Motivation and treatment engagement intervention trial (MotivaTe-IT): The effects of motivation feedback to clinicians on treatment engagement in patients with severe mental illness

Background: Treatment disengagement and non-completion poses a major problem for the successful treatment of patients with severe mental illness. Motivation for treatment has long been proposed as a major determinant of treatment engagement, but exact mechanisms remain unclear. This current study serves three purposes: 1) to determine whether a feedback intervention based on the patients' motivation for treatment is effective at improving treatment engagement (TE) of severe mentally ill patients in outpatient psychiatric treatment, 2) to gather insight into motivational processes and pos

Diferenciais de gênero no impacto do arranjo familiar no status de saúde dos idosos brasileiros Gender differences in the impact of family arrangements on health status of Brazilian elderly

Analisam-se os diferenciais por gênero na relação do arranjo familiar com o status de saúde de pessoas com 65 anos ou mais, incorporando também fatores socioeconômicos e sociodemográficos. Utilizam-se dados da PNAD de 1998. Foram desenvolvidos diversos modelos de regressão logística para duas variáveis dependentes: auto-avaliação da saúde e declaração de doenças. Os fatores explicativos (área rural/urbana, idade, renda per capita, analfabetismo, arranjo familiar e condição no domicílio) foram incorporados seqüencialmente para avaliar as mudanças da inter-relação. Encontrou-se que, embora as mulheres tenham mais desvantagem quanto à declaração de doenças, a auto-avaliação da condição de sua saúde é relativamente similar à dos homens. Os diferenciais de gênero no padrão de arranjo familiar dos idosos são em parte responsáveis pela desvantagem no status de saúde das mulheres. Conclui-se que a formulação de políticas para o melhoramento do status de saúde do idoso deve considerar a existência de importantes diferenças de gênero no padrão da estrutura e arranjo de suas famílias. Existe necessidade de maior disponibilidade de inquéritos para idosos, que permitam aprofundamento na relação entre saúde do idoso, gênero e família.<br>In this work one explores gender differences in family arrangement and its relation to the health status of men and women over 65, taking into account socio-demographic and socioeconomic variables. Data were collected through a National Household Survey in 1998 that included a special supplement on health. Several logistic regression models were run for two dependent variables: health self assessment and report of chronic conditions. The explanatory variables (urban/rural area, age, per capita income, illiteracy, family arrangement, and household condition) were incorporated in a sequential way to assess changes in the relationship. It was found that, although women report more chronic conditions, there is a relative similarity in health self-assessment for both women and men. Gender differences in family arrangements patterns are partially responsible for the poorer health status of women. Health policies oriented to the older people must take into consideration the existent of important gender differences in family structure and family arrangements. There is a need of more detailed information on Brazilian household surveys as to disentangle the relationships between the older people&acute;s health, gender and family