ABSTRACT
Este artigo buscou compreender, a partir do itinerário terapêutico de pessoas em sofrimento psíquico e egressas de internação psiquiátrica, a inserção do centro de atenção psicossocial como equipamento de cuidado em suas trajetórias. Trata-se de estudo inspirado na Epistemologia Qualitativa de Gonzalez Rey no qual foram realizadas entrevistas com seis pessoas, de 27 a 52 anos, em tratamento em um Centro de Atenção Psicossocial tipo 1, e para análise do material transcrito foram adotados procedimentos inspirados no conceito de indicadores de González Rey e na análise temática de conteúdo. Neste artigo, foram discutidas duas categorias: (1) "O manicômio está presente" e (2) "CAPS: espaço de convivência e substituto da vida social?". Os indicadores apontaram que a internação psiquiátrica foi um recurso utilizado após inserção em CAPS, o qual é destacado mais como local de convívio do que de produção de autonomia e de desinstitucionalização. No percurso dos usuários, as internações ocorreram em hospitais gerais, hospitais especializados e comunidades terapêuticas. Os serviços de atenção primária não aparecem como ponto de cuidado à saúde mental, os serviços de urgência estão presentes na atenção às crises, dando ao CAPS contornos de um serviço para a convivência e não para o cuidado na crise. (AU)
Based on the therapeutic itinerary of individuals experiencing psychic distress and who have undergone psychiatric hospitalization, this study aimed to comprehend the integration of the Center of Psychosocial Attention as a care facility along their path. The study is inspired by Gonzalez Rey's Qualitative Epistemology, in which interviews were conducted with six individuals aged between 27 and 52, receiving treatment at a type 1 Center of Psychosocial Attention. Procedures inspired by González Rey's concept of indicators and thematic content analysis were employed to analyze the transcribed material. This paper will discuss two categories: (1) "The presence of the psychiatric hospital," and (2) "CAPS: A space for interaction and a substitute for social life?" The indicators reveal that psychiatric hospitalization was resorted to after involvement with CAPS, which is perceived more as a space for coexis-tence than for fostering autonomy and deinstitutionalization. As per the users' itineraries, hospitalizations occurred in general hospitals, specialized hospitals, and therapeutic communities. Primary care services do not emerge as a focal point for mental health care, whereas emergency services are present for crisis intervention, portraying CAPS as a service more geared towards coexistence rather than crisis management.
Este artículo buscó comprender, a partir del itinerario terapéutico de las personas en distrés psicológico y las dadas de alta de hospitalización psiqui-átrica, la inserción del centro de atención psicosocial como equipamiento de atención en sus trayectorias. Se trata de un estudio inspirado en la Epistemo-logía Cualitativa de González Rey, en el que se realizaron entrevistas a seis personas, de 27 a 52 años, en tratamiento en un Centro de Atención Psicosocial tipo 1 y para el análisis del material transcrito, procedimientos inspirados por el concepto de indicadores de González Rey y el análisis de contenido temático. En este artículo se discutirán dos categorías: (1) "Está presente el asilo" y (2) ¿"CAPS: espacio de convivencia y sustituto de la vida social?". Los indicadores señalaron que la hospitalización psiquiátrica fue un recurso utilizado después de la inserción en CAPS, que se destaca más como un lugar de socialización que para producir autonomía y desinstitucionalización. En el curso de los usuarios, los ingresos se realizaron en hospitales generales, hospitales especializados y comunidades terapéuticas. Los servicios de atención primaria no aparecen como un punto de atención en salud mental, los servicios de emergencia están presentes en la atención de crisis, dando al CAPS los contornos de un servicio de convivencia y no de atención en crisis. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Crisis Intervention , Therapeutic Itinerary , Mental Health Services , Qualitative Research , Hospitals, PsychiatricABSTRACT
La infección intestinal parasitaria afecta principalmente a la población infantil y constituye una de las enfermedades de mayor prevalencia en las comunidades empobrecidas de los países en desarrollo. El objetivo del trabajo fue determinar la prevalencia de parásitos intestinales en niños de edad escolar de una institución educativa del municipio de Fernando de la Mora. Se realizó un estudio observacional, descriptivo de corte transversal, de abril a julio del 2017. Se procesaron muestras fecales de40 niños de 6 a 11 años de edad, procedentes de una escuela pública de la zona sur de Fernando de la Mora. Las muestras obtenidas se fijaron en formol 10%, transportadas y procesadas mediante examen directo y por el método de Ritchie en el laboratorio de Microbiología de la carrera de Biología de la UNA. Se empleó el análisis univariado para calcular frecuencias y para determinar asociaciones entre variables el análisis bivariado prueba de Chi2. La prevalencia fue del 27% y se encontró infección por cinco especies de parásitos. Los parásitos encontrados fueron; Blastocystis hominis (18%), Giardia lamblia (10%), Chilomastix mesnili (10%), Balantidium coli (5%) y huevos de Ascaris lumbricoides (10%). Predominó el multiparasitismo (18%) y se encontró asociación significativa entre el nivel de grado escolar y la infección parasitaria (p=0,04). Se demostró la alta prevalencia de infección parasitaria para el grupo de niños escolares que participaron del estudio. Los resultados reafirman la importancia del constante seguimiento y control de las parasitosis a nivel local y nacional.
Parasitic intestinal infection mainly affects children and is one of the most prevalent diseases in impoverished communities in developing countries. The objective of the work was to determine the prevalence of intestinal parasites in school-age children from an educational institution in the municipality of Fernando de la Mora. An observational, descriptive cross-sectional study was carried out during the period from April to July 2017. Fecal samples from 40 children between 6 and 11 years old, from a public school in Fernando de la Mora, were processed. The obtained samples were fixed in 10% formalin, transported and processed by direct examination and by the Ritchie method in the Microbiology laboratory of the Biology degree program at UNA. Univariate analysis was used to calculate frequencies and bivariate by Chi 2 test to determine associations between variables. The prevalence was 27% and infection was determined by five species of parasites. The high prevalence of parasitic infection was demonstrated for the group of school children who participated in the study. The parasites found were; Blastocystis hominis (18%), Giardia lamblia (10%), Chilomastix mesnili (10%), Balantidium coli (5%) and Ascaris lumbricoides eggs (10%). Multiparasitism predominated (18%) and a significant association was found between grade level and parasitic infection (p = 0.04). The results reaffirm the importance of constant monitoring and control of parasites at the local and national level.
Subject(s)
Child , Parasites , Intestinal Diseases, Parasitic , ChildABSTRACT
The systematic analysis of acting-out episodes can be used in assessing analytic progress. Variables to be considered are the nature of the wish, the type of defense, and the degree of concreteness (versus symbolization) of the mental processes used in attempting actualization (as distinct from the resort to action). Two acting-out episodes of a borderline patient who acted out as a character trait, both occurring outside the analytic setting, are presented as illustrations. In the first one, occurring relatively early in the analysis, when split-off negative and positive self-images had to be rigidly maintained, ejection of the negative self-image was actualized via the regressive use of a symbolic equation and the mechanism of displacement, obliterating the distinction between an internal feeling and an external thing that here was literally thrown out. The later episode, occurring after the split was healed and within the context of a frustrating heterosexual involvement, contained an acted-out allusion to identification and competition with the mother. As in a dream, via associations, an unconscious wish for oedipal victory was revealed. Whereas in the first episode the goal of ejection was central, with splitting and denial the underlying defenses, it was absent from the second, in which an attempt was made to actualize a repressed infantile wish and made greater use of symbolization. It is concluded that acting-out episodes at different periods of the analysis, when systematically analyzed, can serve in assessing a patient's progress.
