ABSTRACT
RESUMO. Trata-se de uma pesquisa qualitativa, des critiva e exploratória, realizada no Tratamento Fora de Domicílio, na cidade de Cuiabá-MT, Brasil, que objetivou levantar reflexões sobre os itinerários terapêuticos de pessoas trans, na busca pelo Processo Transexualizador. Participaram três homens trans, duas mulheres trans e uma mulher travesti, com faixa etária de 21 a 32 anos. Os da dos foram coletados por entrevistas semiestruturadas e analisados mediante análise de conteúdo. Os resultados mostram que essas pessoas trans seguem trajetórias diver sas, procurando serviços institucionalizados ou informais (redes de socialidade trans), para a afirmação de suas identidades de gênero. Destacam-se entraves atinentes à patologização, ao acolhimento, à continuidade do cuidado, à resolutividade e à referência na rede de atenção do processo transexualizador. Observaram-se importantes pontos críticos na assistência social, endocrinológica e para a psicologia, sendo a peregrinação pelos serviços de saúde demarcada por constantes discriminações institucionais, permitindo a compreensão de como o sistema de saúde se organiza em relação ao atendimento dessas pessoas, elencando questões para o trabalho da psicologia, nesse campo, a partir de uma perspectiva da experiência e materialidade do gênero.
RESUMEN. Esta es una investigación cualitativa, descriptiva y exploratoria realizada en el tratamiento fuera del domicilio en la ciudad de Cuiabá, Brasil, que tuvo como objetivo plantear reflexiones sobre los itinerarios terapéuticos de las personas trans en la búsqueda del proceso transexual. Participaron tres hombres trans, 2 mujeres trans y 1 mujer travesti de 21 a 32 años. Los datos fueron recogidos a través de entrevistas semiestructuradas y fueron analizados mediante el Análisis de Contenido. Los resultados muestran que estas personas trans siguen caminos divergentes en busca de servicios institucionalizados o informales (redes sociales trans) para afirmar sus identidades de género. Se destacan los obstáculos relacionados con la patologización, acogida, la continuidad de la atención, la resolución y la referencia en la red de atención del Proceso Transexualizador. Se observaron puntos críticos importantes en la asistencia social, la endocrinología y la psicología, em que la peregrinación por los servicios de salud es delimitada por la constante discriminación institucional que permite comprender cómo se organiza el sistema de salud en relación con la atención de estas personas que señalan los problemas para el trabajo de la Psicología en este campo desde una perspectiva de experiencia y materialidad de género
ABSTRACT. This qualitative, descriptive and exploratory research conducted in the Away from Home Treatment (Tratamento Fora de Domicílio [TFD]), in Cuiabá, Brazil, aimed to raise reflections on the therapeutic process itineraries of trans people in the search for the Transsexualizer Process (Processo Transexual [PT]). Three transgender men, two transgender women and one transvestite woman participated. They were aged between 21 and 32 years. Data were collected through semi-structured interviews and analyzed using Content Analysis. The results show that trans people follow different itineraries, looking for institutionalized or informal services (trans sociality networks) to affirm their gender identities. Obstacles related to pathologization, reception, continuity of care, resolution and reference in the care network of the Transsexualizer Process stand out. Important critical points were observed in social, endocrinological and psychological care. The pilgrimage by health services was marked by constant institutional discrimination, allowing for the understanding of how the health system is organized concerning the care of these people, listing issues for the work of Psychology, in this field, from a perspective of the experience and materiality of gender.
Subject(s)
Humans , Male , Female , Adult , Pathology , Psychology , Unified Health System , Transgender Persons , Therapeutic Itinerary/ethics , Social Behavior , Social Support , Transvestism/psychology , Continuity of Patient Care , Empathy/ethics , User Embracement , Social Discrimination/psychology , Gender Identity , Health Services/supply & distributionSubject(s)
General Surgery/ethics , Health Promotion/ethics , Holistic Health/statistics & numerical data , Empathy/ethics , Health Promotion/methods , Health Services Needs and Demand , Humanism , Humans , Patient Reported Outcome Measures , Philosophy, Medical , Quality of Life , Self-Help Groups/ethics , Surgeons/psychology , Surgeons/statistics & numerical data , Workload/psychologyABSTRACT
BACKGROUND: In spite of emphasis on patient-centered cares and promotion of their quality, shortcomings have been seen in health systems due to lack of compassion. PURPOSE: The aim of the present study was to determine the definition, fields, facilitating and inhibiting factors of compassionate care in healthcare systems and the interventions designed to promote it. METHODS: This study was conducted through narrative synthesis which is supposed to do systematic and synthesized review. Searching was done in English databases including Pub Med, CINAHL, Google Scholar, Web of Science, and Cochrane library, Ovid, Science Direct, WILEY by using keywords of Compassionate Care, Delivery of Health Care, Healthcare Systems, Compassion and Health Care Providers from 1987 to 2017. RESULTS: Compassionate care has some dimensions including ethical, professional, effective communication, human, spiritual/religious and getting involve with patients. Facilitating and inhibiting factors consisted of the nurse's personal characteristics, patients' behavior and organizational factors included workload, role model, and value of compassionate care in healthcare systems. Educational interventions such as providing feedback and reorienting have been mostly used to improve the compassionate care. CONCLUSIONS: Although compassionate care has been known as the main element of improving services quality in health care system, it has been studied restrictively from the viewpoints of the patients and all personnel in healthcare systems. The improvement of compassionate care through education cannot remove completely the gap between theory and practice, because it seems that clinical environment and organizational values of healthcare system are the largest facilitating and inhibiting factors for filling this gap. Therefore, it is necessary to take measures for promoting organizational culture.
Subject(s)
Delivery of Health Care , Empathy , Organizational Culture , Quality Improvement , Attitude of Health Personnel , Communication , Empathy/ethics , Humanism , Humans , Patient-Centered Care/standards , Professionalism , Spirituality , WorkloadABSTRACT
Lo problemático en el estudio de la empatía es su ausencia ante el sufrimiento ajeno. La eutanasia resalta el conflicto moral sobre sufrir o dejar de sufrir frente una enfermedad irreversible y dolorosa. Analizaré el conflicto que presenta el respeto pleno por el principio de dignidad humana, establecido en el artículo 51 del Código Civil y Comercial de la Nación Argentina, en relación con las directivas médicas anticipadas que impliquen una práctica eutanásica que, en función del artículo 60 del mismo cuerpo legal, se deberán tener por no escritas. Dos preguntas cerradas guiarán el análisis: ¿Menoscaba a la dignidad humana la eutanasia, en su modalidad activa? ¿Resulta justa o injusta la restricción a la autonomía personal en relación a la eutanasia? Finalmente, exploraré el rol de la compasión en la eutanasia (AU)
What is problematic in the study of empathy is his absence to the suffering of others. Euthanasia highlights the moral conflict about suffering or stop suffering facing at an irreversible and painful illness. I will analyze the conflict that has full respect of human dignity, laid down in Article 51 of the Civil and Commercial Code of Argentina, in relation to advance medical directives that involve a practice euthanasia, according to the Article 60 of the same legal body, should not be written. Two closed questions will guide this analysis in order to reflect on them: Does euthanasia undermines the human dignity, in its active mode? Is it fair or unfair the restriction of personal autonomy in relation to euthanasia? Finally, I will explore what the role of compassion in euthanasia (AU)
Subject(s)
Euthanasia/ethics , Euthanasia/legislation & jurisprudence , Empathy/ethics , Human Rights/legislation & jurisprudence , Human Rights/standards , Justicia , Personal Autonomy , Bioethics/trendsSubject(s)
Codes of Ethics/history , Delivery of Health Care/history , Empathy , Ethics, Medical/history , Legislation, Medical/history , Physician-Patient Relations , Physicians/history , Austria , Codes of Ethics/legislation & jurisprudence , Delivery of Health Care/ethics , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care/organization & administration , Empathy/ethics , Europe , History, 18th Century , History, 19th Century , History, Ancient , History, Medieval , Humans , Hungary , Malpractice/history , Mesopotamia , Patient Rights/history , Physician-Patient Relations/ethics , Physicians/economics , Physicians/ethics , Physicians/legislation & jurisprudence , Punishment/historyABSTRACT
Introdução: A meditação traz o indivíduo para o estado de observador consciente de suas próprias percepções, ao invés de se deixar arrastar pelo turbilhão de emoções e pensamentos. Diversos estudos têm mostrado a importância de práticas meditativas no controle emocional e na atenção. Esses estudos investigam se a auto-compaixão poderia auxiliar a pessoa a ser gentil e compreensiva com ela mesma, em não ser tão dura e crítica perante os seus fracassos ou falhas. Estudos indicam que o treinamento em meditação, que relaciona-se à habilidade de atentar com maior cuidado para suas percepções e emoções, poderia contribuir no desenvolvimento da auto-compaixão. Objetivos: Estudar os efeitos do treinamento em meditação no sentimento de auto-compaixão e na atenção. Métodos: Foram comparados os resultados antes e depois de um treinamento de meditação de 9 dias em 44 sujeitos, com idade média de 44.14 (± 12.22 DP), sendo 27 mulheres e 17 homens. Cerca de 60 % da amostra tinha ao menos 1 ano de experiência de meditação. O treinamento ocorreu no formato de um retiro. Eles foram avaliados pela Escala de Auto-Compaixão (EAC) e pela Escala de Atentividade (MAAS). Resultados: Houve diferenças significantes em termos de aumento dos escores nas subescalas da EAC auto-julgamento e humanidade e da MAAS comparandos-e os momentos pré e pós retiro. Conclusão: Após o treinamento em meditação houve uma melhora da atenção nas atividades cotidianas e um aumento do auto-julgamento e da percepção de fazermos parte de uma mesma humanidade, estando sujeitos a errar e acertar.
Subject(s)
Attention , Meditation , Empathy/ethics , Emotion-Focused Therapy/methodsABSTRACT
Although literature supports the association between harmonious coparenting practices and lowered child problems, little is known about coparenting influences among family constellations in the foster care system. Via a compilation of a new coparenting practices measure, we examined similarities and differences on foster parent-derived perceptions of support/flexibility, shared communication, conflict/triangulation, and total coparenting between foster and biological parents and their independent contribution to child internalizing and externalizing problems. Self-reports were gathered from foster parents (N=80) in 2 groups: kin and nonkin. As compared with nonkin, kin foster parents reported higher perceived support/flexibility, shared communication, and total coparenting. A tendency for higher conflict/triangulation among kin foster parents was also found. After considering foster parent group, psychological distress, and harsh discipline, hierarchical regression analyses revealed that perceived total coparenting and conflict/triangulation contributed to child internalizing and externalizing problems. Results support the linkage between perceptions of coparenting and child problems among caregivers (foster and biological alike) in kin and nonkin arrangements and highlight training in coparenting in general, and conflict management in particular, as an important intervention focus to reduce the high level of child problems in this vulnerable population.