Risk factors for nosocomial infection in older adult inpatients in some psychiatric hospitals in Ningbo of Zhejiang Province / 中国基层医药

Objective:To investigate the risk factors for nosocomial infection in older adult inpatients in some psychiatric hospitals in Ningbo of Zhejiang Province.Methods:The clinical data of 832 inpatients who received treatment in Ningbo Kangning Hospital and the Third Branch of Healthcare Group of Xiangshan Hospital of Traditional Chinese Medicine were retrospectively analyzed. These patients were divided into one infection group ( n = 45) and one non-infection group ( n = 787). The risk factors for nosocomial infection were analyzed. Results:Univariate analysis results showed that there were significant differences in age, disease type, primary pulmonary infection, time of antibiotics use, length of hospital stay, suffering from mental diseases, and use of urinary catheters ( χ2 = 10.721, 18.127, 12.183, 67.127, 56.326, 65.114, 27.153, all P < 0.001). Multivariate analysis showed that age ≥ 75 years, disease type, primary pulmonary infection, time of antibiotics use, length of hospital stay, suffering from mental diseases, and use of urinary catheter were independent risk factors for nosocomial infection in older adult inpatients ( OR = 3.360, 3.777, 5.238, 3.364, 3.939, 4.428, all P < 0.001). Conclusion:Age ≥ 75 years, disease type, primary pulmonary infection, time of antibiotics use, length of hospital stay, suffering from mental diseases, and use of urinary catheters are independent risk factors for nosocomial infection in older adult inpatients in some psychiatric hospitals in Ningbo of Zhejiang Province.

Forensic Analysis of 105 Autopsy Cases of Psychiatric Patients / 法医学杂志

Objective To provide reference for medical and health services and forensic expertise, the causes and manners of death of psychiatric patients were analyzed retrospectively. Methods A total of 105 autopsy cases of psychiatric patients accepted and settled by Institute of Forensic Science of Criminal Investigation Police University of China from 2004 to 2019 were collected. The cases were divided into four groups： disease death, suicidal death, accidental death and homicidal death. The common causes of death of each group were statistically analyzed and the differences in age, disease duration, body mass index （BMI） and gender among the groups were assessed. Results Of the 105 cases, 60 were male and 45 were female, the course of psychosis was （12.9±10.4） years, the age of the deceased was （51.3±11.4） years, and 61.0% was schizophrenic. There were 50 cases （47.6%） in the disease death group, in which the psychiatric patients were the oldest and had the longest course of psychosis and lowest BMI. Pulmonary thromboembolism, respiratory infections, and cardiogenic disease were the most common causes of death in the group. There were 26 accidental deaths （24.8%）, among which traffic accidents were the most common cause of death. There were 15 homicidal deaths （14.3%）, all of which were male, with craniocerebral injury being the most common cause of death. There were 14 suicidal deaths （13.3%）. In suicidal death group, the age of the deceased was the youngest, the course of psychosis was the shortest and falling from the height was the most common way to commit suicide. Conclusion Understanding the common causes of death of psychiatric patients may contribute to developing measures to reduce the mortality rate of the population. It is necessary to investigate the age, course of psychosis and gender of the deceased when assessing the manner of death.

Um estudo longitudinal sobre a influência do internato em saúde mental na redução de atitudes negativas de estudantes de Medicina em relação a portadores de transtornos mentais / A longitudinal study on the impact of mental health internship in reducing negative attitudes of medical students towards people with mental disorders

RESUMO Objetivo Avaliar o efeito do internato em saúde mental nas atitudes dos alunos de medicina quanto ao portador de transtorno mental (PTM). Métodos Atitudes foram avaliadas por questionário antes e depois do internato, por meio dos fatores: "aceitação social de PTM" (F1), "não acreditar em causas sobrenaturais para doença mental" (F2), "papéis sociais comuns para PTM" (F3), "acreditar em causas psicossociais para doença mental" (F4), "intimidade" (F5). Diferenças foram avaliadas por meio de testes t, fatores confundidores por ANOVA e correlações entre expectativa de melhora e fatores por Pearson. Resultados 74 de 85 alunos responderam ao questionário. Houve redução significativa em quatro fatores avaliados (F1, p < 0,001, F2, p = 0,002, F3, p = 0,04, F5, p < 0,001). Uma associação entre ter um amigo PTM e F3 foi identificada antes do curso (p = 0,04), porém não após (p = 0,13). Houve correlação positiva entre crenças de melhora e atitudes negativas com o F2 antes do curso (p = 0,01), mas não após. F5 esteve relacionado com a expectativa de melhora (p < 0,001) após o curso, indicando melhores atitudes quando melhor expectativa. Observou-se a melhora da expectativa quanto a resposta ao tratamento da esquizofrenia (p = 0,02), transtorno bipolar (p = 0,03) e transtorno de ansiedade (p = 0,03). Conclusões O internato esteve associado à redução de atitudes negativas com relação aos PTMs. O contato direto com o paciente parece ter influência direta nessa redução. Acreditamos que, mais importante do que possíveis efeitos de esclarecimento sobre causas do adoecimento, a desconstrução do mito sobre o louco violento é essencial para a melhora das atitudes. Estudos com populações de outras regiões do Brasil e voltadas para avaliação do medo de violência são necessários para a confirmação dessa hipótese e do efeito do internato sobre os alunos.

ABSTRACT Objective To evaluate and measure the effects of mental health internship on Medicine Students (MS) attitudes towards people with mental illness (PMI). Methods MS was submitted to an attitude questionnaire previously and after the mental health internship. Their attitudes were measured inside five factors: (F1) "social acceptance of PMI", (F2) "normalizing roles for PMI", (F3) "non-belief in supernatural causes for mental illness", (F4) "belief in bio-psychosocial causes for mental illness," and (F5) "near contact with PTM". T-tests were used to evaluate factor differences, confounding factor were analyzed by ANOVA and correlations through Pearson's correlation test. Results 74 of 85 students responded. There were a significant reduction in four factors (F1, p < 0.001, F2, p = 0.002, F3, p = 0.04, F5, p < 0.001). An association between having a PMI friend and F3 was identified before the course (p = 0.04), but not after (p = 0.13). A positive correlation was identified between belief in disease improvement and negative F2 attitudes before course (p = 0.01), but not after (0.40). F5 was related with disease improvement after course (p < 0.001), suggesting positive attitudes when improvement is expected. There were an increase in improvement expectations after course for schizophrenia (p = 0.02), bipolar disorder (p = 0.03) and anxiety (p = 0.03). Conclusions Mental health internship was related to a decrease in negative attitudes towards PMI. Personal contact seems to influence this improvement. We believe that the reduction of fear toward PMI is more powerful to reduce stigma than the acquisition of knowledge about its natural causes. More studies with a regionally distinct population in Brazil and aimed to measure the impact of fear are necessary to confirm this hypothesis.

Knowledge and perceptions of Indian primary care nurses towards mental illness

Objective. To assess nurses' knowledge and perceptions towards mental illness. Methods. This was a crosssectional descriptive study conducted among 126 randomly selected nurses those are working under District Mental Health program in Karnataka (India). The data was collected through self-reported questionnaires Using the modified version of Public perception of mental illness questionnaire and Attitude Scale for Mental Illness. Results. The findings revealed that majority of the subjects were women (74.4%), Hindus (92.1%) and were from rural background (69.8%). The mean Knowledge score 10.8±1.6 adequate knowledge (maximum possible =12) among 91% of the subjects, and 52% of them hold negative attitudes towards people with mental illness (88.9±13.6). While majority of the subjects hold negative attitudes in 'Separatism' (53.5%), 'Stereotyping' (73%), 'Benevolence' (54%), 'Pessimistic prediction' (53%) domains, they hold positive attitudes in 'Restrictiveness'(88%) and 'Stigmatization' (72%) domains. Women than men endorsed positive attitudes towards persons with mental illness in Stereotyping' (p<0.001), 'Restrictiveness' (p<0.01), 'Benevolence' (p<0.001) and 'Pessimistic prediction' (t= 2.22, p<0.05) domains. Similarly, Auxiliary Nursing Midwifery found to be less restrictive (p<0.05), more benevolent (p<0.001) and less pessimistic (p<0.05) compared to nurses with higher education (General Nursing and Midwifery and Bachelor of Science in Nursing). Conclusion. The present study showed adequate knowledge on mental illness among nurses. Yet they hold stigmatizing and negative attitudes towards mental illness. Hence, it is an urgent priority to develop andimplement educational programs to inculcate positive attitudes towards people with mental illness to provide optimal care to this vulnerable population.

Objetivo. Evaluar los conocimientos y percepciones de las enfermeras de atención primaria hacia la enfermedad mental. Métodos. Se realizó un estudio descriptivo transversal con 126 enfermeras que trabajan en el programa de Salud Mental del Distrito en Karnataka (India). Los datos se recolectaron a partir de cuestionarios contestados por autorreporte, empleando la versión modificada del cuestionario Percepción pública de la enfermedad mental y la Escala de Actitudes hacia la enfemedad mental. Resultados. Los hallazgos revelaron que la mayoría de los participantes eran mujeres (74.4%), hindúes (92.1%) y de origen rural (69.8%). El puntaje promedio de conocimiento fue de 10.8±1.6, que indica un conocimiento adecuado (máximo posible = 12). El 52% de los participantes tienen actitudes negativas hacia las personas con enfermedades mentales, siendo mayor este porcentaje en los dominios 'Estereotipos' (73%), 'Benevolencia' (54%), 'Separatismo' (53.5%), 'Predicción pesimista' (53%); mientras que tienen actitudes positivas en 'Restricción' (88%) y 'Estigmatización '(72%). Las mujeres, en mayor porcentaje que los hombres, tuvieron actitudes positivas hacia las personas con enfermedades mentales en los dominios 'Estereotipos' (p<0.001), 'Restricción' (p<0.01), 'Benevolencia' (p<0.001) y 'Predicción pesimista' (p<0.05). Del mismo modo, las enfermeras parteras auxiliares fueron menos restrictivas (p<0.05), más benévolas (p<0.001) y menos pesimista (p<0.05) en comparación con las enfermeras con mayor educación (enfermeras parteras generales y licenciadas en ciencias de la enfermería). Conclusión. El presente estudio mostró un conocimiento adecuado sobre las enfermedades mentales entre las enfermeras. Sin embargo, tienen actitudes estigmatizantes y negativas hacia la enfermedad mental. Por lo tanto, es una prioridad implementar programas educativos para la adquisición de actitudes positivas hacia las personas con enfermedades mentales con el fin de brindar una atención integral a esta población vulnerable.

Objetivo. Avaliar os conhecimentos e percepções à doença mental das enfermeiras de atenção primária. Métodos. Se realizou um estudo descritivo transversal com 126 enfermeiras que trabalham no programa de Saúde Mental do Distrito em Karnataka (Índia). Os dados foram recolhidos a través de questionários respondidos por autorreporte, empregando a versão modificada do questionário Percepção pública da doença mental e a Escala de Atitudes à doença mental. Resultados. As descobertas revelaram que a maioria dos participantes eram mulheres (74.4%), hindus (92.1%) e de origem rural (69.8%). A pontuação média de conhecimento foi de 10.8±1.6 indicando conhecimento adequado (máximo possível = 12). 52% dos participantes têm atitudes negativas às pessoas com doenças mentais, sendo maior esta porcentagem nos domínios 'Estereótipos' (73%), 'Benevolência' (54%), 'Separatismo' (53.5%), 'Predição pessimista' (53%); enquanto que têm atitudes positivas em 'Restrição' (88%) e 'Estigmas'(72%). As mulheres, em maior porcentagem que os homens, tiveram atitudes positivas às pessoas com doenças mentais nos domínios 'Estereótipos' (p<0.001), 'Restrição' (p<0.01), 'Benevolência' (p<0.001) e 'Predição pessimista' (p<0.05). Do mesmo modo, as enfermeiras parteiras auxiliares formam menos restritivas (p<0.05), mais benévolas (p<0.001) e menos pessimista (p<0.05) em comparação com as enfermeiras com maior educação (enfermeiras parteiras gerais e licenciadas em ciências da enfermagem). Conclusão. O presente estudo mostrou um conhecimento adequado sobre as doenças mentais entre as enfermeiras. Porém, tem atitudes de estigmas e negativas à doença mental. Por tanto, é uma prioridade implementar programas educativos para o melhoramento das atitudes positivas às pessoas com doenças mentais com o fim de brindar uma atenção integral a esta população vulnerável.

Apuntes sobre la locura en el Virreinato del Perú / Notes on the madness in the Viceroyalty of Peru

La locura en el Virreinato del Perú fue explicada tanto en términos médicos como sobrenaturales. La medicina se basó principalmente en la teoría de los cuatro humores. Para denominar la locura y sus diversas formas de manifestarse se utilizaron términos tales como falta de juicio, insania, demencia, melancolía, manía y otros, con significados no equivalentes a los actuales. El cuidado de los locos estuvo en manos de los médicos, la familia o los religiosos. La Santa Inquisición debió determinar si los procesados se encontraban o no en su sano juicio, recurriendo a diferentes estrategias ante los casos dudosos, incluyendo la opinión de los médicos. La psiquiatría surgió en el Perú mucho después de la era virreinal, y sus intentos para explicar la locura en aquellos tiempos llevaron por un lado a una valiosa recolección de información, sobre todo por parte de Hermilio Valdizán y Óscar Valdivia Ponce, y por otro lado a la elaboración de diagnósticos retrospectivos, que ilustran sobre el discurso nosológico de sus expositores. En los últimos años las opiniones psiquiátricas sobre el periodo virreinal se han centrado en la figura de Santa Rosa de Lima, llevando a planteamientos variopintos. Los diagnósticos retrospectivos se sustentan en premisas cuestionables, tales como atribuir una naturaleza transhistórica y transcultural a los trastornos mentales y a la idea de normalidad, así como creer que existen fuentes históricas fidedignas que reflejan la verdad de los hechos.

Madness during the Viceroyalty of Peru was explained both in medical and supernatural terms, The medicine was based mainly on the theory of the four humors. To name madness and its various forms of manifestation were used terms such as lack of judgment, insanity, dementia, melancholy, mania and others, with meanings not equivalent to the current ones.The care of the insane was given by doctors, family or clergy. The Holy Inquisition had to determine whether the defendants were mentally sane or not, resorting to different strategies in the doubtful cases, including the opinion of the doctors. Psychiatry emerged in Peru long after the Viceregal era, and its attempts to explain the madness of those times led to the gathering of valuable information, especially by Hermilio Valdizán and Óscar Valdivia Ponce, and, on the other hand, to the formulation of retrospective diagnoses, which illustrate the nosological discourse of its speakers. In recent years, psychiatric opinions on the viceregal period have focused on the figure of Saint Rose of Lima, leading to varied approaches. Retrospective diagnoses are based on questionable premises, such as attributing a transhistorical and transcultural nature to mental disorders and normality idea, as well as believing that there are reliable historical sources that reflect the truth of the facts.

Mediating Effects of Hope and Therapeutic Relationship in the Relation between General Social Functions and Mental Health Recovery of Community People with Mental Illness

PURPOSE: This study tries to test mediating effects of hope and therapeutic relationship in the relation between general social functions and mental health recovery of community people with mental illness. METHODS: This study was carried out in a cross-sectional research design. The participants included 217 people with mental illnesses who were enrolled at eight Mental Health Welfare Centers in the Gyeonggi Province. Data were collected from February to May, 2018. The collected data were analyzed using a regression analysis, and SPSS PROCESS macro was used to test the mediating effects. RESULTS: This study analyzed the direct effects of general social functions on the hope, therapeutic relationship and mental health recovery. And general social functions had indirect effects on their mental health recovery via hope and therapeutic relationship. Both hope and therapeutic relationship had dual mediating effects in the influence of general social functions on mental health recovery. CONCLUSION: The role of hope and therapeutic relationship in the mental health recovery of community people with mental illness is important, and it is confirmed that hope is a powerful factor influencing mental health recovery.

Recent illicit drug use among psychiatric patients in Brazil: a national representative study

ABSTRACT OBJECTIVE To estimate factors associated to illicit drug use among patients with mental illness in Brazil according to gender. METHODS A cross-sectional representative sample of psychiatric patients (2,475 individuals) was randomly selected from 11 hospitals and 15 public mental health outpatient clinics. Data on self-reported illicit drug use and sociodemographic, clinical and behavioral characteristics were obtained from face-to-face interviews. Logistic regression was used to estimate associations with recent illicit drug use. RESULTS The prevalence of any recent illicit drug use was 11.4%. Men had higher prevalence than women for all substances (17.5% and 5.6%, respectively). Lower education, history of physical violence, and history of homelessness were associated with drug use among men only; not professing a religion was associated with drug use in women only. For both men and women, younger age, current hospitalization, alcohol and tobacco use, history of incarceration, younger age at sexual debut, and more than one sexual partner were statistically associated with illicit drug use. CONCLUSIONS Recent illicit drug use among psychiatric patients is higher than among the general Brazilian population and it is associated with multiple factors including markers of psychiatric severity. Our data indicate the need for the development of gender-based drug-use interventions among psychiatric patients in Brazil. Integration of substance use treatment strategies with mental health treatment should be a priority.

Hope Enhancement Program for Increased Hope, Self-Efficacy, and Quality of Life for Mentally Ill Persons in Day Hospitals / 정신간호학회지

PURPOSE: In this study an investigation was done of the effects of a hope enhancement program on hope, self-efficacy, and quality of life for mentally ill persons in day hospitals. METHODS: Research design was a non-equivalent control group pre-post test design as a quasi-experimental study. The participants were selected from mentally ill persons at A day hospital and B day hospital in D city. They were 36 participants (18 in the experimental group and 18 in the control group). The study was conducted from March 17 to April 8, 2014. Data were analyzed using χ² test, Fisher's exact test, t-test, and independent sample t-test with IBM SPSS/WIN 19.0 Program. RESULTS: Participants in the hope enhancement program reported increased hope and higher quality of life scores, which were significantly different from those in the control group. Participants in the hope enhancement program also reported increased self-efficacy but it was not significantly different compared to the control group. CONCLUSION: Findings show that the hope enhancement program is effective in hope and quality of life for mentally ill persons in day hospitals. Therefore, use of the hope enhancement program will contribute as a meaningful nursing intervention for mentally ill persons in day hospitals.

Construction of occupational management skills training mode for the mental rehabilitation patients：an action research / 中国实用护理杂志

Objective To build occupational management skills training mode for the community patients with psychosis in recovery stage by using action research method. Methods Action research method was applied to mental rehabilitation patients in Sunshine Psychiatric Garden of Shanghai to manage vocational rehabilitation support. By literature verification and empirical experience, the key problems were found out, and goals were established. Then management skills according to planning, action, observation, reflection and correction were implemented. This circle were spiraled for 2-3 times stages, and verification and evaluation before and after action practice based on Negative Symptom Rating scale (SANS) and Social Disability Screening Scale (SDSS). Results The community mental vocational rehabilitation was built with action research and based on the evidence of foreign psychic rehabilitation supportive individual placement and support. The mode should consider the professional characteristics of technical, social and economic. Also, it should contain professional ability, social skills and job adaptability training and performance evaluation, and offer salary allowance. The factors of SANS in 21 patients after practice were significantly improved (P < 0.01), and most of the factors in the SDSS were significantly improved (P < 0.01). Conclusions Community psychic vocational rehabilitation using action research method is a kind of advanced nursing practice, and also a process of evidence-based practice, which can provide a systematic, specific, practical work method for community mental rehabilitation institutions to force vocational rehabilitation training.

Mediating Effect of Self-Efficacy in the Relationship between Internalized Stigma and Treatment Adherence of Community Dwelling Patients with Mental Illness / 정신간호학회지

PURPOSE: This study was conducted to explore the mediating effect of self-efficacy in the relationship between internalized stigma and treatment adherence among community dwelling patient with mental illness. METHODS: A cross-sectional study design was employed. Participants were 145 people with mental illness who were enrolled at one of 11 community mental health institutions in Busan, South Korea. Internalized stigma of mental illness, self-efficacy, treatment adherence, and socio-demographic data were examined. Data were collected using self-report questionnaires and analyzed using Baron and Kenny method. RESULTS: Internalized stigma had a significant negative correlation with self-efficacy and treatment adherence. Self-efficacy had a significant positive correlation with treatment adherence. In addition, self-efficacy had a full mediating effect in the relationship between internalized stigma and treatment adherence. CONCLUSION: The results suggest that self-efficacy plays an important role in promoting treatment adherence among patients with mental illness who have high levels of internalized stigma. Therefore, mental health professionals should focus on reducing internalized stigma and also enhancing self-efficacy to increase treatment adherence for persons with mental illness living in the community.

Factors influencing professional relationship establishment between case managers and psychiatric patients in case management / 中华全科医师杂志

The records of 25 psychiatric patients ( clients ) who received case management from November 2009 to July 2010 were retrospectively analyzed.The factors related to the quality of professional relationship established between case managers and the clients were evaluated.The study revealed that timely supports, encourage and affirmation from case managers ( 40%) , the successful coordinate service (40%) , the active care for clients (24%) and helping to build up confidence and hope for clients (24%) were favourable factors for professional relationship establishment, while lack of desire to receive service and change from clients (24%) was adverse factor.

Fatores associados à sobrecarga subjetiva de homens e mulheres cuidadores de pacientes psiquiátricos / Factors associated with the overburden of male and female caregivers of psychiatric patients

ResumoEstudos têm avaliado os fatores associados à sobrecarga dos familiares cuidadores de pacientes psiquiátricos. A pesquisa visou identificar os fatores associados à sobrecarga subjetiva de grupos de homens e mulheres, analisados separadamente. Participaram da pesquisa 50 homens e 50 mulheres cuidadores de pacientes psiquiátricos que responderam às questões da Escala de Avaliação da Sobrecarga dos Familiares de Pacientes Psiquiátricos e a um questionário sociodemográfico. Os resultados mostraram que diferentes fatores estiveram associados à sobrecarga subjetiva em cada grupo. No grupo de mulheres, os fatores preditores de maior sobrecarga foram: ausência de crianças em casa, maior número de pessoas morando com o familiar, o paciente não desempenhar atividades fora de casa, presença de comorbidade e maior número de comportamentos problemáticos dos pacientes. No grupo de homens, os fatores associados foram: o familiar não morar com o paciente, possuir renda, relatar doença resultante do papel de cuidador, maior número de filhos do familiar, o paciente não possuir quarto individual na casa, ter doença física, idade do paciente e quantidade de medicamentos ingeridos pelo paciente. É necessário adotar abordagens diferenciadas para cada grupo nas ações desenvolvidas pelos serviços de saúde mental.

AbstractVarious studies have investigated the factors associated with the overburden of family caregivers of psychiatric patients. This research sought to identify the factors associated with overburden in groups of male and female caregivers, analyzed separately. Fifty people of each sex participated in the study of family caregivers of psychiatric patients who filled out the Family Overburden Interview Schedule and a standardized sociodemographic data questionnaire. The results showed that different factors were associated with overburden in male and female groups. In the female group, the predictors of a greater degree of overburden were: no children at home, greater number of people living with the family, the patient not performing activities outside the home, the presence of comorbidity and greater incidence of patient problematic behavior. For men, the associated variables were: the family caregiver member not living with the patient, having income, reporting illness resulting from the caregiver role, number of children of the family caregiver, the patient not having a single room at home, patient's age, physical illness and quantity of drugs taken by the patient. These results point to the need for differentiated strategies in the family interventions developed by the mental health services.

Violência sexual: narrativas de mulheres com transtornos mentais no Brasil / Sexual violence: narratives of women with mental disorders in Brazil

OBJETIVO: Compreender o impacto da violência sexual sofrida por mulheres com transtornos mentais a partir de autorrelato de suas experiências. MÉTODOS: Os relatos emergiram de entrevistas abertas realizadas com mulheres atendidas em serviços públicos de saúde mental de Minas Gerais e Rio de Janeiro como parte de uma pesquisa de cunho mais amplo que teve como objetivo geral investigar as formas de viver e pensar a sexualidade por esse grupo populacional, visando a contribuir para as ações de promoção da saúde sexual. A coleta dos dados se deu em 2008. RESULTADOS: Foram entrevistadas 17 mulheres com idade entre 18 e 68 anos. Quatorze entrevistadas afirmaram ter vivido relações estáveis, mas somente três permaneciam nessas relações. A maioria dos relacionamentos estáveis não havia sido oficializada. Duas mulheres eram viúvas e 13 tinham filhos. Todas relataram enfrentar dificuldades na convivência com os parceiros e com os filhos, ter poucos amigos e dispor de pouco apoio familiar. A instabilidade dos relacionamentos foi atribuída a situações de agressividade, infidelidade do parceiro e uso de drogas ou álcool. Houve relatos de terem sido vítimas de violência física na família, sobretudo por parte de parceiros, e também de violência sexual, sendo que, em alguns casos, os agressores eram pessoas da família. Duas entrevistadas afirmaram nunca ter tido relação sexual. CONCLUSÕES: Faz-se necessário capacitar os profissionais de saúde para que propiciem o relato de situações de violência sexual por parte das mulheres e para que encaminhem de forma adequada a situação. Também é fundamental a necessidade de ações intersetoriais para o enfrentamento dessa problemática.

OBJECTIVES: To understand the impact of sexual violence suffered by women with mental disorders based on self-reports of these experiences. METHODS: The reports emerged from open interviews with women receiving care at public mental health services in the states of Minas Gerais and Rio de Janeiro, Brazil. These interviews were part of a larger research project that had the overall objective of investigating how this population group lives and thinks sexuality, in order to contribute to actions to promote sexual health. Data collection took place in 2008. RESULTS: Seventeen women with age between 18 and 68 years were interviewed. Fourteen reported having had stable relationships, but only three were still in these relationships. Most of the stable relationships had not been formalized into marriage. Two participants were widows and 13 had children. All the participants reported difficulties in living with their partners and children and having few friends and little family support. The instability of relationships was attributed to situations of aggression, infidelity, and use of drugs and alcohol. Seven women reported having been victims of physical violence within the family, mostly from partners. Two participants reported never having had sexual relations. CONCLUSIONS: Health care professionals must be trained to encourage the report of sexual violence by women and adequately handle the situation. Intersectoral actions to deal with this issue are also essential.

Access to information on diagnosing and hospitalizing an individual with mental illness[xref ref-type="fn" rid="fn01"]¹[ign] / O acesso às informações sobre diagnóstico e internação à pessoa com transtorno mental / El acceso a las informaciones sobre diagnóstico e internamiento de la persona con trastorno mental

The aim of this study was to identify what health care professionals working in psychiatric hospitals think about access to information concerning the disease and hospitalization. Descriptive research using a qualitative approach was conducted in a psychiatric hospital. A total of 33 health care professionals with experience of hospitalizing and directly caring for patients participated in the study. The data were obtained using a semi-structured interview and participant observation and are presented in thematic categories: “The patient and the information provided: hospital norms and routines”; “The role of health care professionals in providing patients with information”; “Lack of information and its causes”. It was concluded that the access those with mental disorders have to information about their disorder and treatment is limited, showing the need to encourage awareness-raising activities in health care professionals about their role in providing information, to ensure the right to information is effectively guaranteed.

O objetivo deste trabalho foi identificar o que os profissionais de saúde que trabalham em um hospital psiquiátrico pensam sobre o acesso às informações, sobre a doença e a internação. Foi realizada uma pesquisa descritiva, com abordagem qualitativa, em um hospital psiquiátrico. Participaram do estudo 33 profissionais que vivenciam o processo de hospitalização e cuidados diretos ao paciente. Os dados foram obtidos mediante entrevista semiestruturada e observação participante e apresentados nas categorias temáticas: “O paciente e as informações prestadas: normas e rotinas do hospital”; “O papel dos profissionais de saúde no oferecimento de informações aos pacientes”; “A insuficiência das informações e suas causas”. Conclui-se que o acesso às informações pelas pessoas com transtornos mentais sobre seu transtorno e tratamento é limitado, o que evidencia a necessidade de promoção de ações de conscientização dos profissionais de saúde a respeito de seu papel na prestação de informações, para que assim o direito à informação seja garantido efetivamente.

El objetivo de este trabajo fue identificar, lo que los profesionales de la salud que trabajan en un hospital psiquiátrico piensan sobre el acceso a las informaciones, sobre la enfermedad y el internamiento. Fue realizada una investigación descriptiva, con un abordaje cualitativo, en un hospital psiquiátrico. Participaron en el estudio 33 profesionales que se ocupaban del proceso de la hospitalización y cuidados directos al paciente. Los datos fueron obtenidos mediante entrevista semi-estructurada y observación activa y presentados en las categorías temáticas: “El paciente y las informaciones prestadas: normas y rutinas del hospital”; “El papel de los profesionales de la salud en el ofrecimiento de información a los pacientes”; “la insuficiencia de las informaciones y sus causas”. Se concluye que el acceso a la información de las personas con trastornos mentales sobre su trastorno y tratamiento es limitado, lo que evidencia la necesidad de promover acciones de concienciación de los profesionales de la salud al respecto de su papel en la prestación de informaciones, para que así el derecho a la información sea garantizado efectivamente.

Los profesionales de la salud mental ante situaciones de violencia familiar / Role of mental health professionals in domestic violence situations

La violencia familiar (VF) o doméstica tiene fuerte impacto en la salud mental de las víctimas. La prevalencia real es muy difícil de medir. Los registros suelen subestimar su magnitud. El principal obstáculo para la visualización del problema que representa la VF es la falta de claridad en el funcionamiento de redes de trabajo entre los ámbitos pertenecientes a la salud, el poder judicial y desarrollo social, lo cual genera un abordaje incompleto de la problemática. Grupos especialmente vulnerables son los niños, adolescentes, mujeres embarazadas o personas en situaciones especialmente difíciles. Como adultos mayores, hombres y mujeres con enfermedad física o mental incapacitante, en desventaja física, económica o cultural, los cuales comparten factores de riesgo que propician la perpetuación de las situaciones de VF. La prevención es presentada como el abordaje más eficaz para esta problemática. Esta perspectiva propone una nueva dinámica de trabajo, de observación, de comprensión y de intervención para que los trastornos no se presenten, avancen y repitan. Para una elaboración acertada de estrategias de trabajo y de intervenciones posibles del profesional, resulta indispensable conocer el marco legal ya que es de vital importancia intervenir y es responsabilidad de todos los profesionales de la salud formarnos en detección y atención a las víctimas. También es fundamental informarnos a cerca de las responsabilidades que nos atañen y de las herramientas con la que contamos en materia legal, para acercar a nuestros pacientes a sus derechos

A violência tem forte impacto sobre a saúde mental das vítimas. A verdadeira prevalência é difícil de medir, pois os dados disponíveis tendem a subestimar a sua magnitude. O principal obstáculo para a visualização do problema do VF é a falta de clareza na operação de rede entre as áreas relativas à saúde, judiciário e de desenvolvimento social, o que gera uma abordagem incompleta do problema. Os grupos particularmente vulneráveis incluem crianças, adolescentes, mulheres grávidas ou pessoas em circunstâncias particularmente difíceis. Como idosos, homens e mulheres com a desativação doença física ou mental, desvantagem física, econômica ou cultural, que compartilham fatores de risco que favorecem a perpetuação de situações de VF. Prevenção é apresentado como a abordagem mais eficaz para este problema. Esta abordagem oferece uma nova forma de trabalhar, observando-se, compreensão e intervenção para os transtornos não estão presentes, mover e repetir. Para um bom desenvolvimento de estratégias e intervenções possíveis de trabalho profissional, é essencial conhecer o enquadramento legal, pois é vital para intervir e é da responsabilidade de todos os profissionais de saúde a se formar na detecção e tratamento das vítimas. Também é essencial para nos informar sobre as responsabilidades que nos afetam e as ferramentas com que nós em matéria jurídica, para trazer os nossos pacientes para os seus direitos

Violence has strong impact on the mental health of the victims. The true prevalence is difficult to measure because the available data tend to underestimate its magnitude. The main obstacle for the visualization of the problem of the VF is the lack of clarity in the operation of networking among the areas pertaining to health, judiciary and social development, which generates an incomplete approach to the problem. Particularly vulnerable groups include children, adolescents, pregnant women or people in particularly difficult circumstances. As seniors, men and women with disabling physical or mental illness, physical, economic or cultural disadvantage, which share risk factors that promote the perpetuation of situations VF. Prevention is presented as the most effective approach to this problem. This approach offers a new way of working; observing, understanding and intervention for the disorders are not present, move and repeat. For a successful development of strategies and possible interventions working professional, it is essential to know the legal framework as it is vital to intervene and is the responsibility of all health professionals to form in detection and care of victims. It is also essential to inform us about the responsibilities that affect us and the tools with which we in legal matters, to bring our patients to their rights

Opinião de pacientes, familiares e profissionais sobre o hábito de fumar em uma enfermaria psiquiátrica / Patients’, families’, and staff’s opinion on smoking within a psychiatric infirmary / Opinión de pacientes, familiares y profesionales sobre el hábito de fumar en una enfermería psiquiátrica

Estudo descritivo quantitativo realizado na enfermaria de psiquiatria do Hospital das Clínicas de Ribeirão Preto. Objetivou conhecer a opinião dos pacientes, familiares e equipe acerca do fumar na internação psiquiátrica e o grau de dependência dos fumantes. Utilizada entrevista semiestruturada e questionário de Fagerstrõm. Entrevistados 98 sujeitos de julho a dezembro de 2010: 25 doentes; 25 familiares; e 48 profissionais. Os pacientes mostraram graus mais elevados de dependência do tabaco. A maioria concorda com a reserva de áreas para fumantes e proibição em locais públicos, sem privilégios para doentes mentais, e com o uso terapêutico de adesivo de nicotina no serviço estudado. Os não fumantes referiram incômodos quando era permitido fumar na internação e acreditavam que o cigarro gerava conflitos e desinteresse pelas atividades terapêuticas. Conclui-se que os profissionais devem abordar o fumo, investindo em pesquisas, na prevenção e promoção de saúde, conscientizando o fumante na busca de tratamento.

Quantitative descriptive study carried out at the psychiatric ward of the Hospital das Clínicas de Ribeirão Preto, Brazil. It aimed at assessing patients’, families’, and team’s opinion concerning smoking during psychiatric hospitalization as well as smokers’ dependence. Semi-structured interview and Fagerstrõm’s questionnaire were used. Ninety-eight (98) subjects were interviewed from July to December, 2010: 25 patients; 25 families; and 48 professionals. Patients showed higher degrees of tobacco dependence. The majority agrees to restricted smoking areas; to no-smoking requirements to all public places, with no exceptions to the mentally ill people; and to mandatory use of nicotine adhesive strips in the studied unit. The non-smoking ones complained about restriction-free smoking while in hospital and believed that cigarette smoking generated conflicts and disinterest in the therapeutic activities. Conclusions suggest that professionals must approach tobacco-related issues investing in research, prevention, and promotion of smoker’s health awareness in the treatment.

Estudio descriptivo cuantitativo realizado en la enfermería de psiquiatría del Hospital das Clínicas de Ribeirão Preto – São Paulo – Brasil. Objetivó conocer la opinión de los pacientes, familiares y equipo referente a fumar en la internación psiquiátrica y el grado de dependencia de los fumantes. Usada entrevista semiestructurada y cuestionario de Fagerstrõm. Entrevistados 98 sujetos de julio a diciembre de 2010: 25 enfermos; 25 familiares; e 48 profesionales. Los pacientes tenían grados más elevados de dependencia del tabaco. La mayoría acuerda con la reserva de áreas para fumantes y la prohibición en lugares públicos, sin privilegios para los enfermos mentales, e con el uso de adhesivo de nicotina en el servicio estudiado. Los no fumadores relacionarón incómodo cuando era permitido fumar en la internación y acreditaban que el cigarrillo generaba conflictos y desinterés por las actividades terapéuticas. Se concluyó que los profesionales deben enfocar el tabaco, investiendo en pesquisas, prevención y promoción de la salud y conciencia del fumador en la búsqueda del tratamiento.

Os profissionais de saúde e o exercício dos direitos humanos por portadores de transtornos mentais / Healthcare professionals and the practice of the human rights of individuals with mental disorders / Profesionales de salud y el ejercicio de los derechos humanos de pacientes con transtornos mentales

Estudo qualitativo cujo objetivo foi descrever a percepção de profissionais de saúde de um Centro de Atenção Psicossocial (CAPS) sobre os direitos humanos dos portadores de transtornos mentais e os meios para efetivação desses direitos durante o cuidado à saúde. Os dados foram coletados em 2010 por meio de entrevistas semi-estruturadas com sete profissionais de saúde e analisados por meio de análise de conteúdo. Foram observadas diferentes percepções sobre os direitos humanos dos portadores de transtornos mentais com enfoques centrados na liberdade, proteção à vida, convivência em sociedade e exercício da cidadania. Apesar dos avanços políticos, foram identificadas lacunas para a consolidação dos direitos dos portadores de transtornos mentais, que podem ser supridas, especialmente, por meio do envolvimento da família, sociedade e governo. Os profissionais de saúde tem assumido importante papel como disseminadores de informações sobre direitos, participando da conscientização dos usuários dos serviços e suas famílias e buscando a reinserção social.

This qualitative study aimed at describing the perception that healthcare professionals of a Psychosocial Care Center (CAPS, as per its acronym in Portuguese) make of the human rights of individuals with mental health disorders and the means used to make rights effective in health care. Data were collected in 2010 by semi-structured interviews with seven professionals, and submitted to content analysis. It was observed that subjects have different perceptions regarding the human rights of individuals with mental health disorders, centered on freedom, protection of life, living in society and being a participative citizen. Despite the political advancements, gaps still hinder making the rights of people with mental disorders effective, which could be supplied by an engagement of the family, society, and government. Healthcare professionals have played an important role as of regarding rights, helping to raise awareness of patients and their families, aiming at their social reinsertion.

Estudio cualitativo objetivando describir la percepción de profesionales de salud de Centro de Atención Psicosocial (CAPS) sobre derechos humanos de pacientes con transtornos mentales, y los medios para efectivizar tales derechos durante el cuidado de salud. Datos recolectados durante 2010 mediante entrevistas semiestructuradas con siete profesionales de salud, analizados según análisis de contenido. Fueron observadas diferentes percepciones sobre derechos humanos de pacientes con transtornos mentales., con enfoques centrados en la libertad, protección de la vida, convivencia en sociedad y ejercicio de la ciudadanía. A pesar de los avance políticos, fueron identificados vacíos en la consolidación de los derechos de pacientes con transtornos mentales, que podrían salvarse, particularmente, con la participación familiar, de la sociedad y del gobierno. Los profesionales de salud han asumido un importante rol como divulgadores de información sobre derechos, participando en la concientización de los pacientes y sus familias, buscando la reinserción social.

Identification of the support needs of individuals with severe mental illness using the Supports Intensity Scale / Identificacao das necessidades de apoio em pessoas com doenca mental grave utilizando a Escala de Intensidade de Apoios / Identificacion de necesidades de apoyo en personas con enfermedad mental severa utilizando la Escala de Intensidad de Apoyos

OBJECTIVE: to characterize the intensity of the support needs of individuals with severe mental illness. METHODS: quantitative and descriptive study that applied the Supports Intensity Scale to a sample comprising 182 individuals. RESULTS: the supports intensity profile identifies groups, individuals, and areas with different needs of support relative to the domains of home living, health, community living, learning, employment, and social living. As a whole, the intensity level of support needs found was low, and the domains with greater needs were employment and social. CONCLUSIONS: identification of the intensity of support needs is helpful in planning integral care and detecting professional training needs. The support provision-centered approach, associated with the person-related outcomes perspective, has been sparsely applied to individuals with mental illness, and this represents the main contribution of the present study. In addition, this study introduces novel approaches to assessment that are both concordant and an innovation in nursing because they might provide a tool for understanding other disabilities. .

OBJETIVO: caracterizar o perfil da intensidade das necessidades de apoio em indivíduos com doença mental grave. METODOLOGIA: quantitativa, no contexto de um estudo descritivo que utilizou a escala de intensidade de apoios como instrumento, sendo aplicada a amostra constituída por 182 pessoas. RESULTADOS: o perfil de intensidade de apoio identifica grupos, pessoas e áreas com diferentes níveis de necessidades de apoio na vida no lar, saúde, comunidade, aprendizagem, emprego e vida social. De modo geral, o perfil identificado foi de baixa intensidade, sendo que as áreas que apresentaram as maiores necessidades foram aquelas correspondentes a emprego e vida social. CONCLUSÕES: essa identificação contribui para o planejamento do cuidado de modo integral e, além disso, permite a identificação de necessidades na formação profissional. Essa abordagem, centrada na proporção de apoios combinada com a perspectiva de resultados referidos à pessoa, tem sido pouco utilizada no caso de indivíduos com doença mental e nisso consiste a contribuição singular do presente estudo. Além disso, este estudo possibilita a inclusão de novas formas de avaliação que são consistentes e inovadoras na área de enfermagem, porque podem representar uma ferramenta para a compreensão de outras deficiências. .

OBJETIVO: caracterizar el perfil de intensidad de necesidades de apoyo de personas con enfermedad mental severa. METODOLOGÍA: cuantitativa desarrollando un estudio descriptivo, utilizando como instrumento la escala de intensidad de apoyos que se aplicó a una muestra de 182 personas. RESULTADOS: el perfil de intensidad de apoyos identifica grupos, personas y áreas con diferentes niveles de necesidades de apoyo en las áreas de vida en el hogar, salud, comunidad, aprendizaje, empleo y vida social. De forma global, el perfil identificado es bajo, mostrando necesidades más elevadas en las áreas de empleo y vida social. CONCLUSIONES: esta identificación ayuda a planificar el cuidado de forma integral permitiendo además identificar necesidades en la formación profesional. Este enfoque centrado en la proporción de apoyos, y relacionado con la perspectiva de resultados referidos a la persona ha sido poco utilizado en personas con enfermedad mental, es ahí donde radica la aportación de este estudio. Además posibilita contar con nuevas formas de valoración que son concordantes y novedosas para la Enfermería porque pueden constituir una herramienta para comprender otras discapacidades. .

Long Term Psychiatric Institution: Profile of patients and human resource indicators / Instituição psiquiátrica de longa permanência: perfil de pacientes e indicadores de recursos humanos / Institución Psiquiátrica de Larga Permanencia: Perfil de pacientes e indicadores de recursos humanos

This descriptive study aimed to investigate the social-demographic and epidemiological profile of patients and human resource indicators in a neuropsychiatric hospital located in southeastern Brazil. The data related to the human resources (2006-2010) and the social-demographic and epidemiological characterization of the patients (2010) were extracted from the hospital management system database and staff scheduling worksheets. The study included 105 patients with a mental disorder diagnosis. Most were male 60 (57.1%), mean age 52.5 (11.4) years, duration of hospitalization up to 15 years 84 (80%), and primary diagnosis of schizophrenia 50 (47.7%), and mental retardation 41 (39%). The nursing staff/bed ratio ranged from 0.52 to 1.15 and the nurse/bed from 0.05 to 0.11. The aim of this research is to contribute to the development of mental health policies and equip the administrator for the strategic decision making processes.

Este estudo descritivo teve como objetivo investigar o perfil sociodemográfico e epidemiológico de pacientes e indicadores de recursos humanos em um hospital neuropsiquiátrico, localizado na Região Sudeste do Brasil. Os dados relativos aos indicadores de recursos humanos (2006-2010) e caracterização sociodemográfica e epidemiológica dos pacientes (2010) foram extraídos da base de dados do sistema de gestão hospitalar e planilhas de escala de pessoal. Participaram do estudo 105 pacientes com diagnóstico de transtorno mental. A maioria era do sexo masculino (60; 57,1%), idade média 52,5 (11,4) anos, tempo de internação até 15 anos 84 (80%) e diagnóstico principal de esquizofrenia 50 (47,7%) e retardo mental 41 (39%). A relação enfermagem/leito variou de 0,52 a 1,15 e a de enfermeiro/leito de 0,05 a 0,11. Almeja-se que os resultados desta investigação possam contribuir para a elaboração de políticas de saúde mental e instrumentalizar o gestor na tomada de decisão e estabelecimento de estratégias de ação.

Este estudio descriptivo tuvo como objetivo investigar el perfil sociodemográfico y epidemiológico de pacientes e indicadores de recursos humanos en un hospital neuro psiquiátrico localizado en la región sudeste de Brasil. Los datos relativos a los indicadores de recursos humanos (2006-2010) y caracterización socio demográfica y epidemiológica de los pacientes (2010) fueron extraídos de la base de datos del sistema de gestión hospitalaria y planillas de escala de personal. Participaron del estudio 105 pacientes con diagnóstico de trastorno mental. La mayoría era del sexo masculino 60 (57,1%), edad media 52,5 (11,4) años, tiempo desde internación hasta 15 años 84 (80%) y diagnóstico principal de esquizofrenia 50(47,7%) y retardo mental 41(39%). La relación enfermería/camas varió de 0,52 a 1,15 y la enfermero/camas de 0,05 a 0,11. El objetivo es que los resultados de esa averiguación puedan aportar en la elaboración de políticas de salud mental e instrumentalizar el gestor en la tomada de decisión y establecimiento de estrategias de acción.

Percepção da doença mental por profissionais de saúde: possibilidades de ampliação do cuidado / Perception of mental illness by health professionals: possibility of broadening mental care

O estudo abordou a percepção da doença mental por dezenove profissionais, membros da equipe de uma Unidade de Saúde de Família, através de representações gráficas (desenhos). Trata-se de pesquisa de natureza qualitativa. Para coleta de dados, foi utilizado o procedimento apresentativoexpressivo com tema. A partir da análise temática, emergiram quatro temas que apontaram para a doença mental ligada ao cuidado em saúde, à visão médico-centrada, à exclusão/inclusão e ao meio social. A análise identificou percepções associadas ao paradigma biologicista, com reprodução de preconceitos. Destacou-se a importância do cuidado ampliado, evidenciando dificuldades de atuação profissional. O estudo apontou para a necessidade de investimento na capacitação profissional, numa tentativa de transformação dos conteúdos ideoafetivos apresentados pelo imaginário dos sujeitos...

This study approached perceptions of mental illness by nineteen professionals who work in a Family Health Unit, by means of graphic representations (drawings). We used qualitative methods. Data was collected by means of a Presentative-Expressive Procedure. Four themes were identified using Thematic Analysis. The professionals associate mental disorders with: health care, medical-centered view, exclusion/inclusion, social environment. These perceptions are related to a biological paradigm, favoring the reproduction of prejudices about mental illness. The analysisalso emphasizes the importance of a wide range of cares, while consideringhow difficult it may be for the professionals. We conclude that it is necessary to invest on professional preparation, in an attempt to transformideoaffective contents presented by the subjects’ imaginary...