Sara Pinto Barbosa

Perception of social support: a comparative study between men with and without substance-related disorders

Abstract The influence of drug abuse on social support has been explored in different studies; however, the social support networks of individuals with substance-related disorders have not been described in comparison with individuals without these diagnoses. Therefore, this study aimed to assess the differences in the perception of men with and without substance-related disorders, specifically with regards to their social support network and the structural characteristics of their personal networks. Data were collected using psychometric scales and analysed through statistical methods that compared the two study groups. One-hundred patients participated in this study; participants were recruited at two public health service centres in an inner city of Brazil. The results showed that individuals with substance-related disorders displayed less satisfaction with their social support network and a lower density in their personal networks compared with the group without substance-related disorders. From these results, it appears that professionals involved in caring for these patients should implement interventions that improve the support networks of this patient population to facilitate both prevention and recovery.

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.

The Role of Social Support for Patients with Mental Disorders in Primary Care in Brazil

ABSTRACT The aim of this article was to identify the health care providers and other agencies in a given region where psychiatric patients included in the study reside. In addition, we evaluated how these patients perceive social support for specific needs related to mental health. This study was carried out using fieldwork and face-to-face semistructured interviews with 25 patients who were receiving psychiatric treatment through primary health care. We performed structural analysis of the data focusing on relationship structure. We identified that a significant number of health care providers were involved with the patients; however, some of them were ignored by patients interviewed. Participants cited mostly general practitioners, psychiatrists, and nurses, as professional references.

Patterns of Alcohol Use among Patients Who Visited Community Emergency Care Services in Southwestern Brazil

Alcohol is among the most frequently consumed drugs worldwide. However, identification and intervention measures for alcohol abuse have not yet been established. This article reports the results of applying the Alcohol Use Disorders Identification Test (AUDIT) in 463 patients from five centers for emergency care community in a large city in the interior of Sao Paulo. The relationship between the AUDIT risk-levels of alcohol use and the socio-demographic variables of individuals seeking treatment between August and November 2010 was also examined. The instrument was administered by seven nurses and six students nurses. Individuals with AUDIT scores ≥07 received brief counseling (BC). The main reasons for seeking emergency care were “headache”, “pain”, and “ill-being”. Among the individuals in the study, 95.9% lived in the municipality where the data was collected, 40.7% had an incomplete elementary school education, and the percentage of alcohol dependence was lower among employed individuals (11.9%). The sample was composed of 61.1%

O uso de álcool entre idosos atendidos na Atenção Primária à Saúde

Escola de Enfermagem, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. Confl icts of interest: there are no confl icts of interest between authors. Abstract Objective: To verify the pattern of alcohol use among the elderly attending a primary health care service and to describe the relationship between the use of alcohol and sociodemographic variables. Methods: Observational, cross-sectional, quantitative study with elderly patients from a primary health care service in a city in the interior of São Paulo/Brazil. Of 750 elderly subjects in total, 112 were included, 85 were interviewed, and the fi nal sample was comprised of 25 subjects who self-reported alcohol use. Data of the study were obtained through interviews for application of the following instruments: sociodemographic questionnaire, Michigan Alcoholism Screening Test-Geriatric Version (MAST-G); and Alcohol Use Disorders Identifi cation Test (AUDIT). Results: There was predominance of the female gender (56%), retirees (56%), mean age was 69.8 years (60-83 years range), educational level of 7.4 years of study, on average, ranging from no education to complete higher education. Fifteen elderly (60%) scored between 8 and 14 points in the AUDIT, which is risk use; and 10 (40%) had a score of 7 points, considered low risk use. In MAST-G, the 25 patients (100%) suggest the presence of problems related to alcohol use. Conclusion: The study contributes to the situation of alcohol use by the elderly. This is based on the existence of a greater number of women at risk in the population studied. These issues should be considered in health professionals’ approach and investigations with a view to adopting strategies for the global and humanized treatment of elderly alcohol users.

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.

ASSERT trial – How to assess the safety and efficacy of a high frequency rTMS in postpartum depression ? A multicenter, double blinded, randomized, placebo-controlled clinical trial

Background Postpartum Depression affects a considerable number of women worldwide. This condition inflicts severe consequences to mother and child health. Thus far, available treatments have low response and high relapse rates. We designed this trial to evaluate a safe and more efficacious innovative therapy. Aims To report a feasible and ethical study design to assess the safety and efficacy of a high frequency repetitive Transcranial Magnetic Stimulation 10 Hz (rTMS) compared to sham rTMS in women with moderate to severe Post-Partum Depression using standard treatment (sertraline). To conduct an ancillary, exploratory, randomized, active controlled, double blind study with a hypothesis to assess the safety and efficacy of 10 Hz rTMS compared to sertraline. Methods A multicenter, parallel arm, randomized, placebo-controlled, double-blind design to assess safety and efficacy of 10 Hz rTMS compared to sham. An ancillary study will be conducted with parallel arm, randomized, active controlled and double dummy design to assess safety and efficacy of 10 Hz rTMS compared to sertraline.

Síndrome de dependencia alcohólica en servicios de urgencia: protocolo de evaluación para la práctica profesional de enfermería

This is a quantitative study carried out in emergency services of Ribeirao Preto, a city located in the countryside of Sao Paulo state. The aim of this study was to assess signs and symptoms of the Alcohol Withdrawal Syndrome (AWS) by the nursing team with the use of a protocol. Data collection took place over 642 on duty hours. Of the 463 participants, 297 had AUDIT ≥7, and of these, 59 (12.7%) had AUDIT ≥20, which indicates the occurrence of SAA and, due to this, were included in this investigation. Concerning the signs, of the 59 users, 8 were unable to tell the time of hospitalization, 7 could not say what year or month it was, and 13 seemed uneasy. In relation to the physical signs of the dependence, 17 had signs of tremor, 8 mentioned to have had seizures. The emergency services may be privileged places to identify symptoms of alcohol abuse and dependence and the use of the nursing assessment protocol may be a useful strategy in the monitoring and intervention.

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.