presenta el factor papel o rol en la organización de la dimensión contexto de trabajo y el factor síntomas subjetivos y alteraciones de la salud -estados psicológicos- respuesta fisiológica de la dimensión desgaste psíquico, por lo cual se necesita un proceso de intervención.

Objective: To describe the work conditions of psycho-social character perceived by the personnel of the department of Public Works of the City Hall of the South of Jalisco (M éxico). Materials and methods: The study was descriptive and was realized in a sample of 53 employees of different areas of the organization composed by 115 workers. CTCPS-MAC: support for the study of the conditions of the psycho-social work, was in use. Results: Social-demographic information was obtained of the participants as well as of the dimensions and the risks factors that compose each of them. It found that though there is a perception of which the conditions of work of psycho-social character are in levels of "good" and "very good". Nevertheless, they present punctuations of regular to harmfully in some cases. Conclusion: The dimension contained of work is perceived by 41.5 % as regular, also in three of its four factors with 41.5 % with work environment, with 45.3 % team and physical agents and, with 32.1 % conception of the tasks of the working place registering in additional cases in harmful level that also presents the role factor in the organization of the dimension of work context and the subjective factor symptoms and alterations of the health -psychological conditions- physiological response of the dimension spoils psychically by what a process of intervention is needed.

Reparación a las víctimas de dictaduras, conflictos armados y violencia política. Parte I / Repair to the victims of dictatorships, armed conflicts, and political violence. Part I

El presente trabajo, el primero de dos entregas, trae a colación investigaciones y reflexiones teóricas que dan cuenta de las experiencias de diversos países que han desarrollado procesos transicionales, teniendo como centro de análisis el proceso de reparación a las víctimas. Es importante anotar que la perspectiva psicosocial constituye el punto de referencia desde el cual se lleva a cabo la revisión y que, en congruencia con ésta, se hace especial énfasis en aquellos estudios que han dado protagonismo a la voz, percepción y significación de las personas víctimas en torno a los fenómenos aquí abordados.

This current paper, the first of two issues, brings up some research and theoretical reflections, which report the experiences of several countries that have developed some transitional processes, taking as the center of analysis, the process of the repair of victims. It is important to highlight that the psycho-social perspective constitutes the point of reference from which the revision is carried out, and that, in line with it, a special emphasis is made on those studies, which have given a leading role to the voice, perception, and significance to those victims of the phenomena addressed here.

Avaliação de política em saúde mental sob o viés da alteridade radical / Mental health policy evaluation under the radical alterity viewpoint

Realizou-se pesquisa de tese em História Social, sob a vertente da História Oral, com o objetivo de avaliar a política de saúde mental do município de Quixadá, no período de 1993 a 2012. Foram selecionados quatro depoimentos de pessoal diretamente responsável pela construção da política, em sua primeira gestão: o prefeito, o supervisor de serviço, um auxiliar de Enfermagem e um médico. Os depoimentos foram analisados utilizando como referencial teórico a ética da alteridade radical. Consensualmente, os depoimentos apontavam para o entendimento de que, além de o paciente e sua família precisarem de cuidados, intervenções se faziam necessárias no sentido de apresentar a loucura à cidade, como forma de diminuir o preconceito. Sugere-se, a partir dos relatos dessa boa prática, a criação de um novo critério de avaliação dos serviços em saúde mental, qual seja, sua efetividade em gerar, na sociedade, novas formas de lidar com a diferença e com o outro...

We conducted thesis research in Social History, under the aspect of Oral History in order to assess the mental health policy of the city of Quixadá, Brazil, from 1993 to 2012. Testimonials from four directly responsible personnel were selected for the construction of politics in their first term: the mayor, the service supervisor, a nursing assistant and a physician. The interviews were analyzed using as a theoretical ethics of radical otherness. Consensually, the testimonies pointed to the understanding that, in addition to the patient and his family need care, interventions were necessary in order to present to the city madness as a way to reduce prejudice. It is suggested, based on the reports of this good practice, the creation of a new criterion for the evaluation of mental health services, namely, its effectiveness in generating, in society, new ways of dealing with difference and with each other...

Fatores de risco relacionados com suicidios em Palmas (TO), Brasil, 2006-2009, investigados por meio de autopsia psicossocial / Risk factors associated with suicides in Palmas in the state of Tocantins, Brazil, between 2006 and 2009 investigated by psycho-social autopsy

Este artigo objetiva analisar e descrever os fatores de risco e seus determinantes, associados a 24 casos de suicídios ocorridos na cidade de Palmas (TO), no período de 2006 a 2009. Utilizou-se o método de autópsia psicológica e psicossocial, a qual, por meio de entrevistas com familiares, busca investigar os suicídios consumados, contextualizando características da vida do sujeito, e compreender os processos familiares e as circunstâncias afetivas, sociais, econômicas e culturais, fundamentando-se na reconstrução da história e da personalidade da pessoa. Os fatores socioeconômicos associados foram: ser do sexo masculino, solteiro, de cor parda, estar na faixa etária de 20 a 40 anos e com ensino fundamental. Os principais fatores de risco identificados foram: transtornos mentais, abuso de álcool e outras drogas, relacionamento familiar conturbado e histórico de tentativas anteriores. Buscamos contextualizar e refletir sobre alguns casos relatados pelos familiares e sobre a resposta das equipes de saúde às demandas das famílias. A necessidade de implantar programas de prevenção e de capacitar os profissionais da atenção básica foi verificada. .

The scope of this article is to analyze and describe the risk factors and determinants linked to 24 suicides in the city of Palmas in the state of Tocantins between 2006 and 2009. The psychological and psycho-social autopsy method was used in order to investigate the consummated suicides by interviewing family members. It contextualized the subjects' life characteristics to understand the family dynamics and the affective, social, economic and cultural background, based on the reconstruction of the history and personality of the individuals. The associated socio-economic factors were: being male, aged between 20 and 40, single, with mixed ethnicity and basic education. The major risk factors identified were: mental disorder, alcohol and other drug abuse, disturbed family relationship and a history of previous suicide attempts. An attempt was made to contextualize and reflect on some cases reported by family members, as well as on the response of the health care teams to the demands of the families. The need to implement prevention programs and to train the primary health care professionals was considered a priority. .

Memoria, historaas de vida y papel de la escuch en la transformación subjetivaa de víctimas / sobrevivientes del conflicto armado Colombiano / Ope chair memoryy, ife stories, and the role of listening in the ssubjective transformation of victims / survivors of the Colombian armed conflict

El presente artículo de investigación pretende, desde una mirada cualitativa, evidenciar la importancia de los procesos de intervención/investigación en memoria colectiva y memoria histórica, fundamentados en la elaboración de historias de vida, para la construcción de miradas complejas y la reflexión sobre aspectos psicosociales, socio-simbólicos y socio-estructurales, tanto de los sujetos participantes, como también de los contextos en los cuales habitan y se mueven estos sujetos, en particular en su relación con el conflicto armado, sus consecuencias en la subjetividad, pero también las resistencias, las formas de afrontamiento y los procesos de transformación vividos. En el presente texto se evidencia cómo se puede hacer una mirada de lógicas del conflicto armado en Colombia a partir de los relatos de vida 58 participantes y las historias de vida de 4 participantes más. Además, de mostrar la importancia del testimonio y su relación con la escucha en los procesos de reconstrucción de la memoria y la acción psicosocial con víctimas del conflicto armado colombiano. Lo que lleva a concluir, que las historias y relatos de vida referidas tienen en común, como hilo conductor la resistencia (incluyendo al afrontamiento y la resiliencia), es decir, una lectura, una interpretación centrada en las capacidades, en la fuerza para asumir, en las salidas que se fueron encontrando, en las luchas cotidianas y en los sentidos encontrados aún en medio del horror.

This research article aims to demonstrate, from a qualitative point of view, the importance of the processes of intervention and research in both collective memory and historical memory, based on the development of life stories, for the construction of complex looks and the reflection on psychosocial, socio-symbolic and socio-structural aspects, both of the participating subjects and the contexts in which these subjects live and move, particularly in their relationship with the armed conflict, their consequences on subjectivity, but also the resistance, the forms of the coping perspective, and the processes of transformation experienced. In this text, it is made evident the manner how the armed conflict in Colombia can be looked logically, from the real-life stories of 58 participants and the life stories of 4 other participants. Besides, of showing the importance of the testimony and its relationship with the listening in the reconstruction processes of the memory and the psychosocial action with victims of the Colombian armed conflict, which leads to the conclusion, that the real-life stories and life stories herein referred, have in common, is resistance as the main driving force (including the coping perspective and resilience), that is to say, a reading, an interpretation based on the capabilities, in the force to assume, in the solutions provided, in the daily struggle, and in the senses found, even in the midst of horror.

Diagnóstico psioosocial de un barrio en la ciudad de Armenia / Psyho-social diaagnosis of a neighborhood in the city of Armenia

Este artículo presenta los resultados un diagnostico psicosocial realizado a un barrio de la ciudad de Armenia, en el cual se identificaron las principales problemáticas que vive esta comunidad: robos, expendio y consumo de sustancias psicoactivas y múltiples manifestaciones de violencia urbana que evidencian el débil capital social existente. Para llevar a cabo este diagnóstico, se realizaron talleres y entrevistas a niños, niñas, jóvenes y adultos del barrio, árbol de problemas y cartografía social. Se evidenció un cambio en la percepción de la comunidad sobre la violencia e inseguridad en el barrio, que indica un supuesto descenso en la ocurrencia de estas problemáticas. Al realizar una discusión retomando teorías que abordan el tema de la violencia y las drogas, se infirió que las bandas dedicadas al control y expendio de drogas en el barrio han pasado de una delincuencia desorganizada a una organizada, lo cual explica la aparente disminución de las problemáticas. Asimismo, se realizó un contraste de resultados a la luz de la teoría del capital social y el bienestar social, en el que se sugirieron posibles estrategias de intervención para que la comunidad participe activamente en la resolución de sus dificultades.

This article presents the results of a psycho-social diagnosis performed to a neighborhood of the city of Armenia, in which the main problems affecting this community were identified: thefts, sale and consumption of psychoactive substances and multiple manifestations of urban violence that underscore the weak existing social capital. To carry out this diagnosis, workshops and interviews with children, young people and adults of the neighborhood, tree problems and social mapping were carried out. A change in the perception of the community on violence and insecurity in the area was made evident, indicating a supposed decline in the occurrence of these problems. By carrying out a discussion and taking up theories that address the issue of violence and drugs, it was inferred that gangs dedicated to the control and sale of drugs in the neighborhood have moved from a disorganized to an organized crime which explains the apparent decline of the problems. In the same way, a contrast of results was made in the light of the theory of the social capital and social welfare, in which possible intervention strategies were suggested so that the community may actively participate in the resolution of their difficulties.

Contribuições da psicanálise para a clínica de atenção psicossocial / Contributions of psychoanalysis to psychosocial care / Les contributions de la psychanalyse à la clinique des soins psycho-sociaux

O psicólogo é o profissional que, mais frequentemente, insere a psicanálise na atenção psicossocial, devendo problematizar e sustentar teoricamente seu fazer sem menosprezar outros saberes. Esta implicação ética viabiliza atuações em equipes multidisciplinares, priorizando o atendimento de qualidade ao atentar para a escuta da singularidade dos usuários. Para responder como a psicanálise tem contribuído para a clínica de atenção psicossocial, foi realizada uma pesquisa qualitativa de caráter bibliográfico, classificada como “Estado da Arte”, no banco de dados do SciELO, a partir das palavras-chave “psicanálise e clínica social”. Os artigos selecionados relacionam psicanálise e atenção psicossocial, problematizando e articulando propostas que, para propiciar uma análise mais específica, foram organizadas neste trabalho em três categorias: a psicanálise na interface com outros saberes, a transferência nos dispositivos psicossociais e a singularidade no espaço coletivo. Percebe-se que as transformações no atendimento aos usuários da atenção psicossocial são proporcionais à escuta realizada pela psicanálise

The psychologist is the professional that is more often, prone to insert psychoanalysis in psychosocial care and whose assignment is to define the issues to be addressed by the psychological treatment and to give it theoretical sustenance to his without ignoring other knowledge. This ethical implication enables him to perform in multidisciplinary teams, prioritizing the quality of the care when attempting to understand the users' singularity. In order to define the ways in which psychoanalysis has contributed to the psychosocial care, a qualitative research of bibliographical character, named as "State of the Art ", in SciELO database, using the keywords "social and clinical psychoanalysis " was performed. The articles that were selected relate psychoanalysis and psychosocial care, discussing and articulating proposals that in order to provide a more specific analysis, were organized into three categories: the interface of psychoanalysis with other knowledge, transference in psychosocial systems and singularity in the collective space. It is noticed that the changes in the treatment of the patients of psychosocial care are proportional to psychoanalytical listening

Le psychologue est un professionnel qui fera le plus souvent l’insertion de la psychanalyse dans les soins psychosociaux , devant savoir problématiser et donner du soutien théorique a sa pratique sans négliger d'autres connaissances. Ce compromis éthique lui permet de participer a des équipes multidisciplinaires qui priorisent la qualité des soins par le biais de l’écoute de la singularité de l’utilisateur. Une étude qualitative de caractère bibliographique classée sous l’expression " état ​​de l'art ", a été réalisée dans la base de données SciELO , a partir des mots clés ® psychanalyse sociale et clinique ¼, pour definir de quelle manière la psychanalyse a contribué à la prise en charge de la clinique psychosociale. Les articles choisis mettent em relation la psychanalyse et les soins psycho-sociaux , tracent des problématiques et articulent des propositions qui ont été organisées en trois catégories pour fournir une analyse plus spécifique: la psychanalyse à l'interface avec d'autres connaissances, le transfert dans les​​ dispositifs psycho-sociaux et la singularité dans l'espace collectif . On remarque que les changements dans les services des utilisateurs des soins psychosociaux sont proportionnels à l’écoute réalisée par la psychanalyse