Thesis (M.H.A.)--University of Michigan, 1974.

Thesis (M.S.)--University of Michigan, 1974.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Michigan, 1974.

Thesis (M.H.A.)--University of Michigan, 1974.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (Ph.D.)--Mississippi State University. Department of Counseling, Educational Psychology and Special Education. / Title from title screen. Includes bibliographical references. Available also in print.

This dissertation examines recurrent patterns in the interaction between psychiatric patients and the systems of knowledge and power that constitute them as patients. These patterns are traced both in the historical migmti::m of patients into and out of the asylum, and in the language used by doctors and patients to account for such migration. Transcripts of interviews with patients and case notes written by doctors are subjected to new forms of quantitative analysis and this is used together with qualitative interpretation to reveal the ways in which disciplinary power operates through confession and surveillance to constitute psychiatric subjects in the tension between freedom and incarceration. / Psychology / D.Litt. et Phil. (Psychology)

O objeto de estudo desta pesquisa qualitativa é o entendimento dos trabalhadores dos hospitais psiquiátricos sobre a Reforma Psiquiátrica e como lidam com esse processo. A finalidade é contribuir para a ampliação arsenal teórico prático da Reforma Psiquiátrica e propor novas luzes para a sua análise. Tem como objetivos: conhecer o que os trabalhadores dos hospitais psiquiátricos pensam sobre a função do hospital psiquiátrico no contexto da Reforma Psiquiátrica; compreender como os trabalhadores de saúde mental lidam com o processo da desinstitucionalização nas suas práticas. O cenário do estudo foi dois hospitais psiquiátricos, um público e outro privado, sem fins lucrativos, integrados ao SUS e situados no município de São Paulo. Participaram deste estudo 12 (doze) trabalhadores (de nível médio e superior). Os dados empíricos foram obtidos por meio de entrevista individual semi-estruturada. O material empírico foi analisado de acordo com as categorias analíticas: instituição, institucionalização, transição, desinstitucionalização e crise e foi referenciado em Minayo. A análise dos dados deu origem às categorias: a) o hospital psiquiátrico: o lugar da crise; b) a internação da crise; c) desinstitucionalização: a desconstrução de saberes; d) o hospital e a rede em crise; e) a persistência da cultura hospitalocêntrica; f) o hospital psiquiátrico e a família em crise; g) o hospital psiquiátrico e a sociedade. Os trabalhadores descrevem um novo hospital, cuja função é o acolhimento da crise e internação de curta permanência; identificam medidas reformistas de ordem técnica e administrativa, ocorridas no hospital como: especialização no atendimento da clientela; regime de internação de curta permanência x cronicidade; intervenção multidisciplinar x trabalho isolado; melhoria da estrutura física e de recursos humanos; melhoria da ambiência; implantação de projeto terapêutico; redução de leitos hospitalares, em função do atendimento às exigências das portarias ministeriais. Evidencia-se o entendimento de desinstitucionalização como desospitalização. Os discursos dos entrevistados evidenciam uma relação em crise do hospital psiquiátrico com a rede substitutiva de atenção à saúde mental de base comunitária. Os trabalhadores enfrentam dificuldades no processo de des-internação de pacientes com grave problemática social. O hospital psiquiátrico tem sido a própria contradição no atual modelo de atenção em saúde mental no Município de São Paulo e, portanto, nesta perspectiva, sustenta dentro de si as várias contradições advindas de sua própria gênese enquanto instituição, somadas às condições atuais em que se encontra “inexistente” na rede. O hospital psiquiátrico: lugar da crise porque lugar das contradições / The object of study of this qualitative research is the understanding of the psychiatric hospital\'s workers about the Psychiatric Reform and how they deal with this process. The purpose of the study is to contribute for the expansion of the Psychiatric Reform\'s theoretical-practical arsenal and propose new lights to its analyses. Objectives are: know what the psychiatric hospital\'s workers think about the psychiatric hospital in the context of the Psychiatric Reform; understand how mental health workers deal with the process of desinstitutionalization in their practices. The scenery of this study were two psychiatric hospitals, one public and the other private, nonprofit, integrated to SUS and placed in the city of São Paulo. 12 (twelve) workers (medium level and high education) participated in the study. Empirical data were gathered through semi-structured individual interview. The empirical material was analyzed according to the categories: institution, transition, desinstitutionalization and crises, according to Minayo. Data\'s analyses originated the categories: a) the psychiatric hospital: the crisis\'s place; b) crisis\' hospitalization; c) desinstitutionalization: knowledge\'s deconstruction ; d) the hospital and the net in crisis; e) hospital-centered culture\'s persistence; f) the psychiatric hospital and the family in crisis g) the psychiatric hospital and society. Workers described a new hospital, which\'s function is welcoming of crises and short-term hospitalization; it\'s identified reformist\'s technical and administrative measures in the hospital, such as: humanization; attendance of clientele\'s specialization ; short term hospitalization regime X chronic ness; muldisciplinary intervention x isolated work; physical structure\'s and human resource\'s improvement; environment\'s improvement; therapeutic project implantation; hospital wards\' reduction, due to the attendance of Ministry laws. It leads to the understanding of desinstitutionalization as des-hospitalization. Interviewed\'s speech show articulation in crisis between the psychiatric hospital and the substitutive mental health care net, community based. Workers deal with difficulties in the process of des-hospitalization of patients with serious social problematic. The psychiatric hospital has been the contradiction itself in the current mental health care model in the city of São Paulo and, therefore, in this perspective has in itself many contradictions that come from it\'s own genesis as an institution, added to current condition in which it \"doesn’t exist\" in the net. The psychiatric hospital: the crisis\'s place because the place of contradictions

M.Cur. (Psychiatric Nursing) / Burnout has severe consequences for the psychiatric nurse as individual and for the mental health delivery system because of an increase in staff turnover and a decrease in the quality of patientcare. Psychiatric nurses suffering from burnout have the potential to experience job satisfaction, if job satisfaction can be facilitated. Job satisfaction of the psychiatric nurse will promote the mental health for her as individual, her patients, colleagues, family and the community. The following aims were set for the research project: Exploring and describing the aspects which cause and promote burnout amongst psychiatric nurses at a private psychiatric hospital; and to formulate guidelines for the psychiatric nursing specialist to facilitate job satisfaction of psychiatric nurses, as an integral part of mental health by means of mobilisation of resources. Nursing for the Whole Person Theory was used as the theoretical framework for this qualitative,contextual study. Botes' Model (1995:4-9) for Nursing Research was used to structure theresearch. The measures which were used to ensure reliability,validity and credibility of the research, were that of Guba (inKrefting, 1991:214-222).A pilot study was conducted to prevent obstacles during gathering and analysis of data. Specific criteria were set for selectionof participants. After conducting a pilot study, fiveparticipants were purposively selected from the target populationat a private psychiatric clinic.Individual focus interviews were recorded on tape and latertranscribed. Data gathering and data analysis were divided in two phases. Three questions were asked during -Phase 1 regarding burnout, and one during - Phase 2- regarding guidelinesfor the prevention of burnout. Data was analyzed systematicallyand descriptive, combining Tesch's (in Creswell, 1994:115) and Kerlinger's (1986:479) methods.