Patient Classification System for alcohol and other drugs: construction and validation. / Sistema de Classificação de Pacientes em álcool e outras drogas: construção e validação.

OBJECTIVE: To construct and validate a nursing care dependency classification system for alcohol and other drugs. METHOD: A psychometric study. We used the agreement percentage and intraclass correlation coefficient for inter-rater agreement. The Receiver Operating Characteristic was used to determine values and accuracy of the cut-off points. The steps were literature review, content validation and clinical validation. RESULTS: Fifteen (15) judges, 6 nurses and 65 users of psychiatric emergency and hospitalization units participated. There were 11 indicators divided into three subcategories of dependency, and a sum between 11 and 33. The agreement regarding the judges' evaluation on the categories was satisfactory, being equal to or higher than 80%. Agreement was satisfactory among the nurses in most of the indicators (K>0.400), and the Intraclass Correlation Coefficient was equal to 0.723. CONCLUSION: The Classification System of Patients for Alcohol and other Drugs presents statistical evidence of reliability, obtained by a satisfactory inter-rater agreement. Its applicability is widely believed to assist in the management of nursing care and team sizing.

Psychosocial rehabilitation in the west network of the municipality of São Paulo: potentialities and challenges. / A reabilitação psicossocial na rede oeste do município de São Paulo: potencialidades e desafios.

OBJECTIVE: To describe the strategies of the Psychosocial Rehabilitation conducted in the Network of Psychosocial Care of the western region of the municipality of São Paulo. METHODOLOGY: Descriptive qualitative study, carried out with 123 professionals, from September 2015 to July 2016. Data processed by the software Alceste and analyzed in light of the analytical category Psychosocial Rehabilitation of Benedetto Saraceno and complementary literature. RESULTS: Three classes emerged that address the potential and scarcity of therapeutic residential services as a space to resume the daily life; importance of cultural activities for the exchange of identities and care beyond the scope of health; the potential of projects to generate work and income to regain the contractual power. CONCLUSION: The strategies contribute to the construction of subjectivity and the resumption of the citizenship. In order to sustain the Psychosocial Rehabilitation it is necessary to overcome the weaknesses of human, physical and structural resources. Still, there is potential in the collaborative work and accountability of the teams.

Women receiving specialized treatment for psychoactive substance use: a cohort study. / Mulheres em tratamento especializado para uso de substâncias psicoativas: estudo de coorte.

OBJECTIVE: To verify the association between the profile of women who seek specialized treatment for the use of psychoactive substances, their treatment adherence time and the types of substance used. METHOD: A retrospective cohort with data from medical records of women who sought care at a referral service for the use of psychoactive substances. RESULTS: The final sample consisted of 411 medical records. A significant association was observed between unemployment (p<0.000), living in the streets/homeless shelters (p=0.003), having HIV/AIDS (p=0.004) and the type of substance used. The best predictors for the treatment adherence time were being a cocaine and crack user (OR=0.22), having family members who use illegal substances (OR=0.36) and reporting suicidal ideation (OR=2.7). CONCLUSION: The sociodemographic and epidemiological factors of the women in this study are associated with the use of psychoactive substances. The therapeutic strategies developed for this group should take into account the risk stratification, seeking comprehensive and individualized care. Persistent approaches to include family members in the treatment, especially of those who present problems related to the use of psychoactive substances should be considered.

Complementary therapies as resources for mental health in Primary Health Care. / Práticas integrativas e complementares como recurso de saúde mental na Atenção Básica.

OBJECTIVE To verify the knowledge of Primary Care professionals about Integrative and Complementary Practices (PIC - "Práticas Integrativas e Complementares") and if they perceive these Practices as a care resource in Mental Health. METHOD Quantitative study carried out with 70 professionals from a Basic Unit of Health in the city of São Paulo between May and June of 2016. The data were collected through a questionnaire elaborated by the researchers. For statistical analysis, the frequency distribution of the variables and the Fisher test were considered. RESULTS The professionals said that they were aware of some PIC (73.9%), that users of the service with Mental Health issues would benefit from them (94.2%), that they would like to receive training (91.3%), and that they consider the practices a possible resource for care in Mental Health (92.8%). CONCLUSION The professionals' knowledge needs to be deepened. Still, they consider PIC as a resource for Mental Health in Primary Care.

Application of the therapeutic relationship to people with common mental disorder. / Aplicação do relacionamento terapêutico a pessoas com transtorno mental comum.

OBJECTIVE: To report the results from applying a therapeutic relationship to people with common mental disorder. METHOD: Quantitative, descriptive, before and after study, conducted with 112 records accessed from an extension project in mental health in primary health care in Santo André, São Paulo. Screening was performed using a Self-Reporting Questionnaire. Data was collected in October 2014 and analyzed using simple frequency measures. RESULTS: The entry score ranged between 7 and18 points, and the higher the frequency, the more relationship sessions were necessary. At the end of the relationship process, 55% had a negative score and 45% passed the score ≤3. CONCLUSION: Therapeutic relationship as nursing care in mental health transcends the area of specialty. Continuous review and process redirecting led users to enlarge their view of the suffering triggers, build coping strategies and exercise changes in daily life.

Practices of primary health care nurses in the care for people in psychological distress.

OBJECTIVE: To understand the practices of nurses working in Primary Health Care in caring for people in psychological distress. METHOD: Qualitative study conducted with 30 nurses working directly in Primary Health Care. Data were collected from January to March 2023 through semi-structured interviews, which were fully transcribed. The resulting material was organized in the IRaMuTeQ® software and subjected to the thematic content analysis, anchored in the precepts of Eric Cassell's Theory of the Nature of Human Suffering. RESULTS: Five categories emerged: 1. Causes of Psychological Distress (14.65%), 2. Needs of the person in psychological distress (31.3%), 3. Team case discussions (26.5%), 4. Care network for the person in psychological distress (15.99%) and 5. Care instruments (11.57%). FINAL CONSIDERATIONS: The practices that nurses perform involve listening spaces to express feelings, case discussions within the team and matrixing and the understanding that psychological distress is the result of environmental, social, and family factors. However, they report a lack of training to assess individuals experiencing psychological distress and request the development of institutional protocols and training to support care.

Internal validity evidence of a knowledge questionnaire on alcohol use, abuse and dependence and associated questions.

OBJECTIVES: to perform content validity and verify the psychometric properties of the adapted version of an alcohol knowledge questionnaire and associated questions. METHODS: a methodological study, in which a committee of judges analyzed the questionnaire item representativeness, clarity and relevance. Item response theory was used to assess the instrument psychometric properties applied to a sample of 240 health professionals. RESULTS: the questions were adjusted according to judges' assessment, obtaining a satisfactory Content Validity Index (0.98). High discrimination ability and adequate difficulty levels were observed in 75% of multiple-choice questions and in 25% of statements. CONCLUSIONS: the instrument presented content validity with satisfactory indices. However, it is recommended that the questionnaire adapted in this study be used in different samples of health professionals from other parts of Brazil, in order to provide greater robustness to its reliability.

Performance of Family Health Strategy Nurses in LGBT+ Healthcare.

OBJECTIVE: To analyze the role of Family Health Strategy (FHS) nurses in the health care of LGBT+ individuals. METHODS: This qualitative study is based on Institutional Analysis. Data was collected in August 2021 through semi-structured interviews with 14 Family Health Strategy nurses from municipalities in the state of São Paulo. The data was processed using the IRaMuTeQ® software and analyzed lexically. RESULTS: The textual corpus gave rise to three themes, which addressed the nurses' practice, the difficulties and challenges they face in providing care to LGBT+ individuals, and the direct association of LGBT+ individuals with sexually transmitted infections. CONCLUSION: Lack of preparedness, access to information, and the need for expanded listening skills are still gaps in the performance of FHS nurses in caring for LGBT+ individuals. However, fostering acceptance and building strong relationships have been effective strategies in bridging the gap in nursing care for the LGBT+ community.

Psychopathological symptoms and work status of Southeastern Brazilian nursing in the context of COVID-19. / Sintomas psicopatológicos e situação laboral da enfermagem do Sudeste brasileiro no contexto da COVID-19.

OBJECTIVE: to evaluate the relationship between psychopathological symptoms and the work situation of nursing professionals in the Southeast Region, Brazil, in the context of the COVID-19 pandemic. METHOD: an observational and cross-sectional study with virtual and snowball data collection from April to July 2020. A questionnaire containing socio-demographic and labor data and the psychopathological symptoms assessment scale (psychoticism, obsessiveness/compulsivity, somatization, and anxiety) were applied. Descriptive and inferential statistics were used to analyze the data. RESULTS: among the 532 participants, there was a relationship between weekly workload and psychoticism. All domains of the scale were associated with embarrassment and/or violence in the course of work and receiving psychological/emotional support from the institution where the individual works/studies. CONCLUSION: the age group, heavy workload, experienced violence and lack of psychological support during the pandemic were associated with increased psychopathological symptoms among nursing professionals. It is suggested the creation of institutional guidelines aimed at the reception and follow-up of these demands.

COVID-19 and the Mental Health of Nursing Professionals in Brazil: Associations between Social and Clinical Contexts and Psychopathological Symptoms.

The COVID-19 pandemic has had an important negative psychological impact on people worldwide, especially nursing professionals who seem to be more vulnerable to the development of psychopathological symptoms. Objective: To analyze relationships between variables from the social and clinical contexts with psychopathological symptoms in nursing professionals from different geographic regions of Brazil during the COVID-19 pandemic. Methods: Cross-sectional study carried out with 1737 nursing professionals from the five regions of Brazil. Data collection was carried out online with a questionnaire made available via Google Forms containing sociodemographic, occupational, and clinical questions, and the Symptom Assessment Scale-40-R, for the assessment of psychopathological symptoms. Differences between mean scores for the severity of psychopathological symptoms were assessed using the Mann-Whitney and Kruskall-Wallis tests. Results: There was a significant difference in the psychoticism domain scores according to Brazilian geographic region, with greater severity among professionals from the North and Northeast regions when compared with those from the South region. Social context variables (gender, age group, and marital status) and clinical variables (psychological and psychiatric follow-up; psychological or emotional support by the institution; family member, friend, neighbor, or co-worker with COVID-19, and death among them; use of psychiatric medication without a medical prescription; and taking steps to take care of their mental health) were significantly related to psychopathological symptoms. Conclusions: The results point to the importance of mental health promotion strategies for professionals through psychological or emotional support, as evidence indicates that this support can be a predictor of reduced psychological distress.

Mental health interventions implemented in the COVID-19 pandemic: what is the evidence?

OBJECTIVE: to map the evidence on mental health interventions implemented during the COVID-19 pandemic. METHOD: this scoping review was carried out in the MEDLINE/PubMed, SCOPUS, Web of Science, PsycINFO, and Science Direct databases and in the medRxiv, bioRxiv, and PsyArXiv preprints servers using the descriptors "Covid-19", "coronavirus infection", "coronavirus", "2019-nCoV", "2019 novel coronavirus disease", "SARS-CoV-2", "health personnel", "general public", and "mental health". RESULTS: eight articles were selected and categorized into mental health interventions for the population, among which mental health interventions were for people diagnosed with suspicion/confirmed COVID-19 and mental health interventions for health professionals. CONCLUSION: telemonitoring, virtual games and strategies focused on social support and muscle relaxation techniques, characterized as non-pharmacological and low-cost, were shown as interventions, which, since they are effective, need to be encouraged and included in mental health care practices.

Men's mental health in the COVID-19 pandemic: is there a mobilization of masculinities?

OBJECTIVE: to understand how the COVID-19 pandemic mobilizes masculinities in relation to mental health. METHODS: qualitative study conducted with 400 men, in a virtual environment, in all regions of Brazil. The data were analyzed by the Discourse of the Collective Subject and based on Symbolic Interactionism. RESULTS: the mobilization of masculinities emerged from men towards the recognition of weaknesses and psycho-emotional vulnerabilities, with narratives that reveal the expression of feelings, pain, discomfort and psychological suffering, and showed themselves to be sensitive and engaged in performing practices, including autonomous ones, of health care mental. FINAL CONSIDERATIONS: the pandemic mobilizes masculinities as men print meanings and senses, in their interaction and interpretation of mental health, and is a marker for the nursing clinic conduct.

Harm reduction in the context of psychoactive substances: nursing discourses in primary health care.

OBJECTIVE: To analyze the production of meanings on interventions considered as Harm Reduction in the discourses of nursing professionals working in Primary Health Care. METHOD: Qualitative study based on the theoretical-methodological framework of French Discourse Analysis. Semi-structured interviews were conducted with 14 nursing professionals working in Primary Health Care, from February to October 2019. RESULTS: Most Harm Reduction practices performed by nursing professionals aim to minimize risks and physical damage. Harm Reduction actions that require welcoming, non-judgment and qualified listening were observed. Some nursing professionals perform Harm Reduction actions, but do not recognize them as such. CONCLUSION: The production of meanings in the discourses of nursing professionals presented evidence of biomedical and/or disease discursive formations, health prevention, interpersonal relationships and health promotion.

Primary health care nurses: attitudes towards the person with mental disorder.

OBJECTIVE: To identify the attitudes of nurses working in Primary Health Care towards the person with mental disorder and the variables related to health care provided. METHODOLOGY: Descriptive, correlational study with 250 nurses from 69 Basic Health Units in the city of São Paulo. Data collection took place between April and August 2019 using the "Opinions about Mental Illness" scale. The data were analyzed using the KrusKal-Wallis test, with a 95% confidence level and statistical significance of p <0.05. RESULTS: The global mean of the scale was 197, which shows negative attitudes especially in the dimensions of Authoritarianism (44.6), Social Restriction (42.0), and positive in the dimension of Benevolence (51.7). CONCLUSION: Nurses tend to have a stigmatizing attitudinal profile. It is necessary formative and permanent intervention so that it is possible to reduce stigma and improve community-based care recommended in the guidelines of the Psychosocial Care Network.

[Nursing undergraduate students' view on listening to patients during care delivery]. / Percepções de graduandos de enfermagem sobre a importância do ato de ouvir na prática assistencial.

The objective of this study was to investigate the views of nursing undergraduate students regarding listening to patients and the importance of listening to nursing care delivery. This investigation is an exploratory study using qualitative methodology and Complex Thinking by Morin as the theoretical reference. It enrolled 12 final-term undergraduate nursing students at Faculdade de Medicina do ABC, Santo André-SP. Study data were collected through individual in-depth interviews and analyzed using the content analysis technique. The resulting categories were: (1) listening: a challenge to the world; (2) the influence of the current biomedical paradigm on nurse's ability to listen to the patient; (3) putting aside preconceived ideas: learning to listen to the patient; and (4) preparing the undergraduate student to listen to patients. The study findings show that the undergraduate participants regard being a good listener as a difficult task because it requires being willing to listen to others and learning how to put aside preconceived ideas in order to not hinder patients from verbally expressing their feelings and needs.

Resources, objectives and guidelines in a Psychosocial Care Network structure.

OBJECTIVE: to analyze a Psychosocial Care Network structure, based on the compromise of its resources and meeting objectives and guidelines recommended in Ordinance 3,088/2011. METHOD: an empirical, quantitative study with 123 primary care professionals, psychosocial and emergency care, who work at Western Network of the city of São Paulo. Questionnaires and statistical analysis were applied through the Exact Fisher's test with 5% significance considering p= <0.05. RESULTS: there is compromise of physical resources in the absence of mental health beds in a general hospital (p=0.047); of technological resources in the lack of discussion forums (p=0.036); of human resources in number of teams (p=0.258); and of financial resources (p=0.159). Psychosocial care is the one that most meets the objectives and guidelines. CONCLUSION: there are insufficient physical, technological, human, and financial resources for the work articulated in the three care modalities that are heterogeneous in terms of meeting the objectives and guidelines.

Effects of the association between spirituality, religiosity and physical activity on health/mental health: a systematic review. / Efeitos da associação entre espiritualidade, religiosidade e atividade física na saúde/saúde mental: revisão sistemática.

OBJECTIVE: To identify evidence in the literature about the effects of the association between spirituality, religiosity and physical activity on physical and mental health. METHOD: A systematic review conducted in January 2019 in the MEDLINE/PubMed, SCOPUS, Web Of Science, CINAHL, PsycINFO, LILACS and SciELO databases with the descriptors: "spirituality", "religion", "physical activity" and "physical exercise ". Primary studies carried out with adults published until 2018 in Portuguese, English or Spanish were included. RESULTS: Nine international studies were selected which had been published between 2011 and 2017, with cross-sectional design (55%) and an evidence level of four (78%). Eight studies addressed effects on physical health and one addressed effects on mental health. CONCLUSION: The association between spirituality, religiosity and physical activity promotes effects on physical and mental health, however the available evidence is not sufficient for this association to be applied in clinical practice.

Nurses' attitudes facing the family involvment in caring for people with mental disorder.

OBJECTIVE: To characterize the attitudes of Primary Health Care nurses, regarding the involvement of the family in the care for people with Mental Disorder. METHODS: Correlational study with 257 nurses from the city of São Paulo. The scale "Importance of Families in Nursing Care- Nurses' Attitudes" was used. For the analysis, descriptive and inferential statistics were used. RESULTS: The scale scores were high, with a mean value of 82.1 (SD=8.4) favorable to the families' involvement, and are related to being a nurse in the Family Health Strategy (p<0.001), having received education/training in family nursing (p<0.005), the workload of 40 hours/week (p<0.005), working in the West, East and Center Regions (p<0.005). CONCLUSION: Most nurses have positive attitudes towards the involvement of families, a relevant indicator for their inclusion in the health-mental care process.

Harm reduction conceptions: speeches of Primary Health Care nursing professionals.

OBJECTIVE: to analyze the discursive memories about the harm reduction strategy, which permeate the knowledge of Primary Health Care nursing professionals. METHOD: a qualitative and exploratory study based on the French Discourse Analysis theoretical-methodological framework. Semi-structured interviews were carried out with 14 Primary Health Care nursing professionals. RESULTS: analysis indicated a predominance of discursive memories related to the biomedical model of health conception as well as religious and moral approaches regarding psychoactive substance use. The perspective of an "expanded clinic" was discreet, highlighting the link and prevention of risks and harms from psychoactive substance use that affect the physiological dimension. FINAL CONSIDERATIONS: the impact of this study emphasizes the need for permanent education proposals on harm reduction concepts in training and qualifying nursing professionals.

Validação do conteúdo de uma tecnologia cuidativo-educacional para mulheres que consomem substâncias psicoativas / Content validation of a care-educational technology for women psychoactive consumers / Validación del contenido de una tecnología cuidativo-educacional para mujeres consumidoras de sustancias psicoactivas

RESUMO: Objetivo: construir e validar o conteúdo de uma Tecnologia Cuidativo-Educacional para mulheres que consomem substâncias psicoativas. Método: pesquisa metodológica conduzida no município de São Paulo, dezembro de 2022 a março de 2023, pelo mapeamento da literatura, elaboração dos temas geradores, escolha da ferramenta base com dinâmica de uso e validação de conteúdo quanto aos aspectos: reflexão, relevância, compreensão e adequação em duas rodadas. Participaram 15 especialistas com índice de concordância estabelecido de 80%. Resultados: 48 cartas foram submetidas à validação. Na primeira rodada, sete cartas não atingiram o índice mínimo. Ao final da segunda rodada, 47 cartas em todas as suas categorias individuais tiveram concordância maior que o estabelecido. Conclusão: os especialistas apontaram a relevância, pertinência dos temas e o potencial para auxiliar os profissionais a intervir de forma mais assertiva ante as necessidades do público-alvo.

ABSTRACT Objective: To build and validate the content of a Care-Educational Technology for women who consume psychoactive substances. Method: Methodological research conducted in the municipality of São Paulo, December 2022 to March 2023 by mapping the literature, drawing up the generating themes, choosing the base tool with dynamics of use, and validating the content in terms of aspects: reflection, relevance, understanding, and suitability in two rounds. Fifteen experts took part, with an agreement rate of 80%. Results: 48 letters were submitted for validation. In the first round, seven cards failed to reach the minimum index. At the end of the second round, 47 cards in all their categories had more agreement than the established level. Conclusion: The experts pointed out the relevance and pertinence of the topics and their potential to help professionals intervene more assertively in the face of the target audience's needs.

RESUMEN Objetivo: construir y validar el contenido de una tecnología educativo-asistencial para mujeres consumidoras de sustancias psicoactivas. Método: investigación metodológica realizada en el municipio de São Paulo, de diciembre de 2022 a marzo de 2023, mediante el mapeo de la literatura, la elaboración de los temas generadores, la elección de la herramienta básica con dinámica de uso y la validación del contenido en cuanto a los aspectos: reflexión, pertinencia, comprensión e idoneidad en dos rondas. Participaron quince expertos, con una tasa de acuerdo del 80%. Resultados: Se presentaron 48 cartas para su validación. En la primera ronda, siete cartas no alcanzaron el índice mínimo. Al final de la segunda ronda, 47 cartas en todas sus categorías individuales tenían más acuerdo del establecido. Conclusión: los expertos señalaron la relevancia y pertinencia de los temas y su potencial para ayudar a los profesionales a intervenir de forma más asertiva ante las necesidades de los destinatarios.