Resumen Se evaluó la percepción sobre las barreras para el acceso al control prenatal (ACP) de las embarazadas atendidas en el Centro de Salud Tipo C Dr. Arnaldo Calderón de Tosagua, Manabí, Ecuador, durante marzo-agosto 2023. Se realizó una investigación observacional, descriptiva de corte transversal. La mayoría de las embarazadas era de procedencia rural (77,78 %), tenía un nivel de escolaridad secundaria (37,91 %) y trabajaba (47,71 %). El 83,01 % de las embarazadas inició el control prenatal en el primer trimestre; el 56,86 % tuvo entre 4 y 6 controles prenatales y un período intergenésico de 1 a 2 años (47,71 %). La accesibilidad fue considerada lejos y difícil (68,83 %) y la calidad de las instalaciones fue buena (43,14 %). El horario de atención se percibió como conveniente y el tiempo de espera fue de entre 15 y 30 minutos (60,78 %). El 71,9 % tuvo dificultades para el acceso al ginecólogo. Las principales barreras individuales/psicosociales fueron embarazo no planificado, no deseado, con síntomas de depresión y desmotivación y dificultad para asistir a las consultas por el cuidado de los demás hijos. Las dificultades económicas (90,2 %), dificultades para el traslado a la institución (93,46 %) y dificultad por quehaceres domésticos (87,58 %), fueron las barreras socioeconómicas que más afectaron el ACP. También incidieron en el ACP, el difícil acceso a las citas para la consulta (98,69 %), tiempo de espera prolongado para su atención (97,38 %) y poco tiempo de duración de la consulta (96,08 %).

Abstract The perception of barriers to access to prenatal care (APC) of pregnant women treated at the Dr. Arnaldo Calderón Type C Health Center in Tosagua, Manabí, Ecuador, from March to August 2023, was evaluated. An observational, descriptive, cross-sectional research was carried out. The majority of pregnant women were from rural origins (77,78%), had a secondary education level (37,91%), and worked (47,71%). 83,01% of pregnant women began prenatal care in the first trimester; 56.86% had between 4 and 6 prenatal care visits and an intergenic period from 1 to 2 years (47,71%). Accessibility was considered far and difficult (68,83%), and the quality of the facilities was good (43,14%). The opening hours were perceived as convenient, and the waiting time was between 15 and 30 minutes (60,78%). The 71,9% had difficulties accessing the gynecologist. The primary individual/psychosocial barriers were unplanned, unwanted pregnancy, with symptoms of depression, lack of motivation, and difficulty attending appointments to care for the other children. Economic difficulties (90,2%), difficulties transferring to the institution (93,46%), and difficulties due to household chores (87,58%) were the socioeconomic barriers that most affected the APC. Difficult access to consultation appointments (98,69%), prolonged waiting time for care (97,38%), and short duration of the consultation (96,08%) also had an impact on the APC.

ABSTRACT This study aimed to verify professionals' perceptions of Psychosocial Care Centers (Centros de Atenção Psicossocial - CAPS) in São Paulo / SP regarding the importance of multiprofessional work in Mental Health for service users and the possible relationships with comprehensive care. The Health and Psychiatric Reforms made comprehensiveness a fundamental principle of health actions, a concept understood through various influences. Twenty-seven higher education professionals were interviewed, and the Content Analysis methodological framework was used. The participants were unclear about integrality care, valuing comprehensiveness and disciplinary integration work concomitantly to tutelage actions that do not favor autonomy. This fact is due to the lack of theoretical knowledge on comprehensiveness issues and the still persistent practice centered on the absence of autonomy and contractuality in the professional-user relationship. The effectiveness of comprehensive care is fundamental to understanding Mental Health users as subjects of rights, an important challenge for Brazilian Psychiatric Reform.

RESUMEN Este estudio tuvo como objetivo verificar la percepción de los profesionales de los Centros de Atención Psicosocial (CAPS) en São Paulo / SP de la importancia del trabajo multiprofesional en Salud Mental para los usuarios del servicio y las posibles relaciones con la atención integral. Con las reformas de salud y psiquiátricas, la integralidad se ha convertido en un principio fundamental de las acciones de salud, un concepto que se ha entendido desde diferentes influencias. Veintisiete profesionales de la educación superior fueron entrevistados y se utilizó el marco metodológico del Análisis de Contenido. Los participantes no tenían claro el concepto de atención integral, valorando el trabajo integral y de integración disciplinaria al mismo tiempo que las acciones tutelares que no favorecen la autonomía. Este hecho se debe a la falta de conocimiento teórico sobre el tema de la exhaustividad y la práctica aún persistente centrada en la falta de autonomía y la ausencia de contractualidad en la relación profesional y de usuario. La efectividad de la atención integral es un aspecto fundamental en la comprensión de los usuarios de salud mental como sujetos de derechos, un desafío importante para la reforma psiquiátrica brasileña.

RESUMO Este estudo teve como objetivo verificar a percepção dos profissionais dos Centros de Atenção Psicossocial (CAPS) de São Paulo/SP da importância do trabalho multiprofissional em saúde mental para os usuários dos serviços e as relações possíveis com a integralidade do cuidado. Com as reformas sanitária e psiquiátrica, a integralidade passou a ser um princípio fundamental das ações de saúde, conceito que vem sendo entendido a partir de diversas influências. Foram entrevistados 27 profissionais de nível superior e utilizado o referencial metodológico da análise de conteúdo. Os participantes não apresentaram clareza sobre a noção de integralidade do cuidado, valorizando a integralidade e o trabalho de integração disciplinar de forma concomitante a ações tutelares e não favorecedoras de autonomia. Tal fato se deve ao pouco conhecimento teórico do tema sobre a integralidade e a prática ainda persistente centrada na falta de autonomia e ausência de contratualidade na relação profissional e usuário. A efetivação da integralidade do cuidado é aspecto fundamental na compreensão dos usuários de saúde mental como sujeitos de direitos, importante desafio à reforma psiquiátrica brasileira.

Abstract The child and adolescent mental health policy, implemented in Brazil from the beginning of the 21st century, established the Centros de Atenção Psicossocial Infantojuvenis (CAPSi - Psychosocial Care Centers for Children and Adolescent) as strategic services to prioritize more complex cases, with emphasis on autism. This study aims to compare two sources of information on the perception family members of autistic people regarding the work carried out by CAPSi: the first was collected in a 2011 survey, which used focus groups; and the second, from the literature produced on the subject in the following 10 years. The family member’s narratives were organized into four thematic axes: perception of the effects of psychosocial care; information sharing; perception about care processes; and demands and claims. Despite the heterogeneity between the studies, the results indicated that the work of the CAPSi produces positive effects, especially regarding socialization. However, this perception is not accompanied by a better understanding of the clinical picture and care processes. The value of treatment is often attributed to the personal attitude of professionals, indicating the lack of sharing and participation by family members. These aspects should encourage the CAPSi to involve family members as partners in care, particularly valuing the transmission of the psychosocial reasoning, its strategies and direction of care.

Resumo A política de saúde mental infantojuvenil, implantada no Brasil no início do século XXI, estabeleceu os Centros de Atenção Psicossocial Infantojuvenis (CAPSi) como equipamentos estratégicos para priorizar os casos de maior complexidade, com destaque para os autistas. Este estudo visa cotejar duas fontes de informação sobre a percepção de familiares de autistas acerca do trabalho desenvolvido pelos CAPSi: a primeira foi colhida em pesquisa de 2011, que utilizou grupos focais; e a segunda, a partir da literatura produzida sobre o tema nos 10 anos seguintes. As narrativas foram organizadas em quatro eixos temáticos: percepção sobre os efeitos do trabalho psicossocial; compartilhamento de informações; percepção sobre os processos de cuidado; e demandas e reivindicações. A despeito da heterogeneidade entre os estudos, os resultados indicaram que o trabalho dos CAPSi produz efeitos positivos, principalmente em relação à socialização. Contudo, essa percepção não é acompanhada de melhor entendimento do quadro clínico e dos processos de cuidado. O valor do tratamento é frequentemente atribuído à atitude pessoal dos profissionais, indicando a ausência de compartilhamento e participação dos familiares. Esses aspectos devem instigar os CAPSi a envolver os familiares como parceiros do cuidado, dando atenção especial à transmissão da lógica psicossocial, suas estratégias e direção do cuidado.

Abstract This study aimed to evaluate trends in the prevalence of dental caries in preschool children and associated factors considering different time variations. This is a time series study performed using data from three cross-sectional studies with pre-school children from southern Brazil in 2008, 2013 and 2019. This children group was born between the years of 2003 to 2018. Dental caries was evaluated by decayed, missing and filled deciduous teeth (dmft index). Demographic, socioeconomic, behavioural and psychosocial variables were also collected. Chi-square test for trends and a hierarchical age-period-cohort (HAPC) analysis using multilevel Poisson regression model for testing the associations between predictor variables and dental caries experience were used. A total of 1,644 pre-school children participated in all surveys. There was a significant difference in caries experience considering all APC effects. The prevalence of dental caries was 25.0% in 2008, 16.3% in 2013, and 19.4% in 2019 (p < 0.01) and no statistical difference was observed. An age effect showed that older children were more likely to experience dental caries. Considering the cohort effect, there is a significant difference between the generations, mainly between 2003 and 2018. Household income, use of dental services, and parent’s perception of child oral health were associated with dental caries experience no matter the time variation. Despite recent declines in dental caries prevalence among preschool children, caries levels increased with age and social inequalities persisted through the years, indicating a need of reviewing the policies to reduce the burden of this oral disease.

Resumen: El envejecimiento es un proceso inevitable que puede asociarse al deterioro cognitivo. La evidencia sobre la evaluación simultánea de variables psicosociales que pudieran estar asociadas con la función cognitiva es crucial. Nuestro objetivo fue determinar la asociación entre las características psicosociales y la cognición en adultos mayores de 50 años en México. La quinta ronda del Estudio Mexicano de Salud y Envejecimiento (ENASEM) (2018) proporciona la base para este trabajo. El estudio forma parte de un análisis longitudinal, para el que se recabaron datos en 2012, 2015 y 2018. La muestra final estuvo compuesta por 6,709 individuos. Se midieron diez variables psicosociales a través de escalas o preguntas específicas. La cognición se evaluó con el Cross-Cultural Cognitive Examination (CCCE). Entre los factores de confusión se incluyeron los sociodemográficos, la multimorbilidad y la funcionalidad. El análisis se realizó ajustando un modelo de regresión. De la muestra total, 2.761 (41,1%) eran hombres; 3.948 (58,8%) eran mujeres. La edad media era de 68,2 años (DE = 8,1). La cognición se ve significativamente afectada en las personas con mayor edad (β=-1,30, Cl 95% -1,54, -.1.06 p<0.001), menor escolaridad (β=-.559, IC 95% .498, .621 p<0.001), síntomas depresivos (β=-.066, IC 95% -.115, -.018 p=0.007), quienes no realizan ningún servicio voluntario (β=-.057, IC 95% -.102, -.102 p=0. 013), o no participan en la toma de decisiones (β=-.242, CI 95% -.295, -.189 p<0.001), presentan bajo locus de control interno (β=-.012., CI 95% -.023, -.001 p=0.023), y pobre percepción económica (β=-.070., CI 95% -.115, -.024 p=0.002). Al analizar la función cognitiva de las personas mayores, es vital considerar las posibles variables psicosociales relacionadas.

Resumo: O envelhecimento é um processo inevitável que pode estar associado a défices cognitivos. A evidência sobre a avaliação simultânea de variáveis psicossociais que podem estar associadas à função cognitiva é crucial. O nosso objetivo foi determinar a associação entre as características psicossociais e a cognição em adultos com mais de 50 anos no México. A quinta rodada do Estudo Mexicano de Saúde e Envelhecimento (MHAS) (2018) fornece a base para este artigo. O estudo faz parte de uma análise longitudinal, para a qual foram realizadas colagens de ondas 2012, 2015 e 2018. A amostra final foi composta por 6.709 indivíduos. Dez variáveis psicossociais foram medidas por meio de escalas ou perguntas específicas. A cognição foi avaliada com o Cross-Cultural Cognitive Examination (CCCE). Os factores de confusão incluíram dados sociodemográficos, multimorbilidade e funcionalidade. A análise foi efectuada através do ajuste do modelo de regressão. Da amostra total, 2.761 (41,1%) eram homens; 3.948 (58,8%) eram mulheres. A idade média foi de 68,2 anos (DP = 8,1). A cognição é significativamente afetada nas pessoas com mais idade (β=-1,30, Cl 95% -1,54, -.1.06 p= 0.000), menor escolaridade (β=.559, IC 95% .498, .621 p<0.001), sintomas depressivos (β=-.066, IC 95% -.115, -.018 p=0.007), aqueles que não realizam nenhum serviço voluntário (β=-.057, IC 95% -.102, -.102 p=0. 013), ou não participam na tomada de decisões (β=-.242, IC 95% -.295, -.189 p<0.001), baixo locus de controlo interno (β=-.012., IC 95% -.023, -.001 p=0.023), e fraca perceção económica (β=-.070., IC 95% -.115, -.024 p=0.002). Ao analisar a função cognitiva dos idosos, é vital considerar as possíveis variáveis psicossociais relacionadas.

Abstract: Aging is an inevitable process that can be associated with cognitive impairment. Evidence about the simultaneous evaluation of psychosocial variables that could be associated with cognitive function is crucial. We aimed to determine the association between psychosocial characteristics and cognition in adults over 50 years in Mexico. The fifth round of the Mexican Health and Aging Study (MHAS) (2018) provides the basis for this paper. The study is part of a longitudinal analysis, for which wave pasting 2012, 2015, and 2018 were performed. The final sample comprised 6,709 individuals. Ten psychosocial variables were measured through scales or specific questions. Cognition was assessed with the Cross-Cultural Cognitive Examination (CCCE). Confounders included sociodemographics, multimorbidity, and functionality. The analysis was performed by adjusting the regression model. Of the total sample, 2,761 (41.1%) were men; 3,948 (58.8%) were women. The mean age was 68.2 years (SD = 8.1). Cognition is significantly affected in people with higher age (β=-1.30, Cl 95% -1.54, -.1.06 p= 0.000), less schooling (β=.559, CI 95% .498, .621 p<0.001), depressive symptoms (β=-.066, CI 95% -.115, -.018 p=0.007), those who do not perform any volunteer service (β=-.057, CI 95% -.102, -.102 p=0.013), or do not participate in decision making (β=-.242, CI 95% -.295, -.189 p<0.001), low internal locus of control (β=-.012., CI 95% -.023, -.001 p=0.023), and poor economic perception (β=-.070., CI 95% -.115, -.024 p=0.002). When analyzing the cognitive function of older people, it is vital to consider the possible related psychosocial variables.

Resumo A viuvez é o “estado de uma pessoa depois da morte de seu cônjuge”. É considerada como um dos eventos de vida não normativos, de mais difícil manejo, particularmente em pessoas idosas, dado o conjunto de demandas emocionais, sociais e comportamentais que acarreta. Este estudo teve o objetivo de identificar as variáveis de saúde e/ou psicossociais relacionadas a viuvez em idosos. Foi realizada uma revisão integrativa da literatura por meio de busca nas bases de dados AgeLine, BVS, PsycoInfo, Pubmed e Scielo. Foram selecionados estudos publicados no idioma inglês, espanhol e português, com idosos de 60 anos ou mais, transversais ou longitudinais que incluíram descrições e detalhamentos sobre o processo de viuvez, como resultado primário e/ou secundário. Sintomas depressivos, suporte social, impacto das experiências prévias da relação marital no estado de viuvez, estado e/ou condição nutricional enquanto auto percepção de saúde, bem-estar psicológico, satisfação com a vida, religiosidade e espiritualidade podem atuar como fatores agravantes ou de proteção na viuvez.

Abstract Widowhood is “the state of a person after the death of his or her spouse”. It is considered one of the most difficult non-normative life events to manage, particularly in the elderly, given the set of emotional, social and behavioral demands that it entails. This study aimed to identify health and/or psychosocial variables related to widowhood in the elderly. An integrative literature review was carried out by searching the AgeLine, BVS, PsycoInfo, Pubmed and Scielo databases. Cross-sectional or longitudinal studies published in English, Spanish and Portuguese, with elderly aged 60 years and over, including descriptions and details about the widowhood process, as a primary and/or secondary result, were selected. Depressive symptoms, social support, impact of previous experiences of the marital relationship on the state of widowhood, nutritional state and/or condition as self-perception of health, psychological well-being, satisfaction with life, religiosity and spirituality can act as aggravating or debilitating factors. widowhood protection.

Abstract Objective: to analyze the psychosocial impacts of the COVID-19 pandemic among Brazilian women from rural settlements. Method: this is a quantitative and longitudinal study conducted with 13 settled women. The data were collected between January 2020 and September 2021 using questionnaires on the perception of the social environment (quality of life, social support, self-efficacy), common mental disorder symptoms and sociodemographic aspects. The data were analyzed using descriptive statistics, cluster analysis and variance analysis. Results: intersecting vulnerability conditions were identified that possibly intensified the challenges arising from the pandemic. The Quality of Life physical domain fluctuated differently and inversely according to the mental disorder symptoms. As for the psychological domain, at the end of the segment, an increase over time was identified in the entire sample, as the women’s perception was better than before the pandemic. Conclusion: worsening of the participants’ physical health deserves to be highlighted and, probably, it can be related to the difficulty accessing health services in this period as well as to the fear of contamination. Despite this, the participants were emotionally resilient throughout the period, including signs of improvement in terms of psychological aspects, suggesting a possible effect of the community organization of the settlement.

Resumen Objetivo: analizar los impactos psicosociales de la pandemia de COVID-19 en mujeres brasileñas de asentamientos rurales. Método: se trata de un estudio longitudinal cuantitativo con 13 mujeres asentadas. Los datos se recolectaron entre enero de 2020 y septiembre de 2021 mediante cuestionarios sobre percepción del entorno social (calidad de vida, apoyo social, autoeficacia), síntomas de trastorno mental común y aspectos sociodemográficos. Los datos se analizaron mediante estadística descriptiva, análisis de conglomerados y análisis de varianza. Resultados: se identificaron condiciones de vulnerabilidad entrelazadas que posiblemente exacerbaron los desafíos impuestos por la pandemia. El dominio físico de la calidad de vida fluctuó de manera diferente e inversa de acuerdo a los síntomas del trastorno mental. En cuanto al dominio psicológico, al final del segmento, se identificó un aumento en el tiempo en toda la muestra, dado que la percepción de las mujeres era mejor que antes de la pandemia. Conclusión: hay que destacar el empeoramiento de la salud física de las participantes que, probablemente, puede estar relacionado con la dificultad para acceder a los servicios de salud durante ese período y el miedo al contagio. A pesar de eso, las participantes fueron resilientes emocionalmente durante todo el período e, inclusive, tuvieron signos de mejoría en los aspectos psicológicos, lo que sugiere un posible efecto de la organización comunitaria del asentamiento.

Resumo Objetivo: analisar os impactos psicossociais da pandemia de COVID-19 entre mulheres brasileiras de assentamentos rurais. Método: trata-se de um estudo quantitativo longitudinal com 13 mulheres assentadas. Os dados foram coletados entre janeiro de 2020 e setembro de 2021 utilizando questionários sobre a percepção do ambiente social (qualidade de vida, apoio social, autoeficácia), sintomas de transtorno mental comum e aspectos sociodemográficos. Os dados foram analisados por meio de estatística descritiva, análise de agrupamento e de variância. Resultados: foram identificadas condições de vulnerabilidade interseccionadas que, possivelmente, exacerbaram os desafios decorrentes da pandemia. O domínio físico da qualidade de vida oscilou diferentemente e inversamente de acordo com os sintomas de transtorno mental. Quanto ao domínio psicológico, no final do segmento, identificou-se em toda a amostra um incremento ao longo do tempo, pois a percepção das mulheres estava melhor do que antes da pandemia. Conclusão: a piora na saúde física das participantes merece destaque e, provavelmente, pode estar relacionada à dificuldade de acesso aos serviços de saúde neste período bem como ao medo da contaminação. Apesar disso, as participantes apresentaram-se emocionalmente resilientes em todo o período, inclusive, com sinais de melhora em relação aos aspectos psicológicos, sugerindo um possível efeito da organização comunitária do assentamento.

ABSTRACT BACKGROUND AND OBJECTIVES: Although craniofacial pain has been associated with negative psychological aspects, how the patient’s perception of their own illness could influence craniofacial pain is not elucidated yet. Therefore, this study aims to identify the main factors and beliefs about the illness that could influence pain intensity and pain duration in people who experienced craniofacial pain in the last 24 hours. METHODS: This cross-sectional study comprised undergraduate students, aged between 18 and 40 years old, who experienced self-reported craniofacial pain in the last 24 hours. Participants answered questions regarding body functions, activities and participation, and personal factors based on the International Classification of Functioning (ICF); In addition, questions from the Brief Illness Perceptual Questionnaire (Brief IPQ) were applied. The analysis was carried out with a single and multiple regression model. RESULTS: The sample comprised 87 volunteers. Pain intensity and duration experienced in the last 24 hours were associate by concerns about the presence of an illness and the need for treatment. Pain intensity was specifically associated with the importance of treatment and the extent to which the patient is concerned about their pain (R2=0.108). Pain duration was associated with how much the individual is worried about their illness (R2=0.1459). CONCLUSION: Both pain intensity and duration experienced in the last 24 hours are associated with concerns regarding the presence of an illness and beliefs related to such illness treatment, which reinforces the influence of psychosocial aspects on pain perception.

RESUMO JUSTIFICATIVA E OBJETIVOS: Embora a dor craniofacial seja associada a aspectos psicológicos negativos, ainda não está totalmente elucidado como a percepção do paciente sobre sua própria doença pode influenciá-la. Portanto, este estudo teve como objetivo identificar os principais fatores e as crenças sobre a doença que podem influenciar a intensidade e a duração da dor em pessoas que sentiram dor craniofacial nas últimas 24 horas. MÉTODOS: Estudo transversal composto por universitários, com idade entre 18 e 40 anos, que relataram dor craniofacial nas últimas 24 horas. Os voluntários responderam a perguntas sobre funções corporais, atividades e participação e fatores pessoais com base na classificação da Classificação Internacional de Funcionalidades (CIF). Além disso, foram aplicadas questões do Questionário de Percepção de Doenças Versão Breve (Brief IPQ). A análise foi realizada com um modelo de regressão simples e múltiplo. RESULTADOS: A amostra foi composta por 87 voluntários. A intensidade e a duração da dor sentida nas últimas 24 horas foram influenciadas pela preocupação com a presença de doença e com a necessidade de tratamento. A intensidade da dor foi associada à importância do tratamento e à preocupação do paciente com sua dor (R2=0,108). A duração da dor associou-se à preocupação do indivíduo com sua doença (R2=0,1459). CONCLUSÃO: Tanto a intensidade quanto a duração da dor vivenciadas nas últimas 24 horas são influenciadas pela preocupação com a presença de doença e crenças relacionadas ao seu tratamento, o que reforça a influência dos aspectos psicossociais na percepção da dor.

Abstract Background: Psychosis is characterized by distortions of thinking and perception, as well as inappropriate emotions. In forensic settings, psychiatric mental health nurses are responsible for preventing violent behaviors through psychotherapeutic interventions. Objective: To characterize participants’ clinical situation based on the following variables: social performance, socially useful activities, personal and social relationships, disturbing and aggressive behavior, assertiveness, and early signs of aggression; and To assess the effectiveness of an intervention program for training social skills and reducing predictors of violence. Methodology: Pre-experimental study with a one-group pretest-posttest design. The sample consisted of 15 patients admitted to forensic psychiatric wards. Results: The intervention proved effective, with statistically significant changes in personal relationships, disturbing and aggressive behaviors, and early signs of aggression. Conclusion: Training social skills and self-control improved participants’ clinical indicators and psychosocial rehabilitation and contributed to better (re)integrating them into their families and communities.

Resumen Marco contextual: La psicosis se caracteriza por distorsiones del pensamiento, de la percepción y de las emociones inapropiadas. En el contexto forense, es responsabilidad del enfermero especialista en salud mental y psiquiátrica prevenir las conductas violentas mediante intervenciones psicoterapéuticas. Objetivo: Caracterizar la situación clínica de los participantes en cuanto a las siguientes variables: funcionamiento social, actividades socialmente útiles, relaciones personales y sociales, comportamiento disruptivo y agresivo, asertividad y signos tempranos de agresión. Evaluar la eficacia de un programa de intervención para entrenar las competencias sociales y reducir los predictores de violencia. Metodología: Estudio preexperimental, con diseño antes y después de la prueba con un único grupo, cuya muestra estaba compuesta por 15 pacientes ingresados en los servicios de psiquiatría forense. Resultados: El programa demostró ser eficaz y se observaron cambios estadísticamente significativos en las relaciones personales, el comportamiento disruptivo y agresivo, y los primeros signos de agresión. Conclusión: El entrenamiento de las competencias sociales y del autocontrol se tradujo en la mejora de los indicadores clínicos y en la rehabilitación psicosocial de los participantes, lo que contribuyó a una mejor (re)integración en la familia y la comunidad.

Resumo Enquadramento: As psicoses são caraterizadas por distorções do pensamento, da perceção e emoções inadequadas. Em contexto forense, cabe ao enfermeiro especialista em saúde mental e psiquiátrica prevenir comportamentos violentos através de intervenções psicoterapêuticas. Objetivo: Caraterizar a situação clínica dos participantes relativamente às variáveis: funcionamento social, atividades socialmente úteis, relações pessoais e sociais, comportamento perturbador e agressivo, assertividade e sinais precoces de agressão; avaliar a eficácia de um programa de intervenção para treino de competências sociais e diminuição de preditores de violência. Metodologia: Estudo pré-experimental, com delineamento de pré e pós-teste com grupo único, cuja amostra foram 15 doentes internados em serviços de psiquiatria forense. Resultados: O programa demonstrou-se eficaz, observando-se mudanças estatisticamente significativas a nível das relações pessoais, dos comportamentos perturbadores e agressivos e dos sinais precoces de agressão. Conclusão: O treino de habilidades sociais e de autocontrolo traduziu-se na melhoria dos indicadores clínicos e na reabilitação psicossocial dos participantes, contribuindo para uma melhor (re)integração na família e na comunidade.

Resumen El objetivo del estudio fue identificar las metas de logro y prácticas parentales de apoyo a la autonomía y control psicológico, para determinar la relación entre estas medidas, según el nivel de estudios, el sexo de los progenitores y de los adolescentes de Cuenca, Ecuador. Para ello, se realizó un estudio cuantitativo, relacional de corte transversal con una muestra constituida por 713 madres (Meda d = 43, DT = 7), 543 padres (Medad = 46, DT = 8) y 1085 adolescentes (Medad = 16.1, DT = 1.1). Se aplicó el cuestionario Parental de Metas Orientadas al Logro, adaptado al español del instrumento Parental Achievement Goals AGQ y Autonomy Support Scale. La subteoría de contenido de metas de la teoría de la autodeterminación ha sido la base teórica para explicar que las metas de logro parental orientan el apoyo a la autonomía y el control psicológico. Se emplearon las pruebas .-Student, ANOVA, chi-Cuadrado de independencia para tablas de contingencia y el coeficiente de correlación . de Pearson para establecer la relación lineal de las variables de estudio. Los resultados revelan que las metas de logro dominio de la tarea y éxito en la tarea son predominantes, mientras que la evitación del fracaso en la tarea es baja. Por otro lado, la práctica de apoyo a la autonomía se percibe alta y significativamente mayor al control psicológico. Finalmente, se confirma la relación de las medidas parentales con el nivel de estudios y el sexo de los progenitores y de los adolescentes.

Abstract The importance of parental practices as one the most direct influences on the development of minors and adolescents has generated an increased relevance in recent decades of the study of parental expectations on the psychological adjustment of children. In this sense, the Goal Content Subtheory of Self-Determination Theory has been the theoretical basis to explain that the purpose of human behavior responds to an extrinsic or intrinsic motivation. That is why, extrinsic motivation guides parents towards parental goals: the success of the task and the avoidance of task failure and they adopt more parental control strategies with their progeny, while intrinsic motivation guides the mastery goals of the task which would explain parental support behaviors. The objective of the study was to identify the achievement goals and parenting practices, support for autonomy-psychological control, and to determine the relationship between these parenting measures, according to the sex and educational level of the parents from Cuenca, Ecuador. For this, a quantitative, relational, cross-sectional study was carried out with 713 mothers (Medad = 43, DT = 7), 543 fathers (Medad = 46, DT = 8) and 1 085 adolescents (Medad = 16.1, DT= 1.1). The participants were selected from within 18 educational institutions through a probabilistic sample calculated with a 95 % confidence level, and a 3 % margin of error. For data collection, the Parental Achievement-Oriented Goals questionnaire was applied, adapted to Spanish from the Parental Achievement Goals AGQ instrument; and Autonomy Support Scale. In the data analysis, the T-Student test, ANOVA, Chi-Square, test of independence for contingency tables and the Pearson r correlation coefficient, were used for the linear relationship of the study variables. The results reveal that the achievement goals: mastery of the task and success in the task predominate and the avoidance of failure in the task is low, in terms of the sex of the parents, the parents were oriented towards the mastery of the task while mothers toward goals focused on homework success. Likewise, parents with a low level of education orient themselves to success in the result of the task and the avoidance of failure in the task, while parents with a higher level of education orient their goals of parental achievement towards the mastery of the homework. The perception of support for autonomy is high and significantly upper than the psychological control of the parents, it was found that the manifestation of support “being aware of accepting and acknowledging the child's feelings” is the most valued statement in the mother in relation to the dad. On the other hand, adolescents perceive greater psychological control from mothers than from fathers, in the demonstrations “threatening to punish the child” and “induce guilt”. Regarding the level of studies of the parents, the results indicate that the higher the level of studies, the greater the support for autonomy and when is lower the level of studies, there is greater psychological control. This research has confirmed the relationship between the level of education of the parents, the sex the adolescent and parents with the goals of parental achievement, support and psychological control; this shows that these characteristics affect parental practices. It is necessary for future research to attention on the educational level of the parents, as this is one of the most consistent family variables that can favor appropriate parental goals and practices for the psychosocial adjustment of the children.

Resumen Los gobiernos municipales de Costa Rica tienen un papel significativo en el Sistema Nacional de Gestión del Riesgo (SNGR) para enfrentar las múltiples amenazas y riesgos que afectan al país desde sus territorios. Los distintos marcos y políticas que trabajan en el enfoque de la Gestión del Riesgo de Desastres (GRD) promueven la realización de análisis de riesgos como proceso que contribuye a su reducción y mitigación, y destacan el enfoque de género como principio o eje para visibilizar la necesidad de realizar revisiones y acciones diferenciadas por género. El presente artículo recoge la investigación realizada que responde a la pregunta “¿Cuáles son los elementos psicosociales que influyen en la puesta en práctica de la transversalización del enfoque de género en los procesos de la GRD de las oficinas municipales?” Esta pregunta se respondió desde la Psicología Social Comunitaria y la Psicología Social Feminista. Se realizó un estudio con enfoque cualitativo y diseño fenomenológico, en el que se aplicaron entrevistas a representantes institucionales en GRD y género. Se identificaron doce elementos psicosociales que influyen en la transversalización del enfoque de género en la GRD municipal, que deben visibilizarse y pueden ser trabajados para abordar los riesgos de dos poblaciones históricamente discriminadas: mujeres y población LGTBIQ+. Trabajar las desigualdades de género como causa subyacente del riesgo es prioritario para la GRD.

Abstract The city governments of Costa Rica have a significant role in the National Risk Management System (SNGR in Spanish) to face the multiple threats and risks that affect the country from their territories. The different frameworks and policies that work with the Disaster Risk Management approach, among which are international (e. g., Sendai Framework for Action), regional (e. g., Central American Policy for Comprehensive Disaster Risk Management), and national instruments (e. g., National Risk Management Policy), promote risk analysis as a process that contributes to their reduction and mitigation, which, together with specific policies focused on gender (e. g., Convention on the Elimination of All Forms of Discrimination Against Women [CEDAW]), highlight the gender approach as a principle or axis, making the need to carry out reviews and actions differentiated by gender visible. The growth of inequalities in events such as disasters emphasizes the fact that there are gender differences in the perception of risks, the levels of vulnerability that exist and the capacities to cope. This article collects the research carried out that answers the question: “What are the psychosocial elements that influence the implementation of mainstreaming the gender approach in DRM processes in municipal offices?” from Community Social Psychology and Feminist Social Psychology. A study with a qualitative approach and phenomenological design was carried out, in which interviews were applied to institutional representatives in DRM and gender. The first seeks to promote processes of social transformation, considering the psychosocial processes that permeate community dynamics, which, in turn, are influenced by specific contexts. As for Feminist Psychology, it promotes the identification of inequalities and the creation of options for change. The relationship between feminist political perspectives and psychological practices and sexual and gender differences were considered as causes of inequalities, generating certain psychosocial analyzes not widely developed so far. A subjective perspective to the lived experience of the people participating in the research was considered in order to emphasize the meanings and knowledge as a process, based on interviews with institutional representatives of municipal offices and national institutions both focused on DRM or gender. Twelve psychosocial elements that influence the mainstreaming of the gender approach in municipal DRM were identified: the need for training and awareness, the requirement of political will, the naturalization of gender roles and stereotypes, the recognition of gender differences, resistance to mainstreaming gender, subjectivity, the presence or absence of inter and intra-institutional articulations, the social participation of women, the recognition of gender violence, the recognition of vulnerable populations, the cultural context and social inequalities. Moreover, gender inequalities are recognized as an element that affects and emphasizes the vulnerabilities of specific populations, such as women of different ages, transgender people, people with disabilities, among others. The research allowed an approach to ten different territorial contexts where DRM is put into practice from an office or as a process, and how the experience of the people who lead them understands the gender approach, contrasting with the institutional perspective applied at the national level. It is concluded that these should be made visible and can be worked on to address the risks of two historically discriminated populations: women and LGTBIQ+ population. Considering gender inequalities as an underlying cause of risk is a priority for Disaster Risk Management.

Abstract Gestational diabetes mellitus (GDM) is a disease with fatal, disabling, and costly consequences for individuals, families, communities and countries. To systematically establish the psychosocial risk factors associated with GDM that should be monitored during and after pregnancy. Systematic review in PubMed/Medline and Cochrane databases. 1188 articles were found and 41 were selected. Some main themes were conflicts with cultural practices, social stigma, ethnicity/race influence, low educational level, sleep quality, breastfeeding problems, concern for one’s own health/baby, low perception of the risk of GDM/DM2 in the future, stress, anxiety and depression, limited knowledge, lack of support from the partner/family/social and health professionals, low levels of self-care/self-efficacy and difficulties with changes in the lifestyle. These factors should be monitored in pregnant women during and after delivery. Treatments should consider the psychological impact and the risk of developing DM2 after childbirth and should be included in clinical practice guidelines. Multi-ethnic populations and the most demographically and socioeconomically vulnerable groups are more susceptible to developing GDM.

Resumen La diabetes mellitus gestacional DMG es una enfermedad con consecuencias mortales, incapacitantes y costosas para las personas, las familias, las comunidades y los países. Con el fin de establecer de manera sistemática los factores de riesgo psicosocial asociados con la DMG que deberían ser monitoreados durante y después del embarazo se realizó una revisión sistemática en las bases de datos PubMed/Medline y Cochrane. Se encontraron 1188 artículos y se seleccionaron 41. Algunos temas principales fueron conflictos con prácticas culturales, estigma social, influencia de la etnia/raza, bajo nivel educativo, calidad del sueño, problemas con la lactancia materna, preocupación por la propia salud o la del bebé, baja percepción de riesgo de DMG o de diabetes mellitus tipo 2 en el futuro, estrés, ansiedad y depresión, conocimiento limitado, falta de apoyo de la pareja, de la familia o social y de los profesionales de la salud, bajos niveles de autocuidado/autoeficacia y dificultades con cambios en el estilo de vida. Estos factores deberían monitorearse en las embarazadas durante y después del parto. Los tratamientos deberían considerar el impacto psicológico y el riesgo de desarrollar diabetes mellitus tipo 2 después del parto, y deberían ser incluidos en las guías de práctica clínica. Las poblaciones multiétnicas y los grupos más vulnerables demográficamente y socioeconómicamente son más susceptibles de desarrollar DMG.

ABSTRACT Introduction: Most patients with serious and progressive diseases such as HIV/AIDS face a variety of psychological challenges, which is why in this research we ask ourselves what is the psychological state of patients with the acquired immunodeficiency syndrome disease interned at the Institute of Tropical Medicine in the year 2022. Objective: To evaluate the psychological state of patients with acquired immunodeficiency syndrome, admitted to the Institute of Tropical Medicine in 2022. Methodology: Descriptive, prospective study of a mixed approach with a non-experimental design in which 100 patients with a diagnosis of HIV/AIDS admitted to the IMT in the period from January to July 2022 were included, finding the following most relevant results: 30 to 66% of the total were 44 years old, coming from Asunción (31%), and Central area (53%). Regarding the cognitive state, 61% were lucid, located in time and space, memory and attention were affected in 51% of the patients; affective state: fear or apprehension were the main stages, followed by worry and impotence. Analyzing the somatic state, it was seen that the rest was bad, as was the diet. In relation to the interpersonal state, 87% had family support, the behavioral state showed inconsistencies in coping with symptoms and adherence. Conclusion: Sociodemographic and psychosocial factors, the perception of social support, beliefs related to the disease, personality traits, social skills, coping styles, among others, may allow patients with HIV/AIDS to face the disease in order to achieve adaptation and well-being of your general health.

RESUMEN Introducción: La mayoría de los pacientes con enfermedades graves y progresivas como el VIH/SIDA se enfrentan a una variedad de desafíos psicológicos, es por eso que en esta investigación nos preguntamos cual es el estado psicológico de pacientes con la enfermedad del síndrome de inmunodeficiencia adquirida, internados en el Instituto de Medicina Tropical en el año 2022. Objetivo: Evaluar el estado psicológico de pacientes con la enfermedad del síndrome de inmunodeficiencia adquirida, internados en el Instituto de Medicina Tropical en el año 2022. Metodología: Estudio descriptivo, prospectivo de enfoque mixto con diseño no experimental en el que se incluyeron a 100 pacientes con diagnóstico de VIH/SIDA internados en el IMT en el periodo de enero a julio de 2022, encontrando los siguientes resultados: 30 a 44 años en el 66% del total, procedentes de Asunción (31%), y del área Central (53%). Con respecto al estado cognitivo el 61% estaba lúcido, ubicado en tiempo y espacio, la memoria y atención se ven afectadas en el 51% de los pacientes; estado afectivo: el miedo o temor fueron los estadíos principales, seguido de la preocupación e impotencia. Analizando el estado somático se vio que el descanso fue malo, al igual que la alimentación. En relación al estado interpersonal el 87% contaba con apoyo familiar, el estado conductual mostró incoherencias en cuanto al afrontamiento de los síntomas y la adherencia. Conclusión: Los factores sociodemográficos y psicosociales la percepción de apoyo social, las creencias relacionadas con la enfermedad, los rasgos de personalidad, las habilidades sociales, los estilos de afrontamiento, entre otras, pueden permitir a los pacientes con VIH/ SIDA afrontar la enfermedad para lograr la adaptación y el bienestar de su salud general

ABSTRACT BACKGROUND AND OBJECTIVES: The hormonal impact on pain perception during the menstrual cycle is a major focus of study, and further elucidation in temporomandibular disorders (TMD) field is necessary. Thus, this cross-sectional study evaluated experimental pain thresholds, psychosocial features, and clinical pain report on TMD women across menstrual cycle versus healthy controls. METHODS: A total of 220 women’s clinical files were screened, with 80 selected and divided into control group (healthy individuals, n=40) and TMD group (myofascial pain, n=40). Regarding the menstrual cycle phases, the files were divided into Pre-Luteal and Luteal. The Perceived Stress Scale (PSS), Pain Catastrophizing Scale (PCS), Mechanical Pain Threshold (MPT), Wind-up (WUR), Pressure Pain Threshold (PPT), Conditioned Pain Modulation (CPM) and Visual Analogue Scale (VAS) were analyzed at a 5% significance level, by Two-Way ANOVA test and post hoc Tukey test. RESULTS: PSS and PCS were significantly different between TMD and control group (p<0.001), regardless of menstrual cycle. Healthy individuals in the Luteal phase presented higher MPT values compared to the other phases (p<0.001). PPT showed significant difference across menstrual phases (p=0.022), but no differences in multiple comparisons. VAS values showed no difference between menstrual cycle phases (p=0.376). CONCLUSION: Finally, healthy individuals in the Luteal phase have higher MPT and PPT values on the orofacial region. Pain report in patients with TMD showed no difference throughout the menstrual cycle, showing that small alterations on experimental pain thresholds may not be clinically relevant. The presence of chronic pain seems to be more related to psychosocial features than hormonal fluctuations.

RESUMO JUSTIFICATIVA E OBJETIVOS: O impacto do ciclo menstrual na percepção da dor é um foco importante de estudo, sendo necessária uma maior elucidação na disfunção temporomandibular (DTM). Assim, este estudo transversal avaliou limiares de dor experimental, características psicossociais e relatos de dor em mulheres com DTM ao longo do ciclo menstrual, comparadas com controles saudáveis. MÉTODOS: 220 prontuários de mulheres foram analisados, sendo 80 selecionados para os grupos de controle (saudáveis, n=40) e DTM (dor miofascial, n=40). Nas fases do ciclo menstrual, as pacientes foram divididas nas categorias Pré-Luteal e Luteal. Os instrumentos Escala de Estresse Percebido (PSS), Escala de Pensamentos Catastróficos (PCS), Limiar de Dor Mecânica (MPT), Wind-up Ratio (WUR), Limiar de Dor à Pressão (PPT), Modulação Condicionada da Dor (CPM) e Escala analógica visual (EAV) foram analisados com nível de significância de 5%, pelos testes ANOVA de dois fatores e Tukey post hoc. RESULTADOS: As escalas PSS e PCS foram significativamente diferentes entre os grupos DTM e controle (p<0,001), independentemente do ciclo menstrual. Indivíduos saudáveis na fase luteal apresentaram MPT maior em comparação com outras fases (p,0,001). O PPT mostrou diferença significativa entre as fases menstruais (p=0,022), sem diferença nas comparações múltiplas. Os valores da EAV não apresentaram diferença entre as fases menstruais (p=376). CONCLUSÃO: Indivíduos saudáveis na fase luteal têm MPT e PPTl maior na região orofacial. Os relatos de dor em pacientes com DTM não mostraram diferença ao longo do ciclo menstrual, indicando que pequenas alterações nos limiares experimentais podem ser clinicamente relevantes. A presença de dor crônica parece estar mais relacionada com características psicossociais do que com flutuações hormonais.

Resumen Existe un creciente consumo de sustancias psicoactivas a pesar de que genere múltiples efectos perjudiciales para la salud y problemáticas psicosociales. Se propone que múltiples creencias sociales de la filosofía contemporánea promueven el consumo de estas sustancias, especialmente en la juventud y adolescencia. Se reflexiona sobre la sinergia entre múltiples ideas postmodernas y los efectos desinhibitorios, sedativos, anestésicos, psicoestimulantes y disociativos de las sustancias psicoactivas para el desarrollo de conductas socialmente esperadas. La diversión como valor fundamental, la búsqueda de excesos, el consumismo, la relativización del conocimiento, la moral estadística, la filosofía de la inmediatez, la digitalización de las interacciones sociales y las relaciones líquidas serían algunos de los factores implicados. La baja percepción de riesgo sobre las sustancias, la publicidad dirigida a jóvenes, el aumento de la prevalencia de la depresión, el estigma sobre la patología psiquiátrica y los servicios de atención de salud mental deficitarios serían otros aspectos que en conjunto con la ideología predominante podría acrecentar estas problemáticas sociales y de salud. La morbi-mortalidad temprana, los incidentes viales, los embarazos adolescentes y conductas violentas son algunas de las consecuencias que se ven potenciadas por el consumo de sustancias. La promoción de estas sustancias está especialmente dirigida a adolescentes que por razones biológicas y sociales se encuentran en la etapa de la vida más vulnerable para iniciar estas conductas de riesgo. Como conclusión se destaca la necesidad de conversar con los más jóvenes a edad temprana sobre estas creencias para prevenir el consumo problemático de sustancias psicoactivas y sus consecuencias sociales.

Summary A steady growth in the use of psychoactive substances is being observed, despite the multiple harmful health and psy-chosocial effects associated with their consumption. The present paper argues that a host of social beliefs emerging from the current zeitgeist or life philosophy encourage substance abuse, especially during youth and adolescence. It analyses the synergy between post-modern life views and the disinhibiting, sedative, anesthetic, psychostimulant and dissociative effects of psychoactive substances in the development of current social standards of behavior. Fun and enjoyment held as core values, the pursuit of excess, consumerism, the relativization of knowledge, a statistical view of morality, the quest for in-stant gratification, the digitalization of social interactions and liquid relationships are some of the contributing factors. Low risk percep-tion about substance use, mass-media campaigns directed at the young, the rise of depression, the stigma associated with mental illness and deficiencies in mental health services further compound this issue. Premature morbidity and mortality, traffic incidents, teenage pregnancy and violent behaviors are some of the consequences exacerbated by substance abuse. The situation is compounded by media promotion of such substances, targeted at teenagers who owing to social and biological reasons find themselves at a higher probability of incurring risky behaviors. As a conclusion, the present study underscores the need to hold early discussions with the young regarding current belief systems in order to mitigate the detrimental social and health effects of substance abuse.