Divane de Vargas

Prevalência de dependência alcoólica em serviços de atenção primária à saúde de Bebedouro, São Paulo, Brasil

This cross-sectional study aimed to estimate the prevalence of alcohol addiction as detected by primary healthcare services, analyzing its association with clinical, socio-demographic, and behavioral characteristics. The sample included 755 individuals who attended primary healthcare services in the city of Bebedouro, São Paulo State, Brazil, from August 30 to September 30, 2006. Alcohol addiction was investigated using the Alcohol Use Disorders Identification Test (AUDIT). According to the findings, 9.8% of the sample showed scores suggestive of alcohol addiction (zone IV) on the AUDIT. This group consisted predominantly of male individuals 20 to 39 years of age, white, married, and Catholic. A significant association remained with male gender, smoking, single marital status, lower income, and higher schooling. The strongest predictors of this association were male gender (OR = 5.18), smoking (OR = 7.01), and university schooling (OR = 2.11). Alcohol addiction affects a significant proportion of users of primary healthcare services. In general, male smokers with more schooling and who report some clinical diagnosis were more likely to show an AUDIT score suggestive of alcohol addiction.Estudo transversal que objetivou estimar a prevalencia de dependencia alcoolica em servicos de atencao primaria a saude, analisando sua associacao com caracteristicas clinicas, socio-demograficas e comportamentais. A amostra constituiu-se de 755 sujeitos que procuraram atendimento de saude em servicos de atencao primaria da cidade de Bebedouro, Sao Paulo, Brasil, entre 30 de agosto a 30 de setembro de 2006. Para a investigacao da dependencia alcoolica, utilizou-se o Alcohol Use Disorders Identification Test (AUDIT). Os resultados apontaram que 9,8% da amostra obtiveram, no AUDIT, pontuacao sugestiva para dependencia alcoolica (zona IV). Esse grupo compos-se predominantemente por individuos do sexo masculino, com idade entre 20 e 39 anos, brancos, casados, catolicos. Mantiveram associacao significativa com a dependencia alcoolica sexo masculino, fumantes, solteiros, menor renda e maior escolaridade. Os maiores preditores dessa associacao foram encontrados para o sexo masculino (OR = 5,18), fumante (OR = 7,01) e com nivel superior (OR = 2,11). A dependencia alcoolica acomete significativa proporcao dos usuarios atendidos em servicos de atencao primaria a saude. De modo geral, os homens tabagistas com maior escolaridade e com relato de algum diagnostico clinico apresentaram pontuacao no AUDIT sugestiva para a dependencia alcoolica.

Alcohol, alcoholism and alcohol addicts: conceptions and attitudes of nurses from district basic health centers

Ese estudio cualitativo tiene el objetivo de conocer las concepciones y tendencias de actitud de enfermeros de servicios publicos de atencion basica de salud, ante el alcohol, alcoholismo y el alcoholico. Participaron diez enfermeros de tres instituciones de una municipalidad del estado de Sao Paulo. Los datos fueron recolectados mediante registros autograbados y sometidos al analisis tematico de contenido. Los temas que emergieron evidenciaron que los enfermeros son permisivos al uso moderado de alcohol, pero rechazan el alcoholismo, concibiendolo como una enfermedad que puede ser fatal y tienden a asociarlo con la voluntad personal, indicando la influencia del concepto moral en sus concepciones y actitudes. Tambien se evidencio el conocimiento de los enfermeros participantes sobre el alcohol y alcoholismo. Con base en los resultados, se sugiere la capacitacion de ese grupo, preparandolo para la atencion, el reconocimiento y la prevencion de trastornos relacionados al uso/abuso de alcohol en esos centros de salud.Esse estudo qualitativo tem por objetivo conhecer as concepcoes e as tendencias de atitudes de enfermeiros de Unidades de Atencao Basica Distritais de Saude (UDBS) frente ao alcool, ao alcoolismo e ao alcoolista. Participaram dez enfermeiros de tres UBDS de um municipio paulista. Os dados foram coletados por meio de registro auto-gravado e submetidos a analise tematica de conteudo. Os temas que emergiram evidenciaram que os enfermeiros sao permissivos ao uso moderado do alcool, no entanto rejeitam o alcoolismo, concebendo-o como uma doenca que pode ser fatal e tendem a associa-lo a vontade da pessoa, revelando a influencia do conceito moral em suas concepcoes e atitudes. Tambem, evidenciou-se o conhecimento dos enfermeiros participantes sobre o alcool e alcoolismo. Com base nos resultados, recomenda-se a capacitacao desse grupo no sentido de prepara-los para o atendimento, o reconhecimento e a prevencao de transtornos relacionados ao uso/abuso do alcool nesses centros de saude.

Development and validation of a scale of attitudes towards alcohol, alcoholism and alcoholics

The objective of this study was the construction and validation of a scale that would measure the attitudes towards alcohol, alcoholism and the alcoholic, called the Scale of Attitudes Towards Alcohol, Alcoholism and the Alcoholic. The face and content validations, as well as the factor analysis of the data obtained in a preliminary test with 144 nursing students resulted in a scale consisting of 96 items, divided into 5 factors: Attitudes towards the alcoholic person: care and interpersonal relations; Etiology; Disease; Repercussions deriving from alcohol use/abuse; Alcoholic beverages. The general scale presented a consistency level of 0.90. The resulting instrument is concluded to be a reliable tool to evaluate attitudes towards alcohol, alcoholism and alcohol addicts.Este estudo teve como objetivo construir e validar instrumento de medida de atitudes frente ao alcool, ao alcoolismo e ao alcoolista (escala de atitudes frente ao alcool, ao alcoolismo e ao alcoolista). A validacao aparente e de conteudo do instrumento, bem como a analise fatorial dos dados de sua aplicacao preliminar, realizada com amostra de 144 estudantes de enfermagem, resultou numa escala composta por 96 itens divididos em cinco fatores: atitudes frente ao alcoolista - o trabalho e as relacoes interpessoais; etiologia; doenca; repercussoes decorrentes do uso/abuso do alcool; a bebida alcoolica. A escala geral apresentou consistencia interna de 0,90. Concluiu-se que o instrumento construido mostrou-se confiavel para avaliacao das atitudes frente ao alcool, ao alcoolismo e ao alcoolista.

Depression prevalence in Intensive Care Unit nursing workers: a study at hospitals in a northwestern city of São Paulo State

Correspondencia: Divane de Vargas Universidade de Sao Paulo. Escola De Enfermagem. Departamento de Enfermagem Materno Infantil e Psiquiatrica. Av. Dr. Eneas de Carvalho Aguiar, 419 Bairro Cerqueira Cesar CEP: 05403-000 Sao Paulo, SP, Brasil E-mail: vargas@usp.br Prevalencia de depresion en trabajadores de enfermeria de Unidades de Terapia Intensiva: estudio en hospitales de una ciudad del noroeste del Estado de Sao Paulo

Reabilitação psicossocial dos usuários de álcool e outras drogas: a concepção de profissionais de saúde

Estudio exploratorio de abordaje cualitativa cuyo objetivo fue identificar las concepciones de profesionales de un Centro de Referencia para el tratamiento de problemas relacionados con alcohol y otras drogas acerca de la rehabilitacion psicosocial. Fueron entrevistados once profesionales de nivel superior, por medio de entrevistas semi-estructuradas. El analisis de los datos fue norteada por los presupuestos de la hermeneutica dialectica, la cual origino la categoria rehabilitacion psicosocial. Los resultados evidenciaron que en la concepcion de los profesionales, la rehabilitacion psicosocial se da en la realizacion de talleres terapeuticos, actividades externas y en el establecimiento de sociedades con otras instituciones. Se concluye que el concepto de rehabilitacion psicosocial que mas se evidencia en la percepcion de esos sujetos esta asociada al modelo psiquiatrico tradicional, arraigado a la logica de la normalidad social, el problema principal a ser superado en la asistencia a los usuarios de alcohol y otras drogas.Exploratory study with qualitative approach that had as its main objective to identify the conception of the health professionals about Psychosocial Rehabilitation from a reference Center for the treatment of alcohol and other drugs related problems. The sample consisted of eleven health professionals with an academic degree, submitted to semi-structured interviews. The data analysis was made according to the hermeneutic dialectic method which originated the Psychosocial Rehabilitation category. The data demonstrated that in the professionals conception, the Psychosocial Rehabilitation is given in the realization of therapeutic workshops, outdoor activities, and the estabilishment of a partnership with other foundations. It is concluded that the concept of Psychosocial Rehabilitation that was made clear in the conception of these subjects is still associated to the traditional psychiatric model, which is attached to the logic of social normality, the main challenge to the psychosocial model of assistance to the alcohol and other drugs users.Exploratory study with qualitative approach that had as its main objective to identify the conception of the health professionals about Psychosocial Rehabilitation from a reference Center for the treatment of alcohol and other drugs related problems. The sample consisted of eleven health professionals with an academic degree, submitted to semi-structured interviews. The data analysis was made according to the hermeneutic dialectic method which originated the Psychosocial Rehabilitation category. The data demonstrated that in the professionals conception, the Psychosocial Rehabilitation is given in the realization of therapeutic workshops, outdoor activities, and the estabilishment of a partnership with other foundations. It is concluded that the concept of Psychosocial Rehabilitation that was made clear in the conception of these subjects is still associated to the traditional psychiatric model, which is attached to the logic of social normality, the main challenge to the psychosocial model of assistance to the alcohol and other drugs users.

Atendimento ao alcoolista em serviços de atenção primária à saúde: percepções e condutas do enfermeiro

Objective: To describe the perceptions and actions of registered nurses regarding the care of alcoholic persons in primary care services. Methods: This was a qualitative exploratory study with 10 registered nurses from three primary care services. Data were collected through tape-recordings and categorized through content analysis. Results: The care of alcoholic persons was characterized by fast care and focused on symptoms needing immediate nursing interventions. This type of care generated dissatisfaction of the alcoholic persons, because they should receive more attention in primary care services. Conclusions: Care of alcoholic persons and actions of registered nurses focused on the symptoms of acute intoxication only. There was no focus on early identification and prevention of problems related to the use of alcohol and alcoholism.Objective: To describe the perceptions and actions of registered nurses regarding the care of alcoholic persons in primary care services. Methods: This was a qualitative exploratory study with 10 registered nurses from three primary care services. Data were collected through tape-recordings and categorized through content analysis. Results: The care of alcoholic persons was characterized by fast care and focused on symptoms needing immediate nursing interventions. This type of care generated dissatisfaction of the alcoholic persons, because they should receive more attention in primary care services. Conclusions: Care of alcoholic persons and actions of registered nurses focused on the symptoms of acute intoxication only. There was no focus on early identification and prevention of problems related to the use of alcohol

Perfil dos usuários de serviços de Saúde Mental do município de Lorena - São Paulo

OBJETIVOS: Identificar o perfil dos usuarios do Ambulatorio de Saude Mental e do Centro de Atencao Psicossocial de Lorena - Sao Paulo. METODOS: Estudo exploratorio descritivo com dados coletados em 5.830 prontuarios dos usuarios desses dois servicos de Saude Mental. RESULTADOS:Foram analisados 5.490 prontuarios no Ambulatorio e 340 no Centro de Atencao Psicossocial. No Ambulatorio 68% dos usuarios eram mulheres e no Centro de Atencao Psicossocial, 61% eram homens. Os diagnosticos que prevaleceram no Ambulatorio foram: transtornos neuroticos, relacionados ao estresse e os somatoformes, e no Centro de Atencao Psicossocial, foram os transtornos decorrentes do uso de substâncias psicoativas. O grupo de medicamentos mais prescritos no Ambulatorio foi o de antidepressivos, e no Centro de Atencao Psicossocial, os antipsicoticos. CONCLUSAO: Verificou-se que os servicos de Saude Mental atuam de forma desarticulada com a Atencao Basica de Saude e faz-se necessario implantar o apoio matricial nesse municipio.

Representação social de enfermeiros de centros de atenção psicossocial em álcool e drogas (CAPS AD) sobre o dependente químico

Resumen Qualitative exploratory study aimed to identify the social representations of nurses from specialist services in alcohol and other drugs compared to the addicts. The subjects were 16 nurses from 13 offices located in the city of Sao Paulo-SP. Data were collected through interviews which were recorded and analyzed according to the referential theory of social representations. The results showed that, in the nurses’ representation, addicts are individuals suffering from a disease that has difficulty limits, and handlers are responsible for the development of dependence. We conclude that the representations of these professionals are sidewalks on common sense and point to strategies to face this problem and change these representations.

Morte e morrer: sentimentos e condutas de estudantes de enfermagem

Objective: Identify behaviors and feelings of nursing students in an hypothetical situation, involving death and dying. Methods: Exploratory and qualitative study with data collected through a self-administered questionnaire in a sample of 51 nursing students at a private school in the north area of Sao Paulo state; it was conducted a thematic analysis of content. Results: The student nurses were not prepared to deal with situations that involve death and dying; the students tend to deny the situation, presenting a inappropriate conduct in face a patient that is about to die. The most common feelings among students towards death were the loss and fear. Conclusion: There is a need to give greater attention to the subject during the training of nurses in order to prepare them to face situations that involve death and dying, including these topics in the daily curriculum practices.OBJECTIVE: Identify behaviors and feelings of nursing students in an hypothetical situation, involving death and dying. METHODS: Exploratory and qualitative study with data collected through a self-administered questionnaire in a sample of 51 nursing students at a private school in the north area of Sao Paulo state; it was conducted a thematic analysis of content. RESULTS: The student nurses were not prepared to deal with situations that involve death and dying; the students tend to deny the situation, presenting a inappropriate conduct in face a patient that is about to die. The most common feelings among students towards death were the loss and fear. CONCLUSION: There is a need to give greater attention to the subject during the training of nurses in order to prepare them to face situations that involve death and dying, including these topics in the daily curriculum practices.

Álcool, alcoolismo e alcoolista: concepções e atitudes de enfermeiros de unidades básicas distritais de saúde

Ese estudio cualitativo tiene el objetivo de conocer las concepciones y tendencias de actitud de enfermeros de servicios publicos de atencion basica de salud, ante el alcohol, alcoholismo y el alcoholico. Participaron diez enfermeros de tres instituciones de una municipalidad del estado de Sao Paulo. Los datos fueron recolectados mediante registros autograbados y sometidos al analisis tematico de contenido. Los temas que emergieron evidenciaron que los enfermeros son permisivos al uso moderado de alcohol, pero rechazan el alcoholismo, concibiendolo como una enfermedad que puede ser fatal y tienden a asociarlo con la voluntad personal, indicando la influencia del concepto moral en sus concepciones y actitudes. Tambien se evidencio el conocimiento de los enfermeros participantes sobre el alcohol y alcoholismo. Con base en los resultados, se sugiere la capacitacion de ese grupo, preparandolo para la atencion, el reconocimiento y la prevencion de trastornos relacionados al uso/abuso de alcohol en esos centros de salud.Esse estudo qualitativo tem por objetivo conhecer as concepcoes e as tendencias de atitudes de enfermeiros de Unidades de Atencao Basica Distritais de Saude (UDBS) frente ao alcool, ao alcoolismo e ao alcoolista. Participaram dez enfermeiros de tres UBDS de um municipio paulista. Os dados foram coletados por meio de registro auto-gravado e submetidos a analise tematica de conteudo. Os temas que emergiram evidenciaram que os enfermeiros sao permissivos ao uso moderado do alcool, no entanto rejeitam o alcoolismo, concebendo-o como uma doenca que pode ser fatal e tendem a associa-lo a vontade da pessoa, revelando a influencia do conceito moral em suas concepcoes e atitudes. Tambem, evidenciou-se o conhecimento dos enfermeiros participantes sobre o alcool e alcoolismo. Com base nos resultados, recomenda-se a capacitacao desse grupo no sentido de prepara-los para o atendimento, o reconhecimento e a prevencao de transtornos relacionados ao uso/abuso do alcool nesses centros de saude.