Ana Elisa Bastos Figueiredo

Autópsia psicológica e psicossocial sobre suicídio de idosos: abordagem metodológica

The article analyzes the quality and consistency of a semi-structured interview script, adapted for the study on suicide among elderly people, and presents the psychological and psychosocial autopsy method, which is the result of application of this instrument. The objective is to demonstrate how the in-depth interview and subsequent data organization and analyses were tested and improved by a network of researchers from eight regions in Brazil. Evaluation of the method was conducted before and after the application of the instruments to collect, systematize and analyze the data. This methodology was applied in 51 cases of elderly people who committed suicide in ten Brazilian municipalities. The study did more than just collect data with scientific rigor, since it also verified the consistency of the instrument used and the applicability of the method. The improved script and the instructions of how to apply and analyze it are thus presented here. The results reveal the rigor and credibility of this methodological approach tested and qualified by a multidisciplinary and inter-institutional procedure.O artigo analisa a qualidade e a consistencia de um roteiro de entrevista semiestruturada, adaptado para o estudo do suicidio de pessoas idosas e apresenta o metodo das autopsias psicossociais que resultou da aplicacao desse instrumento. O objetivo e demonstrar como o uso da entrevista em profundidade e sua forma de organizacao e analise de dados foram testados e aperfeicoados por uma rede de pesquisadores de varios centros de pesquisa do Brasil. O metodo envolveu a aplicacao do instrumento em que se socializou um manual de instrucoes sobre a coleta, sistematizacao e analise de dados. A metodologia foi aplicada no estudo de 51 casos de idosos que faleceram por suicidio em dez municipios brasileiros, e permitiu a verificacao da consistencia do instrumento usado e a aplicabilidade do seu metodo, durante o processo e ao final, por meio de uma avaliacao em rede. O roteiro aperfeicoado e as instrucoes para replica-lo e analisa-lo sao aqui apresentados. Os resultados apontam o rigor e a credibilidade dessa abordagem metodologica testada e qualificada de um modo interdisciplinar e interinstitucional.

Impacto do suicídio da pessoa idosa em suas famílias

The scope of this paper is an analysis of suicide of elderly people and the impact on the dynamics of their families is presented. The method used is of the qualitative research type known as psychosocial autopsy and is based on interviews with the family members of 51 elderly people who committed suicide in 10 Brazilian cities. The study in these cities was defined by epidemiological research that revealed the relevance of this phenomenon. Many themes were analyzed in the investigation. However, this text focuses on how the families coped with the death of the elderly person, their impressions regarding the act, and the repercussions on family members and the social network. Pursuant to a comprehensive analysis of the testimonies, the following nuclei of significance were revealed: feelings of guilt for the act; social isolation and its manifestations on health; social stigma and prejudice; prospects of overcoming family suffering; anger and feelings of the improbability of the act; and care for the family members. The families manifested suffering, sadness, and perplexity at the death of the elderly person, which influences and has repercussions on their dynamics and at an individual level. Such consequences are different in each area researched depending on the experiences the family has had with acts of this nature.

É possível superar ideações e tentativas de suicídio? Um estudo sobre idosos

This study presents a qualitative analysis of how older people who had attempted suicide began to overcome the desire and the urge to take their own life. This article is based on a survey of 87 Brazilian men and women aged 60 and over, living in different regions of Brazil, who have demonstrated suicidal behaviour; twenty of whom gave important information about their coping strategies. The analysis in this article only refers to the aforementioned twenty participants. All the participants were heard through semi-structured interviews, which included questions about the process of overcoming suicidal ideation and suicide attempts. The central focus of the analysis - overcoming suicidal ideation and suicide attempts - was based on the following concepts: coping strategies, autonomy, and emotional balance. Irrespective of the gender of the respondents, five centers of meaning emerged from the discourses of the elderly, which highlighted the effectiveness of the following factors: religiosity and religious practices; social and family support; the support of health services; contact with pets; and the recovery of the autonomy to manage their own lives. This study can help to support the primary and secondary prevention of suicidal behavior in older people.This study presents a qualitative analysis of how older people who had attempted suicide began to overcome the desire and the urge to take their own life. This article is based on a survey of 87 Brazilian men and women aged 60 and over, living in different regions of Brazil, who have demonstrated suicidal behaviour; twenty of whom gave important information about their coping strategies. The analysis in this article only refers to the aforementioned twenty participants. All the participants were heard through semi-structured interviews, which included questions about the process of overcoming suicidal ideation and suicide attempts. The central focus of the analysis - overcoming suicidal ideation and suicide attempts - was based on the following concepts: coping strategies, autonomy, and emotional balance. Irrespective of the gender of the respondents, five centers of meaning emerged from the discourses of the elderly, which highlighted the effectiveness of the following factors: religiosity and religious practices; social and family support; the support of health services; contact with pets; and the recovery of the autonomy to manage their own lives. This study can help to support the primary and secondary prevention of suicidal behavior in older people.

Influências dos problemas e conflitos familiares nas ideações e tentativas de suicídio de pessoas idosas

Conflitos e problemas familiares envolvem significados construidos no decorrer da existencia e se associam a outros fatores nas manifestacoes de pensamentos e tentativas de suicidio em pessoas idosas. Essas questoes sao analisadas por meio de um estudo qualitativo em que os proprios idosos foram ouvidos, em 14 localidades diferentes do Brasil. Participaram 63 homens e mulheres e as entrevistas aconteceram entre 2013 e 2014. Os dados de campo segundo as relevâncias que os idosos apresentaram foram: perdas familiares significativas, conflitos familiares e intergeracionais e violencias explicitas e veladas. A fala dos idosos demonstrou a tristeza, os sentimentos de abandono, o isolamento, a incompreensao de seus desejos pelos familiares e a ausencia de manifestacoes de afeto e respeito, como elementos que os levaram a tentar dar cabo a sua vida. Ao contarem suas historias, eles tambem deram pistas do que esperam de suas familias: acolhimento, compreensao e liberdade para realizar seus pequenos desejos; terminar a vida de forma digna e sem sofrimento; encontrar ajuda e protecao para a progressiva diminuicao de suas capacidades; continuar a participar das decisoes da familia e prolongar ao maximo as conquistas e as prerrogativas sociais, como propriedades, autoridade e respeito.Family conflicts and problems involve meanings that are constructed during the course of an existence, and become associated with other factors in manifestations of suicidal thoughts and suicide attempts in elderly people. These questions are analyzed in a qualitative study of interviews with elderly people in four different locations in Brazil. A total of 63 men and women took part, and the interviews were held in 2013 and 2014. The field data showed the following factors - in order of the importance that the interviewees gave to them: significant family losses; family and inter-generation conflicts; and explicit and veiled violence. The speech of the subjects showed, as elements that led them to try to end their lives: sadness; feelings of abandonment; isolation, incomprehension of their desires by their family members, and absence of manifestations of affection and/or respect. When telling their stories, they also gave clues about what they expect from their families: welcome, acceptance, comprehension and freedom to carry out their minor wishes; to end their lives in a dignified manner without suffering; to find help and protection for the progressive reduction of their capacities; to continue to participate in family decisions, and to prolong to the maximum their social achievements and prerogatives, such as property, authority and respect.

Sofrimento psíquico em policiais civis do Estado do Rio de Janeiro

The paper discusses the relationship between work and psychic suffering among police officers in the State of Rio de Janeiro. A questionnaire was filled out by these professionals in three separate studies: Capital Baixada Fluminense and Interior. The socio-demographic profile, quality of life, health and working conditions were investigated. Psychic suffering was measured by the SRQ-20. A logistic regression model was used to identify factors associated with psychic suffering. The results showed it to be associated with the following variables: level of satisfaction with the ability to react to difficult situations; performing the work for which the officers were trained; suffering some victimization; unit location; problems in the nervous system; and degree of satisfaction with life in general. Those who reported problems in the nervous system and victimization showed an OR of 7.25 and 3.08, respectively. The professionals who considered themselves dissatisfied or very dissatisfied with the ability to react to difficult situations and life in general showed an OR of 10.85 and 6.69, respectively, compared with those who considered themselves satisfied or very satisfied. Professionals from the Baixada showed an increased risk of psychic suffering compared to a reduced risk among those from the Interior.

Instrumentos, estratégias e método de abordagem qualitativa sobre tentativas e ideações suicidas de pessoas idosas

The article analyses the quality and consistency of a comprehensive interview guide, adapted to study attempted suicide and its ideation among the elderly, and imparts the method followed in applying this tool. The objective is to show how the use of a semi-structured interview and the organization and data analysis set-up were tested and perfected by a network of researchers from twelve universities or research centers in Brazil, Uruguay and Colombia. The method involved application and evaluation of the tool and joint production of an instruction manual on data collection, systematization and analysis. The methodology was followed in 67 interviews with elderly people of 60 or older and in 34 interviews with health professionals in thirteen Brazilian municipalities and in Montevideo and Bogotá, allowing the consistency of the tool and the applicability of the method to be checked, during the process and at the end. The enhanced guide and the instructions for reproducing it are presented herein. The results indicate the suitability and credibility of this methodological approach, tested and certified in interdisciplinary and interinstitutional terms.The article analyses the quality and consistency of a comprehensive interview guide, adapted to study attempted suicide and its ideation among the elderly, and imparts the method followed in applying this tool. The objective is to show how the use of a semi-structured interview and the organization and data analysis set-up were tested and perfected by a network of researchers from twelve universities or research centers in Brazil, Uruguay and Colombia. The method involved application and evaluation of the tool and joint production of an instruction manual on data collection, systematization and analysis. The methodology was followed in 67 interviews with elderly people of 60 or older and in 34 interviews with health professionals in thirteen Brazilian municipalities and in Montevideo and Bogota, allowing the consistency of the tool and the applicability of the method to be checked, during the process and at the end. The enhanced guide and the instructions for reproducing it are presented herein. The results indicate the suitability and credibility of this methodological approach, tested and certified in interdisciplinary and interinstitutional terms.

Circunstâncias que envolvem o suicídio de pessoas idosas

O trabalho analisa experiencias e relacoes familiares que antecederam o suicidio de idosos. Trata-se de pesquisa qualitativa, com metodo de autopsia psicossocial. Contempla casos de 16 idosos que cometeram suicidio entre 2006 a 2009 em tres municipios do Nordeste Brasileiro. A luz da Analise de Conteudo, elucidaram-se as categorias: experiencias que antecederam o suicidio de pessoas idosas e enunciacao do suicidio pelo idoso aos seus componentes familiares. Destacam-se os fatores associados ao suicidio: alteracoes de humor e expressoes de estados depressivos, conflitos familiares permeados por dificuldades financeiras, e uso abusivo de alcool e ideacao suicida por anunciacao do desejo de antecipar seu fim. Tornam-se necessarios o olhar abrangente e o ouvir reflexivo sobre o idoso por parte dos agentes sociais, familiares, amigos e diversos setores, especificamente o setor saude, gestores e profissionais que provoquem mudancas significativas na dinâmica do servico.El texto analiza experiencias y relaciones familiares que precedieron el suicidio de ancianos. Se trata de un estudio cualitativo, con metodo de autopsia psicosocial. Incluye 16 casos de ancianos que se suicidaron entre 2006 y 2009 en tres municipios del Nordeste Brasileno. A la luz del analisis de contenido se estudiaron las categorias: experiencias que precedieron el suicidio de ancianos y enunciacion del suicidio por parte del anciano a sus familiares. Se destacan tres factores asociados al suicidio: alteraciones de humor y expresiones de estados depresivos, conflictos familiares juntamente con dificultades financieras y uso abusivo de alcohol e ideas suicidas por anunciacion del deseo de anticipar el fin. Es necesaria la mirada amplia y la escucha reflexiva sobre el anciano por parte de los agentes sociales, familiares, amigos y diversos sectores, especificamente el sector de la salud, gestores y profesionales que causen cambios significativos en la dinamica del servicio.

Lições aprendidas na avaliação de um programa brasileiro de atenção a idosos vítimas de violência

Apresentam-se “licoes aprendidas” no processo de avaliacao e monitoramento dos centros de prevencao de violencia contra os idosos, programa criado em 2007 pela Secretaria de Direitos Humanos da Presidencia da Republica (SDH), cuja proposta se baseia em atencao multidisciplinar oferecida por profissionais de direito, saude e assistencia social. Fez-se uma pesquisa avaliativa do programa durante tres anos, utilizando-se triangulacao de metodos quantitativos e qualitativos. As licoes aprendidas provem da visao dos diferentes atores que compartilharam a experiencia, inclusive os idosos. A eficiencia e a efetividade das acoes mostraram a importância da iniciativa. Mas aqui se apontam, tambem, seus limites, particularmente problemas de sustentabilidade pela falta de investimento dos gestores e pela descontinuidade do apoio e da orientacao da SDH. Em 2013, dos 18 projetos implantados, seis haviam encerrado suas atividades, 12 continuavam ativos, desses, dois expandiram suas acoes.Centro Latino Americano de Estudos sobre Violencia e Saude, Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz (Claves/Ensp/Fiocruz). Avenida Brasil, 4036, Manguinhos. Rio de Janeiro, RJ, Brasil. 21040-210. cecilia@claves.fiocruz.br; edinilsa@claves.fiocruz.br; adalpeixoto@yahoo.com.br; aebfigueiredo@yahoo.com.br This paper presents the “lessons learned” from the process of evaluation and monitoring of centers for prevention of violence against the elderly, a program created in 2007 by the Brazilian Department of Human Rights (DHR). The aims were based on multidisciplinary care provided by legal professionals, healthcare professionals and social workers. An evaluative investigation on this program was conducted over a three-year period by means of triangulation of quantitative and qualitative methods. The lessons learned came from the viewpoints of the different players who shared in these experiences.. The efficiency and effectiveness of the actions performed showed the importance of the initiative. However, the investigation also indicated the limitations of the program, particularly regarding sustainability problems caused by lack of investment by the administrators and discontinuity of support from the DHR. In 2013, out of the 18 projects that had been implemented, six had ceased activities, 12 remained active and two of the latter had expanded their actions. Keywords: Elderly person. Violence against the elderly. Rights of the elderly. Prevention of violence. Evaluation.

Lecciones aprendidas en la evaluación de un programa brasileño de atención a ancianos víctimas de la violencia

Apresentam-se “licoes aprendidas” no processo de avaliacao e monitoramento dos centros de prevencao de violencia contra os idosos, programa criado em 2007 pela Secretaria de Direitos Humanos da Presidencia da Republica (SDH), cuja proposta se baseia em atencao multidisciplinar oferecida por profissionais de direito, saude e assistencia social. Fez-se uma pesquisa avaliativa do programa durante tres anos, utilizando-se triangulacao de metodos quantitativos e qualitativos. As licoes aprendidas provem da visao dos diferentes atores que compartilharam a experiencia, inclusive os idosos. A eficiencia e a efetividade das acoes mostraram a importância da iniciativa. Mas aqui se apontam, tambem, seus limites, particularmente problemas de sustentabilidade pela falta de investimento dos gestores e pela descontinuidade do apoio e da orientacao da SDH. Em 2013, dos 18 projetos implantados, seis haviam encerrado suas atividades, 12 continuavam ativos, desses, dois expandiram suas acoes.Centro Latino Americano de Estudos sobre Violencia e Saude, Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz (Claves/Ensp/Fiocruz). Avenida Brasil, 4036, Manguinhos. Rio de Janeiro, RJ, Brasil. 21040-210. cecilia@claves.fiocruz.br; edinilsa@claves.fiocruz.br; adalpeixoto@yahoo.com.br; aebfigueiredo@yahoo.com.br This paper presents the “lessons learned” from the process of evaluation and monitoring of centers for prevention of violence against the elderly, a program created in 2007 by the Brazilian Department of Human Rights (DHR). The aims were based on multidisciplinary care provided by legal professionals, healthcare professionals and social workers. An evaluative investigation on this program was conducted over a three-year period by means of triangulation of quantitative and qualitative methods. The lessons learned came from the viewpoints of the different players who shared in these experiences.. The efficiency and effectiveness of the actions performed showed the importance of the initiative. However, the investigation also indicated the limitations of the program, particularly regarding sustainability problems caused by lack of investment by the administrators and discontinuity of support from the DHR. In 2013, out of the 18 projects that had been implemented, six had ceased activities, 12 remained active and two of the latter had expanded their actions. Keywords: Elderly person. Violence against the elderly. Rights of the elderly. Prevention of violence. Evaluation.

Lessons learned from the evaluation of a Brazilian healthcare program for elderly victims of violence

Apresentam-se “licoes aprendidas” no processo de avaliacao e monitoramento dos centros de prevencao de violencia contra os idosos, programa criado em 2007 pela Secretaria de Direitos Humanos da Presidencia da Republica (SDH), cuja proposta se baseia em atencao multidisciplinar oferecida por profissionais de direito, saude e assistencia social. Fez-se uma pesquisa avaliativa do programa durante tres anos, utilizando-se triangulacao de metodos quantitativos e qualitativos. As licoes aprendidas provem da visao dos diferentes atores que compartilharam a experiencia, inclusive os idosos. A eficiencia e a efetividade das acoes mostraram a importância da iniciativa. Mas aqui se apontam, tambem, seus limites, particularmente problemas de sustentabilidade pela falta de investimento dos gestores e pela descontinuidade do apoio e da orientacao da SDH. Em 2013, dos 18 projetos implantados, seis haviam encerrado suas atividades, 12 continuavam ativos, desses, dois expandiram suas acoes.Centro Latino Americano de Estudos sobre Violencia e Saude, Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz (Claves/Ensp/Fiocruz). Avenida Brasil, 4036, Manguinhos. Rio de Janeiro, RJ, Brasil. 21040-210. cecilia@claves.fiocruz.br; edinilsa@claves.fiocruz.br; adalpeixoto@yahoo.com.br; aebfigueiredo@yahoo.com.br This paper presents the “lessons learned” from the process of evaluation and monitoring of centers for prevention of violence against the elderly, a program created in 2007 by the Brazilian Department of Human Rights (DHR). The aims were based on multidisciplinary care provided by legal professionals, healthcare professionals and social workers. An evaluative investigation on this program was conducted over a three-year period by means of triangulation of quantitative and qualitative methods. The lessons learned came from the viewpoints of the different players who shared in these experiences.. The efficiency and effectiveness of the actions performed showed the importance of the initiative. However, the investigation also indicated the limitations of the program, particularly regarding sustainability problems caused by lack of investment by the administrators and discontinuity of support from the DHR. In 2013, out of the 18 projects that had been implemented, six had ceased activities, 12 remained active and two of the latter had expanded their actions. Keywords: Elderly person. Violence against the elderly. Rights of the elderly. Prevention of violence. Evaluation.