RESUMO
Abstract Objective To evaluate the impact of the Covid-19 pandemic on depressive symptoms and suicide risk among patients receiving treatment at a Public Health Psychosocial Addiction Care Center (CAPS AD III) in Porto Alegre, Brazil. Methods Questions from the Coronavirus Health Impact Survey (CRISIS) translated into Brazilian Portuguese were used to evaluate 70 patients' perceptions of and behaviors during the Covid-19 pandemic. Validated Brazilian versions of the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder-7 (GAD-7) were used to evaluate the severity of depressive symptoms, suicide risk, and anxiety symptoms. A multiple logistic regression model was used to evaluate predictors of suicide risk in the sample. Results Around 70% of patients reported moderate depressive symptoms and 30% reported severe depressive symptoms, 17% of patients reported having thoughts of suicide or death on more than half of days and 10% reported having them daily. The logistic regression model identified history of alcohol use as the main predictor of suicide risk in (OR 13.0, p = 0.03). Conclusions Individuals with a history of alcohol consumption had significantly higher suicide risk scores at a psychosocial public health care center in Brazil during the Covid-19 pandemic. This result may be important for devising better strategies and interventions to support this specific population profile.
RESUMO
A Atenção Primária à Saúde está alicerçada sobre quatro atributos principais: primeiro contato, integralidade, coordenação do cuidado e longitudinalidade. Este último está associado a diversos benefícios, incluindo menor utilização de serviços e menores taxas de internação hospitalar. Almejando conhecer o processo de reflexão da equipe de uma Unidade de Saúde (US) de Porto Alegre/ RS e de sua população adscrita sobre atenção longitudinal, foi realizado um estudo qualitativo exploratório. Os participantes eram trabalhadores de saúde e usuários cadastrados na US que participaram de grupos focais com duração de 60 minutos. Foram identificadas três categorias referentes ao objeto de pesquisa: conceito de longitudinalidade, dificuldades para sua manutenção e demandas dos usuários. Constatou-se que a comunidade estudada reconhece a US como sua provedora usual de cuidado e que a equipe trabalha com a concepção de cuidado longitudinal que prevê a corresponsabilização entre equipe/profissional e usuário. Os aspectos apontados como dificuldade para a manutenção desse atributo, como tipos de vínculo, acesso e condições de escuta, são elementos intrínsecos ao processo de trabalho da equipe e, assim como a demanda dos usuários, são temas que devem ser aprofundados nos encontros futuros entre profissionais e usuários.
Primary Health Care is based on four main attributes: initial contact, comprehensiveness, coordination of care, and longitudinality. The latter is associated with several benefits, including less use of health care services and lower rates of hospitalization. Seeking to understand the reflection process of a health care unit (HCU) team in Porto Alegre, RS, and the community it serves, with regard to longitudinal care, an exploratory qualitative study was carried out. The participants were the health staff and the registered users at the HCU who participated in 60-minute focus groups. Three categories related to the object of the research were identified: concept of longitudinality, difficulties in its maintenance, and patients? needs. As a result, it was found that the community studied recognizes the HCU as its usual care provider, and that the team works under the concept of providing a longitudinal relationship that includes co-responsibility between the team/provider and the patient. The aspects mentioned as difficulties in maintaining this attribute - such as types of connection, access, and listening conditions - which are intrinsic elements of the team's work process, as well as the patients? needs, are issues that should be further investigated in future encounters between professionals and patients.