Prevalência de sintomas depressivos e qualidade de vida em alunos de enfermagem em uma Universidade Federal

Introdução: Aproximadamente 5,8% da população brasileira sofre de depressão, um total de 11,5 milhões de casos registrados no país, sendo a principal causa de incapacidade laboral. As transições entre as fases da vida são denominadas “crises vitais” e são um momento de adaptação às mudanças. Estes impactos ocorrem várias vezes ao longo da vida, desde a infância até a senilidade. Estudos epidemiológicos têm revelado que transtornos mentais têm maior chance de surgir pela primeira vez no início da vida adulta, principalmente no período universitário. Objetivo: Verificar a prevalência de sintomas depressivos em estudantes de enfermagem da Universidade Federal do Rio Grande do Sul. Metodologia: Estudo quantitativo analítico transversal. A amostra foi constituída por alunos do primeiro ao oitavo semestre da graduação de enfermagem da Universidade Federal do Rio Grande do Sul (UFRGS). O Protocolo utilizado para coleta dos dados incluiu: Inventário de Depressão de Beck (DBI), SQR20 (avaliação de sintomas psiquiátricos mínimos), WHOQOL-bref (qualidade de vida) e o Termo de consentimento Livre e Esclarecido. Resultados: a amostra totalizou 242 estudantes com média de idade de 22,9 anos ± 5,1, sendo 88,8% (215) participantes eram do sexo feminino. Os escores na avaliação da qualidade de vida foram equivalentes entre os semestres. Nesta amostra, 25% dos alunos apresentaram sintomas depressivos graves, sendo maior a frequência entre os alunos do primeiro semestre. Observou-se que quanto maior a prevalência de sintomas depressivos pior foram os escores da qualidade de vida. O SRQ20 indicou que 54% dos alunos apresentaram sintomas psiquiátricos menores, sendo que a distribuição entre os semestres foi parecida com a distribuição do DBI. Conclusão: O estudo chamou a atenção por indicar que 25% dos discentes desta amostra possuíam sintomas depressivos graves e 54% apresentaram sintomas psiquiátricos mínimos. Avaliou-se que, dentre as variáveis de depressão, uma das características mais proeminentes entre os alunos com sintomas depressivos moderados e graves foi a renda menor ou igual a um salário mínimo por pessoa da família

Calidad de vida, síntomas depresivos y psiquiátricos menores en estudiantes de enfermería

Objetivo: Avaliar qualidade de vida, prevalência de sintomas depressivos e psiquiátricos menores em estudantes de Enfermagem. Métodos: Estudo transversal, realizado de março a abril de 2018, em uma universidade federal. Amostra composta por 242 acadêmicos de Enfermagem, do 1º ao 8º semestre. Os dados foram coletados por meio dos instrumentos de qualidade de vida, Inventário de Depressão de Beck e Self-Report Questionnaire. Considerou-se nível de significância de 0,05. Resultados: A média de idade foi de 22,9±5,1 anos. Verificou-se que 25% dos alunos apresentaram sintomas depressivos graves e 54% dos alunos apresentaram transtornos psiquiátricos menores, com maior prevalência nos primeiros semestres. Observouse relação inversa entre frequência de sintomas depressivos e escores da qualidade de vida (p = 0,05). Conclusão: Os acadêmicos de Enfermagem apresentaram elevada prevalência de sintomas depressivos, indicando a importância da implantação de ações para promoção e prevenção da saúde mental.Objective: To assess quality of life, prevalence of depressive and minor psychiatric symptoms in Nursing students. Methods: Cross-sectional study, conducted from March to April 2018, at a federal university. Sample composed of 242 Nursing students, from the 1st to the 8th semester. Data was collected using the quality of life instruments, Beck Depression Inventory and SelfReport Questionnaire. A significance level of 0.05 was considered. Results: The mean age was 22.9 ± 5.1 years. It was found that 25% of the students had severe depressive symptoms and 54% of the students had minor psychiatric disorders, with a higher prevalence in the first semesters. An inverse relationship was observed between the frequency of depressive symptoms and quality of life scores (p = 0.05). Conclusion: Nursing students showed a high prevalence of depressive symptoms, indicating the importance of implementing actions to promote and prevent mental health.Objetivo: Evaluar calidad de vida, prevalencia de síntomas depresivos y psiquiátricos menores en estudiantes de Enfermería. Métodos: Estudio transversal, realizado de marzo a abril de 2018, en una universidad federal. Muestra compuesta por 242 académicos de Enfermería, del 1º al 8º semestre. Los datos han sido recogidos por medio de los instrumentos de calidad de vida, Inventario de Depresión de Beck y Self-Report Questionnaire. Se ha considerado nivel de acepción de 0,05. Resultados: La media de edad ha sido 22,9±5,1 años. Se ha verificado que 25% de los alumnos presentaron síntomas depresivos graves y 54% de los alumnos presentaron trastornos psiquiátricos menores, con mayor prevalencia en los primeros semestres. Se ha observado relación inversa entre frecuencia de síntomas depresivos y escores de la calidad de vida (p = 0,05). Conclusión: Los académicos de Enfermería presentaron elevada prevalencia de síntomas depresivos, indicando la importancia de la implantación de acciones para promoción y prevención de la salud mental

Riesgos de enfermedad ocupacional en profesionales de la salud que atienden pacientes con COVID-19: revisión integradora

Objetivo: analisar as evidências sobre os riscos de adoecimento ocupacional aos quais estão expostos os profissionais de saúde que cuidam de pacientes acometidos pela COVID-19. Método: revisão integrativa da literatura realizada por meio de busca on-line nas bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science (WoS), Excerpta Medica Data-base (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Scopus (Elsevier). Incluíram-se artigos originais, publicados entre novembro de 2019 e junho de 2020, sem restrições de idioma. A análise descritiva dos resultados é apresentada em duas categorias. Resultados: a amostra constituiu-se de 19 produções científicas com predomínio da língua inglesa (n=16, 84%) e estudos de corte transversal, com nível de evidência 2C (n=17, 90%). Os estudos mostraram, como principais eixos temáticos, o risco de contaminação e o risco de adoecimento psicoemocional no atendimento a pacientes acometidos pela COVID-19. Conclusão: a revisão mostrou os potenciais efeitos sobre a saúde dos profissionais durante o atendimento de pacientes acometidos pela COVID-19. Evidenciou-se a importância da implementação de estratégias de intervenção focadas nos riscos ocupacionais mais prevalentes durante a pandemia. O nível de evidência dos estudos sugere a necessidade de desenvolvimento de pesquisas com delineamentos mais robustos.Objective: to analyze evidence concerning the risks of occupational illnesses to which health workers providing care to patients infected with COVID-19 are exposed. Method: integrative literature review conducted in the following online databases: Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science (WoS), Excerpta Medica Data-Base (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus (Elsevier). Original articles published between November 2019 and June 2020, regardless of the language written, were included. A descriptive analysis according to two categories is presented. Results: the sample is composed of 19 scientific papers. Most were cross-sectional studies with an evidence level 2C (n=17, 90%) written in English (n=16, 84%). The primary thematic axes were risk of contamination and risk of psycho-emotional illness arising from the delivery of care to patients infected with COVID-19. Conclusion: the review presents the potential effects of providing care to patients with COVID-19 on the health of workers. It also reveals the importance of interventions focused on the most prevalent occupational risks during the pandemic. The studies’ level of evidence suggests a need for studies with more robust designs.Objetivo: analizar las evidencias sobre los riesgos de enfermedad ocupacional a los cuales están expuestos los profesionales de la salud que cuidan de pacientes afectados por la COVID-19. Método: revisión integradora de la literatura realizada a través de búsqueda online en las bases de datos Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science (WoS), Excerpta Medica Data-base (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) y Scopus (Elsevier). Fueron incluidos artículos originales, publicados entre noviembre de 2019 y junio de 2020, sin restricciones de idioma. El análisis descriptivo de los resultados se presenta en dos categorías. Resultados: la muestra fue constituida por 19 producciones científicas con predominio del idioma inglés (n=16, 84%) y estudios de corte transversal con nivel de evidencia 2C (n=17, 90%). Los estudios mostraron como principales ejes temáticos el riesgo de contaminación y riesgo de enfermedad psicoemocional, en la atención a pacientes afectados por COVID-19. Conclusión: la revisión mostró los potenciales efectos sobre la salud de los profesionales durante la atención de pacientes afectados por COVID-19. Se evidenció la importancia de implementar estrategias de intervención, enfocadas en los riesgos ocupacionales más prevalentes durante la pandemia. El nivel de evidencia de los estudios sugiere la necesidad de desarrollar investigaciones con delineamientos más robustos

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2 : an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine : a pooled analysis of four randomised trials

Background The ChAdOx1 nCoV-19 (AZD1222) vaccine has been approved for emergency use by the UK regulatory authority, Medicines and Healthcare products Regulatory Agency, with a regimen of two standard doses given with an interval of 4–12 weeks. The planned roll-out in the UK will involve vaccinating people in high-risk categories with their first dose immediately, and delivering the second dose 12 weeks later. Here, we provide both a further prespecified pooled analysis of trials of ChAdOx1 nCoV-19 and exploratory analyses of the impact on immunogenicity and efficacy of extending the interval between priming and booster doses. In addition, we show the immunogenicity and protection afforded by the first dose, before a booster dose has been offered. Methods We present data from three single-blind randomised controlled trials—one phase 1/2 study in the UK (COV001), one phase 2/3 study in the UK (COV002), and a phase 3 study in Brazil (COV003)—and one double-blind phase 1/2 study in South Africa (COV005). As previously described, individuals 18 years and older were randomly assigned 1:1 to receive two standard doses of ChAdOx1 nCoV-19 (5×10¹⁰ viral particles) or a control vaccine or saline placebo. In the UK trial, a subset of participants received a lower dose (2·2×10¹⁰ viral particles) of the ChAdOx1 nCoV-19 for the first dose. The primary outcome was virologically confirmed symptomatic COVID-19 disease, defined as a nucleic acid amplification test (NAAT)-positive swab combined with at least one qualifying symptom (fever ≥37·8°C, cough, shortness of breath, or anosmia or ageusia) more than 14 days after the second dose. Secondary efficacy analyses included cases occuring at least 22 days after the first dose. Antibody responses measured by immunoassay and by pseudovirus neutralisation were exploratory outcomes. All cases of COVID-19 with a NAATpositive swab were adjudicated for inclusion in the analysis by a masked independent endpoint review committee. The primary analysis included all participants who were SARS-CoV-2 N protein seronegative at baseline, had had at least 14 days of follow-up after the second dose, and had no evidence of previous SARS-CoV-2 infection from NAAT swabs. Safety was assessed in all participants who received at least one dose. The four trials are registered at ISRCTN89951424 (COV003) and ClinicalTrials.gov, NCT04324606 (COV001), NCT04400838 (COV002), and NCT04444674 (COV005). Findings Between April 23 and Dec 6, 2020, 24422 participants were recruited and vaccinated across the four studies, of whom 17178 were included in the primary analysis (8597 receiving ChAdOx1 nCoV-19 and 8581 receiving control vaccine). The data cutoff for these analyses was Dec 7, 2020. 332 NAAT-positive infections met the primary endpoint of symptomatic infection more than 14 days after the second dose. Overall vaccine efficacy more than 14 days after the second dose was 66·7% (95% CI 57·4–74·0), with 84 (1·0%) cases in the 8597 participants in the ChAdOx1 nCoV-19 group and 248 (2·9%) in the 8581 participants in the control group. There were no hospital admissions for COVID-19 in the ChAdOx1 nCoV-19 group after the initial 21-day exclusion period, and 15 in the control group. 108 (0·9%) of 12282 participants in the ChAdOx1 nCoV-19 group and 127 (1·1%) of 11962 participants in the control group had serious adverse events. There were seven deaths considered unrelated to vaccination (two in the ChAdOx1 nCov-19 group and five in the control group), including one COVID-19-related death in one participant in the control group. Exploratory analyses showed that vaccine efficacy after a single standard dose of vaccine from day 22 to day 90 after vaccination was 76·0% (59·3–85·9). Our modelling analysis indicated that protection did not wane during this initial 3-month period. Similarly, antibody levels were maintained during this period with minimal waning by day 90 (geometric mean ratio [GMR] 0·66 [95% CI 0·59–0·74]). In the participants who received two standard doses, after the second dose, efficacy was higher in those with a longer prime-boost interval (vaccine efficacy 81·3% [95% CI 60·3–91·2] at ≥12 weeks) than in those with a short interval (vaccine efficacy 55·1% [33·0–69·9] at <6 weeks). These observations are supported by immunogenicity data that showed binding antibody responses more than two-fold higher after an interval of 12 or more weeks compared with an interval of less than 6 weeks in those who were aged 18–55 years (GMR 2·32 [2·01–2·68]). Interpretation The results of this primary analysis of two doses of ChAdOx1 nCoV-19 were consistent with those seen in the interim analysis of the trials and confirm that the vaccine is efficacious, with results varying by dose interval in exploratory analyses. A 3-month dose interval might have advantages over a programme with a short dose interval for roll-out of a pandemic vaccine to protect the largest number of individuals in the population as early as possible when supplies are scarce, while also improving protection after receiving a second dose

Assessment of the quality of professional life and occupational stress in nursing workers at a hospital during a COVID-19 pandemic

Introdução: O profissional de enfermagem trabalha com pessoas, saudáveis e doentes, em ambientes de alta, média e baixa complexidade. Dessa forma, esse profissional está sujeito a reagir ao contato com esses pacientes e familiares, podendo experimentar sentimentos de compaixão que podem ou não afetar sua qualidade de vida profissional. O profissional de enfermagem tem de lidar, também, com os colegas, chefias, ambiente e recursos no trabalho, que podem gerar estresse ocupacional nesses indivíduos. Além disso, atualmente o Brasil e o mundo passam por uma nova realidade na sociedade e no ambiente hospitalar devido à pandemia por COVID-19, que se originou na China. Objetivo: Identificar os níveis de qualidade de vida profissional e o estresse ocupacional em profissionais da enfermagem de unidades de internação. Metodologia: Estudo quantitativo transversal e aninhado no projeto de pesquisa “Efeito do biofeedback no estresse, ansiedade e qualidade de vida profissional nas equipes de enfermagem em um hospital universitário: ensaio clínico randomizado”. A pesquisa foi desenvolvida em unidades de internação para pacientes clínicos e cirúrgicos de um hospital de grande porte, com atendimento ao Sistema Único de Saúde. A coleta de dados ocorreu entre abril e agosto de 2020, através do preenchimento de questionários autoaplicáveis: questionário sociodemográfico e de informações sobre saúde, escala de estresse no trabalho e qualidade de vida profissional. O tamanho amostral foi calculado por meio do programa Winpepi com poder de 80%, nível de significância de 5%, resultando em 150 sujeitos. A amostragem foi aleatória, estratificada de acordo com o número de profissionais, com distribuição de dois técnicos ou auxiliares de enfermagem para cada enfermeiro pesquisado. Os dados foram analisados no pacote estatístico SPSS, versão 25, foram utilizados testes não paramétricos. Este projeto foi aprovado por Comitê de Ética em Pesquisa sob Certificado de Apresentação de Apreciação Ética 23346619000005327. Resultados: A amostra incluiu 127 (84,7%) profissionais do sexo feminino com média de idade de 43 anos (± 8,89). Quanto às categorias, 33,3% (50) eram enfermeiros e 66,7% (100) eram técnicos e auxiliares de enfermagem. Na escala de estresse no trabalho, verificou-se que a média total dos escores foi de 1,9 (± 0,71), sendo considerada como nível moderado de estresse. As faixas de idade “menor de 30 anos” e “maior de 60 anos” não apresentaram escores de altos níveis de estresse. Observando separadamente as subescalas de qualidade de vida profissional, verificou-se que satisfação por compaixão (SC) teve mediana de 50,3 (9,1 – 64,6), burnout (BO) de 48,5 (32,2 – 84,8) e estresse pós-traumático (ETS) de 47,1 (38,6 – 98,3). Todos os escores encontrados são considerados como moderados. Entre as subescalas, observou-se que a satisfação por compaixão apresentou correlação inversa e moderada na subescala de burnout (ρ = -0,416; p = 0,000), sendo que na de estresse traumático secundário foi inversa e fraca (ρ = -0,272; p< 0,001). A correlação entre as duas subescalas da fadiga por compaixão foi positiva e moderada (ρ = 0,464; p = 0,000). Relacionando estresse e qualidade de vida no trabalho, observou-se que, conforme aumentam os níveis de estresse, diminuem os níveis de qualidade de vida profissional. Verificou-se associação significativa entre prática de atividade física e resultados elevados de satisfação por compaixão (X² = 6,397; p = 0,041). Ocorreu também uma tendência de relação (X² = 5,992; p = 0,05) entre fadiga por compaixão e renda familiar inferior a quatro mil e quinhentos reais. Conclusão: Observou-se maior prevalência de estresse ocupacional na categoria de técnicos de enfermagem, bem como maiores níveis de Fadiga por Compaixão.Introduction: The nursing professional works with people, healthy and sick, in environments of high, medium and low complexity. Thus, this professional is subject to react to contact with these patients and family members, and may experience feelings of compassion that may or may not affect their quality of professional life. The nursing professional also has to deal with colleagues, managers, environment and resources at work, which can generate occupational stress in these individuals. In addition, Brazil and the world are currently experiencing a new reality in society and in the hospital environment due to the COVID-19 pandemic, which originated in China. Objective: To identify the levels of quality of professional life and occupational stress in nursing professionals from inpatient units. Methodology: Quantitative cross-sectional study nested in the research project “Effect of biofeedback on stress, anxiety and quality of professional life in nursing teams at a university hospital: randomized clinical trial”. The research was developed in inpatient units for clinical and surgical patients of a large hospital, serving the Unified Health System. Data collection took place between April and August 2020, by completing self-administered questionnaires: sociodemographic questionnaire and information on health, work stress scale and quality of professional life. The sample size was calculated using the Winpepi program with a power of 80%, a significance level of 5%, resulting in 150 subjects. The sample selection was random and categorical, proportional to the number of professionals, with the distribution of two nursing technicians or assistants for each nurse surveyed. The data were analyzed using the SPSS statistical package, version 25. This project was approved by the Research Ethics Committee under the Certificate of Presentation of Ethical Appreciation 2334661900005327. Results: The sample included 127 (84.7%) female professionals with an average age of 43 years (± 8.89). As for the categories, 33.3% (50) were nurses and 66.7% (100) were nursing technicians and assistants. On the work stress scale, it was found that the total average of the scores was 1.9 (± 0.71), being considered as a moderate level of stress. The age groups “under 30 years old” and “over 60 years old” did not show high stress levels. Looking separately at the subscales of quality of professional life, it was found that satisfaction for compassion (SC) has a median of 50.3 (9.1 - 64.6), burnout (BO) of 48.5 (32.2 - 84) , 8) and post-traumatic stress (ETS) of 47.1 (38.6 - 98.3). All scores found are considered as moderate. Among the subscales, it was observed that satisfaction with compassion showed an inverse and moderate correlation with the subscale of burnout (ρ = - 0.416; p = 0.000) and inverse and weak with secondary traumatic stress (ρ = -0.272; p = 0.001) . The correlation between the two subscales of compassion fatigue was positive and moderate (ρ = 0.464; p = 0.000). Relating stress and quality of life at work, it is observed that, as the levels of stress increase, the levels of quality of professional life decrease. There was a significant relationship (X² = 6.397; p = 0.041) between performing physical activity and high results of satisfaction for compassion. There was also a tendency for a relationship (X² = 5.992; p = 0.05) between fatigue due to compassion and family income of less than four and a half thousand reais. Conclusion: There was a higher prevalence of occupational stress in the category of nursing technicians, as well as higher levels of Compassion Fatigue. There was a positive and moderate correlation between compassion fatigue and occupational stress

Hospitalizações de residentes na região metropolitana de Porto Alegre/RS por cistite, uma condição sensível à atenção primária (2008-2010)

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