Kelly Graziani Giacchero Vedana

Medication therapy: adherence, knowledge and difficulties of elderly people from bipolar disorder

Este estudo teve como objetivo verificar a adesao, o conhecimento e as dificuldades de idosos com transtorno afetivo bipolar (TAB), em relacao a terapeutica medicamentosa, prescrita para controle do referido transtorno. Participaram do estudo 17 idosos com TAB atendidos em um nucleo de saude mental. Foram realizadas entrevista semiestruturada e aplicacao de escalas. Os dados foram analisados com abordagem quali-quantitativa. Identificou-se baixo grau de adesao ao tratamento farmacologico e deficit no conhecimento sobre os medicamentos, especialmente sobre as doses e frequencia de administracao. Entre as dificuldades inerentes a farmacoterapia relataram-se: a obrigatoriedade da polifarmacoterapia, o desejo de encerrar o tratamento farmacologico, limitacoes na autoadministracao dos farmacos, efeitos colaterais e duvidas sobre a necessidade dos medicamentos. Sao necessarios investimentos em acoes educativas e de promocao da adesao que contemplem as dificuldades vivenciadas pelos idosos com TAB, no seguimento da farmacoterapia, para garantia de seguranca na terapeutica medicamentosa.This study aimed to verify the adherence, knowledge and the difficulties of elderly patients with Bipolar Affective Disorder (BAD) in relation to the prescribed pharmacological therapy for the control of this disorder. The study included 17 elderly patients with BAD treated at a Mental Health Center. Semi-structured interviews were conducted and scales were applied. The data were analyzed using a quali-quantitative approach. A low level of adherence to the pharmacological treatment and a deficit in knowledge in relation to the medication were identified, especially regarding the dose and frequency of administration. Among the difficulties inherent to the pharmacotherapy, the obligation of polypharmacotherapy, the desire to quit the pharmacological treatment, limitations in the self-administration of the medication, collateral effects, and doubts about the need for the medication were related. Investment is needed in educational activities and in the promotion of adherence that address the difficulties experienced by elderly people with BAD in the following of the pharmacotherapy in order to ensure safety in the medication therapy.

Terapêutica medicamentosa: conhecimento e dificuldades de familiares de pessoas idosas com transtorno afetivo bipolar

This study descriptive qualitative and quantitative aimed to verify the level of knowledge and difficulties of relatives of elderly people with Bipolar Affective Disorder regarding the medication treatment prescribed to patients. The participants were 17 relatives of elderly patients with Bipolar Affective Disorder who receive care in a Mental Health Service. Semi-structured interview and a scale were used for data collection. Low level of knowledge from relatives was verified, especially concerning the doses and frequency of the prescribed medications. Among the difficulties related to patients medication treatment reported by the relatives, the following were pointed out: ambiguity regarding the evaluation of the medication benefits, non-adherence of patients to the medication, overload related to care concerning medications, inappropriate treatment, preoccupation with the access to medication and use of alcoholic drinks by patients. It is imperative to offer educational actions to the families, as collaborators and target of the interventions, as well as inserting them in the care provided to patients.

Esquizofrenia: adesão ao tratamento e crenças sobre o transtorno e terapêutica medicamentosa

This study verified the adherence of people with schizophrenia to the medication, identified and compared their beliefs about the disorder and the drug among patients who adhered and those who did not. Participants were 14 patients of a psychiatric outpatient clinic. Semi-structured interviews and the Morisky-Green test were performed. The data was analyzed using a quali-quantitative approach. Results showed that 64.3% of patients do not adhere to treatment. Most participants considered the drug capable of reducing the seriousness and severity of the disorder. However, the drawbacks for patients that did not adhere to the treatment were more expressive. Side effects were the cause for interrupting the treatment for 80% of patients who intentionally did not adhere to treatment. It was observed there is insufficient knowledge about schizophrenia and the drug treatment. Patients referred to faith as a strategy to cope with the process they were experiencing. This study points at the need for strategies directed towards the promotion of drug treatment adherence among people with schizophrenia.This study verified the adherence of people with schizophrenia to the medication, identified and compared their beliefs about the disorder and the drug among patients who adhered and those who did not. Participants were 14 patients of a psychiatric outpatient clinic. Semi-structured interviews and the Morisky-Green test were performed. The data was analyzed using a quali-quantitative approach. Results showed that 64.3% of patients do not adhere to treatment. Most participants considered the drug capable of reducing the seriousness and severity of the disorder. However, the drawbacks for patients that did not adhere to the treatment were more expressive. Side effects were the cause for interrupting the treatment for 80% of patients who intentionally did not adhere to treatment. It was observed there is insufficient knowledge about schizophrenia and the drug treatment. Patients referred to faith as a strategy to cope with the process they were experiencing. This study points at the need for strategies directed towards the promotion of drug treatment adherence among people with schizophrenia.

Schizophrenia: adherence to treatment and beliefs about the disorder and the drug treatment

This study verified the adherence of people with schizophrenia to the medication, identified and compared their beliefs about the disorder and the drug among patients who adhered and those who did not. Participants were 14 patients of a psychiatric outpatient clinic. Semi-structured interviews and the Morisky-Green test were performed. The data was analyzed using a quali-quantitative approach. Results showed that 64.3% of patients do not adhere to treatment. Most participants considered the drug capable of reducing the seriousness and severity of the disorder. However, the drawbacks for patients that did not adhere to the treatment were more expressive. Side effects were the cause for interrupting the treatment for 80% of patients who intentionally did not adhere to treatment. It was observed there is insufficient knowledge about schizophrenia and the drug treatment. Patients referred to faith as a strategy to cope with the process they were experiencing. This study points at the need for strategies directed towards the promotion of drug treatment adherence among people with schizophrenia.This study verified the adherence of people with schizophrenia to the medication, identified and compared their beliefs about the disorder and the drug among patients who adhered and those who did not. Participants were 14 patients of a psychiatric outpatient clinic. Semi-structured interviews and the Morisky-Green test were performed. The data was analyzed using a quali-quantitative approach. Results showed that 64.3% of patients do not adhere to treatment. Most participants considered the drug capable of reducing the seriousness and severity of the disorder. However, the drawbacks for patients that did not adhere to the treatment were more expressive. Side effects were the cause for interrupting the treatment for 80% of patients who intentionally did not adhere to treatment. It was observed there is insufficient knowledge about schizophrenia and the drug treatment. Patients referred to faith as a strategy to cope with the process they were experiencing. This study points at the need for strategies directed towards the promotion of drug treatment adherence among people with schizophrenia.

Attitudes towards suicidal behaviour and associated factors among nursing professionals: A quantitative study

WHAT IS KNOWN ON THE SUBJECT?: Self-confident health professionals with positive and understanding attitudes can take better care of people with suicidal behaviour, but the factors associated with these attitudes are not known. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The majority of nursing professionals had no experience or training in mental health or suicide. They were less self-confident and had more negative attitudes. Nurses and nursing assistants who worked before in mental health services were more understanding with people with suicidal behaviour. Nurses and nursing assistants who were working in prehospital services were less self-confident to taking care of people with suicidal behaviour. Some members of the nursing team had already seriously considered committing suicide. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The practicing, support and training in mental health may improve the nurses attitudes and emotional competencies. It is important to know why few nurses had suicide-related training, despite the relevance of this issue. Training in mental health or suicide need to include attitudinal and emotional competencies. It is important to offer emotional support to emergency nursing professionals.nnnABSTRACTnBackground The attitudes towards suicide of emergency nurses may affect the care provided. However, the factors associated with these attitudes remain unclear. Objective To investigate attitudes towards suicidal behaviour and associated factors among nursing professionals working in emergency settings. Methods A cross-sectional observational study including 28 nurses and 118 who were nursing assistants employed at two emergency services in Brazil was conducted. Data were collected in 2015 using a self-administered sociodemographic questionnaire and the Suicide Behavior Attitude Questionnaire (SBAQ). Results The majority of participants reported having no experience or training in mental health or suicide. They reported more negative feelings towards the patient and a lower self-perception of professional competence regarding suicidal behaviours, and these attitudes seemed to reinforce each other. Nurses who worked in mental health services reported less moralistic/judgemental attitudes. Working in prehospital services was associated with having a lower self-perception of professional competence. There were professionals who reported thinking seriously about committing suicide. Conclusion When combined with support and training, practicing mental health nursing may serve as an opportunity to develop favourable attitudes and emotional competences, and these issues need to be addressed in suicide education strategies.

Atitudes relacionadas ao suicídio entre graduandos de enfermagem e fatores associados

Resumo Objetivo Investigar as atitudes relacionadas ao suicidio entre graduandos de enfermagem e fatores associados. Metodos Estudo transversal quantitativo desenvolvido com 244 graduandos de Enfermagem de uma instituicao de ensino superior do interior de Sao Paulo, Brasil. Os dados foram coletados em 2016 pela autoaplicacao de questionario sociodemografico e do Questionario de Atitudes Frente ao Comportamento Suicida. Para analise dos dados, foram utilizados o teste de correlacao de Spearman e o teste de Mann-Whitney. Resultados Mulheres tiveram atitudes mais negativas [...]

Terapêutica medicamentosa: adesão, conhecimento e dificuldades de idosos com transtorno bipolar

Este estudo teve como objetivo verificar a adesao, o conhecimento e as dificuldades de idosos com transtorno afetivo bipolar (TAB), em relacao a terapeutica medicamentosa, prescrita para controle do referido transtorno. Participaram do estudo 17 idosos com TAB atendidos em um nucleo de saude mental. Foram realizadas entrevista semiestruturada e aplicacao de escalas. Os dados foram analisados com abordagem quali-quantitativa. Identificou-se baixo grau de adesao ao tratamento farmacologico e deficit no conhecimento sobre os medicamentos, especialmente sobre as doses e frequencia de administracao. Entre as dificuldades inerentes a farmacoterapia relataram-se: a obrigatoriedade da polifarmacoterapia, o desejo de encerrar o tratamento farmacologico, limitacoes na autoadministracao dos farmacos, efeitos colaterais e duvidas sobre a necessidade dos medicamentos. Sao necessarios investimentos em acoes educativas e de promocao da adesao que contemplem as dificuldades vivenciadas pelos idosos com TAB, no seguimento da farmacoterapia, para garantia de seguranca na terapeutica medicamentosa.This study aimed to verify the adherence, knowledge and the difficulties of elderly patients with Bipolar Affective Disorder (BAD) in relation to the prescribed pharmacological therapy for the control of this disorder. The study included 17 elderly patients with BAD treated at a Mental Health Center. Semi-structured interviews were conducted and scales were applied. The data were analyzed using a quali-quantitative approach. A low level of adherence to the pharmacological treatment and a deficit in knowledge in relation to the medication were identified, especially regarding the dose and frequency of administration. Among the difficulties inherent to the pharmacotherapy, the obligation of polypharmacotherapy, the desire to quit the pharmacological treatment, limitations in the self-administration of the medication, collateral effects, and doubts about the need for the medication were related. Investment is needed in educational activities and in the promotion of adherence that address the difficulties experienced by elderly people with BAD in the following of the pharmacotherapy in order to ensure safety in the medication therapy.

The meaning of pharmacological treatment for schizophrenic patients

OBJETIVO: compreender o significado da terapeutica medicamentosa para a pessoa com esquizofrenia e formular um modelo teorico sobre o fenomeno estudado. METODO: foi empregada abordagem qualitativa com o Interacionismo Simbolico como referencial teorico e a Teoria Fundamentada como referencial metodologico. A pesquisa foi desenvolvida de 2008 a 2010 em tres servicos comunitarios de saude mental do interior de Sao Paulo, Brasil. Foram selecionados 36 pacientes e 36 familiares por amostragem teorica. Os dados foram coletados principalmente por entrevista aberta e observacao e foram analisados simultaneamente por codificacao aberta, axial e seletiva. RESULTADOS: o significado da farmacoterapia centralizada no fenomeno Convivendo com uma ajuda que atrapalha que expressa a ambivalencia do paciente em relacao ao medicamento e determina sua tomada de decisao. O insight, acesso, limitacoes para a autoadministracao dos farmacos e interacoes com familiares e equipe de saude influenciaram no comportamento do paciente relacionado ao medicamento. CONCLUSAO: a teoria apresentada neste estudo fornece uma compreensao abrangente, contextualizada, motivacional e dinâmica da realidade vivenciada pelo paciente e aponta potencialidades e barreiras para o seguimento do tratamento medicamentoso.OBJECTIVE: to understand the meaning of medication therapy for schizophrenic patients and formulate a theoretical model about the study phenomenon. METHOD: a qualitative approach was employed, using Symbolic Interactionism as the theoretical and Grounded Theory as the methodological framework. The research was developed between 2008 and 2010 at three community mental health services in the interior of the State of São Paulo - Brazil. Thirty-six patients and thirty-six family members were selected through theoretical sampling. The data were mainly collected through open interviews and observation and simultaneously analyzed through open, axial and selective coding. RESULTS: the meaning of the pharmacotherapy is centered on the phenomenon Living with a help that bothers, which expresses the patients ambivalence towards the medication and determines their decision making. The insight, access, limitations for self-administration of the drugs and interactions with family members and the health team influenced the patients medication-related behavior. CONCLUSION: the theory presented in this study provides a comprehensive, contextualized, motivational and dynamic understanding of the relation the patient experiences and indicates potentials and barriers to follow the medication treatment.

Estratégia de Saúde da Família: recursos comunitários na atenção à saúde mental

OBJECTIVE: Assess the perception of the professionals working at the family health strategy on the resources present within the territory toward meeting mental health care demands. METHODS: Cross-sectional, qualitative study carried out with 27 primary health care professionals. Data were collected by means of interviews, focus groups and observation. Following data collection, data were transcribed and analyzed in the light of the structuralist theory. RESULTS: Nurses referred to the existence of formal instruments toward promoting mental health care and highlighted the health services. Care coordinators mentioned health services, universities and partnerships with Child Protective Services and the District Attorneys Office. Community agents showed to be more integrated with the territory and to have a broader knowledge of formal and informal social support sources. The observation of the territory pointed out social resources that were not addressed in the interviews. CONCLUSION: The perception of the nurses regarding the community resources focused on formal health institutions or other entities related to the health care or health education areas. The coordinators identified other health services and social protection instruments. Community agents have a clearer perception of existing mental health resources.

Common Mental Disorders in Primary Health Care Units: Associated Factors and Impact on Quality of Life

BACKGROUND: Considering the high worldwide prevalence of common mental disorders (CMDs), characterizing the association between CMD and quality of life (QoL) constitute a valuable measure to gauge patient’s functional impairment due to CMD symptoms. OBJECTIVE: To investigate factors associated with the incidence of CMD and its impact on the QoL in primary health care (PHC) patients. DESIGN: Cross-sectional study completed in a municipality in Brazil. Standardized tools included the Self-Reporting Questionnaire–20 to detect CMDs and the WHOQOL-brief to assess QoL, in addition to a sociodemographic and treatment-related questionnaire. RESULTS: A total of 41.4% of the patients met cutoff scores for a CMD, and the presence of a CMD was associated with female gender and marital status. Patients with CMDs had lower QoL scores than patients who were negative for a CMD. CONCLUSIONS: CMDs are highly prevalent in PHC settings and affect patients’ QoL. The high frequency of CMD in those that seek care through PHC necessitate incorporating mental health services into the range of available services.