ResumoFoi avaliada a sobrecarga de familiares cuidadores de pacientes psiquiátricos e sua relação com as habilidades sociais e assertividade. Participaram 53 familiares, atendidos em um CAPS tipo I. Utilizou-se a Escala de Sobrecarga BI, o Inventário de Habilidades Sociais IHS-Del-Prette, a Escala de Assertividade RAS e um Questionário Sociodemográfico e Clínico. Os resultados mostraram que os familiares com maior grau de inibição e timidez (RAS) apresentaram escores significativamente mais elevados de sobrecarga. A análise de regressão múltipla mostrou que a timidez foi o principal fator preditivo da sobrecarga. Não foi encontrada relação da sobrecarga com os escores do IHS-Del-Prette. Os dados apontam para a necessidade de implementar ações psicoeducacionais nos serviços de saúde mental, envolvendo o treinamento de assertividade dos familiares cuidadores, contribuindo, assim, para um melhor relacionamento com os pacientes e uma busca mais eficiente de suporte social, para o desempenho do papel de cuidador com menor sobrecarga. Palavras-chave: Cuidadores; Pacientes; Habilidades sociais; Assertividade; Serviços de saúde mental. Burden in family caregivers of psychiatric patients: relation with assertive behavior AbstractThis research evaluated the family caregivers' burden regarding the care of psychiatric patients and its relation to social skills and assertiveness. The sample was composed of 53 family caregivers of patients who were treated in a community mental health service (CAPS type I). They were interviewed with the application of the Burden Scale BI, the Social Skills Inventory IHS-Del-Prette, the Assertiveness Scale RAS, and a Sociodemographic and Clinical Questionnaire. Results showed that family caregivers presenting higher degree of inhibition and shyness (RAS) had significantly higher burden scores. Multiple regression analysis showed that shyness was the main predictive factor for burden. No relation was found between burden and IHS-DelPrette scores. Data indicated the need to implement psychoeducational programs in mental health services in order to increase caregivers' assertive behavior, so that they could develop a better relationship with patients and a more efficient search for social support, contributing to decrease burden. Sobrecarga de familiares cuidadores de pacientes psiquiátricos: relación con assertividad ResumenFue evaluada la sobrecarga de familiares cuidadores de pacientes psiquiátricos y suya relación con las habilidades sociales y asertividad. Participaran 53 familiares, atendidos en un CAPS tipo I. Fueron utilizados Escala de Sobrecarga BI y asertividad RAS, el Inventario de Habilidades Sociales IHS-Del-Prette y un Cuestionario Sociodemográfico y Clínico. Resultados mostraran que los familiares con el más alto grado de inhibición y timidez (RAS) presentaran escores significativamente más elevados de sobrecarga. El análisis de regresión múltiple mostró que la timidez fue el principal factor predictivo de sobrecarga. No fue encontrado relación de la sobrecarga con los escores del...
Estudos de Psicologia I Campinas I 31(4) I 549-558 I outubro -dezembro 2014 ResumoCom a desinstitucionalização psiquiátrica, as famílias passaram a ter papel fundamental na reinserção social dos pacientes, bem como um sentimento de sobrecarga com esse papel. Um bom relacionamento entre familiares e pacientes constitui um importante fator modulador que pode diminuir a sobrecarga. Entretanto, poucos estudos avaliaram as habilidades sociais dos familiares cuidadores, embora elas sejam necessárias para o desenvolvimento de um bom relacionamento com o paciente. O objetivo desta pesquisa foi avaliar essas habilidades. Foram entrevistados 53 familiares, com aplicação dos instrumentos: Inventário de Habilidades Sociais, Rathus Assertiveness Schedule e questionário sociodemográfico. Os resultados mostraram porcentagem elevada de familiares com baixos escores de habilidades sociais e da subclasse de assertividade. Esses resultados sugerem a necessidade de serem implantados programas de treinamento de habilidades sociais nos serviços de saúde mental, para que os familiares cuidadores desenvolvam um melhor relacionamento com o paciente, potencializando a prestação de cuidados mais adequados. Palavras-chave:
Interventions to reduce stigma related to people who use drugs can improve their quality of life and adherence to treatment. This review aimed to identify and analyze studies on interventions to reduce the stigma related to people who use drugs. Searches were performed in the following databases, without period delimitation: PubmMed, APA PsycNET, ScienceDirect, Web of Science, and VHL. Considering secondary referencing, we identified a total of 5,488 records. This review covered 28 articles and was based on PRISMA. Although target audiences comprising students and health professionals were predominant, as well as the use of quantitative methods, sample size and interventions varied among studies. The selected studies present considerable methodological limitations. We concluded that no evidence confirms the effectiveness of the proposed interventions and which of them should continue to be applied for this specific aim. It is essential to invest in approaches other than those traditionally adopted.
Global alcohol consumption and harmful use of alcohol is projected to increase in the coming decades, and most of the increase will occur in low- and middle-income countries (LMICs); which calls for cost-effective measures to reduce alcohol exposure in these countries. One such evidence based measure is screening and brief intervention (BI) for alcohol problems. Some of the characteristics of BI make them a particularly appealing choice of interventions in low-resource settings. However, despite evidence of effectiveness, implementation of BI in LMICs is rare. In this paper we discuss barriers to implementation of BI in LMICs, with examples from Latin America and India. Key barriers to implementation of BI in LMICs are the lack of financial and structural resources. Specialized services for alcohol use disorders are limited or non-existent. Hence primary care is often the only possible alternative to implement BI. However, health professionals in such settings generally lack training to deal with these disorders. In our review of BI research in these countries, we find some promising results, primarily in countries from Latin America, but so far there is limited research on effectiveness. Appropriate evaluation of efficacy and effectiveness of BI is undermined by lack of generalisability and methodological limitations. No systematic and scientific efforts to explore the implementation and evaluation of BI in primary and community platforms of care have been published in India. Innovative strategies need to be deployed to overcome supply side barriers related to specialist manpower shortages in LMICs. There is a growing evidence on the effectiveness of non-specialist health workers, including lay counsellors, in delivering frontline psychological interventions for a range of disorders including alcohol use disorders in LMICs. This paper is intended to stimulate discussion among researchers, practitioners and policy-makers in LMICs because increasing access to evidence based care for alcohol use disorders in LMICs would need a concerted effort from all these stakeholders.
Health professionals are in a strategic position to help people with substance use disorders (SUDs) who seek health services for support or treatment. However, it is known that professionals' attitudes towards people who use alcohol and other drugs are marked by stigmatizing attitudes that create barriers to access quality treatment and make it difficult for the user to adhere to it. From this, the present study aimed to investigate the attitudes of 264 health professionals from specialised services and primary health care (PHC) in the Southeast region of Brazil, through Opening Minds Scale for Healthcare Providers (OMS-HC), taking into account the hypothesis of contact with the subject as a predictor of more positive attitudes. For this, a Multiple Hierarchical Regression was carried out to ascertain the contribution of the variables used in the explanatory model of attitudes. In addition, the measure of social desirability (SD), assessed by Brazilian Portuguese adaptation of Marlowe-Crowne Social Desirability Scale, was used as a control variable in the regression model to obtain a more robust and accurate model regarding the presence of biased responses, pervasive in studies on attitudes. In general, our findings showed that contact/familiarity with substance use, either through direct contact with users or through the respondent's own use, predicted more positive attitudes, with specialised service professionals expressing more positive attitudes than those working in PHC. Blaming the user for his/her condition presented itself as a predictor of more negative attitudes.Studies like this are of paramount importance for understanding the relationship established between professionals and service users and, therefore, for tailoring interventions and programs that aim to reduce stigmatizing attitudes and provide better access to health for people with SUDs. The importance of using the SD measure as a control variable in Regression is also emphasised, as an effective way to overcome to a common limitation in studies of attitudes.
O objetivo deste estudo foi avaliar as atitudes das pessoas que moram na vizinhança de Serviços Residenciais Terapêuticos (SRTs) em relação aos pacientes psiquiátricos e aos serviços de saúde mental, no município de Barbacena, Minas Gerais, Brasil. Foi avaliada uma amostra probabilística estratificada, composta por 110 vizinhos. Utilizou-se a Escala de Atitudes da Comunidade em Relação aos Doentes Mentais (CAMI-BR) e um questionário sociodemográfico e de informações sobre saúde mental. O resultado do escore global da CAMI-BR mostrou que, em geral, as atitudes dos vizinhos tenderam do neutro ao positivo. Os escores das subescalas foram significativamente diferentes entre si, com atitudes mais positivas na subescala de Benevolência e mais negativas na subescala de Autoritarismo. Observou-se uma ambivalência nas atitudes, apontando para a necessidade das pessoas receberem mais informações sobre os transtornos psiquiátricos e os serviços comunitários de saúde mental, visando a combater as atitudes estigmatizantes e a possibilitar uma melhor reinserção social dos pacientes na comunidade.
O estudo apresenta o protocolo de acolhimento do Calma Nessa Hora, um serviço de e-health via chat, de apoio a pessoas em sofrimento psicológico diante da COVID-19. Foi elaborado um diagrama de fluxo de atendimento com previsão de início e fim em uma sessão, contendo três etapas: avaliação, acolhimento e finalização. Cada etapa possuía marcos de tomada de decisão sobre o fluxo diante do conteúdo e grau de risco da demanda. Na etapa de acolhimento foram priorizadas demandas de baixo e médio risco associadas à Covid-19, como questões sociais e de saúde; ansiedade, depressão ou luto; conflitos familiares e de trabalho. Situações de elevado risco, como intenção suicida e violência, seguiram fluxo específico de encaminhamento para a rede de saúde. O artigo descreve cada etapa e os diferentes fluxos a partir de casos-exemplo. O protocolo é interdisciplinar, com potencial aplicação em serviços de atenção à saúde e serviços-escola nas universidades.
Viabilidade da terapia de aceitação e compromisso para dependentes de drogas Feasibility of acceptance and commitment therapy for drug addicts
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