Iracema da Silva Frazão

Práticas de saúde das equipes dos Consultórios de Rua

Existem dois fenomenos distintos que se interligam, considerados graves problemas de saude publica: o viver nas ruas e o uso de drogas. Diante dessa problematica os Consultorios de Rua foram implementados privilegiando a abordagem nos contextos de vida do usuario morador de rua. O objetivo foi conhecer as praticas de saude realizadas no cotidiano das equipes dos Consultorios de Rua, alem de descrever as estrategias de atuacao das equipes, conhecer o entendimento das equipes sobre educacao em saude e desvelar os sentimentos sobre o processo de trabalho na rua. Trata-se de uma pesquisa qualitativa, com observacao participante e analise de conteudo proposta por Bardin. Da analise das entrevistas de 15 participantes, emergiram cinco categorias tematicas. As praticas de saude pelas equipes privilegiam o vinculo e o acolhimento das pessoas em situacao de rua, reforcando a importância do protagonismo do usuario e da interdisciplinaridade, bem como o trabalho em rede intersetorial.

Bioethical analysis to the therapeutic use of Cannabis: Integrative review.

Introduction: Despite being considered as a contravention under some countries’ legislation, the therapeutic use of Cannabis sativa has been growing in Brazil, due to the promising results observed in many pathologies. Such a scenario has fostered the need to deepen discussions on the subject and possibly revise legislation governing the substance use and access. Objectives: Identify the types of stigma related to the therapeutic use of Cannabis and describe the strategies people use to overcome stigma. Methods: This integrative review was carried out in the databases PubMed, Scopus, CINAHL, MEDLINE, PsycINFO, Web of Science, and Cochrane Library, with 565 articles being retrieved. Triads’ cross-check were done, first maintaining the “cannabis” and “therapeutic use” pair, added by “stigma,” “bioethics,” “ethics,” “social consequences,” and “legal consequences.” The final selection resulted in six articles. Ethical Consideration: However, the ethical issues that pervade and regulate decisions on this subject must be considered. Results: Different dimensions and types of stigma related to the therapeutic use of Cannabis have been identified. The bioethical principle of autonomy was an expression of citizenship and human rights, mitigating internal conflicts related to self-stigma and the effects of external stigma on the person’s life. Conclusion: It was possible to identify the types of stigma related to the therapeutic use of Cannabis is an internal dimension represented (self-stigma) and an external dimension, represented (social and structural stigmas) and to identify strategies adopted to face this stigma: skills training group for users, elaboration of laws and specific programs to clarify the therapeutic use of Cannabis with a greater social scope, and support for family members. Thus, contributing to the building of people’s autonomy in a broader context of decision-making autonomy and executive autonomy will provide the development of people’s capacity to perform complex tasks of self-management and, consequently, to continue promoting and preserving their decision-making process and their capacity to plan and perform tasks associated with managing their lives and their treatments.

INSTRUMENTOS RELACIONADOS AO CONSUMO DE DROGAS EM ADOLESCENTES: REVISÃO INTEGRATIVA

Objective: to identify validated instruments and related to drug use among adolescents. Method: an integrative review that included studies on elaborating and validating or evaluating the psychometric properties of instruments for analysing drug use by adolescents in Portuguese, English and Spanish. The search was performed in the following databases: MEDLINE, LILACS, SCOPUS, CINAHL, COCHRANE and Web of Science. For this, the descriptors “Validation Studies”, “Validation studies as subject”, “adolescent” and “disorders related to the use of psychoactive substances” were crossed, resulting in 743 articles retrieved, with a total of 11 composing this review after the selection process and analysis of methodological rigor were performed. The data collection was performed using a validated instrument and the results were categorized based on the objectives of the tests. Results: ten instruments were identified: five questionnaires, one inventory and four scales. The instruments addressed the risk, use/abuse of psychoactive substances and treatment issues. Two showed greater reliability: ASTEQ-COUNSELOR and the DCI-A-SF. Conclusion:information on ten validated instruments was summarized focused on adolescent drug use. These instruments enable measuring and identifying drug use and treatment-related aspects for problems arising from using these substances. Two instruments were considered to be the most reliable because they presented better alpha values for the items individually and together; the ASTEQ-COUNSELOR and the DCI-A-SF. The availability of reliable measurement instruments assists nursing research and praxis

Assessment tools for the measurement of the self-efficacy of drug users: protocol for a systematic review

Introduction The abuse of alcohol and other drugs is a worldwide problem, the treatment of which poses a challenge to healthcare workers. Objective This study presents a proposal for a systematic review to analyse the psychometric properties of assessment tools developed to measure the self-efficacy of drug users with regard to resisting the urge to take drugs in high-risk situations. Methods and Analysis The guiding question was based on PICOS (Population Intervention Comparator Outcome Setting), and the report of the methods of review protocol was written in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Searches will be performed in the PsycINFO, Cochrane, Pubmed, Web of Science, SCOPUS and CINAHL databases, followed by the use of the ‘snowball’ strategy. The inclusion criteria for the articles will be (1) assessment tool validation studies; (2) assessment tools developed to measure self-efficacy; (3) quantitative measures; (4) measures designed for use on adults; (5) data from self-reports of the participants; (6) studies involving a description of psychometric properties of the measures; and (7) studies that explain how the level of self-efficacy is scored. The search, selection and analysis will be performed by two independent reviewers. In cases of a divergence of opinion, a third reviewer will be consulted. The COSMIN checklist will be used for the appraisal of the methodological quality of the assessment tools and the certainty of the evidence in the articles (risk of bias) will be analysed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Ethics and dissemination This protocol does not require ethical approval. However, this protocol is part of the thesis entitled Drug-Taking Confidence Questionnaire for use in Brazil, presented for obtaining a doctorate in neuropsychiatry and behavioural sciences from the Federal University of Pernambuco, and has received approval from the human research ethics committee of the Federal University of Pernambuco (reference number: 1.179.162). The results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences. PROSPERO registration number CRD42017068555.

Quem são os moradores de residências terapêuticas? Perfil de usuários portadores de transtornos mentais desinstitucionalizados

RESUMO Este artigo teve como objetivo caracterizar o perfil sociodemografico e clinico de moradores de Servicos Residenciais Terapeuticos (SRT). Trata-se de um estudo transversal, censitario, com 190 moradores de SRT de Recife (PE), analisando as variaveis de perfil sociodemografico e o historico psiquiatrico. Observou-se que os moradores se caracterizam, em sua maioria, por homens, solteiros, idosos, analfabetos e historico de multiplos e longos internamentos psiquiatricos. Conclui-se que as condutas iatrogenicas praticadas no hospital deixaram sequelas importantes em diversos aspectos da vida dos usuarios e tornaram-se numa divida social que ainda precisa ser paga pela sociedade.

Nursing Diagnoses of the Homeless Population in Light of Self-care Theory

BACKGROUND: A growing number of people find themselves in conditions of extreme poverty, which often makes living on the streets the only option. Living conditions in this setting exert a direct impact on health and self‐care. Health care for the homeless population should be planned in an interdisciplinary and intersectoral manner. In this context, nursing diagnoses constitute an essential part of the systemization of care. OBJECTIVES: The aims of the present study were to identify nursing diagnoses of a homeless population and propose nursing interventions based on the findings in light of the Nursing Outcomes Classification and Nursing Interventions Classification. DESIGN AND SETTING: A descriptive, cross‐sectional study with a quantitative approach was conducted on the streets of the city of Recife in northeastern Brazil. PARTICIPANTS: The sample consisted of 274 male and female adult homeless individuals. METHODS: Data collection involved the administration of a semi‐structured interview, the Alcohol, Smoking and Substance Involvement Screening Test and the International Neuropsychiatric Interview. RESULTS: The most prevalent diagnoses were related to risk‐prone health behaviors (78.1%), inadequate health maintenance (67.1%), along with sleep deprivation (100%), feelings of hopelessness (100%) and low self‐esteem (99%). CONCLUSIONS: The experience enabled the identification of the peculiarities of the population, bringing nursing practice closer to health promotion for the homeless. Adequate public policies and training for health teams are needed to address the health needs of the homeless population. HIGHLIGHTSMain nursing diagnoses were related to the health promotion, activity/rest and self‐perception domains.Self‐care is key strategie that can minimize risks and harm and reduce homelessness.Daily drug intake may be related to a mechanism of adjustment to unfulfilled needs.Nursing interventions should be focused on a support system and health education.

Knowledge and Perceptions of Undergraduate Nurses towards the Use of Cocaine (Smoked) in a Brazilian Context

ABSTRACT The aim of the study was to evaluate the perceptions and knowledge of nursing students on the identification and intervention care among users of cocaine (smoked) patients. A cross‐sectional survey design was conducted with 164 undergraduate nursing students of two nursing school from Northeast of Brazil. A questionnaire on knowledge and attitudes and therapeutic commitment towards the use of cocaine (smoked) were used. The students stated that they received contents of substance misuse in the curriculum of nursing. Only 10% of the students reported that they had adequate knowledge on addiction to dealing with cocaine (smoked) users and wish to work with these users. There are positive perceptions on motivation, task specific self‐esteem and work satisfaction among students. HIGHLIGHTSNurses play an important role in direct assistance to drug users.Therapeutic commitment is fundamental for intervention of problems related to drug use.Formal educational is a contributing factor to enhance the ability and performance of future nurses.

Health practices by teams from Street Outreach Offices

Existem dois fenomenos distintos que se interligam, considerados graves problemas de saude publica: o viver nas ruas e o uso de drogas. Diante dessa problematica os Consultorios de Rua foram implementados privilegiando a abordagem nos contextos de vida do usuario morador de rua. O objetivo foi conhecer as praticas de saude realizadas no cotidiano das equipes dos Consultorios de Rua, alem de descrever as estrategias de atuacao das equipes, conhecer o entendimento das equipes sobre educacao em saude e desvelar os sentimentos sobre o processo de trabalho na rua. Trata-se de uma pesquisa qualitativa, com observacao participante e analise de conteudo proposta por Bardin. Da analise das entrevistas de 15 participantes, emergiram cinco categorias tematicas. As praticas de saude pelas equipes privilegiam o vinculo e o acolhimento das pessoas em situacao de rua, reforcando a importância do protagonismo do usuario e da interdisciplinaridade, bem como o trabalho em rede intersetorial.

Prácticas de salud de los equipos de atención callejera

Existem dois fenomenos distintos que se interligam, considerados graves problemas de saude publica: o viver nas ruas e o uso de drogas. Diante dessa problematica os Consultorios de Rua foram implementados privilegiando a abordagem nos contextos de vida do usuario morador de rua. O objetivo foi conhecer as praticas de saude realizadas no cotidiano das equipes dos Consultorios de Rua, alem de descrever as estrategias de atuacao das equipes, conhecer o entendimento das equipes sobre educacao em saude e desvelar os sentimentos sobre o processo de trabalho na rua. Trata-se de uma pesquisa qualitativa, com observacao participante e analise de conteudo proposta por Bardin. Da analise das entrevistas de 15 participantes, emergiram cinco categorias tematicas. As praticas de saude pelas equipes privilegiam o vinculo e o acolhimento das pessoas em situacao de rua, reforcando a importância do protagonismo do usuario e da interdisciplinaridade, bem como o trabalho em rede intersetorial.

Situações estressantes de trabalho dos enfermeiros de um hospital escola

Aim: to analyze stressful situations of nurses working in a university hospital. Method: cross-sectional study that used a part of a data bank from a master dissertation regarding the topic. The sample consisted of 73 nurses of a university hospital in the city of Recife, Pernambuco. Information about stressful work situations were collected through the summarized version of the Scale of Karasek (Job Stress Scale). For data analysis we used the chi-square test and Fisher exact test. Results: only the job sector had a statistically significant association with exposure to stressful situations (p-value = 0.05). Conclusions : obtained results suggest that nurses experience stressful work situations. However, it is recommended to conduct further studies to obtain more representative estimates, which explore occupational stress and other factors not addressed in this study. Descriptors: Burnout, professional; Nursing; Occupational health.