Michele Mandagará de Oliveira

Descrição de oferta e consumo dos psicofármacos em Centros de Atenção Psicossocial na Região Sul brasileira

The description of the supply and use of psychotropic drugs at the Centers for Psychosocial Care (CAPS) is relevant for the effectiveness of assistance from mental health services. The objective was to describe the use and supply of these drugs in CAPS types I and II, in Southern Brazil. This is a cross-sectional study, in which surveys were conducted, in May and June 2006, on the structural aspects of the referred service using charts of 1162 users, and self-applied questionnaires answered by 30 engineers working at CAPS where these users were being monitored. Users were identified as mostly female, adult, middle-aged, low economic status, mainly with a diagnosis of major depression and using antidepressants. It was also found that there might be a lack of distribution and supply of psychotropic drugs in the public health system (SUS) network, which affects the drug therapy of this specialized mental health service, given the socioeconomic conditions of the users.

Limitações de comportamento social entre usuários da Rede de Atenção Psicossocial no sul do Brasil

This cross-sectional study aims to assess through analysis of data suggested by the Social Behavior Schedule (SBS) quantitatively and qualitatively distinguishing between the limitations of social interaction presented by users of substitute services. Analyses were performed of 385 instruments applied to users of Therapeutic Residential Services (SRT) and the Centers for Psychosocial Care (CAPS). Twenty-one items from the Social Behaviour Schedule (SBS, BR). The data indicate that the individuals studied had from zero to 15 social behavior problems, with an average of 2.5 problems per service user with a standard deviation of 2.84. The majority of the sample appeared to have 1-2 problems among those identified by the scale, and the nonspecific behaviors are present in greater proportion in both services, followed by panic attacks among CAPS users and problems with personal appearance and hygiene in SRT users. In this way, the use of tools that make it possible to assess the data on the social aspects of the psychological distress deserves to be encouraged as a way to further research in this area, and rethink ways of effecting social reintegration of these individuals.This cross-sectional study aims to assess through analysis of data suggested by the Social Behavior Schedule (SBS) quantitatively and qualitatively distinguishing between the limitations of social interaction presented by users of substitute services. Analyses were performed of 385 instruments applied to users of Therapeutic Residential Services (SRT) and the Centers for Psychosocial Care (CAPS). Twenty-one items from the Social Behaviour Schedule (SBS, BR). The data indicate that the individuals studied had from zero to 15 social behavior problems, with an average of 2.5 problems per service user with a standard deviation of 2.84. The majority of the sample appeared to have 1-2 problems among those identified by the scale, and the nonspecific behaviors are present in greater proportion in both services, followed by panic attacks among CAPS users and problems with personal appearance and hygiene in SRT users. In this way, the use of tools that make it possible to assess the data on the social aspects of the psychological distress deserves to be encouraged as a way to further research in this area, and rethink ways of effecting social reintegration of these individuals.

Satisfaction with mental health community services among patients' relatives.

Objective:nThis study aims to assess the satisfaction of family members of patients of mental health community services through a tested, validated and previously applied scale in order to allow comparison of results.nnnMethods:nThe results were obtained by applying the scale SATIS-BR to 1242 relatives of patients of 40 mental health community services in Brazil. The average scores of the three subscales of the SATIS-BR scale were compared using the Wilcoxon test. To measure statistical significance for each item of the scale, the Friedman test was applied, considering significant p-value < 0.05.nnnResults:nThe average overall satisfaction score was 4.35 with a standard deviation (SD) of 0.44, with a range varying from 1 to 5. The subscale with the highest score refers to the Results of Treatment, what presents scores of 4.54 with SD of 0.66. As for the other subscales, which refer to Reception and Staff Competence and Service Privacy and Confidentiality had scores of 4.25 (SD: 0.51) and 4.17 (SD: 0.51).nnnConclusion:nThe high level of satisfaction with the service among families of patients highlights the potential of these services and their contribution to the advance of a model of mental health community care, as it seems to be the global trend. The different results between the scales further suggest that the family distinguishes different aspects of the service and evaluates separately, providing a good reference for evaluation studies.

Prevalence of alcohol dependence in psychoactive substances users / Prevalência da dependência de álcool em usuários de substâncias psicoativas / Prevalencia de la dependencia de alcohol en usuarios de sustancias psicoativas

Objetivo: analisar a prevalencia da dependencia de alcool em usuarios de substâncias psicoativas do municipio de Pelotas-Rio Grande do Sul. Metodologia: pesquisa transversal, exploratoria de abordagem quantitativa, recorte da pesquisa intitulada “Perfil dos Usuarios de Crack e Padroes de Uso”. A coleta de dados foi realizada entre outubro de 2011 e outubro de 2012, durante o trabalho de campo da equipe de Estrategia de Reducao de Danos e no Centro de Atencao Psicossocial Alcool e Drogas no municipio de Pelotas. Resultados: Nos dados encontrados foi possivel observar semelhanca entre a prevalencia segundo avaliacao da dependencia do alcool entre o grupo dos homens e o das mulheres, 33,4% e 31,7%, respectivamente. A idade apresentou significância estatistica, sendo o grupo etario entre 30 e 49 anos, o grupo com maior prevalencia (33,1%). Se observou um nivel alto de dependencia de alcool em 32,2% da populacao estudada, assim, e possivel verificar que mais de um terco da populacao estudada faz uso frequente de alcool. Conclusao: A partir dos dados obtidos com a realizacao deste estudo, espera-se que seja possivel contribuir para o desenvolvimento de politicas e do cuidado com os usuarios de substâncias psicoativas. Descritores: Abuso de Alcool. Transtornos Relacionados ao Uso de Alcool. Transtornos Relacionados ao Uso de Substâncias. Usuarios de Drogas.

Ser autônomo: o que os serviços de saúde mental indicam?

OBJECTIVEnTo build qualitative outcome indicators in psychosocial care regarding autonomy from the perspective of users and their families.nnnMETHODOLOGYnThis is an evaluative case study based on the dialectical hermeneutics theoretical framework, conducted at a mental health community service, in the state of Rio Grande do Sul, Brazil. The first stage of data collection occurred between February and July 2014, and consisted of constructing indicators based on qualitative data analysis of the two evaluative studies conducted at this same service. The second stage, between August and September 2014, consisted of validating the indicators constructed through the focus groups with nine users and nine family members.nnnRESULTSnThe users and relatives stated three qualitative indicators related to their autonomy resulting from their insertion in the service. The indicators were better self-management of income, improved everyday activities, and greater bargaining power.nnnCONCLUSIONnThe methodology proved appropriate to create qualitative indicators, from the perspective of the participants, and revealed that the service helps users achieve autonomy.

Socio-affective strategies used by families of women who are crack users

ABSTRACT Objective: to know the socio-affective strategies used by family members during the maternity process of women users of crack. Method: a qualitative study based on semi-structured interviews with five relatives of mothers using crack. The data were produced at the residence of each participant and analyzed using the Content Analysis technique, in the Thematic Analysis modality. Results: some relatives presented an overload in relation to the care of the child and reported that they left their activities aside to provide care and support to the children and users during this process. Conclusion: It is believed that the needs of family members should be prioritized by the health services and also by researchers, especially as they are the main support network for women who use crack during the maternity process. Descritores : Family Relations; Crack Cocaine; Social Support; Pregnancy; Caregivers; Women. RESUMO Objetivo : conhecer as estrategias socioafetivas utilizadas por familiares durante o processo de maternidade de mulheres usuarias de crack . Metodo : estudo qualitativo realizado a partir de entrevistas semiestruturadas com cinco familiares de maes usuarias de crack . Os dados foram produzidos na residencia de cada participante e analisados a partir da tecnica de Analise de Conteudo, na modalidade Analise Tematica. Resultados : alguns familiares apresentaram sobrecarga em relacao aos cuidados da crianca e referiram que deixaram as suas atividades de lado para prestar cuidado e apoio as criancas e as usuarias durante esse processo. Conclusao : acredita-se que as necessidades dos familiares devem ser priorizadas pelos servicos de saude e tambem por pesquisadores, especialmente, por serem eles a principal rede de apoio das mulheres usuarias de crack durante o processo de maternidade. Descritores : Relacoes Familiares; Cocaina crack; Apoio social; Gravidez; Cuidadores; Mulheres. RESUMEN Objetivo : conocer las estrategias socioafectivas utilizadas por familiares durante el proceso de maternidad de mujeres usuarias de crack . Metodo: estudio cualitativo realizado a partir de entrevistas semiestructuradas con cinco familiares de madres usuarias de crack . Los datos fueron producidos en la residencia de cada participante y analizados a partir de la tecnica de Analisis de Contenido en la modalidad Analisis Tematico. Resultados: algunos familiares presentaron sobrecarga en relacion a los cuidados del nino y mencionaron que dejaron sus actividades de lado para prestar el cuidado y apoyo a los ninos y las usuarias durante este proceso. Conclusion : se cree que las necesidades de los familiares deben ser priorizadas por los servicios de salud y tambien por investigadores, especialmente por ser ellos la principal red de apoyo de las mujeres usuarias de crack durante el proceso de maternidad. Descritores : Relaciones Familiares; Cocaina Crack; Apoyo Social; Embarazo; Cuidadores; Mujeres.

Contexto de vida de pessoas usuárias de drogas na perspectiva de gênero

Objetivo: Caracterizar o contexto de vida e vulnerabilidade de pessoas usuarias de drogas na perspectiva do genero. Metodo: Estudo transversal exploratorio com 505 usuarios de drogas. Foram consideradas as variaveis: sexo, perfil socioeconomico e eventos ocorridos no ultimo ano. Resultados: Observa-se que mulheres usuarias de drogas, mesmo em menor numero do que os homens, apresentam maior ocorrencia de violencia sofrida e abuso sexual, perda de seus filhos para o conselho tutelar e mudancas em seus habitos de vida, como o sono. Conclusoes: E necessario refletir a respeito do desenvolvimento de politicas publicas sobre a atencao oferecida para as pessoas que considerem a perspectiva de genero.

FATORES DEMOGRÁFICOS E SOCIOECONÔMICOS ASSOCIADOS AO CONSUMO DE CRACK

Este estudo teve como objetivo verificar a associacao entre os fatores socioeconomicos e demograficos com o consumo de crack. Trata-se de uma pesquisa de corte transversal, com amostra de 505 usuarios, destes 136 usuarios de crack. Utilizou-se os Testes Qui-quadrado, de Pearson e de Tendencia linear para verificar diferencas proporcionais e como medida de associacao foi utilizada a razao de prevalencia. A prevalencia de uso de crack entre os usuarios de drogas foi de 26,9%, e maior no sexo feminino. Observou-se uma associacao positiva entre o uso de crack e as seguintes variaveis: idade entre 25 e 29 anos 10,6 (4,32-25-78), ser autonomo 2,6 (1,91-3,43), morar na casa de amigos 2,6 (1,94-3,43) e divorciado ou separado 2,0 (1,19 - 3,53). Com isso, e essencial conhecer as diferentes variaveis sociais, educacionais, economicas e demograficas que estiveram associadas e, particularmente, investir em estrategias de prevencao ao uso abusivo de crack. Descritores: Cocaina Crack; Vulnerabilidade Social; Prevalencia.

AS ATRIBUIÇÕES DA ENFERMAGEM NO EXERCÍCIO DO ACOMPANHAMENTO TERAPÊUTICO EM UM SERVIÇO RESIDENCIAL TERAPÊUTICO

Objetivo: identificar as atividades e atribuicoes do acompanhamento terapeutico desenvolvidas pela enfermagem em um Servico Residencial Terapeutico. Materiais e Metodos: pesquisa de abordagem qualitativa e descritiva. Foram realizadas entrevistas semiestruturadas, gravadas e transcritas na integra, com 12 acompanhantes terapeuticos da equipe de enfermagem de um Servico Residencial Terapeutico do Rio Grande do Sul. A analise dos dados baseia-se na proposta de analise tematica, sendo investigados e sistematizados a partir das atribuicoes e atividades do acompanhamento terapeutico. Resultados: nota-se que os profissionais de enfermagem que compoem a equipe de acompanhantes terapeuticos do servico possuem um forte potencial cuidador e sao dotados de caracteristicas essenciais para reinsercao social dos sujeitos em sofrimento psiquico. Conclusao: ressalta-se a importância da enfermagem como profissao, uma vez que sua essencia esta no cuidado, que e fundamental para a pratica em saude mental e, principalmente, para o acompanhamento terapeutico.

Minor psychiatric disorders and their associations in family caregivers of people with mental disorders

This study aims to analyze the occurrence of minor psychiatric disorder and their associations in relatives of people with mental disorders. This is a cross-sectional study of 1164 relatives. For the tracking of minor psychiatric disorders the Self-Reporting Questionnaire Scale (SRQ20) was used, adopting 6/8 as cut-off point. Bivariate analyzes were conducted using Chi-squared test. Trends among strata of independent variables were investigated in relation to the outcome using nonparametric linear trend test. Statistic significance was defined as p-value < 0.05. Crude and adjusted binary logistic regressions were conducted using as a basis the hierarchical model developed through a systematic literature review. It was observed in the population a prevalence of 46.9% for minor psychiatric disorders. Higher prevalence of minor psychiatric disorders were strongly associated with the female gender, older age, first degree family ties, not having a paid work, lower education level, lower income, health problems, lower quality of life and feeling of burden. Many factors are related to the emotional and mental illness of family caregivers, demanding health services to be prepared to recognize and intervene in these situations.