No abstract

RESUMO O artigo busca discutir singularidades do trabalho da atenção primária à saúde (APS) em contextos onde a violência, apoiada fortemente pelo uso de armas de fogo, tem expressão rotineira, crônica e sistêmica, e dimensionar a potência da APS enquanto canal de empoderamento da comunidade onde a violência armada é uma vulnerabilidade expressiva. Com base na Declaração de Alma-Ata e nos princípios da APS enumerados por Barbara Starfield, e com enfoque na participação comunitária e na perspectiva de determinantes sociais de saúde, a discussão tem como ponto de partida realidades observadas em países da América Latina e os compromissos voltados ao acesso e cobertura universal à saúde previstos no terceiro dos Objetivos de Desenvolvimento Sustentável. É necessário qualificar a caracterização qualitativa e quantitativa da violência armada e de suas consequências, a partir de uma abordagem intersetorial com ampla participação comunitária na busca por respostas coerentes e significativas. Também é preciso garantir a proteção e a segurança dos profissionais para que a presença dos serviços de saúde nos espaços seja contínua.

Introduction Music performance anxiety (MPA) is characterized by long-lasting, high intensity apprehension associated with performing music in public. At extreme levels, MPA can impair the career and quality of life. Our goal is to describe the clinical profile, perceived causes and coping strategies associated with MPA. Methods In this cross-sectional study, several self-assessment instruments were administered to a sample of 214 Brazilian musicians (68% male, 53.3% classical/46.7% popular musicians). Data were analyzed using descriptive and parametric statistics, based on the variables of musical training and level of MPA. Results Percentages of indicators of pathology were high (40% high MPA levels, 37% social anxiety, 12.5% depression, 13.5% alcohol abuse), and musicians with high MPA levels were the most affected. A wide variety of situations were associated with MPA, especially those related to the individual (pressure from self/concern about audience). Emotion-focused coping and internal resources were prominent among the resources used for coping with MPA (breathing, increased practice, familiarization with performance venue), although they were not always effective. It was relatively uncommon for musicians to seek specialized resources and treatments. Conclusions The results demonstrate the vulnerability of the targeted professional groups and the need for preventive strategies and behavioral, environmental, educational, and pharmacological interventions to change this scenario.

Objective: To assess the discriminative capacity of the Kenny Music Performance Anxiety Inventory (K-MPAI), in its version adapted for Brazil, in a sample of 230 Brazilian adult musicians. Method: The Social Phobia Inventory (SPIN) was used to assess the presence of social anxiety indicators, adopting it as the gold standard. The Mann-Whitney U test and the receiver operating characteristic (ROC) curve were used for statistical analysis, with p f 0.05 set as the significance level. Results: Subjects with social anxiety indicators exhibited higher mean total K-MPAI scores, as well as higher individual scores on 62% of its items. The area under the ROC curve was 0.734 (p = 0.001), and considered appropriate. Within the possible cutoff scores presented, the score -15 had the best balance of sensitivity and specificity values. However, the score -7 had greater specificity and accuracy. Conclusion: The K-MPAI showed appropriate discriminant validity, with a marked association between music performance anxiety and social anxiety. The cutoff scores presented in the study have both clinical and research value, allowing screening for music performance anxiety and identification of possible cases.

Background: The Kenny Music Performance Anxiety Inventory (K-MPAI) is very significant among the available instruments which measures Musical Performance Anxiety (MPA). Objective: The aim of this study is to find evidence of validity of the Kenny Music Performance Anxiety Inventory (K-MPAI), in its translated and adapted Brazilian version, through the study of its factor structure. Methods: A convenience sample of 230 amateur musicians completed the K-MPAI. Results: The initial factor analysis yielded eight factors, explaining 62.4% of variance. However, due to the factors' composition and internal consistency values lower than 0.50, the number of factors was later set at three, considering the internal consistency of those, the theoretical propositions and symptomatology aspects that supported the construction of scale. They were named "Worries and insecurity" (α = 0.82), "Depression and hopelessness" (α = 0.77) and "Early parental relationships" (α = 0.57). Discussion/Conclusions: These results point to the scale's construct validity, since they support the theoretical basis used for the development of the K-MPAI and the clinical manifestations of the MPA.