Analysis of nursing dissertations and theses on adolescence--Brazil, 1979-2000

This study aimed at checking the nursing knowledge produced about adolescence in Brazil from 1979 to 2000. The document-based research listed abstracts of dissertations and theses contained on the CD-ROM of the Centro de Estudos e Pesquisas em Enfermagem (CEPEN), the topics of which were adolescence/adolescent. The results, discussed in accordance with the concepts of Meleis (1997) and the relevant literature, show 46 works, 37 of them dissertations, defended in the Southeast Region (32), developed mostly between 1995 and 1999. The theoretical and methodological tendencies showed prevalence of clinical studies (22) related to the adolescent, of a qualitative nature (34). We concluded that there is a need for studies that include the adolescent in his/her family and community context. Also, greater incentive is necessary for the development of theses in poorer regions of the country.     

Resource distribution in mental health services: changes in geographic location and use of personnel in Norwegian mental health services 1979-1994

BACKGROUND: During the last decades, a central aim of Norwegian health policy has been to achieve a more equal geographical distribution of services. Of special interest is the 1980 financial reform. Central government reimbursements for the treatment of in-patients were replaced by a block grant to each county, based on indicators of relative "need". AIMS OF THE STUDY: The aim of this paper is to assess whether the distribution of specialized mental health services did take the course suggested by the proponents of the reform (i.e. a more equal distribution), or the opposite (i.e. a more unequal distribution) as claimed by the opponents. METHODS: Man year per capita ratios were used as indicators for the distribution of mental health services by county. Ratios were estimated for "all personnel", and for MDs and psychologists separately. Man years were assigned to counties by location of services (i.e. in which county the services were produced), and by residence of users (i.e. in which county the services were consumed). Indicators of geographic variation were estimated using the standard deviation (STD) as a measure of absolute variation, and the coefficient of variation (CV) and the Gini index as indicators of relative variation. Indicators were estimated for 1979, 1984, 1989 and 1994, based on data for all specialized adult mental health services in the country. Changes in distributions over the period were tested, using Levene's test of homogeneity. RESULTS: Relative variations in the distribution of personnel by location of services were substantially reduced over the period, the CV being reduced by more than 50% for all groups. Variations in the personnel ratios by residence of users were smaller at the start of the period, and the reductions were also smaller. Still, relative variations were reduced by 20-35, 40 and 60% approximately for "all personnel", MDs and psychologists respectively. In spite of a major increase in the supply of MDs and psychologists, absolute variations in the personnel ratios were in all cases either reduced, or fairly stable. These results give little support to the views expressed by the opponents of the 1980 reform, although the main result seems to have been relocations in the production of services, more than re-distributions in the consumption of services. DISCUSSION: These results can be seen as a result of three aspects of the reform: 1 Distributing government grants to counties in their capacity as users of services rather than producers of services. This shift has primarily facilitated relocations in the production of services. 2 Relocation of services was also expected to produce a more equal distribution in the use of services, since reduced distances would increase accessibility. This, however, was counteracted by increased county control with use of services in other counties. 3 Distribution of grants based on "needs" rather than services produced was expected to produce a more equal distribution in the use of services. This effect seems to have been less than expected, probably because counties with high reimbursements under the old system also provided services to people from other counties. Other policy reforms have, however, contributed to the results. These reforms include increased supply of personnel, de-institutionalization of services, regionalization/sectorization of services, and the establishment of smaller psychiatric units in general hospitals. POLICY IMPLICATIONS: In recent years the 1980 reform has been under attack; partly due to alleged inequalities created by the system. As a result of the critique, government reimbursements for in-patient treatment have been reintroduced for general hospital services. In mental health services, more resources are distributed to specific projects. According to this study, this shift in policy is based on faulty premises and might lead to greater inequalities in the future.     

Knowledge derived from studies on crack: an incursion into Brazilian dissertations and theses

This is a systematic review based on the integrative review method, which sought to analyze the characteristics of knowledge produced by studies on crack, in Brazilian Master's and Doctoral courses. The investigation comprised 33 studies (18 dissertations and 15 theses). Among them, 51.5% were from the Health Science area with emphasis on the Postgraduate Program in Psychiatry (and Medical Psychology), which provided five dissertations/theses. Most of the knowledge on the epidemic (51.5%) are from the Universidade Federal de S?o Paulo and Universidade de S?o Paulo, with the largest number of studies (81.8%) concentrated in the southeast. The themes most analyzed were: organic alterations, drug trafficking and crack use, HIV/Aids, types and strategies of treatment. The results showed that Brazilian stricto sensu knowledge about crack is still incipient, sketchy and ineffectual, albeit promising due to demands and implications that this epidemic imposes upon society.     

Hospital beds and mental health reform in Brazil

The objective of this study was to estimate the number of psychiatric beds occupied per State in Brazil and the amount paid by the Unified National Health System (SUS) for hospitalizations, professional services, tests, and medicines in the country in 2004. The mean number of psychiatric beds occupied, estimated on the basis of total days of hospitalization during the year, and the amount paid by the SUS were obtained from the Hospital Admissions Authorizations (AIH). A total of 45 thousand psychiatric beds were occupied by the SUS in 2004. The SUS paid a total of BRL$487 million (some U$270 million) for hospitalization of patients with mental disorders in 2004. Private hospitals accounted for 78.8% of all psychiatric beds occupied by the SUS. Although the deactivation of 15 mil psychiatric beds could currently generate BRL$162 million (U$90 million) to be reallocated to non-hospital psychiatric services, planning and implementation of the Psychiatric Reform have been very limited. The precarious extra-hospital network has been used as a barrier to deactivation of psychiatric beds, although the latter generates the necessary resources for the former.     

Work conditions and mental health among doctors from Salvador, Bahia, Brazil

This cross-sectional study investigated the association between work conditions and minor psychological disorders (MPD) in a random sample of 350 doctors from Salvador City, State of Bahia, Brazil. Data were gathered using an individual, self-report questionnaire that incorporated the demand-control model (Job Content Questionnaire) to evaluate psychosocial aspects of the doctors' work and the Self-report Questionnaire (SRQ-20) to evaluate their mental health. The study found increased work overload, overtime and extended work shifts, multiple jobs, low income per hour worked, and unstable work arrangements with payment per procedure. The prevalence of MPD was 26.0% and was more strongly associated with aspects of the psychological demands of work than with the doctors' control over it. Doctors with high strain (high demand and low control) jobs showed MPD prevalence of 3.07 (95%IC: 1.38-6.85) times higher than those in low strain (low demand and high control) jobs.     

2007年～2008年江西省卫生总费用的核算结果及分析

利用传统的来源法和机构法,采用卫生部卫生经济研究所最新的数据收集模板,初步探索并运用现有数据对2007年～2008年江西省的卫生总费用进行测算。通过对卫生总费用的筹资水平、筹资结构及分配状况的研究与分析,结合江西省自身特点与国家的统计数据进行综合比较,揭示卫生领域的客观实际及存在的主要问题,为该地区的卫生经济政策的制定和卫生资源进一步合理配置提供参考数据。     

2007—2012年我国部分主流报纸精神卫生报道内容分析

目的回顾分析部分主流平面媒体上的精神卫生相关报道,为开展精神卫生宣传报道工作提供参考。方法采用典型抽样和文献检索方法,收集2007—2012年间6家报纸上的所有精神卫生相关报道共605篇,采用内容分析方法对报道的主题和类型等进行定量编码分析。结果 6年间精神卫生相关报道的数量逐年增加,在2011年达到峰值157篇(26.0%)。每年精神卫生报道集中在10月份,6年共计120篇(19.8%)。报道议题以医疗信息(171篇)和个案报道(137篇)为多,50.4%的报道类型是消息。各类型报纸间在报道议题和类型分布上存在明显区别。结论精神卫生主题报道在媒体的议程设置中日益得到重视,建议媒体根据时势发展和各自定位进行全面、系统的精神卫生报道。     

Medicaid payment rates for nursing homes, 1979-86

The issue of the cost containment effects of payment systems on per diem payments by Medicaid to nursing homes is addressed. Estimates of real payment rates as a function of broadly defined payment system classifications and economic and demographic variables using State-level data are presented. Little support for the notion that prospective payment systems substantially restrain payment rates for intermediate care facilities is found, but some model specifications indicate possible cost savings associated with prospective payment systems for skilled nursing facilities. Significant methodological concerns that need to be addressed in future research on the cost containment effects of payment systems are also discussed.     

Health education: object of study in dissertations and theses by Brazillian nurses

This study was aimed at surveying the quantity of dissertations and theses written by nurses on health education, identifying and analyzing their methodological steps. 17 Catalogs of Information about Research and Researchers from CEPEn/ABEn--published from 1979 to 1999--have been examined. The sample comprises 105 dissertations and 15 theses about the theme. Chronic diseases, pregnancy-puerperal cycle, health education, management and perisurgery situation have stood out as objects of study. The populations were adults, nursing professionals, women, children and adolescents. Interviewing was the most used technique. Authors indicated the need to improve educative practices and considered that health education motivates changes in lifestyle. It was concluded that there is a need to strengthen research into the everyday of Nursing in a historical and social context.     

Psychiatric nursing production in Brazil, 1932-1993

The present research aims at studying the psychiatric nursing bibliographical production in Brazil, from 1932 to 1993. Therefore, the authors searched national journals, annals of the Brazilian Nursing Congresses, Annals of the National Seminars on Nursing Research and Catalogues of the Brazilian Nursing Association--Center of Nursing Studies and Research. In addition, the authors selected publications of the following events: III Meeting of Researchs on Mental Health, II Meeting of Specialists on Psychiatric Nursing, Nursing Undergraduation Golden Jubilee and National Meeting of University Hospitals. After the conclusion of this study, discussions were based on the central themes of the texts as well as on historical development of Psychiatric Nursing in Brazil.     

Attitudes of graduate nursing students towards mental disorders in Brazil, Chile and Peru

This study aimed to draw a profile of nursing graduate students' attitudes towards mental disorders in three different cultures: Brazil, Chile and Peru. The opinion scale for mental disorders was applied. The results showed statistically significant differences (5%) in terms of authoritarianism, mental hygiene ideology, serial restriction and minority vision, which were favorable to Brazilian students. As to the factor interpersonal etiology, the results were favorable to Peruvians, while the results for etiology of mental strain were favorable to Chileans. There was no statistical evidence to confirm any difference in terms of benevolence. These results reveal that Brazilian students present more positive attitudes towards mental disorders, as they showed to be less authoritarian, restrictive and discriminative than the Chilean and Peruvian students. Therefore, they are more likely to develop a more therapeutic behavior towards people with mental disorders.     

云南省2007-2011年学校突发公共卫生事件分析

目的 了解云南省学校突发公共卫生事件的流行特点,为有效预防和控制学校突发公共卫生事件提供科学依据.方法 应用描述性流行病学方法,对云南省2007-2011年通过网络报告的学校突发公共卫生事件资料进行统计分析.结果 2007-2011年云南省共报告学校突发公共卫生事件660起,占同期突发公共卫生事件报告起数的65.02％(660/1 015).学校突发公共卫生事件以传染病事件为主,占总起数的89.09％ (588/660),呼吸道传染病占传染病事件数的84.18％ (495/588);报告事件数最多的是2009年,占总报告起数的35％ (231/660);出现2个发病高峰期,分别为4-6月和9-12月;农村学校的事件数和发病数均高于城市学校,死亡病例仅出现在乡镇学校.结论 学校突发公共卫生事件频发,应更加关注学校卫生工作,特别是农村学校的传染病预防控制.加强突发公共卫生事件的监测和及时预警是关键.     

Farmers' occupational health programme in Finland, 1979-1987

At the beginning of 1985, the National Board of Health in Finland issued directives for the initiation of farmers' occupational health services in municipal health care centres. The directives were based on the evaluation study on farmers' occupational health services in Finland. The main aim of this study is to analyse the current problems of the farmers' occupational health care system and to analyse how effective the system is. The efficiency of the occupational health services has been surveyed with postal inquiries twice, first in 1982 and later in 1986. The farmers' knowledge of appropriate means for reducing hazardous exposures had improved significantly since the initiation of the occupational health services. The effect of the occupational health services was evident particularly in the more effective use of personal safety devices. The limited resources at the municipal health care centres form the main obstacle in the provision of occupational health services for all farmers who would like to have them. 25-35% of the farmers in Finland (total 45,000 farmers) are willing to participate in the occupational health care system. Participation is voluntary for self-employed farmers.     

护理学硕士生心理健康状况及其影响因素分析

目的 探讨护理硕士研究生心理健康状况及其影响因素.方法 采用症状自评量表(SCL-90)、社会支持量表(SSRS)和应对方式量表,对273名护理学硕士研究生进行调查.结果 (1)护理硕士生SCL-90阳性检出率为12.45％.(2) Logistic回归分析显示,学费来源(OR=2.982)、自责(OR=2.731)是护理学硕士研究生心理健康的危险因素,年龄(OR=0.242)、解决问题(OR=0.357)是保护因素,以上4项可预测护理硕士生心理健康变异量的36.9％.结论 护理学硕士研究生心理健康状况较好,但仍存在一些心理问题;教育者应关注年龄较小、自费的学生群体,在护理学硕士研究生教育中,需注重培养其成熟的应对方式.     

Analysis of scientific production of mental health researcher and psychiatric nursing specialist meetings

This literature review was organized on the basis of the Annals of Mental Health Researcher and Psychiatric Nursing Specialists Meetings promoted by the University of S?o Paulo at Ribeir?o Preto College of Nursing. It aimed to describe the history of these events, investigating the scenario and trends through the reading of texts published in these documents. All annals available from 1990 to 2004 were analyzed and read, based on an analysis protocol. The results showed that the published texts reflect the historical momentum of each national mental health policy movement in Brazil, indicating contradictions and advances. The conclusion is that the events provided a privileged forum to discuss and exchange experiences about the future of psychiatric nursing and mental health care, teaching and research in Brazil.     

护理人员心理健康状况分析

目的为提升护理质量，探讨护理人员心理健康问题发生的原因和提高其心理健康水平的对策。方法采取收集既往研究资料和结合临床工作经验的方法，总结护理人员心理健康问题发生的原因。结果护理人员心理健康水平总体低于国内一般人群；心理问题发生的原因主要有危重患多、抢救多、工作压力大、工作模式改变、突发事件心理危机干预不及时、心理健康维护培训不足。结论要提高护理质量首先应关注该人群的心理健康问题，应该从健康教育和科学管理多个层面人手，通过各种活动缓解护理人员的心理压力，为护理人员营造一个宽松、愉悦、团结的工作环境，提高其心理健康水平。     

Income, relative income, and self-reported health in Britain 1979-2000

We test the relative income hypothesis that an individual's health depends on the distribution of income in a reference group, as well as on the income of the individual. We use data on 231 208 individuals in Great Britain from 19 rounds of the General Household Survey between 1979 and 2000. Results are insensitive to the measure of self-assessed health used but the sign and significance of the effect of relative income depend on the reference group (national or regional) and the measure of relative income (Gini coefficient, absolute or proportional difference from the reference group mean, Yitzhaki absolute and proportional relative deprivation and affluence). Only one model (relative deprivation measured as income proportional to regional mean income) performs better than the model without relative income and has a positive estimated effect of absolute income on health. In this model the increase in the probability of good health from a ceteris paribus reduction in relative deprivation from the upper quartile to zero is 0.010, whereas an increase in income from the lower to the upper quartile increases the probability by 0.056. While our results provide only very weak support for the relative deprivation hypothesis, the inevitable correlation of measures of individual income and relative deprivation measured by comparing income and incomes in a reference group makes identification of the separate effects of income and relative deprivation problematic.