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- ItemAcesso aberto (Open Access)Prescrição de benzodiazepínicos em Unidades Básicas de Saúde em uma comunidade com alta vulnerabilidade social(Jamili Silva Santos, 2024-09-26) Bigal, André Luiz [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; https://lattes.cnpq.br/1233550646836875; http://lattes.cnpq.br/4675292090990088Os benzodiazepínicos, medicamentos mais prescritos no mundo, são extremamente úteis no manejo de patologias relativas ao sistema nervoso central, porém, nem sempre sua prescrição está relacionada com uma patologia. Este estudo buscou identificar os fatores influenciadores na prescrição de benzodiazepínicos na Atenção Básica do Sistema Único de Saúde e suas consequências, em uma região com alta vulnerabilidade social. Foram utilizados os princípios de um estudo qualitativo com amostra intencional de médicos prescritores construída com a ajuda dos Informantes-Chave e com tamanho (n = 10) definido pelo princípio da saturação teórica. A coleta de dados ocorreu mediante entrevistas semiestruturadas nas unidades básicas onde os profissionais atuavam. Os temas identificados relativos aos motivos da prescrição foram: relativos ao paciente (demanda do paciente; problemas sociais); relativos ao medicamento (dependência); relativos ao prescritor (uso irracional). A prescrição do benzodiazepínico deu-se devido às baixas condições sociais dos usuários nessa região e as consequências dessa conjuntura (vulnerabilidade social, problemas angustiantes de difícil resolução). Educação permanente para profissionais, ações interprofissionais e integralidade do cuidado foram demandas dos profissionais. O problema extrapola a ação do médico, e são sugeridas políticas públicas que garantam, às populações com essas características, acesso a saúde, trabalho e educação.
- ItemAcesso aberto (Open Access)Exploring the impact of depression, anxiety, stress, academic engagement, and dropout intention on medical students' academic performance: a prospective study(Elsevier, 2025-01-01) Sinval, Jorge [UNIFESP]; Oliveira, Pedro; Novais, Filipa; Almeida, Carla Maria; Telles-Correia, Diogo; http://lattes.cnpq.br/9227052078286181Background Depression, anxiety, and stress (DAS) have been linked to poor academic outcomes. This study explores the relationships among DAS, academic engagement, dropout intentions, and academic performance—measured by Grade Point Average (GPA)—in medical students. It aims to understand how these factors relate to each other and predict academic performance. Methods Data were collected from 351 medical students (74.9% female) through an online survey. The average age was 20.2 years. Psychometric instruments measured DAS, academic engagement, and dropout intentions. Structural equation modeling was used to test the relationships between these variables and their prediction of GPA. Results DAS negatively associated academic engagement β ̂=− 0.501 p< 0.001 and positively connected to dropout intentions β ̂= 0.340 p< 0.001. Academic engagement positively predicted GPA β ̂= 0.298 p< 0.001 and negatively associated with dropout intentions β ̂=− 0.367 p< 0.001. DAS had a nonsignificant direct effect on GPA β ̂=− 0.008 p= 0.912. However, DAS indirect effect—via academic engagement—on GPA and dropout intention was statistically significant. Limitations The study's limitations include the use of a convenience sample and the collection of all variables—except GPA—at the same time point, which may affect the generalizability of the results. Conclusions The study supports the important role of DAS in associating with academic engagement and dropout intentions, which can predict GPA. Addressing DAS could enhance academic engagement and reduce dropout rates, leading to better academic performance.
- ItemEmbargoThe walsh family resilience questionnaire: validity evidence from Portugal(Wiley, 2024-09-19) Morais, Inês; Carneiro, Francis Anne; Sinval, Jorge [UNIFESP]; Costa, Pedro Alexandre; Leal, Isabel; http://lattes.cnpq.br/9227052078286181Background: Family resilience refers to a family's capacity to face and manage adversities, emerging as a stronger and more resourceful unit. A family system approach enlarges the lens to the broad relational network, identifying potential resources for resilience within the immediate and extended family. This approach emphasizes a family's innate ability to adapt in the face of adversities. Objective: This study aims to test the psychometric properties of the Walsh Family Resilience Questionnaire (WFRQ) using a sample of Portuguese caregivers with children aged between 10 and 15 years. Method: A total of 267 caregivers of children aged 10 to 15 years completed a sociodemographic questionnaire and the WFRQ. Analyses were performed to evaluate the WFRQ's validity evidence based on the internal structure (i.e., dimensionality and reliability) and on its relationship to other variables. Results: The findings supported a 31-item version of the WFRQ with one third-order latent factor, three second-order factors, and nine first-order factors for the Portuguese population. The WFRQ exhibited satisfactory validity evidence based on the internal structure and relation to other variables. Conclusion: Overall, the results of this study demonstrate the suitability of the WFRQ as a holistic measure to gauge resilience at the family level, going beyond individual assessments. Implications: This instrument holds significant utility in family resilience research and clinical interventions involving families.
- ItemAcesso aberto (Open Access)Correlates of burnout and dropout intentions in medical students: a cross-sectional study(Elsevier, 2024-08-10) Sinval, Jorge [UNIFESP]; Oliveira, Pedro; Novais, Filipa; Almeida, Carla Maria; Telles-Correia, Diogo; http://lattes.cnpq.br/9227052078286181Background: Burnout is a pervasive issue among medical students, exhibiting a high prevalence that jeopardizes their academic success and may also predispose them to more severe affective disorders such as depression. This study aims to explore the complex relationships between psychological capital (PsyCap), general social support, educational satisfaction, and burnout, and how these factors collectively influence dropout intentions. Methods: A non-probabilistic convenience sample was collected through an online survey from first- and second-year medical students at a Faculty of Medicine in Portugal. The survey employed psychometric instruments to measure burnout (BAT-12), social support (F-SozU K-6), PsyCap (CPC-12R), satisfaction with education, and dropout intentions (Screening Instrument for Students At-Risk of Dropping Out). Structural equation modeling was applied to analyze the data from 351 participants. Results: The model demonstrated a significant positive association between burnout and dropout intentions (β = 0.37; p < 0.001), underscoring burnout as a direct correlate of dropout intentions alongside educational satisfaction (β = −0.25; p = 0.003) and PsyCap (β = −0.22; p = 0.005). Higher social support is associated with reduced burnout (β = −0.28; p < 0.001) and increased educational satisfaction (β = 0.22; p = 0.002). Limitations: The non-probabilistic sampling method prevents the generalization of the findings. The cross-sectional data do not permit the inference of temporal relationships between the studied variables. Conclusions: These findings emphasize the importance that burnout may have on dropout intentions, and contribute to the understanding of affective syndromes such as burnout in educational settings.
- ItemAcesso aberto (Open Access)Myopathic manifestations across the adult lifespan of patients with malignant hyperthermia susceptibility: a narrative review(British Journal of Anaesthesia, 2024-08-05) Moreno, Carlos A Ibarra; Silva, Helga Cristina Almeida da [UNIFESP]; Voermans, Nicol C; Jungbluth, Heinz; Bersselaar, Luuk R. van den; Rendu, John; Cieniewicz , Agnieszka; Hopkins, Philip M; Riazi, Sheila; http://lattes.cnpq.br/0844918862241102Malignant hyperthermia susceptibility (MHS) designates individuals at risk of developing a hypermetabolic reaction triggered by halogenated anaesthetics or the depolarising neuromuscular blocking agent suxamethonium. Over the past few decades, beyond the operating theatre, myopathic manifestations impacting daily life are increasingly recognised as a prevalent phenomenon in MHS patients. At the request of the European Malignant Hyperthermia Group, we reviewed the literature and gathered the opinion of experts to define MHS-related myopathy as a distinct phenotype expressed across the adult lifespan of MHS patients unrelated to anaesthetic exposure; this serves to raise awareness about non-anaesthetic manifestations, potential therapies, and management of MHS-related myopathy. We focused on the clinical presentation, biochemical and histopathological findings, and the impact on patient well-being. The spectrum of symptoms of MHS-related myopathy encompasses muscle cramps, stiffness, myalgias, rhabdomyolysis, and weakness, with a wide age range of onset mainly during adulthood. Histopathological analysis can reveal nonspecific abnormalities suggestive of RYR1 involvement, while metabolic profiling reflects altered energy metabolism in MHS muscle. Myopathic manifestations can significantly impact patient quality of life and lead to functional limitations and socio-economic burden. While currently available therapies can provide symptomatic relief, there is a need for further research into targeted treatments addressing the underlying pathophysiology. Counselling early after establishing the MHS diagnosis, followed by multidisciplinary management involving various medical specialties, is crucial to optimise patient care.