O estudo teve por objetivo avaliar as características de usuários de substâncias psicoativas internados por ordem judicial. Trata-se de um estudo transversal retrospectivo, baseado em dados secundários, realizado na Defensoria Pública do Estado de São Paulo, unidade Araraquara. A amostra foi composta por 217 processos judiciais de indivíduos internados por mandato judicial em função do uso de substâncias psicoativas. Utilizou-se um questionário estruturado, contendo perguntas fechadas, obtidas no formulário de informações da internação compulsória na Defensoria Pública. As informações referem-se a informações sociodemográficas, substância psicoativa utilizada, à internação e sobre o tratamento, bem como aspectos concernentes a própria internação. A amostra caracterizou-se predominantemente por indivíduos do sexo masculino, com faixa etária de 21 a 40 anos, solteiros e desempregados. Em relação ao uso de substâncias psicoativas, 78 (35,9%) usavam álcool e/ou maconha e 139 (64%) faziam uso de cocaína (inalada ou fumada). A amostra diferenciou-se em relação à faixa etária, estado civil e ocupação. Usuários de álcool e/ou maconha se caracterizaram por serem adultos, separados/divorciados e exercerem trabalho informal. Os usuários de cocaína/crack são jovens, solteiros e desempregados. Observa-se associações estatisticamente significativas entre uso de droga, solicitante da internação e a presença de agressividade. A presença de situações de agressividade foi predominante entre usuários de cocaína/crack, quando comparado aos usuários de álcool/ maconha. Os resultados podem auxiliar no entendimento do perfil do usuário de substâncias psicoativas internado compulsoriamente, trazendo luz a questões que relacionam-se ao processo de internação e ao fenômeno do uso de drogas, bem como podem levantar discussões sobre estratégias de cuidado atualmente oferecidas aos usuários de substâncias psicoativas em processo de judicialização / The study has as objective evaluate psychoactive substances users\' characteristics hospitalised by court order. This is a cross-sectional retrospective study, based on secondary data, held in the Public Defender\'s Office of the State of São Paulo, Araraquara\'s unit. A sample composed by 217 court lawsuits of hospitalized individuals by court orders due to abuse of psychoactive substances. A structured questionnaire was used, containing closed questions, obtained from the data of compulsory hospitalization in the Public Defender\'s Office. The data refers to sociodemographic information, drug used, hospitalization and treatment. The sample was predominantly male, aged between 21 and 40 years old, single and unemployed. Regarding the use of psychoactive substances, 78 (35.9%) used alcohol and / or marijuana and 139 (64%) used cocaine (inhaled or smoked). The sample was differentiated in relation to age, marital status and occupation. Alcohol and / or marijuana users were characterized as adults, separated / divorced, and engaged in informal work. Cocaine / crack users are young, single and unemployed. Statistically significant associations between drug use, hospitalization requestor and the presence of aggressiveness are observed. The presence of aggressive situations was predominant among cocaine / crack users when compared to alcohol / marijuana users. The results can help to understand the profile of compulsory hospitalized drug user\'s, bringing light to issues that relate to the hospitalization process and the phenomenon of drug use, as well as to raise discussions about care strategies currently offered to users of psychoactive substances in court orders

<p>SAMMANFATTNING</p><p><strong>Bakgrund</strong>: Patienters upplevelser av att vårdas inom slutenvården med stöd av Lagen om psykiatrisk tvångsvård. Människor med en allvarlig psykisk störning eller ett oundvikligt behov av vård får med stöd av lagen tvångsvårdas. Patienterna fråntas självbestämmandet och blir tvungna att delta i vård och behandling mot sin vilja. När självbestämmandet fråntas patienterna övertar vårdpersonalen ansvaret vilket kan leda till ett lidande för patienterna (1991:1128).</p><p><strong>Syfte</strong>: Syftet var att beskriva patienters upplevelser av tvångsvård inom psykiatrisk slutenvård. </p><p><strong>Metod</strong>: Systematisk litteraturstudie, sex artiklar användes för uppnått resultat.</p><p><strong>Resultat: </strong>Både positiva och negativa upplevelser av tvångsvård påvisades. Patienterna beskrev ett möte med vården kantat av upplevelser kring människovärde, delaktighet i sin egen vård, kommunikation, relationer, synen på våld, hot och straff samt upplevt lidande.</p><p><strong>Slutsats</strong>: Om patienterna bemöttes med respekt, människovärde samt fick tillräcklig information kring vård och behandling blev upplevelserna av tvångsvården mer positiv. Brist på delaktighet i fråga om vård och behandling och kommunikationsbrister var ett problem då patienterna hade lite sjukdomsinskt samt inte hade förståelse för behovet av tvångsvård.</p><p>Vidare forskning med kvalitativa intervjuer om patienters upplevelser av tvångsvård föreslås för att ge utökad förståelse och kunskap.</p>

SAMMANFATTNING Bakgrund: Patienters upplevelser av att vårdas inom slutenvården med stöd av Lagen om psykiatrisk tvångsvård. Människor med en allvarlig psykisk störning eller ett oundvikligt behov av vård får med stöd av lagen tvångsvårdas. Patienterna fråntas självbestämmandet och blir tvungna att delta i vård och behandling mot sin vilja. När självbestämmandet fråntas patienterna övertar vårdpersonalen ansvaret vilket kan leda till ett lidande för patienterna (1991:1128). Syfte: Syftet var att beskriva patienters upplevelser av tvångsvård inom psykiatrisk slutenvård.  Metod: Systematisk litteraturstudie, sex artiklar användes för uppnått resultat. Resultat: Både positiva och negativa upplevelser av tvångsvård påvisades. Patienterna beskrev ett möte med vården kantat av upplevelser kring människovärde, delaktighet i sin egen vård, kommunikation, relationer, synen på våld, hot och straff samt upplevt lidande. Slutsats: Om patienterna bemöttes med respekt, människovärde samt fick tillräcklig information kring vård och behandling blev upplevelserna av tvångsvården mer positiv. Brist på delaktighet i fråga om vård och behandling och kommunikationsbrister var ett problem då patienterna hade lite sjukdomsinskt samt inte hade förståelse för behovet av tvångsvård. Vidare forskning med kvalitativa intervjuer om patienters upplevelser av tvångsvård föreslås för att ge utökad förståelse och kunskap.

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 66-67).

O estudo teve por objetivo avaliar as características de usuários de substâncias psicoativas internados por ordem judicial. Trata-se de um estudo transversal retrospectivo, baseado em dados secundários, realizado na Defensoria Pública do Estado de São Paulo, unidade Araraquara. A amostra foi composta por 217 processos judiciais de indivíduos internados por mandato judicial em função do uso de substâncias psicoativas. Utilizou-se um questionário estruturado, contendo perguntas fechadas, obtidas no formulário de informações da internação compulsória na Defensoria Pública. As informações referem-se a informações sociodemográficas, substância psicoativa utilizada, à internação e sobre o tratamento, bem como aspectos concernentes a própria internação. A amostra caracterizou-se predominantemente por indivíduos do sexo masculino, com faixa etária de 21 a 40 anos, solteiros e desempregados. Em relação ao uso de substâncias psicoativas, 78 (35,9%) usavam álcool e/ou maconha e 139 (64%) faziam uso de cocaína (inalada ou fumada). A amostra diferenciou-se em relação à faixa etária, estado civil e ocupação. Usuários de álcool e/ou maconha se caracterizaram por serem adultos, separados/divorciados e exercerem trabalho informal. Os usuários de cocaína/crack são jovens, solteiros e desempregados. Observa-se associações estatisticamente significativas entre uso de droga, solicitante da internação e a presença de agressividade. A presença de situações de agressividade foi predominante entre usuários de cocaína/crack, quando comparado aos usuários de álcool/ maconha. Os resultados podem auxiliar no entendimento do perfil do usuário de substâncias psicoativas internado compulsoriamente, trazendo luz a questões que relacionam-se ao processo de internação e ao fenômeno do uso de drogas, bem como podem levantar discussões sobre estratégias de cuidado atualmente oferecidas aos usuários de substâncias psicoativas em processo de judicialização / The study has as objective evaluate psychoactive substances users\' characteristics hospitalised by court order. This is a cross-sectional retrospective study, based on secondary data, held in the Public Defender\'s Office of the State of São Paulo, Araraquara\'s unit. A sample composed by 217 court lawsuits of hospitalized individuals by court orders due to abuse of psychoactive substances. A structured questionnaire was used, containing closed questions, obtained from the data of compulsory hospitalization in the Public Defender\'s Office. The data refers to sociodemographic information, drug used, hospitalization and treatment. The sample was predominantly male, aged between 21 and 40 years old, single and unemployed. Regarding the use of psychoactive substances, 78 (35.9%) used alcohol and / or marijuana and 139 (64%) used cocaine (inhaled or smoked). The sample was differentiated in relation to age, marital status and occupation. Alcohol and / or marijuana users were characterized as adults, separated / divorced, and engaged in informal work. Cocaine / crack users are young, single and unemployed. Statistically significant associations between drug use, hospitalization requestor and the presence of aggressiveness are observed. The presence of aggressive situations was predominant among cocaine / crack users when compared to alcohol / marijuana users. The results can help to understand the profile of compulsory hospitalized drug user\'s, bringing light to issues that relate to the hospitalization process and the phenomenon of drug use, as well as to raise discussions about care strategies currently offered to users of psychoactive substances in court orders

<p>The use of coercion in psychiatry involves clinical, legal, scientific, ethical and emotional considerations. This thesis represents an attempt to further increase our understanding of some empirical aspects of this phenomenon. </p><p>Interviews with 202 involuntarily admitted psychiatric patients and 201 voluntarily admitted patients and 295 of their next of kins were performed and analysed together with data from records and assessments made by professionals. Data was collected during two different periods of time with a compulsory psychiatric care law reform in between.</p><p>Experience of at least one coercive measure was more common amongst patients who had been committed during the most recent legislation. Otherwise there were no differences in patient experiences during the different laws.</p><p>Subjective short-term outcome was associated with having a contact person at the ward and being subjectively treated well. There were no relationships between subjective and assessed outcome or between legal status, perceived coercion at admission and subjective or assessed improvement.</p><p>The changed legislation had no clear effect on the attitudes of patients and next of kins towards coercion.</p><p>A majority of patients were able to accurately answer the question whether they had been restrained by belt or not during a specific treatment episode. Nineteen of 115 patients reported they had been restrained by belt. Eleven of these cases were true positive and 8 cases were false positive. </p><p>In conclusion, the main results were first that when it comes to issues related to psychiatric coercion there are typically considerable differences between how these are perceived and interpreted by the professional and by the patient, and second that efforts made to change the face of psychiatric coercion in the minds of patients as well as the public on part of public policymakers have had limited effects.</p>

The use of coercion in psychiatry involves clinical, legal, scientific, ethical and emotional considerations. This thesis represents an attempt to further increase our understanding of some empirical aspects of this phenomenon. Interviews with 202 involuntarily admitted psychiatric patients and 201 voluntarily admitted patients and 295 of their next of kins were performed and analysed together with data from records and assessments made by professionals. Data was collected during two different periods of time with a compulsory psychiatric care law reform in between. Experience of at least one coercive measure was more common amongst patients who had been committed during the most recent legislation. Otherwise there were no differences in patient experiences during the different laws. Subjective short-term outcome was associated with having a contact person at the ward and being subjectively treated well. There were no relationships between subjective and assessed outcome or between legal status, perceived coercion at admission and subjective or assessed improvement. The changed legislation had no clear effect on the attitudes of patients and next of kins towards coercion. A majority of patients were able to accurately answer the question whether they had been restrained by belt or not during a specific treatment episode. Nineteen of 115 patients reported they had been restrained by belt. Eleven of these cases were true positive and 8 cases were false positive. In conclusion, the main results were first that when it comes to issues related to psychiatric coercion there are typically considerable differences between how these are perceived and interpreted by the professional and by the patient, and second that efforts made to change the face of psychiatric coercion in the minds of patients as well as the public on part of public policymakers have had limited effects.

Bakgrund: Vård i Sverige ska bedrivas med patientens självbestämmande i fokus. I vissa fall kan patienter inom psykiatrin dock vårdas mot sin vilja. Sjuksköterskor i Sverige ska arbeta för att främja patientens autonomi och delaktighet. Att då använda tvång kan ge upphov till etiska dilemman. Att beskriva hur sjuksköterskor hanterar arbete med tvångsvård anses viktigt för att öka förståelsen för en svår situation i arbetet, och kan i förlängningen öka vårdens kvalitet.   Syfte: Att beskriva sjuksköterskors upplevelser och erfarenheter av att arbeta med tvångsvård i den psykiatriska vården samt beskriva hur utvalda artiklar presenterar sina urvalsgrupper.  Metod: Studien genomfördes som en deskriptiv litteraturstudie. Artiklar söktes i Medline och Cinahl. Totalt valdes 14 artiklar ut och bearbetades till fyra underrubriker och en metodologisk aspekt för att svara på syftet.  Resultat: Resultatet visade att sjuksköterskor upplever mestadels negativa känslor som oro, rädsla och sårbarhet vid arbete med tvångsvård. Användandet av tvång rättfärdigades genom att det beskrevs som en del av sjuksköterskornas jobb. Tvånget beskrevs skada vårdrelationen och gav upphov till etiska konflikter i sjuksköterskorna. Resultatet beskrevs i fyra underrubriker Känslor kring utförandet av tvångsåtgärder, Rättfärdigande av tvångsåtgärder, Tvångets inverkan på vårdrelationen och Etiska konflikter i samband med tvångsåtgärder. Artiklarna varierade i sina beskrivningar av urvalsgrupper, men flertalet beskrev deltagarnas kön, ålder och arbetslivserfarenhet. Majoriteten av artiklarna har 11-50 deltagare.   Slutsats: Föreliggande litteraturstudie har funnit att sjuksköterskor upplever tvångsvård som övervägande negativt. Det har påvisats att utbildningsgraden hos sjuksköterskan har en effekt på utförandet och hanterandet av tvångsmedel. Författarna drar slutsatsen att sjuksköterskor önskar minska på användandet av tvång, och att forskning bör koncentreras på att skapa alternativa behandlingsmetoder. / Background: Health care in Sweden shall be conducted with the patients’ autonomy in center. However, in some cases in the psychiatric care, patients can be treated against their will. A nurse shall work towards increasing patient autonomy and participation. The use of involuntary treatment can due to this cause ethical dilemmas. To describe how nurses cope with using involuntary treatment is important since it can increase the understanding of a complicated situation, and in the long run increase the quality of the health care services. Aim: To describe the experiences of a nurse working with involuntary treatment and to describe how the chosen articles presents their selection groups. Method: The study was conducted as a descriptive literature review. Articles was searched in the databases Medline and Cinahl with a ten-year age limit. A total of fourteen articles was selected and processed into four subcategories and a methodological aspect to answer to the study’s aim. Results: The results show that nurses experience mostly negative feelings like anxiety, fear and vulnerability while working with involuntary treatment. The use of involuntary treatment was justified by the thought that the practice was a part of the nurses’ job and duty. The use of involuntary treatment was describes as damaging on the nurse-patient relationship and caused ethical conflicts. The result was described in four subcategories Feelings about the use of involuntary treatment, Justifying involuntary treatment, Involuntary treatment and the effects on the nurse-patient relationship and Ethical conflicts due to involuntary treatment. The articles varied in their descriptions of their selection groups. Most described the participants gender, age and work experience. Most of the articles had 11-50 participants.    Conclusions: This study has found that nurses experience involuntary treatment as having mostly negative effects. It has been shown that the nurses’ level of education has an effect on both the execution and the handling of involuntary treatment. The writers of this study have come to the conclusion that nurses wish to decrease the use of involuntary treatment, and that research should be focused on finding alternative methods of treatment.

Thesis (doctoral)--Universität, Tübingen, 2007. / Includes bibliographical references.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The historical of the mental health has been marked by the discrimination, exclusion and removal of the persons with mental upset of the society. In this sense, one has like objective, to analyses the understanding of active nurses in mental health about the compulsory admissions and involuntary proposals for the Law of the Brazilian Psychiatric Reform. It is the question of an exploratory-descriptive inquiry with qualitative approach carried out in unities of psychiatric admission in general hospitals and services substitutive in the area of mental health of the Only System of Health in the local authority of Saint Maria. The data collection took place of March to May of 2014, through interview semi-structured with open question, developed in individual and carved form, in a room reserved in the above-mentioned services with eight active nurses in mental health. For so much, the next question happened: which his understanding of compulsory and involuntary admission? The data were subjected to the Analysis of Content and 7.0 (Qualitative Research and Solutions) organized with help of the Software Atlas You, it was inspired in the theoretical referential system of Paulo Amarante. They were respected all the aspects ethical of the inquiries with human beings ruled in the Resolution N. 466 of 2012 of the National Council of Health. Of the analysis of the finds from the reading of the content of the interviews, two categories surfaced: compulsory and involuntary admissions: understanding of the active nurses in mental health; and, compulsory and involuntary admission in the professional daily life of the active nurse in mental health. The results showed up that the nurses understand the compulsory and involuntary admissions as something that must be seen besides the disease, since social, economic, familiar factors when they are in imbalance can bring in an admission. They understand that the Law of the Psychiatric Reform brought changes in the presence in mental health, however it is still not totally in accordance with the ideals of the Law, since the changes are situated more specifically in the services without reaching the community, being the fragmentation of the Net of Attention Psychosocial one of the challenges so that the ideal is reached. Another challenge pointed by the nurses there are the readmissions for the precarious adherence of the users to the services substitutive. Besides, the nurses try to establish a communication with the judicial thing in an attempt of reducing the compulsory admissions. The nurses can differentiate the different types of admission, being that the compulsory and involuntary admissions from the understanding of the nurses do not appear effective, but in crisis situations there are still the most used resource. Between the feelings that these two types of admission wake in the nurses they are the satisfaction feeling when they manage to avoid the admissions and it of frustration when they do not manage. It is ended that so that there is a desinstitucionalização, besides the constitution of a Net of Attention continuous and resolute Psychosocial it is necessary to surpass the readmissions that produce the so-called phenomenon revolving-door. / O histórico da saúde mental tem sido marcado pela discriminação, exclusão e afastamento das pessoas com transtorno mental da sociedade. Neste sentido, tem-se como objetivo, analisar a compreensão de enfermeiros atuantes em saúde mental acerca das internações compulsórias e involuntárias propostas pela Lei da Reforma Psiquiátrica brasileira. Trata-se de uma pesquisa exploratório-descritiva com abordagem qualitativa, realizada em unidades de internação psiquiátrica em hospitais gerais e serviços substitutivos na área de saúde mental do Sistema Único de Saúde no município de Santa Maria. A coleta de dados ocorreu de março a maio de 2014, por meio de entrevista semi-estruturada com pergunta aberta, desenvolvida de forma individual e gravada, em uma sala reservada nos referidos serviços com oito enfermeiros atuantes em saúde mental. Para tanto, realizou-se a seguinte questão: qual seu entendimento de internação compulsória e involuntária? Os dados foram submetidos à Análise de Conteúdo e organizados com auxílio do Software Atlas Ti 7.0 (Qualitative Research and Solutions), inspirou-se no referencial teórico de Paulo Amarante.. Foram respeitados todos os aspectos éticos das pesquisas com seres humanos pautados na Resolução Nº 466 de 2012 do Conselho Nacional de Saúde. Da análise dos achados a partir da leitura do conteúdo das entrevistas, emergiram duas categorias: internações compulsórias e involuntárias: compreensão dos enfermeiros atuantes em saúde mental; e, internação compulsória e involuntária no cotidiano profissional do enfermeiro atuante em saúde mental. Os resultados evidenciaram que os enfermeiros compreendem as internações compulsórias e involuntárias como algo que deve ser visto além da doença, pois fatores sociais, econômicos, familiares quando se encontram em desequilíbrio podem acarretar em uma internação. Compreendem que a Lei da Reforma Psiquiátrica trouxe mudanças na assistência em saúde mental, porém ainda não está totalmente de acordo com os ideais da Lei, pois as mudanças se situam mais especificamente nos serviços não chegando à comunidade, sendo a fragmentação da Rede de Atenção Psicossocial um dos desafios para que se alcance o ideal. Outro desafio apontado pelos enfermeiros são as reinternações pela precária aderência dos usuários aos serviços substitutivos. Além disso, os enfermeiros procuram estabelecer uma comunicação com o judiciário em uma tentativa de reduzir as internações compulsórias. Os enfermeiros sabem diferenciar os diferentes tipos de internação, sendo que as internações compulsórias e involuntárias a partir da compreensão dos enfermeiros não se mostram efetivas, mas em situações de crise ainda são o recurso mais utilizado. Entre os sentimentos que esses dois tipos de internação despertam nos enfermeiros estão o sentimento de satisfação quando conseguem evitar as internações e o de frustação quando não conseguem. Conclui-se que para que haja uma desinstitucionalização, além da constituição de uma Rede de Atenção Psicossocial contínua e resolutiva é necessário sobrepujar as reinternações que geram o fenômeno denominado revolving-door ou porta-giratória.