Telenfermagem em saúde mental: efeito em sintomas de ansiedade e consumo de álcool durante a pandemia COVID-19

Objetivo: investigar o efeito de uma intervenção remota nos sintomas de ansiedade e no uso de álcool em usuários do serviço de Atenção Primária à Saúde. Método: estudo quase experimental, realizado com 1270 participantes que responderam o Alcohol Use Disorders Identification Test e a State-Trait Anxiety Inventory 6. Desses, 1033 entrevistados pontuaram para sintomas de ansiedade moderada/severa (STAI-6>3) e uso de risco de álcool moderado/severo (AUDIT-C>3), e receberam as intervenções via chamada telefônica com follow-up de sete e 180 dias. Para análise dos dados utilizou-se um modelo de regressão de efeitos mistos. Resultados: o efeito da intervenção realizada foi positivo na redução dos sintomas de ansiedade entre T0 e T1 (µ=1,6 p<0.001) e na redução do padrão de uso de álcool entre t1 e t3 (µ=1,57 p<0.001). Conclusão: os resultados do follow-up sugerem efeito positivo da intervenção na redução da ansiedade e no padrão de uso de álcool, o qual tende a se manter ao longo do tempo. Há evidências de que a intervenção proposta pode ser uma alternativa para o cuidado preventivo em saúde mental, em situações nas quais a acessibilidade do usuário ou do profissional encontram-se comprometidas.

Women’s alcohol Consumption During The Restriction Phases of the COVID-19 Pandemic in Brazil: a Phone Based Survey (preprint)

Background: Women were more prone to consuming alcohol as a coping mechanism, towards the COVID-19 pandemic stressors than men. There are worldwide evidences of an increase in this consumption during the social restriction phases and its association with negative impact on women's health conditions. The study aimed to describe women’s alcohol use throughout the restriction phases of the COVID-19 pandemic in São Paulo, Brazil. Method: Cross-sectional survey based on telephonic self-reports, and enrolled women who sought health care at primary health care. The sample comprised 3252 women, of whom 1308 (40%) reported consuming alcohol. The independent variable was the timing of the COVID-19 pandemic’s restriction phases. Data collection was based on telephonic self-reports, and enrolled women who sought health care at primary health care. The AUDIT-C was used as a measurement instrument. The covariates included socio-demographics, lifestyle, and outcomes related to the COVID-19 infection. Univariate and multivariate models were used for analysis. A generalized linear model with a negative binomial distribution and zero inflation for the AUDIT-C score as an outcome variable was used for the entire sample.  Findings: Women’s alcohol consumption during the COVID-19 restriction phases was compatible with moderate-risk use 3.5 (SD=2.9). Binge drinking was observed in 41.8% of the participants. Alcohol consumption was 28.9% higher in the transition phase of social restriction than in the restriction and flexibilization phases. Hospitalization for COVID-19 and loss of loved one due to COVID-19 were associated with alcohol consumption. Conclusions: Women presented a pattern of moderate risk of alcohol. This consumption were higher during the restriction phase of the pandemic in South America’s largest city; tehrefore, it brought important reflections on the women’s pattern of alcohol consumption revealing social and clinical vulnerability of this population, which might be taken into account in future health policies and programs.