A pessoa com deficiência intelectual e a compreensão de sua existência / The person with intellectual disability and the understanding of their existence / La persona con discapacidad intelectual y la comprensión de su existencia

Frequentemente as pessoas com deficiência intelectual (DI) não são reconhecidas como capazes de atribuírem significados a sua existência, por apresentarem uma limitação intelectual. Contudo, elas podem compreender diversas questões psicológicas em sua vida. Embasado na Psicologia Existencial Sartriana, o objetivo deste estudo é investigar como a pessoa com DI compreende sua existência, a partir dos sentidos que atribui a si e as suas relações. O método fenomenológico foi escolhido para a coleta e a análise dos dados. Participaram dez adultos com DI, estudantes de uma Escola Especial de Curitiba. Os resultados evidenciaram sentimentos de solidão e abandono por parte dos participantes, decorrente da ausência afetiva e do diálogo com outras pessoas; a angústia diante da sua liberdade, em um contexto onde não lhes são permitidos fazerem escolhas autênticas; a dificuldade de compreensão de seus sentimentos e o desejo de valorização de suas emoções; a escola como o local onde encontram maiores oportunidades de relacionamentos, mas onde a reflexão sobre as situações cotidianas que vivenciam apresentam-se de modo limitado. Reflete-se que estes aspectos existenciais devem ser considerados nos estudos e nos serviços direcionados às pessoas com DI, para que sua liberdade seja reconhecida, viabilizando a construção de seu projeto existencial.

Often people with intellectual disabilities (ID) are not recognised as capable of attributing meanings to their existence because they have an intellectual limitation. However, they can understand various psychological issues in their lives. Based on the Sartrian existential psychology, the objective of this study is to investigate how the person with ID understands his/her existence, from the meanings they attribute to themselves and their relationships. The phenomenological method was chosen for data collection and analysis. Ten adults with ID participated, students of a Special School in Curitiba. The results showed feelings of loneliness and abandonment on the part of the participants, resulting from absence of affect and dialogue with others; the anguish before their freedom, in a context where they are not allowed to make authentic choices; the difficulty of understanding their feelings, and the desire to value their emotions; the school as the place where they find greatest opportunities for relationships, but where reflection on the everyday situations they experience is limited. It is argued that these existential aspects must be considered in the studies and services directed to people with ID, so that their freedom is recognized, enabling the construction of their existential project.

A menudo las personas con discapacidad intelectual (DI) no son reconocidas como capaces de atribuir significados a su existencia por su limitación intelectual. Sin embargo, pueden comprender diversas cuestiones psicológicas en su vida. Basado en la Psicología existencial Sartriana, el objetivo de este estudio es investigar cómo la persona con DI comprende su existencia, a partir de los sentidos que se atribuye a sí mismo y sus relaciones, por medio del el método fenomenológico. Participaron diez adultos con DI, estudiantes de una escuela especial de Curitiba. Los resultados evidenciaron sentimientos de soledad y abandono por parte de los participantes, resultante de la ausencia afectiva y del diálogo con otras personas; la angustia ante su libertad, en un contexto donde no se les permite hacer elecciones auténticas; la dificultad de comprender sus sentimientos y el deseo de valorar sus emociones; la escuela como el lugar donde encuentran mayores oportunidades de relaciones, pero donde la reflexión sobre las situaciones cotidianas que experimentan se presentan de modo limitado. Se refleja que estos aspectos existenciales deben ser considerados en los estudios y en los servicios dirigidos a las mismas, para que su libertad sea reconocida, permitiendo la construcción de su proyecto existencial.

Intervenções Assistidas por Animais na expressão psíquica de Deficientes Intelectuais Adultos (IAA e Deficiência intelectual) / Intervenciones Asistidas por Animales en la expresión psíquica de Deficientes Intelectuales Adultos (IAA e Deficientes Intelectuales) / Animal-Assisted Interventions in the Psychic Expression of Intellectually Disabled Adults (IAA and Intellectually Disabled)

INTRODUÇÃO: Esta pesquisa problematiza a interação entre sujeitos adultos com Deficiência Intelectual e cães, sob a perspectiva das Intervenções Assistidas por Animais (IAA). OBJETIVO: Descrever os efeitos da IAA na expressão verbal e não verbal de conteúdos psíquicos em sujeitos adultos com deficiência intelectual. MÉTODO: Pesquisa de natureza qualitativa. Participaram 04 sujeitos do sexo feminino, idades entre 39 a 63 anos, com deficiência intelectual. Cão co-terapeuta: Amin, da raça Golden Retriever, 7 anos, selecionado de acordo com critérios de protocolos internacionais, conduzido pela pesquisadora. Foram realizadas 07 sessões de IAA, em grupo, com duração de 35 minutos cada, no decorrer de 03 meses. Foram aplicados os testes HTP e Wartegg realizados pré e pós sessões de IAA, cujos resultados foram analisados comparativamente intra sujeito. RESULTADOS: Na população estudada verificou-se em todos os sujeitos a expansão da personalidade e a redução da ansiedade pós IAA, além do aumento de verbalização e o cão como forte instrumento motivador. CONCLUSÃO: Os resultados desta pesquisa indicam a ocorrência de modificações psíquicas, verbais e não verbais, em diferentes graus, nos sujeitos com DI estudados.

INTRODUCTION: This research problematizes the interaction between adult subjects with Intellectual Disability and dogs, from the perspective of Animal-Assisted Interventions (IAA). OBJECTIVE: To describe the effects of IAA on verbal and nonverbal expression of psychic contents in adults with intellectual disabilities. METHOD: Qualitative research. Four female subjects, aged between 39 and 63 years, with intellectual disability participated. Dog co-therapists: Amin, Golden Retriever, 7 years old, selected according to criteria of international protocols, conducted by the researcher. There were 07 IAA sessions, in a group, lasting 35 minutes each, during the course of 03 months. The HTP and Wartegg tests were performed before and after IAA sessions, the results of which were analyzed comparatively. RESULTS: In the studied population, all subjects showed personality expansion and reduction of anxiety after IAA, in addition to increased verbalization and the dog as a strong motivating instrument.. CONCLUSION: The results of this research indicate the occurrence of psychic, verbal and nonverbal expression changes in different degrees in subjects with DI studied.

INTRODUCCIÓN: Esta investigación problematiza la interacción entre sujetos adultos con discapacidad intelectual y perros, desde la perspectiva de las intervenciones asistidas por animales (IAA). OBJETIVO: Describir los efectos de la IAA en la expresión verbal y no verbal de contenidos psíquicos en sujetos adultos con discapacidad intelectual. MÉTODO: Investigación de naturaleza cualitativa. Participaron 04 sujetos del sexo femenino, edades entre 39 a 63 años, con discapacidad intelectual. Perro co-terapeutas: Amin, de la raza Golden Retriever, 7 años, seleccionado de acuerdo con criterios de protocolos internacionales, conducido por la investigadora. Se realizaron 7 sesiones de IAA, en grupo, con una duración de 35 minutos cada una, en el transcurso de 03 meses. Se aplicaron las pruebas HTP y Wartegg realizadas pre y post sesiones de IAA, cuyos resultados se analizaron comparativamente. RESULTADOS: En la población estudiada se verificó en todos los sujetos la expansión de la personalidad y la reducción de la ansiedad post IAA además de una mayor verbalización y el perro como un fuerte instrumento de motivación.. CONCLUSIÓN: Los resultados de esta investigación indican la ocurrencia de modificaciones psíquicas, expresión verbal y no verbal en diferentes grados en los sujetos con DI estudiados.

¿Sé y puedo? Toma de decisión y consentimiento informado en los trastornos demenciantes: dilemas diagnósticos y jurídicos en Chile / Decision making and consents given by demented patients. Are they valid?

In Chile, more than 180 thousand people (1% of the population) have some form of dementia. The figure should increase to approximately 600,000 (3% of Chileans) by 2050. This disease poses major challenges to the society. One of them is the effective recognition of the autonomy and responsibility of the person living with this condition. This article aims to review the clinical assessment of competence, its agreement with the Chilean legal system and the challenges that the assessment of competence poses in clinical decision-making and the capacity of an individual make decisions, according to the new international obligations subscribed by Chile. It is concluded that inclusion is a pending challenge, reflected among other things, by the non-compliance with binding rules such as Article 12 of the Convention on the Rights of Persons with Disabilities, which affirms that persons with disabilities have the right to be recognized as a person everywhere, before the law.

Representações de profissionais da saúde mental sobre sexualidade de pessoas com transtornos mentais / Representations by mental health care professionals about the sexuality of people with mental disabilities

Entre os obstáculos para a promoção da saúde sexual no campo da saúde mental encontram-se dificuldades dos profissionais para lidar com a temática da sexualidade. Isto gera barreiras que impedem a expressão de necessidades e dúvidas das pessoas com transtornos mentais sobre o assunto, deixando em aberto aspectos importantes que contribuem para a integralidade da atenção à saúde dessa população. Nos modos de cuidar, encontram-se representações dos profissionais sobre a sexualidade e os transtornos mentais que podem favorecer ou impedir avanços das ações em saúde. O objetivo deste estudo foi compreender representações de profissionais que atuam nos serviços de saúde mental da rede pública de Minas Gerais sobre sexualidade de pessoas com transtornos mentais. Trata-se de um estudo qualitativo, fundamentado em noções das representações, no eixo proposto por Alain Giami. Foi realizado por meio de seis grupos focais com 54 profissionais de serviços públicos de saúde mental em Minas Gerais, Brasil, em 2011, após aprovação pelo Comitê de Ética da UFMG. A seguinte questão central guiou a discussão nos grupos: ”Falem sobre o que pensam da sexualidade das pessoas com transtornos mentais”. Questões de relance foram utilizadas para aprofundar a questão central do estudo. A análise das discussões dos grupos focais foi realizada pelo método de Análise Estrutural de Narração. Os resultados permitiram a identificação de categorias empíricas que resultaram em duas categorias teóricas: Roteiros culturais e Formação acadêmica; Promoção da saúde sexual e Vulnerabilidade. Emergiram representações de negação da sexualidade das pessoas com transtorno mental, com censuras expressas de manifestações como a masturbação, homossexualismo e relação sexual entre pessoas com transtornos mentais, consideradas “fora do normal”. Os profissionais acreditam que esses modos de gestão da vida sexual são correntes e provenientes da “própria...

Among the obstacles confronting the promotion of sexual health in the mental health field is the difficulty of professionals to deal with the topic of sexuality. This creates barriers that prevent people with mental disabilities from expressing their needs and questions about the topic, resulting in not addressing important issues that could contribute to more complete health care for this population. In the various types of care, there are representations by health professionals regarding sexuality and mental disability, which could contribute to or impede advances in health care. The objective of this study was to understand the representations about sexuality and people with mental disabilities by the professionals who work in mental health services in the public system of Minas Gerais. It is a qualitative study founded on the understanding of representations, as proposed by Alain Giami. The study was carried out using six focus groups with 54 public mental health care professionals in Minas Gerais, Brazil, in 2011, after receiving approval from the Ethics Committee at UFMG. The following central issue guided the discussion of the groups: “Share what you think about the sexuality of people with mental disabilities”. Reframed questions were used to more deeply investigate the central issue of the study. The analysis of the discussion of the focus groups was conducted using the Structural Analysis of Narration method. The results allowed for the identification of empirical categories divided into two theoretical groups: Cultural scripts and Education; Sexual health promotion and Vulnerability. There were representations where people with mental disabilities denied their sexuality, with expressed condemnation of activities considered “abnormal”, such as masturbation, homosexuality and sexual relations between people with mental disabilities. Health professionals believe that these means of managing their sex life are the everyday result...

Percepções sobre o HIV/Aids e desigualdades em saúde entre pacientes psiquiátricos no Brasil / Perceptions about HIV/Aids and health inequalities among psychiatric patients in Brazil

Objetivo: descrever as percepções sobre o conceito e formas de transmissão HIV/Aids em pacientes psiquiátricos e verificar se essas percepções são diferentes segundo características sociodemográficas e de condições psiquiátricas. Investigou-se também se essas características foram associadas ao desconhecimento sobre o conceitoe as formas de transmissão do HIV/Aids. Métodos: estudo transversal multicêntrico realizado com 2.475 usuários de 26 serviços públicos de saúde mental (11 hospitais e 15 CAPS) no Brasil. As percepções emergiram das seguintes questões semiabertas: o que é Aids para você?; como você acha que a Aids é transmitida? O material textual foi analisado segundo a técnica de análise de conteúdo. Esses resultados foram estratificados segundo variáveis sociodemográficas e de condições psiquiátricas e analisados por meio do teste de qui-quadrado. Os participantes que não souberam responder sobre o conceito ou formas de transmissão do HIV/Aids foram comparados aos demais por meio de regressão logística. Resultados: em geral, as percepções foram de doença, transmissível (por via sexual e sanguínea), incurável e foram permeadas por aspectos negativos. Estas percepções apresentaram diferenças significativas segundo características sociodemográficas e de condições psiquiátricas por 18,6% não souberam indicar o conceito ou forma de transmissão do HIV/Aids e esse grupo teve mais chances deter acima de 40 anos, menos de oito anos de estudo, não ter renda individual e estar recebendo tratamento em hospitais psiquiátricos. Conclusões: os resultados reforçam a necessidade de medidas macrossociais para minimizar as desigualdades e políticas de prevenção do HIV direcionadas para pacientes com transtornos mentais no Brasil...

Objectives: To describe perceptions about concept and modes of HIV/Aids transmission among psychiatric patients and to assess whether these perceptions differed according to sociodemographic characteristics and psychiatric conditions. We also investigated whether these characteristics were associated with the completely ignorance about theconcept and the modes of transmission of HIV/Aids. Methods: Cross-sectional national multicenter study among 2,475 patients selected from 26 Brazilian mental health centers (11 hospitals, 15 outpatient). The perceptions emerged from the following open ended questions: What is Aids for you?; and, How do you think Aids is transmitted?. The textualmaterial was analyzed using content analysis methods. Results were stratified according to sociodemographic variables and psychiatric conditions and analyzed using the chisquared test. Participants who did not know how to answer any of these questions were compared to the others by logistic regression. Results: Overall, perceptions were of disease, transmissible (through blood and sexual contact), incurable and were permeated by negative aspects as threat, suffering and death. These perceptions showed significant differences according to sociodemographic characteristics and psychiatric conditions. 18.6% did not know how to answer the concept or mode of transmission of HIV/Aids and these were more likely to be older (40+ years old), to have less than 8 years of education, no individual income and be on treatment in psychiatric hospitals. Conclusion: The results reinforce the need formacro-level social policy to reduce inequalities and to implement HIV prevention policies targeted at psychiatric patients in Brazil...

Acolhimento na perspectiva dos profissionais de saúde que atendem indivíduos com transtorno mental / User embracement from the perpective of the health professionals serving individuals with mental disorder

Esta pesquisa teve como objetivos identificar o conhecimento que a equipe de saúde mental tem em relação aos conceitos de acolhimento e conhecer as ações realizadas aos clientes quanto ao acolhimento. Trata-se de uma pesquisa de campo, exploratória, com abordagem qualitativa. Foi desenvolvida nos serviços de saúde mental de um município da região oeste do Paraná e participaram dela 16 profissionais de saúde. Concluiu-se com esta pesquisa que os profissionais entendem o significado de acolhimento, porém realizam esse método de forma incipiente.

Social cognitive performance and different communication settings in groups of children with different disorders / Desempenho sócio-cognitivo e diferentes situações comunicativas em grupos de crianças com diagnósticos distintos

PURPOSE: To investigate the social-cognitive performance of children with diagnostics of autism spectrum disorder (ASD), mental disability (MD) and hearing impairment (HI) in two different communicative situations. METHODS: Participated in this study 30 children ages between 3 and 12 years starting speech language therapy processes, divided in three groups: Group 1 - ten children with diagnoses included in the Autism Spectrum Disorders (ASD); Group 2: ten children diagnosed with mental disabilities (MD) and Group 3: ten children diagnosed with hearing impairment (HI). The subjects were assessed in two different communicative situations (group and individual therapy situation) for 12 months. RESULTS: Data regarding the performance of the three groups in the two situations show that G3 had better absolute performance when compared with other groups, with the variable symbolic play as an important differential criterion for the three groups. CONCLUSION: We conclude that the social-cognitive performance can be used as an auxiliary tool for intervention, helping the identification of variables that could interfere in the communicative performance.

OBJETIVO: Verificar o desempenho sócio-cognitivo de crianças com diagnósticos inseridos nos distúrbios do espectro do autismo (DEA), deficiência mental (DM) e deficiência auditiva (DA) em duas diferentes situações comunicativas. MÉTODOS: Participaram desta pesquisa 30 crianças, entre 3 e 12 anos de idade, em início de atendimento fonoaudiológico, que foram divididas em três grupos: Grupo 1: dez crianças com diagnóstico inserido nos distúrbios do espectro do autismo (DEA); Grupo 2: dez crianças com diagnóstico de deficiência mental (DM); Grupo 3: dez crianças com diagnóstico dentro do grupo de deficiência auditiva (DA). Os sujeitos foram analisados em duas situações comunicativas distintas (situação em grupo e situação individual de terapia), durante 12 meses. RESULTADOS: O grupo composto por crianças e adolescentes com diagnóstico de deficiência auditiva apresentou melhor desempenho absoluto quando comparado com os outros grupos, sendo a variável jogo simbólico um importante critério diferencial nos três grupos. CONCLUSÃO: O desempenho sócio-cognitivo pode ser utilizado como instrumento auxiliar no planejamento terapêutico, facilitando a identificação de variáveis que possam interferir no desempenho comunicativo.

A rehabilitaçao e reinserçao social do doente mental em Cataluña, España / Rehabilitation and social reinsertion of the mentally Ill in Cataluña, Spain / A reabilitação e reinserção social do doente mental em Cataluña, Espanha

La rehabilitación psicosocial es entendida actualmente no tan sólo como un objetivo, sino como un proceso, ya que la mayoría de los problemas relacionados con los transtornos mentales se manifiestan desde el inicio de la enfermedad, por lo que las estrategias de rehabilitación han de ponerse en marcha desde la base del diagnóstico. En el presente trabajo se describe la situación actual de la rehabilitación en Cataluña, tomando como referencia las directivas europeas y del estado español que la orientan, así como las fortalezas y las deficiencias que presenta.

Psychosocial rehabilitation is currently understood not only as an objective, but also as a process, because most mental disorder related problems appear since the onset of the disease. Hence, rehabilitating strategies should be initiated soon after reaching the diagnosis. The present study describes the current status of rehabilitation in Cataluña, using as reference the guidelines of Europe and the Spanish State ruling them, as well as its strengths and weaknesses.

A reabilitação psicosocial é entendida na atualidade não somente como um objetivo, mas como um processo, já que a maioria dos problemas relacionados com os transtornos mentais se manifesta desde o início da doença. Desta forma, as estratégias reabilitadoras devem ser iniciadas logo que for realizado o diagnóstico. No presente trabalho se descreve a situação atual da reabilitação em Cataluña, tomando-se como referência as diretrizes européias e do estado espanhol que as orientam, assim como seu aspectos fortes e suas falhas.

Maltrato infanto juvenil en discapacitados cognitivos / Infantile-juvenile ill-treatment in cognitive handicapped

El maltrato infantil es uno de los temas más álgidos dentro de la práctica médica pediátrica; si a esto se le suma la condición de discapacidad cognitiva que convierte a niños y adolescentes en población más expuesta y menos apta para identificarlo y defenderse, se estaría tratando un problema médico de alta complejidad. Es importante el conocimiento de este tema en el personal de salud más cercano a la familia, lo que puede contribuir a la disminución de la frecuencia del maltrato y a reducir el tiempo de daño al niño o adolescente. Todo lo anterior puede evitar que estos pequeños sean mal diagnosticados y mal tratados a punto de partida de la desorganización conductual y emocional que en ellos pueden aparecer secundarios al maltrato, muchas veces inexplicables para padres y médicos. Es importante poner a disposición de los especialistas de la atención primaria y personal de salud comunitario, algunos apuntes sobre las particularidades del maltrato infantil en niños y adolescentes con necesidades cognitivas especiales, sus causas, tipos y consecuencias más frecuentes para su salud mental. El maltrato infanto juvenil en discapacitados cognitivos no es probablemente infrecuente en las comunidades y sí quizás poco identificado. La capacidad del personal de salud para encontrarlo siempre será oportuna y salvadora, de ahí la necesidad de conocimientos sobre el tema

The infantile ill-treatment is one of the more inhuman subjects in the pediatric medical practice and if to this feature we added the cognitive inability status converting children and adolescents into a more exposed and less able population to identify it and to defend itself, this will becomes in very complex medical problem. It is important the knowledge of this subject by health staff nearest of family, contributing to decrease of ill-treatment frequency and reducing the damage time to child or adolescent. The above mentioned may to avoid that these little children be ill-diagnosed and ill-treated from the point of view of behavioral and emotional disorganization t hat in their case may to appear secondary to ill-treatment, many times inexplicable for parents and physicians. It is important that primary care specialists and community health staff have some notes on distinctive features of infantile ill-treatment in children and adolescents with special cognitive needs, its causes, types and more frequent consequences for its mental hygiene. The infantile-juvenile ill-treatment in cognitive disabled is frequent in communities and maybe not much identified. Ability of health staff to find it always will be appropriate and savior, thus the need of knowledges on this subject

Attitudes of Family Members Towards Mentally Handicapped Children and Family Burden.

Background — The burden associated with rearing such mentally handicapped children usually affects whole of atmosphere of home including routine family life, emotional aspects and financial resources of family. The present study has been undertaken with the aim of determining the attitudes of family members towards a mentally handicapped child in their family and it has been assessed whether such children are considered as burden to their families. Material and Methods — The study was carried out in psychiatry OPD of the civil hospital, Gurdaspur in Punjab. Parents of children suffering from mental handicap who came for getting mental disability certificate for their children were included in the study. Total 200 families of mentally handicapped children were included in age group of upto 16 years of age. They were interviewed using a questionnaire based on ‘ Questionnaire on Resources and stress ‘scale to measure burden in their families. During the interview, an attempt was made to have both the parents present. Results — Basic psychometric properties of the questionnaire were sound. Findings revealed that mean burden was minimal to moderate in all the 200 families. The intelligence quotient was between 36 and 51 in 120 children, 70 children had IQ between 20 and 35, 10 children had IQ below 20. The education of parents was upto 5th standard in 100 children, upto 8th standard in 80 children, upto12th standard in 15 children and upto graduation in 5 children. 80% of families belonged to poor socioeconomic status. 10% of families belonged to middle class background. Conclusion — Our findings support the fact that children suffering from mental handicap are considered as burden by their family members. Negative parental attitude leads to rejecting attitude towards mentally retarded children. This adversely affects the interaction within the family and also with outsiders. Such children should be offered support by family members to enable them to cope with stressful situations and in their rehabilitation. There is a need for implementation of family based schemes for such disabled children.

Realidad virtual: un aporte real para la evaluación y el tratamiento de personas con discapacidad intelectual / Virtual reality: a real contribution for the evaluation and treatment of people with intelectual disability

La Realidad Virtual es un tipo de simulación computacional que permite recrear ambientes para que un sujeto pueda interactuar en ellos, y vivenciar esta experiencia como si ocurriera en un entorno verdadero. El presente artículo expone las principales aplicaciones de esta tecnología en el diseño de ambientes para la evaluación e intervención de personas con discapacidad intelectual, focalizándose en las utilidades que la Realidad Virtual tiene para la neuropsicología en general, y para esta población en particular. Asimismo, se analizan aspectos del diseño de ambientes y de los dispositivos de entrada de datos que podrían condicionar la efectividad de tales intervenciones, y ciertos aspectos éticos necesarios de considerar en su utilización. Finalmente, los aportes y limitaciones de la aplicación de esta tecnología en el campo de la discapacidad intelectual son ponderados y se sugieren otras áreas potenciales de desarrollo.

Virtual Reality is a particular computational simulation which allows recreating real environments where the subject is able to interact and live the experience as it were in a real setting. This article presents the principal applications of this technology in the design of environments for assessment and intervention of intellectually disabled persons, focusing in the advantages of Virtual Reality for neuropsychology in general and this population in particular. Moreover, environment design features and data device are analyzed as variables which could condition the intervention effectiveness. At the same time, it is remarked that some ethic aspects must be considered in the application of this technology. Finally, the contributions and limita-tion of the application of Virtual Reality in the intellectual disability field are considered and other ßreas of potential development are suggested.

Prevalencia de discapacidad mental en adultos mayores en cinco provincias de Cuba, 2000-2004 / Prevalence of physical disability in aged people from five provinces in Cuba, 2000-2004

La discapacidad mental en la tercera edad es uno de los problemas más importantes que enfrenta la comunidad científica cubana en la actualidad. Estimar la prevalencia de discapacidad mental en adultos mayores de Ciudad de La Habana, Las Tunas, Granma, Holguín y Camagüey, entre los años 2000 y 2004. Se realizó un estudio descriptivo de corte transversal, sobre muestras complejas (muestreo por conglomerados polietápico) de adultos mayores seleccionados de forma independiente para cada provincia, cuyos tamaños se determinaron mediante la fórmula de cálculo para estudios descriptivos en poblaciones finitas. Se aplicó el Examen Mínimo del Estado Mental. Se estimaron tasas de prevalencia de discapacidad mental, globales y específicas. El procesamiento de los datos se efectuó mediante programas computarizados. La discapacidad mental varió entre 4,5 por ciento (Holguín) y 21,5 por ciento (Granma) Se incrementó con la edad, desde 0,3 por ciento, para los adultos mayores de 60-69 años que residen en Holguín, hasta 56,3 por ciento en los de 80 y más de Granma; predominó en mujeres de todas las provincias, con tasas que alcanzaron el 20 por ciento, excepto para Las Tunas (13,5 por ciento) y Holguín (5,8 por ciento). Las principales afectaciones en la esfera mental se relacionaron con el cálculo y el recuerdo tanto para el grupo con discapacidad como para los que no la tenían, independientemente de la provincia. La prevalencia de discapacidad mental en las provincias investigadas varía desde un bajo nivel en Holguín hasta uno alto en Granma. Los mayores niveles de discapacidad mental encontrados en todos los territorios se corresponde con la edad avanzada, el sexo femenino, la baja escolaridad y la desocupación. Las afectaciones mentales más frecuentes de los adultos mayores investigados se presenta en el cálculo y el recuerdo; ello debe tomarse en cuenta en cualquier estrategia de intervención que se diseñe al efecto.

Mental disability in the aged people is one of the most important problems that the Cuban scientific community currently faces. To estimate the prevalence of mental disability in the aged people from the City of Havana, Las Tunas, Gramma, Holguín and Camagüey provinces from 2000 and 2004. A cross-sectional descriptive study of complex samples (multi-stage cluster sampling) of randomly selected aged people from each of the above provinces, whose size was estimated through a calculation formula for descriptive studies in finite populations, was conducted. The Minimal Mental Status Examination was applied. Global and specific mental disability prevalence rates were estimated. Data processing was computerized. Results Mental disability ranged from 4.5 percent (Holguín province) to 21.5 percent (Gramma province). It increased with the age, from 0.3 percent in 60-69 y age group dwelling in Holguín to 56.3 percent in the 80 years and over group in Las Tunas and it was predominant in females from all these provinces, with 20 percent rates, except for Las Tunas (13.5 percent) and Holguin (5.8 percent). The main problems in the mental status were related to calculating and remembering, both in the disabled group and in the non-disabled group regardless of the province. Mental disability prevalence changes in the studied provinces, ranging from low rates in Holguin provinces to high rates in Gramma province. The highest rates of mental disability found in all these territories were associated with old age, female, low education and inactivity. The most frequent mental disturbances were calculation and remembering; all this should be taken into account for any intervention strategy to be designed to this end.

A experiência de ter um filho com deficiência mental: narrativas de mães / Raising children with mental disabilities: mothers' narratives

Avanços tecnológicos neonatais têm proporcionado maior sobrevida de bebês com problemas graves de saúde. Muitos terão seu desenvolvimento comprometido (deficiência mental) e demandarão cuidados diferenciados. A família necessita se reorganizar a fim de poder atender às necessidades desta criança. Esta pesquisa buscou identificar os significados construídos por estas mães diante desta situação e os obstáculos que tiveram que enfrentar para alcançar o que consideravam o melhor tratamento para os filhos. Utilizou-se como metodologia a análise de narrativas, a partir de referências da antropologia médica e da lingüística. As narrativas revelaram em seus enredos mais típicos o impacto do diagnóstico e a busca de artifícios no cotidiano para adaptar-se aos cuidados com o filho, assim como as dificuldades enfrentadas na rede pública para obterem uma atenção que consideravam adequada. A valorização dos personagens da rede de apoio revelou a importância deste tipo de suporte nestas situações.

Technical advances in neonatology have increased the life expectancy of children with serious health problems. Many of these children experience developmental delay (mental disability) and require special care. The family must adapt to better provide for the child's needs. This study aimed to identify mothers' reactions and the obstacles they face to obtain what they consider the best treatment for their children. The study methodology was based on analysis of the mothers' narratives, drawing on medical anthropology and linguistics. The most typical plots in the narratives showed the impact of the diagnosis and the search for means to adapt to the child's care, as well as the difficulties encountered in the public health system to obtain what the mothers considered adequate care. The value ascribed to characters in the support network showed the importance of such support in these situations.

Psicologia e inclusão: aspectos subjetivos de um aluno portador de deficiência mental / Psychology and school inclusion: subjective aspects of a student with mental disability

Este trabalho teve como objetivo explorar a configuração de sentidos de um aluno portador de necessidades especiais mentais acerca do processo de inclusão escolar. Para tanto, foi participante desta pesquisa um aluno adolescente de 16 anos de idade portador de deficiência mental, matriculado na 7ª série do Ensino Fundamental da Rede Regular. Como recursos para coleta de informações o delineamento de estudo de caso mostrou-se adequado, priorizando-se os sistemas conversacionais firmados com o aluno durante sete meses. As informações obtidas foram elencadas em categorias de indicadores significativos. Pôde ser constatado que uma das maiores barreiras a ser transposta pelo aluno no processo de inclusão escolar diz respeito à organização simbólica da própria instituição escolar, que atrelada aos padrões massificadores do desenvolvimento humano, vem a se estruturar muito mais como uma prática social e compensatória do que formadora ao aluno, ao dimensionar sua diferenciação e não considerar adequadamente sua singularidade.

This article explored the configuration of a student with mental disability's feelings during the process of school inclusion. To achieve this objective, a sixteen-year-old student with mental disability who was enrolled in the seventh grade of a public elementary school participated in this research study. The delineation of the case study was deemed adequate as a resource for collecting information. The main research procedures were conversation sessions with the student undertaken during the seven months of investigation. The information collected was listed by categories of significant indicators. The study showed that one of the greatest barriers to be overcome in this process referred to the symbolic organization of the school, which, along with the generalizing patterns of human development, comes to structure itself much more as a social and compensatory practice than one that fostered the student's preparation. This organization focuses on how different the student is, instead of appreciating his uniqueness.

Interação entre irmãos: deficiência mental, idade e apoio social da família / Siblings' interaction: mental disability, age and family social support

Os objetivos deste estudo foram: (a) caracterizar a interação entre díades de irmãos, divididas em dois grupos - G1, com o irmão deficiente mental pré-adolescente, e G2, com esse irmão adulto; (b) comparar os desempenhos dos grupos nas interações; e (c) avaliar diferenças entre os grupos nas interações, considerando o apoio social da família. Foram realizadas sessões de observação de interações, e aplicação de instrumentos de auto-relato; os cuidadores responderam escalas para avaliação do apoio social. Os resultados sugeriram diferença no comportamento de ajudante do irmão com desenvolvimento típico, com taxa de ocorrência maior para G1. Nas escalas, houve diferença estatisticamente significativa na Escala de Apoio à Maternidade/Paternidade, revelando-se menor apoio para G1. Especula-se que, como as famílias do G1 recebem menor apoio deste nível, há maior demanda de ajuda requerida pelo filho deficiente, que pode ser suprida pelos irmãos menores com desenvolvimento típico, que desempenham o papel de ajudante em maior escala que os adultos.

The purpose of the present study was: (a) To describe the relationship in sibling's dyads, separated in two groups - G1, with pre-adolescent mentally retarded sibling, and G2, with this adult sibling; (b) To compare the performance of both groups in the interactions; and (3) To evaluate differences in the relationships between the groups when family social support is taken into account. Sessions of sibling's interactions were videotaped, and self-report instruments were used. The caretakers answered scales of social support. Results suggested differences concerning the behavior of the helper of the sibling with characteristic development, with highest occurrence in G1. Scales' results indicated statistically significant difference for the Parenting Support from Family/Friends Scale, showing less support for G1. It is possible to suggest that because families from G1 have less support from this level from families and friends, a bigger demand of help is required from the disabled member, which can be compensated by the young siblings with typical development, who perform the helper's role in greater level than the adults.

Vulnerability to depression in mother of emotionally and physically handicapped children from different socio-economic status

In the present study, it was hypothesized that mothers of emotionally and physically handicapped children from lower socio-economic status will be more vulnerable to depression as compared to the mothers from upper socioeconomic status. In order to test these hypotheses the Beck Depression Inventory [BDI] was given to 300 mothers. Sample was divided into 3 groups, 100 mothers of emotionally handicapped children, 100 mothers of physically handicapped children and 100 mothers of healthy children. Z-test was applied in order to get statistical significance of the results. The results of the present study show that the mothers of emotionally and physically handicapped children from lower economic status were more depressed than the mothers of emotionally and physically handicapped children from upper status

The impact of stress and social support on the mental health of individuals with intellectual disabilities: [review]

People with intellectual disabilities (ID) are at increased risk for mental health problems than the general population. The reasons for this are both biological and social. Current treatment for mental health problems tends to be reactive in nature with less emphasis on how mental health problems can be prevented. A better understanding of the social contributors to mental health in individuals with ID should lead to the prevention of mental health problems in this particularly vulnerable population. Two promising areas of research when thinking about mental health promotion and ID are stress and social support, which are reviewed here.

Las personas con discapacidad intelectual (DI) están más expuestas a sufrir problemas de salud mental que la población general. Las razones son tanto biológicas como sociales. El tratamiento actual para los problemas de salud mental tiende a ser reactivo por naturaleza, poniendo menor énfasis en la prevención. Una mejor comprensión de los contribuyentes sociales en la salud mental de los individuos con DI debería llevar a la prevención de problemas de salud mental en esta población particularmente vulnerable. Dos áreas de investigación promisorias cuando se piensa en promoción de la salud mental y DI son el estrés y el apoyo social, que aquí se revisan.

The Effects of Psychosocial Rehabilitation Programs on the Levels of Self-Efficacy for Mentally Disabled Persons

PURPOSE: This study investigated the effects of psychosocial rehabilitation programs provided by a psychosocial rehabilitation center on the levels of self-efficacy for mentally disabled persons. We followed the study subjects for 2 yr in order to examine whether the psychosocial rehabilitation programs had a positive impact on their levels of self-efficacy. METHODS: There were 18 subjects in the experimental group and they received all the psychosocial rehabilitation services available at the psychosocial rehabilitation center for 2 yr. In the comparison group, there were 17 participants who voluntarily refused to participate in the psychosocial rehabilitation programs. RESULTS: The results indicated that the psychosocial rehabilitation programs were effective in increasing the levels of the self-efficacy total score and specific self-efficacy score. CONCLUSION: The overall study results indicated that psychosocial rehabilitation programs provided by a psychosocial rehabilitation center had a positive impact on increasing the levels of self-efficacy for mentally disabled persons.

Predictors of Employment Intention for Mentally Disabled Persons / 간호학회지

PURPOSE: This study was conducted to determine the predictors of employment intention for mentally disabled persons. METHODS: Mentally disabled persons who had participated in rehabilitation programs in one of 16 mental health centers and 9 community rehabilitation centers located in Seoul and Kyunggi province were recruited for this study. A random sampling method was used and 414 respondents were used for final analysis. Data was analyzed by Pearson's correlation, and stepwise multiple regression using the SPSS Win 14.0. RESULTS: The predictors influencing employment intention of the mentally disabled person were observed as employment desire (beta=.48), guardian's expectation (beta=.26), professional's support (beta=.23), financial management (beta=.10), eating habits (beta=.07), and quality of life (beta=-.01). Six factors explained 61.1% of employment intention of mentally disabled persons. CONCLUSION: The employment intention of a mentally disabled person was influenced by employment desire, diet self-efficacy, guardian's expectation, professional's support, quality of life, financial management and eating habits.