Max dos Santos Afonso

RESUMO Objetivo: Analisar como e por que famílias adotivas de crianças com deficiência inventam e estabilizam normas de cuidado inclusivo no cotidiano. Método: Estudo qualitativo, fundamentado na Grounded Theory, realizado em um município do sul do Brasil, com 11 famílias adotivas. Foram realizadas entrevistas individuais, presenciais e semiestruturadas, analisadas por comparação constante e codificação aberta, axial e seletiva. Resultados: A análise revelou uma teoria substantiva que explica a invenção de normas de cuidado inclusivo como processo relacional, dinâmico e situado. O modelo articula causas, contexto e condições intervenientes a estratégias de ação/interação orientadas por uma ética do cuidado, expressas em três movimentos: coordenar rotinas, acionar redes e advocacy e performar a filiação. Esses movimentos produzem participação, previsibilidade, conforto e continuidade, sustentando o cuidado em contextos marcados por fragmentação institucional. Considerações finais: A invenção de normas de cuidado inclusivo expressa a produção de respostas situadas frente às demandas da criança e às limitações institucionais. Os achados reforçam a importância da coordenação do cuidado, da participação familiar e da atuação da Enfermagem na mediação entre famílias e serviços.

RESUMEN Objetivo: Analizar cómo y por qué las familias adoptivas de niños con discapacidad inventan y establecen normas de atención inclusiva en su vida diaria. Método: Un estudio cualitativo, basado en la Teoría Fundamentada, realizado en un municipio del sur de Brasil, con 11 familias adoptivas. Se realizaron entrevistas individuales, presenciales y semiestructuradas, que se analizaron mediante comparación constante y codificación abierta, axial y selectiva. Resultados: El análisis reveló una teoría sustantiva que explica la invención de normas de atención inclusivas como un proceso relacional, dinámico y situado. El modelo vincula las causas, el contexto y las condiciones intervinientes con estrategias de acción/interacción guiadas por una ética del cuidado, expresada en tres movimientos: coordinar rutinas, activar redes y advocacy, y establecer vínculos de filiación. Estos movimientos generan participación, previsibilidad, comodidad y continuidad, lo que permite mantener la atención en contextos marcados por la fragmentación institucional. Conclusión: La invención de normas de atención inclusiva expresa la producción de respuestas contextualizadas a las necesidades del niño y a las limitaciones institucionales. Los resultados refuerzan la importancia de la coordinación de la atención, la participación familiar y el papel de la enfermería como mediadora entre las familias y los servicios.

Objective: To analyze how and why adoptive families of children with disabilities invent and establish norms of inclusive care in their daily lives. Method: Qualitative study, based on Grounded Theory, carried out in a municipality in southern Brazil, with 11 adoptive families. Individual, face-to-face, semi-structured interviews were conducted and analyzed using constant comparison and open, axial, and selective coding. Results: The analysis revealed a substantive theory that explains the invention of inclusive care norms as a relational, dynamic, and situated process. The model links causes, context, and intervening conditions to action/interaction strategies guided by an ethics of care, expressed in three movements: coordinating routines, activating networks and advocacy, and recognizing social-affective parentage. These movements produce participation, predictability, comfort, and continuity, sustaining care in contexts marked by institutional fragmentation. Conclusion: The invention of inclusive care standards expresses the production of situated responses to the child’s needs and institutional limitations. The findings reinforce the importance of care coordination, family involvement, and the role of Nursing in mediating between families and services.

Background/Objectives: Nursing professionals were among the most affected groups during the COVID-19 pandemic, exposed to simultaneous physical demands and emotional strain. This study examined the interplay between work engagement, compassion fatigue, and musculoskeletal symptoms among frontline nurses in a Brazilian public hospital. Methods: A cross-sectional study (n = 77) was conducted between February and April 2022 using validated instruments (Work Stress Scale, ProQoL-BR, Nordic Musculoskeletal Questionnaire, and UWES-9). Descriptive and inferential analyses were performed (p ≤ 0.05). Results: Most participants did not report occupational stress (84.4%). No profiles of compassion fatigue were identified, although notable rates of burnout (26.0%) and secondary traumatic stress (23.4%) were observed. Engagement scores were very high in vigor and dedication. Musculoskeletal symptoms were prevalent, especially in the lumbar region (chronic: 60.0%). Female sex, statutory employment, and lack of physical activity were associated with a higher prevalence of symptoms and sick leave. Work engagement (vigor and overall score) showed negative correlations with absenteeism. Conclusions: The coexistence of high engagement and emotional vulnerability, in the absence of compassion fatigue, suggests that higher levels of engagement may be associated with lower occupational stress. These findings highlight the importance of integrated strategies, including ergonomic interventions, health promotion, and organizational support, to preserve the physical and mental health of frontline nursing professionals. This study provides new evidence of engagement as a potential protective factor that may mitigate physical and emotional burden among nurses in resource-limited settings.

Objective: to identify sociodemographic and regional differences in the lack of access of aged Brazilians to medicines for hypertension and/or diabetes mellitus in the last 30 days, in the years 2017, 2018 and 2019, based on data from the Telephone-based Surveillance of Risk and Protective Factors for Chronic Diseases (VIGITEL).Methods: a population-based transversal study using data from VIGITEL. Were eligible the elderly (≥60 years) who answered affirmatively to the questions “In the past 30 days, did you have been without any hypertension medications for some time?”, “In the past 30 days did you have been without any high to control diabetes for some time?”, and “In the past 30 days, did you ran out of insulin?” Chi-squared test was used to describe the prevalence of the outcome in accordance with the independent variables, and ajusted Poisson Regression was used to estimate the prevalence ratio and respective 95% confidence intervals (95% CI).Results: the prevalence of the outcome was 11.8% in 2017, 11.4% in 2018, and 11.2% in 2019. A higher prevalence of lack of access to medications for hypertension and diabetes mellitus was observed among elderly people of black/brown/yellow/ indigenous skin color, less educated, beneficiaries of Bolsa Família, without private health plan and living in the Northeast and North regions.Conclusion: there was a small reduction in the lack of access to medication for hypertension and diabetes between 2017 and 2019. Furthermore, the results reveal inequality in access to these medicines.

To investigate the presence of burnout syndrome in child athlete tryouts for the Brazilian Handball Team, before and after the National Development and Technical Improvement Camp is of great interest. A correlational study, with longitudinal design of the before-and-after type, carried out with 64 male athletes in the children’s category, immersed in the National Camp for Development and Improvement of Handball Technique, in the municipality of São Bernardo do Campo, São Paulo, Brazil, in December 2018. To evaluate burnout syndrome, we used the Athlete Burnout Questionnaire (ABQ). There was a statistically significant increase of the mean scores for burnout and dimensions (Physical and Emotional Exhaustion = 1.5 to 1.6; p-value < 0.001; Reduced Sense of Accomplishment = 2.7 to 2.9; p-value < 0.001; Sports Devaluation = 1.4 to 1.6; p-value < 0.001; and General Burnout = 1.9 to 2.0; p-value < 0.001). The athletes selected for the national team had lower mean scores for general burnout and dimensions (Physical and Emotional Exhaustion = 1.5; Reduced Sense of Accomplishment = 2.7; Sports Devaluation = 1.5; General Burnout = 1.9). The National Camp for Development and Technical Improvement can have a negative impact on the mental health of athletes. This event is important to select the competitors with greater ability to face the pressure and adversities present in the sport environment.

Objetivo: Descrever o perfil de óbitos por COVID-19 no município de Rio Grande, Rio Grande do Sul, Brasil. Metodologia: Trata-se de um estudo transversal, descritivo, com dados oriundos do banco de óbitos da Vigilância Epidemiológica, registrados no período de março a dezembro de 2020. Resultados: Dos 194 óbitos, a maioria era do sexo masculino (63,4%), com 60 anos ou mais (82,5%), de cor da pele branca (82,5%), residentes na região central histórica do município (11,3%). Quanto à ocupação, a maior ocorrência de óbitos foi entre os aposentados (69,5%), seguido por comerciante ou autônomo (17,7%). Com relação às morbidades, 38,7% tinha cardiopatias, 29,4% hipertensão arterial sistêmica, 28,0% diabetes mellitus e praticamente a metade dos indivíduos tinha multimorbidade (49,0%). Conclusões: Com a identificação do perfil de óbitos por COVID-19 no município de Rio Grande no período de março a dezembro de 2020, esses dados podem contribuir para auxiliar os gestores no planejamento de ações estratégicas e educativas de prevenção e combate à COVID-19, principalmente no direcionamento de grupos prioritários nas campanhas de vacinação.

Objective: To analyze the coping strategies used by primary healthcare (PHC) professionals. Methods: A cross-sectional, descriptive-analytical study realized with professionals working in primary healthcare units in São José do Rio Preto, a large city in the interior of São Paulo, Brazil. For data collection, we used an instrument developed by the researchers containing sociodemographic and professional variables, as well as the Problem Coping Modes Scale (EMEP). Results: We evaluated 333 PHC professionals. A difference was observed between the scores of the four coping strategies (p < 0.001), with the highest score for the problem-focused strategy (3.8) and the lowest score for the emotion-focused strategy (2.4). Physicians had the lowest scores in coping strategies focused on religious practices/fantastical thinking (p < 0.001) and pursuit of social support (p = 0.045), while community health agents had the highest scores in these coping strategies. Conclusions: Professionals working in PHC have different coping strategies for the problems and stressful situations experienced in the work environment. These strategies can involve more positive attitudes focused on confrontation and problem solving, and on emotional responses that involve attitudes of avoidance and denial of the problem.