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 2014-12-17T15:38:43Z (GMT). No. of bitstreams: 1 AlexRA.pdf: 567074 bytes, checksum: 3a5ebacebe919f714caca1b9d3cbff94 (MD5) Previous issue date: 2004-12-20 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Psychiatric reform occurring in Brazil has progressed significantly during the last two decades, both in the transformation of the help structure and in the treatment of madness. At the same time a paralell movement is observed marked by the maintenance of the hospital centered or psychiatric ward ideology present not only in the psychiatric institutions but also in the substitute services in the cities and , above all, in the ways of contemporary subjectivation. We affirm that the idea of deinstitutionalization is intertwined with capitalistic agent both from the epistomological, assistance, and legal aspect as from the cultural one. This work aims mainly to discuss madness and subjectivity from the ethic esthetic-political perspective, specially the wishes of the psychiatric hospital, which we inhabit and who inhibits our interactions and our desired and creative productivity. We do also want to access the invisible threads that capture and modify madness, which make our cities a means for the production of pathologies, and those that, on the contrary, insinuate a process of resistance, facilitating life and health / O processo de Reforma Psiqui?trica em curso no pa?s vem avan?ando significativamente ao longo das duas ?ltimas d?cadas no que diz respeito ? transforma??o da estrutura asilar e das pr?ticas de cuidado para com a loucura. Por?m, observa-se que, paralelamente a esse movimento, h? um outro marcado pela manuten??o da l?gica hospitaloc?ntrica ou manicomial, presente n?o s? no interior das institui??es psiqui?tricas, mas nos servi?os substitutivos, nas cidades e, sobretudo, nos modos de subjetiva??o contempor?neos. Dir?amos que o ide?rio da desinstitucionaliza??o ? atravessado por um agenciamento do tipo "capital?stico" tanto do ponto de vista epistemol?gico, assistencial e jur?dico, quanto cultural. Esse trabalho visa, dentre outras coisas, discutir loucura e subjetividade numa perspectiva ?tico-est?tica-pol?tica, especialmente sobre os "desejos de manic?mio" que nos habitam e que obstruem nossa pot?ncia de agir, nossa produ??o desejante e criadora. De outro modo, queremos acessar as malhas invis?veis que capturam e mortificam a loucura, que fazem das cidades um dispositivo de produ??o de patologias e, aquelas redes que, contrariamente, insinuam processos de resist?ncia, possibilitam a inven??o da vida e da sa?de

Made available in DSpace on 2014-12-17T15:38:46Z (GMT). No. of bitstreams: 1 AnaKS.pdf: 949155 bytes, checksum: 510b8189ff7d40e57f75385d069921bc (MD5) Previous issue date: 2009-06-26 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The research objective is explore practices to mutual help between CAPS users from the east and west regions of the city of Natal, RN, in Brazil. In the mental health field, we observe the care from substitutive services is based on technical knowledge where the person of the mental health professional is predominant. The Brazilian psychiatry reform invests in equipments and mental health care protocols, but it is necessary to invest more vigorously in new strategies and actors capable of obtaining resources to achieve this goal, such as the users. If one cornerstone of the psychiatric reform consists of changing the type of relationship established with the person with mental disorders, why this relationship, nowadays, is still dominated by technique and unevenness, where on one side we have a person who knows something and who needs take care of someone, and on other side we have another who knows nothing and thus needs to be cared for? Starting from this problematization of the traditional methods of health/mental health care, an attempt was made to investigate in what ways the mutual help practices between people with mental disorders can realize potential avenues not yet explored within the scope of psychiatric reform. The objective of this research was to map possible mutual help practices among the users, and the technical understanding of such practices. For that, we took part in the daily activities of the CAPS, mapping the experiences of mutual help among users. In addition, we accompanied the users in external activities (such as return home, trips, etc), and we had roundtables with the professionals. The research was guided by theoretical methodological references of the institutional analysis. The results pointed to a lack of behaviors of mutual help or support among users, something that can probably be explained by the service work dynamics, as well as the relationship between technicians and users, which has a tendency to create hurdles for meetings among users, as well as being non-conducive to theirempowerment / Essa pesquisa objetivou investigar pr?ticas de ajuda m?tua entre usu?rios dos CAPS leste e oeste da cidade de Natal-RN. No campo da sa?de mental, observamos que o cuidado proporcionado pelos servi?os substitutivos tende a ser pautado pelo saber t?cnico onde a figura do profissional predomina. A reforma psiqui?trica brasileira tem investido em equipamentos e pol?ticas de aten??o em sa?de mental, mas ? preciso investir mais fortemente em novas estrat?gias e atores capazes de agenciar for?as instituintes a esse movimento, tais como os usu?rios. Se um dos eixos da reforma psiqui?trica consiste em uma mudan?a no tipo de rela??o que se estabelece com o portador de transtorno mental, porque essa rela??o, nos dias de hoje, ainda se configura de maneira t?cnica e desigual, onde de um lado h? um sujeito que sabe e deve cuidar e de outro um que nada sabe, devendo, portanto, ser cuidado? Partindo dessa problematiza??o acerca dos modos tradicionais de cuidado em sa?de/sa?de mental, buscou-se investigar de que maneira as pr?ticas de ajuda m?tua entre portadores de transtorno mental podem agenciar potencialidades ainda n?o exploradas no ?mbito da reforma psiqui?trica. O objetivo da pesquisa foi mapear poss?veis pr?ticas de ajuda entre os usu?rios, bem como a concep??o dos t?cnicos sobre tais pr?ticas. Para isso, participamos cotidianamente das atividades desenvolvidas nos CAPS, mapeando as experi?ncias de ajuda entre os usu?rios. Al?m disso, acompanhamos os usu?rios nos ambientes extra-servi?os (volta para casa, passeios, etc.), e realizamos rodas de conversa com os profissionais. A pesquisa foi orientada pelo referencial te?rico-metodol?gico da an?lise institucional. Os resultados apontaram para uma falta de atitudes de ajuda ou suporte m?tuo entre usu?rios, provavelmente explicado pela din?mica de funcionamento do servi?o e pela rela??o entre t?cnicos e usu?rios, que tende a dificultar encontros entre usu?rios, al?m de n?o favorecerem o empoderamento dos mesmos.

Made available in DSpace on 2014-12-17T15:39:01Z (GMT). No. of bitstreams: 1 AriadneC.pdf: 385711 bytes, checksum: dcc828db10778b9bff5343cd3bed9087 (MD5) Previous issue date: 2006-09-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The purpose of this study is to discuss the therapeutic workshops function, while questioning if they constitute a mechanism for change of the traditional asylum logic. The Psychiatric Reform was materialized with the financing and regulation of alternative services that substitute the psychiatric hospital. This change was promoted by the anti asylum debate and the deinstitutionalization besides psychosocial rehabilitation paradigms. Mental health care, therefore, acquired a new form and the Centers for Psychosocial Care (CAPS) are considered the main services of the health network presently under construction. They are services that offer a variety of therapeutics and amongst them is the workshop, considered essential for the advancement of the Reform ideas. The study was conducted in a CAPS II in Natal, RN. Systematic visits were made using the Institutional Analysis perspective, futhermore were made interviews with professionals who was related to workshops. In the end, data were then discussed according to Schizoanalysis. Results denot that workshops represents, in the same time, progress and regress of Psychiatric Reform. It was observed that workshops were oftentimes reduced to strategies for the occupation of time, and as a means for the transmission of social values considered correct. The relationship between professionals and the user of the service was hierarchical and both players was seeing the workshop as a task to be met. Although users expressed intreresting about wokshops, was reported that the work was boring. Besides, except for some cases, the therapeutic workshops wasn t helping clients to create other possibilites in theirs life and stops the job inside the mental care service / Este trabalho objetivou investigar as oficinas terap?uticas num servi?o substitutivo ao hospital psiqui?trico, observando se seu funcionamento condiz ou n?o com preceitos da Reforma Psiqui?trica. Esta, tendo sido fomentada pela luta antimanicomial e embasada pela desinstitucionaliza??o e pela reabilita??o psicossocial, materializou-se com o financiamento e regulamenta??o de servi?os substitutivos ao manic?mio. Desde ent?o, novas formas de cuidado se configuram e os Centros de Aten??o Psicossocial (CAPS) s?o um dos principais servi?os da nova rede de sa?de. Os CAPS s?o servi?os abertos que oferecem uma variada gama de terap?uticas, dentre elas, destacam-se as oficinas terap?uticas: estrat?gias fundamentais por serem consideradas o baluarte dos novos servi?os. A coleta de dados ocorreu num CAPS II, em Natal-RN, onde foram realizadas visitas sistem?ticas orientadas pela An?lise Institucional, al?m de entrevistas com os funcion?rios que se encontravam ligados ao exerc?cio das oficinas. Os dados foram discutidos ? luz da Esquizoan?lise, revelando que o funcionamento das oficinas traduzem avan?os e retrocessos da Reforma. Notou-se que as oficinas eram espa?os onde alguns preconceitos eram desconstru?dos, auxiliando os usu?rios no estabelecimento de novas rela??es consigo, com outros e com o mundo. Entretanto, tamb?m foi observado que muitas vezes as oficinas se reduziam a meras estrat?gias de ocupa??o do tempo e serviam de ve?culo de transmiss?o de valores socialmente legitimados como certos. Percebeu-se que a rela??o entre profissionais e usu?rios era hierarquizada e que, por vezes, ambos viam a oficina como uma tarefa a ser cumprida. Da mesma forma, foi notado que os usu?rios, concomitantemente, mantinham um discurso de interesse pelas oficinas e expressavam que elas eram repetitivas e enfadonhas. J? a equipe t?cnica mantinha o discurso da luta antimanicomial, mas n?o conseguia sustent?-lo nas suas pr?ticas cotidianas. Al?m disso, afora exce??es, as oficinas eram espa?os que n?o possibilitam a cria??o e conservam o servi?o fechado em si mesmo

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 2014-12-17T14:46:51Z (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.

Made available in DSpace on 2014-12-17T14:52:35Z (GMT). No. of bitstreams: 1 JaideBD.pdf: 1078056 bytes, checksum: 49512b9c9d781821439a1a35147fbabe (MD5) Previous issue date: 2007-12-18 / This dissertation has as aim the praxis of co-management of the health service of CAPS II OESTE of Natal-RN, where health workers, family members got to materialize guidelines and principles of psychiatric Brazilian reform in real possibilities of subjectivity construction, whereas they changed social relations in daily life. The path chosen to record was from testimonials and contributions of those who meant their done. Redeeming this story from social representations of the majority of their builders was an instigating, delicate and rewarding task, emphasizing the living memory, rebuilt in a line of time which could not be found in simple documentary collections. Mainly, by knowing that service routine was intense and had as characteristic the singular mobility itself from a creation process and therefore not always its dynamic allowed adequate records. At the same time, from this occurred the field and bibliographic research which allowed the detailed information from the prior milestones and motivated to the practice here reported. The rereading of concepts in an interface with the reports of the interviewees enabled the verification that the model of mental health advocated by psychiatric reform was understood. Once noticed the presence of the beliefs and values of people in motivating energy for the progress of reform, it has gone to fetch theoretical subsidies of administrative order to understand how they saw this building and that uniqueness has been printed. The theoretical way and praxis have tracked here has allowed to analyze how occurred such a process of production and subjectivity and collectives that when organize enabled themselves for analysis and intervention, including in crisis situations. Therefore, it was revealed that ethical and multi-disciplinarity, the humanitarian sense, the coresponsibility, co-production and horizontal management were the key factors for spread from a changing protagonist. One can thus conclude that co-management from that collective has been multi-disciplinary weaving a cross / Esta disserta??o tem como objeto a pr?xis de co-gest?o do servi?o de sa?de CAPS II OESTE de Natal/RN, onde trabalhadores de sa?de, usu?rios e familiares conseguiram materializar diretrizes e princ?pios da reforma psiqui?trica brasileira em possibilidades reais e concretas de constru??o de subjetividades, ao passo que se transformavam as rela??es sociais num cotidiano. O caminho escolhido para registro foi a partir dos depoimentos e contribui??es daqueles que significaram seu feito. Resgatar esta hist?ria a partir das representa??es sociais da maioria dos seus construtores foi uma tarefa instigante, delicada e recompensadora, enfatizando a mem?ria viva, reconstru?da numa linha do tempo que n?o poderia ser encontrada em simples acervos documentais. Principalmente, por saber que a rotina daquele servi?o era intensa e teve como caracter?stica a mobilidade singular pr?pria de um processo em cria??o e por isso nem sempre sua din?mica permitia adequados registros. Em vista disto ocorreu, concomitantemente, a pesquisa de campo e a bibliogr?fica que permitiu o levantamento detalhado dos marcos que antecederam e motivaram a pr?tica aqui retratada. A releitura de conceitos numa interface com os depoimentos dos entrevistados possibilitou a verifica??o de que o modelo de sa?de mental preconizado pela reforma psiqui?trica fora compreendida. Uma vez percebido a presen?a das cren?as e valores das pessoas na energia motivadora para o avan?o da reforma, passou-se a buscar subs?dios te?ricos de ordem administrativa para compreender de que forma se deu tal constru??o e com que singularidade foi impressa. O caminho te?rico e pr?xis aqui percorrida permitiram analisar como se deu tal processo de produ??o de subjetividades e de coletivos que ao se organizarem capacitaram-se para an?lise e interven??o, inclusive em situa??es de crise. Revelou-se, portanto, que a ?tica e multidisciplinaridade, o sentido humanit?rio, a co-responsabiliza??o, a co-produ??o e a horizontalidade gerencial foram os fatores fundamentais para dissemina??o de um protagonismo transformador. Pode-se assim concluir que a co-gest?o daquele coletivo se deu numa tecelagem transdisciplinar

Made available in DSpace on 2014-12-17T14:46:35Z (GMT). No. of bitstreams: 1 DulcianMA.pdf: 2296903 bytes, checksum: 1b8fc8d6f65f47312f361768e8bbb2ae (MD5) Previous issue date: 2008-04-30 / Comprehending social representations of users relatives of Psychosocial Care Centers (CAPS) from Natal-RN, about their participation in the activities of these services, was the purpose of this study. The research instrument used was a semi-structured interview, led to 28 relatives of users of East and West CAPS II, East and North CAPS-ad, involved in the Relative Therapeutic Group, in Relative Meeting, in the Assembly of Users, Technicians and Relatives, according to the therapeutic schedule of each health services, between August to November 2007. Data obtained in family and users identification were characterized with the aid of charts and boards in absolute and/or percentage values. The discursive material from the guide from interviews was submitted to the informational resource ALCESTE (Analyse Lexicale par Contexte d'un Ensemble of Segments of Texte), and analyzed on the basis of the Theory of Social Representations and Central Nucleus Theory. Most of the relatives were women, married, aged over 50 years, who participated for more than two years in CAPS activities, and a coexistence of more than 11 years with the user. From the classification system of ALCESTE were selected categories, identified by: Category 1, Treatment Improvements and Expectations; Category 2, Living User Before and After; Category 3, Activities Relevance, Contradictions and Suggestions; Category 4, Guidelines -- Psychopharmacology and Medicalization; Category 5, Family Participation and Activities; and Category 6, Therapeutic Conditions Thanks, Tips and Vulnerability. The social representation of the family exists in the desire for change, identifying that we need to promote change by the continuity of therapeutic activities and overcome the detected inconsistencies, targeted by strengthening and by the stability of improvements in living and health conditions of users, experienced in CAPS treatment. The central nucleus had corresponded to positive changes in health and living conditions of users, and the peripheral elements were constituted by family conducts before and during treatment, and the expectations of changes in activities, especially in workshops. Despite this family participation be considered important, it still does not meet conditions to promote the inclusion of family, under an emancipating point of view, capable of causing in subject the hope for autonomy, initiative, individual and collective growths, a closer and active involvement in therapeutic activities, in workshops and discussions / Apreender as representa??es sociais dos familiares de usu?rios dos Centros de Aten??o Psicossocial (CAPS) do Munic?pio de Natal-RN, a respeito de sua participa??o nas atividades desses servi?os, foi o objetivo deste estudo. O instrumento de pesquisa utilizado foi entrevista semi-estruturada, dirigida a 28 familiares de usu?rios dos CAPS II Leste e Oeste e CAPSad Leste e Norte, que participavam do Grupo Terap?utico de Familiares, da Reuni?o de Familiares, da Assembl?ia de Usu?rios, T?cnicos e Familiares, segundo a agenda terap?utica de cada servi?o de sa?de, no per?odo de agosto a novembro de 2007. Os dados obtidos na identifica??o dos familiares e usu?rios foram caracterizados com o aux?lio de tabelas e quadros em valores absolutos e/ou percentuais. O material discursivo, proveniente do roteiro das entrevistas, foi submetido ao recurso informacional do ALCESTE (Analyse Lexicale par Contexte d un Ensemble de Segments de Texte) e analisado com base na Teoria das Representa??es Sociais e na Teoria do N?cleo Central. A maioria dos familiares foram mulheres, casadas, com idade superior a 50 anos, que participavam h? mais de dois anos das atividades nos CAPS, e uma conviv?ncia superior a 11 anos com o usu?rio. A partir do sistema de classifica??o do ALCESTE foram elegidas categorias identificadas por: Categoria 1, Tratamento - Melhoras e Expectativas; Categoria 2, Conviv?ncia Usu?rio Antes e Depois; Categoria 3, Atividades Import?ncia, Contradi??es e Sugest?es; Categoria 4, Orienta??es Psicofarmacologia e Medicaliza??o; Categoria 5, Fam?lia - Participa??o e Atividades; e Categoria 6, Condi??es Terap?uticas Agradecimentos, Sugest?es e Vulnerabilidade. A representa??o social dos familiares ancora no desejo por mudan?as, identificando que ? preciso promover mudan?as pela continuidade das atividades terap?uticas e supera??o das inconsist?ncias detectadas, objetivada pelo refor?o e pela estabilidade das melhorias nas condi??es de vida e sa?de dos usu?rios, vivenciadas no tratamento dos CAPS. O n?cleo central correspondeu a mudan?as positivas nas condi??es de sa?de e de vida dos usu?rios, j? os elementos perif?ricos foram constitu?dos pelas condutas familiares antes e durante o tratamento, e, pelas expectativas de mudan?as nas atividades, especialmente as oficinas. Apesar dessa participa??o familiar ser considerada importante, ainda n?o re?ne condi??es para promover a inser??o do familiar, sob um ponto de vista emancipador, capaz de suscitar no sujeito o desejo da autonomia, da iniciativa, do crescimento individual e coletivo, de um envolvimento mais pr?ximo e ativo nas atividades terap?uticas, nas oficinas e nas discuss?es

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-03T20:30:21Z No. of bitstreams: 1 ClarissaAndiraXavierESilva_DISSERT.pdf: 989946 bytes, checksum: af3b49e7dc7e045b144a309b03efdf2d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-08T22:11:38Z (GMT) No. of bitstreams: 1 ClarissaAndiraXavierESilva_DISSERT.pdf: 989946 bytes, checksum: af3b49e7dc7e045b144a309b03efdf2d (MD5) / Made available in DSpace on 2016-03-08T22:11:38Z (GMT). No. of bitstreams: 1 ClarissaAndiraXavierESilva_DISSERT.pdf: 989946 bytes, checksum: af3b49e7dc7e045b144a309b03efdf2d (MD5) Previous issue date: 2014-09-26 / A reforma psiqui?trica consiste num processo que busca desconstruir a l?gica excludente provocada pelas interna??es, proporcionando aos sujeitos estrat?gias de reinser??o social. Nesse sentido, a aten??o b?sica, atrav?s da Estrat?gia de Sa?de da Fam?lia - ESF vem, progressivamente, tornando-se espa?o estrat?gico nas interven??es em sa?de mental, configurando-se como campo de pr?ticas e produ??o de novos modos de cuidado. Nesta perspectiva, em Areia Branca-RN vem ocorrendo um processo de implementa??o dessa proposta, atrav?s da articula??o da rede de Aten??o Psicossocial e da Estrat?gia Sa?de da Fam?lia/ESF. As discuss?es acerca da implementa??o da aten??o integral ? sa?de mental no munic?pio de Areia Branca avan?am significativamente. Por?m, esta discuss?o n?o tem sido capaz de provocar mudan?as na pr?tica. Ao partir da concep??o de que a articula??o entre sa?de mental e aten??o b?sica ? um desafio a ser enfrentado atualmente, que a melhoria da assist?ncia prestada e a amplia??o do acesso da popula??o aos servi?os com garantia de continuidade da aten??o dependem da efetiva??o dessa articula??o, estabeleceu-se como objetivo de pesquisa: investigar como se d? a rela??o entre as equipes de ESF e a equipe de CAPS na aten??o ? sa?de mental no munic?pio de Areia Branca ? RN a partir dos discursos dos profissionais. Para tanto, tiveram-se como objetivos espec?ficos: Conhecer a demanda em sa?de mental existente no munic?pio de Areia Branca ? RN atendida pela ESF; Identificar limites e dificuldades na rela??o entre as equipes da ESF e do CAPS; Identificar potencialidades para articula??o entre as equipes da ESF e do CAPS para a constitui??o da RAPS local. Tratou-se de um estudo descritivo-explorat?rio, com desenho metodol?gico de natureza qualitativa, cujos sujeitos foram profissionais da Estrat?gia Sa?de da Fam?lia, profissionais do Centro de Aten??o Psicossocial e o respons?vel pela condu??o/gest?o da sa?de mental no munic?pio. Como instrumentos de pesquisa foram utilizadas observa??es informais, entrevista semiestruturada e grupos focais. As informa??es obtidas foram analisadas considerando a an?lise de conte?do de Bardin, o que possibilitou discutir a pertin?ncia do referencial te?rico com os dados obtidos atrav?s da observa??o e interpreta??o da articula??o entre a Estrat?gia de Sa?de da Fam?lia e a rede de Aten??o Psicossocial no munic?pio de Areia Branca-RN. Por um lado, registrou-se intensa demanda em sa?de mental advinda de usu?rios e de seus familiares e/ou cuidadores. Por outro, verificaram-se que apesar de existir alguns avan?os com rela??o a percep??es sobre sa?de mental, existem ainda pr?ticas, hist?rica e contextualmente arraigadas, que atuam como obst?culos para a resposta efetiva a essa demanda na perspectiva da desinstitucionaliza??o. Nesse sentido, considera-se importante ressaltar que as equipes da Estrat?gia de Sa?de da Fam?lia devem ser capacitadas para garantir a pr?tica de sa?de com integralidade e a incorpora??o ? rede de sa?de mental do munic?pio. Essa capacita??o deve ocorrer atrav?s da educa??o permanente em sa?de. / The antimanicomial psychiatric reform is a process that seeks to deconstruct the exclusionary logic caused by hospitalizations, providing strategies for social reintegration of individuals. In this sense, the primary care through the Family Health Strategy - FHS comes progressively becoming strategic space in mental health interventions, configured as a field of practice and production of new modes of care. In this perspective, there has been a process of implementing this proposal in the Areia Branca City/RN, through the articulation of Psychosocial Care Network and the Family Health Strategy / ESF. However, this process has not been able to bring changes in practices. From the view that the relationship between mental health and primary care is a challenge currently being faced, that improving the care provided and the expansion of the access to services with guaranteed continuity of care depend on the effectiveness of this joint, established themselves as research objective: To investigate how is the relationship between the FHS team and CAPS team in care mental health in the town of Areia Branca - RN from the speeches of professionals. And if you had specific purposes: 1) Know the demand in existing mental health in the town of White Sand - RN served by FHS; 2) Identify limits and difficulties in the relationship between the ESF teams and CAPS; 3) Identify potential for linkages between ESF teams and CAPS for the establishment of local RAPS. This was a descriptive, exploratory study with a qualitative methodological design, whose subjects were professionals from the Family Health Strategy, professionals Psychosocial Care Center and responsible for the conduct / management of mental health in the municipality. The research tools used informal observations, semistructured interviews and focus groups were used. The data obtained were analyzed for the content analysis of Bardin, allowing discuss the relevance of the theoretical framework with data obtained through observation and interpretation of the relationship between the Family Health Strategy and the network of Psychosocial Care in Areia Branca-RN. On the one hand, there was strong demand for mental health arising from users and their families and / or caregivers. On the other, it was verified that although there is some progress with regard to perceptions of mental health, there are still practical, historical and contextually rooted, which act as barriers to effective response to this demand in view of deinstitutionalization. In this sense, it is considered important to emphasize that the teams of the Family Health Strategy should be trained to ensure the health practice with integrity and incorporating the mental health network in the municipality. This training must occur through continuing health education.

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2017-06-28T19:53:20Z No. of bitstreams: 1 2016 - Janine Lopes Carvalho.pdf: 1105457 bytes, checksum: 0ca104adc2e98838d0aab84d801f62dc (MD5) / Made available in DSpace on 2017-06-28T19:53:20Z (GMT). No. of bitstreams: 1 2016 - Janine Lopes Carvalho.pdf: 1105457 bytes, checksum: 0ca104adc2e98838d0aab84d801f62dc (MD5) Previous issue date: 2016-03-30 / The late 70 was the beginning of the current movement of Brazilian psychiatric reform. In this period several criticisms of psychiatric care appeared, such as inefficiency of attention, fraud in the financing system and especially the abandonment, abuse and violence suffered by the patients in the main hospices in the country. Progressively, the asylum psychiatric model was being replaced by the model of psychosocial care, in which the Centers for Psychosocial Care (CAPS) have assumed the roles of organizers of the care network, searching forms of singular care, to be developed in the territory of people's lives. It is important the notion of Psychosocial Rehabilitation, in order to develop the work in the new mental health services, which is not just a technical necessity, it is an ethical requirement that should involve all workers and other people that are linked to the health disease process, such as the patients themselves, their families, and finally the entire community. In this context, this research aims to discuss how the psychosocial rehabilitation practice is done, in the services of the professionals of two CAPS of Manhua?u / MG micro region. Therefore, it will be adopted a qualitative research, based on the constructivist paradigm and Hermeneutics Gadamerian. The observed aspects were: poor relation between inter and intra-sectoral network and the acts of municipal administration as a barrier to work concerning the purchase of inputs and training. In regard to psychosocial rehabilitation it was observed that professionals associate the concept of psychosocial rehabilitation to the return to the labor market and it still persists in the minds of professionals the mad stigma as being incapable. / No final da d?cada de 70 deu-se o in?cio do atual movimento pela reforma psiqui?trica brasileira. Neste per?odo surgiram v?rias cr?ticas ? assist?ncia psiqui?trica, tais como: inefici?ncia da aten??o, fraude no sistema de financiamento e, principalmente, o abandono, os maus tratos e a viol?ncia a que eram submetidos os pacientes nos principais hosp?cios do pa?s. Progressivamente, o modelo psiqui?trico manicomial foi sendo substitu?do pelo modelo da aten??o psicossocial, no qual os Centros de Aten??o Psicossocial (CAPS) assumiram a posi??o de organizadores da rede assistencial, assumindo o mandato de agenciar formas de cuidado singular, a serem desenvolvidos no territ?rio de vida das pessoas. Para trabalhar nos novos servi?os de sa?de mental uma importante no??o ? de Reabilita??o Psicossocial, esta n?o ? apenas uma necessidade t?cnica, ? uma exig?ncia ?tica que deve englobar a todos os trabalhadores e demais atores do processo de sa?de doen?a, ou seja, usu?rios, suas fam?lias e, finalmente, a comunidade inteira. Inserida neste contexto, esta pesquisa tem por objetivo discutir como os profissionais de dois CAPS da microrregi?o de sa?de de Manhua?u/MG operacionalizam as pr?ticas de reabilita??o psicossocial nos respectivos servi?os. Para tanto, adotaremos a pesquisa qualitativa, baseada no paradigma construtivista e na Hermen?utica Gadameriana. Foram observados os seguintes aspectos: articula??o prec?ria entre a rede inter e intra-setorial, a administra??o municipal funciona como um entrave para o trabalho em rela??o ? compra de insumos e capacita??o. Em rela??o ? reabilita??o psicossocial observamos que os profissionais associam o conceito de reabilita??o psicossocial como retorno ao mercado de trabalho e que ainda persiste no imagin?rio dos profissionais o estigma do louco como incapaz.