Stigma and prejudice: the experience of crack users.

OBJECTIVE: to evaluate the stigma and prejudice experienced by crack users in their social context. METHOD: a qualitative study developed through the Fourth Generation Evaluation, conducted with four interest groups (ten users, eleven families, eight employees, and seven managers), components of the mental health care network. For data collection, we used observation and individual interview. The analysis was performed through the constant comparative method. RESULTS: crack users suffer prejudice and are stigmatized as those who do not fit in the systems established by society (without family links, formal employment and dwelling), and are thus excluded. They exhibit undisciplined behavior and, therefore, are discriminated, marginalized and considered as criminals, losing their uniqueness and living in vulnerable situations. CONCLUSION: the evaluation process emphasized the need to demystify the social imaginary that demonizes the chemically dependent, being thus important to develop public policies with actions focused on health, prevention, information and combat to stigma.

[Mental health care technologies for treating crack users]. / Tecnologias de cuidado em saúde mental para o atendimento ao usuário de crack.

The aim of this study was to identify mental health care technologies for treating crack users in a Psychosocial Care Center for Alcohol and other Drugs (CAPsad, as per its acronym in Portuguese). A qualitative, evaluative case study was developed in a CAPSad, using fourth generation evaluation. Data collection occurred from January to March 2013 by means of semi-structured interviews applied to 36 subjects, these being health care professionals, patients, patients' relatives and managers. Data analysis identified the category strategies in mental health work. Results showed that recovery programs should provide spaces for dialogue, aiming to clarify the process of psychiatric internment to the user and family, and involve these in the therapy, implementing educational practices and ongoing consideration of mental health activities. In conclusion, it is important to discuss the technologies used in everyday care services, in light of the complexity of crack use.

[The network of mental health care from the family health strategy service]. / A rede de atenção à saúde mental a partir da Estratégia Saúde da Família.

The Family Health Strategy Service (FHSS) is an important ally in the mental health system, contributing to the completeness and effectiveness of care. This study aimed to discuss the mental health care network as compared to the daily routine of an FHSS. It is an evaluative study with a qualitative methodological approach. It was developed in an FHSS in Porto Alegre-RS, Brazil. Data was collected between July and December of 2010 through interviews with 16 workers and ten relatives. We identified important resources in primary health care, such as partnerships with academia. However, the constitution of this care is still based on specialty, following the logic of patient referral. Our intention for this study was to contribute to the operationalization of the mental health care network, consolidating the partnership with the FHSS and developing activities in the territorial space, raising awareness, demystifying health care service in the area, and countering the perception that it is uniquely specialized.

[Risk of falls in the elderly: an integrative review based on the North American Nursing Diagnosis Association]. / Risco de quedas em idosos: revisão integrativa pelo diagnóstico da North American Nursing Diagnosis Association.

The objective of this study was to analyze the scientific production regarding risk factors for falls in the elderly, based on the North American Nursing Diagnosis Association found in the Brazilian and international literature from 2005 to 2010. This integrative review was performed using the descriptors: accidental falls and elderly, utilizing the following databases: Cumulative Index to Nursing and Allied Health Literature and Latin-American and Caribbean Health Sciences Literature. Thirty-two articles were selected for content analysis. The results are presented according to the risk factors indicated by the North American Nursing Diagnosis Association, which are: environmental risk factors, such as rooms with excessive furniture and objects/rugs on the floor, poor illumination, and slippery floors; cognitive risk factors such as reduced mental state; risk factors in adults such as age above 65 years; physiological risk factors such as impaired balance, visual difficulties, incontinence, difficulty in walking, and neoplasms; and risk factors associated with the use of certain medications. An examination of the risk factors for falls in the elderly shows the need to develop new strategies to change environments and intrinsic components.

[Qualitative assessment of the relationship of social actors with madness in a substitutive mental health service]. / Avaliação qualitativa da relação de atores sociais com a loucura em um serviço substitutivo de saúde mental.

This study aims to evaluate qualitatively the relationship between social actors and the madness. It was based in experiences produced in a Psychosocial Care Center in the Southern Brazilian context. This is a clipping from an evaluative and qualitative study. Was utilized the Fourth Generation Evaluation as a theoretical-philosophical framework. The methodological device applied was a adapted version of the Hermeneutic-dialectic circle. The statements haunt deinstitutionalization as a paradigm of mental health care, highlighting the need to combat the vices born of crystallized and exclusionary conduct, the typical model asylum. However, we can still see in practice a mixture of models, responsible for enhanced and innovative practices, and other crystallized and exclusive. Hopefully he can discuss the daily life of them, opening the way for understanding best madness, crazy and their relationships.

[Psychic crisis care in the emergency room nursing staff's view]. / Atendimento à crise psíquica no pronto-socorro: visão de profissionais de enfermagem.

This study was aimed at finding out the nursing staff's view about psychic crisis care in an emergency room unit. This is a qualitative study that used the application of semi-structured interviews as data collecting technique. Five nursing professionals that worked in the emergency room during the morning and afternoon shifts participated in the research. Data analysis was conducted based on the discussion of the following categories: concept of crisis for the emergency room team and the different suffering expressions and therapeutic resources to face and minimize the crisis' burdens. Professionals usually justify their difficulties on treating a psychic crisis due to lack of time, space and proper training.

[Mental health in primary care: an assistant research approach]. / Saúde mental na atenção básica: uma abordagem convergente assistencial.

This study aims to comprehend the expectations and aspirations of a community about the deployment of a group of mental health in primary care. This is a qualitative study that uses the assistant convergent research approach. Data were collected through workshops with psychotropics users, accompanied by Primary Care in the South of Brazil. The first workshop aimed to reflect on and develop strategies to dealing with asylum model. The second discussed the importance of spaces that strengthen bonds of affection and act as means of prevention in mental health. The third discussed the issue of restriction of liberty imposed by mental suffering. It was found that spaces dedicated to mental health in the primary care will add to the effectiveness of the practices and to the construction of new knowledge to the user's health and life

Psychiatric care in the Brazilian context.

This study seeks to present an updated discussion concerning psychiatric care in Brazil. It is based upon a historical review of psychiatric knowledge and practices within the Brazilian context and knowledge about the phenomenon of madness. It discusses the appearance of modern medical science as an area of knowledge designed for the treatment and comprehension of mental suffering. It also presents a discussion on psychiatric reform, stressing how it is a movement that seeks to redefine the significance of knowledge and practices about the phenomenon of madness, by concentrating on the application of such knowledge and practices in the psychiatric hospital. This paper concludes with a brief critical reflection on prevailing mental healthcare in Brazil, singling out the potential and the difficulties faced within the scope of health policies and the day-to-day working life of professionals of the area.

[Concept of clientele: discourse analysis of the benevolence in the context of the Brazilian psychiatrich reform]. / Concepção de clientela: análise do discurso da benevolência no contexto da reforma psiquiátrica brasileira.

This study aims to know the dynamic and controversial which is the practice in mental health. For that, it's analyzes the discourse of workers of mental health about the concept of on the concept of the clientele of the service. The corpus of this work is composed for interviews applied to 17 of the 25 professionals of mental health who work in a service substitute of a city of the Brazilian South Region. The theoretical-philosophical referential was the Critical Discourse Análisis. The methodological device was the "axiologic-discursive diagram". The results demonstrate that the workers assume relations of benevolence because the clientele conceptual undefinition, fruit of the difficulty in establishing what is normal and pathological in mental health. We wait that the study it contributes to problematize the process of consolidation of the Brazilian psychiatric reform.

Critical discourse analysis: new possibilities for scientific research in the mental health area.

The present study aims to get to know the philosophical, conceptual and methodological aspects of Critical Discourse Analysis, as a theoretical-methodological framework for research in the mental health area. Initially, the study presents a reflection on psychiatric discourse in history and at present, with the goal of introducing concepts and presuppositions that would guide the analysis of discursive processes. Discussions are presented about the historical milestones of Critical Discourse Analysis as an analytical framework in social sciences. Finally, the study presents its conceptual and methodological applications to research in the mental health area.

[Dialectics for humanized care in ICU's: contradictions between professional nursing discourse and practice]. / Dialética do cuidado humanizado na UTI: contradições entre o discurso e a prática profissional do enfermeiro.

This study attempts to unveil contradictions in humanized nursing care in ICUs. It is a qualitative, dialectic-based study involving 7 nurses, 4 family members and one patient of the Adult ICU of the Hospital of the Federal Universityof Santa Catarina. Participatory observation and semi-structured interviews were applied to collect the data. Marxist and Gramscian ideas of contradiction were used as the theoretical-philosophical reference. This study demonstrates that humanized care is part of a complex network, in which care knowledge seems to give way to closer network ties, while care practicefollows an impersonalized strategy within the logic of partitioned and routine health care production. The dissociation between knowledge and practice also contemplates the difficulties in dealing with the burdens of suffering and institutional-professional limitations. The conclusion is that knowledge of this reality should be a renewed, yet age-old challenge for the nurse in the search for the constant construction/ reconstruction of Nursing in terms of practice, knowledge and work relations.

[Teaching apprenticeship in psychiatric nursing: an experience during the postgraduate period]. / Estágio de docência em enfermagem psiquiátrica: uma experiência durante a pós-graduação.

I present my experience related to an internship on teaching upon developing activities in the discipline of Psychiatric Nursing II, during the Nursing graduation at Universidade Federal de Santa Catarina in the first semester of 2004. It is a theoretical-practical subject, divided into two blocks. The internships take place in a psychiatric hospital and in the community through domicile visits. I have found out that the psychiatric hospital was the scenario of several significances. The students appreciated the domicile visits, even under a few difficulties. After a discussion based on the relevant literature, I came to the conclusion that this experience was beneficial to me for allowing the integration between graduation and postgraduation.

[Therapeutic relationship and teaching of mental health and psychiatric nursing: trends in the state of São Paulo]. / Relacionamento terapêutico e ensino de enfermagem psiquiátrica e saúde mental: tendências no estado de São Paulo.

This study presents a panorama of the insertion of the thematic of therapeutic relationship and therapeutic communication in undergraduate courses in Nursing in the public universities of the State of São Paulo. This is a qualitative and descriptive-analytical research. Data was collected through a questionnaire applied on professors of the area of Psychiatric Nursing and Mental Health from 8 schools and grouped according to the institution, the disciplines, the program and the objectives of the practical activities and practical fields. It was verified that most schools include the therapeutic relationship in their teaching approach, which makes possible the rescue of Nursing as a profession that is concerned with the human being in his/her complexity, in which the know-how is directed to the respect of the patients' limitations, potentialities, needs and interpersonal relations.

[Knowledge and theoretical studies in psychiatric nursing and mental health]. / Saberes e estudos teóricos em enfermagem psiquiátrica e saúde mental.

The present article consists of a bibliographical research developed with 109 articles published in Brazilian journals classified by CAPES as 'National B' or superior. Of these articles, 33 focused on knowledge and theoretical studies in psychiatric nursing and mental health which were rearranged in the sub-themes: theoretical studies with historical focus (focus in the sheltering model and focus in the transformation of the attendance of psychiatric nursing), participation of the family in the patient's process health-disease, the bearer's of psychic suffering comprehension of him/herself, stigma, use of the results of the research in psychiatric nursing, rethinking of the teaching, research instruments and work in nursing.