Pregnancy is associated with psychiatric symptoms in a low-income countryside community of Brazil

Fernando MV Dias1–3, Claudio SD Junior4, Glaura C Franco5, Antônio L Teixeira3, Angela M Ribeiro21Department of Medicine and Nursing, Federal University of Viçosa, Viçosa; 2Graduate Program in Neurosciences, Laboratory of Molecular and Behavioral Neuroscience (LaNeC); 3Graduate Program in Neurosciences, Neuropsychiatric Branch Research; 4Department of Sociology and Anthropology; 5Department of Statistics, Federal University of Minas Gerais, Belo Horrizonte, BrazilBackground: Psychiatric symptoms during pregnancy induce an increase in morbidity and also in the mortality levels among women and children. However, the real association between pregnancy and psychiatric disorders and the peculiarities of the phenomenology of symptoms in underprivileged countryside communities remain uncertain.Objective: To verify the association between psychiatric disorder, symptoms, and pregnancy among women from a low-income countryside community and to determine the specific cutoff points for major depression diagnosis according to Beck Depression Inventory for the different trimesters of pregnancy in this population.Methods: Ninety-four pregnant women and 38 healthy women from the Conceição do Mato Dentro health service, a rural low-income community in Brazil, participated in the present study. Psychiatric examination included a structured clinical interview for psychiatric disorders according to Mini International Neuropsychiatric Interview and psychometric scales such as the Yale–Brown Obsessive Scale, the Beck Depression Inventory, and the Hamilton Anxiety Scale. The cutoff points for Beck Depression Inventory were determined through the application of receiver operating characteristic curves considering the diagnosis of major depression according to Mini International Neuropsychiatric Interview.Results: The pregnant women had a higher frequency of psychiatric disorders and depression and anxiety symptoms. All cutoff points of Beck Depression Inventory were equal or higher than 12 with high sensitivity and specificity. Although the modified cutoff was selected based on both high sensitivity and high specificity, they were lower than when the cutoff was applied to nonpregnant women.Conclusion: Pregnancy was associated with the occurrence of psychiatric disorders and depressive and anxiety symptoms. In comparison to the literature, the present results indicate that there are different cutoff points in the Beck Depression Inventory for pregnant women from different cultures and in different pregnancy trimesters.Keywords: pregnancy, psychiatric symptoms, low-income countryside communitie

Intervenções de enfermagem nas complicações mais freqüentes durante a sessão de hemodiálise: revisão da literatura Intervenciones de enfermería en las complicaciones más frecuentes durante la sesión de hemodialisis: revisión de la literatura Nursing interventions for the most frequent complications during hemodialysis procedure: literature review

O procedimento hemodialítico tem complicações potenciais e o enfermeiro deve estar apto a intervir em tais complicações. Considerando este contexto, este artigo tem como objetivo descrever as complicações mais freqüentes relacionadas à hemodiálise e as intervenções de enfermagem a elas relacionadas. Esta revisão de literatura consiste em pesquisa as Bases de Dados, LILACS, BEDENF E MEDLINE, utilizando descritores pertinentes. Os resultados demonstraram que as complicações que ocorrem com maior freqüência são: hipotensão, hipertensão, cãibras musculares, náusea e vômito, cefaléia, dor torácica e lombar, prurido, febre e calafrios. Concluiu-se que o papel do enfermeiro é essencial para a monitorização, detecção e intervenção em tais complicações e que este é um diferencial para a obtenção de segurança e qualidade no procedimento hemodialítico. No entanto, existe a necessidade de realização de mais pesquisas na área de enfermagem para melhor definir a atuação do enfermeiro.<br>Lo procedimiento de hemodialisis tiene complicaciones potenciales y los enfermeros deben estar aptos a intervenir en ellos. Al considerar esto contexto, lo artículo objectiva describir las complicaciones más frecuentes relacionadas a la hemodialisis así como las intervenciones de enfermería. Esta revisión bibliografica ha consistido de busqueda a las basis de datos LILACS, DBENF y MEDLINE usandose descriptores pertinentes. Resultados han demonstrado que las mayores complicaciones son: hipotensión, hipertensión, distres musculares, nausea, vomitos, cefalea, dolor toracica y lumbar, prurido, fiebre y calafrios. Se ha concluido que el papel del enfermero es esencial para la monitorización, identificación y intervención en estas complicaciones y que esto papel tanbien es uno diferencial para obterse la calidad en lo procedimiento hemodialitico. Entremientes, hay una necessidad de realizarse más pesquisas en la area de enfermería para mejor definirse el papel de lo enfermero.<br>Hemodialysis procedure has potential complications and nurses must be able to intervent on them. Considering this context, this article aims to describe the most frequent hemodialysis-related complications as well as nursing-related interventions. This bibliographic review consists in LILACS, BDENF and MEDLINE search using pertinent descriptors. Results demonstrated that major complications are: hypotension, hypertension, cramps, nausea and vomiting, headache, chest and low back pain, scratching, fever and shriving. For these complications there are specific nursing interventions that can be delivered. It was concluded that nurse's role is essential for monitoring, identification, and intervention in such complications and that this role also is a differential to obtain quality in hemodialysis procedure. However, there is a need to perform more research in nursing area to better define the nurse's role