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1.
Washington, D.C.; OPS; 2020-11-17.
em Espanhol | PAHO-IRIS | ID: phr-53027

RESUMO

El presente documento técnico es un marco para la acción. Su objetivo es orientar el proceso de desinstitucionalización de la atención psiquiátrica en el contexto de América Latina y el Caribe. La finalidad esencial de la desinstitucionalización es limitar el papel de los hospitales psiquiátricos, incorporando camas de hospitalización aguda en el hospital general y reemplazándolos por soluciones de vivienda con apoyo en la comunidad para personas con enfermedades mentales graves. Paralelamente, se necesita una red de servicios de salud mental basados en la comunidad que sea eficiente. Esto implica el desarrollo prioritario de nuevas prácticas y servicios comunitarios de eficacia demostrada que protejan los derechos de las personas con enfermedades mentales. Esta publicación resume qué elementos facilitadores y qué barreras encontrarán los procesos de desinstitucionalización, identificando intervenciones de utilidad y eficacia demostrada en los países de América Latina y el Caribe. Se identifican cuatro áreas de trabajo con sus respectivas pautas o sugerencias para la acción, que deben constituir una guía operativa para los países que aborden la reestructuración de los servicios de salud mental en favor de la desinstitucionalización de la atención psiquiátrica.


Assuntos
Hospitais Psiquiátricos , Psiquiatria , Desinstitucionalização , Hospitais , Saúde Mental , Serviços Comunitários de Saúde Mental , América Latina , Região do Caribe
3.
J Nurs Adm ; 50(11): 598-604, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33074955

RESUMO

Congregate settings such as psychiatric units have an increased risk of disease transmission because of the milieu setting and the inability to isolate patients. Interventions to prevent infection and cross-contamination are discussed including monitoring of patient temperatures, personal protective equipment, remote care, monitoring of human resources, and reinforcement of infection prevention strategies. We discuss the effectiveness of those interventions and the lessons learned, including implications for psychiatric clinical care, during future pandemics or a next wave of COVID-19.


Assuntos
Infecções por Coronavirus/enfermagem , Infecção Hospitalar/enfermagem , Hospitais Psiquiátricos/organização & administração , Controle de Infecções/métodos , Transtornos Mentais/enfermagem , Pneumonia Viral/enfermagem , Infecções por Coronavirus/epidemiologia , Humanos , Cidade de Nova Iorque/epidemiologia , Pesquisa em Avaliação de Enfermagem , Pandemias , Pneumonia Viral/epidemiologia
4.
Psychiatr Danub ; 32(Suppl 3): 316-319, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030446

RESUMO

The paper gives an overview of the spatial conditions, human resources and development course of child and adolescent psychiatry as an independent profession. The beginnings of the development date back to 1959, when the Department of children and youth is opened in Sarajevo at the Neuropsychiatric Clinic, which continues without interruption even today. After that was opened same department in Banja Luka and after a certain period of outpatient work, and stationary departments in Tuzla and Mostar. Over time, as the world's developed and improved understanding of the needs of treatment of mental disorders, and as the trends of professional approaches changed from time to time, the same set of guidelines were followed by the professional work of staff members in the departments. As the material opportunities allowed, in all localities there is a clear tendency to improve spatial conditions. However, personnel capability has improved at a slightly faster pace, so by the war time in Bosnia-Herzegovina (BH) between 1992 and 1995, in BH were mostly trained professional teams. In meanwhile, the need for psychiatric assistance has largely exceeded the human resource capabilities. The situation of war has changed dramatically in the present situation, departments are empty, and there is a paradoxical situation that the patient in the hospitals does not exist, but the reason is bizarre, since because of the war, physically, patients are not able to access to hospitals. This situation also contributes to the departure a large number of staff, which is in the child psychiatry, and so was insufficient. Despite this, during the war in Sarajevo, the Psychiatric Clinic conducts research on psychiatric morbidity and evaluation of population trauma due to war stress in the city of Sarajevo, and included the population of children and adolescents who remained in the city. The project is implemented only in the city area, because Sarajevo was city, three and half years under the total military siege. Further on, the paper elaborates the status of spatial and human resources capacity in the post-war period up to the present day. There is an evident expansion of the psychological assistance service throughout the territory of BH, which has been largely on the initiative and all the necessary assistance of the international community through non-governmental organizations, but with the involvement of the remaining domestic staffs. They were also stated the government projects, in the last two decades, on the professional training of staff working in Mental Health Centers across the country. In the latest age of the last ten years, a number of private psychological counselling centers have been opened that, beside the psychiatrists, are led by certified psychotherapists, psychologists, pedagogues, and teachers. This fact is very important for the future, because this is a good part solving the current lack of professionalism to provide psychological assistance to the population in developmental age. All professionals involved in the human psyche were aware of how important the timely recognition and provided expert assistance, when it comes to developmental age. In the post-war period, certain scientific researches on the psychological trauma severity of the population are being carried out, and the results of some of these researches are mentioned in this paper. The paper concludes with the statement that the current state of development of child psychiatry in the country is satisfactory in relation to the conditions that we had the past decade, but with the suggestion that a long way to furthering this profession and its affirmation at the global level is in the future.


Assuntos
Psiquiatria do Adolescente/história , Psiquiatria Infantil/história , Adolescente , Bósnia e Herzegóvina , Criança , História do Século XX , História do Século XXI , Hospitais Psiquiátricos/história , Humanos
5.
Psychiatr Serv ; 71(10): 1088-1090, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32998660

RESUMO

Specific guidance on how to manage COVID-19 in forensic psychiatric institutions is necessary because these settings differ substantially from both acute-care psychiatric hospitals and correctional institutions. The challenges raised by COVID-19 in these settings are unique, given the nature of the patients treated, length of stay, and need to collaborate with various partners in the criminal justice system during both the admission and discharge planning processes. This column outlines these specific challenges, which are likely to recur in subsequent epidemics, and suggests potential strategies to address them.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Psiquiatria Legal/métodos , Hospitais Psiquiátricos , Transtornos Mentais/complicações , Transtornos Mentais/terapia , Pneumonia Viral/complicações , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle
7.
Rev Med Suisse ; 16(704): 1582-1585, 2020 Sep 02.
Artigo em Francês | MEDLINE | ID: mdl-32880117

RESUMO

Our medical practice brings us to meet people from all walks of life. Some of our patients experience multiple vulnerabilities and are at greater risk of stigma and discrimination. In the field of asylum, they are often firstly designated by words reflecting their socio-administrative reality. These words are supposed to define their identity. The individual is dehumanized because reduced to an administrative status. These terms carry a denotative meaning, valuable in understanding the context in which the patient evolves ; but also a connotative meaning, which through implicit bias leads the caregiver to adopt attitudes that may be detrimental to the proper care of the patient. Words must be carefully chosen and brought in a timely manner, because words matter.


Assuntos
Hospitais Psiquiátricos , Idioma , Saúde Mental , Preconceito , Humanos , Vergonha , Estigma Social
9.
Rev Med Suisse ; 16(707): 1733-1736, 2020 Sep 23.
Artigo em Francês | MEDLINE | ID: mdl-32969607

RESUMO

Due to the rapid spread of the novel coronavirus pandemic, a reorganization of the health care sector was needed. Many questions arose concerning the specificity of psychiatric care in this unprecedented situation. In Geneva, Switzerland, the department of psychiatry decided to open a new ward for its infected patients. Beyond the challenge of setting it up quickly, we faced the challenges of taking care of a heterogeneous group of patients and of incorporating protection measures we were not accustomed to, which add a significant amount of time to the daily care of patients. The staff recruitment on a voluntary basis, close supervision, availability of the personal protective material as well as support from the infection prevention and control unit have enabled proper functioning of the ward.


Assuntos
Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/métodos , Hospitais Psiquiátricos/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Psiquiatria , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Suíça/epidemiologia
10.
Epidemiol Psychiatr Sci ; 29: e167, 2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32895087

RESUMO

AIMS: The number of mental hospital beds per population varies widely across countries, and the reasons for this variation are not fully understood. Given that differences in disease prevalence do not explain variation in inpatient mental health care availability, we examined the relationship between mental hospital beds and national income, education and longevity as measured by the Human Development Index (HDI). METHODS: We used an international dataset of social, economic and structural measures to conduct a mixed-effects longitudinal regression of predictors of the number of mental hospital beds per 100 000 in the overall population for 86 countries for years 2005-2015. RESULTS: Our initial dataset contained 1881 observations consisting of 11 years of potential measurements across 171 countries. After eliminations based on missing data and subsequent imputation, the dataset for the final regression model included 946 observations over 86 countries. The primary predictors of a country's number of mental hospital beds were year, HDI and GINI coefficient, the latter being a measure of income disparity. Holding all other factors constant, the number of beds decreased 8% per year, reflecting the ongoing international trend of deinstitutionalisation. As hypothesised, higher HDI predicted more mental hospital beds. Every 0.1 increase in HDI (0-1.0) was associated with a 126% increase in the number of hospital beds at the sample's mean GINI index score of 38 (0-100). However, a strong interaction between HDI and the GINI coefficient indicated that a high level of income disparity attenuated the positive association between HDI and mental hospital beds. At a GINI index score of 48, every 0.1 increase in HDI was associated with a 71% increase in the number of hospital beds. CONCLUSIONS: As countries reduce the number of hospital beds over time, higher levels of economic disparity are associated with a reduction in the strength of the association between national prosperity and investment in mental hospitals. As power becomes increasingly concentrated, perhaps those with the least are more easily forgotten.


Assuntos
Número de Leitos em Hospital/estatística & dados numéricos , Hospitais Psiquiátricos , Desenvolvimento Humano , Fatores Socioeconômicos , Ocupação de Leitos , Acesso aos Serviços de Saúde , Humanos
11.
Neuropsychiatr ; 34(3): 101-107, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32813228

RESUMO

The first psychiatric chairs and university departments of psychiatry in Austria were founded in Vienna and Graz in 1870: hence they celebrate their 150th anniversary this year 2020. These foundations represent a peak in the development of psychiatry as a scientific medical discipline. It is the aim of this paper to sketch that step by step development in its connection with the development of care institutions of the time and with reference to important personalities in the field. Vienna-as the metropole of the state and the most prominent place in the field-is taken as an example. One can distinguish four developmental periods: (1) The establishment of care institutions (asylums), at first without an own medical staff and unqualified male and female keepers (late 18th century up to early 19th). (2) The growing independance of these institutions-in Vienna the 'Tower of Fools'-and the emergence of 'alienists' who began to reflect on their activities and to share their experiences on academic grounds and the publication of a first Austrian textbook (1st half of 19th century). (3) From the 1850s on several alienists habilitated, partly with special emphasis on forensic psychology or cerebral anatomy and physiology, and developed a systematic academic teaching, again with a new 'modern' textbook, in some connection with a new care institution, and the foundation of a scientific association of psychiatry and forensic psychology in 1868. (4) An early activity of that association was to call for the institution of a chair and a university department of psychiatry within the asylum, both realised in 1870.


Assuntos
Psiquiatria , Áustria , Feminino , História do Século XIX , História do Século XX , Hospitais Psiquiátricos , Humanos , Psiquiatria/história , Universidades
12.
Transl Psychiatry ; 10(1): 268, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-32753618

RESUMO

Coronavirus disease 2019 (COVID-19) has been recognized as a global pandemic, and psychiatric institutions located in the epicenter of the epidemic in China are facing severe challenges in fighting the epidemic. This article presents the accumulated experience of the authors during the process of combating COVID-19 in a psychiatric hospital. The aim of this article is to provide a reference for psychiatric specialty hospitals and institutions that treat large populations of chronically ill patients in other parts of the world.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Hospitais Psiquiátricos , Controle de Infecções/métodos , Transtornos Mentais/complicações , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , China , Humanos
13.
Int J Law Psychiatry ; 71: 101572, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32768110

RESUMO

Psychiatric inpatients are particularly vulnerable to the transmission and effects of COVID-19. As such, healthcare providers should implement measures to prevent its spread within mental health units, including adequate testing, cohorting, and in some cases, the isolation of patients. Respiratory isolation imposes a significant limitation on an individual's right to liberty, and should be accompanied by appropriate legal safeguards. This paper explores the implications of respiratory isolation in English law, considering the applicability of the common law doctrine of necessity, the Mental Capacity Act 2005, the Mental Health Act 1983, and public health legislation. We then interrogate the practicality of currently available approaches by applying them to a series of hypothetical cases. There are currently no 'neat' or practicable solutions to the problem of lawfully isolating patients on mental health units, and we discuss the myriad issues with both mental health and public health law approaches to the problem. We conclude by making some suggestions to policymakers.


Assuntos
Infecções por Coronavirus/prevenção & controle , Hospitais Psiquiátricos/ética , Hospitais Psiquiátricos/legislação & jurisprudência , Controle de Infecções/legislação & jurisprudência , Competência Mental/legislação & jurisprudência , Pandemias/prevenção & controle , Isolamento de Pacientes/ética , Isolamento de Pacientes/legislação & jurisprudência , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Inglaterra/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , País de Gales/epidemiologia
14.
J Adolesc Health ; 67(4): 612-614, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32798098

RESUMO

PURPOSE: We report on a coronavirus disease 2019 (COVID-19) outbreak among adolescents at an inpatient behavioral health facility that was identified within 5 weeks of known viral transmission in the surrounding community. METHODS: Clinical records were reviewed for all inpatients aged <18 years with laboratory-confirmed COVID-19 between March 23 and April 21, 2020. RESULTS: A total of 19 COVID-19-positive patients aged 11-17 years were identified. Patients most commonly presented with sore throat (37%) and nausea/vomiting (32%). Only 26% of patients presented with cough, shortness of breath, or fever. The most common medical comorbidity was asthma (32%), and the most common psychiatric comorbidity was posttraumatic stress disorder (63%). Infected patients were colocated and managed together on a separate COVID-19 unit to maintain a therapeutic group milieu. Mental health treatment was modified to limit staff exposure. Patients received daily medical assessment by an in-house pediatrician. One patient required intravenous fluids. No patients required transfer to a medical facility. CONCLUSIONS: Adolescents in psychiatric inpatient settings may be especially vulnerable to COVID-19 infection. Close collaboration between medical and psychiatric care providers is needed to optimize care for this population and to address admission and disposition options for infected patients.


Assuntos
Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Hospitais Psiquiátricos , Pneumonia Viral/epidemiologia , Adolescente , Asma/complicações , Betacoronavirus , Criança , Infecções por Coronavirus/complicações , Feminino , Humanos , Pacientes Internados , Masculino , Pandemias , Philadelphia , Pneumonia Viral/complicações , Transtornos de Estresse Pós-Traumáticos/complicações
15.
Curationis ; 43(1): e1-e7, 2020 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-32787430

RESUMO

BACKGROUND: Nurses are exposed to stress when working in the mental health care environment. This may be because of nurses being frontline health care providers. They develop close interpersonal relationships with mental health care users (MHCUs), which is inherent in the type of care that is provided. Mental health nursing may therefore be demanding and stressful, which could render mental health nurses susceptible to burnout. OBJECTIVES: To determine the prevalence of burnout among nurses working at a selected psychiatric hospital in the Western Cape. METHODS: A quantitative, descriptive, survey design, by using simple random sampling was used to select 198 nurses employed at a psychiatric hospital in the Western Cape, South Africa. Maslach Burnout Inventory-Human Services Survey measuring emotional exhaustion, depersonalisation and personal accomplishment was used to collect the data. Domain scores were calculated, and the influence of the demographic variables on the domains was tested with independent samples Kruskal-Wallis tests and Mann-Whitney U tests. RESULTS: The study had a 100% response rate. Most of the respondents experienced low emotional exhaustion, low depersonalisation and high personal accomplishment. Enrolled nursing assistants reported significantly higher emotional exhaustion than did the advanced psychiatric nurses and professional registered nurses. Respondents with more than 5 years of experience scored significantly higher in depersonalisation. No respondents met the criteria for burnout on all three domains. CONCLUSION: Maintaining a safe working environment with adequate nursing staff is recommended. Strategies to prevent burnout in the future include the provision of resources and the promotion of open communication between staff and management.


Assuntos
Esgotamento Profissional/etiologia , Enfermeiras e Enfermeiros/psicologia , Prevalência , Adulto , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Feminino , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/normas , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Enfermagem Psiquiátrica/métodos , Enfermagem Psiquiátrica/normas , Enfermagem Psiquiátrica/estatística & dados numéricos , África do Sul , Inquéritos e Questionários
16.
Curationis ; 43(1): e1-e8, 2020 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-32787431

RESUMO

BACKGROUND: Professional nurses are responsible for the provision of care, treatment and rehabilitation of all mental healthcare users (MHCUs) in the institutions for mental healthcare. However, professional nurses find themselves in difficult circumstances under which they must provide quality healthcare services to MHCUs. OBJECTIVES: The study explored and described the challenges experienced by the professional nurses working in a mental healthcare institution in Limpopo province of South Africa. METHOD: A qualitative approach was used to explore and describe the challenges faced by professional nurses working in a mental healthcare institution. The study was conducted from July 2016 to December 2016. Purposive sampling was used to select participants. Data were obtained through individual in-depth interviews with professional nurses between the ages of 26 and 50 years. Data collection continued until data saturation, which occurred after interviewing 18 participants. Tech's open coding method was used to analyse data in this study. RESULTS: Four themes emerged from data analysis, namely: inadequate safety measures, inadequate resources, impact of high workload and shortage of staff. The themes were further sub-divided into sub-themes. CONCLUSION: The study revealed several challenges that professional nurses face in mental healthcare institutions which might be a barrier to the provision of quality healthcare. Conducive working environments should be established to enable professional health nurses to provide quality nursing care, thereby promoting the health of MHCUs.


Assuntos
Hospitais Psiquiátricos/normas , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Local de Trabalho/normas , Adulto , Feminino , Recursos em Saúde/normas , Recursos em Saúde/provisão & distribução , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , África do Sul , Carga de Trabalho/psicologia , Carga de Trabalho/normas , Local de Trabalho/psicologia , Local de Trabalho/estatística & dados numéricos
17.
Washington, D.C.; PAHO; 2020-08-10. (PAHO/NMH/MH/Covid-19/20-0041).
em Inglês | PAHO-IRIS | ID: phr-52557

RESUMO

Mental health conditions include a range of mental, neurological, and substance use (MNS) disorders and their associated psychosocial, cognitive and intellectual disabilities. The direct and indirect consequences of the pandemic impact these conditions in many ways. People living in psychiatric hospitals, inpatient units, and other psychiatric institutions are likely to need special attention during disease outbreaks such as COVID-19. SARS-CoV-2 can spread rapidly within congregate residential settings, especially complex residential settings such as psychiatric hospitals. Congregate care facilities can increase the risk of COVID-19 transmission. In addition, people with mental health conditions often have medical comorbidities some of which may increase the risk of developing severe illness following COVID-19 infection. Mental health services in general hospitals and crisis intervention units take care of acute cases. All treatment facilities for people with mental disorders need to adhere to the prevailing procedures for other inpatient units in hospitals, following national and international guidelines.


Assuntos
Infecções por Coronavirus , Coronavirus , Fatores de Risco , Saúde Mental , Impacto Psicossocial , Hospitais Psiquiátricos , Serviços de Saúde Mental , Deficiência Intelectual
18.
Psychiatr Prax ; 47(8): 446-451, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-32659795

RESUMO

This study provides for the first time a comprehensive overview of the state-of-the-practice of clinical ethics consultation in German psychiatric hospitals. Structures for ethics counselling were available in only 57 % of the hospitals. In about one third of the participating hospitals, structures of ethics counselling had not yet been considered or were actively dismissed. The remaining hospitals reported to be in the process of establishing ethical structures. With regard to team characteristics and concrete practical implementation, qualitative differences were found between the hospitals. In summary, ethical structures are already established in the more than half of the German psychiatric hospitals, but still there is a clear need both in terms of dissemination and the quality of practical implementation.


Assuntos
Consultoria Ética , Hospitais Psiquiátricos , Alemanha , Humanos
20.
J Relig Health ; 59(5): 2531-2555, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32691189

RESUMO

The current paper sought to thematically present common challenges associated with mental healthcare services in Africa. We largely limited our search for literature materials to studies published from 2003 to 2019 in African countries from which the findings showed that there are common challenges confronting mental healthcare services in Africa. The challenges include: inadequate mental healthcare facilities, funding constraints, shortage of professional healthcare workers, inadequate training and development scheme for mental health workers and weak mental healthcare policies. Implications for policy and practice are disclosed and recommendations are stated to trigger actions to remedy the situation. This information is beneficial for researchers, policymakers, mental healthcare providers and community members who are interested in mental healthcare issues. It was concluded that in order for Africa to enjoy successful mental healthcare service, critical and enduring attention must focus on sound and enforceable government policy on mental healthcare service, provision of adequate and regular funding, availability of adequate mental healthcare facilities, provision of training and development facilities for the mental health professionals and collaboration of mental healthcare providers.


Assuntos
Serviços de Saúde Mental , África , Assistência à Saúde , Pessoal de Saúde , Hospitais Psiquiátricos , Humanos
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