Lilian Palazzo

Síndrome de burnout e fatores associados: um estudo epidemiológico com professores

This article presents the results of an epidemiological study on burnout syndrome among private school teachers in Greater Metropolitan Porto Alegre, Rio Grande do Sul, Brazil, testing possible associations with demographic, work-related, and stress-related variables. The target population consisted of 217 teachers, of whom 190 participated (87.5%). The Maslach Burnout Inventory (MBI) was used to measure burnout, together with a questionnaire to record the other variables. The results showed that teachers have a low score in the three dimensions comprising burnout: emotional exhaustion, depersonalization, and decreased personal fulfillment at work. Demographic variables did not show any association with burnout, while occupational variables, workload, and number of students were associated with emotional exhaustion. Bad conduct by students, family expectations, and limited participation in institutional decisions were the stress factors associated with burnout.

A Case-Control Study of Factors Associated With Multiple Psychiatric Readmissions

OBJECTIVE This case-control study explored factors associated with multiple psychiatric admissions, focusing on service-related and individual-level factors. METHODS The case group consisted of 307 adults admitted to either of two public psychiatric hospitals in southern Brazil during a 12-month period; they had had three or more psychiatric admissions in the two years before the current admission. To account for the recurrent nature of psychiatric admissions, a concurrent case-control design was adopted, which allowed patients in the case group to return at discharge to the population at risk of readmission. The control group consisted of individuals who had their first inpatient readmission in 2006 (N=354). A hierarchical model with four levels was used for data analysis. RESULTS Individuals who had been referred to community psychosocial support units after their most recent discharge had about 20% lower odds of multiple readmissions than those referred to usual outpatient care. Those who lived closer to the hospital (residents of the same city) were more likely to have multiple readmissions. The adjusted multivariate hierarchical analysis revealed that a diagnosis of schizophrenia or psychotic symptoms was associated with multiple readmissions, as were younger age at first admission and a greater number of previous admissions. CONCLUSIONS The study suggests that community psychosocial support services play a strong role in preventing multiple psychiatric admissions. Further research is needed to identify the specific components of these services that reduce readmission and to analyze their cost-effectiveness.

Child sexual abuse in southern Brazil and associated factors: a population-based study

BackgroundThe prevalence of child sexual abuse (CSA) in the population has been poorly described in developing countries. Population data on child sexual abuse in Brazil is very limited. This paper aims to estimate lifetime prevalence of child sexual abuse and associated factors in a representative sample of the population aged 14 and over in a city of southern Brazil.MethodsA two-stage sampling strategy was used and individuals were invited to respond to a confidential questionnaire in their households. CSA was defined as non-consensual oral-genital, genital-genital, genital-rectal, hand-genital, hand-rectal, or hand-breast contact/intercourse between ages 0 and 18. Associations between socio-demographic variables and CSA, before and after age 12, were estimated through multinomial regression.ResultsComplete data were available for 1936 respondents from 1040 households. Prevalence of CSA among girls (5.6% 95%CI [4.8;7.5]) was higher than among boys (1.6% 95%CI [0.9;2.6]). Boys experienced CSA at younger ages than girls and 60% of all reported CSA happened before age 12. Physical abuse was frequently associated with CSA at younger (OR 5.6 95%CI [2.5;12.3]) and older (OR 9.4 95%CI [4.5;18.7]) ages. CSA after age 12 was associated with an increased number of sexual partners in the last 2 months.ConclusionResults suggest that CSA takes place at young ages and is associated with physical violence, making it more likely to have serious health and developmental consequences. Except for gender, no other socio-demographic characteristic identified high-risk sub-populations.

Prevalência de internação hospitalar e fatores associados: um estudo de base populacional em um centro urbano no Sul do Brasil

This cross-sectional study investigates the use of health services and associated factors in individuals > or = 14 years of age in Canoas, Rio Grande do Sul, Brazil. 1,954 persons were interviewed in 40 census tracts. One-year prevalence of hospital admissions was 9.4%. Adjusted data analysis showed that hospitalization was associated with: age > or = 60 years (RP = 4.14; 95% CI: 2.07-8.25), physician visit in the previous two months (RP = 2.79; 95%CI: 2.03-3.83), and > or = 2 stressful life events (RP = 1.83; 95%CI: 1.19-2.80). Individual income of > or = 2.10 times the prevailing minimum wage was associated with decreased likelihood of hospitalization (RP = 0.60; 95% CI: 0.41-0.87). Prevalence of hospital admissions was consistent with other studies. Higher prevalence of hospitalization in lower-income groups may indicate decreased access to primary health care. Other possible factors are higher morbidity and severity of diseases among lower-income groups. Future research should focus on the relationship between morbidity and stressful life events.

Access by hearing-disabled individuals to health services in a southern Brazilian city

This cross-sectional study aimed to compare access to health services and preventive measures by persons with hearing disability and those with normal hearing in Canoas, Rio Grande do Sul State, Brazil. The sample included 1,842 individuals 15 years or older (52.9% of whom were females). The most frequent income bracket was twice the minimum wage or more, or approximately U

Planejamento suicida entre adolescentes escolares: prevalência e fatores associados

360/month (42.7%). Individuals with hearing disability were more likely to have visited a physician in the previous two months (PR = 1.3, 95%CI: 1.10-1.51) and to have been hospitalized in the previous 12 months (PR = 2.1, 95%CI: 1.42-3.14). Regarding mental health, individuals with hearing disability showed 1.5 times greater probability of health care due to mental disorders and 4.2 times greater probability of psychiatric hospitalization as compared to those with normal hearing. Consistent with other studies, women with hearing disability performed less breast self-examination and had fewer Pap smears. The data indicate the need to invest in specific campaigns for this group of individuals with special needs.

Adolescentes que utilizan servicios de atención primaria: ¿Cómo viven? ¿Por qué buscan ayuda y cómo se expresan?

This cross-sectional study evaluated the prevalence of suicide planning and associated factors in a representative sample of 12- to-18-year-old students in Porto Alegre, Rio Grande do Sul State, Brazil. Two self-administered questionnaires were used to collect data: a questionnaire, standardized by the World Health Organization, about use of alcohol and drugs, violence, feelings of loneliness and sadness, family relationships, suicide planning, behavior in school, and relationships with friends; and the Body Shape Questionnaire. Prevalence of suicide planning was 6.3%. Multivariate analysis using Cox regression showed that the prevalence of suicide planning was higher among girls and among adolescents that reported problems in the relationships with their parents. Drug use by friends and having a small number of close friends increased suicide planning by 90% and 66%, respectively. Prevalence of suicide planning was two to three times greater among adolescents bullied by classmates or who reported feelings of loneliness or sadness. Adverse family relationships, aggressive interactions with classmates, and depressive symptoms increase the prevalence of suicide planning. Therefore, preventive measures should be developed in schools and should include the family.

Síndrome de Burnout: estudo de base populacional com servidores do setor público

The objective of this study was to characterize adolescent clients of community-based primary health care services in order to understand: 1) how they express themselves when they seek medical help; 2) the health care they receive; and 3) key social and family factors. Among 35 urban primary care services belonging to the municipal public health department in Pelotas, Rio Grande do Sul State, Brazil, 10 were randomly selected, and all individuals between 13 and 19 years of age who had previously had an appointment with a non-psychiatric physician were interviewed during a three-month period (n = 463). Use of the services has more of a more curative than preventive focus. Males seek medical help less frequently and mainly due to physical complaints. Females tend to express themselves on the basis of sexual problems. Few adolescents expressed their emotional problems, although some mentioned family and school problems as well as stressful situations.

Violência física e fatores associados: estudo de base populacional no sul do Brasil

OBJETIVO: Identificar predictores del Sindrome de Burnout en trabajadores del sector publico. METODOS: Estudio transversal con muestra representativa de 879 servidores publicos municipales de una ciudad de la region metropolitana de Porto Alegre, RS, Brasil. Se utilizo un cuestionario elaborado para la colecta de variables demograficas y relacionadas a las caracteristicas del trabajo. La percepcion sobre el ambiente laboral fue analizada a partir de la Work Atmosphere Scale; para evaluar el sindrome de Burnout, se utilizo el Maslach Burnout Inventory. Se realizaron tres analisis de regresion linear multiple por el metodo stepwise en el que cada dimension del sindrome fue considerada como resultado, mientras que las demas variables fueron estimadas como predictores y controladas por sexo y edad. RESULTADOS: Las variables relacionadas a la percepcion del ambiente de trabajo fueron las que mas contribuyeron en la ocurrencia de burnout. La percepcion del trabajo como estresante y la presencia de personas que causan confusion en el ambiente laboral participaron del modelo explicativo de las tres dimensiones. Nueve variables conformaron el modelo predictor, explicando 43% de la ocurrencia del agotamiento emocional. “Percibir el trabajo como estresante” presento mayor poder explicativo. En la despersonalizacion, ocho variables constitutyeron el modelo en 25%; “percibir el trabajo como estresante” fue una vez mas, la variable de mayor poder explicativo. La baja realizacion profesional mostro un conjunto de variables con poder explicativo de 20%; ambiente de trabajo considerado bueno, presento mayor peso, asociandose inversamente. CONCLUSION: La percepcion de los servidores publicos sobre su ambiente de trabajo tiene importante papel como predictor del sindrome de Burnout. Evaluar el trabajo como estresante y presencia de personas que originan confusion en el ambiente se mostraron como elementos de mayor relevancia.

Burnout Syndrome: population-based study on public servants

OBJETIVO: Estimar a prevalencia de violencia fisica e sua associacao com aspectos sociodemograficos, eventos estressantes e utilizacao de servicos de saude por problemas emocionais. METODOS: Estudo transversal de base populacional realizado em amostra de 1.954 sujeitos com 14 anos ou mais, residentes em Canoas, RS, 2002-2003. A amostragem por conglomerados seguiu sistematica pre-estabelecida. Os dados foram coletados em visitas domiciliares com questionario semi-estruturado e confidencial. Foram realizadas as analises: bivariada, por meio de regressao logistica multinomial e multivariada, por regressao politomica, categorizando o desfecho por faixa etaria. RESULTADOS: Foi encontrada prevalencia de 9,7% (IC 95%: 8,37;11,03) e associacao com: sexo feminino a partir dos 20 anos de idade (OR=2,74; IC 95%: 1,52;4,94), maior escolaridade (p 0,001). CONCLUSOES: A prevalencia da violencia fisica na populacao foi significativa, com consequencias emocionais e impacto nos servicos de saude, requerendo capacitacao dos profissionais da area.