Made available in DSpace on 2014-12-17T15:38:39Z (GMT). No. of bitstreams: 1 EdilaneNRB.pdf: 461531 bytes, checksum: c5da09252b0d8ed8dcd729ccb9aa7745 (MD5) Previous issue date: 2008-02-27 / This study aims to analyzing the implementation of the Matrix Support proposal with professionals of Substitutive Services in Mental Health in the city of Natal/RN. The Matrix Support (MS) is an institutional arrangement which has been recently adopted by the Health Ministry, as an administrative strategy, for the construction of a wide care net in Mental Health, deviating the logic of indiscriminate follow-through changed by one of co-responsibility. In addition to this, its goal is to promote a major resolution as regards health assistance. Integral attention, as it is intended by the unique health system, may be reached by means of knowledge and practices interchange, establishing an interdisciplinary work logic, through an interconnected net of health services. For the accomplishment of this study, individual interviews of semi-structured character were used as instrument, with the coordinators and technical staff of the CAPs. The data collection was done in the following services: CAPS II ( East and West) and CAPS ad ( North and East), in the city of Natal/RN. The results point out that the CAPs to initiate of the discussion the process in the implementation of the MS aiming, to promote the reorganization and redefinition of the flow in the net, thus not acting in a fragmented way. Nevertheless, there is no effective articulation concerning the basic attention services, there is a major focus of the attention in mental health on the specialized services, little insertion in the territory and in the everyday life of the community / O objetivo deste estudo ? analisar a implementa??o da proposta do Apoio Matricial com profissionais de Servi?os Substitutivos em Sa?de Mental no munic?pio de Natal/RN. O Apoio Matricial (AM) ? um arranjo institucional recentemente incorporado pelo Minist?rio da Sa?de como estrat?gia de gest?o para a constru??o de uma rede ampla de cuidados em Sa?de Mental, desviando a l?gica de encaminhamentos indiscriminados para uma l?gica da co-responsabiliza??o. Ademais, visa produzir maior resolutividade ? assist?ncia em sa?de. Uma aten??o integral, como a pretendida pelo sistema ?nico de sa?de, poder? ser alcan?ada atrav?s da troca de saberes e de pr?ticas, instituindo uma l?gica de trabalho interdisciplinar, por meio de uma rede interligada de servi?os de sa?de. Para operacionaliza??o deste estudo, foram utilizadas como instrumento entrevistas individuais de car?ter semi-estruturado com os coordenadores e equipe t?cnica dos CAPS. A coleta de dados foi realizada nos seguintes servi?os: CAPS II (Leste e Oeste) e CAPSad (Norte e Leste), na cidade de Natal/RN. Os resultados apontam que os CAPS iniciaram o processo de discuss?o da implementa??o do AM, no intuito de promover a reorganiza??o e redefini??o do fluxo na rede, n?o atuando de forma fragmentada. Entretanto falta articula??o efetiva com os servi?os de Aten??o B?sica; h? uma centraliza??o da aten??o em Sa?de Mental nos servi?os especializados, com pouca inser??o no territ?rio e na vida cotidiana da comunidade

Made available in DSpace on 2014-12-17T15:39:02Z (GMT). No. of bitstreams: 1 MarceloMC_DISSERT.pdf: 1182325 bytes, checksum: 37d3d7b4f21c05733759bc6c11d3a94b (MD5) Previous issue date: 2013-05-02 / Currently, several models of management services from the public administration are in operation in Brazil following a global trend. Besides the traditional public management operated in SUS, there are ongoing experiments of privately management in the public health services. Accordingly, we have developed an investigation into two Psychosocial Care Centers operating between these two forms of financial resources management: the first is the CAPS II - PAR situated in the municipality of Parnamirim whose form is private and the second is the CAPS II West Christmas is that the municipal government. We seek to know the workings of services, planning forms and criteria for use of financial resources, identify differences between departments on ways to run and see how technicians and users participate in the planning and management of these resources. Documentary Research was conducted by the municipal Christmas and the financial administration of the CAPS service in Parnamirim. Were conducted an interview with manager (mental health coordinator of Natal) and another interview with an employee of planning department in the Health Department of Natal, an interview with the coordinator and financial administrator of CAPS - PAR and two groups of discussion taped conversation with semi structured script interviews with six technicians in CAPS PAR and six professionals crowded in CAPS - West.Differences were observed in the management of resources funded from four blocks of discussion and analysis of results, where the privately-run service for the direct management and bureaucracy without being discussed and planned spending on staff, as well as through meetings with users, the use of the financial resources available in box; already in service with municipal public administration there is a hierarchy, this answering the coordination of mental health and the local health department that centralizes resources and defines their spending. There are meetings with patients and families, but the demands are limited as to what can be sued because of the manager s authorization. Such differentiation would be related to differences in the articulation of public management with the different types of possible management in public services, where from the implementation of new public administration in the Brazilian s State Management Reform initiated in the second half of the 1990s, benefit management services with private regime, with autonomy and direct transfer of resources / Atualmente, diversos modelos de ger?ncia dos servi?os a partir da gest?o p?blica est?o em opera??o no Brasil seguindo uma tend?ncia mundial. Al?m da tradicional ger?ncia p?blica operada na rede SUS, h? experi?ncias em curso de ger?ncia privada de servi?os p?blicos de sa?de. Nesse sentido, desenvolvemos uma investiga??o em dois Centros de Aten??o Psicossocial que operam entre essas duas formas de ger?ncia os seus recursos financeiros: o primeiro deles ? o CAPS II PAR situado no munic?pio de Parnamirim cuja forma ? a privada e o segundo ? o CAPS II - Oeste de Natal que ? da administra??o p?blica municipal. Buscamos conhecer o modo de funcionamento dos servi?os, as formas de planejamento e crit?rios para utiliza??o dos recursos financeiros, identificar diferen?as entre os servi?os quanto ?s formas de ger?ncia e verificar como t?cnicos e usu?rios participam no processo de planejamento e manejo desses recursos. Foi realizada Pesquisa Documental junto ? gest?o municipal de Natal e ? administra??o financeira do servi?o CAPS em Parnamirim. Foram realizadas uma entrevista com gestor (coordenadora de sa?de mental do munic?pio de Natal) e outra entrevista com funcion?ria de planejamento da secretaria municipal de sa?de de Natal, uma entrevista com coordenadora e administradora financeira do CAPS - PAR e duas rodas de conversa gravadas com roteiro de entrevista semiestruturado com seis t?cnicos no CAPS PAR e seis profissionais lotados no CAPS Oeste. Foram constatadas diferen?as na ger?ncia dos recursos financiados a partir de quatro blocos de discuss?o e an?lise dos resultados, em que no servi?o com ger?ncia privada h? o manejo direto e sem burocracia, sendo discutidos e planejados os gastos em equipe, bem como atrav?s de assembleias com usu?rios, a utiliza??o do recurso financeiro dispon?vel em caixa; j? no servi?o com gest?o p?blica municipal h? uma hierarquiza??o, este respondendo ? coordena??o de sa?de mental, sendo a secretaria municipal de sa?de que centraliza os recursos e define os seus gastos. H? assembleias com usu?rios e familiares, mas as demandas s?o limitadas quanto ao que pode ser demandado devido ? autoriza??o do gestor. Tal diferencia??o estaria relacionada com as diferen?as na articula??o da gest?o p?blica com os diferentes tipos de ger?ncia poss?veis nos servi?os p?blicos, onde a partir da implanta??o da nova administra??o p?blica na reforma gerencial do Estado brasileiro iniciada na segunda metade da d?cada de 1990, s?o beneficiados os servi?os com ger?ncia em regime privado, com autonomia e repasse direto dos recursos

Made available in DSpace on 2014-12-17T15:40:37Z (GMT). No. of bitstreams: 1 SilvaniaCB.pdf: 663508 bytes, checksum: 80efd72b9e7e65a84c35430d8a931d06 (MD5) Previous issue date: 2008-05-05 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The importance of identifying the consequence of the hours worked on people in society has been well recognized within Organizational and Work Psychology. From this point of view, the present research had the objective of analysing the effects of work regimes on the mental health of petroleum operators of Petrobr?s. The sample totaled 144 subjects, corresponding to 27% of the work population. The mental health of the participants was evaluated using the following instruments of measurement: QSG-12, Scale of self-esteem, Scale of Positive and Negative Affections and the Scale of Valuable Attributes of IMST, each representing an empirical factor used to indicate and measure the five dimensions of mental health. The subjects perceptions of their work regime and the rest of their conditions of work were evaluated using scales of descriptive attributes of IMST, by applying a semi-structured questionnaire and by use of interviews. A socio-demographic file was used to collect information related to the biographical and socio-occupational profile of the worker sample. The answers to the questionnaire were inserted into the data bank of SPSS (Statistical Package for Social Science), for statistical analysis, and the interviews were analised based on the technique of Contents Analysis recommended by Bardin (1995). The main results revealed that one third of the worker sample were tense; however, the mental health of the majority was preserved. Cluster Analysis applied to the group of seven factors which measured the five dimensions of mental health identified four profiles of psychological well-being shared between members of the sample. It was observed that the people working in the system of Continuous Shift Alternation (TIR) and in the system of Pre-advising tended to present balanced and satisfactory profiles, while the ones which worked in the Administrative Field tended to present anxious and oscillating profiles, and thus were more affected psychologically. These were also the ones that also perceived the more negative aspects of their laborious conditions (reduced chances of self-improvement, physically stressful and financial resources below expectations with which to supply family and personal necessities. In agreement with the ecological model formulated by Warr (1987), the present study concluded that the positive and negative effects on the psychological well-being tended to occur as a consequence of the perceptions the petrol operators developed to face their work conditions / A import?ncia de identificar as conseq??ncias dos hor?rios de trabalho para os indiv?duos inseridos na atual sociedade 24 horas, tem sido amplamente reconhecida dentro da Psicologia Organizacional e do Trabalho. Partilhando desse interesse, a presente pesquisa objetivou analisar os efeitos dos regimes de trabalho sobre a sa?de mental dos operadores de petr?leo da Petrobr?s. A amostra totalizou 144 sujeitos, correspondendo a 27% da popula??o. A sa?de mental dos participantes foi avaliada por meio dos seguintes instrumentos: QSG-12, Escala de Auto-estima, Escala de Afetos Positivos e Negativos e a escala de atributos valorativos do IMST, sendo cada fator emp?rico usado como indicador para medir cinco dimens?es da sa?de mental. A percep??o sobre os regimes e demais condi??es de trabalho foram avaliadas por meio das escalas de atributos descritivos do IMST, de um question?rio semi-estruturado e de entrevistas. Tamb?m se usou uma ficha s?cio-demogr?fica para colher informa??es relativas ao perfil biogr?fico e s?cio-ocupacional da amostra. As respostas aos question?rios foram digitadas na forma de banco de dados do SPSS (Statistical Package for Social Science for Windows), por meio do qual se procedeu com as an?lises estat?sticas, e as entrevistas foram analisadas com base na t?cnica de an?lise de conte?do recomendada por Bardin (1995). Os principais resultados revelam que um ter?o da amostra se encontra tensa, contudo a sa?de mental est? preservada para a maioria. A an?lise de cluster aplicada ao conjunto dos sete fatores que mediram as cinco dimens?es de sa?de mental identificou quatro perfis de Bem-estar Psicol?gico compartilhados entre a amostra. Observou-se que o pessoal engajado em regimes de Turno Ininterrupto de Revezamento (TIR) e de Sobreaviso tende a apresentar perfis Equilibrado e Satisfat?rio, enquanto os que trabalham em regimes Administrativo de Campo e Administrativo tendem a apresentar perfis Ansioso e Oscilante, sendo estes ?ltimos os mais afetados psiquicamente e que percebem mais negativamente as condi??es laborais (chances reduzidas de aperfei?oamento, fisicamente desgastantes e recursos financeiros reduzidos ou abaixo do esperado para suprir as necessidades pessoais e familiares). Em conformidade com o modelo ecol?gico formulado por Warr (1987), o presente estudo concluiu que os efeitos positivos ou negativos no bem-estar psicol?gico tendem a acontecer como conseq??ncia da percep??o que os operadores desenvolvem frente ?s condi??es de trabalho

Made available in DSpace on 2014-12-17T15:40:37Z (GMT). No. of bitstreams: 1 AnaKMAA.pdf: 721472 bytes, checksum: 5cd824660d049da327ec362a175c2783 (MD5) Previous issue date: 2008-10-24 / This thesis seeks to uphold the idea that the therapeutic residential service, as hybrid device and recent process of deinstitutionalization in mental health, works as a problem producer while it also indicates challenges and potentialities in this process, the attention on mental health and on its own care production. To that end, we work with the prospect map with which we approach reality as the subjectivities production field which transformations and intensities are the major thought propellants. From this perspective, it was possible to produce three "purpose maps" from meetings with actors and groups involved with the TRS and the theoretical study carried out. On the first map we mapped the conditions of possibility of this device and its design in the midst of the process of institutionalization and health policies. We indicate on it the TRS configuration as a hybrid and we hassled its proposition as a means of "social rehabilitation" that can work as a social homogeneity mechanism. On a second map, we cartographied mental captures through images and ways historically built from madness presented in the biopolitical contemporary game and we indicated that the resistance to such catches should be built on a politic daily basis as important vectors of the institutionalization process in mental health. Finally, on a third map we mapped the carefulness produced in the TRS, by analyzing the transition psychiatric hospital - TRS and the caregivers? team work. On this mapping, the care, for the weakness in the coresponsibility field, is reveled crossed by mental, disciplinary and normality elements, but it is also built in resistance born from links in the intersubjective field of the caring work. We conclude, then, that the TRS power and the deinstitutionalization process itself were in building and strengthening affective labor micro political networks of life and liberty producers / Esta tese procura defender a id?ia de que o servi?o residencial terap?utico, enquanto dispositivo h?brido e recente do processo de desinstitucionaliza??o em sa?de mental, funciona como problematizador ao mesmo tempo em que indica desafios e potencialidades desse processo, da aten??o em sa?de mental e dele pr?prio na produ??o do cuidado. Para tanto, trabalhamos com a perspectiva cartogr?fica com a qual nos aproximamos da realidade como campo de produ??o de subjetividades cujas transforma??es e intensidades s?o os principais propulsores do pensamento. Desde tal perspectiva, foi poss?vel produzir tr?s mapas de efeitos dos encontros com os atores e coletivos envolvidos com o SRT e do estudo te?rico realizado. No primeiro mapa cartografamos as condi??es de possibilidade desse dispositivo e a sua concep??o no bojo do processo de desinstitucionaliza??o e das pol?ticas de sa?de. Indicamos nele a configura??o do SRT como um h?brido e problematizamos a sua proposi??o como um dispositivo de reabilita??o social que pode funcionar como mecanismo de homogeneiza??o social. Num segundo mapa, cartografamos capturas manicomiais em imagens e sentidos historicamente constru?dos da loucura presentes no jogo biopol?tico contempor?neo e indicamos que as resist?ncias a tais capturas precisam ser constru?das na micropol?tica cotidiana enquanto vetores importantes do processo desinstitucionaliza??o em sa?de mental. Por fim, num terceiro mapa cartografamos o cuidado produzido no SRT, atrav?s da an?lise da transi??o hospital psiqui?trico - SRT e do trabalho da equipe de cuidadores. Nessa cartografia, o cuidado, pela fragilidade no campo da co-responsabiliza??o, revela-se atravessado por elementos manicomiais, disciplinares e normatizantes, mas tamb?m constru?do nas resist?ncias que nascem dos v?nculos, no campo intersubjetivo do trabalho de cuidar. Conclu?mos, ent?o, que a pot?ncia do SRT e do pr?prio processo de desinstitucionaliza??o estariam na constru??o e fortalecimento de redes micropol?ticas de trabalho afetivo produtoras de vida e liberdade

Submitted by Verena Bastos (verena@uefs.br) on 2015-08-06T00:19:00Z No. of bitstreams: 1 disserta??o - Thalles da Costa Lob? Pereira.pdf: 6508056 bytes, checksum: c0141171c50a301a2950a9cf4fd5b1a2 (MD5) / Made available in DSpace on 2015-08-06T00:19:00Z (GMT). No. of bitstreams: 1 disserta??o - Thalles da Costa Lob? Pereira.pdf: 6508056 bytes, checksum: c0141171c50a301a2950a9cf4fd5b1a2 (MD5) Previous issue date: 2012-04-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Primary health care structure the Unified Health System in Brazil. However, the primary health care workers experience increasing demands, repetitive tasks, fast pace and lack of autonomy on their jobs. These are organizational factors, which can be grouped by psychosocial work characteristics of demand-control model. Demand-control model has assessed job stress and mental and physical illness. Then this study examined the association between psychosocial work characteristics and common mental disorders (CMD) in primary health care workers of Belo Horizonte, Brazil. This study examined the association between psychosocial work characteristics and common mental disorders (CMD) in primary health care workers of the city of Belo Horizonte, Southeastern Brazil. A cross-sectional study was conducted. A stratified random sampling method was used to select 1,808 health workers. A total of 1,024 participants worked in primary care services. Psychosocial work characteristics were assessed using the demand control model, while common mental disorders were evaluated with the Self-Reporting Questionnaire. The association measures were crude and adjusted prevalence ratios, 95% confidence intervals and p-values. The prevalence of CMD was 27.9% (95%CI = 25.1%-30.7%). Associations were found between common mental disorders and demands (p < 0,001), control (p = 0,008) and social support (p < 0,001). High strain was strongly associated with CMD after adjusting for confounders (PR = 2,52, 95%CI = 1.55-4.08). There was a high prevalence of CMD among primary health care workers. In this study, psychological demands and control had the same influence on mental health. It is recommended that changes should be made in the work characteristics of primary health care. Additionally, the quality of health services will not improve while workers? health policies are not applied. / A aten??o b?sica ? o primeiro n?vel de aten??o e estrutura o Sistema ?nico de Sa?de. Entretanto, o trabalho nos servi?os de aten??o b?sica apresenta demandas crescentes, repetitividade das tarefas, rapidez no atendimento e perda da autonomia. Tais caracter?sticas podem ser agrupadas segundo aspectos psicossociais do modelo demanda-controle. O modelo demanda-controle tem sido usado para avaliar a rela??o entre estresse ocupacional e agravos ? sa?de, entre os quais transtornos mentais. Logo, este estudo avaliou a associa??o entre aspectos psicossociais do trabalho e transtornos mentais comuns em trabalhadores da aten??o b?sica de Belo Horizonte. Trata-se de uma investiga??o com delineamento transversal. A amostra foi aleat?ria, estratificada por ?reas geogr?ficas, setor de atua??o e grupos ocupacionais. A amostra totalizou 1.808 indiv?duos, dos quais 1.072 eram trabalhadores da aten??o b?sica. Os aspectos psicossociais foram avaliados por meio das categorias do modelo demanda-controle, enquanto transtornos mentais comuns (TMC) foram avaliados pelo Self-Reporting Questionnaire (SRQ-20). Adotou-se o ponto de corte 6/7 para mulheres e 5/6 para homens no SRQ-20. Os pontos de corte dos indicadores do JCQ foram as m?dias. As medidas de associa??es foram raz?es de preval?ncias intervalos de 95% de confian?a e valores de p. A an?lise ajustada envolveu a constru??o de um modelo de regress?o log?stica. A preval?ncia de TMC foi de 27,9%. Houve associa??o entre transtornos mentais e os aspectos de demandas (p?0,001), controle (p=0,008) e suporte social (p?0,001). A categoria de alta exig?ncia apresentou forte associa??o com TMC ap?s ajuste por confundidores (RP=2,52, IC95%=1,55-4,08). Neste estudo, demandas psicol?gicas e controle tiveram influ?ncias semelhantes sobre a sa?de mental. Sugerem-se mudan?as no processo de trabalho na aten??o b?sica e execu??o das pol?ticas de sa?de do trabalhador da sa?de.

Made available in DSpace on 2015-04-14T13:22:18Z (GMT). No. of bitstreams: 1 456113.pdf: 759751 bytes, checksum: e615c642846b03f23356fb7c530a205e (MD5) Previous issue date: 2014-01-21 / This study aimed at investigating the work process called Matrix Support in Mental Health in Primary Health Care by taking into account the guidelines issued by the Brazilian Unified Health System and Psychiatric Reform so that its guidelines, professional principles and values could be identified. This qualitative study was carried out with both experts in mental health and generalist professionals who work in Family Health in Gravata?, RS, Brazil. Tools were semi-structured interviews and focal groups. Results show that the work gets support on collective work carried out between the expert and the generalist, through personalized relations developed among supporters and generalists, on immaterial resources and on assistance broadening. The psychosocial paradigm as well as the one that deals with life production was also identified. The systematicity of meetings, experts&#8223; bias in public health, identification with the work itself and decentralization as a life ideal were considered the elements that lever work. One of the findings, in agreement with literature published worldwide, is the existence of leadership in mental health; it has been acknowledged by Primary Health Care peers and professionals who deal with people and mediate relations with other services in the network. Complexity results from different wishes, interests and forces expressed by all agents involved in the process; thus, structural, organizational and managerial issues, which may become obstacles, also have to be addressed. Factors that boost the process are professionals&#8223; personalized relations, availability, commitment, clear communication and co-responsibilization. Professional principles that underlie the practice trigger the wish to work in a community, to decentralize positions, to know the network, to know how to listen and to reach consensus. Values found in the relations and interaction are based on reception, on care relations among professionals in their teams, with other teams and users, on humbleness, on generosity regarding knowledge sharing and on commitment. Concerning Primary Health Care professionals, knowledge and background assistance contribute to solve cases collectively, rather than take them to specialized services, as before. It must be highlighted that this methodology qualifies interventions in mental health because, when experience and knowledge are shared, care is provided as a whole. Boosting factors were the bond with the supporter, communication, the structure of the Family Health teams, the systematicity of meetings, the longitudinality, the co-responsibilization and the support itself. An obstacle to the work is the imposition of barriers to access the Psychosocial Care Center after the Matrix Support was institutionalized. Results of both groups under investigation show that the focus is on the people involved in the process, rather than on the process itself. Data infer that the quality of relations, the professionals&#8223; characteristics and the personal and professional principles and values involved in the process support this practice which has such specific features. / A pesquisa teve por objetivo geral investigar o processo de trabalho Apoio Matricial em Sa?de Mental na Aten??o Prim?ria, levando em conta as diretrizes do Sistema ?nico de Sa?de e da Reforma Psiqui?trica, com vistas ? identifica??o das diretrizes, princ?pios profissionais e valores que permeiam o processo. O delineamento do estudo ? qualitativo. Os participantes foram profissionais especialistas em sa?de mental e generalistas da Estrat?gia Sa?de da Fam?lia de Gravata?/RS, Brasil. Os instrumentos utilizados foram entrevistas semiestruturadas e grupos focais. Os resultados evidenciam que o trabalho sustenta-se no trabalho relacional em ato, mediante as rela??es personalizadas institu?das entre apoiadores e generalistas; nos recursos imateriais; e na amplia??o da cl?nica. Dois outros paradigmas foram identificados, o psicossocial e o de produ??o de vida. A sistematicidade dos encontros, o vi?s de sa?de p?blica dos especialistas, a identifica??o com o trabalho, a descentraliza??o como um ideal de vida foram identificados como elementos que subsidiam o trabalho. descentraliza??o como um ideal de vida foram identificados como elementos que subsidiam o trabalho. Um achado, que encontra resson?ncia na literatura internacional, ? a exist?ncia de lideran?a em sa?de mental, reconhecida pelos pares e profissionais da APS, que mobiliza pessoas e intermedia as rela??es com os demais servi?os da rede. A complexidade decorre em raz?o dos diferentes desejos, interesses e for?as dos distintos agentes envolvidos, que remete ?s quest?es de ordem estrutural, organizacional e de gest?o. Estes podem atuar como obst?culos ao processo. Dentre os fatores facilitadores est?o as rela??es personalizadas entre os profissionais; a disponibilidade; o comprometimento; a comunica??o fluida e dial?gica; e a corresponsabiliza??o. Os princ?pios profissionais que subjazem ?s pr?ticas organizam-se em torno do desejo de trabalhar na comunidade; n?o centralizar fun??es; conhecer a rede; ter habilidades de escuta; e de construir consensos. Os valores presentes nas rela??es e intera??es pautam-se no acolhimento; nas rela??es de cuidado intra e interequipes e com os usu?rios; na humildade; na generosidade de partilhar o saber; e no comprometimento. Com rela??o aos profissionais da APS, o aporte de conhecimentos e a retaguarda assistencial contribuem para a abordagem conjunta e resolu??o de casos, que anteriormente eram referenciados a servi?os especializados. Evidencia-se que esta metodologia qualifica as interven??es em sa?de mental, mediante a troca de experi?ncias e saberes, colaborando para a integralidade da aten??o. O v?nculo com o apoiador, a comunica??o, a estrutura das equipes de Sa?de da Fam?lia, a sistematicidade dos encontros, a longitudinalidade e a corresponsabiliza??o foram apontadas como fatores facilitadores. Um obst?culo ao trabalho diz respeito ? imposi??o de barreiras de acesso ao Centro de Aten??o Psicossocial, ap?s a institui??o do Apoio Matricial. Os resultados dos dois grupos investigados evidenciam que o enfoque n?o ? sobre o processo propriamente dito, mas primordialmente sobre as pessoas envolvidas nele. Os dados permitem inferir que a qualidade das rela??es, as carater?sticas dos profissionais, os princ?pios e valores profissionais e pessoais envolvidos sustentam uma pr?tica com contornos singulares.

Submitted by Celso Magalhaes (celsomagalhaes@ufrrj.br) on 2018-03-14T14:33:47Z No. of bitstreams: 1 2017 - Geruza Valadares Souza.pdf: 1005345 bytes, checksum: 523605753069c0de09582df153affbb0 (MD5) / Made available in DSpace on 2018-03-14T14:33:47Z (GMT). No. of bitstreams: 1 2017 - Geruza Valadares Souza.pdf: 1005345 bytes, checksum: 523605753069c0de09582df153affbb0 (MD5) Previous issue date: 2017-07-19 / Avec le mouvement de la r?forme des centres psychiatriques de soins psychosociaux qui font la cr?ation d'ateliers importants dispositifs d'accueil des sujets en d?tresse mentale sont cr??s. L'objectif de ce travail est de discuter du fonctionnement de la cr?ation d'ateliers, remettant en question dans quelles conditions les actions constituent ou non un dispositif de promouvoir l'autonomie et l'inclusion sociale dans le domaine de la sant? mentale. Avec la proposition de rechercher des discours / pratiques qui guident une vision de la d?valuation des activit?s manuelles et de domination d'exploitation et la capture subjectivit?s par la production capitaliste imp?ratif, nous adoptons la m?thode g?n?alogique Foucault - qui consiste ? l'analyse historique des connaissances et pratiques - pour enqu?ter sur les conditions de possibilit? qui favorisaient la d?valuation du manuel ? la clinique et la dissociation cons?quente entre cela et faire intellectuel. Notre engagement est de proc?der ? l'analyse du travail comme ontologie, nous trouvons dans les hypoth?ses Arts and Crafts (MAO) ? penser ? d'autres rapports du sujet avec le travail et le faire manuel. Le MAO propose l'appr?ciation du m?tier de fabrication comme une alternative au travail m?canique et st?r?otyp?e de l'?re industrielle qui appauvrit les exp?riences de l'homme dans leurs actions quotidiennes. Nous croyons que la recherche sur les bateaux de fabrication, peut contribuer ? l'analyse de l'utilisation des activit?s manuelles dans la perspective historico-politique de faire manuel comme un dispositif pour favoriser l'autonomie et l'inclusion sociale. Nous comprenons que la recherche sur l'activit? artisanale du travail de conception comme ontologie permettent d'accro?tre la connaissance de la sant? mentale sur la relation de l'homme ? faire aussi bien que contribuer ? une analyse plus puissante sur les faits et gestes des ateliers de cr?ation / Com o movimento da Reforma Psiqui?trica s?o criados os Centros de Aten??o Psicossociais que tomam as oficinas de cria??o como importantes dispositivos de acolhimento dos sujeitos em sofrimento mental. O objetivo deste trabalho ? problematizar o funcionamento das oficinas cria??o, questionando em que condi??es os fazeres constituem ou n?o um dispositivo de promo??o de autonomia e inclus?o social no campo da Sa?de Mental. Com a proposta de pesquisar os discursos/pr?ticas que norteiam uma vis?o de desvaloriza??o das atividades manuais e que operam a domina??o e captura de subjetividades, atrav?s do imperativo capitalista de produ??o, adotamos a metodologia geneal?gica de Foucault ? que consiste na an?lise hist?rica de saberes e pr?ticas ? para investigar as condi??es de possibilidades que promoveram a desvaloriza??o do fazer manual na cl?nica e a consequente dissocia??o entre este e o fazer intelectual. Nossa aposta consiste em realizar a an?lise do trabalho como ontologia, encontramos no Movimento de Artes e Of?cios (MAO) pressupostos para pensar outras rela??es do sujeito com o trabalho e o fazer manual. O MAO prop?e a valoriza??o do fazer artesanal como alternativa ao trabalho mec?nico e estereotipado da ?poca industrial que empobrecia as experi?ncias do homem em suas a??es cotidianas. Acreditamos que a pesquisa sobre o fazer artesanal, possa contribuir para a an?lise do uso das atividades manuais sob a perspectiva hist?rico-pol?tica do fazer manual, como dispositivo que promova a autonomia e inclus?o social. Entendemos que a pesquisa sobre a atividade artesanal a partir da concep??o do trabalho como ontologia, permita ampliar os conhecimentos da Sa?de Mental sobre a rela??o do sujeito com o fazer, assim como contribuir para an?lises mais potentes acerca do fazeres nas oficinas de cria??o.

Made available in DSpace on 2014-12-17T14:46:45Z (GMT). No. of bitstreams: 1 RafaellaLF_DISSERT.pdf: 2798066 bytes, checksum: 2879911f6624e66fe714a101150fa9dc (MD5) Previous issue date: 2010-10-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The psychiatric care and mental health are undergoing constant change over the History. The Brazilian Psychiatric Reform, which brings up the deinstitutionalization as a structuring in the restorative care process. The Reform has as one of the mainly substitutive services the Centers for Psychosocial Care (CAPS), which work from the Singular Therapeutic Project (PTS) in order to restore the autonomy and restore the dignity of users. The therapeutic workshop is some of the resources used and work several kinds of activities as: writing, handcraft, music, poetry, and so forth. This study set up to apprehend the social representations of helping of the music workshop carried out in the CAPS II east of Natal/RN, from the reports given by the participants of the workshop, using the focal group as technique. This is a descriptive exploratory study with a qualitative approach. A total of 16 users participated in four musical therapeutic workshops from April to May 2010. The study was approved by the Ethics and Research Committee of UFRN. The discursive material from the workshop was submitted to the informational resource of Analyse Lexicale par Contexte d um Ensemble de Segments de Texte, ALCESTE, and analyzed based on the Theory of Representations and the Central Core Theory. The majority of subjects were men (62.5%), single (62.5%), aged 40-49 years (37.6%) and elementary school level (56.2 %). The reports were transcribed and submitted to the classification system of ALCESTE, which elected the following categories: Category 1 - Experience in the Word Family Sung, Category 2 - Musical Experiences and Approaches, and Category 3 - Feelings and emotions evoked by music. The representation of these individuals is anchored in the experience they have with the CAPS, lived and socialized by common sense, through this particular social group workshop objectified in music therapy as a therapeutic modality enjoyable. The central core revealed the intrinsic relationship between users and the music, establishing a relationship of openness to use the same while its therapeutic use in workshops of substitute services for mental health. Peripherals elements issues are related to listen, share and experience music in the family. Intermediary Elements relate to the feelings and emotions evoked by music, given her close relationship with it. It was found in the study that music can be construed as an artifact of good therapeutic responsiveness to users, configuring it as an invigorating and enjoyable therapy, confirming the need for continuity of this activity, as well as its expansion into the service / O cuidado em psiquiatria e sa?de mental, ao longo da hist?ria, vem passando por constantes mudan?as. A Reforma Psiqui?trica Brasileira, que traz ? tona a desinstitucionaliza??o como eixo estruturante do processo de reestrutura??o da assist?ncia, tem como um dos principais servi?os substitutivos os Centros de Aten??o Psicossocial (CAPS). Estes trabalham a partir do Projeto Terap?utico Singular (PTS) a fim de restituir a autonomia e resgatar a dignidade dos usu?rios. As oficinas terap?uticas s?o alguns dos recursos utilizados e trabalham v?rios tipos de atividades como: escrita, artesanato, m?sica, poesia, dentre outros. Este estudo teve como objetivo apreender as representa??es sociais das contribui??es da oficina de m?sica desenvolvida no CAPS II Oeste do munic?pio de Natal/RN, a partir dos relatos dos participantes da oficina, utilizando a t?cnica do grupo focal. Trata-se de um trabalho descritivo explorat?rio com abordagem qualitativa. Participou de quatro oficinas terap?uticas de m?sica um total de 16 usu?rios, no per?odo de abril a maio de 2010. A pesquisa foi aprovada pelo Comit? de ?tica e Pesquisa da UFRN. O material discursivo proveniente das oficinas foi submetido ao recurso informacional do Analyse Lexicale par Contexte d um Ensemble de Segments de Texte, ALCESTE, e analisado com base na Teoria das Representa??es Sociais e na Teoria do N?cleo Central. Os sujeitos se caracterizaram em sua maioria como homens (62,5%), solteiros (62,5%), com idade entre 40-49 anos (37,6%) e grau de escolaridade prevalente no Ensino Fundamental Incompleto (56,2%). Os relatos foram transcritos e submetidos ao sistema de classifica??o do ALCESTE, que elegeu as seguintes categorias: Categoria 1 Experi?ncia da Palavra Cantada na Fam?lia; Categoria 2 Experi?ncias e Aproxima??es Musicais; e Categoria 3 Sentimentos e emo??es evocados pela m?sica. A representa??o desses indiv?duos encontra-se ancorada na experi?ncia que eles t?m com o CAPS, vivenciada e socializada pelo senso comum, por meio desse grupo social espec?fico objetivada na oficina terap?utica de m?sica, enquanto modalidade terap?utica prazerosa. O N?cleo Central evidenciou a rela??o intr?nseca existente entre os usu?rios e a m?sica, estabelecendo uma abertura ao v?nculo de aproveitamento da mesma enquanto seu uso terap?utico em oficinas de servi?os substitutivos de sa?de mental. Os Elementos Perif?ricos apontam quest?es relacionadas ao ouvir, partilhar e vivenciar a m?sica em fam?lia. Os Elementos Intermedi?rios relacionam-se aos sentimentos e emo??es evocados pela m?sica, diante de sua rela??o estreita com a mesma. Constatou-se no estudo que a m?sica se configura como um artefato terap?utico de boa receptividade pelos usu?rios, configurando-se como uma terapia revigorante e prazerosa, firmando a necessidade de continuidade dessa atividade, bem como sua expans?o, dentro do servi?o

Made available in DSpace on 2014-12-17T14:46:45Z (GMT). No. of bitstreams: 1 TarcianaSC_DISSERT.pdf: 2117561 bytes, checksum: a2f9349c2f46dbd6ce80b38d80f3068e (MD5) Previous issue date: 2010-10-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Brazilian health public assistance is going through two Reforms, Sanitary and Psychiatric, and through these the assistance is guaranteed in the three levels: primary, secondary and tertiary. Thus, mental health assistance should be offered since preventive cares until the ones that demand larger technological apparatus. Programs like Health Community Agent's Program (HCAP) and Family Health Strategy (FHS), besides increasing the services coverage, have been making possible the system reorientation in the meaning of integrality, universalization and equity. Thus, united intervention of mental health team and FHS can offer several benefits to the population, providing assistance and follow-up to patients with mental disorder. It was aimed to assess health community agents facing the user of Family Health Strategy in depressive state. This quanti-qualitative study took place in the municipal district of Abaiara-CE. Semi-structured interview was applied with health community agents and Beck Depression Inventory with the users registered in Family Health Strategy. It was verified that among the 64 users interviewed, 12.5% didn't present symptoms of depression, 10.9% presented symptoms of light depression, 14.1% symptoms of moderate depression and 62.5% symptoms of serious depression. For the 22 health community agents interviewed, they all reported the existence of people with symptoms of depression in their personal micro-areas, being difficult to work with them, once the FHS team is not qualified to work with mental health problems. It was verified that the Municipal district doesn't have specialized professionals, making difficult the routing and treatment. Based on these results, it was concluded that in spite of the articulation of mental health with FHS is necessary and benefactor to the population, it still doesn't exist, worsening the situation, mainly in small Municipal districts, once they don't have mental health services. Thus, the population is exposed and without follow-up, which allows the identification of installed diseases and with gravity, like depression, because there are no prevention and control activities. It is recommended, due the extreme need, the elaboration and implantation of a mental health program in these municipal districts, articulated with FHS / A assist?ncia p?blica ? sa?de brasileira perpassa por duas Reformas, a Sanit?ria e a Psiqui?trica, e trav?s destas garante-se a assist?ncia nos tr?s n?veis: prim?ria, secund?ria e terci?ria. Neste sentido, a assist?ncia ? sa?de mental deve ser prestada desde os cuidados preventivos at? os que exigem maior aparato tecnol?gico. Programas como o Programa de Agentes Comunit?rios de Sa?de (PACS)/ Estrat?gia Sa?de da Fam?lia (ESF), al?m de ampliarem a cobertura de servi?os, t?m possibilitado reorienta??es do sistema no sentido da integralidade, universaliza??o e equidade. Assim, a interven??o conjunta da equipe em sa?de mental e a ESF podem oferecer diversos benef?cios ? popula??o, proporcionando assist?ncia e acompanhamento aos portadores de transtorno mental. Desse modo, objetivou-se avaliar as a??es dos agentes comunit?rios de sa?de diante do usu?rio da Estrat?gia Sa?de da Fam?lia com estados depressivos. Este estudo do tipo quantiqualitativo, realizou-se no munic?pio de Abaiara-CE. Aplicou-se a entrevista semiestruturada com os agentes comunit?rios de sa?de e o Inqu?rito de Beck aos usu?rios cadastrados na Estrat?gia Sa?de da Fam?lia. Verificou-se que dentre os 64 usu?rios entrevistados, 12,5% n?o apresentaram sintomas depressivos, 10,9% sintomas de depress?o leve, 14,1% sintomas de depress?o moderada e 62,5% sintomas de depress?o grave. Os 22 agentes comunit?rios de sa?de entrevistados relataram a exist?ncia de pessoas com sintomas depressivos em suas micro ?reas e destacaram a dificuldade em atuar junto a esta clientela, pois para eles a equipe da ESF n?o se encontrava capacitada para lidar com problemas de sa?de mental. Constatou-se que o Munic?pio n?o dispunha de profissional especializado, o que dificultava o encaminhamento e tratamento. Com base nestes resultados, concluiu-se que apesar da articula??o da sa?de mental com a ESF ser necess?ria e benfeitora ? popula??o, esta ainda ? inexistente, agravando a situa??o, principalmente em munic?pios de pequeno porte, uma vez que estes n?o disp?em de servi?os de sa?de mental. Assim, a popula??o permanece exposta e sem acompanhamento, o que permite a identifica??o de doen?as instaladas e com gravidade, como a depress?o, por n?o haver atividades de preven??o e controle. Recomenda-se a elabora??o e implanta??o de um programa de sa?de mental nestes munic?pios, de forma articulada com a ESF

Made available in DSpace on 2014-12-17T14:46:51Z (GMT). No. of bitstreams: 1 JoaoMPJ_DISSERT_1-24.pdf: 559047 bytes, checksum: 9b5f4e9a34444f63318115efbb2f6428 (MD5) Previous issue date: 2011-12-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / In Brazil, the mental health network proposed by the Psychiatric Reform inserts the intermediate and replacement services in the pursuit of alignment or resocialization of patients with mental and behavioral disorder in the community. Was adopted, among other services, the Center for Psychosocial Care, Home Therapy, Sheltered Home, Day Hospital and psychiatric beds in general hospital. In this context, the State of Rio Grande do Norte implanted the Day Hospital Dr. Elger Nunes (HDEN) in Natal / RN in 1996, linked to State Department of Public Health. At HDEN happened a multi and interdisciplinary therapeutic work, besides being the scene of disciplinary practices, and extension projects for graduate courses in Higher Education Institutions in the city. However, with the process of decentralization of local services, the hospital was terminated by an administrative state act in 2006, leaving damage to the activities provided to users, disciplinary practices and extension activities. From this breakdown, the objective was to narrate the trajectory of HDEN through a multidisciplinary team of professionals and teachers who used it as a field of disciplinary practices. It is characterized as a documental and qualitative, backed in the technique of thematic oral history, following the phases: authorization of the interviewee, interview recording, transcription, textualization and transcreation of the material obtained. We used documents, ordinances, general reports of activities, among others, plus interviews to fifteen employees who used this service, being thirteen part of the multidisciplinary team of professionals and two graduation professors of health care area, nursing and medicine. The stories collected were organized according to the technique chosen, respecting its steps. In preparing the body subjected to ALCESTE computer program, priority was given to the vital tone for the formation of categories and classes elected by the program, structured in three thematic areas. In the first axis, called Trajectory of HDEN, were recalled the beginning of its activities, the steps of that time, their activities, and its actors - users, families, professionals, and teaching practices. The second axis has dealt with the process of extinction of HDEN, rescuing the feelings of employees, the main reasons given at the time and immediate postextinction scenario. And the third axis revealed in an articulated form the situation of mental health in Natal / RN, listing to the challenges and prospects for the psychosocial care, starting from the trajectory of HDEN with emphasis on activities. Moreover, the trajectory of HDEN provides recognition of the historical basis outlined in the constitution of the network of substitute services present in the current scenario of psychosocial care in the city of Natal and in RN. / No Brasil, a rede de sa?de mental proposta pela Reforma Psiqui?trica insere os servi?os intermedi?rios e substitutivos, na busca pela aproxima??o ou ressocializa??o do portador de transtorno mental e comportamental junto ? comunidade. Adotou-se, entre outros servi?os, o Centro de Aten??o Psicossocial, Resid?ncia Terap?utica, Lar Abrigado, Hospital-dia, Leito Psiqui?trico em Hospital Geral. Nesse contexto, o Estado do Rio Grande do Norte, implantou o Hospital-Dia Dr. Elger Nunes (HDEN) em Natal/RN no ano de 1996 ligado ? Secretaria Estadual de Sa?de P?blica. No HDEN acontecia um trabalho terap?utico multi e interdisciplinar, al?m de ser palco de pr?ticas disciplinares e projetos de extens?o de cursos em gradua??o de Institui??es de Ensino Superior no munic?pio. Entretanto, com o processo de municipaliza??o dos servi?os locais, o Hospital foi extinto por ato administrativo estadual em 2006, deixando preju?zo para as atividades prestadas aos usu?rios, as pr?ticas disciplinares e as atividades extensionistas. Partindo dessa ruptura, objetivou-se narrar a trajet?ria do HDEN atrav?s dos profissionais da equipe multidisciplinar e dos professores que o utilizaram como campo de pr?ticas disciplinares. Caracteriza-se como estudo documental e qualitativo, respaldado na t?cnica da hist?ria oral tem?tica, seguindo as fases: autoriza??o do colaborador, grava??o da entrevista, transcri??o, a textualiza??o e a transcria??o do material obtido. Utilizaram-se documentos, portarias, relat?rios gerais de atividades, entre outros; somada a realiza??o de entrevistas a quinze colaboradores que utilizaram esse servi?o, sendo treze profissionais da equipe multidisciplinar e dois docentes da gradua??o da ?rea da sa?de, Enfermagem e Medicina. As hist?rias coletadas foram organizadas conforme a t?cnica escolhida, respeitando-se suas etapas. Na prepara??o do corpus submetido ao programa inform?tico ALCESTE, priorizou-se o tom vital para a forma??o das categorias e classes elegida por ele, estruturada sob tr?s eixos tem?ticos. No primeiro eixo denominado Trajet?ria do HDEN rememorou-se o in?cio de suas atividades, os percal?os nesse momento, as atividades desenvolvidas, al?m dos seus atores os usu?rios, familiares, profissionais, e as pr?ticas de ensino. O segundo eixo ocupou-se do Processo de extin??o do HDEN, resgatandose os sentimentos dos colaboradores, as principais justificativas dadas na ?poca e o cen?rio imediato p?s-extin??o. E, o terceiro eixo analisado revelou de forma articulada a situa??o da Sa?de mental em Natal/RN, elencando-se os desafios e perspectivas para a aten??o psicossocial, partindo-se da pr?pria trajet?ria do HDEN com ?nfase nas atividades desenvolvidas. Ademais, a trajet?ria do HDEN propicia o reconhecimento das bases hist?ricas tra?adas na constitui??o da rede de servi?os substitutivos presente no atual cen?rio de aten??o psicossocial do munic?pio de Natal e no RN.