Magister Curationis - MCur / The current debate on knowledge, attitudes and perceptions of medical staff and the broader community towards mentally ill patients across the world is also quite extensive in South Africa. The literature on the subject matter demonstrates poor knowledge of mental illness in the general population and also indicates that people often have stigmatising attitudes towards mental illness. However, while most studies have explored the attitudes, perceptions and behaviour towards mentally ill patients with respect to various staff categories such as doctors, nurses, pharmacists, psychologist and the community globally and particularly in Sub-Saharan Africa, few studies have extended the analysis to include general assistants. Moreover, little research has been carried out on the knowledge, attitudes and perceptions towards mental illness and mentally ill patients of non-medical staff such as general assistants, who on a daily basis spend time with mentally health care users, ensuring hygiene in psychiatric hospitals in South Africa. This study intended to fill the gap by using a quantitative, descriptive approach encompassing a cross-sectional survey design to identify the level of basic mental health knowledge and determine attitudes and perceptions of general assistants towards mental illness and mentally ill patients in four government funded psychiatric hospitals in Cape Town, South Africa. A random sample of 124 was selected from the general assistants of the four psychiatric hospitals in Cape Town. The results established that the majority of General Assistants (75.6%) in all four psychiatric hospitals demonstrated fair basic mental health knowledge pertaining to mental illness and positive attitudes and perceptions towards mentally ill patients. Although the attitudes and perceptions are mostly positive, item analysis revealed that there are disparities in the results. One third of the general assistants find it stressful to work with mentally ill people. Others displayed frustration (30,1% ), mistrust (52%) and fear(12%). In addition, 82.9% of the general assistants like working with mentally ill people and the majority of the general assistants are comfortable working with mentally ill patients. The recommendation is that basic mental health awareness programmes or in-service training should be implemented for general assistants especially newly appointed general assistants to improve the knowledge and understanding, attitudes and perceptions of general assistants and to reduce fear and negative perceptions and attitudes in order to enhance positive patient experiences.

Esta dissertação aborda a escrita enquanto experiência em que vida e pensamento se engendram mutuamente. Integra o grupo de pesquisa “Potência Clínica das Memórias da Loucura”, que se dá junto à Oficina de Criatividade do Hospital Psiquiátrico São Pedro, e que se ocupa, em parte, com a escrita da vida de alguns internos. Escreve-se, portanto, através da aproximação com certa vida em risco e arriscada, que lança linhas de criação e sobrevivência de si em um mundo que está, para todos os efeitos, arrematado. Assim, a escrita traça contornos no encontro com a linguagem em desrazão, a qual busca, sem encontrar, um ponto de ancoragem. É na afirmação de uma diferença que está o espaço de um percurso de experimentação. / This thesis approaches the writing as an experience in which life and thought engender themselves mutually. It integrates the research group “Clinical Potency of the Memories of Madness”, which happens along with the Creativity Workshop of the Psychiatric Hospital São Pedro, working, in part, with the writing of the life of some patients. It is written, therefore, by an approach to a certain risky and at stake life, which launches lines of creation and survival of oneself in a world that is, for all intents and purposes, finished. Therefore, the thesis draws borders when meeting with the language in unreason, which seeks, without finding, an anchor point. It is in the affirmation of a difference that is the space of a journey of experimentation.

This dissertation reports on the lived experiences of four child psychiatric nurses. The territory of child psychiatric nursing is explored in this investigation through the punctuation of many voices within this field of study. The methodology of the investigation is descriptive phenomenology and Colaizzis’ steps in descriptive phenomenology (map) are used to discover and describe the different template theories (the territory) that are unique to each of the four child psychiatric nurses who were interviewed. Following this, a story is punctuated, which is referred to as the structural synthesis. It is the heartbeat of the investigation. The dissertation concludes by reflecting on the paradox of how the invisibility of the child psychiatric nurses allowed for the visibility of the dissertation and encourages the reader to ask pivotal questions about the important role of the child psychiatric nurse, working as part of a multidisciplinary team, in order to improve patient care. / Psychology / M.A. (Clinical psychology)

A descriptive survey to identify factors influencing relapse of psychiatric outpatients in the rural communities of the Eastern Cape was undertaken. A questionnaire was used to collect data from family caregivers who were relatives of psychiatric patients receiving their monthly medications from two rural clinics. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 17. A total number of 92 family caregivers participated. Respondents reported side effects of psychotropic drugs, poor family role, poor referral system, lack of home visits, non-compliance and stigmatization as major factors contributing to relapse of psychiatric outpatients. Active involvement of caregivers in follow up care of their relatives is effective in fostering collaboration between the psychiatric hospitals and patients with the common goal of relapse avoidance. It is recommended that adequate provision of resources in conjunction with health education is effective in enhancing collaboration towards prevention of relapse in psychiatric patients. This would promote team work among patients, caregivers and health care providers. / Public Health / M.A. (Public Health)

Made available in DSpace on 2013-01-07T15:55:05Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 46.pdf: 807849 bytes, checksum: c59d73b984951f5c996545039717c453 (MD5) Previous issue date: 2004 / Procura compreeender o Hospício da Diamantina desde 1889, quando começou a receber alienados, até 1906, quando fechou devido a retirada dos recursos públicos que até então lhe tinham sido destinados. Tal pesquisa se insere nos estudos de História das Instituições e no campo da História da Saúde Mental. Pretende compreender o que significou o hospício no momento de mudanças histórico-sociais em que foi construído, o que justificou a sua necessidade e quais as intenções da sociedade civil e da ciência de então para com o atendimento aos alienados. Tendo como referência o hospício moderno na Europa e o Hospício de Pedro II no Rio de Janeiro, tenta compreender o perfil sócio-cultural dos pacientes do Hospício da Diamantina, mediante os padrões de normalidade criados pela psiquiatria e incorporados pela sociedade diamantinense que pretendia se modernizar.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Este trabalho se ocupa da discussão e reflexão sobre a formação do trabalhador de saúde mental no contexto da Reforma Psiquiátrica brasileira. A formação é entendida como um importante dispositivo no sentido de manter vivo o caráter instituinte de uma proposta de transformação quando ela se torna política pública, como é o caso da assistência pública em saúde mental a partir do movimento de Reforma Psiquiátrica. Inicialmente, a dissertação apresenta algumas formulações de Antonio Gramsci, uma das principais matrizes do pensamento basagliano, na crença de que potencializa o entendimento construído sobre o processo de Reforma, de modo a melhor situá-la enquanto elemento na luta democrática em um sentido ampliado, politizando tal processo. Apresenta, em seguida, algumas linhas constitutivas do movimento no cenário brasileiro e a noção de desinstitucionalização, cunhada por Franco Basaglia, principal marco a partir do qual o processo de Reforma é analisado. A formação é pensada no plano daquilo que o processo de trabalho, refletido, produz enquanto conhecimento para o trabalhador, enquanto saber sobre o seu próprio trabalho. Formação e assistência são analisadas, assim, em um plano de imanência, o serviço é tomado como o lócus da formação do trabalhador e a discussão sobre os processos de trabalho adquire centralidade. Considera que a ética que rege as relações com a loucura não se apresenta destacada da ética que rege as relações de trabalho neste campo. Também leva em conta que há uma dimensão afetiva nos processos de formação normalmente negligenciada e que a dissertação procura afirmar, dotando as relações de trabalho de relevância também no âmbito da formação. Defende que a restauração da reciprocidade nas relações com a loucura, como pressupõe um projeto de desinstitucionalização, não pode estar separada da possibilidade de os próprios trabalhadores estabelecerem relações também mais recíprocas. Neste sentido, os espaços de reflexão e auto-questionamento, que possibilitam aos trabalhadores se apropriarem de seu trabalho, e as relações entre a equipe são valorizados. Foram entrevistados trabalhadores de dois serviços de saúde mental públicos do Rio de Janeiro: um CAPS e um Serviço Residencial Terapêutico, modalidades escolhidas pelo entendimento de se tratarem de serviços de ponta da Reforma Psiquiátrica no Brasil hoje. Suas falas são tomadas enquanto forças presentes no campo, que se expressam através delas, mas que não se circunscrevem àqueles que as emitem. As entrevistas são analisadas segundo seis eixos principais para a análise, a partir da percepção de forças que se fizeram mais presentes neste campo, entendendo que todos eles constituem e são atravessados pelo tema da formação. Assim, são abordadas as trajetórias, a interdisciplinaridade, a supervisão, os processos de trabalho, as concepções de serviços substitutivos e as formulações sobre clínica/política. / This paper aims at examining and discussing the training of health workers in the Brazilian Psychiatric Reform context. Training in this sense is understood as an important measure geared to maintaing alive the disciplinary character of a transformation proposal turned into public policy, as is the case of the public assistance in mental health resulting from the Psychiatric Reform movement. The dissertation opens with some formulations by Antonio Gramsci, one of the main matrixes of the Basaglian thought, in the belief that this will add to the understanding of the Reform process inasmuch as it introduces it in a broader and more political sense as an element in the democratic struggle. This is followed by some reflections regarding both the movement in the Brazilian scenery and the concept of deinstitutionalization, coined by Franco Basaglia, main landmark for analyzing the Reform process. The training itself is perceived on the basis of the results obtained by workers from the work process itself, in the sense of the learning and knowledge gained by them after reflection over the work accomplished. Training and assistance are analyzed within a domain of immanence. In other words, the service itself is seen as the locus of the workers training, and discussions surrounding the work process are, therefore, the central issue. Ethics involved in relations referring to madness are considered inseparable from the ethics ruling work-related issues in this field. Furthermore, the normally neglected affective level present in training processes is both taken into account and asserted by the dissertation, as work relations are viewed as relevant in the training context as well. In coherence with a deinstitutionalization project, the study also supports the fact that restoring reciprocity in relations involving madness cannot be separated from allowing workers to, in the same manner, establish more reciprocal relations. In that sense, furthermore, periods for self-questioning and reflection, which help workers to effectively occupy their work place, added to possibilities for exchanges among team members, are important aspects to consider. Workers from the following two public mental health services in Rio de Janeiro were interviewed: those from CAPS and those from the Therapeutic Residential Service. These two services were chosen because in Brazil they are considered outstanding modalities in the contemporary Psychiatric Reform. The statements by workers, though taken as a strong expression of their presence in the field, are not restricted to those emitting them. The interviews are analyzed according to six main axes for the analysis, as well as on the basis of what was perceived as the strongest manifestations in this field. It is important to stress that training, as a theme, both constitutes and runs through each of these axes. Thus, pathways, interdisciplinarity, supervision, work processes, conceptions of substitutive services and formulations regarding clinic/policies, are among the topics covered.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O presente estudo teve por objetivo analisar o processo de fechamento da Casa de Saúde Dr. Eiras- Paracambi, uma clínica psiquiátrica privada que esteve em processo de fechamento por 12 anos e que efetivamente foi fechada em março de 2012. Este processo envolveu a gestão estadual de saúde mental, o município de Paracambi, os municípios que tinham pacientes internados, o Ministério Público Federal e Estadual e a Área Técnica de Saúde Mental do Ministério da Saúde. A pesquisa pretendeu analisar as respostas políticas que o município do Rio de Janeiro, que apresentava o maior número de internações, articulou para seus munícipes que se encontravam internados nesta instituição, focando na transinstitucionalização, ou seja, na transferência dos pacientes da Casa de Saúde Dr. Eiras-Paracambi para outras instituições de internações psiquiátricas ou clínicas. Procurou-se entender por que essa resposta foi pensada e como foi realizada por este município e compreender, a partir dos profissionais, como foi feita a passagem dos pacientes da Casa de Saúde Dr. Eiras-Paracambi para outra instituição e quais são as perspectivas para a continuidade do acompanhamento dos casos transinstitucionalizados. A pesquisa se dividiu em duas fases, em ambas foram realizadas entrevistas semi-estruturadas. A primeira fase partiu do recolhimento das falas de gestores, numa visada mais geral do processo, inclusive investigando a participação de outros municípios. A segunda fase, por sua vez, priorizou a experiência dos profissionais, que trabalham ou trabalharam mais diretamente com os pacientes transferidos no município do Rio de Janeiro. As instituições escolhidas para a segunda fase foram o Instituto Municipal Nise da Silveira e o Centro de Atenção Psicossocial Torquato Neto. Constatamos que além de diferentes sentidos para desinstitucionalização (desospitalização; desassistência;desconstrução; novas institucionalidades e intencionalidade do tratamento), podemos falar em vários tipos de transinstitucionalização: para hospital ou outro estabelecimento asilar; para estabelecimento privado ou público; para estabelecimento psiquiátrico ou clínico. O tema da transinstitucionalização foi abordado como um paradoxo, superando a dicotomia problema- solução. / The present study aimed to analyze the closing process of the Casa de Saúde Dr. Eiras-Paracambi, a private psychiatric clinic that has been in a closing process for 12 years and effectively closed in March 2012. It involved the states mental health management, the Paracambis local government, the local governments that had interned patients, federal and state Public Ministry and the technical Department of Mental Health, on the Health Ministry . This research tries to analyze the policy responses that the city of Rio de Janeiro, which had the largest number of hospitalization, articulated to the citizens who were interned in this institution, focusing on transinstitutionalization. That is, the transfering of patients from the Casa de Saúde Dr. Eiras-Paracambi to other institutions: psychiatric or clinics. We tried to understand why this response was considered and how the patients passage was made from Casa de Saúde Dr Eiras- Paracambi to others institutions and which are the prospects for continued monitoring of transinstitutionalized cases. The research was divided into two phases, in both were made semistructured interviews. The first phase starts from collecting speeches of the managers, in a general view of the process, including investigating the participation of other municipalities. The second phase, stood on the professionals experience who work or worked more directly with patients transferred in the municipality of Rio de Janeiro. The institutions chosen for the second phase were Instituto Municipal Nise da Silveira and the CAPS Torquato Neto. We note that apart from different senses given to deinstitutionalization (dehospitalization, lack of assistance; deconstruction, new institutions and treatment intentionality), we can speak of various transinstitutionalization types: to hospital or other establishment for asylum, to private or public establishment, to psychiatric institution or clinical. The theme of transinstitutionalization was approached as a paradox, overcoming the dichotomy problem-solution.

Made available in DSpace on 2014-06-11T19:35:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-02-16Bitstream added on 2014-06-13T21:07:06Z : No. of bitstreams: 1 borges_rf_dr_assis.pdf: 1175506 bytes, checksum: c9e3177cd98c468e32d32be59cf8c9af (MD5) / Este trabalho objetiva desvelar dificuldades e possibilidades de implantar a Política Nacional de Saúde Mental e de construir o modelo de atenção psicossocial a partir de uma experiência desenvolvida na Atenção Básica no município de Itambé - PR. Esta experiência foi estabelecida pela parceria entre esse município e a Universidade Estadual de Maringá - PR para a realização de um projeto de extensão desenvolvido entre os anos 2006 e 2008. Pautado no método da análise histórica, foi realizado um estudo de caso do município a partir de pesquisa documental, entrevistas e observações descritivas. Foi possível vislumbrar algumas possibilidades que justificam a afirmação de que a experiência foi exitosa e que a Atenção Básica deve estar na centralidade do cuidado em saúde/saúde mental. Em relação aos usuários, os vínculos de confiança construídos a partir do acolhimento e do acompanhamento contínuo e a formação de um grupo de convivência deram suporte à produção de cuidado antes, durante e depois de situações de crise. As equipes de saúde pouco a pouco passaram a se envolver nas ações voltadas a estes usuários e a buscar novas formas de cuidado, marcadas por mudanças nos processos e na dinâmica de trabalho. A família passou a ter maior envolvimento e participação no processo de cuidado. Em relação aos estagiários de Psicologia, o contato frequente com pessoas em sofrimento psíquico em instituições não manicomiais e a inserção no cotidiano do serviço da Atenção Básica (UBS) puderam proporcionar-lhes importantes subsídios para a formação, quer pelo conhecimento de uma forma diferenciada de... / This study aims at unveiling the troubles and possibilities of establishing a National Policy of Mental Health and building a model for psychosocial care on the basis of some previous experience at the Basic Health Care Service in the county of Itambé in the State of Paraná. An academic extension project was developed between 2006 and 2008. It consisted of a case study carried out in the county of Itambé based on the method of historical analysis through documental analyses, interviews and descriptive observations. It was considered a successful experience which evidenced that the Basic Health Care Service should be primarily on the center of healthcare / mental health. Regarding its patients/users, trust was firmed from their sheltering and continuous care as well as with the formation of a sharing group which supported care before, during and after their crises. Gradually the health care teams became involved in the events related to these users and sought new means of health care resulting in some changes in the processes and work dynamics. Likewise, families were more involved and took part in the health care process. With regards to the undergraduate students / trainees in psychology, their frequent contact with psycho disabled people in non-mental handicap asylums and their insertion in the routine of the Basic Health Care Service (UBS) brought them some relevant mindset for professional education, such as, knowledge of a different way of working at UBS as a psychologist and the demystification of madness... (Complete abstract click electronic access below)

Esta dissertação aborda a escrita enquanto experiência em que vida e pensamento se engendram mutuamente. Integra o grupo de pesquisa “Potência Clínica das Memórias da Loucura”, que se dá junto à Oficina de Criatividade do Hospital Psiquiátrico São Pedro, e que se ocupa, em parte, com a escrita da vida de alguns internos. Escreve-se, portanto, através da aproximação com certa vida em risco e arriscada, que lança linhas de criação e sobrevivência de si em um mundo que está, para todos os efeitos, arrematado. Assim, a escrita traça contornos no encontro com a linguagem em desrazão, a qual busca, sem encontrar, um ponto de ancoragem. É na afirmação de uma diferença que está o espaço de um percurso de experimentação. / This thesis approaches the writing as an experience in which life and thought engender themselves mutually. It integrates the research group “Clinical Potency of the Memories of Madness”, which happens along with the Creativity Workshop of the Psychiatric Hospital São Pedro, working, in part, with the writing of the life of some patients. It is written, therefore, by an approach to a certain risky and at stake life, which launches lines of creation and survival of oneself in a world that is, for all intents and purposes, finished. Therefore, the thesis draws borders when meeting with the language in unreason, which seeks, without finding, an anchor point. It is in the affirmation of a difference that is the space of a journey of experimentation.

abstract: Music is often used to induce relaxation and encourage calm surroundings, but in a group psychiatric treatment environment creating such a space can be complicated by varying and conflicting music preferences. Although best practices in music therapy encourage use of preferred music in sessions, adolescents’ tastes can be so closely tied with their sense of identity that tension may arise between peers in a group setting. On an inpatient adolescent psychiatric unit this issue becomes compounded by additional factors such as inadequate communication skills and difficulties with self-regulation. Although one must be careful not to generalize or romanticize, current literature suggests specific nature sounds may have a calming effect across settings and cultural backgrounds. However, nature sound research done from the music therapy perspective is scarce, and thus evidence-based guidelines for the use of such sounds could prove useful in further exploration of their potential uses in music therapy interventions. This thesis explores the use of nature sounds as a part of music therapy treatment interventions, as well as on the behavioral health adolescent unit during daily routine where environmental sounds can be a problem. If successfully implemented in an acute psychiatric setting with adolescent patients, both during the therapy session and throughout the day, administered by the person receiving treatment and under the guidance of the music therapist, these interventions have the potential to decrease the number and severity of behavioral emergency codes, potentially leading to fewer instances of restraint, as well as more effective functioning after discharge from the inpatient setting. / Dissertation/Thesis / Masters Thesis Music Therapy 2018