O Impacto da Histerectomia e a Participação dos Profissionais de Saúde Durante o Processo Cirúrgico / The Impact of Hysterectomy and the Involvement of Healthcare Professionals During the Surgical Process / El impacto de la histerectomía y la participación de los profesionales de la salud durante el proceso quirúrgico

Objetivo:descrever a o impacto da histerectomia e a participação dos profissionais de saúde durante o processo cirúrgico. O problema de pesquisa parte do seguinte questionamento: que impacto tem a histerectomia na vida da mulher em idade reprodutiva? Que participação tem os profissionais de saúde no processo cirúrgico? Método: Estudo de natureza descritiva com abordagem qualitativa conforme os pressupostos de Minayo (2009) com método de pesquisa exploratória. Resultados:Foram entrevistadas 7 mulheres que foram submetidas a histerectomia, com idade acima de 18 anos, que responderam perguntas referentes ao impacto do diagnóstico, conhecimento sobre a cirugia e experiências sobre o acolhimento dos profissionais da saúde no processo cirúrgico. A entrevista foi realizada em ambiente virtual na plataforma Google Forms. Conclusão: As entrevistadas revelaram sentimentos de angústia e medo ao se depararem com o diagnóstico cirúrgico por ausência de conhecimento inicialmente, evidenciando insatisfação e ausência dos profissionais da saúde quanto à cirurgia. O estudo reforça a importância das equipes multidisciplinares em hospitais e/ou locais de cuidados de saúde, uma vez que o foco principal no trabalho com pessoas acometidas por uma enfermidade não é a doença em si, mas elas mesmas.

Objective: to describe the impact of hysterectomy and the involvement of healthcare professionals during the surgical process. The research problem originates from the following questions: What impact does hysterectomy have on the life of a woman of reproductive age?What role do healthcare professionals play in the surgical process? Method:A descriptive study with a qualitative approach according to Minayo's (2009) assumptions using an exploratory research method. Results:Seven women who underwent hysterectomy, aged over 18 years, were interviewed. They answered questions regarding the impact of the diagnosis, knowledge about the surgery, and experiences of healthcare professionals' support during the surgical process. The interviews were conducted in a virtual environment using the Google Forms platform. Conclusion:The interviewees revealed feelings of anguish and fear when faced with the surgical diagnosis due to initial lack of knowledge, showing dissatisfaction and absence of healthcare professionals regarding the surgery. The study reinforces the importance of multidisciplinary teams in hospitals and/or healthcare facilities, as the main focus in working with people affected by an illness is not the disease itself, but the individuals themselves

Objetivo: describir el impacto de la histerectomía y la participación de los profesionales de la salud durante el proceso quirúrgico. El problema de investigación se basa en la siguiente pregunta: ¿qué impacto tiene la histerectomía en la vida de las mujeres en edadreproductiva? ¿Qué papel juegan los profesionales de la salud en el proceso quirúrgico? Método:Se trata de un estudio descriptivo con enfoque cualitativo según los supuestos de Minayo (2009) con un método de investigación exploratorio. Resultados:Se entrevistó a 7 mujeres mayores de 18 años sometidas a histerectomía, quienes respondieron preguntassobre el impacto del diagnóstico, conocimientos sobre cirugía y experiencias sobre la recepción de profesionales de la salud en el proceso quirúrgico. La entrevista se realizó en un entorno virtual en la plataforma Google Forms. Conclusión:Los entrevistados revelaron sentimientos de angustia y miedo frente al diagnóstico quirúrgico debido a la falta de conocimiento inicial, evidenciando insatisfacción y ausencia de profesionales de la salud con respecto a la cirugía. El estudio refuerza la importancia de los equipos multidisciplinarios en los hospitales y/o en los entornos sanitarios, ya que el foco principal en el trabajo con personas afectadas por una enfermedad no es la enfermedad en sí, sino ellos mismos.

Prevention of drug diversion and substance use disorders among anesthesiologists: a narrative review

Abstract Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering, transmission of disease, as well as the risk associated with impaired vigilance. Healthcare providers may be harmed by the physical and mental impact of their addictions. Healthcare systems are placed in jeopardy by the legal impact associated with illegal routes of drug release including sanction and financial liability and loss of public trust. Healthcare institutions have implemented many measures to reduce diversion from the perioperative area. These efforts include education, medical record surveillance, automated medication dispensing systems, urine drug testing, substance waste management systems, and drug diversion prevention teams. This narrative review evaluates strengths, weaknesses, and effectiveness of these systems and provides recommendations for leaders and care providers.

Condições de trabalho e biossegurança dos profissionais de saúde e trabalhadores invisíveis da saúde no contexto da COVID-19 no Brasil / Work conditions and biosafety of health professionals and invisible health workers in the context of COVID-19 in Brazil

Resumo O artigo versa sobre as condições de trabalho na saúde no contexto da pandemia no Brasil. Trata-se de estudo transversal que utilizou dados de recorte das pesquisas "Condições de trabalho dos profissionais de saúde no contexto da Covid-19 no Brasil" e "Os Trabalhadores invisíveis da saúde: condições de trabalho e saúde mental no contexto da Covid-19 no Brasil", objetivando conhecer as condições de trabalho e a biossegurança desses dois contingentes profissionais distintos e desiguais, socialmente. A análise dos dados comprova que as condições de trabalho foram extremamente afetas em função da infraestrutura inadequada, trabalho extenuante, biossegurança em risco, exaustão, medo da contaminação e da morte, fortes sinais de esgotamento físico e mental entre os trabalhadores. Aponta também para discriminação e desigualdades de direitos sociais e de valorização profissional que demarcam os mundos do trabalho apontados nas pesquisas, enfatizando as profundas desigualdades existentes no Brasil e em suas regiões. Conclui-se mostrando a importância de formulação de políticas públicas no âmbito da gestão do trabalho no SUS que assegurem a proteção, valorização e redução das desigualdades apontadas no artigo.

Abstract The present article addresses the work conditions in health in the context of the COVID-19 pandemic in Brazil. This is a cross-sectional study that used data from the surveys "Working conditions of healthcare professionals in the context of Covid-19 in Brazil" and "Invisible healthcare workers: work conditions and mental health in the context of Covid-19 in Brazil", seeking to better understand the working conditions and biosafety of these two distinct and socially unequal professional contingents. Data analysis proves that work conditions were extremely affected due to inadequate infrastructures, strenuous work, biosecurity at risk, exhaustion, fear of contamination and death, strong signs of physical and mental exhaustion, among workers. It also points out the discrimination and inequalities of social rights and professional development that mark the worlds of work highlighted in the surveys, emphasizing the profound inequalities that exist in Brazil and in its regions. It concludes by showing the importance of formulating public policies within the scope of work management in SUS, which ensures the protection, appreciation and reduction of inequalities pointed out in this article.

Tradução, validação e adaptação transcultural da Frommelt Attitude Toward Care of the Dying Scale Form B para o português brasileiro / Translation, validation and cross-cultural adaptation of the Frommelt Attitude Toward Care of the Dying Scale Form B into Brazilian Portuguese

Resumo: Trata-se de um estudo metodológico, com o objetivo de traduzir e adaptar transculturalmente a Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B scale) para o português brasileiro e avaliar sua validade de conteúdo e a consistência interna. Essa escala favorece a eficácia da assistência prestada pela equipe de saúde na temática da morte. Foi projetada pela enfermeira Katherine Helen Murray Frommelt em 1989, com o objetivo de avaliar as atitudes dos enfermeiros em relação ao cuidado de pessoas em estado terminal e suas famílias. Posteriormente, sua aplicação foi estendida para outros profissionais, como médicos. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa em Seres Humanos do Setor de Ciências da Saúde da Universidade Federal do Paraná com a CAEE 55547522.1.0000.0102. Foi desenvolvido entre julho de 2021 a janeiro de 2023, no formato online e envolveu as etapas: tradução; síntese; retrotradução; revisão por um comitê de especialistas; pré-teste e versão final da escala. Foram recrutados como participantes: tradutores juramentados; tradutor da área da saúde; retrotradutores norte-americanos; especialistas, dentre os quais médicos, enfermeiros, profissional formado em letras português-inglês e profissionais médicos e enfermeiros associados à Sociedade Brasileira de Geriatria e Gerontologia que participaram do pré-teste. Todos foram selecionados mediante critérios de inclusão e exclusão. A versão da FATCOD-B scale finalizada pelos especialistas, foi aplicada no pré-teste a 75 médicos e 12 enfermeiros, que também responderam a um questionário sociodemográfico que continha perguntas referentes a sexo, idade, religião, profissão, educação prévia sobre o morrer e a morte, experiência prévia com a perda, experiência presente com a perda e experiência prévia no cuidado de pessoas com doenças terminais. Para avaliar as associações entre as respostas da FATCOD-B scale foi utilizado o teste qui-quadrado ou o teste exato de Fisher. Todos os testes foram realizados considerando o nível de 5% de significância e utilizou-se a linguagem de programação R.4.1.2. Dos 87 participantes, 57,4% tinham até 45 anos; 66,7% eram mulheres; 55,2% eram católicos; 73,6% apontaram a crença religiosa como geradora de atitudes sobre o morrer e a morte; 96,6% tinham experiência prévia no cuidado de pessoas com doenças terminais, 72,43% experienciaram a perda de familiares próximos ou outra pessoa significante, 65,5% não fizaram curso específico sobre o morrer e a morte, mas tiveram o assunto abordado em outros cursos. Observou-se que as variáveis idade, sexo, religião, experiência prévia com a perda e a educação prévia sobre o morrer e a morte são fatores associados às atitudes diante do morrer e da morte (p<0,05). Os participantes apresentaram atitudes positivas diante do morrer e da morte, pontuando 121 ± 0,68 na escala FATCOD-B. O Alfa de Cronbach atingiu 0,81 e o Índice de Validade de Conteúdo 88,27 os quais foram empregados para avaliar a consistência interna da versão final da FATCOD-B scale, obtendo-se valor adequado. A versão brasileira da FATCOD-B scale (FATCOD-B-B), traduzida e adaptada transculturalmente para o português brasileiro através de processos científicos rigorosos, apresentou validade de conteúdo e alta consistência interna, logo poderá ser aplicada em todo território nacional.

Abstract: This is a methodological study, with the objective of performing the translation and crosscultural adaptation of the Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B scale) into Brazilian Portuguese and the evaluation of its content validity and internal consistency. This scale is a measurement instrument, which favors the effectiveness of the assistance provided by the health team on the theme of death. It was designed by the nurse Katherine Helen Murray Frommelt in 1989, with the objective of evaluating the attitudes of nurses in relation to the care of terminally ill people and their families. Later, its application was extended to other healthcare professionals, such as physicians. This study was approved by the Ethics Committee on Human Research of the Health Sciences Sector of the Federal University of Paraná with CAEE 55547522.1.0000.0102. It was developed between July 2021 and January 2023, in the online format and involved the following stages: translation; synthesis; back translation; review by a committee of experts; pre-test and final version of the scale. The study participants were recruited as: translators sworn; a translator in the health area; North American back-translators; specialists, among which there are physicians, nurses and a professional graduated in Portuguese-English letters and physicians and nurses associated with the Brazilian Society of Geriatrics and Gerontology who participated in the pre-test. All participants were selected through pre-established inclusion and exclusion criteria. The version of the FATCOD-B scale finalized by the specialists was applied in the pre-test to 75 physicians and 12 nurses, who also answered a sociodemographic questionnaire that contained questions regarding sex, age, religion, profession, previous education about dying and death, previous experience with the loss, present experience with the loss and previous experience in caring for people with terminal illnesses. To evaluate the associations between the answers of the FATCOD-B scale, it was used the chi-square test or Fisher's exact test. All tests were performed considering a 5% significance level and using the R.4.1.2 programming language. From the 87 participants, 57.4% were up to 45 years old; 66.7% were women; 55.2% were catholic; 73.6% pointed to religious belief as a generator of attitudes about dying and death; 96.6% had previous experience in caring for people with terminal illnesses, 72.43% had experienced the loss of close family members or another significant person, 65.5% had not taken a specific course on dying and death, but had the subject approached in other courses. It was observed that the variables age, gender, religion, previous experience with loss and previous education about dying and death are influential in the attitudes towards dying and death (p<0.05). Participants showed positive attitudes towards dying and death, scoring 121 ± 0.68 on the FATCOD-B scale. Cronbach's alpha reached 0.81 and the Content Validity Index 88.27, wich were used to assess the reliability and internal consistency of the final version of the FATCOD-B scale, obtaining adequate values. The Brazilian version of the FATCOD-B scale, translated and cross-culturally adapted through rigorous scientific processes, showed content validity and high internal consistency, and could soon be applied throughout the country.

Síndrome de Burnout en profesionales de la salud antes y durante la pandemia de COVID-19 / Burnout Syndrome Among Health Professionals Before and During the COVID-19 Pandemic

Objective: To describe the differences in burnout syndrome (BS) before and during the COVID-19 pandemic among health professionals, according to prevalence, levels, sociodemographic, occupational, risk, and protective factors. Methods: A comparative descriptive study was conducted, with two samples of similar characteristics from public hospitals in Peru. The sample was 177 for 2019 and 167 for 2021. The instrument used was the Maslach Burnout Inventory. Results: It was found that there is a higher prevalence of BS and lower personal fulfillment (PF) during the pandemic. For BS, female sex is a risk factor during the pandemic. For emotional exhaustion (EE), the female gender is a risk factor before and during the pandemic. For depersonalization (DP), being 39 years of age or older is a protective factor before the pandemic. Conclusions: There are significant differences in the scores of BS, EE, and PF; no significant differences for DP were found in both periods(AU)

Objetivo: Describir las diferencias en el síndrome de burnout (BS) antes y durante la pandemia de COVID-19 en los profesionales de la salud, según la prevalencia, niveles, factores sociodemográficos, ocupacionales, de riesgo y protectores. Materiales y Métodos: Se realizó un estudio descriptivo comparativo, con dos muestras de características similares de hospitales públicos en Perú. La muestra fue de 177 para 2019 y 167 para 2021. El instrumento utilizado fue el Inventario de Burnout de Maslach. Resultados: Se encontró que existe una mayor prevalencia de BS y menor realización personal (RP) durante la pandemia. Para BS, el sexo femenino es un factor de riesgo durante la pandemia. Para el agotamiento emocional (AE), el género femenino es un factor de riesgo antes y durante la pandemia. Para la despersonalización (DE), la edad de 39 años y más es un factor protector antes de la pandemia. Conclusiones: Existen diferencias significativas en las puntuaciones de BS, AE y RP; para DE no se encontraron diferencias significativas en ambos períodos(AU)

Bienestar en mujeres trans: aproximaciones desde las trayectorias ocupacionales de profesionales de la salud / Well-being in trans women: approaches from the occupational trajectories of health professionals

Resumen El bienestar de las mujeres trans se ha visto afectado por el estigma, la discriminación, las altas brechas en salud, la falta de oportunidades laborales y educativas, además de la ausencia de apoyo social. Los profesionales de la salud juegan un papel importante dentro del bienestar y la salud de las mujeres trans, por tanto, en este estudio se planteó como objetivo reconocer el significado que tienen los profesionales de la salud sobre el bienestar en mujeres trans. Esta es una investigación cualitativa, diseño narrativo, en la cual participaron ocho profesionales de la salud (medicina, psicología y auxiliar de enfermería) con experiencia en atención a la comunidad, con quienes se realizó una entrevista en profundidad. Estos profesionales reconocen que el bienestar de las mujeres trans se ve afectado por múltiples factores socioculturales, económicos, relacionados con la salud mental, la discriminación a las que siguen expuestas, la transfobia internalizada y el poco apoyo familiar y social. Se requieren acciones concretas desde las entidades de salud, de educación superior y gubernamentales, que favorezcan procesos afirmativos de las mujeres trans, y la promoción en los procesos de atención en salud de la sensibilidad y compromiso con el desarrollo humano de estas mujeres a partir de la protección de sus derechos.

Abstract The well-being of trans women has been affected by stigma and discrimination, and great gaps in health, employment and educational opportunities and the absence of social support. The role of health professionals plays an important role in the well-being and health of trans women, therefore, the objective is to recognize the meaning that health professionals have on the well-being of trans women. Method: Qualitative research, narrative design. Eight health professionals (medicine, psychology, and nursing assistant) with experience in community care participated in an in-depth interview. In conclusion, the health professionals recognize that the well-being of trans women is affected by multiple sociocultural and economic factors related to mental health, discrimination to which they are still exposed, internalized transphobia, and the lack of family and social support. Concrete actions are required from health, higher education, and governmental entities capable of favoring affirmative processes for trans women and promoting in healthcare processes the sensitivity and commitment to their human development based on the protection of their rights.

Psychometric properties of the Brazilian Portuguese version of the Copenhagen Burnout Inventory (CBI) in healthcare professionals

Abstract Introduction Burnout syndrome (BS) in healthcare professionals (HCP) has been a major concern, and even more so during the coronavirus disease 2019 (COVID-19) pandemic. The need for adequate tools to assess BS is urgent. The objective of this study was to validate the Brazilian Portuguese version of the Copenhagen Burnout Inventory (CBI) in HCP. Methods The sample comprised 1,054 Brazilian HCP. Data were collected for 1 month (May-2020 to June-2020) using an online self-administered questionnaire. Results All three CBI dimensions demonstrated optimal reliability. All consistency measures attained values > 0.90. Split-half correlation values with Spearman-Brown reliability were higher than 0.8. The parallel analysis suggested two factors: personal burnout (PB) and work-related burnout (WB) items were associated with factor 1, and client-related burnout (CB) items were associated with factor 2. Conclusion Our study corroborates the validity of the Brazilian Portuguese version of the CBI, pointing to a close relation between PB and WB in HCP. A public domain tool with evidence quality to ensure sufficient content validity can aid in burnout evaluation and encourage both expansion of the research field and accurate detection and treatment of this syndrome in Brazilian HCP.

Success factors for evidence-based healthcare practice adoption

Background: Evidence-based health policies are widely acknowledged as being essential for attaining ongoing improvements in health outcomes. This study represents a theoretical model to test and identify to identify the key drivers for adopting evidence-based healthcare practice (EBHP). Objectives: The goal of this study was to investigate the critical success factors for the adoption of evidence-based healthcare at a South African public hospital. Methods: Medical healthcare professionals were surveyed using a questionnaire developed by the researcher. The results were analysed with SPSS 23 and AMOS. A hypothetical model based on updated (D&M) IS Success Model, Technology, Organization and Environment framework (TOE) as well as Technology Acceptance Model (TAM) was developed and analysed using structural equation modelling (SEM). Results: The findings of this study indicate that EHR is crucial and the main construct influencing the adoption of EBHP. The findings of this study indicated a positive relationship between the construct electronic health records (EHR) with medical error reduction (MER), information quality (IQ) and knowledge quality (KQ), all showed a strong positive correlation towards the adoption of EBHP. Conclusions: Better coordination of patient care (BCP) typically results in lower health care costs. The results also show that using EBHP improves the accuracy of disease diagnosis and treatment, which lowers the burden of disease. Contribution: The developed framework will help healthcare systems that are strapped for money, particularly in developing countries.

Healthcare professionals' perceived stigmatization about direct care of COVID-19 Patients: development and validation of the discrimination about COVID-19 (DisCOV-19) instrument

Background: The novel coronavirus disease 2019 (COVID-19) is a public health concern worldwide. Healthcare professionals are among the most vulnerable groups in the fight against COVID-19 because they are directly involved in the care of at-risk persons and patients with Covid-19. Objectives: This study aimed to measure the level to which healthcare workers feel that they can be discriminated due to their involvement in the direct care of COVID-19 patients. Methods: A cross-sectional online survey was conducted among healthcare professionals in Nigeria. A nineteen-item discrimination against COVID-19 (DisCOV-19) questionnaire was developed and validated for the study. Descriptive statistics and OneWay Analysis of Variance were used for data analysis. P<0.05 was considered statistically significant. Results: Out of the 286 healthcare practitioners that participated in the study, 58.4% and 30.1% were pharmacists and physicians, respectively. The majority of the participants were at least "moderately concerned" about disability (60.9%), death (71.7%), unknown complications (65.1%), and risk of infecting family members and friends (83.2%) if asked to provide care for COVID-19 patients. The physicians had a significantly higher mean discrimination score compared to the pharmacists (p=0.041). Pharmacists had a significantly lower mean discrimination score than the nurses (p=0.011). Conclusions: Many of the healthcare professionals reported a certain level of concern and perceived that they could face some forms of discrimination for providing care to COVID-19 patients

Adolescents' lived experiences of substance abuse in the Greater Giyani Municipality

Background: Adolescence is a unique and distinct stage of development that involves changes in the physical, psychological and social aspects of adolescents. It is a critical transition into adulthood whereby heightened risk-taking and sensation-seeking takes place, such as substance abuse. In a South African context, this transition sometimes occurs under economic stress, poverty, unemployment, high levels of crime and political instability. This can place adolescents at risk of substance abuse. Objectives: To explore and describe the lived experiences of adolescents abusing substances in the Greater Giyani Municipality in the Limpopo province, South Africa. Method: A qualitative, exploratory, descriptive and contextual research design with a phenomenological approach was used. Data were collected through individual, in-depth, phenomenological interviews and field notes. Thematic coding was utilised to analyse the collected data, and literature was reviewed to support the findings. Moreover, measures to ensure trustworthiness and ethical principles were applied throughout the research process. Results: Five themes were identified: substance abuse behaviour among adolescents, adolescents' motivation for continuing substance abuse, the effects of substance abuse on the lives of adolescents, factors affecting adolescents' discontinuation of substance abuse and a need to discontinue substance abuse. Conclusion: The study concluded that adolescents abusing substances in the Greater Giyani, Limpopo province, experience loss of control, broken relationships, poor academic performance, stigma attached to mental illness and negative emotions. The adolescents foresaw their future as uncertain and without direction. It is recommended that mental healthcare professionals introduce and implement interventions that will assist the adolescents who abuse substances in the Greater Giyani, Limpopo province. Contribution: The findings in this study could add knowledge in developing and implementing of strategies for psychiatric nurses to support adolescents abusing substances in the Greater Giyani, Limpopo province.

Validez del cuestionario PHQ-2 para la detección de depresión en personal sanitario colombiano durante Covid-19 / Validity of the PHQ-2 questionnaire for the detection of depression in Colombian health personnel during Covid-19

RESUMEN: Introducción: La sintomatologia depresiva en profesionales de la salud asociado a crisis virales es de alta prevalencia a nivel global, siendo su detección una prioridad por lo cual, el objetivo de esta investigación fue analizar la validez convergente y consistencia interna del cuestionario de salud del paciente-2 (PHQ-2) en profesionales sanitarios. Método: Estudio eSalud donde se recopilaron datos transversales en línea (n=725), de 281 médicos generales, 237 médicos especialistas y 207 enfermeras durante la cuarentena colombiana, entre el 20 de abril y el 10 de agosto de 2020. Edad promedio 41,3 años (± 8,76). El 38,4% eran hombres (278) y el 61.6% mujeres (447). El 66.1% del personal sanitario atendió pacientes contagiados por coronavirus y el 33,9% no prestó estos servicios. Se administró la versión de 9 ítems del PHQ, validada en población colombiana junto a la versión de 2 ítems del PHQ. Resultados: Se encontró una alta correlación entre las escalas (r=.860, P<0.001), demostrando la validez convergente del PHQ-2 para medir la sintomatología depresiva. La consistencia interna del PHQ-2 fue adecuada, con un Alpha de Cronbach de 0.80 (I.C.= 0.76 - 0.83). Conclusiones: El PHQ-2 presenta adecuados estándares psicométricos de confiabilidad y validez, por lo que su rápida administración, fácil calificación e interpretación, lo convierte en un instrumento confiable y valido para la detección rápida, sin sobrecargas laborales, de los síntomas depresivos en médicos y enfermeras que atiendan o no pacientes en condiciones de brotes virales.

ABSTRACT Background: Depressive symptomatology in health professionals associated with viral crises is highly prevalent globally, being its detection a priority. Therefore, the objective of this research was to analyze the convergent validity and internal consistency of the Patient Health Questionnaire (PHQ-2) in healthcare professionals. Method: E-Health study where cross-sectional data was collected online (n = 725), from 281 general practitioners, 237 specialist doctors and 207 nurses during the Colombian quarantine, between April 20 and August 10, 2020. Average age 41.3 years (± 8.76). 38.4% were men (278) and 61.6% women (447). 66.1% of health personnel treated patients infected with coronavirus and 33.9% did not provide these services. The 9-item version of the PHQ was administered, validated in the Colombian population together with the 2-item version of the PHQ. Results: A high correlation was found between the scales (r = .860, P <0.001), demonstrating the convergent validity of the PHQ-2 to measure depressive symptomatology. The internal consistency of the PHQ-2 was adequate, with a Cronbach's Alpha of 0.80 (I.C. = 0.76 - 0.83). Conclusions: The PHQ-2 has adequate psychometric standards of reliability and validity, so its rapid administration, easy qualification and interpretation, makes it a reliable and valid instrument for the rapid detection, without work overload, of depressive symptoms in doctors and nurses whether or not they care for patients with viral outbreaks.

Las competencias investigativas en los profesionales de la salud / Research skills in health professionals / Habilidades de pesquisa em profissionais de saúde

RESUMEN Introducción: El desarrollo de las competencias investigativas en la Educación Médica permite a los graduados universitarios brindar solución a problemas profesionales desde una concepción científica e investigativa. Su formación y desarrollo se encuentra condicionado por el currículo de una carrera universitaria que responde a intereses, necesidades y demandas de la sociedad, así como a los recursos personales que posee el individuo. Objetivo: Sistematizar información actualizada relacionada con las competencias investigativas en los profesionales de la salud para la comprensión de los aspectos que influyen en su formación y desarrollo. Método: Se realizó una amplia revisión bibliográfica relacionada con la formación y desarrollo de competencias investigativas en Educación Médica. Se consideraron artículos originales y de revisión, también cartas al editor. Se consultaron bases de datos como: SciELO, PubMed, Science Direct y Elsevier. Resultados: La investigación junto con la docencia y su vinculación son los pilares fundamentales de la Universidad Médica a nivel mundial, no se puede concebir una institución de este tipo en la que se formen profesionales de la salud sin la gestión de estos tres procesos elementales que rectoren la construcción del conocimiento y el cambio social. Conclusiones: Se debe encaminar la educación continua a potenciar los conocimientos de los profesionales de la salud en metodología de la investigación, bioestadística y redacción científica. Por otra parte, es necesario el desarrollo de estudios de posgrados como doctorados y maestrías para que los graduados potencien sus conocimientos en estas temáticas.

ABSTRACT Introduction: The development of research skills in medical education allows graduates to provide solutions to professional problems from a scientific and investigative conception. The training and development of these skills are conditioned by the program of a major that responds to the interests, needs and demands of society and the personal resources that the individual also possesses. Objective: To systematize updated information related to investigative skills in health professionals, to understand the aspects that influence the skills´ training and development. Method: an extensive literature review related to the training and development of research skills in medical education was carried out. Original and review articles, as well as letters to the editor were considered. Databases such as: SciELO, PubMed, Science Direct and Elsevier were consulted. Results: Research together with teaching and engagement are the fundamental pillars of the medical college worldwide, an institution of this type in which health professionals are trained, cannot be conceived without the management of these three elementary processes that guide the construction of knowledge and social change. Conclusions: Continuing education should be aimed at enhancing the knowledge of health professionals in research methodology, biostatistics and scientific writing. On the other hand, it is necessary to develop postgraduate studies such as doctorates and master's degrees so that graduates enhance their knowledge in these subjects.

RESUMO Introdução: O desenvolvimento de habilidades investigativas na Educação Médica permite que os graduados universitários forneçam soluções para problemas profissionais a partir de uma concepção científica e investigativa. A sua formação e desenvolvimento está condicionado pelo currículo de uma carreira universitária que responda aos interesses, necessidades e exigências da sociedade e aos recursos pessoais que o indivíduo também possui. Objetivo: Sistematizar informações atualizadas relacionadas às habilidades investigativas em profissionais de saúde para compreender os aspectos que influenciam sua formação e desenvolvimento. Método: Foi realizada uma extensa revisão de literatura relacionada ao treinamento e desenvolvimento de habilidades de pesquisa em Educação Médica. Foram considerados artigos originais e de revisão, bem como cartas ao editor. Bases de dados como: SciELO, PubMed, Science Direct e Elsevier foram consultadas. Resultados: A pesquisa junto com o ensino e o vínculo são os pilares fundamentais da Universidade de Medicina em todo o mundo, uma instituição desse tipo na qual os profissionais de saúde são formados não pode ser concebida sem a gestão desses três processos elementares que orientam a construção do conhecimento e a mudança social. Conclusões: A educação permanente deve ter como objetivo aprimorar o conhecimento dos profissionais de saúde em metodologia de pesquisa, bioestatística e redação científica. Por outro lado, é necessário desenvolver estudos de pós-graduação, como doutorados e mestrados, para que os egressos aprimorem seus conhecimentos nessas disciplinas.

Copper-based fabric for healthcare professionals to prevent healthcare-associated infections: A futuristic/dreamed uniform

Healthcare-associated infections (HAIs) have a major impact on public health worldwide. Till now, we are relying on hand washing and environmental disinfection, but the compliance rate of hand washing and adequate supply of materials is always a catch. Alongside patients, surfaces and supplies act as reservoirs of microorganisms in healthcare settings. The reduction in organisms may prove to be an effective strategy to decline HAIs. The use of gold and silver in commercial textiles is prohibited because of the high cost rather than having excellent antibacterial and antimicrobial properties, so copper has become the best choice for researchers as it possesses similar properties to gold and silver and has other characteristics such as its durability, corrosion resistance, prestigious appearance, and ability to form complex shapes. It has been found that copper brings down the microbial burden of high-touch surfaces in healthcare settings. The fundamental properties of copper offer a theoretical advantage to regular cleaning, as the effect is continuous rather than episodic. So the use of copper-impregnated textiles in hospital areas whether in form of bed linen or uniforms for health professionals, as well as patients, can be a viable alternative to decline the levels of infection in healthcare settings, and with the discovery of copper-encapsulated hospital beds and fabrics, dividends will likely be paid in improved patient outcomes, lives saved, and healthcare cost saved. The application of copper in fabrics for healthcare professionals will be a sound initiative to prevent HAIs. The fabric may help decline the infection rate and mortality among hospitalized patients.

Ethical dilemmas encountered in suicide research and management: Experiences of young mental health professionals

This study aimed to explore ethical dilemmas and challenges faced by young mental healthcare researchers and professionals working with survivors of suicide (hereinafter suicide survivors). Two focus group discussions (FGDs) Researcher FGD (with those engaged in suicide research) and Clinician FGD (with those providing treatment to suicide survivors) – consisting of open-ended questions and lasting for 70-90 minutes were conducted and analysed using Thematic Analysis. Five themes were identified: i) struggling with the incongruity of harm within benefit, ii) difficulty in delineating boundaries, iii) self-doubt in one’s professional competence, iv) nature of suicide straining the limits of confidentiality, and v) working with structural limitations. The study helps to understand the obstacles and dilemmas encountered in adhering to ethical principles while working with vulnerable individuals.

Trastornos mentales y calidad de vida relacionada con la salud en profesionales de Unidades de Cuidados Intensivos / Mental disorders and health-related quality of life in Intensive Care Units professionals

Resumen Los profesionales de la salud de las Unidades de Cuidados Intensivos (UCI) enfrentan situaciones de sufrimiento humano, competitividad y demanda, que podrían perjudicar su calidad de vida y su salud mental. El objetivo del estudio fue describir los trastornos mentales comunes y la calidad de vida relacionada con la salud en profesionales de la salud de la UCI en Salvador, Brasil. Este estudio transversal con 195 profesionales utilizó un cuestionario sociodemográfico y laboral, el Self-Reporting Questionnaire (SRQ-20) de trastornos mentales comunes y el 36-Item Short Form Health Survey (SF-36v2) de calidad de vida relacionada con la salud. El 29.7 % de los profesionales presentaron trastornos mentales comunes, especialmente entre profesionales de enfermería (RP = 2.28; IC 1.19-4.39; p = .007). La calidad de vida relacionada con la salud para todos los profesionales estuvo disminuida, principalmente en función social (44.25 ± 10.15) y rol emocional (45.86 ± 10.58). El SRQ-20 correlacionó fuertemente con los dominios dolor corporal (r = -.502), salud general (r = -.526), vitalidad (r = -.656), función social (r = -.608), salud mental (r = -.631) y el componente de salud mental (r = -.638) del SF-36v2 (p < .01). Los profesionales con trastornos mentales comunes mostraron una calidad de vida relacionada con la salud más deteriorada, esencialmente en dominios del componente de salud mental, y refirieron también dolor corporal. Es necesario discutir e implementar estrategias de evaluación, prevención y promoción de la salud mental entre los profesionales de las UCI para que sean consideradas dentro de las políticas de salud laboral.

Tobacco Harm Reduction Approach in Clinical Practice: A Qualitative Study among Multi-Specialty Healthcare Professionals in an Indian Metropolitan City

Background:Tobacco harm reduction when advocated by care providers as continuum of care towards the goal of tobacco cessation might result in long-term abstinence than it is currently seen. This study aimed to qualitatively explore the healthcare professionals approach and self-reported practices related to tobacco harm reduction and smoking cessation. Methods: A purposive sample (N=36) of multi-specialty healthcare professionals providing tobacco related cessation services at six private medical teaching institutes were engaged in semi-structured qualitative interviews between July 2020 and October 2020 in Chennai. Results: The results indicated that majority of the healthcare professional抯 lack conceptual understanding about tobacco harm reduction. Harm reduction was practised and nicotine replacement therapy was prescribed by psychiatrists in this study. Majority of the healthcare professionals were found to have misconceptions that promoting harm reducing practices instead of cessation might result in continued addiction to nicotine products among the clientele. Conclusions: The findings reveal that tobacco harm reduction remains an under-utilized clinical practise in Indian setting due to knowledge and awareness gaps among multi-specialty healthcare professionals. Improved sensitization through continuous medical education updates is needed to inform effective clinician-affirmative tobacco harm reduction practices.

Reporting adverse events of ChAdOx1 nCoV-19 coronavirus vaccine (Recombinant) among the vaccinated healthcare professionals: A cross-sectional survey

Background & objectives: The safety of the ChAdOx1 nCoV-19 vaccine is a cause of concern for many who have been vaccinated. The people have multiple concerns and fear regarding the adverse events of the vaccine. Thus, this study was undertaken to establish the safety profile of ChAdOx1 nCoV-19 Corona Virus Vaccine (Recombinant) among the healthcare professionals. Methods: This was a descriptive cross-sectional survey. After taking clearance from the institutional ethics committee 1500 healthcare professionals, who had their vaccination in the past two weeks were selected. They were provided with an online survey proforma regarding adverse events following immunization (AEFIs) of COVID-19 vaccine developed using google forms with an informed consent form affixed to it. Results: A total of 1036 individuals participated in the study. The mean and median (inter quartile range) age of the participants was 37.7 ±11.25 and 35 (29-46) yr, respectively. Of these, 52.1 per cent were female, 29.3 per cent were doctors, 33.4 per cent were nurses and 9.5 per cent were paramedical staff. Forty six per cent participants experienced one or more minor AEFIs such as pain, tenderness, redness, etc. at the injection site. Fatigue (31.75%), generalized feeling of unwell (28.57%), muscle pain (23.16%) and fever (21.71%) were the most commonly reported systemic AEFIs followed by headache (20.07%), dizziness (10.03%) and joint pains (15.25%). Most of them experienced these AEFIs within 24 h of the first dose of administration. About 42 per cent of the participants took oral antipyretics/analgesics for managing the AEFIs. Interpretation & conclusions: ChAdOx1 nCoV-19 Corona Virus Vaccine was found to be associated with mild local and systemic AEFIs that were more common after the first dose as compared to the second dose. There adverse events could be dealt with oral over-the-counter medications, with no requirement of hospitalization

El vínculo en la intervención social: un componente paradójico del acompañamiento domiciliario / O vínculo na intervenção social: um componente paradoxico do acompanhamento domiciliar / Relationship bonds in social intervention: a paradoxical component of home accompaniment

RESUMEN. Este estudio4 cualitativo describe las percepciones de profesionales de la salud acerca del componente relacional de un Modelo de Visita Domiciliaria Avanzada (ViDA). La implementación del modelo contempló una fase de capacitación de los profesionales y al mismo tiempo su participación en la puesta en práctica. Los datos cualitativos se obtuvieron de la aplicación de una entrevista telefónica a 12 profesionales, una entrevista en profundidad a 6 profesionales, 3 de ellos directores de centros de salud familiar, y del análisis de 85 reportes individuales de 34 profesionales capacitados en el modelo ViDA, pertenecientes a dos comunas de la Región Metropolitana de Chile. Los datos fueron organizados por temas y analizados usando el análisis de contenido. Los resultados señalan que el componente vincular del modelo es percibido como un aspecto clave en la realización de las visitas, siendo valorado positivamente por las y los profesionales. Desde su percepción este componente favorece la vinculación con las personas visitadas, motiva una actitud más favorable al cambio, genera transformaciones más profundas, facilita el logro de los objetivos de la intervención y promueve el empoderamiento de las mujeres. Asimismo, perciben desafíos que la capacitación no resuelve: la mejora en los registros, la planificación de la intervención y la formulación de objetivos de la visita.

RESUMO. Este estudo qualitativo descreve as percepções dos profissionais da saúde sobre o componente relacional de um Modelo de Visita Domiciliar Avançada (ViDA). A implementação do modelo considerou uma fase de capacitação dos profissionais e ao mesmo tempo a participação deles na práctica. O dados qualitativos foram obtidos através de uma entrevista telefônica à 12 profissionais, uma entrevista em profundidade à 6 profissionais, 3 deles eram diretores de centros de saúde familiar, e da análise de 85 informes individuais de 34 profissionais capacitados no modelo ViDA, que pertencem a duas comunas da Região Metropolitana do Chile. Os dados foram organizados por temas e trabalhados usando a análise de conteúdo. Os resultados mostram que o componente relacional do modelo é percebido como um aspecto central na realização das visitas, sendo valorizado positivamente pelo/as profissionais. A partir da percepção dele/as, este componente favorece a vinculação com as pessoas visitadas, motiva uma atitude mais favorável à mudanças, gera transformações mais profundas, facilita alcançar os objetivos da intervenção e promove o empoderamento das mulheres. Além disso, o/as profissionais também percebem desafios que a capacitação não resolve: a melhora nos registros, a planificaçao da intervenção e a formulação dos objetivos da visita.

ABSTRACT. This qualitative study describes the insights of health professionals on the relationship component of an Advanced Home Visit Model (ViDA). The implementation of this model involved a training stage for professionals together with their participation in the execution stage. Qualitative data were obtained through phone interviews to 12 professionals, in-depth interviews to 6 professionals, being 3 of them directors of family healthcare centers, and the analysis of 85 individual reports from 34 professionals trained in the ViDA model in two districts of the Metropolitan Region of Chile. Data were organized by subject and analyzed through content analysis. Results highlight the relationship component of the model is perceived as a key aspect in the home visit schedule and is also valued by the professionals as a positive aspect. From such point of view, this component favors the bonding of visited people, increases a favorable attitude towards change, generates deeper transformations, facilitated the achievement of goals, and promotes women empowerment. Also, professionals remarked some challenges the training stage is not solving such as improvement in records, planning of interventions and development of visit purposes.

Determinants of COVID-19 vaccine acceptance and hesitancy among healthcare professionals in the Kintampo North Municipality, Bono East Region, Ghana

tives: To assess the determinants of COVID-19 vaccine acceptance and hesitation among Health Care Professionals (HCPs) in the Kintampo North Municipality of Ghana. Design: An analytical cross-sectional study. Setting: The study was carried out in the Kintampo North Municipality. Participants: All health care professionals within the Kintampo North Municipality of Ghana. Main outcome measure: Acceptance of COVID-19 vaccine. Results: In all, 215 HCPs were included in this study. The overall vaccine acceptance was 78.6% among HCPs, while 21.4% were hesitant to receive the COVID-19 vaccine. Majority (57.7%) of HCPs believed that COVID-19 vaccines were safe. The following factors were found to influence vaccine acceptance significantly; those who knew someone who has taken the vaccine (adjusted Odds Ratio [aOR]; 14.9, 95% Confidence Interval [95% CI];5.0-45.0, p<0.001), those who think COVID -19 vaccine in Ghana was safe (AOR;9.2, 95%CI;3.3-25.8, P<0.001), those who said vaccines are effective in controlling COVID-19 transmission (aOR=5.0, 95%CI;2.1-12.4, p<0.001), and those who have never refused vaccines in the past (aOR=7.8, 95CI;1.6-37.8, p=0.01). Conclusion: The study indicated high COVID-19 vaccination acceptability among HCPs. However, some HCPs are hesitant to take COVID-19 vaccinations immediately. Increased adoption of COVID-19 vaccinations among HCPs and the broader Ghanaian population requires concerted efforts, including strengthening public health education on the perceived risks and safety of COVID-19 vaccines

Um olhar psicanalítico sobre a amamentação de bebês prematuros na UTI neonatal / A psychoanalytic view at breastfeeding premature babies in the neonatal ICU / Una mirada psicoanalítica para la lactancia de los bebés prematuros en la UCI neonatal

Este artigo consiste em um estudo teórico sobre a complexidade dos fatores físicos, psíquicos e socioculturais implicados na vivência das mães de bebês prematuros em relação à amamentação, na unidade de terapia intensiva neonatal (UTIN). Busca-se problematizar a prática de prescrever a amamentação às gestantes e lactantes, sem levar em consideração aspectos subjetivos e inconscientes que influenciarão na adesão a esta recomendação. Os discursos dos profissionais de saúde, apoiados no excesso de informações científicas sobre a amamentação, bem como argumentos moralistas que circunscrevem este tema, não são suficientes para que se estabeleça o aleitamento materno. A amamentação vai além de um processo meramente fisiológico, exigindo da mulher condições psíquicas favoráveis para que ela possa desempenhar o papel de nutriz. Pode haver casos em que não amamentar a criança no seio traga mais benefícios à saúde mental da díade, sem que isso signifique ser a mãe menos zelosa ou cuidadosa do que as demais.

This paper consists of a theoretical study on the complexity of the physical, psychic, and sociocultural factors involved in the premature-baby-mother's breastfeeding experience, in the neonatal intensive care unit (NICU). It looks to problematize the practice of prescribing breastfeeding to pregnant and lactating women without considering subjective and unconscious aspects that will influence adherence to this recommendation. The speech of health professionals, supported by the excess of scientific information about breastfeeding, as well as moralistic arguments that circumscribe this theme, are not enough for breastfeeding to be established. Breastfeeding goes beyond a purely physiological process, requiring favorable psychic conditions from the woman so that she can play the role of a nursing mother. There may be cases in which not breastfeeding the child brings more benefits to the mental health of the dyad, without this being the mother less zealous or careful than the others.

Este artículo consiste en un estudio teórico sobre la complejidad de los factores físicos, psicológicos y socioculturales involucrados en la experiencia de las madres de bebés prematuros en relación con la lactancia materna, en la unidad de cuidados intensivos neonatales (UCIN). Buscamos problematizar la práctica de prescribir la lactancia materna a mujeres embarazadas y lactantes, sin tener en cuenta los aspectos subjetivos e inconscientes que influirán en el cumplimiento de esta recomendación. Los discursos de los profesionales de la salud, respaldados por el exceso de información científica sobre la lactancia materna, así como los argumentos moralistas que circunscriben este tema, no son suficientes para establecer la lactancia materna. La lactancia materna va más allá de un proceso puramente fisiológico, y requiere condiciones psicológicas favorables de las mujeres para que puedan desempeñar el papel de una madre lactante. Puede haber casos en los que no amamantar al niño traiga más beneficios para la salud mental de la díada, sin que esto signifique que la madre sea negligente o menos cuidadosa que las demás.