Orientador: Debora Isane Ratner Kirschbaum / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T03:29:19Z (GMT). No. of bitstreams: 1 Miranda_Lilian_M.pdf: 8136611 bytes, checksum: 77bfe79abb75ef29eb47b7c2c73563ab (MD5) Previous issue date: 2004 / Resumo: O objetivo deste trabalho é construir um quadro esclarecedor do modo de produção da psicose a partir dos percalços que a libido softe em sua trajetória pelo desenvolvimento psicossexual, tendo a psicanálise fteudiana como referencial teórico. A metodologia utilizada foi a da análise de conteúdo dos textos que continham os termos ligados ao conceito a ser estudado. Baseando-nos no pressuposto de que os sintomas psicóticos advêm de uma fixação no narcisismo primário, concluímos que a fusão das pulsões de vida e de morte e a constituição egóica através de processos de identificação na fase oral podem, mediante problemas no desenvolvimento psicossexual, manter um individuo ligado a primitivas figuras de identificação e impedido de fazer novos investimentos libidinais próprios da fase genital, o que lhes imprime uma constante sensação de ameaça e de morte em vida. As tentativas que o psicótico apresenta de fugir desse estado de morte e de se relacionar com a realidade externa são expressas sob as formas que conhecemos como sintomas, a exemplo dos delírios e dos quadros de agressividade. Embora Freud não tenha articulado um texto que compilasse, de modo lógico e linear, todas as suas formulações acerca da psicose, percebemos que há, ao longo de sua obra, a construção de uma proposta coerente sobre o funcionamento psicótico e alguns indícios, ainda que pouco aprofundados, da existência de possibilidadesde tratamento para esse quadro patológico / Abstratct: The goal of the present study is to build a framework based on Freudian psychoanalysis to understand the production mode of psychosis based on the troubles that the libido suffers during its psychosexual development. Methodology consisted of analysis of texts contents that contained the terms related to the concept studied. Based on the rationale that psychotic symptoms are the result of a fixation of primary narcissism, we conclude that the fusion of life and death pulses, as well as the egoic constitution through identification processes during the oral phase, might, due to problems of the psychosexual development, maintain the individual tied to primitive figures of identification and prevent him from making new libidinal investments proper of the genital phase, which causes him to feel a constant sensation of threat and death in life. The attempts made by the psychotic person to escape from that state of death and to relate with external reality are expressed in forms we know as symptoms, such as deliria and the pictures of aggressiveness. Although Freud did not articulate a text that compiles all his formulations on psychosis in a logical and linear fashion,we found, throughout his work, a construction of a coherent proposal on psychotic functioning and some indications, albeit not very elaborated, regarding possible ways of treatment of that pathological picture / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

No description available.

Nurses are an integral part of the health care system and their job encompasses a wide range of responsibilities including the promotion of health, prevention of illness and care for physically, mentally ill and disabled people. Nurses have a mandate to be responsible and accountable to the public they serve. For these reasons, it is crucial that nurses possess attitudes that allow them to provide optimal care in a supportive manner for patients. Despite the fact that considerable research on the experiences of nurses caring for the mentally ill in general hospitals has been done globally, none has been conducted in the Eastern Cape, South Africa. Additionally, no studies could be obtained from anywhere in the world on the experiences of non-psychiatric trained nurses caring for mental health care users on 72 hour observations. Studies indicated that nurses have different experiences when caring for mental health care users. It was therefore considered necessary to find out how non-psychiatric trained nurses perceive the caring of mental health care users during the 72 hour observations. The research design used to explore and describe their experiences was qualitative, descriptive, explorative, phenomenological and contextual in character. Semi-structured interviews were conducted with eight (8) participants who were purposively selected. This was done after necessary permission from the Department of Health and informed consent from the research participants. Steps were taken throughout the course of the study to ensure trustworthiness. Data were analysed using Tesch’s methods and the services of an independent coder were used. The results indicate that there are different experiences with regard to the caring for mental health care users during the 72 hour observations. The major themes identified are: feelings experienced by these nurses, lack of knowledge, challenges and strategies used for coping with a violent user, need for support from security staff and lack of policies. v Guidelines as a supportive action are suggested. From the results of the study recommendations are made in the areas of nursing education, nursing practice and nursing research. It is concluded that for non-psychiatric trained nurses to provide optimal care to mental health care users, the nurses need knowledge and skills in order to facilitate the promotion, maintenance and restoration of mental health of these patients as an integral part of health.

<p> The Health and Retirement Study (HRS) is a twenty-five-year longitudinal study that studies populations over the age of fifty. There is a lack of studies that examine depression and social isolation as comorbid conditions. The purpose of this study was to examine secondary data from the 2014 wave of the HRS regarding associations between depression, social isolation and demographic characteristics, including age (50&ndash;104 years), gender, and marital status. Self-reported data from 18,289 participants (10,703 females and 7,586 males) suggested a positive association between depression and social isolation (<i> r</i> = .365, <i>p</i> &lt; .001) in that as levels of depression increase so do feelings of social isolation. Significantly more females than males reported having depression. Those who were married reported less depression and social isolation. Younger ages experienced depression and older ages social isolation. Further research should explore solutions to decreasing depression and social isolation among older adults in the United States.</p><p>

No description available.

Restraint has been used as a method of managing untoward incidents in mental health practice since mental health care began. Although methods of managing untoward incidents have evolved over time, restraint remains to this day the principal model for managing violent and aggressive behaviour in acute mental health settings. Despite restraint being a dominant force in acute mental health care, the psychological impact of this intervention upon staff and patients is relatively unknown with very little research devoted to this area. Guidelines suggest that some form of Post Incident Review should take place following untoward incidents but this is patchy in many areas, and the efficacy of approaches to Post Incident Review has not been clearly documented in related literature. Furthermore, some staff and patients have reported that the experience of restraint triggers memories of previous traumatic encounters which have caused further distress to them during, and in the aftermath of, restraint. This study explores the psychological impact of restraint for staff and patients who are involved in these procedures. In addition, a framework for Post Incident Review is evaluated to establish whether this is a helpful tool to address some of the limitations of current approaches to Post Incident Review. The phenomena of restraint reawakening memories of previous traumatic encounters is also considered within the study to establish whether this has a bearing upon the experience of restraint for those involved in the procedure. The results highlight that the experience of restraint is distressing for staff and patients. The psychological impact ranges from minimal effects, to distress, through to full-blown Post Traumatic Stress Disorder (PTSD). The framework for reviewing incidents was well received by staff and patients and is offered as a way forward in providing a more structured approach to considering untoward incidents between staff and patients. This study has found that the experience of restraint does reawaken memories of previous traumatic encounters for both staff and patients. The study concludes with recommendations for education, further research and clinical practice.

Growth in stepfamily research in recent years has mirrored the growth in the number of stepfamilies in society, however research specific to the role of the stepmother has been recognised to be limited (Coleman, Ganong & Fine, 2000). This study has been designed to address this limitation by conducting a mixed methods approach to research on stepmothers in order to understand the effects of the stepmother role on women’s wellbeing. The research was conducted on a representative stepmother sample of two hundred and fifty stepmothers and eighty biological mothers. The sample was further segmented by residency of the stepchildren and family complexity, to identify differences both between stepmothers and biological mothers, and between different types of stepmother. Results indicated that stepmothers display significantly higher depression and anxiety than biological mothers together with lower perceived social support when compared with biological mothers, particularly from extended family and friends. They were also found to engage in significantly more maladaptive coping mechanisms than biological mothers. The adaptability of stepmothers to their role was found to be predicted by their satisfaction in their spousal relationship and the length of the relationship. The findings from the qualitative study suggested that stepmothers’ anxiety was predominantly related to the presence of the biological mother, the stepchildren and the inherent difficulties with the role itself; with social support from extended family members also affected by the enduring relationship between the stepmother’s in-laws and the biological mother. Further significant differences between the four identified types of stepmother were also found leading to the recommendation that future research recognises and distinguishes between stepmother led families, based on their family complexity and the residency of the stepchildren. The evidence overwhelmingly identifies an urgent need for stepfamily interventions that will facilitate the development of more effective functioning stepfamily units via education and support.

An increasing body of evidence suggests that, in comparison to the general population, patients with severe mental illnesses such as schizophrenia or bipolar disorder have worse physical health and a far shorter life expectancy, due primarily to co-morbid chronic diseases. The standardised mortality ratio for all forms of mental disorder is at least 1.5 and varies with the type and severity of the disorder. Whilst data on the prevalence of chronic diseases in primary care is available nationally, there is a lack of health intelligence on medical co-morbidities associated with chronic mental illnesses. The aim of this PhD was to develop and validate epidemiological models for predicting expected prevalence of two major chronic medical conditions namely, coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD), on general practice data for people with concurrent serious mental illness (SMI) group. The study probed the national epidemiological synthetic estimation of the two physical disorders to determine their prevalence within a local primary care setting and their co-existence within the serious mentally ill (SMI) group identified through the Quality Framework dataset (QOF) within GP practices and their localities. The expected prevalence was compared with recorded cases.

La presente investigación tuvo como objetivo describir, analizar y comprender el cotidiano del cuidador familiar de niños con discapacidad intelectual. Es importante la participación del cuidador familiar, quienes se organizan en función a las necesidades del niño, ya sea en su autocuidado, ayudarlo a desarrollar destrezas sociales y reforzar su razonamiento mediante diferentes actividades de aprendizaje. Esta investigación fue de tipo cualitativa, con metodología de estudio de caso; asimismo, se sustentó con Tedesco para cotidiano; Ferré, Rodero y Aparicio para cuidador familiar; UNICEF para infancia y la Asociación Americana sobre Retraso Mental para discapacidad infantil. Los sujetos de investigación fueron 10 cuidadores familiares de niños con discapacidad intelectual de 7 a 12 años, la muestra se determinó por la técnica de saturación y redundancia. Los datos se recolectaron mediante la entrevista semi estructurada a profundidad, se analizó a través del análisis de contenido temático. Asimismo, durante la investigación se tuvo en cuenta, los criterios de rigor científico y principios bioéticos. Obteniéndose las siguientes categorías: Satisfacción de necesidades básicas y dedicación exclusiva del cuidador familiar. Participación cotidiana en las terapias de rehabilitación: compromiso y responsabilidad. Apoyo familiar para acompañamiento y seguridad del niño con discapacidad intelectual. Concluyéndose, que generalmente son las madres quienes asumen el rol del cuidador familiar, siendo ellas las encargadas de satisfacer las necesidades básicas en sus niños, quienes en ocasiones reciben el apoyo de sus demás familiares a fin que perciban que no están solos y que tienen el soporte físico y moral que necesitan. / Tesis

<p> The purpose of this qualitative study was to explore correctional mental health clinicians&rsquo; views of the role mental illness plays in offending behavior, barriers to effective treatment and receptiveness to criminogenic interventions. The sample consisted of 15 mental health clinicians working in an urban jail. The consensus among participants that was untreated mental illness is a vulnerability factor leading to criminal risk factors. As such, limited support was found for the criminalization hypothesis. There was general endorsement of implementing criminogenic interventions to target criminal risk factors. Barriers to effective treatment largely pertained to lack of collaboration with the sheriff&rsquo;s department and environmental constraints. There was a perceived need for increased community services for continuity of care of inmates following release. The results suggest that social workers should advocate for an integrated treatment approach to target criminal risk factors in addition to mental health needs.</p><p>