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1.
PLoS One ; 15(5): e0233015, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32421731

RESUMO

AIM: To identify potential predictors of community integration in individuals after stroke using a residential setting-based strategy. METHOD: A prospective cohort of post-stroke individuals was recruited from the Stroke Unit of the Roberto Santos General Hospital (UAVC-HGRS). All included individuals were aged over 18 years, received a diagnosis of ischemic stroke confirmed by neuroimaging and resided in the city of Salvador (Bahia, Brazil). Following discharge from the stroke unit, the individuals themselves, or their responsible parties, were contacted by telephone to schedule a home visit no less than three months after discharge. All subjects were examined in their homes, at which time the Community Integration Questionnaire (CIQ) was also applied. A robust linear regression model was used to assess community reintegration using CIQ score as the outcome variable. RESULTS: A total of 124 individuals effectively fulfilled the eligibility criteria: 51.6% were females, the median (IQR) age was 63(53-69) years, 82.3% were non-white, 53.2% were married, the median (IQR) of years of schooling was 6 (4-12) and family income averaged two minimum monthly wages. Investigated individuals presented a median (IQR) NIH Stroke Scale (NIHSS) score of 7 (4-12). Multivariate linear regression identified the following independent predictors of community integration: age (ß = -0.095; 95% CI = -0.165 to -0.025; p = 0.008), diabetes mellitus (ß = -2.348; 95% CI = -4.125 to -0.571; p = 0.010), smoking habit (ß = -2.951; 95% CI = -5.081 to -0.821; p = 0.007), functional capacity upon hospital discharge (ß = 0.168; 95% CI = 0.093 to 0.242; p = <0.001) and stroke severity (ß = -0.163; CI = -0.318 to -0.009); p = 0.038). CONCLUSIONS: Regardless of length of time since stroke, individuals present restrictions that compromise their reintegration into their respective communities. The demographic, clinical and functional factors identified herein as potential predictors should be considered when conducting regular follow-up, as well as in the rehabilitation of individuals after stroke with the purpose to identify the interventions necessary to optimize their reintegration into the community.


Assuntos
Integração Comunitária/psicologia , Qualidade de Vida/psicologia , Acidente Vascular Cerebral/psicologia , Atividades Cotidianas , Idoso , Brasil , Feminino , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Estudos Prospectivos , Fatores Socioeconômicos , Inquéritos e Questionários
2.
NeuroRehabilitation ; 46(2): 243-253, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083599

RESUMO

BACKGROUND: The primary goal of neurorehabilitation for individuals with acquired brain injury (ABI) is successful community reintegration, which commonly focuses on home independence, productivity, and social engagement. Previous research has demonstrated that holistic treatment approaches have better long-term outcomes than other treatment approaches. Holistic approaches go beyond the fundamental components of neurorehabilitation and address metacognition and self-awareness, as well as interpersonal and functional skills. OBJECTIVES: The present study aimed to examine community reintegration of individuals with ABI who completed holistic milieu-oriented neurorehabilitation at the Center for Transitional Neuro-Rehabilitation (CTN), Barrow Neurological Institute (BNI) at up to 30-years post-discharge. We evaluated (a) functional independence, (b) productivity and driving status, and (c) psychosocial profiles of the brain injury survivors. METHOD: Participants included 107 individuals with ABI with heterogeneous etiologies who attended holistic milieu-oriented neurorehabilitation between 1986 and 2016. These participants completed the Mayo-Portland Adaptability Inventory-4 (MPAI-4) and a long-term outcome questionnaire (LOQ) specifically developed for this study. RESULTS: The results demonstrate that 89% of participants were productive at up to 30 years post-discharge (73% engaged in competitive work and/or school) after excluding the retired participants. Almost all of the participants who were engaged in work and/or school reported using compensatory strategies on a long-term basis. Furthermore, only 14% out of 102 study participants were driving at the time of program admission; whereas 58% out of 96 were driving at the time of discharge; and impressively, 70% out of 107 participants were driving at the time of follow-up. Regression analyses revealed that older age at the time of injury, shorter duration between injury and treatment, and better functionality indicated by lower MPAI-4 Ability Index scores significantly predicted a return to driving status at the time of study participation. Psychosocial data from the LOQ revealed positive findings with respect to patients' marital status, living situation, income, and quality of social life. CONCLUSION: The findings from this study suggest that functional gains made during holistic neurorehabilitation have enduring effects and that patients can benefit highly from holistic milieu therapy beyond the early post-acute phases of their recovery. Additionally, they provide evidence that there is potential to return to driving, years after treatment completion.Our holistic milieu treatment approach addressing metacognition, self-awareness, social and coping skills training, and actively transitioning to community settings, is thought to have contributed to the exceptional and long-lasting outcomes in this study.


Assuntos
Lesões Encefálicas/psicologia , Lesões Encefálicas/reabilitação , Integração Comunitária/psicologia , Saúde Holística/tendências , Reabilitação Neurológica/tendências , Alta do Paciente/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Condução de Veículo/psicologia , Integração Comunitária/tendências , Aconselhamento/métodos , Aconselhamento/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Neurológica/métodos , Fatores de Tempo , Adulto Jovem
3.
NeuroRehabilitation ; 46(2): 195-204, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083601

RESUMO

BACKGROUND: A stroke event, sometimes referred to as a cerebrovascular accident (CVA), is a sudden and often traumatic life event that results in life-changing consequences with which affected people must cope. There are nearly 800,000 instances of stroke annually in the U.S. (American Heart Association, 2018). Stroke is the leading cause of disability in adults, and more than one-third of people who survive a stroke will have severe disability in the U.S. (Mayo, 2005). Between 35% and 75% of stroke survivors will have significant cognitive impairment (Tatemichi et al., 1994; Nys et al., 2007). An estimated one-third of people suffer depression after stroke (Hackett et al., 2005), about one-fourth experience significant anxiety (Barker-Collo, 2007), and about one-fifth suffer from insomnia (Leppavuoria et al., 2002). These and other stroke-related psychological issues negatively influence rehabilitation and outcomes through a variety of mechanisms. For example, post-stroke depression has been shown to be related to more negative functional consequences (Kneebone et al., 2000; Matsuzaki et al., 2015). Psychological disturbances may affect rehabilitation outcomes through a reduction in adherence to home exercise programs, reduced energy level, increased fatigue, reduced frustration tolerance, and potentially less motivation and hope about the future. OBJECTIVES: This manuscript aims to identify and describe the role of rehabilitation psychology in treating these common post-stroke complaints and, ultimately, optimizing post-stroke outcomes via two case examples. METHODOLOGY: This manuscript describes two cases of individuals in post-acute rehabilitation who had psychological issues which were negatively affecting outcomes. CONCLUSION: Given the abrupt and significant life-changing nature of stroke, it is often necessary to manage a diverse array of psychological issues that often cannot be simply managed via psychotropic medications. Moreover, an understanding of the patients' emotional adjustment and issues can help them maximize their rehabilitation, recovery, and community integration. For the cases discussed, psychology consultations were central in helping optimize their rehabilitation and functional outcomes.


Assuntos
Reabilitação do Acidente Vascular Cerebral/psicologia , Acidente Vascular Cerebral/psicologia , Acidente Vascular Cerebral/terapia , Adulto , Ansiedade/etiologia , Ansiedade/psicologia , Ansiedade/reabilitação , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/reabilitação , Integração Comunitária/psicologia , Depressão/etiologia , Depressão/psicologia , Depressão/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Estresse Psicológico/reabilitação , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento
4.
Soc Psychiatry Psychiatr Epidemiol ; 55(1): 89-99, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31300892

RESUMO

PURPOSE: Despite increasing legal protections and supportive attitudes toward sexual minorities (e.g., those who identify as lesbian, gay, and bisexual [LGB]) in recent decades, suicidality remains more common among this population than among heterosexuals. While barriers to societal integration-or a lack of meaning, purpose, and belonging as derived from societal norms, goals, and attachment-have been widely theorized as determinants of suicidality for the general population, they have not been comprehensively explored to explain the sexual orientation disparity in suicidality. The aim of this study was to examine differences in suicidal ideation and attempts between LGB and heterosexual individuals in a nationally representative sample, and to examine barriers to societal integration as a potential explanation for any observed disparities over-and-above the influence of established contributors to sexual orientation disparity in suicidality. METHODS: Data come from the cross-sectional Swedish National Public Health Survey, which collected data from unrestricted random samples of individuals (16-84 years of age) living in Sweden, annually from 2010 to 2015 (n = 57,840 individuals [response rates: 48.1-51.3%]; 1281 (2.2%) self-identified as LGB). Analyses examined sexual orientation differences in suicidality (i.e., past-12-month ideation and attempts), and explored the role of barriers to societal integration (i.e., not living with a partner or children, unemployment, and lack of societal trust) in explaining this disparity over-and-above more commonly explored psychological (e.g., depression, substance use) and interpersonal (e.g., discrimination, victimization, lack of social support) suicidality risk factors. RESULTS: Compared to heterosexuals, suicidal ideation and attempts were more common among both gay men/lesbians (adjusted odds ratio [AOR] for suicide ideation: 2.69; 95% confidence intervals [CI]: 2.09, 3.47; AOR for suicide attempts: 5.50; 95% CI: 3.42, 8.83), and bisexuals (AOR for suicide ideation: 3.83; 95% CI: 3.26, 4.51; AOR suicide attempts: 6.78; 95% CI: 4.97, 9.24). Barriers to societal integration mediated the association between sexual orientation and suicidality even in models adjusting for established risk factors for suicidality. CONCLUSION: Our results suggest that previously under-examined factors, namely the disproportionate barriers to societal integration that LGB individuals experience, are important contributors to the substantially elevated risk of suicidality among sexual minorities. Preventive interventions should consider innovative ways to foster societal integration within sexual minority populations and to adjust hetero-centric social institutions to better include sexual minority individuals.


Assuntos
Integração Comunitária/psicologia , Disparidades nos Níveis de Saúde , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Heterossexualidade/psicologia , Heterossexualidade/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Minorias Sexuais e de Gênero/psicologia , Apoio Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Suécia/epidemiologia , Adulto Jovem
5.
J Pastoral Care Counsel ; 73(2): 106-114, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31189446

RESUMO

The significance of the body has emerged as a vital yet neglected element in the transition from military to civilian life. The recognition of a military body enhances the understanding of potential pastoral and counseling needs among veterans beyond the mind and the soul. This article attempts to contribute to further knowledge about this topic, drawing from both theory and empirical research, in an effort to provide insights for pastoral care and counseling.


Assuntos
Integração Comunitária/psicologia , Aconselhamento , Assistência Religiosa , Veteranos/psicologia , Feminino , Humanos , Masculino
6.
Top Spinal Cord Inj Rehabil ; 25(2): 164-185, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31068748

RESUMO

Background: Various injury characteristics such as cause, level, severity, and time since injury divide individuals with spinal cord injury (SCI) into many subgroups. The heterogeneity among individuals' injuries and personal characteristics has significant implications for SCI rehabilitation practice, specifically directed toward community reintegration, which is a key goal of rehabilitation interventions for people with disabilities. Purpose: This study aims to summarize the evidence on attributes that make the SCI population heterogeneous, the impact of these attributes on community reintegration, and the implications of heterogeneity for rehabilitation interventions directed toward optimizing community reintegration. Methods: We used an integrative review approach to conduct this study. MEDLINE, PubMed, CINAHL, EMBASE, Google Scholar, and PsycINFO were searched from inception until May 2017. Out of 670 articles retrieved, 49 provided evidence on the impact of various attributes that make SCI heterogeneous on rehabilitation outcomes related to community reintegration. Results: An array of injury-related, personal, social, and environmental factors are associated with various rehabilitation outcomes that affect community reintegration of people with SCI. There is level 1 evidence that social support, self-efficacy, and self-esteem facilitate community reintegration among people with SCI while there is level 5 evidence that presence of psychological or medical complications decreases it. There is lack of clarity on the impact of injury-related factors on community reintegration. Conclusion: This integrative review found that social support and individuals' self-efficacy can improve community reintegration of people with SCI. However, evidence regarding the impact of injury characteristics on community reintegration is still underdeveloped. Approaches directed at community reintegration should involve components of psychosocial, physical, and vocational rehabilitation while considering personal and societal aspects of an individual's life.


Assuntos
Adaptação Psicológica/fisiologia , Integração Comunitária/psicologia , Traumatismos da Medula Espinal/reabilitação , Atitude Frente a Saúde , Planejamento Ambiental , Acesso aos Serviços de Saúde , Humanos , Características de Residência , Autoimagem , Apoio Social , Traumatismos da Medula Espinal/psicologia
7.
Afr J Prim Health Care Fam Med ; 11(1): e1-e8, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31038341

RESUMO

BACKGROUND: The South African health system has policies and strategies to ensure effective rehabilitation and reintegration of individuals who have survived a cerebrovascular accident into their respective communities. However, implementation of such guidelines remains an issue. AIM: This study sought to explore cerebrovascular accident (CVA) survivors' experiences of community integration. SETTING: The study was located in a peri-urban community within the KwaZulu-Natal Province, South Africa. METHODS: An explorative qualitative study with eight purposively selected CVA survivors was conducted via semi-structured individual interviews. Data were audio-recorded and manually transcribed prior to thematic analysis. Trustworthiness of the study was maintained by strategies such as analyst triangulation, an audit trail and use of thick descriptions. Ethical principles of autonomy, informed consent, confidentiality and privacy were also maintained in the study. RESULTS: Six themes emerged that highlighted (1) loss of autonomy and roles, (2) barriers to community reintegration, (3) social isolation of participants, (4) finding internal strength, (5) enablers of community reintegration including the positive influence of support and the benefits derived from rehabilitation and (6) recommendations for rehabilitation. CONCLUSION: The study revealed both positive and negative influences that impact CVA survivors' ability to effectively reintegrate into their respective communities following a CVA. Recommendations include the need for education and awareness around access to rehabilitation services for CVA survivors, advice on how to improve CVA survivors' ability to mobilise in the community and make environmental adaption to facilitate universal access, provision of home programmes and caregiver training for continuity of care and for inclusion of home-based rehabilitation into current models of care.


Assuntos
Integração Comunitária/psicologia , Acidente Vascular Cerebral/psicologia , Sobreviventes/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , África do Sul , Cuidado Transicional , População Urbana
8.
Phys Med Rehabil Clin N Am ; 30(1): 43-54, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30470428

RESUMO

The Department of Veterans Affairs Polytrauma Transitional Rehabilitation Program was established to extend the rehabilitation of veterans and active duty service members past the acute phase and reintegrate them into the community. Effective community reintegration is best achieved with a diverse interdisciplinary team that treats patients' physical, cognitive, and psychological deficits in a collaborative approach. Barriers, such as lack of accurate awareness of functional limitations and premorbid psychosocial stressors, can limit the recovery process. Recovery from polytrauma injuries is often a lifelong process, with the goal of maximizing functional independence and quality of life.


Assuntos
Integração Comunitária , Traumatismo Múltiplo/reabilitação , Cuidado Transicional , Integração Comunitária/psicologia , Humanos , Traumatismo Múltiplo/psicologia , Centros de Reabilitação , Estados Unidos , United States Department of Veterans Affairs , Veteranos
9.
Arch Phys Med Rehabil ; 100(3): 464-473, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30092203

RESUMO

OBJECTIVE: To investigate whether emotional intelligence (EI) skills measured via the Perceiving, Understanding, and Managing Emotions branches of the Mayer-Salovey-Caruso Emotional Intelligence Test V2.0 are associated with community integration (CI) and return to work (RTW) after moderate-to-severe acquired brain injury (ABI), after accounting for other established predictors. DESIGN: Retrospective cohort study. SETTING: Outpatient follow-up services within 2 specialist ABI rehabilitation centers in Melbourne, Australia. PARTICIPANTS: Individuals (N=82) with moderate-to-severe ABI discharged from inpatient rehabilitation and living in the community (2mo to 7y postinjury). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Community Integration Questionnaire scores for the total sample (N=82; age range 18-80) and RTW status (employed vs not employed) for the subset of participants employed prior to ABI (n=71; age range 19-66). RESULTS: Hierarchical logistic and multiple regression analyses were used to examine the unique contribution of Perceiving, Understanding, and Managing Emotions scores to RTW and CI, after controlling for demographic, injury-related, psychological, and cognitive predictors. As a set, the 3 EI variables did not explain incremental variance in outcomes. However, individually, Understanding Emotions predicted RTW (adjusted odds ratio=3.10, P=.03), χ2 (12)=35.52, P<.001, and Managing Emotions predicted CI (ß=0.23, P=.036), F12,69=5.14, P<.001. CONCLUSION: Although the EI constructs in combination did not improve prediction beyond the effects of established variables, individual components of strategic EI may be important for specific participation outcomes after ABI.


Assuntos
Lesões Encefálicas/psicologia , Integração Comunitária/psicologia , Inteligência Emocional , Retorno ao Trabalho/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Lesões Encefálicas/reabilitação , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem
10.
Apuntes psicol ; 37(1): 21-29, 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188343

RESUMO

Este artículo es producto de un estudio cuantitativo llevado a cabo con 150 sujetos residentes en España, entre los cuales figuran algunos presos del Centro Penitenciario de Málaga (n = 76) y algunos estudiantes de la Universidad de Málaga (n = 74). Tiene por objetivo observar fenómenos contemporáneos que están ampliando vulnerabilidad social y pensar la delincuencia a partir de ello. Las variables analizadas serán la satisfacción vital, el fatalismo, la participación social (comunitaria y política) y el sentido de comunidad. Los resultados de los análisis estadísticos indican que (1) la satisfacción vital en presos es inferior a la de universitarios; (2) el fatalismo y casi todas las dimensiones del sentido de comunidad son superiores en presos; (3) la participación política es superior en universitarios; (4) el sentido de comunidad predomina en el modelo de regresión de la satisfacción vital en presos (predicción positiva) a la vez que el fatalismo lo hace en universitarios (predicción negativa). También se verifican diferencias entre presos reincidentes y no reincidentes. Se discute la idea de crimen como "comunidad de resistencia", la relación negativa entre crimen y fatalismo (mediada por la exclusión social) y la instrumentalización de las relaciones comunitarias


This article is the result of a quantitative study carried out with 150 subjects living in Spain, among which are some prisoners of the Malaga Penitentiary Center (n = 76) and some students of the University of Málaga (n = 74). Its objective is to observe contemporary phenomena that are broadening social vulnerability and, based on that, reflect on crime. The variables analyzed will be life satisfaction, fatalism, social participation (community and political) and the sense of community. The results of the statistical analysis indicate that: 1. the life satisfaction of prisoners is lower than that of university students; 2. fatalism and almost all the dimensions of the sense of community are superior in prisoners; 3. political participation is higher in university students; 4. the sense of community predominates in the regression model of life satisfaction in prisoners (positive prediction) while fatalism does in university students (negative prediction). There are also differences between recidivist and non-recidivist prisoners. The following issues will also be discussed: the idea of crime as a "community of resistance", the negative relation between crime and fatalism (mediated by social exclusion) and the instrumentalization of community relations


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Relações Interpessoais , Integração Comunitária/psicologia , Satisfação Pessoal , Prisioneiros/psicologia , Estudantes/psicologia , Inquéritos e Questionários
12.
Rev. Asoc. Esp. Neuropsiquiatr ; 38(134): 515-545, jul.-dic. 2018.
Artigo em Espanhol | IBECS | ID: ibc-176433

RESUMO

Desde que apareció como rama de la medicina en la estela de la ilustración y la Revolución Francesa, la psiquiatría ha experimentado importantes transformaciones en el marco de diferentes cambios socioeconómicos y políticos ocurridos en las sociedades occidentales. En este contexto más amplio, puede observarse una tensión recurrente entre el interés del individuo y el del cuerpo social en su conjunto. Esta fricción está íntimamente relacionada con una serie de dinámicas contrapuestas que han marcado el desarrollo de la psiquiatría y la atención a la salud mental: humanización versus disciplina, emancipación versus coerción, inclusión versus exclusión y ciudadanía democrática versus sometimiento político. Este artículo aporta un análisis conceptual y una panorámica histórica de las ambivalentes relaciones entre la psiquiatría y la atención a la salud mental, por un lado, y la política, más en concreto, el desarrollo de la noción moderna de ciudadanía, por otro


Since its emergence as a branch of medicine in the wake of the Enlightenment and French Revolution, psychiatry has experienced significant transformations against the background of different socio-economic and political changes In Western societies. In this wider context we see a recurring tension between the interest of the individual and that of the social body as a whole. This friction is closely related to opposing dynamics in psychiatry and mental health care: humanisation versus disciplining, emancipation versus coercion, inclusion versus exclusion, and democratic citizenship versus political subjection. This article provides a conceptual analysis and an historical overview on the ambivalent relations between on the one hand psychiatry and mental health care and on the other politics, and, more particularly, the development of the modern understanding of citizenship


Assuntos
Humanos , Transtornos Mentais/psicologia , Defesa do Paciente/tendências , Integração Comunitária/psicologia , Individualidade , Direitos Civis/tendências , Desinstitucionalização/tendências , Participação da Comunidade , Política , Transtornos Psicóticos , Hospitais Psiquiátricos/história , Coerção
13.
Rev. Asoc. Esp. Neuropsiquiatr ; 38(134): 547-565, jul.-dic. 2018.
Artigo em Espanhol | IBECS | ID: ibc-176434

RESUMO

En el presente artículo se analiza la salud mental como una tecnología de gobierno que centra su campo de actuación en la experiencia vital de los individuos, a escala mundial y en todas las esferas de la vida. Tomando el concepto de tecnologías del yo de Michel Foucault, se propone pensar un cambio en las formas de producción de sí mismo a raíz de la presencia de la salud mental como organizador vital. A través del análisis de las interacciones en una consulta de un centro de atención primaria de la provincia de Barcelona, se describen tres tecnologías de autogobierno que toman a la experiencia como objeto. Se concluye que dichas tecnologías no están dirigidas a la producción de un sí mismo, sino de un nosotros, que se presenta como modalidad normativa que define la pertenencia política y biológica a un ideal de especie


In this article, mental health is analyzed as a governmental technology whose field of action focuses on the life experience of individuals, both worldwide and in all spheres of life. On the basis of Michel Foucault's concept of technologies of the self, it is proposed to think about a change in the forms of production of oneself as a result of the presence of mental health as a vital organizer. Through the analysis of the interactions in a consultation room of a primary care center in the province of Barcelona, three self-governance technologies that take experience as an object are described. It is concluded that these technologies are not aimed at the production of one's self, but at the production of ourselves, which is presented as a normative modality that defines political and biological belonging to an ideal of species


Assuntos
Humanos , Transtornos Mentais/psicologia , Defesa do Paciente/tendências , Integração Comunitária/psicologia , Integração Comunitária/tendências , Saúde Mental/tendências , Atenção Primária à Saúde/tendências , Participação da Comunidade , Comportamento Social , Relações Profissional-Família
14.
Rev. Asoc. Esp. Neuropsiquiatr ; 38(134): 567-585, jul.-dic. 2018.
Artigo em Espanhol | IBECS | ID: ibc-176435

RESUMO

A la luz del amplio crecimiento de colectivos, entidades y federaciones que se definen como "en primera persona", la intención aquí es problematizar la cuestión de los llamados saberes profanos, su contexto y sus circunstancias de expresión y desarrollo, así como los obstáculos y dificultades a la hora de adquirir un estatus socialmente legitimado. Cuando hablamos de saberes profanos, hacemos referencia a aquel conocimiento y elaboración conceptual que deriva de la experiencia subjetiva del sufrimiento psíquico/emocional/social. Un saber que frecuentemente corre el riesgo de ser un "punto ciego" para la mirada experta, pero que, de diversas maneras, actúa y emerge como elemento constitutivo de las estrategias de supervivencia y autoatención en los sujetos de la locura. Un saber que busca ser reconocido, acogido, y que se presenta como un elemento clave a la hora de habilitar las condiciones del diálogo en el ámbito de la reflexión sobre el sufrimiento y la construcción de los itinerarios hacia un mejor estar


In light of the broad growth of collectives, entities and federations that are defined as "in the first person", the intention here is to problematize the question of the so-called profane or lay knowledge, its contexts and circumstances of expression and development, as well as its obstacles and difficulties to acquire a socially legitimized status. When we talk about profane knowledge, we refer to that conceptual elaboration that derives from the subjective experience of the psychic/emotional/social suffering. This knowledge frequently runs the risk of being a "blind spot" for the expert look, but, in various ways, acts and emerges as a constitutive element of survival strategies and self-care in the subjects of the so-called madness. This knowledge seeks to be accepted, recognized, and is presented as a key element when it comes to enabling the conditions of dialogue in the field of reflection on suffering and the construction of itineraries towards better living


Assuntos
Humanos , Transtornos Mentais/psicologia , Defesa do Paciente/tendências , Integração Comunitária/psicologia , Luto , Coerção , Padrões de Prática Médica/tendências , Estresse Psicológico/psicologia , População Institucionalizada
15.
Rev. Asoc. Esp. Neuropsiquiatr ; 38(134): 587-606, jul.-dic. 2018.
Artigo em Espanhol | IBECS | ID: ibc-176436

RESUMO

La inmadurez biológica del ser humano cuando nace hace que para su supervivencia y desarrollo sea necesario alguien que le cuide y posibilite el paso de cachorro de la especie a sujeto psíquico, es decir, social. Ello se produce en un entramado de vínculos en el seno de una comunidad que ofrece soportes. Las fallas en ese proceso generan diversas experiencias de desvalimiento y predisponen a una fragilidad que emerge cuando fallan los soportes necesarios para hacer frente a las adversidades. Estas situaciones de carencia impactan sobre el sujeto, lo exponen a intensos sufrimientos y al riesgo de apartamiento de su comunidad y del no disfrute de sus derechos de ciudadanía. Sus relatos transmiten la idea de ser sujetos a la intemperie y sus manifestaciones pueden ser descritas como una clínica del desamparo. Cuando ello ocurre, urge la facilitación de experiencias de cuidado que se sustenten en un trato atento y en la recuperación de sus derechos de ciudadanía


The biological immaturity of human beings at birth demands, for their survival and development, that someone takes care of them and makes possible the passage from puppy of the species to psychic subject, i. e., social. This occurs in a network of links within a community that offers support. Failures in this process generate various experiences of helplessness that predispose to a fragility that emerges when the necessary supports to cope with adversity fail. These situations of lack impact on the subject, exposing him to intense suffering and to the risk of being separated from his community and of not enjoying his citizenship rights. Their stories convey the idea of a subject left out in the open and their manifestations can be described as a clinic of helplessness. When this happens, it is urgent to provide experiences of care based on an attentive treatment and on the recovery of their citizenship rights


Assuntos
Humanos , Transtornos Mentais/psicologia , Integração Comunitária/psicologia , Assistência à Saúde Mental , Integração Comunitária/tendências , Participação da Comunidade , Desamparo Aprendido , Processos Grupais , Determinantes Sociais da Saúde/tendências
16.
Top Spinal Cord Inj Rehabil ; 24(4): 306-314, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30459493

RESUMO

Background: The bio-psychosocial model for comprehensive understanding of community reintegration among individuals with spinal cord injury (SCI) varies across communities. Yet, information about community reintegration in Nigeria is not available. Objective: To investigate the association between community reintegration and clinical and psychosocial attributes among Nigerians with SCI. Methods: Fifty individuals (31 females; 19 males) with SCI aged 38.6 ± 11.1 years participated in this longitudinal survey. Pain, functional ability, and severity of injury were assessed at discharge and at 1, 2, and 3 months post-discharge from inpatient care using the Visual Analogue Scale (VAS), FIM®, and American Spinal Injury Association Impairment Scale (AIS), respectively. Self-esteem (SE), social support (SS), and depression were also assessed using the Self-Esteem Questionnaire, Social Support Questionnaire, and Beck Depression Inventory, respectively. CR was assessed at 1, 2, and 3 months post-discharge using the Reintegration to Normal Living Index (RNLI). Data were analyzed using Spearman's rho correlation and Friedman test. Results: The psychosocial and clinical attributes were significantly different from baseline and across the 3 months post-discharge (p < .0001), except for SS. CR significantly correlated with level of injury, function ability, SE, and depression across the 3 months post-discharge (p < .01). CR was significantly correlated with SS only at 1 month post-discharge (p = .027). Conclusion: Individuals with SCI had significant improvement in clinical and psychosocial attributes from discharge to 3 months post-discharge. Improvements in these variables were associated with better reintegration into the community.


Assuntos
Atividades Cotidianas/psicologia , Integração Comunitária/psicologia , Qualidade de Vida/psicologia , Apoio Social , Traumatismos da Medula Espinal/psicologia , Adulto , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Autoimagem , Autoeficácia
17.
Proc Natl Acad Sci U S A ; 115(45): 11483-11488, 2018 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-30348786

RESUMO

The successful integration of immigrants into a host country's society, economy, and polity has become a major issue for policymakers in recent decades. Scientific progress in the study of immigrant integration has been hampered by the lack of a common measure of integration, which would allow for the accumulation of knowledge through comparison across studies, countries, and time. To address this fundamental problem, we propose the Immigration Policy Lab (IPL) Integration Index as a pragmatic and multidimensional measure of immigrant integration. The measure, both in the 12-item short form (IPL-12) and the 24-item long form (IPL-24), captures six dimensions of integration: psychological, economic, political, social, linguistic, and navigational. The measure can be used across countries, over time, and across different immigrant groups and can be administered through short questionnaires available in different modes. We report on four surveys we conducted to evaluate the empirical performance of our measure. The tests reveal that the measure distinguishes among immigrant groups with different expected levels of integration and also correlates with well-established predictors of integration.


Assuntos
Integração Comunitária/psicologia , Emigrantes e Imigrantes/psicologia , Projetos de Pesquisa , Adolescente , Adulto , Integração Comunitária/economia , Integração Comunitária/tendências , Emigrantes e Imigrantes/classificação , Emigrantes e Imigrantes/educação , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Humanos , Idioma , Masculino , Percepção Social , Inquéritos e Questionários
18.
Oral Maxillofac Surg Clin North Am ; 30(4): 499-512, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30266192

RESUMO

Head and neck cancer is known to be both physically and psychologically challenging. The present review summarizes the literature on the psychosocial effects of head and neck cancer by distinguishing features in the preoperative and postoperative periods. It outlines the importance of an integrated collaborative care approach in clinics as well as areas worthy of further program development.


Assuntos
Adaptação Psicológica , Neoplasias de Cabeça e Pescoço/psicologia , Qualidade de Vida , Imagem Corporal/psicologia , Integração Comunitária/psicologia , Tomada de Decisões , Medo/psicologia , Comportamentos Relacionados com a Saúde , Humanos , Manejo da Dor , Relações Médico-Paciente
19.
Transl Behav Med ; 8(4): 554-564, 2018 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-30016524

RESUMO

Military service assimilates individuals into a socially cohesive force to address dangerous and traumatic situations that have no counterpart in civilian life. Upon leaving active duty, many veterans experience a "reverse culture shock" when trying to reintegrate into civilian institutions and cultivate supportive social networks. Poor social reintegration is associated with greater morbidity and premature mortality in part due to adoption of risky health behaviors, social isolation, and inadequate engagement in health care services. Although institutions like the Veterans Health Administration (VA) do much to address the complex psychosocial and health care needs of veterans and their families with evidence-based care, only 61% of Operations Enduring and Iraqi Freedom (OEF/OIF) Veterans are enrolled in VA care and there are numerous perceived barriers to care for enrollees. To address this gap, a community-based nonprofit organization, Team Red, White & Blue (RWB), was created to help veterans establish health-enriching social connections with communities through the consistent provision of inclusive and locally tailored physical, social, and service activities. This article provides an overview of the development and refinement of a theory-based framework for veteran health called the Enrichment Equation, comprised of three core constructs: health, people, and purpose. By operationalizing programming activities and roles, we describe how theoretical components were translated into a social networking implementation package that enabled rapid national spread of Team RWB. We conclude with future opportunities to partner with researchers and other organizations to understand program impact, and to identify effective intervention components that could be adapted for similar vulnerable groups.


Assuntos
Integração Comunitária , Promoção da Saúde/métodos , Rede Social , Veteranos , Medicina do Comportamento/métodos , Integração Comunitária/psicologia , Exercício Físico , Humanos , Modelos Teóricos , Apoio Social , Estados Unidos , United States Department of Veterans Affairs , Veteranos/psicologia
20.
Behav Med ; 44(3): 209-218, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30020868

RESUMO

Human trafficking exerts psychological effects on survivors that persist after intervention, and even after community reintegration. Effects include anxiety, depression, alienation, disorientation, aggression, suicidal ideation, attention deficit, and posttraumatic stress disorder (PTSD). Community supports and coping mechanisms may mitigate these effects. The report presented here is part of a long-term program of research to develop and test evidence-informed mental health and human capacity-building intervention programs for women and girls who are victims of trafficking. Structural equation modeling was used to assess a conditional process model (moderated mediation) of the effect of social support, coping, and community reintegration on PTSD among n = 144 girls and women. Participants received psychosocial intervention at a residential care facility for trafficking survivors. Results indicate model fit was excellent. Results indicate community reintegration indirectly influenced PTSD through its effect on perceived social support. Survivors who reported more difficulty reintegrating back into the community perceived less social support than those that reported easier community reintegration, and trafficking survivors who perceived less social support indicated more PTSD. Survivors with more PTSD symptoms tended to report using more dysfunctional coping mechanisms.


Assuntos
Adaptação Psicológica , Integração Comunitária/psicologia , Tráfico de Pessoas , Apoio Social , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/reabilitação , Sobreviventes/psicologia , Adolescente , Adulto , Feminino , Humanos , Modelos Psicológicos , Desenvolvimento de Programas , Instituições Residenciais , Fatores de Risco , Adulto Jovem
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