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1.
Post Reprod Health ; 27(1): 10-18, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33673758

RESUMO

Menopause is a major life event affecting all women in a variety of ways, both short and long term. All women should have access to accurate information, available in all forms and through all recognised sources. All healthcare professionals should have a basic understanding of the menopause and know where to signpost women for advice, support and treatment whenever appropriate. Every primary care team should have at least one nominated healthcare professional with a special interest and knowledge in menopause. All healthcare professionals with a special interest in menopause should have access to British Menopause Society Menopause Specialists for advice, support, onward referral and leadership of multidisciplinary education. With the introduction of the comprehensive British Menopause Society Principles and Practice of Menopause Care programme, the society is recognised throughout the UK as the leading provider of certificated menopause and post reproductive health education and training for healthcare professionals. Restrictions imposed by the coronavirus pandemic have been a springboard for the British Menopause Society to bring innovations to the services provided for our membership and for healthcare professionals throughout the UK.


Assuntos
Menopausa , Programas Nacionais de Saúde , Equipe de Assistência ao Paciente , Qualidade de Vida , /epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Comunicação Interdisciplinar , Menopausa/fisiologia , Menopausa/psicologia , Saúde Mental/normas , Programas Nacionais de Saúde/organização & administração , Programas Nacionais de Saúde/tendências , Inovação Organizacional , Assistência ao Paciente/métodos , Assistência ao Paciente/normas , Equipe de Assistência ao Paciente/organização & administração , Equipe de Assistência ao Paciente/tendências , Melhoria de Qualidade , Comportamento de Redução do Risco , Reino Unido/epidemiologia
2.
BMC Pregnancy Childbirth ; 21(1): 171, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33648450

RESUMO

BACKGROUND: Psychological stress and coping experienced during pregnancy can have important effects on maternal and infant health, which can also vary by race, ethnicity, and socioeconomic status. Therefore, we assessed stressors, coping behaviors, and resources needed in relation to the COVID-19 pandemic in a sample of 162 perinatal (125 pregnant and 37 postpartum) women in the United States. METHODS: A mixed-methods study captured quantitative responses regarding stressors and coping, along with qualitative responses to open-ended questions regarding stress and resources needed during the COVID-19 pandemic. Logistic and linear regression models were used to analyze differences between pregnant and postpartum participants, as well as differences across key demographic variables. Qualitative content analysis was used to analyze open-ended questions. RESULTS: During the COVID-pandemic, food scarcity and shelter-in-place restrictions made it difficult for pregnant women to find healthy foods. Participants also reported missing prenatal appointments, though many reported using telemedicine to obtain these services. Financial issues were prevalent in our sample and participants had difficulty obtaining childcare. After controlling for demographic variables, pregnant women were less likely to engage in healthy stress-coping behaviors than postpartum women. Lastly, we were able to detect signals of increased stressors induced by the COVID-19 pandemic, and less social support, in perinatal women of racial and ethnic minority, and lower-income status. Qualitative results support our survey findings as participants expressed concerns about their baby contracting COVID-19 while in the hospital, significant others missing the delivery or key obstetric appointments, and wanting support from friends, family, and birthing classes. Financial resources, COVID-19 information and research as it relates to maternal-infant health outcomes, access to safe healthcare, and access to baby supplies (formula, diapers, etc.) emerged as the primary resources needed by participants. CONCLUSIONS: To better support perinatal women's mental health during the COVID-19 pandemic, healthcare providers should engage in conversations regarding access to resources needed to care for newborns, refer patients to counseling services (which can be delivered online/via telephone) and virtual support groups, and consistently screen pregnant women for stressors.


Assuntos
Adaptação Psicológica , Recursos em Saúde/organização & administração , Acesso aos Serviços de Saúde , Poder Familiar/psicologia , Assistência Perinatal , Educação Pré-Natal/métodos , /epidemiologia , /psicologia , Feminino , Alocação de Recursos para a Atenção à Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/tendências , Humanos , Recém-Nascido , Saúde Mental/normas , Determinação de Necessidades de Cuidados de Saúde , Assistência Perinatal/métodos , Assistência Perinatal/organização & administração , Assistência Perinatal/tendências , Gravidez , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Telemedicina/métodos , Telemedicina/organização & administração , Estados Unidos
3.
Mo Med ; 118(1): 7-12, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33551470

RESUMO

Medical students, residents, and practicing physicians experience high burnout, depression, and suicide rates, and the COVID-19 pandemic has exacerbated stress for many.1-6 While laudable, current well-being efforts appear insufficient to meet the challenges that so many are facing. This essay explores approaches that individuals and organizations can take to promote mental health and well-being from medical school to practice.


Assuntos
/psicologia , Saúde Mental/normas , Médicos/psicologia , Estudantes de Medicina/psicologia , Adaptação Psicológica/fisiologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/terapia , /epidemiologia , Terapia Cognitivo-Comportamental/métodos , Depressão/epidemiologia , Depressão/terapia , Humanos , Sistema Límbico/fisiopatologia , Saúde Mental/estatística & dados numéricos , Atenção Plena/métodos , Faculdades de Medicina/organização & administração , Faculdades de Medicina/normas , Estresse Psicológico/complicações , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Suicídio/prevenção & controle , Suicídio/psicologia , Suicídio/estatística & dados numéricos
4.
J Med Internet Res ; 23(1): e24983, 2021 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-33411670

RESUMO

BACKGROUND: The death toll of COVID-19 topped 170,000 in Europe by the end of May 2020. COVID-19 has caused an immense psychological burden on the population, especially among doctors and nurses who are faced with high infection risks and increased workload. OBJECTIVE: The aim of this study was to compare the mental health of medical professionals with nonmedical professionals in different European countries during the COVID-19 pandemic. We hypothesized that medical professionals, particularly those exposed to COVID-19 at work, would have higher levels of depression, anxiety, and stress. We also aimed to determine their main stressors and most frequently used coping strategies during the crisis. METHODS: A cross-sectional online survey was conducted during peak COVID-19 months in 8 European countries. The questionnaire included demographic data and inquired whether the participants were exposed to COVID-19 at work or not. Mental health was assessed via the Depression Anxiety Stress Scales32 (23.53)-21 (DASS-21). A 12-item checklist on preferred coping strategies and another 23-item questionnaire on major stressors were completed by medical professionals. RESULTS: The sample (N=609) consisted of 189 doctors, 165 nurses, and 255 nonmedical professionals. Participants from France and the United Kingdom reported experiencing severe/extremely severe depression, anxiety, and stress more often compared to those from the other countries. Nonmedical professionals had significantly higher scores for depression and anxiety. Among medical professionals, no significant link was reported between direct contact with patients with COVID-19 at work and anxiety, depression, or stress. "Uncertainty about when the epidemic will be under control" caused the most amount of stress for health care professionals while "taking protective measures" was the most frequently used coping strategy among all participants. CONCLUSIONS: COVID-19 poses a major challenge to the mental health of working professionals as a considerable proportion of our participants showed high values for depression, anxiety, and stress. Even though medical professionals exhibited less mental stress than nonmedical professionals, sufficient help should be offered to all occupational groups with an emphasis on effective coping strategies.


Assuntos
/psicologia , Pessoal de Saúde/psicologia , Saúde Mental/normas , Estresse Psicológico/epidemiologia , /epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Internet , Masculino , Pandemias , Inquéritos e Questionários
6.
J Child Psychol Psychiatry ; 62(1): 1-4, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33368223

RESUMO

Since the COVID-19 pandemic took hold in the first quarter of 2020, children and their families across the world have experienced extraordinary changes to the way they live their lives - creating enormous practical and psychological challenges for them at many levels. While some of these effects are directly linked to COVID-related morbidity and mortality, many are indirect - due rather to governmental public health responses designed to slow the spread of infection and minimise the numbers of deaths. These have often involved aggressive programmes of social distancing and quarantine, including extended periods of national social and economic lockdown, unprecedented in the modern age. Debates about the appropriateness of these measures have often referenced their potentially negative impact on people's mental health and well-being - impacts which both opponents and advocates appear to accept as being inevitable.


Assuntos
Comunicação em Saúde , Política de Saúde , Saúde Mental , Quarentena/psicologia , Adulto , Criança , Comunicação em Saúde/normas , Humanos , Saúde Mental/normas
7.
J Med Internet Res ; 23(1): e18722, 2021 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-33347423

RESUMO

BACKGROUND: China was the first country in the world to experience a large-scale COVID-19 outbreak. The rapid spread of the disease and enforcement of public health measures has caused distress among vulnerable populations such as pregnant women. With a limited understanding of the novel, emerging infectious disease, pregnant women have sought ways to access timely and trusted health care information. The mental health status of pregnant women during this public health emergency, as well as how they responded to the situation and where and how they obtained antenatal care information, remain to be understood. OBJECTIVE: This study aimed to evaluate the mental health status of pregnant women during the COVID-19 epidemic in China by measuring their perceived stress, anxiety, and depression levels; explore the approaches used by them to access antenatal health care information; and determine their associations with maternal mental health status. METHODS: We conducted a web-based, cross-sectional survey to assess the mental health status of Chinese pregnant women by using the validated, Chinese version of Perceived Stress Scale, Self-Rating Anxiety Scale, and Edinburgh Depression Scale. We also collected information on the various approaches these women used to access antenatal care information during the early stage of the COVID-19 epidemic, from February 5 to 28, 2020. RESULTS: A total of 1873 pregnant women from 22 provinces or regions of China participated in the survey. The prevalence of perceived stress, anxiety, and depression among these participants was 89.1% (1668/1873; 95% CI 87.6%, 90.4%), 18.1% (339/1873; 95% CI 16.4%, 19.9%), and 45.9% (859/1873; 95% CI 43.6%, 48.1%), respectively. Hospitals' official accounts on the Chinese social media platforms WeChat and Weibo were the most popular channels among these pregnant women to obtain antenatal care information during the COVID-19 outbreak. Access to antenatal care information via the hospitals' official social media accounts was found to be associated with a significantly lower risk of perceived stress (adjusted odds ratio [aOR] 0.46, 95% CI 0.30-0.72; P=.001), anxiety (aOR 0.53, 95% CI 0.41-0.68; P<.001), and depression (aOR 0.73, 95% CI 0.59-0.91; P=.005). Access to health care information via hospital hotlines or SMS was found to be significantly associated with a lower risk of anxiety only (OR 0.77, 95% CI 0.60-0.98; P=.04). CONCLUSIONS: During the COVID-19 outbreak in China, pregnant women experienced high levels of perceived stress, anxiety, and depression. During such public health emergencies, mental health care services should be strengthened to reassure and support pregnant women. Specific information targeted at pregnant women, including information on how to cope in an emergency or major disease outbreak, developed and disseminated by health care institutions via social media platforms could be an effective way to mitigate mental health challenges and ensure epidemic preparedness and response in the future.


Assuntos
/complicações , Nível de Saúde , Saúde Mental/normas , Cuidado Pré-Natal/métodos , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Internet , Gravidez , Mídias Sociais , Inquéritos e Questionários
8.
Rev. enferm. UERJ ; 28: 49923, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1097213

RESUMO

Objetivo: refletir sobre as intervenções/ações de cuidado em saúde mental voltados aos profissionais da saúde que prestam assistência ao paciente suspeito ou diagnosticado com COVID-19. Conteúdo: A pandemia de COVID-19 traz o desafio para profissionais da saúde em lidar com sua própria saúde mental e a dos pacientes. É fundamental conhecer e refletir sobre iniciativas que países apresentam para lidar com a manutenção da saúde mental de profissionais da saúde em tempos de pandemia e que contribuem para repensar o planejamento, execução e avaliação de estratégias a serem utilizadas no Brasil. Considerações finais: foi possível elencar ações em saúde mental que têm se mostrado assertivas no cuidado aos trabalhadores de saúde, atuantes na ponta do cuidado, sobretudo as baseadas no esclarecimento da doença, uso adequado de equipamentos de proteção individual, além do mapeamento daqueles profissionais fragilizados emocionalmente e/ou com sofrimento mental anterior à pandemia, além do suporte emocional oferecido por meio de plataformas digitais.


Objective: to reflect on mental health care interventions/actions aimed at health professionals who provide assistance to patients suspected or diagnosed with COVID-19. Content: The COVID-19 pandemic challenges health professionals to lead with their own and patients' mental health. It is essential to know and to reflect about countries' initiatives to deal with health professional's mental health maintenance in times of pandemic, and to help to re-think strategies planning, execution and evaluation to be used in Brazil. Final considerations: it was possible to list actions in mental health that have shown to be assertive in the care of health workers who are in the front line of caring, especially those based on clarifying the disease, appropriate use of individual protective equipment, in addition to mapping those emotionally weakened professionals and or with mental suffering prior to the pandemic, in addition to the emotional support offered through digital platforms.


Objetivo: reflexionar sobre las intervenciones/acciones de atención de salud mental dirigidas a profesionales de la salud que prestan asistencia a pacientes sospechosos o diagnosticados con COVID-19. Contenido: La pandemia COVID-19 desafía a los profesionales de la salud a hacer frente con la salud mental propia y de los pacientes. Es esencial conocer y reflexionar sobre las iniciativas de los países para enfrentar al mantenimiento de la salud mental de los profesionales de la salud en tiempos de pandemia, y para ayudar a repensar la planificación, ejecución y evaluación de estrategias que se utilizarán en Brasil. Consideraciones finales: fue posible enumerar acciones en salud mental que han demostrado ser asertivas en la atención de los trabajadores de salud que trabajan en la primera línea de atención de la salud, especialmente aquellos basados en la aclaración de la enfermedad, el uso apropiado de equipos de protección individual, además de mapear aquellos profesionales debilitados emocionalmente y / o con sufrimiento mental antes de la pandemia, además del apoyo emocional ofrecido a través de plataformas digitales.


Assuntos
Humanos , Masculino , Feminino , Saúde Mental/normas , Pessoal de Saúde/psicologia , Infecções por Coronavirus , Pandemias , Betacoronavirus , Brasil , Saúde do Trabalhador , Disseminação de Informação , Equipamento de Proteção Individual
9.
BMC Psychol ; 8(1): 124, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33239078

RESUMO

BACKGROUND: Marital separation is associated with mental health problems, but little is known about how this translates into healthcare use. In this study, we examine the relationship between marital separation and primary healthcare use for mental health problems. METHODS: We used data covering the period from 2005 to 2015 from the Norwegian Population Register, Statistics Norway's Educational Registration System and the Norwegian Health Economics Database. Data were analyzed using logistic regression analysis. To control for time invariant characteristics, we estimated fixed-effect models. RESULTS: Marital separation was associated with increased contact with primary healthcare services for mental health problems (MH-consultations). The prevalence of MH-consultations peaked during the year of marital separation. MH-consultations were more common following marital separation than prior to the separation. This pattern remained significant in the fixed-effect models. CONCLUSIONS: Men and women who experienced marital separation were more likely to consult primary healthcare services for mental health problems than those who remained married. Our study suggests that several mechanisms are in play. The prevalence of MH-consultations of those who eventually separated were higher several years prior to the separation. This lends support to selection mechanisms, whereas the sharp rise in the prevalence of MH-consultations around the time of marital separation coupled to higher levels several years after separation, indicate that marital separation induces both transient stress and leads to more lasting strain.


Assuntos
Divórcio/psicologia , Saúde Mental/normas , Atenção Primária à Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Estado Civil , Noruega/epidemiologia , Prevalência
10.
J Occup Health ; 62(1): e12169, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33009709

RESUMO

In this Opinion, we synthesize recent evidence regarding the mental health impacts of the pandemic with an emphasis on health care workers. Departing from the literature that has already been published on this topic, we focus on health care workers with mental health concerns that preexisted the pandemic and discuss evidence suggesting that this population has suffered disproportionately from pandemic conditions.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/psicologia , Saúde Mental/normas , Estresse Ocupacional/epidemiologia , Pneumonia Viral/epidemiologia , Atitude do Pessoal de Saúde , Betacoronavirus , Humanos , Pandemias
11.
Trials ; 21(1): 870, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33087178

RESUMO

BACKGROUND: The acknowledgment of the mental health toll of the COVID-19 epidemic in healthcare workers has increased considerably as the disease evolved into a pandemic status. Indeed, high prevalence rates of depression, sleep disorders, and post-traumatic stress disorder (PTSD) have been reported in Chinese healthcare workers during the epidemic peak. Symptoms of psychological distress are expected to be long-lasting and have a systemic impact on healthcare systems, warranting the need for evidence-based psychological treatments aiming at relieving immediate stress and preventing the onset of psychological disorders in this population. In the current COVID-19 context, internet-based interventions have the potential to circumvent the pitfalls of face-to-face formats and provide the flexibility required to facilitate accessibility to healthcare workers. Online cognitive behavioral therapy (CBT) in particular has proved to be effective in treating and preventing a number of stress-related disorders in populations other than healthcare workers. The aim of our randomized controlled trial study protocol is to evaluate the efficacy of the 'My Health too' CBT program-a program we have developed for healthcare workers facing the pandemic-on immediate perceived stress and on the emergence of psychiatric disorders at 3- and 6-month follow-up compared to an active control group (i.e., bibliotherapy). METHODS: Powered for superiority testing, this six-site open trial involves the random assignment of 120 healthcare workers with stress levels > 16 on the Perceived Stress Scale (PSS-10) to either the 7-session online CBT program or bibliotherapy. The primary outcome is the decrease of PSS-10 scores at 8 weeks. Secondary outcomes include depression, insomnia, and PTSD symptoms; self-reported resilience and rumination; and credibility and satisfaction. Assessments are scheduled at pretreatment, mid-treatment (at 4 weeks), end of active treatment (at 8 weeks), and at 3-month and 6-month follow-up. DISCUSSION: This is the first study assessing the efficacy and the acceptability of a brief online CBT program specifically developed for healthcare workers. Given the potential short- and long-term consequences of the COVID-19 pandemic on healthcare workers' mental health, but also on healthcare systems, our findings can significantly impact clinical practice and management of the ongoing, and probably long-lasting, health crisis. TRIAL REGISTRATION: ClinicalTrials.gov NCT04362358 , registered on April 24, 2020.


Assuntos
Betacoronavirus/genética , Terapia Cognitivo-Comportamental/métodos , Infecções por Coronavirus/terapia , Pessoal de Saúde/psicologia , Intervenção Baseada em Internet/estatística & dados numéricos , Pneumonia Viral/terapia , Adulto , Idoso , Biblioterapia/métodos , Estudos de Casos e Controles , Terapia Cognitivo-Comportamental/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/virologia , Assistência à Saúde/estatística & dados numéricos , Depressão/epidemiologia , Depressão/prevenção & controle , Feminino , França/epidemiologia , Humanos , Masculino , Saúde Mental/normas , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/virologia , Prevalência , Estudos Prospectivos , Resiliência Psicológica , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/prevenção & controle , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Resultado do Tratamento
13.
Eur Urol ; 78(5): 731-742, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32893062

RESUMO

CONTEXT: The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid changes in medical practice. Many of these changes may add value to care, creating opportunities going forward. OBJECTIVE: To provide an evidence-informed, expert-derived review of genitourinary cancer care moving forward following the initial COVID-19 pandemic. EVIDENCE ACQUISITION: A collaborative narrative review was conducted using literature published through May 2020 (PubMed), which comprised three main topics: reduced in-person interactions arguing for increasing virtual and image-based care, optimisation of the delivery of care, and the effect of COVID-19 in health care facilities on decision-making by patients and their families. EVIDENCE SYNTHESIS: Patterns of care will evolve following the COVID-19 pandemic. Telemedicine, virtual care, and telemonitoring will increase and could offer broader access to multidisciplinary expertise without increasing costs. Comprehensive and integrative telehealth solutions will be necessary, and should consider patients' mental health and access differences due to socioeconomic status. Investigations and treatments will need to maximise efficiency and minimise health care interactions. Solutions such as one stop clinics, day case surgery, hypofractionated radiotherapy, and oral or less frequent drug dosing will be preferred. The pandemic necessitated a triage of those patients whose treatment should be expedited, delayed, or avoided, and may persist with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in circulation. Patients whose demographic characteristics are at the highest risk of complications from COVID-19 may re-evaluate the benefit of intervention for less aggressive cancers. Clinical research will need to accommodate virtual care and trial participation. Research dissemination and medical education will increasingly utilise virtual platforms, limiting in-person professional engagement; ensure data dissemination; and aim to enhance patient engagement. CONCLUSIONS: The COVID-19 pandemic will have lasting effects on the delivery of health care. These changes offer opportunities to improve access, delivery, and the value of care for patients with genitourinary cancers but raise concerns that physicians and health administrators must consider in order to ensure equitable access to care. PATIENT SUMMARY: The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the care provided to many patients with genitourinary cancers. This has necessitated a transition to telemedicine, changes in threshold or delays in many treatments, and an opportunity to reimagine patient care to maintain safety and improve value moving forward.


Assuntos
Infecções por Coronavirus , Assistência à Saúde , Pandemias , Pneumonia Viral , Padrões de Prática Médica , Telemedicina/métodos , Neoplasias Urogenitais , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/ética , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Assistência à Saúde/tendências , Humanos , Saúde Mental/normas , Inovação Organizacional , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/tendências , Neoplasias Urogenitais/psicologia , Neoplasias Urogenitais/terapia
14.
Clin Ter ; 171(5): e399-e400, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901781

RESUMO

COVID-19 pandemic affected the psychological health of nurses. Numerous nurses have been facing mental complications associated with quarantine such as psychological distress and fear. The gravity of COVID-19 pandemic is triggering further mental health challenges among nurses. The continuous stress nurses are facing, could trigger post-traumatic stress symptoms, poor service delivery, suicide ideation and suicide. Assessing and preserving the mental health of nurses and the health care workers in general is necessary for optimal disease control. Psychiatric interventions are needed to attend to the psychological need of nurses treating COVID-19 patients. Such interventions imply using E-learning and video platforms to educate nurses on communication skills, case handling skills and problem-solving tactics to deal with the possible psychological problems that might arise from treating COVID-19 patients.


Assuntos
Infecções por Coronavirus , Saúde Mental , Enfermeiras e Enfermeiros , Saúde do Trabalhador , Estresse Ocupacional/prevenção & controle , Pandemias , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Infecções por Coronavirus/psicologia , Humanos , Controle de Infecções/organização & administração , Saúde Mental/normas , Saúde Mental/tendências , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/normas , Saúde do Trabalhador/normas , Saúde do Trabalhador/tendências , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Pneumonia Viral/psicologia , Desenvolvimento de Pessoal/métodos , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Suicídio/prevenção & controle , Desempenho Profissional
17.
Lancet Psychiatry ; 7(8): 682-691, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32711709

RESUMO

BACKGROUND: Self-harm is a leading cause of morbidity in prisoners. Although a wide range of risk factors for self-harm in prisoners has been identified, the strength and consistency of effect sizes is uncertain. We aimed to synthesise evidence and assess the risk factors associated with self-harm inside prison. METHODS: In this systematic review and meta-analysis, we searched four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) for observational studies on risk factors for self-harm in prisoners published from database inception to Oct 31, 2019, supplemented through correspondence with authors of studies. We included primary studies involving adults sampled from general prison populations who self-harmed in prison and a comparison group without self-harm in prison. We excluded studies with qualitative or ecological designs, those that reported on lifetime measures of self-harm or on selected samples of prisoners, and those with a comparison group that was not appropriate or not based on general prison populations. Data were extracted from the articles and requested from study authors. Our primary outcome was the risk of self-harm for risk factors in prisoners. We pooled effect sizes as odds ratios (OR) using random effects models for each risk factor examined in at least three distinct samples. We assessed study quality on the basis of the Newcastle-Ottawa Scale and examined between-study heterogeneity. The study protocol was registered with PROSPERO, CRD42018087915. FINDINGS: We identified 35 independent studies from 20 countries comprising a total of 663 735 prisoners, of whom 24 978 (3·8%) had self-harmed in prison. Across the 40 risk factors examined, the strongest associations with self-harm in prison were found for suicide-related antecedents, including current or recent suicidal ideation (OR 13·8, 95% CI 8·6-22·1; I2=49%), lifetime history of suicidal ideation (8·9, 6·1-13·0; I2=56%), and previous self-harm (6·6, 5·3-8·3; I2=55%). Any current psychiatric diagnosis was also strongly associated with self-harm (8·1, 7·0-9·4; I2=0%), particularly major depression (9·3, 2·9-29·5; I2=91%) and borderline personality disorder (9·2, 3·7-22·5; I2=81%). Prison-specific environmental risk factors for self-harm included solitary confinement (5·6, 2·7-11·6; I2=98%), disciplinary infractions (3·5, 1·2-9·7; I2=99%), and experiencing sexual or physical victimisation while in prison (3·2, 2·1-4·8; I2=44%). Sociodemographic (OR range 1·5-2·5) and criminological (1·8-2·3) factors were only modestly associated with self-harm in prison. We did not find clear evidence of publication bias. INTERPRETATION: The wide range of risk factors across clinical and custody-related domains underscores the need for a comprehensive, prison-wide approach towards preventing self-harm in prison. This approach should incorporate both population and targeted strategies, with multiagency collaboration between the services for mental health, social care, and criminal justice having a key role. FUNDING: Wellcome Trust.


Assuntos
Prisioneiros/psicologia , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/prevenção & controle , Transtorno da Personalidade Borderline/psicologia , Estudos de Casos e Controles , Vítimas de Crime/psicologia , Direito Penal/organização & administração , Transtorno Depressivo Maior/psicologia , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental/normas , Estudos Observacionais como Assunto , Prisioneiros/estatística & dados numéricos , Fatores de Risco , Comportamento Autodestrutivo/mortalidade , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos
18.
Inf. psiquiátr ; (240): 43-52, abr.-jun. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-194757

RESUMO

Se describe el grupo multifamiliar que está en marcha desde Septiembre de 2012 en L'Hospitalet de Llobregat. Un grupo que atiende a personas diagnosticadas de trastorno mental severo y sus familiares, con el objetivo general de mejorar su salud y calidad de vida. Se trata de facilitar la comunicación para trabajar aspectos relacionales y vinculares. Se pretende ofrecer un espacio donde poder pensar conjuntamente las experiencias vividas en la propia familia. El SCORE-15 es un cuestionario que se ha demostrado útil para analizar los cambios en terapia de familia. Estudiamos su aplicabilidad en el contexto de terapia de grupo multifamiliar. Se investiga si los asistentes y los terapeutas observan cambios en el funcionamiento de la familia a lo largo de varias sesiones del grupo multifamiliar. Es un estudio observacional en un contexto asistencial público. Se invita a participar en el estudio a los nuevos participantes del grupo multifamiliar entre Enero y Julio de 2017, se les aplica el cuestionario SCORE en 3 ocasiones: antes de comenzar su vinculación al grupo, al cabo de 3 sesiones y en la última sesión. En base a los resultados obtenidos, valoramos el SCORE-15 como una herramienta útil a incluir en el proceso terapéutico de las personas que participan en el grupo multifamiliar que nos permite disponer de un registro de los cambios que se producen a nivel de funcionamiento familiar


It is described a multifamily group that has been ongoing in L'Hospitalet Llobregat since 2012. A group that handles both persons diagnosed with severe mental disorders and their families, with a general goal to improve their health and quality of their lives. It is about facilitating the communication in order to work on the rational and bonding aspects. It is intended to offer a space where it is possible to reflect together the experiences lived within their own family. SCORE is a tool which turned out to be useful for analysis of the changes in family therapy. We are studying its applicability in the context of multifamily group therapy. It is being researched if the assistants and therapists observe the changes in the family function over the series of sessions in the multifamily group. It is an observational study in the context of public assistance. New participants of a multifamily group are invited to participate between January and July 2017. SCORE is applied on 3 occasions: before starting their introduction to the group, after 3 sessions and in the last session. Based on the obtained results, we evaluate SCORE- 15 as a useful tool to include persons who participate a multifamily group in a therapeutic process which further permits us have at our disposal a register of the produced changes at the level of family function


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Projetos Piloto , Família/psicologia , Testes Psicológicos/normas , Transtornos Mentais/psicologia , Terapia Familiar/normas , Relações Familiares/psicologia , Terapia Familiar/métodos , Psicometria , Saúde Mental/normas
19.
J Med Internet Res ; 22(5): e15817, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32441654

RESUMO

BACKGROUND: Approximately 42.5 million adults have been affected by mental illness in the United States in 2013, and 173 million people have been affected by a diagnosable psychiatric disorder in China. An increasing number of people tend to seek health information on the Web, and it is important to understand the factors associated with individuals' mental health information seeking. Identifying factors associated with mental health information seeking may influence the disease progression of potential patients. The planned risk information seeking model (PRISM) was developed in 2010 by integrating multiple information seeking models including the theory of planned behavior. Few studies have replicated PRISM outside the United States and no previous study has examined mental health as a personal risk in different cultures. OBJECTIVE: This study aimed to test the planned risk information seeking model (PRISM) in China and the United States with a chronic disease, mental illness, and two additional factors, ie, media use and cultural identity, among college students. METHODS: Data were collected in both countries using the same online survey through a survey management program (Qualtrics). In China, college instructors distributed the survey link among university students, and it was also posted on a leading social media site called Sina Weibo. In the United States, the data were collected in a college-wide survey pool in a large Northwestern university. RESULTS: The final sample size was 235 for the Chinese sample and 241 for the US sample. Media use was significantly associated with mental health information-seeking intentions in the Chinese sample (P<.001), and cultural identity was significantly associated with intentions in both samples (China: P=.02; United States: P<.001). The extended PRISM had a better model fit than the original PRISM. CONCLUSIONS: Cultural identity and media use should be considered when evaluating the process of mental health information seeking or when designing interventions to address mental health information seeking.


Assuntos
Comparação Transcultural , Comportamento de Busca de Informação/ética , Saúde Mental/normas , Estudantes/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Universidades , Adulto Jovem
20.
Br J Psychiatry ; 217(4): 537-539, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32423523
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