O transplante de fígado é considerado um dos procedimentos mais complexos da medicina moderna. O ensino do paciente é relevante no contexto da saúde e pode contribuir para o sucesso do tratamento. Dentre as atividades do enfermeiro, ressalta-se o papel de educador. No período pós-operatório de transplante de fígado, este profissional deve implementar intervenções educativas direcionadas para o preparo do paciente no enfrentamento das mudanças no estilo de vida, decorrentes de procedimento cirúrgico complexo. Para tal, o primeiro passo consiste no conhecimento das necessidades de informação indicadas pelos receptores de transplante de fígado. O objetivo geral do estudo foi avaliar as necessidades de informação de receptores de transplante de fígado em atendimento ambulatorial em hospital público. A amostra foi composta por 92 receptores de transplante de fígado atendidos em ambulatório de hospital público do interior do Estado de São Paulo. A coleta de dados ocorreu no período de fevereiro a junho de 2014, por meio da aplicação de instrumento adaptado. Os principais resultados da pesquisa indicaram que a maioria dos receptores de transplante de fígado era do sexo masculino (77,17%) e casada (76,09%). A idade média foi de 54,48 anos, a média de anos de estudo foi de 9,02 anos, sendo 70,65% dos receptores moradores na zona urbana. Dos 92 participantes, 46,74% estavam aposentados e 26,09%, afastados de suas atividades laborais e 36,96%, com renda familiar entre dois e três salários-mínimos. Em relação às características clínicas, observou-se que 47,83% dos receptores eram do grupo sanguíneo tipo O, 72,83% tinham escore MELD entre 20 e 29 pontos, 41,30% estavam com cirrose de etiologia viral (B ou C). Dos 92 pacientes, 45,65% tinham IMC entre 18,50 e 24,99 Kg/m2 (peso normal) e 33,70% estavam acima de 25 Kg/m2 (sobrepeso). A média de dias após o transplante foi de 1.508,85 dias, o tacrolimus era empregado como terapia medicamentosa de imunossupressão principal em 36,96% dos receptores e era associado ao micofenolato sódico em 38,04% dos pacientes. As necessidades de informação que obtiveram as médias maiores foram: sugestão de assunto no 3 (média 5,35) refere- se aos sinais e sintomas de complicações (rejeição, infecção, diabetes, hipertensão arterial, entre outras) agrupada na categoria manejo das potenciais complicações; sugestão no 2 (média 5,29) relativa aos efeitos colaterais e cuidados sobre medicamentos (categoria manejo dos medicamentos) e sugestão no 14, alimentação segura após o transplante (média 4,53), também agrupada na categoria manejo das potenciais complicações. Os resultados evidenciados oferecem subsídios sobre o perfil sociodemográfico e clínico de receptores de transplante de fígado na realidade nacional, bem como das necessidades de informação, as quais podem auxiliar o planejamento de intervenções educativas direcionadas para o processo de transplante de fígado, para principalmente melhorar a qualidade da assistência, a adesão ao tratamento e a prevenção de complicações após o transplante / Liver transplantation is considered one of the most complex procedures in modern medicine. The patient education is relevant in the context of health and may contribute to the success of treatment. Among the activities of nurses, the role of educator is highlighted. In the postoperative period of liver transplantation, this professional must implement educational interventions directed to the preparation of the patient in coping with changes in lifestyle resulting from complex surgical procedure. For this, the first step consists in the identification of information needs indicated by liver transplant recipients. This study aimed to assess the information needs of liver transplant recipients in outpatient treatment at a public hospital. The sample consisted of 92 liver transplant recipients assisted in outpatient clinic at a public hospital in the state of São Paulo. Data collection was performed from February to June 2014, through the application of the adapted instrument. The main results indicated that most liver transplant recipients were male (77.17%) and married (76.09%). The average age was 54.48 years, the average years of schooling was 9.02; and 70.65% of recipients lived in the urban area. Of the 92 participants, 46.74% were retired, 26.09% were on leave from work and 36.96% had incomes between two and three minimum wages. Regarding clinical characteristics, 47.83% of recipients were type O blood group, 72.83% had MELD scores between 20 and 29 score points, and 41.30% had cirrhosis of viral etiology (B or C). Of the 92 patients, 45.65% had a BMI between 18.50 to 24.99 Kg/m2 (normal weight) and 33.70% greater than 25 Kg/m2 (overweight). Average days after the transplantation was 1508.85 days, the tacrolimus was used as the primary immunosuppression drug therapy in 36.96% of the recipients, and associated with mycophenolate sodium in 38.04% of the patients. Information needs with the highest averages were: suggestion of topic no 3 (5.35) which refers to the signs and symptoms of complications (rejection, infection, diabetes, hypertension, etc.), grouped in the category management of potential complications; suggestion no 2 (5.29) related to the side effects and care of medicines (category management of medicines); and suggestion no 14, safe food after transplantation (4.53), also grouped in the category management of potential complications. The results show subsidies on the sociodemographic and clinical profile of liver transplant recipients in the national reality and the information needs which may assist the planning of educational interventions directed to the process of liver transplantation, mainly aiming to improve quality of care, adherence to treatment and prevention of complications after transplantation

Pessoas com transtornos psicóticos enfrentam mudanças e limitações na vida cotidiana. Suas necessidades podem ser complexas e envolver vários tipos e níveis de cuidados. A avaliação sistemática das necessidades de usuários dos serviços de saúde é importante para a organização dos serviços e para estabelecer propostas individualizadas de tratamento. A avaliação de necessidades de usuários de serviços de saúde mental tem sido utilizada em vários países, mas ainda não é rotineira no Brasil. A CAN avalia necessidades em 22 domínios que envolvem diversas necessidades de ajuda, como problemas com moradia, alimentação, sintomas psicóticos, saúde física e outros. OBJETIVOS: Traduzir e adaptar a versão brasileira da CAN para pesquisa (CAN-R), e avaliar a sua confiabilidade entre avaliadores, em uma amostra de casos incidentes de psicoses funcionais na cidade de São Paulo. MÉTODO: Foram selecionados aleatoriamente participantes do \"Estudo de casos incidentes (primeiro contato com serviços de saúde) de psicoses funcionais no Brasil\", no qual este estudo está inserido. Os critérios de inclusão foram: contato pela primeira vez com serviços de saúde no período do estudo, diagnóstico de esquizofrenia, outras psicoses do espectro da esquizofrenia, mania ou depressão psicótica (DSM-IV); idade entre 18 e 64 anos; residir em determinadas regiões geográficas da cidade de São Paulo. A versão da CAN, traduzida e adaptada para o português pelo grupo de pesquisadores do estudo de casos incidentes, foi aplicada aos participantes do estudo por cinco auxiliares de pesquisa. Posteriormente um avaliador cego em relação às avaliações realizadas pelos auxiliares de pesquisa realizou a pontuação da escala de modo independente, utilizando fitas com a gravação das entrevistas. As pontuações das entrevistas realizadas pelos assistentes de pesquisa foram comparadas com as pontuações do avaliador independente utilizando-se o coeficiente kappa e o coeficiente de correlação intraclasse (CCI). RESULTADOS: Cinqüenta e dois sujeitos foram incluídos no estudo. Cinqüenta e dois por cento eram mulheres, a maioria dos participantes estava na faixa etária entre 18 e 39 anos, tinha no máximo oito anos de estudo e diagnósticos de esquizofrenia ou outros transtornos mentais do espectro da esquizofrenia. A confiabilidade entre avaliadores para os 22 domínios da escala foi substancial, quase perfeita ou total para 19 (87%) domínios. A confiabilidade para o total de necessidades, avaliada através do ICC, foi 0,95 (IC95% 0,90 - 1,00). CONCLUSÕES: A CAN mostrou boa aplicabilidade e reprodutibilidade segundo avaliação de profissionais de saúde mental com indivíduos em um primeiro episódio psicótico. O uso de instrumentos padronizados como a CAN em serviços de saúde mental no Brasil deve contribuir para a avaliação da efetividade das ações e para o cuidado individualizado das pessoas com transtornos mentais. / People with psychotic disorders usually face changes and limitation in their daily life activities. Their needs are complex and involve different types and levels of care. In several countries, the systematic assessment of needs is considered essential for service planning and to establish treatment goals. However, in Brazil, the assessment of needs is still limited. The Camberwell Assessment of Needs (CAN) assess needs in 22 domains that encompass a wide range of needs of care, as problems with accommodation, food, psychotic symptoms, physical health, and others. OBJECTIVES: The aims of this study were to translate and adapt the CAN for research (CAN-R) and to assess its inter-rater reliability, in a sample of first contact psychosis in São Paulo. METHOD: Subjects were randomly selected from the \'Brazilian First Contact Psychosis Study\' sample. The inclusion criteria were: first contact with health services due to a psychotic episode at the study period; diagnosis of schizophrenia, other psychotic disorders of schizophrenia spectrum, mania or psychotic depression (DSM-IV); age between 18 and 64 years; living in pre-defined areas of São Paulo. Five research assistants carried out the CAN version, adapted and translated into Portuguese by the investigators? group of the incidence study. Afterwards a blind investigator carried out the assessment independently, through tape-records of the interviews. Kappa coefficient and intraclass correlation coefficient were used to compare ratings of the independent investigator with ratings of the research assistants group. RESULTS: Fifty-two subjects were included, 27 (52%) of them were women. Most were in 18-39 age group, had studied eight years or less, and had diagnosis of schizophrenia or other schizophrenia spectrum disorders. Inter-rater reliability to 19 (87%) domains was substantial, almost perfect or total as measured by kappa coefficient. Reliability to total of needs measured by ICC was 0.95 (CI 95% 0,90 - 1,00). CONCLUSIONS: The Can showed good applicability and reliability with first contact psychotic individuals. The use of standardized instruments as the CAN in mental health services in Brazil, can contribute to the assessment of effectiveness of interventions, and individualized care to people with mental disorders.

Suicide is a public health problem and complex relationships exist between intrapersonal suicide risk factors and interpersonal risk factors. Health-related quality of life (HRQL) may interact with difficulties with interpersonal relationships and psychopathology. We examined thwarted interpersonal needs and depressive symptoms as potential mediators on the association between HRQL and suicidal behaviors. It was hypothesized that thwarted interpersonal needs would mediate the association between HRQL and suicidal behavior, and that this mediating effect would be dependent on the moderating effect of depressive symptoms. It was hypothesized that thwarted interpersonal needs and then depressive symptoms would sequentially mediate the association between HRQL and suicidal behavior. The mediating roles of thwarted belongingness and perceived burdensomeness on the association between HRQL and suicidal behaviors were supported. Moderated-mediation results were not significant. Serial mediations analyses were partially supported. Our findings suggest the importance of considering both interand intrapersonal factors on suicidal behavior.

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In this study, authors examined basic psychological needs (namely, competence, autonomy, and relatedness) as potential mediators of the association between sexual assault and depressive symptoms in a sample of 342 college students. Results from conducting a multiple mediation test provided support for partial mediation involving the indirect effects of competence and autonomy. In contrast, no support for mediation was found involving relatedness. It is notable that sexual assault remained a significant predictor of depressive symptoms in students. Therefore, findings indicate how sexual assault may both directly and indirectly (through psychological needs) lead to greater depressive symptoms in students. Authors concluded the article with a discussion of the implications of their findings for expanding the study of basic psychological needs in college students and the need for greater efforts to prevent and treat sexual assault on campus.

Suicide rates are higher in veterans than civilians, perhaps due to increased trauma exposure (e.g., sexual trauma, combat). However, not all veterans who experience trauma are at increased risk for suicidal behavior as some may experience an increased sense of purpose and meaning in life via posttraumatic growth (PTG). PTG, conceptualized as a positive transformation following trauma that results in improved function, may involve changes in cognitive-emotional processing, including increased feelings of connectedness and perceptions of value and contribution contributing to the well-being of others, as well as beneficial shifts in mood. The interpersonal theory of suicide posits that individuals who feel isolated (thwarted belongingness; TB), or like a burden (perceived burdensomeness; PB) are at increased risk for depression and suicidal ideation and attempts. Veterans who experience PTG after trauma may experience a beneficial shift in perceptions related to interpersonal needs (e.g., feel more connected, feel like less of a burden), with consequent benefits to mood and suicide risk. This premise has not been previously examined; therefore, we assessed the serial mediating effects of thwarted interpersonal needs (i.e., TB and PB, in separate models) and depression on the link between PTG and suicidal behavior. Participants (N=545; 70.1% male (n=382); 86.4% Caucasian (n=469), Mean Age=49.86, SD=16.78) were community-dwelling veterans, who completed the Posttraumatic Growth Inventory, Interpersonal Needs Questionnaire, Multidimensional Health Profile, and Suicide Behaviors Questionnaire-Revised. Bivariate correlations and serial mediation analyses were conducted covarying age, sex, and ethnicity. Serial mediation analyses supported hypotheses (10,000 bootstrapped samples); the total indirect effect of PTG on suicidal behaviors was significant when thwarted belongingness (IE= -.024, SE= .005, CI= -.036 to -.015) and perceived burdensomeness (IE= -.024, SE= .006, CI= -.036 to -.014), along with depression, were examined as serial mediators. Specific indirect effects of PTG on suicidal behaviors were also significant through thwarted belongingness (IE= -.015, SE= .005, CI= -.026 to -.008) in the first model and perceived burdensomeness (IE= -.016, SE= -.005, CI= -.027 to -.008) in the second model; however, there were no specific indirect effects observed through depressive symptoms in either model. Our results suggest that the relation between PTG and reduced suicidal behavior may be due to serial, adaptive shifts in cognitive-emotional processing related to interpersonal functioning and mood which, in turn, beneficially impact mood and suicide risk. Of note, there were no significant specific indirect effects with depressive symptoms. This pattern elucidates a potential mechanism between PTG and suicidal behavior, highlighting that the process of PTG does not, initially, involve a reduction of depressive symptoms but, rather, an improvement in perceptions regarding social connectedness and social self-value that has a cascading effect on mental health functioning. Our findings may have clinical implications. Cognitive reframing of traumatic events (e.g., via Cognitive Processing Therapy) and bolstering relationships and the perception of one’s value in a social network (e.g., via Interpersonal Therapy) may reduce depression and suicide risk in veterans.

The current prevailing approach to managing offenders in the community involves community supervision professionals such as probation and parole officers partnering with other community professionals, such as psychologists, social workers, and other mental health providers to address offenders’ needs. Each type of professional draws from a unique field with goals, values, and theoretical orientations, which do not necessarily overlap. These relationships are rarely studied, and previous examinations are limited. The current study aims to address this deficit in the empirical literature. Drawing on data obtained from qualitative interviews, four aims were examined. First, using thematic analysis, interview data are analyzed open-endedly to identify major themes. Second, these partnerships are examined against the interprofessional competencies in the healthcare system. Third, the perceived impact of partnerships on offenders’ success in the community is discussed. Finally, differences in themes within community supervision professionals and mental health providers were quantitatively examined by comparing groups using a variety of demographic variables. Major themes identified by mental health providers include the appreciation for and challenges to collaboration, individual characteristics and roles, characteristics of collaboration, elements of interprofessional relationship, and the involvement of the courts. Community supervision professionals discussed issues pertaining to collaboration and services coordination, professional roles, when conflict occurs, and their lack of basic knowledge about other professionals. Themes identified in the initial thematic analysis resembled healthcare values and ethics competencies and roles and responsibilities competences; healthcare competencies regarding interprofessional communication and teamwork showed partial congruence with the current data’s themes. Perceived impact on offender outcomes was most evident in how collaboration helps each professional complement the others’ work. Few significant quantitative patterns within groups were evident. Overall, treatment providers and supervision professionals value interprofessional collaboration. Their priorities differ, which provides better opportunities to address clients’ needs but also creates the potential for conflict. Benefits to re-entry outcomes are the result of treatment providers addressing the needs of clients and supervision professionals addressing the motivation of clients. This research highlights the strengths of this type of interprofessional collaboration, and offers suggestions for improving the efficacy of collaborations.

Thesis (M.Inf.) --University of Limpopo, 2018 / The purpose of this research is to investigate the information needs of rural communities in Bushbuckridge. Investing information of communities is vital because information plays an important role in enabling communities to meet their development needs, such as employment, education, health, safety, food security, and leisure. Libraries are therefore instrumental in helping library users to meet these needs. The study utilised triangulated (quantitative) and (qualitative) research methods. Participants in this study included 100 library users, four librarians and one library manager drawn from four local libraries through a combination of random (probability) and purposive (non-probability) sampling. The quantitative part of the study i.e. survey measured the perceptions of users on library services through questionnaires, while unstructured interviews elicited the experiences of librarians in addressing the information needs of library users in the four libraries of Bushbuckridge. Findings from the survey revealed, inter alia, that: most (65%) users had access to library services, although high travelling costs were a major barrier for those living in remote villages; a large number of users (60%) still depended on librarians to help them find information, while a growing number of users (33% had begun using computers and the internet to meet their information needs; the most important reasons for using the library were: assignments, study and careers, and, the majority of users in all four libraries were generally satisfied with the quality of the services rendered, although significant improvements were required in the supply of materials and water. Findings from interviews with librarians demonstrated that significant steps had been taken to address information needs of users across the four libraries. Common examples include: books and materials; computers and internet services; study groups; user training, and outreach programmes – although these were hampered by shortage of staff and vehicles. Cross-cutting problems included delays in purchasing of library materials; shortage of water and low perceptions about the benefits of library services in the community. In light of these results, it was concluded that information needs of library users had been partially met, with greater room for improvement in areas like human resources, information technology, transport and procurement systems and processes. The research findings have demonstrated that if provided well, library information services may help reduce the challenges of illiteracy, poverty and unemployment in this area. In light of these findings, the study recommended, inter alia, that the skills of library staff along with procurement systems and processes be upgraded in order to satisfy the information needs of library users in the study area. The study further recommended that outreach programmes be scaled up to increase awareness in the community about the role and benefits of library services in facilitating community development, particularly in Bushbuckridge where challenges of illiteracy, poverty and unemployment continue unabated.