O acesso e a vinculação da clientela mais vulnerada dos CAPS AD: mapeando fragilidades e fortalezas na sustentação do cuidado
Data
2023-08-25
Autores
Barreiros, Graziella Barbosa 
Orientadores
Surjus, Luciana Togni de Lima e Silva
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A presente pesquisa busca contribuir para o entendimento e enfrentamento aos desafios de promover o acesso e a vinculação da porção mais vulnerada e mais grave da clientela dos Centros de Atenção Psicossocial – Álcool e Outras Drogas (CAPS-AD). Teve por objetivo identificar fragilidades e fortalezas desse processo/desafio de possibilitar (ou não) acesso e vinculação ao cuidado, em serviços da Rede de Atenção Psicossocial (RAPS), para as pessoas, já vulneradas, e com demandas e/ou necessidades relacionadas ao consumo de álcool e outras drogas, focando em pontos de atenção daquela rede que são ordenadores do cuidado e têm por finalidade ofertar atenção às pessoas usuárias de drogas e suas famílias - os denominados CAPS AD. Concentramos nossa investigação nas fragilidades e fortalezas do acesso e vinculação das pessoas mais vulneradas e entendidas nesse trabalho como os mais graves, usualmente denominadas/os como pessoas difíceis ou que não aderem ao serviço e suas propostas terapêuticas. A pesquisa foi desenvolvida em um (01) CAPS AD II situado em Brasília, Distrito Federal, que é também campo de práticas do Programa de Residência Multiprofissional em Saúde Mental, Álcool e Outras Drogas, da Fiocruz Brasília (PRMSMAD). Adotando um método qualitativo, apoiado na hermenêutica crítica e narrativa, realizamos grupos focais, para a produção de narrativas coletivas que foram colocadas em diálogo, de modo a produzir reflexões que possam contribuir com a implementação do trabalho desenvolvido e qualificação do cuidado ofertado, no que tange ao acesso e vinculação da porção da clientela especificada. Trabalhamos a partir do ponto de vista da clientela presente, dos trabalhadores/trabalhadoras e profissionais residentes inseridos nos serviços. Pela presença dos profissionais residentes, foi objetivo específico do trabalho identificar estratégias de ensino-aprendizagem relevantes para formar profissionais para trabalhar em serviços de reabilitação psicossocial de base comunitária. São categorias centrais do estudo acesso, vinculação, gravidade e vulneração, por essa especificidade indicada para clientela (a mais vulnerada), por entendermos que esse processo de vulneração resulta em maior gravidade dos casos e pela ambição de responder as perguntas disparadoras da pesquisa. Os resultados encontrados apontam para a necessidade de qualificar as estratégias de acolhimento dos serviços, flexibilizar as relações serviço-clientela, adotando posturas de baixa exigência, fortalecer trabalhos coletivos, grupais e de apoio mútuo, fortalecer e ampliar ações de defesa de direitos e de busca de autonomia, implementar a formação dos profissionais e investir fortemente na infraestrutura dos serviços.
The present research seeks to contribute to the understanding and coping of the challenges that are to promote the access and binding to the most vulnerable and severe portion of the clientele of the Psychosocial Care Center- Alcohol and Other Drugs. (CAPS-AD). It aimed to identify the weaknesses and strengths of this process/challenge which means to provide (or not) the access and binding to the Psychosocial Attention Network Services (RAPS) care, for the already vulnerated people with demands and/or needs related to alcohol and other drugs consumption, focusing in that net services that are care orders and has the purpose of offering care to people who use drugs and their families – the called CAPS AD. We focused our investigation on the weaknesses and strengths of the access and binding process of the most vulnerable people those who are known in this line of work as difficult clients or those who don’t adhere to the services and its therapeutic proposals. The study was developed in a CAPS AD II, located in Brasilia, Distrito Federal, that is also the field of practices of the multidisciplinary residency program in mental health alcohol and other drugs, by Fiocruz Brasilia (PRMSMAD). Adopting a qualitative method, supported by the critic and narrative hermeneutics, we conducted focal groups to produce collective narratives that were placed in dialogues, in order to generate reflections that can contribute with the improvement of the developed work and qualification of the care offered, in regard to the access and binding of the specified portion of clientele. We worked it from the perspective of the present clientele, of the workers and residents inside the services. From the presence of resident professionals, it was a specific goal of this work to identify teaching-learning strategies relevant to train professionals to work in community-based psychosocial rehabilitation services. Are central categories of the study access, binding, severity and vulnerability, by this specificity indicated to the clientele (the most vulnerable one), because we understand that this vulneration process results in greater severity of cases and by the ambition to answer the triggered questions in this research. The results found point to the need to qualify the reception strategies of the services, make service-client relations more flexible, adopting low-demand attitudes, strengthen collective, group and mutual support work, strengthen and expand actions to defend rights and seek of autonomy, implement the training of professionals, and invest heavily in the infrastructure of services.
The present research seeks to contribute to the understanding and coping of the challenges that are to promote the access and binding to the most vulnerable and severe portion of the clientele of the Psychosocial Care Center- Alcohol and Other Drugs. (CAPS-AD). It aimed to identify the weaknesses and strengths of this process/challenge which means to provide (or not) the access and binding to the Psychosocial Attention Network Services (RAPS) care, for the already vulnerated people with demands and/or needs related to alcohol and other drugs consumption, focusing in that net services that are care orders and has the purpose of offering care to people who use drugs and their families – the called CAPS AD. We focused our investigation on the weaknesses and strengths of the access and binding process of the most vulnerable people those who are known in this line of work as difficult clients or those who don’t adhere to the services and its therapeutic proposals. The study was developed in a CAPS AD II, located in Brasilia, Distrito Federal, that is also the field of practices of the multidisciplinary residency program in mental health alcohol and other drugs, by Fiocruz Brasilia (PRMSMAD). Adopting a qualitative method, supported by the critic and narrative hermeneutics, we conducted focal groups to produce collective narratives that were placed in dialogues, in order to generate reflections that can contribute with the improvement of the developed work and qualification of the care offered, in regard to the access and binding of the specified portion of clientele. We worked it from the perspective of the present clientele, of the workers and residents inside the services. From the presence of resident professionals, it was a specific goal of this work to identify teaching-learning strategies relevant to train professionals to work in community-based psychosocial rehabilitation services. Are central categories of the study access, binding, severity and vulnerability, by this specificity indicated to the clientele (the most vulnerable one), because we understand that this vulneration process results in greater severity of cases and by the ambition to answer the triggered questions in this research. The results found point to the need to qualify the reception strategies of the services, make service-client relations more flexible, adopting low-demand attitudes, strengthen collective, group and mutual support work, strengthen and expand actions to defend rights and seek of autonomy, implement the training of professionals, and invest heavily in the infrastructure of services.
Descrição
Citação
BARREIROS, Graziella Barbosa. O Acesso e a vinculação da clientela mais vulnerada dos CAPS AD: mapeando fragilidades e fortalezas na sustentação do cuidado. 2023. 220 f. Dissertação (Mestrado Profissional em Ensino em Ciências da Saúde) - Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2023.