학술논문
Mental health in general family medicine obstacles and expectations perceived by family physicians/Saude mental em medicina geral familiar obstaculos e expectativas percecionados pelos medicos de familia
Document Type
Academic Journal
Source
Ciência & Saúde Coletiva. March, 2017, Vol. 22 Issue 3, p797, 9 p.
Subject
Language
Portuguese
ISSN
1413-8123
Abstract
Introducao Segundo a Organizacao Mundial de Saude (OMS), a Saude Mental e o "estado de bem-estar em que o individuo tem consciencia da sua capacidade de manter atividades produtivas, construir [...]
This study seeks to understand the difficulties experienced by family physicians (FP) in the management of mental disorders (MD) and their proposals to improve the quality of care. It is qualitative study with semi-structured interviews with ten family physicians. These were recorded, transcribed and their content analyzed. Eight thematic categories were identified: perceived working conditions and available resources; perceived level of training in mental health; therapies used for treatment of MD; mental health instruments used in consultation; MD addressed in Primary Health Care (PHC) and referral to hospitals; patient's reaction to referral; articulation of PHC with hospitals; proposals to improve mental health care in PHC. Articulation with the Mental Health Services suffers from lack of accessibility, one-way communication and delayed response. The FP propose creation of consultancies; multidisciplinary teams in the community; creating a two-way communication platform; continuous learning through discussion of cases. The FP have responsibilities in providing MHC. This requires working in a multidisciplinary team. Services should be organized to function as a learning system that allows the progressive improvement of the professionals and the improvement of the interfaces between them. Key words Mental health, Primary health care, Ongoing medical education Pretende-se conhecer as dificuldades sentidas pelos medicos de familia (MF) na abordagem dos doentes com transtornos mentais (TM) e conhecer as suas propostas para melhorar os cuidados os cuidados de saude mental (CSM). Estudo qualitativo. Realizaram-se entrevistas semiestruturadas e audio-gravadas a 10 MF. Com analise de conteudo identificaram-se oito categorias tematicas: condicoes de trabalho percecionadas; formacao em saude; terapeuticas usadas para tratamento dos TM; instrumentos de saude mental usados na consulta; TM abordados na atencao primaria (AP) e referenciadas a cuidados hospitalares; reacao do doente a referenciacao; articulacao da atencao primaria com a psiquiatria; propostas para melhorar os CSM na AP. A articulacao com os servicos de saude mental e deficiente pela falta de acessibilidade, comunicacao unidirecional e atraso na resposta. Para melhorar os MF propoem criacao de consultorias; equipes multidisciplinares; plataformas que permitam a comunicacao bidirecional; aprendizagem continua com a discussao de casos. O MF presta CSM, o que exige trabalho em equipe, com elementos da comunidade e dos hospitais. Os servicos devem organizar-se como sistemas aprendentes que permitam a progressiva melhoria dos profissionais e o aperfeicoamento das interfaces entre os mesmos. Palavras-chave Saude mental, Cuidados de saude primarios, Formacao medica continua
This study seeks to understand the difficulties experienced by family physicians (FP) in the management of mental disorders (MD) and their proposals to improve the quality of care. It is qualitative study with semi-structured interviews with ten family physicians. These were recorded, transcribed and their content analyzed. Eight thematic categories were identified: perceived working conditions and available resources; perceived level of training in mental health; therapies used for treatment of MD; mental health instruments used in consultation; MD addressed in Primary Health Care (PHC) and referral to hospitals; patient's reaction to referral; articulation of PHC with hospitals; proposals to improve mental health care in PHC. Articulation with the Mental Health Services suffers from lack of accessibility, one-way communication and delayed response. The FP propose creation of consultancies; multidisciplinary teams in the community; creating a two-way communication platform; continuous learning through discussion of cases. The FP have responsibilities in providing MHC. This requires working in a multidisciplinary team. Services should be organized to function as a learning system that allows the progressive improvement of the professionals and the improvement of the interfaces between them. Key words Mental health, Primary health care, Ongoing medical education Pretende-se conhecer as dificuldades sentidas pelos medicos de familia (MF) na abordagem dos doentes com transtornos mentais (TM) e conhecer as suas propostas para melhorar os cuidados os cuidados de saude mental (CSM). Estudo qualitativo. Realizaram-se entrevistas semiestruturadas e audio-gravadas a 10 MF. Com analise de conteudo identificaram-se oito categorias tematicas: condicoes de trabalho percecionadas; formacao em saude; terapeuticas usadas para tratamento dos TM; instrumentos de saude mental usados na consulta; TM abordados na atencao primaria (AP) e referenciadas a cuidados hospitalares; reacao do doente a referenciacao; articulacao da atencao primaria com a psiquiatria; propostas para melhorar os CSM na AP. A articulacao com os servicos de saude mental e deficiente pela falta de acessibilidade, comunicacao unidirecional e atraso na resposta. Para melhorar os MF propoem criacao de consultorias; equipes multidisciplinares; plataformas que permitam a comunicacao bidirecional; aprendizagem continua com a discussao de casos. O MF presta CSM, o que exige trabalho em equipe, com elementos da comunidade e dos hospitais. Os servicos devem organizar-se como sistemas aprendentes que permitam a progressiva melhoria dos profissionais e o aperfeicoamento das interfaces entre os mesmos. Palavras-chave Saude mental, Cuidados de saude primarios, Formacao medica continua