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1.
Psychol Trauma ; 12(S1): S79-S81, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32525382

RESUMO

The COVID-19 health crisis is strongly affecting the mental health of the general population. In particular, the pandemic may be producing psychological distress and collateral concerns for parents in lockdown, due to unstable financial circumstances, school closures, and suspended educational services for children. A call for measures to increase family-based interventions during the emergency is urgently needed to forestall psychopathological trajectories and prevent the exacerbation of vulnerable conditions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Esgotamento Psicológico/psicologia , Infecções por Coronavirus/psicologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/normas , Pandemias , Pais/psicologia , Pneumonia Viral/psicologia , Angústia Psicológica , Adolescente , Adulto , Criança , Humanos , Itália
2.
Psychol Trauma ; 12(S1): S222-S224, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32478541

RESUMO

The United States has more confirmed deaths from coronavirus 2019 (COVID-19) than any other country in the world. State governors made decisions around social distancing in their jurisdictions, which caused schools and businesses to close. Those with broadband access continued a sense or normalcy in their lives. However, for the more than 20 million people who do not have broadband access, a different set of barriers has been experienced. These challenges are especially prominent in rural communities throughout various states. The present commentary addresses how health disparities for preexisting conditions place rural residents at greater risk for morbidity during COVID-19. Reasons for physical and mental health disparities, such as limited access to hospitals or specialty providers (e.g., psychiatrists), are described. Whereas telehealth is promoted as a way to meet health access needs, especially during a pandemic, this luxury is not readily available for all U.S. residents. Recent actions brought about by the government (e.g., the CARES Act) have tried to address the rural-urban gap in telehealth, but more is needed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Infecções por Coronavirus , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Acesso à Internet , Serviços de Saúde Mental/normas , Pandemias , Pneumonia Viral , População Rural , Telemedicina/normas , População Urbana , Adulto , Humanos , Estados Unidos
3.
Psychol Trauma ; 12(S1): S281-S283, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32538651

RESUMO

This paper describes national-level mental health responses to COVID-19 in Lebanon. It then notes factors that have supported the mental health response, including how COVID-19 represents a window of opportunity to help strengthen the mental health system in Lebanon. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Infecções por Coronavirus , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/normas , Pandemias , Pneumonia Viral , Humanos , Líbano
4.
Psychol Trauma ; 12(S1): S279-S280, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32551754

RESUMO

The ubiquitous exposure to COVID-19 argues for governments to use a trauma-informed response as a universal precaution, with the goal of promoting the recovery and resilience of their residents. How a system defines trauma will drive its administrative policies, research, and clinical services. The Substance Abuse and Mental Health Services Administration's Concept of Trauma and Guidance for a Trauma-Informed Approach offers governments a framework to define trauma and incorporate trauma-informed principles and tasks into their COVID-19 responses. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Infecções por Coronavirus , Serviços de Saúde Mental/normas , Pandemias , Pneumonia Viral , Trauma Psicológico/diagnóstico , Trauma Psicológico/terapia , Adulto , Humanos , Trauma Psicológico/etiologia , Estados Unidos , United States Substance Abuse and Mental Health Services Administration
5.
Psychol Trauma ; 12(5): 494-496, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32525385

RESUMO

This paper evaluated the unique challenges of Australians in relation to the global novel coronavirus (COVID-19) pandemic. The 2019-2020 bushfires and COVID-19 outbreak have increased rates of anxiety and distress in Australia. On the contrary, unprecedented spending by the Australian Government on health care, employment, and housing has potentially lowered anxiety and stress for some Australians. Research is required to monitor the potential long-term mental health consequences of COVID-19 in Australia. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Sintomas Comportamentais/terapia , Infecções por Coronavirus , Controle de Infecções , Serviços de Saúde Mental , Pandemias , Pneumonia Viral , Telemedicina , Austrália , Infecções por Coronavirus/prevenção & controle , Humanos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/organização & administração , Telemedicina/normas
7.
J Am Acad Child Adolesc Psychiatry ; 59(6): 686-688, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32389695

RESUMO

As we pen these words, the COVID-19 pandemic is having profound impacts on human society. Based on decades of research, we know that the accompanying illness,1 death,2 social isolation,3,4 and malnutrition5 will have deep and lasting impacts on our children and adolescents, their families, and the communities in which they develop. The pandemic is exposing, with terrible clarity, the disparities in human society-racism,6 poverty,7,8 domestic violence,9,10 and child maltreatment and neglect11-and tragically will likely amplify the negative impacts that each has on child development and mental health.


Assuntos
Infecções por Coronavirus , Transtornos Mentais/epidemiologia , Saúde Mental/normas , Pandemias , Pneumonia Viral , Editoração/normas , Adolescente , Betacoronavirus/isolamento & purificação , Criança , Maus-Tratos Infantis/prevenção & controle , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Violência Doméstica/prevenção & controle , Violência Doméstica/psicologia , Políticas Editoriais , Humanos , Serviços de Saúde Mental/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Sistemas de Apoio Psicossocial , Fatores de Risco , Isolamento Social/psicologia
9.
BMC Psychiatry ; 20(1): 55, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32033603

RESUMO

BACKGROUND: The Delphi technique is a proven and reliable method to create common definitions and to achieve convergence of opinion. This study aimed to prioritize suicide prevention guideline recommendations and to develop a set of quality indicators (QIs) for suicide prevention in specialist mental healthcare. METHODS: This study selected 12 key recommendations from the guideline to modify them into QIs. After feedback from two face-to-face workgroup sessions, 11 recommendations were rephrased and selected to serve as QIs. Next, a Delphi study with the 11 QIs was performed to achieve convergence of opinion among a panel of 90 participants (23 suicide experts, 23 members of patients' advisory boards or experts with experiences in suicidal behavior and 44 mental healthcare professionals). The participants scored the 11 QIs on two selection criteria: relevance (it affects the number of suicides in the institution) and action orientation (institutions or professionals themselves can influence it) using a 5-point Likert scale. Also, data analysts working in mental healthcare institutions (MHIs) rated each QI on feasibility (is it feasible to monitor and extract from existing systems). Consensus was defined as 70% agreement with priority scores of four or five. RESULTS: Out of the 11 recommendations, participants prioritized five recommendations as relevant and action-oriented in optimizing the quality of care for suicide prevention: 1) screening for suicidal thoughts and behavior, 2) safety plan, 3) early follow-up on discharge, 4) continuity of care and 5) involving family or significant others. Only one of the 11 recommendations early follow-up on discharge reached consensus on all three selection criteria (relevance, action orientation, and feasibility). CONCLUSIONS: The prioritization of relevant and action-oriented suicide prevention guideline recommendations is an important step towards the improvement of quality of care in specialist mental healthcare.


Assuntos
Serviços de Saúde Mental/normas , Guias de Prática Clínica como Assunto/normas , Suicídio , Consenso , Técnica Delfos , Humanos , Indicadores de Qualidade em Assistência à Saúde , Suicídio/prevenção & controle , Suicídio/psicologia
10.
PLoS One ; 15(2): e0229385, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32106225

RESUMO

Stigma and discrimination toward individuals experiencing homelessness and mental disorders remain pervasive across societies. However, there are few longitudinal studies of stigma and discrimination among homeless adults with mental illness. This study aimed to identify the two-year group trajectories of stigma and discrimination and examine the predictive role of mental health characteristics among 414 homeless adults with mental illness participating in the extended follow-up phase of the Toronto At Home/Chez Soi (AH/CS) randomized trial site. Mental health-related perceived stigma and discrimination were measured at baseline, one, and two years using validated scales. Group-based-trajectory modelling was used to identify stigma and discrimination group trajectory memberships and the effect of the Housing First treatment (rent supplements and mental health support services) vs treatment as usual on these trajectories. The associations between mental health-related characteristics and trajectory group memberships were also assessed using multinomial logistic regression. Over two-years, three group trajectories of stigma and discrimination were identified. For discrimination, participants followed a low, moderate, or increasingly high discrimination group trajectory, while for stigma, participants followed a low, moderate or high stigma group trajectory. The Housing First treatment had no significant effect on discrimination or stigma trajectories groups. For the discrimination trajectories, major depressive episode, mood disorder with psychotic features, alcohol abuse, suicidality, severity of mental health symptoms, and substance use severity in the previous year were predictors of moderate and increasingly high discrimination trajectories. History of discrimination within healthcare setting was also positively associated with following a moderate or high discrimination trajectory. For the stigma trajectories, substance dependence, high mental health symptoms severity, substance use severity, and discrimination experiences within healthcare settings were the main predictors for the moderate trajectory group; while substance dependence, suicidality, mental health symptom severity, substance use severity and discrimination experiences within health care setting were also positive predictors for the high stigma trajectory group. Ethno-racial status modified the association between having a major depression episode, alcohol dependence, and the likelihood of being a member of the high stigma trajectory group. This study showed that adults experiencing mental illness and homelessness followed distinct stigma and discrimination group trajectories based on their mental health-problems. There is an urgent need to increase focus on strategies and policies to reduce stigma and discrimination in this population.


Assuntos
Pessoas em Situação de Rua/psicologia , Transtornos Mentais/psicologia , Serviços de Saúde Mental/normas , Saúde Mental , Discriminação Social/estatística & dados numéricos , Problemas Sociais/estatística & dados numéricos , Estigma Social , Adulto , Feminino , Pessoas em Situação de Rua/estatística & dados numéricos , Habitação , Humanos , Masculino , Transtornos Mentais/fisiopatologia
11.
Int J Psychol ; 55 Suppl 1: 78-87, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31313297

RESUMO

A randomised, waitlist controlled, trial was conducted to evaluate the effects of the Adult Resilience Program (ARP), a universal prevention social-emotional programme for adolescents and adults, on self-reported depression, anxiety, stress, resilience, and self-esteem. Seventy-six students from a private university in Singapore were randomised to the ARP group or wait-list control (WLC) group and assessments were conducted at pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). A 2 × 3 mixed between-within groups multivariate analysis of variance with the between-group factor of Group (ARP, WLC) and the within-group factor of time (T1, T2, and T3) and the dependent variables of depression, anxiety, stress, resilience and self-esteem, with age and stage of degree as covariates showed a significant decrease over time in depression (ηp2  = .20), and anxiety (ηp2  = .06). There was a significant decrease in stress for the ARP only from T1 to T2 (ηp2  = .16). While there was a significant interaction of Time and Group for resilience (ηp2  = .07), there was no significant change in resilience for the ARP group alone. The results provide preliminary support that the ARP can impart essential skills that can have a positive impact on mental health in university students.


Assuntos
Serviços de Saúde Mental/normas , Medicina Preventiva/métodos , Resiliência Psicológica , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Adulto Jovem
13.
Epidemiol Psychiatr Sci ; 29: e80, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31839026

RESUMO

AIMS: No instrument has been developed to explicitly assess the professional culture of mental health workers interacting with severely mentally ill people in publicly or privately run mental health care services. Because of theoretical and methodological concerns, we designed a self-administered questionnaire to assess the professional culture of mental health services workers. The study aims to validate this tool, named the Mental Health Professional Culture Inventory (MHPCI). The MHPCI adopts the notion of 'professional culture' as a hybrid construct between the individual and the organisational level that could be directly associated with the professional practices of mental health workers. METHODS: The MHPCI takes into consideration a multidimensional definition of professional culture and a discrete number of psychometrically derived dimensions related to meaningful professional behaviour. The questionnaire was created and developed by a conjoint Italian-Canadian research team with the purpose of obtaining a fully cross-cultural questionnaire and was pretested in a pilot study. Subsequently, a validation survey was conducted in northern Italy and in Canada (Montreal area, Quebec). Data analysis was conducted in different steps designed to maximise the cross-cultural adaptation of the questionnaire through a recursive procedure consisting of performing a principal component analysis (PCA) on the Italian sample (N = 221) and then testing the resulting factorial model on the Canadian sample (N = 237). Reliability was also assessed with a test-retest design. RESULTS: Four dimensions emerged in the PCA and were verified in the confirmatory factor analysis: family involvement, users' sexuality, therapeutic framework and management of aggression risk. All the scales displayed good internal consistency and reliability. CONCLUSIONS: This study suggests the MHPCI could be a valid and reliable instrument to measure the professional behaviour of mental health services workers. The content of the four scales is consistent with the literature on psychosocial rehabilitation, suggesting that the instrument could be used to evaluate staff behaviour regarding four crucial dimensions of mental health care.


Assuntos
Atitude do Pessoal de Saúde/etnologia , Competência Cultural , Assistência à Saúde Culturalmente Competente , Pessoal de Saúde/psicologia , Serviços de Saúde Mental/normas , Inquéritos e Questionários/normas , Adulto , Canadá , Comparação Transcultural , Humanos , Itália , Saúde Mental , Pessoa de Meia-Idade , Cultura Organizacional , Psicometria , Reprodutibilidade dos Testes
14.
Ir J Psychol Med ; 36(4): 243-248, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31747987

RESUMO

Early intervention in psychosis (EIP) services are now a priority for Ireland's Health Service Executive (HSE). A Model of Care for EIP services has been completed after wide consultation. It has just been launched by the Minister for Mental Health and the aim now is to roll out EIP services throughout the country. The Model of Care outlines the rational, configuration, resources, governance, and quality assurance required to operate EIP services. Two models are recommended. The first is a Hub & Spoke service model for rural and smaller urban areas. The second is a Stand-Alone service model for large urban and metropolitan areas. Introducing EIP services is going to be a challenge but there are plenty of good examples overseas. They have been shown to greatly enhance local services' ability to meet the needs of people developing psychotic disorders. They bring with them better outcomes, service satisfaction and cost savings.


Assuntos
Intervenção Médica Precoce/normas , Serviços de Saúde Mental/organização & administração , Transtornos Psicóticos/diagnóstico , Atitude Frente a Saúde , Diagnóstico Precoce , Intervenção Médica Precoce/métodos , Indicadores Básicos de Saúde , Humanos , Irlanda/epidemiologia , Serviços de Saúde Mental/normas , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia
15.
Ir J Psychol Med ; 36(4): 249-258, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31747988

RESUMO

OBJECTIVE: In Ireland, National Clinical Programmes are being established to improve and standardise patient care throughout the Health Service Executive. In line with internationally recognised guidelines on the treatment of first episode psychosis the Early Intervention in Psychosis (EIP) programme is being drafted with a view to implementation by mental health services across the country. We undertook a review of patients presenting with a first episode of psychosis to the Dublin Southwest Mental Health Service before the implementation of the EIP. This baseline information will be used to measure the efficacy of our EIP programme. METHODS: Patients who presented with a first episode psychosis were retrospectively identified through case note reviews and consultation with treating teams. We gathered demographic and clinical information from patients as well as data on treatment provision over a 2-year period from the time of first presentation. Data included age at first presentation, duration of untreated psychosis, diagnosis, referral source, antipsychotic prescribing rates and dosing, rates of provision of psychological interventions and standards of physical healthcare monitoring. Outcome measures with regards to rates of admission over a 2-year period following initial presentation were also recorded. RESULTS: In total, 66 cases were identified. The majority were male, single, unemployed and living with their family or spouse. The mean age at first presentation was 31 years with a mean duration of untreated psychosis of 17 months. Just under one-third were diagnosed with schizophrenia. Approximately half of the patients had no contact with a health service before presentation. The majority of patients presented through the emergency department. Two-thirds of all patients had a hospital admission within 2 years of presentation and almost one quarter of patients had an involuntary admission. The majority of patients were prescribed antipsychotic doses within recommended British National Formulary guidelines. Most patients received individual support through their keyworker and family intervention was provided in the majority of cases. Only a small number received formal Cognitive-Behavioural Therapy. Physical healthcare monitoring was insufficiently recorded in the majority of patients. CONCLUSIONS: There is a shortage of information on the profile and treatment of patients presenting with a first episode of psychosis in Ireland. This baseline information is important in evaluating the efficacy of any new programme for this patient group. Many aspects of good practice were identified within the service in particular with regards to the appropriate prescribing of antipsychotic medication and the rates of family intervention. Deficiencies remain however in the monitoring of physical health and the provision of formal psychological interventions to patients. With the implementation of an EIP programme it is hoped that service provision would improve nationwide and to internationally recognised standards.


Assuntos
Serviços de Saúde Mental/normas , Assistência ao Paciente/normas , Transtornos Psicóticos/terapia , Esquizofrenia/diagnóstico , Adulto , Antipsicóticos/uso terapêutico , Terapia Cognitivo-Comportamental/métodos , Terapia Cognitivo-Comportamental/estatística & dados numéricos , Demografia , Intervenção Médica Precoce/métodos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hospitalização/tendências , Humanos , Irlanda/epidemiologia , Masculino , Avaliação de Resultados em Cuidados de Saúde , Aptidão Física/psicologia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Estudos Retrospectivos , Esquizofrenia/epidemiologia
16.
Ir J Psychol Med ; 36(4): 239-241, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31747989

RESUMO

Psychotic disorders are central to mental health service provision and a common theme of academic research programmes in Ireland, which explore the neurobiological and psychosocial risk factors underpinning the development and progression of these illnesses. While we await the discovery of novel pharmacological treatment targets for psychotic disorders, it is important to employ our existing management strategies to optimal effect. In this special issue on psychosis, a selection of clinical research studies and reviews from Irish researchers, and often of Irish populations, are brought together which span the trajectory of psychotic illness from early intervention to treatment resistance. The topics include the characteristics and course of first episode psychosis cohorts, real-world evaluation of early intervention services, management strategies for treatment resistant schizophrenia and neurobiological research into social stress. The current editorial provides an overview of these papers and highlights the initial steps of the Irish Psychosis Research Network towards developing an integrated clinical research network focusing on the treatment and research into psychotic disorders.


Assuntos
Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Transtornos Psicóticos/terapia , Esquizofrenia/terapia , Resistência a Medicamentos/fisiologia , Intervenção Educacional Precoce , Humanos , Irlanda/epidemiologia , Serviços de Saúde Mental/normas , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/fisiopatologia , Fatores de Risco , Resultado do Tratamento
17.
Harv Rev Psychiatry ; 27(6): 342-353, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31714465

RESUMO

BACKGROUND: As an alternative to co-located integrated care, off-site integration (partnerships between primary care and non-embedded specialty mental health providers) can address the growing need for pediatric mental health services. Our goal is to review the existing literature on implementing off-site pediatric integrated care. METHODS: We systematically searched the literature for peer-reviewed publications on off-site pediatric integrated care interventions. We included studies that involved systematic data collection and analysis, both qualitative and quantitative, of implementation outcomes (acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability). RESULTS: We found 39 original articles from 24 off-site programs with a variety of study designs, most with secondary implementation outcomes. Models of off-site integration varied primarily along two dimensions: direct vs. indirect, and in-person vs. remote. Overall, off-site models were acceptable to providers, particularly when the following were present: strong interdisciplinary communication, timely availability and reliability of services, additional support beyond one-time consultation, and standardized care algorithms. Adoption and penetration were facilitated by enhanced program visibility, including on-site champions. Certain clinical populations (e.g., school-age, less complicated ADHD) seemed more amenable to off-site integrated models than others (e.g., preschool-age, conduct disorders). Lack of funding and inadequate reimbursement limited sustainability in all models. CONCLUSIONS: Off-site interventions are feasible, acceptable, and often adopted widely with adequate planning, administrative support, and interprofessional communication. Studies that focus primarily on implementation and that consider the perspectives of specialty providers and patients are needed.


Assuntos
Serviços de Saúde da Criança/normas , Bem-Estar da Criança , Serviços de Saúde Mental/normas , Criança , Centros Comunitários de Saúde/normas , Acesso aos Serviços de Saúde/normas , Humanos , Pediatria/normas , Encaminhamento e Consulta/normas
18.
BMC Health Serv Res ; 19(1): 687, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31601199

RESUMO

BACKGROUND: Social inequities are widening globally, contributing to growing health and health care inequities. Health inequities are unjust differences in health and well-being between and within groups of people caused by socially structured, and thus avoidable, marginalizing conditions such as poverty and systemic racism. In Canada, such conditions disproportionately affect Indigenous persons, racialized newcomers, those with mental health and substance use issues, and those experiencing interpersonal violence. Despite calls to enhance equity in health care to contribute to improving population health, few studies examine how to achieve equity at the point of care, and the impacts of doing so. Many people facing marginalizing conditions experience inadequate and inequitable treatment in emergency departments (EDs), which makes people less likely to access care, paradoxically resulting in reliance on EDs through delays to care and repeat visits, interfering with effective care delivery and increasing human and financial costs. EDs are key settings with potential for mitigating the impacts of structural conditions and barriers to care linked to health inequities. METHODS: EQUIP is an organizational intervention to promote equity. Building on promising research in primary health care, we are adapting EQUIP to emergency departments, and testing its impact at three geographically and demographically diverse EDs in one Canadian province. A mixed methods multisite design will examine changes in key outcomes including: a) a longitudinal analysis of change over time based on structured assessments of patients and staff, b) an interrupted time series design of administrative data (i.e., staff sick leave, patients who leave without care being completed), c) a process evaluation to assess how the intervention was implemented and the contextual features of the environment and process that are influential for successful implementation, and d) a cost-benefit analysis. DISCUSSION: This project will generate both process- and outcome-based evidence to improve the provision of equity-oriented health care in emergency departments, particularly targeting groups known to be at greatest risk for experiencing the negative impacts of health and health care inequities. The main deliverable is a health equity-enhancing framework, including implementable, measurable interventions, tested, refined and relevant to diverse EDs. TRIAL REGISTRATION: Clinical Trials.gov # NCT03369678 (registration date November 18, 2017).


Assuntos
Assistência à Saúde/normas , Serviço Hospitalar de Emergência/normas , Equidade em Saúde/organização & administração , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Colúmbia Britânica , Protocolos Clínicos , Serviço Hospitalar de Emergência/organização & administração , Humanos , Índios Norte-Americanos/estatística & dados numéricos , Análise de Séries Temporais Interrompida , Serviços de Saúde Mental/normas , Serviços de Saúde Mental/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Racismo/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Violência/estatística & dados numéricos
19.
Rev Bras Enferm ; 72(6): 1624-1631, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644753

RESUMO

OBJECTIVE: to investigate the criteria used by health professionals to identify the phase of consumption of alcohol and drug users, and actions directed to their care. METHOD: a qualitative study developed with 14 professionals from a Brazilian Psychosocial Care Center for Alcohol and Drugs (Centro de Atenção Psicossocial Álcool e Drogas) based in the south of the country. Data were collected in June 2017 through semi-structured interviews and then submitted to thematic analysis. RESULTS: the criteria used by the professionals were: periodicity of use; amount and type of drug used; repercussions of misuse; and place that the drug occupies in the person's life. The actions developed were orientation and referral to support groups, therapeutic workshops and individual care. FINAL CONSIDERATIONS: the chronic nature of alcohol/drug use/dependence requires specific care in each phase, and objective criteria to identify and intervene in early phases, aiming at the prevention of chemical dependence.


Assuntos
Alcoolismo/classificação , Pessoal de Saúde/psicologia , Serviços de Saúde Mental/normas , Transtornos Relacionados ao Uso de Substâncias/classificação , Adulto , Alcoolismo/psicologia , Alcoolismo/terapia , Atitude do Pessoal de Saúde , Brasil , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia
20.
Rev Bras Enferm ; 72(6): 1699-1706, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644763

RESUMO

OBJECTIVE: to evaluate the relation between sociodemographics factors, stress and burden of care of family caregivers of patients at a psychiatric hospital admission. METHOD: quantitative study, with a cross-sectional correlation design. A total of 112 family caregivers participated, older than 18, in a Brazilian psychiatric hospital. A sociodemographic questionnaire was used to collect data, the Zarit Burden Interview and LIPP Adult Stress Symptom Inventory. RESULTS: burden of care in family caregivers at a psychiatric hospital admission was significantly associated with stress (p=0.000). The psychological symptoms of stress predicted severe burden. Most caregivers presented a moderate or severe burden, with 52.7% in the resistance phase of stress; 66.1% presented psychological symptoms. CONCLUSION: results show the alarming situation of caregivers of patients from a psychiatric hospital, evidencing their own vulnerability to illness. Indeed, the during admission in a psychiatric hospital, not only patients need care, but also their caregivers.


Assuntos
Cuidadores/psicologia , Efeitos Psicossociais da Doença , Serviços de Saúde Mental/normas , Estresse Psicológico/etiologia , Adaptação Psicológica , Adulto , Idoso , Brasil , Cuidadores/estatística & dados numéricos , Estudos Transversais , Feminino , Hospitalização/estatística & dados numéricos , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Estresse Psicológico/psicologia , Inquéritos e Questionários
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