Multidisciplinary Health Team Research Articles

Beyond stereotypes of cerebral palsy: Exploring the lived experiences of young Canadians.

BackgroundHealth for people with cerebral palsy (CP) must extend beyond physical impairments to include social, environmental, and psychological factors that are rarely captured by quantitative research alone. This qualitative study sought to explore the lived experience of young people with CP with their physical, mental, and emotional health in the context of a larger longitudinal Canadian study focusing on brain function, physical and mental health, and well‐being.MethodsAn integrated research team (including people with CP or other impairments, clinicians, and researchers) was formed to study participant‐identified research needs. A purposive sample of 16 people with CP (seven female), aged 17–29, Gross Motor Function Classification System (GMFCS) levels I–V, participated in three focus groups that were conceptualized and analysed using interpretive description methodology.ResultsThis study reports the experiences of people with CP across GMFCS levels and identifies some consequences of growing up with the condition: physical and mental health issues, importance of meaningful participation, impact of the environment, and identity formation. Participants shared challenges related to accessibility, healthcare, social/environmental supports, relationships, and sustainable employment.DiscussionBody structure and function challenges impact participation in activities of daily living, threatening participants' ability to form positive identities and live meaningful lives. People with CP desire to work but may require additional training, accommodation, and support to do so. Environmental conditions, including relationships, supportive people, and accessibility, shape participants' health, well‐being, and social/civic engagement. This study confirms the need for improved care for adults with CP, including multidisciplinary adult health team(s) and community services.

P2‐041: ALZHEIMER DISEASE AND THE IMPORTANCE OF HOME PHYSIOTHERAPY TO PREVENT BED IMMOBILITY SYNDROME IN BEDRIDDEN PATIENTS

Alzheimer's disease is the most common type of dementia in the world and affects, mainly Alzheimer's disease is the most common type of dementia in the world and mainly affects people over 60 years of age. According to the World Health Organization, it is estimated that more than 30 million people around the world live with the disease, which is neither reversible nor cured. With the final progression of the disease, the carrier becomes dependent on the daily care of other people, being susceptible to the labeling of the team as immobility syndrome in the bed, which affects bedridden and unmoving individuals. Often, they are patients who still have undetected, neglected potentials, sufficient enough to alleviate the degree of dependence, requiring a specific physiotherapeutic look. Adequate treatment and care can provide greater survival and a better quality of life for people and relatives living with Alzheimer's dementia patients. The clinical concept of immobility is defined as the difficulty or inability to walk or change position (lying down to sit and sitting down). Immobility is inconsistent with human life. It is extremely important that the physician in charge assess and reassess the patient's current health status through a complete diagnosis, at the risk of depriving him of benefits, sometimes through extremely simple procedures. In this way, we do not accept immobilization as a definite fact. The aim of this article is to discuss the importance of home rehabilitation and physiotherapy in Alzheimer's disease at all stages of the disease, preventing the consequences of immobility. It is necessary that the whole multidisciplinary Health Team Act in order to encourage more and more early mobilization in bed. It is necessary to develop different studies and papers that show the deleterious effects of immobilization in order to create an increasing awareness of the importance of teamwork aiming at the early recovery of every patient bedridden as soon as possible.

Estudo transversal da saúde física e funcional de agricultores expostos a agrotóxicos: uma aplicação do modelo biopsicossocial da CIF na perspectiva da fisioterapia

Introdução: A investigação das condições e riscos ocupacionais através de uma abordagem biopsicossocial no diagnóstico da condição de saúde dos trabalhadores rurais é geralmente negligenciada nos serviços de saúde. Consequentemente, algumas incapacidades funcionais não são identificadas. Objetivo: Avaliar a saúde de trabalhadores agrícolas por meio da perspectiva da fisioterapia aplicando o modelo de Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), que possui um modelo biopsicossocial de domínios múltiplos e relacionados. Identificar as áreas da saúde funcional mais debilitadas e determinar a sua influência na atividade laboral. Métodos: Trata-se de um estudo transversal com abordagem descritiva e analítica realizado em trabalhadores agrícolas expostos a agrotóxicos. Resultados: Participaram do estudo 99 agricultores. Observou-se que o domínio função corporal apresentou maiores prejuízos, onde a dor foi a incapacidade predominante nos agricultores, com impactos no trabalho (domínio participação), e consequente piora da qualidade de vida (em maioria abrangendo os fatores contextuais). Conclusão: A CIF pode ser utilizada não só pela fisioterapia mas também pelas equipes multidisciplinares de saúde para identificar as incapacidades funcionais complexas na saúde do trabalhador rural. Pode ser utilizada também na vinculação da situação de saúde do trabalhador com as condições ocupacionais, bem como, na vinculação de tais incapacidades com os diversos aspectos envolvidos na vida dos trabalhadores e do seu coletivo.

Iatrogenic Related to the Knowledge Deficit of Patient Safety in the Care: A Descriptive Analysis

Iatrogenic conditions are those that result from the intervention of the multidisciplinary health team, whether correct or incorrect, justified or not, but which result in detrimental consequences for the patient's health. Few studies have focused on assessing the risks to patients, especially those hospitalized in emergency and intensive care services, and only in the last decades attention has been drawn to the importance of these problems.

Two-Year Clinical and Functional Outcomes of an Asian Cohort at Ultra-High Risk of Psychosis.

Background: To determine the 2-year clinical and functional outcomes of an Asian cohort at ultra-high risk (UHR) of psychosis.Method: This was a longitudinal study with a follow-up period of 2 years on 255 help-seeking adolescents and young adults at UHR of psychosis managed by a multi-disciplinary mental health team in Singapore. Clients received case management, psychosocial, and pharmacological treatment as appropriate. Data comprising symptom and functional outcomes were collected over the observation period by trained clinicians and psychiatrists.Results: The 2-year psychosis transition rate was 16.9%, with a median time to transition of 168 days. After 2 years, 14.5% of the subjects had persistent at-risk symptoms while 7.5% developed other non-psychotic psychiatric disorders. 38.4% of the cohort had recovered and was discharged from mental health services. The entire cohort's functioning improved as reflected by an increase in the score of the Social and Occupational Functioning Assessment Scale during the follow-up period. Predictors to psychosis transition included low education level, baseline unemployment, a history of violence, and brief limited intermittent psychotic symptoms, while male gender predicted the persistence of UHR state, or the development of non-psychotic disorders.Conclusion: Use of the current UHR criteria allows us to identify individuals who are at imminent risk of developing not just psychosis, but also those who may develop other mental health disorders. Future research should include identifying the needs of those who do not transition to psychosis, while continuing to refine on ways to improve the UHR prediction algorithm for psychosis.

Women care in situations of sexual violence: an integrative literature review

Abstract Objective: to identify Brazilian and international scientific evidence about women in situation of sexual violence service by a multidisciplinary health team. Method: an integrative literature review carried out in four databases and in a digital library, with the following inclusion criteria: type of study, language and temporal cut. The final sample consisted of 34 studies. Results: nine categories emerged: service network; teamwork; health professional in the service network; qualification and training; comprehensiveness; protocols; services; access to services and support from managers. They were organized into potentialities, demands and weaknesses, constituting elements necessary for assistance effectiveness by the multidisciplinary team to women in situation of sexual violence. Conclusion an Implications for practice: despite the potential of providing women care in situations of sexual violence, weaknesses stand out as an incipient and inexistent articulation of the intersectoral care network, generating demands for the networks’ construction, articulation and sustainability. In addition, professional qualification and support of managers in the performance of public policies make possible care comprehensiveness, updates and service evidence.

Tackling Childhood Overweight: Parental Perceptions of Stakeholders' Roles in a Community-Based Intervention.

Introduction. Collaborative efforts among communities, schools, parents, and health professionals are needed to prevent childhood obesity, which touches one third of Canadian youth. The purpose of this case study was to obtain parents’ experience and perceptions about stakeholder roles in a multidisciplinary community-based intervention aiming to tackle childhood overweight. Methods. Data were collected from semistructured interviews with 10 parents following their participation in a community-based program designed to help families with overweight children adopt a healthier lifestyle. Results and Discussion. All parents preferred a multidisciplinary health team to monitor their children’s health. They expect that a physician or a pediatrician could diagnose overweight, explain results to parents, and refer families to resources. The team could also include professionals from health and education such as nutritionists/dietitians, nurses, physical education teachers, psychologists, kinesiologists, and social workers. Parents’ own perceived role would consist of instructing and reinforcing their children about healthy behaviors, role modeling for a healthy lifestyle, and seeking for professional help when needed. Conclusion. Parents involved in a support group with overweight child consider their own role as crucial to help changing their family lifestyle. They also prefer a multidisciplinary team that can address different aspects of overweight/obesity. However, the physician was perceived as having the central role in mobilizing a group of stakeholders around youth with overweight/obese, including the parents. A further step would be to understand barriers and facilitators to collaboration among health professionals in childhood overweight prevention and treatment.

La elaboración de un folder sobre cáncer de la próstata

Introducción: El cáncer de próstata es una importante patología, con baja letalidad cuando se diagnostica prematuramente. Para ello, uno de los procedimientos necesarios es la realización del examen de tacto rectal, que trae resistencia entre los hombres. Cuestiones simbólicas y culturales fomentan la vergüenza y el prejuicio. Con el objetivo de tratar la cuestión, un equipo multidisciplinario de salud elaboró un folder para tratar el tema. Objetivo: describir el proceso de elaboración un folder sobre el cáncer de próstata. Métodos: Se trabajó con investigación-acción, utilizando delineamientos exploratorio y descriptivo. La información fue obtenida a través de artículos disponibles online, en el período entre 2011 y 2015, en las bases de datos: Scielo, Lilacs y Google Académico. Resultados: Se puntúa como resultado el interés y la utilización del material, que fue puesto a disposición en un evento sobre cáncer de próstata. El material se agotó rápidamente. Conclusiones: Se destaca que más estudios serán necesarios para canalizar los folletos como material de educación y promoción de salud.

The next step: a strategic focus on physical activity and sedentary behaviour in Irish mental health care.

People with severe mental illnesses have dramatically reduced life expectancy compared with the general population, which is largely attributed to physical comorbidity. Physical activity and sedentary behaviour interventions offer a safe and viable therapeutic resource for multi-disciplinary mental health care teams. The accumulating evidence supporting the role of these interventions has changed the focus of mental health strategy in some countries, with new developing roles for certain mental health professionals in this field. However, in Ireland the absence of specialised exercise practitioners places a leadership role for mental health nurses in this regard. National mental health strategy in Ireland should prioritise physical activity and sedentary behaviour interventions, make recommendations for the integration of specialised exercise practitioners in all mental health multidisciplinary teams, and recommend the provision of training and awareness for mental health nurses and other multidisciplinary professionals who are already well placed to address this issue.

Costs of a primary health care program for the management of high blood pressure in Colombia

To determine the cost of care related to high blood pressure management and its impact on the stage of the disease in a group of patients from Tunja, Boyacá, Colombia. Cost-effectiveness, cross-sectional study. 172 clinical histories of patients with high blood pressure from Tunja, Colombia, were included. The average cost of care in the primary care service was $184 631 pesos per month/patient; 61% of this amount is spent on human resources, 20% on laboratory tests and 10% on medication. Compliance with the program was 72.1%. The expenditure on human talent is more than 50% of the resources allocated for the management of high blood pressure, but this has positive repercussions on the control and management of this condition. High blood pressure figures show controlled management of the patients included in the program: 61% of them had normal figures and 53% were classified in the normal stages. High blood pressure requires a large amount of resources, so it should be studied by multidisciplinary health teams in order to find more efficient management alternatives.

Intervenções de enfermagem nas alterações dos parâmetros clínicos cardiorrespiratórios em pacientes com sepse

Objetivo: refletir acerca das evidências sobre as alterações clínicas cardiorrespiratórias relacionadas à sepse, bem como as principais intervenções de enfermagem na prática clínica. Método: estudo teórico-reflexivo, construído com base no levantamento bibliográfico nas bases de dados LILACS e BDENF, com auxílio da Biblioteca Virtual em Saúde, utilizando as palavras-chave “sepse”, “cuidados de enfermagem” e “manifestações clínicas” com inter-relação do operador booleano and. Resultados: os estudos trazem descrições da sepse, sinais clínicos, alterações diversas e as principais intervenções de enfermagem. Foram abordadas em especial, as alterações cardiovasculares e respiratórias, pois são fatores determinantes para evolução do quadro séptico. Conclusões: as intervenções multidisciplinares da equipe de saúde têm como objetivo triar os diversos fatores que predispõe o paciente a um quadro séptico. Neste contexto, as intervenções de enfermagem são indispensáveis e deverão atingir resolutividade para a prevenção e correção das alterações clínicas trazidas pela sepse.

Avaliação nutricional pela Mini avaliação Nutricional: uma ferramenta para o enfermeiro

Objetivo: Caracterizar el estado nutricional de los ancianos institucionalizados según el test Mini Nutritional Assessment (MNA®). <br />Métodos: Estudio transversal, basado en la población, con enfoque cuantitativo, realizado con 321 ancianos residentes en centros de atención a largo plazo de João Pessoa/PB. Fue aprobado por el Comité de Ética en Investigación del CCS/UFPB, CAEE: 02043712.4.0000.5188.<br />Resultados: La edad media de los participantes era de 81,09 años y la mayoría eran mujeres (75,7%). En primer lugar, los ancianos fueron evaluados por una triaje, en los que 86 (26,8%) tenían un estado nutricional adecuado y 235 (73,2%) pasaron a la evaluación general; 7 (3,0%) de estos tuvieron un estado nutricional adecuado. Por lo tanto, de acuerdo con el test MNA®, el total fue de 93 (29,0%) ancianos con estado nutricional adecuado; 127 (39,6%) estaban en riesgo de desnutrición y 101 (31,5%) estaban desnutridos.<br />Conclusión: Es indispensable establecer programas de prevención en las instituciones a largo plazo que apoyen las actividades del equipo de salud multidisciplinar, con el fin de controlar los factores de riesgo, incluyendo parámetros nutricionales.<br /><br />

Administration of low-level laser on muscles of mastication following the induction of initial fatigue: protocol for a randomized, controlled, clinical trial.

Background:Orofacial pain encompasses painful conditions, such as temporomandibular disorder (TMD). Multidisciplinary health teams seek to control such musculoskeletal disorders to improve the quality and functional capacity of the muscles of mastication. The aim of the proposed study is to evaluate the effect of low-level laser therapy as a form of treatment for the prevention of initial fatigue of the muscles of mastication (masseter and anterior temporal muscles) as well as the recovery of these muscles after induced exhaustion (caused by isometric contraction) in young adults.Methods:The participants will be 78 healthy male and female volunteers between 18 and 34 years of age. The volunteers will be randomly allocated to a laser group (n = 26), sham group (n = 26), and control group (n = 26). All participants will be submitted to a clinical evaluation to record mandibular movements, bite force, muscle sensitivity to palpation, and initial muscle fatigue. Initial fatigue will be induced by isometric contraction of the jaws. Maximum voluntary contraction will be performed to record the time until initial exhaustion of the masseter muscle (determined by electromyography). The groups will then be submitted to the interventions: active laser therapy (wavelength: 780 nm; fluence: 134 J/cm2; power: 50 mW; irradiance: 1.675 W/cm2; exposure time: 80 seconds per point) on 3 points of the masseter and 1 point on the anterior temporal muscles on each side; sham laser (placebo effect); or no intervention (control). Maximum voluntary contraction will be performed again after the interventions to record the time until initial exhaustion of the masseter muscle (determined by electromyography). Differences in individual time until exhaustion between the pre- and postintervention evaluations will be measured to determine the effect of low-level laser therapy.Discussion:Although studies have been made with the use of low-level laser therapy in TMDs and on the effect of photobiomodulation on fatigue, this the first study to test this therapy in the prevention of fatigue in this region. The clinical relevance lies in the fact that longer dental procedures could take place if the patients are less prone to fatigue.

The Role of Sport, Exercise, and Physical Activity in Closing the Life Expectancy Gap for People with Mental Illness: An International Consensus Statement by Exercise and Sports Science Australia, American College of Sports Medicine, British Association of Sport and Exercise Science, and Sport and Exercise Science New Zealand

In the general population, the worldwide pandemic of physical inactivity is responsible for an estimated 13.4 million disability-adjusted life-years, costs the worldwide economy an estimated INT$53.8 billion (1), and is the cause of approximately 9% of premature mortality worldwide (2). People experiencing mental illness represent a particularly vulnerable population at high risk for poor lifestyle factors such as physical inactivity and experience an unacceptable level of early mortality of between 15 and 25 yr (3). People experiencing mental illness engage in significantly lower levels of moderate–vigorous physical activity and spend significantly more time engaging in sedentary behavior (4). A growing number of clinical trials (5,6) demonstrate efficacy of lifestyle interventions including exercise, for both physical and mental health in people with mental illness. However, large-scale translation into routine clinical care has not occurred. This international consensus statement aims to delineate the key factors that must be addressed by key decision makers to increase access to appropriate exercise programs for people with mental illness and subsequently contribute to closing the life expectancy gap. CULTURE CHANGE Psychiatric services at all levels of care (acute and long-term inpatient, transition/outpatient, and community care) need to provide holistic care for people with mental illness, addressing the body and the mind simultaneously (7). Typically, psychiatric services have prioritized symptoms of mental illness, whereas physical health care is often disregarded or deemed to be a low priority. Increasingly, people with mental illness are seeking integrated physical and mental health care (8). Exercise practitioners, as members of the multidisciplinary team, have a core role as advocates for positive lifestyle change, addressing all major modifiable risk factors contributing to premature mortality. Embedded within the multidisciplinary team, these exercise practitioners can affect change among staff through staff wellness programs that leads to positive role modeling for patients, increasing the likelihood of long-term behavior change (9). In addition, exercise is a highly acceptable intervention strategy, and dedicated interventions may act as a facilitator to help-seeking or stigma reduction among vulnerable populations such as young people experiencing mental illness. INFRASTRUCTURE Advocating for access to trained exercise practitioners and appropriate exercise facilities across all treatment settings, and for all mental health conditions, regardless of patient age, socioeconomic, or physical health status is a key requirement for ensuring integration within mental health and primary care settings. This must include acute and long-term inpatient settings, community mental health centers, and primary care facilities. Taking into account local health system contexts, it may be necessary to draw on resources from both the general medical and mental health budgets to provide access to necessary infrastructure and human resources. Partnering with nongovernment and not-for-profit community agencies to deliver exercise interventions may aid in providing human and physical resources, while managing health service governance and financial barriers. TRAINING To effectively integrate exercise practitioners within the multidisciplinary mental health team, exercise practitioners (e.g., exercise physiologists, physiotherapists, and kinesiologists) must receive training in basic mental health literacy and in illness-specific exercise prescription considerations. Likewise, to facilitate referral and maximize long-term behavior change, mental health and general medical practitioners working with people with mental illness need to understand the role, scope of practice, and competencies of exercise practitioners working in mental health settings. Ideally, training should take place at the undergraduate level and be reinforced through pragmatic student placements established within functional multidisciplinary mental health teams. Postgraduate courses for exercise practitioners focusing on mental illness (such as those available in Belgium and Scandinavia [10]) should be designed and delivered in consultation with psychiatric services to promote an integrated approach to mental health service delivery. Professional organizations representing exercise practitioners have an obligation to provide opportunity for upskilling and continuing professional development to provide the highest levels of evidence-based exercise prescription to people with mental illness. The organizations that endorse this consensus statement commit to promoting the role of exercise interventions as a key component of a global strategy toward achieving a 50% reduction in the life expectancy gap of people experiencing mental illness by 2032. We believe that enhanced training of our members, facilitating culture change within mental health services, and advocating for the provision of required infrastructure are the cornerstones of achieving this goal.

Barriers to Education and Shared Decision Making in the Chronic Kidney Disease Population: A Narrative Review.

Purpose of review:Provision of education to inform decision making for renal replacement therapy (RRT) is a key component in the management of chronic kidney disease (CKD), yet patients report suboptimal satisfaction with the process of selecting a dialysis modality. Our purpose is to review the influencers of RRT decision making in the CKD population, which will better inform the process of shared decision making between clinicians and patients.Sources of information:PubMed and Google Scholar.Methods:A narrative review was performed using the main terms “chronic kidney disease,” “CKD,” “dialysis,” “review,” “decision-making,” “decision aids,” “education,” and “barriers.” Only articles in English were accessed. The existing literature was critically analyzed from a theoretical and contextual perspective and thematic analysis was performed.Key findings:Eight common themes were identified as influencers for decision making. “Patient-focused” themes including social influence, values and beliefs, comprehension, autonomy and sociodemographics, and “clinician-focused” themes including screening, communication, and engagement. Early predialysis education and decision aids can effectively improve decision making. Patient-valued outcomes need to be more fully integrated into clinical guidelines.Limitations:This is not a systematic review; therefore, no formal tool was utilized to evaluate the rigor and quality of studies included and findings may not be generalizable.Implications:Standardized comprehensive RRT education programs through multidisciplinary health teams can help optimize CKD patient education and shared decision making. Involving patients in the research process itself and implementing patient values and preferences into clinical guidelines can help to achieve a patient-centered model of care.

Odontologic atention on oncological practice

Introduction: According to the World Health Organization, cancer is a public health problem, especially among developing countries, where it is expected that in the coming decades, the impact of the disease on the population will correspond to 80% of the more than 20 million cases new estimates for 2025. Despite the advances in the technologies and drugs of antineoplastic therapy, several oral repercussions can be observed. Thus, dentistry plays a fundamental role in the restoration of general health and, consequently, the quality of life of these individuals. Objectives: To verify the dental assistance in the oncological practice. Methodology: Literature review where we searched for published articles available on the internet in the database systems: Medlars on line International Literature (Medline), Latin American and Caribbean Literature in Health Sciences (Lilacs) and Brazilian Bibliography of Dentistry (BBO) present on the website of the Virtual Health Library (BVS). Results and Discussion: The literature evidences the need for oral-dental care and the inclusion of the dental surgeon in the multi and inter-transdisciplinary medical team required for good oncological practice. The literature is unanimous in indicating the need for medical intervention with the support of a multidisciplinary health team, including dental surgeon, in order to ensure adequate performance of antineoplastic therapies and specific care in the control of oral side effects and consequent general repercussions. Dentistry, for example, the prevention, treatment and control of diseases such as mucositis, xerostomia, cavities, dental infections and opportunistic mouth. Precariousness or even lack of adequate dental care may compromise oncological practice. Conclusion: The dentist incorporated into the oncological practice contributes to the quality of the care, favoring the integral care with attention to the oral condition and systemic repercussions.

Depression in the wives of convicted men: prevalence and associated factors.

To estimate the prevalence of depression and to identify the main risk factors associated with depression in wives of convicted men. Descriptive, cross - sectional, quantitative approach. The data were collected with 349 female partners of convicted patients in three penitentiaries in the state of Paraná, with a semistructured research, between January and June of 2016, being compiled in a database and analyzed using SPSS® 20.0 software. It was possible to identify vulnerability to depression among wives of convicted men, most were young and 42.2% have or already had depression. It was verified that the variables to depression were ages equal to or above 30 years (50.3%, p <0.001), smoking (61.1%, p <0.013) and alcoholism (16.1%, p <0.001). It is the responsibility of the nurse with the multidisciplinary health team to invest in health promotion and prevention actions against these risk factors that were associated with depression in this population.

BENEFÍCIOS DECORRENTES DE PRÁTICA DO CUIDADO FARMACÊUTICO EM HIPERTENSÃO E DIABETES TIPO 2 PARA SUA EFETIVAÇÃO EM UNIDADES DE SAÚDE

Pacientes portadores de doenças crônicas, em especial, hipertensão e diabetes, necessitam acompanhamento constante do profissional da saúde, pois o descontrole tanto da glicemia como da pressão arterial é precursora de crises fatais do funcionamento de rins, problemas cardiovasculares e motores, gerando custos evitáveis ao sistema público de saúde. O objetivo desse trabalho é buscar evidências que demonstrem os benefícios dos cuidados farmacêuticos a pacientes portadores de doenças crônicas não transmissíveis, em especial, hipertensão e diabetes tipo 2, por meio A pesquisa é uma revisão narrativa utilizando busca de artigos nas bases científicas de dados Web of Science, SciELO, BibliotecaVirtual em Saúde, Bancos de Dados Bibliográficos da USP (DEDALUS) e PubMed-NCBI, bem como dados epidemiológicos do DATASUS e diretrizes brasileiras, para a contextualização de hipertensão e diabetes. Foi observado que a prática de cuidados farmacêuticos impactou no índice de adesão ao tratamento em pacientes hipertensos e/ou diabéticos, proporcionando melhora clínica e na qualidade de vida gerando, ainda, um benefício socioeconômico. É importante enfatizar que o cuidado farmacêutico não é praticado isoladamente de outros serviços de saúde, mas em colaboração com os pacientes e a equipe multidisciplinar em saúde; cada profissional deve atuar em seu âmbito de competência, o que resultará em benefício ao paciente e ao setor público.

Tecnologias leves para o cuidado de enfermagem na atenção psicossocial: contribuições à superação de estigmas sobre a doença mental

OBJETIVO: Desenvolver intervenções com vistas à superação de concepções estigmatizantes sobre o processo saúde-adoecimento mental, vivenciando a atuação do enfermeiro no âmbito da atenção psicossocial. METODOLOGIA: Trata-se de relato de experiência descritivo, de abordagem qualitativa, realizado no município de Pesqueira, PE no período de fevereiro a dezembro de 2015. RESULTADOS: Desenvolvemos intervenções psicossociais contribuindo para discussões sobre o estigma com os profissionais de saúde e usuários de uma unidade básica de saúde. Promovemos a conscientização sobre o uso indiscriminado de medicamentos psicotrópicos e a abertura para novos modelos de atenção à saúde, como as práticas integrativas e complementares. CONCLUSÕES: A estigmatização da loucura faz com que seja negada à pessoa em sofrimento psíquico sua cidadania. A ressocialização ainda é difícil pois a doença mental, é interpretada como transgressão de normas sociais, o que demanda das equipes multiprofissionais de saúde intervenções no território e com a comunidade.

The Development of a Programme of Mental Health Services for People with Intellectual Disability in Ireland

Introduction: Within the current mental health policy in Ireland, Vision for Change (HSE, 2006), people with intellectual disabilities (I.D.) (target population) should have access to high quality mental health services, including an I.D. specific multi-disciplinary community mental health team. Historically mental health services for this population were poorly developed, without a clear policy or implementation strategy. Services that did exist were often embedded within social care services, with unclear pathways and models of care. Resources are being allocated to Mental Health of Intellectual Disability (MHID) services on an ongoing basis. Therefore the requirement to develop a clear strategy of implementing Vision for Change (HSE, 2006) for MHID was clear. Aim: To develop a clear programme of development of MHID services for children and adults, for full national implementation across mental health and social care services (key stakeholders). The timeline for the programme is 2 years beginning July 2016. The programme involves a number of key stages including: Scoping and mapping of existing resources Defining a clear pathway to care Developing clear governance arrangements Developing clinical activity metrics Key initial results from this programme will be presented including key service mapping data, as well as planned governance and care pathway arrangements. As this is a national programme, it is envisaged that there will be full be transferability of services achieved through collaboration and partnership across the relevant key divisions, organisations, disciplines and with Service Users and their families. Given the inclusive nature of the design of the programme, it’s sustainability potential is strong Developing a complex programme of service development involving existing and new resources across different service divisions requires services to be planned in an integrated manner. The intended impact of this programme is to improve the quality of mental health care and service experience.