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Estratégias institucionais para enfrentamento de sofrimento mental entre graduandas de enfermagem

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O artigo publicado nesta Revista em julho de 2019, intitulado “Alterações de saúde em estudantes de Enfermagem um ano depois do ingresso no curso de graduação”(11. Silva RM, Costa ALS, Mussi FC, Lopes VC, Batista KM, Santos OP. Health alterations in nursing students after a year from admission to the undergraduate course. Rev Esc Enferm USP. 2019;53:e03450. DOI: https://doi.org/10.1590/S1980-220X2018008103450
https://doi.org/10.1590/S1980-220X201800...
)
, traz à tona uma temática relevante e emergente. Publicações recentes vêm abordando o problema do sofrimento psíquico entre estudantes universitários no Brasil(11. Silva RM, Costa ALS, Mussi FC, Lopes VC, Batista KM, Santos OP. Health alterations in nursing students after a year from admission to the undergraduate course. Rev Esc Enferm USP. 2019;53:e03450. DOI: https://doi.org/10.1590/S1980-220X2018008103450
https://doi.org/10.1590/S1980-220X201800...

2. Fagundes VLD, Lurdemir AB. Commonn mental disorders among health care students, Rev Bra de Psiquiatr. 2005;27(3):194-200. DOI: https://doi.org/10.1590/S1516-44462005000300007
https://doi.org/10.1590/S1516-4446200500...

3. Costa EFO, Rocha MMV, Santos ATRA, Melo EV. Common mental disorders and associated factors among final-year healthcare students. Rev Assoc Med Bras. 2014;60(6):525-30. DOI: https://doi.org/10.1590/1806-9282.60.06.009
https://doi.org/10.1590/1806-9282.60.06....

4. Souza FGM, Menezes MGC. Estresse nos estudantes de medicina da Universidade Federal do Ceará. Rev Bras Edu Med. 2005;29(2):91-6. DOI: https://doi.org/10.1590/S0047-20852009000100005
https://doi.org/10.1590/S0047-2085200900...

5. Amaral GA, Gomide PM, Batista MPB, Piccolo PP, Teles TBG, Oliveira PM, et al. Sintomas depressivos em acadêmicos de medicina da Universidade Federal de Goiás: um estudo de prevalência. Rev Psiquiatr Rio Gd Sul. 2008;30(2):124-30. DOI: https://doi.org/10.1590/S0101-81082008000300008
https://doi.org/10.1590/S0101-8108200800...
-66. Mussi FC, Pires CGS, Carneiro LS, Costa ANS, Ribeiro FMSS, Santos AF. Comparison of stress in freshman and senior nursing students. Rev Esc Enferm USP. 2019;53:e03431. DOI: https://doi.org/10.1590/S1980-220X2017023503431
https://doi.org/10.1590/S1980-220X201702...
)
e no mundo(77. Mc Carthy B, Trace A, O'Donovan M, Brady-Nevin C, Murphy M, O'Shea M, et al. Nursing and midwifery students' stress and coping during their undergraduate education programmes: an integrative review. Nurse Educ Today. 2018; 61:197-209. DOI: 10.1016/j.nedt.2017.11.029
https://doi.org/10.1016/j.nedt.2017.11.0...

8. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006;81(4):354-73. DOI: 10.1097/00001888-200604000-00009
https://doi.org/10.1097/00001888-2006040...

9. Saïas T, du Roscoält E, Véron L, Guinard R, Richard JB, Legleye S, et al. Psychological distress in French college students: demographic, economic and social stressors. Results from the 2010 National Health Barometer. BMC Public Health). 2014;14:256. DOI: 10.1186/1471-2458-14-256
https://doi.org/10.1186/1471-2458-14-256...
-1010. El Ansari W, Oskrochi R, Haghgoo G. Are students' symptoms and health complaints associated with perceived stress at university? Perspectives from the United Kingdom and Egypt. Int J Environ Res Public Health. 2014;11(10):9981-10002. DOI: 10.3390/ijerph111009981
https://doi.org/10.3390/ijerph111009981...
)
. Um relatório(1111. Associação Nacional dos Dirigentes das Instituições Federais de Ensino Superior. IV Pesquisa do Perfil Socioeconômico e Cultural dos Estudantes de Graduação das Instituições Federais de Ensino Superior Brasileiras, 204 Internet . Uberlândia: ANDIFES; 2016 citado 2019 jul. 7 . Disponível em: http://www.andifes.org.br/wp-content/uploads/2017/11/Pesquisa-de-Perfil-dos-Graduanso-das-IFES_2014.pdf
http://www.andifes.org.br/wp-content/upl...
)
publicado em 2014 já mostrava dados alarmantes: 79,8% dos estudantes relataram sofrimento psíquico nos 12 meses anteriores à pesquisa; 59.969 (6,38%) apresentaram “ideias de morte” e 38.838 (4,13%) “pensamento suicida”.

Passado o período de diagnóstico, é chegada a hora de agir. Em todo o mundo, ações realizadas com estudantes universitários, incorporadas ao currículo ou não, já apresentam resultados positivos, apesar de incipientes(1212. Winzer R, Lindberg L, Guldbrandsson K, Sidorchuk A. Effects of mental health interventions for students in higher education are sustainable over time: a systematic review and meta-analysis of randomized controled trials. Peer J. 2018;6:e4598. DOI: 10.7717/peerj.4598
https://doi.org/10.7717/peerj.4598...
)
. Estas intervenções compreendem cursos para promoção da saúde(1313. McCarthy B, Trace A, O'Donovan M, O'Regan P, Brady-Nevin C, O'Shea M, et al. Coping with stressful events: a pre-post-test of a psycho-educational intervention for undergraduate nursing and midwifery students. Nurse Educ Today. 2018;61:273-80. DOI: 10.1016/j.nedt.2017.11.034
https://doi.org/10.1016/j.nedt.2017.11.0...

14. Pines EW, Rauschhuber ML, Cook JD, Norgan GH, Canchola L, Richardson C, et al. Evaluation of a stress coping course for psychological resilience among a group of university nursing students. Perspect Psychiatr Care. 2019;55(2):233-8. DOI: 10.1111/ppc.12340
https://doi.org/10.1111/ppc.12340...
-1515. Dyrbye LN, Shanafelt TD, Werner L, Sood A, Satele D, Wolanskyj AP. The impact of a required longitudinal stress management and resilience training course for first-year medical students. J Gen Intern Med. 2017;32(12):1309-1314.)
, práticas de meditação para atenção plena(1616. Jain S, Shapiro SL, Swanick S, Roesch SC, Mills PJ, Bell I, et al. A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. Ann Behav Med. 2007;33(1):11-21. DOI: 10.1207/s15324796abm3301_2
https://doi.org/10.1207/s15324796abm3301...

17. Kuhlmann SM, Huss M, Bürger A, Hammerle F. Coping with stress in medical students: results of a randomized controlled trial using a mindfulness-based stress prevention training (MediMind) in Germany. BMC Med Educ. 2016;16(1):316. DOI: 10.1186/s12909-016-0833-8
https://doi.org/10.1186/s12909-016-0833-...

18. Ratanasiripong P, Park JF, Ratanasiripong NT, Kathalae D. Stress and anxiety management in nursing students: biofeedback and mindfulness meditation. J Nurs Educ. 2015;54(9):520-24. DOI: 10.3928/01484834-20150814-07
https://doi.org/10.3928/01484834-2015081...
-1919. Van der Riet P, Rossiter P, Kirby D, Dluzewska T, Harmon C. Piloting a stress management and mindfulness program for undergraduate nursing students: student feedback and lessons learned. Nurse Educ Today. 2015;35(1):44-9. DOI: 10.1016/j.nedt.2014.05.003
https://doi.org/10.1016/j.nedt.2014.05.0...
)
, apoio psicológico profissional e incorporação de prática de atividade física e cuidados com alimentação(2020. Hsieh PL. A school-based health promotion program for stressed nursing students in Taiwan. J Nurs Res. 2011;19(3):230-7. DOI: 10.1097/JNR.0b013e318228d010
https://doi.org/10.1097/JNR.0b013e318228...
)
.

Desta forma, constata-se, através das pesquisas publicadas, que cursos para promoção da saúde estimulam hábitos de vida saudáveis, refletindo nos níveis de estresse e ansiedade(2121. Stark MA, Hoekstra T, Hazel DL, Barton B. Caring for self and others: increasing health care students' healthy behaviors. Work. 2012;42(3):393-401. DOI: 10.3233/WOR-2012-1428
https://doi.org/10.3233/WOR-2012-1428...
,2222. Mc Sharry P, Timmins F. An evaluation of the effectiveness of a dedicated health and well being course on nursing students' health. Nurse Educ Today. 2016;44:26-32. DOI: 10.1016/j.nedt.2016.05.004
https://doi.org/10.1016/j.nedt.2016.05.0...
,2323. Kingston R, Coumaravelou S. The effectiveness of psychoeducation and systematic desensitization to reduce test anxiety among first-year pharmacy students, Am J Pharmac Educ. 2014;78(9):163. DOI: 10.5688/ajpe789163
https://doi.org/10.5688/ajpe789163...
)
. A meditação tem se mostrado eficaz na redução do sofrimento psíquico e melhora no desempenho acadêmico(1515. Dyrbye LN, Shanafelt TD, Werner L, Sood A, Satele D, Wolanskyj AP. The impact of a required longitudinal stress management and resilience training course for first-year medical students. J Gen Intern Med. 2017;32(12):1309-1314.,1919. Van der Riet P, Rossiter P, Kirby D, Dluzewska T, Harmon C. Piloting a stress management and mindfulness program for undergraduate nursing students: student feedback and lessons learned. Nurse Educ Today. 2015;35(1):44-9. DOI: 10.1016/j.nedt.2014.05.003
https://doi.org/10.1016/j.nedt.2014.05.0...
,2424. Hsiao Y, Chiang H, Lee H, Chen S. The effects of a spiritual learning program on improving spiritual health and clinical practice stress among nursing students. J Nurs Res. 2012;20(4):281-90. DOI: 10.1097/jnr.0b013e318273642f
https://doi.org/10.1097/jnr.0b013e318273...
)
. O apoio psicológico para gerenciar as emoções é também eficaz(1414. Pines EW, Rauschhuber ML, Cook JD, Norgan GH, Canchola L, Richardson C, et al. Evaluation of a stress coping course for psychological resilience among a group of university nursing students. Perspect Psychiatr Care. 2019;55(2):233-8. DOI: 10.1111/ppc.12340
https://doi.org/10.1111/ppc.12340...
,2424. Hsiao Y, Chiang H, Lee H, Chen S. The effects of a spiritual learning program on improving spiritual health and clinical practice stress among nursing students. J Nurs Res. 2012;20(4):281-90. DOI: 10.1097/jnr.0b013e318273642f
https://doi.org/10.1097/jnr.0b013e318273...
)
. Mas todos estes estudos refletem experiências de outros países.

Nossa experiência na Escola de Enfermagem da Universidade Federal da Bahia, após a implantação do Núcleo de Apoio Psicopedagógico e Social (NAPP), tem mostrado resultados animadores. Construído com participação da comunidade acadêmica, conta com uma pedagoga, duas psicólogas, uma assistente social, além de representantes estudantis e docentes. Promove atendimentos individuais e ações coletivas focadas em bem-estar, integração, autoconhecimento, planejamento de estudos, sendo avaliado positivamente pelas estudantes.

Certas de não sermos a única instituição a realizar intervenções desta natureza, propomos a divulgação com brevidade de outras ações, proporcionando, assim, uma discussão ampliada. O objetivo de cada instituição de ensino superior deve ser adotar e disseminar mais medidas institucionais eficazes, baseadas em evidências, permanentes, no intuito de impactar sobre os indicadores que assolam os jovens universitários em todo o território nacional.

References

  • 1
    Silva RM, Costa ALS, Mussi FC, Lopes VC, Batista KM, Santos OP. Health alterations in nursing students after a year from admission to the undergraduate course. Rev Esc Enferm USP. 2019;53:e03450. DOI: https://doi.org/10.1590/S1980-220X2018008103450
    » https://doi.org/10.1590/S1980-220X2018008103450
  • 2
    Fagundes VLD, Lurdemir AB. Commonn mental disorders among health care students, Rev Bra de Psiquiatr. 2005;27(3):194-200. DOI: https://doi.org/10.1590/S1516-44462005000300007
    » https://doi.org/10.1590/S1516-44462005000300007
  • 3
    Costa EFO, Rocha MMV, Santos ATRA, Melo EV. Common mental disorders and associated factors among final-year healthcare students. Rev Assoc Med Bras. 2014;60(6):525-30. DOI: https://doi.org/10.1590/1806-9282.60.06.009
    » https://doi.org/10.1590/1806-9282.60.06.009
  • 4
    Souza FGM, Menezes MGC. Estresse nos estudantes de medicina da Universidade Federal do Ceará. Rev Bras Edu Med. 2005;29(2):91-6. DOI: https://doi.org/10.1590/S0047-20852009000100005
    » https://doi.org/10.1590/S0047-20852009000100005
  • 5
    Amaral GA, Gomide PM, Batista MPB, Piccolo PP, Teles TBG, Oliveira PM, et al. Sintomas depressivos em acadêmicos de medicina da Universidade Federal de Goiás: um estudo de prevalência. Rev Psiquiatr Rio Gd Sul. 2008;30(2):124-30. DOI: https://doi.org/10.1590/S0101-81082008000300008
    » https://doi.org/10.1590/S0101-81082008000300008
  • 6
    Mussi FC, Pires CGS, Carneiro LS, Costa ANS, Ribeiro FMSS, Santos AF. Comparison of stress in freshman and senior nursing students. Rev Esc Enferm USP. 2019;53:e03431. DOI: https://doi.org/10.1590/S1980-220X2017023503431
    » https://doi.org/10.1590/S1980-220X2017023503431
  • 7
    Mc Carthy B, Trace A, O'Donovan M, Brady-Nevin C, Murphy M, O'Shea M, et al. Nursing and midwifery students' stress and coping during their undergraduate education programmes: an integrative review. Nurse Educ Today. 2018; 61:197-209. DOI: 10.1016/j.nedt.2017.11.029
    » https://doi.org/10.1016/j.nedt.2017.11.029
  • 8
    Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006;81(4):354-73. DOI: 10.1097/00001888-200604000-00009
    » https://doi.org/10.1097/00001888-200604000-00009
  • 9
    Saïas T, du Roscoält E, Véron L, Guinard R, Richard JB, Legleye S, et al. Psychological distress in French college students: demographic, economic and social stressors. Results from the 2010 National Health Barometer. BMC Public Health). 2014;14:256. DOI: 10.1186/1471-2458-14-256
    » https://doi.org/10.1186/1471-2458-14-256
  • 10
    El Ansari W, Oskrochi R, Haghgoo G. Are students' symptoms and health complaints associated with perceived stress at university? Perspectives from the United Kingdom and Egypt. Int J Environ Res Public Health. 2014;11(10):9981-10002. DOI: 10.3390/ijerph111009981
    » https://doi.org/10.3390/ijerph111009981
  • 11
    Associação Nacional dos Dirigentes das Instituições Federais de Ensino Superior. IV Pesquisa do Perfil Socioeconômico e Cultural dos Estudantes de Graduação das Instituições Federais de Ensino Superior Brasileiras, 204 Internet . Uberlândia: ANDIFES; 2016 citado 2019 jul. 7 . Disponível em: http://www.andifes.org.br/wp-content/uploads/2017/11/Pesquisa-de-Perfil-dos-Graduanso-das-IFES_2014.pdf
    » http://www.andifes.org.br/wp-content/uploads/2017/11/Pesquisa-de-Perfil-dos-Graduanso-das-IFES_2014.pdf
  • 12
    Winzer R, Lindberg L, Guldbrandsson K, Sidorchuk A. Effects of mental health interventions for students in higher education are sustainable over time: a systematic review and meta-analysis of randomized controled trials. Peer J. 2018;6:e4598. DOI: 10.7717/peerj.4598
    » https://doi.org/10.7717/peerj.4598
  • 13
    McCarthy B, Trace A, O'Donovan M, O'Regan P, Brady-Nevin C, O'Shea M, et al. Coping with stressful events: a pre-post-test of a psycho-educational intervention for undergraduate nursing and midwifery students. Nurse Educ Today. 2018;61:273-80. DOI: 10.1016/j.nedt.2017.11.034
    » https://doi.org/10.1016/j.nedt.2017.11.034
  • 14
    Pines EW, Rauschhuber ML, Cook JD, Norgan GH, Canchola L, Richardson C, et al. Evaluation of a stress coping course for psychological resilience among a group of university nursing students. Perspect Psychiatr Care. 2019;55(2):233-8. DOI: 10.1111/ppc.12340
    » https://doi.org/10.1111/ppc.12340
  • 15
    Dyrbye LN, Shanafelt TD, Werner L, Sood A, Satele D, Wolanskyj AP. The impact of a required longitudinal stress management and resilience training course for first-year medical students. J Gen Intern Med. 2017;32(12):1309-1314.
  • 16
    Jain S, Shapiro SL, Swanick S, Roesch SC, Mills PJ, Bell I, et al. A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. Ann Behav Med. 2007;33(1):11-21. DOI: 10.1207/s15324796abm3301_2
    » https://doi.org/10.1207/s15324796abm3301_2
  • 17
    Kuhlmann SM, Huss M, Bürger A, Hammerle F. Coping with stress in medical students: results of a randomized controlled trial using a mindfulness-based stress prevention training (MediMind) in Germany. BMC Med Educ. 2016;16(1):316. DOI: 10.1186/s12909-016-0833-8
    » https://doi.org/10.1186/s12909-016-0833-8
  • 18
    Ratanasiripong P, Park JF, Ratanasiripong NT, Kathalae D. Stress and anxiety management in nursing students: biofeedback and mindfulness meditation. J Nurs Educ. 2015;54(9):520-24. DOI: 10.3928/01484834-20150814-07
    » https://doi.org/10.3928/01484834-20150814-07
  • 19
    Van der Riet P, Rossiter P, Kirby D, Dluzewska T, Harmon C. Piloting a stress management and mindfulness program for undergraduate nursing students: student feedback and lessons learned. Nurse Educ Today. 2015;35(1):44-9. DOI: 10.1016/j.nedt.2014.05.003
    » https://doi.org/10.1016/j.nedt.2014.05.003
  • 20
    Hsieh PL. A school-based health promotion program for stressed nursing students in Taiwan. J Nurs Res. 2011;19(3):230-7. DOI: 10.1097/JNR.0b013e318228d010
    » https://doi.org/10.1097/JNR.0b013e318228d010
  • 21
    Stark MA, Hoekstra T, Hazel DL, Barton B. Caring for self and others: increasing health care students' healthy behaviors. Work. 2012;42(3):393-401. DOI: 10.3233/WOR-2012-1428
    » https://doi.org/10.3233/WOR-2012-1428
  • 22
    Mc Sharry P, Timmins F. An evaluation of the effectiveness of a dedicated health and well being course on nursing students' health. Nurse Educ Today. 2016;44:26-32. DOI: 10.1016/j.nedt.2016.05.004
    » https://doi.org/10.1016/j.nedt.2016.05.004
  • 23
    Kingston R, Coumaravelou S. The effectiveness of psychoeducation and systematic desensitization to reduce test anxiety among first-year pharmacy students, Am J Pharmac Educ. 2014;78(9):163. DOI: 10.5688/ajpe789163
    » https://doi.org/10.5688/ajpe789163
  • 24
    Hsiao Y, Chiang H, Lee H, Chen S. The effects of a spiritual learning program on improving spiritual health and clinical practice stress among nursing students. J Nurs Res. 2012;20(4):281-90. DOI: 10.1097/jnr.0b013e318273642f
    » https://doi.org/10.1097/jnr.0b013e318273642f

Datas de Publicação

  • Publicação nesta coleção
    16 Set 2020
  • Data do Fascículo
    2020

Histórico

  • Recebido
    23 Out 2019
  • Aceito
    23 Nov 2019
Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br