Psychosocial care Center for Alcohol and Drugs (CAPS ad): nursing insertion and practices in São Paulo City, Brazil

Abstract

This exploratory study with a qualitative approach aimed to identify nurses' insertion and practices at Psychosocial Care Centers for alcohol and drugs in São Paulo City, Brazil.Sixteen nurses participated in the study. Data were recorded and were analyzed by dialectic hermeneutics and guided by Brazilian psychiatric reform premises. The results evidenced nurses' difficulties to take part in the care recommended at these services, as their practices are more linked up with the traditional mental health care model. Causes of this phenomenon include nurses' lack of preparation to act in psychoactive substance-related issues and lack of knowledge on specific contents that would favor their insertion into care practice in these scenarios. It is concluded that more attention should be paid to these contents in nursing education, as the legal requirement of nursing presence at these services is insufficient as a strategy to guarantee their actual insertion. Inclusión y prácticas del enfermero en los Centros de AtenciónPsicosocial para alcohol y drogas (CAPS AD) de la ciudad de Sao Paulo, BrasilEstudio exploratorio de abordaje cualitativo que objetivó identificar la inclusión y las prácticas del enfermero en los Centros de Atención Psicosocial para alcohol y drogas de la ciudad de Sao Paulo, Brasil. Participaron del estudio 16 enfermeros, los datos fueron recolectados por medio de registro autograbado y fueron analizados por la hermenéutica dialéctica orientada por los presupuestos teóricos de la Reforma Psiquiátrica Brasileña.Se evidenciaron dificultades del enfermero para ingresar en el campo de la atención preconizada en esos servicios, siendo sus prácticas más orientadas por el modelo tradicional de atención a la salud mental. Se apuntan como causas de ese fenómeno la carencia de preparación del enfermero para actuación en esa área y el poco conocimiento de contenidos específicos que favorecen su inclusión en el campo de las prácticas. Se concluyó que debe ser dada mayor atención a esos contenidos en la formación del enfermero, ya que la exigencia legal del mismo en esos espacios no se constituye en una estrategia suficiente para garantizar su efectiva inserción.

Cuidar de dependentes de substâncias psicoativas: percepções dos estudantes de enfermagem

“…It is possible that the students' percep on refers to the perpetua on of a way of caring based on moral explana ons for chemical dependence. If the student or new professional enters the service without any training, he would have li le prepara on for and knowledge of the issue and may ul mately repeat intervenons based on the experience of his colleagues, which is not always appropriate (14) . Regarding the training defi cit of professionals in the fi eld of chemical dependence, a study (8) showed that insuffi cient training of professionals is due to the undergraduate curriculum because the workload allocated to the topic is limited and is not systema cally integrated with the curriculum.…”

“…In pre-contempla on, the person does not even realize she has a problem and has no intenon of changing her behavior; in contempla on, the person already has some awareness of the problem and is seriously considering changing her behavior; in determina on, there have been signifi cant changes in lifestyle and there is engagement in meaningful ac ons in pursuit of change; and in ac on, there is less chance of relapse and increased confi dence that the process of change can be con nued (15) . While apprecia ng the importance of the internship, some students s ll feared dealing with a pa ent who presents resistance a er the internship, possibly because they had not overcome their nega ve beliefs about such pa ents (14) . Studies (11,16) have shown that dissa sfac on in dealing with pa ents who use/abuse psychoac ve substances may be related to several factors, among them the features that these pa ents present in the mo va onal stages, such as irritability, denial and independence, as well as emo onal aspects of the students or healthcare professionals, the variable e ology of chemical dependence and the professional's unpreparedness and lack of knowledge.…”

O cuidado aos dependentes químicos: com a palavra profissionais de saúde de centros de atenção psicossocial em álcool e drogas The care for chemically dependent: with words from health professional of centers of psychosocial on alcohol and drugs

“…7,14 From the analysis of the speeches the following categories emerged: 1. The process of work and its impact on care for substance dependents; and 2.…”

“…This factor related to professional unpreparedness is one of the causes for professional turnover in area. 7,13 Authors state that these factors described also affect directly on the individual and team in production, generating an inadequate product which results in a lower quality of care or lower than the expectation of professional.…”

“…4351 dimension refers to the epistemological or theoretical-conceptual field, which is the production of knowledge and expertise; the second is the technical assistance dimension, which emerges in the care model; the third dimension refers to the legal and political field, which re-discusses and redefines social and civil relations in terms of citizenship, human and social rights; and the fourth dimension is the sociocultural, which expresses the transformation of the social place of madness. [7][8] The interviews were recorded just after the acquiescence of health professionals and subsequently transcribed in order to ensure the confidentiality of information and anonymity by adopting the letters: MP for psychiatrists, P -psychologists, M -primary care physicians, TO for occupational therapists, F -pharmaceutical, FI -Physiotherapist, E -nurses, EDphysical educator, TE -nursing technicians, AX -nursing assistants, followed by the sequential number of the interviews.…”