SAÚDE MENTAL DE INTERNAUTAS UNIVERSITÁRIOS

O presente estudo teve como objetivo avaliar a saúde mental de internautas universitários. Trata-se de uma pesquisa com delineamento transversal e quantitativa. Participaram deste estudo 150 usuários de internet, dos gêneros, masculino e feminino, com idade entre 17 e 53 anos, estudantes universitários de diversos cursos de graduação da faculdade de saúde, de um único campus, de uma universidade privada, localizada na cidade de São Bernardo do Campo, na região metropolitana de São Paulo. A amostra foi selecionada por critério de conveniência, porém considerou-se a amostragem por cotas para melhor representatividade da população estudada. Os instrumentos utilizados foram o Questionário de Morbidade Psiquiátrica para Adultos (QMPA) e um questionário complementar desenvolvido para caracterização da amostra. Após coleta, os dados foram lançados e tratados estatisticamente. Os resultados mostraram prevalência de saúde mental em 58% dos internautas universitários. Entre os participantes que apresentaram sintomas de morbidade psiquiátrica (42%) prevaleceram os sintomas de exaltação do humor, ansiedade, somatização, irritabilidade e depressão, sintomas comumente referidos como transtornos psiquiátricos menores. Dos internautas estudados 55% foram considerados usuários pesados por utilizarem a internet acima de 60 horas mensais. A média de horas de acesso à internet apresentou correlação com os sintomas de morbidade psiquiátrica avaliados. Contudo estes sintomas de morbidade psiquiátrica não apresentaram diferenciação entre tipo de usuário (pesado e leve), em ambos os casos prevaleceram a avaliação de saúde mental. As horas de acesso à internet foram consideradas um dos indícios do uso patológico da internet, porém insuficiente para estabelecer qualquer diagnóstico. O uso patológico da internet mostrou-se presente em 57% dos internautas, por utilizarem a internet em detrimento de outros aspectos de suas vidas. Os sintomas de morbidade psiquiátrica apresentaram correlações positivas e significativas com as questões sobre o uso patológico da internet. Os resultados desta pesquisa sugerem que o uso patológico da internet revela-se como um novo campo de expressão de morbidades psiquiátricas já conhecidas. Deste modo, a internet não se mostra como um fator de risco para saúde mental de seus usuários. Ela seria um amplificador, uma ferramenta que facilitaria a expressão de tais comportamentos patológicos, que são provenientes de transtornos já existentes, assim como a utilização de diversas outras práticas sociais, que podem se tornar patológicas pela manifestação de diferentes transtornos do indivíduo.

As ações em saúde mental nos Núcleos de Apoio à Saúde da Família - NASF

The National Police for Basic Care (PNAB), regulated by ordinance nº2488 from October 2011, restates the Family Health Strategy (ESF) as a priority to the expansion, consolidation and qualification of basic attention to health matters in Brazil. In order to bring it about, city counsellors along with other federal entities ought to ordinate their work process deepening principals, directions and fundaments of Basic Care (AB). Besides ESF, the new PNAB expatiates on the Family Health Support Centres (NASF), reaffirming their role on broadening the scope of basic care actions and their improvements, ratifying their ability to share knowledge and support Basic Care professionals. All this considered, the purpose of this work is to investigate how NASF is currently structured in João Pessoa and what has been achieved by it on what concerns to mental health. Its main objectives are to analyse the practices of mental health professionals that are part of NASF teams and if they differ from what has been developed by the other members of the teams; to discuss the articulation of NASF in managing mental health measures on what concerns to internal organisatio n and to the city health network; to identify strategies used to organise such measures on mental health in Basic Care. To reach such goals, individual interviews have taken place two city health managers and four of NASF professionals that participated on the Mental Health Office as representatives of their sanitary districts. Also a focal group formed by various supporters of NASF was created, contemplating the diversity of professional categories involved with the teams and sanitary districts. It was possible to identify in NASF, in João Pessoa, an organisation based by the matrix support in which both management and basic care demands reflect a series of actions developed alongside with ESF. Amongst such actions, matrixing, home visits and the Singular Therapeutic Project (PTS) stand out. These activities have been discussed on the focal group and integrate the daily work of all NASF supporters despite their professional categories. NASF presents itself as a powerful strategy to SUS proper qualification and support to strengthen Basic Care and broaden family health teams‟actions.

A produção do cuidado no período gravídico-puerperal: experiência de mulheres usuárias de serviços públicos de saúde

Despite numerous government projects aimed at reorganizing and qualifying obstetric and neonatal care in Brazil, it remains problematic, with repercussions for maternal and newborn mortality and humanized care of both the mother and child. The objective of this study was to analyze the care provided to women during the pregnancy-puerperium cycle, based on reports of public health service users regarding their pregnancy and delivery experiences, using comprehensiveness and humanization as reference. The study applied a qualitative approach and the methodological strategy consisted of listening to the women, in order to identify, based on the meanings of their discourse concerning their experiences with health services, continuities and discontinuities of care during the pregnancy-puerperium cycle. Study participants were women who gave birth at a municipal public maternity, residents of Natal, Brazil, who at the time of the interviews, were between 10 and 42 days postpartum. Seven women reported their pregnancy and delivery experiences at public services. As interviews and observation took place, the material produced was also analyzed, in order to achieve simultaneous production and data analysis. Using systematization, a dialogue was established between the women’s discourses and production in the field of Collective Health, with respect to concepts and discussion about obstetric and neonatal care as well as the Comprehensiveness and Humanization of such care. Participant discourses underscored aspects related to prenatal care starting at pregnancy and its repercussions as well as prenatal monitoring by health services; aspects associated with care during labor and delivery, as well as those involved in postpartum in the maternity, both with respect to newborn and maternal careç and lastly, puerperium care after discharge from the maternity. Analysis of results sought to identify lines of continuity and discontinuity in the comprehensiveness and humanization of care. Based on these lines and as final contributions of the study, the following paths were proposed to achieve comprehensive and humanized production of health care for women during the pregnancy-puerperium cycle: Path 1- Reassess care in the maternal and newborn health network, aimed at comprehensiveness in terms of guaranteeing access to the various services and technological resources available to enhance health and life. Path 2- Reorganize work processes in order to attain comprehensive and humanized care for women in the pregnancy-puerperium cycle. Path 3 – Qualify the professional-user relationship in care management during the pregnancy-puerperium cycle. Path 4 – Invest in the qualification of communication processes in the different dimensions of care during the pregnancy-puerperium cycle.

A produção do cuidado no período gravídico-puerperal: experiência de mulheres usuárias de serviços públicos de saúde

Despite numerous government projects aimed at reorganizing and qualifying obstetric and neonatal care in Brazil, it remains problematic, with repercussions for maternal and newborn mortality and humanized care of both the mother and child. The objective of this study was to analyze the care provided to women during the pregnancy-puerperium cycle, based on reports of public health service users regarding their pregnancy and delivery experiences, using comprehensiveness and humanization as reference. The study applied a qualitative approach and the methodological strategy consisted of listening to the women, in order to identify, based on the meanings of their discourse concerning their experiences with health services, continuities and discontinuities of care during the pregnancy-puerperium cycle. Study participants were women who gave birth at a municipal public maternity, residents of Natal, Brazil, who at the time of the interviews, were between 10 and 42 days postpartum. Seven women reported their pregnancy and delivery experiences at public services. As interviews and observation took place, the material produced was also analyzed, in order to achieve simultaneous production and data analysis. Using systematization, a dialogue was established between the women’s discourses and production in the field of Collective Health, with respect to concepts and discussion about obstetric and neonatal care as well as the Comprehensiveness and Humanization of such care. Participant discourses underscored aspects related to prenatal care starting at pregnancy and its repercussions as well as prenatal monitoring by health services; aspects associated with care during labor and delivery, as well as those involved in postpartum in the maternity, both with respect to newborn and maternal careç and lastly, puerperium care after discharge from the maternity. Analysis of results sought to identify lines of continuity and discontinuity in the comprehensiveness and humanization of care. Based on these lines and as final contributions of the study, the following paths were proposed to achieve comprehensive and humanized production of health care for women during the pregnancy-puerperium cycle: Path 1- Reassess care in the maternal and newborn health network, aimed at comprehensiveness in terms of guaranteeing access to the various services and technological resources available to enhance health and life. Path 2- Reorganize work processes in order to attain comprehensive and humanized care for women in the pregnancy-puerperium cycle. Path 3 – Qualify the professional-user relationship in care management during the pregnancy-puerperium cycle. Path 4 – Invest in the qualification of communication processes in the different dimensions of care during the pregnancy-puerperium cycle.

Cuidado psicossocial em saúde mental: estudo em assentamentos rurais do Rio Grande do Norte

Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people’s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

Cuidado psicossocial em saúde mental: estudo em assentamentos rurais do Rio Grande do Norte

Dwellers of agrarian reform settlements have a life conditioned by poor living and work conditions, difficulties accessing health programs, social assistance and other public policies and by this exacerbating their psychosocial and environmental vulnerability, which has an impact on their mental health. This research investigates the availability of support by the health and social assistance staff, regarding the demands of common mental disorders and alcohol abuse of dwellers of nine settlements in Rio Grande do Norte. Fifty three experts from different professional categories were interviewed individually or in groups. The results indicate that the workers suffer from poor working conditions, attributes of patrimonial heritage and welfare, which still survives in Brazilian social policies and particularly at local administrations of the countryside. The staffs have little knowledge of the local conditions and of the mental health needs, which has a negative impact on the reception and offered care. The implemented health care still corresponds to the biomedical logic, characterized by ethnocentrism, technicality, biology, cure, individualism and specialization, with little participation of the dwellers and disregarding the traditional knowledge and practices of local health care and by this not achieving the expected results. The psychosocial attendance is not well coordinated, presenting problems with the follow-up and continuity of care. The psychosocial mental health care in rural context has to face the challenge of the reorganization of the health care networks, the establishment of primary health care close to the people’s everyday life, building intersectional practices considering a health multidetermination and health education connected to these specific contexts. Due to the lack of knowledge of the specifics of the life conditions of the dwellers and the fragmentation of the psychosocial health care network, these staffs do not abide and are not ready to face the mental health needs in order to interfere with these health iniquities.

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Representações Sociais da Doença Mental: um estudo qualitativo com profissionais da Saúde Mental

Este trabalho pretende conhecer as representações sociais de Psiquiatras, Internos de Psiquiatria, Pedopsiquiatras e Psicólogos Clínicos sobre a doença mental em quatro dimensões: (1) conceptual – conceitos de saúde e doença mental, (2) explicativa – causalidade da doença mental (3) interventiva – modelos de intervenção e objetivos da prática clínica, e (4) contextual – influência do contexto na prática clínica. É um estudo qualitativo de carácter exploratório, pontuado epistemologicamente pelo construcionismo social e teoricamente pelo quadro das representações sociais. Participaram 30 profissionais (13 Psicólogos, 10 Psiquiatras, 5 Internos de Psiquiatria e 2 Pedopsiquiatras) aos quais foi aplicada uma entrevista semi-estruturada que foi analisada quanto ao seu conteúdo (através do software NVivo 10). Da análise dos resultados salienta-se que as representações dos profissionais quanto à conceptualização da doença mental são heterogéneas. A saúde mental é equacionada como flexibilidade, adaptação, funcionalidade e bem-estar biopsicossocial do indivíduo. A causalidade atribuída à doença mental assenta no modelo interacionista biopsicossocial. Quanto à intervenção, os participantes utilizam estratégias e modelos de intervenção ecléticos, salientando-se como objetivos a promoção do bem-estar e diminuição do sofrimento, a promoção do funcionamento e autonomia e a “cura”. O contexto institucional surge como comprometedor da liberdade de atuação na prática pública e como facilitador da liberdade de atuação do clínico na prática privada. Conclui-se que a análise individual (disposicional) do comportamento patológico é privilegiada em detrimento da análise contextual (situacional). Implicações do presente estudo para o quadro teórico das representações sociais da doença mental são consideradas. / The present aims to acknowledge the social representations about mental disease of Psychiatrists, Psychiatrist Interns, Child Psychiatrists and Clinical Psychologists. Four dimensions were considered: (1) conceptual - concepts about health and mental disease; (2) descriptive – mental disease causes; (3) intervention – models for clinical intervention and clinical procedures; and (4) context – influence of the context in clinical procedures. A qualitative and exploratory study was developed based, epistemologically, on social constructionism and social representations. Through the course of the research 30 semi-structured interviews were conducted (13 psychologists, 10 psychiatrists, 5 Internal Psychiatry and 2 child psychiatrists) to which it was applied a semi-structured interview. A content analysis of the interviews was performed by NVivo 10. Results showed that the social representations of mental disease are heterogeneous. Mental health is conceptualized according to the flexibility, adaptation, functionality and the biopsychosocial well-being of the individual. The causality of mental disease is explained by the interactionist biopsychosocial model. Professionals mainly adopt eclectic intervention models and strategies in clinical practice. Participants refer that their goals are to promote the well-being, diminish the suffering and promote the functioning, the autonomy and “cure”. The public institutional framework compromises the flexibility in the clinical procedures. Private practices increases the procedural possibilities of the professionals. Concludes that the individual analysis (dispositional) of the pathological behavior is privileged in detriment of the contextual analysis (situational). Implications of this study to the theoretical framework of social representations of mental illness are considered.

Literacia em saúde mental acerca da depressão e abuso de álcool de adolescentes e jovens Portugueses

RESUMO Objetivo: Este estudo tem como objetivos comparar a literacia em saúde mental dos adolescentes e jovens portugueses, relativamente à depressão e ao abuso de álcool e analisar o padrão de respostas em termos de consistência e concordância para ambas as perturbações. Método: A amostra é constituída por 4938 adolescentes e jovens, 43,0% do sexo masculino e 56,7% do sexo feminino, com uma média de idades de 16,75 anos (desvio padrão = 1,62 anos), que frequentam as escolas do 3.º ciclo do ensino básico e do ensino secundário, pertencentes à Direção Regional de Educação do Centro. Para a colheita de dados foi utilizado o QuALiSMental (LSM). Resultados: Os resultados revelam um nível de LSM modesto na generalidade das componentes. Ainda que se encontrem diferenças estatisticamente significativas (p < 0,05) em 88,0% dos itens da LSM, o que indicia diferentes formas de encarar ambos os problemas de saúde mental, os resultados revelam consistência, em termos das componentes conhecimentos e competências para prestar a primeira ajuda e apoio aos outros e conhecimentos acerca do modo de prevenção das perturbações mentais. ABSTRACT Objectives: This study aims to compare mental health literacy of adolescents and young Portuguese in what concerns depression and alcohol abuse and analyzes the pattern of responses in terms of consistency and agreement for both disorders. Method: The sample consisted of 4938 adolescents and young people, 43.0% males and 56.7% females with a mean age of 16.75 years (standard deviation = 1,62 years), who attend schools of the 3rd cycle of basic education and secondary school, belonging to the Regional Education Directorate – Center. For data collection was used QuALiSMental (MHL). Results: The results showed a modest level of MHL in most components. Although there are statistically significant differences (p < 0.05) in 88.0% of the items of MHL, suggesting different ways of looking to both mental health problems, the results show consistency in terms of the components of knowledge and skills to providing first aid and support to others and knowledge about the prevention of mental disorders.

Centro de dia e lar: saúde mental de idosos e capacidade para o trabalho dos seus cuidadores formais

O Envelhecimento da população é uma realidade cada vez mais presente na nossa sociedade. A investigação junto da população idosa e dos seus cuidadores requer que sejam criadas condições para que, estes grupos, possam usufruir de uma boa qualidade de vida. Propõe-se analisar a capacidade de trabalho dos cuidadores formais de idosos em contexto institucional mas com modalidades de trabalho distintas, no Centro de Dia, onde praticam um horário diurno e fixo, em paralelo com o horário por turnos rotativos diurnos/noturnos praticados no Lar. Foi proposto também analisar o estado mental dos idosos dessas mesmas instituições. A amostra deste estudo contou com 90 participantes dos quais 50 idoso e 40 cuidadores formais. Utilizou-se para a recolha de dados com os idosos o MMSE – Mini-Mental State Examination e a GDS-30 – Escala de Depressão Geriátrica, com os cuidadores a Escala de Graffar e o ICT – Índice de Capacidade para o Trabalho. Os resultados demonstraram não existirem diferenças significativas ao nível da demência e da depressão entre os idosos do Lar e do Centro de Dia. Outros resultados refletiram, para os cuidadores formais, uma capacidade para o trabalho excelente, ligeiramente superior aos dados de referência. Não foi conseguida uma relação entre a saúde mental dos idosos e a capacidade de trabalho dos seus cuidadores formais o que pode retratar o sucesso das medidas de apoio e educação desenvolvidas nesta área.

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Saúde Mental e Pessoas Sem Abrigo

A situação das pessoas sem abrigo implica uma abordagem interdisciplinar onde as intervenções de saúde mental comunitária têm um especial relevo.Esta comunicação teve como objectivo sintetizar os objectivos e modelos de intervenção comunitária em saúde mental, tendo como foco, a promoção da saúde, a prevenção de DMG e a reinserção social de pessoas em situação de sem abrigo.

CIÊNCIA ONLINE - A UTILIZAÇÃO DE E-QUESTIONÁRIOS NA PESQUISA EM ENFERMAGEM DE SAÚDE MENTAL

O número de questionários online com finalidade de colheita de dados para investigação científica tem aumentado drasticamente nos últimos anos, devido à exponencial disseminação da utilização da internet e das redes sociais. Este facto observa-se também na investigação em Enfermagem de Saúde Mental. Este artigo pretende analisar de forma crítica as questões éticas, metodológicas e os procedimentos na realização de pesquisa online na área da saúde mental. Apresentam-se algumas propostas e recomendações para que este tipo de pesquisa seja realizada com rigor metodológico e possa contribuir para o desenvolvimento da investigação em enfermagem.