Tatiana Longo Borges

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.

The Meaning of Stigma for People with Mental Disorders in Brazil

ABSTRACT Objective: To understand the meaning of stigma for people with mental disorders. Method: A qualitative study with 46 Brazilian adults with mental disorders. Data were collected through semistructured interviews and nonparticipant observation and submitted for a thematic analysis with symbolic interactionism. Results: Stigma was considered as an experience of incomprehension and suffering. The society has difficulty in empathizing, respecting differences and understanding the extent of the suffering of people with mental disorders. Participants recommended anti-stigma strategies that included promoting knowledge and respecting differences. Conclusions: The present study contributes new insights to be addressed in interventions to reduce the suffering and impact of stigma.

Emergency Nursing Experiences in Assisting People With Suicidal Behavior: A Grounded Theory Study

AIM To understand emergency nursing experiences in assisting people with suicidal behavior. METHOD Grounded theory study with symbolic interactionism conducted in 2015 to 2016 in Brazil with 19 nurses. RESULTS Assistance for people with suicidal behavior is critical, challenging, evokes different feelings and requires knowledge, skills and emotional control. Nurses did not feel prepared or supported, and identified recurrent gaps and problems. Nurses occupied a limited role, restricted to attending to physical needs. They predominantly manifested opposition, judgments and incomprehension about patients. CONCLUSION This study presents key elements to be addressed in interventions and investigations regarding nursing support, training and supervision. HIGHLIGHTSAssisting suicidal patients is pressing, unpredictable, challenging, and critical for nurses in nonfavorable conditions.Nurses mainly manifesting opposition, incomprehension, judgments, and conflictive attitudes about the patients’ behavior.Nurses occupied a secondary and diffuse role in the assistance of suicidal patients and restricted it to physical demands.There are recurrent assistance problems and barriers related to patients, healthcare context and professional competence.It is needed training, support and supervision for nurses, addressing emotional competences, empathy and comprehensive care.

Adherence to Psychotropic Medications and Associated Factors in Primary Health Care

The study aims were to analyze patients’ adherence to psychotropic medications and its association with sociodemographic factors, therapeutic regimen, presence of common mental disorders, and illness factors. A descriptive cross-sectional study was carried out in ten Primary Health Care units in Brazil. The tools were the Measurement of Treatment Adherence Test and the Self Reporting Questionnaire. Nonadherence to psychotropic drugs was 88.9%. There was association between adherence and age and among patients positive for Common Mental Disorders (97.8%). In the multivariate analysis this association was not maintained. Findings indicate strategies are needed to improve medication adherence in the Primary Health Care services. However, no strategy will be effective if patients and their families are not involved in the process.

Meaning of Pharmacological Treatment for Families of People With Depression

Medication adherence is related to patient satisfaction with family support. This research aimed to understand the meaning of pharmacotherapy to families of people with major depressive disorder. This qualitative study employed Grounded Theory and Symbolic Interactionism. Seventeen families of people with depression from a Brazilian clinic were included. Data was collected from 2013 to 2014, using open interviews, which were analyzed by open, axial, and selective coding. Medication represented “Tranquility and worry” because it re-established tranquility in family routine, but generated concerns. Thus, families were conflicted and ambivalent about medications, and they interfered with the promotion or impairment of adherence.

Prevalência do uso de psicotrópicos e fatores associados na atenção primária à saúde

Objective Investigating the prevalence in the use of psychotropics and associated factors in primary health care withsocio-demographic and pharmacotherapeutic factors, medical history, and Common Mental Disorders. Methods A cross-section study which includes 430 primary health care patients. The research instruments were Self-reporting Questionnaires and medical records. A chi-squared test was used in the univariate analysis, and a logistic regression was used in the multivariate analysis. Results The prevalence in the use of psychotropics was 25.8%. There was an association among the use of psychiatric drugs and common mental disorders, use of non-psychiatric drugs, number of medications prescribed,number of pills a day, clinical pathologies, age, and schooling. In the multivariate analysis, the predictors for the use of psychiatric drugs were: common mental disorders, clinical pathologies, and schooling. Conclusion The prevalence in the use of psychiatric drugs and the associated factors varied according to the univariate or the multivariate analyses.

Factors Associated With Psychotropic Medication Use in Individuals in Brazilian Primary Health Care Units: A Descriptive, Cross-Sectional Study

The current descriptive, cross-sectional study aimed to investigate the rate of psychotropic medication use and its association with sociodemographic factors, pharmacotherapy, health history, and presence of common mental disorders in individuals in Brazilian primary health care (PHC) units. A sample of 442 individuals was interviewed in 10 PHC units. Tools used included a structured questionnaire and the Self Reporting Questionnaire-20. The rate of psychotropic medication use was 38.7%. Demographic characteristics associated with psychotropic medication use were age 60 or older with common mental disorders and physical illness, a primary-level education or less, no occupation, and family income greater than three times the minimum wage. The strongest predictor of psychotropic medication use was monthly family income. The results highlight the need for interventions to improve patient outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 55(3), 38-45.].