Tecnologias educacionais para o ensino de semiologia e semiotécnica em enfermagem no distanciamento social: revisão integrativa / Educational technologies for teaching semiology and semiotechniques in nursing during social distancing: integrative review / Tecnologías educativas para la enseñanza de semiología y semiotecnicas en enfermería durante el distancia social: revisión integrativa

Objetivo: mapear as tecnologias educacionais utilizadas para apoiar o ensino de semiologia e semiotécnica em enfermagem durante o distanciamento social ocasionado pela pandemia de COVID-19. Métodos:realizou-se revisão integrativada literatura por meio de busca nas bases de dados MEDLINE, CINAHL, Scopus e Library, information Science & Technology Abstract, com a questão norteadora: quais as tecnologias educacionais utilizadas para apoiar o ensino de semiologia e semiotécnica em enfermagem durante o distanciamento social ocasionado pela pandemia de COVID-19? Resultados: a amostra foi composta por sete artigos, quantoao tipo de tecnologia, vídeos educativos foram predominantes, acerca dos conteúdos abordados, encontrou-se cuidado de feridas, aplicação de injeção intramuscular ventroglútea, medida indireta da pressão arterial, banho no leito, estratégias efetivas de prevenção, manejo, tratamento e controle da hipertensão arterial, pensamento crítico por meio da aplicação do processo de enfermagem, habilidades de segurança do paciente. Considerações finais: Conclui-se que as tecnologias educacionais utilizadas para apoiar o ensino de Semiologia e Semiotécnica durante o distanciamento social foram: dois aplicativos, tecnologia de comunicação utilizando WhatsApp Messenger; uma simulação de alta fidelidade e três vídeos educativos. O uso dessas tecnologias possibilitou a continuidade do ensino e a inclusão da disciplina de Semiologia e Semiotécnica, sendo imprescindíveis para continuidade do processo de ensino-aprendizagem em tempos de distanciamentosocial, como napandemia da COVID-19.

Objective:to map the educational technologies used to support the teaching of semiology and semiotechnics in nursing during the social distancing caused by the COVID-19 pandemic. Method:an integrative literature review was carried out by searching the MEDLINE, CINAHL, Scopus and Library, information Science & Technology Abstract databases, with the guiding question:what are the educational technologies used to support the teaching of semiology and semiotechnics in nursing during the social distancing caused by the COVID-19 pandemic? Results:the sample consisted of seven articles, regarding the type of technology, educational videos were predominant, about the contents covered, wound care, application of ventrogluteal intramuscular injection, indirect blood pressure measurement, bed bath, strategies effective prevention, management, treatment and control of arterial hypertension, critical thinking through the application of the nursing process, patient safety skills. Final considerations:it is concluded that the educational technologies used to support the teaching of Semiology and Semiotechnics during social distancing were: two applications, communication technology using WhatsApp Messenger; a high fidelity simulation and three educational videos. The use of these technologies enabled the continuity of teaching and the inclusion of the discipline of Semiology and Semiotechnics, being essential for the continuity of the teaching-learning process in times of social distancing, such as the COVID-19 pandemic.

Objetivo:mapear las tecnologías educativas utilizadas para apoyar la enseñanza de la semiología y la semiotecnia en enfermería durante el distanciamiento social provocado por la pandemia de COVID-19. Método:se realizó una revisión integrativa de la literatura mediante la búsqueda en las bases de datosMEDLINE, CINAHL, Scopus y Library, Information Science & Technology Abstract, con la pregunta orientadora: ¿qué tecnologías educativas se utilizan para apoyar la enseñanza de la semiología y la semiotecniaen enfermería durante el distanciamiento social provocado por la pandemia del COVID-19?Resultados:la muestra estuvo conformada por siete artículos, en cuanto al tipo de tecnología predominaron los videos educativos, sobre los contenidos abordados, cuidado de heridas, aplicación de inyección intramuscular ventroglútea, toma indirecta de presión arterial, baño en cama, estrategias efectivas de prevención, manejo, tratamiento y control de la hipertensión arterial, pensamiento crítico mediante la aplicación del proceso de enfermería, habilidades de seguridad del paciente. Consideraciones finales:se concluye que las tecnologías educativas utilizadas para apoyar la enseñanza de Semiología y Semiotecnia durante el distanciamiento social fueron: dos aplicaciones, tecnología de comunicación mediante WhatsApp Messenger; una simulación de alta fidelidad y tres videos educativos. El uso de estas tecnologías permitió la continuidad de la enseñanza y la inclusión de la disciplina de Semiología y Semiotecnia, siendo fundamentales para la continuidad del proceso de enseñanza-aprendizaje en tiempos de distanciamiento social, como la pandemia del COVID-19.

Can depression in psychogeriatric inpatients at one year follow-up be explained by locus of control and coping strategies?

OBJECTIVES: Treatment of depression (in late life) is good. The short-term, but not long-term prognosis after treatment of depression in late life is good. To identify modifiable factors, we wanted to examine whether coping in terms of locus of control and coping strategies in depressed patients were associated with the prognosis of depression at follow-up, adjusted for sociodemographic information and health variables. METHOD: In total, 122 patients (mean age 75.4 years; SD = 6.6) were followed up (median 13.7 months, Q1-Q3 386-441) with a diagnostic evaluation(ICD-10) for depression and assessment of depressive symptoms (MADRS). Coping was assessed using Locus of Control of behavior (LoC-scale) and Ways of Coping questionnaire (WoC-scale). RESULTS: At follow-up, 37.7% were diagnosed with a depressive episode. A stronger external LoC and lower MMSE-NR score at baseline were in adjusted linear regression analysis significantly more associated to higher depressive symptom scores (MADRS). More use of problem-focused coping, a lower I-ADL functioning, but not emotion-focused coping at baseline were significantly associated with being depressed (ICD-10), at follow-up in adjusted logistic regression analysis. CONCLUSION: LoC and coping strategies at baseline were associated with the prognosis of depression at follow-up, and may further be studied as indicators for choice of baseline intervention strategies.

Prevalence and Correlates of Elder Abuse in São Paulo and Rio de Janeiro.

OBJECTIVES: To assess the prevalence of elder abuse and to investigate potential sociodemographic, health behavior, and medical correlates. DESIGN: Cross-sectional data were collected in face-to-face assessments. SETTING: São Paulo and Rio de Janeiro, Brazil. PARTICIPANTS: Individuals aged 60 to 75. MEASUREMENTS: Information on elder abuse was obtained using the Brazil-adapted, nine-item Hwalek-Sengstock Elder Abuse Screening Test. Sampling design-adjusted descriptive statistics and logistic regression were used in analyses. RESULTS: The overall prevalence of abuse was 14.4% (n = 46/259, 95% confidence interval (CI) = 9.82-20.61) in São Paulo and 13.3% (n = 27/197, 95% CI = 8.76-19.74) in Rio de Janeiro. Unadjusted analyses indicated that poor education, low physical activity, unemployment, heart disease, and psychiatric problems were associated with abuse, but in adjusted analyses, self-reported elder abuse was significantly associated only with psychiatric problems (São Paulo: OR = 4.48, 95% CI = 1.75-11.45; Rio de Janeiro: OR = 21.61, 95% CI = 6.39-73.14). CONCLUSION: Elder abuse is prevalent in São Paulo and Rio de Janeiro, but whether concomitants of abuse are cause, effect, or both is unclear because this was a cross-sectional study. These findings highlight the importance of the problem, as well as the need to develop measures to increase awareness, facilitate prevention, and fight against abuse of elderly adults.

Locus of control and coping strategies in older persons with and without depression.

OBJECTIVES: To compare locus of control and coping strategies in older persons with and without depression. METHOD: This cross-sectional study included 144 depressed in-patients from seven psychogeriatric hospital units, and 106 community-dwelling older persons without depression. All participants were 60 years and older. Locus of control was assessed by a 17-items self-report questionnaire with six response categories. Coping strategies were assessed by a 26-items self-report questionnaire with five response categories. For analytical purposes, age (<75 years vs. ≥75 years), level of education (<10 years vs. ≥10 years) and general medical health (poor vs. not poor) were categorized. RESULTS: In linear regression analysis, controlling for demographics, health, and social variables, the depressed in-patients showed a higher external locus of control orientation and a less frequent use of problem-focused coping strategies compared with the non-depressed group. No differences in use of emotion-focused strategies were found between the two groups. CONCLUSION: Compared with the non-depressed old persons, the depressed hospitalized older persons were characterized by perceptions of less personal control, and less use of problem-focused strategies, what also might have brought positive alterations into their situation.

Peritraumatic tonic immobility is associated with PTSD symptom severity in Brazilian police officers: a prospective study

Objective: Peritraumatic reactions feature prominently among the main predictors for development of posttraumatic stress disorder (PTSD). Peritraumatic tonic immobility (PTI), a less investigated but equally important type of peritraumatic response, has been recently attracting the attention of researchers and clinicians for its close association with traumatic reactions and PTSD. Our objective was to investigate the role of PTI, peritraumatic panic, and dissociation as predictors of PTSD symptoms in a cohort of police recruits (n=132). Methods: Participants were asked to complete the following questionnaires during academy training and after the first year of work: Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C), Physical Reactions Subscale (PRS), Peritraumatic Dissociative Experiences Questionnaire (PDEQ), Tonic Immobility Scale (TIS), and Critical Incident History Questionnaire. Results: Employing a zero-inflated negative binomial regression model, we found that each additional point in the TIS was associated with a 9% increment in PCL-C mean scores (RM = 1.09), whereas for PRS, the increment was 7% (RM = 1.07). As the severity of peritraumatic dissociation increased one point in the PDEQ, the chance of having at least one symptom in the PCL-C increased 22% (OR = 1.22). Conclusions: Our findings highlight the need to expand investigation on the incidence and impact of PTI on the mental health of police officers. .

Peritraumatic tonic immobility is associated with PTSD symptom severity in Brazilian police officers: a prospective study.

OBJECTIVE: Peritraumatic reactions feature prominently among the main predictors for development of posttraumatic stress disorder (PTSD). Peritraumatic tonic immobility (PTI), a less investigated but equally important type of peritraumatic response, has been recently attracting the attention of researchers and clinicians for its close association with traumatic reactions and PTSD. Our objective was to investigate the role of PTI, peritraumatic panic, and dissociation as predictors of PTSD symptoms in a cohort of police recruits (n=132). METHODS: Participants were asked to complete the following questionnaires during academy training and after the first year of work: Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C), Physical Reactions Subscale (PRS), Peritraumatic Dissociative Experiences Questionnaire (PDEQ), Tonic Immobility Scale (TIS), and Critical Incident History Questionnaire. RESULTS: Employing a zero-inflated negative binomial regression model, we found that each additional point in the TIS was associated with a 9% increment in PCL-C mean scores (RM = 1.09), whereas for PRS, the increment was 7% (RM = 1.07). As the severity of peritraumatic dissociation increased one point in the PDEQ, the chance of having at least one symptom in the PCL-C increased 22% (OR = 1.22). CONCLUSIONS: Our findings highlight the need to expand investigation on the incidence and impact of PTI on the mental health of police officers.

Predictors of PTSD symptoms in brazilian police officers: the synergy of negative affect and peritraumatic dissociation.

BACKGROUND: Exposure to traumatic events is a necessary but not a sufficient condition for the development of posttraumatic stress disorder (PTSD). Pretrauma, peritrauma and posttrauma factors interact to impact on symptom severity. The aim of the present study is to determine risk factors for PTSD symptoms in Brazilian police officers. METHOD: In a cross-sectional sample of active duty officers (n = 212), participants were asked to complete a socio-demographic questionnaire and self-report scales on affective traits, cumulative critical incident exposure, peritraumatic distress and dissociation, PTSD symptoms, and social support. Hierarchical linear regression analysis was conducted to examine predictors of PTSD symptoms. RESULTS: Variables related to negative affect, job duration, frequency of critical incident exposure, peritraumatic dissociation, and lack of social support remained significant in the final model and explained 55% of the variance in PTSD symptoms. When interaction terms were evaluated, a synergistic effect between negative affect and peritraumatic dissociation was found. CONCLUSIONS: The risk factors found in this study provide clues on how to elaborate primary prevention strategies regarding PTSD symptoms in police officers. Such initiatives may lessen the impact of repeated exposure to traumatic events on police officers over the course of their careers.

Predictors of PTSD symptoms in brazilian police officers: the synergy of negative affect and peritraumatic dissociation / Preditores de sintomas de transtorno de estresse pós-traumático em policiais brasileiros: a interação entre afeto negativo e dissociação peritraumática

BACKGROUND: Exposure to traumatic events is a necessary but not a sufficient condition for the development of posttraumatic stress disorder (PTSD). Pretrauma, peritrauma and posttrauma factors interact to impact on symptom severity. The aim of the present study is to determine risk factors for PTSD symptoms in Brazilian police officers. METHOD: In a cross-sectional sample of active duty officers (n = 212), participants were asked to complete a socio-demographic questionnaire and self-report scales on affective traits, cumulative critical incident exposure, peritraumatic distress and dissociation, PTSD symptoms, and social support. Hierarchical linear regression analysis was conducted to examine predictors of PTSD symptoms. RESULTS: Variables related to negative affect, job duration, frequency of critical incident exposure, peritraumatic dissociation, and lack of social support remained significant in the final model and explained 55 percent of the variance in PTSD symptoms. When interaction terms were evaluated, a synergistic effect between negative affect and peritraumatic dissociation was found. CONCLUSIONS: The risk factors found in this study provide clues on how to elaborate primary prevention strategies regarding PTSD symptoms in police officers. Such initiatives may lessen the impact of repeated exposure to traumatic events on police officers over the course of their careers.

INTRODUÇÃO: A exposição a eventos traumáticos é uma condição necessária, porém não única, para o desenvolvimento de transtorno de estresse pós-traumático (TEPT). Fatores individuais pré, peri e pós-trauma exercem impacto sobre a gravidade dos sintomas. O objetivo do presente estudo é determinar os fatores de risco para o desenvolvimento de sintomas de TEPT em policiais brasileiros. MÉTODO: Uma amostra transversal de policiais em atividade (n = 212) foi convidada a responder um questionário sóciodemográfico e escalas autoaplicáveis sobre afeto positivo e negativo, frequência de incidentes críticos, sofrimento e dissociação peritraumáticos, sintomas de TEPT e apoio social. Regressão linear hierárquica foi utilizada para avaliar fatores de risco. RESULTADOS: Afeto negativo, tempo de trabalho, frequência de exposição a eventos traumáticos, dissociação peritraumática e apoio social diminuído permaneceram no modelo final e explicaram 55 por cento das variações dos sintomas de TEPT. Foi observado efeito sinérgico entre dissociação peritraumática e afeto negativo. CONCLUSÃO: Baseados nos achados os autores discutem estratégias de prevenção que visam diminuir o impacto da exposição a eventos traumáticos em policiais ao longo de suas carreiras.

The impact of tonic immobility reaction on the prognosis of posttraumatic stress disorder.

Tonic immobility is the last defense reaction to entrapment by a predator. In humans, peritraumatic tonic immobility was correlated with PTSD severity and poor response to treatment. This study compared the role of peritraumatic dissociation, panic physical symptoms and tonic immobility as predictors of response to standard pharmacotherapy for PTSD. Thirty-six PTSD patients underwent a naturalistic pharmacological treatment. The Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) and the Clinical Global Impressions Severity of Illness item scores (CGI-S) were employed at baseline and endpoint to examine treatment outcome. Peritraumatic reactions were assessed using the Physical Reactions Subscale, the Peritraumatic Dissociative Experiences Questionnaire and four motor questions of the Tonic Immobility Scale. After controlling for confounders, tonic immobility was the best predictor of a poor response to treatment, either considering the PCL-C or the CGI-S scores. Tonic immobility seems to have a greater negative impact on PTSD prognosis than peritraumatic panic or dissociation. Additional translational and clinical research may inform about particular mechanisms underlying tonic immobility and open new avenues for prevention and treatment of PTSD.

Abnormal serum lipid profile in Brazilian police officers with post-traumatic stress disorder.

BACKGROUND: To measure the serum lipid composition of a sample of Brazilian police officers with and without PTSD regularly exposed to potentially traumatic situations. METHODS: A cross-sectional survey was conducted with 118 active duty male police officers. Serum concentrations for total cholesterol, LDL-C, HDL-C, and triglycerides were enzymatically determined. Body mass index (BMI) was obtained for each participant. RESULTS: Officers with PTSD exhibited significantly higher serum total cholesterol, LDL-C and triglycerides levels than those without PTSD. Total cholesterol and triglycerides, but not LDL-C, remained associated with PTSD diagnosis after controlling for confounding influences (i.e. socio-demographics, BMI, and tobacco, alcohol and medication use). LIMITATIONS: The sample size was small. A nutritional interview was employed instead of established scales to assess alimentary habits, tobacco or alcohol consumption. A self-report screening tool was used to assess the prevalence of PTSD. CONCLUSIONS: The association between PTSD and abnormal serum lipid profile and a tendency to exhibit higher BMI suggests that individuals with PTSD may be at increased risk for developing metabolic syndrome, a condition that by itself could account for many of the most serious PTSD-related physical health problems.

Post-traumatic stress symptoms in an elite unit of Brazilian police officers: prevalence and impact on psychosocial functioning and on physical and mental health.

BACKGROUND: Frequent exposure to traumatic situations put police officers under an increased risk for developing post-traumatic stress disorder (PTSD). The goals of this study were to determine the current prevalence of post-traumatic stress symptoms (PTSS) in Brazilian police officers and to compare groups with and without PTSS in terms of associated morbidity. METHODS: Police officers from an elite unit (n=157) were asked to fill out a socio-demographic questionnaire, the 12-item General Health Questionnaire and the Post-Traumatic Stress Disorder Checklist-Civilian Version. The latter's scores were used to establish the diagnoses of "full PTSD" and of "partial PTSD". RESULTS: Prevalence rates of "full PTSD" and "partial PTSD" were 8.9% and 16%, respectively. Compared with the "no PTSD" group, police officers with "full PTSD" were five times more likely to be divorced (21.6% vs. 4.3%, p=0.008), felt that their physical health was poorer (64.3% vs. 6%, p<0.001), had more medical consultations during the last 12 months [2.00 (+/-1.62) vs. 1.09 (+/-1.42), p=0.03] and reported more often lifetime suicidal ideation (35.7% vs. 5.2%, p=0.002). LIMITATIONS: The sample was relatively small. A screening tool was employed instead of a semi-structured interview. The cross-sectional design is unsuitable for ascertaining cause-effect relations. CONCLUSIONS: PTSD prevalence in our sample was comparable to those reported for North American and Dutch policemen. The presence of "full PTSD" was associated with evidences of considerable morbidity. These findings may contribute to the development of effective policies aimed at the prevention and treatment of PTSD in law enforcement agents.

Evaluation of the emotional peritraumatic response: transcultural adaptation of the Peritraumatic Distress Inventory into Portuguese

Objetivo: Traduzir e determinar a equivalência semântica da Peritraumatic Distress Inventory (PDI) para o Português. Métodos: A versão da escala PDI em português foi ralizada em quatro etapas: tradução, retradução, apreciação formal de equivalência semântica e pré-teste na população-alvo de 22 policiais militares. Uma fase adicional incluiu a análise da equivalência semântica por um dos autores da escala original. Resultados: A versão T1 e a retradução B1 obtiveram maiores escores entre ambos os avaliadores, atingindo notas máximas em 13 dos 15 itens. A população-alvo consistiu em 22 policiais militares (17 homens e 5 mulheres) sem queixas psiquiátricas. A média de idade foi de 33,9 (+- 4,63) anos e todos tinham o ensino médio completo. A população-alvo compreendeu todos os itens da PDI em português e o tempo médio de resposta da escala foi de 90 (+- 10,48) segundos. Conclusões: Este trabalho torna disponível em português a PDI, a primeira escala que avalia objetivamente o critério A2 para o diagnóstico do transtorno de estresse pós-traumático. As propriedades psicométricas da PDI em português devem ser estudadas posteriormente.

Transtorno de estresse pós-traumático como acidente de trabalho em um bancário: relato de um caso / Post-traumatic stress disorder as a result of occupational injury: the case of a bank employee

Este artigo relata o caso de um gerente de banco atendido por uma equipe multidisciplinar através de anamnese psiquiátrica e ocupacional e aplicação de entrevista psiquiátrica semi-estruturada (SCID) para transtorno de estresse pós-traumático (TEPT). O objetivo do artigo é exemplificar, com um caso clínico, as relações entre o TEPT e eventos traumáticos ocorridos no trabalho, demonstrando que o TEPT pode ser uma conseqüência de acidente de trabalho bancário. A visão do TEPT como doença ocupacional é um conceito novo e relevante devido aos índices elevados de violência no Brasil. O reconhecimento do TEPT no contexto do trabalho bancário é importante para orientar serviços de saúde, administradores e profissionais de recursos humanos na prevenção de TEPT (treinamento adequado, suporte psicológico, emissão de Comunicação de Acidente de Trabalho, intervenções na organização do trabalho), visando à melhoria da qualidade de vida.