Fernanda Carolina Capistrano

Perfil sociodemográfico e clínico de dependentes químicos em tratamento: análise de prontuários

Resumen Crosscut descriptive research study carried out at a rehabilitative unit of a psychiatric hospital, objectifying to feature the clinical sociodemographic profile of chemically dependents under treatment. Data of 350 records from 2010 were collected. Patients’ mean age was 35.8 years: 39.4% were single; 67.3% studied up to incomplete high-school level; 45.1% were unemployed. Mean age of the first drug use was under 18 years: 54.9% were alcohol dependents and 43.7% were crack users; 79.6% took more than one substance, 99.4% reported daily use, 13% presented some kind of psychiatric comorbidities and 30.1%, clinical comorbidities; 69% had family members involved in substance abuse, among them, 48.3% were parents, alcohol standing out in 86% of the cases. Chemical dependency runs in varied ages, star ting early in adolescence, causing significant changes in biological, family, social, and occupational scopes.Investigacion descriptiva transversal realizada en una unidad de rehabilitacion de un hospital psiquiatrico con el objetivo de caracterizar el perfil sociodemografico y clinico de dependientes quimicos en tratamiento. Fueron recogidos datos de 350 prontuarios referentes al ano de 2010. La media de edad de los pacientes fue de 35,8 anos: 39,4% eran solteros; 67,3% estudiaron hasta la ensenanza primaria; y 45,1% eran desempleados. La media de edad del primer consumo de drogas ocurrio antes de los 18 anos: 54,9% eran dependientes de alcohol y 43,7%, de crack; 79,6% utilizaban mas de una substancia; 99,4% hacian uso diario; 13% presentaban algun tipo de comorbilidades psiquiatricas y 30,1% comorbilidades clinicas; 69% tenian familiares envueltos con drogas, y de esos, 48,3% eran padres, con destaque para el alcohol en 86% de los casos. Conclusion: la dependencia quimica alcanza diversas edades, iniciando precozmente en la adolescencia, ocasionando significativas alteraciones en el ambito biologico, familiar, social y ocupacional.

Fatores que interferem na adesão ao tratamento de dependência química: percepção de profissionais de saúde

Exploratory, qualitative research performed at a Psychosocial Care Center for Alcohol and Other Drugs in the metropolitan area of the city of Curitiba, Paraná, Brazil, from March to April 2013. This study aimed to identify health professionals’ perceptions on the factors that interfere in patient compliance with chemical dependence treatments. All health professionals from the Care Center participated in the research (9). Data were collected by means of semi-structured interviews and analyzed by Minayo’s Qualitative Data Interpretation, resulting in two categories: drug users’ intrinsic factors for treatment compliance, which entailed motivational influences, use of medication, and the type of psychoactive substance; and drug users’ extrinsic factors for treatment compliance, which included influences from the family, socioeconomics, and healthcare services. It could therefore be concluded that the identification of such factors may well aid in identifying more appropriate therapeutic intervention planning, in an attempt to increase both compliance and quality of life.Pesquisa qualitativa e exploratoria realizada de marco a abril de 2013 em um centro de atencao psicossocial alcool e outras drogas da regiao metropolitana de Curitiba, com o objetivo de identificar a percepcao dos profissionais de saude sobre os fatores que interferem na adesao ao tratamento da dependencia quimica. Participaram da pesquisa todos os profissionais de saude. Os dados foram coletados mediante entrevista semiestruturada e analisados pela interpretacao qualitativa de dados de Minayo, resultando em duas categorias: fatores intrinseco sao dependente quimico na adesao ao tratamento, que compreendeu influencias de motivacao, de uso de medicamentos e tipo de substância psicoativa; e fatores extrinsecos ao dependente quimico na adesao ao tratamento, que englobou influencias familiares, socioeconomicas e dos servicos de saude. Concluiu-se que a identificacao desses fatores ofertam subsidios para o planejamento de intervencoes terapeuticas mais apropriadas, com vistas ao aumento da adesao e da qualidade de vida. (AU) Exploratory, qualitative research performed at a Psychosocial Care Center for Alcohol and Other Drugs in the metropolitan area of the city ofCuritiba, Parana, Brazil, from March to April 2013. This study aimed to identify health professionals’ perceptions on the factors that interfere inpatient compliance with chemical dependence treatments. All health professionals from the Care Center participated in the research (9). Data werecollected by means of semi-structured interviews and analyzed by Minayo’s Qualitative Data Interpretation, resulting in two categories: drug users’intrinsic factors for treatment compliance, which entailed motivational influences, use of medication, and the type of psychoactive substance; anddrug users’ extrinsic factors for treatment compliance, which included influences from the family, socioeconomics, and healthcare services. It could there fore be concluded that the identification of such factors may well aid in identifying more appropriate therapeutic intervention planning, in anattempt to increase both compliance and quality of life. (AU) Estudio cualitativo exploratorio realizado entre marzo y abril de 2013 en un centro de atencion psicosocial de alcohol y otras drogas en la regionmetropolitana de Curitiba, con el fin de identificar la percepcion de los profesionales de la salud acerca de los factores que influyen en la adherenciaal tratamiento de la dependencia quimica. Todos los profesionales de la salud (9) participaron de la investigacion. Los datos fueron recogidos atraves de la entrevista semi-estructurada y analizados por medio de la Interpretacion Cualitativa de Datos de Minayo, que dio como resultado doscategorias: factores intrinsecos al dependiente quimico en la adhesion al tratamiento, incluyendo influencias de motivacion, uso de medicamentosy tipo de sustancia psicoactiva; y factores extrinsecos al dependiente quimico en la adhesion al tratamiento, incluyendo influencias familiares,socioeconomicas y servicios de salud. Se concluye que la identificacion de los factores ofrece apoyo a la planificacion de las intervencionesterapeuticas mas adecuadas, con el fin de aumentar la adhesion y la calidad de vida. (AU)

Clinical sociodemographic profile of chemically dependents under treatment: record analysis

Resumen Crosscut descriptive research study carried out at a rehabilitative unit of a psychiatric hospital, objectifying to feature the clinical sociodemographic profile of chemically dependents under treatment. Data of 350 records from 2010 were collected. Patients’ mean age was 35.8 years: 39.4% were single; 67.3% studied up to incomplete high-school level; 45.1% were unemployed. Mean age of the first drug use was under 18 years: 54.9% were alcohol dependents and 43.7% were crack users; 79.6% took more than one substance, 99.4% reported daily use, 13% presented some kind of psychiatric comorbidities and 30.1%, clinical comorbidities; 69% had family members involved in substance abuse, among them, 48.3% were parents, alcohol standing out in 86% of the cases. Chemical dependency runs in varied ages, star ting early in adolescence, causing significant changes in biological, family, social, and occupational scopes.Investigacion descriptiva transversal realizada en una unidad de rehabilitacion de un hospital psiquiatrico con el objetivo de caracterizar el perfil sociodemografico y clinico de dependientes quimicos en tratamiento. Fueron recogidos datos de 350 prontuarios referentes al ano de 2010. La media de edad de los pacientes fue de 35,8 anos: 39,4% eran solteros; 67,3% estudiaron hasta la ensenanza primaria; y 45,1% eran desempleados. La media de edad del primer consumo de drogas ocurrio antes de los 18 anos: 54,9% eran dependientes de alcohol y 43,7%, de crack; 79,6% utilizaban mas de una substancia; 99,4% hacian uso diario; 13% presentaban algun tipo de comorbilidades psiquiatricas y 30,1% comorbilidades clinicas; 69% tenian familiares envueltos con drogas, y de esos, 48,3% eran padres, con destaque para el alcohol en 86% de los casos. Conclusion: la dependencia quimica alcanza diversas edades, iniciando precozmente en la adolescencia, ocasionando significativas alteraciones en el ambito biologico, familiar, social y ocupacional.

Adaptation and validation of the Measuring of Treatment Adherence for mental health

OBJECTIVE to adapt culturally and validate the Measuring Instrument of Treatment Adherence for mental health. METHOD methodological study, carried out with 300 individuals with mental disorders, in two Psychosocial Care Centers in Curitiba, state of Paraná, Brazil, from April to June 2014. The cross-cultural adaptation was developed according to international recommendations, the construct validation was made by exploratory factor analysis, and internal consistency was verified by Cronbachs alpha. RESULTS through the evaluation of a committee of experts and completion of the pre-testing, face and content validation was achieved. From the factor analysis, we identified two factors of the instruments construct: involuntary action and voluntary action, with a total explanation variance of 55.7%. The value of Bartletts test of sphericity was p<0.001. Cronbachs alpha was 0.74. CONCLUSION the adapted and validated instrument proved to be trustworthy to be applied to the verification of adherence to drug therapy for individuals with mental disorders.

A VIVÊNCIA DO PORTADOR DE TRANSTORNO MENTAL NO USO DE PSICOFÁRMACOS NA PERSPECTIVA DO PENSAMENTO COMPLEXO

Objective: to understand how mental disorder patients experience the use of psychotropic drugs. Method: a qualitative, exploratory and descriptive research, which used Edgar Morin’s complex thinking as theoretical reference. The data were collected through a semi-structured interview applied to 26 mental disorder patients with psychotropic medical prescription and subjected to theme category-based analysis. Results: a central category emerged “The complex experience of mental disorder patients in the use of psychotropic drugs”. This category shows the interrelations between thematic categories, such as: experiencing the effects of psychotropic drugs; irregularly using psychotropic drugs; identifying the easiness and difficulties of using psychotropic drugs; and developing strategies to maintain the regular use of psychotropic drugs. Conclusions: that the experience of mental disorder patients in the use of psychotropic drugs is a dynamic and complex process that encompasses the multidimensionality involving the human beings and their treatment. DESCRIPTORS: Psychotropic drugs. Mental health. Psychiatric nursing. Mental disorders. Community mental health centers. http://dx.doi.org/10.1590/0104-07072017001000016Objetivo: conocer como el portador de trastorno mental vivencia el uso de psicofarmacos. Metodo: investigacion cualitativa, exploratoria y descriptiva que utilizo como referencial teorico el pensamiento complejo de Edgar Morin. Datos fueron recolectados por entrevista semiestructurada aplicada a 26 portadores de trastorno mental con la prescripcion de psicofarmacos y fueron sometidos al analisis categorial tematico. Resultados: emergio una categoria central: “La vivencia compleja del portador de trastorno mental en el uso de psicofarmacos”, que muestra las interrelaciones entre las categorias tematicas: vivenciando los efectos de los psicofarmacos; utilizando los psicofarmacos de modo irregular; identificando facilidades y dificultades en el uso de psicofarmacos; y desarrollando estrategias para mantenimiento del uso regular de psicofarmacos. Conclusion: que la vivencia del portador de trastorno mental en el uso de psicofarmacos es un proceso dinamico y complejo que engloba la multidimensionalidad que envuelve el ser humano y su tratamiento.

Determinantes intra e interpessoais percebidos pela família como causa da recaída do dependente químico

Pesquisa qualitativa, descritiva, realizada em uma unidade de internamento de reabilitacao para dependentes de substâncias psicoativas no estado do Parana, em 2012, com o objetivo de identificar as causas de recaida de dependentes quimicos com base em determinantes intrapessoais e interpessoais percebidos pelos familiares. Foram realizadas 19 entrevistas semiestruturadas com familiares de dependentes quimicos em tratamento. Os resultados foram analisados segundo determinantes intrapessoais e interpessoais propostos por Marlatt e Witkiewitz e organizados em categorias tematicas com interpretacao qualitativa dos dados. Os determinantes intrapessoais autoeficacia,motivacao, enfrentamento, estados emocionais, fissura e o determinante interpessoal apoio social emergiram dos relatos dos familiares, com excecao do determinante intrapessoal expectativa de resultados. Concluiu-se que a identificacao desses determinantes no tratamento da dependencia quimica pode auxiliar os profissionais de saude a desenvolverem estrategias de prevencao da recaida de dependentes quimicos. (AU) Descriptive qualitative research conducted in an in-patient rehabilitation center for drug users in the state of Parana, Brazil, in 2012, which aimedto identify the causes of these patients’ relapses based on intrapersonal and interpersonal determinants perceived by family members. Nineteen(19) semi-structured interviews were carried out with the family members of drug users who were under going treatment. Results were analyzed according to Marlatt and Witkiewitz’s intrapersonal and interpersonal determinants and organized in thematic categories by means of Qualitative Data Interpretation. Self-efficacy, motivation, coping, emotional states, craving as intrapersonal determinants, and social support as an interpersonal determinant emerging from the family members’ accounts, with the exception of the intrapersonal determinant of outcome expectancy. It was there fore concluded that the identification of such determinants in the treatment of chemical dependency may help health professionals to develop strategies to prevent drug users’ relapses. (AU) Estudio cualitativo descriptivo realizado en una unidad de internacion de rehabilitacion para dependientes de sustancias psicoactivas del estado deParana, en 2012,. Su objetivo fue identificar las causas de recaida del adicto en base a los determinantes intrapersonales e interpersonales observados por la familia. Se realizaron 19 entrevistas semi-estructuradas con familiares de dependientes quimicos en tratamiento. Los resultados fueron analizados segun los determinantes intrapersonales e interpersonales propuestos por Marlatt y Witkiewitz y organizados en categorias tematicas con interpretacion cualitativa de datos. Los determinantes intrapersonales auto-eficacia, motivacion, enfrentamiento, estados emocionales, fisuray el determinante interpersonal apoyo social surgieron de los relatos de los familiares, a excepcion del determinante intrapersonal expectativa de resultados. Llegamos a la conclusion que la identificacion de los determinantes en el tratamiento de la dependencia quimica puede ayudar a los profesionales de la salud a desarrollar estrategias para la prevencion de recaida del dependiente quimico.(AU)

Perfil de internações hospitalares em unidade psiquiátrica de um hospital geral

Pesquisa descritiva, transversal que teve por objetivo descrever o perfil das internacoes em unidade psiquiatrica de um hospital geral do estado do Parana. Os dados foram coletados de janeiro a junho de 2011, por meio de um questionario estruturado com informacoes de 240 internacoes. Foram analisados os dados sociodemograficos e da internacao, expressos em frequencias e percentuais. Os resultados revelam perfil de internacoes voluntarias de individuos com problemas de utilizacao abusiva de substâncias psicoativas, advindos da atencao primaria de saude, sendo um familiar o responsavel pela internacao. Evidenciou-se em 47,5% do total o diagnostico de transtornos relacionados ao uso/abuso de alcool e drogas e em 75,5% foi observada a melhora do quadro na alta. O tempo medio de internacao foi de 26,2 dias. Para o enfermeiro, estes resultados podem contribuir para planejar o cuidado de enfermagem e acoes assistenciais que visem ao tratamento eficaz, com desfecho positivo.(AU) This is a cross-sectional, descriptive study aimed at describing the hospitalization profile in the psychiatric unit of a general hospital in the state of Parana. Data was collected from January to July, 2011 using a structured questionnaire with information on 240 hospitalizations. Demographic and hospitalization data were analyzed and expressed as frequencies and percentages. The results show a profile of voluntary admissions by individuals struggling with psychoactive substance abuse and who come from primary healthcare. A family member was usually responsible for hospitalization. We found that in 47.5% of cases the diagnosis was related substance abuse and clinical improvement at discharge was observed in 75.5% of admissions. Average length of hospitalization was 26.2 days. These results can help nurses in planning care and assistance actions that seek effective treatments with more positive outcomes.(AU) Se trata de una investigacion descriptiva transversal que tuvo como objetivo describir el perfil de las internaciones en la unidad psiquiatrica de un hospital general del Estado de Parana. Los datos fueron recogidos entre enero y julio de 2011, a traves de un cuestionario estructurado con informacion de 240 internaciones. Fueron analizados los datos sociodemograficos y de internacion, expresados como frecuencias y porcentajes. Los resultados muestran un perfil de internacion voluntaria de personas con problemas de abuso de sustancias psicoactivas, derivadas de la atencion primaria de salud y que un familiar es responsable de la hospitalizacion. Es evidente que en el 47,5% del total el diagnostico fue de trastornos relacionados con abuso de alcohol y drogas y que hubo mejoria clinica en el alta en el 75,5% de los casos. El promedio de estadia hospitalaria fue de 26,2 dias. Para las enfermeras, estos resultados pueden ayudar a planificar los cuidados de enfermeria y las medidas de asistencia con miras a un tratamiento eficaz con resultados positivos.(AU)This is a cross-sectional, descriptive study aimed at describing the hospitalization profile in the psychiatric unit of a general hospital in the state of Paraná. Data was collected from January to July, 2011 using a structured questionnaire with information on 240 hospitalizations. Demographic and hospitalization data were analyzed and expressed as frequencies and percentages. The results show a profile of voluntary admissions by individuals struggling with psychoactive substance abuse and who come from primary healthcare. A family member was usually responsible for hospitalization. We found that in 47.5% of cases the diagnosis was related substance abuse and clinical improvement at discharge was observed in 75.5% of admissions. Average length of hospitalization was 26.2 days. These results can help nurses in planning care and assistance actions that seek effective treatments with more positive outcomes.

Perfil sociodemográfico y clínico de dependientes químicos en tratamiento: análisis de prontuarios

Resumen Crosscut descriptive research study carried out at a rehabilitative unit of a psychiatric hospital, objectifying to feature the clinical sociodemographic profile of chemically dependents under treatment. Data of 350 records from 2010 were collected. Patients’ mean age was 35.8 years: 39.4% were single; 67.3% studied up to incomplete high-school level; 45.1% were unemployed. Mean age of the first drug use was under 18 years: 54.9% were alcohol dependents and 43.7% were crack users; 79.6% took more than one substance, 99.4% reported daily use, 13% presented some kind of psychiatric comorbidities and 30.1%, clinical comorbidities; 69% had family members involved in substance abuse, among them, 48.3% were parents, alcohol standing out in 86% of the cases. Chemical dependency runs in varied ages, star ting early in adolescence, causing significant changes in biological, family, social, and occupational scopes.Investigacion descriptiva transversal realizada en una unidad de rehabilitacion de un hospital psiquiatrico con el objetivo de caracterizar el perfil sociodemografico y clinico de dependientes quimicos en tratamiento. Fueron recogidos datos de 350 prontuarios referentes al ano de 2010. La media de edad de los pacientes fue de 35,8 anos: 39,4% eran solteros; 67,3% estudiaron hasta la ensenanza primaria; y 45,1% eran desempleados. La media de edad del primer consumo de drogas ocurrio antes de los 18 anos: 54,9% eran dependientes de alcohol y 43,7%, de crack; 79,6% utilizaban mas de una substancia; 99,4% hacian uso diario; 13% presentaban algun tipo de comorbilidades psiquiatricas y 30,1% comorbilidades clinicas; 69% tenian familiares envueltos con drogas, y de esos, 48,3% eran padres, con destaque para el alcohol en 86% de los casos. Conclusion: la dependencia quimica alcanza diversas edades, iniciando precozmente en la adolescencia, ocasionando significativas alteraciones en el ambito biologico, familiar, social y ocupacional.