Cristina Maria Douat Loyola

Illicit drug use in seven Latin American countries: critical perspectives of families and familiars

This cross-sectional multi-centre study explored how family members and friends of illicit drug users perceived protective and risk factors, treatment facilities and policies and laws regarding illicit drug use. Family members and friends of illicit drug users were recruited in 10 urban health care outpatient units in 7 Latin American countries (Brazil, Colombia, Costa Rica, Ecuador, Guatemala, Honduras and Mexico) to complete a questionnaire. The majority of the respondents chose psycho-social factors over genetic or biological explanations as causes of drug problems. Respondents felt that families and governments were responsible for preventing drug problems. Church/religious institutions were most often mentioned in the context of accessible treatment. When asked about access to treatment facilities, the majority said that there were not enough. Shame about drug use, cost, and limited treatment options were most often cited as barriers to treatment.Este estudo multicentrico corte temporal explorou a perspectiva de familiares e pessoas proximas a usuarios de drogas ilicitas sobre fatores de risco e protecao, servicos de tratamento, politicas e leis relacionadas ao uso de drogas ilicitas. Os familiares e pessoas proximas a usuarios de drogas ilicitas foram recrutados em dez unidades de saude, localizadas em grandes centros urbanos de sete paises da America Latina (Brasil, Colombia, Costa Rica, Equador, Guatemala, Honduras e Mexico), para responderem um questionario. A maioria dos participantes escolheu fatores psicossociais e nao fatores geneticos ou biologicos para explicar a causa dos problemas do uso de drogas. Responderam que familiares e governantes sao os principais responsaveis pela prevencao dos problemas das drogas. As igrejas e outras instituicoes religiosas foram mencionadas com frequencia dentro do contexto de acesso ao tratamento. A maioria dos entrevistados apontou que o acesso aos servicos que oferecem tratamentos aos usuarios de drogas nao e suficiente. Vergonha sobre o uso de drogas, custo e opcoes insuficientes de tratamento foram citados com mais frequencia como as principais barreiras para o tratamento.

Pintando novos caminhos: a visita domiciliar em saúde mental como dispositivo de cuidado em enfermagem

Estudo sobre a analise do cotidiano domiciliar do paciente psiquiatrico egresso da internacao hospitalar, por meio da visita domiciliar, dando enfase a compreensao da pratica de Enfermagem Psiquiatrica em domicilio. Abordamos as dificuldades, as relacoes e as possibilidades de cuidado. O estudo e qualitativo com enfoque na etnometodologia. A producao de dados foi por meio de observacao participante e entrevistas abertas. Foi adotado o conceito de cotidiano de Michel de Certeau como referencial teorico. Os temas oriundos das discussoes formaram eixo para o processo reflexivo, tendo como base o entendimento acerca de familia, trabalho, lazer e mito/espiritualidade. Os dados refletem como o cuidado oferecido pela enfermeira na internacao hospitalar tem poucas perspectivas de construcao. A visita domiciliar mostrou a importância da participacao da familia e do sujeito em um processo continuo de cuidado, permitindo a enfermeira construir um cuidado criativo, solidario e sensivel, que possibilite aos sujeitos novos contratos com a vida.

Os sentidos e destinos do cuidar na preparação dos cuidadores de idosos

Neste trabalho apresentamos alguns pressupostos teoricos que informam a preparacao de cuidadores de idosos, proposta por dois cursos realizados na cidade do Rio de Janeiro. Utilizamos uma metodologia qualitativa adotando como instrumentos de coleta de dados a observacao participante e gravacao das aulas, entrevistas com os coordenadores e, como fontes documentais, os programas, apostilas e referencias bibliograficas. Os dados, ordenados em categorias descritivas, foram analisados a luz da literatura. Concluimos com uma reflexao acerca dos pressupostos que tem referenciado a preparacao dos cuidadores de idosos e suas consequencias para o cuidar, inclusive o debate entre estes e a enfermagem. Destacamos: a oposicao entre cuidados invisiveis, cuidados visiveis e cuidados tecnicos; a naturalizacao do cuidar como um valor em detrimento de um aprendizado tecnico; e as concepcoes de cuidado social e cuidado com a saude. Consideramos que tanto a enfase no cuidado social, ao afastar a figura medica da doenca, quanto a enfase no cuidado a saude, que tem a doenca como mote reflexivo, ao desconsiderarem a importância do cuidado tecnico, podem, com isso, nao levar em consideracao a complexidade dos aspectos subjetivos e fisicos ligados a existencia concreta do enfermo idoso.

A Universidade extendida: estratégias de ensino e aprendizagem em enfermagem

Es una reflexion sobre la practica de enfermeria que aproxima, teoricamente y de una manera propositiva, las actividades de extension a la ensenanza de pregrado. La ensenanza de enfermeria es enfocada desde la practica de extension universitaria, que tiene que ser basada en el proceso ensenanza-aprendizaje y que representa un plus de refinamiento universitario en la medida en que organiza un movimiento de llevar la universidad para fuera del campus y de traer la ciudad para dentro de la universidad. La extension es una ensenanza viva, en el cual el aprendizado del plan de estudios que estan expuesto a la incertidumbre del saber haciendo. Se reflexiona la practica de la enfermera bajo la oferta de la extension universitaria como una posibilidad de llevar conocimiento a la comunidad y al mismo tiempo aprender con ella.

Qualidade de oficinas terapêuticas segundo pacientes

This is a descriptive, qualitative case study about the speech of patients related to the quality of the therapeutic workshop on mental health. As guidelines we used the Project Quality Indexes, a set of techniques carried out and tested in the field of education, used in evaluating educational projects. Their use favored reaching the goal of the study: to point out the quality characteristics of therapeutic workshops based on patient commentary. The study was based on concepts guided by citizenship and contemplated in the psychosocial rehabilitation proposal that orients mental health care at the Psychiatric Institute in Rio de Janeiro, Brazil. Data was analyzed through speech analysis. Our reflections were based on the data obtained from 12 interviews carried out in a therapeutic workshop of the Psychiatric Institute Day-Hospital. From this data, we have perceived that psychiatric patient participation in these workshops may be associated to four main desires: better social relationships, decreased symptoms, aid with respect, and some remuneration. DESCRIPTORS: Psychiatric nursing. Mental health. Rehabilitation. Quality indicators health care. LA CALIDAD DE LOS TALLERES TERAPEUTICOS SEGUN LOS PACIENTES RESUMEN: Es un estudio descriptivo, de naturaleza cualitativa, del tipo estudio de caso, acerca del discurso de los pacientes sobre la calidad de los talleres terapeuticos en salud mental. Utilizamos como guias los Indicadores de Calidad de Proyecto, un conjunto de tecnicas elaboradas y probadas en el area educacional, cuya finalidad es evaluar proyectos educacionales. Con ese metodo se pudo atender nuestro objetivo: senalar las caracteristicas de calidad de los talleres terapeuticos, a partir de lo que dicen los pacientes. El estudio se apoyo en conceptos basados en la ciudadania, y tambien incluidos en la propuesta de rehabilitacion psicosocial que orienta la asistencia en salud mental del Instituto de Psiquiatria de Rio de Janeiro. El analisis de los datos se realizo mediante el analisis de discurso. Nuestras reflexiones se basaron en los datos obtenidos en 12 entrevistas realizadas en un taller terapeutico del Hospital-dia del Instituto de Psiquiatria. Los datos obtenidos permiten percibir que la participacion de los pacientes psiquiatricos en esos talleres puede estar asociada a cuatro deseos principales: mejores relaciones sociales, disminucion de sintomas, ayuda con respeto y alguna remuneracion. DESCRIPTORES: Enfermeria psiquiatrica. Salud mental. Rehabilitacion. Indicadores de calidad de la atencion de salud.RESUMO: Estudodescritivo,�denaturezaqualitativa,�tipoestudodecaso,�acercadodiscursodospacientessobrequalidadedasoficinas� terapeuticasemsaudemental.�UtilizamoscomoguiasosIndicadoresdeQualidadedeProjeto,�conjuntodetecnicaselaboradasetestadas� na�areaeducacional,�cujafinalidade� e�avaliarprojetoseducacionais.�Estepropiciouatenderaoobjetivodeapontarascaracteristicasde� qualidadedasoficinasterapeuticas,�apartirdafaladospacientes.�Oestudobaseou-seemconceitospautadosemcidadania,�tambem� contempladosnapropostadereabilitacaopsicossocialqueorientaaassistenciaemsaudementaldoInstitutodePsiquiatriadoRio� deJaneiro.�Aanalisedosdadosfoirealizadaatravesdaanalisedediscurso.�Nossasreflexoesbasearam-senosdadosobtidosde�12� entrevistasrealizadasemumaoficinaterapeuticadoHospital-diadoInstitutodePsiquiatria.�Atravesdosdadospercebemosquea� participacaodospacientespsiquiatricosnestasoficinaspodeestarassociadaaquatrodesejosprincipais:�melhoresrelacoessociais,� diminuicaodesintomas,�ajudacomrespeitoealgumaremuneracao.� DESCRITORES: Enfermagempsiquiatrica.�Saudemental.�Reabilitacao.�Indicadoresdequalidadeemassistencia�a�saude.� QUALITY OF THERAPEUTIC WORKSHOPS ACCORDING TO PATIENTS ABSTRACT: Thisisadescriptive,�qualitativecasestudyaboutthespeechofpatientsrelatedtothequalityofthetherapeuticworkshop� onmentalhealth.�AsguidelinesweusedtheProjectQualityIndexes,�asetoftechniquescarriedoutandtestedinthefieldofeducation,� usedinevaluatingeducationalprojects.�Theirusefavoredreachingthegoalofthestudy:�topointoutthequalitycharacteristicsof� therapeuticworkshopsbasedonpatientcommentary.�Thestudywasbasedonconceptsguidedbycitizenshipandcontemplatedinthe� psychosocialrehabilitationproposalthatorientsmentalhealthcareatthePsychiatricInstituteinRiodeJaneiro,�Brazil.�Datawasanalyzed� throughspeechanalysis.�Ourreflectionswerebasedonthedataobtainedfrom�12�interviewscarriedoutinatherapeuticworkshop� ofthePsychiatricInstituteDay-Hospital.�Fromthisdata,�wehaveperceivedthatpsychiatricpatientparticipationintheseworkshops� maybeassociatedtofourmaindesires:�bettersocialrelationships,�decreasedsymptoms,�aidwithrespect,�andsomeremuneration. DESCRIPTORS:�Psychiatricnursing.�Mentalhealth.�Rehabilitation.�Qualityindicatorshealthcare.�

Um entendimento linear sobre a teoria de Peplau e os Princípios da Reforma Psiquiátrica Brasileira

Trata de uma analise sobre os conceitos contidos na teoria de Hildegard Peplau, datados de 1952 e associa-los aos preceitos da Reforma Psiquiatrica Brasileira considerando a realidade social e historica dessa associacao. Partiu-se da analise sistematica do livro Interpersonal Relations in Nursing e dos conceitos nele existentes. O estudo foi realizado sob o enfoque da metanalise, que ajudou na compreensao dos conceitos estudados. A partir da analise das duas referencias teoricas, compreendemos que os conceitos chaves de Hildegard Peplau ainda hoje sao aplicaveis e capazes de orientar com excelencia para um cuidado de enfermagem psiquiatrica que atenda aos preceitos organizadores da Reforma Psiquiatrica Brasileira.

Uso de drogas ilícitas e perspectivas críticas de familiares e pessoas próximas, na cidade do Rio de Janeiro, Zona Norte, Brasil

This article presents the partial results of a multicenter, qualitative study, which involved seven Latin-American countries and Canada. The results presented refer to Northern Rio de Janeiro (city), Brazil. The objective of the study was to describe the perspective of relatives/acquaintances of illicit drug users about protective and risk factors, prevention initiatives, treatment services, and legal aspects regarding illicit drugs. Interviews were performed with 99 individuals, who reported being affected by their relationship with an illicit drug user (relative or acquaintance), approaching their perspectives regarding the key-domains. Most participants were women (73.7%); relatives who used drugs were mostly men (78.2%); the most consumed drug was marijuana (77.8%). The highlighted protective factor was having recreational-sports activities in the community (88.9%), and the risk factor was curiosity for trying something new (94.4%). The main treatment services were Church Groups (51.5%), and participants stated that laws should be more punitive (82.8%). In conclusion, this information is essential to fight against drug use/abuse, showing that there is a need for actions that consider different perspectives at different levels.

Involuntary commitment: implication for psychiatric nursing practice

The characteristics of involuntary psychiatric commitment (IPI) may cause implications on the nursing/patient relationship. The objectives of this study were to list the forms of nursing care delivered to psychiatric patients, according to the type of commitment; analyze the reaction of the nursing team towards the IPI patient, and discuss on the implications that IPI have on the practice o psychiatric nursing. A field research was performed with the nursing team of a psychiatric institution in Rio de Janeiro. After 50 hours of participant observation and 9 of focal group meetings, we found that the teams are concerned with the clinical evolution of the patients. No references of the nursing team to the IPI patient were observed. There are no records or actions of any kind that would suggest a specific look towards this type of patient. Nursing professionals are not able to clearly identify this type of patient, thus the care is provided as per the patients needs or requests.The characteristics of involuntary psychiatric commitment (IPI) may cause implications on the nursing/patient relationship. The objectives of this study were to list the forms of nursing care delivered to psychiatric patients, according to the type of commitment; analyze the reaction of the nursing team towards the IPI patient, and discuss on the implications that IPI have on the practice o psychiatric nursing. A field research was performed with the nursing team of a psychiatric institution in Rio de Janeiro. After 50 hours of participant observation and 9 of focal group meetings, we found that the teams are concerned with the clinical evolution of the patients. No references of the nursing team to the IPI patient were observed. There are no records or actions of any kind that would suggest a specific look towards this type of patient. Nursing professionals are not able to clearly identify this type of patient, thus the care is provided as per the patients needs or requests.

Internação involuntária: as implicações para a clínica da enfermagem psiquiátrica

The characteristics of involuntary psychiatric commitment (IPI) may cause implications on the nursing/patient relationship. The objectives of this study were to list the forms of nursing care delivered to psychiatric patients, according to the type of commitment; analyze the reaction of the nursing team towards the IPI patient, and discuss on the implications that IPI have on the practice o psychiatric nursing. A field research was performed with the nursing team of a psychiatric institution in Rio de Janeiro. After 50 hours of participant observation and 9 of focal group meetings, we found that the teams are concerned with the clinical evolution of the patients. No references of the nursing team to the IPI patient were observed. There are no records or actions of any kind that would suggest a specific look towards this type of patient. Nursing professionals are not able to clearly identify this type of patient, thus the care is provided as per the patients needs or requests.The characteristics of involuntary psychiatric commitment (IPI) may cause implications on the nursing/patient relationship. The objectives of this study were to list the forms of nursing care delivered to psychiatric patients, according to the type of commitment; analyze the reaction of the nursing team towards the IPI patient, and discuss on the implications that IPI have on the practice o psychiatric nursing. A field research was performed with the nursing team of a psychiatric institution in Rio de Janeiro. After 50 hours of participant observation and 9 of focal group meetings, we found that the teams are concerned with the clinical evolution of the patients. No references of the nursing team to the IPI patient were observed. There are no records or actions of any kind that would suggest a specific look towards this type of patient. Nursing professionals are not able to clearly identify this type of patient, thus the care is provided as per the patients needs or requests.

Illicit drug use and the critical perspectives of drug users' relatives and acquaintances in Northern Rio de Janeiro (City), Brazil

This article presents the partial results of a multicenter, qualitative study, which involved seven Latin-American countries and Canada. The results presented refer to Northern Rio de Janeiro (city), Brazil. The objective of the study was to describe the perspective of relatives/acquaintances of illicit drug users about protective and risk factors, prevention initiatives, treatment services, and legal aspects regarding illicit drugs. Interviews were performed with 99 individuals, who reported being affected by their relationship with an illicit drug user (relative or acquaintance), approaching their perspectives regarding the key-domains. Most participants were women (73.7%); relatives who used drugs were mostly men (78.2%); the most consumed drug was marijuana (77.8%). The highlighted protective factor was having recreational-sports activities in the community (88.9%), and the risk factor was curiosity for trying something new (94.4%). The main treatment services were Church Groups (51.5%), and participants stated that laws should be more punitive (82.8%). In conclusion, this information is essential to fight against drug use/abuse, showing that there is a need for actions that consider different perspectives at different levels.