Letícia Yamawaka de Almeida

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.

Current advances in drug discovery for Chagas disease

Chagas disease, also known as American trypanosomiasis, is one of the 17 neglected tropical diseases (NTDs) according to World Health Organization. It is estimated that 8-10 million people are infected worldwide, mainly in Latin America. Chagas disease is caused by the parasite Trypanosoma cruzi and is characterized by two phases: acute and chronic. The current therapy for Chagas disease is limited to drugs such as nifurtimox and benznidazole, which are effective in treating only the acute phase of the disease. In addition, several side effects ranging from hypersensitivity to bone marrow depression and peripheral polyneuropathy have been associated with these drugs. Therefore, the current challenge is to find new effective and safe drugs against this NTD. The aim of this review is to describe the advances in the medicinal chemistry of new anti-chagasic compounds reported in the literature in the last five years. We report promising prototypes for drug discovery identified through target-based and phenotype-based strategies and present some important targets for the development of new synthetic compounds.

Structure of the Social Support Network of Patients with Severe and Persistent Psychiatric Disorders in Follow-Ups to Primary Health Care

The objective of this study is to analyze the characteristics of social support networks of patients with psychiatric disorders at follow-up to primary care. This is a cross-sectional qualitative research study. Forty-five interviews were held with patients and their supporters. The results showed small and dense networks, with a strong emphasis on the bonds with formal supporters and a scant network of informal supporters. It is recommended to develop strategies to improve social support networks and use this as an outcome indicator related to social integration of these patients and to the quality of services involved with outpatient healthcare.

CONSUMO DE DROGAS E CONHECIMENTO SOBRE SUAS CONSEQUÊNCIAS ENTRE ESTUDANTES DE GRADUAÇÃO EM ENFERMAGEM

Objective: to analyze the use of psychoactive substances and the knowledge of the consequences of alcohol, marijuana and cocaine use among first-year and final-year undergraduate nursing students. Method: descriptive cross-sectional study, with 141 nursing undergraduates from a public university in the state of São Paulo. Data was collected using the Questionnaire for Screening the Use of Alcohol, Tobacco and Other Substances and a questionnaire on the knowledge of the consequences of alcohol, marijuana and cocaine use. Fisher’s exact test, Pearson’s chi-square and Student’s t-test were applied for analysis. Results: alcohol and marijuana were the substances most commonly used by students. Concerning students’ knowledge of the consequences of alcohol, marijuana and cocaine use, the majority answered more than 50% of the questionnaire correctly, which is considered a good level of knowledge. Furthermore, 86.5% answered more than half of the questions correctly in relation to alcohol, 68.8% to marijuana and 76.6% to cocaine. Regarding the mean scores on the knowledge of the consequences of substance use between first-year and final-year students, there was a statistically significant difference for alcohol (p=0.026) and cocaine (p<0.001), with final-year students obtaining higher scores. Conclusion: the hypothesis that knowledge of the consequences of drug use affects drug use was confirmed only for marijuana. The results highlight the need to consider reviewing content being taught to undergraduate nursing students on psychoactive substance use. DESCRIPTORS: Drug abuse. Alcohol. Knowledge. Students. Nursing.

Mental health in the Family Health Strategy as perceived by health professionals.

Objective: to analyze the management of mental health needs in primary care as perceived by Family Health Strategy professionals. Method: this was a qualitative descriptive exploratory study developed within the coverage area of five family health teams. The data were collected using observation, group interviews, individual semi-structured interviews, and focus groups. Content analysis was conducted using text analysis software and interpretation was based on the corresponding analytical structures. Results: numerous and challenging mental health demands occur in this setting, for which the teams identified care resources; however, they also indicated difficulties, especially related to the operationalization and integration of such resources. Conclusion: there is a need for a care network sensitive to mental health demands that are better coordinated and more effectively managed. Objetivo: analisar o manejo das necessidades de saúde mental na atenção primária à saúde de acordo com a percepção dos profissionais da Estratégia Saúde da Família. Método: estudo qualitativo, descritivo exploratório, desenvolvido no território de abrangência de cinco equipes de saúde da família. Os participantes foram cinco enfermeiras, cinco coordenadores e 17 agentes comunitários de saúde. Os dados foram coletados utilizando observação, entrevistas grupais, entrevistas individuais semiestruturadas e grupos focais. Fez-se a análise de conteúdo com o auxílio de um Software de análise textual, e a interpretação baseou-se nas estruturas analíticas correspondentes. Resultados: inúmeras e desafiadoras demandas de saúde mental têm sido acolhidas nesse setting, para as quais as equipes identificaram recursos de atendimento; no entanto, apontaram dificuldades, sobretudo relacionadas à operacionalização e integração destes recursos. Conclusão: destaca-se a necessidade de uma rede de cuidados sensível a tais demandas, mais articulada e gerida de modo eficaz.

Mental health care situation in family health units: perceptions of community health agents

Se trata de una investigacion descriptiva cualitativa, con 17 Agentes Comunitarios de Salud tuvo como objetivo analizar la percepcion de estos profesionales con respecto a las situaciones de salud mental frecuente. Las tareas de los agentes comunitarios de salud son la identificacion, prevencion, promocion de la salud de las familias en el territorio. Se les considera actores importantes en la identificacion de las necesidades de salud mental en la atencion primaria. Para la recoleccion de datos se utilizo la observacion y dos grupos focales. Para el analisis de los datos se utilizo la perspectiva estructuralista. El metodo utilizado fue la observacion del territorio y grupos focales. Los resultados mostraron que estos profesionales tienen una vision amplia de las necesidades de salud mental y que los recursos de atencion de salud se insertan en una propuesta intersectorial. Estos profesionales, aunque las dificultades que senalan, estan desarrollando acciones basadas en las tecnologia ligeras, y no necesariamente centrado en la enfermedad. Se concluye que estos aspectos refuerzan el poder de la agentes comunitarios de salud como actores de practicas de salud mental y importante vinculo entre el servicio de salud y la comunidad.This was a qualitative, descriptive study, performed with 17 Community Health Agents. The aim was to analyze the perception of these professionals regarding the most frequent mental health cases in the region. Data was collected through observation of the region and two focus groups. We used the structuralist perspective for the analysis. The results showed that these professionals perceived mental health demands from an expanded concept of health, in which the resources fit together between the various sectors. They deal with difficulties, develop actions based on soft technologies and do not necessarily focus on the disease. It was concluded that these elements reinforce the power of the Community Health Agents as performers of mental health care practices and as an important link between the healthcare service and the community. DESCRIPTORS: Primary health care. Family health. Mental health. Community health workers.

SITUAÇÕES DE SAÚDE MENTAL NAS UNIDADES DE SAÚDE DA FAMÍLIA: PERCEPÇÃO DOS AGENTES COMUNITÁRIOS DE SAÚDE

Se trata de una investigacion descriptiva cualitativa, con 17 Agentes Comunitarios de Salud tuvo como objetivo analizar la percepcion de estos profesionales con respecto a las situaciones de salud mental frecuente. Las tareas de los agentes comunitarios de salud son la identificacion, prevencion, promocion de la salud de las familias en el territorio. Se les considera actores importantes en la identificacion de las necesidades de salud mental en la atencion primaria. Para la recoleccion de datos se utilizo la observacion y dos grupos focales. Para el analisis de los datos se utilizo la perspectiva estructuralista. El metodo utilizado fue la observacion del territorio y grupos focales. Los resultados mostraron que estos profesionales tienen una vision amplia de las necesidades de salud mental y que los recursos de atencion de salud se insertan en una propuesta intersectorial. Estos profesionales, aunque las dificultades que senalan, estan desarrollando acciones basadas en las tecnologia ligeras, y no necesariamente centrado en la enfermedad. Se concluye que estos aspectos refuerzan el poder de la agentes comunitarios de salud como actores de practicas de salud mental y importante vinculo entre el servicio de salud y la comunidad.This was a qualitative, descriptive study, performed with 17 Community Health Agents. The aim was to analyze the perception of these professionals regarding the most frequent mental health cases in the region. Data was collected through observation of the region and two focus groups. We used the structuralist perspective for the analysis. The results showed that these professionals perceived mental health demands from an expanded concept of health, in which the resources fit together between the various sectors. They deal with difficulties, develop actions based on soft technologies and do not necessarily focus on the disease. It was concluded that these elements reinforce the power of the Community Health Agents as performers of mental health care practices and as an important link between the healthcare service and the community. DESCRIPTORS: Primary health care. Family health. Mental health. Community health workers.

Situaciones de salud mental en las unidades de salud familiar: percepción de los agentes comunitarios de salud

Se trata de una investigacion descriptiva cualitativa, con 17 Agentes Comunitarios de Salud tuvo como objetivo analizar la percepcion de estos profesionales con respecto a las situaciones de salud mental frecuente. Las tareas de los agentes comunitarios de salud son la identificacion, prevencion, promocion de la salud de las familias en el territorio. Se les considera actores importantes en la identificacion de las necesidades de salud mental en la atencion primaria. Para la recoleccion de datos se utilizo la observacion y dos grupos focales. Para el analisis de los datos se utilizo la perspectiva estructuralista. El metodo utilizado fue la observacion del territorio y grupos focales. Los resultados mostraron que estos profesionales tienen una vision amplia de las necesidades de salud mental y que los recursos de atencion de salud se insertan en una propuesta intersectorial. Estos profesionales, aunque las dificultades que senalan, estan desarrollando acciones basadas en las tecnologia ligeras, y no necesariamente centrado en la enfermedad. Se concluye que estos aspectos refuerzan el poder de la agentes comunitarios de salud como actores de practicas de salud mental y importante vinculo entre el servicio de salud y la comunidad.This was a qualitative, descriptive study, performed with 17 Community Health Agents. The aim was to analyze the perception of these professionals regarding the most frequent mental health cases in the region. Data was collected through observation of the region and two focus groups. We used the structuralist perspective for the analysis. The results showed that these professionals perceived mental health demands from an expanded concept of health, in which the resources fit together between the various sectors. They deal with difficulties, develop actions based on soft technologies and do not necessarily focus on the disease. It was concluded that these elements reinforce the power of the Community Health Agents as performers of mental health care practices and as an important link between the healthcare service and the community. DESCRIPTORS: Primary health care. Family health. Mental health. Community health workers.