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Previous issue date: 2014-12-11 / Na rede de aten??o psicossocial brasileira, os profissionais de sa?de s?o atores importantes no
processo de transforma??o das pol?ticas p?blicas em sa?de mental entre os diversos servi?os.
Na realidade do hospital psiqui?trico, entende-se a necessidade de ampliar o debate em torno
do atual contexto de pr?ticas desenvolvidas. O estudo objetivou analisar o processo de
reforma psiqui?trica e a pol?tica de sa?de mental no Estado do Rio Grande do Norte (RN) a
partir dos perfis e pr?ticas dos profissionais de n?vel superior em dois hospitais psiqui?tricos.
Pesquisa transversal e descritiva, com dados quantitativos e qualitativos, realizada em dois
hospitais psiqui?tricos do RN. O universo da popula??o alvo foi de 95 profissionais,
considerando-se a margem de erro de 8%, taxa de n?o resposta e os crit?rios de inclus?o:
possuir v?nculo efetivo com a institui??o por meio de aprova??o em concurso p?blico por, no
m?nimo, seis meses, sendo servidor estadual ou municipal; possuir uma carga hor?ria semanal
m?nima de 20 horas no servi?o; participar diretamente de atendimento e/ou atividades com
pacientes e familiares. A amostra final foi de 60 profissionais. Utilizou-se como instrumento de
coleta de dados um question?rio de perguntas fechadas e semiabertas sobre o perfil
socioecon?mico, as pol?ticas, as pr?ticas e a forma??o em sa?de mental. Tabularam-se os
dados quantitativos no software estat?stico SPSS e para an?lise utilizou-se estat?stica simples e
bivariada, do tipo qui-quadrado, adotando-se o n?vel de signific?ncia valor p<0,05. Para
an?lise dos dados utilizou-se a an?lise de conte?do de Bardin. Os achados qualitativos obtidos
com as quest?es semiabertas no Analyse Lexicale par Contexte d'un Ensemble de Segment de
Texte (ALCESTE) foram agrupados em quatro eixos tem?ticos: Atua??o profissional em
sa?de mental; Forma??o em sa?de mental; Cen?rios da reforma psiqui?trica e o hospital
psiqui?trico; Pol?ticas e pr?ticas em sa?de mental: desafios para profissionais no hospital. O
perfil dos profissionais revelou a maioria do sexo feminino (89,7%), enfermeiras (36,7%),
faixa et?ria de 50-59 anos (42,9%), carga hor?ria de 40 horas semanais (52,4%), tempo de
conclus?o da gradua??o de seis a 15 anos (57%) e 21,4% mencionaram ter especializa??o em
sa?de mental. Sobre as pr?ticas desenvolvidas, no atendimento individual encontrou-se
associa??o entre quem n?o constr?i ou faz parcialmente o projeto terap?utico associado a
quem realiza cuidados de observa??o e anota??o. No atendimento familiar, obteve-se cuidado
de consulta na crise; e, no atendimento de grupo a recrea??o. Na an?lise dos eixos tem?ticos
observou-se que apesar de mudan?as identificadas nos perfis e pr?ticas dos profissionais de
n?vel superior nos servi?os de aten??o ? sa?de mental, com a implementa??o de novas
pol?ticas p?blicas para a ?rea, os achados sugerem a conflu?ncia de assimetrias e diverg?ncias
na atua??o das equipes nos hospitais psiqui?tricos, ? dificuldades na gest?o do servi?os, as
reinterna??es frequentes, reduzido quantitativo de servi?os e equipamentos dispon?veis, ? alta
demanda de usu?rios, desarticula??o da rede de aten??o psicossocial, e a pr?pria escassez de
recursos humanos qualificados para compor esses servi?os. Assim, os cen?rios evidenciados
circunscrevem, em parte, o descompasso pol?tico e ideol?gico atual do processo de reforma
psiqui?trica nacional que nega o papel da assist?ncia realizada no ambiente hospitalar, embora
n?o tenha avan?ando o suficiente com a cria??o de novos servi?os que justifiquem a extin??o
total dessa institui??o / In the Brazilian network of psychosocial care, health professionals are important actors in the
process of transformation of mental health public policies among various services. In the
reality of psychiatric hospitals, one should understand the need to expand the debate about the
current context of practices developed. This study aimed at analyzing the process of
psychiatric reform and the mental health policy in the State of Rio Grande do Norte (RN)
from the profiles and practices of higher-level professionals in two psychiatric hospitals. This
is a cross-sectional and descriptive research, with quantitative and qualitative data, conducted
in two psychiatric hospitals of RN. The universe of the target population was 95
professionals, taking into account the margin of error of 8%, non-response rate and the
inclusion criteria: holding effective link with the institution by means of approval in public
examination for, at least, six months, being state or municipal servant; having a minimum
weekly workload of 20 hours in service; participating in care and/or activities with patients
and families in a direct way. The final sample consisted of 60 professionals. The tool for data
collection was a questionnaire with closed and semi-open questions about socioeconomic
profile, and mental health policies, practices and training. Quantitative data were tabulated in
the statistical software SPSS, and simple and bivariate statistics, chi-square type, was used for
analysis by adopting the significance level with the value p<0,05. In order to analyze data, the
content analysis of Bardin was used. The qualitative findings obtained with the semi-open
questions in Analyse Lexicale par Context d'un Ensemble de Segments de Texte (ALCESTE)
were grouped into four thematic axes: Professional action in mental health; Mental health
training; Scenarios of psychiatric reform and psychiatric hospitals; Mental health policies and
practices: challenges for professionals in hospitals. The profile of professionals has revealed
the majority of women (89,7%), nurses (36,7%), aged 50-59 years (42,9%), weekly workload
of 40 hours (52,4% ), time of completion of graduation from six to 15 years (57%), and
21,4% reported to have specialization in mental health. Regarding the practices developed in
individual care, it was found an association between those who do not build or partially
conducts the therapeutic project and those who conduct care related to observation and
annotation. In family care, it was obtained care consultation during crisis; and, in group care,
recreational activities. In the analysis of thematic axes, it was noted that, despite changes
identified in the profiles and practices of higher-level professionals in care services for mental
health, with the implementation of new public policies for this field, the findings indicate the
confluence of asymmetries and divergences in the actions of the teams in psychiatric
hospitals, difficulties in managing services, frequent readmissions, reduced quantitative of
available services and equipment, high demand of users, disarticulation of the network of
psychosocial care, and the very shortage of skilled human resources to compose these
services. Accordingly, the evidenced scenarios partially outline the current political and
ideological mismatch of the national process of psychiatric reform that denies the role of care
actions conducted within hospitals, although it has not gone far enough with the creation of
new services that justify the total extinction of this institution
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/19650 |
| Date | 11 December 2014 |
| Creators | Pessoa J?nior, Jo?o M?rio |
| Contributors | 04960360330, http://lattes.cnpq.br/9242337504601387, Furegato, Antonia Regina Ferreira, 86263790806, http://lattes.cnpq.br/4312020032304532, Torres, Gilson de Vasconcelos, 51326728415, http://lattes.cnpq.br/1944547152815226, Martino, Milva Maria Figueiredo de, 58771212868, http://lattes.cnpq.br/7096939242634758, 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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