RESUMO
There are large disparities in access to mental health care, especially in low- and middle-income countries. Telemental health is a viable solution to reducing these disparities, but quality research demonstrating its effectiveness is needed. The purpose of this pilot study was to examine the feasibility of a telemental health approach in a rural region of Brazil. Primary care providers referred patients diagnosed with depression and anxiety to a 12-session family systems-oriented telemental health program developed by the researchers. Participants (n = 10) received therapy by family systems trained therapists. While sessions were delivered via telemental health, each received one face-to-face session as part of the treatment regimen. Results from the one-tailed t-tests indicate reductions in psychosocial symptoms and improvements in family functioning with medium and large effect sizes. Findings reveal that a family systems-oriented telemental health approach is a promising intervention for improving mental health outcomes in a middle-income country.
Assuntos
Ansiedade , População Rural , Brasil , Humanos , Projetos PilotoRESUMO
Rural proofing ensures that policies, practice guidelines, strategies, and techniques can be applied to rural populations with approximately equal benefit as what would be obtained in urban areas. Extending this concept internationally, the authors argue the importance of global proofing mental health strategies developed in well-resourced, high-income areas in order to determine their appropriateness in areas that have resource poverty such as middle- and low-income countries. An example is used to illustrate both rural and global proofing. Through this example, the authors demonstrate how they proofed urban-inspired models of mental health care in rural areas of the United States. The result is a model of rural mental health care that emphasizes collaborative care and telemental health. This model is now being global proofed in Brazil. The authors describe the application of this model in a remote rural town in Brazil. Consistent with World Health Organization recommendations, the integration of mental health care into primary care medical settings is being discovered as essential to addressing mental health disparities worldwide. (PsycINFO Database Record
Assuntos
Comportamento Cooperativo , Serviços de Saúde Mental/normas , Telemedicina/normas , Brasil , Saúde Global , Humanos , Serviços de Saúde Mental/tendências , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Serviços de Saúde Rural/normas , Serviços de Saúde Rural/tendências , População Rural , Telemedicina/métodosRESUMO
Objetivo: O objetivo deste trabalho foi verificar a relação entre a satisfação conjugal e a depressão pós-parto e o impacto destas variáveis nos níveis de satisfação conjugal e depressão futuros, em uma amostra brasileira. Estudos revelam que o conflito conjugal é um antecedente importante no desenvolvimento da depressão e que a depressão pós-parto influencia significativamente a satisfação conjugal. Métodos: Este estudo longitudinal com 99 mulheres brasileiras utilizou análises de regressão múltipla para verificar a associação entre a satisfação conjugal e a depressão. A sintomatologia depressiva foi avaliada pelo instrumento Self-Reporting Questionnaire (SRQ-20). A satisfação conjugal foi verificada a partir de itens sobre a percepção de satisfação conjugal das participantes. Os dados foram coletados 4 meses e 2 anos após o parto. Os dados longitudinais possibilitaram a análise cronológica da interação entre as duas variáveis. Resultados e Conclusões: Os resultados indicam que o modelo teórico que estabelece a relação entre conflito conjugal e depressão é também apropriado para casais brasileiros, sugerindo a utilização potencial da terapia de casal no tratamento da depressão pós-parto no Brasil.
Objective: This study examined the relationship between marital satisfaction and postpartum depression as well as the impact of postpartum depression and marital satisfaction on later relational characteristics among Brazilian couples. Studies have shown that marital satisfaction is an important antecedent to depression and that postpartum depression has an influence on marital satisfaction. Methods: A longitudinal study using multiple regression to test the association between marital satisfaction and depression was conducted among Brazilian women. Depressive symptomatology was assessed using the Self-Reporting Questionnaire 20 and marital satisfaction using an instrument developed by the researchers to test the individuals' perception of their marital quality. Data were collected at 4 months and 2 years after childbirth. The longitudinal data allowed researchers to chronologically analyze the interaction of key variables. Results and Conclusions: Results showed that the model established between marital satisfaction and depression is appropriate for Brazilian couples as well as for postpartum women. This study highlights the potential impact of marital treatment on postpartum depression in Brazil.
Objetivo: El objetivo de este trabajo fué verificar la relación existente entre la satisfacción con la relación de pareja y la depresión pos-parto y el impacto de esas variables en los niveles de satisfacción con la relación de pareja y depresión futuros, en una muestra brasileña. Estudios revelan que el conflicto de pareja és un antecedente importante en el desarollo de depresión y que la depresión pos-parto provoca influencia significativa en la relación de pareja. Métodos: Este estudio longitudinal con 99 mujeres brasileñas hizo uso de análisis de regresión multiple para estudiar la asociación entre la satisfacción en la relación de pareja y la depresión. Los sintomas depresivos fueron evaluados por el instrumento Self-Reporting Questionnaire (SRQ-20). La satisfacción con la relación de pareja fué verificada utilizando datos sobre la percepción de satisfacción de las participantes. Los datos fueron obtenidos 4 meses y 2 años después del parto. Resultados y Conclusiones: Los resultados indican que el modelo teórico que establece la relación entre conflicto de pareja y depresión és tambien apropriado para parejas brasileña s y sugiere la posibilidad de utilización de la terapia de pareja en el tratamiento de la depresión pos-parto en Brasil.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Depressão Pós-Parto , Conflito Familiar , Terapia Familiar , Terapia ConjugalRESUMO
The absence of a translated and validated instrument for measuring marital satisfaction in Brazil, the largest country in South America and fifth most populous country in the world, is a significant barrier for research and mental health service delivery. The purpose of this study was to translate and validate a marital satisfaction scale into Portuguese that would have both empirical credibility and cultural relevance in Brazil. A six-step serial approach was used to simultaneously translate and culturally validate the Revised Dyadic Adjustment Scale (RDAS). The translated instrument (RDAS-P) demonstrated good psychometric properties during field testing.