1,721,048 research outputs found
Acceptability and feasibility of a psychosocial and collaborative intervention for older adults with depression delivered by non-specialists from a primary care clinic
No full textCom o envelhecimento populacional crescente, a escassez de cuidados em saúde mental com o público idoso se tornou um grande problema. A depressão afeta muitos idosos no Brasil, que frequentemente não são identificados ou tratados no sistema de saúde. Para atender esta demanda, muitos países utilizam o cuidado colaborativo, a alternância de tarefas e o tratamento em etapas na atenção primária, de forma a melhorar a atenção à saúde, reduzir custos e suprir a falta de profissionais especializados. Essas estratégias já mostraram ser custo-efetivas, mas pouco se sabe sobre sua aplicação com idosos na atenção primária no Brasil. Portanto, foi realizado um estudo piloto, do qual o presente estudo é parte, para avaliar a exequibilidade de um programa de intervenção psicossocial complexo para idosos com depressão cadastrados na Estratégia Saúde da Família no município de São Paulo. Os objetivos deste estudo são: (1) Verificar a fidelidade dos agentes de saúde na aplicação do protocolo da intervenção psicossocial; (2) Investigar a compreensão do conteúdo e a aceitação dos princípios norteadores da intervenção psicossocial pelos participantes idosos; e (3) Avaliar a aceitação dos princípios norteadores da intervenção psicossocial (alternância de tarefas, cuidado colaborativo, tratamento em etapas e suporte de tecnologia) pelos agentes de saúde. Foram utilizados métodos qualitativos de pesquisa para avaliar a aceitação e a viabilidade dos princípios da intervenção psicossocial com 11 agentes de saúde e 31 idosos que realizaram e receberam a intervenção, respectivamente. Os dados foram coletados através de observação não-participante, entrevista estruturada e grupo focal. Os resultados mostram que a intervenção foi bem aceita pelos agentes de saúde e idosos, e é viável na atenção primária. Os agentes de saúde se sentiram capacitados para realizar a intervenção e os idosos aceitaram e gostaram de ser atendidos por profissionais não especializados. O uso de tecnologia permitiu melhor comunicação entre a equipe, garantiu fidelidade ao protocolo e tornou a intervenção padronizada e atraente para os participantes. Os resultados do estudo também sugeriram algumas modificações na intervenção para facilitar sua implementação na atenção primáriaPopulation aging and the scarcity of mental health care for the elderly has become a major issue nowadays. Depression affects many older adults in Brazil and many cases are not identified nor treated. To meet this issue, many countries use collaborative care, taskshifting and stepped-care in primary care, in order to improve health care, reduce costs and cover the lack of specialized professionals. These strategies have proven to be costeffective, but little is known about their implementation in primary care in Brazil. A pilot study was carried out, in which the present study is part of, to assess the feasibility of a complex psychosocial intervention program for the elderly with depression registered in the Family Health Strategy in the city of São Paulo. The aims of this study are: (1) Assess the fidelity of health workers when applying the protocol of the intervention, (2) Assess older adults\' views of the psychosocial intervention, and (3) Assess the perceptions of health workers about the guiding principles of the psychosocial intervention (collaborative care, stepped-care, task-shifting and technology support). Qualitative research methods were used to assess the acceptance and feasibility of the guiding principles of the psychosocial with 11 health workers and 31 older adults who performed and received the intervention, respectively. Data were collected through non-participant observation, structured interview, and focus group. The results show that the intervention was well accepted by health workers and older adult, and it is feasible in primary care. Health workers felt empowered to carry out the intervention and the older adults accepted and liked to receive the intervention by non-specialized professionals. The use of technology allowed better communication between the team, guaranteed fidelity to the protocol and made the intervention standardized and attractive to participants. The study results also suggested some changes in the intervention to facilitate its implementation in primary care
Disability in older adults registered in Family Health Strategy at the cities of São Paulo and Manaus: prevalence and associated factors
No full textIntrodução: O envelhecimento da população é uma preocupação mundial, principalmente quando acompanhado de incapacidade funcional (IF). Compreender a prevalência de IF e seus fatores associados é, portanto, apropriado para planejar estratégias de cuidados em saúde. Objetivos: Este estudo investigou a prevalência e os fatores associados à IF entre idosos atendidos pela Estratégia Saúde da Família (ESF) nas cidades brasileiras de São Paulo e Manaus. Métodos: Foram utilizadas bases de dados coletadas entre 2010 - 2011 de uma investigação sobre a prevalência de depressão e fatores associados em idosos com 60 anos ou mais cadastrados na Atenção Primária de São Paulo e Manaus, Brasil. 1.375 participantes foram selecionados aleatoriamente, sendo 702 em São Paulo e 673 em Manaus. O desfecho principal foi a IF, avaliada através do instrumento WHODAS 2.0. versão 12 itens. Investigou-se a associação entre IF global e grave com características sociodemográficas, de saúde, suporte social e estilo de vida dos idosos, e identificou-se quais áreas de vida são afetadas pela IF. Resultados: A prevalência de IF global foi maior em Manaus em relação a São Paulo (66,2% vs. 56,4%). O nível de desenvolvimento socioeconômico foi menor em Manaus. Em ambas as cidades, os domínios da participação social e mobilidade do WHODAS 2.0 apresentaram maior comprometimento. Ter duas ou mais morbidades e autopercepção pior de saúde foram associadas à IF em ambas as cidades. O número de consultas médicas na Unidade Básica de Saúde não foi associado à IF. Conclusão: Maior prevalência de morbidades e menor desenvolvimento socioeconômico em Manaus podem explicar a maior prevalência de IF nessa cidade. Este dado pode ser um sinal de alerta para outros países de baixa e média renda, onde a população idosa tenha menos acesso à Atenção Primária quando comparado ao BrasilBackground: Population aging is a concern worldwide, especially when accompanied by disability. Understanding the prevalence of disability and associated factors is therefore appropriate to plan health care strategies. Objectives: This study estimates the prevalence of disability and associated factors in older adults living in areas covered by Family Health Strategy in the Brazilian cities of São Paulo and Manaus. Methods: Databases were collected between 2010 and 2011 from a larger investigation on the prevalence of depression and associated factors in older adults aged 60 years or over, registered in Primary Care Clinics in São Paulo and Manaus, Brazil. 1,375 participants were randomly selected, 702 in São Paulo and 673 in Manaus. Disability was the main outcome, evaluated using the 12-items WHODAS 2.0 instrument. We investigated the association between global and severe disability with socio-demographic characteristics, health, social support and lifestyle of older adults. We also identified which areas of life are affected by disability. Results: The prevalence of global disability was higher in Manaus than in São Paulo (66.2% vs. 56.4%). The level of socioeconomic development was lower in Manaus. In both cities, social participation and mobility domains of WHODAS 2.0 were the most affected. Having two or more morbidities and worse self-perception of health were associated with disability in both cities. The number of medical consultations in Primary Care Clinics was not associated with disability. Conclusion: Greater prevalence of morbidities and lower socioeconomic development in Manaus may explain the higher prevalence of disability in this city. This data may be a warning for other low- and middle-income countries, where the elderly population has less access to primary health care when compared to Brazi
Association between mindfulness with burnout and with quality of life in professionals from psychiatric inpatient units
No full textProfissionais de saúde mental geralmente relatam altos níveis de estresse e burnout relacionado ao ambiente de trabalho. Mindfulness, definida como consciência do momento presente, com atitude de aceitação e sem julgamento das experiências, parece regular o impacto do estresse crônico que leva ao burnout e ter um efeito positivo sobre a qualidade de vida. O presente trabalho teve como objetivo verificar a associação entre mindfulness com burnout e com qualidade de vida em profissionais de Unidades de Internação (UI) psiquiátrica. Foram utilizados um questionário para a caracterização sociodemográfica e profissional/funcional, a Escala Filadélfia de Mindfulness (EFM), o Maslach Burnout Inventory versão Human Services Survey (MBI-HSS) e o World Health Organization Quality of Life (WHOQOL-brief). A amostra foi composta por 106 profissionais de saúde, que compõem as equipes das Unidades de Internação de um hospital psiquiátrico. Foi realizada regressão múltipla, considerando fatores sócio demográficos de confusão para identificar associações entre mindfulness (total) nos desfechos de burnout (exaustão emocional, despersonalização e realização pessoal) e qualidade de vida (geral, física e psicológica). Resultados: Os participantes tinham em média 39 anos (IC-95%: 36,9-41,5), 75,5% eram do sexo feminino, 54,7% tinham pós-graduação, Enfermagem foi a categoria profissional com mais participantes (38,7%), 64,2% dos profissionais atuavam somente em uma UI e 35,8% dos participantes trabalhavam de 13 a 39 horas por semana na (s) UI. Profissionais com maior nível de mindfulness apresentaram menor exaustão emocional (Beta= -0,37; p=0,01), menor despersonalização (Beta= -0,14; p=0,02) e melhor qualidade de vida no domínio psicológico (Beta= 0,405; p=0,01). Não houve evidência de associação significativa entre mindfulness (total) com a dimensão realização pessoal de burnout, ou com a qualidade de vida geral e o domínio físico da qualidade de vida. Conclusão: Este trabalho encontrou associação entre maior nível de mindfulness com menor exaustão emocional, menor despersonalização e melhor qualidade de vida psicológica, contribuindo para melhor fundamentar intervenções que promovam o desenvolvimento da característica mindfulness em profissionais da saúde que atuam em ambientes de internação psiquiátricaMental health professionals generally report high stress and burnout levels related to their work environment. Mindfuness, defined as awareness of the present moment, with acceptance attitude and without judgment of the experiences, seems to regulate the impact of the chronic stress that leads to burnout and to have a positive effect in quality of life. The present work aims to verify the association between mindfulness with burnout and with quality of life in professionals working at psychiatric Inpatients Units (IU). For the sociodemographic and professional/functional characterization, a questionnaire was used along with the Philadelphia Mindfulness Scale (PMS), the Maslach Burnout Inventory Human Services Survey version (MBI-HSS), and the World Health Organization Quality of Life (WHOQOL-BREF). The sample consisted of 106 healthcare professionals who are part of the teams in the Inpatient Units of a psychiatric hospital. Multiple regression was performed, considering sociodemographic confounding factors, in order to identify associations between total mindfulness (total) and the outcomes of burnout (emotional exhaustion, depersonalization, and personal accomplishment) and quality of life (overall, physical, and psychological). Results: The participants had an average age of 39 years (95% CI: 36.9-41.5); 75.5% were female, 54.7% had postgraduate degrees, and nurses were the professional category with the most participants (38.7%), 64.2% of the professionals worked in one single IU and 35.8% of the participants worked between 13 and 39 hours per week in the IUs. Professionals with higher levels of mindfulness exhibited lower emotional exhaustion (Beta = -0.37; p = 0.01), lower depersonalization (Beta = -0.14; p = 0.02), and better quality of life in the psychological domain (Beta = 0.405; p = 0.01). There was no evidence of a significant association between mindfulness and the personal accomplishment dimension of burnout, or with overall quality of life and the physical domain of quality of life. Conclusion: This work has found association between higher level of mindfulness and lower emotional exhaustion, lower depersonalization and psychological quality of life, contributing with a better foundation for interventions that promote the development of the mindfulness characteristic in healthcare professionals working in psychiatric inpatients setting
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Service design in public mental health: the experience of Viva Vida programme participants
No full textOs transtornos depressivos afetam cerca de 21,5 milhões de brasileiros, especialmente entre 60 e 64 anos, tendo alto impacto social e econômico. Tecnologias digitais para promoção de saúde mental estão se popularizando, mas muitas vezes são inacessíveis para pessoas idosas de baixa renda devido a custos, dificuldade de uso e falta de engajamento. O design de serviços pode ajudar a criar intervenções que atendam melhor às necessidades desses usuários vulneráveis. Este projeto teve por objetivo realizar uma investigação qualitativa do programa Viva Vida intervenção psicossocial via WhatsApp para idosos de baixa renda em São Paulo com objetivo de explorar os componentes do serviço, jornada dos usuários e atores sociais envolvidos. Foram coletados dados por meio de revisão exploratória da literatura e entrevistas com 55 participantes após a participação no programa Viva Vida. A análise dos dados verbais revelou novas perspectivas acerca dos componentes do serviço, tais como: as ligações telefônicas serviram como componente de acolhimento, houve identificação e engajamento com as histórias narradas nos áudios, enquanto imagens estáticas tinham baixa retenção e enquetes pelo WhatsApp causavam medo em usuários com baixa literacia digital. Durante a jornada do serviço do programa, os usuários enfrentaram dificuldades devido à baixa literacia digital, problemas técnicos, dificuldades relacionadas à acessibilidade auditiva e/ou visual, analfabetismo, estigmas, além de barreiras contextuais como a pandemia de COVID-19, doenças crônicas e dificuldades financeiras. No entanto, relataram que o programa os ajudou a sentirem- -se melhor, a se motivarem, a aprenderem sobre depressão, a prevenir suicídio e a desabafar. Os principais atores do programa apontados incluíram rede de apoio (familiares, locais de lazer), sistema de saúde (profissionais e equipamentos do sistema de saúde) e o grupo responsável pela criação e operação do programa. O estudo revelou, entre outros aspectos relevantes, as nuances do ensaio clínico, fornecendo dados qualitativos acerca das barreiras para a inclusão de idosos em serviços públicos digitais. O estudo indica a necessidade do uso de métodos cocriativos no desenvolvimento de intervenções semelhantes, envolvendo diversos atores para melhor mapear necessidades e integrar intervenções no sistema de saúde e contextos sociais.Depressive disorders affect approximately 21.5 million Brazilians, particularly among those aged 60 to 64, with a high social and economic impact. Digital technologies for promoting mental health are becoming popular, but often inaccessible to low-income older persons due to costs, usability challenges, and lack of engagement. Service design can help create interventions that better meet the needs of these vulnerable users. This study aimed to conduct a qualitative investigation of the Viva Vida program a psychosocial intervention via WhatsApp for low-income older persons in São Paulo to explore the service components, user journey, and social actors involved. Data were collected through exploratory literature review and interviews with 55 program participants. Analysis of verbal data revealed new perspectives on service components, such as: phone calls served as a welcoming component, there was identification and engagement with the stories narrated in audio messages, while static images had low retention, and WhatsApp polls caused fear in users with low digital literacy. During the program service journey, users faced challenges due to low digital literacy, technical issues, difficulties related to auditory and/or visual accessibility, illiteracy, stigmas, as well as contextual barriers such as the COVID-19 pandemic, chronic illnesses, and financial difficulties. However, they reported that the program helped them feel better, motivated them, taught them about depression, prevented suicide, and provided a platform for expression. The main actors identified in the program included support networks (family members, leisure facilities), the healthcare system (healthcare professionals and facilities), and the group responsible for creating and operating the program. The study revealed, among other relevant aspects, the nuances of the clinical trial, providing qualitative data on barriers to the inclusion of older persons in digital public services. The study indicates the need for the use of co-creative methods in the development of similar interventions, involving various actors to better map needs and integrate interventions into the healthcare system and social contexts
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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