Caracterización de la situación problémica en un estudio psicosocial con pacientes con enfermedad renal crónica

Introducción: La enfermedad renal crónica es un problema de salud a nivel mundial, su manifestación más grave, la insuficiencia renal crónica, incide en el contexto cubano y determina el crecimiento de pacientes en hemodiálisis. El objetivo del texto es valorar los principales resultados del diagnóstico y caracterización de la situación problémica en un estudio de carácter psicosocial con pacientes con Insuficiencia Renal Crónica en la sala de Hemodiálisis del municipio Florida, de la provincia de Camagüey. Método: Es una investigación-acción participativa de corte experimental, que se desarrolla entre enero 2023 y diciembre del 2024 la cual constituye salida del proyecto de investigación Sistema de acciones psicosociales para el perfeccionamiento de la atención integral a los pacientes con enfermedades no transmisibles. El universo está constituido por 56 pacientes y la muestra por 22, que reciben tratamiento depurador y conservador, 22 familiares y 12 profesionales del servicio. El instrumento de investigación por excelencia fue la encuesta a participantes. Resultados: La edad de los pacientes no es definitiva de un grupo etario; predominan los hombres; se constata un elevado por ciento de pacientes con poca tolerancia a la adherencia al tratamiento e insuficiente desarrollo de las habilidades psicosociales y declaran la necesidad de poseer conocimientos para lograr estados de salud que conlleven a la sobrevida. Discusión: No existe coincidencia con lo constatado en la determinación de los grupos etarios de prevalencia para la enfermedad, pero los especialistas insisten en que la enfermedad no es privativa de un período de vida específico; reconocen la importancia del conocimiento de los factores de riesgo por el paciente para la prevención, promoción y educación en salud y resaltan la necesidad de la comunicación y la empatía entre el personal de salud y el paciente, para lograr resultados y estados emocionales favorables ante la enfermedad y el tratamiento.

Introduction: Chronic kidney disease is a global health problem. Its most serious manifestation, chronic kidney failure, affects the Cuban context and determines the growth of patients on hemodialysis. The objective of the text is to evaluate the main results of the diagnosis and characterization of the problematic situation in a psychosocial study with patients with Chronic Renal Failure in the Hemodialysis room of the Florida municipality, of the county of Camagüey. Method: It is an experimental participatory action research, which takes place between January 2023 and December 2024, which constitutes the output of the research project System of psychosocial actions for the improvement of comprehensive care for patients with non-communicable diseases. The universe is made up of 56 patients and the sample is made up of 22, who receive purifying and conservative treatment, 22 family members and 12 service professionals. The research instrument par excellence was the participant survey. Results: The age of the patients is not definitive of an age group; men predominate; A high percentage of patients are found to have low tolerance for adherence to treatment and insufficient development of psychosocial skills and declare the need to possess knowledge to achieve health states that lead to survival. Discussion: There is no coincidence with what was found in the determination of the prevalence age groups for the disease, but specialists insist that the disease is not exclusive to a specific period of life; recognize the importance of the patient's knowledge of risk factors for prevention, promotion and health education and highlight the need for communication and empathy between health personnel and the patient, to achieve favorable results and emotional states in the face of the disease and treatment.

Development of a self-management mobile app for bereaved adolescents: evaluating patient and public involvement.

Background: Losing a family member during childhood is a potentially traumatic event and increases the risk of mental health difficulties. Adolescents have the right to express their views in research of relevance to them, but few studies have involved bereaved adolescents as collaborators (i.e. Patient and Public Involvement (PPI)). Furthermore, to ensure meaningful and non-tokenistic involvement, bereaved adolescents' levels of participation and experiences of taking part in research need to be evaluated.Objectives: The aim was to describe and evaluate a PPI process working with bereaved adolescents to develop a self-management mobile app for adolescents in grief.Methods: The PPI process consisted of four workshops during which the app's logo, colours, name, content, and layout were discussed with six parentally bereaved adolescents aged 13-18 years. The adolescents were recruited through a non-profit organisation providing support for adolescents in grief. The PPI process was documented and evaluated using participant observations and an online survey completed by the adolescents, covering the themes of social context, participation, and influence.Results: The adolescents perceived the social context as comfortable and inclusive, where their knowledge was valued. Their participation was characterised by ownership and motivated by a desire to help others with similar experiences. The adolescents' ability to participate in PPI activities was assisted by the researchers' flexibility, although challenging assignments may have made participation harder. Throughout PPI activities, adolescents contributed with relevant input and reported feeling influential. The study reached the intended levels of participation and appeared to adequately fulfil the adolescents' right to participation.Conclusions: Engaging adolescents who have undergone a potentially traumatic event, such as the loss of a family member, in research can enhance the overall relevance of the study. Moreover, it can entail a meaningful and positive experience for the participating adolescents, while also fulfilling their fundamental right to participation.

A collaborative process with parentally bereaved adolescents to develop a psychosocial self-management mobile app for adolescents in grief was described and evaluated.Adolescents made significant contributions, took ownership, and experienced having influence over the decisions made, which increased the relevance of the intervention.The collaborative process reached the intended level of participation and created a positive and meaningful experience for the adolescents.

Experience with the use of the DIALOG+ intervention in patients with severe mental illness in outpatient services in Colombia.

INTRODUCTION: Severe mental disorders can cause significant and lasting distress for patients and their families and generate high costs through the need for care and loss of productivity. This study tests DIALOG+, an app-based intervention to make routine patient-clinician meetings therapeutically effective. It combines a structured evaluation of patient satisfaction with a solution-focused approach. METHODS: We conducted a qualitative study, based on a controlled clinical trial, in which 9 psychiatrists and 18 patients used DIALOG+ monthly over a six-month period. Semi-structured interviews were used to explore the experiences of participants and analysed in an inductive thematic analysis focusing on the feasibility and effects of the intervention in the Colombian context. RESULTS: Experiences were grouped into five overall themes: a) impact of the intervention on the consultation and the doctor-patient relationship; b) impact on patients and in promoting change; c) use of the supporting app, and d) adaptability of the intervention to the Colombian healthcare system. CONCLUSIONS: DIALOG+ was positively valued by most of the participants. Participants felt that it was beneficial to the routine consultation, improved communication and empowered patients to take a leading role in their care. More work is required to identify the patient groups that most benefit from DIALOG+, and to adjust it, particularly to fit brief consultation times, so that it can be rolled out successfully in the Colombian healthcare system.

Ajuste y adaptación psicosocial de adultos jóvenes supervivientes de un cáncer en etapa pediátrica: Revisión sistemática / Psychosocial adjustment and adaptation in young adults surviving pediatric cancer: A systematic review

Introducción: Los efectos a largo plazo de tumores en la infancia pueden alterar la trayectoria de adaptación y ajuste psicosocial de los supervivientes en etapas de vida posteriores. Objetivo: Esta revisión sistemática se centra en analizar las experiencias de crecimiento postraumático, estrés postraumático, malestar emocional y dificultades psicosociales sufridas por jóvenes adultos supervivientes a un cáncer en etapa pediátrica. Resultados: Los resultados sugieren una trayectoria mayoritaria que podría definirse como adaptativa, en la que se observa tanto crecimiento postraumático (prevalencia superior al 60%), como síntomas de estrés postraumático (prevalencia inferior al 30%). No obstante, en comparación con población control no oncológica, estos supervivientes tienen mayor riesgo de padecer síntomas de ansiedad y depresión, de alcanzar menores logros educativos y profesionales, y de permanecer solteros o vivir solos, lo que se hipotetiza que podría estar relacionado con las secuelas de cada tipo de tumor y tratamiento, y no únicamente con la vivencia de la enfermedad. Conclusiones: La atención a jóvenes adultos supervivientes a un cáncer pediátrico debería centrarse en proporcionar mayor apoyo médico y psicosocial a largo plazo, a través del abordaje interdisciplinar y la atención centrada en la persona, como aproximación que favorezca una trayectoria de ajuste adaptativa.(AU)

Introduction: Long-term effects of childhood tumors can alter the trajectory of adjustment and psychosocial adjustment of survivors later in life. Purpose: This systematic review focuses on analyzing the experiences of posttraumatic growth, posttraumatic stress, emotional distress, and psychosocial difficulties experienced by young adult survivors of pediatric cancer. Results: The results suggest a more prevalent trajectory that could be conceptualize as adaptive, in which both post-traumatic growth (prevalence greater than 50%) and post-traumatic stress symptoms (prevalence less than 30%) are observed. However, compared to the non-oncology control population, these survivors are at higher risk for anxiety and depressive symptoms, lower educational and occupational attainment, and remaining single or living alone, which is hypothesized to be related to the sequelae of each tumor type and treatment, and not just the disease experience. Conclusions: Care for young adult survivors of pediatric cancer should focus on providing enhanced long-term medical and psychosocial support through an interdisciplinary approach and person-centered care as an approach that supports a trajectory of adaptive adjustment.(AU)

Systematic Review of the Evaluation of Foster Care Programs / [Revisión sistemática sobre evaluación de programas de acogimiento familiar]

Objetive: The aim of this study was to conduct an exhaustive synthesis to determine which instruments and variables are most appropriate to evaluate foster care programs (foster, kinship, and professional families). This evaluation includes the children, their foster families, their families of origin, professionals, and foster care technicians. Method: The systematic review included randomized, quasi-randomized, longitudinal, and control group studies aimed at evaluating foster care interventions. Results: A total of 86 studies, 138 assessment instruments, 18 constructs, and 73 independent research teams were identified. Conclusions: (1) although the object of the evaluations was the children, the informants were usually the people in charge of their care; therefore, effort should be made to involve the children in a more participatory way; (2) psychosocial functioning, behavior, and parenting are transversal elements in most evaluations, while quality of life and coping are not sufficiently well incorporated; (3) practical instruments (brief and easy to apply and correct) that are widely used and carry scientific guarantees should be prioritized to ensure the comparability and reliability of the conclusions; and (4) progress should be made in the study of evaluation models for all forms of foster care, including foster, extended, and specialized families.(AU)

Objetivo: El objetivo es realizar una síntesis exhaustiva que contribuya a determinar qué instrumentos y variables son las más adecuadas para evaluar programas de acogimiento familiar (familias extensas, ajenas y profesionalizadas), incluyendo en esta evaluación a los niños, sus familias acogedoras, sus familias de origen y a los profesionales y técnicos del acogimiento familiar. Método: La revisión sistemática incluyó estudios aleatorizados, cuasialeatorizados, longitudinales y con grupo control dirigidos a evaluar intervenciones de acogimiento familiar. Resultados: Se identificaron 86 estudios, 138 instrumentos de evaluación, 18 constructos y 73 equipos de investigación independientes. Conclusiones: (1) aunque el objeto de las evaluaciones sean los niños, habitualmente los informantes son las personas a cargo de sus cuidados, con lo que se debe hacer un esfuerzo por involucrarlos de forma más participativa; (2) el funcionamiento psicosocial, el comportamiento o la parentalidad son elementos transversales en la mayor parte de evaluaciones, sin embargo la calidad de vida y el afrontamiento no están suficientemente bien incorporados; (3) deben priorizarse instrumentos prácticos (breves y fáciles de aplicar y corregir), de amplio uso y con garantías científicas para asegurar la comparabilidad y fiabilidad de las conclusiones; (4) debe avanzarse en la investigación de modelos de evaluación en todas las modalidades de acogimiento familiar, ya sea en familias ajenas, extensas o especializadas.(AU)

Early Family Experiences, Drug Use, and Psychosocial Adjustment across the Life Span: Is Parental Strictness Always a Protective Factor? / [Las experiencias tempranas en la familia, el uso de drogas y el ajuste psicosocial: ¿es siempre la severidad parental un factor de protección?]

Objective: This study analyzes whether parental strictness, which is shared by authoritative parenting (strictness and warmth) and authoritarian parenting (strictness without warmth) styles, always acts as a main protective factor against drug use and psychosocial maladjustment in children. This conclusion has already been stated in numerous classic studies, though emergent research suggests that there are benefits to parental warmth regardless of whether strictness is present or not. Method: Sample were 2,095 Spanish participants (1,227 females, 58.6%), 581 adolescent children (aged 12-18 years, 27.7%) and 1,514 adult children (72.3%). The measures were the main parenting style dimensions (warmth and strictness), drug use, and a set of indicators of psychosocial adjustment. A 4 × 2 × 4 MANOVA was applied for all outcomes with parenting style, sex, and age as independent variables. Results: Indulgent parenting (warmth without strictness) was related to less drug use than parenting without warmth (authoritarian and neglectful). Additionally, indulgent and authoritative parenting styles were related to better scores on psychosocial adjustment than authoritarian and neglectful styles, although the indulgent parenting was the only style related to the optimal scores being equal or even more effective than the authoritative style. Conclusion: Contrary to classical studies, present findings suggest that it is the parental warmth instead of the parental strictness that seems to be effective in protecting against drug use and psychosocial maladjustment.(AU)

Objetivo: En este estudio se analiza si, como asumen numerosos estudios clásicos, el componente de severidad que comparte el estilo parental autorizativo (severidad y afecto) con el estilo autoritario (severidad sin afecto) actúan siempre como el principal factor protector del consumo de drogas y el desajuste psicosocial de los hijos. Sin embargo, la investigación emergente sugiere los beneficios del afecto parental independientemente de la severidad. Método: Los participantes fueron 2,095 hijos españoles (1,227 mujeres, 58.6%), 581 adolescentes (de 12 a 18 años, 27.7%) y 1,514 adultos (72.3%). Las medidas fueron de las principales dimensiones del estilo parental (afecto y severidad), del consumo de drogas y un conjunto de indicadores del ajuste psicosocial. Se aplicó un MANOVA 4 × 2 × 4 con todos los criterios evaluados analizando el estilo parental, el sexo y la edad como variables independientes. Resultados: El estilo indulgente (afecto sin severidad) se relacionó con un menor consumo de drogas que los estilos sin afecto (autoritario y negligente). Además, los estilos indulgente y autorizativo se relacionaron con mejores puntuaciones en ajuste psicosocial, aunque el indulgente fue el único estilo relacionado con las puntuaciones óptimas siendo igual o incluso más eficaz que el estilo autorizativo. Conclusión: A diferencia de los estudios clásicos, los presentes resultados sugieren que el afecto parental, en vez de la severidad, parece ser eficaz como protección frente al consumo de drogas y el desajuste psicosocial.(AU)

Acceso y adhesión a proceso de intervención psicosocial diferenciado para los servicios y sistemas de salud en varones gay adultos viviendo con el VIH, Paraguay, 2022 / Access and adherence to a differentiated psychosocial intervention process for health services and systems in adult gay men living with HIV, Paraguay, 2022

Introducción: el acceso a los servicios de salud en Paraguay, está determinado por varios tipos de barreras. Por ello, es preciso describir el impacto que tienen las políticas públicas y sus implicancias en la mitigación de las mismas. Objetivo: describir el acompañamiento diferenciado y su contribución al apoyo socio emocional, adhesión al tratamiento y acceso a servicios de salud en el área de atención a personas varones que viven con el VIH. Metodología: estudio de carácter cualitativo, descriptivo, con entrevistas semi estructuradas y muestra no probabilística, dirigida e intencional; Resultados: este estudio cualitativo exploró las experiencias de personas viviendo con VIH que recibieron acompañamiento psicosocial diferenciado en un servicio de atención integral. Los participantes destacaron la importancia del acompañamiento para afrontar la crisis posterior al diagnóstico. La orientación presencial, escucha empática y seguimiento facilitaron la vinculación y adherencia al servicio de salud y al tratamiento antirretroviral. El apoyo psicosocial fue clave para desmitificar ideas erróneas sobre el VIH/SIDA, empoderarse sobre su estado serológico y mejorar la calidad de vida. Se enfatizó el rol de los grupos de pares para brindar contención. Algunos participantes reportaron experiencias previas de revelación no consentida y vulneración de confidencialidad. El acompañamiento psicosocial diferenciado resultó fundamental para facilitar la inserción y permanencia de las personas con VIH en los servicios de atención integral (adhesión al tratamiento). Conclusiones: el acompañamiento psicosocial diferenciado resultó clave para facilitar la vinculación y adherencia en personas con VIH. La atención integral requiere identificar situaciones particulares, establecer relaciones de confianza y comunicación efectiva. El apoyo inicial es fundamental brindando contención ante el impacto emocional del diagnóstico. El seguimiento continuo es esencial dada la doble discriminación. La confidencialidad y capacidad de generar vínculos empáticos son elementos centrales. Los factores mencionados favorecen la adhesión al tratamiento. Los resultados sugieren que estas prácticas psicosociales pueden optimizar modelos de atención integral a personas con VIH.

Introduction: access to healthcare services in Paraguay is influenced by various barriers. Thus, it is essential to describe the impact of public policies and their implications in mitigating these barriers. Objective: to describe the differentiated support and its contribution to socio-emotional support, therapeutic adherence, and access to healthcare services in the area of care for males living with HIV. Methodology: a qualitative, descriptive study with semi-structured interviews and a non-probabilistic, directed, and intentional sample. Results: this qualitative study explored the experiences of individuals living with HIV who received differentiated psychosocial support in an integrated care service. Participants emphasized the importance of support in coping with the post-diagnosis crisis. In-person guidance, empathetic listening, and follow-up facilitated engagement and adherence to healthcare services and antiretroviral treatment. Psychosocial support played a critical role in debunking misconceptions about HIV/AIDS, empowering individuals regarding their serostatus, and improving their quality of life. The role of peer groups in providing emotional support was emphasized. Some participants reported previous experiences of non-consensual disclosure and confidentiality breaches. Differentiated psychosocial support was essential in promoting the integration and retention of people with HIV in integrated care services (therapeutic adherence). Conclusions: differentiated psychosocial support was crucial in facilitating the engagement and adherence of individuals with HIV. Comprehensive care necessitates identifying specific situations, establishing trust-based relationships, and effective communication. Initial support is vital for providing emotional support in the face of the diagnostic impact. Ongoing follow-up is essential due to the dual discrimination faced. Confidentiality and the ability to build empathetic relationships are central elements. The aforementioned factors favor adherence to treatment. The results suggest that these psychosocial practices can enhance models of comprehensive care for people with HIV.

Repercussões psicossociais da pandemia da covid-19 para mães de crianças com transtorno do espectro autista / Psychosocial repercussions of the covid-19 pandemic for mothers of children with autism spectrum disorder / Repercusiones psicosociales de la pandemia de covid-19 en las madres de niños con trastorno del espectro autista

RESUMO Objetivo: compreender as repercussões psicossociais da pandemia da COVID-19 para mães de crianças com Transtorno do Espectro Autista. Método: estudo qualitativo, com a participação de 22 mães. Os dados foram coletados de maio a julho de 2022, no interior da Paraíba, Brasil, por meio de uma Dinâmica de Criatividade e Sensibilidade. A análise deu-se através do referencial teórico-analítico da análise de discurso francesa. Resultados: medo, ansiedade, angústia, preocupações assumiram um lugar central no movimento dialógico das mães. Diante das demandas e reconfigurações na rotina, houve uma sobrecarrega física, emocional e psicológica, com repercussões na vida materna. A solidão pôde ser evidenciada pela frágil ou inexistente rede de apoio durante o período pandêmico. Conclusão: o estudo pode subsidiar a reflexão sobre as repercussões da pandemia na vida de mães de crianças com autismo e viabilizar a elaboração de ações que priorizem a saúde mental, auxiliando-as na superação de momentos de adversidades.

ABSTRACT Objective: to understand the psychosocial repercussions of the COVID-19 pandemic for mothers of children with Autism Spectrum Disorder. Method: a qualitative study, with participation of 22 mothers. The data were collected from May to July 2022 in the inland of Paraíba, Brazil, through the Dynamics of Creativity and Sensitivity. The analysis took place through the theoretical-analytical framework of French discourse analysis. Results: fear, anxiety, anguish and concerns assumed a central place in the mothers' dialogical movement. Faced with the demands and reconfigurations in the routine, there was physical, emotional and psychological overload, with repercussions on maternal life. Loneliness can be seen in the weak or non-existent support network during the pandemic. Conclusion: the study can support reflection on the repercussions of the pandemic on the lives of mothers of children with autism and enable the development of actions that prioritize mental health, helping them to overcome moments of adversity.

RESUMEN Objetivo: comprender las repercusiones psicosociales de la pandemia de COVID-19 en las madres de niños con Trastorno del Espectro Autista. Método: estudio cualitativo, con la participación de 22 madres. Los datos fueron recolectados de mayo a julio de 2022, en el interior de Paraíba, Brasil, mediante una Dinámica de Creatividad y Sensibilidad. El análisis se realizó siguiendo el marco teórico-analítico del análisis del discurso francés. Resultados: el miedo, la ansiedad, la angustia y las preocupaciones ocuparon un lugar central en el movimiento dialógico de las madres. Ante las exigencias y reconfiguraciones de la rutina, las madres sufrieron una sobrecarga física, emocional y psicológica que afectó su vida. La soledad se puede ver en la débil o nula red de apoyo que tuvieron durante la pandemia. Conclusión: el estudio puede contribuir a la reflexión sobre las repercusiones de la pandemia en la vida de las madres de niños con autismo y posibilitar el desarrollo de acciones que prioricen la salud mental que las ayuden a superar momentos de adversidad.

Arranjos assistenciais em uma rede atenção psicossocial no sul do Brasil / Arreglos asistenciales en una red de apoyo psicosocial en sur de Brasil / Care arrangements on a psychosocial care network in southern Brazil

RESUMO. A implementação da reforma psiquiátrica é tema de recorrentes discussões no campo da saúde mental. Essa implementação não é padrão para todas as localidades brasileiras, uma vez que depende dos recursos materiais, humanos e aspectos culturais de cada região. A esta singularidade retoma-se a noção de arranjo assistencial. Este trabalho se propôs a conhecer a implementação numa regional de saúde da região Sul. Foi realizado um mapeamento descritivo, seguindo método empírico-fenomenológico. Descrevem-se serviços que acolhem todos os públicos, mas que encontram dificuldades no trabalho com a população usuária de álcool e outras drogas. Foram elencados sete dispositivos assistenciais: acolhimento, grupos terapêuticos, oficinas, atendimentos individuais, uso da medicação, encaminhamentos e reuniões de equipe. Expõe-se a ideia de que a estrutura de um serviço de saúde mental não pode ser estanque. Os arranjos assistenciais estão relacionados às vivências e soluções criativas e humanas como também práticas irrefletidas e normatizadoras na atenção do sofrimento mental.

RESUMEN. La implementación de la reforma psiquiátrica no se encuentra estandarizada para todas las regiones brasileras, una vez que eso depende de recursos materiales, humanos y de aspectos culturales. Por cuenta de esta singularidad, se retoma la noción de arreglo asistencial. En este trabajo se propone conocer la implementación en una regional de salud de sur de Brasil. Se realizó un mapeo descriptivo, siguiendo el método empírico-fenomenológico. Se describen servicios que acogen a todos los públicos, pero que encuentran dificultades en el trabajo con usuarios de alcohol y drogas. Fueran enumerados siete dispositivos asistenciales: Acogimiento, grupos terapéuticos, talleres, atendimientos individuales, uso de medicación, encaminamientos y reuniones de equipo. Se expone la idea de que la estructura de un servicio de Salud Mental no puede ser hermética. Los arreglos asistenciales están relacionados con las vivencias y soluciones creativas y humanas como también prácticas irreflexivas y normalizadoras en la atención del sufrimiento mental.

ABSTRACT. The psychiatric reform is not standard in all Brazilian places, as it depends on different factors such as material, human and cultural aspects of each region. As for its singularity, it is seen as a care arrangement. This article aims to study the psychosocial care network on a regional health department in south Brazil. A descriptive mapping has been performed, following the empirical-phenomenological method. The services described welcome the entire community, people from all walks of life, but when it comes Drug and Alcohol addicted, the approach becomes more challenging. There have been seven care services listed: Hosting, Therapeutic Groups, Workshops, Individual Treatment, Medication usage, Referrals and Support Group Meetings. The approach for care arrangement is related to the creative experiences and human solutions as well as thoughtless and normative practices in the attention of mental suffering.

Riesgo de enfermedad cardiovascular e indicadores de adiposidad corporal y su relación con el riesgo psicosocial en trabajadores del sector económico de comercio / Indicadores de risco de doenças cardiovasculares e de adiposidade corporal e sua relação com o risco psicossocial em trabalhadores do setor econômico do comércio / Cardiovascular disease risk and body adiposity indicators and their relationship with psychosocial risk in workers of the commerce economic sector

Resumen Introducción Cada año a nivel mundial se presentan millones de muertes y lesiones no mortales por inadecuadas prácticas en salud laboral, muertes por cardiopatías isquémicas y accidente cerebrovascular son causadas por largas jornadas y altas cargas laborales. Objetivo Identificar el grado de correlación del riesgo psicosocial con el riesgo de enfermedad cardiovascular e indicadores de adiposidad corporal: IMC (índice de masa corporal), PA (perímetro abdominal) y BFP (porcentaje de grasa corporal) en trabajadores del sector económico de comercio. Método Estudio de enfoque cuantitativo y alcance correlacional no causal, con una muestra de 118 sujetos (56.7% mujeres y 43.3% hombres). Se evaluó los indicadores de adiposidad mediante el protocolo internacional para la valoración antropométrica ISAK, el riesgo cardiovascular por medio de la escala de Framingham y para evaluar el riesgo psicosocial se aplicó la Batería de Instrumentos para la Evaluación de Factores de Riesgos Psicosociales validada para la población colombiana. Estos datos fueron procesados y analizados estadísticamente mediante SPSS versión 28. Resultados Se destaca una relación significativa (p < .05) entre las variables en diferentes grados, en el caso de la correlación entre enfermedad cardiovascular y el riesgo psicosocial su coeficiente de correlación es de (r = .62), para la correlación entre el IMC y el riesgo psicosocial un coeficiente de (r = .52), en el caso del BFP y el riesgo psicosocial en mujeres fue de (r = .45) y en hombres de (r = .67) y para el PA y el riesgo psicosocial, su coeficiente de correlación fue de (r = .42) y (r = .64) respectivamente. Conclusión Existe una correlación positiva y fuerte entre el riesgo psicosocial y el riesgo de enfermedad cardiovascular, del mismo modo, entre el IMC y el riesgo psicosocial. En el caso del BFP y el riesgo psicosocial, el grado de correlación fue moderado en mujeres y fuerte en hombres al igual que en la correlación entre el PA y el riesgo psicosocial.

Resumo Introdução Todos os anos, em todo o mundo, ocorrem milhões de mortes e lesões não fatais devido a práticas inadequadas de saúde ocupacional, as mortes por doença cardíaca isquêmica e acidente vascular cerebral são causadas por longas jornadas de trabalho e altas cargas de trabalho. Objetivo Identificar o grau de correlação do risco psicossocial com o risco de doenças cardiovasculares e com os indicadores de adiposidade corporal: IMC (índice de massa corporal), PA (circunferência abdominal) e PBC (percentagem de gordura corporal) em trabalhadores do sector econômico do comércio. Método Estudo quantitativo de âmbito correlacional não causal, com uma amostra de 118 indivíduos (56.7% mulheres e 43.3% homens). Os indicadores de adiposidade foram avaliados através do protocolo internacional de avaliação antropométrica ISAK, o risco cardiovascular foi avaliado através da escala de Framingham e o risco psicossocial foi avaliado através da Bateria de Instrumentos para a Avaliação de Factores de Risco Psicossocial validada para a população colombiana. Estes dados foram processados e analisados estatisticamente utilizando o SPSS versão 28. Resultados Existe uma relação significativa (p < .05) entre as variáveis em diferentes graus, no caso da correlação entre doença cardiovascular e risco psicossocial o seu coeficiente de correlação é (r = .62), para a correlação entre IMC e risco psicossocial um coeficiente de (r = .52), para a PAF e risco psicossocial nas mulheres um coeficiente de (r = .52). 62), para a correlação entre o IMC e o risco psicossocial um coeficiente de (r = .52), no caso da PA e do risco psicossocial nas mulheres foi (r = .45) e nos homens (r = .67) e para a PA e o risco psicossocial, o seu coeficiente de correlação foi (r = .42) e (r = .64) respetivamente. Conclusão Existe uma forte correlação positiva entre o risco psicossocial e o risco de doença cardiovascular, bem como entre o IMC e o risco psicossocial. No caso da PAF e do risco psicossocial, o grau de correlação foi moderado nas mulheres e forte nos homens, tal como a correlação entre a PA e o risco psicossocial.

Abstract Introduction Every year worldwide millions of deaths and non-fatal injuries occur due to inadequate occupational health practices, deaths from ischemic heart disease and stroke are caused by long working hours and high workloads. Objective To identify the degree of correlation of psychosocial risk with the risk of cardiovascular disease and body adiposity indicators: BMI (body mass index), AC (abdominal circumference) and BFP (body fat percentage) in workers of the commerce economic sector. Method A study with a quantitative approach and non-causal correlational scope, with a sample of 118 subjects (56.7% women and 43.3% men). Adiposity indicators were evaluated by means of the international protocol for anthropometric assessment ISAK, cardiovascular risk by means of the Framingham scale and to evaluate psychosocial risk, the Battery of Instruments for the Evaluation of Psychosocial Risk Factors validated for the Colombian population was applied. These data were processed and analyzed statistically using SPSS version 28. Results A significant relationship (p < .05) between the variables is highlighted in different degrees, in the case of the correlation between cardiovascular disease and psychosocial risk its correlation coefficient is (r =. 62), for the correlation between BMI and psychosocial risk a coefficient of (r = .52), in the case of BFP and psychosocial risk in women it was (r = .45) and in men (r = .67) and for AC and psychosocial risk, its correlation coefficient was (r = .42) and (r = .64) respectively. Conclusion There was a strong positive correlation between psychosocial risk and cardiovascular disease risk, as well as between BMI and psychosocial risk. In the case of BFP and psychosocial risk, the degree of correlation was moderate in women and strong in men, as was the correlation between AC and psychosocial risk.

Entre "centrado na pessoa" e "freestyle": a abordagem do sofrimento mental comum em residências de medicina de família e comunidade / The "patient-centered" or "freestyle" method: the approach to common mental suffering in family and community medicine residency programs / Entre "centrado en la persona" y "freestyle": el abordaje del sufrimiento mental común en residencias de medicina de familia y comunidad

Este trabalho apresenta um estudo qualitativo sobre a abordagem do sofrimento mental comum (SMC) em programas de residência de Medicina de Família e Comunidade de Minas Gerais. Foram realizadas entrevistas semiestruturadas com 16 participantes de três programas de residência, entre março e maio de 2022. A interpretação dos dados seguiu os princípios da Análise Temática de Braun e Clarke. Para os participantes, o SMC é uma demanda frequente na Atenção Primária que deve ser abordada, principalmente com intervenções psicossociais. Contudo, os participantes reconhecem que não têm aplicado essas intervenções nos moldes recomendados pela literatura. Os entrevistados relatam conhecer diversas técnicas de intervenção, mas só sabem aplicar algumas, com destaque para os componentes do "método clínico centrado na pessoa". Esse fato contribui para despertar emoções negativas, como angústia e frustração, e aumentar o número de referenciamentos desnecessários para outros profissionais.

This work presents a qualitative study of the approach to common mental suffering (CMS) in family and community medicine residency programs in the state of Minas Gerais, Brazil. Semi-structured interviews were conducted with 16 participants from three residency programs between March and May 2022. The data were interpreted drawing on the principles of Braun and Clarke's thematic analysis method. According to the participants, CMS is a frequent demand in primary care and should be approached using mainly psychosocial interventions. However, the participants recognize that they have not applied these interventions in the manner recommended by the literature. The interviewees reported that despite being aware of a diverse range of intervention techniques, they only know how to apply some, with emphasis on the components of the "patient-centered clinical method". This fact has contributed to the awakening of negative emotions, such as anguish and frustration, and increased the number of unnecessary referrals to other professionals.

Este trabajo presenta un estudio cualitativo sobre el abordaje del sufrimiento mental común (SMC) en programas de residencia de Medicina de Familia y Comunidad del estado de Minas Gerais. Se realizaron entrevistas semiestructuradas con 16 participantes de tres programas de residencia, entre marzo y mayo de 2022. La interpretación de los datos siguió los principios del Análisis Temático de Braun y Clarke. Para los participantes, el SMC es una demanda frecuente en la atención primaria que hay que abordar, principalmente, con intervenciones psicosociales. No obstante, los participantes reconocen que no han aplicado esas intervenciones en los estándares recomendados por la literatura. Los entrevistados relatan que conocen diversas técnicas de intervención, pero que solo saben aplicar algunas, con destaque para los componentes del método clínico centrado en la persona?. Este hecho contribuye para despertar emociones negativas, tales como angustia y frustración, y para aumentar el número de derivaciones innecesarias para otros profesionales.

Conhecimento de profissionais de centros de atenção psicossocial sobre segurança do paciente / Conocimiento de profesionales de centros de atención psicosocial sobre seguridad del paciente / Knowledge of professionals from psychosocial care centers on patient safety

RESUMO. O objetivo deste estudo foi compreender os significados atribuídos pelos profissionais dos Centros de Atenção Psicossocial acerca das terminologias da Classificação Internacional para Segurança do Paciente (CISP). Estudo de abordagem qualitativa, conduzido com 31 profissionais de CAPS III de um município da região Centro-Oeste do Brasil. A coleta de dados foi realizada por técnica de grupo, guiada pelo Ciclo de Aprendizagem Vivencial. Os dados foram submetidos à análise de conteúdo, com auxílio do software Atlas.ti. Os resultados possibilitaram ir além do diagnóstico situacional sobre o conhecimento prévio da CISP pelos profissionais; promoveram a sensibilização para o reconhecimento de incidentes nas unidades; e constituíram estratégia inicial de desenvolvimento de consciência quanto à necessidade do planejamento do cuidado seguro na atenção psicossocial. Destacou-se a necessidade de desenvolver formação para segurança do paciente nos CAPS, a fim de promover uma assistência mais segura, em consonância com os objetivos das organizações internacionais e nacionais de saúde e necessidades de construção da cultura de segurança nos serviços de saúde mental.

RESUMEN. El objetivo de este estudio fue comprender los significados atribuidos por los profesionales de los Centros de Atención Psicosocial sobre las terminologías de la Clasificación Internacional para la Seguridad del Paciente (CISP). Estudio de abordaje cualitativo, realizado con 31 profesionales CAPS III de un municipio de la región central de Brasil. La recolección de datos se realizó mediante una técnica grupal, guiada por el ciclo de aprendizaje experiencial. Los datos se sometieron a análisis de contenido con la ayuda del software Atlas.ti. Los resultados permitieron ir más allá del diagnóstico situacional sobre el conocimiento previo de CISP por parte de los profesionales; promovió la conciencia para el reconocimiento de incidencias en las unidades; y constituyó la una estrategia inicial para desarrollar la conciencia de la necesidad de una planificación de la atención segura en la atención psicosocial. Se destacó la necesidad de desarrollar la formación en seguridad del paciente en CAPS, con el fin de promover una atención más segura, en consonancia a los objetivos de los organismos de salud internacionales y nacionales y la necesidad de construir una cultura de seguridad en los servicios de salud mental.

ABSTRACT. The objective of this study was to understand the meanings attributed by the professionals of the Psychosocial Care Centers about the terminologies of the International Classification for Patient Safety (ICPS). A qualitative study was conducted with 31 PSCC III professionals from a city in the Midwest region of Brazil. Data collection was performed by group technique, guided by the Experiential Learning Cycle. The data were submitted to content analysis using the Atlas.ti software. The results made it possible to go beyond situational diagnosis of prior knowledge of ICPS by professionals; promoted awareness of incident recognition in units; and constituted an initial strategy for developing awareness of the need for safe care planning in psychosocial care. It was highlighted the need to develop training for patient safety in PSCC, in order to promote safer care, in line with the objectives of international and national health organizations and needs to build safety culture in mental health services.

Psychosocial characteristics and cognitive function in community-dwelling adults over 50 years old from the Mexican Health and Aging Study (MHAS)

Aging is an inevitable process that can be associated with cognitive impairment. Evidence about the simultaneous evaluation of psychosocial variables that could be associated with cognitive function is crucial. We aimed to determine the association between psychosocial characteristics and cognition in adults over 50 years in Mexico. The fifth round of the Mexican Health and Aging Study (MHAS) (2018) provides the basis for this paper. The study is part of a longitudinal analysis, for which wave pasting 2012, 2015, and 2018 were performed. The final sample comprised 6,709 individuals. Ten psychosocial variables were measured through scales or specific questions. Cognition was assessed with the Cross-Cultural Cognitive Examination (CCCE). Confounders included sociodemographics, multimorbidity, and functionality. The analysis was performed by adjusting the regression model. Of the total sample, 2,761 (41.1%) were men; 3,948 (58.8%) were women. The mean age was 68.2 years (SD = 8.1). Cognition is significantly affected in people with higher age (ß=-1.30, Cl 95% -1.54, -.1.06 p= 0.000), less schooling (ß=.559, CI 95% .498, .621 p<0.001), depressive symptoms (ß=-.066, CI 95% -.115, -.018 p=0.007), those who do not perform any volunteer service (ß=-.057, CI 95% -.102, -.102 p=0.013), or do not participate in decision making (ß=-.242, CI 95% -.295, -.189 p<0.001), low internal locus of control (ß=-.012., CI 95% -.023, -.001 p=0.023), and poor economic perception (ß=-.070., CI 95% -.115, -.024 p=0.002). When analyzing the cognitive function of older people, it is vital to consider the possible related psychosocial variables.

El envejecimiento es un proceso inevitable que puede asociarse al deterioro cognitivo. La evidencia sobre la evaluación simultánea de variables psicosociales que pudieran estar asociadas con la función cognitiva es crucial. Nuestro objetivo fue determinar la asociación entre las características psicosociales y la cognición en adultos mayores de 50 años en México. La quinta ronda del Estudio Mexicano de Salud y Envejecimiento (ENASEM) (2018) proporciona la base para este trabajo. El estudio forma parte de un análisis longitudinal, para el que se recabaron datos en 2012, 2015 y 2018. La muestra final estuvo compuesta por 6,709 individuos. Se midieron diez variables psicosociales a través de escalas o preguntas específicas. La cognición se evaluó con el Cross-Cultural Cognitive Examination (CCCE). Entre los factores de confusión se incluyeron los sociodemográficos, la multimorbilidad y la funcionalidad. El análisis se realizó ajustando un modelo de regresión. De la muestra total, 2.761 (41,1%) eran hombres; 3.948 (58,8%) eran mujeres. La edad media era de 68,2 años (DE = 8,1). La cognición se ve significativamente afectada en las personas con mayor edad (ß=-1,30, Cl 95% -1,54, -.1.06 p<0.001), menor escolaridad (ß=-.559, IC 95% .498, .621 p<0.001), síntomas depresivos (ß=-.066, IC 95% -.115, -.018 p=0.007), quienes no realizan ningún servicio voluntario (ß=-.057, IC 95% -.102, -.102 p=0. 013), o no participan en la toma de decisiones (ß=-.242, CI 95% -.295, -.189 p<0.001), presentan bajo locus de control interno (ß=-.012., CI 95% -.023, -.001 p=0.023), y pobre percepción económica (ß=-.070., CI 95% -.115, -.024 p=0.002). Al analizar la función cognitiva de las personas mayores, es vital considerar las posibles variables psicosociales relacionadas.

O envelhecimento é um processo inevitável que pode estar associado a défices cognitivos. A evidência sobre a avaliação simultânea de variáveis psicossociais que podem estar associadas à função cognitiva é crucial. O nosso objetivo foi determinar a associação entre as características psicossociais e a cognição em adultos com mais de 50 anos no México. A quinta rodada do Estudo Mexicano de Saúde e Envelhecimento (MHAS) (2018) fornece a base para este artigo. O estudo faz parte de uma análise longitudinal, para a qual foram realizadas colagens de ondas 2012, 2015 e 2018. A amostra final foi composta por 6.709 indivíduos. Dez variáveis psicossociais foram medidas por meio de escalas ou perguntas específicas. A cognição foi avaliada com o Cross-Cultural Cognitive Examination (CCCE). Os factores de confusão incluíram dados sociodemográficos, multimorbilidade e funcionalidade. A análise foi efectuada através do ajuste do modelo de regressão. Da amostra total, 2.761 (41,1%) eram homens; 3.948 (58,8%) eram mulheres. A idade média foi de 68,2 anos (DP = 8,1). A cognição é significativamente afetada nas pessoas com mais idade (ß=-1,30, Cl 95% -1,54, -.1.06 p= 0.000), menor escolaridade (ß=.559, IC 95% .498, .621 p<0.001), sintomas depressivos (ß=-.066, IC 95% -.115, -.018 p=0.007), aqueles que não realizam nenhum serviço voluntário (ß=-.057, IC 95% -.102, -.102 p=0. 013), ou não participam na tomada de decisões (ß=-.242, IC 95% -.295, -.189 p<0.001), baixo locus de controlo interno (ß=-.012., IC 95% -.023, -.001 p=0.023), e fraca perceção económica (ß=-.070., IC 95% -.115, -.024 p=0.002). Ao analisar a função cognitiva dos idosos, é vital considerar as possíveis variáveis psicossociais relacionadas.

Influencia de factores psicosociales en el control de la hipertensión arterial

Introducción: La hipertensión arterial es una enfermedad crónica con gran prevalencia, que repercute en la calidad de vida, donde influyen múltiples factores psicosociales que ayudan a garantizar un control adecuado. Objetivo: Determinar el impacto de la influencia de factores psicosociales en el control de la tensión arterial de los pacientes hipertensos en régimen penitenciario. Materiales y métodos: Se realizó un estudio observacional, descriptivo y longitudinal sobre el valor de factores psicosociales en el control de la hipertensión arterial, tratados en un establecimiento penitenciario perteneciente a los Servicios Médicos del Ministerio del Interior, en la provincia de Camagüey, durante los años 2020-2022. La muestra quedó conformada por 82 pacientes hipertensos de difícil control atendidos en consulta, en los cuales se estudiaron diversos factores psicosociales que pudieran intervenir en el control de la tensión arterial. Resultados: La muestra quedó conformada por 82 pacientes hipertensos de difícil control, atendidos en consulta. Predominaron los blancos, con edad entre 41 y 60 años, nivel secundario, con incumplimiento del tratamiento médico, poco apoyo social, con familia con trastornos de violencia, y aislamiento social con condenas anteriores. Conclusiones: En el recluso hipertenso los factores psicosociales cobran un papel muy importante, partiendo de los trastornos afectivos que tienen estos enfermos por falta de apoyo social, convivir en un medio muy agresivo que produce trastornos de sus funciones cognitivas, que afecta el control de la tensión arterial, los cuales están organizados desde un paradigma biomédico, clínico y farmacológico. De esta forma, la somatización de los factores psicosociales juega un importante -aunque no determinante- papel en el descontrol de las cifras tensionales y la no adherencia al tratamiento.

Introduction: Arterial hypertension is chronic illness with great prevalence that rebounds on the quality of life, where many psychosocial factors influence that help ensure the appropriate control. Objective: To determine the impact of the influence of psychosocial factors in the control of the arterial tension of the hypertensive patient in the penitentiary system. Materials and methods: An observational, descriptive and longitudinal study was carried out on the value of psychosocial factors in the control of arterial hypertension in a prison facility belonging to the Medical Services of the Ministry of the Interior, in the province of Camaguey, during the years 2020-2022. The sample was made up of 82 hypertensive patients of difficult control attended in consultation, in which diverse psychosocial factors were studied that could intervene in the control of the arterial tension. Results: The sample was composed of 82 hypertensive patients of difficult control, attended in consultation. White people predominated, aged between 41 and 60 years, secondary level of schooling, with non-compliance with medical treatment and little social support; from a family with violence disorders; socially isolated and with previous convictions. Conclusions: In the hypertensive inmate, psychosocial factors play a very important role, based on the affective disorders that these patients have due to lack of social support, living together in a very aggressive environment that produces disorders of their cognitive functions, which affects the control of arterial tension; these are organized from a biomedical, clinical and pharmacological paradigm. In this way, the somatization of psychosocial factors plays an important-although not determining-role in the lack of blood pressure control and non-adherence to the treatment.

Depresión posparto: prevalencia y relación con la tipología y función familiar / Postpartum depression: its prevalence and relation to family typology and functioning

Introducción: la depresión posparto (DPP) constituye un problema de salud pública. Se han descrito múltiples factores de riesgo biológicos y psicosociales. En Colombia no existen estudios que determinen su prevalencia con base en escalas de tamizaje y aplicación de criterios diagnósticos, así como su relación con los instrumentos de valoración familiar. Objetivo:estimar la prevalencia de DPP y su relación con condiciones clínicas, curso de vida, tipología y función familiar, en mujeres en puerperio mediato (2 a 48 horas posteriores al parto). Materiales y métodos: estudio observacional de corte transversal analítico en puerperio mediato, aplicando la escala de Edimburgo (EPDS) y los criterios DSM5 para tamizaje y diagnóstico de DPP. Se evaluaron variables sociodemográficas, antecedentes ginecoobstétricos, perinatales, condiciones clínicas y se aplicaron instrumentos de valoración familiar como curso de vida, tipología de familia y APGAR familiar. Resultados: se incluyeron 336 participantes con edad media de 27,3 años, la prevalencia de DPP fue 5.1%, las patologías prevalentes fueron preeclampsia (8.3%) y diabetes gestacional (6.3%), 58% (p<0,001) presentaban algún grado de disfunción familiar y 88% (p 0,01) hacían parte de familias nucleares. No se encontró significancia estadística para las condiciones clínicas y el curso de vida. Conclusiones: la DPP es un problema de salud mental prevalente que está relacionado con múltiples factores, entre ellos la tipología y la función familiar. Se requieren más estudios cuantitativos que permitan establecer relaciones de causalidad y con metodología cualitativa para explicar mejor este fenómeno.

Introduction: postpartum depression (PPD) is a public health issue. Multiple biological and psychosocial risk factors have been described. In Colombia there are no studies determining its prevalence based on screening scales and diagnostic criteria, as well as its relation to family functioning assessment instruments. Objective: to determine PPD prevalence in in women in the immediate postnatal period and its association with clinical conditions, life-course, and family typology and functioning. Materials and methods: an analytical cross-sectional observational study conducted in the immediate postnatal period (2 to 48 hours after delivery), using the Edinburgh scale (EPDS) and the DSM5 criteria for PPD screening and diagnosis. Sociodemographic variables such as, gynecological-obstetric, and perinatal history, and clinical conditions, were analyzed. Family functioning assessment instruments such as life-course, family typology and family APGAR, were applied. Results: 336 participants with a mean age of 27.3 years, were included. The prevalence of PPD was 5.1%, while prevalent pathologies were preeclampsia (8.3%) and gestational diabetes (6.3%). 58% (p<0.001) had a dysfunctional family to some degree and 88% (p 0.01) belonged to nuclear families. No statistical significance was found for clinical conditions and life-course. Conclusions: PPD is a prevalent mental health issue caused by multiple factors, such as family typology and functioning. Further quantitative and qualitative studies to establish causal relationships, are needed, to better understand this phenomenon.

Contemporary slave labor and subjectivity: psychosocial perspectives on the enslaved's narratives / Trabalho escravo contemporâneo e subjetividade: considerações psicossociais sobre narrativas de escravizado(a)s / Trabajo esclavo contemporáneo y subjetividad: consideraciones psicosociales sobre narrativas de personas esclavizadas

This study addresses the relation between subjectivity and contemporary enslaved labor from the enslaved workers' narratives in Brazil. A qualitative social research was carried out based on a constructionist perspective. We sought interaction with rescued workers and used (a) participant observation of workers' routine in an institutional project that supports them and a field diary, (b) semi-structured and open individual interviews with workers and a member of the team project. The fieldwork lasted a year and a half and the analysis followed Content Analysis. Freudian theory and Foucault's thought were used for interpretation, which managed to understand aspects of workers' experiences, exploitation characteristics, parental abandonment, as well as the tensions in self-classification as enslaved. The narratives pointed to a dramatic reality manifested in body exploitation, authoritarian abuses, violence, and negligence. At the same time, these narratives showed forms of worker resistance that calls for further investigations to increase knowledge on the subjective experiences of those who were enslaved.(AU)

O artigo aborda as relações entre subjetividade e trabalho escravo contemporâneo a partir da narrativa de trabalhadores(as) escravazados(as). Foi realizada uma pesquisa social qualitativa em uma perspectiva construcionista. Buscamos a interação com trabalhadores resgatados e realizamos a observação participante da rotina de trabalhadores atendidos em um projeto institucional, com diário de campo, e entrevistas individuais (semiestruturadas e abertas) com trabalhadores(as) e equipe do projeto institucional. O trabalho de campo durou um ano e meio, e a pesquisa foi realizada com o suporte da Análise de Conteúdo. Para a interpretação utilizamos aportes da teoria freudiana e do pensamento de Foucault, com os quais foi possível compreender aspectos das vivências dos trabalhadores, características da exploração, abandonos parentais e tensões em torno da autoclassificação como "escravo". As narrativas apontaram uma realidade dramática manifesta na exploração do corpo, em abusos autoritários, na violência e negligência. Ao mesmo tempo, as narrativas evidenciaram formas de resistência dos trabalhadores que convocam mais investigações para adensar o conhecimento sobre as experiências subjetivas desses que estão num lugar de escravizado(a).(AU)

Este artículo aborda la relación entre la subjetividad y el trabajo esclavo contemporáneo desde la narrativa de trabajadores esclavizados. Se realizó una investigación social cualitativa desde una perspectiva construccionista. Buscamos la interacción con los trabajadores liberados y utilizamos la observación participante de la rutina de los trabajadores atendidos en un proyecto institucional, diario de campo y entrevistas individuales (semiestructuradas y abiertas) con trabajadores y miembros del equipo del proyecto institucional. El trabajo de campo duró un año y medio, y se utilizó como apoyo el análisis de contenido. Para la interpretación se utilizaron aportes de la teoría freudiana y el pensamiento de Foucault, con lo que fue posible comprender aspectos de las vivencias de los trabajadores, características del escenario de explotación, abandono parental y las tensiones relacionadas con la autoclasificación "esclavo". Las narrativas apuntan a una realidad dramática manifestada en la explotación del cuerpo, abuso autoritario, violencia y abandono. Al mismo tiempo, evidenciaron formas de resistencia por parte de los trabajadores, que reclaman más investigaciones para profundizar en el conocimiento sobre las vivencias subjetivas de quienes se encuentran en esclavitud.(AU)

Processos de desproteção e de proteção de crianças, adolescentes e suas famílias - uma análise de múltiplas evidências dos reflexos da pandemia / Processes of deprotection and protection of children, adolescents and their families - an analysis of multiple evidence of the consequences of the pandemic / Procesos de desprotección y protección de niños, adolescentes y sus familias - un análisis de múltiples evidencias de las consecuencias de la pandemia

O objetivo deste artigo é apresentar uma visão geral de múltiplas evidências, levantadas de forma sistemática na literatura, sobre processos de desproteção de crianças, adolescentes e suas famílias, bem como estratégias de proteção e atuação durante a crise sanitária causada pela Covid-19 e no contexto pós-pandêmico. Para tanto, foram selecionados 13 artigos de revisão, entre 2020 e 2023, os quais trazem os principais aspectos que incidem nas desproteções de crianças e adolescentes, afetando a saúde mental, a convivência familiar e comunitária, bem como estratégias de intervenção para o enfrentamento dessas situações. Assim, este estudo traz uma discussão que pode ser subsídio para que profissionais do campo da proteção infantojuvenil possam planejar ações diante dos reflexos da crise pandêmica, política, social e econômica nos últimos tempos. Os efeitos das desproteções ligadas à insegurança de renda, à falta de acesso aos serviços, à redução de autonomia e a problemas de saúde mental ampliaram desproteções relacionais e contextos de violência. Por outro lado, o acesso a serviços e políticas públicas, com apoio às famílias, é o que a literatura destaca para ampliar a proteção infantojuvenil. Portanto, é fundamental identificar demandas para a busca de atuações com foco na melhoria das ofertas de serviços e na promoção de espaços de convivências protetivas.

The objective of this study is to present an overview of multiple evidence, systematically collected in the literature, on processes of deprotection for children, adolescents and their families, as well as protection and action strategies during the health crisis caused by Covid-19 and in the post-pandemic context. To this end, 13 review articles were selected, between 2020 and 2023, which bring the main aspects that affect the deprotection of children/adolescents, affecting mental health, family and community coexistence, as well as intervention strategies to combat these issues. Thus, this article brings a discussion that can provide support for professionals in the field of child and youth protection to plan actions in light of the consequences of this pandemic, political, social and economic crisis in recent times. The effects of lack of protection linked to income insecurity, lack of access to services, reduced autonomy and mental health problems have increased relational lack of protection and contexts of violence. On the other hand, access to services and public policies, with support for families, is what the literature highlights to expand child and youth protection. Therefore, it is essential to identify demands to seek actions focused on improving service offerings and promoting protective spaces.

El objetivo de este estudio es presentar un panorama de múltiples evidencias, recogidas sistemáticamente en la literatura, sobre procesos de desprotección de niños, niñas, adolescentes y sus familias, así como estrategias de protección y acción durante la crisis sanitaria provocada por el Covid-19 y en el contexto pospandemia. Para ello se seleccionaron 13 artículos de revisión, entre 2020 y 2023, que traen los principales aspectos que inciden en la desprotección de niños/adolescentes, afectando la salud mental, la convivencia familiar y comunitaria, así como estrategias de intervención para combatir estas situaciones. Así, este artículo proporciona una discusión que puede brindar apoyo a los profesionales del campo de la protección de niños y jóvenes para planificar acciones ante las consecuencias de esta pandemia, crisis política, social y económica de los últimos tiempos. Los efectos de la desprotección vinculados a la inseguridad de ingresos, la falta de acceso a servicios, la reducción de la autonomía y los problemas de salud mental han aumentado la desprotección relacional y los contextos de violencia. Por otro lado, el acceso a servicios y políticas públicas, con apoyo a las familias, es lo que destaca la literatura para ampliar la protección de niños y jóvenes. Por lo tanto, es fundamental identificar demandas para buscar acciones enfocadas a mejorar la oferta de servicios y promover espacios protectores de convivencia.

Improving mental health following multiple disasters in Australia: a randomized controlled trial of the Skills for Life Adjustment and Resilience (SOLAR) programme.

Background: The mental health impacts of climate change-related disasters are significant. However, access to mental health services is often limited by the availability of trained clinicians. Although building local community capability for the mental health response is often prioritised in policy settings, the lack of evidence-based programs is problematic. The aim of this study was to test the efficacy of the Skills for Life Adjustment and Resilience programme (SOLAR) delivered by trained local community members following compound disasters (drought, wildfires, pandemic-related lockdowns) in Australia.Method: Thirty-six community members were trained to deliver the SOLAR programme, a skills-based, trauma informed, psychosocial programme. Sixty-six people with anxiety, depression and/or posttraumatic stress symptoms, and impairment were randomised into the SOLAR programme or a Self-Help condition. They were assessed pre, post and two months following the interventions. The SOLAR programme was delivered across five 1-hourly sessions (either face to face or virtually). Those in the Self-Help condition received weekly emails with self-help information including links to online educational videos.Results: Multigroup analyses indicated that participants in the SOLAR condition experienced significantly lower levels of anxiety and depression, and PTSD symptom severity between pre - and post-intervention (T1 to T2), relative to the Self-Help condition, while controlling for scores at intake. These differences were not statistically different at follow-up. The SOLAR programme was associated with large effect size improvements in posttraumatic stress symptoms over time.Conclusion: The SOLAR programme was effective in improving anxiety, depression and posttraumatic stress symptoms over time. However, by follow-up the size of the effect was similar to an active self-help condition. Given the ongoing stressors in the community associated with compounding disasters it may be that booster sessions would have been useful to sustain programme impact.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12621000283875..

We tested the efficacy of a brief, skills-based psychosocial programme under randomised controlled conditions following compound disasters.The SOLAR programme was associated with improvements in anxiety, depression and posttraumatic stress symptoms across time.The SOLAR programme may benefit from booster sessions especially where there are ongoing impacts of disaster.

Relatos de madres de desaparecidos: voces desde el colectivo / Stories of mothers of the disappeared: voices from the collective

La desaparición forzada en el país es alarmante, sobre todo de jóvenes de 15 a 29 años. Este evento rompe el lazo social y deja a las madres en estado traumático. El propósito de esta investigación fue triangularlas narrativas de desaparición, denuncia e integración de las madres al colectivo. Los resultados muestran que la vivencia de desaparición y el proceso de denuncia son tramas de degradación, donde las madres quedan revictimizadas, dado el maltrato de servidores públicos; mientras que, la integración a un colectivo hace de ideal reparatorio, pues confraternizan las madres en su dolor y resistencia en la búsqueda. Se concluye invitando a los psicólogos a buscar modos de elaboración acordes a la vivencia de trauma social AU

The enforced disappearance in this country is alarming, especially for young people between 15 and 29 years old. This event breaks the social bond and leaves mothers in a traumatic state. The purpose of this research is to triangulate the narratives of disappearance, filling in reportsand integration of the mothers into the collective. The results show that the experience of disappearance and the reporting processesare degrading,where the mothers are re-victimized, given the mistreatment of public servants. Beingthe integration to a collective a reparatory ideal, because the mothers fraternize in their pain and resistance in the searching. It concludes by inviting psychologists to seek ways of elaboration according to the experience of social trauma AU

Factores psicosociales de riesgo y burnout en policías: un análisis de redes / Psychosocial risks factors and burnout in police officers: a network analysis

El estrés laboral crónico ha sido identificado como uno de los riesgos laborales más importantes que afecta a la salud mental de los agentes de policía. Existen ciertos factores psicosociales que incrementan el estrés laboral en la policía y que, a largo plazo, desencadenan síntomas compatibles con el burnout. En este trabajo se ha utilizado una muestra integrada por 323 policías para valorar la relación que se establece entre los factores psicosociales de riesgo y la probabilidad de experimentar síntomas compatibles con el burnout. Las respuestas de los participantes al MBI-GS y al F-PSICO (versión 4.0) fueron examinadas utilizando análisis de redes. Los resultados muestran que existen redes de factores psicosociales de riesgo más cohesionadas cuando los niveles de cinismo y agotamiento emocional son más elevados. Además, se observa mayor nivel de burnout asociados con una baja autonomía, altas demandas psicológicas, conflictos en el desempeño de rol y un bajo apoyo social percibido. Los resultados son discutidos en términos de su implicación teórica y de su utilidad práctica frente al diseño de entornos de trabajo más saludables, así como frente a la intervención psicológica.(AU)

Chronic work stress has been identified as one of the most important occupational hazards affecting the mental health of police officers. There are certain psychosocial factors that increase job stress in the police and, in the long term, trigger symptoms compatible with burnout. In this work, a sample made up of 323 police officers has been used to assess the relationship established between psychosocial risk factors and the probability of experiencing symptoms compatible with burnout. Participant responses to the MBI-GS and F-PSICO (version 4.0) were examined using network analysis. The results show that there are more cohesive networks of psychosocial risk factors when the levels of cynicism and emotional exhaustion are higher. In addition, a higher level of burnout is observed associated with low autonomy, high psychological demands, conflicts in role performance, and low perceived social support. The results are discussed in terms of their theoretical implication and their practical utility in the design of healthier work environments, as well as in psychological intervention.(AU)