[Conception of family members of people with mental disorders on self-help groups]. / Concepção de familiares de pessoas com transtorno mental sobre os grupos de autoajuda.

The aim of this study was to understand how family members of people with mental disorders conceive the performance of self- help groups (SG). This qualitative study was conducted with eleven family members who participate in a SG of the Maringaense Mental Health Association. Data were collected from April to June 2010 during group meetings, in an adjoining room, by means of semi-structured interviews, which were then subjected to content analysis. Two categories emerged: "The group compensates for deficiencies in care", which points out deficiencies arising from the formal care services and the benefits of SG for family members and, "Idealized care", which reveals the expectations of the family in relation to mental health care. It was concluded that family members would like activities of the SG to be incorporated by mental health care services and for family care to become a part of the care plan.

[Acceptance of patients with mental illness: a family perspective]. / Aceitação da pessoa com transtorno mental na perspectiva dos familiares.

The aim of this descriptive and qualitative study is to analyse how acceptance of mental illness is perceived by family members of the patient and the surrounding community. This study was conducted with the help of 10 families of patients with mental disorders admitted to the psychiatric emergency unit of the Municipal Hospital of Maringá, state of Parana, Brazil. Data were collected from October to December 2010, in open interviews and submitted to thematic content analysis, resulting in three categories: "Care, a constant requirement", "Living with a patient with mental illness: a whirlwind of emotions", "A wall constructed with stigma and prejudgement: the need for deconstruction". The conclusion is that an understanding of the disease is vital for acceptance of the illness itself and of the patient, and that healthcare professionals must remain close to the family to provide support, answer queries related to the disease, and help the family to face the difficulties of everyday life.

[Community Health Agents' perceptions and practice in mental health]. / Percepções e atuação do Agente Comunitário de Saúde em saúde mental.

The objectives of this study are to identity the perceptions of community health agents regarding health and mental disorders, and to verify the preparation these agents receive to work in this field. This qualitative study was performed using semi-structured interviews for data collection and utilizing content analysis to interpret the data. Interviews were performed with 45 community health agents working in the Family Health Strategy, who reported to 21 basic health units in the city of Maringá, PR. Results show the prejudice that these workers have regarding mental disorders. They recognize the importance of working with the patient and the family but do not feel prepared to provide adequate care. Because they share the same social context and have a close experience with the community dynamics, we see them as important facilitators of mental healthcare.

[Factors affecting the interventions of the Family Health Strategy team towards individuals with mental disorders]. / Fatores interferentes nas ações da equipe da Estratégia Saúde da Família ao portador de transtorno mental.

This qualitative study was performed with Family Health Strategy teams in Maringá - PR. The objective of the study was to identify the factors that affect interventions provided to individuals with mental disorders. Data were collected through focal groups and were subjected to content analysis. Participants reported personal and professional issues related to the structure of the service, such as negative feelings, lack of professional skills, and a prioritization towards curative interventions. The mental healthcare network establishes criteria for assistance, deficient reference and counter-reference and the matrix activity. Factors affecting the interventions included attachment, lack of family involvement, lack of team participation and poor patient adherence. It was found that few factors contributed to the interventions while many were viewed as hindrances; however, by identifying these factors, the teams can work to improve mental health care.

[Stress symptoms in female nurses working in emergency rooms]. / Sintomas de estresse em trabalhadoras de enfermagem de uma unidade de Pronto Socorro.

This is a sectional study carried out in an emergency room, with the purpose of identifying the association of socio-demographic, occupational and economic data in nursing workers presenting stress symptoms. Data was collected from 33 subjects, in July and August 2009, using an inventory of stress symptoms for adults. Results show that most of the workers presented stress symptoms at resistance and almost-exhaustion stages, with presence of psychological and physical symptoms. The highest occurrence was found in female younger workers that were married, graduated, catholic, without a second job, working as nursing technicians in the afternoon or at night, in the emergency room for more than six years, and in the nursing field for less than ten years. It was concluded that something should be done to treat the existing cases of stress in order to avoid their evolution to more serious stages, and prevent new occurrences.

[Living with mental disorders: family members' perspective have on primary care]. / Convivendo com transtorno mental: perspectiva de familiares sobre atenção básica.

The objective of this qualitative study was to identify the service that is offered to the family members of patients with mental disorders at Primary Care Units, and understand the everyday life of that family. Data collection was performed from May to June 2007, by means of semi-structured interviews and observation of five families at their homes. Thematic analysis of the data was performed, generating two categories: 1) mental disorder from the family's perspective and the relation with the health service; 2) living with the mental illness. Result confirm the importance of seeing the family of patients with mental disorders as clients of the care process, and the need to prepare health professionals to answer the needs of the people that seek these services.

[Emotions of people living with ostomies: existential comprehension]. / Sentimentos de pessoas ostomizadas: compreensão existencial.

The objective of this study was to better understand the emotions of ostomy patients and to reinforce their own moral value as beings-in-the-world, through actions of humanized care. This qualitative study followed the existential phenomenology school of thought and was performed at a teaching hospital in Northwestern Paraná-Brazil. Interviews were performed with 15 ostomy patients receiving care at the stomal therapy outpatient clinic during the months of June and July, 2006. The guiding question was: What does being on ostomy patient mean to you? From the analysis, three existential themes emerged: finding oneself in the world of ostomy; daily life with an ostomy bag; and the importance of spirituality in understanding the situation. It was observed that ostomy patients, in their existentiality, express their vicissitudes differently, revealing how painful or pleasant life events can be to them. It is the nurse's challenge to be mindful of their varying forms of expression.

[Support netwrok to the families of children admitted in a pediatric intensive care unit]. / Rede social de apoio à família de crianças internadas em uma unidade de terapia intensiva pediátrica.

With the intention of understanding how the support network of the families of children admitted in a hospital Pediatric Intensive Care Unit (PICU) is established, and its importance in the life of their relatives, a descriptive study with qualitative approach was carried out with 21 parents of children admitted in a PICU of a University Hospital located in the northwest area of Paraná State. It was observed that, the support network to the families was made of a mixed of affectivity, faith and solidarity as the fundamental components to relieve the suffering and out-of-hospital support. The study also showed, that the work with families should be permeated by the special attention to the peculiarities that surround each family context and its relationships, what ratifies the importance of a more comprehensive performance of nursing, better understanding the multiple influences of the different configurations of the family and social support network on the quality and effectiveness of the implemented interventions.

[The family's perception of its presence at the pediatric and neonatal intensive care unit]. / A percepçãa família sobre sua presença em uma Unidade de Terapia Intensiva Pediátrica e Neonatal.

This qualitative-based study aimed to understand how families perceive their own presence at the Pediatric and Neonatal Intensive Care Unit, as well as the acceptance of their presence by healthcare workers. Data was collected through semi-structured interviews with 14 parents of children admitted to the pediatric and neonatal ICU at two hospitals in northwestern Paraná State, Brazil. Content analysis was chosen to interpret the data. The results revealed the suffering experienced by parents, the alteration of family dynamics resulting from the child's hospitalization, and the perception of the benefits of remaining close to the child in terms of welcoming and quality of care. It was concluded that parents value the professionals' respect and attention towards the child, thus creating bonds of affection, trust and gratitude for the care received.

[Feelings and conflicts of women living with HIV/AIDS: a literature research]. / Conflitos e sentimentos de mulheres portadoras de HIV/AIDS: um estudo bibliográfico.

This is a literature review with the purpose to identify how the conflicts and feelings of women living with HIV/AIDS are addressed in the national literature, and the proposed pathways for an integral care approach. Data were collected in November, 2006, in the LILACS database, using the following keywords: women, feelings, HIV, AIDS, suffering, depression and fear. The inclusion criterion was that these studies should have been published in the past five years. The sample was made up of 14 studies (four dissertations, two theses and eight articles). The content analysis method allowed for the identification of three thematic categories: the researcher's perspective, what their perspective identifies and their perspective beyond the physical body--which reveal the necessity of addressing women considering their whole context as human beings, including issues of vulnerability, social gender ideology and the promotion of self-esteem and citizenship.

[Adhesion and non adhesion to anti-retroviral therapy: the two faces of a same experience]. / Adesão e não-adesão à terapia anti-retroviral: as duas faces de uma mesma vivência.

The objective of the study was to understand, from the perspective of HIV bearers and family, the aspects that influence in the adhesion to the antiretroviral therapy. It is a descriptive study, of qualitative nature, carried out from June 2006 to July 2007, with 10 HIV/Aids positive individuals, attended at the Service of Specialized Care on Aids of Campo Mourão - PR and their relatives. The considered facilitative factors of the adhesion are: adoption of strategies to remind schedules and to mask the taste of the medicine, absence of side effects, reduced number of medicines to be taken and capacity to recognize them, memory of the symptoms of the disease and the support of the social group. The absence of these factors can culminate in non adhesion.

[Training local teams as a strategy to institutionalize evaluation in the health system]. / Capacitação das equipes locais como estratégia para a institucionalização da avaliação em saúde.

This article reports on the methodology used by the research team of the State University in Maringá in the Baseline Study in 20 municipalities in the States of Paraná and Santa Catarina, Brazil, with more than 100,000 inhabitants each, in the implementation of the Project for Expansion and Consolidation of the Family Health Strategy. Workshops to discuss the evaluation of programs, construction and application of research instruments, site visits to supervise activities in disseminating the program, and development of a database with the local and regional scientific output were carried out. There was an obvious sense of responsibility and commitment on the part of municipal and State representatives, the majority of whom immediately agreed to the activities. They also showed interest in both the learning process and institutionalization of the evaluation. Fourteen municipalities incorporated other actors to build a support network for the evaluation of the primary health care system. The strategies contributed to the incorporation of evaluation into the planning process, indicating that training can be a constructive and powerful mechanism for institutionalizing evaluation.

[Nursing in the light of family relations problems]. / A enfermagem frente a problemas de relacionamento na família.

The objective is to present some aspects of the family relationship due to communication problems. It is a part of a three generation qualitative study about the experience of families as they raise their children. The historical method was adopted as the methodological line and in the collection of data, in association of the participant observation of life history. The existence of problems/difficulties were identified in family communication within the scope of intra- and inter-generation, as well as changes in this communication throughout the three generations with respect to form, quality, quantity, types, resources, and others. The conclusion is that there are many problems/difficulties in communication within the family, especially within the inter-generation sphere, and nursing staff should be aware to these issues if a global assistance is intended for the family.

[Assistance for people with hypertension in the perspective of the health professional]. / Assistência à pessoa com hipertensão arterial na ótica do profissional de saúde.

The study aimed at learning about the care provided to people with hypertension in primary care from the perspective of health workers. The data was collected through focus groups in five cities in the northwest of the state of Paraná. It was observed that, although the study was conducted with teams of different municipalities, the meanings and perceptions regarding the care provided and the difficulties experienced are similar in many aspects. In general, the Basic Health Units meet the most urgent needs of users, despite the adoption of strategies for treatment adherence, for various reasons, cannot reach the entire population, undermining the quality of care, even with the commitment of the team.

Feelings and codependent behavior in the family of illicit drugs users / Sentimentos e comportamentos codependentes em familiares de usuários de drogas ilícitas

Current descriptive and qualitative study described feelings and codependent behavior in relatives of illicit drug users. Data were collected between March and April 2012 by an open interview with eight family members of illicit drugs-dependent individuals and subjected to theme-mode content analysis. Results were classified into two categories which showed intense suffering coupled to feelings of guilt, fear, shame, sadness, shame and manifestation of codependent behaviors such as denial and control of the one´s situation and that of others. Professionals should know the situation in which the families of drug addicts live to assist them in a different way. They should also identify codependent relatives, since they also need care so that their behavior does not worsen the symptoms and behavior of the drug user and prevents a possible medical or psychiatric diagnosis.

Estudo descritivo de natureza qualitativa que teve por objetivo descrever sentimentos e comportamentos codependentes em familiares de usuários de drogas ilícitas. Os dados foram coletados no período de março a abril de 2012 por meio de entrevista aberta com oito familiares de indivíduos com dependência química e submetidos à análise de conteúdo, modalidade temática. Os resultados foram compilados em duas categorias, as quais evidenciaram a vivência de intenso sofrimento com sentimentos de culpa, medo, vergonha, tristeza, pena e manifestação de comportamentos codependentes, como a negação, assumir o controle da situação sozinho entre outros. Conclui-se que os profissionais precisam conhecer a realidade das famílias de dependentes químicos a fim de poder assisti-las de forma diferenciada, identificando o familiar codependente, pois este também precisa de cuidado para que seu comportamento não agrave os sintomas e comportamentos de seu familiar-dependente e nem resulte para si, em um diagnóstico clínico ou psiquiátrico.

Prevalence and factors associated with drug use in pregnant women assisted in primary care / Prevalencia y factores asociados con el uso de drogas en el embarazo en atención primaria / Prevalência e fatores associados ao uso de medicamentos por gestantes atendidas na atenção primária

The aim of this study was to identify the prevalence of drug use by pregnant women assisted in primary care; classifying the medications used according to the risk according to the Food and Drug Administration and grouping drugs used according to the Anatomical Therapeutic Classification. A cross-sectional analytical study was developed in Maringá, Paraná. Data were collected between January and July 2012 through semi-structured interviews in households. The sample comprised 394 pregnant women at different gestational ages. Results revealed that 94.67% of the pregnant women (2.03%) used at least one medication without medical prescription and the most used drugs were antianemics, followed by antiemetics and analgesics. Data showed a statistically significant relationship between the use of medicines and marital conditions, trimester of pregnancy, chronic disease, mental illness and orientation of professionals at the Basic Health Units about medicines. It is noteworthy that, given the complexity of the theme, health professionals, especially nurses, should approach the subject in the care of pregnant women.

El objetivo del estudio fue identificar la prevalencia del consumo de drogas por mujeres embarazadas inscritas en la atención primaria; la clasificación de los medicamentos utilizados en función del riesgo de acuerdo a las drogas Food and Drug Administration y la agrupación usadas de acuerdo con la Clasificación Anatómica Terapéutica. Se trata de un estudio transversal analítico, en Maringá, Paraná que incluyó 394 embarazadas, en el periodo enero-julio de 2012, a través de entrevistas semi-estructuradas en los hogares. Los resultados mostraron que el 94,67% de las mujeres embarazadas usaron al menos un medicamento (2,03% sin receta médica) y los fármacos más utilizados fueron antianémicos, seguido de los antieméticos y analgésicos. Los datos mostraron una relación estadísticamente significativa entre el uso de medicamentos y el estado civil, trimestre de embarazo, enfermedad crónica, enfermedad mental y la orientación de los profesionales de la salud primaria sobre los medicamentos. Es conocido por la complejidad de la cuestión que los profesionales de la salud, especialmente las enfermeras, desarrollar el papel importante de la educación continua y educación para la salud.

O objetivo do estudo foi identificar a prevalência do uso de medicamentos por gestantes atendidas na atenção primária; classificar os medicamentos utilizados de acordo com o risco segundo a Food and Drug Administration e agrupar os medicamentos utilizados segundo a Anatomical Therapeutic Classification. Trata-se de estudo transversal, analítico, realizado em Maringá, Paraná. Os dados foram coletados no período de janeiro a julho de 2012, por meio de entrevista semiestruturada, nos domicílios. A amostra constou de 394 gestantes em diferentes idades gestacionais. Os resultados revelaram que 94,67% das gestantes já havia utilizado, pelo menos, um tipo de medicamento durante a gestação atual, e 2,03% sem prescrição médica. Os medicamentos mais consumidos foram os antianêmicos, seguidos dos antieméticos e analgésicos. Observou-se relação estatisticamente significativa entre uso de medicamentos e situação conjugal, doença crônica, doença mental, trimestre de gestação e orientação de profissionais das Unidades Básicas de Saúde sobre o uso de medicamentos. É notória, pela complexidade do tema, a necessidade que profissionais de saúde, principalmente o enfermeiro, abordem essa problemática na assistência à gestante.

Prevalência de transtornos mentais e fatores associados em gestantes / Prevalence of mental disorders and associated factors in pregnant women

Objetivo Identificar a prevalência de transtornos mentais e fatores associados em gestantes. Métodos Estudo transversal realizado com 394 gestantes, selecionadas de forma aleatória e proporcional. Os dados foram coletados nos domicílios, com aplicação de questionário semiestruturado. Para a análise foi utilizada a regressão logística bivariada. Resultados Referiram diagnóstico de transtorno mental 51 gestantes (12,94%) e isto foi significativamente maior entre aquelas com idade entre 19 e 30 anos, sem companheiro, de cor branca, que estavam no segundo trimestre de gestação, tinha alguma doença crônica associada e foi internada na gestação atual. Nove delas faziam uso de psicofármacos, sendo os antidepressivos os mais utilizados. Conclusão A prevalência de transtornos mentais foi de 12,94% e os fatores associados foram: idade, situação conjugal, cor, trimestre de gestação, internação durante a gestação e doença crônica.

Objective To identify the prevalence of mental disorders and associated factors in pregnant women. Methods Cross-sectional study with 394 pregnant women, randomly and proportionally selected. Data were collected during home visits, using a semi-structured questionnaire. Bivariate logistic regression was used for the analysis. Results A total of 51 pregnant women (12.94%) were diagnosed with mental disorder and this number was significantly higher among those between 19 and 30 years of age, unmarried, white skin colored, who were in the second trimester of pregnancy, had a chronic disease associated and had been hospitalized during the current pregnancy. Nine of them were taking psychotropic drugs, and antidepressants were the most commonly used drug. Conclusion The prevalence of self-reported mental disorders was 12.94% and the associated variables were: age, marital status, skin color, pregnancy trimester, hospitalization during pregnancy and chronic disease.

Percepções e práticas de gestantes atendidas na atenção primária frente ao uso de drogas / Perceptions and practices of pregnant women attended in primary care using illicit drugs

Objetivo: Identificar percepções e práticas de gestantes atendidas na atenção primária frente ao uso de drogas de abuso. Métodos: Pesquisa descritiva de abordagem qualitativa desenvolvida com 25 mulheres usuárias de drogas. Os dados foram coletados em julho de 2012 em Maringá - PR, por meio de entrevista aberta e submetidos à análise de conteúdo. Resultados: As gestantes relataram dificuldade em abandonar o uso de drogas e que as informações, sobre isto, durante a assistência pré-natal são insuficientes. Observou-se que algumas sentem medo e culpa decorrente da possibilidade de agravos ao feto e outras não se preocupam com esta possibilidade e ainda, que as usuárias de drogas ilícitas sentem-se julgadas e não apoiadas pelos profissionais. Conclusão: É necessário sensibilizar os profissionais que fazem o acompanhamento pré-natal sobre a importância de acolher, esclarecer, orientar e apoiar gestantes usuárias de drogas, com vistas a promover uma assistência pré-natal qualificada e a redução de danos.

Conception of family members of people with mental disorders on self-help groups / Grupo de autoayuda de la familia y la persona con trastorno mental: la concepción de la familia / Concepção de familiares de pessoas com transtorno mental sobre os grupos de autoajuda

The aim of this study was to understand how family members of people with mental disorders conceive the performance of self-help groups (SG). This qualitative study was conducted with eleven family members who participate in a SG of the Maringaense Mental Health Association. Data were collected from April to June 2010 during group meetings, in an adjoining room, by means of semi-structured interviews, which were then subjected to content analysis. Two categories emerged: "The group compensates for deficiencies in care", which points out deficiencies arising from the formal care services and the benefits of SG for family members and, "Idealized care", which reveals the expectations of the family in relation to mental health care. It was concluded that family members would like activities of the SG to be incorporated by mental health care services and for family care to become a part of the care plan.

El objetivo fue comprender cómo los familiares de las personas con trastorno mental conciben el desempeño del grupo de autoayuda (GA). Estudio de enfoque cualitativo consumado con once familias participantes en un GA de Asociación Maringaense de Salud Mental. Los datos fueron recogidos entre abril y junio de 2010, durante las reuniones del grupo en sala anexa, a través de entrevistas semiestructuradas y más sometidos a análisis de contenido. Emergieron dos categorías: "El grupo cumple deficiencias de la atención", que señala las deficiencias derivadas de los servicios de atención formales y beneficios de GA para los familiares y, "El cuidado idealizado", que revela las expectativas de la familia en relación con la atención de salud en salud mental. Se concluye que la familia tiene como objetivo las actividades desarrolladas por el GA se incorporan los servicios de atención en salud mental y la de atención a la familia se convierte en parte del plan de atención.

O objetivo foi compreender como os familiares de pessoas com transtorno mental concebem a atuação do grupo de autoajuda (GA). Estudo de abordagem qualitativa realizado com onze familiares participantes de um GA da Associação Maringaense de Saúde Mental. Os dados foram coletados no período de abril a junho de 2010, durante as reuniões do grupo, em sala anexa, por meio de entrevistas semiestruturadas e, em seguida, submetidos à análise de conteúdo. Emergiram duas categorias: "O grupo supre deficiências da assistência", que aponta as lacunas dos serviços formais de assistência e os benefícios do GA para os familiares; e "O cuidado idealizado", que revela a expectativa dos familiares em relação à atenção em saúde mental. Conclui-se que os familiares almejam que as atividades desenvolvidas pelo GA sejam incorporadas pelos serviços de assistência em saúde mental e que o cuidado à família passe a integrar o plano de assistência.

Família da pessoa com transtorno mental e suas necessidades na assistência psiquiátrica / Family of people with a mental disorder and needs in psychiatric care / Familia de la persona con trastorno mental y sus necesidades en la asistencia psiquiátrica

Objetivou-se conhecer as necessidades da família cuidadora de uma pessoa com transtorno mental no atual modelo de atenção em saúde. Trata-se de um estudo qualitativo, realizado em municípios de três regionais de saúde do Estado do Paraná, empregando-se a coleta de dados com trinta e duas famílias. Os dados foram analisados por meio de indicadores. Os resultados apontam lacunas nos serviços da rede de saúde mental em relação aos cuidados às pessoas com transtorno mental e seus familiares no que diz respeito à necessidade de: adaptação após o diagnóstico da patologia; orientação familiar; adesão ao tratamento; internação; auxílio financeiro; assistência para transporte, reinserção na sociedade; inclusão nos serviços extra-hospitalares após internação; e vínculo entre profissional e pessoa assistida. Conclui-se que estas necessidades precisam ser exploradas pelos profissionais da rede em saúde mental para possibilidade e concretização de uma assistência desinstitucionalizada, integral e resolutiva à pessoa com transtorno mental e sua família.

We aimed to learn about the needs of the family which provides care to a person with a mental disorder in the current model of health care. This is a qualitative study conducted in the municipalities of three regional health units in the state of Paraná, using data collection with thirty-two families. Data were analyzed by means of indicators. The results show gaps in the mental health services in relation to the care provided to people with a mental illness and their families with regard to the need for: adaptation after diagnosis of the pathology, family counseling, treatment compliance, hospitalization, financial assistance, transportation assistance, reintegration into society, inclusion in outpatient services after hospitalization, and the bond between professionals and people assisted. We conclude that these requirements need to be explored by mental health network professionals as to the possibility and implementation of deinstitutionalized, integral and decisive assistance to the person with a mental illness and his/her family.

Se tuvo por objetivo conocer las necesidades de la familia cuidadora de una persona con trastorno mental en el actual modelo de atención en la salud. Se trata de un estudio cualitativo, realizado en municipios de tres regiones de salud del Estado de Paraná, empleando la recolección de datos de treinta y dos familias. Los datos fueron analizados por medio de indicadores. Los resultados apuntan carencias en los servicios de la red de salud mental en relación a los cuidados a las personas con trastorno mental y sus familiares en lo que concierne la necesidad de: adaptación tras el diagnostico de la patología; orientación familiar; adhesión al tratamiento; ingreso; auxilio financiero; asistencia para transporte; reinserción en la sociedad; inclusión en los servicios extra hospitalarios tras el ingreso y el vínculo entre el profesional y la persona asistida. Por lo tanto llegamos a la conclusión de que estas necesidades necesitan ser exploradas por los profesionales de la red en salud mental para la posibilidad y la concretización de una asistencia no institucionalizada, integral y resolutiva a la persona con trastorno mental y a su familia.