Marco Antonio de Castro Figueiredo

Concepções sobre a doença mental em profissionais, usuários e seus familiares

Abstract Concepts on mental diseases held by professionals, users and their families . Transforming mental healthinstitutions has been defying because it is necessary to deconstruct ideologies in all areas of knowledge.Therefore we want to discuss contents, beliefs and values held by professionals, mental health servicepatients and their families in relation to mental health. Reification is a concept of the Social PsychologicalTheory and it has been used to discuss people’s concepts towards mental health. This study has beendeveloped with thirty people: 10 professionals, 10 users and 10 family members in Marilia area (SP)outpatient service. Data were collected in semi-structured interviews, according to a technique developed byFigueiredo (1989). The interviews were a technical adaptation of content analysis. Based on these dataanalysis, the following subcategories were found: emotional instability, loss of normality pattern, biologicalvision, inherited predisposition and stigma. These six subcategories suggested that often mental healthconcepts are stereotyped from acquired knowledge and praxis maintains the

Uma análise de conteúdo de crenças relacionadas com a AIDS entre participantes em O.N.G.s.

Uma amostra de sete sujeitos, pertencentes a Organizacoes Nao Governamentais (ONGs) de Ribeirao Preto, foi entrevistada atraves de procedimentos semi estruturados para verificacao de cognicoes associadas a quatro categorias de conteudos relacionados a AIDS: a doenca em si, o tratamento, o paciente e prevencao. Uma analise de conteudo das entrevistas foi processada sobre avaliacoes feitas por 10 juizes universitarios, com base em procedimentos de calculo das entropias relativas (Hr), tomando-se, como criterio, escores iguais ou inferiores ao percentil 33 das distribuicoes de Hr e verificando-se a fidedignidade dos julgamentos para cada categoria (Zk>3.39; p<.05). Foram identificadas crencas de forte conotacao teleologica (Hr<.29) relacionadas com a morte, a vergonha dentro da familia e o silencio das pessoas para a categoria doenca. A respeito do paciente, apareceram representacoes ligadas ao estigma, perda da cidadania e responsabilidade pela propria condicao (Hr<.35). Confirmando dados de literatura, a visao do tratamento e da prevencao se respalda em crencas altamente socializadas (Hr<.39) que envolvem a participacao da familia e a atribuicao de fortes estigmas por parte dos especialistas que atendem ao paciente.

Vivência profissional: subsídios à atuação em HIV/Aids

No contexto do HIV/Aids, alguns desdobramentos psicossociais sao elementos-chaves para a concepcao de projetos voltados a superacao de dificuldades determinadas pela racionalidade das abordagens especializadas. Este trabalho visou identificar, no processo de atendimento a pessoas com Aids, alguns elementos emergentes da relacao terapeutica, com o objetivo de subsidiar a concepcao de programas de formacao profissional. Entrevistas semiestruturadas com dez profissionais junto a um hospital-escola do interior de Sao Paulo permitiram estabelecer seis categorias tematicas relacionadas ao contexto do atendimento em HIV/Aids: tratamento dispensado, relacao estabelecida, limites da atuacao, abordagens teleologicas, apropriacao do trabalho e contraponto as vivencias da atuacao. Tais resultados demonstram que o atendimento a pessoas com HIV/Aids exige outros elementos, alem do conhecimento tecnico especializado, determinando uma simetria no estabelecimento do vinculo profissional-paciente e viabilizando uma construcao conjunta com o trabalho das equipes.Some psychosocial developments in the context of HIV/Aids are key elements for designing projects focused on overcoming difficulties generated by the rationality of specialized approaches. This study aimed to identify some emerging elements of the therapeutic relation in the process of caring for people with Aids in order to support the development of professional training programs. Semi-structured interviews with ten professionals in a teaching hospital in the interior of Sao Paulo permitted the establishment of six thematic categories related to the context of HIV/Aids care: delivered treatment, established relationship, limits of care, teleological approaches, work ownership and counterpoint to experience of practice. These results reveal that caring for people with HIV/Aids requires other elements in addition to specialized technical knowledge, which in turn generates symmetry in the establishment of bonds between professional-patient, allowing to construct together with the professional teams work.

O Voluntariado em questão: a subjetividade permitida

In many countries, particularly in Brazil, we have observed a stimulus in relation to the volunteer work as a way of the democratization of the State, increasing the participation of all the actors in the serious social problems. Taking into consideration the several faces of the volunteer work, the aim of the present article is to discuss the exercise of these activities and their logical of support through the main axle of identification with the volunteer activity. case studies were carried out in two companies with lucrative ends and in two Non Governmental Organizations. (N.G.Os) in the town of Ribeirao Preto (Sao Paulo State - Brazil). The data showed up that the volunteer work, indirectly, generates value to capital and that we can invest in the autonomy of the Non Governmental Organizations and in the overcoming of the social services models, with particular actions, strengthening collective enterprising of the supportive economy and base social movements. In this analysis, it was considered that the volunteer work is an allowed way of the construction of the subjectivity within the logical of the capital.

Tabalho, HIV/AIDS: enfrentamento e dificuldades relatadas por mulheres

AIDS is among the leading causes of mortality in women of childbearing age, demonstrating the extent to which this infection has reached the female population. This research aimed at understanding the role of work in responding to AIDS among women. The survey was conducted in the Humanitarian Group of Incentive Life (GHIV), with 10 women, aged between 27 and 57 years and duration of seropositivity between 5 and 10 years. Analysis of the contents of the full transcript of the interviews have identified the following themes: meanings of work, psychosocial support prejudice, treatment and absenteeism as a result, work is seen as a place of welcome and support, but also a hostile environment, with prejudice still visible. The need to develop programs in institutions in order to minimize stigmatization and discrimination is seen as an alternative to maintaining the quality of life of people living with HIV.

Desemprego e subjetividade: estratégias de inclusao social e sobrevivência

The structural unemployment is a current phenomenon of the capitalism. The aim of this study was to investigate which are the major effects of the unemployment. A total of 20 study cases were developed with unemployed people; all of them were applying for jobs offered by the National Employment System in Ribeirao Preto (Brazil). Both genders and ages ranging from 35 to 45 years old were accepted for the positions. The results showed some strategies (predominantly individualized) used when facing unemployment situations. These strategies were characterized by the realization of precarious work and search for jobs in specialized organizations. Our results pointed out the necessity of searching new forms of supporting the studied population, considering affective features associated to the unemployment phenomenon and favoring shared actions and not individualized ones.

Estudo qualitativo de crenças relativas aos cuidados domiciliares e à morte entre familiares de portadores de HIV/AIDS e câncer

AIDS and cancer have incited prejudiced attitudes of segregation and fear; however, the constant work of people involved with care taking made respectable and humanitarian life possible to individuals that were taken ill. The present study has the objective of surveying the beliefs of the HIV/AIDS and cancer patients relatives related to death and home care. Therefore separate and semi-structured appointments were done with 15 relatives of HIV sick people and 10 relatives of cancer patients based on procedures of evocation-enunciation-verification to survey the beliefs related to death and home care. The beliefs surveyed demonstrate the lack of preparation and the difficulties that relatives have towards death and care of the patients. It is observed the need of creating projects that would aim emotional advising and aid to patients and relatives as well.

Gestantes Soropositivas ao HIV: Maternidade, Relações Conjugais e Ações da Psicologia

Mudancas no perfil da epidemia de HIV/Aids ampliaram discussoes sobre condicoes materiais e subjetivas de vida e seu impacto como elemento estruturante da vulnerabilidade a contaminacao. Neste contexto, estudar relacoes de genero e submissao das mulheres aos parceiros e relevante para analise da vulnerabilidade entre elas. Este artigo apresenta resultados extraidos de estudo que analisou como mulheres, vulneraveis ao HIV pela propria relacao de genero, lidam com parceiros e com seus direitos reprodutivos. Realizaram-se entrevistas semi-estruturadas com dez gestantes soropositivas ao HIV em atendimento pre-natal em ambulatorio de ginecologia e obstetricia especializado no atendimento a pacientes portadores de doencas infecto-contagiosas, inserido em hospital da rede publica de saude no interior do Estado de Sao Paulo e referencia para a regiao em que residiam as participantes. Os resultados apontam dificuldades a distribuicao do poder nas relacoes de genero como elemento estruturante da vulnerabilidade ao HIV. Entre as participantes, a maioria reconhece a si como vitima da acao de seus parceiros, culpando-os pelo contagio. Aponta-se necessidade de reestruturar praticas de saude no atendimento psicologico a mulheres soropositivas, considerando a necessidade de fortalecimento de recursos cognitivos/afetivos para o enfrentamento das vicissitudes do contagio e consequente ruptura com a naturalizacao como vitimas. Dentre as estrategias para fortalecimento destas mulheres estao: discussao da apropriacao do processo do contagio; problematizacao do aceite tacito da pretensa superioridade masculina e das exigencias do parceiro ou da familia. O efeito da proposta e reconhecer a passividade feminina como elemento de vulnerabilidade das mulheres e fragilidade das praticas preventivas (CAPES)

Determinantes sócio-históricos do cuidado na Estratégia Saúde da Família: a perspectiva de usuários da área rural

O presente estudo teve por objetivo identificar os determinantes socio-historicos atribuidos pelos usuarios as vivencias de cuidado na Estrategia Saude da Familia (ESF) na area rural do municipio de Sacramento/MG. Trata-se de um estudo exploratorio com abordagem qualitativa, utilizando para a coleta de dados a tecnica de grupos focais e para a interpretacao dos resultados, a analise de conteudo. Foram constituidos tres grupos com representantes das familias de tres, dentre seis, povoados rurais, totalizando 36 sujeitos, doze em cada grupo, residentes na area rural e usuarios da ESF ha pelo menos dois anos, escolhidos com base em fichas de cadastro das familias na ESF estudada. Sob a perspectiva do materialismo historico, a analise de conteudo dos grupos foi concentrada em quatro categorias: disponibilidade; acesso a recursos; movimento socialecondicoes materiais. Os resultados demonstraram satisfacao dos usuarios em relacao a disponibilidade da equipe para a atencao, e o tato nas relacoes; engajamento na manutencao das condicoes de saude e atuacao na dimensao socio-historica do processo saude/doenca com objetivo de melhorar as condicoes de vida e trabalho. Houve insatisfacao em relacao ao aspecto organizacional, remetendo a tudo que ainda esta insuficiente, precario ou inexistente nas comunidades. Observou-se na acao da equipe o desenvolvimento de capacidades junto a comunidade que garantiam seus direitos sociais e sua politizacao. Conclui-se que o enfrentamento do processo saude/doenca pela comunidade e equipe da ESF envolve outros elementos, alem do conhecimento tecnico-cientifico, que determinam a simetria do vinculo profissional/usuario viabilizando a producao conjunta de saude na comunidade.

Relações conjugais de parceiros HIV soropositivos concordantes: uma visão masculina

Since females are more vulnerable to HIV infection and since more women have been AIDS-infected, current study identifies representations of conjugal relationships with special reference to males who have transmitted HIV to their wives. Based on semi-structured interviews with 10 serum-positive males who transmitted the disease to their wives, the following thematic categories have been identified: a) male wage-earner who relegated partners work as secondary income; b) active-passive dialectics which counterpoints the contemplative traits of female roles to an initiative-taking one, considered a male role; c) naturalization of male infidelity, with gender asymmetry linked to male sexual freedom; d) female prevalence in caretaking, which emphasizes womens continence traits, naturalized by domestic attributions to women. Results show that important items may be presented towards the development of programs for the orientation and resistance against gender subordination within the context of the womens vulnerability to HIV-Aids infection.Since females are more vulnerable to HIV infection and since more women have been AIDS-infected, current study identifies representations of conjugal relationships with special reference to males who have transmitted HIV to their wives. Based on semi-structured interviews with 10 serum-positive males who transmitted the disease to their wives, the following thematic categories have been identified: a) male wage-earner who relegated partners work as secondary income; b) active-passive dialectics which counterpoints the contemplative traits of female roles to an initiative-taking one, considered a male role; c) naturalization of male infidelity, with gender asymmetry linked to male sexual freedom; d) female prevalence in caretaking, which emphasizes womens continence traits, naturalized by domestic attributions to women. Results show that important items may be presented towards the development of programs for the orientation and resistance against gender subordination within the context of the womens vulnerability to HIV-Aids infection.