Health literacy, a more complex concept than knowledge, is a required capacity to obtain, understand, integrate and act on health information [1], in order to enhance individual and community health, which is defined by different levels, according to the autonomy and personal capacitation in decision making [2]. Medium levels of Health literacy in an adolescent population were found in a study conducted in 2013/2014, being higher in sexual and reproductive health and lower in substance use. It was also noticed that the higher levels of health literacy were in the area adolescents refer to have receipt more health information. The health literacy competence with higher scores was communication skills, and the lower scores were in the capacity to analyze factors that influence health. Higher levels were also found in younger teenagers, but in a higher school level, confirming the importance of health education in these age and development stage. Adolescents seek more information in health professionals and parents, being friends more valued as a source information in older adolescents, which enhance the importance of peer education mainly in older adolescents [3]. As a set of competences based on knowledge, health literacy should be developed through education interventions, encompassing the cultural and social context of individuals, since the society, culture and education system where the individual is inserted can define the way the development and enforcement of the health literacy competences [4]. The valued sources of information should be taken into account, as well as needs of information in some topics referred by adolescents in an efficient health education. Schizophrenia is a serious and chronic mental illness which has a profound effect on the health and well-being related with the well-known nature of psychotic symptoms. The exercise has the potential to improve the life of people with schizophrenia improving physical health and alleviating psychiatric symptoms. However, most people with schizophrenia remains sedentary and lack of access to exercise programs are barriers to achieve health benefits. The aim of this study is to evaluate the effect of exercise on I) the type of intervention in mental health, II) in salivary levels of alpha-amylase and cortisol and serum levels of S100B and BDNF, and on III) the quality of life and selfperception of the physical domain of people with schizophrenia. The sample consisted of 31 females in long-term institutions in the Casa de Saúde Rainha Santa Isabel, with age between 25 and 63, and with diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Physical fitness was assessed by the six-minute walk distance test (6MWD). Biological variables were determined by ELISA (Enzyme-Linked Immunosorbent Assay). Psychological variables were assessed using SF-36, PSPP-SCV, RSES and SWLS tests. Walking exercise has a positive impact on physical fitness (6MWD -p = 0.001) and physical components of the psychological test...

Social prescribing (SP) is an approach that promotes the use of local non-clinical activities by people. The referral is usually made by primary health-care professionals, in a process wherein local providers play a pivotal role. The main objective of this study was to identify domains of intervention and evidence about the effectiveness of SP programs regarding health-related outcomes. A systematic literature review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted in PubMed, CINHAL, and SCOPUS. Inclusion criteria of the reviewed papers were as follows: (i) effectiveness studies of interventions designated as SP or interventions entailing SP conceptual components; (ii) interventions with adults. Quality assessment was performed with the Cochrane tool for assessing risk of bias in randomized trials; an assessment tool developed by the US National Heart, Lung and Blood Institute was applied to observational studies. Overall, 13 articles were included for analysis, with a total of 4603 patients. Although three studies comprised a control group, only two followed a randomized controlled trials (RCT) design. Nine principal domains of intervention within SP were identified, with three categories of outcome measures: Physical and psychological wellbeing; Health behaviors and self-efficacy; and Health care resources end economic evaluation. SP is an emergent and promising health-care intervention, and it has been used to promote different health behaviors. Evidence of SP effectiveness on patient’s health and wellbeing is not strong. Further research is needed for understanding how SP can be applied efficiently.

Our aim was to identify factors that contribute to a better outcome in drug users and to understand the effectiveness of nursing interventions, by applying "Nursing Role Effectiveness Model" (NREM). It's a correlational, cross-sectional study with 180 drug users in a methadone program, randomly selected from three community services. We identified that treatment time, lower co-morbidities, less poly-drug use, family support and being employed contribute to a better quality of life, better mental health, less substance addiction consequences and more satisfaction with nursing care (p < 0.05). Those data were also related with nursing interventions using Structural Equation Model and we found that nursing care contributes 29% to health outcome improvement. The model revealed itself adequate to assess the effectiveness of nursing interventions (X: 82.51/(34) = 2.426; p < 0.01, NFI = 0.927, CFI = 0.955, RFI = 0.903, GFI = 0.917, PGFI = 0.567, PCFI = 0.722, PNFI = 0.700, RMSEA = 0.089). Compared with the NREM original model, our findings reveal new relationships between the users' structural variables and the health outcomes and also relationship between units' structural variables and nurses' structural variables.

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Our aim was to contribute to the clinical validation of "Substance Addiction Consequences" (SAC) derived from the nursing outcomes classification (NOC), and to analyse psychometric properties. To that purpose, we applied a methodological design. The study's outcome comprises 16 nursing-sensitive indicators, within four different consequence factors: psychological and family; physical and cognitive ability; self-care; economic and work. The psychometric properties were considered good. We concluded that the scale can be used as a valid tool to measure the consequences of substance addiction and to assess the health status as a nursing sensitive outcome. The scale is considered valid to monitor nursing interventions in the clinical setting; being a comprehensive tool it allows the nurse to understand better this complex health problem.

Objective: To assess the level of Burnout among nurses in a general emergency department. Method: Quantitative, descriptive, correlational and cross-sectional study. 32 nurses from a general adult emergency department answered a questionnaire to evaluate Burnout. (Copenhagen Burnout Inventory). Result: It was verified that 59.4% of the nurses presented total Burnout. Work-related burnout was the subscale with the highest average score. It was found that the lower the age and the longer the time working in the institution, the higher the level of Burnout. Longer professional experience was related to lower levels of Burnout. There were also higher scores of Burnout among participants who thought about changing their profession, their institution or their service. Conclusion: The prevalence of Burnout is high. Professional Burnout was the most critical subscale. Age and the current work are the subscales that most influence perceived Burnout

RESUMO CONTEXTO:A forma como cada pessoa vive e sente satisfação com a sua experiência de vida, tem naturalmente uma dimensão subjetiva mas reveladora de aspetos intrínsecos da dimensão humana. A felicidade pode ser um conceito agregador dessas dimensões embora de difícil definição para pessoas com ou sem doença mental. OBJETIVO: Identificar a perceção de felicidade em pessoas com doença mental, os fatores que contribuem para aumentar ou menorizar essa perceção. MÉTODOS: Revisão Integrativa da Literatura. Pesquisa em bases de dados internacionais, realizada em agosto de 2016. Foi aplicado um conjunto de descritores e critérios de inclusão. Obteve-se uma amostra final de 7 estudos, publicados entre 2006-2014. RESULTADOS: Não se encontraram definições aprofundadas do conceito expressas pelos participantes. Emerge como aproximação ao conceito a capacidade para interação social ou enquanto fenómeno intrinsecamente relacionada com a religiosidade. A felicidade depende pouco de eventos externos e reforça-se com fatores duradouros e de uma dimensão mais interior e predeterminada previamente à doença. Os fatores que contribuem são essencialmente de ordem pessoal, familiar, suporte social alargado e emocional. Os que contribuem para menorizar a felicidade são de ordem pessoal, efeitos secundários da medicação, escassez de suporte social alargado, disfunção afetiva e emocional. A família não surgiu enquanto fator associado a menor felicidade. CONCLUSÕES: A felicidade está interligada à vivência social e ao bem-estar, à resiliência, a fatores protetores internos da própria pessoa.

Aim This study aimed to analyse risk and protective factors for teen suicide and bullying. Background Research shows that high percentages of bully‐victims report suicidal thinking or suicide attempts. Design This was an international integrative review. Data sources Five databases including CINAHL, Scopus, PubMed, Google Scholar and Cuiden were searched between January 2010 and December 2020. Review methods Review methods included problem identification; search, evaluation and analysis of literature; and presentation of results. Results Eighteen studies were included. We grouped the selected articles into seven thematic categories. The most significant risk factors were being male, having a previous personal and/or family suicide attempt, mental health problems, substance abuse, previous physical and/or sexual abuse, low socio‐economic level, belonging to a single‐parent family, underachievement, family dysfunction and violent environment. The most common protective factors for both suicide and bullying were being female, having good mental health, belonging to a two‐parent family, safe school environment, good family relationships and having an involved teacher. Conclusion Suicide resulting from bullying is a social and public health problem, so nurse practitioners and paediatric primary care nurses have a responsibility to educate teachers and parents in order to promote early detection and the development of more effective prevention and action plans.