The mediating role of life satisfaction in the relationship between depression, anxiety, stress and burnout among Portuguese nurses during COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic had a large consequence on healthcare systems, increasing the risks of psychological issues in health professionals. Nurses, in particular, have been exposed to multiple psychosocial stressors and struggled with intensive work, insufficiency of resources and uncertainty in the face of an unknown disease. Life satisfaction might protect nurses from the consequences of chronic stress. The aim of this study was to explore the mediating role of satisfaction with life in the relationship between depression, stress, anxiety and burnout (personal, work-related, and client-related). METHODS: A cross-sectional, descriptive, correlational study design was performed, using an online questionnaire distributed via social networks. A total of 379 nurses completed the survey, comprising standardized measures of satisfaction with life, resilience (Resilience Scale), depression, anxiety, stress (Depression Anxiety Stress Scales), and burnout (Copenhagen Burnout Inventory Scale). A hierarchical regression model was estimated for each burnout dimension. RESULTS: Participants showed high levels of work, personal and client-related burnout, 57.3%, 57%, and 35.1%, respectively. More than 70% of the respondents had a normal level of depressive symptoms, 66.8% presented normal level of anxiety and 33.5% of the respondents reported mild, moderate, severe or extremely severe symptoms of stress. The results revealed that life satisfaction partially mediated the association between stress and personal burnout, depression and work-related burnout, and the association between anxiety and client-related burnout in nurses. CONCLUSIONS: The COVID-19 pandemic brought added difficulties for nurses' work conditions, whereby it became necessary to develop adaptative measures that reduce stressors in work environment and promote nurses' life satisfaction.

Burnout among Portuguese healthcare workers during the COVID-19 pandemic.

BACKGROUND: During COVID-19 pandemic, healthcare workers (HCWs) have had high workload and have been exposed to multiple psychosocial stressors. The aim of this study was to evaluate HCWs in terms of the relative contributions of socio-demographic and mental health variables on three burnout dimensions: personal, work-related, and client-related burnout. METHODS: A cross-sectional study was performed using an online questionnaire spread via social networks. A snowball technique supported by health care institutions and professional organizations was applied. RESULTS: A total of 2008 subjects completed the survey. Gender, parental status, marriage status, and salary reduction were found to be significant factors for personal burnout. Health problems and direct contact with infected people were significantly associated with more susceptibility to high personal and work-related burnout. Frontline working positions were associated with all three dimensions. Higher levels of stress and depression in HCWs were significantly associated with increased levels of all burnout dimensions. Higher levels of satisfaction with life and resilience were significantly associated with lower levels of all burnout dimensions. CONCLUSIONS: All three burnout dimensions were associated with a specific set of covariates. Consideration of these three dimensions is important when designing future burnout prevention programs for HCWs.

Mediation of Self-Compassion on Pathways from Stress and Anxiety to Depression among Portuguese Higher Education Students.

Higher education is a context that requires students to develop academic, social and institutional tasks. As a result of this complex and multidimensional process, students tend to experience greater stress, anxiety and depression, making it crucial for students to mobilize a set of essential personal, social and instrumental resources, for a more positive adaptation to the academic context. Self-compassion is an adaptative emotion-regulation strategy and may help students to better adjust to academic issues. The purpose of this study was to investigate the role of self-compassion as a mediator in the relationship between anxiety and depression, as well as stress and depression. Methods: A cross-sectional study was conducted using an online questionnaire distributed through social media. Stress and anxiety were found to be positively related to depression scores and negatively related to self-compassion. A bootstrapped mediation model confirmed the existence of a significant positive partial mediation effect exerted by self-compassion on the relationship between stress and depression (b = 0.12, 95% CI [0.05, 0.18]). The analysis also showed a significant positive partial mediation effect exerted by self-compassion in the relationship between anxiety and depression (b = 0.13, 95% CI [0.08, 0.18]). Conclusions: Self-compassion might partially mediate the relationship between stress and depression and between anxiety and depression. Findings underscore self-compassion as a potentially protective factor against negative psychological symptoms.

Burnout, resilience, and subjective well-being among Portuguese lecturers' during the COVID-19 pandemic.

Background: Lecturers face a large wide of occupational stressors. If the prolonged stress and the symptomatology associated with the working conditions to which lecturers were exposed were already a concern before the pandemic, the pandemic may have exacerbated this psychosocial vulnerability. Burnout is a psychological syndrome that develops in response to chronic work stress. This study aims to describe burnout amongst lecturers working in Portugal and to analyse potential determinants of burnout during the COVID-19 pandemic. Methods: A cross-sectional study was performed using an online questionnaire distributed via social networks. The survey collected sociodemographic and sleep patterns data in addition to applying the Copenhagen Burnout Inventory (personal, work- and student-related burnout), the Resilience Scale, the Depression Anxiety and Stress Scales, and the Satisfaction with Life Scale. Results: The sample included 331 lecturers from 35 different colleges and faculties. Three significant models explained personal (R2 = 54%), work- (R2 = 47%) and student- (R2 = 19%) related burnout. Lower levels of resilience and higher levels of depression and stress were significantly associated with personal and work-related burnout. Changes in sleep patterns were additionally associated with both personal and work-related burnout. Conclusion: Higher education institutions must recognize the impact of the work environment and organizational culture on faculty mental health and take proactive measures to improve this environment. These institutions can implement support strategies such as educational technology training, professional development programmes, emotional support resources, and workload flexibility. Implementing measures to enhance lecturers' resilience and overall life satisfaction could potentially help mitigate burnout and improve the well-being of educators, ultimately contributing to the overall quality of education.

The impact of teleworking in psychologists during COVID-19: Burnout, depression, anxiety, and stress.

Background: The COVID-19 pandemic has forced mental health professionals to adapt quickly. The pandemic has created multiple new tasks for the psychologist. In addition to the various stressors closely linked to the COVID-19 pandemic, psychologists were forced to make their services more flexible. Teleworking was a way of continuing to work. Objective: This study aimed to identify the impact of working pattern on the levels of burnout, depression, anxiety, and stress. Methods: This was a cross-sectional study based on an online questionnaire applied to eighty-three Portuguese psychologists. Data were collected from May 9 to June 8, 2020, a period comprising the declaration of a national calamity and then state of emergency, and the subsequent ease of lockdown measures. The Copenhagen Burnout Inventory Scale and Depression Anxiety and Stress Scale were used. Univariate multiple linear regression models were estimated for each mental health outcome. Results: Significant differences were found between psychologists working in the workplace and in teleworking at the personal burnout, work-related burnout, client-related burnout, depression, and stress. In multiple linear regression, teleworking, not working, and being unmarried was significantly associated with higher levels of depression. Teleworking was significantly associated with higher stress scores and client-related and work burnout. Conclusions: This exceptional time of sudden, mandatory, and high-intensity teleworking, required rapid adaptation, giving rise to new stressors that might have been responsible for burnout levels in psychologists.

Professional Quality of Life Among Physicians and Nurses Working in Portuguese Hospitals During the Third Wave of the COVID-19 Pandemic.

BACKGROUND: In the last 2 weeks of January 2021, Portugal was the worst country in the world in incidence of infections and deaths due to COVID-19. As a result, the pressure on the healthcare system increased exponentially, exceeding its capacities and leaving hospitals in near collapse. This scenario caused multiple constraints, particularly for hospital medical staff. Previous studies conducted at different moments during the pandemic reported that COVID-19 has had significant negative impacts on healthcare workers' psychological health, including stress, anxiety, depression, burnout, post-traumatic stress symptoms, and sleep disturbances. However, there are many uncertainties regarding the professional quality of life of hospital nurses and physicians. To address gaps in previous research on secondary traumatic stress, we focused on healthcare workers working in hospitals affected by a major traumatic event: the third wave of COVID-19. OBJECTIVES: The aim of the present study was to identify the contribution of personal and work-related contextual variables (gender, age, parental status, occupation, years of experience, working with patients affected by COVID-19) on professional quality of life of healthcare workers. METHODS: Cross-sectional study with a web-based questionnaire given to physicians and nurses working in a hospital setting. A total of 853 healthcare professionals (276 physicians and 586 nurses; median age 37 years old) participated in the survey assessing professional quality of life compassion satisfaction, secondary traumatic stress, and burnout. Factors of professional quality of life were assessed using regression analysis. RESULTS: Most of the participants showed moderate (80%; n = 684) or high (18%; n = 155) levels of compassion satisfaction, whereas the majority of them experienced moderate levels of burnout (72%; n = 613) and secondary traumatic stress (69%; n = 592). The analyzed variables demonstrated no differences between professionals who were directly or not involved in the care of COVID-19 patients. Parental status was found to be a significant factor in compassion satisfaction. Female gender was significantly associated with more susceptibility to secondary traumatization. Factors that may potentially contribute to burnout include years of professional experience and the number of work hours per week. CONCLUSION: The COVID-19 pandemic has created a new challenge for the healthcare system. Burnout and secondary traumatic stress can lead to medical errors and impact standards of patient care, particularly compromising compassionate care. It is therefore recommended that hospitals develop psychoeducational initiatives to support professionals in dealing with barriers to compassion.

Impact of COVID-19 pandemic on the mental health of healthcare workers during the first wave in Portugal: a cross-sectional and correlational study.

OBJECTIVES: The COVID-19 pandemic has had a negative impact on the mental health of healthcare workers (HCWs) worldwide. This study aims to identify the degree to which sociodemographic variables and indicators of subjective well-being and psychological resilience are associated, positively and negatively, with the outcomes of burnout, stress, depression and anxiety among Portuguese HCWs observed during the first wave. It also aims to evaluate the strength of association of these variables and indicators with each outcome. DESIGN: Cross-sectional quantitative study. The statistical methods used are simple logistic model, multiple logistic regression model and -2*log-likelihood statistic. SETTING: Portuguese HCWs living in Portugal and working in the Portuguese healthcare system. PARTICIPANTS: The study included 1535 professionals, with a mean age of 38 years. PRIMARY AND SECONDARY OUTCOMES MEASURES: Psychological variables were measured by Copenhagen Burnout Inventory, the Resilience Scale, the Depression, Anxiety and Stress Scales and the Satisfaction with Life Scale. RESULTS: High levels of personal (55%; n=844), work-related (55.1%; n=846) and client-related burnout (35.4%; n=543) were found. Additionally, participants expressed substantial levels of depression (28.7%; n=441), stress (36.4%; n=558) and anxiety (33.1%; n=508). About 1202 participants (78.3%) demonstrated moderate-to-high levels of resilience. Profession, work regime during the pandemic, having a health problem, resilience and satisfaction with life are independent variables significantly associated with the outcomes of burnout, stress, depression and anxiety. Satisfaction with life was the independent variable that had a major association with all outcomes. CONCLUSIONS: Governments and hospital administrations should take action to promote resilience and satisfaction with life as these variables are protective relating to mental health problems. Interventions as educational sessions, psychological support at work, programmes promoting resilience and coping mechanisms and better work conditions may improve mental health. The implementation of measures to protect healthcare students from developing prejudicial outcomes seams very adequate and important.

The Mediating Role of Resilience and Life Satisfaction in the Relationship between Stress and Burnout in Medical Students during the COVID-19 Pandemic.

Following the WHO's declaration of a public health emergency due to the COVID-19 outbreak, the subsequent quarantine and confinement measures that were adopted, including distance learning measures, were shown to have caused a significant deterioration in the mental health of medical students. The goal of this study was to explore the mediating role of resilience and life satisfaction in the relationship between perceived stress and burnout among medical students in the context of COVID-19. A transversal assessment was performed using an online questionnaire, to which 462 students responded. The instruments applied were the Perceived Stress Scale-10, the Resilience Scale-25 items, the Satisfaction with Life Scale (SWLS), and the Burnout Scale (Oldenburg Inventory). A regression model was estimated for each dimension of burnout. The results revealed that resilience and life satisfaction play a mediating role in the association between stress and the dimensions of burnout. This suggests that measures of promoting mental health based on resilience and improving perceptions of life should be implemented.

Burnout and Depression in Portuguese Healthcare Workers during the COVID-19 Pandemic-The Mediating Role of Psychological Resilience.

During the COVID-19 pandemic, healthcare workers (HCW) have been exposed to multiple psychosocial stressors. Resilience might protect employees from the negative consequences of chronic stress. The aim of this study was to explore the mediating role of resilience in the relationship between depression and burnout (personal, work-related, and client-related). A cross-sectional study was performed using an online questionnaire distributed via social networks. A survey was conducted comprising standardized measures of resilience (Resilience Scale-25 items), depression (subscale of Depression Anxiety Stress Scales-21 items), and burnout (Copenhagen Burnout Inventory Scale-19 items). A total of 2008 subjects completed the survey, and a hierarchical regression model was estimated for each burnout dimension. The results revealed that depression had not only a directed effect on personal, work- and client-related burnout, but also an indirect small effect on it through resilience. Psychological resilience played a partial mediating role between depression and all burnout dimensions. This partial mediation suggests that there may be other possible variables (e.g., social connection, self-compassion, gratitude, sense of purpose) that further explain the associations.

[Resilience in Physicians: Contributions to the Validation of the European Portuguese Version of the Resilience Scale]. / Resiliência em Médicos: Contributos para a Validação da Versão Portuguesa da Escala de Resiliência.

INTRODUCTION: The aim of this study is to explore the validation of the Resilience Scale in its long and brief versions (25 items and 14 items). This instrument assesses the individual's ability to withstand stressors, thrive and make sense of vital challenges. MATERIAL AND METHODS: The sample included 511 Portuguese physicians. Both versions were validated through the study of internal structure validity, reliability, and convergent validity. The validity of the internal structure was analysed using the principal component analysis technique. Reliability was verified by the internal consistency study. For convergent validity, the correlation coefficients between these versions of the Resilience Scale and other scales validated to measure depression, anxiety, stress, and life satisfaction were calculated. RESULTS: Both versions of Resilience Scale showed good internal consistency. For each of the versions, one factor was retained in the principal component analysis. Convergent validity was verified by significant positive correlations between Resilience Scale (25 and 14) and a life satisfaction scale and significant negative correlations between Resilience Scale and depression, anxiety, and stress subscales. DISCUSSION: The results show the one-dimensional character of both versions of the Resilience Scale and support their usefulness and validity in the physician's class. CONCLUSION: This is the first validation study of this scale in a group of physicians. Its results are very satisfactory, and its use in this specific group is recommended.

Introdução: Este estudo visa explorar a validação da Escala de Resiliência (25 itens e 14 itens), nas suas versões longa e breve. Este instrumento avalia a capacidade de o indivíduo suportar os fatores de stress, de prosperar e dar sentido a desafios vitais.Material e Métodos: A amostra integrou 511 médicos portugueses. Ambas as versões foram validadas através do estudo de validade de estrutura interna, de fiabilidade e de validade convergente. A validade de estrutura interna foi analisada através da técnica da análise de componentes principais. A fiabilidade foi verificada pelo estudo de consistência interna. Para a validade convergente, calculou-se os coeficientes de correlação entre estas versões da Escala de Resiliência e outras escalas validadas para medir depressão, ansiedade, stress e satisfação com a vida.Resultados: Ambas as versões da Escala de Resiliência apresentaram boa consistência interna. Para cada uma das versões, optou-se pela análise de componentes principais a um fator. A validade convergente foi verificada por correlações positivas significativas entre a Escala de Resiliência 25 e Escala de Resiliência 14 e uma escala de satisfação com a vida e por correlações negativas significativas entre as duas versões da Escala de Resiliência e as subescalas de depressão, ansiedade e stress.Discussão: Os resultados evidenciaram o caráter unidimensional das duas versões da Escala de Resiliência e apoiam a sua utilidade e validade na classe dos médicos.Conclusão: Trata-se do primeiro estudo de validação desta escala num grupo de médicos. Os seus resultados são muito satisfatórios, recomendando-se o uso deste instrumento neste grupo específico.

Physician Burnout in Primary Care during the COVID-19 Pandemic: A Cross-Sectional Study in Portugal.

BACKGROUND: Primary care physicians have been present on the frontline during the ongoing pandemic, adding new tasks to already high workloads. Our aim was to evaluate burnout in primary care physicians during the COVID-19 pandemic, as well as associated contributing factors. METHODS: Cross-sectional study with an online questionnaire disseminated through social media, applying the snowball technique. The target population was primary care physicians working in Portugal during the first outbreak of the COVID-19 pandemic. In addition to sociodemographic data, the questionnaire collected responses to the Copenhagen Burnout Inventory (CBI), the Resilience Scale and the Depression, Anxiety, and Stress Scales (DASS-21). Data were collected from May 9 to June 8, 2020, a period comprising the declaration of a national calamity and then state of emergency, and the subsequent ease of lockdown measures. Levels of burnout in 3 different dimensions (personal, work, and patient-related), resilience, stress, depression, and anxiety were assessed. Logistic regression analyses were conducted to identify factors associated with burnout levels. RESULTS: Among the 214 physician respondents, burnout levels were high in the 3 dimensions. A strong association was found between gender, years of professional experience, depression and anxiety, and burnout levels. CONCLUSIONS: Physician burnout in primary care is high and has increased during the pandemic. More studies are needed in the long term to provide a comprehensive assessment of COVID-19'simpact on burnout levels and how to best approach and mitigate it during such unprecedented times.

Impact of COVID-19 on Medicine Lecturers' Mental Health and Emergency Remote Teaching Challenges.

COVID-19 has presented a novel pedagogical challenge in dealing with the sudden shift from classic instruction to emergency remote teaching (ERT). It had an impact on the well-being and mental health of lecturers, increasing burnout risk. A cross-sectional, quantitative, qualitative and analytical online study was conducted to collect participants' sociodemographic data, responses to ERT open-ended questions and mental health assessments using relevant instruments (CBI for burnout, Resilience Scale, DASS for depression, anxiety and stress, SWLS for satisfaction with life). High personal burnout levels were found in 41.2% of participants, high work-related burnout in 37.3% and high student-related burnout in 15.7%. Satisfaction with life, sleep routine changes and stress were determinants for personal burnout; stress and resilience for work-related burnout; satisfaction of life and sleep routine changes for students-related burnout. Opportunities for pedagogical innovation were pointed out as the main advantages to ERT, while the main negative impacts were on practical lessons and social interaction. Students and lecturers' safety and adequate institutional support might be insured, considering their expectations and needs, promoting mental health. Combining the advantages of online and traditional methods in a so-called "blended learning" approach, with close collaboration and communication between all those involved, appears to achieve better results.

Burnout in Portuguese physiotherapists during COVID-19 pandemic.

OBJECTIVE: This study described the burnout experienced by physiotherapists during the COVID-19 pandemic and analysed the role of possible factors of this occupational phenomenon. METHODS: Cross-sectional study based on a web-based survey applied to physiotherapists living in Portugal. The survey included sociodemographic, health status and clinical practice questions. The Copenhagen Burnout Inventory (personal, work- and patient-related burnout), the Resilience Scale, the Depression Anxiety and Stress Scales and the Satisfaction with Life Scale were used. RESULTS: A total of 511 physiotherapists (median 33 years old, 82% females) completed the survey. The participants worked mainly in private practice (50%) and wards (35%). During COVID-19, 52% were working directly with patients, but only 18% were working with COVID-19 patients. Personal (42%), work- (42%) and patient-related burnout (25%) was observed. Three significant models explained personal- (R2  = 51%), work- (R2  = 31%) and patient-related burnout (R2  = 16%). Lower levels of resilience and higher levels of depression and stress were significantly associated with personal, work- and patient-related burnout. Being female and working directly with patients were additionally associated with both personal and work-related burnout. Having health problems and working with COVID-19 patients were only associated with personal burnout. CONCLUSIONS: More than 40% of physiotherapists experienced personal and work-related burnout and 25% patient-related burnout, with resilience, depression and stress having a relevant role in the three burnout dimensions. Early detection and management strategies need to be implemented to address physiotherapists' physical and psychological fatigue and exhaustion.

Cultural adaptation and reliability of the questionnaire of sex education in schools.

Sexuality is embedded in a social and cultural origin and its approach must go beyond biological aspects. Questionnaire on Sex Education in Schools (QUSES) assesses the knowledge, comfort, motivation and involvement of teachers in relation to sex education. This article aims to culturally adapt and verify the reliability of QUSES. The Experts Committee realized the Cultural adaptation and content validation. The Cronbach's alpha and its stratification were tested for reliability. It was applied to 100 teachers with an average of 44.45 (9.62) years of age. Words and phrases were modified, maintaining the equivalences of the original version. Question of knowledge was the most modified due to regulatory differences between countries. Reliability data was similar to the original instruments and were considered good. The lowest values were α = 0.741 for subscale of efficacy of results, α = 0.812 and α = 0.849 for subscale of involvement (cognitive). QUSES was culturally adapted for Brazilian elementary schools teachers presenting good reliability. It is relevant, because it evaluates sex education fully and may support in implementation and monitoring public policies related to health promotion in schools.

Função urinária e sexual de mulheres puerperais que usaram o balão vaginal na preparação para o parto vaginal ­ um estudo transversal / Urinary and sexual function of puerperal women who used the vaginal balloon in preparation for vaginal birth ­ a cross sectional study

INTRODUÇÃO: O balão vaginal pode ser uma opção para preparar os músculos do assoalho pélvico para o parto vaginal. Suas implicações para as funções urinária e sexual precisam ser mais estudadas. OBJETIVO: Avaliar as implicações do balão vaginal na preparação para o parto vaginal nas funções sexual e urinária. METODOLOGIA: Estudo transversal realizado em Belém do Pará, com primíparas de partos vaginais, de 18 a 40 anos. Formouse dois grupos: o GE se constituiu de puérperas que usaram o balão vaginal durante a gravidez provenientes da Clínica Cafisio Mulher e o GC de puérperas que não fizeram uso do balão vaginal durante a gestação, provenientes do Centro de Saúde Escola do Marco. Utilizou-se uma ficha de avaliação sociodemográfica, um questionário com perguntas acerca dos eventos do trabalho de parto, o International Consultation on Incontinence Questionnaire Short Form e o Female Sexual Function Index. Foi utilizado o software Excel para entrada dos dados, confecção das tabelas e análise estatística descritiva das variáveis. RESULTADOS: Em ambos os grupos, a maioria das mulheres apresentou alguma perda urinária, com impactos diferentes na qualidade de vida. Quanto à função sexual, ambos os grupos estão abaixo do ponto de corte, o que indica disfunção sexual. No entanto, não foi possível estabelecer uma associação entre a função urinária e sexual entre os dois grupos devido às diferenças no tamanho da amostra entre os grupos. CONCLUSÃO: As funções urinária e sexual de ambos os grupos estavam alteradas.

INTRODUCTION: Vaginal balloon can be an option to prepare the pelvic floor muscles for vaginal birth. Its implications for urinary and sexual functions need to be further studied. OBJECTIVE: To evaluate the implications of the vaginal balloon in preparation for vaginal birth on sexual and urinary functions. METHODOLOGY: Cross-sectional study was carried out in Belém do Pará, with primiparous women from vaginal births, aged between 18 and 40 years. Two groups were formed: the EG consisted of postpartum women who used the vaginal balloon during pregnancy from the Clínica Cafisio Mulher and the CG of postpartum women who did not use the vaginal balloon during pregnancy, from the Centro de Saúde Escola do Marco. A sociodemographic evaluation form, a questionnaire with questions about labor events, the International Consultation on Incontinence Questionnaire Short Form, and the Female Sexual Function Index were used. Excel software was used for data entry, preparation of tables, and descriptive statistical analysis of the variables. RESULTS: Most women had some urinary loss in both groups, with different impacts on quality of life. As for sexual function, both groups are below the cutoff point, which indicates sexual dysfunction. However, it was impossible to establish an association between urinary and sexual function between the two groups due to differences in sample size. CONCLUSION: The urinary and sexual functions of both groups were altered.

Cultural adaptation and reliability of the questionnaire of sex education in schools / Adaptação cultural e confiabilidade do questionário de educação sexual em meio escolar

Abstract Sexuality is embedded in a social and cultural origin and its approach must go beyond biological aspects. Questionnaire on Sex Education in Schools (QUSES) assesses the knowledge, comfort, motivation and involvement of teachers in relation to sex education. This article aims to culturally adapt and verify the reliability of QUSES. The Experts Committee realized the Cultural adaptation and content validation. The Cronbach's alpha and its stratification were tested for reliability. It was applied to 100 teachers with an average of 44.45 (9.62) years of age. Words and phrases were modified, maintaining the equivalences of the original version. Question of knowledge was the most modified due to regulatory differences between countries. Reliability data was similar to the original instruments and were considered good. The lowest values were α = 0.741 for subscale of efficacy of results, α = 0.812 and α = 0.849 for subscale of involvement (cognitive). QUSES was culturally adapted for Brazilian elementary schools teachers presenting good reliability. It is relevant, because it evaluates sex education fully and may support in implementation and monitoring public policies related to health promotion in schools.

Resumo Sexualidade insere-se num cenário de controle social e cultural, portanto sua abordagem deve ir além dos aspectos biológicos. O Questionário de Educação Sexual em Meio Escolar (QUESME) avalia o conhecimento, o conforto, a motivação e o envolvimento dos/as professores/as em relação à educação sexual. O objetivo deste artigo é adaptar culturalmente e verificar a confiabilidade do QUESME. Foi realizada adaptação cultural e validação de conteúdo pelo comitê de especialistas. Para a confiabilidade utilizou-se o alpha de Cronbach e sua estratificação. Foi aplicado a 100 professores/as com idade média de 44,45 (9,62) anos. Expressões foram modificadas mantendo-se o conteúdo da versão original. A questão sobre conhecimento foi a mais modificada devido às diferenças normativas dos países. A confiabilidade foi semelhante ao instrumento original: os menores valores encontrados foram α = 0,741 para eficácia de resultado, α = 0,812 e α = 0,849 para envolvimento cognitivo. Conclusão: O QUESME foi adaptado culturalmente para o Brasil apresentando boa confiabilidade. É relevante, pois avalia as ações de educação sexual amplamente, podendo auxiliar na implementação e acompanhamento de políticas públicas relacionadas à promoção de saúde nas escolas.

Exploração da autocompaixão no contexto de um programa de mindfulness-based cognitive therapy / Exploration of self-compassion in the context of a mindfulness-based cognitive therapy / Exploración de la autocompasión en el contexto de un programa de mindfulness-based cognitive therapy

CONTEXTO: Os profissionais de saúde e da área social estão diariamente expostos a situações de sofrimento que podem gerar stresse e burnout e afetar a tarefa de cuidar. Desenvolvidos sobretudo em populações clínicas, os programas de intervenção baseados em Mindfulness - especificamente o Mindfulness-Based Cognitive Therapy (MBCT) - têm demonstrado resultados promissores na redução da depressão, do stresse e da ansiedade. OBJETIVO(S): Avaliar o efeito do MBCT, desenvolvido junto de profissionais de saúde e da área social, nos níveis de Mindfulness, autocompaixão, stresse, ansiedade e depressão e explorar a relação entre a autocompaixão e as restantes variáveis em estudo. METODOLOGIA: 26 profissionais/futuros profissionais de saúde e da área social que participaram no programa MBCT completaram a avaliação pré e pós-intervenção; Instrumentos: Escala de Autocompaixão, Questionário Cinco Facetas Mindfulness, Escala de Stresse Percebido, Inventário de Depressão de Beck e Inventário de Ansiedade de Beck. RESULTADOS: Os participantes aumentaram nos níveis de Mindfulness e de autocompaixão e reduziram nos sintomas de depressão e de ansiedade. Os resultados indicam ainda uma associação, entre moderada e forte, entre as diferentes componentes da autocompaixão e o Mindfulness e o stresse antes e após o programa. CONCLUSÕES: Os resultados positivos do programa de MBCT sugerem o seu potencial para desenvolver nos profissionais competências essenciais à intervenção terapêutica, designadamente uma maior compreensão e aceitação da pessoa e do seu sofrimento.

BACKGROUND: Health and social workers are daily exposed to suffering situations that can generate stress and burnout and affect the task of caring. Developed primarily in clinical settings, Mindfulness-Based intervention programs - specifically Mindfulness-Based Cognitive Therapy (MBCT) - have shown promising results in reducing depression, stress, and anxiety. AIM: To evaluate the effect of MBCT on health and social professionals in the Mindfulness, self-compassion, stress, anxiety and depression levels, and explore the relationship between self-compassion and the remaining variables under study. METHODOLOGY: 26 professionals/future health and social workers who participated in the MBCT program completed the pre and post-intervention evaluation; Instruments: Self-compassion Scale, Five Facet Mindfulness Questionnaire, Perceived Stress Scale, Beck Depression Inventory, and Beck Anxiety Inventory. RESULTS: Participants increased levels of Mindfulness and self-compassion and reduced symptoms of depression and anxiety. Results also indicate an association, between moderate and strong, between the components of self-compassion and Mindfulness and stress before and after the program. CONCLUSIONS: The positive effects of the MBCT program suggest its potential to foster in professionals the development of essential skills for therapeutic intervention, namely a greater understanding and acceptance of the person and the suffering experience.

CONTEXTO: Los profesionales de salud y del área social están diariamente expuestos a situaciones de sufrimiento que pueden generar estrés y burnout y afectar la tarea de cuidar. Desarrollados sobre todo en las poblaciones clínicas, los programas de intervención basados ​​en Mindfulness, especialmente el Mindfulness-Based Cognitive Therapy (MBCT), han demostrado resultados prometedores en la reducción de la depresión, el estrés y la ansiedad. OBJETIVO(S): Evaluar el efecto del MBCT, desarrollado junto a profesionales de la salud y del área social, en los niveles de Mindfulness, autocompasión, estrés, ansiedad y depresión y explorar la relación entre la autocompasión y las restantes variables en estudio. MÉTODOLOGÍA: 26 profesionales/futuros profesionales de salud y del área social que participaron en el programa MBCT completaron la evaluación pre y post-intervención. Instrumentos: Self-compasión Scale, Cinco Facet Mindfulness Cuestionario, Perceived Stress Scale, Beck Depression Inventory, y Beck Anxiety Inventory. RESULTADOS: Participantes aumentaron en los niveles de Mindfulness y de autocompasión y redujeron en los síntomas de depresión y de ansiedad. Hay una asociación, entre moderado y fuerte, entre los componentes de la autocompasión y el Mindfulness y el estrés antes y después del programa. CONCLUSIONES: Los resultados positivos obtenidos con el MBCT sugieren su potencial para desarrollar en los profesionales competencias esenciales para la intervención terapéutica, en particular una mayor comprensión y aceptación de la persona y de su sufrimiento.

[Evaluation of T tube trial as a strategy of weaning from mechanical ventilation]. / Avaliação de teste de tubo T como estratégia inicial de suspensão da ventilação mecânica.

BACKGROUND AND OBJECTIVES: Weaning from mechanical ventilation (MV) is an important strategy to reduce morbidity and mortality in critical care patients. In this setting, this study aimed at evaluation of T-tube trial (TT) in weaning from MV. METHODS: Patient admitted in the ICU were included if they present the following inclusion criteria: MV > 24 hours, no neuromuscular disorders, PaO2/FiO2 ratio >200, hemodynamic stability, reversion of the cause of respiratory failure, adequate respiratory drive. All were submitted to TT. Failure was defined by the presence of one of these symptoms: RR > 30 ipm, hypoxemia, tachycardia, arrhythmia, hypertension or hypotension. After two hours of TT, patients without failure criteria were extubated. After 48 hours of adequate spontaneous respiration the patient was considered successful weaned. Results were considered significant if p < 0.05. RESULTS: Forty-nine patients were included with a mean age 51.8 ± 21.7 years. The incidence of ARDS and septic shock were 26.5% and 32.7% and mean duration of MV was 11.9 ± 13 days. Discontinuation of MV occurred in 79.2%, reintubation in 31.6%, in a mean time of 13 ± 8.7 hours and in 75% of the cases it was due to respiratory failure. There was no correlation between success in TT and hemoglobin levels, PaO2/FiO2 ratio, age, gender, prior ARDS or septic shock. Weaning success was not correlated with none of the above variables. CONCLUSIONS: TT was adequated for weaning from mechanical ventilation in the majority of the cases. However, reintubation rate was high. Possible causes are the long period of TT, prior mechanical ventilation or the failure in the criteria used to indicate extubation.

Avaliação de teste de tubo T como estratégia inicial de suspensão da ventilação mecânica / Evaluation of T tube trial as a strategy of weaning from mechanical ventilation

JUSTIFICATIVA E OBJETIVOS: A retirada precoce da ventilação mecânica (VM) é importante para reduzir a morbimortalidade de pacientes internados em Unidades de Terapia Intensiva. O objetivo deste estudo foi avaliar a utilização do teste de Tubo T (TT) como método de retirada de VM. MÉTODO: Foram incluídos neste estudo os pacientes admitidos na UTI que apresentavam os seguintes critérios: VM > 24 horas, ausência de doença neuromuscular, relação PaO2/FiO2 > 200, estabilidade hemodinâmica, reversão da causa da intubação traqueal e drive respiratório adequado. Todos foram submetidos ao teste de tubo T. Considerou-se falha a ocorrência de FR > 30 irpm, hipoxemia, taquicardia, disritmias cardíacas, hipertensão ou hipotensão arterial. Após 2 horas de teste TT sem critérios de falha, os pacientes foram extubados. Considerou-se como sucesso na retirada da VM a manutenção por 48 horas de autonomia ventilatória. RESULTADOS: Foram incluídos 49 pacientes com idade média de 51,8 ± 21,7 anos. As incidências de SDRA e choque séptico foram 26,5 por cento e 32,7 por cento e o tempo médio de VM foi 11,9 ± 13 dias. A retirada da VM ocorreu em 79,2 por cento, re-intubação em 31,6 por cento, com tempo médio 13 ± 8,7 horas, sendo 75 por cento devido à falência respiratória. Não houve correlação entre extubação e níveis de hemoglobina, PaO2/FiO2, idade, sexo, SDRA ou choque séptico prévios. O sucesso da retirada da VM (48 horas de autonomia) não se correlacionou com nenhuma das variáveis descritas. Os resultados foram considerados significativos se p < 0,05. CONCLUSÕES: O tubo T mostrou ser método adequado para a retirada da VM na maioria dos pacientes. Entretanto, a taxa de re-intubação foi elevada, podendo ser conseqüência do longo tempo do TT, da ventilação mecânica prévia ou da falha dos critérios de indicação de extubação traqueal.

BACKGROUND AND OBJECTIVES: Weaning from mechanical ventilation (MV) is an important strategy to reduce morbidity and mortality in critical care patients. In this setting, this study aimed at evaluation of T-tube trial (TT) in weaning from MV. METHODS: Patient admitted in the ICU were included if they present the following inclusion criteria: MV > 24 hours, no neuromuscular disorders, PaO2/FiO2 ratio >200, hemodynamic stability, reversion of the cause of respiratory failure, adequate respiratory drive. All were submitted to TT. Failure was defined by the presence of one of these symptoms: RR > 30 ipm, hypoxemia, tachycardia, arrhythmia, hypertension or hypotension. After two hours of TT, patients without failure criteria were extubated. After 48 hours of adequate spontaneous respiration the patient was considered successful weaned. Results were considered significant if p < 0.05. RESULTS: Forty-nine patients were included with a mean age 51.8 ± 21.7 years. The incidence of ARDS and septic shock were 26.5 percent and 32.7 percent and mean duration of MV was 11.9 ± 13 days. Discontinuation of MV occurred in 79.2 percent, reintubation in 31.6 percent, in a mean time of 13 ± 8.7 hours and in 75 percent of the cases it was due to respiratory failure. There was no correlation between success in TT and hemoglobin levels, PaO2/FiO2 ratio, age, gender, prior ARDS or septic shock. Weaning success was not correlated with none of the above variables. CONCLUSIONS: TT was adequated for weaning from mechanical ventilation in the majority of the cases. However, reintubation rate was high. Possible causes are the long period of TT, prior mechanical ventilation or the failure in the criteria used to indicate extubation.

Análise da manovacuometria em indivíduos sadios nas posições sentada e em pé / Analysis manovacuometry in healthy people in sitting and upright positions

Objetivo: analisar a manovacuometria em indivíduos sadios nas posições sentada e em pé. Método: avaliado um grupo de 54 indivíduos, sendo 37 mulheres e 17 homens, todos sadios, na faixa etária de 18 a 25 anos submetidos à mensuração de Pressão inspiratória máxima (Pimáx) e Pressão expiratória máxima (Pemáx) nas posições sentada e em pé, sendo utilizado como instrumento o manovacuômetro da marca GERAR. Resultados: Os resultados obtidos de Pimáx sentada e em pé não foram, estatisticamente, significativos (p > 0,05) com valores obtidos iguais nas posições (p = 0,3505); com relação, a Pemáx sentada e em pé, também não foram, estatisticamente, significativos (p > 0,05), com valores obtidos iguais (p = 0,2961). Conclusão: A força muscular respiratória, ou seja, a Pimáx e a Pemáx não apresentam valores diferentes nas posições sentada e em pé