Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-02-01T21:54:02Z No. of bitstreams: 1 FranciscoDeSalesClementino_TESE.pdf: 1510623 bytes, checksum: fdf66297c2127011707b0004cc2aa57f (MD5) / Approved for entry into archive by Elisangela Moura (lilaalves@gmail.com) on 2016-03-07T21:04:06Z (GMT) No. of bitstreams: 1 FranciscoDeSalesClementino_TESE.pdf: 1510623 bytes, checksum: fdf66297c2127011707b0004cc2aa57f (MD5) / Made available in DSpace on 2016-03-07T21:04:06Z (GMT). No. of bitstreams: 1 FranciscoDeSalesClementino_TESE.pdf: 1510623 bytes, checksum: fdf66297c2127011707b0004cc2aa57f (MD5) Previous issue date: 2014-12-11 / No Brasil, a Reforma Psiqui?trica organiza-se com base nos pressupostos da Reforma Sanit?ria e da Psiquiatria Democr?tica Italiana com vistas a eliminar o modelo hospitaloc?ntrico. Objetivo: Avaliar a estrutura e o processo de trabalho desenvolvido nos Centros de Aten??o Psicossocial (CAPS), englobando a satisfa??o, o perfil, as condi??es e a sobrecarga de trabalho dos profissionais. Aprovado pela Comiss?o de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte (UFRN), protocolo n? 719.435, de 30/05/2014. M?todos: Estudo descritivo, com abordagem quantitativa, desenvolvido em cinco Centros de Aten??o Psicossocial, a saber: 02 CAPS I, 01 CAPS II, 01 CAPS III e 01 CAPSAD, de Campina Grande-PB. A popula??o do estudo constitui-se de todos os coordenadores dos cinco CAPS, incluindo 42 profissionais de n?vel superior, 71 de n?vel m?dio (t?cnicos e auxiliares de enfermagem, e cuidadores), e os prontu?rios referentes a 2.297 usu?rios atendidos. Para assegurar a representatividade das informa??es, calculou-se uma amostra aleat?ria estratificada com partilha proporcional, considerando-se os seguintes par?metros: erro ? de 5%, n?vel de confian?a de 95%, poder do estudo de 80%, estimativa de propor??o de 10% e o ?ndice de proporcionalidade espec?fico para os profissionais de n?vel (superior e m?dio) e os prontu?rios. Coletou-se os dados atrav?s de question?rios validados, elaborados para o estudo CAPSUL (Avalia??o dos CAPS da Regi?o Sul do Brasil), entre julho e outubro de 2014. Os question?rios foram duplamente digitados e submetidos ? valida??o no sub-programa Validate do Epi Info 3.5.4, utilizado juntamente com o SPSS, 17.0 para o processamento das an?lises estat?sticas. Resultados: A partir da an?lise dos prontu?rios dos usu?rios atendidos nos CAPS, observou-se um predom?nio de mulheres na faixa et?ria adulta. Destacou-se como psicopatologia mais frequente, ? esquizofrenia. Quanto ?s interna??es antes e ap?s o ingresso nos CAPS, registrou-se para o hospital geral 14 interna??es (3,5%) antes e sete (1,7%) depois, diferen?a n?o significante (p=0,612). Ressalta-se que, em hospitais psiqui?tricos, ap?s o ingresso, houve redu??o para o m?ximo de tr?s interna??es. O n?mero total reduziu de 117 (29,1%) para apenas 11 (2,7%); redu??o estatisticamente significante (p=0,002). Quanto ?s formas de contra??o dos profissionais de sa?de, os resultados evidenciam a exist?ncia de contrato tempor?rio. A maior propor??o de insatisfa??o com todos os par?metros avaliados deu-se naqueles profissionais que se consideram sobrecarregados no trabalho. Entretanto, a ?nica diferen?a estatisticamente significante estava relacionada com o ?grau de responsabilidade? (90,9%; p=0,04). Observou-se forte associa??o da insatisfa??o dos profissionais de sa?de com fatores relacionados ao conte?do e ?s condi??es de trabalho no CAPS, relativa ?s medidas de seguran?a, conforto e apar?ncia dos CAPS, contato entre as equipes e usu?rios, e tratamento das fam?lias por parte das equipes. Chama ? aten??o que estes aspectos s?o aqueles que n?o dependem diretamente da atua??o dos profissionais. Conclui-se que o fortalecimento dos CAPS requer e exige um compromisso intersetorial, a partir do n?vel governamental, em garantir os recursos para a operacionaliza??o de suas a??es e assegurar aos usu?rios e ? sua fam?lia a oferta e o acesso aos servi?os de sa?de. / Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program ?Validate Epi Info 3.5.4? , used along with the ?SPSS 17.0? for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; ?Fisher's? exact test to check the CAPS impact on hospital admissions and the ?Bonferroni? adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.