ABSTRACT
El presente artículo relaciona bioética y discapacidad psíquica. Mediante entrevistas a los equipos profesionales que representan la unidad de análisis, se trazan los objetivos de describir las consideraciones bioéticas en las intervenciones realizadas a personas con discapacidad psiquiátrica, esperando así contribuir con un enfoque bioético para la optimización de estas atenciones. La investigación fue desarrollada en los tres Hospitales de Día de la Región del Maule -dispositivos en que se otorga tratamiento preferente a personas con patologías psiquiátricas crónicas-, mediante un estudio cualitativo de tipo exploratorio-descriptivo. El estudio da cuenta de que en nuestro país es necesario implementar modelos de atención en salud que integren de manera pragmática los conceptos de justicia y equidad como transversales, ante todo en las atenciones propias de salud mental, considerando la especial vulnerabilidad de parte de esos usuarios y usuarias; por ejemplo, a través del desarrollo de una bioética comunitaria y social. Finalmente, es esperable que, a partir de este trabajo, se puedan generar líneas de investigación que aporten al progreso en el mejoramiento de la calidad de atenciones a personas con discapacidad psíquica.
This article relates bioethics and psychiatric disabilities. Through interviews with professional teams that representing the unit of analysis, describe the objectives of existing bioethical considerations in interventions for people with psychiatric disabilities are plotted, hoping to contribute a bioethical approach for optimizing these attentions. The research was conducted in the three Day Hospitals in the Maule Region -devices which accord preferential treatment to people with chronic psychiatric disorders- through a qualitative, exploratory and descriptive study. During the course of the study is possible to appreciate that our country is necessary to implement health care models that integrate a pragmatic concepts of justice and fairness as transverse, strongly on their own mental health care, given the particular vulnerability of those users and users; for example, through the development of a community and social bioethics. Finally, it is expected that from this work can generate lines of research that contribute to the progress in improving the quality of care for people with psychiatric disabilities.
O presente artigo relaciona bioética e descapacidade psíquica. Mediante entrevistas a equipes profissionais que representam a unidade de análise, se traçam os objetivos de descrever as considerações bioéticas nas intervenções realizadas a pessoas com descapacidade psiquiátrica, esperando assim contribuir com um enfoque bioético para a otimização destas atenções. A investigação foi desenvolvida nos três Hospitais Dia da Região do Maule -dispositivos em que se outorga tratamento preferencial a pessoas com patologias psiquiátricas crônicas-, mediante um estudo qualitativo do tipo exploratório-descritivo. O estudo dá conta de que em nosso país é necessário implementar modelos de atenção em saúde que integrem de maneira pragmática os conceitos de justiça e equidade como transversais, antes de tudo nas atenções próprias de saúde mental, considerando a especial vulnerabilidade de parte desses usuários e usuárias; por exemplo, por meio do desenvolvimento de uma bioética comunitária e social. Finalmente, é esperável que, a partir deste trabalho, possam ser geradas linhas de investigação que contribuam para o progresso na melhoria da qualidade de atenções a pessoas com descapacidade psíquica.
Subject(s)
Humans , Bioethics , Day Care, Medical/ethics , Mental Disorders/rehabilitation , Chile , Interview , Qualitative ResearchABSTRACT
OBJECTIVE: The aim of this study was to identify components of cultural competence in mental health programs developed for cultural groups by community and mental health professionals from these groups. METHODS: Three programs were studied: a prevention program primarily serving African-American and Afro-Caribbean youth, a Latino adult acute inpatient unit, and a Chinese day treatment program in a community-based agency. Nine study-trained field researchers used a semistructured instrument that captures program genealogy, structure, processes, and cultural infusion. Program cultural elements were identified from field notes and from individual and group interviews of consumers and staff (N=104). A research-group consensus process with feedback from program staff was used to group elements by shared characteristics into the program components of cultural competence. RESULTS: Components included communication competencies (with use of colloquialisms and accepted forms of address); staff in culturally acceptable roles; culturally framed trust building (such as pairing youths with mentors), stigma reduction, friendly milieus (such as serving culturally familiar foods and playing music popular with the culture), and services; and peer, family, and community involvement (including use of peer counselors and mentors, hosting parent weekends, and linking clients with senior center and community services). CONCLUSIONS: Incorporating these components into any program in which underserved cultural populations are seen is recommended for improving cultural competence.
Subject(s)
Community Mental Health Services/standards , Cultural Competency/psychology , Ethnicity/psychology , Mental Disorders/ethnology , Adolescent , Adult , Black or African American/psychology , Asian/psychology , Communication , Community Mental Health Services/ethics , Cultural Competency/ethics , Cultural Diversity , Day Care, Medical/ethics , Day Care, Medical/standards , Ethics, Professional , Evidence-Based Practice/ethics , Evidence-Based Practice/standards , Female , Health Services Research/ethics , Hispanic or Latino/psychology , Hospitalization , Humans , Male , Mental Disorders/psychology , Middle Aged , New York City , Patient Care Team/standards , Patient-Centered Care/ethics , Patient-Centered Care/standards , Professional-Patient Relations/ethics , Social Environment , Young AdultSubject(s)
Day Care, Medical/ethics , Day Care, Medical/psychology , Empathy , Nurse-Patient Relations/ethics , Psychiatric Nursing/ethics , Clinical Competence , Countertransference , Day Care, Medical/organization & administration , Humanism , Humans , Mental Disorders/nursing , Mental Disorders/psychology , Nurse's Role/psychology , Philosophy, Nursing , Psychiatric Nursing/organization & administration , Psychological Distance , Psychotherapy/ethics , Psychotherapy/organization & administrationSubject(s)
Ambulatory Care/organization & administration , Caregivers , Dementia/therapy , Family , Social Support , Aged , Ambulatory Care/ethics , Caregivers/psychology , Day Care, Medical/ethics , Day Care, Medical/organization & administration , Dementia/psychology , Family/psychology , Humans , Quality of Life/psychologySubject(s)
Ambulatory Care Facilities , Commerce , Day Care, Medical , Ethics, Medical , Physician's Role , Physician-Patient Relations , Ambulatory Care Facilities/economics , Ambulatory Care Facilities/ethics , Commerce/ethics , Commodification , Day Care, Medical/economics , Day Care, Medical/ethics , Delivery of Health Care/economics , Delivery of Health Care/ethics , Entrepreneurship , Health Care Sector , Humans , Physician-Patient Relations/ethics , United StatesSubject(s)
Day Care, Medical/organization & administration , Home Care Services/organization & administration , Aged , Day Care, Medical/ethics , Day Care, Medical/statistics & numerical data , Day Care, Medical/trends , Home Care Services/ethics , Home Care Services/statistics & numerical data , Home Care Services/trends , Humans , Middle Aged , United StatesABSTRACT
Routine management of geriatric problems often raises ethical problems, particularly regarding autonomy of the old person. The carers or children may be unaware of the sensitivity of role reversal in dealing with the financial affairs; the need for a residential carer may compromise the old person's privacy. Attending a day centre confers much benefit, but one must understand the old person's resistance to change in the proposal of a new daily regimen. Similarly his or her autonomy must be the priority in planning for admittance to an old age home, and not the assumption that the family knows best. A common dilemma is the assessment of an old person's competency in decision making, either about management of his affairs, or regarding consent to treatment, or participation in research. Because cognitive capacity is not always identical with competency, meaningful tools have recently been developed in which the emphasis is on the specific situation to be investigated.
