Bakgrund. Psykiatrisk slutenvård lider brist på kompetens och väl utnyttjade resurser för att möta patienternas komplexa behov. Specialistsjuksköterskor inom vårdformen sysslar huvudsakligen med grundläggande psykiatrisk omvårdnad. Deras breda kompetens underskattas och osynliggörs när slutenvården saknar omvårdnadsfokus. Forskning påvisar behov att tydliggöra specialistkompetensens betydelse inom psykiatrisk slutenvård, eftersom ökad förståelse inom området kan medföra bättre vård för patienten. Design. En kvalitativ design med fenomenografisk ansats användes. Metod. Fjorton semistrukturerade intervjuer med specialistsjuksköterskor verksamma i patientnära omvårdnadsarbete inom psykiatrisk slutenvård vid tre psykiatriska kliniker i norra Sverige genomfördes under tiden november 2015 – januari 2016. Intervjuerna transkriberades och analyserades sedan med kvalitativ analys. Resultat. Specialistsjuksköterskans kompetens möjliggör personcentrerad psykiatrisk omvårdnad och är betydelsefull för kunskapsspridning i personalgruppen. Betydelsen kan ökas genom att utrymme för mer patientnära arbete och utvecklingsarbete ges. Specialistkompetensen inom slutenvården behöver synliggöras och omvårdnad framhävas som behandlingsalternativ. Åtgärder för att öka specialistkompetensens betydelse kan påverka den psykiatriska slutenvårdens kvalitet och den enskilde patientens vård positivt. Slutsats. Specialistsjuksköterskans kompetens är betydelsefull för omvårdnadsarbetet inom psykiatrisk slutenvård, men får inte alltid nödvändigt utrymme för att möjliggöra vård av högsta kvalitet. Resultatet kan bidra till ökad förståelse för vikten av att framhäva specialistsjuksköterskans position, så att fler lockas att stanna kvar inom slutenvården och för att specialistkompetensen ska komma de patienter som är i störst behov av den till gagn. / The specialist nurse’s competence within the psychiatric inpatient care - An important resource that needs more space Aim. To illuminate the specialist nurse’s perception of significance of the own competence within the psychiatric inpatient care. Background. There is shortage of competence and well utilized resources to meet the patients’ needs within the psychiatric inpatient care. The competence of specialist nurses is underestimated and obscured as there is an absence of nursing focus. Clarifying the significance of the specialist competence could imply better care. Design. A qualitative design with a phenomenographic approach. Method. Fourteen semi-structured interviews with specialist nurses in patient-oriented inpatient nursing at three psychiatric clinics in north Sweden were conducted during November 2015-January 2016. The interviews were analysed by using a qualitative analysis. Result. The specialist nurse’s competence enables a person-centred psychiatric nursing and shares knowledge within the team. Enabling more patient-oriented and development related work could increase the significance of specialist competence. The specialist competence needs to be visualized and nursing highlighted as a treatment alternative. Increasing the significance of the specialist competence could affect the quality of care and influence the patient’s care positively. Conclusion. The specialist nurse’s competence is important within the inpatient care but needs more space to enable high quality care. The result demonstrates the significance to stress the specialist nurse’s position within psychiatric inpatient care. This could attract specialist nurses to stay within inpatient care and enable the competence to come to use for the patients who needs it the most.

Thesis (MCur)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: No clear description exists in S.A. of the role and functions of a forensic psychiatric nurse. The researcher conducted a research project based on more than 20 years of practice experience to define and describe the role and functions of the forensic nurse practitioner. A non-experimental descriptive study was done. Questionnaires and checklists were compiled to determine the perceptions of forensic psychiatric patients/clients (n =24) and nursing staff (n = 15) .The nursing activities in a selected forensic psychiatric unit was evaluated through nonparticipative observation. Results indicated that: • Patients experienced their environment as isolated and has a need for better support by the nursing staff; • Nursing staff indicated their need for more specific training in forensic psychiatric nursing; and • A need exists for specific protocols and procedures to guide his/her practice. The recommendations are made that: • A special training program for forensic psychiatric nursing needs to be planned and implemented; and • Procedures and guidelines must be established to guide the practice of the nurse practitioner. / AFRIKAANSE OPSOMMING: Daar bestaan in S.A. geen duidelike omskrywing van die rol en funksies van die forensiese psigiatriese verpleegkundige nie. Die navorser het gegrond op meer as 20 jaar praktykervaring 'n navorsingsprojek gedoen om die rol en funksies van die verpleegpraktisyn te definieer en te omskryf. 'n Nie-eksperimentele, beskrywende studie is gedoen. Vraelyste en kontrolelyste is opgestel om die persepsies van forensiese psigiatriese pasiënte/kliënte (n=24) en verpleegpersoneel (n=15) te bepaal. Die verpleegaktiwiteite in 'n geselekteerde forensiese psigiatriese eenheid is deur nie-deelnemende observasie geëvalueer. Resultate het daarop gedui dat: • Pasiënte hulle omgewing as geïsoleerd ervaar en het 'n behoefte aan beter ondersteuning deur die verpleegpersoneel; • Verpleegpersoneel het aangedui dat hulle 'n behoefte het aan spesifieke opleiding in forensiese psigiatriese verpJeging;en • Daar 'n behoefte is aan spesifieke protokolle en prosedures om sy/haar praktyk te rig . Die aanbevelings word gemaak dat: • 'n Spesiale opleidingsprogram vir forensiese psigiatriese verpleging beplan en geïmplementeer word; en • Prosedures en riglyne daargestel moet word om die praktyk van die verpleegpraktisyn te rig.

Bakgrund: Flera studier har visat att personer med bipolär sjukdom har en sämre livskvalitet jämfört med övriga befolkningen. Som sjuksköterska inom psykiatrisk vård är det viktigt att ha kunskap om sjukdomen för att ge bästa möjliga behandling med mål att stabilisera symtom, förebygga återfall och främja livskvalitet. Syfte: Att utifrån sjuksköterskans uppfattning beskriva vilka omvårdnadsinsatser som främjar livskvalitet vid bipolär sjukdom. Metod: En kvalitativ innehållsanalys som baserades på åtta semistrukturerade intervjuer. Resultat: Resultatet visade tre huvudteman: Kunskap om sjukdomen: betydelsen av att både patient och anhöriga fick kunskap om sjukdomen; Trygghet och kontinuitet i vården: veta var och till vem man vänder sig i vården hade stor betydelse samt Personcentrerad vård: att bli sedd och bemött som en unik person. Slutsats: Patientutbildning där man tar upp vikten av regelbundna levnadsvanor, att undvika stress samt att bli medveten om sina tidiga tecken kan hjälpa att stabilisera symtom och förebygga återfall. / Background: Several studies have shown that persons with bipolar disorder have a poorer quality of life compared to the rest of the population. As a nurse in psychiatric care it is important to have knowledge about the disease in order to provide the best possible treatment with the goal to stabilize symptoms, prevent relapse and promote quality of life. Objective: Based on the nurse's perception, describe the nursing interventions promoting quality of life in bipolar disorder. Method: A qualitative content analysis based on eight semi-structured interviews. Results: The results showed three main themes: Knowledge about the disease: the importance of that both the patient and family members gain knowledge about the disease; Safety and continuity of care: knowing where and who to contact in care was of great importance and Person-centered care: be seen and treated as a unique person. Conclusion: Patient education which highlights the importance of regular habits, to avoid stress and to become aware of early signs can help stabilize symptoms and prevent relapse.

Bakgrund: Andlighet kan definieras som ett mångdimensionellt begrepp och inom vårdvetenskapen ses människan som en helhet av kropp, själ och ande. Tidigare forskning visar på att patienterna ser den andliga dimensionen som viktig för dem och att de gärna själva vill bli tillfrågade om andliga behov av vårdpersonal. En personcentrerad vård ställer krav på att ta hänsyn till patientens kultur och livsåskådning, då man som vårdare söker diagnosticera och hjälpa patienten på bästa sätt. Syfte: Att beskriva sjuksköterskors föreställningar om andlighet och deras erfarenheter kring bemötande av patienters andlighet inom den psykiatriska vården. Metod: Sex sjuksköterskor med minst ett års erfarenhet av arbete inom psykiatrisk vård deltog i studien genom enskilda, semistrukturerade intervjuer. Materialet bearbetades genom kvalitativ innehållsanalys med en induktiv ansats. Resultat: Tre kategorier framkom i analysarbetet: Beskrivning av andlighet som fenomen; Andlighetens påverkan på den psykiska hälsan; Bemötande av patienternas uttryck för andlighet. Kategorierna utmynnade i tio subkategorier. Diskussion: Resultatet har diskuterats främst med Jean Watsons teori om mänsklig omsorg som reflexionsinstrument, vilken har lyft fram självkännedom och intentionalitet som viktiga faktorer i mötet med patienters andlighet. Sjuksköterskor beskriver andlighet på olika sätt, men med flertalet gemensamma faktorer och kan se andlighet som en hälsoresurs, men även som något som kan skada den psykiska hälsan om andligheten är skev. Sjuksköterskan tillgodoser i möjligaste mån praktiska önskemål från patienten gällande andlighet, men initierar inte själv samtal om andlighet och tar inte upp frågan i inskrivningssamtalet. Okunskap samt rädsla att skada patienten ligger till grund för detta. Utbildning kring andlighet och hälsa kan vägleda sjuksköterskan i mötet med patienters andlighet samt i utvecklingen av en personcentrerad vård. / Background: Spirituality can be defined as a multidimensional concept and in nursing science the human is seen as a unity of body, soul and spirit. Previous research shows that that patient in the psychiatric care considers the spiritual dimension to be of importance to them, and that they would like to be asked about spiritual needs by mental health care staff. A person-centered care demands taking into consideration the culture and view of life of the patient, when seeking to diagnose and help the patient in the best possible way. Aim: To describe nurse’s perceptions of spirituality and their experiences of meeting patients spirituality in the mental health care. Method: Six nurses with experience from psychiatric care for at least one year participated in the study through separate, semi structured interviews. A qualitative content analysis with an inductive approach was chosen as method for analysis. Result: Three categories were identified in the analysis: Description of spirituality as a phenomenon; The impact of spirituality on the mental health; Personal treatment of the patient’s expressions for spirituality. Ten subcategories followed.  Discussion: The result has been discussed mainly with Jean Watsons theory for human care as a reflective instrument, which emphazised self-knowledge and intentionality as important factors in meeting with patients spirituality. Nurses in the psychiatric care describes spirituality in different ways, but with many common factors, they can see spirituality as a resource of health, but also as something that can damage the mental health, if the spirituality is askew. The nurse helps the patients with practical issues considering spirituality, but does not initiate conversations about spirituality and does not bring up the question in the patient enrollment interview. Lack of knowledge and fear of hurting the patient are reasons for this. Education about spirituality and health can guide the nurse in their meeting with the patients spirituality and in the development of a person-centered care.

M.Cur. / Violence and aggression in psychiatric hospitals are a worldwide known phenomenon. South Africa is no exception to the rule. Previous researches conducted in psychiatric institutions have mainly focused on the patients, leaving everyone to guess how this violence affects nurses who are in contact with the patients on a daily basis and who are key role-players in the care, treatment, and rehabilitation of the patients under their responsibility. The research aimed to explore and describe the lived experience of aggression and violence by the registered nurses in a Gauteng psychiatric institution, the essence of this violence, and how nurses cope with this violence, in order to formulate guidelines and recommendations that could assist them to manage violence. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews, and naïve sketches. Tesch’s method was used for data analysis, here and an independent coder was utilised. The uniqueness of this study was to bring to the surface the other side of violence as it is perceived and lived by the nurses. The findings show that the nurses face violence on a daily basis. Among the contributing factors there are: the type of patients admitted in the hospital; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation. The consequences of this violence to the nurses are emotional, psychological, and physical and take the form of: fear, anger, frustration, despair, hopelessness and helplessness, substance abuses, absenteeism, retaliation, a development of an “I don’t care attitude”, injuries, and damage to personal properties such as clothes, and spectacles.

Bakgrund: Fastspänning i en bältessäng är relativt vanligt förekommande i Sverige och flera andra länder inom den slutna psykiatriska vården. Forskning kring sjuksköterskors upplevelse om fastspänning visar på att det dels uppfattas som någonting etiskt svårt, samtidigt anses fastspänning vara någonting nödvändigt ur en säkerhetsaspekt.  Lite är känt forskningsmässigt kring vad som är patienters upplevelser av fastspänning, och kring det som är känt saknas det aktuell litteraturöversikt. Syfte: Syftet med föreliggande uppsats var att beskriva patienters upplevelser kring tvångsåtgärden fastspänning inom den slutna psykiatriska vården. Metod: Denna uppsats är en systematisk litteraturöversikt som bygger på en sammanställning av nio kvalitativa artiklar. Dataanalysen genomfördes enligt Evans tolkande dataanalysmetod. Resultat: Tre teman framkom kring upplevelsen av fastspänning, dessa var: innan fastspänning, under fastspänning och efter fastspänning. Tio subteman framkom: Patienters upplevelse av en bristande och provokativ vård, patienters önskan av vård när den upplevs bristande och provokativ, maktlöshet och rädsla, känslan av att vara totalt utlämnad och försvarslös, en förlorad verklighetsuppfattning, fastspänning som någonting säkert och tryggt, patienters upplevelse av personalens bemötande, patienters synpunkter på personalens bemötande, patienters behov av att få delge sin uppfattning samt skapa möjlighet till förståelse och negativa konsekvenser av fastspänning. Resultatets teman och subteman ledde fram till en sammantagen syntetisering i form av: Patienters utsatthet skapar längtan efter en vårdande kommunikation. Slutsats: Fastspänning är i de flesta fall en mycket negativ upplevelse för patienter. Patienters upplevelser av fastspänning kan dock förbättras om sjuksköterskan innan, under och efter fastspänning har en vårdande kommunikation gentemot patienter. / Background: Mechanical restraint is relatively common in Sweden and several other countries within the psychiatric inpatient care. Research on nurses' experience of restraining shows that it’s perceived as something ethically difficult. Mechanical restraints is also considered to be something necessary in terms of safety. Little is known scientifically about what the patient’s experiences of mechanical restraints are, and there’s no current literature review. Aim: The purpose of the present study was to describe patients’ experiences of the coercive measure mechanical restraint in psychiatric inpatient care. Method: A systematic review of literature based on a compilation of nine qualitative articles. The data analysis was carried out according to Evans interpretive data analysis method. Results: Three main themes emerged in the experience of restraints, which were: before restraint, during restraint and after restraint. Ten subthemes emerged: Patients' experience of a lacking and provocative care, patients' needs in the experience of a lacking and provocative care, powerlessness and fear, the feeling of being totally extradited and defenseless, a lost sense of reality, restraint as something safe and secure, patients' perception of the staff's treatment, patients' thoughts on the staff's treatment, patients' need to share their thoughts and create opportunities for being understood and negative consequences of restraint. The themes and sub-themes led to a total synthesis in the form of: The exposed patients' longing for a caring communication. Conclusion: Restraint is in most cases a very negative experience for patients. Patients' experience of restraint can, however, be improved if the nurse before, during and after restraint provides a caring communication with patients.

A maioria dos estudos sobre o papel da família na continuidade do tratamento após o primeiro episódio psicótico investigam os casos de abandono de tratamento e apontam para aspectos \"negativos da família\". Poucos estudos investigam o papel da família nos casos de pacientes que se mantém no tratamento. Objetivo: Compreender a experiência de cuidar de um familiar no PEP e evidenciar as motivações para manter-se no cuidado. Método: Trata-se de pesquisa qualitativa que utilizou a teoria sistêmica familiar como referencial teórico e a narrativa como referencial metodológico. Foram entrevistados 13 familiares cuidadores de 12 pacientes. Para a realização das entrevistas em profundidade com enfoque narrativo foi utilizada a seguinte questão norteadora: Nós sabemos que poucos familiares se mantêm no tratamento em saúde mental junto ao seu jovem familiar adoecido após o primeiro episódio psicótico. Se manter no tratamento conjuntamente ao paciente e cuidar do mesmo é chamado por nós de engajamento. São ações como levar nas consultas, administrar a medicação, modo de se relacionar, cuidar da higiene e assim por diante. Sendo assim, gostaríamos que você nos contasse sobre o que te motiva a permanecer cuidando e tudo que você e sua família fazem pelo seu familiar adoecido. Para a exploração das narrativas foi utilizada a técnica de análise de conteúdo indutiva. Resultados: A análise das narrativas definiu o engajamento familiar em três grandes categorias interdependentes. Uma é relacionada ao contexto de sentimentos envolvidos no cuidar denominada \"Motivações para o engajamento\", as outras duas referem-se às ações relacionadas ao cuidar denominadas \"As ações de engajamento\" e \"Avaliação constante do cuidar\". Conclusão: A pesquisa contribui com o conhecimento ao apresentar famílias ativamente envolvidas no cuidado com o jovem em tratamento para o primeiro episódio psicótico. O referencial teórico - metodológico possibilitou destacar e valorizar as histórias, experiências e as relações familiares envolvidos no cuidado de um ente querido. Os cuidados foram descritos e contextualizados nos valores culturais das famílias. Verificamos que os familiares percebem o cuidado como uma responsabilidade do seu papel na família / Most studies of the family\'s role in the continuity of treatment after the first epidode psychosis investigate cases of abandonment treatment and point to \"negative aspects of family\". Few studies have investigated the role of the family in cases of patients who remain in treatment. Objective: Understand the experience of caring of a familiar in PEP and highlight the motivations to remain in care. Method: This is a qualitative research that used the systemic family theory as the theoretical framework and the narrative as a methodological framework. 13 family caregivers of 12 patients were interviewed. To carry out the interviews with narrative approach was used the following question: We know that few families remain in mental health treatment of their sick young familiar after the first episode psychosis. Maintain the treating and taking care of the patient is called engagement. These are actions like take into consultations, administer medications, so as to relate, take care of hygiene and so on. Therefore, we would like you to tell us what motivates you to stay caring after everything you and your family are sickened by his family. For the exploration of the narratives was used the inductive content analysis technique. Results: The analysis of the narrative set the familiar engagement in three major interdependent categories. One is related to the context of feelings involved in the care called \"Motivations for engagement,\" the other two refer to actions related to care called \"The engagement actions\" and \"The assessment of care.\" Conclusion: The study contributes to the knowledge to present actively involved families in caring of the young in treatment of first episode psychosis. The theoretical - methodological possible highlight and enhance the stories, experiences and family relations involved in the care of a loved one. Care were described and contextualized in the cultural values of families. We found that family members perceive care as a responsibility of their role in the family

Tendo como meta a reabilitação psicossocial, o Centro de Reabilitação e Hospital-Dia do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (CRHD do IPqHCFMUSP) propicia aos pacientes uma gama variada de atividades terapêuticas grupais, com a finalidade de resgatar habilidades que o adoecer psíquico comprometeu, e de estimular potenciais não prejudicados assim como sua autonomia. Oferece a possibilidade de participar de psicoterapia, terapia ocupacional, atividade externa, convivência, desenho e pintura, literatura, cidadania, conscientização, psicodrama, cozinha experimental, reorientação ocupacional, vídeo, lazer, dança, massoterapia e atividade física. Esse leque de atividades, porém, torna difícil, para o pesquisador, avaliar a influência de cada uma isoladamente. Neste estudo, optamos por estudar o comportamento do paciente no Grupo de Atividade Física do CRHD citado, tendo foco a atividade terapêutica desenvolvida nesse grupo. Seus objetivos foram. 1)Validar um instrumento para observação da evolução do comportamento do paciente no Grupo de Atividade Física programada: 2) Observar a evolução do paciente nos aspectos dos domínios motor, cognitivo e afetivo-social no Grupo de Atividade Física do CRHD, segundo o instrumento elaborado; 3) Levantar hipóteses sobre a contribuição da atividade física programada no comportamento do portador de transtorno mental e na reabilitação psicossocial. Esta pesquisa foi desenvolvida em duas etapas: na primeira, utilizamos a pesquisa metodológica para a construção de um instrumento que nos permitisse, na segunda etapa, observar a evolução dos pacientes no Grupo de Atividade Física, por meio da pesquisa exploratória-descritiva. O local da pesquisa foi o CRHD citado. A população, constituída por dez pacientes admitidos no CRHD, que participaram do Grupo de Atividade Física. Eram adultos, de ambos os sexos, de diferentes faixas etárias, níveis sócio-econômico-cultural e condições físico-motoras. Foram respeitados os aspectos éticos preconizados pelo Conselho Nacional de Saúde e obteve-se a aprovação do Comitê de Ética da Escola de Enfermagem da USP e da Comissão de Ética da Diretoria Clínica do Hospital das Clínicas da Faculdade de Medicina da USP e assinado Termo de Consentimento Livre e Esclarecido. A maioria (9) dos participantes recebeu o diagnóstico de esquizofrenia e a totalidade (10) fazia tratamento com drogas psicotrópicas. O presente estudo não permite generalizações, portanto, as conclusões a seguir aplicam-se à população estudada: o instrumento construído para observação do comportamento do paciente no Grupo de Atividade Física foi validado, pré-testado e considerado adequado para a finalidade do estudo; as atividades físicas programadas estimularam o desenvolvimento dos participantes nos domínios motor, afetivo-social e cognitivo, tanto pela análise do pesquisador como na visão dos pacientes; e, foi possível identificar várias hipóteses sobre os resultados para futuros estudos. / Focusing on the psychosocial rehabilitation, the Rehabilitation Center and Day Hospital (RCDH) of the Psychiatry Institute at Hospital das Clínicas of the School of Medicine at University of Sao Paulo offers its patients a wide range of therapeutic activities, aimed at retrieving abilities compromised by psychiatric condition, as well as stimulating unharmed potential abilities and patients’ autonomy. Therapeutic activities include psychotherapy, occupational therapy, field trips, exchange experience group, citizenship, conscientization, sketching and painting, literature, psychodrama, cooking, vocational orientation, video, leisure, dance, massage therapy, and physical activity. This array of activities makes it difficult for a researcher to evaluate the influence of each activity. In the present research, we studied the behavior of patients of the Physical Activity Group at the RCDH, focusing on the therapeutic activity carried out by that group. The aims of the study were: 1) To validate a tool to observe the evolution of patient behavior at the Physical Activity Group; 2) Observe the evolution of patient concerning motor, cognitive and affective domains, according to the previously mentioned tool; 3) Establish hypotheses regarding the contribution of programmed physical activity to behavior and psychosocial rehabilitation of outpatients with mental health problems. The study was carried out in two phases: in the first phase, methodological research was used to develop a tool to be used in the second phase, which consisted of the observation of the evolution of patients in the Physical Activity Group, through exploratory-descriptive research. The setting was the RCDH mentioned above. The participants were ten patients at the Rehabilitation Center – participating in the Physical Activity Group – adults, both male and female, from different age groups and social backgrounds and presenting different physical-motor skills. Ethical aspects recommended by National Council of Health were observed and approval was obtained both from the Ethics Committees of School of Nursing – USP and Clinical Board of Hospital das Clínicas – School of Medicine – USP. Written informed consent was obtained from participants. Most participants (n=9) were diagnosed with schizophrenia and all participants (n= 10) were using psychotropic drugs. The present study does not allow for generalizations. Therefore, following conclusions apply solely to the population studied: the tool developed for observation of behavior of the patient in the Physical Activity Group was validated, pre-tested and considered adequate for the purpose of the study; the programmed physical activities stimulated development of participants in motor, affective-social and cognitive domains, both from the point-of-view of the researcher as well as of patients; and, finally, it was possible to establish various hypotheses about the results for future investigation.

Este estudo teve por objetivo analisar as implicações da Terapia Comunitária (TC) enquanto instrumento de intervenção no sofrimento dos trabalhadores de uma Unidade de Internação Psiquiátrica de um Hospital Geral (UIPHG). Trata-se de uma pesquisa de natureza qualitativa do tipo estudo de caso e participante. A coleta de dados foi realizada em três fases, sendo que na primeira recorreu-se à entrevista semiestruturada que buscou conhecer o trabalho, as dificuldades e frustrações de membros da equipe de enfermagem. A segunda fase constituiu na aplicação de 26 sessões de Terapia Comunitária, desenvolvidas de acordo com sua metodologia. A última fase foi composta por entrevista semiestruturada de modo a conhecer as implicações da Terapia Comunitária no sofrimento dos trabalhadores. A análise foi conduzida segundo a Análise Temática de Conteúdo. Os dados foram discutidos à luz da Psicodinâmica do Trabalho de Christopher Dejours. Construíram-se os núcleos temáticos com base em dois grandes temas: o cuidar e o sofrer dos trabalhadores de enfermagem da UIPHG e a Terapia enquanto instrumento de intervenção neste sofrimento. Dentre as categorias do cuidar, foi encontrado o cuidar centrado na doença e o cuidar do paciente em crise; entre as categorias do sofrer, estão o sofrer pela ameaça física, pelo medo, pelos conflitos nas relações de trabalho, e pela falta de reconhecimento. Por meio da análise da TC, observou-se que essa metodologia funciona como um espaço público para a re-significação das relações de trabalho, por meio da convivência, troca de experiências de vida, alívio das tensões do trabalho, de apoio, construção de vínculos e resgate da cooperação. Considera-se que a TC intervem no sofrimento dos trabalhadores uma vez que, por meio de um espaço de partilha, o qual proporciona conhecimento mútuo, identificação, sensibilização, admiração pelas histórias de sofrimento e superação, muitos trabalhadores passam a considerarem-se antes de tudo como seres humanos e, somente então, como trabalhadores. Ao melhor conhecerem o homem do trabalho e não apenas o trabalho do homem re-significam suas relações, os conflitos interpessoais são redimensionados pela compreensão, colaboração e vínculos solidários. Assim, o sofrimento no trabalho torna-se passivel de intervenção. / This research is aimed at analising the emplications of Community Therapy (CT) while an instrument for the intervention into the suffering of the workers at the Psychiatric Admission Unit of a General Hospital (PAUGH). It consists of a research of a qualitative nature of the case-participant study. Data collection was carried out in three steps, the first one being performed through semi-structured interview with the purpose of getting acquainted with the a work, and the difficulties and frustrations of the nursing team members. The second step consisted in the holding of twenty six Community Therapy sessions, developed according to its own methodology. The last step comprised semi-structured interviews performed in such a way as to get acquainted with the implications of Community Therapy in the suffering of the workers. The analysis was conducted according to the Content Subject Analysis. These data were discussed in the light of Christopher Dejours\'s Work Psychodynamics. The subject or theme nuclei were formed basing on two major themes: the care and the suffering of the nursing workers of the PAUGH and the therapy while an instrument of intervention into said suffering. Among the categories of care, two features were observed, i.e., the care centered on the disease and the care of the patient in crisis; among the categories of suffering are suffering under physical threat, fear, conflicting work relations and lack of acknowledgement. Through the analysis of CT it was observed that this methodology works as a public space for the resignification of the work relationships, by means of living together, exchange of life experiences, relief of work stresses, support, a building up of ties and reestablishment of cooperation. It is assumed that CT intervenes in the suffering of the workers as - by means of a sharing space, which provides mutual knowledge, identification, sensitization, admiration for histories of suffering and the subsequent overcoming - many workers begin to the consider themselves, above all, as human beings and, only then, as workers. Upon getting a better knowledge of the working man, and not only of the work of man, resignify their relations, redimension their interpersonal conflicts through understanding, cooperation and solidarity ties. Thus, suffering in the work becomes liable to intervention.

A equipe de enfermagem sofre influências do seu ambiente laboral que podem afetar sua saúde e desempenho no trabalho e tais influências relacionam-se a fatores que podem estar relacionados à instituição, características individuais e profissionais. Nesta situação o esgotamento emocional revela-se um problema de saúde pública, num contexto laboral sujeito a diferentes graus de sobrecarga de trabalho e satisfação laboral. Objetivos: Avaliar o nível de esgotamento emocional de enfermeiros profissionais que atuam na atenção de saúde mental e sua relação com variáveis sociodemográficas e ocupacionais, satisfação no trabalho e sobrecarga de trabalho percebida. Método: Foram entrevistados 116 profissionais da equipe de enfermagem de saúde mental de oito serviços de saúde em um município do interior de São Paulo (Brasil). Os instrumentos utilizados foram: um questionário ad hoc com informações sobre variáveis sociodemográficas e de trabalho, Escala de Avaliação do Impacto do Trabalho em Serviços de Saúde Mental, Escala de Avaliação da Satisfação da Equipe em Serviços de Saúde Mental e a dimensão de esgotamento emocional do Maslach Burnout Inventory. Realizou-se a análise das propriedades psicométricas (fatorial exploratória, a confiabilidade e consistência interna), análises descritivas (frequências, médias e desvios- padrão) e análise de correlação de Pearson entre a exaustão emocional e grau de satisfação e sobrecarga de trabalho. Adotou-se um nível de significância de 0,05. Resultados: Os resultados evidenciaram que a população investigada apresentou um nível médio-baixo para sobrecarga laboral, médio-alto para satisfação de trabalho e médio-alto para esgotamento emocional. Os resultados também confirmaram a correlação diretamente proporcional da sobrecarga de trabalho com o esgotamento emocional e inversamente proporcional da satisfação laboral com o esgotamento emocional. Os dados evidenciaram não haver correlações significativas entre nível de esgotamento emocional com as variáveis sociodemográficas. Os dados analisados também evidenciaram uma reestruturação em conteúdo e número de itens das escalas SATIS-BR abreviada e IMPACTO-BR abreviada. Conclusões: O elevado nível de esgotamento emocional para a maioria dos participantes sugere a existência de um risco de desgaste laboral ou síndrome de Burnout nos profissionais de enfermagem de saúde mental. As correlações negativas de esgotamento emocional com a satisfação laboral e as elevadas pontuações desta última, também sugerem a necessidade de considerar a importância em proporcionar ambientes que promovam a segurança e bem-estar no trabalho, uma vez que a satisfação poderia atuar como um fator de proteção ao desgaste. Um produto importante desta pesquisa foi a reestruturação das escalas SATIS-BR abreviada e IMPACTO-BR abreviada, adaptadas para profissionais da equipe de enfermagem / The nursing staff is influenced by their work environment that may affect their health and performance at work and such influences are related to factors that could be related to the institution, individual and professional characteristics. In this situation the emotional exhaustion proves to be a public health problem in workplace settings is subject to different degrees of workload and job satisfaction. Objectives: Evaluate the degree of emotional exhaustion of professional nurses working in mental health care and the relationship with sociodemographic and occupational variables, job satisfaction and perceived work overload. Method: 116 nursing team professionals in mental health of eight health services were interviewed in an inner city of São Paulo (Brazil). The instruments used were: a questionnaire ad hoc with informations about sociodemographic and occupational variables, Workload Assessment for Mental Health Services, Staff Satisfaction Assessment for Mental Health Services and the dimension of emotional exhaustion of the Maslach Burnout Inventory. Was conducted the psychometric properties analysis (exploratory factor, reliability and internal consistency), descriptive analyzes (frequencies, means and standard deviations) and Pearson correlation analysis between emotional exhaustion and satisfaction and workload. Was adopted a 0.05 of significance level. Results: The results showed that the investigated population has a medium-high level of emotional exhaustion and job satisfaction while the workload appears with a medium-low level. It is also confirmed that emotional exhaustion correlates positively and significantly with the increased workload and negatively related to job satisfaction. No significant correlations between the level of emotional exhaustion and sociodemographic variables were found. The analyzes performed on the SATIS-BR-BR abbreviated and the IMPACT-BR abbreviated scales suggest a restructuring of the factors according to the number and content of the items. Conclusions: The high level of emotional exhaustion for most participants suggests the existence of a risk for work wear or Burnout syndrome in mental health nursing team professionals. Negative correlations of emotional exhaustion with job satisfaction and the high scores of job satisfaction also suggest the need to consider the importance of providing an environment that fosters the safety and well-being at work, since the satisfaction could act as a factor of wear protection. An important product of this research was the restructuring of the SATIS-BR abbreviated scale and the IMPACT- BR abbreviated scale, adapted for nursing team professionals