Experiences in elderly people with chronic obstructive pulmonary disease in relation to the use of long-term home oxygen therapy: a qualitative study about feelings attributed to therapy.

BACKGROUND: Elderly people are more likely to suffer severe chronic obstructive pulmonary disease (COPD) and require long-term home oxygen therapy (LTOT) as part of their treatment. LTOT has advantages such as improvement in symptoms, but there are also disadvantages such as physical barriers, psychosocial barriers and emotional challenges. The aim of this study is to understand the experiences of elderly people with COPD using LTOT with respect to their feelings attributed to therapy. METHODS: Qualitative study. Seven semidirected interviews were conducted with patients with a confirmed COPD diagnosis who used LTOT and were treated at an outpatient service. The content analysis technique was applied with the support of WebQDA software 2.0. RESULTS: Three categories emerged that were associated with the use of LTOT: (1) poor self-image; (2) feelings of sadness and (3) the impact of LTOT on others such as family and friends. CONCLUSIONS: LTOT in elderly people with COPD was associated with a poor self-image, feelings of sadness and impacted on others apart from the patient. When LTOT is prescribed, healthcare practitioners should proactively address these concerns to minimise the negative biopsychosocial experiences caused by LTOT.

[The use of active methodology in nursing care and teaching in national productions: an integrative review]. / Utilização de metodologia ativa no ensino e assistência de enfermagem na produção nacional: revisão integrativa.

The objective of this integrative review was to identify and analyze the scientific publications regarding the use of active methodologies in nursing care and teaching in Brazil. The survey included national publications, from 1999 to 2009, using the following databases: LILACS, BDENF, MEDLINE and SciELO. A total of 28 articles were selected. The results and analysis pointed to problematization as the primary active methodology used, the lack of theoretical frameworks to plan the pedagogical action, and the excessive use of teaching techniques that do not always characterize innovation. In conclusion, the implementation of innovative methodologies requires further studies and more investment in research and dissemination on the subject.

Seven steps for qualitative treatment in health research: the Clinical-Qualitative Content Analysis.

Qualitative Health research procedures that are not always applied, mainly in the analysis phase. Our objective is to present a systematized technique of step-by-step procedures for qualitative content analysis in the health field: Clinical-Qualitative Content Analysis. Our proposal consider that the qualitative research applied to the field of health, can acquire a perspective analogous to clinical practice and aims to interpret meanings expressed in reports through individual interviews or statements. This analysis takes part of the Clinical-Qualitative Method. The literature review was realized through: a book chapter, eight original articles and three methodological articles. The Clinical-qualitative Content Analysis technique comprises seven steps: 1) Editing material for analysis; 2) Floating reading; 3) Construction of the units of analysis; 4) Construction of codes of meaning; 5) General refining of the codes and the Construction of categories; 6) Discussion; 7) Validity. The clinical-qualitative analysis presupposes and involves a critical reflection on the processes carried out at each step. This reflection is an extremely rich process, if carried out collectively and in dialogue with other researchers with some proficiency in qualitative methods.

[Hemodialysis treatment as perceived by the renal patient: clinical qualitative study]. / Tratamento hemodialítico sob a ótica do doente renal: estudo clínico qualitativo.

The objective of this paper was to analyze the meaning attributed by renal patients to the hemodialysis treatment received. Using the clinical-qualitative method interviews were conducted, following a semi-structured questionnaire with seven patients from a hemodialysis unit, selected through intentional sampling. The data were examined by thematic content analysis. Survival emerged as the most significant objective of the treatment. The fact that the treatment was mandatory placed the patient in a situation of implicit transference of responsibilities, when making decisions about the adopted therapeutic, to the team of health professionals, generating compliance or conformity regarding his/her own participation in this process. The patients attributed to culture lack of knowledge about the treatment.

Discourse of psychoactive substance dependents on their discursively constructed image.

OBJECTIVE: to analyze the discourse of psychoactive substance users undergoing treatment regarding their image of themselves as drug dependent subjects, of other dependents and the social position assumed by them. METHOD: qualitative study conducted between March and September of 2016 through a semi-structured interview and drawings, based on the theoretical-methodological reference of French Discourse Analysis. Participation of 12 drug dependent subjects undergoing treatment in the service that substitutes the asylum. RESULTS: The images that psychoactive substance dependents have of themselves and of chemically dependent subjects are associated with the image of a negative, diabolical, transgressive, sick and socially excluded individual. FINAL CONSIDERATIONS: The ideological effects of meanings produced by users' discourses reproduce the biological and moral model. Health professionals, including nurses, need to invest in discourses that address the psychosocial model to demythologize this stigmatizing image and modify their work practice.

Content analysis in studies using the clinical-qualitative method: application and perspectives.

Content analysis comprises a set of techniques for organizing communication/information - a procedure used with qualitative data to make themes/topics and concepts/knowledge emerge. Communication content, considering human written or spoken discourse, is complex and presents valuable polysemous characteristic. With the dissemination of the clinical-qualitative method, the use of content analysis, considered an important methodological tool, raises theoretical-practical issues that need to be taken into consideration for its academically precise use. Thus, this article aimed to enumerate specific elements of the content analysis technique and discuss its suitability for the clinical-qualitative method that combines generic qualitative methods from Human and Cultural Sciences with the area of Health Sciences. Concepts were selected due to their pertinence, use and eventual adaptation to the method focused on.

The free spirit: spiritualism meanings by a Nursing team on psychiatry.

OBJECTIVE: To analyze the meanings attributed by nursing professionals in psychiatry to spirituality and its relationship with care. METHOD: Clinical-qualitative, with appreciation of symbolic meanings. We interviewed 18 individuals for a semi-structured script of open questions and the data were analyzed in the light of psychoanalytic hermeneutics. The discussion was undertaken with the overlap of understanding of the sacred symbol, psychological and the meaning of life. RESULTS: Different spiritualities are interposed by personal restlessness and the experience of transience. Spirituality aids in social functions, personal balance and commitment to endure the anguish of transience. Among professionals, it has been shown as an ethical-combative attitude to evil forms, but there is a restriction in dealing with patients' spirituality. FINAL CONSIDERATIONS: The meanings pointed to the limits of human reason, resembling caregivers and patients in subjective conditions by which they avoid spirituality in psychiatry. It is suggested that spiritual attention be given to professionals.

Spirituality review on mental health and psychiatric nursing.

OBJECTIVE: Gather the concepts, theories and interventions about spirituality, its nature and functions in mental health and psychiatric nursing. METHOD: A literature review proceeded on February 2016. It has integrated 214 studies published until December 2015 by crossing Spirituality and Psychiatric Nursing mesh terms in databases. RESULTS: Conceptualization about spirituality and religion, their complexity in nursing research, education, and clinical approach; their functions to human being correlated to the purpose of life, transcendental connections, and support in mental health; the professional boundaries in address to spirituality in mental health scenery, and a descriptive literature recommendations and a instruments catalog. CONCLUSIONS: Spirituality in nursing mental health and psychiatry remains a theoretical problem, and has a clinical mischaracterized approach; recently publications try to promote a human and holistic trend in the practice, as a challenge to lead the current circumstances to valid nursing bases.

Vivências de idosos com doença pulmonar crônica em uso de oxigenoterapia domiciliar prolongada no relacionamento amoroso e sexual / Experiences of older adult with chronic pulmonary disease using long-term home oxygen therapy in romantic and sexual relationships

Resumo Objetivo Compreender os significados atribuídos pela pessoa idosa com Doença Pulmonar Obstrutiva Crônica (DPOC) em uso da Oxigenoterapia Domiciliar Prolongada (ODP) referente ao relacionamento amoroso e a prática sexual. Método Estudo qualitativo, no qual foram realizadas sete entrevistas semidirigidas com pacientes com diagnóstico confirmado de DPOC e em uso de ODP, atendidos em serviço ambulatorial. A técnica de análise de conteúdo foi aplicada com o apoio do software WebQDA 2.0®. Os critérios COREQ foram usados ​​para relatar o método e o resultado. Resultados Duas categorias emergiram: 1- Desestabilização no relacionamento amoroso e na vida sexual do usuário de ODP: revelou que a terapia causa perturbação nos relacionamentos, mudança de parceiro depois que foi prescrita a ODP ou até a ideia de procurar uma pessoa extraconjugal. 2- Vivência e significados da DPOC e da oxigenoterapia durante a relação sexual: o sofrimento com as questões fisiológicas, o quanto o paciente sente falta de ar para ter relação sexual e o impacto disso no desempenho e na frequência, diminuindo esses momentos com o parceiro Conclusão A percepção da pessoa idosa com DPOC em uso da ODP indica que a oxigenoterapia impactou sobre a prática sexual e nos relacionamentos amorosos. Ter boa qualidade nos relacionamentos e na prática sexual é condição fundamental para promover a saúde.

Abstract Objective To understand the meanings attributed by older adult with Chronic Obstructive Pulmonary Disease (COPD) using the Long-Term Home Oxygen Therapy (LTOT) regarding romantic relationships and sexual practice. Method Qualitative study in which seven semi-structured interviews were carried out with patients with a confirmed diagnosis of COPD and using LTOT, treated in an outpatient service. The content analysis technique was applied with the support of the WebQDA2.0 software license. COREQ criteria were used to report method and outcome. Results Two categories emerged: 1- Destabilization in the romantic relationship and in the sexual life of the LTOT user: : revealed that therapy causes relationship breakup, change of partner after prescription of the LTOT or even the idea of ​​looking for an extramarital person; 2- Experience and meanings of COPD and oxygen therapy during sexual intercourse: suffering with physiological problems, how much the patient feels short of breath to have sexual intercourse and the impact of this on performance and frequency, reducing these moments with the partner. Conclusion The perception of elderly people with COPD using LTOT indicates that oxygen therapy had an impact on sexual practice and romantic relationships. Having good quality in relationships and sexual practice is a fundamental condition for health promotion.

Assistência à saúde mental nos serviços médicos de emergência: revisão integrativa / Asistencia a la salud mental en los servicios médicos de emergencia: revisión integrativa / Mental health care in emergency medical services: an integrative review

Objetivos: conhecer as características da assistência à saúde mental dispensada por profissionais de enfermagem nos serviços médicos de emergência. Método: revisão integrativa de literatura nas bases de dados Literatura Latino-Americano e do Caribe em Ciências da Saúde (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) e Cumulative Index to Nursing and Allied Health Literature (CINAHL), no período de março a junho de 2023, utilizando-se critérios de inclusão e exclusão previamente definidos. Resultados: obteve-se uma amostra final de 59 artigos os quais foram agrupados nas seguintes categorias temáticas: concepções em saúde mental, comunicação, intervenções, atendimento em rede, competência em cuidado em saúde mental e barreiras durante os atendimentos. Conclusão: o cuidado é feito de forma incipiente e permeado por elementos dificultadores. Os achados do presente estudo servem para rever e repensar práticas e políticas de cuidado em saúde mental e promover estratégias de aperfeiçoamento dos processos de trabalho.

Objetivos: conocer las características de la asistencia a la salud mental dispensada por profesionales de enfermería en los servicios médicos de emergencia. Método: revisión integrativa de literatura en las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) y Cumulative Index to Nursing and Allied Health Literature (CINAHL), en el período de marzo a junio de 2023, utilizando criterios de inclusión y exclusión previamente definidos. Resultados: se obtuvo una muestra final de 59 artículos los cuales fueron agrupados en las siguientes categorías temáticas: concepciones en salud mental, comunicación, intervenciones, atención en red, competencia en atención en salud mental y barreras durante los atendimientos. Conclusión: el cuidado es hecho de forma incipiente y permeado por elementos difíciles. Los hallazgos del presente estudio sirven para revisar y repensar prácticas y políticas de cuidado en salud mental y promover estrategias de perfeccionamiento de los procesos de trabajo.

Objective: to know the characteristics of mental health care provided by nursing professionals in emergency medical services. Method: integrative literature review in the databases Latin American and Caribbean Health Sciences Literature (LILACS), Publisher Medline (PUBMED), SciVerse Scopus (SCOPUS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL), from March to June 2023, using previously defined inclusion and exclusion criteria. Results: the final sample included 59 articles, which were grouped into the following thematic categories: conceptions in mental health, communication, interventions, network care, competence in mental health care and barriers during care. Conclusion: care is done incipient and permeated by difficult elements. The findings of this study serve to review and rethink mental health care practices and policies and promote strategies for improving work processes.

Social representations of nurses of the Emergency Care Unit towards people with mental disorder / Representaciones sociales de las enfermeras y enfermeros de la Unidad de Cuidados de Urgencia hacia las personas con trastornos mentales / Representações sociais de enfermeiros da Unidade de Pronto Atendimento às pessoas com transtorno mental

ABSTRACT Objective: To understand the Social Representations of nurses from an Emergency Care Unit about the care provided to people with mental disorders. Method: Qualitative exploratory study, supported by the theoretical and methodological framework of the Theory of Social Representations. Interviews were conducted from July to August 2021. The data were processed using the IRaMuTeQ software. Results: 22 nurses were interviewed. From the processed data, three discursive categories were constructed: the tortuousness of the Psycho-Social Care Network (RAPs): in search of a path; the abyss between the health professional and the person with mental disorder; and unveiling the care of nurses in the Mental Health Emergency Care Unit. Conclusion: We identified a lack of knowledge about the Psychosocial Care Network, anchoring elements associated with previous negative experiences that influence the professional-patient relationship, and nursing care permeated by cognitive barriers. Such findings are unprecedented in the locality studied and relevant to promote the qualification of the work of nurses in mental health in the Emergency Care Unit.

RESUMEN Objetivo: Conocer las Representaciones Sociales de las enfermeras de una Unidad de Cuidados de Urgencia sobre los cuidados prestados a personas con trastornos mentales. Método: Estudio exploratorio cualitativo, apoyado en el marco teórico y metodológico de la Teoría de las Representaciones Sociales. Las entrevistas se realizaron entre julio y agosto de 2021. Los datos se procesaron con el software IraMuTeQ. Resultados: Fueron entrevistadas 22 enfermeras. A partir de los datos procesados, se construyeron tres categorías discursivas: lo tortuoso de la Red de Atención Psicosocial: en busca de un camino; el abismo entre el profesional de la salud y la persona con trastorno mental; y develar el cuidado de las enfermeras en la Unidad de Atención de Emergencias en Salud Mental. Conclusiones: Identificamos un desconocimiento de la Red de Atención Psicosocial, elementos de anclaje asociados a experiencias negativas previas que influyen en la relación profesional-paciente, y cuidados de enfermería permeados por barreras cognitivas. Tales hallazgos son inéditos en la localidad estudiada y relevantes para promover la cualificación del trabajo de enfermería en salud mental en la Unidad de Cuidados de Urgencia.

RESUMO Objetivo: Compreender as Representações Sociais de enfermeiros de uma Unidade de Pronto Atendimento sobre o cuidado dispensado às pessoas com transtornos mentais. Método: Estudo exploratório qualitativo, sustentado pelo referencial teórico-metodológico da Teoria das Representações Sociais. Foram realizadas entrevistas no período de julho a agosto de 2021. Os dados foram processados com o auxílio do software IraMuTeQ. Resultados: Foram entrevistados 22 enfermeiros. A partir dos dados processados foram cosntruídas três categorias discursivas: a tortuosidade da Rede de Atenção Psiscossocial: em busca de um caminho; O abismo entre o profissional de saúde e a pessoa com transtorno mental; e desvelando o cuidado dos enfermeiros da Unidade de Pronto Atendimento em saúde mental. Conclusão Identificou-se falta de conhecimento sobre a Rede de Atenção Psicossocial, elementos de ancoragem associados à experiências prévias negativas que influenciam a relação profissional-paciente e, um cuidado de enfermagem permeado por barreiras cognitivas. Tais achados são inéditos na localidade estudada e relevantes para promover a qualificação do trabalho do enfermeiro em saúde mental na Unidade de Pronto Atendimento.

Lunchtime as a therapeutic moment: a health education approach with alcohol-dependent women.

Alcoholism is a relevant problem in public health. The use of alcohol among women has increased as well as the search for treatment. This research proposes the resignification of food to these women, as a harm reduction strategy. The research aimed to study and to discuss the experience of lunchtime as a therapeutic moment, presenting theoretic assumptions, strategies and immediate results. The clinical-qualitative methodology and the content analysis were used. The results, divided in seven categories, refer to the educational intervention process: environment as facilitator; sharing food--becoming a partner; broadening the perception of food; food and its meanings; sexuality; relapses; depression x motivation. The heath education performed during lunch is a possibility of therapeutic intervention, provided that the health professionals perceive the multidimensionality of food, considering the nutritional aspects as much as the symbolic ones, which are relevant for the creation of bonding and motivation for the treatment.

[Parents and caregivers of depressed adolescents: learning about experiences that led to the search for specialized care]. / Pais e responsáveis do adolescente deprimido: buscando conhecer experiências que levaram a procura de atendimento especializado.

This study is aimed at analyzing the processes and the motivations that lead parents and caregivers to notice the depressive illness in adolescents and at understanding the influence of health beliefs and cultural habits in the search of specialized treatment. Using the qualitative case study method, four parents and/or caregivers of adolescents with diagnoses of depression under treatment at a mental health clinic in the city of Campinas, State of São Paulo, were interviewed. In accordance with the theoretical presumptions of the Health Belief Model (HBM), the categories that were created and discussed were: the perception of parents and caregivers regarding the susceptibility to the depressive illness; the perception of parents and caregivers regarding the severity of the depressive illness; external stimuli influencing the search for specialized treatment; the barriers and benefits perceived for the search for specialized attendance; structural and social variables influencing the search for specialized attendance.

[Demands for attention experienced by a patient in a bone marrow transplants unit]. / Demandas de atenção de um paciente na unidade de transplante de medula ossea.

The capacity to focus attention is essential for the effective handling of everyday life for it allows one to perceive, think clearly and keep the intended activity in course despite environmental distractions. This qualitative approached study was aimed at identifying the attention demands experienced by a patient diagnosed with sharp myeloid leukemia submitted to a bone marrow transplants (BMT) following the theoretical reference of attention and attention demands. The data was collected through a semi-structured interview and a-systematic observation, with later content thematic analysis. The results pointed out that the patient in BMT lives multiple attention demands, such as: absence of family, fear of death, uncertainty about the future, restricted physical space, removal from work and too much handling by the Nursing staff, among others.

Family of older adults with mental disorder: perception of mental health professionals.

Objective: to understand the perceptions of healthcare professionals of the Psychosocial Care Centers regarding the family of older adults with mental disorders. Method: study of a Qualitative Case conducted with 12 healthcare professionals from a Psychosocial Care Center, with a convenient and exhaustive sample. Conducting semi-structured interviews to collect data, which were analyzed with the Content Analysis technique. Results: the following categories stood out: "Family exhaustion and deterioration in the perception of the healthcare professional" and "The abandonment of older adults by family members and their distancing in the perception of the healthcare professional." Final considerations: culpability of older adults and penalization of the family were verified by healthcare professionals. To bring awareness about the difficulties faced in the attempt to bring the family closer to the healthcare service, it is necessary to analyze the care given to the older adult and to overcome challenges in the effective construction of the bond between family, healthcare user and mental health service.

Objetivo: compreender as percepções dos profissionais do Centro de Atenção Psicossocial acerca da família do idoso em sofrimento psíquico. Método: estudo de Caso Qualitativo conduzido com 12 profissionais de um Centro de Atenção Psicossocial com amostra composta por intencionalidade e fechada por exaustão. Realização de entrevistas semiestruturadas para coleta de dados, analisados por meio da técnica de Análise de Conteúdo. Resultados: destacaram-se as categorias "O cansaço e o desgaste familiar na percepção do profissional" e "O abandono e o afastamento do idoso pela família na percepção do profissional". Considerações finais: verificou-se a culpabilização do idoso e a penalização da família pelos profissionais. Visando à conscientização das dificuldades em aproximar a família, é necessária a criação de espaços reflexivos sobre o cuidado a essa população, bem como a superação dos desafios na construção efetiva do vínculo entre família, usuário e serviço de saúde mental.

Data collection in clinical-qualitative research: use of non-directed interviews with open-ended questions by health professionals.

Non-directed interviews constitute the main data collection instrument in qualitative health research. Studies in which this is evident are well documented in international literature. For health professionals, knowing what people feel and imagine makes it possible to develop a more adequate clinician-patient relationship. It is indispensable to know what the life phenomena mean for individuals, because the meanings have a structuring function. People organize their lives around the meaning they attribute to situations or object. This is also relevant to their health care. From research conducted at the Laboratory of Clinical-Qualitative Research, State University of Campinas, Campinas (São Paulo), Brazil, the authors address, in this article, the following matters: characterization of non-directed interviews, directiveness of interviews, approach techniques, observation of non-verbal and paraverbal manifestations, registry techniques / speech transcription, and validity/reliability of non-directed interviews. This is useful for people interested in research at graduate and undergraduate level.

Seven steps for qualitative treatment in health research: the Clinical-Qualitative Content Analysis / Sete passos para o tratamento de dados qualitativos em pesquisa em saúde: a Análise de Conteúdo Clínico-Qualitativa

Abstract Qualitative Health research procedures that are not always applied, mainly in the analysis phase. Our objective is to present a systematized technique of step-by-step procedures for qualitative content analysis in the health field: Clinical-Qualitative Content Analysis. Our proposal consider that the qualitative research applied to the field of health, can acquire a perspective analogous to clinical practice and aims to interpret meanings expressed in reports through individual interviews or statements. This analysis takes part of the Clinical-Qualitative Method. The literature review was realized through: a book chapter, eight original articles and three methodological articles. The Clinical-qualitative Content Analysis technique comprises seven steps: 1) Editing material for analysis; 2) Floating reading; 3) Construction of the units of analysis; 4) Construction of codes of meaning; 5) General refining of the codes and the Construction of categories; 6) Discussion; 7) Validity. The clinical-qualitative analysis presupposes and involves a critical reflection on the processes carried out at each step. This reflection is an extremely rich process, if carried out collectively and in dialogue with other researchers with some proficiency in qualitative methods.

Resumo Os procedimentos da pesquisa qualitativa em saúde nem sempre são bem aplicados, principalmente na fase de análise de dados. Nosso objetivo é apresentar uma técnica sistematizada de procedimentos, passo a passo, para análise de conteúdo qualitativa no campo da saúde: A Análise de Conteúdo Clínico-Qualitativa. Nossa proposta considera que a pesquisa qualitativa aplicada ao campo da saúde, pode adquirir uma perspectiva análoga à prática clínica e visa interpretar significados expressos em relatos por meio de entrevistas ou depoimentos individuais. Esta análise faz parte do Método Clínico-Qualitativo. A revisão de literatura foi realizada por meio de: capítulo de livro, oito artigos originais e três artigos metodológicos. A técnica de Análise Clínico-Qualitativa de Conteúdo compreende sete passos: 1) Edição de material para análise; 2) leitura flutuante; 3) Construção das unidades de análise; 4) Construção de códigos de significado; 5) Refinação geral dos códigos e construção de categorias; 6) Discussão; e 7) Validade. A análise clínico-qualitativa envolve uma reflexão crítica sobre os processos realizados em cada etapa. Essa reflexão é um processo extremamente rico, se realizado coletivamente e em diálogo com outros pesquisadores com alguma proficiência em métodos qualitativos.

A percepção dos profissionais de saúde sobre o cuidado ao idoso com transtorno mental / The perception of health professionals regarding the care for the elderly with mental disorders / La percepción de los profesionales de la salud sobre el cuidado al anciano con el trastorno mental

OBJETIVO: compreender as percepções da equipe de um Centro de Atenção Psicossocial sobre o cuidado ao idoso com transtorno mental. MÉTODO: estudo qualitativo com referencial teórico-metodológico: Teoria das Representações Sociais. O campo de estudo foi um Centro de Atenção Psicossocial no interior do estado de São Paulo. Amostra composta por conveniência, fechada por exaustão, constituída por 12 profissionais. A coleta de dados foi realizada por meio da entrevista semiestruturada e estes foram analisados pela análise temática de conteúdo. RESULTADOS: emergiram três categorias que evidenciam contradições sobre a percepção dos profissionais acerca do papel do CAPS. Essas contradições podem estar ancoradas nas representações sobre as dificuldades relatadas na assistência ao idoso, que se sobrepõem às dificuldades no cuidado ao indivíduo com transtorno mental. A ausência de estratégias para o atendimento cotidiano é abordada e a educação profissional é apontada como importante, porém ausente. O desgaste do profissional em saúde mental emerge e a percepção sobre a falta de recursos humanos é revelada nos discursos. Essas problemáticas trazem uma representação de práticas insuficientes que refletirão no cuidado ao idoso com transtorno mental. CONCLUSÃO: o estudo contribui com esclarecimentos a serem abordados em estudos de intervenção para potencializar a transformação do cuidado.

OBJECTIVE: to understand the perceptions of the staff of a Psychosocial Care Center regarding the care for the elderly with mental disorders. METHOD: qualitative study with a theoretical and methodological framework: Theory of Social Representations. The field of study was a Psychosocial Care Center in the state of São Paulo. Convenience sampling was used, and the sample consisting of 12 professionals was determined by saturation. Data were collected by semi-structured interviews and analyzed by thematic content analysis. RESULTS: three categories emerged, and they showed contradictions regarding the professionals' perceptions of the CAPS' role. Such contradictions may be supported on the representations concerning the difficulties reported in the care for the elderly, which overlap with those in the care for individuals with mental disorders. The lack of strategies for routine care is discussed, and professional education is mentioned as important although it is non-existent. The burnout of mental health professionals emerges, and the perception of the lack of human resources is revealed in the discourses. These problems bring about a representation of insufficient practices that will reflect on the care for the elderly with mental disorders. CONCLUSION: the study contributes with clarifications to be addressed in intervention studies in order to strengthen heath care change.

OBJETIVO: comprender las percepciones del equipo de un Centro de Atención Psicosocial sobre el cuidado al anciano con trastorno mental. MÉTODO: estudio cualitativo con referencial teórico-metodológico: Teoría de las Representaciones Sociales. El campo de estudio fue un Centro de Atención Psicosocial en el interior del estado de São Paulo. Una muestra compuesta por conveniencia, cerrada por agotamiento, constituida por 12 profesionales. La recolección de datos fue realizada, a través de la entrevista semiestructurada y el análisis de los datos del análisis temático de contenido. RESULTADOS: surgieron tres categorías que evidencian contradicciones sobre la percepción de los profesionales acerca del papel del CAPS. Estas contradicciones pueden estar ancladas en las representaciones acerca de las dificultades relatadas en la asistencia al anciano que se superpone con dificultades en el cuidado al individuo con trastorno mental. La ausencia de estrategias para la atención cotidiana es abordada y la educación profesional es señalada como importante, pero ausente. El desgaste del profesional en salud mental emerge y la percepción sobre la falta de recursos humanos es revelada en los discursos. Estas problemáticas traen una representación de prácticas insuficientes que reflejará en el cuidado al anciano con trastorno mental. CONCLUSIÓN: el estudio contribuye con aclaraciones para ser abordados en estudios de intervención para potenciar la transformación del cuidado.

Vivências de pacientes diante de incapacidades funcionais pós-tratamento em Unidade de Terapia Intensiva / Post-ICU Treatment Experiences of Patients with Functional Disabilities / Experiencias de pacientes con discapacidades funcionales posteriores al tratamiento en la Unidad de Cuidados Intensivos / Post-ICU Treatment Experiences of Patients with Functional Disabilities

Introdução: Compreender as vivências de pacientes diante de incapacidades funcionais pós-tratamento em Unidade de Terapia Intensiva no retorno ao domicílio. Materiais e Métodos: trata-se de um estudo de abordagem qualitativa que utilizou o Estudo de Caso como método de pesquisa. A amostra de oito participantes foi composta de modo intencional e fechada por saturação teórica. A coleta de dados ocorreu por meio de entrevistas semiestruturadas domiciliares complementadas por anotações em diário de campo. Os dados foram analisados pela análise temática de conteúdo proposta por Minayo. Resultados: a atenção primária, por meio da Atenção Domiciliar, foi a principal responsável pelo acompanhamento pós-alta dos participantes. Do material empírico emergiram as categorias "O sofrimento emocional e sua repercussão na recuperação funcional" e "A perda do papel familiar e os conflitos com cuidadores". Discussão e Conclusões: a recuperação funcional do paciente com incapacidades funcionais pós-terapia intensiva pode ser complexa, exigindo além de reabilitação física o adequado acompanhamento psicoemocional, a elucidação de memórias da internação e o apoio profissional à família. Sugere-se que a atenção primária receba capacitação sobre a complexidade desses pacientes e a criação de estratégias que a aproximem da atenção hospitalar, permitindo um cuidado compartilhado e continuado.

Introduction: Understanding the experiences of patients with functional disabilities after Intensive Care Unit treatment following their return home. Materials and methods: A qualitative study was conducted using the case study as a research method. The sample of eight participants was intentionally composed and closed by theoretical saturation. Data was collected through semi-structured home interviews supplemented by field notes and diaries. Collected data were analyzed using the thematic content analysis proposed by Minayo. Results: Primary care, through home care, was the main responsible for the post-discharge follow-up of participants. From the empirical material, the categories "emotional distress and its impact on functional recovery" and "loss of family role and conflicts with caregivers" were created. Discussion and conclusions: Functional recovery of patients with functional disabilities after going through intensive care can be complex that, besides physical rehabilitation, adequate psycho-emotional monitoring, requires clarification of memories of hospitalization and professional support to the family. It is suggested that primary care staff receive training on the complexity of these patients and the creation of strategies that bring them closer to inpatient care, thus allowing shared and continuous care.

Introducción: Comprender las experiencias de los pacientes con discapacidades funcionales después del tratamiento en la Unidad de Cuidados Intensivos a su regreso a casa. Materiales y métodos: Se trata de un estudio de enfoque cualitativo que utilizó el estudio de caso como método de investigación. La muestra de ocho participantes fue compuesta intencionalmente y cerrada por saturación teórica. La recolección de datos se realizó a través de entrevistas domiciliarias semiestructuradas complementadas con notas y diarios de campo. Los datos fueron analizados mediante el análisis de contenido temático propuesto por Minayo. Resultados: La atención primaria, a través de la atención domiciliaria, fue la principal responsable del seguimiento posterior al alta de los participantes. Del material empírico, surgieron las categorías "sufrimiento emocional y sus repercusiones en la recuperación funcional" y "la pérdida del rol familiar y los conflictos con los cuidadores". Discusión y conclusiones: La recuperación funcional de pacientes con discapacidades funcionales después de pasar por cuidados intensivos puede ser compleja y requiere, además de rehabilitación física, monitoreo psicoemocional adecuado, aclaración de los recuerdos de hospitalización y apoyo profesional a la familia. Se sugiere que la atención primaria reciba capacitación sobre la complejidad de estos pacientes y la creación de estrategias que lo acerquen a la atención hospitalaria, lo que permite una atención compartida y continua.

Discourse of psychoactive substance dependents on their discursively constructed image / Discurso de los dependientes de sustancias psicoactivas sobre su imagen construida discursivamente / Discursos de dependentes de substâncias psicoativas sobre sua imagem discursivamente construída

ABSTRACT Objective: to analyze the discourse of psychoactive substance users undergoing treatment regarding their image of themselves as drug dependent subjects, of other dependents and the social position assumed by them. Method: qualitative study conducted between March and September of 2016 through a semi-structured interview and drawings, based on the theoretical-methodological reference of French Discourse Analysis. Participation of 12 drug dependent subjects undergoing treatment in the service that substitutes the asylum. Results: The images that psychoactive substance dependents have of themselves and of chemically dependent subjects are associated with the image of a negative, diabolical, transgressive, sick and socially excluded individual. Final considerations: The ideological effects of meanings produced by users' discourses reproduce the biological and moral model. Health professionals, including nurses, need to invest in discourses that address the psychosocial model to demythologize this stigmatizing image and modify their work practice.

RESUMEN Objetivo: analizar el discurso del consumidor de sustancias psicoactivas en tratamiento sobre la imagen que tiene de sí mismo como un sujeto dependiente de las drogas, sobre otros dependientes y sobre la posición social asumida por él. Método: investigación cualitativa realizada entre marzo y septiembre de 2016 a través de una entrevista semiestructurada y dibujos basados en la referencia teórico-metodológica de la escuela francesa del Análisis del Discurso. Doce adictos a las drogas fueron tratados en el servicio de sustitución del manicomio. Resultados: las imágenes que los dependientes de sustancias psicoactivas tienen de sí mismos y de los dependientes químicos se asocian con la imagen negativa, diabólica, transgresora, enferma y de una persona socialmente excluida. Consideraciones finales: los efectos de significado producidos ideológicamente por los discursos de los dependientes reproducen el modelo biológico y moral. Los profesionales de la salud, incluidos los enfermeros, deben invertir en discursos que aborden el modelo psicosocial, para desmitificar esta imagen estigmatizante y modificar su práctica en el trabajo.

RESUMO Objetivo: analisar o discurso do usuário de substâncias psicoativas em tratamento sobre a imagem que ele tem de si mesmo enquanto sujeito dependente de drogas, dos outros dependentes e da posição-social assumida por ele. Método: estudo qualitativo, realizado em março e setembro de 2016, por meio de entrevista semiestruturada e desenhos, baseado no referencial teórico-metodológico da Análise de Discurso de linha francesa. Participaram 12 dependentes de drogas em tratamento no serviço substitutivo ao manicômio. Resultados: As imagens que o dependente de substâncias psicoativas tem de si e do dependente químico estão associadas com a imagem negativa, diabólica, transgressora, de doente e socialmente excluído.Considerações finais: Os efeitos de sentido ideologicamente produzidos pelos discursos dos usuários reproduzem o modelo biológico e moral. Os profissionais de saúde, inclusive o enfermeiro, necessitam investir em discursos que abordem o modelo psicossocial, para desmitificar esta imagem estigmatizante e modificar sua prática no âmbito de seu trabalho.