Maria Conceição Bernardo de Mello e Souza

A doença mental sob o olhar de pacientes e familiares

With the aim of studying the comprehension of mental illness of patients and their families, we conducted a bibliographical study of articles in Brazilian periodicals, theses and dissertations in the period between 1993 and 2003. The identification of the sources was done through the automated search systems Latin American Literature on Health Sciences (LILACS) and the University of Sao Paulos Bibliographic Data Bank On-line Global Catalog (DEDALUS). Nineteen papers were selected and four categories identified: family difficulty in the relationship with the patient; prejudice and stigma; organic/biological explanation for the illness; and fear and pain of insanity. Most of the papers show that, regarding assistance, there is a need for support and expansion of the public health system in order to meet the demands. It is believed that the number of publications is small considering the importance of the problem, showing the need for new research.With the aim of studying the comprehension of mental illness of patients and their families, we conducted a bibliographical study of articles in Brazilian periodicals, theses and dissertations in the period between 1993 and 2003. The identification of the sources was done through the automated search systems Latin American Literature on Health Sciences (LILACS) and the University of São Paulos Bibliographic Data Bank On-line Global Catalog (DEDALUS). Nineteen papers were selected and four categories identified: family difficulty in the relationship with the patient; prejudice and stigma; organic/ biological explanation for the illness; and fear and pain of insanity. Most of the papers show that, regarding assistance, there is a need for support and expansion of the public health system in order to meet the demands. It is believed that the number of publications is small considering the importance of the problem, showing the need for new research.

Relacionamento terapêutico e ensino de enfermagem psiquiátrica e saúde mental: tendências no Estado de São Paulo

Este estudo apresenta um panorama sobre a insercao da tematica do relacionamento terapeutico e da comunicacao terapeutica no ensino de graduacao em enfermagem, mais particularmente nas universidades publicas do Estado de Sao Paulo. Trata-se de uma pesquisa qualitativa e descritivo-analitica. O instrumento de coleta de dados foi um questionario aplicado a professores da area de enfermagem psiquiatrica e saude mental das nove escolas do Estado, sendo que oito devolveram o questionario preenchido. Os dados foram agrupados levando-se em consideracao a instituicao, as disciplinas, os conteudos abordados, os objetivos das atividades praticas e campos praticos. Verificamos que a maioria das escolas aborda o relacionamento terapeutico em suas propostas de ensino, configurando-se como uma possibilidade de se resgatar a enfermagem enquanto profissao que se preocupa com o ser humano em sua complexidade, em que o saber-fazer preconizado e direcionado ao respeito das limitacoes, potencialidades, necessidades e relacoes interpessoais dos pacientes.

Diabetes Mellitus: desafios relacionados ao autocuidado abordados em Grupo de Apoio Psicológico

The purpose was to identify the feelings of users associated with the diagnosis of Diabetes Mellitus (DM), the difficulties inherent of glycemic control and coping strategies adopted in face of the demands imposed by the disease. Qualitative study carried out with patients followed by a multiprofessional team group in a research center from a university in Ribeirão Preto, SP, Brazil. Four group sessions, that were audio recorded and transcribed, constituted the corpus of research. The thematic analysis led to the categories: feelings aroused from the diagnosis of DM; difficulties in controlling the disease and coping strategies. The results showed different ways of dealing with the challenges posed by the disease on the diary activities, that directly influence on the treatment adherence and factors which are relevant for the design of more effective interventions.El objetivo fue identificar los sentimientos de los usuarios asociados con el diagnostico de Diabetes Mellitus (DM), las dificultades inherentes al control de la glucemia y las estrategias adoptadas en la cara de las exigencias impuestas por la enfermedad. Estudio cualitativo realizado con un grupo de personas atendidas por el equipo multidisciplinario en un centro de investigacion y extension de la universidad en Ribeirao Preto, SP, Brasil. Fueron audio grabadas y transcritas cuatro sesiones de grupo, que constituye el corpus de la investigacion. El analisis tematico dirigido a las categorias: sentimientos que a partir del diagnostico de la DM, las dificultades en el control de la enfermedad y las estrategias de afrontamiento. Los resultados muestran diferentes maneras de lidiar con los desafios planteados por la enfermedad los procesos que influyen directamente en la adherencia al tratamiento y los factores que son relevantes para el diseno de intervenciones mas eficaces.

Reflexões sobre o ensino de dinâmica de grupo para alunos de graduação em enfermagem

Este artigo resgata, descreve e remete a uma reflexao sobre nossa experiencia com o ensino de dinâmica de grupos para graduandos de enfermagem, iniciada em 1992. Focaliza a questao da enfermagem e o trabalho com grupos; a estrutura, conteudo e desenvolvimento da disciplina.

Cotidiano de portadores de esquizofrenia após uso de clozapina e acompanhamento grupal

Este estudio describio el punto de vista de los portadores de esquizofrenia en su cotidiano despues del uso de clozapina y acompanamiento en grupo. La muestra fue constituida por 11 portadores de esquizofrenia que participaron del grupo de medicacion clozapina del Hospital das Clinicas de Ribeirao Preto/USP. Para la coleccion de datos se utilizo una entrevista orientada por guion, en abril de 2003. Las entrevistas fueron registradas y despues transcritas por entero. Los resultados indicaron la mejoria de los pacientes con respecto a los sintomas de la enfermedad, evidenciada por la disminucion del aislamiento social, recomienzo de actividades domesticas/trabajo, estudio y participacion en actividades de convivencia social. Tales resultados senalan la necesidad de una nueva manera de mirar el portador de trastorno mental y sus familiares en el sentido de buscar actitudes terapeuticas que actuen en la produccion de vida, en un nuevo sentido para la existencia, en las diferentes formas de convivencia y de sociabilidad.

Ações de enfermagem no cenário do cotidiano de uma instituição psiquiátrica

This qualitative study had the purpose to observe and describe nursing actions performed by nurses at a state psychiatric institution. Eight nurses who work in the institution participated in the study. In order to collect data, authors used participant observation and registration in a field record book. The discussions regarding the results were based on research about nursing practice in psychiatric institutions. Data evidenced that nursing actions were predominantly bureaucratic and administrative and that the professionals studied did not have a defined position about the need to perform interventions in the nursing care provided in this institution.This qualitative study had the purpose to observe and describe nursing actions performed by nurses at a state psychiatric institution. Eight nurses who work in the institution participated in the study. In order to collect data, authors used participant observation and registration in a field record book. The discussions regarding the results were based on research about nursing practice in psychiatric institutions. Data evidenced that nursing actions were predominantly bureaucratic and administrative and that the professionals studied did not have a defined position about the need to perform interventions in the nursing care provided in this institution.

Grupos realizados por enfermeiros na área de saúde mental

Este articulo tuvo por objetivo realizar una revision de la literatura nacional sobre el trabajo en grupos realizados por enfermeros en el area de salud mental, en el periodo de enero de 1994 a abril de 2004. La identificacion de las fuentes fue realizada a traves de los sistemas informatizados de busqueta Literatura Latinoamericana de Ciencias de la Salud (LILACS) y el Banco de Datos Bibliograficos de la USP - Catalogo on-line Global (DEDALUS). Fueron encontrados 38 trabajos, 17 del area de enfermeria y seis especificamente sobre el trabajo en grupo realizado por enfermeros en el area de salud mental. Los seis articulos fueron analizados segun: el tipo de grupo; la coordinacion; los integrantes; local y objetivo de la formacion. Se constato que existe la necesidad de la preparacion del enfermero para la realizacion de esa actividad, delante de la relevancia de esa estrategia para la asistencia de enfermeria en salud mental. Existe la necesidad de nuevas publicaciones mediante al numero pequeno de publicaciones sobre la tematica.

Enfermeiros assistenciais das instituições psiquiátricas de Ribeirão Preto: caracterização, formação e atuação

This is a quanti-qualitative study that had the purpose to characterize nurses who work in psychiatric institutions at the city of Ribeirao Preto, focussing on their education, identifying nursing actions that those professionals perform daily and finding out about practice and knowledge that they consider specific to their area. The discussions on the results were based on authors who study psychiatric nursing teaching and research. Data evidenced a sample mainly formed by adult women, with a reasonable period of service in the area. The majority of the professionals did not search for specialization or continuing education courses and did not participate in training courses and scientific events. Among the actions that nurses perform daily, the bureaucratic-administrative ones are emphasized. They mentioned some themes such as specific knowledge on psychiatric nursing, especially therapeutic relationship. They also pointed out some difficulties and facilities they found regarding their professional education and knowledge updating.This is a quanti-qualitative study that had the purpose to characterize nurses who work in psychiatric institutions at the city of Ribeirao Preto, focussing on their education, identifying nursing actions that those professionals perform daily and finding out about practice and knowledge that they consider specific to their area. The discussions on the results were based on authors who study psychiatric nursing teaching and research. Data evidenced a sample mainly formed by adult women, with a reasonable period of service in the area. The majority of the professionals did not search for specialization or continuing education courses and did not participate in training courses and scientific events. Among the actions that nurses perform daily, the bureaucratic-administrative ones are emphasized. They mentioned some themes such as specific knowledge on psychiatric nursing, especially therapeutic relationship. They also pointed out some difficulties and facilities they found regarding their professional education and knowledge updating.

Produção da enfermagem psiquiátrica no Brasil, 1932-1993

La propuesta de este trabajo fue la de realizar un estudio bibliografico de la produccion de la enfermeria psiquiatrica de Brasil comprendido entre 1932 al 1993. Para eso se recogieron las publicaciones que habia en ese campo, en periodicos nacionales, Anales de los Congresos Brasilenos de Enfermeria y Catalogos del Centro de Estudios e Investigaciones en Enfermeria de la Asociacion Brasilena de Enfermeria. Ademas, se seleccionaron publicaciones de los siguientes eventos: III Encuentro de Investigadores en Salud Mental y II Encuentro de Especialistas en Enfermeria Psiquiatrica, Jubileo de Oro de Graduacion en Enfermeria y Encuentro Nacional de los Hospitales de Ensenanza. Una vez concluido el levantamiento, las discuciones se pautaron por las tematicas centrales de los textos y por el desarrollo historico de la Enfermeria Psiquiatrica en el pais.The present research aims at studying the psychiatric nursing bibliographical production in Brazil, from 1932 to 1993. Therefore, the authors searched national journals, annals of the Brazilian Nursing Congresses, Annals of the National Seminars on Nursing Research and Catalogues of the Brazilian Nursing Association--Center of Nursing Studies and Research. In addition, the authors selected publications of the following events: III Meeting of Researchs on Mental Health, II Meeting of Specialists on Psychiatric Nursing, Nursing Undergraduation Golden Jubilee and National Meeting of University Hospitals. After the conclusion of this study, discussions were based on the central themes of the texts as well as on historical development of Psychiatric Nursing in Brazil.

O PREPARO DE ENFERMEIROS QUE ATUAM EM GRUPOS NA ÁREA DE SAÚDE MENTAL E PSIQUIATRIA

Resumen Introducción: el trabajo en grupo ha sido enfatizado porque ofrece la posibilidad de promover la rehabilitación psicosocial de las personas con trastornos psíquicos. Objetivo: identificar cómo ocurre la formación del enfermero en grupos en el área de Psiquiatría y Salud Mental. Métodos: estudio cualitativo de tipo descriptivo y exploratorio. 26 enfermeros participaron en esa pesquisa, todos pertenecientes a la red de servicios de psiquiatría y salud mental. Los datos fueron recolectados a través de entrevistas individuales, siguiéndo un guión con preguntas guía. Para el análisis de los datos, se utilizó la ordenación, la clasificación de los datos y el análisis final. Resultados y discusión: el análisis indicó que el enfermero se desarrolla para actuar en grupos más de forma vivencial, algunos hacen cursos extracurriculares y otros lecturas específicas. Consideraciones finales: existe la necesidad de hacer mayores inversiones durante la formación del enfermero en lo que a la coordinación de grupos se refiere, lo que no difiere de los datos encontrados en la bibliografía a este respecto. Palabras-clave: Salud Mental. Enfermería. Educación en Salud. 1 Enfermeira Especialista e Mestre em Psiquiatria e Saúde Mental pela Escola de Enfermagem da Universidade de São Paulo da USP de Ribeirão Preto/ SP. Brasil. E-mail: luspadini@hotmail.com,2 Professor Doutor do Depar tamento de Enfermagem Psiquiatria e Ciências Humanas da Escola de Enfermagem de Ribeirão Preto – USP. Brasil. E-mail: consouza@eerp.usp.br PESQUISA RESEARCH INVESTIGACIÓN Introduction: Teamwork has been emphasized to enable the promotion of psychosocial rehabilitation of people with psychic disturbances. Objective: to identify how nurse team education happens in the Psychiatric and Mental Health areas. Methodology: qualitative study of descriptive-exploratory. 26 nurses were participants in this research, all of them from the psychiatry and mental health services chain. The data were collected by means of individual interviews, followed by an outline of orientating questions. For the data analysis, the ordination and classification of the data and the final analysis were applied. Results and discussion: the analyses indicated that nurses develop themselves for teamwork mostly in an experience-based way; some take extracurricular courses and do specific readings. Final considerations: there is a need for more investment during the nurses’ training while they are undergraduates, in relation to team coordination, and this does not differ from the data found in the pertinent literature.Introducao: o trabalho em grupo tem sido enfatizado na possibilidade de promover a reabilitacao psicossocial das pessoas com transtornos psiquicos. Objetivo: identificar como ocorre a formacao do enfermeiro em grupos na area de Psiquiatria e Saude Mental. Metodos: estudo qualitativo do tipo descritivo exploratorio. Foram 26 enfermeiros os participantes dessa pesquisa, todos da rede de servicos de psiquiatria e saude mental. Os dados foram coletados por meio de entrevista individual, seguindo roteiro com questoes norteadoras. Para analise dos dados utilizou-se a ordenacao e classificacao dos dados e analise final. Resultados e discussao: as analises indicaram que o enfermeiro se desenvolve para atuar em grupos de forma mais vivencial, alguns fazem cursos extracurriculares e outros, leituras especificas. Consideracoes finais: ha a necessidade de maior investimento durante a formacao do enfermeiro durante a graduacao em relacao a coordenacao de grupos, o que nao difere dos dados encontrados na literatura a esse respeito.