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Previous issue date: 2014-12-11 / No Brasil, a Reforma Psiqui?trica organiza-se com base nos pressupostos da Reforma Sanit?ria e da Psiquiatria Democr?tica Italiana com vistas a eliminar o modelo hospitaloc?ntrico. Objetivo: Avaliar a estrutura e o processo de trabalho desenvolvido nos Centros de Aten??o Psicossocial (CAPS), englobando a satisfa??o, o perfil, as condi??es e a sobrecarga de trabalho dos profissionais. Aprovado pela Comiss?o de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte (UFRN), protocolo n? 719.435, de 30/05/2014. M?todos: Estudo descritivo, com abordagem quantitativa, desenvolvido em cinco Centros de Aten??o Psicossocial, a saber: 02 CAPS I, 01 CAPS II, 01 CAPS III e 01 CAPSAD, de Campina Grande-PB. A popula??o do estudo constitui-se de todos os coordenadores dos cinco CAPS, incluindo 42 profissionais de n?vel superior, 71 de n?vel m?dio (t?cnicos e auxiliares de enfermagem, e cuidadores), e os prontu?rios referentes a 2.297 usu?rios atendidos. Para assegurar a representatividade das informa??es, calculou-se uma amostra aleat?ria estratificada com partilha proporcional, considerando-se os seguintes par?metros: erro ? de 5%, n?vel de confian?a de 95%, poder do estudo de 80%, estimativa de propor??o de 10% e o ?ndice de proporcionalidade espec?fico para os profissionais de n?vel (superior e m?dio) e os prontu?rios. Coletou-se os dados atrav?s de question?rios validados, elaborados para o estudo CAPSUL (Avalia??o dos CAPS da Regi?o Sul do Brasil), entre julho e outubro de 2014. Os question?rios foram duplamente digitados e submetidos ? valida??o no sub-programa Validate do Epi Info 3.5.4, utilizado juntamente com o SPSS, 17.0 para o processamento das an?lises estat?sticas. Resultados: A partir da an?lise dos prontu?rios dos usu?rios atendidos nos CAPS, observou-se um predom?nio de mulheres na faixa et?ria adulta. Destacou-se como psicopatologia mais frequente, ? esquizofrenia. Quanto ?s interna??es antes e ap?s o ingresso nos CAPS, registrou-se para o hospital geral 14 interna??es (3,5%) antes e sete (1,7%) depois, diferen?a n?o significante (p=0,612). Ressalta-se que, em hospitais psiqui?tricos, ap?s o ingresso, houve redu??o para o m?ximo de tr?s interna??es. O n?mero total reduziu de 117 (29,1%) para apenas 11 (2,7%); redu??o estatisticamente significante (p=0,002). Quanto ?s formas de contra??o dos profissionais de sa?de, os resultados evidenciam a exist?ncia de contrato tempor?rio. A maior propor??o de insatisfa??o com todos os par?metros avaliados deu-se naqueles profissionais que se consideram sobrecarregados no trabalho. Entretanto, a ?nica diferen?a estatisticamente significante estava relacionada com o ?grau de responsabilidade? (90,9%; p=0,04). Observou-se forte associa??o da insatisfa??o dos profissionais de sa?de com fatores relacionados ao conte?do e ?s condi??es de trabalho no CAPS, relativa ?s medidas de seguran?a, conforto e apar?ncia dos CAPS, contato entre as equipes e usu?rios, e tratamento das fam?lias por parte das equipes. Chama ? aten??o que estes aspectos s?o aqueles que n?o dependem diretamente da atua??o dos profissionais. Conclui-se que o fortalecimento dos CAPS requer e exige um compromisso intersetorial, a partir do n?vel governamental, em garantir os recursos para a operacionaliza??o de suas a??es e assegurar aos usu?rios e ? sua fam?lia a oferta e o acesso aos servi?os de sa?de. / Objective: Evaluate the work structure and process in Psychos
ocial Care Centers (CAPS) and
the professionals profile, the satisfaction, conditions and work overload. Methods: Cross
-
sectional study conducted in five CAPS in Campina Grande city. The study sample consisted
of five coordinators, 42 graduate professional
s, 26 mid
-
level (technical and auxiliary nurses,
and caregivers), and the medical records pertaining to 413 users followed up. Data were
collected using validated questionnaires (CAPSUL
-
rating CAPS in southern Brazil) and
adapted to the study, between July
and October 2014. The questionnaires were double entered
and submitted to validation in the sub
-
program
?Validate Epi Info 3.5.4?
, used along with the
?SPSS 17.0?
for processing the statistical analyzes. Measures of central tendency and
dispersion were ap
plied to the descriptive analyzes;
?Fisher's?
exact test to check the CAPS
impact on hospital admissions and the
?Bonferroni?
adjusted to verify the diagnoses
according to sex. 5% significance level was adopted. The study was approved by the Ethics
Committ
ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of
05.30.2014. Results: From the structure analysis were identified contextual factors that
influenced the work process of CAPS professionals, such as: deficiencies with regard to
h
uman resources; forms of health professionals employment and qualifications; temporary
contract existence. As to process dimension, it was found that the home visits performance by
health professionals shows to be ineffective, given its insufficiency and i
rregularity, which
can be explained by the high demand, reduced staff and transportation lack. It was low
coverage of items inherent to Therapeutic Individual Project, as the income generation
program, insertion at work and home visit. The reference and co
unter reference flow are still
not satisfactorily organized. There was statistically significant difference for the diagnosis,
with a predominance of mood disorders related to stress among women and those related to
alcohol and other drugs among men (p <0.
05). There was an association between the degree
of health professionals satisfaction and working conditions, overload and factors related to
the content and working conditions, the security measures, comfort and CAPS appearance,
contact between the teams
and users, families treatment by the teams, temporary employment
relationship. Conclusion: The data collected indicate the need for the CAPS organization
through increased investments in the sector in order to enhance the infrastructure as
potentiating el
ement of practices with a view to changing the care model for mental health
proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to
better planning in CAPS unit management, with another tool to improve the dimensions
involving the structure and the professional work process and improve this mental health care
model.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/19972 |
| Date | 11 December 2014 |
| Creators | Clementino, Francisco de Sales |
| Contributors | 04960360330, http://lattes.cnpq.br/9242337504601387, Carvalho, Danielle Franklin de, 02698813440, http://lattes.cnpq.br/8539437540131131, Torres, Gilson de Vasconcelos, 51326728415, http://lattes.cnpq.br/1944547152815226, Costa, Isabelle Katherinne Fernandes, 06605883403, http://lattes.cnpq.br/5903265312273525, Almeida, Sandra Aparecida de, 05485226850, http://lattes.cnpq.br/6689781886879777, Miranda, Francisco Arnoldo Nunes de |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM ENFERMAGEM, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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