Background The COVID-19 pandemic has led to high levels of physical, psychological, and social stress among health care professionals, including postgraduate students in medical and multidisciplinary residencies. This stress is associated with the intense fear of occupational exposure to SARS-CoV-2, the virus known to cause COVID-19. These professionals are at risk of developing physical and mental illnesses not only due to the infection but also due to prolonged exposure to multidimensional stress and continued work overload. Objective This study aims to evaluate the prevalence of symptoms suggestive of mental disorders and burnout syndrome and determine the risk factors for burnout among postgraduate students in medical and multidisciplinary residencies in Brazil during the COVID-19 pandemic. Methods For this prospective cohort study with parallel groups, participants were recruited between July and September 2020 to achieve a sample size of at least 1144 participants. Research instruments such as Depression, Anxiety, and Stress Scale; Patient Health Questionnaire; Brief Resilient Coping Scale; and Oldenburg Burnout Inventory will be used to collect data. Data will be collected in 2 waves: the first wave will include data related to sample characterization and psychosocial evaluation, and the second wave will be launched 12 weeks later and will include an evaluation of the incidence of burnout as well as correlations with the potential predictive factors collected in the first wave. Additionally, we will collect data regarding participants’ withdrawal from work. Results The recruitment took place from July 29 to September 5, 2020. Data analyses for this phase is already in progress. The second phase of the study is also in progress. The final data collection began on December 1, 2020, and it will be completed by December 31, 2020. Conclusions We believe the findings of this study will help evaluate the impact of the COVID-19 pandemic on the mental health conditions of health professionals in Brazil as well as contribute to the planning and implementation of appropriate measures that can alleviate these mental health challenges. International Registered Report Identifier (IRRID) DERR1-10.2196/24298

O Programa Nacional de Reorientação da Formação Profissional em Saúde (Pró-Saúde) e o Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) encontram-se articulados com a perspectiva de reorientar a formação profissional. Deste modo, busca-se a substituição do modelo tradicional de organização do cuidado em saúde, historicamente centrado na doença e no atendimento hospitalar. Uma das premissas fundamentais é fortalecer a integração ensino-serviço tendo a Estratégia Saúde da Família, onde a atuação está pautada nos princípios da integralidade, equidade e universalidade do Sistema Único de Saúde, como espaço para o desenvolvimento de ações numa abordagem integral do processo saúde-doença. Este artigo apresenta a experiência dos autores como preceptores e tutores de projetos e ações do PET Saúde /Distrito Federal em parceria com a Universidade de Brasília na visão interdisciplinar do desenvolvimento das ações. Ao expor os aspectos facilitadores das estratégias de enfrentamento, bem como aqueles que as dificultam, suscita-se a reflexão sobre a concepção da educação médica integrando ensino e serviço à luz da Andragogia, que considera a experiência profissional como elemento fundamental dos métodos educativos.

Objective: To evaluate the profile of femur fractures in older adults in Brazil between 2008 and 2018. Methods: Population-based time series study with data from the Department of Informatics of the Unified Health System (Datasus), including 480,652 hospitalizations, of adults from 60 years and over, with hip fracture (ICD10-S72). Results: There was an increase of 76.9% in the hospitalization register (mean 5.87%/year) and an average incidence rate of 19.46 fractures for every 10,000 older adults. In total, 68% of hospitalizations were female, 28% from São Paulo. The average length of stay was 8.9 days, being higher in the Northern Region (11.8) and in the Federal District (18.7). Average mortality rate was 5%, being higher in men (5.45%) and over 80 years old. Northeast Region had the lowest mortality rate (3.54%). Southeast Region had the highest rate (5.53%). Total cost of hospitalizations was R$ 1.1 billion, with an average of R$ 100 million/year. Average cost per hospitalization was higher in the Southern Region (R$ 2,491.00). Conclusion: Femoral fracture is an important cause of mortality among older adults, with a higher incidence in women but higher mortality in men, with high cost to the system and regional differences. Level of Evidence II, Economic and decision analyses - developing an economic or decision model.

Neste artigo discutiremos as competências da Matriz de Competências do Programa de Residência Médica em Psiquiatria e a importância de cada uma delas. Na construção da atual matriz de competências da Residência Médica em Psiquiatria foram consideradas a seguintes habilidades a serem adquiridas e de domínio dos futuros especialistas da área: Diagnosticar, tratar e prevenir de forma precisa doenças ou transtornos mentais; Dominar ferramentas clínicas e exames complementares para o diagnóstico e o tratamento das diversas doenças ou transtornos mentais nas diferentes faixas etárias; Desenvolver relação respeitosa e produtiva com pacientes, familiares e demais profissionais da área da saúde, em diferentes contextos culturais. Dominar as interações entre a psicopatologia, genética, neurobiologia, biografia, história médica, personalidade e relações do paciente no desenvolvimento de uma compreensão do indivíduo em seu contexto cultural e social; Dominar a indicação, realização e acompanhamento de psicoterapias, psicofarmacoterapia e outros tratamentos para doenças ou transtornos mentais; Aplicar a atividade pericial em psiquiatria; Dominar ferramentas de prevenção, promoção da saúde e recuperação das doenças ou transtornos mentais. Tais habilidades foram descritas no item objetivos. Com este novo documento fica estabelecida a formação mínima de um médico psiquiatra e auxilia na criação de formas de avaliação específicas.

Background Since the beginning of the COVID-19 pandemic, health professionals have been working under extreme conditions, increasing the risk of physical and mental illness. We evaluated the prevalence of burnout and its associated factors among postgraduate student residents in health professions during the global health crisis. Methods Healthcare residents were recruited from all across Brazil between July and September 2020 through digital forms containing instruments for assessing burnout (Oldenburg Burnout Inventory (OLBI)), resilience (brief resilient coping scale (BRCS)) and anxiety, stress and depression (depression, anxiety and stress scale (DASS-21) and Patient Health Questionnaire (PHQ-9)). Additionally, the relationships between burnout and chronic diseases, autonomy and educational adequacy in the residency programme, personal protective equipment (PPE), workload and care for patients with COVID-19 were evaluated. The chi-square test, Student’s t test, Pearson’s correlation test and logistic regression were performed. Results A total of 1,313 participants were included: mean (standard deviation) age, 27.8 (4.4) years; female gender, 78.1%; white race, 59.3%; and physicians, 51.3%. The overall prevalence of burnout was 33.4%. The odds (odds ratio [95% confidence interval]) of burnout were higher in the presence of pre-existing diseases (1.76 [1.26–2.47]) and weekly work > 60 h (1.36 [1.03–1.79]) and were lower in the presence of high resilience (0.84 [0.81–0.88]), autonomy (0.87 [0.81–0.93]), and educational structure (0.77 [0.73–0.82]), adequate availability of PPE (0.72 [0.63–0.83]) and non-white race (0.63 [0.47–0.83]). Burnout was correlated with anxiety (r = 0.47; p < 0.05), stress (r: 0.58; p < 0.05) and depression (r: 0.65; p < 0.05). Conclusions We observed a high prevalence of burnout among residents during the COVID-19 pandemic. Individual characteristics and conditions related to the work environment were associated with a higher or lower occurrence of the syndrome.

Relato da experiência dos serviços de atenção a Saúde para a população idosa da Regional do Paranoá, por meio de uma pactuação coletiva entre os diversos atores envolvidos, a fim de subsidiar a construção da rede de Atenção à Saúde do Idoso, Método: Pesquisa qualitativa e descritiva, por meio de levantamento de dados em fontes oficiais do governo acerca de informações de saúde e dados demográficos populacionais, além de descrição das experiências dos serviços de saúde da Regional do Paranoá. Resultados: A constituição de um grupo de trabalho com os profissionais que atuam na assistência direta ao idoso para identificação e discussão dos processos de trabalho, alencando prioridades como a caracterização do perfil da população atendida e necessidade da sistematização dos dados, para estratificação em linhas de cuidado, ênfase no acolhimento com escuta qualificada e estratégias para criação de vínculos entre os profissionais e instituições parceiras, para a integralidade da Atenção, foram potencialidades do processo, em meio às dificuldades como indefinição de território de abrangência, fragilidades sociais e fragmentação da assistência. Conclusão: Uma Rede de Atenção à Saúde, mais do que estruturada em ofertas de serviços, só ganha forma e permite seu dinamismo, operando por meio da formação e consolidação de vínculos que perpassam as estruturas organizacionais e influenciam os modos como os processos de trabalho transcorrem para o funcionamento da rede.

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Background: Since the beginning of the COVID-19 pandemic, health professionals have been working under extreme conditions, increasing the risk of physical and mental illness. We evaluated the prevalence of burnout and its associated factors among postgraduate student residents in health professions during the global health crisis. Methods : Healthcare residents were recruited from all across Brazil between July and September 2020 through digital forms containing instruments for assessing burnout (Oldenburg Burnout Inventory (OLBI)), resilience (brief resilient coping scale (BRCS)) and anxiety, stress and depression (depression, anxiety and stress scale (DASS-21) and Patient Health Questionnaire (PHQ-9)). Additionally, the relationships between burnout and chronic diseases, autonomy and educational adequacy in the residency programme, personal protective equipment (PPE), workload and care for patients with COVID-19 were evaluated. The chi-square test , Student’s t test, Pearson’s correlation test and logistic regression were performed. Results : A total of 1,313 participants were included: mean (standard deviation) age, 27.8 (4.4) years; female gender, 78.1%; white race, 59.3%; and physicians, 51.3%. The overall prevalence of burnout was 33.4%. The odds (odds ratio [95% confidence interval]) of burnout were higher in the presence of pre-existing diseases (1.76 [ 1.26–2 .47]) and weekly work > 60 h (1.36 [1.03–1.79]) and were lower in the presence of high resilience (0.84 [0.81–0.88]), autonomy (0.87 [0.81–0.93]), and educational structure (0.77 [0.73–0.82]), adequate availability of PPE (0.72 [0.63–0.83]) and non-white race (0.63 [0.47–0.83]). Burnout was correlated with anxiety (r = 0.47; p < 0.05), stress (r: 0.58; p < 0.05) and depression (r: 0.65; p < 0.05). Conclusions : We observed a high prevalence of burnout among residents during the COVID-19 pandemic. Individual characteristics and conditions related to the work environment were associated with a higher or lower occurrence of the syndrome.