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Previous issue date: 2015-06-12 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A Pol?tica Nacional de Sa?de Mental se caracteriza como uma pol?tica territorial-comunit?ria e tem a Estrat?gia Aten??o Psicossocial (Eaps) como norteadora para a proposi??o e o desenvolvimento de suas a??es. Em seu desenho, o CAPS ? um equipamento estrat?gico dentro da Rede de Aten??o Psicossocial/RAPS. O apoio matricial e a aten??o ? crise configuram frentes estrat?gicas de a??o dos CAPS em sua miss?o substitutiva e, guiados pela b?ssola da desinstitucionaliza??o, s?o essenciais para o ?xito desses servi?os. Defendemos que sustentar crises nos territ?rios existenciais de vida ? uma condi??o para a efetiva??o da Aten??o Psicossocial e, no limite, para a sustentabilidade da pr?pria Reforma. Nesta dire??o, a ferramenta do apoio matricial se revela uma apoiadora territorial, intercessora e potente na constru??o de uma Aten??o Psicossocial ? crise. Reconhecidos como grandes desafios pelo Minist?rio da Sa?de, avan?ar estas frentes se materializa para os trabalhadores em seus of?cios micropol?ticos. A nossa pesquisa se coloca como um investimento na dire??o de potencializ?-las e teve como objetivo conhecer a operacionaliza??o da aten??o ? crise e do apoio matricial em um CAPS II, na perspectiva dos seus trabalhadores, bem como analisar tais pr?ticas frente aos princ?pios e prop?sitos da Estrat?gia Aten??o Psicossocial. Inspirados na pesquisa-interven??o e no ide?rio pol?tico-social da An?lise Institucional, ofertamos um espa?o de reflex?o e troca, atrav?s de entrevistas de implica??o, possibilitando que os trabalhadores se lan?assem em an?lise das pr?ticas na perspectiva da Eaps. Fizemos consulta documental ao Projeto T?cnico do CAPS e uma etapa de restitui??o, organizada em formato de oficina e rodas de conversa. L?gicas institucionais competem no Servi?o. Operando pela l?gica do risco, dificuldades em sustentar situa??es de crises mais intensas foram identificadas, de modo que o hospital psiqui?trico termina sendo utilizado como um recurso de interna??o, principalmente diante de casos em que o elemento da agressividade se faz contundente, e quando os suportes do SAMU, dos CAPS III e dos Leitos de Aten??o Integral n?o respondem a contento. Indicam-se fragilidades de ordem macro e micro interferindo no suporte da rede. As a??es do matriciamento, mesmo identificadas como um potente recurso intercessor no cuidado ? crise, apareceram enfraquecidas, apontando pouca porosidade na rela??o Servi?o com o territ?rio. Marcadas pela l?gica do atendimento domiciliar, sem operar prioritariamente como dispositivo de troca de saberes, v?-se pontos de captura na l?gica da assist?ncia, com produ??o de ambulatoriza??o do CAPS, pr?ticas assistencialistas e de ?apaga-fogo?. Efeitos das a??es de cuidado nos usu?rios s?o identificados pelos trabalhadores sem as repercuss?es desejadas no horizonte de expans?o da vida e a Eaps, ainda que desponte como um norteador, n?o ? vista como pr?tica efetivada. Apesar de os resultados sinalizarem que a aten??o ? crise e as a??es do matriciamento s?o desenvolvidas sem conex?o tenaz com os prop?sitos da Eaps, casos exitosos s?o indicados tendo como principais fios condutores a tessitura micropol?tica da intersetorialidade das a??es, dos v?nculos potentes e da participa??o do usu?rio em seu processo de cuidado, indicando for?as insurgentes que tencionam por deslocamentos de l?gicas tradicionais. / The National Policy on Mental Health is characterized as a territorial
-
political
community
,
and it has the Psychoso
cial Care Strategy (Eaps) as
guideline for the proposal and the
development of their actions. In its design, CAPS is
idealized to be
a strategic equipment
within the Psychoso
cial Care Network/RAPS. Matricial
support and at
tention to the crisis
constitute strategic areas of action of CAPS in
its
replacement mission
, and as it is g
uided by
the scope of deinstitutionalization,
those
are essential to the success of these services. We
argue that sustain crises in existential territories of life is a condition for the effectiveness of
psychosocial care and, ultimately, to the sustainability of
its
Reform. In this direction, the
matricial
support tool reveals a territorial supporter, intercessory and powerful in building a
psychosocial care to the crisis. Recognized as
one of the
major challenges by the
Brazilian
Ministry of Health, forward these fronts materializes for workers in their mi
cropolitical
crafts. Our research
arises
as an investment toward empower them
,
and aimed to
understand
the operationalization of attention to the crisis and
matricial
support in a CAPS II, in
the
view
of
its
workers
. Besides, it aims to
examine such practi
ces forward the principles and purposes
of Psychosocial Care Strategy. Inspired by the research
-
intervention and
by the
political and
social ideas of Institutiona
l Analysis, we offer a space for reflection and exchange, by
implicational interviews
, enablin
g workers to launch them in analysis of practices in the
EAPs view. We have done a documentary consulting CAPS Technical Project, and a return
stage to the institution, by organizing workshop and conversation groups with CAPS
workers. The results have show
n that there are institutional logics in competition on that
service. When operating the logic risk, some difficulties in sustaining most intense crisis
situations were identified, the psychiatric hospital internment is used as a facility, particularly
in
view of some cases, in which the aggressiveness of the person in crises becomes
aggressive, and when the brackets SAMU, the CAPS III and Comprehensive Care Beds do
not respond satisfactorily to their users requests. Order weaknesses were indicated in this
thesis as macropolitical and micropolitical interfering in network support. The matricial
actions were identified as a powerful intercessor resource in crisis care appeared weakened,
and indicates little porosity in the relationship between the Service and
the territory where it
takes place. Noticed by the logic of home care, without operate primarily as a knowledge
exchange device, we saw capture points in the logic of
assistance with
ambulatoriza
tion
production of CAPS, welfare practices and "ext
empore
"
.
T
he E
APs
, although
it
emerge
s
as a
guiding,
it
is not seen
to workers
as effective practice.
On the one hand,
the results signaled
that the attention to the crisis and the matricial actions are developed without tenacious
connection with the purposes of EA
Ps,
on the other hand,
successful cases
were
indicated
with the main leads to
conducting wire of intersectoral actions to
the powerful bonds and
to
the
participation
of
user in their care process
es
, indicating insurgent forces tha
t intend by
traditional lo
gic
.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/20258 |
| Date | 12 June 2015 |
| Creators | Silva, Maura Lima Bezerra e |
| Contributors | 24383481353, http://lattes.cnpq.br/9681334300604531, Ara?jo, Li?ge Uch?a Azevedo de, 31398995487, http://lattes.cnpq.br/8477262306974827, Pereira, Maria Teresa Lisboa Nobre, 22256741400, http://lattes.cnpq.br/1234091318043836, Yasui, Silvio, 84603674872, http://lattes.cnpq.br/6805148444025544, Paulon, Simone Mainieri, 41643151053, http://lattes.cnpq.br/6053363307031981, Dimenstein, Magda Diniz Bezerra |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM PSICOLOGIA, 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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