Sueli Aparecida Frari Galera

Encontrando-se em casa: uma proposta de atendimento domiciliar para famílias de idosos dependentes*

Objective: This qualitative study intends to identify how a family system reacts before the situation of dependence of a senior family member, which resources it uses to maintain the stability and the nursing attendance made available in this context. Methods: The approach of the family systems was used as the theoretical reference, and action-research as the method. The data were collected in the period from November/2004 to January/2005, through the construction of a genogram, an ecomap and problem definition. Results: Main family demands: anticipated mourning, overload on the role of caregiver, lack of knowledge regarding the disease and family maladjustment before the crisis. Main interventions: motivating the family to speak openly about the illness, offering suggestions and information, praising the family strength and ensuring prompt service. Conclusions: With family attendance as the systemic focus, it was possible to propose

Aplicação do Modelo Calgary para avaliação de famílias de isodos na prática clínica

Este trabajo de investigacion cualitativa tiene como objetivo presentar la experiencia de evaluar familias de ancianos dependientes bajo la perspectiva sistemica. El Modelo Calgary fue utilizado como marco teorico y como estrategia metodologica el estudio de caso. Los datos fueron recogidos con cinco familias de personas mayores dependientes, en el periodo entre septiembre y diciembre de 2005, por medio de instrumento elaborado previamente. El uso de este modelo permitio realizar el analisis familiar a partir de los aspectos principales de su estructura, desarrollo y funcionamiento. Se cree que el enfermero debe buscar el endoso en literatura cientifica y adoptar los instrumentos pertinentes, para contribuir para el desarrollo de sus capacidades para realizar el abordaje familiar.This qualitative study has as objective to present the experience to assessment of the families of dependent aged under the systemic approach. The Calgary Model was used as theoretical framework and as methodological strategy the case study. The data had been collected with five families of dependent older person, from September of December of 2005, by means of the instrument elaborated previously. The application of this model allowed doing the familiar analysis raising the main aspects of its structure, development and functioning. We believe that the nurse must search endorsement in the scientific literature and adopts pertinent instruments to contribute for the development of its abilities to do the familiar approach.

Doentes mentais e seu perfil de adesão ao tratamento psicofarmacológico

Non-compliance with drug-based treatment is a complex and universal phenomenon that develops gradually during psychiatric treatments, and is related to disease aggravation. The purpose of this study was to describe the profile of using a given medication in the clientele of a community mental healthcare service and its characteristics. We performed a retrospective study in the medical records of patients who used Haloperidol Decanoate in a period of 1 year and 8 months. 167 medical records were analyzed. 60% of the patients presented irregular use of medication, which reflects in high risks of relapse and re-hospitalizations. This profile configures low compliance with the prescribed drug treatment, leading to reflections about which factors influence this behavior and which measures could be implemented in the maintenance of extra-hospital treatment for these patients.A nao adesao ao tratamento medicamentoso e um fenomeno complexo e universal que se desenvolve gradualmente no curso dos tratamentos psiquiatricos e esta relacionado ao agravamento das doencas. O objetivo deste estudo foi descrever o perfil de utilizacao de um psicofarmaco na clientela de um servico de saude mental comunitario e suas caracteristicas. Realizamos um estudo retrospectivo, nos prontuarios de pacientes que fizeram uso de Decanoato de Haloperidol, num periodo de 1 ano e 8 meses. Analisamos 167 prontuarios. O uso irregular da medicacao esteve presente em 60% dos pacientes e reflete um grande risco para ocorrencia de recaidas e reinternacoes. Este perfil configura uma baixa adesao ao tratamento medicamentoso prescrito, o que remete a reflexao sobre quais fatores estao influenciando este comportamento e quais medidas podem ser implementadas na manutencao do tratamento extra-hospitalar destas pessoas.

Principais conceitos da abordagem sistêmica em cuidados de enfermagem ao individuo e sua família

With the current emphasis in the family question it is important to discuss some concepts underlying the systemic approach to the family nursing care, which has in the interview with the family its main instrument. In this paper the following concepts are discussed: system, human being, family, familiar health, nursing intervention, hypotheses, circularity, systemic hypothesis and neutrality. It was aimed to supply practical examples that could facilitated the understanding of the concepts, as well as its applicability.Considerando la enfasis actual en la cuestion familia surgio el interes en traer para la discusion algunos conceptos que fundamentan el abordaje sistemico en cuidados de enfermeria, que tiene como principal instrumento la entrevista con lafamilia. Los conceptos discutidos son: sistema, ser humano, familia, salud familiar, intervencion de enfermeria, hipotesis,circularidad, hipotesis sistemica, neutralidad. Se buscd fornecer ejemplos practicos que facilitasen la comprension de los conceptos, bien como su aplicabilidad.With the current emphasis in the family question it is important to discuss some concepts underlying the systemicapproach to the family nursing care, which has in the interview with the family its main instrument . In this paper thefollowing concepts are discussed: system, human being, family, familiar health, nursing intervention, hypotheses, circularity,systemic hypothesis and neutrality. It was aimed to supply practical examples that could facilitated the understandingof the concepts, as well as its applicability.

Women living in a drug (and violence) context: the maternal role

Although the drug problem is more present among men, women are an increasing group and a vulnerable subgroup, since many of them are involved in motherhood. In this paper, the partial results of an ethnographic study on maternal role-related perceptions, beliefs and attitudes are presented, as well as the context in which women with small children and are undergoing or underwent treatment for alcohol or drug addiction live. Mothers undergoing treatment participated in interviews about their maternal role and how it developed in a family context marked by violence, affective experiences and drug use.Although the drug problem is more present among men, women are an increasing group and a vulnerable subgroup, since many of them are involved in motherhood. In this paper, the partial results of an ethnographic study on maternal role-related perceptions, beliefs and attitudes are presented, as well as the context in which women with small children and are undergoing or underwent treatment for alcohol or drug addiction live. Mothers undergoing treatment participated in interviews about their maternal role and how it developed in a family context marked by violence, affective experiences and drug use.

Discurso de los padres sobre el uso de drogas lícitas e ilícitas percibido por estudiantes universitarios

Los problemas asociados al uso de drogas licitas e ilicitas es considerado una epidemia mundial. Aunque se considere el uso drogas una decision individual es importante resaltar que la familia tiene un rol muy importante en la conservacion y cambio de habitos, costumbres y comportamientos entre sus miembros y entre sus generaciones. Los objetivos de esta pesquisa fueran identificar el discurso de los padres sobre el uso de drogas licitas e ilicitas y explorar las convergencias y divergencias entre ellos. Metodo: La investigacion fue realizada a traves de entrevista individual con 13 estudiantes universitarios en la ciudad de Bogota. Los datos fueron analizados con el enfoque de la teoria sistemica del construccionismo y la analice de la narrativa. Entre los resultados se destaca: a) los discursos se inscriben en la cultura patriarcal y en las expectativas de genero, b) tres tipos de discurso de los padres fueron identificados y presentan convergencias e divergencias tipicas de la familia nuclear.

O cuidado em saúde mental na atualidade

The objective of this study was to identify the sociodemographic characteristics of caregivers to people who have been discharged from psychiatric hospitalization. A quantitative exploratory study was performed at an outpatient clinic of a mental health service. The sample consisted of patients who had been discharged and their caregivers. A questionnaire was used, and the study was approved by the local research ethics committee. Of the 48 discharged patients, 21 had a caregiver. All the identified caregivers were relatives of the patients, and their average age was 46.6 years. In 38% of cases, the patients mother was the caregiver. In terms of marital status, 61.9% of the caregivers were married or living in common-law relationships, and only one caregiver did not have children. The main source of income for 28.6% of the participants was temporary keeping eventual jobs. By knowing who is the caregiver of a patient discharged from psychiatric hospitalization it is possible to identify the characteristics that may help to determine the best treatment and professional support for that population.The objective of this study was to identify the sociodemographic characteristics of caregivers to people who have been discharged from psychiatric hospitalization. A quantitative exploratory study was performed at an outpatient clinic of a mental health service. The sample consisted of patients who had been discharged and their caregivers. A questionnaire was used, and the study was approved by the local research ethics committee. Of the 48 discharged patients, 21 had a caregiver. All the identified caregivers were relatives of the patients, and their average age was 46.6 years. In 38% of cases, the patients mother was the caregiver. In terms of marital status, 61.9% of the caregivers were married or living in common-law relationships, and only one caregiver did not have children. The main source of income for 28.6% of the participants was temporary keeping eventual jobs. By knowing who is the caregiver of a patient discharged from psychiatric hospitalization it is possible to identify the characteristics that may help to determine the best treatment and professional support for that population.

Internação psiquiátrica e a manutenção do tratamento extra-hospitalar

O objetivo desse trabalho foi identificar caracteristicas comuns entre pessoas que tiveram alta hospitalar de internacao psiquiatrica recente. Foi realizado um estudo quantitativo exploratorio em um servico ambulatorial de saude mental. A amostra foi composta por pacientes egressos de internacao. Utilizou-se um questionario e a pesquisa foi aprovada pelo CEP. Estrevistou-se 48 pacientes com idade media de 39 anos. Diagnosticos de Esquizofrenia e Transtornos Esquizotipicos foram prevalentes em 33,3% da amostra. Em media treze pacientes recebem alta de internacao psiquiatrica hospitalar ao mes e 62,5% deles tinham internacoes anteriores. No periodo, 12,5% da amostra necessitou de reinternacao. A internacao psiquiatrica demonstrou ser um recurso necessario aos momentos de crise e parte da manutencao do tratamento psiquiatrico, principalmente dos transtornos mentais graves. O que evidencia a necessidade de uma manutencao adequada do tratamento nos servicos de atendimento comunitario para que a necessidade de reinternacoes seja evitada.

Adesão ao tratamento psicofarmacológico

Nesta revisao de literatura procuramos identificar os principais conteudos relacionados a adesao do doente mental ao tratamento psicofarmacologico: definicoes, implicacoes, resultados. Realizamos a revisao bibliografica nas bases Medline e Pubmed com as palavras chave adesao, medicacao antipsicotica e doenca mental. Foram selecionados 52 trabalhos. A maioria deles (73 %) buscou identificar fatores que podem influenciar adesao aos tratamentos. Os 27% restantes buscaram avaliar a influencia de intervencoes profissionais na adesao. Os principais fatores relatados relacionaram-se ao paciente, tipo de medicamento, fatores sociais. Com respeito as intervencoes, aquelas que combinaram estrategias educacionais e comportamentais foram mais eficientes. Descritores: Adesao a diretivas antecipadas; Agentes antipsicoticos; Saude mental; Avaliacao em enfermagem; Enfermagem psiquiatrica

Perception of the mothering role of women who live in a context of drugs and violence

O numero de mulheres envolvidas com drogas esta aumentando e a violencia contra elas tambem. Muitas destas mulheres sao maes. O objetivo deste estudo e investigar a percepcao de mulheres que recebem tratamento para dependencia de droga, vivem em um contexto de drogas e violencia, tem criancas com idade entre um mes e cinco anos e sua interpretacao acerca. Este trabalho individual e multicentrico, envolvendo Colombia e Brasil, apresenta os resultados individuais de Colombia. Foram entrevistadas 6 mulheres. Foi adotado o foco etnografico e as entrevistas foram submetidas a analise de conteudo latente. Os resultados desta pesquisa apresentam a violencia do contexto social-cultural dos participantes e o consumo de drogas no ambiente da familia de origem. Esses aspectos possivelmente induziram ao uso de drogas e influenciaram no papel materno deste grupo de mulheres, que expressam isto como ambivalente, entre a idealizacao de ser mae e ser mae viciada.