Subject(s)
Humans , Male , Female , Adult , Middle Aged , Postoperative Care , Humanization of Assistance , Nursing Care , Patients , Surveys and Questionnaires , Health Personnel , Patient CareABSTRACT
Los programas de continuidad de cuidados surgen a finales de los años 70 en EEUU, en respuesta a los problemas detectados durante del proceso de desintitucionalización de los hospitales psiquiátricos. Desde entonces, se han extendido por todo el mundo, con variaciones y peculiaridades según las regiones, convirtiéndose en piedra angular de la atención a las personas con enfermedad mental grave y persistente. En este artículo se revisa el origen de estos programas, su desarrollo a lo largo de más de treinta años, la filosofía que los ha guiado en su devenir, así como los éxitos y fracasos en su desarrollo.
The case management programs arise in the late 70's in the U.S., in response to problems identified during the process of deinstitutionalization of psychiatric hospitals. Since then, the case management and the assertive community treatment programs have spread throughout the world, with variations and particularities in different regions, becoming the cornerstone of the community care for people with severe and persistent mental illness. This article reviews the origins of these programs in U.S., their development for over thirty years around the world, the philosophy and objectives that have guided its evolution, as well as successes and failures in their development.
Subject(s)
Community Mental Health Services , Community Psychiatry , Health Care Reform , Mental Health Services , SpainABSTRACT
Se presenta el programa de continuidad de cuidados del Centro de Salud Mental de Chamartín en Madrid, para ilustrar con una experiencia fuera del ámbito anglosajón donde surgen estos programas, la teoría expuesta en la primera parte acerca del surgimiento, desarrollo y filosofía de los programas de continuidad de cuidados. Se describen los recursos sanitarios, sociales y personales de los que dispone la población a la que va dirigido y la forma de intervención, con el tipo de actuaciones que se realizan. Por último, se señalan algunos riesgos en el desarrollo y mantenimiento de los programas de continuidad de cuidados.
The case management program of Chamartin Mental Health Center in Madrid is presented to illustrate with an experience outside the Anglo-Saxon context, where such programs arise, the theory advanced in the first part about the emergence, development and philosophy of continuity of care programs. Finally, some risks in the development and maintenance of continuity of care programs are pointed out. The health, social and staff resources are described, and also the population to be targeted, the form of intervention and the type of actions that are performed. Finally, we point out some risks in the development and maintenance of continuity of care programs.
Subject(s)
Community Mental Health Services , Community Psychiatry , Mental Health Services , Rehabilitation , SpainABSTRACT
El presente artículo tiene como objetivo describir un programa de salud mental innovador que desde mayo de 2003 se viene realizando en la ciudad de Madrid. El objetivo del mismo es atender, acudiendo a su entorno, a las personas sin hogar que padecen enfermedades mentales graves y servir de puente hacia los servicios sociosanitarios de la red general a los que normalmente no tiene acceso. Se describen los modelos teóricos para esta atención (outreach, tratamiento comunitario asertivo y modelo de recuperación) y el trabajo diario que se realiza; así como, las dificultades y barreras que se enfrentan en un trabajo de estas características.
The aim of this article is to describe an innovative mental health unit running in Madrid city since May 2003. The main purposes of this unit is to provide sociosanitary attention, going to their own enviroment- the streets-, to all those homeless persons suffering severe mental disorders. This unit provide a transitional care and engagment to mainstream social and sanitary services that usually they can't reach. It's described the theoretical models sustaining this work (outreach, Assertive Community treatment and Recovery) and also the team's daily practices. As well we described some of the challenges and barriers to face working in this particular job.
Subject(s)
Community Mental Health Services , Intellectual Disability/rehabilitation , Mentally Ill Persons , Ill-Housed Persons/psychology , SpainABSTRACT
Dispepsia funcional (DF) é um distúrbio gastrintestinal de natureza multifatorial, caracterizado por sintomas como dor ou desconforto na região superior do abdome. Não possui causa orgânica, e fatores psicológicos parecem estar presentes no desencadeamento e na manutenção dos sintomas. O comportamento assertivo caracteriza-se pela capacidade do indivíduo em expressar pensamentos e sentimentos em momentos adequados. Este trabalho relacionou DF e comportamento inassertivo, e comparou o nível de assertividade em 16 pacientes com DF e 16 participantes sem transtornos gastrintestinais, todos provenientes de um hospital particular universitário. Os participantes foram submetidos à aplicação de um instrumento baseado na Rathus Assertiveness Scale (RAS) (RATHUS, 1973) para medir o nível de assertividade. Os dados mostraram que os pacientes com DF possuíram mais comportamentos inassertivos se comparados aos participantes sem transtornos gastrintestinais.
Functional dyspepsia (FD) is a gastrointestinal disorder developed as a result of various underlying conditions, characterized by pain or discomfort in the upper abdomen. There is no organic cause and psychological factors may be involved in the symptoms' beginning. The assertive behavior is characterized by a person's capacity to express his/her feelings and thoughts in an appropriate time. This study investigated the relation between FD and inassertive behavior; and compared the assertiveness in 16 FD patients and 16 people with no gastrointestinal disorders, all from a private university hospital. The assertiveness was measured by an instrument based in Rathus Assertiveness Scale (RAS) (RATHUS, 1973). The collected data shows that FD patients had more inassertive behaviors than people with no gastrointestinal disorders.
Dispepsia funcional (DF) es un problema gastrointestinal de naturaleza multifactorial, caracterizado por sintomas como dolor o incomodidad en la región superior del abdomen. No posee causa organica y parece haber factores psicologicos en el esencadenamiento y mantencion de los sintomas. El comportamiento no asertivo se caracteriza por La capacidad del individuo de expresar pensamientos y sentimientos en momentos adecuados. Este trabajo relacionó la DF y el comportamiento no asertivo y comparó el nivel de asertividad en 16 pacientes con DF y en 16 pacientes sin trastornos gastrointestinales, todos estos provenientes de un hospital universitario privado. El nível de asertividad foi medido con um instrumento motivado Rathus Assertiveness Scale (RAS) (RATHUS, 1973). Los resultados demostraron que los pacientes con DF poseen mas comportamientos no asertivos si son comparados con los participantes sin trastornos gastrointestinales.