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2.
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
3.
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
4.
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
5.
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
6.
Hist Psychiatry ; 31(4): 455-469, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32748672

RESUMO

This article discusses the Admission and Treatment Unit at Fair Mile Hospital, in Cholsey, near Wallingford, Berkshire (now Oxfordshire). This was the first new hospital to be completed in England following the launch of the National Health Service. The building was designed by Powell and Moya, one of the most important post-war English architectural practices, and was completed in 1956, but demolished in 2003. The article relates the commission of the building to landmark policy changes and argues for its historic significance in the context of the NHS and of the evolution of mental health care models and policies. It also argues for the need for further study of those early NHS facilities in view of current developments in mental health provision.


Assuntos
Arquitetura Hospitalar/história , Hospitais Psiquiátricos/história , Hospitais Estaduais/história , Medicina Estatal/história , Inglaterra , Política de Saúde/história , Política de Saúde/legislação & jurisprudência , História do Século XX , História do Século XXI , Hospitais Psiquiátricos/organização & administração , Humanos , Serviços de Saúde Mental/história , Serviços de Saúde Mental/legislação & jurisprudência , Medicina Estatal/organização & administração
7.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(4): 201-205, jul.-ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-199467

RESUMO

INTRODUCCIÓN: El objetivo del estudio fue analizar la tendencia en el porcentaje de hospitalizaciones psiquiátricas en población mayor, así como, estudiar las características de la población mayor ingresada en una unidad de hospitalización psiquiátrica. MATERIAL Y MÉTODOS: Se analizaron las tendencias en los porcentajes de altas de población mayor a nivel nacional y de los porcentajes de ingresos de la Unidad de Hospitalización de Salud Mental (UHSM) del Hospital Regional Universitario de Málaga durante un periodo de al menos 18años mediante regresión segmentada. Para el estudio de las características de la población mayor ingresada se compararon todos los pacientes (n=5.925) y los episodios de ingreso (n=15.418) consecutivos entre los años 1999 y 2017 en la UHSM. RESULTADOS: A nivel nacional hubo un incremento de las altas hospitalarias por trastorno mental en personas mayores con un significativo cambio de porcentaje anual medio del 2,0%. En la unidad de estudio esta población fue en mayor medida de género femenino, admitida de forma involuntaria y tuvo un tiempo de estancia mayor. Presentaron con más frecuencia trastornos mentales de tipo orgánico y trastorno depresivo y con menor frecuencia esquizofrenia, trastornos por consumo de sustancias y trastornos de personalidad. CONCLUSIONES: Hubo una tendencia creciente en el porcentaje de personas mayores con hospitalizaciones psiquiátricas en el periodo de estudio. Estos resultados alertan sobre el aumento de admisiones de esta población en las unidades de hospitalización de psiquiatría y la necesidad de adaptación de estas unidades a las características particulares de estos pacientes


BACKGROUND: The aim of this study was to analyse the trend in the percentages of elderly patients admitted to hospital for psychiatric reasons. An additional aim was to analyse the characteristics of the elderly population admitted to a psychiatric hospitalisation unit. Material an METHODS: An analysis was made of the trends in the percentages of discharges in elderly population at the national level and in the Mental Health Hospitalisation Unit (MHHU) of the Regional University Hospital of Malaga for a period of at least 18years using segmented regression. For the study of the characteristics of the elderly population, all patients (N=5,925) and consecutive episodes of admission (N=15,418) were compared between 1999 and 2017 in the MHHU. RESULTS: At the national level, there was an increase in hospital discharges in elderly patients with a significant mean annual percent change of 2.0%. In the study unit, the elderly population were more frequently female, involuntarily admitted, and had a longer hospital stay. They had been diagnosed more frequently with organic and depressive mental disorders, and less frequently with schizophrenia, substance use, and personality disorders. CONCLUSIONS: There was a growing trend in the percentage of elderly psychiatric patients admitted to hospitals during the study period. These results point to the increase in elderly psychiatric admissions and thus the need to adapt psychiatric units to the characteristics of this population


Assuntos
Humanos , Masculino , Feminino , Idoso , Transtornos Mentais/epidemiologia , Envelhecimento , Fragilidade/epidemiologia , Tratamento Involuntário/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Hospitais Psiquiátricos/organização & administração , Unidades Hospitalares/organização & administração , Alta do Paciente/estatística & dados numéricos , Estudos Retrospectivos
8.
Global Health ; 16(1): 53, 2020 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-32580774

RESUMO

During the COVID-19 pandemic, as a large city located in Southwest China, Chengdu was mainly affected by imported cases. For a psychiatric hospital, the enclosed management model, the crowded wards and the uncooperative patients are the risk factors of nosocomial infection. Admitting new patients while preventing the COVID-19 outbreak within the institutions was a crucial challenge. The Mental Health Centre of Chengdu proposed a series of effective management strategies to deal with the rapidly evolving situation during the COVID-19 pandemic which included regulation for the inpatients, their families and staff, and achieved Zero infection in our hospital.


Assuntos
Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Hospitais Psiquiátricos/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
9.
Can J Psychiatry ; 65(10): 695-700, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32573397

RESUMO

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic presents major challenges to places of detention, including secure forensic hospitals. International guidance presents a range of approaches to assist in decreasing the risk of COVID-19 outbreaks as well as responses to manage outbreaks of infection should they occur. METHODS: We conducted a literature search on pandemic or outbreak management in forensic mental health settings, including gray literature sources, from 2000 to April 2020. We describe the evolution of a COVID-19 outbreak in our own facility, and the design, and staffing of a forensic isolation unit. RESULTS: We found a range of useful guidance but no published experience of implementing these approaches. We experienced outbreaks of COVID-19 on two secure forensic units with 13 patients and 10 staff becoming positive. One patient died. The outbreaks lasted for 41 days on each unit from declaration to resolution. We describe the approaches taken to reduction of infection risk, social distancing and changes to the care delivery model. CONCLUSIONS: Forensic secure settings present major challenges as some proposals for pandemic management such as decarceration or early release are not possible, and facilities may present challenges to achieve sustained social distancing. Assertive testing, cohorting, and isolation units are appropriate responses to these challenges.


Assuntos
Infecções por Coronavirus/terapia , Deficiências do Desenvolvimento/terapia , Psiquiatria Legal , Hospitais Psiquiátricos , Isolamento de Pacientes , Pneumonia Viral/terapia , Transtornos Psicóticos/terapia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Idoso , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Deficiências do Desenvolvimento/epidemiologia , Feminino , Hospitais Psiquiátricos/organização & administração , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Pandemias/prevenção & controle , Isolamento de Pacientes/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Transtornos Psicóticos/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
10.
Bull World Health Organ ; 98(6): 426-430, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32514217

RESUMO

Problem: In Latvia, the move towards community-based mental health-care services has been slow. Approach: The hospital managers of the only psychiatric hospital in Riga decided to establish two community-based clinics that were financially and administratively integrated with the hospital. The clinics were established using a step-wise approach by redistributing resources, including psychiatrists, nurses and beds, from the hospital to the new clinics. In 2005, the Veldre clinic started outpatient consultations and day care admissions. In 2009, Pardaugava clinic opened as an outpatient clinic. In 2012, an open-door inpatient ward with 30 beds was transferred from the psychiatric hospital to Veldre. In 2013, Pardaugava clinic opened a day care clinic and an open-door inpatient ward, transferring 26 beds from the psychiatric hospital. Local setting: Latvians have worse mental health indicators than those of the average population in Europe. Mental care has traditionally focused on inpatient care. Relevant changes: The clinics are now providing most of the outpatient services and the number of inpatients treated at the hospital has declined from 5696 patients in 2004 to 4957 patients in 2018. Patients are treated in a more open and patient-centred environment. Lessons learnt: The administrative and financial integration of the new community-based clinics within the existing structures of the hospital is a successful approach. Transferring resources to the clinics seems to have improved the quality of care without requiring additional funding apart from the initial investment costs. Involving the staff members during the planning phase reduced resistance to the project.


Assuntos
Serviços Comunitários de Saúde Mental/organização & administração , Hospitais Psiquiátricos/organização & administração , Instituições de Assistência Ambulatorial/organização & administração , Humanos , Letônia , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia
11.
Salud trab. (Maracay) ; 28(1): 47-60, jun. 2020. tab, ilus
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1104337

RESUMO

En Uruguay, la información sobre absentismo laboral en trabajadores vinculados a la salud mental ha presentado dificultades en su sistematización. Surge entonces, la posibilidad de abordar dicha problemática en el único hospital psiquiátrico público del país, dado el interés de autoridades, profesionales y constatar la existencia de mejoras en la calidad de los registros institucionales. Objetivo general: Caracterizar el absentismo laboral en trabajadores del hospital psiquiátrico Vilardebó de Montevideo, durante el año 2013, según certificaciones médicas. Metodología: Convergen aspectos exploratorios, descriptivos y correlaciones, bajo un diseño cuantitativo, no experimental, transversal, retrospectivo. Resultados: El mayor ausentismo laboral se observó en el turno matutino, en mujeres auxiliares de enfermería; sin embargo, los mayores ausentismos días promedio se dieron en hombres por causa de salud mental. Asimismo, 33, 6% de la población estudiada presentó más de 2 certificaciones. Dado el Test Chi-Cuadrado se constató la no independencia entre: motivo de certificación en función del turno y/o cargo del trabajador/a. Discusión: algunos de los resultados se reconocen en otros estudios; siendo uno de los primeros trabajos en la materia se sugiere la realización de nuevas investigaciones con el fin de observar la dinámica temporal del fenómeno estudiado, dadas sus implicancias individuales, colectivas, asistenciales e institucionales(AU)


In Uruguay, the systematic gathering of information on worker absenteeism due to mental health has been difficult. We had an opportunity to address this problem in the only public psychiatric hospital in the country, given the interest of authorities, professionals on verifying improvements in the quality of institutional records. Overall objective. To describe the medical certifications of workers of the Vilardebó psychiatric hospital in Montevideo in 2013. Methodology. Approach that brings together exploratory, descriptive and correlation aspects, using a quantitative, nonexperimental, cross-sectional, retrospective study design. Results. The greatest absenteeism from work was observed in the morning shift among female nursing assistants; however, the highest average number of absenteeism days 33.6% of the study population had more than two medical certifications. Based on chi-square statistics, non-independence was found between the reason for medical certification depending on the shift and / or job title of the worker. Discussion. Some of the results are consistent with prior studies. However, being one of the first studies on this subject, more research is needed to further examine the temporal dynamics of these observations, given their individual, collective, healthcare and institutional implications(AU)


Assuntos
Uruguai , Sistema Único de Saúde , Saúde Mental , Absenteísmo , Hospitais Psiquiátricos/organização & administração , Estudos Transversais , Categorias de Trabalhadores
12.
Ir J Psychol Med ; 37(3): 172-177, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32456715

RESUMO

The COVID-19 pandemic poses a particular set of challenges for health services. Some of these are common across all services (e.g. strategies to minimise infections; timely testing for patients and staff; and sourcing appropriate personal protective equipment (PPE)) and some are specific to mental health services (e.g. how to access general medical services quickly; how to safely deliver a service that traditionally depends on intensive face to face contact; how to isolate someone who does not wish to do so; and how to source sufficient PPE in the face of competing demands for such equipment). This paper describes how St Patrick's Mental Health Services (SPMHS) chose to address this unfolding and ever-changing crisis, how it developed its strategy early based on a clear set of objectives and how it adapted (and continues to adapt) to the constantly evolving COVID-19 landscape.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Hospitais Psiquiátricos/organização & administração , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/métodos , Humanos , Irlanda , Equipamento de Proteção Individual
13.
Encephale ; 46(3S): S81-S84, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32471705

RESUMO

OBJECTIVES: The sudden changes of healthcare system due to COVID-19 particularly affect the organization of psychiatry. The objective of this review is to examine the adaptations of psychiatric care in France during this pandemic. METHOD: This narrative review is based on the observation of changes made in French psychiatric hospitals and on an analysis of the literature. RESULTS: Regarding psychiatric hospitalization, the COVID-19 epidemic required rapid measures that profoundly modified the conditions of patients' reception, forcing the medical staffs to adapt their methods of care. The authors noted the creation of at least 89 wards specifically dedicated to patients with COVID-19 needing psychiatric hospitalization, allowing dual care of general medicine and psychiatry. Regarding ambulatory care, maintaining patients with long-term follow-up was a priority. Patients recalling and teleconsultation have been precious resources but cannot entirely replace face-to-face consultations. DISCUSSION: COVID-19 epidemic created unprecedented situation of large-scale upheavals in the healthcare system and in society. Despite the absence of previous recommendations on the subject, French psychiatry has shown great adaptability. Some changes could inspire post-COVID-19 care.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Reestruturação Hospitalar , Hospitais Psiquiátricos/organização & administração , Serviços de Saúde Mental/organização & administração , Pandemias , Pneumonia Viral , Psicoterapia/organização & administração , Assistência Ambulatorial/organização & administração , Conversão de Leitos , França/epidemiologia , Pessoal de Saúde/psicologia , Acesso aos Serviços de Saúde , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Serviços de Saúde Mental/provisão & distribução , Saúde do Trabalhador , Quartos de Pacientes , Psicoterapia/estatística & dados numéricos , Mudança Social , Estresse Psicológico/etiologia , Estresse Psicológico/terapia , Telemedicina
14.
Encephale ; 46(3S): S40-S42, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32370981

RESUMO

The recent COVID-19 pandemic has led to major organisational changes in health care settings, especially in psychiatric hospitals. We conducted a national online survey to assess the evolution of electroconvulsive therapy (ECT) in the different centres practicing this treatment. 65 responses from all over France were analysed. More than 90 % of the centres practising ECT experienced a decrease in their activity. Half of the centres experienced a total cessation of activity and 25 % of the centres experienced a decrease of more than half of their usual activity. Post-pandemic COVID-19 psychiatric care is expected to be difficult. It is essential not to add to this difficulty the complications, often serious, that will be associated with delaying or stopping the practice of ECT. It will also be necessary to remain vigilant with regard to the specific neuropsychiatric consequences that will follow the pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Eletroconvulsoterapia/tendências , Hospitais Psiquiátricos/organização & administração , Pandemias , Pneumonia Viral , Transtorno Bipolar/terapia , Controle de Doenças Transmissíveis , Continuidade da Assistência ao Paciente , Assistência à Saúde , Transtorno Depressivo/terapia , Eletroconvulsoterapia/estatística & dados numéricos , França , Humanos , Utilização de Procedimentos e Técnicas
15.
Encephale ; 46(3): 193-201, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32370982

RESUMO

OBJECTIVE: The lack of resources and coordination to face the coronavirus epidemic raises concerns for the health of patients with mental disorders in a country where we still have memories of the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims to propose guidance to ensure mental health care during the SARS-CoV epidemic in France. METHODS: The authors performed a narrative review identifying relevant results in the scientific and medical literature and in local initiatives in France. RESULTS: We identified four types of major vulnerabilities among patients with mental disorders during this pandemic: (1) medical comorbidities that are more frequently found among patients with mental disorders (cardiovascular and pulmonary pathologies, diabetes, obesity, etc.) which are risk factors for severe covid-19 infection; (2) age (the elderly form the population most vulnerable to the coronavirus); (3) cognitive and behavioural disorders, which can hamper compliance with confinement and hygiene measures and finally and (4) psychosocial vulnerability as a result of stigmatization and/or socio-economic difficulties. Furthermore, the mental health healthcare system is more vulnerable than other healthcare systems. Current government plans are poorly suited to psychiatric establishments in a context of major shortages of organizational, material and human resources. In addition, a certain number of structural aspects make the psychiatric institution particularly vulnerable: many beds have been closed, wards have high densities of patients, mental health community facilities are closed, and medical teams are understaffed and poorly trained to face infectious diseases. There are also major issues when referring patients with acute mental disorders to intensive care units. To maintain the continuity of psychiatric care in this pandemic situation, several directions can be considered, in particular with the creation of "COVID+ units". These units are under the dual supervision of a psychiatrist and an internist/infectious disease specialist; all new entrants are placed in quarantine for 14 days; the nursing staff receives specific training, daily medical check-ups and close psychological support. Family visits are prohibited and replaced by videoconference. At the end of hospitalization, in particular for the population of patients in compulsory ambulatory care situations, specific case-management are organized with the possibility of home visits, in order to support patients when they get back home and to help them cope with the experience of confinement, which is liable to induce recurrences of mental disorders. The total or partial closure of community mental health facilities is particularly disturbing for patients, but a regular follow-up is possible with telemedicine and should include the monitoring of suicide risk and psycho-education strategies; developing support platforms could also be very helpful in this context. Private practice psychiatrists also have a crucial role of information towards their patients on confinement and barrier measures, and also on measures to prevent the psychological risks inherent in confinement: maintenance of regular sleep r, physical exercise, social interactions, stress management and coping strategies, prevention of addictions, etc. They should also be trained to prevent, detect and treat early warning symptoms of post-traumatic stress disorder, because their prevalence was high in the regions of China most affected by the pandemic. DISCUSSION: French mental healthcare is now facing a great and urgent need for reorganization and must also prepare in the coming days and weeks to face an epidemic of emotional disorders due to the confinement of the general population.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Transtornos Mentais/terapia , Saúde Mental , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Idoso , Idoso de 80 Anos ou mais , Epidemias , França/epidemiologia , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/normas , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/prevenção & controle , Pandemias , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/terapia , Quarentena/psicologia , Quarentena/estatística & dados numéricos , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Suicídio/prevenção & controle , Suicídio/estatística & dados numéricos
16.
Encephale ; 46(3S): S3-S13, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32312567

RESUMO

OBJECTIVE: The lack of ressources and coordination to face the epidemic of coronavirus raises concerns for the health of patients with mental disorders in a country where we keep in memory the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims at proposing guidance to ensure mental health care during the SARS-CoV epidemy in France. METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature and local initiatives in France. RESULTS: We identified four types of major vulnerabilities in patients suffering from mental disorders during this pandemic: (1) medical comorbidities that are more frequently found in patients suffering from mental disorders (cardiovascular and pulmonary pathologies, diabetes, obesity, etc.) which represent risk factors for severe infections with Covid-19; (2) age (the elderly constituting the population most vulnerable to coronavirus); (3) cognitive and behavioral troubles which can hamper compliance with confinement and hygiene measures and finally and (4) psychosocial vulnerability due to stigmatization and/or socio-economic difficulties. Furthermore, the mental health healthcare system is more vulnerable than other healthcare systems. Current government plans are poorly adapted to psychiatric establishments in a context of major shortage of organizational, material and human resources. In addition, a certain number of structural aspects make the psychiatric institution particularly vulnerable: many beds are closed, wards have a high density of patients, mental health community facilities are closed, medical teams are understaffed and poorly trained to face infectious diseases. We could also face major issues in referring patients with acute mental disorders to intensive care units. To maintain continuity of psychiatric care in this pandemic situation, several directions can be considered, in particular with the creation of Covid+ units. These units are under the dual supervision of a psychiatrist and of an internist/infectious disease specialist; all new entrants should be placed in quarantine for 14 days; the nurse staff should benefit from specific training, from daily medical check-ups and from close psychological support. Family visits would be prohibited and replaced by videoconference. At the end of hospitalization, in particular for the population of patients in compulsory ambulatory care situations, specific case-management should be organized with the possibility of home visits, in order to support them when they get back home and to help them to cope with the experience of confinement, which is at risk to induce recurrences of mental disorders. The total or partial closure of mental health community facilities is particularly disturbing for patients but a regular follow-up is possible with telemedicine and should include the monitoring of the suicide risk and psychoeducation strategies; developing support platforms could also be very helpful in this context. Private psychiatrists have also a crucial role of information with their patients on confinement and barrier measures, but also on measures to prevent the psychological risks inherent to confinement: maintenance of sleep regularity, physical exercise, social interactions, stress management and coping strategies, prevention of addictions, etc. They should also be trained to prevent, detect and treat early warning symptoms of post-traumatic stress disorder, because their prevalence was high in the regions of China most affected by the pandemic. DISCUSSION: French mental healthcare is now in a great and urgent need for reorganization and must also prepare in the coming days and weeks to face an epidemic of emotional disorders due to the containment of the general population.


Assuntos
Betacoronavirus , Continuidade da Assistência ao Paciente/organização & administração , Infecções por Coronavirus/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Assistência ao Convalescente , Fatores Etários , Idoso de 80 Anos ou mais , Antivirais/farmacocinética , Antivirais/uso terapêutico , Criança , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/terapia , Comorbidade , Infecções por Coronavirus/psicologia , Interações Medicamentosas , França/epidemiologia , Unidades Hospitalares/organização & administração , Hospitais Psiquiátricos/organização & administração , Humanos , Controle de Infecções/métodos , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Serviços de Saúde Mental/provisão & distribução , Equipe de Assistência ao Paciente , Cooperação do Paciente , Pneumonia Viral/psicologia , Prisioneiros/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Estresse Psicológico/etiologia , Estresse Psicológico/terapia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Suicídio/prevenção & controle , Populações Vulneráveis
18.
Rev Bras Enferm ; 73(1): e20170864, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049217

RESUMO

OBJECTIVE: to analyze a Psychosocial Care Network structure, based on the compromise of its resources and meeting objectives and guidelines recommended in Ordinance 3,088/2011. METHOD: an empirical, quantitative study with 123 primary care professionals, psychosocial and emergency care, who work at Western Network of the city of São Paulo. Questionnaires and statistical analysis were applied through the Exact Fisher's test with 5% significance considering p= <0.05. RESULTS: there is compromise of physical resources in the absence of mental health beds in a general hospital (p=0.047); of technological resources in the lack of discussion forums (p=0.036); of human resources in number of teams (p=0.258); and of financial resources (p=0.159). Psychosocial care is the one that most meets the objectives and guidelines. CONCLUSION: there are insufficient physical, technological, human, and financial resources for the work articulated in the three care modalities that are heterogeneous in terms of meeting the objectives and guidelines.


Assuntos
Redes Comunitárias/tendências , Recursos em Saúde/tendências , Sistemas de Apoio Psicossocial , Brasil , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Inquéritos e Questionários
19.
Rev Bras Enferm ; 73(1): e20180175, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049233

RESUMO

OBJECTIVE: To analyze the practices developed by nursing professionals in a Psychosocial Care Center (CAPS). METHOD: A qualitative and evaluative research based on the Fourth Generation Assessment and conducted in a CAPS II of Santa Catarina State in 2014. For data collection, semi-structured interviews, field observation, and data recycling group were used with workers. Constant Comparative Method was used for data analysis. RESULTS: Practices aimed at the subject and their clinical, social, prevention, treatment and articulation with the health network were identified. Medication care is a specificity of nursing that aims to promote autonomy and social reintegration. There is a need for greater articulation between the nursing and pharmacy staff, as well as creating spaces for users to talk about medication. CONCLUSION: Nursing practices are focused on biopsychosocial care, aiming to deconstruct care models focused on the disease and symptoms.


Assuntos
Processo de Enfermagem/tendências , Enfermagem Psiquiátrica/métodos , Brasil , Hospitais Psiquiátricos/organização & administração , Humanos , Entrevistas como Assunto/métodos , Enfermagem Psiquiátrica/tendências , Pesquisa Qualitativa
20.
Rev Bras Enferm ; 73(1): e20180519, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049249

RESUMO

OBJECTIVE: to comprehend the existing possibilities for the exercise of human rights by persons with mental disorders who are institutionalized in a psychiatric hospital, from the perception of professionals. METHOD: this is a qualitative descriptive-exploratory study conducted at a Psychiatric Hospital in the state of São Paulo, Brazil. For data obtention, eleven professionals responded to a semistructured questionnaire. The traditional content analysis proposed by Bardin based the data analysis. RESULTS: the professionals know the human rights and try to preserve them in the hospital scope, although they recognize that the persons hospitalized are not entirely respected due to the lack of public policies or their non-suitability to the Brazilian reality. FINAL CONSIDERATIONS: the structuring of extra-hospital services is necessary, as well as the comprehension of the professionals that act in psychiatric hospitals about the objectives and the functioning of such devices to assure opportunities of exercising rights by institutionalized persons.


Assuntos
Direitos Humanos/psicologia , Institucionalização/ética , Percepção , Brasil , Política de Saúde , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/normas , Hospitais Psiquiátricos/estatística & dados numéricos , Direitos Humanos/normas , Direitos Humanos/tendências , Humanos , Institucionalização/tendências , Pesquisa Qualitativa
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