Avaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionais
Ano de defesa: | 2021 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Tese |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Pontifícia Universidade Católica do Rio Grande do Sul
|
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Psicologia
|
Departamento: |
Escola de Ciências da Saúde e da Vida
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://tede2.pucrs.br/tede2/handle/tede/9757 |
Resumo: | National and international literature highlights the importance of evaluating and monitoring services and assistance for the qualification of mental health care. In Brazil, different research on qualitative and quantitative approaches has been discussing the advances, limitations and challenges of implementing the psychosocial care model. This study is part of this situation and its general objective was to assess the extent to which the different proposals of the psychiatric reform law and the political guidelines for the functioning of the Psychosocial Care Centers (CAPS) can be implemented in the daily mental health care, from the assessment of CAPS professionals. This is a sequential, qualitative and quantitative mixed method research, operationalized in 2 studies. The first study, of a qualitative character, exploratory and analytical, aimed to analyze the role of CAPS in articulation with different components of the network and its operationalization based on the experience of RAPS professionals in Porto Alegre. Eleven professionals were interviewed and the transcripts of the interviews were submitted to Thematic Analysis, with the help of the Atlas.ti software. Two categories were discussed: 1) the articulation of the CAPS with the Psychosocial Care Network and 2) the articulation of the CAPS with the intersectoral network. The results show that, although specific practices that seek to articulate mental health policy with other sectors occur and that these present promising outcomes, the implementation of the principle of intersectorality remains limited. The second study, of a quantitative character, sought to psychometrically validate the Avalia-CAPS instrument, professional version. A total of 195 professionals, from CAPS from different locations, answered the final version of the instrument with 38 items and the reduced version of SATIS-BR. A Confirmatory Factor Analysis (AFC) of the Avalia-CAPS-P was carried out, testing two models of factor structure, and Convergence Analysis of the two scales. The AFC pointed out satisfactory results with the two models, the single-factor model and the eight-factor model. A third model, which consisted of an adjustment of the eight-factor model, was also presented, in which the four items with the lowest factor loads were excluded. It is noteworthy that the adjusted model presented the best adjustment indexes. The scale as a whole presents adequate reliability indicators (Ωt=0,93 e α=0,92) and the internal consistency of the scale factors varies between α = 0.63 and α = 0.75, with the exception of the family participation, α = 49. In the Convergence analysis, the dimensions of the Avalia-CAPS-P correlate significantly and moderately with the global assessment and the SATIS-BR dimensions. It was found that the Avalia-CAPS-P instrument has significant indexes of validity and can assist in assessing the quality of services. The results of the studies are complementary in understanding this field, since the data referring to the difficulties encountered by professionals in comprehensive care and in the intersectoral articulation of the CAPS with other devices, helps to deepen the analysis of the results of the respective factors of the validated scale. The importance of developing new studies is highlighted, aiming to compare the assessment of the different actors in this field, for a better understanding, monitoring and effectiveness of quality psychosocial care. |
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Rocha, Kátia Boneshttp://lattes.cnpq.br/6669702121291518http://lattes.cnpq.br/2655168471542905Zanardo, Gabriela Lemos de Pinho2021-06-24T14:48:32Z2021-03-24http://tede2.pucrs.br/tede2/handle/tede/9757National and international literature highlights the importance of evaluating and monitoring services and assistance for the qualification of mental health care. In Brazil, different research on qualitative and quantitative approaches has been discussing the advances, limitations and challenges of implementing the psychosocial care model. This study is part of this situation and its general objective was to assess the extent to which the different proposals of the psychiatric reform law and the political guidelines for the functioning of the Psychosocial Care Centers (CAPS) can be implemented in the daily mental health care, from the assessment of CAPS professionals. This is a sequential, qualitative and quantitative mixed method research, operationalized in 2 studies. The first study, of a qualitative character, exploratory and analytical, aimed to analyze the role of CAPS in articulation with different components of the network and its operationalization based on the experience of RAPS professionals in Porto Alegre. Eleven professionals were interviewed and the transcripts of the interviews were submitted to Thematic Analysis, with the help of the Atlas.ti software. Two categories were discussed: 1) the articulation of the CAPS with the Psychosocial Care Network and 2) the articulation of the CAPS with the intersectoral network. The results show that, although specific practices that seek to articulate mental health policy with other sectors occur and that these present promising outcomes, the implementation of the principle of intersectorality remains limited. The second study, of a quantitative character, sought to psychometrically validate the Avalia-CAPS instrument, professional version. A total of 195 professionals, from CAPS from different locations, answered the final version of the instrument with 38 items and the reduced version of SATIS-BR. A Confirmatory Factor Analysis (AFC) of the Avalia-CAPS-P was carried out, testing two models of factor structure, and Convergence Analysis of the two scales. The AFC pointed out satisfactory results with the two models, the single-factor model and the eight-factor model. A third model, which consisted of an adjustment of the eight-factor model, was also presented, in which the four items with the lowest factor loads were excluded. It is noteworthy that the adjusted model presented the best adjustment indexes. The scale as a whole presents adequate reliability indicators (Ωt=0,93 e α=0,92) and the internal consistency of the scale factors varies between α = 0.63 and α = 0.75, with the exception of the family participation, α = 49. In the Convergence analysis, the dimensions of the Avalia-CAPS-P correlate significantly and moderately with the global assessment and the SATIS-BR dimensions. It was found that the Avalia-CAPS-P instrument has significant indexes of validity and can assist in assessing the quality of services. The results of the studies are complementary in understanding this field, since the data referring to the difficulties encountered by professionals in comprehensive care and in the intersectoral articulation of the CAPS with other devices, helps to deepen the analysis of the results of the respective factors of the validated scale. The importance of developing new studies is highlighted, aiming to compare the assessment of the different actors in this field, for a better understanding, monitoring and effectiveness of quality psychosocial care.A literatura nacional e internacional destaca a importância da avaliação e do monitoramento dos serviços e da assistência para a qualificação da atenção à saúde mental. No Brasil, diferentes pesquisas de abordagens qualitativas e quantitativas vêm discutindo os avanços, limitações e desafios da efetivação do modelo de atenção psicossocial. Esse estudo insere-se nesta conjuntura e teve como o objetivo geral avaliar em que medida as diferentes proposições da lei da reforma psiquiátrica e as diretrizes políticas de funcionamento dos Centros de Atenção Psicossocial (CAPS) conseguem ser efetivadas no cotidiano de atenção em saúde mental, a partir da avaliação dos profissionais do CAPS. Trata-se de uma pesquisa de método misto sequencial, qualitativo e quantitativo, operacionalizada em 2 estudos. O primeiro estudo, de caráter qualitativo, exploratório e analítico, objetivou analisar a articulação do CAPS com diferentes componentes da rede e sua operacionalização a partir da experiência de profissionais de Porto Alegre. Foram entrevistados onze profissionais e as transcrições das entrevistas foram submetidas à Análise Temática, com o auxílio do software Atlas.ti. Foram discutidas duas categorias: 1) a articulação do CAPS com a Rede de Atenção Psicossocial e 2) a articulação do CAPS com a rede intersetorial. Os resultados apontam que, embora ocorram práticas pontuais que busquem a articulação da política de saúde mental com outros setores e que estas apresentem desfechos promissores, a efetivação do princípio da intersetorialidade permanece limitada. O segundo estudo, de caráter quantitativo, buscou validar psicometricamente o instrumento Avalia-CAPS, versão profissionais. Um total de 195 profissionais, de CAPS de diferentes localidades, responderam a versão final do instrumento com 38 itens e a versão reduzida do SATIS-BR. Realizou-se uma Análise Fatorial Confirmatória (AFC) do Avalia-CAPS-P, testando dois modelos de estrutura fatorial, e Análise de Convergência das duas escalas. A AFC apontou resultados satisfatórios com os dois modelos, modelo unifatorial e o modelo de oito fatores. Um terceiro modelo, que consistiu em um ajuste do modelo de oito fatores, também foi apresentado, nele foram excluídos os quatro itens com menores cargas fatoriais. Destaca-se que o modelo ajustado apresentou os melhores índices de ajuste. A escala como um todo apresenta indicadores adequados de confiabilidade (Ωt=0,93 e α=0,92) e a consistência interna dos fatores da escala varia entre α=0,63 e α=0,75, com exceção do fator de participação da família, α=49. Na análise de Convergência, as dimensões do Avalia-CAPS-P se correlacionam significativamente e moderadamente com a avaliação global e das dimensões SATIS-BR. Verificou-se que o instrumento Avalia-CAPS-P apresenta índices significativos de validade e poderá auxiliar na avaliação da qualidade dos serviços. Os resultados dos estudos apresentamse complementares na compreensão deste campo, visto que os dados referentes as dificuldades encontradas pelos profissionais no cuidado integral e na articulação intersetorial do CAPS com outros dispositivos, auxilia no aprofundamento da análise dos resultados dos respectivos fatores da escala validada. Destaca-se a importância de desenvolver novos estudos, visando comparar a avaliação dos diferentes atores deste campo, para uma melhor compreensão, monitoramento e efetivação de uma atenção psicossocial de qualidade.Submitted by PPG Psicologia (psicologia-pg@pucrs.br) on 2021-06-21T17:39:11Z No. of bitstreams: 1 Tese Gabriela Lemos de Pinho Zanardo [versão final].pdf: 2923099 bytes, checksum: c2bc6fa6a9958a3a7b148b2108b614b8 (MD5)Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2021-06-24T14:44:09Z (GMT) No. of bitstreams: 1 Tese Gabriela Lemos de Pinho Zanardo [versão final].pdf: 2923099 bytes, checksum: c2bc6fa6a9958a3a7b148b2108b614b8 (MD5)Made available in DSpace on 2021-06-24T14:48:32Z (GMT). No. of bitstreams: 1 Tese Gabriela Lemos de Pinho Zanardo [versão final].pdf: 2923099 bytes, checksum: c2bc6fa6a9958a3a7b148b2108b614b8 (MD5) Previous issue date: 2021-03-24Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/181450/TES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdf.jpgporPontifícia Universidade Católica do Rio Grande do SulPrograma de Pós-Graduação em PsicologiaPUCRSBrasilEscola de Ciências da Saúde e da VidaServiços de Saúde MentalAvaliação de Processos e Resultados em Cuidados de SaúdeInquéritos e QuestionáriosCentro de Atenção Psicossocial (CAPS)Mental Health ServicesOutcome and Process Assessment, Health CareSurveys and QuestionnairesPsychosocial Care Center (CAPS)CIENCIAS HUMANAS::PSICOLOGIAAvaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionaisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisTrabalho será publicado como artigo ou livro60 meses24/06/2026438234878069743636150050060034118672558173774233590462550136975366info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILTES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdf.jpgTES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdf.jpgimage/jpeg4082http://tede2.pucrs.br/tede2/bitstream/tede/9757/4/TES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdf.jpg5b48948d7cc49751a13b460fd52dfecfMD54TEXTTES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdf.txtTES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdf.txttext/plain2432http://tede2.pucrs.br/tede2/bitstream/tede/9757/3/TES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdf.txt953bcef6e473ca9af8236a1177b62258MD53ORIGINALTES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdfTES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdfapplication/pdf257691http://tede2.pucrs.br/tede2/bitstream/tede/9757/2/TES_GABRIELA_LEMOS_DE_PINHO_ZANARDO_CONFIDENCIAL.pdfdaa0243e236d6b196c5a0340c9a37049MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8590http://tede2.pucrs.br/tede2/bitstream/tede/9757/1/license.txt220e11f2d3ba5354f917c7035aadef24MD51tede/97572021-06-24 12:00:17.528oai:tede2.pucrs.br:tede/9757QXV0b3JpemE/P28gcGFyYSBQdWJsaWNhPz9vIEVsZXRyP25pY2E6IENvbSBiYXNlIG5vIGRpc3Bvc3RvIG5hIExlaSBGZWRlcmFsIG4/OS42MTAsIGRlIDE5IGRlIGZldmVyZWlybyBkZSAxOTk4LCBvIGF1dG9yIEFVVE9SSVpBIGEgcHVibGljYT8/byBlbGV0cj9uaWNhIGRhIHByZXNlbnRlIG9icmEgbm8gYWNlcnZvIGRhIEJpYmxpb3RlY2EgRGlnaXRhbCBkYSBQb250aWY/Y2lhIFVuaXZlcnNpZGFkZSBDYXQ/bGljYSBkbyBSaW8gR3JhbmRlIGRvIFN1bCwgc2VkaWFkYSBhIEF2LiBJcGlyYW5nYSA2NjgxLCBQb3J0byBBbGVncmUsIFJpbyBHcmFuZGUgZG8gU3VsLCBjb20gcmVnaXN0cm8gZGUgQ05QSiA4ODYzMDQxMzAwMDItODEgYmVtIGNvbW8gZW0gb3V0cmFzIGJpYmxpb3RlY2FzIGRpZ2l0YWlzLCBuYWNpb25haXMgZSBpbnRlcm5hY2lvbmFpcywgY29ucz9yY2lvcyBlIHJlZGVzID9zIHF1YWlzIGEgYmlibGlvdGVjYSBkYSBQVUNSUyBwb3NzYSBhIHZpciBwYXJ0aWNpcGFyLCBzZW0gP251cyBhbHVzaXZvIGFvcyBkaXJlaXRvcyBhdXRvcmFpcywgYSB0P3R1bG8gZGUgZGl2dWxnYT8/byBkYSBwcm9kdT8/byBjaWVudD9maWNhLgo=Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2021-06-24T15:00:17Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Avaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionais |
title |
Avaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionais |
spellingShingle |
Avaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionais Zanardo, Gabriela Lemos de Pinho Serviços de Saúde Mental Avaliação de Processos e Resultados em Cuidados de Saúde Inquéritos e Questionários Centro de Atenção Psicossocial (CAPS) Mental Health Services Outcome and Process Assessment, Health Care Surveys and Questionnaires Psychosocial Care Center (CAPS) CIENCIAS HUMANAS::PSICOLOGIA |
title_short |
Avaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionais |
title_full |
Avaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionais |
title_fullStr |
Avaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionais |
title_full_unstemmed |
Avaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionais |
title_sort |
Avaliação dos centros de atenção psicossocial (Caps) a partir da perspectiva de profissionais |
author |
Zanardo, Gabriela Lemos de Pinho |
author_facet |
Zanardo, Gabriela Lemos de Pinho |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Rocha, Kátia Bones |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/6669702121291518 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/2655168471542905 |
dc.contributor.author.fl_str_mv |
Zanardo, Gabriela Lemos de Pinho |
contributor_str_mv |
Rocha, Kátia Bones |
dc.subject.por.fl_str_mv |
Serviços de Saúde Mental Avaliação de Processos e Resultados em Cuidados de Saúde Inquéritos e Questionários Centro de Atenção Psicossocial (CAPS) |
topic |
Serviços de Saúde Mental Avaliação de Processos e Resultados em Cuidados de Saúde Inquéritos e Questionários Centro de Atenção Psicossocial (CAPS) Mental Health Services Outcome and Process Assessment, Health Care Surveys and Questionnaires Psychosocial Care Center (CAPS) CIENCIAS HUMANAS::PSICOLOGIA |
dc.subject.eng.fl_str_mv |
Mental Health Services Outcome and Process Assessment, Health Care Surveys and Questionnaires Psychosocial Care Center (CAPS) |
dc.subject.cnpq.fl_str_mv |
CIENCIAS HUMANAS::PSICOLOGIA |
description |
National and international literature highlights the importance of evaluating and monitoring services and assistance for the qualification of mental health care. In Brazil, different research on qualitative and quantitative approaches has been discussing the advances, limitations and challenges of implementing the psychosocial care model. This study is part of this situation and its general objective was to assess the extent to which the different proposals of the psychiatric reform law and the political guidelines for the functioning of the Psychosocial Care Centers (CAPS) can be implemented in the daily mental health care, from the assessment of CAPS professionals. This is a sequential, qualitative and quantitative mixed method research, operationalized in 2 studies. The first study, of a qualitative character, exploratory and analytical, aimed to analyze the role of CAPS in articulation with different components of the network and its operationalization based on the experience of RAPS professionals in Porto Alegre. Eleven professionals were interviewed and the transcripts of the interviews were submitted to Thematic Analysis, with the help of the Atlas.ti software. Two categories were discussed: 1) the articulation of the CAPS with the Psychosocial Care Network and 2) the articulation of the CAPS with the intersectoral network. The results show that, although specific practices that seek to articulate mental health policy with other sectors occur and that these present promising outcomes, the implementation of the principle of intersectorality remains limited. The second study, of a quantitative character, sought to psychometrically validate the Avalia-CAPS instrument, professional version. A total of 195 professionals, from CAPS from different locations, answered the final version of the instrument with 38 items and the reduced version of SATIS-BR. A Confirmatory Factor Analysis (AFC) of the Avalia-CAPS-P was carried out, testing two models of factor structure, and Convergence Analysis of the two scales. The AFC pointed out satisfactory results with the two models, the single-factor model and the eight-factor model. A third model, which consisted of an adjustment of the eight-factor model, was also presented, in which the four items with the lowest factor loads were excluded. It is noteworthy that the adjusted model presented the best adjustment indexes. The scale as a whole presents adequate reliability indicators (Ωt=0,93 e α=0,92) and the internal consistency of the scale factors varies between α = 0.63 and α = 0.75, with the exception of the family participation, α = 49. In the Convergence analysis, the dimensions of the Avalia-CAPS-P correlate significantly and moderately with the global assessment and the SATIS-BR dimensions. It was found that the Avalia-CAPS-P instrument has significant indexes of validity and can assist in assessing the quality of services. The results of the studies are complementary in understanding this field, since the data referring to the difficulties encountered by professionals in comprehensive care and in the intersectoral articulation of the CAPS with other devices, helps to deepen the analysis of the results of the respective factors of the validated scale. The importance of developing new studies is highlighted, aiming to compare the assessment of the different actors in this field, for a better understanding, monitoring and effectiveness of quality psychosocial care. |
publishDate |
2021 |
dc.date.accessioned.fl_str_mv |
2021-06-24T14:48:32Z |
dc.date.issued.fl_str_mv |
2021-03-24 |
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Programa de Pós-Graduação em Psicologia |
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PUCRS |
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Brasil |
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Escola de Ciências da Saúde e da Vida |
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