Marcio Roberto Paes

Perfil dos dependentes químicos atendidos em uma unidade de reabilitação de um hospital psiquiátrico

Investigacion descriptiva. Objetivo: caracterizar el perfil de los dependientes quimicos atendidos en la unidad de rehabilitacion de un hospital psiquiatrico. Participaron 30 dependientes quimicos. Los datos fueron colectados por medio de entrevista. El grupo etario prevalente fue entre 26 y 33 anos, 50% empleados; 77% perdio el empleo por lo menos una vez por abuso de drogas; el 80% tuvo episodios de separacion relacionada con el uso de drogas; 11 participantes fueron diagnosticados con trastorno mental antes de la internacion y de estos, 9 intentaron el suicidio; 71% inicio el uso de drogas por el alcohol con mayor predominancia en el rango de edad de 12 hasta 19 anos; 71% tuvo contacto con la droga en el ambiente familiar y en 30% de los casos fue a traves de amigos. El abuso de esas sustancias afecta personas en edad productiva, adultos jovenes, cuyo inicio ocurrio en el circulo familiar y afecto el desempeno en el trabajo y la relacion familiar del usuario.

A família e o portador de transtorno mental: dinâmica e sua relação familiar

Pesquisa exploratoria realizada de setembro a novembro de 2008, com seis familias de portadores de transtorno mental em uma Associacao de pacientes e familiares em Curitiba. Objetivos: conhecer o papel da familia em relacao ao portador de transtorno mental, e identificar a percepcao da familia com relacao a saude mental-transtorno mental, ao portador de transtorno mental e ao tratamento em saude mental. Os dados foram obtidos mediante a tecnica de Discussao de Grupo e organizados em categorias tematicas. Constatou-se que o papel da familia e cuidar, incentivar, estar presente; a saude mental e a capacidade de se relacionar, desempenhar atividades sem sofrimento; transtorno mental e o inverso, diante dele as familias se percebem impotentes; o internamento e percebido como sofrimento, e destaca-se a importância do tratamento farmacologico. Ha a necessidade de discutir essas questoes com as familias e instrumentalizar os profissionais de saude para atender essas novas demandas de cuidados.UNLABELLED This exploratory study was performed from September to November 2008, with six families of patients with mental disorders from a patients and family association in Curitiba. OBJECTIVES to learn about the role of the family of patients with mental disorders, and to identify the familys perception of mental health - mental disorder, the patient with mental disorder and the mental health treatment. The data was obtained through Group Discussions and organized into thematic categories. It was found that the role of the family is to care, encourage, be there; mental health is the ability to establish relationships, perform activities without suffering; mental disorder is the opposite, in face of which the families feel helpless; hospitalization is seen as suffering, and the highlight is on the importance of the drug treatment. It is necessary to discuss on these issues with the families and prepare health professionals to meet these new health needs.

Cuidado de enfermagem ao paciente com comorbidade clínico-psiquiátrica em um pronto atendimento hospitalar

Pesquisa qualitativa, descritiva, exploratoria desenvolvida em 2009 no pronto atendimento de um hospital geral de Curitiba, Parana. Teve como objetivo conhecer o cuidado de enfermagem desenvolvido ao paciente com comorbidade clinico-psiquiatrica. Participaram seis enfermeiros, sete tecnicos de enfermagem e 14 auxiliares de enfermagem. Os dados foram obtidos mediante entrevista semiestruturada e submetidos a analise de conteudo tematico-categorial. As categorias que emergiram dos dados foram: O cuidado e tecnico e sem especificidade; Seguranca e protecao ao paciente; e Contencao fisica e quimica como medidas de protecao. Evidenciouse que os cuidados de enfermagem desenvolvidos aos pacientes com comorbidade clinico-psiquiatrica sao sem especificidade, com enfase em cuidados basicos, contencao quimica e fisica. Concluiu-se que ha necessidade da implantacao de programas locais de capacitacao em saude mental e sensibilizacao dos profissionais de enfermagem quanto aos cuidados a tal clientela.Qualitative descriptive, exploratory research developed in 2009, in the emergency service of a general hospital in Curitiba, Paraná, Brazil. It aims to investigate how nurses take care of patients with clinical and psychiatric comorbidity. Six nurses, seven nursing technicians and 14 nursing assistants participated. We obtained data through semi-structured interviews and submitted to analysis of thematic content. The categories that emerged from the data were: Care is technical and without specificity; Safety and protection of patient; and Physical and chemical restraint as protective measures. The study revealed that nursing care of patients with clinical and psychiatric comorbidity does not have any specificity, with emphasis on basic care, physical and chemical restraint. We concluded that it is necessary to establish local training in mental health and make nurses aware of the care needs of this clientele.

O tratamento ao portador de transtorno mental: um diálogo com a legislação federal brasileira (1935-2001)

The objective of this historical study, based on social history and developed in 2008 was to identify Mental Health Brazilian Federal Legislation from 1935 to 2001 and analyze treatment modes used on patients with mental disorders. Thirty-six legal displays were accessed. From 1935 to 1990, Brazilian legislation treated administrative questions in mental health with references to terms like psychopath, mental alienation, and psychopathic reactions, which are now considered pejorative and prejudicial. The results of the legal displays show that in recent years mental health assistance has suffered several transformations. In the period from 1991 to 2001, treatment modes have focused on the care model which seeks a rupture from the hospital-centered model and which emphasizes humanization, social reinsertion, the preservation and rescue of the citizenship of people with mental disorders, as well as the evaluation of these services in order to guarantee these patients’ rights. DESCRIPTORS: Mental health. Legislation. Treatment. EL TRATAMIENTO A PACIENTES CON TRASTORNO MENTAL: UN DIALOGO CON LA LEGISLACION FEDERAL BRASILENA (1935-2001) RESUMEN: Investigacion de caracter historico-social, desarrollada en 2008, con el objetivo de identificar la legislacion federal de salud mental de 1935 a 2001, y analizar los modos de tratamiento recomendados para pacientes con trastorno mental. Se obtuvieron treinta y seis aparatos legales. Se verifico que la legislacion en el periodo de 1935 a 1990 trataba de las cuestiones administrativas de la salud mental. La legislacion contiene referencias a terminos, tales como: psicopata, alienacion mental y reacciones psicopaticas, que en la actualidad son considerados peyorativos y prejuicios. Los resultados demuestran que en los ultimos anos, la legislacion sobre la atencion a la salud mental sufrio amplias modificaciones, y en el periodo de 1991 a 2001, los modos de tratamientos se centran en el modelo asistencial que pretende romper con el modo hospitalocentrico, enfatizar la humanizacion, la reinsercion social, la preservacion y restauracion de la ciudadania de las personas con trastornos mentales y la evaluacion de esos servicios para garantizar los derechos de ese grupo. DESCRIPTORES: Salud mental. Legislacion. Tratamiento.

Abordagem da equipe de enfermagem ao usuário na emergência em saúde mental em um pronto atendimento

This qualitative exploratory study was conducted in 2008, at a Municipal Emergency Care Center in Curitiba. Objective: to learn about the conception of the nursing team about emergencies in mental health, and analyze how the nursing team approaches users with mental disorders in cases of emergency. Participants were 6 nurses and 7 nursing technicians working in emergency and hospitalization. Data collection was performed using semi-structured interviews and organized into thematic categories. Participants considered psychiatric emergencies as situations that may threat their own lives or that of others. The emergency characteristics they mentioned were: aggressive and agitated behavior, suicide attempt and substance abuse. The first impression of the patients behavior and an attempt to have conversation determine the conducts adopted by the professionals. They recognize their difficulty and lack of preparation to approach the patient. In conclusion, there is a need for permanent education on new services and for adjustments to existing services for care in this area.Investigacion cualitativa, exploratoria, desarrollada en 2008, en Centro Municipal de Emergencias Medicas/Curitiba. Objetivos: conocer la concepcion del equipo de enfermeria sobre emergencias psiquiatricas y analizar como se desarrolla el abordaje del equipo al usuario con transtorno mental en emergencia. Participaron 6 enfermeros y 7 tecnicos en enfermeria que actuan en emergencias e internaciones. Los datos fueron obtenidos mediante entrevista semiestructurada y organizados en categorias tematicas. Para los participantes, las emergencias psiquiatricas son situaciones que presentan riesgo vital para la persona o terceros. Como caracteristicas de la emergencia, citaron: comportamiento agresivo y agitado, tentativa de suicidio y abuso de sustancias. La primera impresion del comportamiento del paciente y la tentativa de dialogo determinan las conductas a adoptarse por los profesionales. Reconocen dificultad e inexperiencia en el abordaje del paciente. Se concluye en que hay necesidad de educacion permanente sobre nuevos servicios y adaptaciones de los existentes para la atencion del area.UNLABELLED This qualitative exploratory study was conducted in 2008, at a Municipal Emergency Care Center in Curitiba. OBJECTIVE to learn about the conception of the nursing team about emergencies in mental health, and analyze how the nursing team approaches users with mental disorders in cases of emergency. Participants were 6 nurses and 7 nursing technicians working in emergency and hospitalization. Data collection was performed using semi-structured interviews and organized into thematic categories. Participants considered psychiatric emergencies as situations that may threat their own lives or that of others. The emergency characteristics they mentioned were: aggressive and agitated behavior, suicide attempt and substance abuse. The first impression of the patients behavior and an attempt to have conversation determine the conducts adopted by the professionals. They recognize their difficulty and lack of preparation to approach the patient. In conclusion, there is a need for permanent education on new services and for adjustments to existing services for care in this area.

O ensino de saúde mental na graduação de enfermagem: um estudo de caso

This case study aimed to describe how the teaching of mental health is developed in a nursing undergraduate course and to verify how this teaching of mental influences the formation of the students. The sources of information were: the teaching plan, chronogram of the discipline and direct observation of the activities developed by a professor and 60 students. Luckesis philosophy of education was the theoretical framework used. The students said that the strategies and the teaching methodology provided learning based on reality and that they motivated the search for extracurricular work which assisted the construction of knowledge. They also identified an environment of significant learning that encouraged them to exchange experiences with each other, with the professor and with other healthcare professionals. The adoption of active methodologies is shown as a viable route to achieve the pedagogic proposal in the teaching of mental health and in the formation of competent professionals. DESCRIPTORS: Nursing. Psychiatric nursing. Mental health. Teaching. Learning.Investigacion con el metodo estudio de caso con el objetivo de describir como se desarrolla la ensenanza de la salud mental en un programa de graduacion de Enfermeria y verificar como la ensenanza de la salud mental influye en la formacion de los alumnos. Las fuentes de informaciones fueron: plan de ensenanza, cronograma de la disciplina y observacion directa de las actividades desarrolladas por un profesor y 60 estudiantes. Se utilizo el referencial de educacion de Luckesi. Los estudiantes refirieron que las estrategias y la metodologia de ensenanza proporcionan aprendizaje a partir de la realidad, e incentivan la busqueda de locales extra-clase para auxiliar en la construccion del conocimiento, por medio de ambientes de aprendizaje significativo, que les proporciona el intercambio de experiencias entre si, con la profesora y con otros profesionales de salud. La adopcion de metodologias activas se muestra un camino viable para alcanzar la propuesta pedagogica en la ensenanza de salud mental y en la formacion de profesionales competentes.

The family and the mental disturbance carrier: dynamics and their family relationship

Pesquisa exploratoria realizada de setembro a novembro de 2008, com seis familias de portadores de transtorno mental em uma Associacao de pacientes e familiares em Curitiba. Objetivos: conhecer o papel da familia em relacao ao portador de transtorno mental, e identificar a percepcao da familia com relacao a saude mental-transtorno mental, ao portador de transtorno mental e ao tratamento em saude mental. Os dados foram obtidos mediante a tecnica de Discussao de Grupo e organizados em categorias tematicas. Constatou-se que o papel da familia e cuidar, incentivar, estar presente; a saude mental e a capacidade de se relacionar, desempenhar atividades sem sofrimento; transtorno mental e o inverso, diante dele as familias se percebem impotentes; o internamento e percebido como sofrimento, e destaca-se a importância do tratamento farmacologico. Ha a necessidade de discutir essas questoes com as familias e instrumentalizar os profissionais de saude para atender essas novas demandas de cuidados.UNLABELLED This exploratory study was performed from September to November 2008, with six families of patients with mental disorders from a patients and family association in Curitiba. OBJECTIVES to learn about the role of the family of patients with mental disorders, and to identify the familys perception of mental health - mental disorder, the patient with mental disorder and the mental health treatment. The data was obtained through Group Discussions and organized into thematic categories. It was found that the role of the family is to care, encourage, be there; mental health is the ability to establish relationships, perform activities without suffering; mental disorder is the opposite, in face of which the families feel helpless; hospitalization is seen as suffering, and the highlight is on the importance of the drug treatment. It is necessary to discuss on these issues with the families and prepare health professionals to meet these new health needs.

The teaching of mental health in a nursing undergraduate course: a case study

This case study aimed to describe how the teaching of mental health is developed in a nursing undergraduate course and to verify how this teaching of mental influences the formation of the students. The sources of information were: the teaching plan, chronogram of the discipline and direct observation of the activities developed by a professor and 60 students. Luckesis philosophy of education was the theoretical framework used. The students said that the strategies and the teaching methodology provided learning based on reality and that they motivated the search for extracurricular work which assisted the construction of knowledge. They also identified an environment of significant learning that encouraged them to exchange experiences with each other, with the professor and with other healthcare professionals. The adoption of active methodologies is shown as a viable route to achieve the pedagogic proposal in the teaching of mental health and in the formation of competent professionals. DESCRIPTORS: Nursing. Psychiatric nursing. Mental health. Teaching. Learning.Investigacion con el metodo estudio de caso con el objetivo de describir como se desarrolla la ensenanza de la salud mental en un programa de graduacion de Enfermeria y verificar como la ensenanza de la salud mental influye en la formacion de los alumnos. Las fuentes de informaciones fueron: plan de ensenanza, cronograma de la disciplina y observacion directa de las actividades desarrolladas por un profesor y 60 estudiantes. Se utilizo el referencial de educacion de Luckesi. Los estudiantes refirieron que las estrategias y la metodologia de ensenanza proporcionan aprendizaje a partir de la realidad, e incentivan la busqueda de locales extra-clase para auxiliar en la construccion del conocimiento, por medio de ambientes de aprendizaje significativo, que les proporciona el intercambio de experiencias entre si, con la profesora y con otros profesionales de salud. La adopcion de metodologias activas se muestra un camino viable para alcanzar la propuesta pedagogica en la ensenanza de salud mental y en la formacion de profesionales competentes.

[A nursing team's approach to users of a mental health emergency room].

This qualitative exploratory study was conducted in 2008, at a Municipal Emergency Care Center in Curitiba. Objective: to learn about the conception of the nursing team about emergencies in mental health, and analyze how the nursing team approaches users with mental disorders in cases of emergency. Participants were 6 nurses and 7 nursing technicians working in emergency and hospitalization. Data collection was performed using semi-structured interviews and organized into thematic categories. Participants considered psychiatric emergencies as situations that may threat their own lives or that of others. The emergency characteristics they mentioned were: aggressive and agitated behavior, suicide attempt and substance abuse. The first impression of the patients behavior and an attempt to have conversation determine the conducts adopted by the professionals. They recognize their difficulty and lack of preparation to approach the patient. In conclusion, there is a need for permanent education on new services and for adjustments to existing services for care in this area.Investigacion cualitativa, exploratoria, desarrollada en 2008, en Centro Municipal de Emergencias Medicas/Curitiba. Objetivos: conocer la concepcion del equipo de enfermeria sobre emergencias psiquiatricas y analizar como se desarrolla el abordaje del equipo al usuario con transtorno mental en emergencia. Participaron 6 enfermeros y 7 tecnicos en enfermeria que actuan en emergencias e internaciones. Los datos fueron obtenidos mediante entrevista semiestructurada y organizados en categorias tematicas. Para los participantes, las emergencias psiquiatricas son situaciones que presentan riesgo vital para la persona o terceros. Como caracteristicas de la emergencia, citaron: comportamiento agresivo y agitado, tentativa de suicidio y abuso de sustancias. La primera impresion del comportamiento del paciente y la tentativa de dialogo determinan las conductas a adoptarse por los profesionales. Reconocen dificultad e inexperiencia en el abordaje del paciente. Se concluye en que hay necesidad de educacion permanente sobre nuevos servicios y adaptaciones de los existentes para la atencion del area.UNLABELLED This qualitative exploratory study was conducted in 2008, at a Municipal Emergency Care Center in Curitiba. OBJECTIVE to learn about the conception of the nursing team about emergencies in mental health, and analyze how the nursing team approaches users with mental disorders in cases of emergency. Participants were 6 nurses and 7 nursing technicians working in emergency and hospitalization. Data collection was performed using semi-structured interviews and organized into thematic categories. Participants considered psychiatric emergencies as situations that may threat their own lives or that of others. The emergency characteristics they mentioned were: aggressive and agitated behavior, suicide attempt and substance abuse. The first impression of the patients behavior and an attempt to have conversation determine the conducts adopted by the professionals. They recognize their difficulty and lack of preparation to approach the patient. In conclusion, there is a need for permanent education on new services and for adjustments to existing services for care in this area.

A aplicação do método do arco da problematização na coleta de dados em pesquisa de enfermagem: relato de experiência

This study was developed with 152 employees of a psychiatric hospital of the state network of Parana in 2008. Aim: to report the experience of applying the Arch Method in the data collection of a nursing study. The data used for the description of the experience were obtained through the application of the Arch Method. The development of the steps of this method requires critical analysis and reflection of the study object and well-designed planning so that the results are achieved. The experience of applying the Method in the research to construct a benchmark for mental healthcare allowed the reflection-action-reflection, from the experiences of the work quotidian of the subjects, and presented a possibility for research data collection It contributed to the humanization of the care provided and mobilized those involved for the significant learning of the reality, in a dynamic and complex form. DESCRIPTORS: Methodology. Data collection. Research. Nursing.Estudio desarrollado con 152 trabajadores de un hospital psiquiatrico de la red estatal del Parana, Brasil, en 2008. Objetivo: relatar la experiencia de la aplicacion del Metodo del Arco en la colecta de datos de una investigacion en Enfermeria. Los datos utilizados para la descripcion de la experiencia se obtuvieron mediante la aplicacion del Metodo del Arco. El desarrollo de las etapas de este metodo requiere analisis juicioso y reflexion del objeto de estudio y un planeamiento bien delineado para que los resultados sean alcanzados.La experiencia de aplicar el Metodo en la investigacion para construccion de un marco de referencia para el cuidado en salud mental permitio la reflexion-accion- reflexion a partir de las experiencias del cotidiano de trabajo de los sujetos, asi como presentar la oportunidad de recoger los datos en la investigacion. Contribuyo para la humanizacion del cuidado prestado y movilizo los envueltos para un aprendizaje significativo de la realidad de forma dinamica y compleja.