RENERIO FRAGUAS JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/21 - Laboratório de Neuroimagem em Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Líder
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- The Association of Life Events Outside the Workplace and Burnout: A Cross-Sectional Study on Nursing Assistants(2022) TORTORELLI, Mariana; TRIGO, Telma Ramos; BOLIBIO, Renata; FREITAS, Camila Colas Sabino de; RIBEIRO, Floracy Gomes; LUCIA, Mara Cristina Souza de; V, Dan Iosifescu; FRAGUAS, RenerioBackground: Burnout, by definition, is related to adverse chronic workplace stressors. Life events outside the workplace have been associated with an increased risk of psychiatric morbidity. However, it is unknown whether life events outside the workplace increase the severity of burnout. Purpose: The aim of the study was to investigate the association between burnout and life events outside the workplace in nursing assistants. Methods: In an observational, cross-sectional, single-site study of 521 nursing assistants at a university hospital, we assessed burnout with the Maslach Burnout Inventory-Human Services Survey, and life events with the Social Readjustment Rating Scale. We constructed equations of multiple linear regression analyses that included each burnout subscale as the dependent variable and a domain of life events as the independent variable. Results were adjusted for potential confounders, including gender, no religion or faith, years of work, and depression. Results: An increase in the number of life events in the domain of personal changes or difficulties (e.g., personal injury or illness, sexual difficulties, change in recreation, church activities, social activities, sleeping habits, eating habits and revision of personal habits) was associated with increased severity of emotional exhaustion. An increase in the number of life events in the domain of changes in familial situation and in the domains of death of relatives or friends were associated with increased severity of depersonalization. Those associations were independent of work-related life events and other potential confounders. Conclusions: Life events outside the workplace may increase the levels of burnout in nursing assistants.
- Recommendations for the pharmacological treatment of treatment-resistant depression: A systematic review protocol(2022) GABRIEL, Franciele Cordeiro; STEIN, Airton Tetelbom; MELO, Daniela Oliveira de; FONTES-MOTA, Gessica Caroline Henrique; SANTOS, Itamires Benicio dos; RODRIGUES, Camila da Silva; RODRIGUES, Monica Cristiane; FRAGUAS, Renerio; FLOREZ, Ivan D.; CORREIA, Diogo Telles; RIBEIRO, ElianeIntroductionDepression is a serious and widespread mental health disorder. Although effective treatment does exist, a significant proportion of patients with depression fail to respond to antidepressant treatment trials, a condition named treatment-resistant depression. Efficient approach should be given this condition in order to revert the burden caused by depression. Clinical practice guidelines (CPGs) are evidence-based health promotion instruments to improve diagnosis and treatment. CPGs recommendations for treatment-resistant depression must be trustworthy. The objective of the proposed study is to systematically identify, appraise the quality of CPGs for the treatment of depression and elaborate a synthesis of recommendations for treatment-resistant depression of CPGs considered to be of high quality and with high quality recommendations. Methods and analysisWe will search the databases of organizations, such as PubMed, Embase, Cochrane Library, PsycInfo, and the Virtual Health Library, and organizations that develop CPGs. Three independent researchers will assess the quality of the CPGs and their recommendations using the AGREE II and AGREE-REX instruments, respectively. Given the identification of divergences and convergences as well as weak and strong points among high quality CPGs, our work may help developers, clinicians and eventually patients. Ethics and disseminationNo ethical approval is required for a systematic review, as no patient data will be used. The research results will be disseminated in conferences and submitted to a peer reviewed journal.
- Quality of clinical practice guidelines for inadequat response to first-line treatment for depression according to AGREE II checklist and comparison of recommendations: a systematic review(2022) GABRIEL, Franciele Cordeiro; STEIN, Airton Tetelbom; MELO, Daniela Oliveira de; FONTES-MOTA, Gessica Caroline Henrique; SANTOS, Itamires Benicio dos; OLIVEIRA, Aliandra Fantinell de; FRAGUAS, Renerio; RIBEIRO, ElianeObjective To assess similarities and differences in the recommended sequence of strategies among the most relevant clinical practice guidelines (CPGs) for the treatment of depression in adults with inadequate response to first-line treatment. Data sources We performed a systematic review of the literature spanning January 2011 to August 2020 in Medline, Embase, Cochrane Library and 12 databases recognised as CPGs repositories. CPGs quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). Study selection The eligibility criteria were CPGs that described pharmacological recommendations for treating depression for individuals aged 18 years or older in outpatient care setting. We included CPGs considered of high-quality (>= 80% in domain 3 of AGREE II) or recognised as clinically relevant. Data extraction Two independent researchers extracted recommendations for patients who did not respond to first-line pharmacological treatment from the selected CPGs. Results We included 46 CPGs and selected 8, of which 5 were considered high quality (>= 80% in domain 3 of AGREE II) and 3 were recognised as clinically relevant. Three CPGs did not define inadequate response to treatment and 3 did not establish a clear sequence of strategies. The duration of treatment needed to determine that a patient had not responded was not explicit in 3 CPGs and was discordant in 5 CPGs. Most CPGs agree in reassessing the diagnosis, assessing the presence of comorbidities, adherence to treatment, and increase dosage as first steps. All CPGs recommend psychotherapy, switching antidepressants, and considering augmentation/combining antidepressants. Conclusion Relevant CPGs present shortcomings in recommendations for non-responders to first-line antidepressant treatment including absence and divergencies in definition of inadequate response and sequence of recommended strategies. Overall, most relevant CPGs recommend reassessing the diagnosis, evaluate comorbidities, adherence to treatment, increase dosage of antidepressants, and psychotherapy as first steps. PROSPERO registration number CRD42016043364.