Humanization of care in acute psychiatric hospitalization units: A scoping review.

WHAT IS KNOWN ON THE SUBJECT?: Humanizing the world of health is a complex process that includes all the dimensions of the person. When a person has from a mental illness, the humanization of care becomes more important, as the disorder itself prevents the person to participate in their health process, even when showing self-harm or aggressive behaviours. These situations jointly with other factors related with professionals (insufficient ratio, inadequate treatment or lack of training) may cause the patient admitted to the acute psychiatric hospitalization unit to require the use of restrictive measures (involuntary admissions, mechanical restraints or forced administration of medication). WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We identify the relevance of the perception the patient and family have regarding the care received, as well as the relevance of factors related to the professionals, among which the attitude, the staff ratio, the nursing time of direct dedication, and the therapeutic environment and safety of the patient and the professionals. All patients must be treated with dignity, respect, regardless of the aggressive manifestations caused by their pathology. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: A greater understanding of the care offered to admitted people affected by a mental disorder, their families and professionals who care for them in acute mental health units, giving greater importance to "caring" and not exclusively to "curing." ABSTRACT: INTRODUCTION: Humanization in Mental Health refers to give the same relevance to the clinical needs and to the social, emotional and psychological needs. AIM: To identify the published knowledge on current care models related to the humanization of care in acute psychiatric units. METHOD: Scoping review based on the methodological model of Arksey and O'Malley, and PRISMA methodology. Database searches (Pubmed, Cinahl, Virtual Library, Cuiden, Academic Google and PsycInfo) with the terms: "Humanization," "Hospitals Psychiatric," "Emergency Psychiatric," "Psychiatric Service" and "Psychiatric intensive care units." RESULTS: Twenty-two articles met the inclusion criteria. Four thematic units were identified: aspects related to (i) patient perceptions; (ii) Government policies and hospitality organizational culture; (iii) external factors such as the environment, family or associations; and (iv) safety and security. DISCUSSION: Only one of the articles mentions the concept analysed, although all of them contribute with key aspects of healthcare humanization, such as the empowerment of the patient, the care model, the staff ratio, the therapeutic relationship, the nursing time of direct dedication to the patient, the therapeutic environment, safety and patient and staff perception of feeling safe. IMPLICATIONS FOR PRACTICE: The present study can help to improve the care offered in acute mental health units.

Travestis e o cuidado humanizado em saúde / Transvestites and humanized health care / Travestis y el cuidado humanizado en salud

Com base nas diretrizes do SUS, com princípios de universalidade, integralidade e equidade, realizamos um estudo com o objetivo de identificar concepções, desejos, receios e sugestões quanto ao cuidado humanizado em saúde dirigido às pessoas travestis, no âmbito da atenção primária. O caminho teórico-metodológico foi a Hermenêutica Dialética com utilização de entrevista em profundidade e uso de "cenas", com sete participantes. As entrevistadas relataram dificuldades quanto ao acesso e uso dos serviços de saúde. Diante das dificuldades encontradas, para a efetivação de um cuidado humanizado identificamos algumas mudanças necessárias na interlocução da saúde com a população travesti: Capacitação dos profissionais de saúde, diálogo com o movimento social, campanhas de divulgação e a aproximação com o significado da vivência de ser travesti. É urgente um trabalho efetivo na formação dos profissionais de saúde, bem como no cotidiano de nossa vida cercada por atitudes discriminatórias, em nome do compromisso com o sofrer do outro.

Based on SUS guidelines, with principles of universality, completeness and equity, we carried out a study with the objective of identifying conceptions, desires, fears and suggestions regarding humanized health care for transvestites, in primary health care. The theoretical-methodological path was the Dialectic Hermeneutics using an in-depth interview and use of "scenes", with seven participants. The interviewees reported difficulties in accessing and using health services. In view of the difficulties encountered, in order to carry out a humanized care, we identify some necessary changes in the interlocution of health with the transvestite population: Training of health professionals, dialogue with the social movement, dissemination campaigns and the approximation with the meaning of the experience of being transvestite There is an urgent need for effective work in the training of health professionals, as well as in the daily lives of our lives, surrounded by discriminatory attitudes, in the name of commitment to suffering the other.

Con base en las directrices del SUS, con principios de universalidad, integralidad y equidad, realizamos un estudio con el objetivo de identificar concepciones, deseos, temores y sugerencias en cuanto al cuidado humanizado en salud dirigido a las personas travestis, en el ámbito de la atención primaria. El camino teórico-metodológico fue la Hermenéutica Dialéctica con utilización de entrevista en profundidad y uso de escenas, con siete participantes. Las entrevistadas relataron dificultades en cuanto al acceso y uso de los servicios de salud. Ante las dificultades encontradas, para la efectividad de un cuidado humanizado identificamos algunos cambios necesarios en la interlocución de la salud con la población travesti: Capacitación de los profesionales de salud, diálogo con el movimiento social, campañas de divulgación y la aproximación con el significado de la vivencia de ser travesti. Es urgente un trabajo efectivo en la formación de los profesionales de salud, así como en el cotidiano de nuestra vida rodeada por actitudes discriminatorias, en nombre del compromiso con el sufrimiento del otro.

Comprehension on doula's work at a maternity in Jequitinhonha Valley - MG / Compreensão sobre o trabalho da doula em uma maternidade do Vale do Jequitinhonha - MG

Abstract Objectives: to analyze the understanding of puerperae, doulas and the care team about the presence of a doula during the pregnant women's parturition process. Methods: this is a qualitative study, using semi-structured interviews as a data collection instrument. The saturation criterion was used to limit the sample and proceed to the Content Analysis. Results: 19 participants were interviewed, 10 were the health team, 5 were doulas and 4 were puerperae. After the analysis, three categories were identified: the doula's presence during the pregnant women's labor and their meaning, the doula's follow up during the pregnant women's labor and its improvements, the influence of doulagem in the academic formation. The presence of doulas brought to the parturient security, support, humanization and follow-up on childbirth process. The team brought comfort and tranquility.The doulas scored benefits for academic training. Conclusions: it was possible to recognize doula as part of the humanized care, to provide subsidies for a reflection of her work, and to reveal the influence of the practice of doulagem for academic formation of doulas at university.

Resumo Objetivos: analisar a compreensão das puérperas, das doulas e da equipe assistencial sobre a presença da doula durante o processo de parturição das gestantes. Métodos: trata-se de estudo qualitativo, utilizando como instrumento de coleta de dados entrevistas semiestruturadas. O critério de saturação foi utilizado para limitar a amostra e procedida a Análise de Conteúdo. Resultados: foram entrevistados 19 participantes, sendo 10 da equipe de saúde, 5 das doulas e 4 das puérperas. Após análise, foram identificadas três categorias, sendo elas: presença da doula durante o trabalho de parto das gestantes e seus significados, acompa-nhamento da doula durante o trabalho de parto das gestantes e suas melhorias, a influência da doulagem na formação acadêmica. A presença das doulas trouxe para a parturiente segurança, apoio, humanização e acompanhamento do processo de parto. Para a equipe trouxe conforto e tranquilidade. As doulas pontuaram benefícios na formação acadêmica. Conclusões: foi possível reconhecer a doula como parte do cuidado humanizado, prover subsídios para uma reflexão do seu trabalho, além de revelar a influência da prática da doulagem para formação acadêmica das doulas universitárias.