BackgroundRegional networking between services that provide mental health care in Brazil’s decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network.Case presentationAfter a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients’ status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding.ConclusionWe have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation.
Estudo exploratório-descritivo que objetivou descrever variáveis sociodemográficas e de saúde dos cuidadores de idosos com Alzheimer, associando os cuidados realizados à resiliência. Participaram do estudo 101 cuidadores, maiores de 18 anos, que acompanhavam os idosos em unidade básica e em hospital público, no ano 2009. Foram aplicados questionários para perfil, Inventário de Depressão de Beck e Escala de Resiliência. Realizada análise estatística dos dados. A maioria dos cuidadores eram mulheres, sem depressão, recebia ajuda de outras pessoas para cuidar e possuía alto grau de resiliência. Houve associação significativa da resiliência com as variáveis: grau de parentesco, tratamento médico, uso de medicamentos, cansaço, esgotamento, desânimo e saúde mental do cuidador. Saúde física foi associada, significativamente, à experiência no cuidado, sendo que 82 idosos tinham prejuízos cognitivos graves. O idoso no contexto familiar pode ser beneficiado quando o cuidador é mais resiliente.
Objective: to identify the presence of stress and depression among final year students of two nursing courses, and the association between these variables. Method: an exploratory-descriptive study, undertaken with final-year students from the Bachelor's degree and Licenciate's degree courses at the Ribeirão Preto College of Nursing, of the University of São Paulo. The Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) were applied. Results: of the total of 88 participants in the study, 69.8% have no depression, 18.2% presented dysphoria, 6.8% moderate depression, and 5.7% severe depression, which is a low rate compared to the general population. Medium stress levels were the most frequent (76.9%). There was no significant statistical difference in the stress score between the two groups of students (Student's t-test: p=0.295>0.05). The data showed a relation between the stress and the presence of indicative signs of depression, especially severe depression (Pearson: r-0.755 and p<0.01). Discussion:The majority did not show signs of depression. The depressive states found among the students on the two courses accompanied proportionately those who obtained high stress scores, as recorded by other studies on this issue. Conclusion: Students with higher levels of stress are more prone to present depression, deserving educators' attention. El estrés y la depresión entre los estudiantes de ultimo periodo de dos cursos de enfermeríaObjetivo: Identificar la presencia de estrés y depresión entre estudiantes del ultimo año de dos cursos de enfermería y la asociación entre estas variables. Método: Estudio exploratorio, realizado con alumnos del último año de dos cursos de pregrado en la Escuela de Enfermería de Ribeirão Preto, de la Universidad de São Paulo. Se aplicó la Escala de Estrés Percibido-PSS y el Inventario de Depresión de Beck-BDI. Resultados: De los 88 sujetos de la muestra, 69,8% no mostró señales de depresión, 18,2% tenía disforia, 6,8% con depresión moderada y 5,7%, depresión severa, puntuación baja en relación a la población general. Los niveles medios de estrés fueron los más frecuentes (76,9%). No hubo diferencias significativas entre los escores de estrés de los dos grupos de estudiantes (t de Student: p =0,295> 0,05). Los datos muestran relación del estrés con la presencia de señales de depresión, especialmente en la depresión grave (Pearson: r-0, 755 y p <0,01). Discusión: La mayoría no mostró signos de depresión. Los estados depresivos, entre los estudiantes de los dos cursos de enfermería, coinciden con los que obtuvieron puntajes altos de estrés, como se ha encontrado en otros estudios sobre este tema. Conclusión: Los alumnos con mayores niveles de estrés son más propensas a experimentar depresión, mereciendo la atención de los educadores.
Silva MCF, Furegato ARF, Costa ML Júnior. Depressão: pontos de vista e conhecimento de enfermeiros da rede básica de saúde. Rev Latino-am Enfermagem 2003 janeiro-fevereiro; 11(1):7-13. Objetivou-se identificar os pontos de vista e o conhecimento
Segregated individuals with mental disorders, families without support or guidance concerning disease and treatment, and unprepared professionals are some of the factors that can contribute to re-hospitalizations. This study identifies sociodemographic variables, clinical conditions, diagnoses and treatments in order to identify their relationship with psychiatric re-hospitalizations. This is an exploratory and descriptive study. A form was used to search data in patients' files from 2006 and 2007 in a regional psychiatric facility. A total of 681 re-hospitalizations were identified, the majority due to treatment abandonment.Length of hospitalization was higher for women between 40 and 49 years of age. Positive associations of sociodemographic data with previous hospitalizations were found, such as type of discharge, and physical and mental condition, which is in accordance with the literature. Readmissions are associated with sociodemographic and clinical indicators. These findings can guide care and public policies regarding mental health. Caracterización sociodemográfica y clínica de reinternaciones psiquiátricasAlgunos de los factores que pueden contribuir para las reinternaciones psiquiátricas son los trastornos mentales que ocurren en familias sin apoyo u orientación acerca de la enfermedad y tratamientos y, por causa de profesionales mal preparados. El objetivo de este estudio fue identificar las variables sociodemográficos, las condiciones clínicas, los diagnósticos médicos, los tratamientos y su relación con las reinternaciones psiquiátricas.Se trata de un estudio exploratorio y descriptivo, en el cual se utilizó un guía para recolectar datos en los registros médicos de 2006 y 2007, en un hospital psiquiátrico regional.Fueron identificadas 681 reinternaciones, la mayoría por abandono de tratamiento. El tiempo de permanencia en la internación fue mayor para la mujeres que tenían de 40 a 49 años. Se encontró asociaciones positivas de los datos sociodemográficos con internaciones anteriores, tipo de alta, estado físico y mental, los cuales están de acuerdo con otros datos de la literatura. Se concluye que las reinternaciones están asociadas con indicadores sociodemográficos y clínicos; conocimiento que puede ser utilizado en las políticas públicas en salud mental sobre el cuidado.
Furegato ARF, Santos JLF, Silva EC. Depression among nursing students associated to their self-esteem, health perception and interest in mental health. Rev Latino-am Enfermagem 2008 março-abril; 16(2):198-204. This study aimed to identify the presence of depression among nursing students in relation to
O trabalho objetiva fazer um resgate dos 25 anos da Pós-Graduação da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, 1975-2000, através de reflexão crítica sobre sua criação e desenvolvimento. A metodologia baseou-se na análise quantitativa da produção da Pós-Graduação (número de alunos, docentes, dissertações e teses defendidas, tempo médio de duração e outros) e em bibliografias sobre o assunto. Os resultados demonstram que a Pós-Graduação se consolidou nos anos 90, criando os níveis de doutorado nos três programas
ResumoContexto: Há evidências sobre o aumento dos casos de depressão e suas conseqüências na vida das pessoas. Objetivos: Este estudo objetivou conhecer sinais indicativos de depressão e níveis de auto-estima entre acadêmicos de enfermagem, correlacionando esses indicadores. Metodologia: aplicou-se 2 escalas de avaliação (depressão e auto-estima), auto-respondidas por 242 alunos do 1º, 2º e 3º anos de enfermagem que concordaram em participar. Resultados: Idade entre 17 e 44 anos, sendo 40% acima dos 25, 4,4% não solteiros e 4,9% homens, indicando mudança no perfil dos alunos. Encontrou-se 80,8% de alunos sem depressão sendo que todos com altos níveis de estima pessoal (17%) estavam neste grupo. Os demais (80,4%) tinham níveis médios de auto-estima. A porcentagem de disforia (10,3%) e de depressão moderada e grave (6,7%) bem como os níveis de auto-estima condizem com os índices referidos na literatura. Conclusões: a freqüência de depressão entre estudantes está em níveis esperados, porém níveis de estima pessoal estão abaixo.Palavras-chave: Estima, depressão, enfermagem, psiquiatria, estudante. AbstractBackground: There is growing evidence about the increasing incidence of depression and the consequences in people's lives. Objectives: This study aymed to describe and correlate depression symptoms and self-esteem levels among nursing students. Methods: 242 first, second and third-year nursing students agreed to participate and answered two depression scales and one self-esteem assessment instrument. Results: Participants were between 17 and 44 years old; 40% were older than 25; 4.4% were not single and 4.9% were men. These results indicate that the students' profile is changing. 80.8% of students did not present any signs of depression and all students with high self-esteem scores belonged to this group. The remaining (80.4%) presented average self-esteem levels. Levels of dysphoria (10.3%), moderate and severe depression (6.7%) and low and average self-esteem correspond to results mentioned in literature. Conclusions: Depression symptoms among nursing students are in accordance with the literature, but measures of self-esteem are below the expected levels.
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