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The following study was performed to identify factors related to medication errors in the computerized physician order entry and their advantages and disadvantages according to doctors, nursing team and administrative officers. It is a survey descriptive study carried out at three units of a Brazilian academic hospital in the southeast area. The study was divided in two phases. In the first phase, we analyzed a total of 1,349 prescriptions from general medical unit, surgical and orthopaedic wards during 30 days consecutively. A semi-structured instrument, elaborated by a group of researchers for the study proposals, was used. In the second phase, a semi-structured questionnaire was applied to the health professionals containing closed and open items approaching their opinion about the composition of electronic prescription, the advantages and disadvantages of them, and their suggestions for its improvement. Out of 1,349 prescriptions observed, 17.5% presented deletions, 25.0% medicines written manually and 17.0% of them were incomplete. Some of the advantages pointed by health professionals were its legibility (37.5%), little time spent when elaborating and emitting them (20.5%) and the way they are a practical and organized (8%). The disadvantages pointed were repetition of previous prescriptions (34%), typing mistakes (17%), dependence on computers (11%) and alterations made manually (7%). We conclude, this way, that the computerized prescription order entry represents a great progress among the strategies used to minimize medication errors caused by prescriptions badly formulated. However, it doesn't eradicate the possibility of medication error occurrences, needing some system modifications.

This qualitative study aimed to understand the meaning of drug consumption from the view of users who receive care in an outpatient clinic of a Mental Health Service on an island of the Cape Verde archipelago. The methodological framework was based on the Data-founded Theory, in the light of Symbolic Interactionism. Participants were nine drug users from the mentioned outpatient clinic. Recorded interviews and observation were the strategies for data collection. The comparative data analysis resulted in the central phenomenon 'An attractive force', which expresses the great difficult users have to stop the abusive consumption of psychoactive substances, knowing that all problems faced in the personal, familiar and social areas come from drug habituation. Thus, this study permitted the identification of vulnerable points for possible action by the health team, aiming for the prevention of drug abuse. [ABSTRACT FROM AUTHOR]

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Bipolar Affective Disorder (BAD) is a chronic disease and requires medication treatment. This study verified the adherence of people with BAD to medication and compared, among adherent and non-adherent patients, satisfaction with the health team and treatment. Twenty-one patients with BAD receiving care in a mental health unit participated in the study. The Morisky-Green test and another instrument elaborated by the researchers were used for interviews. Data were analyzed with qualitative and quantitative approaches. Results showed that the majority of patients did not adhere to the medication treatment due to 'non-intentional behavior' (negligence or forgetfulness). The majority reports satisfaction with information received regarding the medication and its effectiveness, though there were reports of collateral effects, doubts and lack of motivation to keep up the treatment. This research shows the need for strategies directed at promoting adherence to medication therapy in patients with BAD. [ABSTRACT FROM AUTHOR]

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study aimed to determine the consumption of benzodiazepines without prescription among first-year students from a nursing school of a public University in Ecuador. This is a descriptive, transversal and explanatory study with a quantitative approach. A questionnaire was used for data collection. The population studied was of 181 students. The results showed that 10.5% of the students had consumed benzodiazepine without prescription once in their lives. Of these, 6.1% consumed benzodiazepine in the last year, and 3.9% are currently consuming it. The diazepam was the most consumed BZD without prescription and pharmacies, were the place of higher access. The main reasons for the benzodiazepine consumption were: insomnia, anxiety, stress, depression, family and economical problems. The use of benzodiazepines with non-medicinal purposes is related to problems such as memory loss, retirement syndrome and sedation. When benzodiazepines are consumed jointly with alcohol or other drugs they can lead to coma or death. This study shows the serious consequences benzodiazepines cause when used by nursing students in Ecuador. [ABSTRACT FROM AUTHOR]

This study identified the barriers faced by people with bipolar affective disorder (BAD) regarding the need for continuous medication. The qualitative approach was used, and the methodological framework was based on the Grounded Theory in the light of Symbolic Interactionism. In total, of 14 people with BAD, who were being attended at the Outpatient Unit for Mood Disorders of a university hospital, and 14 relatives indicated by them participated in the study. The data collection was carried out through interviews and observation. Two categories emerged from the results, describing the barriers faced by people with BAD: to have affective and cognitive losses and to have several limitations. People with BAD feel ambivalent regarding medication adherence, as they perceive that, no matter the direction they take, it will lead to a context of prejudice, losses and limitations in various spheres of daily life. [ABSTRACT FROM AUTHOR]

This study aimed to identify variables associated to the consumption of benzodiazepine among workers of a private company in the VIII Region, Chile. This is a cross-sectional and correlative study. Study population: 40 employees of a private company. The instruments included a questionnaire on socio-demographic variables and a benzodiazepine questionnaire. There was no record of benzodiazepine consumption at the moment of the study. Twenty percent (20%) of the interviewees had already used benzodiazepine in the past, whereas, half of them (10%) in the last year. The bivariate analysis of the last year consumption of benzodiazepine with work hours variables showed no significant relation (p=0.073). No association was found between benzodiazepine consumption and socio-demographic variables among the study participants. [ABSTRACT FROM AUTHOR]

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To analyze the association between sociodemographic variables, lifestyle and mental health habits, and long Covid in nursing professionals., Method: Quantitative, observational, cross-sectional and analytical study, with 109 nursing professionals who had Covid-19 between 2020 and 2022. Data collection was carried out using an online form, with the following variables of interest: resilience, subjective well-being, age, sex, professional category, vaccination, physical activity, presence of symptoms resulting from Covid-19 infection after the acute phase of the disease and long Covid. Data were analyzed descriptively and inferentially using Poisson regression with robust variance and a significance level of 5%., Results: Male sex, high resilience, and high positive affect decrease the prevalence of long Covid by 71% (RP = 0.29), 40% (RP = 0.60) and 43% (RP = 0.57), respectively, while being in the nursing technician category increases its prevalence by 74% (RP = 1.74)., Conclusion: The results emphasize the importance and support the development of promotion, prevention, treatment, and rehabilitation actions for individuals with long Covid. To achieve this, multidisciplinary care, centered on the person and directed at the context and work environment is required.

This study aimed to investigate the presence of mental illness in victims of soil instability in neighborhoods affected by rock salt extraction from a mining company located in the city of Maceió, Alagoas, Brazil. It is a quantitative, descriptive-analytical, and cross-sectional study. The sample was intentional and non-probabilistic and consisted of 158 participants, with a 0.50 "power of effect" (moderate size effect) and a 99.9% confidence level. A link was made available on social media with an invitation to participate in the online survey. Most participants were adult, female, black/mixed-race, with a high level of education, and reported a perceived worsening in monthly income, physical and mental health, and in the self-perception of their lives after the relocation of their homes. Most participants had depressive symptoms (87.34%), moderate and severe anxiety (55.7%), and positive screening for common mental disorders (77.22%). By analyzing the current perception of the changes in the lives of former residents before and after being relocated due to the ground instability, it was identified that, after relocation, those with greater psychiatric demand and suicidal ideation had a higher prevalence of depressive symptoms, symptoms of severe anxiety, and positive screening for common mental disorders. This research highlights the importance of elaborating policies, strategies and actions to prevent impacts on mental health, recovery, and health rehabilitation in scenarios of socio-environmental disasters. Implementing preventive measures and offering adequate psychological and social support can reduce the detrimental effects of such disasters on the affected population.

Objective: To describe the profile of individuals with depression who received assistance at CAPS in Brazil between 2013 and 2019, focusing on their clinical and demographic characteristics, and to calculate the estimated coverage of CAPS across the national territory and its constituent federal units., Methods: Descriptive, ecological, time-series study with secondary data from national databases, referring to care provided at CAPS in the country for adults aged 18 years or over-diagnosed with depression (F32-32.9 and F33-F33.9). The estimated coverage of CAPS was calculated for 2013 and 2019 using registered and active services., Results: There was a 107% increase in the number of patients with depression receiving treatment at CAPS between 2013 and 2019. Women accounted for 77% of the patients, with the majority falling within the age range of 41 to 61years (49%). The predominant racial demographics were white (38%) and brown (34%). The diagnosis of depressive episodes was prevalent among 65% of the patients, and individual care was administrated to 75% of them. The presumed CAPS coverage was 71% in 2013 and increased to 87% in 2019 nationwide, although significant discrepancies were observed among different states., Conclusion: Progress was evident in the implementation of CAPS across Brazil during the period spanning 2013 to 2019. Nonetheless, disparities persist among the federative units, and there remains an underutilization of group and family care within CAPS services., Competing Interests: The authors declared that there are no conflict interests., (Copyright: © 2024 Paiva do Carmo Mercedes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Benzodiazepines are frequently prescribed to treat anxiety and insomnia, but long-term use has been associated with the development of dependence, tolerance, and cognitive decline, especially among older adults. This study aimed to investigate the pattern of consumption and factors associated with inappropriate prescribing of benzodiazepines in primary health care., Methods: This is a cross-sectional analytical study, using dispensing records of diazepam, clonazepam, and nitrazepam from public pharmacies in a Brazilian municipality between 2018 and 2022. Metrics for benzodiazepine consumption were DDD (Defined Daily Dose) and DDD/1000PD (per 1000 population per day). Long-term/prolonged benzodiazepine use was defined as consuming at least 90 DDD and at least 2 dispensations per year. To ascertain associations between long-term use and predictor variables, a multivariate logistic regression model was utilized., Findings: A total of 40402 participants were included, with an average age of 55 years (SD = 0.30), 38.5% were older aged. Diazepam and nitrazepam exceeded the daily dose recommended. There was a reduction in diazepam consumption during the study period, as calculated by DDD/1.000PD, while the consumption of other benzodiazepines remained stable. However, a significant increase in diazepam consumption is noted when considering the last decade. Prolonged use was observed in 29.1% of participants, with a significant prevalence among the older people (34.8% of them were long-term users) and advancing age was identified as a risk factor for long-term use. Higher PDDs were also associated with long-term use and aging. Participants who used different benzodiazepines during the period had a higher risk of prolonged use., Conclusions: These results provide insights into the prevalence of problematic utilization of benzodiazepines in primary health care. Authorities and health care providers must take steps to encourage gradual cessation of prolonged benzodiazepine prescriptions and the embrace of suitable strategies for addressing anxiety and insomnia within primary health care settings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Barboza Zanetti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Polypharmacy and the use of high-alert medications in patients with nasally placed feeding tube (NPFT) increase the risks of drug related problems., Objective: Characterize drugs prescribed to patients with NPFT and compare the rates of polypharmacy and high-alert medication use at admission and hospital discharge., Design and Setting: Multicenter cross-sectional study with 327 participants., Methods: Data of patients with NPFT were obtained from the medical records and recorded in an electronic data collection tool. Mean number of drugs, polypharmacy and number of high-alert medications prescribed on admission and at discharge were compared using Wilcoxon or McNemar's tests. Generalized Estimating Equations analyzed the relationship between polypharmacy and high-alert medications according to age and time point. Primary reason for hospital admission, level of consciousness, severity of comorbid diseases and patient care complexity were also assessed., Results: Most patients were male, older people, hospitalized for circulatory system diseases and had at least one comorbidity. On admission, a significant number of patients were alert (59.9%), at high risk for death (43.1%) and high dependent on nursing care (35.4%). Additionally, 92% patients were on polypharmacy on admission, versus 84.7% at hospital discharge ( p  = 0,0011). The occurrence of polypharmacy was independent of age ( p  = 0.2377). >17% of all drugs prescribed were high-alert medications, with no statistically significant difference between admission and discharge (p = 0,3957). There was no statistical evidence that the use of high-alert medications increases with age ( n  = 0,5426)., Conclusions: These results support the planning of multidisciplinary qualified actions for patients using NPFT., Competing Interests: The authors declare no conflicts of interest that are directly relevant to the content of this study., (© 2024 The Authors. Published by Elsevier Inc.)

Though pandemic-related suicides are a concern, little is known about factors potentially linking graduate student life and suicide risk. This study identified factors associated with suicide risk among Brazilian graduate students ( N  = 5,344) during the COVID-19 pandemic. Utilizing the Mini International Neuropsychiatric Interview, this study revealed that 31.5% of participants presented some risk for suicide: 16.6% "low risk," 4.7% "moderate risk," and 10.2% "high risk." Higher income and religious affiliation were identified as protective factors. Identified risk factors encompass non-heterosexual orientation, a history of depression or posttraumatic stress or common mental disorders diagnoses, the use of medications-both general and psychopharmaceuticals-without medical prescription, antipsychotics use, alcohol consumption, lack of health insurance, and dissatisfaction with life as a result of accessing social media networks. The high vulnerability of graduate students to suicide risk highlights the need for institutional suicide prevention initiatives.

Background: Serious games are play-based technologies designed to teach users a wide range of concepts and skills applicable in the non-virtual environment., Objectives: This paper describes the process of developing a serious game for people with bipolar disorder to promote symptom recognition and the safe use of medications., Methods: This study was based on the User-Centered Design methodological model and the theoretical framework for Participatory Design. We conducted interviews with health professionals and discussion circles with people with bipolar disorder and their family members in order to identify the learning needs related to symptom recognition and safe medication use. A categorical analysis was completed of the participants' reports and the scientific literature and formed the basis for the design of Mundo de Pólus., Results: The game development process had three pillars (detailed in this manuscript): missions, simulation, and journal. The serious game focuses on the users' perceptions about their experience with the disorder, their interpersonal relationships, coping strategies, use of medications, and non-pharmacological treatments., Conclusions: These scientific and technological outcomes are useful to promote literacy and safety in medication therapy for people with bipolar disorder., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Depression is disabling disorder and cause functional impairments, and high costs for the health and social security system., Objective: The direct and indirect costs of depression from the societal perspective were estimated for the period 2010 to 2018., Methods: This cost-of-illness study in adults is based on prevalence, with a top-down approach, from the societal perspective. Direct (hospital and outpatient) and indirect (absenteeism) costs were included. Data were extracted from the Hospital and Outpatient Information Systems and the National Social Security Institute., Results: The cost of depression was Int$ 2,288,511,607.39 in the analyzed period, with an average annual cost of Int$ 254,279,067.49. From 2014 to 2018, had a sharp and persistent decrease in the cost of depression (-44.24%), mainly in indirect costs (-55.83%). In the period investigated, indirect costs represented 74.85% of the total cost. Over time, outpatient surpassed hospital cost. In 2017 and 2018, outpatient costs represented 43.22% and 39.57% of total costs. In all the years and cost components analyzed, women predominated., Conclusions: Depression is a disease with a high economic burden for the healthcare system. Investments are still needed, such as higher coverage of services, multidisciplinary teams, and training of health professionals for psychosocial care.

This study aimed to identify the sociodemographic and clinical factors associated with the occurrence and recurrence of intentional self-poisoning with medications (ISP-M), and suicide deaths by ISP-M in the state of Mato Grosso, Brazil. In this cross-sectional analytical study, we used logistic regression models to analyze data obtained through health information systems. Factors associated with use of ISP-M as a method were female gender, white skin color, occurrence in urban areas and at home. The ISP-M as a method was less reported in people presumed under the influence of alcohol. Lower chance of death by suicide using ISP-M was found among young people and adults (under 60 years old).

Objective: to develop and validate educational material to strengthen adolescent health care on non-suicidal self-injury., Method: methodological research designed in three stages: (1) construction of the material based on a mixed study on needs related to the theme through social networks and an umbrella review on health care related to non-suicidal self-injury; (2) validation with 10 experts in mental health and/or self-inflicted violence selected through the Lattes Platform; (3) evaluation by the target public, with health professionals being invited, without restriction of training. Validation and evaluation data were collected by using a sociodemographic questionnaire and the Suitability Assessment of Materials for evaluation of health-related information for adults. We used descriptive statistics, content validity index, and Gwet's AC1 test., Results: the material obtained good general acceptance and reliability in the validation by the experts (AC1= 0.633; p=0.0000) and in the evaluation by the target public (AC1=0.716; p=0.0000). All professionals pointed out the personal contribution and educational potential of the material., Conclusion: we highlight the construction of science-based educational material to strengthen the health care for adolescents with non-suicidal self-injury., Keypoints: (1) Scientific data-based construction of educational material for prevention of non-suicidal self-injury (NSSI). (2) General acceptance and reliability in the validation of the material by experts. (3) Acceptance and reliability in the evaluation of the material by health professionals. (4) Dissemination of material for health education initiatives to prevent NSSI.

The present study aimed to identify the predictors of job stress and alcohol consumption amongst 253 professors at a public university. Previous history of psychotropic drug use, as well as the Scale of Work Stress, the Alcohol Use Disorders Identification Test, and the Self-Report Questionnaire were used. Being female, younger than 40 years of age; of homosexual orientation; a workload of weekly classes of >10 h in total; and being positive for common mental disorders were identified as predictors of moderate or high work stress. The predictors of risky drinking or probable alcohol dependence were: male; younger than 40 years of age; tobacco use; health problems; teaching applied social sciences; and use of hypnotic medications. The findings could be used to develop strategies for the prevention or reduction of work stress and alcohol consumption amongst university professors., Competing Interests: Declaration of competing interest The authors report no conflict of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: Identify the predictors of common mental disorders (CMD) and psychiatric medication use by faculty members in different teaching units of a public university., Design and Methods: A cross-sectional study on 253 faculty., Findings: Being single, not having children, and not practicing physical activity were identified as predictors of CMD. Relative to psychiatric medication use, the predictors were the following: being homosexual, teaching classes in the biological sciences field, using medication for the urinary tract and sexual hormones, presenting mental disorder/sleep disorder diagnoses, and being positive for CMD., Practice Implications: The findings of this study may subsidize more effective interventions aimed toward protecting the health and preventing aggravation in these professionals, as well as measures for promoting changes in the university work context., Design and Methods: A cross-sectional study on 253 faculty., Findings: Being single, not having children, and not practicing physical activity were identified as predictors of CMD. Relative to psychiatric medication use, the predictors were the following: being homosexual, teaching classes in the biological sciences field, using medication for the urinary tract and sexual hormones, presenting mental disorder/sleep disorder diagnoses, and being positive for CMD., Practice Implications: The findings of this study may subsidize more effective interventions aimed toward protecting the health and preventing aggravation in these professionals, as well as measures for promoting changes in the university work context., (© 2021 Wiley Periodicals LLC.)

Objective: To evaluate the relationship between crack/cocaine use and domestic violence perpetration from the perspective of substance users' families. A secondary retrospective cross-sectional study, with 3162 family members of crack/cocaine users seeking treatment in the Recomeço Família Programme in São Paulo/Brazil was undertaken. Family members of crack/cocaine users reported that their relatives were more involved in domestic violence such as stealing (money and objects) at home [Odds Ratio Adjusted ORA = 2.17 (CI 95% 1.87; 2.53)], the family gave money to the user to buy drugs [ORA = 1.27 (1.08; 1.48)], and having problems with the judiciary [ORA = 1.48 (CI 95% 1.28; 1.71)]. Relatives of snorted cocaine users reported that there was physical and interpersonal violence, such as fathers being assaulted [ORA = 2.50 (CI 95% 1.08; 5.82)], assaulted someone else [ORA = 1.86 (CI 95% 1.32; 2.60)], threats of violence fights, arguments when the family talk about problematic drug use [ORA = 1.50 (CI 95% 1.13; 1.96)] and threatened some family members [ORA = 1.52 (CI 95% 1.14; 2.04)]. In this sample, there was a connection between crack/cocaine use and the perpetuation of domestic violence, corroborating with important implications for public policies, substance use treatment and prevention of domestic violence interventions.

The objectives of this study were to identify the interaction between drug interaction risk, common mental disorders, use of psychiatric medication and quality of life in patients treated in primary health care settings in Brazil. In this quantitative research, 452 patients were interviewed in ten basic Brazilian health units. Sociodemographic and pharmacotherapeutic questionnaires, use of psychiatric medication, prevalence of common mental disorders, and quality of life were utilised. The structural equation model was used to evaluate the relationships among the variables. The prevalence of drug interaction risk was 66.59%. The variables associated with drug interaction risk were polypharmacy and income. The use of psychiatric medication was associated with diagnosis of common mental disorders, income and gender. The use of psychiatric medication and common mental disorders negatively influenced quality of life., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Understanding the meaning of life after a suicide attempt experience provides greater knowledge about the process of resignification, connections and commitment to life, which can be useful in different therapeutic approaches., Objective: Understand the meaning of life after a suicide attempt., Method: Qualitative study with eight Brazilian adults assisted in mental health service. The data were collected in 2018 by semi-strutured interviews and group meetings that used artistic resources to facilitate expression.The Symbolic Interactionism was the theoretical reference used and the data were submitted to thematic analysis., Results: Three themes were identified: "Searches in the affective, relational and spiritual field" (manifestations of affection, zeal, understanding and welcome and seemed to increase the link and commitment to life, as well as the openness to resignify it); "Life and the constancy of impermanence" (life as an alternation between weakness and strength, crisis and well-being, problems and overcoming); and "Discoveries and relationship with one's own self" (a self previously self-destructive could be resigned as capable of overcoming, resisting and developing resilience)., Conclusions: The study provides important insights to be addressed in clinical practice, in the protocol design, institutional policies, as well as in the training of professionals., (Copyright © 2021. Published by Elsevier Inc.)

Introduction: Drug-drug interactions among people with suicidal behavior is a challenging topic, considering the harm it poses for patients already vulnerable and the lack of literature on the thematic. This aspect must not be neglected in research and clinical practice, and thus requires thorough investigation., Objective: to investigate predictors of drug-drug interaction of prescribed drugs and the prescription of two or more drugs for people admitted due to suicidal behavior in a psychiatric emergency department (short-stay hospital ward)., Method: A cross-sectional study with retrospective approach, carried out in a Brazilian psychiatric emergency unit in 2015. Data about first and last medical prescriptions were collected from 127 patients' files. Descriptive statistics and the Zero Adjusted Logarithmic Distribution (ZALG) model were adopted, with the significance level α = 0.05., Results: Potential drug-drug interactions were found in most of the first and last prescriptions. The sample majority were female, with previous suicide attempts, being discharged from the hospital with three drugs (or more) prescribed, and without referral to any health service. Age and comorbidities were predictors of more drug prescriptions and the amount of prescribed drugs was the most important predictor of drug-drug interactions (quantity and severity)., Conclusions: the variables associated with drug-drug interactions and prescription of two or more drugs among people with suicidal behavior needs to be investigated in different contexts and addressed in interventions with the aim to promote patient safety., Competing Interests: The authors declare no conflict of interest., (© 2022 The Authors. Published by Elsevier Ltd.)

The main goal of this study was to identify the prevalence of alcohol use and associations with selected variables among clients in a primary healthcare setting. A quantitative, cross-sectional study was carried out using structured questionnaires to measure the pattern of alcohol consumption, quality of life and common mental disorders. The results showed that men, people between 18 and 40 years old, with income between $300.00 and 1200.00 and smokers were at a higher risk of problematic alcohol use. Healthcare professionals should include alcohol screening questions to identify the hazardous consumption of alcohol at an early stage and prevent negative consequences., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: To explore the meaning of suicidal behavior from the perspective of family health professionals., Method: A qualitative study developed during 2017-2018 with 18 primary care professionals from a Brazilian municipality. Grounded theory was used as the methodological framework. Semi-oriented interviews were conducted, transcribed, and analyzed by open, axial, and selective coding., Findings: The professionals perceived themselves as unprepared, emotionally affected, and fearful to work in suicide prevention, prioritizing the referral of people to specialized services regardless of the severity of the situation. Suicide was represented as both a choice and a condition of vulnerability, being more reprehensible when associated with individual choice., Conclusion: We identified beliefs related to suicidal behavior that could affect the care of people at risk. Our findings reinforce the need for education and training in the prevention of suicidal behavior in primary care., (© 2021 Wiley Periodicals, Inc.)

The aim of this study is to evaluate the associations between having parents with substance use problems, and having suffered neglect within the family, and behavioral problems (psychological and drug use) among adolescents. All the participants were enrolled on the socio-educational parole scheme, 'Assisted Freedom'. In this cross-sectional study, 150 adolescents were interviewed using the Drug Abuse Screening Test, Teen Addiction Severity Index, and Childhood Trauma Questionnaire. Ninety-five percent of the participants were male ( n = 143), aged 13-17. Thirty percent of adolescents had a parent who used substances and had experienced neglect from their families. Those adolescents who were living with both parents (odds ratio adjusted (ORA) = 2.7, 95% confidence interval (CI) = 1.13-6.37), from a low-income family (ORA = 6.7, 95% CI = 1.85-24.22), experienced hallucinations (ORA = 2.8, 95% CI = 1.25-6.14), had problems controlling violent behavior (ORA = 2.6, 95% CI = 1.12-5.87), and were physically neglected (ORA = 3.0, 95% CI = 1.24-7.49) were more likely to have parents who used substances and to have experienced parental neglect. This article concludes that adolescents, who are on parole, come from families with high level of psychosocial vulnerabilities, including substance use, experience neglect by their families leading to adverse emotional and psychological states.

To analyze the predictors of internalized stigma among people with mood disorders, we conducted an analytical observational cross-sectional study with 108 people with mood disorders in a public service setting in Sao Paulo, Brazil. We applied a sociodemographic and clinical questionnaire, the Internalized Stigma of Mental Illness Scale, the Medication Adherence Scale, the Brief Psychiatric Rating Scale-Anchored, and the Herth Hope Index. We analyzed the data using descriptive statistics, average comparison tests, a correlation test, and multiple linear regression. Internalized stigma was associated with symptomatology, history of aggressive behavior, psychiatric hospitalizations, suicide attempts, hopelessness, nonadherence to psychotropic medications, and unemployment. The predictors of internalized stigma were unemployment, more psychiatric symptoms, history of previous suicide attempts, and less hope. Clinical interventions and investigations for stigma reduction and psychosocial rehabilitation should incorporate the factors associated with self-stigma (aggressive behavior, history of psychiatric hospitalizations, suicide attempts, hopelessness, nonadherence to medication, and unemployment).

Background: The work environment is a place in which different kinds of interpersonal relationships are developed and can contribute positively or negatively to productivity and to workers' well-being. Discussion on this topic may contribute to building more coping strategies to fight against gender inequality and the emotional repercussions of these conditions., Objective: This is a cross-sectional study that investigated the possible influence of work environment relationships on the mental health of Brazilian seamstresses., Methods: The participants were seamstresses from four clothing factories in a city in the southwest of Brazil. For data collection, we used the Social Support Perception at Work Scale; Self-Report Questionnaire; Alcohol, Smoking and Substance Involvement Screening Test; and a focus group. The quantitative data were statistically analyzed, and data from the focus groups were analyzed using content analysis., Results: Interpersonal relationships at work were mentioned as sources of conflict and stress but also as emotional and material social support providers. In the sample studied, these relationships did not influence directly the development of mental health disorders., Conclusions: Study results suggest that a low level of education is an important factor that increases the vulnerability of these women to the precariousness of work, and, consequently to developing mental health symptoms or aggravating previous mental health distress. However, emotional and material support from peers likely protects these workers' mental health.

We provide an integrative review of non-pharmacological interventions for children with mental health problems. A total of 262 studies were found in three databases, of which 12 met the inclusion criteria, indicating a shortage of research on the subject. The most frequently used type of intervention was cognitive-behavioural therapy-based interventions, and attention deficit hyperactivity disorder was the most frequent problem. Non-pharmacological interventions help to improve the symptoms of childhood mental health problems, so there is a need to carry out further research on this issue in Brazil and the rest of Latin America.

Aims: To identify the types of nasogastric/nasoenteric tube (NGT/NET)-related adverse events and to analyze the degree of harm and the factors associated with mechanical device-related complications., Materials and Methods: A prospective cohort study was conducted from October 2017 to April 2019 in seven Brazilian hospitals. Data from 447 adult patients with NGT/NET were collected through electronic forms. Three methods were used to assess the NGT/NET-related adverse events: (1) encouraging spontaneous reports; (2) regular visits to the wards; and (3) review of medical records. The events were classified as mechanical device-related complications and other events. The degree of harm was classified according to the World Health Organization's International Classification for Patient Safety. Data were analyzed using the R program, version 3.5.3. The following tests were applied to identify associations between the explanatory and response variables: Cochran-Armitage Chi-Square test, Fisher's exact test, and Linear-by-linear Chi-Square test. Logistic regression analysis was performed to verify the predictors of mechanical device-related complications. All analyses were performed considering a 5% significance level., Results: 191 NGT/NET-related adverse events were identified in 116 patients; the majority were mechanical device-related complications and resulted in mild harm to the patient. At the moment of the event, patients had a mean of 3.27 comorbidities, were highly dependent on nursing care, with high risk of death and altered level of consciousness. There was no association between the degree of harm and the care complexity, disease severity or level of consciousness. Intensive care was the strongest predictor for mechanical device-related complications and critical patients had a four times greater likelihood of presenting this type of event when compared to patients receiving minimal care., Conclusion: Intensive care patients should receive special attention as the complexity of care is an important predictor for mechanical device-related complications in tube fed patients., Competing Interests: The authors have declared that no competing interests exist.

Background: Considering the high incidence of cancer in Brazil and worldwide, the high prevalence and relevance of Common Mental Disorders (CMD) in the treatment of cancer patients, and the use of psychiatric drugs without reliably proven effectiveness, studies that contemplate this topic are needed to understand and provide rationale for the treatment of CMD in these individuals., Objectives: This study identified prevalence and factors associated with Common Mental Disorders (CMD) and psychotropic use in cancer outpatients., Method: This is a cross-sectional study with descriptive correlational design. It was developed in the chemotherapy sector of a hospital specialized in cancer. The tools used were: Self Reporting Questionnaire (SRQ-20) and structured questionnaires., Findings: Among 403 respondents, CMD prevalence was 31.5% and psychotropic use was 25.8%. CMD were associated with gender, education, family income, psychotropic use and cancer surgery. Psychotropic use was associated with gender, employment status, cancer surgery, treatment period and other physical health conditions. Logistic regressions showed CMD were associated with gender and other physical health conditions; psychotropic use was associated with gender, employment status and other conditions., (Copyright © 2019. Published by Elsevier Inc.)

This cross-sectional study interviewed Brazilian women regularly attending primary care to investigate whether the relationship between social support and alcohol use is direct or is mediated by stress, in order to support the development of recommendations related to health prevention and mental health promotion actions. The results suggest that social support affects the outcome alcohol use in the women studied by buffering the effect of stress. Based on these results, recommendations are made for amplifying the social support network that prevents stress-induced alcohol use.

Aims: The primary aims were to determine the rate of potential drug-drug interactions (pDDIs) in patients with nasally placed feeding tubes (NPFT) and the factors significantly associated with pDDIs. The secondary aim was to assess the change in pDDIs for patients between admission and discharge., Material and Methods: This multicentre study applied a cross-sectional design and was conducted in six Brazilian hospitals, from October 2016 to July 2018. Data from patients with NPFT were collected through electronic forms. All regular medications prescribed were recorded. Medications were classified according to the World Health Organization (WHO) Anatomical Therapeutic Chemical code. Drug-drug interaction screening software was used to screen patients' medications for pDDIs. Negative binomial regression was used to account for the over dispersed nature of the pDDI count. Since the number of pDDIs was closely related to the number of prescribed medications, we modelled the rate of pDDIs with the count of pDDIs as the numerator and the number of prescribed medications as the denominator; six variables were considered for inclusion: time (admission or discharge), patient age, patient gender, age-adjusted Charlson Comorbidity Index (CCI) score, type of prescription (electronic or handwritten) and patient care complexity. To account for correlation within the two time points (admission and discharge) for each patient a generalised estimating equations approach was used to adjust the standard error estimates. To test the change in pDDI rate between admission and discharge a full model of six variables was fitted to generate an adjusted estimate., Results: In this study, 327 patients were included. At least one pDDI was found in more than 91% of patients on admission and discharge and most of these pDDIs were classified as major severity. Three factors were significantly associated with the rate of pDDIs per medication: patient age, patient care complexity and prescription type (handwritten vs electronic). There was no evidence of a difference in pDDI rate between admission and discharge., Conclusion: Patients with a NPFT are at high risk of pDDIs. Drug interaction screening tools and computerized clinical decision support systems could be effective risk mitigation strategies for this patient group., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Hospitalised patients with nasogastric/nasoenteric tube (NGT/NET) are at constant risk of incidents; therefore, healthcare professionals need to routinely monitor risks and adopt strategies for patient safety and quality of care., Aim: This study aimed to evaluate the NGT/NET-related incidents in hospitalised patients and associated factors., Methods: This is a multicentre study, with a prospective cohort design. Data will be collected at the general medical ward of seven Brazilian hospitals in the north, northeast, southeast and south. The sample will consist of 391 patients that require an NGT/NET during hospitalisation. Three different methods will be used to identify the incidents: (1) healthcare professionals and patients/caregivers will be required to report any NGT/NET-related incidents; (2) researchers will visit the wards to get information about the incidents with healthcare professionals and patients/caregivers; (3) the researchers will review the medical records looking for information on the occurrence of any NGT/NET-related incidents. Demographic, clinical and therapeutic details will be obtained from the medical records and will be registered in an electronic data collection tool developed for the purposes of this study. The complexity of patients will be assessed by the Patient Classification System, and the severity of comorbid diseases will be assessed through the Charlson Comorbidity Index., Implication for Practice: The results may encourage the use of evidence effectively to influence the scientific foundation for clinical practice and the development of evidence-based policies that will prevent, manage and eliminate complications caused by NGT/NET-related incidents, and improve the quality and safety of care provided to hospitalised patients., Ethics and Dissemination: The study has been approved by the Research Ethics Committee. Detailed information about the study can be provided by the principal investigator. The findings will be reported through academic journals, seminar and conference presentations, social media, print media, the internet and community/stakeholder engagement activities., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

It is important to investigate the care given to people with suicidal behavior, as it is an important predictor of future death by suicide and there is a lack of studies on this issue in Brazil. This study had the objective of investigating assistance related to suicidal behavior at a mobile emergency service and sociodemographic and clinical associated factors. This was a quantitative, cross-sectional study based on documental information. The data were collected through manual consultation of nursing records in which call-outs for suicidal behavior in the year 2014 were documented. The data were analyzed using descriptive statistics, Chi-squared test, Fisher's exact test, correlation tests, and comparison of means tests. In the 313 records analyzed there was a predominance of adult women with self-inflicted drug poisoning, attended to in their own residence and referred to pre-hospital emergency medical services. There was a lack of documentation on signs, symptoms, and grievances in most cases. The interventions most carried out by the nurses were related to monitoring of clinical parameters. There were differences related to the victim's sex and lethality, suicide attempt method, referral to emergency services, and semester of occurrence (January-June, July-December). Suicide attempts through self-poisoning or self-inflicted injuries differed in relation to time of call-out, waiting time, lethality, documentation on clinical assessment and interventions, and referral to emergency services. This study enabled the charting of factors linked with suicidal behavior and associated factors; it offers reflections on limitations and nursing care potential in the prevention of reoccurrence of suicidal behavior., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Aim: To investigate the prevalence of depressive symptoms, psychological problems, suicidal behaviour and their associations in substance users in treatment., Methods: A cross-sectional study, with 307 substance users in an out-patient treatment facility, was undertaken. Socio-demographic data, psychoactive substances used, depressive symptoms, and suicide information were obtained., Results: 70% of participants were depressed; of those, 8.1% were either under the influence of drugs or in withdrawal. Suicidal ideation was found to be present in those who had anxiety, were nervous, had depressive symptoms, or were under drug influence or in withdrawal., Conclusion: It is important to identify potential suicidal risk factors and implement the management of these conditions in substance users., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Physical restraint in psychiatric units is a common practice but extremely controversial and poorly evaluated by methodologically appropriate investigations. The cultural issues and professionals' perceptions and attitudes are substantial contributors to the frequency of restraint that tend to be elevated. Aim In this qualitative study, we aimed to understand the experiences and perceptions of nursing staff regarding physical restraint in psychiatric units., Method: Through theoretical sampling, 29 nurses from two Brazilian psychiatric units participated in the study. Data were collected from 2014 to 2016 from individual interviews and analyzed through thematic analysis, employing theoretical presuppositions of symbolic interactionism., Results: Physical restraint was considered unpleasant, challenging, risky, and associated with dilemmas and conflicts. The nursing staff was often exposed to the risks and injuries related to restraint. Professionals sought strategies to reduce restraint-related damages, but still considered it necessary due to the lack of effective options to control aggressive behavior., Conclusions: This study provides additional perspectives about physical restraint and reveals the need for safer, humanized and appropriate methods for the care of aggressive patients that consider the real needs and rights of these patients., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The meaning ascribed to suicidal behaviours may influence the quality of the care provided to people at risk of suicide. Such a phenomenon has yet to be properly investigated amongst nursing undergraduate students, the aim of this study being to gain an understanding of the meanings of suicidal behaviour for a particular group of nurses. The study, which utilized grounded theory, was conducted in Brazil in 2016-2017 with 30 undergraduate students. The findings indicated that suicidal behaviour, classified according to the individual beliefs and judgements of the participants, presented a significant barrier to the delivery of care and was complex and multifaceted care phenomenon. Participants were often reluctant to discuss the topic, seemingly wanting to distance themselves from the care of persons exhibiting suicidal behaviour, and to avoid professional engagements relating to suicide prevention. Significant work is required in raising both an awareness and knowledge of suicidal behaviour befitting the promotion of tolerance, emotional competency, resilience, and empathy amongst nursing students., (© 2017 Australian College of Mental Health Nurses Inc.)

WHAT IS KNOWN ON THE SUBJECT?: Older individuals constitute an increasing proportion of the population, and therefore, are the major consumers of drugs. The elderly, especially those with mental disabilities, frequently develop chronic diseases and start using numerous drugs. Drug-drug interactions (DDIs) are a major clinical problem in the elderly population, and previous studies have focused only on antidepressants and others types of drugs used to treat mental health conditions. WHAT THIS ARTICLE ADDS TO EXISTING KNOWLEDGE?: This study shows that in hospitalized elderly patients with mental disorders (aged 60-69 years), polypharmacy (≥5 drugs) and the use of drugs that act on the cardiovascular, respiratory and nervous systems can lead to potential drug-drug interactions. Moreover, it was reported that the prevalence of drug-drug interactions in elderly patients with mental disorders was high during their hospitalization in a public hospital in Brazil. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses should know the factors associated with drug-drug interactions in hospitalized elderly patients with mental disorders to choose appropriate strategies for avoiding treatment failure and adverse events in patients., Abstract: Introduction Despite the impact on patient safety and the fact that prevalence is higher in older patients, previous research did not analyse drug-drug interactions (DDIs) in view of nursing care of elderly psychiatric patients. Aim To identify potential drug-drug interactions and polypharmacy in prescriptions of aged inpatients with psychiatric disorders and analyse associated factors. Methods In this retrospective cross-sectional study, we analysed the medical records of institutionalized patients diagnosed with psychiatric disorders (n = 94), aged >60 years, and prescribed multiple medications. Drug prescriptions were checked at admission, midway through and the last prescription. Factors associated with DDI occurrence were assessed using multivariable logistic regression analysis. Results A DDI prevalence potential of 67.0%, 74.5% and 80.8% occurred in patients at admission, midway through hospitalization and the last prescription, respectively. Most of the prescribed drugs were nervous system agents. A high percentage of serious and contraindicated potential DDIs occurred. Age between 60 and 69 years, use of cardiovascular and respiratory system drugs, and the number of medications contributed significantly to DDI. Implications for mental health nursing Knowledge on the factors associated with DDIs in patients with mental disorders can contribute to the improvement of effectiveness and safety of nursing care., (© 2017 John Wiley & Sons Ltd.)

Objective: Assess the relationship between psychiatric relapses of patients with a diagnosis of schizophrenia, the levels of expressed emotion among their relatives and related factors., Method: Prospective study carried out at a mental health outpatient clinic and two Psychosocial Care Centers, with patients and relatives responding to the Family Questionnaire - Brazilian Portuguese Version, a form containing socio-demographic and clinical variables and a structured script to assess relapses. A logistic regression model was used for the analysis., Results: A total of 89 dyads participated in the study. Of the patients investigated, 31% presented relapses and, among the relatives, 68% presented elevated levels of expressed emotion. The relationship between expressed emotion and the relapses was not significant. The logistic regression analysis demonstrated that when there were a higher number of hospital admissions in the two years preceding the study, the chance of the patient relapsing in the 24-month period is 1.34., Conclusion: Expressed emotion was insufficient to predict relapses. Thus, a relapse should be understood as a multifactorial phenomenon. These results provide support for interventions and investigations on the multiple factors involved in the evolution of schizophrenia patients in follow-up at community-based health services.

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.

WHAT IS KNOWN ON THE SUBJECT?: Self-confident health professionals with positive and understanding attitudes can take better care of people with suicidal behaviour, but the factors associated with these attitudes are not known. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The majority of nursing professionals had no experience or training in mental health or suicide. They were less self-confident and had more negative attitudes. Nurses and nursing assistants who worked before in mental health services were more understanding with people with suicidal behaviour. Nurses and nursing assistants who were working in prehospital services were less self-confident to taking care of people with suicidal behaviour. Some members of the nursing team had already seriously considered committing suicide. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The practicing, support and training in mental health may improve the nurses' attitudes and emotional competencies. It is important to know why few nurses had suicide-related training, despite the relevance of this issue. Training in mental health or suicide need to include attitudinal and emotional competencies. It is important to offer emotional support to emergency nursing professionals., Abstract: Background The attitudes towards suicide of emergency nurses may affect the care provided. However, the factors associated with these attitudes remain unclear. Objective To investigate attitudes towards suicidal behaviour and associated factors among nursing professionals working in emergency settings. Methods A cross-sectional observational study including 28 nurses and 118 who were nursing assistants employed at two emergency services in Brazil was conducted. Data were collected in 2015 using a self-administered sociodemographic questionnaire and the Suicide Behavior Attitude Questionnaire (SBAQ). Results The majority of participants reported having no experience or training in mental health or suicide. They reported more negative feelings towards the patient and a lower self-perception of professional competence regarding suicidal behaviours, and these attitudes seemed to reinforce each other. Nurses who worked in mental health services reported less moralistic/judgemental attitudes. Working in prehospital services was associated with having a lower self-perception of professional competence. There were professionals who reported thinking seriously about committing suicide. Conclusion When combined with support and training, practicing mental health nursing may serve as an opportunity to develop favourable attitudes and emotional competences, and these issues need to be addressed in suicide education strategies., (© 2017 John Wiley & Sons Ltd.)

There were no Brazilian studies regarding potential drug-drug interactions (DDIs) in primary health care (PHC) analysing common mental disorders (CMDs) and psychotropic medication., Objectives: To identify DDI prevalence in that setting; to classify DDI; to verify correlations with demographics, pharmacotherapeutics, psychotropic medication and CMDs. Among 430 patients interviewed 190 had more than two medications prescribed, 58.4% had DDI. Factors associated were age and number of medications. Nine types of severe DDI composed 28% patients' prescriptions, 71.9% involving psychotropic medication. Only the number of types of drugs contributed to the regression model. Results raise important aspects regarding patient safety in PHC units in Brazil are where patients with psychological complaints have to seek for health care firstly.

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., (Copyright © 2017 Elsevier Inc. All rights reserved.)

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.]., (Copyright 2017, SLACK Incorporated.)

The aim of the study was to evaluate the patients' quality of life in Brazil's Family Health Strategy and its association with sociodemographic factors, presence of common mental disorders, and use of psychotropic drugs. Were interviewed 442 patients. Tools were: World Health Organization Quality of Life Assessment-Bref and Self Reporting Questionnaire. Male and low education were strongly associated with higher quality of life. Use of psychotropic drugs and the presence of CMD were strongly associated with poor quality of life. There is a pressing need for primary health care professionals to invest in tracking, and in holistic interventions that are able to cover the healthcare needs of these vulnerable groups., (Copyright © 2016 Elsevier Inc. All rights reserved.)

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.