Depression among nursing students and its association with academic life.

OBJECTIVE: To measure the levels of depression among Nursing students from a public institution of higher education and the association with aspects of academic life. METHOD: Analytical and quantitative study with 203 students from a higher education institution that uses active methodologies. We used Beck's Depression Inventory and the Likert type scale of academic factors. RESULTS: We verified that 19.2% had moderate or severe levels of depression. Higher levels of depression were associated with female gender (p=0.003), working more than 40 hours per week (p=0.047), spending more than 90 minutes to reach academic activities (p=0.043) and with 12 academic factors specific to routines of the studied institution. CONCLUSION: The results contribute to managers' and professors' reflection and analysis concerning nursing students' mental health, in addition to indicating in which aspects there is a need to provide greater support to these students.

Depression among nursing students and its association with academic life / Depresión entre estudiantes de enfermería y su asociación con la vida estudiantil / Depressão entre estudantes de enfermagem e sua associação com a vida acadêmica

ABSTRACT Objective: To measure the levels of depression among Nursing students from a public institution of higher education and the association with aspects of academic life. Method: Analytical and quantitative study with 203 students from a higher education institution that uses active methodologies. We used Beck's Depression Inventory and the Likert type scale of academic factors. Results: We verified that 19.2% had moderate or severe levels of depression. Higher levels of depression were associated with female gender (p=0.003), working more than 40 hours per week (p=0.047), spending more than 90 minutes to reach academic activities (p=0.043) and with 12 academic factors specific to routines of the studied institution. Conclusion: The results contribute to managers' and professors' reflection and analysis concerning nursing students' mental health, in addition to indicating in which aspects there is a need to provide greater support to these students.

RESUMEN Objetivo: Medir los niveles de depresión entre estudiantes de enfermería de una institución pública de enseñanza superior y la asociación con aspectos de la vida estudiantil. Método: Estudio analítico y cuantitativo con 203 estudiantes de una institución de enseñanza superior que utiliza metodologías activas. Se utilizó el Inventario de Depresión de Beck y la escala de factores académicos del tipo Likert. Resultados: se verificó que el 19,2% presentó niveles de depresión moderados o graves. Los mayores niveles de depresión se asociaron al sexo femenino (p = 0,003), trabajar más de 40 horas semanales (p = 0,047), gastar más de 90 minutos para llegar a las actividades académicas (p = 0,043) y a 12 factores estudiantiles específicos a las rutinas de la institución estudiada. Conclusión: los resultados contribuyen con gestores y docentes en la reflexión y el análisis de la salud mental de los estudiantes de enfermería, además de indicar en qué aspectos hay necesidad de proporcionar mayor apoyo a esos estudiantes.

RESUMO Objetivo: Medir os níveis de depressão entre estudantes de Enfermagem de uma instituição pública de ensino superior e a associação com aspectos da vida acadêmica. Método: Estudo analítico e quantitativo com 203 estudantes de uma instituição de ensino superior que utiliza metodologias ativas. Utilizaram-se o Inventário de Depressão de Beck e a escala de fatores acadêmicos do tipo Likert. Resultados: Verificou-se que 19,2% apresentaram níveis de depressão moderados ou graves. Maiores níveis de depressão foram associados ao sexo feminino (p=0,003), trabalhar mais de 40 horas semanais (p=0,047), despender mais de 90 minutos para chegar às atividades acadêmicas (p=0,043) e a 12 fatores acadêmicos específicos às rotinas da instituição estudada. Conclusão: Os resultados contribuem com gestores e docentes na reflexão e na análise da saúde mental dos discentes de enfermagem, além de indicar em quais aspectos há necessidade de fornecer maior apoio a esses estudantes.

Love and the Value of Life in Health Care: A Narrative Medicine Case Study in Medical Education.

This case study is an example of narrative medicine applied to promote self-awareness and develop humanistic contents in medical education. The impact and the human appeal of the narrative lie in the maturity and empathy shown by a student when reporting his dramatic experience during the care given to a newborn (with Patau syndrome and multiple malformations diagnosed at birth) and to her mother. The narrative approach helped the student to be successful in bringing out the meaning behind the story and to position himself from the mother's and newborn's perspective. The student's introspection changed a seemingly scary interaction into a positive experience, overcoming many initial negative emotions, such as fear, disappointment, horror, hopelessness, and insecurity in the face of the unexpected. It is uplifting how the student was strengthened by the power of maternal love to the point of overcoming any remaining feelings of eugenics or rejection. Other important lessons emerging from the case study were the art of listening and the value of silence. This narrative shows how the development of narrative competence can help establish a good physician-patient relationship, because the physician or the student with such competence usually confirms the patient's value and demonstrates concern for them, focusing on what they say and allowing genuine contact to be established, which is necessary for effective therapeutic alliance. The student's interpretations of the meaning of love and value of life inspired him on his reframing process of a medical practice marked by vicarious suffering.

Suicide is a Baobab Tree: A Narrative Medicine Case Study.

This case study is an example of applying narrative medicine as a useful tool for health professionals to manage an existential and complex scenario such as the suicide of a sibling. Some suicides are like baobab trees­these large and resilient trees grow deep roots for many years, only spreading their limbs above ground once they are firmly established. Like the baobab, when suicide or a suicide attempt occurs, suicidal ideations are well cultivated and have often already been repeatedly planted. Consequently, suicide is often difficult to prevent: once the death seed is planted, it is difficult to recreate life. Every year, more than 800,000 people die by suicide worldwide (1.4% of all deaths), which is approximately 1 person every 40 seconds. These unexpected deaths, predominantly occuring among young and middle-aged adults, have a continuing ripple effect and result in a huge economic, social, and psychological burden for individuals, families, communities, and countries. The complexity of suffering and pain experienced by suicidal individuals and their families, regardless of the success or failure of the suicidal act, is intensified by strong stigmas attached to traditional concepts of sin and eternal damnation. This unfortunate reality emerges in the narrative as a tragic family drama, which is permeated by deep feelings of helplessness. But suicide is preventable. Prevention requires 3 important factors: knowledge, public support, and creation of strategies to enact social change. Now is the time to act and make suicide prevention an imperative goal.

A model for humanization in critical care.

We present a case in which narrative medicine was used to assist a patient with amyotrophic lateral sclerosis who was dependent on mechanical ventilation and prolonged hospitalization. Implementing narrative medicine led to the development of more effective communication that strengthened the therapeutic relationship, enhanced humane care practices, and resulted in greater physical and psychological comfort for the patient. Narrative medicine is a discipline that has been progressively incorporated into medical training to restore a humane and individual physician-patient relationship. The patient is viewed, not merely as a case to diagnose, but as a person with a story that evokes emotions in those who assist him or her. In fact, narrative medicine can be understood as a model of medical practice based on narrative competence, ie, the ability to acknowledge, to absorb, to interpret, and to respond to a person's story. It strengthens empathy, rescues patient individuality, and facilitates solutions to conflicts in complex settings, such as critical care units, where clinicians are constantly exposed to existential issues, both moral and ethical.