Alberto Olavo Advincula Reis

Articulação entre serviços públicos de saúde nos cuidados voltados à saúde mental infantojuvenil

O objetivo do estudo e descrever e analisar as articulacoes que se realizam entre as equipes da Estrategia Saude da Familia (ESF) e Centro de Atencao Psicossocial Infantojuvenil (CAPSI), tendo em vista as acoes voltadas a saude mental de criancas e adolescentes. Foram realizadas entrevistas semidirigidas com gerentes de cinco CAPSI e 13 Unidades Basicas de Saude com ESF, de 5 regioes distintas no Municipio de Sao Paulo, Brasil, que foram transcritas e analisadas mediante perspectiva hermeneutica. A articulacao entre as equipes da ESF e CAPSI se da prioritariamente por encaminhamento de casos, apoio matricial ou parceria para casos considerados pertinentes ao CAPSI. Falta de recursos humanos, cobranca por produtividade e ausencia de capacitacao dos profissionais da ESF para trabalhar com saude mental foram mencionadas como obstaculos para a efetiva articulacao entre os servicos. A logica do encaminhamento e da desresponsabilizacao, bem como a hegemonia do modelo biomedico e a consequente fragmentacao dos cuidados se mostram vigentes no cotidiano dos servicos.

A humanização na saúde como instância libertadora

O texto discute a politica de Humanizacao em Saude do ponto de vista da logica que a sustenta, em particular como uma acao da singularidade dos atores implicados no processo de producao da Saude. A analise desenvolvida aponta para o fato de que as praticas de atencao a saude, quando de acordo com os cânones da logica utilitaria, refletem nao apenas uma ordem autoritaria, como produzem sujeitos cerceados, fragmentados e incapazes. A humanizacao em Saude e considerada uma possibilidade politica de se alterar essa logica e de instaurar, no interior das instituicoes, espacos de liberdade capazes de acolher, amparar, sustentar e dar significado a presenca e as acoes de profissionais de saude, gestores e pacientes, ao considerar suas dimensoes subjetivas e singulares.

Fatores associados à capacidade para o trabalho e percepção de fadiga em trabalhadores de enfermagem da Amazônia ocidental

OBJECTIVE To analyze factors associated with inadequate work ability and perceived fatigue among nursing professionals. METHODS A cross-sectional study was conducted involving 272 nursing personnel at an emergency hospital in Rio Branco/State of Acre, Brazil. Data collection was performed using the following instruments: questionnaire on sociodemographic data, working conditions and life styles; the Work Ability Index - WAI, and a questionnaire on perceived fatigue. Bivariate and multiple Poisson regression was used in the analysis of factors associated with work ability and perceived fatigue. RESULTS The prevalence of inadequate work ability was 40.8% and presented the following associated factors: female sex (RP = 1.84; 95% CI 1.06 - 3.18); refering: other job commitment (RP = 1.71; 1.25 - 2.35); understaffing (RP = 1.96; 1.10 - 3.47); repetitive and monotonous tasks (RP = 1.84; 1.24 - 2.72); reporting three or more clinically undiagnosed morbidities (RP = 1.48; 1.06 - 2.06); excessive reported fatigue (RP = 2.37; 1.81 - 3.12). The prevalence of severe fatigue was 25.7% and the associated factors were: repetitive and monotonous tasks (RP = 1.74; 1.00 - 3.03); reporting three to five clinically-diagnosed morbidities (RP = 1.98; 1.00 - 3.11) and six or more self-reported morbidities (RP = 3.79; 2.04 - 7.03). CONCLUSIONS The study revealed that most of the studied population showed reduced work ability and high levels of fatigue. These results point toward the need for interventions on an individual level (such as life conditions) and workplace improvements, looking jointly at the organizational aspects and work environment, particularly organizational aspects.

O lugar do feminino na construção do conceito de adolescência

Sao discutidas as origens do conceito de adolescencia procurando explicar aspectos criticos do conceito, como a presenca hegemonica do pensamento bio-naturalista e a presenca de um androcentrismo nocional na sua formulacao. Destaca-se a pertinencia dessa discussao no sentido de contribuir para uma assistencia mais adequada aos adolescentes, alem de colaborar para expansao do conceito de adolescencia no campo da Saude Publica.The origins of the concept of adolescence arc discussed with a view to explaning certain of its critical aspects such as the predominance of bio-naturist though and notional androcentrism in its development. The discussion of this theme seeks also to contribute to a more adequate assistance to adolescents as well as to on enlargement of the concept of adolescence as related to the field of Public Health.The origins of the concept of adolescence are discussed with a view to explaining certain of its critical aspects such as the predominance of bio-naturist though and notional androcentrism in its development. The discussion of this theme seeks also to contribute to a more adequate assistance to adolescents as well as to on enlargement of the concept of adolescence as related to the field of Public Health.

Spirituality in childhood cancer care

To deal with the suffering caused by childhood cancer, patients and their families use different coping strategies, among which, spirituality appears a way of minimizing possible damage. In this context, the purpose of the present study was to analyze the influence of spirituality in childhood cancer care, involving biopsychosocial aspects of the child, the family, and the health care team facing the disease. To accomplish this purpose, a nonsystematic review of literature of articles on national and international electronic databases (Scientific Electronic Library Online [SciELO], PubMed, and Latin American and Caribbean Health Sciences Literature [LILACS]) was conducted using the search terms “spirituality,” “child psychology,” “child,” and “cancer,” as well as on other available resources. After the search, 20 articles met the eligibility criteria and were included in the final sample. Our review showed that the relation between spirituality and health has lately become a subject of growing interest among researchers, as a positive influence of spirituality in the people’s welfare was noted. Studies that were retrieved using the mentioned search strategy in electronic databases, independently assessed by the authors according to the systematic review, showed that spirituality emerges as a driving force that helps pediatric patients and their families in coping with cancer. Health care workers have been increasingly attentive to this dimension of care. However, it is necessary to improve their knowledge regarding the subject. The search highlighted that spirituality is considered a source of comfort and hope, contributing to a better acceptance of his/her chronic condition by the child with cancer, as well as by the family. Further up-to-date studies facing the subject are, thus, needed. It is also necessary to better train health care practitioners, so as to provide humanized care to the child with cancer.

Childhood depression: a systematic review.

As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH]), “child” (MeSH), and “childhood depression” (keyword). Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children’s quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs concerning childhood depression are not always taken into consideration. In this context, this review demonstrated that childhood-onset depression commonly leads to other psychiatric disorders and co-morbidities. Many of the retrieved studies also confirmed the hypothesis that human resources (eg, health care team in general) are not yet adequately trained to address childhood depression. Thus, further research on the development of programs to prepare health care professionals to deal with childhood depression is needed, as well as complementary studies, with larger and more homogeneous samples, centered on prevention and treatment of childhood depression.

Fatores psicossociais e comportamentais associados ao risco de DST/AIDS entre estudantes da área de saúde

This study aimed to identify and compare psychosocial and behavioral factors associated to STD/AIDS risk among students enrolled in the first and last years of the Nursing and Medical Undergraduate Programs at State University of Londrina. A convenience sample was selected from 263 enrolled students, and the 183 students who were sexually active (70.4%) had their data assessed. The Aids Risk Reduction Model framework was used to design the questionnaire in which a 5% statistical significance level was considered. Some risk factors were identified such as the perception of invulnerability, multiple sexual partners, consumption of alcoholic beverages before intercourse, and the discontinuous use or no use of condom. The risk factors are common both to the freshman and senior students, with no significant differences related to the passage of time or to the students’ higher educational level. Senior students tend to be monogamous which makes them feel safer and decrease the use of condom with their sexual partners.

A representação social da mãe acerca da criança com síndrome de down

Desenvolvido a luz da Teoria das Representacoes Sociais, o estudo buscou compreender a representacao social da mae acerca da crianca com Sindrome de Down. Participaram nove maes, cujos filhos tinham idade escolar e frequentavam um servico especializado no municipio de Sao Paulo. Os dados, obtidos por entrevista semi-estruturada e individual, foram analisados por meio do metodo de analise de conteudo, especificamente a analise tematica. Os resultados apontaram para urna representacao da crianca na qual predominaram elementos negativos, levando a mae a experimentar sentimentos ambivalentes em relacao ao filho e comportar-se de modo superprotetor.

Análise metafórico-metonímica do processo de constituição do pensamento da saúde pública acerca da adolescente grávida: os anos 60

This article is an analytical essay on a historical moment in the formation of public health thinking vis-à-vis adolescent pregnancy: the 1960s. Its relevance lies in the fact that several assertions produced then still bear great influence on ideas and models concerning adolescent maternity in current public health thinking. From the technical and methodological point of view, one can assume two levels: an explicit one pertaining to the documentary record, consisting of messages clearly communicated by authors of scientific texts, and an implicit one, with elements that could only surface in text discourse through stylistic effects. Based on such assumptions, we explored the specialized literature using a metaphorical/metonymical analysis in search of such implicit dimensions.

Narrative interviews: an important resource in qualitative research

Objetivo Este estudio es un aporte metodologico en que se explica y destaca el alcance y la fertilidad de la entrevista narrativa en la investigacion cualitativa. Metodo Describir el metodo de la narrativa en la investigacion cualitativa. Resultados El metodo de investigacion cualitativa se caracteriza por abordar las cuestiones relacionadas con las singularidades del campo y de las personas encuestadas, siendo las entrevistas narrativas un metodo potente para uso de los investigadores que toman posesion de ella. Permiten que la profundizacion de la investigacion, la combinacion de historias de vida con los contextos socio-historicos e la comprension de los sentidos que producen cambios en las creencias y valores que motivan y justifican las acciones de los posibles informantes. Conclusion El uso de la narrativa se presenta un recurso de investigacion ventajosa en la investigacion cualitativa, la narrativa es una forma tradicional de comunicacion cuyo objetivo es servir contenido a partir de la que se pueden transmitir las experiencias subjetivas.Objetives This methodological study explain and emphasize the extent and fertility of the narrative interview in qualitative research. Methods To describe the narrative method within the qualitative research. Results The qualitative research method is characterized by addressing issues related to the singularities of the field and individuals investigated, being the narrative interviews a powerful method for use by researchers who aggregate it. They allow the deepening of research, the combination of life stories with socio-historical contexts, making the understanding of the senses that produce changes in the beliefs and values that motivate and justify the actions of possible informants. Conclusion The use of narrative is an advantageous investigative resource in qualitative research, in which the narrative is a traditional form of communication whose purpose is to serve content from which the subjective experiences can be transmitted.