Tratamento no modelo hospitalocêntrico: percepções de familiares e portadores de transtorno mental

Abstract

RESUMO: Pesquisa com o método da história oral temática, desenvolvida no ano de 2009, em Curitiba, com oito participantes pertencentes a três famílias que tinham um integrante com transtorno mental. Objetivou-se descrever a percepção de familiares e de portadores de transtorno mental sobre a assistência em saúde mental sustentada no modelo hospitalocêntrico. Os dados foram obtidos por meio de entrevista semiestruturada e analisados de acordo com a análise temática. Os sujeitos atribuíram ao modelo hospitalocêntrico as sucessivas internações em instituições com características asilares, o emprego de espaços restritivos, como as celas fortes no tratamento da pessoa com transtorno mental. Mencionaram o uso da força, da sedação, da eletroconvulsoterapia, da contenção física no leito e do enfaixamento como recursos utilizados sem critérios e de forma indiscriminada. Conclui-se que as narrativas contribuem para o entendimento das mudanças atuais na forma de assistir e tratar da pessoa com transtorno mental. Palavras-Chave: Assistência em saúde mental; transtornos mentais; família; tratamento. ABSTRACT: Thematic oral history-based research conducted in Curitiba, PR, Brazil, in 2009, with eight subjects in three families with a member affected by mental disturbance. The study aimed at describing the perception of both those affected by mental disturbance and of their relatives on hospital-centered assistance for mental health. Data were obtained through semi-structured interviews and treated on the basis of thematic analysis. Subjects charged the hospital-centered model with the successive internments in shelter-like institutions, and with the restrictive spaces such as strong cells used in the treatment of those affected by mental disturbance. They reported the use of the force, sedation, electro-convulse-therapy, physical contention in bed, and bandaging as some of the resources used lacking criteria. In conclusion, narratives help understand current changes in the assistance of those with mental disturbance.

Cuidado de enfermagem às pessoas com transtorno de personalidade borderline na perspectiva freireana

“…However, it should not be considered as the only possible intervention but should be combined with other modalities of care (14) . It is known that non-adherence to drug treatment or the irregular use of psychotropic drugs may have repercussions in successive hospitalizations for implying new crises (15) . However, medicalization can sometimes serve the non-accountability of the subject for his problem, since the improvement is deposited in a magical and external solution (16) .…”

“…It is a technique indicated for frames, and in that the patient exhibits exacerbated behavioral manifestations that endanger one's own physical integrity or of others. It should be used as a last resort when all others are inefficient (14)(15) .…”

“…Still about this, it should be noted that the prescription of mechanical restraint is a medical indication (15) . The Federal Nursing Council, through resolution number 427/2012, normalized the nursing procedures in the use of mechanical containment.…”

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

“…This process should take place in respect to some of the difficulties experienced by the person with psychological distress, imposed by the mental disorder and long hospitalizations. Moreover, their singularity should be acknowledged and their distress should be evaluated with everyday contact (21)(22)(23) . The moment in which the family gets closer, as reported by the healthcare workers, is anchored on the biomedical and medicalizing model, in which the doctor and the medication are the center of the treatment.…”

“…However, this care has not been satisfactorily provided, thus the families do not meet the expectations of enabling social reintegration (21) . These representations come from the consensual universe of healthcare workers, i.e., from their everyday experience with healthcare users and often from contact with the family.…”