Renata Marques de Oliveira

Nicotine dependence in the mental disorders, relationship with clinical indicators, and the meaning for the user

OBJECTIVE: to identify the degree of nicotine dependence among patients with schizophrenia and other mental disorders hospitalized in a general hospital, correlating these indices with clinical indicators and the meaning for the user. METHOD: the study was performed in the psychiatric unit of a general hospital, interviewing 270 patients with mental disorders using a questionnaire and the application of the Fagerstrom test. A descriptive statistical analysis of the data and thematic analysis of the content were performed. RESULTS: among the 270 patients with mental disorders, 35.6% were smokers; of whom, 53.2% presented high or very high nicotine dependence. Of the 96 smokers, 32 (33.3%) were schizophrenic, among whom, 59.4% presented high or very high dependence. Higher levels of dependence were also found among the 59 elderly people (61.5%) and 60 subjects with somatic comorbidities (62.5%). Meanings of smoking for the subjects: helps to forget problems and face daily conflicts; alleviates side effects of the medications; self-control; distraction; part of life. CONCLUSION: more intense tobacco dependence among schizophrenic patients is justified due to it helping them to cope with the difficulties of the disease. Nurses occupy a strategic position in the care.OBJECTIVE: to identify the degree of nicotine dependence among patients with schizophrenia and other mental disorders hospitalized in a general hospital, correlating these indices with clinical indicators and the meaning for the user. METHOD: the study was performed in the psychiatric unit of a general hospital, interviewing 270 patients with mental disorders using a questionnaire and the application of the Fagerstrom test. A descriptive statistical analysis of the data and thematic analysis of the content were performed. RESULTS: among the 270 patients with mental disorders, 35.6% were smokers; of whom, 53.2% presented high or very high nicotine dependence. Of the 96 smokers, 32 (33.3%) were schizophrenic, among whom, 59.4% presented high or very high dependence. Higher levels of dependence were also found among the 59 elderly people (61.5%) and 60 subjects with somatic comorbidities (62.5%). Meanings of smoking for the subjects: helps to forget problems and face daily conflicts; alleviates side effects of the medications; self-control; distraction; part of life. CONCLUSION: more intense tobacco dependence among schizophrenic patients is justified due to it helping them to cope with the difficulties of the disease. Nurses occupy a strategic position in the care.

Um casal de idosos e sua longa convivência com quatro filhos esquizofrênicos

The objective was to identify, among parents of schizophrenics, elements of their daily life in coping with the disorder and the care offered and received through the health system. This is a field research, using thematic oral history. The parents of four patients with schizophrenia took part in this study. Interviews were conducted, recorded and transcribed, based on three instruments (two specific questionnaires and a field diary). Three categories were identified that reflect difficulties experienced in daily life: limitations in knowledge about schizophrenia; fatigue and burden with impairment of quality of life; and uncertainly about the future and resilience strengthened by faith in God. The concept of care was associated with technical procedures, revealing general satisfaction with the care received. The suffering related to living with schizophrenic relatives is intense, and professionals must be prepared to deal with these experiences of pain and suffering from patients with mental disorder and their relatives.The objective was to identify, among parents of schizophrenics, elements of their daily life in coping with the disorder and the care offered and received through the health system. This is a field research, using thematic oral history. The parents of four patients with schizophrenia took part in this study. Interviews were conducted, recorded and transcribed, based on three instruments (two specific questionnaires and a field diary). Three categories were identified that reflect difficulties experienced in daily life: limitations in knowledge about schizophrenia; fatigue and burden with impairment of quality of life; and uncertainly about the future and resilience strengthened by faith in God. The concept of care was associated with technical procedures, revealing general satisfaction with the care received. The suffering related to living with schizophrenic relatives is intense, and professionals must be prepared to deal with these experiences of pain and suffering from patients with mental disorder and their relatives.

An elderly couple and their long life raising four schizophrenic children

The objective was to identify, among parents of schizophrenics, elements of their daily life in coping with the disorder and the care offered and received through the health system. This is a field research, using thematic oral history. The parents of four patients with schizophrenia took part in this study. Interviews were conducted, recorded and transcribed, based on three instruments (two specific questionnaires and a field diary). Three categories were identified that reflect difficulties experienced in daily life: limitations in knowledge about schizophrenia; fatigue and burden with impairment of quality of life; and uncertainly about the future and resilience strengthened by faith in God. The concept of care was associated with technical procedures, revealing general satisfaction with the care received. The suffering related to living with schizophrenic relatives is intense, and professionals must be prepared to deal with these experiences of pain and suffering from patients with mental disorder and their relatives.The objective was to identify, among parents of schizophrenics, elements of their daily life in coping with the disorder and the care offered and received through the health system. This is a field research, using thematic oral history. The parents of four patients with schizophrenia took part in this study. Interviews were conducted, recorded and transcribed, based on three instruments (two specific questionnaires and a field diary). Three categories were identified that reflect difficulties experienced in daily life: limitations in knowledge about schizophrenia; fatigue and burden with impairment of quality of life; and uncertainly about the future and resilience strengthened by faith in God. The concept of care was associated with technical procedures, revealing general satisfaction with the care received. The suffering related to living with schizophrenic relatives is intense, and professionals must be prepared to deal with these experiences of pain and suffering from patients with mental disorder and their relatives.

Desenvolvimento do aplicativo TabacoQuest para informatização de coleta de dados sobre tabagismo na enfermagem psiquiátrica

Objetivo: desenvolver aplicativo mobile para pesquisa sobre o uso de tabaco entre pacientes psiquiatricos e a populacao geral. Metodos: pesquisa aplicada com o desenvolvimento tecnologico de um aplicativo para coleta de dados em tablet Android. Para seu desenvolvimento, consideraram-se tres criterios: seguranca dos dados, beneficios para os participantes e otimizacao do tempo dos pesquisadores. Testes com 20 participantes ficticios e teste final com seis pilotos. Resultados: o aplicativo coleta os dados, armazena-os no banco de dados do tablet e os exporta para planilha Excel. Recursos: calculadora; cronometro; funcionamento off-line, logica de ramificacao, validacao de campos e tabulacao automatica. Conclusao: o aplicativo previne erros humanos e aumenta a qualidade dos dados ao valida-los durante a entrevista, permite realizar tabulacao automatica e torna as entrevistas menos cansativas. Seu sucesso podera incentivar o uso desse e outros recursos computacionais pelos enfermeiros, como ferramenta de pesquisa.ABSTRACT Objective: to develop a mobile app for research on the use of tobacco among psychiatric patients and the general population. Method: applied research with the technological development of an app for data collection on an Android tablet. For its development, we considered three criteria: data security, benefits for participants and optimization of the time of researchers. We performed tests with twenty fictitious participants and a final test with six pilots. Results: the app collects data, stores them in the database of the tablet and export then to an Excel spreadsheet. Resources: calculator, stopwatch, offline operation, branching logic, field validation and automatic tabulation. Conclusion: the app prevents human error, increases the quality of the data by validating them during the interview, allows the performing of automatic tabulation and makes the interviews less tiring. Its success may encourage the use of this and other computational resources by nurses as a research tool.

The opinion of patients with mental disorder about tobacco and its prohibition in psychiatric hospitalization

OBJECTIVE To identify the opinion of patients with mental disorder about tobacco and its prohibition during psychiatric hospitalization. METHOD An exploratory study with 96 patients smokers with mental disorders hospitalized in a psychiatric ward of a general hospital. The interviews were conducted individually, using an instrument designed for this study. The content from the interviews was recorded, transcribed and submitted to a thematic content analysis. RESULTS The patients with mental disorder were identified as perceiving smoking during the psychiatric hospitalization as a help to support the difficulties in socialization and in the lack of activities. The permission for smoking is seen as a signal of respect to their needs. The subjects mentioned to not accept the total smoking prohibition. CONCLUSION Tobacco helps to face difficulties and conflicts in the psychiatric hospitalization. There is resistance regarding the possibility to totally withdraw the smoking permission during hospitalization.Objetivo: Identificar a opiniao dos portadores de transtorno mental sobre o fumo e sua proibicao durante a internacao psiquiatrica. Metodo: Estudo exploratorio com 96 portadores de transtorno mental, tabagistas, internados em enfermaria psiquiatrica de hospital geral. As entrevistas foram realizadas individualmente, utilizando-se o instrumento elaborado para este estudo. O conteudo verbalizado nas entrevistas foi gravado, transcrito e submetido a analise de conteudo tematico. Resultados: Identificou-se que os portadores de transtorno mental veem o tabagismo na internacao psiquiatrica como ajuda para suportar a dificuldade de convivio e a falta de atividades. A permissao do tabagismo e vista como sinal de respeito as suas necessidades. Os sujeitos relatam nao aceitar a proibicao total do tabagismo. Conclusao: O tabagismo ajuda a enfrentar dificuldades e conflitos na internacao psiquiatrica. Existe resistencia quanto a possibilidade de retirar totalmente a permissao para fumar na internacao.

Perfil sociodemográfico de tabagistas internados em enfermaria psiquiátrica de hospital geral

From the interest of health professionals in tobacco control, stood out its high frequency in psychiatric population. This paper aimed to identify the socio-demographic profile of psychiatric patients who are also smokers, comparing with former smokers and non smokers. Exploratory survey, conducted from August 2010 to February 2012, involving psychiatric patients hospitalized in a general hospital, through interviews using a structured questionnaire. Out of the 433 persons hospitalized, 270 took part of this study; 83.7% are carriers of severe mental disorders; 35.6% are smokers, 14.1% former smokers and 50.4% non smokers. Higher proportion of smokers was found among male, 30-49 years old, junior high schooling, rural area, separated/divorced, without occupation, income and religion practice. This profile is similar to smokers of other groups of population. There was difference in the profile of psychiatric patients according to smoking. This knowledge may help nurse to plan interventions, according the needs and possibilities of the subjects.

CUIDADOS DE ENFERMAGEM MAIS VALORIZADOS E FREQUENTES DURANTE INTERNAÇÃO PSIQUIÁTRICA

Objetivo: identificar os cuidados de enfermagem mais valorizados e frequentes na assistencia aos pacientes psiquiatricos, internados em hospital geral, segundo percepcao dos portadores de transtornos mentais e enfermagem. Metodos: estudo descritivo de abordagem quantitativa. Participaram 27/84 pacientes, 6/6 enfermeiros e 10/14 tecnicos enfermagem de unidade de internacao psiquiatrica. Realizadas entrevistas a partir de 13 fotos de cuidados de enfermagem. Elas eram embaralhadas e entregues aos participantes para que as ordenassem segundo importância e ocorrencia. Analise descritiva. Resultados: os participantes discordaram sobre os cuidados mais importantes: enfermeiros (50%: “passagem plantao”), tecnicos (40%: “ouvir atentamente”), (37%: “apoio espiritual”). Embora o apoio espiritual tenha sido a intervencao mais valorizada pelos pacientes, foi a menos frequente na opiniao dos tres grupos(76,7%). Conclusao: o cuidado de enfermagem ocorria de modo generalista com enfase em cuidados tecnicos basicos. E preciso considerar a opiniao dos usuarios, pois o cuidado que eles mais valorizavam era o menos implementado.

Tobacco addiction in the psychiatric population and in the general population

ABSTRACT Objective: To estimate the degree of tobacco addiction and identify independently associated factors by comparing the psychiatric population of secondary and tertiary care with the general population of the primary healthcare network. Method: This is a cross-sectional epidemiological study, conducted in a municipality of São Paulo, with 134 smokers of a Mental Health Outpatient Unit (MHOU), a Psychiatric Hospital (PH), and a Primary Healthcare Unit (PHU). Data were collected by means of individual interviews, recorded on a mobile device. Data were statistically processed using Stata/12 Results: Of the 134 participants, 54.5% were women. While 49.1% of the psychiatric population (MHOU/PH) had medium/high nicotine addiction, 58.3% of smokers of the general population had very low/low dependency. The Poisson regression model indicated a higher prevalence of smokers with high dependence among men (PR = 1.41), people aged 49 years or less (15 - 29 years, PR = 4.06, 30 - 39 PR = 2.96 years, 40 - 49 years PR = 1.84), with severe mental disorders (PR = 3.05), with anxiety disorders/other (PR = 3.98), and with high suicide risk (PR = 1.55). Conclusion: Nicotine dependence was greater in the psychiatric population than in the general population. The independent factors associated with severe dependence were sex, age group, diagnosis, and current risk of suicide. These results trigger reflection among nurses on the need to focus more attention on a neglected subject in mental health services.

Desarrollo del aplicativo TabacoQuest para informatizar la recolección de datos sobre tabaquismo en la enfermería psiquiátrica

Objetivo: desenvolver aplicativo mobile para pesquisa sobre o uso de tabaco entre pacientes psiquiatricos e a populacao geral. Metodos: pesquisa aplicada com o desenvolvimento tecnologico de um aplicativo para coleta de dados em tablet Android. Para seu desenvolvimento, consideraram-se tres criterios: seguranca dos dados, beneficios para os participantes e otimizacao do tempo dos pesquisadores. Testes com 20 participantes ficticios e teste final com seis pilotos. Resultados: o aplicativo coleta os dados, armazena-os no banco de dados do tablet e os exporta para planilha Excel. Recursos: calculadora; cronometro; funcionamento off-line, logica de ramificacao, validacao de campos e tabulacao automatica. Conclusao: o aplicativo previne erros humanos e aumenta a qualidade dos dados ao valida-los durante a entrevista, permite realizar tabulacao automatica e torna as entrevistas menos cansativas. Seu sucesso podera incentivar o uso desse e outros recursos computacionais pelos enfermeiros, como ferramenta de pesquisa.ABSTRACT Objective: to develop a mobile app for research on the use of tobacco among psychiatric patients and the general population. Method: applied research with the technological development of an app for data collection on an Android tablet. For its development, we considered three criteria: data security, benefits for participants and optimization of the time of researchers. We performed tests with twenty fictitious participants and a final test with six pilots. Results: the app collects data, stores them in the database of the tablet and export then to an Excel spreadsheet. Resources: calculator, stopwatch, offline operation, branching logic, field validation and automatic tabulation. Conclusion: the app prevents human error, increases the quality of the data by validating them during the interview, allows the performing of automatic tabulation and makes the interviews less tiring. Its success may encourage the use of this and other computational resources by nurses as a research tool.

Development of the TabacoQuest app for computerization of data collection on smoking in psychiatric nursing

Objetivo: desenvolver aplicativo mobile para pesquisa sobre o uso de tabaco entre pacientes psiquiatricos e a populacao geral. Metodos: pesquisa aplicada com o desenvolvimento tecnologico de um aplicativo para coleta de dados em tablet Android. Para seu desenvolvimento, consideraram-se tres criterios: seguranca dos dados, beneficios para os participantes e otimizacao do tempo dos pesquisadores. Testes com 20 participantes ficticios e teste final com seis pilotos. Resultados: o aplicativo coleta os dados, armazena-os no banco de dados do tablet e os exporta para planilha Excel. Recursos: calculadora; cronometro; funcionamento off-line, logica de ramificacao, validacao de campos e tabulacao automatica. Conclusao: o aplicativo previne erros humanos e aumenta a qualidade dos dados ao valida-los durante a entrevista, permite realizar tabulacao automatica e torna as entrevistas menos cansativas. Seu sucesso podera incentivar o uso desse e outros recursos computacionais pelos enfermeiros, como ferramenta de pesquisa.ABSTRACT Objective: to develop a mobile app for research on the use of tobacco among psychiatric patients and the general population. Method: applied research with the technological development of an app for data collection on an Android tablet. For its development, we considered three criteria: data security, benefits for participants and optimization of the time of researchers. We performed tests with twenty fictitious participants and a final test with six pilots. Results: the app collects data, stores them in the database of the tablet and export then to an Excel spreadsheet. Resources: calculator, stopwatch, offline operation, branching logic, field validation and automatic tabulation. Conclusion: the app prevents human error, increases the quality of the data by validating them during the interview, allows the performing of automatic tabulation and makes the interviews less tiring. Its success may encourage the use of this and other computational resources by nurses as a research tool.