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1.
Cien Saude Colet ; 28(10): 3033-3044, 2023 Oct.
Article in Portuguese, English | MEDLINE | ID: mdl-37878944

ABSTRACT

The aim of the present study was to map the available evidence on the mental health risk factors of frontline health professionals during the COVID-19 pandemic. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was independently carried out by four researchers, following the selection criteria in the electronic databases: PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. The data processing used Zotero software, responsible for creating and importing items according to the criteria established by the research. A total of 18,733 articles were found, of which 2,722 were excluded by the Zotero software because they were in duplicate, and another 366 were manually excluded. After applying the selection criteria, 43 articles entered the final analysis of this review. It is recommended that new scientific research be carried out, especially focusing on the analysis of health workers' mental health, aiming at providing the basis to create and implement public mental health programs and policies for workers.


Neste estudo, nosso objetivo foi mapear as evidências disponíveis sobre os fatores de risco à saúde mental dos profissionais de saúde trabalhadores da linha de frente durante a pandemia de COVID-19. Trata-se de uma revisão sistemática que seguiu os critérios dos Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca foi realizada independentemente, por quatro pesquisadores, seguindo os critérios de seleção nas bases de dados eletrônicas PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. No processamento de dados foi utilizado o software Zotero, responsável por criar e importar itens de acordo com os critérios estabelecidos pela pesquisa. Foram encontrados 18.733 artigos, dos quais 2.722 foram excluídos, a partir do programa Zotero, por estarem duplicados, e outros 366 excluídos manualmente. Após aplicação dos critérios de seleção, 43 artigos entraram na análise final desta revisão. Recomenda-se a elaboração de novas pesquisas científicas, sobretudo colocando como objeto a análise da saúde mental desses trabalhadores, com o objetivo de embasar a elaboração e implementação de programas e políticas públicas de saúde mental para os trabalhadores.


Subject(s)
COVID-19 , Humans , Mental Health , Pandemics , Risk Factors , Delivery of Health Care
2.
Ciênc. Saúde Colet. (Impr.) ; 28(10): 3033-3044, out. 2023. graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1520599

ABSTRACT

Resumo Neste estudo, nosso objetivo foi mapear as evidências disponíveis sobre os fatores de risco à saúde mental dos profissionais de saúde trabalhadores da linha de frente durante a pandemia de COVID-19. Trata-se de uma revisão sistemática que seguiu os critérios dos Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca foi realizada independentemente, por quatro pesquisadores, seguindo os critérios de seleção nas bases de dados eletrônicas PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. No processamento de dados foi utilizado o software Zotero, responsável por criar e importar itens de acordo com os critérios estabelecidos pela pesquisa. Foram encontrados 18.733 artigos, dos quais 2.722 foram excluídos, a partir do programa Zotero, por estarem duplicados, e outros 366 excluídos manualmente. Após aplicação dos critérios de seleção, 43 artigos entraram na análise final desta revisão. Recomenda-se a elaboração de novas pesquisas científicas, sobretudo colocando como objeto a análise da saúde mental desses trabalhadores, com o objetivo de embasar a elaboração e implementação de programas e políticas públicas de saúde mental para os trabalhadores.


Abstract The aim of the present study was to map the available evidence on the mental health risk factors of frontline health professionals during the COVID-19 pandemic. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was independently carried out by four researchers, following the selection criteria in the electronic databases: PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. The data processing used Zotero software, responsible for creating and importing items according to the criteria established by the research. A total of 18,733 articles were found, of which 2,722 were excluded by the Zotero software because they were in duplicate, and another 366 were manually excluded. After applying the selection criteria, 43 articles entered the final analysis of this review. It is recommended that new scientific research be carried out, especially focusing on the analysis of health workers' mental health, aiming at providing the basis to create and implement public mental health programs and policies for workers.

3.
Work ; 76(3): 941-951, 2023.
Article in English | MEDLINE | ID: mdl-37248942

ABSTRACT

BACKGROUND: The arrival of COVID-19 in Brazil and the accelerated process of dissemination/contamination added to the evolution of the clinical picture of the disease, and the saturation of the capacity of health services, creating new challenges for researchers, governments, and professionals involved in the occupational health area. OBJECTIVE: This article aims to systematize and synthesize the proposals adopted by the legislation and by the Brazilian State, with a focus on worker protection and guaranteeing a safe work environment for the performance of their professional activities. METHODS: This is qualitative bibliographical research of the narrative literature review type, developed from October 2020 to June 2021 in legislation databases using the strategy: "COVID-19" AND "coronavirus/coronavirus" AND "worker health" on official Brazilian government websites. RESULTS: The lack of an emergency plan for efficient actions to respond to the epidemic caused and is still causing the daily deaths of workers. CONCLUSION: There is a need to guarantee the effectiveness of national and international policies and norms that have been neglected by the Brazilian government.


Subject(s)
COVID-19 , Occupational Health , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Health Personnel , Workplace , Brazil/epidemiology
4.
Am J Occup Ther ; 76(3)2022 May 01.
Article in English | MEDLINE | ID: mdl-35648118

ABSTRACT

IMPORTANCE: The occupational therapy clinical reasoning literature includes a large proportion of peer-reviewed qualitative and conceptual articles. Although these articles can contribute to the understanding of how clinical reasoning has been conceptualized in occupational therapy, they have not yet received in-depth analytic attention. To address this gap, we conducted a scoping review. OBJECTIVE: To examine how qualitative and conceptual literature has addressed clinical reasoning in occupational therapy. DATA SOURCES: Database searches were conducted in Scopus, Web of Science, PsycINFO, Embase, and MEDLINE. STUDY SELECTION AND DATA COLLECTION: Included articles were published between 2010 and 2019, were peer reviewed, addressed clinical reasoning in occupational therapy, were qualitative or conceptual articles, focused on practitioners, and were in English. Twenty-six articles met the inclusion criteria. Data were extracted according to relevant categories and were analyzed numerically and thematically. FINDINGS: Four themes were identified: clinical reasoning processes, factors influencing clinical reasoning, new models or frameworks to guide clinical reasoning, and emergent perspectives on clinical reasoning. CONCLUSIONS AND RELEVANCE: This review advances knowledge about how clinical reasoning has been conceptualized in occupational therapy and has been applied in a range of practice contexts. The review highlights discussions about types of reasoning, the dynamic and iterative nature of reasoning, contextual dimensions of reasoning, client-centered and occupation-based approaches, new frameworks and models, and emergent and innovative perspectives on clinical reasoning in occupational therapy. What This Article Adds: This scoping review represents an important contribution to knowledge about how clinical reasoning has been conceptualized in occupational therapy by mapping key themes and illuminating scholarly conversations in the qualitative and conceptual clinical reasoning literature.


Subject(s)
Occupational Therapy , Clinical Reasoning , Communication , Humans , Occupational Therapy/methods , Occupations , Peer Review
5.
Cad. Bras. Ter. Ocup ; 30: e2964, 2022. graf
Article in Portuguese | LILACS-Express | LILACS, Index Psychology - journals | ID: biblio-1364622

ABSTRACT

Resumo Introdução A reflexão sobre a prática, na perspectiva da epistemologia da racionalidade prática, favorece o ganho de consciência sobre seus aspectos tácitos, como do raciocínio profissional. Estudos que focalizam a reflexão sobre a prática para sustentar o raciocínio profissional de terapeutas ocupacionais têm emergido; porém, eles ainda são incipientes, especialmente no Brasil. Objetivo Analisar o conteúdo e a aplicabilidade de uma ferramenta reflexiva para sustentar o raciocínio profissional no processo de análise situada das necessidades da pessoa em acompanhamento em terapia ocupacional. Método Pesquisa-ação, com participação de 11 terapeutas ocupacionais atuantes na Atenção Básica à Saúde, desenvolvida com as seguintes etapas: elaboração prévia da ferramenta; utilização da ferramenta pelas participantes e análise de seu conteúdo e estrutura; entrevistas individuais após a utilização; análise descritiva e temática; adequação da ferramenta; oficinas de validação; e construção da versão final da ferramenta. Resultados As modificações sugeridas abarcaram alterações de termos, acréscimos e integração de diferentes domínios. A versão final da ferramenta se estruturou em 20 questões, organizadas em sete domínios. As possibilidades de aplicabilidade foram: dar visibilidade para as especificidades da terapia ocupacional no trabalho em equipe; possibilitar a reflexão sobre a prática e melhorar o raciocínio profissional; utilizar a ferramenta em outros contextos de prática e no ensino da prática profissional. Conclusão A ferramenta apresenta aplicabilidade prática, contribuindo para fortalecer o núcleo profissional em terapia ocupacional e o diálogo interprofissional, facilitando a reflexão sobre a prática e ampliando a consciência sobre processos de raciocínio profissional.


Abstract Introduction Reflection on practice, from the epistemology of practical rationality perspective, favors gaining awareness of tacit aspects of the practice, such as professional reasoning. Studies focusing the reflection on practice to support occupational therapists' reasoning have emerged. However, they are still incipient, especially in Brazil. Objective To analyze the content and applicability of a reflective tool to support professional reasoning in the process of situated analysis of the needs of the assisted person in occupational therapy. Method Action research, with the participation of 11 occupational therapists working in Primary Health Care, was developed following the steps: previous development of the tool; use of the tool by the participants and analysis of its content and structure; individual interviews after its use; descriptive and thematic analysis; tool suitability; validation workshops and construction of the final version of the tool. The data were produced through a participants characterization form, an agreement questionnaire to analyze the content and structure of the tool, and individual interviews about its applicability. Data were analyzed descriptively and thematically. The reflective tool was adjusted based on the participants' suggestions. Validation workshops were held with the participants to build the final version of the tool. Results The suggested modifications in the tool included changes in terms, and also additions and integration of different domains. Its final version was structured on 20 questions, organized in seven domains. The applicability possibilities were: to give visibility to the specificities of occupational therapy in interprofessional teams; to enable reflection on practice and to improve professional reasoning; to use the tool in other contexts of practice; and for teaching of professional practice. Conclusion The tool has practical applicability, contributing to strengthening the professional core in occupational therapy and for interprofessional dialogue, facilitating the reflection on practice, and increasing the awareness about professional reasoning processes.

6.
Fisioter. Bras ; 22(5): 733-757, Nov 11, 2021.
Article in Portuguese | LILACS | ID: biblio-1353562

ABSTRACT

A estimulação elétrica transcraniana (EET) é uma técnica de neuromodulação não invasiva, que tem sido utilizada como coadjuvante no tratamento de transtornos depressivos devido à sua capacidade de modificar a excitabilidade cortical. Objetivo: Analisar os efeitos da EET nos transtornos depressivos e propor parâmetros para a prática clínica. Métodos: Estudo de revisão sistemática no qual foram incluídos ensaios clínicos randomizados que utilizaram a EET no tratamento dos transtornos depressivos, publicados entre 2010 e junho de 2018, nas línguas inglesa e portuguesa. Resultados: Foram encontrados 14.775 estudos, sendo selecionados para a amostra apenas 15 trabalhos. Todos os estudos selecionados utilizaram a EET por corrente contínua e apresentaram semelhanças em relação aos demais parâmetros elétricos de tratamento e locais de aplicação dos eletrodos. Em 12 dos 15 estudos avaliados foi observada melhora significativa (p < 0,05) dos sintomas depressivos e, em relação aos efeitos adversos, constatou-se que são inferiores aos tratamentos convencionais. Conclusão: A EET apresenta eficácia no tratamento dos transtornos depressivos e que isto está diretamente relacionado ao uso adequado dos parâmetros e técnicas de aplicação da corrente elétrica. (AU)


Subject(s)
Depression , Depressive Disorder , Transcranial Direct Current Stimulation , Neurotransmitter Agents , Electric Stimulation
7.
Eng. sanit. ambient ; 26(2): 239-249, Mar.-Apr. 2021. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1249755

ABSTRACT

RESUMO A promulgação da Lei Federal n° 9.433, de 8 de janeiro de 1997, foi um marco político e técnico da gestão dos recursos hídricos no Brasil, ao instituir a Política Nacional de Recursos Hídricos, que, nos seus fundamentos, preconiza a gestão dos recursos hídricos descentralizada e a participação do Poder Público, dos usuários e das comunidades. Nesse contexto, o objetivo deste artigo é estabelecer indicadores de sustentabilidade para a área de manancial do município de Paranavaí, no estado do Paraná, Brasil, usando uma abordagem de gestão participativa das partes interessadas associada a ferramentas de análise multicritério para auxílio à tomada de decisão. A área de manancial está inserida numa área de proteção ambiental (APA) denominada de APA Arara. Os métodos utilizados foram mapeamento cognitivo e measuring attractiveness by a categorical-based evaluation technique (MACBETH), aplicados durante uma conferência de decisão com a participação de diversos atores diretamente atingidos e fortemente interessados no tema, tais como órgãos gestores, produtores rurais, empresários do ramo imobiliário, vereadores, instituições de ensino superior etc. No fim da conferência de decisão, 14 indicadores foram definidos e seus pesos estabelecidos. Os resultados obtidos servem de subsídios para a gestão mais eficiente do recurso hídrico, pois conduziram à solução de maior comprometimento, ao envolver muitos atores representantes das partes interessadas. Além disso, mostraram que o uso combinado de mapas cognitivos e da abordagem MACBETH possibilitou a definição de indicadores de sustentabilidade para a APA de forma transparente e eficaz, demonstrando o sucesso na gestão participativa do recurso hídrico.


ABSTRACT The enactment of Federal Act nº 9433, on January 8th, 1997, was a political and technical milestone in water resources management in Brazil, by instituting the National Water Resources Policy which, in its foundations, stablishes decentralized management with the involvement of official authorities, customers and communities. In this context, the purpose of this paper is to set out sustainability indicators for a spring area in the municipality of Paranavaí, located in the state of Paraná, Brazil, using an approach based on the participatory management of stakeholders associated with multi-criteria analysis tools for decision-making support. The spring is located in an Environmental Protection Area, named APA Arara. The methodology consisted in cognitive mapping and the Measuring Attractiveness by a Categorical-Based Evaluation Technique (MACBETH) approach, applied during a decision conference attended by a number of agents directly affected by, and strongly interested in, the issue, such as managing agencies, rural producers, real estate businessmen, councilors, representatives of higher education institutions, among others. By the end of the decision conference, 14 indicators were defined and their weights stablished. The obtained results provide the basis for more efficient water resources management, as they led to the most committed solution by involving many different stakeholders. Furthermore, they showed that the combined use of cognitive maps and the MACBETH approach enabled the setting of sustainability indicators for the APA Arara in a transparent and effective way, emphasizing their success in the participatory water resources management.

8.
Aust Occup Ther J ; 68(1): 3-11, 2021 02.
Article in English | MEDLINE | ID: mdl-32798251

ABSTRACT

INTRODUCTION: New contexts of practice demand that professionals engage in critical reflection to handle new situations and to create new knowledge that is responsive to professional practices situated in unique historical and social contexts. Community of Practice offers a framework for professions to reflect together on practice dilemmas and to generate practical solutions. METHODS: This paper presents a participatory action research project that traces the trajectory of a Community of Practice made up of seven occupational therapists working in primary health care and a researcher team, in Brazil. This study mapped the Community of Practice's trajectory between 2013 and 2017 through a group timeline analysis, which occurred gradually, in a collaborative mode. RESULTS: Three distinct phases in the trajectory of the development of the Community of Practice were identified: narrative perspectives were utilised as a means to identify dilemmas and difficulties in practice; the investigation of clients' needs and identification of issues was an ongoing process; and the generation of practice-based knowledge through the development of instruments to sustain clinical reasoning was a creative solution to practical dilemmas. CONCLUSION: Three main aspects were highlighted: the partnership between researchers and practitioners as a potential avenue for the production of knowledge relevant to professional practice; the negotiation of the dilemma of "putting practice into words" in the context of constantly changing local and global perspectives; and the investigation of situated practice as an important element that can strengthen, strain, resist or even modify hegemonic perspectives of knowledge production in our field.


Subject(s)
Occupational Therapists/psychology , Occupational Therapy/organization & administration , Primary Health Care/organization & administration , Attitude of Health Personnel , Brazil , Clinical Competence , Health Services Research , Humans , Interviews as Topic , Needs Assessment , Reference Standards
9.
Cad. Bras. Ter. Ocup ; 29: e2859, 2021. tab
Article in English | LILACS-Express | LILACS, Index Psychology - journals | ID: biblio-1339506

ABSTRACT

Abstract Introduction Meaning-making is an experience-centred process. It is an essential element for understanding the impact of occupational therapy interventions focused on fostering processes of becoming, one of the four integrated dimensions of meaningful occupation (along with doing, being, and belonging). Objective This paper aims to explore further some of the aspects that are essential for meaning-making in occupational therapy interventions. Method A scoping review guided by Arksey and O'Malley's methodological framework was conducted. In the initial search, 528 articles were retrieved from three databases; 16 met the criteria for inclusion: articles in English, peer-reviewed, published between January 2008 and December 2017, that addressed some type of occupational therapy intervention, with data related to the meanings of the participants of the studies. Results The articles address a multiplicity of populations, services, and fields of practice, in qualitative studies, with methodologies that prioritise reflection on the lived experience. Thematic analysis highlights the interconnection between being, doing, and belonging to foster meaning-making; implications of professional actions; and meaning-making triggered by reflective processes. Conclusion Meaning-making demands reflection on the lived experience, and is influenced by human and physical environments. Both conditions/limitations and new skills/abilities enhance processes of meaning-making. Implications for future research are considered.


Resumo Introdução A construção de sentidos é um processo centrado na experiência, essencial para a compreensão do impacto das intervenções em terapia ocupacional voltadas para a promoção de processos de transformação/becoming, uma das quatro dimensões integradas da ocupação significativa (juntamente com o fazer/doing, ser/being e pertencer/belonging). Objetivo Este artigo tem como objetivo identificar aspectos essenciais para a construção de sentido em intervenções de terapia ocupacional. Método Foi realizada uma revisão de escopo. Na busca inicial, 528 artigos foram recuperados de três bases de dados; 16 atenderam aos critérios de inclusão: artigos em inglês, revisados por pares, publicados entre janeiro de 2008 e dezembro de 2017, que abordassem algum tipo de intervenção de terapia ocupacional, com dados referentes aos sentidos construídos pelos participantes dos estudos. Resultados Os artigos abordam múltiplas populações, serviços e campos de prática, em estudos qualitativos, com metodologias que priorizam a reflexão sobre a experiência vivida. A análise temática destaca a interconexão entre ser, fazer e pertencer para promover a construção de sentido; implicações para ações profissionais; e construção de sentido desencadeada por processos reflexivos. Conclusão A construção de sentidos demanda reflexão sobre a experiência vivida, é influenciada pelos ambientes humanos e físicos. Tanto as condições limitantes como as novas habilidades adquiridas desencadeiam processos de construção de sentido. Implicações para pesquisas futuras são indicadas.

10.
Cad. Bras. Ter. Ocup ; 28(4): 1322-1334, Oct.-Dec. 2020.
Article in Portuguese | LILACS-Express | LILACS, Index Psychology - journals | ID: biblio-1153630

ABSTRACT

Resumo Este ensaio busca tecer reflexões em torno da temática da inserção social, caminhando pela construção de conhecimento em terapia ocupacional, em sua lida com sujeitos imersos em problemáticas ligadas à exclusão social. Tais reflexões sustentam-se no trabalho desenvolvido por Bruno Latour, sociólogo francês, em especial em seu trabalho metodológico sobre a Teoria Ator-Rede, que busca desvelar a ação de seres humanos e não humanos que leva outros a agirem no mundo; e nas proposições do Método Terapia Ocupacional Dinâmica, desenvolvido por Jô Benetton, terapeuta ocupacional brasileira, em seu arcabouço metodológico para ajudar pessoas a agirem no mundo. Assim, este ensaio busca desvelar pontos nos quais essas duas propostas teórico-metodológicas se aproximam e podem oferecer novas possibilidades para compreender a inserção social em construção, no movimento dinâmico, fluido e instável do social, em processos que favoreçam a participação dos sujeitos na construção do coletivo, com base em seu modo de ser, de fazer e de se relacionar.


Abstract This essay aims to weave reflections around the theme of social insertion, walking through the construction of knowledge in occupational therapy, in its deal with persons immersed in issues related to social exclusion. These reflections are based on the Bruno Latour's work, a French sociologist, in particular his Actor-Network Theory, which seeks to unveil the action of human and non-human beings that leads others to act in the world; and on the propositions of the Dynamic Occupational Therapy Method, developed by Jô Benetton, a Brazilian occupational therapist, in her methodological framework to help people to act in the world. This essay aims to reveal points in which these two theoretical-methodological proposals approach and can offer new possibilities to understand social insertion in construction, in the dynamic, fluid and unstable movement of the social, in processes that favor people´s participation in the construction of the collective, based on their way of being, doing and relating.

11.
Cad. Bras. Ter. Ocup ; 27(4): 743-753, out.-dez. 2019. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1055567

ABSTRACT

Resumo Introdução Mudanças geradas pela reforma psiquiátrica brasileira reaproximaram as pessoas com transtornos mentais de suas famílias, que passaram a ser responsáveis pela oferta de cuidados. Objetivo O objetivo deste estudo foi investigar a emoção expressa, o estresse precoce e os sintomas de estresse entre cuidadores informais de pessoas com transtornos mentais no momento da internação psiquiátrica. Método Participaram 112 cuidadores. Para coleta de dados foram utilizados quatro instrumentos: questionário sociodemográfico, Family Questionnaire - Versão Português do Brasil, Questionário sobre Traumas na Infância e Inventário de Sintomas de Estresse para adultos de Lipp. Foram realizadas análises estatísticas descritivas, bivariadas e de regressão logística. Os cuidadores foram avaliados com alta emoção expressa tanto no componente superenvolvimento emocional quanto no componente comentários críticos. Resultados O componente superenvolvimento emocional da emoção expressa foi significativamente associado com o estresse precoce e com a fase dos sintomas de estresse. O estresse precoce, a idade e a escolaridade dos cuidadores foram identificadas como variáveis preditoras de alta emoção expressa. Conclusão Esses resultados confirmam a relevância dessas variáveis para o planejamento de ações de assistência no contexto da saúde mental.


Abstract Introduction Changes resulting in Brazilian psychiatric reform brought people with mental disorders closer to their families, who became responsible for the offer of care. Objective The aim of this study was to investigate the expressed emotion, the early stress, and the stress symptoms among informal caregivers of people with mental disorders at the time of psychiatric hospitalization. Method 112 caregivers participated. Four instruments were used to collect data: socio-demographic questionnaire, Family Questionnaire - Brazilian Portuguese Version (FQ-BPV), Childhood Trauma Questionnaire (CTQ) and Lipp Adult Stress Symptom Inventory (ISLL). Descriptive, bivariate and logistic regression analyses were performed. Caregivers were assessed with high emotion expressed both in the emotional over-involvement component and in the critical comments component. Results The emotional over-involvement component of expressed emotion was significantly associated with early stress and stage of stress symptoms. Early stress, age, and the education level of caregivers were identified as predictive variables of high expressed emotion. Conclusion These results confirm the relevance of these variables for the planning of care actions in the context of mental health.

12.
Rev. bras. enferm ; 72(6): 1699-1706, Nov.-Dec. 2019. graf
Article in English | LILACS, BDENF - Nursing | ID: biblio-1042169

ABSTRACT

ABSTRACT Objective: to evaluate the relation between sociodemographics factors, stress and burden of care of family caregivers of patients at a psychiatric hospital admission. Method: quantitative study, with a cross-sectional correlation design. A total of 112 family caregivers participated, older than 18, in a Brazilian psychiatric hospital. A sociodemographic questionnaire was used to collect data, the Zarit Burden Interview and LIPP Adult Stress Symptom Inventory. Results: burden of care in family caregivers at a psychiatric hospital admission was significantly associated with stress (p=0.000). The psychological symptoms of stress predicted severe burden. Most caregivers presented a moderate or severe burden, with 52.7% in the resistance phase of stress; 66.1% presented psychological symptoms. Conclusion: results show the alarming situation of caregivers of patients from a psychiatric hospital, evidencing their own vulnerability to illness. Indeed, the during admission in a psychiatric hospital, not only patients need care, but also their caregivers.


RESUMO Objetivo: avaliar a relação entre fatores sociodemográficos, estresse e sobrecarga de cuidado de cuidadores familiares na internação de pacientes em um hospital psiquiátrico. Método: estudo quantitativo, com desenho de correlação transversal. Um total de 112 cuidadores familiares participaram do estudo, maiores de 18 anos, em um hospital psiquiátrico brasileiro. Um questionário sociodemográfico, o Zarit Burden Interview e o LIPP Adult Stress Symptom Inventory foram usados para a coleta de dados. Resultados: a carga de cuidado dos familiares cuidadores em internação no hospital psiquiátrico foi significativamente associada ao estresse (p=0,000). Os sintomas psicológicos do estresse previam uma sobrecarega. A maioria dos cuidadores apresentava sobrecarga moderada ou grave, com 52,7% na fase de resistência ao estresse, e 66,1% apresentavam sintomas psicológicos. Conclusión: os resultados mostram a situação alarmante dos cuidadores de pacientes na admissão ao hospital psiquiátrico, evidenciando sua própria vulnerabilidade à doença. De fato, a internação em um hospital psiquiátrico não requer cuidados apenas para o paciente, mas também para os cuidadores familiares.


RESUMEN Objetivo: evaluar la relación entre los factores sociodemográficos, el estrés y la carga de atención de los cuidadores familiares en el ingreso de pacientes en un hospital psiquiátrico. Método: estudio cuantitativo, con diseño de correlación transversal. Participaron 112 cuidadores familiares, mayores de 18 años, en un hospital psiquiátrico brasileño. Para la recolección de datos se utilizó un cuestionario sociodemográfico, el Zarit Burden Interview y el LIPP Adult Stress Symptom Inventory. Resultados: la carga de atención de los cuidadores familiares en el ingreso al hospital psiquiátrico se asoció significativamente con el estrés (p=0,000). Los síntomas psicológicos del estrés predijeron una carga severa. La gran parte de los cuidadores presentaron una carga moderada o grave, con un 52,7% en la fase de resistencia del estrés, y el 66,1% presentó síntomas psicológicos. Conclusión: los resultados muestran la situación alarmante de los cuidadores de pacientes en el ingreso al hospital psiquiátrico, evidenciando su propia vulnerabilidad a la enfermedad. De hecho, el ingreso al hospital psiquiátrico no requiere cuidado solamente al paciente, sino también a los cuidadores familiares.


Subject(s)
Humans , Male , Female , Adult , Aged , Stress, Psychological/etiology , Caregivers/psychology , Cost of Illness , Mental Health Services/standards , Psychometrics/instrumentation , Psychometrics/methods , Stress, Psychological/psychology , Brazil , Adaptation, Psychological , Cross-Sectional Studies , Surveys and Questionnaires , Caregivers/statistics & numerical data , Hospitalization/statistics & numerical data , Hospitals, Psychiatric/organization & administration , Hospitals, Psychiatric/statistics & numerical data , Mental Health Services/statistics & numerical data , Middle Aged
13.
Rev. chil. ter. ocup ; 19(2): 39-49, dic. 2019.
Article in Portuguese | LILACS | ID: biblio-1121423

ABSTRACT

O início da prática é um período de intensa socialização profissional e de vivências dilemáticas e estressantes. Este artigo apresenta parte dos resultados de uma pesquisa-ação que objetivou compreender aspectos do desenvolvimento profissional em terapia ocupacional, e contou com participação de seis terapeutas ocupacionais iniciantes, da pesquisadora e de dois terapeutas ocupacionais experientes em uma comunidade de prática, com encontros presenciais gravados e transcritos, e atividades virtuais ­ dados analisados tematicamente. A temática dos dilemas vividos na prática iniciante e a construção de sentidos sobre eles organizaram-se em quatro subtemas: O não-saber como alimento para o desenvolvimento profissional; Ser terapeuta na saúde mental; O uso de atividades em saúde mental e o que é específico em terapia ocupacional; Aprender a encontrar o foco em atendimentos de curto tempo. Esperamos que este artigo possa ampliar reflexões sobre a formação inicial e continuada em terapia ocupacional, além de indicar novas possibilidades de pesquisa na temática.


El inicio de la práctica profesional es un período de intensa socialización y vivencias de dilemas y estrés. Este artículo presenta parte de los resultados de una investigación-acción con el objetivo de comprender algunos aspectos del desarrollo profesional en terapia ocupacional; participan seis terapeutas ocupacionales que inician su trabajo , la investigadora y dos terapeutas ocupacionales con experiencia, en una comunidad de práctica. Los encuentros presenciales fueron grabados y transcritos, además de actividades virtuales y los datos fueron analizados por tema. La temática de los dilemas vividos en la práctica inicial y la construcción de significados de éstos se organizaron en cuatro subtemas: La falta de conocimiento para el desarrollo profesional; ser terapeuta en la salud mental; el uso de actividades específicas de TO en salud mental y qué es para terapia ocupacional; aprender a encontrar el foco de la intervención de corto tiempo. Esperamos que este artículo pueda ampliar reflexiones sobre la formación inicial y continuada en terapia ocupacional, e indicar nuevas posibilidades de investigación en la temática.


The beginning of practice has been considered an intense professional period of socialization and high level of stress. This article presents some results from an Action Research which included the participation of six beginners occupational therapists, the researcher and two experienced occupational therapists in a community of practice. The meetings were recording and transcribing beside virtual activities. All data were thematically analyzed. The theme of dilemmas in the beginning of practice and the construction of meaning were organized in four themes: Non-knowing nurturing professional development; being a therapist in mental health; use of activities and occupational therapy specificity; learning to find the focus of the intervention on short-term care. We hope this study could expand reflections on initial and continuing training in occupational therapy, and to indicate new possibilities for research in the subject.


Subject(s)
Humans , Male , Female , Professional Practice , Mental Health , Occupational Therapists , Work , Surveys and Questionnaires , Mentoring
14.
Rev Bras Enferm ; 72(6): 1699-1706, 2019.
Article in English | MEDLINE | ID: mdl-31644763

ABSTRACT

OBJECTIVE: to evaluate the relation between sociodemographics factors, stress and burden of care of family caregivers of patients at a psychiatric hospital admission. METHOD: quantitative study, with a cross-sectional correlation design. A total of 112 family caregivers participated, older than 18, in a Brazilian psychiatric hospital. A sociodemographic questionnaire was used to collect data, the Zarit Burden Interview and LIPP Adult Stress Symptom Inventory. RESULTS: burden of care in family caregivers at a psychiatric hospital admission was significantly associated with stress (p=0.000). The psychological symptoms of stress predicted severe burden. Most caregivers presented a moderate or severe burden, with 52.7% in the resistance phase of stress; 66.1% presented psychological symptoms. CONCLUSION: results show the alarming situation of caregivers of patients from a psychiatric hospital, evidencing their own vulnerability to illness. Indeed, the during admission in a psychiatric hospital, not only patients need care, but also their caregivers.


Subject(s)
Caregivers/psychology , Cost of Illness , Mental Health Services/standards , Stress, Psychological/etiology , Adaptation, Psychological , Adult , Aged , Brazil , Caregivers/statistics & numerical data , Cross-Sectional Studies , Female , Hospitalization/statistics & numerical data , Hospitals, Psychiatric/organization & administration , Hospitals, Psychiatric/statistics & numerical data , Humans , Male , Mental Health Services/statistics & numerical data , Middle Aged , Psychometrics/instrumentation , Psychometrics/methods , Stress, Psychological/psychology , Surveys and Questionnaires
15.
Int Urogynecol J ; 29(11): 1565-1573, 2018 Nov.
Article in English | MEDLINE | ID: mdl-29644384

ABSTRACT

INTRODUCTION AND HYPOTHESIS: Our objective was to evaluate the effectiveness of pelvic floor muscle training (PFMT) in reducing overactive bladder (OAB) symptoms in women. METHODS: Searches were performed at MEDLINE, PubMed, Physiotherapy Evidence Database (PEDro), Scielo, and Central Cochrane Library PubMed until January 2017. Controlled trials were researched by two independent reviewers. Eligible studies were restricted to random and controlled clinical trials that investigated the effectiveness of PFMT in decreasing OAB symptoms. Qualitative methodology was evaluated using the PEDro scale. Data was analyzed and interpreted qualitatively. RESULTS: The final search retrieved eight studies (n = 1161 women with urgency symptoms), which were published between 2002 and 2016. The methodological scores varied between 4 and 7 in the PEDro scale. PFMT, with the objective of controlling urgent micturition, demonstrated improvements in quality of life in women with OAB. Most data in this revision came from small- to moderate-sized trials, with different and inconsistent outcome measures, which could have impacted the end results. CONCLUSIONS: The literature regarding the effectiveness of PFMT in OAB remains heterogeneous and inconclusive.


Subject(s)
Exercise Therapy/methods , Physical Therapy Modalities , Urinary Bladder, Overactive/therapy , Adult , Female , Humans , Middle Aged , Pelvic Floor/physiopathology , Syndrome , Treatment Outcome , Urinary Bladder, Overactive/physiopathology
16.
Fisioter. Bras ; 19(2): f:202-I:209, 2018.
Article in Portuguese | LILACS | ID: biblio-911287

ABSTRACT

A acne vulgar é uma desordem da unidade pilosebácea que apresenta alta prevalência e incidência, principalmente em adolescentes. Atualmente, existem diversas intervenções terapêuticas, porém os dispositivos de baixa intensidade têm ganhado destaque. Frente a isso, foi realizada uma revisão sistemática sobre os efeitos da luz de baixa intensidade no tratamento da acne vulgar e investigado os parâmetros adequados para esta aplicação. Uma pesquisa bibliográfica foi conduzida no período de maio a junho de 2017, em quatro bases de dados (Medline, PEDro database, Lilacs e PubMed). Foram incluídos estudos experimentais, publicados no período entre janeiro de 1970 a junho de 2017, nas línguas inglesa e portuguesa. Avaliou-se a qualidade metodológica e os parâmetros luminosos. A pesquisa resultou em 21 artigos. Destes, apenas 4 foram estudos randomizados. Na escala PEDro (0 a 10), um estudo recebeu nota 10, 2 receberam nota 8 e os demais receberam notas de 0 a 5. Nos parâmetros luminosos, os comprimentos de ondas mais utilizados foram 415 nm e 633 nm e a fluência mais utilizada foi 48 J/cm². No presente estudo, alguns parâmetros variaram significativamente, não sendo possível estabelecer qual dose seria a mais adequada para o manejo da acne vulgar. Desta forma, conclui-se que a luz terapêutica de baixa intensidade tem vantagens no tratamento da acne, porém são necessários novos estudos com amostragens maiores, controlados e randomizados, para melhor determinar os parâmetros adequados. (AU)


Acne vulgaris is a disorder of the pilosebaceous unit that has a high prevalence and incidence, especially among teenagers. Currently, there are various therapeutic interventions, but the lowpower devices have been highlighted. Accordingly to this, we performed a systematic review on the effects of low-power light treatment of acne vulgaris and to determine the appropriate parameters for this application. A literature search was conducted from May to June 2017, in four databases (Medline, PEDro database, Lilacs and PubMed). We included experimental studies, published from January 1970 to June 2017, in english and portuguese. The methodological quality and light parameters were assessed. The bibliographic search resulted in 21 articles. About these only 4 were randomized trials. In the PEDro scale (score 0 to 10) one study received the total score (10), two studies received score 8 and the others received scores between 0 and 5. The wavelengths most commonly used were 415 nm e 633 nm. The fluency more used was 48 J/cm². In the present study, some parameters varied significantly, not been possible to establish what would be the most appropriate dose for the management of acne vulgaris. By this, we conclude that low-power light therapy has advantages in the treatment of acne, but new studies with larger samples, monitored and randomized, are necessary to best determine the parameters. (AU)


Subject(s)
Low-Level Light Therapy , Acne Vulgaris , Phototherapy , Therapeutics
17.
Biosci. j. (Online) ; 32(6): 1703-1716, nov./dec. 2016. ilus, tab
Article in English | LILACS | ID: biblio-965841

ABSTRACT

This study aimed to simulate heat transfer in thermal equilibrium in the canine knee joint. We analyzed the impact of different values of blood perfusion available in the literature and considered blood perfusion rates. The geometric models of canine knee joints were created from a photographic record of a cross section of an anatomical part. Two geometric models were developed: one without the epidermis and one with the epidermis. A heat diffusion equation was used to model the heat transfer phenomenon. Numerical simulations of the canine knee in a thermal neutrality condition were performed using the ANSYS-CFX® program. The simulation results were compared with experimental in vivo data. The smaller percentage differences between the experimental and simulated in vivo results were found in simulations that used the blood flow rate as a function of temperature. The computer simulation proved to be a good alternative to evaluate the temperature of biological tissues.


O presente trabalho visa simular a transferência de calor, em equilíbrio térmico, na articulação do joelho canino e analisar o impacto dos diferentes valores de perfusão sanguínea disponíveis na literatura e das considerações da taxa de perfusão sanguínea. Os modelos geométricos da articulação do joelho canino foram criados com base em um registro fotográfico de um corte transversal de uma peça anatômica. Foram desenvolvidos dois modelos geométricos: 1- sem epiderme e 2 ­ com epiderme. A equação de difusão de calor foi utilizada para modelar o fenômeno de transferência de calor. As simulações numéricas do joelho canino na condição de neutralidade térmica foram realizadas utilizando o programa ANSYS-CFX®. Os resultados da simulação foram comparados com os dados experimentais in vivo. As menores diferenças percentuais, entre o experimento in vivo e os resultados simulados, foram encontradas nas simulações que utilizaram a taxa de perfusão sanguínea em função da temperatura. A simulação computacional mostrou-se uma boa alternativa para avaliar a temperatura dos tecidos biológicos.


Subject(s)
Stifle , Joints
18.
Ribeirão Preto; s.n; 2016. 115 p. ilus, tab.
Thesis in Portuguese | LILACS, BDENF - Nursing | ID: biblio-1443971

ABSTRACT

A Emoção Expressa (EE) é um conceito referente à qualidade das relações familiares e pode ser considerada como um traço ou como um estado das interações, caracterizada por três dimensões: comentários críticos (CC), hostilidade e superenvolvimento emocional (SEE). Obje tivos: avaliar e descrever o nível de EE entre cuidadores de pessoas com transtorno mental e sua associação com variáveis sociodemográficas, estresse precoce, sintomas se estresse, estilo de vida e sofrimento mental. Método: estudo com abordagem quantitativa, epidemiológico, corte transversal e caráter correlacional. Participaram 112 familiares cuidadores de pessoas com transtorno mental admitidas para internação em um hospital psiquiátrico no interior do Estado de São Paulo. Os instrumentos utilizados foram: Questionário sociodemográfico, de condições ocupacionais e de saúde; Questionário Familiar; Questionário sobre Traumas na Infância; Inventário de Sintomas de Estresse para Adultos de LIPP; Questionário Estilo de Vida Fantástico; Self-Reporting Questionnaire 20. A análise da confiabilidade e da consistência interna das escalas foi feita por meio do cálculo do coeficiente Alfa de Cronbach. Seguiu-se as análises estatísticas descritivas (cálculo das frequências, médias e desvio-padrão das respostas dos cuidadores aos instrumentos), bivariadas (para verificar a associação entre as variáveis, por meio dos testes Qui -Quadrado de Pearson, Exato de Fisher e Mann-Whitney) e de regressão logística, utilizando-se o programa SPSS versão 22.0. O nível de significância adotado foi de 5% (alfa <= 0,05). Todas as questões éticas foram respeitadas. Re sultados : a maioria dos cuidadores de pessoas com transtornos mentais em início de internação foi avaliada com altos níveis de EE (tanto global quanto nos domínios CC e SEE), com presença de estresse precoce, com presença de sintomas de estresse e com presença de sofrimento mental. Quanto ao estilo de vida, a maioria foi avaliada com estilo de vida bom ou muito bom. A EE no domínio SEE apresentou associação estatisticamente significativa com as variáveis uso frequente de medicamentos, estresse precoce, fase do estresse e sofrimento mental . Foram identificados como fatores de proteção para alta EE no domínio CC o ensino fundamental e a renda familiar. Já a idade foi fator de risco para alta EE no domínio CC. Já para alta EE no domínio SEE, o estresse precoce e o sofrimento mental foram fatores de risco. Conclusõe s : este estudo possibilitou avaliar importantes aspectos que podem influenciar a qualidade das relações entre cuidador e pessoa com transtorno mental. Emoção Expressa, estresse precoce, sintomas de estresse e sofrimento mental destacam- se como fenômenos relevantes ao planejamento do cuidado à familiares cuidadores de pessoas com transtornos mentais. Dada a complexidade desse fenômeno, são necessários estudos ampliados que abordem características tanto dos famil iares quanto dos pacientes e do ambiente, em diversos momentos, tais como na internação, após a alta e ao longo dos tratamentos extra hospitalares


Emotion Express (EE) is a concept referring to the quality of family relationships and can be considered as a stroke or as a state of the interactions, characterized by three dimensions: critical comments (CC), hostility and emotional overinvolvement (EOI). Objectives: to evaluate and describe the EE level among caregivers of people with mental disorders and their association with sociodemographic variables, early stress symptoms stress, lifestyle and mental suffering. Method: study of quantitative epidemiological approach, cross-sectional and correlational character. Participated 112 family caregivers of people with mental illness admitted to hospital in a psychiatric hospital in the state of São Paulo. The instruments used were: sociodemographic questionnaire, occupational and health conditions; Family Questionnaire; Questionnaire on Trauma in Childhood; Inventory of Stress Symptoms for Adults Lipp; Fantastic Lifestyle Questionnaire; Self-Reporting Questionnaire 20. The analysis of reliability and internal consistency of the scales was done by calculating Cronbach's alpha coefficient. Descriptive statistical analysis was followed (calculation of frequencies, means and standard deviations of the responses of caregivers instruments), bivariate (to verify the association between variables, using the chi -square tests of Pearson, Fisher exact and Mann Whitney) and logistic regression using SPSS version 22.0. The significance level was 5% (alpha <= 0.05). All ethical issues have been met. Results: most of the carers of people with mental disorders in early hospitalization was evaluated with high levels of EE (both globally and in the CC and EOI domains), with the presence of early stress, with the presence of stress symptoms and the presence of suffering mental. As for the lifestyle, most were evaluated with style good or very good life. EE in the EOI domain showed a statistically significant association with the variables frequent medicines use, early stress, stress phase and mental suffering. They were identified as EE for high protection factors in the CC domain elementary school and family income. In contrast, age was a risk factor for high EE in the CC domain. As for high EE in the EOI domain, early stress and mental suffering were risk factors. Conclus ions : this study evaluates important aspects that can influence the quality of the relationship between caregiver and person with mental disorder. Expressed Emotion, early stress, stress symptoms and mental suffering stand out as phenomena relevant to the planning of care for family caregivers of people with mental disorders. Given the complexity of this phenomenon, we need expanded studies that address characteristics of both relatives and patients and the environment, at various times, such as in hospital after discharge and over the extra hospital treatment


Subject(s)
Humans , Male , Female , Mental Health , Caregivers , Involuntary Treatment, Psychiatric , Psychological Distress
19.
An Bras Dermatol ; 90(5): 707-21, 2015.
Article in English | MEDLINE | ID: mdl-26560216

ABSTRACT

The nonablative radiofrequency is a procedure commonly used for the treatment of skin laxity from an increase in tissue temperature. The goal is to induce thermal damage to thus stimulate neocollagenesis in deep layers of the skin and subcutaneous tissue. However, many of these devices haven't been tested and their parameters are still not accepted by the scientific community. Because of this, it is necessary to review the literature regarding the physiological effects and parameters for application of radiofrequency and methodological quality and level of evidence of studies. A literature search was performed in MEDLINE, PEDro, SciELO, PubMed, LILACS and CAPES and experimental studies in humans, which used radiofrequency devices as treatment for facial or body laxity, were selected. The results showed that the main physiological effect is to stimulate collagen synthesis. There was no homogeneity between studies in relation to most of the parameters used and the methodological quality of studies and level of evidence for using radiofrequency are low. This fact complicates the determination of effective parameters for clinical use of this device in the treatment of skin laxity. The analyzed studies suggest that radiofrequency is effective, however the physiological mechanisms and the required parameters are not clear in the literature.


Subject(s)
Collagen/radiation effects , Radiofrequency Therapy , Skin Aging/radiation effects , Collagen/biosynthesis , Cosmetic Techniques , Female , Humans , Male , Rejuvenation , Reproducibility of Results , Treatment Outcome
20.
An. bras. dermatol ; 90(5): 707-721, tab
Article in English | LILACS | ID: lil-764420

ABSTRACT

AbstractThe nonablative radiofrequency is a procedure commonly used for the treatment of skin laxity from an increase in tissue temperature. The goal is to induce thermal damage to thus stimulate neocollagenesis in deep layers of the skin and subcutaneous tissue. However, many of these devices haven't been tested and their parameters are still not accepted by the scientific community. Because of this, it is necessary to review the literature regarding the physiological effects and parameters for application of radiofrequency and methodological quality and level of evidence of studies. A literature search was performed in MEDLINE, PEDro, SciELO, PubMed, LILACS and CAPES and experimental studies in humans, which used radiofrequency devices as treatment for facial or body laxity, were selected. The results showed that the main physiological effect is to stimulate collagen synthesis. There was no homogeneity between studies in relation to most of the parameters used and the methodological quality of studies and level of evidence for using radiofrequency are low. This fact complicates the determination of effective parameters for clinical use of this device in the treatment of skin laxity. The analyzed studies suggest that radiofrequency is effective, however the physiological mechanisms and the required parameters are not clear in the literature.


Subject(s)
Female , Humans , Male , Collagen/radiation effects , Radio Waves/therapeutic use , Skin Aging/radiation effects , Cosmetic Techniques , Collagen/biosynthesis , Rejuvenation , Reproducibility of Results , Treatment Outcome
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