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Authors
Advisor(s)
Abstract(s)
As orientações políticas sobre a saúde, e particularmente sobre a saúde mental vão
no sentido de se manterem os doentes mentais na comunidade, tendo-se verificado um
aumento do número de doentes com esquizofrenia a viver com os cuidadores informais.
Neste sentido, julgamos que se torna fundamental refletir sobre as necessidades educativas
reais dos cuidadores informais da pessoa com esquizofrenia, no contexto onde este presta
os cuidados: o domicílio.
Este estudo tem como objetivos: caracterizar sócio demograficamente o cuidador
informal da pessoa com esquizofrenia; compreender o significado atribuído pelo cuidador
informal, à doença mental da pessoa com esquizofrenia; conhecer as dificuldades sentidas
pelo cuidador informal ao cuidar da pessoa com esquizofrenia; descrever as estratégias
utilizadas pelo cuidador informal face às dificuldades em lidar com a pessoa com
esquizofrenia; conhecer a ajuda prestada pelos profissionais de saúde, percebida pelo
cuidador informal da pessoa com esquizofrenia.
Do ponto de vista metodológico, o presente estudo enquadra-se no método de
investigação qualitativa, com características fenomelógicas. Participaram no estudo nove
cuidadores informais de pessoas com esquizofrenia, seguidas na consulta externa do
DPSM-CHTV, EPE. O instrumento de colheita de dados utilizado foi a entrevista
semiestruturada.
Os resultados sugerem que o doente com esquizofrenia é cuidado sobretudo pela
família, sendo as mães os cuidadores por excelência. Trata-se de cuidadores idosos que
cuidam do doente há vários anos. Revelam ter poucos conhecimentos acerca da doença
mental (esquizofrenia). Apresentam várias dificuldades no papel de cuidador, tais como:
dificuldades em lidar com os sintomas do doente, sendo a mais mencionada a agressividade
e o isolamento social; dificuldades na execução de tarefas, onde referem a má adesão do
doente ao regime terapêutico; dificuldades sociais, relacionadas com a escassez de
recursos comunitários; dificuldades psicológicas, através de emoções negativas vividas e
dificuldades financeiras. Os cuidadores usam como principal estratégia de coping a fuga ao
problema (67%), emoções negativas (22%) e apenas 11% aceita o problema. Quanto ao
contributo dos profissionais de saúde, percebidos pelo cuidador informal na sua preparação
para o cuidar, a maioria referenciou uma parceria de cuidados não vivida, com ausência de
planeamento de alta (78%) e com desconhecimento das suas necessidades (100%). Os
enfermeiros (segundo os cuidadores) não contribuíram na preparação para o cuidar. Como
necessidades educativas surgem: fatores básicos sobre a doença mental; lidar com os
sintomas do doente; aumentar o funcionamento social do doente e recursos/apoios
comunitários.
Podemos concluir, que os cuidadores sentem que os serviços de saúde mental não
lhes dão o apoio de que necessitam, esperando dos profissionais de saúde/enfermeiros
mais informação tendo em conta as suas necessidades como cuidadores.
Em função dos dados obtidos, propõe-se que haja uma evolução no sentido de gerar
parcerias no cuidar com os cuidadores informais.
Deste modo, pretende-se suscitar uma reflexão sobre os cuidados numa área cheia
de desafios que implica mais e melhores competências para o enfermeiro - a área da
psicoeducação.
Policy guidelines on health, particularly on mental health are guided towards keeping the mentally ill in the community, and it has been verified that an increasing number of patients with schizophrenia live with their informal caregivers. In this sense, we believe that it is important to reflect upon the real educational needs of informal caregivers of people with schizophrenia in the context where they provide care: the home. This study aims at the following goals: characterize, socio demographically, the informal caregivers of people with schizophrenia; understand the meaning assigned by informal caregivers, the mental illness of the person with schizophrenia; describe the strategies used by informal caregivers face difficulties in dealing with the person with schizophrenia; get to know the difficulties faced by informal caregivers in caring for the person with schizophrenia and get acquainted with the help provided by health professionals, perceived by informal caregivers of people with schizophrenia. From a methodological standpoint, this study fits the research method of qualitative investigation, with phenomenological features. The study involved nine informal carers of people with schizophrenia, followed in the outpatient services of DPSM CHTV, EPE. The data collection instrument used was the semistructured interview. The results suggest that patients with schizophrenia are particularly cared for by the family, with mothers being caregivers par excellence. These are elderly caregivers who have been caring for the patient for several years. A majority of them report having little knowledge about mental illness (schizophrenia). They reveal several difficulties in the role of caregiver, such as: difficulties in dealing with the patient's symptoms, with aggression and social isolation being the most mentioned; difficulties in performing tasks, which relate to the patient's poor adherence to the therapeutic regimen; social difficulties, related to the scarcity of community resources; psychological difficulties through experienced negative emotions and financial difficulties. Caregivers use ,as a primary coping strategy, avoidance of the problem (67%), negative emotions (22%) and only 11% accept the problem. Regarding the contribution of health professionals, perceived by informal caregivers in their preparations for caring, the most referenced an ineffective partnership of care, with special highlight to the lack of planned discharge (78%) and ignorance of their needs (100%). Nurses (according to caregivers) have not contributed in the preparation for caring. As educational needs, the following arise: basic factors about mental illness, dealing with the patient's symptoms, improve social functioning of the patient and resources / community supports. We can conclude that caregivers feel that mental health services do not give them the support they need, expecting from health professionals / nurses more information, taking into account their needs as caregivers. According to the data obtained, it is proposed that there is a trend towards generating partnerships in care with informal caregivers. Thus, it is intended to prompt a reflection about care in an area full of challenges that requires more and better skills for nurses-the area of psychoeducation.
Policy guidelines on health, particularly on mental health are guided towards keeping the mentally ill in the community, and it has been verified that an increasing number of patients with schizophrenia live with their informal caregivers. In this sense, we believe that it is important to reflect upon the real educational needs of informal caregivers of people with schizophrenia in the context where they provide care: the home. This study aims at the following goals: characterize, socio demographically, the informal caregivers of people with schizophrenia; understand the meaning assigned by informal caregivers, the mental illness of the person with schizophrenia; describe the strategies used by informal caregivers face difficulties in dealing with the person with schizophrenia; get to know the difficulties faced by informal caregivers in caring for the person with schizophrenia and get acquainted with the help provided by health professionals, perceived by informal caregivers of people with schizophrenia. From a methodological standpoint, this study fits the research method of qualitative investigation, with phenomenological features. The study involved nine informal carers of people with schizophrenia, followed in the outpatient services of DPSM CHTV, EPE. The data collection instrument used was the semistructured interview. The results suggest that patients with schizophrenia are particularly cared for by the family, with mothers being caregivers par excellence. These are elderly caregivers who have been caring for the patient for several years. A majority of them report having little knowledge about mental illness (schizophrenia). They reveal several difficulties in the role of caregiver, such as: difficulties in dealing with the patient's symptoms, with aggression and social isolation being the most mentioned; difficulties in performing tasks, which relate to the patient's poor adherence to the therapeutic regimen; social difficulties, related to the scarcity of community resources; psychological difficulties through experienced negative emotions and financial difficulties. Caregivers use ,as a primary coping strategy, avoidance of the problem (67%), negative emotions (22%) and only 11% accept the problem. Regarding the contribution of health professionals, perceived by informal caregivers in their preparations for caring, the most referenced an ineffective partnership of care, with special highlight to the lack of planned discharge (78%) and ignorance of their needs (100%). Nurses (according to caregivers) have not contributed in the preparation for caring. As educational needs, the following arise: basic factors about mental illness, dealing with the patient's symptoms, improve social functioning of the patient and resources / community supports. We can conclude that caregivers feel that mental health services do not give them the support they need, expecting from health professionals / nurses more information, taking into account their needs as caregivers. According to the data obtained, it is proposed that there is a trend towards generating partnerships in care with informal caregivers. Thus, it is intended to prompt a reflection about care in an area full of challenges that requires more and better skills for nurses-the area of psychoeducation.
Description
Keywords
Adaptação psicológica Avaliação de necessidades Conhecimentos, atitudes e prática em saúde Enfermagem psiquiátrica Esquizofrenia Família Papel do enfermeiro Prestadores de cuidados Adaptation, psychological Caregivers Coping Family Health knowledge, attitudes, practice Needs assessment Nurse's role Psychiatric nursing Schizophrenia
Citation
Publisher
Instituto Politécnico de Viseu, Escola Superior de Saúde de Viseu