Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial

Detalhes bibliográficos
Ano de defesa: 2014
Autor(a) principal: Clementino, Francisco de Sales
Orientador(a): Não Informado pela instituição
Banca de defesa: Não Informado pela instituição
Tipo de documento: Tese
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal do Rio Grande do Norte
Brasil
UFRN
PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: https://repositorio.ufrn.br/jspui/handle/123456789/19972
Resumo: Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program “Validate Epi Info 3.5.4” , used along with the “SPSS 17.0” for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; “Fisher's” exact test to check the CAPS impact on hospital admissions and the “Bonferroni” adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.
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spelling Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocialWork structure and process evaluation of psychosocial care centersSaúde MentalCentros de Atenção Psicossocial - CAPSEnfermagemCNPQ::CIENCIAS DA SAUDE::ENFERMAGEMObjective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program “Validate Epi Info 3.5.4” , used along with the “SPSS 17.0” for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; “Fisher's” exact test to check the CAPS impact on hospital admissions and the “Bonferroni” adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.No Brasil, a Reforma Psiquiátrica organiza-se com base nos pressupostos da Reforma Sanitária e da Psiquiatria Democrática Italiana com vistas a eliminar o modelo hospitalocêntrico. Objetivo: Avaliar a estrutura e o processo de trabalho desenvolvido nos Centros de Atenção Psicossocial (CAPS), englobando a satisfação, o perfil, as condições e a sobrecarga de trabalho dos profissionais. Aprovado pela Comissão de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte (UFRN), protocolo nº 719.435, de 30/05/2014. Métodos: Estudo descritivo, com abordagem quantitativa, desenvolvido em cinco Centros de Atenção Psicossocial, a saber: 02 CAPS I, 01 CAPS II, 01 CAPS III e 01 CAPSAD, de Campina Grande-PB. A população do estudo constitui-se de todos os coordenadores dos cinco CAPS, incluindo 42 profissionais de nível superior, 71 de nível médio (técnicos e auxiliares de enfermagem, e cuidadores), e os prontuários referentes a 2.297 usuários atendidos. Para assegurar a representatividade das informações, calculou-se uma amostra aleatória estratificada com partilha proporcional, considerando-se os seguintes parâmetros: erro α de 5%, nível de confiança de 95%, poder do estudo de 80%, estimativa de proporção de 10% e o índice de proporcionalidade específico para os profissionais de nível (superior e médio) e os prontuários. Coletou-se os dados através de questionários validados, elaborados para o estudo CAPSUL (Avaliação dos CAPS da Região Sul do Brasil), entre julho e outubro de 2014. Os questionários foram duplamente digitados e submetidos à validação no sub-programa Validate do Epi Info 3.5.4, utilizado juntamente com o SPSS, 17.0 para o processamento das análises estatísticas. Resultados: A partir da análise dos prontuários dos usuários atendidos nos CAPS, observou-se um predomínio de mulheres na faixa etária adulta. Destacou-se como psicopatologia mais frequente, à esquizofrenia. Quanto às internações antes e após o ingresso nos CAPS, registrou-se para o hospital geral 14 internações (3,5%) antes e sete (1,7%) depois, diferença não significante (p=0,612). Ressalta-se que, em hospitais psiquiátricos, após o ingresso, houve redução para o máximo de três internações. O número total reduziu de 117 (29,1%) para apenas 11 (2,7%); redução estatisticamente significante (p=0,002). Quanto às formas de contração dos profissionais de saúde, os resultados evidenciam a existência de contrato temporário. A maior proporção de insatisfação com todos os parâmetros avaliados deu-se naqueles profissionais que se consideram sobrecarregados no trabalho. Entretanto, a única diferença estatisticamente significante estava relacionada com o “grau de responsabilidade” (90,9%; p=0,04). Observou-se forte associação da insatisfação dos profissionais de saúde com fatores relacionados ao conteúdo e às condições de trabalho no CAPS, relativa às medidas de segurança, conforto e aparência dos CAPS, contato entre as equipes e usuários, e tratamento das famílias por parte das equipes. Chama à atenção que estes aspectos são aqueles que não dependem diretamente da atuação dos profissionais. Conclui-se que o fortalecimento dos CAPS requer e exige um compromisso intersetorial, a partir do nível governamental, em garantir os recursos para a operacionalização de suas ações e assegurar aos usuários e à sua família a oferta e o acesso aos serviços de saúde.Universidade Federal do Rio Grande do NorteBrasilUFRNPROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEMMiranda, Francisco Arnoldo Nunes dehttp://lattes.cnpq.br/0790305094050471http://lattes.cnpq.br/9242337504601387Carvalho, Danielle Franklin dehttp://lattes.cnpq.br/8539437540131131Torres, Gilson de Vasconceloshttp://lattes.cnpq.br/1944547152815226Costa, Isabelle Katherinne Fernandeshttp://lattes.cnpq.br/5903265312273525Almeida, Sandra Aparecida dehttp://lattes.cnpq.br/6689781886879777Clementino, Francisco de Sales2016-03-07T21:04:06Z2016-03-07T21:04:06Z2014-12-11info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfCLEMENTINO, Francisco de Sales. Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial. 2014. 139f. Tese (Doutorado em Enfermagem na Atenção à Saúde) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2014.https://repositorio.ufrn.br/jspui/handle/123456789/19972porinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRNinstname:Universidade Federal do Rio Grande do Norte (UFRN)instacron:UFRN2017-11-04T08:47:17Zoai:repositorio.ufrn.br:123456789/19972Repositório InstitucionalPUBhttp://repositorio.ufrn.br/oai/repositorio@bczm.ufrn.bropendoar:2017-11-04T08:47:17Repositório Institucional da UFRN - Universidade Federal do Rio Grande do Norte (UFRN)false
dc.title.none.fl_str_mv Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial
Work structure and process evaluation of psychosocial care centers
title Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial
spellingShingle Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial
Clementino, Francisco de Sales
Saúde Mental
Centros de Atenção Psicossocial - CAPS
Enfermagem
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
title_short Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial
title_full Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial
title_fullStr Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial
title_full_unstemmed Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial
title_sort Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial
author Clementino, Francisco de Sales
author_facet Clementino, Francisco de Sales
author_role author
dc.contributor.none.fl_str_mv Miranda, Francisco Arnoldo Nunes de

http://lattes.cnpq.br/0790305094050471

http://lattes.cnpq.br/9242337504601387
Carvalho, Danielle Franklin de

http://lattes.cnpq.br/8539437540131131
Torres, Gilson de Vasconcelos

http://lattes.cnpq.br/1944547152815226
Costa, Isabelle Katherinne Fernandes

http://lattes.cnpq.br/5903265312273525
Almeida, Sandra Aparecida de

http://lattes.cnpq.br/6689781886879777
dc.contributor.author.fl_str_mv Clementino, Francisco de Sales
dc.subject.por.fl_str_mv Saúde Mental
Centros de Atenção Psicossocial - CAPS
Enfermagem
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
topic Saúde Mental
Centros de Atenção Psicossocial - CAPS
Enfermagem
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
description Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program “Validate Epi Info 3.5.4” , used along with the “SPSS 17.0” for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; “Fisher's” exact test to check the CAPS impact on hospital admissions and the “Bonferroni” adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.
publishDate 2014
dc.date.none.fl_str_mv 2014-12-11
2016-03-07T21:04:06Z
2016-03-07T21:04:06Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
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dc.identifier.uri.fl_str_mv CLEMENTINO, Francisco de Sales. Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial. 2014. 139f. Tese (Doutorado em Enfermagem na Atenção à Saúde) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2014.
https://repositorio.ufrn.br/jspui/handle/123456789/19972
identifier_str_mv CLEMENTINO, Francisco de Sales. Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial. 2014. 139f. Tese (Doutorado em Enfermagem na Atenção à Saúde) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2014.
url https://repositorio.ufrn.br/jspui/handle/123456789/19972
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language por
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dc.publisher.none.fl_str_mv Universidade Federal do Rio Grande do Norte
Brasil
UFRN
PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM
publisher.none.fl_str_mv Universidade Federal do Rio Grande do Norte
Brasil
UFRN
PROGRAMA DE PÓS-GRADUAÇÃO EM ENFERMAGEM
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