Meanings attributed to changes experienced by individuals after COVID-19 hospitalization.

OBJECTIVES: to understand the meanings attributed to the experiences of individuals after hospitalization for COVID-19. METHODS: qualitative study, with a theoretical framework based on Symbolic Interactionism and a methodological approach grounded in Grounded Theory. Nineteen participants who had moderate and severe forms of COVID-19 after hospitalization were interviewed. Data collection took place between April and November 2021 through online interviews, and the data were analyzed using initial and focused coding in the MAXQDA software. RESULTS: the data illustrate new meanings attributed to different aspects of life after hospitalization, including relationships with others, the environment, physical and mental health, finances, identity, and interactions with a new social reality. CONCLUSIONS: the meanings are intrinsically linked to the value of interpersonal relationships, the perception of their impact, and the consequences after hospitalization. This allows professionals to understand the importance of this information to improve care and prepare for future epidemics.

Factors associated with university students' knowledge about HIV and preand post-exposure prophylaxis.

OBJECTIVES: to analyze the factors associated with university students' knowledge about HIV and preand post-exposure prophylaxis. METHODS: a cross-sectional study was conducted with 503 university students from a southern state in Brazil; data were collected using a characterization tool and a questionnaire containing 16 statements about the topic; descriptive measures and Poisson regression models with robust variance were used for analysis. RESULTS: the prevalence of adequate knowledge (i.e., scoring more than 12 correct answers) was 27.83%; students older than 24 years, enrolled in health-related courses, who had not engaged in sexual relations in the last quarter, with a history of rapid HIV testing, and who knew or had heard about the prophylaxes showed a higher likelihood of scoring more than 12 correct answers. CONCLUSIONS: generally, the knowledge of young people about HIV and its prophylaxes was found to be inadequate and influenced by sociodemographic, educational, and behavioral factors.

[Acceptance of patients with mental illness: a family perspective]. / Aceitação da pessoa com transtorno mental na perspectiva dos familiares.

The aim of this descriptive and qualitative study is to analyse how acceptance of mental illness is perceived by family members of the patient and the surrounding community. This study was conducted with the help of 10 families of patients with mental disorders admitted to the psychiatric emergency unit of the Municipal Hospital of Maringá, state of Parana, Brazil. Data were collected from October to December 2010, in open interviews and submitted to thematic content analysis, resulting in three categories: "Care, a constant requirement", "Living with a patient with mental illness: a whirlwind of emotions", "A wall constructed with stigma and prejudgement: the need for deconstruction". The conclusion is that an understanding of the disease is vital for acceptance of the illness itself and of the patient, and that healthcare professionals must remain close to the family to provide support, answer queries related to the disease, and help the family to face the difficulties of everyday life.

Meanings and Experiences of Prisoners and Family Members Affected by the COVID-19 Pandemic in a Brazilian Prison Unit: A Grounded Theory Analysis.

Worldwide, the COVID-19 pandemic represented a health emergency for prisons. This study sought to understand the meanings and experiences through the narratives of prisoners and family members affected by the COVID-19 pandemic in the context of a maximum-security state penitentiary complex in southern Brazil. For this purpose, a qualitative study was developed based on the methodological framework of constructivist grounded theory. Data were collected between February and August 2022 through individual in-depth interviews and field notes. The sample consisted of 41 participants: 28 male prisoners, and 13 family members. Guided by the Charmaz method of grounded theory analysis, the study afforded the core category "Feeling trapped in prison during the COVID-19 pandemic" with three interrelated phases: "Triggering", "Escalating", and "Readjustment". The "Triggering" phase refers to COVID-19-related elements or events that triggered certain reactions, processes, or changes in prison. During the "Escalating" phase, participants became overwhelmed by the suffering caused by incarceration and the pandemic crisis. The "Readjustment" phase involved adapting, reorienting, or reformulating previous approaches or strategies for dealing with a specific situation. Prisons faced complex challenges during the pandemic and were forced to prioritize protecting public health. However, the measures adopted must be carefully evaluated, ensuring their needs and that they are based on scientific evidence. The punitive approach can undermine inmate trust in prison authorities, making it difficult to report symptoms and adhere to preventive measures.

Matrix support in specialized care backed by the care model for chronic conditions: evaluative research.

OBJECTIVE: To analyze the matrix support for health teams in Specialized Outpatient Care, according to the Chronic Conditions Care Model. METHOD: Qualitative evaluative research, conducted by the Chronic Conditions Care Model, carried out from February to July 2020. For data collection, interviews were carried out with 21 health professionals, assistance observation and document analysis of the service. Data were analyzed by data triangulation, with the aid of the MAXQDA software, respecting all ethical aspects. RESULTS: The matrix support provided approximation between Primary and Secondary Care; implemented case management and qualified comprehensive care for people with chronic conditions. Weaknesses in communication and understanding of the theoretical bases of matrix support were obstacles to the proper implementation of matrix strategies. FINAL CONSIDERATION: Matrix support for specialized health teams qualified the professional care given to people with chronic conditions treated at the service.

Illness Experiences of Brazilian People Who Were Hospitalized Due to COVID-19 and Faced Long COVID Repercussions in Their Daily Life: A Constructivist Grounded Theory Study.

Long COVID is a multisystem condition that has multiple consequences for the physical, mental, and social health of COVID-19 survivors. The impact of the long COVID condition remains unclear, particularly among middle-aged and older adults, who are at greater risk than younger people of persisting symptoms associated with COVID-19. Therefore, we aimed to understand the experiences of middle-aged and older people who had been hospitalized for COVID-19 and the repercussions of long-term COVID symptoms in their daily lives. A qualitative study was carried out, adopting the framework of the constructivist grounded theory (CGT) proposed by Kathy Charmaz. Fifty-six middle-aged and older adult participants from the southern region of Brazil were recruited. Data were gathered from semi-structured telephone interviews. Concomitantly a comparative analysis was performed to identify categories and codes using the MaxQDA® software (version 2022). Three subcategories were identified: (1) experiencing COVID-19 in the acute phase; (2) oscillating between 'good days' and 'bad days' in long COVID; and (3) (re)constructing identity. These concepts interact with each other and converge upon the central category of this study: recasting oneself to the uniqueness of the illness experience of long COVID. Our findings provided insights related to the disruption in the lives of long COVID-19 sufferers who still live with persistent symptoms of the disease, including physical, social, family, emotional and spiritual repercussions. Likewise, this study may aid in developing friendly and welcoming social environments, lowering stigma and prejudice towards patients with long COVID, and fostering prompt and suitable policy support and mental health care for these individuals.

Assessment of the Psychosocial Care Center multidisciplinary team from users' and family members' perspective.

OBJECTIVES: to assess the multidisciplinary team of a Psychosocial Care Center I from users' and family members' perspective. METHODS: an evaluative study, anchored in the fourth generation evaluation theoretical-methodological framework, carried out in a Psychosocial Care Center I, from September 2021 to March 2022. Eleven users and 06 family members participated. Data were collected through non-participant observation, individual interviews and negotiation sessions, and analyzed using the Constant Comparative Method, using the MAXQDA software. RESULTS: the team develops its care based on individual and collective care, with integrated and complementary work by professionals. They seek to facilitate treatment initiation and continuation, considering health needs and offering support, understanding and guidance to users and their families. FINAL CONSIDERATIONS: the multidisciplinary team's work is based on the psychosocial paradigm, which can qualify care and strengthen the service role in the mental health network.

[Community Health Agents' perceptions and practice in mental health]. / Percepções e atuação do Agente Comunitário de Saúde em saúde mental.

The objectives of this study are to identity the perceptions of community health agents regarding health and mental disorders, and to verify the preparation these agents receive to work in this field. This qualitative study was performed using semi-structured interviews for data collection and utilizing content analysis to interpret the data. Interviews were performed with 45 community health agents working in the Family Health Strategy, who reported to 21 basic health units in the city of Maringá, PR. Results show the prejudice that these workers have regarding mental disorders. They recognize the importance of working with the patient and the family but do not feel prepared to provide adequate care. Because they share the same social context and have a close experience with the community dynamics, we see them as important facilitators of mental healthcare.

Assessment of organizational dynamics in a Psychosocial Care Center from the multidisciplinary team's perspective.

OBJECTIVES: to assess organizational dynamics in a Psychosocial Care Center for Alcohol and Drugs from the multidisciplinary team's perspective. METHODS: an evaluative, qualitative study, supported by the Fourth Generation Assessment theoretical-methodological framework. It was carried out in a Psychosocial Care Center for Alcohol and Drugs from September 2019 to March 2020. Data collection took place through observation, individual open-ended interviews and negotiation sessions. The informants were 12 professionals. Analysis was based on Constant Comparative Method. RESULTS: it was highlighted as potential of organizational dynamics, being an outpatient service, trying to address the deficiencies of RAPS and understanding the importance of matrix support. Among the challenges are the fragility of teamwork, reception, insufficient training, worker profile and overload. FINAL CONSIDERATIONS: the importance of understanding the work process and the care flow is highlighted, in order to strengthen the Psychosocial Care Network.

Post-acute COVID and long-COVID among adults and older adults in the State of Paraná, Brazil: protocol for an ambispective cohort study.

INTRODUCTION: Since 2020, the world has been going through a viral pandemic with a high morbidity and mortality rate along with the potential to evolve from an acute infection to post-acute and long-COVID, which is still in the process of elucidation. Diagnostic and prognostic research is essential to understand the complexity of factors and contexts involving the illness's process. This protocol introduces a study strategy to analyse predictors, sequelae, and repercussions of COVID-19 in adults and older adults with different disease severities in the State of Paraná, Brazil. METHODS AND ANALYSIS: A mixed-methods sequential explanatory design. The quantitative data will be conducted by an ambispective cohort study, which will explore the manifestations of COVID-19 for 18 months, with nearly 3000 participants with confirmed diagnoses of COVID-19 (reverse transcription-PCR test) between March and December of 2020, retrieved from national disease reporting databases, over 18 years old, living in a Brazilian State (Paraná) and who survived the viral infection after being discharged from a health service. Data collection will be conducted through telephone interviews, at two different occasions: the first will be a recall 12 months after the acute phase as a retrospective follow-up, and the second will be another prospective interview, with data of the following 6 months. For the qualitative step, Grounded Theory will be used; participants will be selected from the cohort population. The first sample group will be composed of people who were discharged from the intensive care unit, and other sample groups will be composed according to theoretical saturation. The qualitative data will follow the temporal design and classification of the disease provided for in the cohort. ETHICS AND DISSEMINATION: Ethics approval was granted by the State University of Maringá, under opinion number: 4 165 272 and CAAE: 34787020.0.0000.0104 on 21 July 2020, and Hospital do Trabalhador (Worker's Hospital), which is accountable for the Health Department of the State of Paraná, under opinion number: 4 214 589 and CAAE: 34787020.0.3001.5225 on 15 August 2020. The participants will verbally consent to the research, their consent will be recorded, and the informed consent form will be sent by mail or email. Outcomes will be widely disseminated through peer-reviewed manuscripts, conference presentations, media and reports to related authorities.