CAPS Users Research Articles

PERCEPÇÃO DE ENFERMEIROS DO CAPS DURANTE A PANDEMIA DA COVID-19

Introduction: The current pandemic becomes a concern for the mental health of the population, because in addition to the fear of contracting the disease, COVID-19 has caused a feeling of insecurity in all aspects of life, from the collective to the individual perspective, the daily functioning of the society to changes in interpersonal relationships. One of the services that has been challenged are the Psychosocial Care Centers, which offer care to people in mental suffering. Objective: to describe the experience of CAPS nurses during the covid-19 pandemic and how much this can interfere with care in the sector Method: An interview was conducted with nurses who work at the Psychosocial Care Center in the municipality of São Sebastião do Paraíso. Thematic content analysis was used for data analysis. Results and discussion: According to the nurses, the perception of the pandemic in the sector was revealed with feelings of apprehension, fear, lack of security and preparation; professional performance in this period has been a challenge and involved changes in the routine of the place and changes in the physical and mental health of the interviewees and, at the same time, an appreciation of the professional and an improvement in human relations and the difficulties and challenges facing the pandemic in the CAPS are centered on physical and social distance, lack of PPE, fear of contamination, difficulty in socializing, sleep problems and the worsening of the mental health of patients in general, which is in line with most of the studies referring to this topic. Final Considerations: The COVID-19 pandemic is part of the crisis conditions that the population is experiencing, including CAPS users, family members and users, conditions that, despite the circumstances, require solid bonds and the creation of care strategies that can guarantee safe assistance at a time of extreme insecurity for everyone, it being important to promote important changes for the continuation of assistance in demand, as far as possible, bringing the need for work by sectors, emphasizing communication in partnership with other health services and of other public policies. It was evident that professionals feel the need for training, material, physical resources and also to overcome difficulties and challenges, mainly related to the pandemic and reflection on the subject to recreate ways in order to continue carrying out their work in the best possible way.

CARTOGRAPHIC WRITING: Institutional analysis in the context of a psychosocial care center (CAPS) II

This experience report is an institutional analysis based on the experiences of two interns at a Psychosocial Care Center (CAPS) II. Our intention is to raise some questions and reflections about Institutional Psychology and the institutionalities that permeate the service, the tension between the instituted and the instituting, focusing on the language that operates as an institution. The objectives are: to investigate the possible logic of subversion in such a scenario, still permeated by the asylum model; to examine how Institutional Psychology can assist in this subversion; to determine if language, as an institution, can free bodies from such a model. We used the cartography method, where the procedures involved observation, field diary recording, sharing in supervisions, and literature review. Five examples of language observed in the service are used: invalidation of suffering, infantilization, LGBTI+phobia, stereotypes against psychoactive substance users, and re-signification of the language of madness. A discussion is conducted on these five examples based on the results obtained, which point to the importance of Institutional Psychology and the need for training professionals and emancipating users as political subjects. We understand that, with the raised reflections and discussions, room can be opened for transformations. In the final considerations, it is concluded that language has the potential to contribute to reinforcing or liberating the abjection of certain bodies produced by the asylum model. This liberation occurs when there is analysis, redesign, and collaboration with CAPS users.

Multicenter propensity score-matched analysis comparing short versus long cap-assisted colonoscopy for acute hematochezia.

While short and long attachment caps are available for colonoscopy, it is unclear which type is more appropriate for stigmata of recent hemorrhage (SRH) identification in acute hematochezia. This study aimed to compare the performance of short versus long caps in acute hematochezia diagnoses and outcomes. We selected 6460 patients who underwent colonoscopy with attachment caps from 10 342 acute hematochezia cases in the CODE BLUE-J study. We performed propensity score matching (PSM) to balance baseline characteristics between short and long cap users. Then, the proportion of definitive or presumptive bleeding etiologies found on the initial colonoscopy and SRH identification rates were compared. We also evaluated rates of blood transfusions, interventional radiology, or surgery, as well as the rate of rebleeding and mortality within 30 days after the initial colonoscopy. A total of 3098 patients with acute hematochezia (1549 short cap and 1549 long cap users) were selected for PSM. The rate of colonic diverticular bleeding (CDB) diagnosis was significantly higher in long cap users (P = 0.006). While the two groups had similar rates of the other bleeding etiologies, the frequency of unknown etiologies was significantly lower in long cap users (P < 0.001). The rate of SRH with active bleeding was significantly higher in long cap users (P < 0.001). Other clinical outcomes did not differ significantly. Compared to that with short caps, long cap-assisted colonoscopy is superior for the diagnosis of acute hematochezia, especially CDB, and the identification of active bleeding.

Challenges of nursing care in psychosocial rehabilitation: a study from the constructionist perspective.

To identify the nursing staff's difficulties in providing care in psychosocial rehabilitation to CAPS users. Qualitative study based on constructionism. Sixteen members of the CAPS nursing staff participated in the study in the city of Rio de Janeiro. The data collected in the interviews and observations were organized in Nvivo software and analyzed based on thematic content. The difficulties identified were: the territorial violence that imposes a silence to the actions of CAPS, low user education as a barrier to protagonism, impaired family adhesion, the technical-conceptual discomfort of nursing in acting in the crisis and material and human of CAPS dismantlement. The challenges consist of overcoming staff exhaustion; however, they do not prevent nursing from betting on the possibility of protagonist care. Therefore, such care is dimensioned by the clinical-political-ethical relation in constant negotiation with the territory.

Adherence to treatment in collective multiprofessional activities and factors associated with adherence in a specialized center for psychosocial care.

IntroductionSpecialized psychosocial care centers (Centros de Atenção Psicossocial [CAPS]) are mental health services focused on social rehabilitation and reducing hospitalization of patients with severe and persistent mental illness. Collective multiprofessional activities (CMPA) are the main therapeutic tools used at CAPS. This study aimed to determine rates of adherence to CMPA and identify factors associated with adherence.MethodsThis is a cross-sectional study in which 111 CAPS users were evaluated using questionnaires covering patient characteristics, clinical status, and treatment and incorporating the Functioning Assessment Short Test (FAST), the Clinical Global Impression – Severity scale (CGI-S), and the Clinical Global Impression – Improvement scale (CGI-I). Adherence was defined as attendance at 50% or more CMPA during the previous 3 months. Data were analyzed using descriptive statistics, bivariate analysis, and Poisson logistic regression with robust variance to estimate prevalence ratios.ResultsCPMA adherence was 43%. Having children aged 14 years or younger was significantly associated with non-adherence (71%, p = 0.001). Poor or partial adherence to psychotropic drugs tended to be associated (p = 0.066) with poor adherence (33% higher risk), as was the number of psychiatric hospitalizations during CAPS (p = 0.076), with a cumulative association of 5% non-adherence per hospitalization.ConclusionsCMPA adherence was low in the study. It is necessary to consider the environment in which the individual lives and invest in support networks, providing patients and family members with explanations about the importance of CMPA to rehabilitation and attempting to tailor the care provided to each patient’s needs. There was an association between greater number of psychiatric hospitalizations and non-adherence, suggesting that CAPS are fulfilling a preventive role.

Teatro do Oprimido Como Possibilitador da Reabilitação Psicossocial de Pessoas em Sofrimento Psíquico

O objetivo é avaliar as repercussões do Teatro do Oprimido (TO) no cotidiano de pessoas em sofrimento psíquico usuários do Centro de atenção Psicossocial (CAPS) I em Cuité, Paraíba-PB. Trata-se de uma pesquisa-intervenção com abordagem qualitativa, realizada com quatorze usuários do CAPS. Os dados foram coletados no período de junho a julho de 2014, por meio de entrevistas semiestruturadas e, em seguida, submetidos à análise de conteúdo proposta por Bardin. O TO mostrou-se um importante recurso terapêutico e foram observados benefícios como: expressão de sentimentos de confiança, alegria, satisfação; ruptura do medo, timidez e das aflições; fortalecimento do diálogo; descoberta de novos valores e atributos de cidadania; melhoria na qualidade do sono e repouso; e desejo de reabilitação social. Conclui-se que o TO oferta um cuidado constituinte de novas práticas e saberes direcionados ao protagonismo do usuário na conjuntura da arte do cuidar. Palavras-chave: Saúde; Arte; Reabilitação.

Brazilian Mental Health Services Assessment: user satisfaction and associated factors.

Patient satisfaction is an important criterion for assessing the quality of Brazilian mental health services at Psychosocial Care Centers (CAPS - from the Portuguese 'Centro de Atenção Psicossocial'). The aim of this study was to evaluate the satisfaction of users at the main CAPS in a region of Minas Gerais state, Brazil, as well as associated factors. This was a cross-sectional study with 11 CAPS. Patients were interviewed using the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and a semi-structured questionnaire containing sociodemographic and clinical variables. The users were satisfied with the CAPS, particularly in terms of staff competence and the welcome received and care provided. The physical facilities and comfort at the centers obtained the lowest satisfaction scores on the scale. Almost half of the users were unfamiliar with basic aspects of their drug therapy, such as the name of medicines, and one-third reported inappropriate use of medications. Users of midsize CAPS and those providing treatment for alcohol and drug addiction were more satisfied than patients at mental health or 24-hour CAPS. Although this study identified a need for improvement in physical facilities, mechanisms of participation and patient empowerment, the users were satisfied with the CAPS care model.

Functioning of Psychosocial Care centers in four cities in BrazilActuación de los Centros de Atención Psicosocial en cuatro centros urbanos en Brasil

RESUMOObjetivoDescrever a atuação dos Centros de Atenção Psicossocial (CAPS) em quatro centros urbanos no Brasil.MétodosRealizou-se um estudo transversal (AcesSUS) com entrevista a 917 usuários acompanhados nos CAPS de Campinas, São Paulo, Porto Alegre e Fortaleza. Foram incluídas apenas as modalidades de CAPS destinadas a transtorno mental grave em adultos, sendo excluídos os CAPS voltados para uso de substâncias e para crianças e adolescentes. Os usuários responderam a questionário de múltipla escolha sobre seu percurso entre os serviços de atenção primária, CAPS e hospitais em relação aos problemas de saúde mental.ResultadosAtendimento psiquiátrico e uso de medicação foram relatados em 90% a 100% dos usuários acompanhados nos CAPS, combinado com atendimento multiprofissional e grupos terapêuticos. O acesso à medicação foi interrompido nos 6 meses que antecederam a entrevista, especialmente em Fortaleza (64%) e Porto Alegre (51%). Em todos os municípios, menos de 10% dos usuários tiveram internação psiquiátrica após início do tratamento no CAPS.ConclusõesA transição do modelo hospitalar para o comunitário continua em processo de efetivação no Brasil, com avanços comprovados. A situação, porém, é diversa nas diferentes redes de atenção, requerendo análise contextualizada de cada localidade, com identificação de dificuldades que impedem o adequado funcionamento dessas redes no paradigma psicossocial.

Narratives of users of mental health services in an experiment with autonomous management of medication

Numerous studies have highlighted the tendency to chronicity of treatments centered on the use of medications. This study was conducted in a large Brazilian city with users of Centers for Psychosocial Care (CAPS), with the aim of evaluating the effects of experimenting with the personal Guide for Autonomous Management of Medication (GAM) and the users' relationship to their treatments and participation. The instrument, created in Canada and translated and adapted to Brazil, was tested in intervention groups with users of CAPS with severe mental disorders and a history of political participation in the field of health. Focus groups and in-depth interviews were performed. The transcriptions were transformed into narratives, and four analytical categories were defined: subjects with radical experiences of suffering; experiences with medication; users' rights; and participation and political activism. In testing GAM, users expressed a tension between reproduction of illness-centered identity and the legitimate uniqueness of their personal experiences. They showed greater knowledge of the medications they were taking, began to recognize their own expertise in their use of medications, and some sought adjustments to their treatment. They reported the need for support in claiming their rights and strengthening their participation as mental health activists. In conclusion, the Brazilian version of the GAM guide has the potential to contribute to users' empowerment, thus allowing dialogue between the results in mental health care in Brazil and the international scenario.

User embracement in practices care in psychosocial care centers the perspective of local managers

Introduction: Psychosocial care centres (CAPS), strategic IN articulation of psychosocial care network and health system gateway, propose to the reorganization of health practices, by adopting a new ethic of care, based on respect to the singularity of the subjects and in the reception to the health needs of the users. Reception is a device for transforming practices and humanizing health care. &#x0D; Objective: To analyse the operation of the host users of CAPS from the perspective of local coordinators in Fortaleza, Ceará, Brazil. &#x0D; Method: Qualitative research with case study design, performed with CAPS coordinators of the city of Fortaleza, Ceará, Brazil. Data were collected through semi-structured interviews and observation, being submitted to the analysis of thematic content. &#x0D; Results: The host constituted innovative device in mental health practices, as triggered the construction of new ways of dealing with the subject in psychological distress, by incorporating technologies such as qualified listening, building autonomy, with attention focused on the user. Provided a reorientation of work and service processes, requesting the articulation for network care. In addition, it was configured as a strategy for humanization in the CAPS. Was presented, however, operational difficulties related to the environment and to the effectiveness of the network of attention. &#x0D; Final considerations: The host device configured for reorienting health practices, enhancing the consolidation of psychosocial care model, with humanization and increased solvability. However, challenges remain to be overcome, related to the environment and to the effectiveness of the network of care.

Satisfacción de familiares de usuarios de servicios de salud mental: informaciones sobre tratamiento y enfermedad

Objective: to identify the satisfaction of CAPS users’ relatives about the information offered by professionals regarding their disorder and treatment. METHODS: a cross-sectional study was performed with 1242 relatives in 40 CAPS from 39 municipalities. Specific variables were selected to access the evaluation of the relatives about the information provided by the CAPS on the disease and the treatment of the user. Chi square test was used. Results: most of the studied individuals were very satisfied with the information about the treatment obtained by users in the CAPS and on the individual’s disorder. However, not receiving information about the treatment was a greater predictor of dissatisfaction than not receiving information about the disorder. Conclusions: the results of this study stress the need of qualify the dialogue between the services team and the users' families, especially about the treatment provided to the user .

A mudança percebida pelo usuário do Centro de Atenção Psicossocial frente ao tratamento

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Occupational possibilities in a Brazilian mental health service: The perspective of users

Background: Psychosocial care centers (CAPS) are a type of service that redirects care to people with mental health problems in Brazil, de-emphasizing the asylum model and promoting the psychosocial model. Aim: To understand and analyze how CAPS contribute to the possibilities of occupational engagement of users. Methods: A qualitative research methodology was used and semi-structured interviews were conducted with 17 users of CAPS and 12 people from their social networks, totaling 29 interviews. Discourse analysis was used as a reference for data analysis. Results: CAPS provide opportunities, and, as users engage in the activities offered by CAPS, they can find the types of occupations that they want to perform and what they like to do, as their range of opportunities and access are expanded. However, promoting these occupational opportunities and choices in the community remains a challenge. Conclusions: CAPS have been able to help users improve their occupations in everyday life. Occupational therapists must build their clinical strategies in association with the opportunities offered by the health services and the community.

Limitations of social behavior among users of the psychosocial care network in the south of Brazil

This cross-sectional study aims to assess through analysis of data suggested by the Social Behavior Schedule (SBS) quantitatively and qualitatively distinguishing between the limitations of social interaction presented by users of substitute services. Analyses were performed of 385 instruments applied to users of Therapeutic Residential Services (SRT) and the Centers for Psychosocial Care (CAPS). Twenty-one items from the Social Behaviour Schedule (SBS, BR). The data indicate that the individuals studied had from zero to 15 social behavior problems, with an average of 2.5 problems per service user with a standard deviation of 2.84. The majority of the sample appeared to have 1-2 problems among those identified by the scale, and the nonspecific behaviors are present in greater proportion in both services, followed by panic attacks among CAPS users and problems with personal appearance and hygiene in SRT users. In this way, the use of tools that make it possible to assess the data on the social aspects of the psychological distress deserves to be encouraged as a way to further research in this area, and rethink ways of effecting social reintegration of these individuals.

Avaliação da estrutura e processo na visão dos familiares de usuários de saúde mental

This study consists of a part of the evaluation research of the Psychosocial Attention Centers in Southern of Brazil (CAPSUL), and aims to make a qualitative evaluation of the physical structure and the working process of a Psychosocial Attention Center (CAPS) in the interior of Rio Grande do Sul/ Brazil, from the view of the family of users of this service. This is a descriptive and exploratory study, with qualitative approach, which was developed from the adaptation of the evaluation of the dimensions of “Structure and Process” proposed by Donabedian. Data was collected through 14 semi-structured interviews with the family members of users of CAPS, from January 2006 to February 2008. Results: To the family, the ambience and the receptivity in the service means the resolution in the adversities they face in their daily lives. In the family view, these tools enable a free caregiving practice, facilitating the social and familiar inclusion of the users with mental disorders.

Adaptação da "Critical Time Intervention" para o contexto brasileiro e sua implementação junto a usuários dos centros de atenção psicossocial do município do Rio de Janeiro

Brazilian Psychiatric Reform proposes a mental healthcare model based on the implementation of a community-based service network, in which Psychosocial Service Centers (CAPS) play a fundamental role. The report presents the results of a pilot study which aimed to adapt Critical Time Intervention to the Brazilian context, and to test its feasibility to provide it to persons with schizophrenic spectrum disorders who are enrolled in CAPS of Rio de Janeiro. The research design included three inter-related phases. Phase one consisted in carrying out qualitative and quantitative field work. This phase included mapping out the socio-demographic, clinical and service utilization data of CAPS users, as well as assessing the mental health needs of participants in the study. The second phase consisted in translation of the CTI clinical manual to include the adaptations made for use in Brazil, which were based on data collected in the first phase, as well as training individuals with moderate education as CTI intervention workers. The third phase consisted of pilot implementation of the adapted intervention among a group of individuals with schizophrenia spectrum disorders enrolled in CAPS, but with difficulties in being included in treatment.

Analysis of the general health condicition of the users of caps i and ii in the south region of Brazil

Analysis of the general health condicition of the users of caps i and ii in the south region of Brazil

Rede social dos usuários de um Centro de Atenção Psicossocial e o desenvolvimento de sua autonomia

This study aimed to evaluate the representations of the users of CAPS on the themes: Home, Work and Leisure, guiding psychosocial rehabilitation, as well as their contribution to the development of client autonomy. For this we used a qualitative approach based on MARES, methodology for data collection. Data were collected in December 2009, in a CAPS II, in a county in southern Brazil, through two focus groups conducted with six (6) users, who were enrolled in treatment modalities or semi-intensive intensive. As a result of data analysis, one can see that the subject is concerned about having a house that stigma and psychic suffering to cause a disruption in the lives of individuals, insofar as they do not see themselves inserted into the labor market because of prejudice. As for leisure realize that users fail to realize it by the prejudice that society and prejudice themselves, showing us that they should also find ways to rescue their autonomy. Descriptors: mental health; health care reform; nursing; personal autonomy.

PRÁTICAS CORPORAIS EM CENA NA SAÚDE MENTAL: POTENCIALIDADES DE UMA OFICINA DE FUTEBOL EM UM CENTRO DE ATENÇÃO PSICOSSOCIAL DE PORTO ALEGRE

Normal 0 21 Physical education is emerging in the field of mental health in order to contribute to the therapeutic process of users of mental health services, such as the Centers for Psychosocial Care (CAPS). In this work our objective was to analyze the meanings that users of CAPS, located in Porto Alegre / RS, attributed to the workshop of soccer that took place there. The research is of a qualitative nature and draws on ethnographic perspective. One of the facts that emerged from the workshop of soccer, and it deserved greater attention to analysis, the active participation of users in many moments of the workshop. This increased participation has enabled the participants interesting moments of ownership, little experienced by them in their life histories.

Reforma psiquiátrica e inclusão social pelo trabalho

This study aims at understanding the link among labor, mental distress, and psychosocial rehab from the point of view of people with either mental disorders or psychoactive substance addiction, regarding the meaning of laboring in their lives. The study took place in Psychosocial Attention Centers(CAPS), in the city of Goiânia, State of Goiás, Brazil. There were eight participants of both genders, who would consider labor something important in their daily lives. Two different types of data were used, as to mention, qualitative and exploratory methodology, by means of a focal group. The content analysis was used in evaluating the data provided. The results point at the importance of rescuing the history of labor among CAPS users. It is also of significance the profusion of meanings attributed to working by the users of mental health services. Labor proves to have an interface that is understood as a factor of protection and/or worsening of the condition of the subjects. The exclusion processes are reflected by the difficulty in obtaining social security/welfare benefits.