Mudanças ocorridas na prática profissional na área da saúde mental frente à reforma psiquiátrica brasileira na visão da equipe de enfermagem Changes in professional practice in the mental health area against brazilian psychiatric reform in the vision of the nursing team

Abstract

Pesquisa qualitativa descritiva realizada em 2010 num hospital especializado em psiquiatria do Paraná. Objetivo: Verificar as mudanças ocorridas na prática profissional decorrentes da Reforma Psiquiátrica na visão da equipe de enfermagem. Métodos: Participaram da pesquisa 15 profissionais de enfermagem. Os dados foram obtidos mediante entrevista semiestruturada e os resultados organizados em categorias temáticas. Resultados: Obteve-se que os sujeitos perceberam mudanças na organização da assistência e no modo de assistir a pessoa com transtorno mental, a importância da equipe multiprofissional nesse processo e a transformação do papel da equipe de Enfermagem e do enfermeiro frente às novas formas de tratamento surgidas. Conclusão:Há avanços decorrentes da Reforma e que estes interferem diretamente na formação e atuação das equipes de Enfermagem gerando a necessidade de preparo e capacitação destes profissionais.

Psychiatric nursing and mental health teaching in relation to Brazilian curriculum

“…During this period, the Mental Health Workers Movement (MTSM -Movimento dos Trabalhadores em Saúde Mental) emerged, promoted by the dissatisfaction of professionals (44) , who had influence of the psychiatric reform in Italy, which aimed at improving psychiatric care with deinstitutionalization (12,28) . In 1987 the 2 nd Congress of Mental Health Workers and the 1 st Brazilian National Conference on Mental Health took place, which were settings that precipitated the discussion about Psychiatric Reform in Brazil, with harsh criticism of the current asylum model (15) .…”

Care strategies adopted by nurses for the implementation of Psychosocial Care Centers

“…The care for people with mental disorders has undergone changes with the Psychiatric Reform movement in Brazil since 1978. The National Mental Health Conferences and government actions in the 1990s have led to changes in the care model, until then only centered on the hospital mental basis for a territorially based model with the Psychosocial Care Centers (1)(2) .…”

“…The nurse is fundamental in the composition of the Psychosocial Care Centers team with a mandatory presence in the minimum team (3) . The process of care from the substitutive services had a direct impact on nursing work, because, in the psychiatric hospital, it was centered on the biomedical model and, in the Psychosocial Care units, it was centered on the psychosocial care, in which acting in a multi-professional team with an interdisciplinary approach was foreseen (1)(2) .…”

“…In the hospital-centered model, the nurse was responsible for the team of nursing technicians, whose main function was to develop technical and bureaucratic activities, such as controlling and administering medications; food and hygiene; checking vital signs; disciplining patients in wards; and organizing the environment (2,4) .…”

“…The nurse needed to have other care strategies to act in a Psychosocial Care device, such as relational technologies -bonding, fostering, and co-responsibility. Working only with traditional and technicist practices linked to the hospital-centered model implied a risk of reproducing the asylum context in a psychosocial rehabilitation service (2)(3)(4)(5)(6) . The use of subjective tools is part of a complex but less technical treatment, in accordance with the Psychiatric Reform movement (2,5) .…”