Serviço de atendimento móvel de urgência (SAMU) e a assistência às urgências psiquiátricas

The objective of this work which is characterized as an applied research, with a qualitative exploratory approach and has case study character has been the analysis of the conceptions and dealings of health professionals of SAMU in Natal RN about the attendance of psychiatric urgencies. The information was collected between the months of March and April of 2010, by means of semi-structured interviews, performed with 24 health professionals integrating of SAMU-Natal as well as the usage of direct observation technique, performed in the institution's medical regulation room. Both the number of professionals involved in the interviews and the bringing about of the observations, were determined by saturation methods in qualitative research's information collecting. The interviews and observations were transcribed and submitted to contents analysis technique , more specifically, to thematic analysis, which made possible to reach the deepest levels, that go beyond what has simply been manifest in the speech of the interviewed, getting to the relations among the categories and social structures of the issue of the research. Keeping this in mind, three analysis categories have been built, namely: conceptions and concepts of psychiatric urgencies shared by health professionals in SAMU-Natal; attendances to psychiatric urgencies in SAMU-Natal; and the Brazilian Psychiatric Reformation under the view of the SAMU-Natal's health professionals. Reflection about the analyzed information revealed discussions pertaining to the stigma and prejudice on mental illness, and also, pointed out to some hindrances which impair the attendance to individuals in mental suffering in SAMU-Natal. The interviewed health professionals' conceptions on the individual in psychical crisis involve concepts of unpredictability, aggressiveness and risk, stigmatizing elements and historically associated to the social hazard ideology and need for mentally sicks' segregation. The predominance of these conceptions, seen in health professionals speech, had identifiable reflexes on assistance to psychiatric demands performed by SAMU-Natal, namely: indiscriminate request for military police's presence during psychic crisis intervention, neglect about occasions that involve mental health patients, as well as repetitive assisting practice directed on physical contention, and transportation to psychiatric hospital. Associated to it, the professionals have shown distorted and reductionist understanding about Brazilian Psychiatric Reformation, and, in the majority, haven't lent credibility to present model of attention to mental health, based on psycho-social treatment, pointing their speech to a need for psychiatric patient's internment. In this sense, we notice that the hospital-centered and excluding model conceived by classical psychiatry still remains alive in these health professionals' mentality as a reference to psychiatric urgency's assistance. Therefore, the research revealed a sequence of elements, that make us think about the challenges that health sector and society must face to realize Brazilian Psychiatric Reformation's principles and guidelines

Problematizando a Reforma Psiquiátrica na atualidade: a saúde mental como campo da práxis

Mental Health, in the form of the Psychiatric Reform, and the Anti-Asylum Movement do not ignore the production of knowledge about that field, mainly due to the consolidation of Public Health as a field of knowledge. The article explores some authors who consider Mental Health as a new field of knowledge, introducing a new paradigm in the perception of health - Disease and Care -; however, the goal is to introduce Psychosocial Care as a means to enforce the transdisciplinary and multiprofessional practices. The possibility is that mental health produces developments in Health, consolidating the public policies. In practice, the hospital-centered and drug-based model still predominates, and there are setbacks to be overcome by taking advantage of loopholes capable of breaking with what is instituted.

Resiliência no trabalho contemporâneo: promoção e/ou desgaste da saúde mental

Este estudo teórico resgata a concepção processual e contextual de resiliência, a qual compreende esse fenômeno enquanto relação complexa entre indivíduo e ambiente na produção de fatores de risco e no provimento de fatores protetores da subjetividade do indivíduo, buscando aplicá-la à realidade organizacional, haja vista que o mundo do trabalho contemporâneo demanda uma força de trabalho específica, qual seja, o trabalhador flexível, polivalente, sujeito a mudanças - portanto, um trabalhador resiliente. A partir dessas considerações, realiza-se um processo de reflexão sobre as situações em que a resiliência pode ser promotora de saúde mental, bem como acerca dos contextos que contribuem para o processo de adoecimento do trabalhador, buscando aventar possibilidades de atuação do profissional psicólogo diante de um contexto de trabalho adverso, considerando-se que o principal objetivo dessa atuação profissional é garantir a proteção/promoção da saúde e qualidade de vida no ambiente de trabalho.

A atuação do psicólogo no contexto das referências ambulatoriais em saúde mental de Aracaju - SE

Psychologists‟ insertion in mental healthcare ambulatory clinics occurred during the decade of 1980, in the context of the claims disseminated by sanitary and psychiatric reforms, of the formation of minimum mental healthcare teams and of the retraction of the private clinic. Historically, this migration had been accompanied by the importation of practices traditionally applied at the clinics. Furthermore, the lack of clear guidelines from the Health Ministery occasioned the opening of ambulatory clinics with diversified structures at each city. The objective of this dissertation was to study the practices of psychologists at mental healthcare ambulatory references at Aracaju-SE. Were interviewed psychologists of these services and managers of the municipal health secretary using a semi-structured interview guideline, in addition to the analysis of management reports. It was observed that the mental healthcare references had experienced substantial changes referred to its structures and operation, leading to a present framework of expansion and readjustment. It was realized that there is an effort by the psychologists to maintain individual and group assistance, using adjustments in the frequency of the sessions and in the focus of the activities. Besides the progresses, the relation with the psychiatrist still works basically through the medical record, blocking advances on joint discussions of the cases. Some advances toward the amplified clinic are notable, like the overcoming of the isolated usage of psychiatric diagnostic and the replacement of the line‟ criterion by the urgency one. Sheltering had become an interesting strategy on flux ordination, however the mismatch between offer and demand seems to be a matter which extrapolates the psychologists‟ sphere at the references. For this reason the narrow of the relation with family healthcare centers seems to be the major challenge to be faced by psychologists at mental healthcare ambulatory references

Efeitos do turno fixo sobre a saúde mental em operadores de petróleo :um estudo de caso em dois ativos produção da Petrobrás

Un conjunto de cambios viene siendo implantado en la Petrobrás procurando que sus unidades de negocios resulten más modernas y competitivas para atender las necesidades del mercado. Dentro de esta perspectiva, un nuevo régimen de trabajo, denominado turno fijo , ha sido implantado en dos activos de producción de la provincia de Rio Grande do Norte. Tal situación originó varios reclamos de los petroleros y, consecuentemente, el interés del SINDIPETRO-RN en obtener una evaluación más precisa de las consecuencias de los mismos. Este estudio, realizado a partir de la demanda sindical de esos trabajadores, ha tenido como objetivo central analizar los efectos del turno fijo sobre la salud mental de los operadores de producción, actualmente lotados en los referidos activos. El estudio ha sido realizado con 39 operadores que representan el 82,9% de la población objeto de este estudio. La muestra ha sido homogénea en cuanto al género, grado de instrucción, edad y tiempo de servicio en la compañía, lo que ha posibilitado un mayor control de las variables y un estudio comparativo entre los dos activos. Para el desarrollo del estudio, se han aplicado los siguientes instrumentos de colecta de datos: una escala de medida probada y validada (QSG-12), un cuestionario abierto, entrevistas individuales y una ficha socio-demográfica. Las respuestas del cuestionario abierto han sido categorizadas mediante la aplicación de análisis de contenido. Los resultados de ese tratamiento y las respuestas del QSG-12 han sido registradas en la forma de banco de datos del SPSS for Windows (Statical Package for social sciense for Windows) para luego procederse con el desarrolllo de los análisis estadísticos. Los principales resultados encontrados en el estudio han sido que la mitad de los participantes de la muestra han presentado resultados de deteriorización de la autoeficacia más elevado que 1,44 (un una escala de 0 a 3) y, en tensión emocional y depresión, el resultado es más elevado que 1,67; la mayoría se da cuenta del aumento de carga de trabajo, revela acentuado sufrimiento con el distanciamiento de la familia, y 58,8% presenta enfermedades psicosomáticas crónicas. La percepción de los operadores sobre el turno fijo e el análisis de éste, conforme el modelo vitamínico de Warr, conducen a la conclusión de que el turno fijo es uno de los factores que está influyendo negativamente en la salud mental de esos trabajadores

A redução de danos no atendimento especializado em álcool e outras drogas

The harm reduction HR is the official policy of Ministry of Public Health to deal with problem derived from alcohol consumption and other drugs AD. The HR refers to policies and support programs whose purpose is to reduce the risks related to the use of AD, without necessarily decrease individual consumption. This research aim was to analyze the HR conceptions and practices at two specialized institutions for AD users: 1) Psychosocial Care Center Alcohol and Drugs III (CAPSad III); 2) Therapeutic Community Fazenda da Esperança (FE) Dom Bosco. This is a qualitative research that used the following methodological tools: semi-structured interview with 21 professionals; socio demographic file and rounds of conversation with 63 participants users; participant observation and field journal. The interviews with professionals have characterized HR as a less complex and cheap treatment. At FE the HR proposal does not make part of their actions, being considered ―against the human being dignity‖. At CAPSad III is understood as an ―inevitable‖ guideline to service, once users do not remain abstinent. The users understand RD as an improvement in healthy conditions, social relations and work that occurs with the decreasing consumption of AD. They use the HR when they avoid situations that facilitate AD consumption, share relapse prevention strategies and, exclusively at CAPSad III, decrease psychotropic consumption. Stands out as an analyzer the HR comprehension as a less efficient treatment that opposes to the objective of both institutions, which is abstinence. The HR is not operationalize in daily routine by professionals and users as a healthy promotion strategy, however, the users are more affected to HR and produce strategies to face the difficulties arising from the AD consumption

Saúde mental em operadores de petróleo do Rio Grande do Norte

The importance of identifying the consequence of the hours worked on people in society has been well recognized within Organizational and Work Psychology. From this point of view, the present research had the objective of analysing the effects of work regimes on the mental health of petroleum operators of Petrobrás. The sample totaled 144 subjects, corresponding to 27% of the work population. The mental health of the participants was evaluated using the following instruments of measurement: QSG-12, Scale of self-esteem, Scale of Positive and Negative Affections and the Scale of Valuable Attributes of IMST, each representing an empirical factor used to indicate and measure the five dimensions of mental health. The subjects perceptions of their work regime and the rest of their conditions of work were evaluated using scales of descriptive attributes of IMST, by applying a semi-structured questionnaire and by use of interviews. A socio-demographic file was used to collect information related to the biographical and socio-occupational profile of the worker sample. The answers to the questionnaire were inserted into the data bank of SPSS (Statistical Package for Social Science), for statistical analysis, and the interviews were analised based on the technique of Contents Analysis recommended by Bardin (1995). The main results revealed that one third of the worker sample were tense; however, the mental health of the majority was preserved. Cluster Analysis applied to the group of seven factors which measured the five dimensions of mental health identified four profiles of psychological well-being shared between members of the sample. It was observed that the people working in the system of Continuous Shift Alternation (TIR) and in the system of Pre-advising tended to present balanced and satisfactory profiles, while the ones which worked in the Administrative Field tended to present anxious and oscillating profiles, and thus were more affected psychologically. These were also the ones that also perceived the more negative aspects of their laborious conditions (reduced chances of self-improvement, physically stressful and financial resources below expectations with which to supply family and personal necessities. In agreement with the ecological model formulated by Warr (1987), the present study concluded that the positive and negative effects on the psychological well-being tended to occur as a consequence of the perceptions the petrol operators developed to face their work conditions

Impacto do trabalho em profissionais de Saúde Mental de serviços de saúde do município de Mossoró-RN, 2012

The Psychiatric Reform has brought profound changes in assistance to people affected by mental disorders and behavior. In this context, mental health workers have played decisive roles of great impact, acting driving the process. Objective: To evaluate the impact felt by working professionals, because of the daily work with people who have psychiatric disorders. Methodology: This is a search field, a quantitative approach, sectional, descriptive and applied. Data collection occurred through the Assessment Scale Impact of Working in Mental Health Services (IMPACT-BR) applied to mental health researchers city Mossoró - RN. Results: Participants in this study 87 professionals, mostly female married, which took charge of higher education, working on a single service, working in the area for more than six years, aged between 25 and 64 years. There were a low effect of overloading the professionals surveyed. Discussion: Our results corroborate findings in other surveys conducted previously, not identifying large impact load at work among professionals of mental health teams studied. Subscales studied the highest score was observed in measuring the impact of work on team functioning. It was observed that the greater age and duration of action, reduced the emotional impact at work, suggesting that the experience enhances safety in decisions made and the possibility of greater control over the demands of work. Final Thoughts: The work presented showed that the interactive relationships between professionals and users are not the causes of greatest impact in the workplace, although it revealed overload in relation to specific aspects such as: fear of being assaulted by a patient and the feeling of physical exhaustion the end of the workday. Further investigations should be conducted on this topic in order to contribute to the implementation of psychiatric reform proposed by advances both in terms of assistance to individuals and the quality of life in the work of the professionals involved