Participação da Família no Tratamento em Saúde Mental como Prática no Cotidiano do Serviço

Martins, Pedro Pablo Sampaio; Guanaes‐Lorenzi, Carla

doi:10.1590/0102.3772e324216

Cited by 21 publications

(33 citation statements)

References 17 publications

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“…Apesar das atividades com as famílias terem sempre sido consideradas parte importante do tratamento no HD, a partir de 2009 a equipe se mobilizou para reestruturar um programa com o objetivo de ampliar as formas de participação dos familiares na instituição. A ideia central trata de oferecer assistência às famílias, em uma abordagem biopsicossocial de cuidado em saúde mental (Martins, 2013). Assim, o Programa de Assistência Familiar (PROAF), coordenado pelo Dr. Sérgio Ishara, oferece algumas modalidades de atendimento que têm em comum a preocupação de cuidar das famílias dos pacientes.…”

Section: Sobre a Práticaunclassified

“…A prática dos processos reflexivos tem sido descrita na literatura (McNamee & Gergen, 1992) como uma forma de elaboração das contribuições construcionistas sociais no campo da terapia familiar. Amplamente difundida, ela tem sido adotada como recurso para a organização das reuniões familiares desde seu início (Guanaes-Lorenzi et al, 2012;Martins, 2013;Martins, Santos & Guanaes-Lorenzi, 2014). O uso desse recurso se dá porque, para além de sua reconhecida contribuição no campo da terapia familiar, a própria estrutura da instituição favorece a possibilidade de que a equipe profissional esteja disponível, em um mesmo momento, para somar seus conhecimentos e compartilhar de uma mesma prática.…”

Section: Sobre a Práticaunclassified

“…O autor principal do trabalho, Pedro P. S. Martins, passou a participar ativamente junto a este contexto em 2011. Isso ocorreu a partir de sua inserção no Mestrado, que tinha o HD como local de pesquisa (Martins, 2013). Nesse período, ele ministrou palestras, participou das supervisões e, ainda, esteve na Equipe Reflexiva de um caso por semana, sempre que possível.…”

Section: Sobre a Práticaunclassified

“…O interesse em pesquisar especificamente as reuniões familiares surgiu a partir dos resultados de outra pesquisa, que visava ampliar o entendimento sobre como o PROAF se constitui em um espaço de cuidado para a família (Martins, 2013;Martins & Guanaes-Lorenzi, no prelo). Naquela ocasião, entrevistamos familiares que já participaram das modalidades de atendimento oferecidas no HD.…”

Section: Sobre a Pesquisaunclassified

“…Por um lado, as reuniões pareciam promover um espaço de diálogo diferente do cotidiano da família, capaz de proporcionar melhorias na qualidade de suas relações. Por outro, apesar de ter sido possível entender que este contexto funciona para a promoção da saúde mental da família, ficou ainda a questão de investigar mais precisamente como tal espaço de diálogo é capaz de transformar, de alguma forma, as relações familiares (Martins, 2013). A fim de investigar mais profundamente esse como, delineamos o projeto de pesquisa que deu origem a esta tese.…”

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Recursos conversacionais para a clínica ampliada com famílias em saúde mental

Martins¹

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Since the Brazilian Psychiatric Reform, we have witnessed an increased value of family participation in treatment. Alternatives of attention to family members in the context of services have been sought. When the challenges of bringing clinical practices into the Unified Health System are added to the debate, the concept of the expanded clinic arises, and this concept associates the notions of subjectivity and citizenship. Emphasis is placed on the importance of dealing with each concrete situation as part of contexts and social relations. A Program of Family Care in a Psychiatric Day Hospital exists in line with these concerns. This program offers several activities for families. Family Reunions are amongst these activities, and they are the specific context of this research. The contributions of a social constructionist orientation for family therapy guide family reunions with a focus on processes of meaning making. This research aimed to analyze the approximation of a practice with families (family reunions) to the notion of the expanded clinic in mental health care. The research specifically aims to: a) understand the process of meaning making in this practice, while analyzing the construction of conversational resources in the interaction, as well as their effects to the transformations of the meanings of problem and self throughout the process; and b) describe how these resources contribute to the expansion of clinical practices with families. Thirtythree family reunions (three family cases) were followed in the institution. These sessions were audio recorded, and fully transcribed, in order to constitute the research corpus. A social constructionist understanding about research practices is the methodological guide for this investigation. All sessions were submitted to a thematic-sequential analysis of the process of meaning making. We have described the negotiation and transformation of meanings about a problem that was considered, by the patient and by their family, as central to their lives. For each case, the main conversational resource constructed during the process was analyzed and described. These conversational resources are: a) inviting the social into the individual; b) weaving family dialogue; and c) knowing yourself in other voices. The analysis of each case considered: how something was constructed as a problem to be worked out; how the use of the resources was carried through; and the effects the use of this resource created throughout the case. We offer, as our thesis, a social constructionist reading of the expanded clinic, where we call attention to how the expansion of clinical practice is crafted from the effects that particular ways of interacting create in the context of practices. It is in the interactive moment that professionals and patients jointly generate understandings about who they are, what their problems are, and what they can do in relation to them, while they talk about their health issues. We discuss how the use of these resources is constructed in interactions, and how ...

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Section: Sobre a Práticaunclassified

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Recursos conversacionais para a clínica ampliada com famílias em saúde mental

Martins¹

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A participação regular continuada e as relações desenvolvidas com o Grupo Comunitário de Saúde Mental

Minaré¹

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The Mental Health Community Group (MHCG) is a care strategy developed at a Day-Hospital (DH). It is an open, single-session group that aims to promote mental health through the proposal of attention to daily experiences. Among its members, there are former DH's users, who attend MHCG on a regular, voluntary and active way for a period of more than two years, which characterizes a regular continued participation. The purpose of this research is to understand the relation modes of former DH's users with the MHCG, who present regular continued participation in the Group. It is a qualitative study, which used participant observation and open interview with seven participants as instruments. The technique of thematic analysis was used for data analysis, in conjunction with a dialogue with authors who study mental health and the theoretical foundation of the MHCG to support the discussion. The analysis resulted in three main themes: the first, "'I had to learn to join the Group': the process of regular continued participation", which presented the development of regular continued participation as a process, and understands it from the history of the interviewed in different contexts of mental health care services and in the MHCG. The second theme, "'I am a simple person who helps people': finding a place through the MHCG", which emphasized experiences of place performed by regular participants from the group context, highlighting the place of being open, the place of singularity and expression of itself, and the place of protagonism and recognition. The third theme, "'Everyone is the Community Group': relationships developed with the Group", which presented the main relationships of the participants with the Group, among which it was identified empathic, community and belonging relationships, in addition to expressions of gratitude and desire to contribute to the Group, which suggests relation modes with the MHCG that support engagement in regular continued participation. Thus, it is possible to understand that maintaining the presence and participation of the people interviewed in the MHCG is associated with the development of a sense of belonging to a community in which there can be an experience of oneself and with the other, intersubjective relationships and significant repercussions in personal life of each participant. The study of people who establish a unique relationship with an open mental health promotion group, which proposes a return to the community dimension and provides attention to life experiences, contributes to the fields of research and multidisciplinary action in mental health and public health, as it broadens the understanding of subjectification processes in the community context. In the context of the MHCG, the emphasis on regular continued participation refers to an attention to microprocesses of constituting group practices, in addition to focusing on the relational environment and its relevance to the subjective human experience. This research collaborated to discussions and practices in men...

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Family functionality and burden of family caregivers of users with mental disorders

et al. 2021

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Objective: to verify the difference of mean or median in the scores of family functionality and burden of family caregivers of people with mental disorders. Methods: cross-sectional study carried out in a Psychosocial Care Center with 61 family caregivers. Instruments were used for sociodemographic characterization, care process, Family Apgar Index and Family Burden Interview Schedule. Mean/median difference tests were adopted. Results: women with mental disorders and the presence of children in the home decreased the median of the family Apgar score. Difficulty in the relationship between caregiver/user, nervousness/tension, physical aggression and agitation of patients increased the global average of subjective burden. Conclusions: nursing interventions to reduce burden and promote family functionality should prioritize caregivers of women with mental disorders, assist them in managing troublesome behaviors and raising awareness of family nucleus to co-responsibility for caring for sick people, especially in families with children who demand daily care.

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Participação da Família no Tratamento em Saúde Mental como Prática no Cotidiano do Serviço

Cited by 21 publications

References 17 publications

Recursos conversacionais para a clínica ampliada com famílias em saúde mental

Recursos conversacionais para a clínica ampliada com famílias em saúde mental

A participação regular continuada e as relações desenvolvidas com o Grupo Comunitário de Saúde Mental

Family functionality and burden of family caregivers of users with mental disorders

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