Made available in DSpace on 2014-12-17T14:46:52Z (GMT). No. of bitstreams: 1 DeborahKRR_DISSERT.pdf: 2051904 bytes, checksum: 77b58bf6f5ba60a2334606e0fc1eaf95 (MD5) Previous issue date: 2011-12-08 / The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital Jo?o Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care. / A Reforma Psiqui?trica brasileira pautada sobre o ide?rio de desinstitucionaliza??o da assist?ncia, traduzido na ?nfase no tratamento de base comunit?ria/territorial e na inclus?o social do sofredor ps?quico, promoveu avan?os significativos na reestrutura??o da psiquiatria. No cen?rio do Estado do Rio Grande do Norte (RN), podemos enumerar como avan?os da Reforma Psiqui?trica brasileira a expans?o da rede de aten??o ? sa?de mental e a implementa??o de estrat?gias que, em conjunto, visam favorecer a aten??o psicossocial do indiv?duo em sofrimento ps?quico e reduzir os ?ndices de reinterna??es psiqui?tricas no Estado. Diante do panorama atual da sa?de mental no Brasil nos empenhamos em responder ao seguinte questionamento: qual o impacto da amplia??o dos dispositivos substitutivos no fen?meno da porta girat?ria na realidade da aten??o ? sa?de mental do Rio Grande do Norte? Assim, o presente estudo teve como objetivo analisar a ocorr?ncia do fen?meno da porta girat?ria ? luz das novas estrat?gias de aten??o ? sa?de mental no RN. Trata-se de uma pesquisa qualitativa do tipo explorat?rio-descritiva, norteada por um arcabou?o te?rico de enfoque cr?tico-dial?tico sobre a Reforma Psiqui?trica brasileira e tendo a hist?ria oral tem?tica como m?todo de coleta de informa??es. O cen?rio da pesquisa foi o Hospital Jo?o Machado (HJM), refer?ncia para o atendimento em psiquiatria no Estado do Rio Grande do Norte e os sujeitos da pesquisa foram 20 profissionais da institui??o. A coleta das informa??es foi iniciada ap?s a libera??o do Comit? de ?tica em Pesquisa da UFRN atrav?s do parecer no 216/2011 e CAAE no 0021.0.051.000-11 e realizada mediante a utiliza??o de observa??o direta e de entrevista semi-estruturada. A operacionaliza??o das informa??es suscitou o surgimento de duas categorias e cinco subcategorias de an?lise. CATEGORIA 1) A atualidade da Rede de Aten??o ? Sa?de Mental no RN, com as subcategorias: 1.1 Impacto da rede de sa?de mental no fen?meno da porta girat?ria no RN; 1.2 Implica??es dos novos servi?os de sa?de mental na assist?ncia aos usu?rios do HJM; 1.3 Problem?ticas que permeiam a rede de sa?de mental do RN. CATEGORIA 2) Principais causas da porta girat?ria no RN, com as subcategorias: 2.1 Problem?tica familiar e 2.2 desassist?ncia p?s-alta. Em s?ntese, conclu?mos que a amplia??o da rede sa?de mental contribuiu para a redu??o das reinterna??es psiqui?tricas no RN. No entanto, vimos que os dispositivos territoriais de sa?de mental n?o s?o os ?nicos respons?veis pela perpetua??o do fen?meno da porta girat?ria. Fatores como a problem?tica familiar e a desarticula??o de assist?ncia p?s-alta influenciam nas interna??es e reinterna??es psiqui?tricas na realidade estadual. Estudar a porta girat?ria da assist?ncia psiqui?trica e as novas estrat?gias de aten??o ? sa?de mental nos permitiu a aproxima??o com os avan?os e desafios trazidos pela Reforma Psiqui?trica brasileira e pela desinstitucionaliza??o no ?mbito estadual, apontando para a necessidade de novas discuss?es e estrat?gias de resolubilidade da aten??o psicossocial.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2015-07-28T21:57:00Z No. of bitstreams: 1 Disserta??o - Ionara Magalh?es de Souza.pdf: 374012 bytes, checksum: 43497c3ab61d6a39cbfba2f163596455 (MD5) / Made available in DSpace on 2015-07-28T21:57:00Z (GMT). No. of bitstreams: 1 Disserta??o - Ionara Magalh?es de Souza.pdf: 374012 bytes, checksum: 43497c3ab61d6a39cbfba2f163596455 (MD5) Previous issue date: 2014-03-20 / This dissertation constitutes the final project of the Master?s program in Collective Health, in the concentration area Epidemiology, line of research: health of specific population groups, and is based on the article ?Hospital Morbidity and factors associated according to race/color of the skin in Bahia, Brazil, 2008-2012. The objective of this article is to analyze the association between hospital morbidity and socioeconomic factors and demographics, according to race/color of the skin in Bahia, Brazil, from 2008-2012. This is an ecologic, exploratory study consisting of various cross-sectional studies performed at different moments in time. The study used secondary data from the System of Hospital Information of SUS-SIH/SUS of the department of information of SUS-DATASUS, including all of the municipalities of the state of Bahia for which existed registries of hospitalizations of SIH-SUS. Socioeconomic data was provided by the Brazilian Institute of Geography and Statistics (IBGE). This study enables a broader comprehension of disparities mediating the process of health-illness and identifies areas where populations in situations of social vulnerability are concentrated. Little research exists on hospital morbidity, and research on this topic that considers race/color of the skin is inexistent. Color of the skin, race, and ethnicity are constructs still rarely recognized in practice or in the scientific literature on health in Brazil. This article aims to contribute to the production of scientific knowledge on health inequalities so that morbidities that disproportionally affect the black population can be identified and monitored. Equally, this article aims to assist in planning and implementation of public policies to improve the health of the black population in the state of Bahia, Brazil. / Essa disserta??o constitui o trabalho de conclus?o de curso de Mestrado Acad?mico em Sa?de Coletiva, ?rea de concentra??o Epidemiologia, Linha de Pesquisa: Sa?de de Grupos Populacionais Espec?ficos e baseia-se na apresenta??o do artigo ?Morbidade Hospitalar e fatores associados segundo a ra?a/cor da pele na Bahia, 2008-2012? ao Programa de P?s-Gradua??o em Sa?de Coletiva da Universidade Estadual de Feira de Santana. No artigo objetiva-se analisar a associa??o entre morbidade hospitalar e fatores socioecon?micos e demogr?ficos, segundo a ra?a/cor da pele na Bahia, durante o per?odo 2008-2012. Trata-se de um estudo ecol?gico, explorat?rio, constitu?do de v?rias observa??es de corte transversal mensuradas em diferentes momentos no tempo. No estudo foram utilizados os dados secund?rios dispon?veis no Sistema de Informa??es Hospitalares do SUS - SIH/SUS do Departamento de Inform?tica do SUS ? DATASUS, inclu?dos todos os munic?pios que constituem o estado da Bahia e para os quais houve registros de interna??es hospitalares do SIH-SUS e dados socioecon?micos fornecidos pelo Instituto Brasileiro de Geografia e Estat?stica (IBGE). Esse estudo possibilita ampliar a compreens?o sobre disparidades mediante o processo sa?de-adoecimento e apontar ?reas onde se concentram popula??es em situa??es sociais de vulnerabilidade. Escassos s?o os estudos sobre morbidade hospitalar e inexistentes os estudos nessa perspectiva que considerem a ra?a/cor da pele das popula??es. Cor da pele, ra?a e etnia s?o construtos ainda pouco reconhecidos nas pr?ticas de sa?de e literatura cient?fica sobre a sa?de no Brasil. Dessa forma, pretende-se contribuir com a produ??o cient?fica acerca das desigualdades em sa?de e subsidiar para que as morbidades que afetam em maior grau a popula??o negra sejam identificadas, evidenciadas e monitoradas. Igualmente, busca-se auxiliar no planejamento e efetiva??o de pol?ticas p?blicas direcionadas ? sa?de da popula??o negra no estado da Bahia.

Made available in DSpace on 2014-12-17T15:24:27Z (GMT). No. of bitstreams: 1 FrancenildoDR_DISSERT.pdf: 1441958 bytes, checksum: 084daa6b15b408dd79e5f9d215bf8101 (MD5) Previous issue date: 2013-12-19 / This dissertation try to understand how management actions implemented by Monsenhor Walfredo Gurgel Hospital in the city of Natal promote effectively the benefits of Home Care Services / Programa Melhor em Casa . The research is exploratory and descriptive, qualitative approach. Data were collected through document analysis and the interviews with the managers of the Program in Health Department and Hospital beyond the questionnaires with the home care teams and technical management unit of Hospital Jobs. The information were treatment trough categories that analyzed to implemented actions and program objectives. The results show that: the practices carried out by the host teams produce the humanization of care by seeking to ensure access to health services and solving human form; networks of health care are not yet finalized hindering the referral of patients to other units, the networks allow support from other institutions to minimize the problems encountered, the management unit vacancies allows the reduction of costs, mainly by regulating beds and record of health initiatives in home care assists in the monitoring and evaluation process of the Services Home Care / Programa Melhor em Casa primarily the epidemiological profile and patients individual treatment plan. Concludes that most of the actions implemented by the Hospital contribute to the effectiveness of the goals of Programa Melhor em Casa / Esta disserta??o busca compreender como as a??es gerenciais implementadas pelo Hospital Monsenhor Walfredo Gurgel no munic?pio do Natal promovem de forma eficaz os benef?cios do Servi?o de Aten??o Domiciliar/ Programa Melhor em Casa. A pesquisa tem natureza explorat?ria e descritiva, com abordagem qualitativa. Os dados foram coletados atrav?s da an?lise documental e com a realiza??o de entrevistas com os gestores do Programa na Secretaria Estadual de Sa?de e no Hospital al?m da aplica??o de question?rios com as equipes de aten??o domiciliar e com os t?cnicos da unidade de gerenciamento de vagas do Hospital. No tratamento das informa??es foram analisadas categorias vinculadas ?s a??es implementadas e aos objetivos do programa. Os resultados mostram que: as praticas de acolhimento realizadas pelas equipes produzem a humaniza??o do atendimento por buscar garantir o acesso ao servi?o de sa?de de forma humana e resolutiva; as redes de aten??o em sa?de ainda n?o est?o conclu?das dificultando o referenciamento dos pacientes para outras unidades; as redes possibilitam buscar apoio de outras institui??es para minimizar os problemas encontrados; a unidade de gerenciamento de vagas possibilita a redu??o dos custos, principalmente por regular os leitos de interna??o e o registro ambulatorial das a??es em sa?de em aten??o domiciliar auxilia no processo de monitoramento e avalia??o do Servi?o de Aten??o Domiciliar/Programa Melhor em Casa principalmente por conhecer o perfil epidemiol?gico e o plano terap?utico individual dos pacientes. Conclui assim que a maioria das a??es implementadas pelo Hospital contribuem para a efic?cia dos objetivos do Programa Melhor em Casa