O acolhimento do enfermeiro da estratégia de saúde da família como instrumento de intervenção e educação em saúde no atendimento de indivíduos em sofrimento mental
Data
2024-06-27
Autores
Deglesposti, Camila Borsari 
Orientadores
Mazzaia, Maria Cristina
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O acolhimento apresenta-se como potente instrumento de sensibilização e vinculação das pessoas aos serviços, além de contribuir com o processo de assistência e cuidado. Objetivo: Conhecer a experiência dos enfermeiros da Estratégia da Saúde da Família sobre o acolhimento de pessoas que apresentam demandas de saúde mental e promover espaços de discussão sobre intervenções e educação em saúde nessa temática. Metodologia: trata-se de pesquisa qualitativa, pesquisa-ação, com enfermeiros da Estratégia Saúde da Família de Guarulhos-São Paulo, explorando a experiência do acolhimento das demandas de saúde mental na UBS. Foram realizadas entrevistas individuais com questionário semi estruturado de modo virtual, bem como dois encontros entre participantes e pesquisadores, em formato de oficina. Os conteúdos das entrevistas e dos encontros foram transcritos e analisados, por meio de análise de conteúdo gerando sínteses que foram avaliadas e validadas pelos participantes por meio de formulário eletrônico. Para a análise também foi utilizado o software IRaMuTeQ®. Os conteúdos das entrevistas, norteou a construção da oficina de sensibilização sobre o acolhimento em saúde mental na Atenção Primária à Saúde. O ciclo da pesquisa-ação, assim, foi composto de três etapas, a 1ª etapa online e a 2ª e 3ª etapas de modo presencial. Como fundamentação para a análise dos dados foi utilizada a Teoria das Representações Sociais. Na última etapa os participantes avaliaram o processo vivenciado. Resultados e Discussão: Participaram quatro enfermeiras, e, a análise do conteúdo das entrevistas desvelou quatro categorias: potencialidades como resolutividade-escuta-promoção/prevenção-vínculo; identificação dos casos de saúde mental; fragilidades como gestão e organização do serviço e educação em saúde-educação permanente-educação continuada. Na análise do conteúdo das falas nos encontros desvelou-se três categorias: fragilidades como angústia e adoecimento profissional-descaracterização do acolhimento-falta de manejo de casos de saúde mental e medo de assumir pacientes de saúde mental; potencialidades como percepção do profissional sobre importância do acolhimento, da escuta qualificada e do vínculo e, educação em saúde-educação permanente-educação continuada com perspectiva de promoção e prevenção. Da primeira para a segunda análise as categorias foram mantidas, porém, aspectos referentes ao sofrimento do profissional em identificar a demanda e não contar com apoio da gestão para estrutura e organização do serviço, destacou-se como fragilidades, além disso, aspectos relacionados à educação, passam a ser percebidos como fragilidades. Outra mudança incorre na categoria potencialidades que desloca-se do lugar de mais uma atividade para o enfermeiro para a percepção do profissional sobre importância do acolhimento para as demandas de saúde mental. Também fica evidente que o serviço não tem como prioridade a educação permanente e nem a educação em saúde, quando o assunto é saúde mental, pois não há espaço na organização do serviço para preparo e realização das ações de educação em saúde, o que gera desgaste e frustração com a impossibilidade de promoção e prevenção, apesar de ser um dos pilares da Estratégia de Saúde da Família. Conclusão: No início da pesquisa-ação observou-se que a representação social para o acolhimento estava na crença de que este é pouco potente, com a finalidade de triagem e anamnese para encaminhamentos, e sua objetivação é de que é um instrumento restrito e não associado nem a cuidado e nem à educação em saúde. Entretanto, no decorrer das etapas, as discussões contribuíram para o início de um processo de desmistificação dos estigmas da saúde mental, por meio do compartilhamento de saberes, além de despertar a percepção do acolhimento como um potente instrumento de intervenção e educação em saúde, sendo este um organizador na linha de cuidado; também houve o despertar para a potência do profissional enfermeiro na Estratégia de Saúde da Família como principal ator na realização do acolhimento. Desta maneira, o produto educacional, a oficina, fortaleceu o trabalho já realizado pelas participantes, esclarecendo dúvidas sobre manejo de pacientes em sofrimento mental no território, permitindo trocas importantes de saberes, além do reconhecimento da necessidade do aprendizado, despertando o interesse pela temática.
Introduction: The embracement is a powerful instrument for raising people's awareness and bonding with services, in addition to contributing to the process of assistance and care. Objective: To know the experience of nurses from the Family Health Strategy on the reception of people who have mental health demands and to promote spaces for discussion on health interventions and education on this theme. Methods: This is a qualitative research, action research, with nurses from the Family Health Strategy of Guarulhos-São Paulo, exploring the experience of welcoming mental health demands at the UBS. Individual interviews were conducted with a semi-structured questionnaire in a virtual way, as well as two meetings between participants and researchers, in a workshop format. The contents of the interviews and meetings were transcribed and analyzed through content analysis, generating syntheses that were evaluated and validated by the participants through an electronic form. The IRaMuTeQ® software was also used for the analysis. The contents of the interviews guided the construction of the sensitization workshop on mental health care in Primary Health Care. The action research cycle, therefore, was composed of three stages, the 1st stage online and the 2nd and 3rd stages in person. The Theory of Social Representations was used as a basis for data analysis. In the last stage, the participants evaluated the process experienced. Results and Discussion: Four nurses participated, and the analysis of the content of the interviews revealed four categories: potentialities such as problem-solving-listening-promotion/prevention-bonding; identification of mental health cases; weaknesses such as management and organization of the service and health education-continuing education-continuing education. In the analysis of the content of the statements in the meetings, three categories were revealed: weaknesses such as anguish and professional illness - mischaracterization of the user embracement - lack of management of mental health cases and fear of taking on mental health patients; potentialities such as the professional's perception of the importance of welcoming, qualified listening and bonding, and health education-continuing education-continuing education with a perspective of promotion and prevention. From the first to the second analysis, the categories were maintained, however, aspects related to the professional's suffering in identifying the demand and not having the support of the management for the structure and organization of the service, stood out as weaknesses, in addition, aspects related to education, are perceived as weaknesses. Another change is incurred in the category of potentialities, which moves from the place of another activity for the nurse to the professional's perception of the importance of welcoming mental health demands. It is also evident that the service does not prioritize continuing education or health education when it comes to mental health, as there is no space in the organization of the service to prepare and carry out health education actions, which generates exhaustion and frustration with the impossibility of promotion and prevention, despite being one of the pillars of the Family Health Strategy. Conclusion: At the beginning of the action research, it was observed that the social representation for user embracement was based on the belief that it is not very powerful, with the purpose of screening and anamnesis for referrals, and its objectification is that it is a restricted instrument and not associated with care or health education. However, during the stages, the discussions contributed to the beginning of a process of demystifying the stigmas of mental health, through the sharing of knowledge, in addition to awakening the perception of user embracement as a powerful instrument of intervention and education in health, which is an organizer in the line of care; there was also an awakening to the power of the professional nurse in the Family Health Strategy as the main actor in the performance of user embracement. In this way, the educational product, the workshop, strengthened the work already carried out by the participants, clarifying doubts about the management of patients in mental suffering in the territory, allowing important exchanges of knowledge, in addition to the recognition of the need for learning, arousing interest in the theme.
Introduction: The embracement is a powerful instrument for raising people's awareness and bonding with services, in addition to contributing to the process of assistance and care. Objective: To know the experience of nurses from the Family Health Strategy on the reception of people who have mental health demands and to promote spaces for discussion on health interventions and education on this theme. Methods: This is a qualitative research, action research, with nurses from the Family Health Strategy of Guarulhos-São Paulo, exploring the experience of welcoming mental health demands at the UBS. Individual interviews were conducted with a semi-structured questionnaire in a virtual way, as well as two meetings between participants and researchers, in a workshop format. The contents of the interviews and meetings were transcribed and analyzed through content analysis, generating syntheses that were evaluated and validated by the participants through an electronic form. The IRaMuTeQ® software was also used for the analysis. The contents of the interviews guided the construction of the sensitization workshop on mental health care in Primary Health Care. The action research cycle, therefore, was composed of three stages, the 1st stage online and the 2nd and 3rd stages in person. The Theory of Social Representations was used as a basis for data analysis. In the last stage, the participants evaluated the process experienced. Results and Discussion: Four nurses participated, and the analysis of the content of the interviews revealed four categories: potentialities such as problem-solving-listening-promotion/prevention-bonding; identification of mental health cases; weaknesses such as management and organization of the service and health education-continuing education-continuing education. In the analysis of the content of the statements in the meetings, three categories were revealed: weaknesses such as anguish and professional illness - mischaracterization of the user embracement - lack of management of mental health cases and fear of taking on mental health patients; potentialities such as the professional's perception of the importance of welcoming, qualified listening and bonding, and health education-continuing education-continuing education with a perspective of promotion and prevention. From the first to the second analysis, the categories were maintained, however, aspects related to the professional's suffering in identifying the demand and not having the support of the management for the structure and organization of the service, stood out as weaknesses, in addition, aspects related to education, are perceived as weaknesses. Another change is incurred in the category of potentialities, which moves from the place of another activity for the nurse to the professional's perception of the importance of welcoming mental health demands. It is also evident that the service does not prioritize continuing education or health education when it comes to mental health, as there is no space in the organization of the service to prepare and carry out health education actions, which generates exhaustion and frustration with the impossibility of promotion and prevention, despite being one of the pillars of the Family Health Strategy. Conclusion: At the beginning of the action research, it was observed that the social representation for user embracement was based on the belief that it is not very powerful, with the purpose of screening and anamnesis for referrals, and its objectification is that it is a restricted instrument and not associated with care or health education. However, during the stages, the discussions contributed to the beginning of a process of demystifying the stigmas of mental health, through the sharing of knowledge, in addition to awakening the perception of user embracement as a powerful instrument of intervention and education in health, which is an organizer in the line of care; there was also an awakening to the power of the professional nurse in the Family Health Strategy as the main actor in the performance of user embracement. In this way, the educational product, the workshop, strengthened the work already carried out by the participants, clarifying doubts about the management of patients in mental suffering in the territory, allowing important exchanges of knowledge, in addition to the recognition of the need for learning, arousing interest in the theme.
Descrição
Citação
DEGLESPOSTI, Camila Borsari. O acolhimento do enfermeiro da estratégia de saúde da família como instrumento de intervenção e educação em saúde no atendimento de indivíduos em sofrimento mental. 2024. 191 f. Dissertação ( Mestrado Profissional em Ensino em Ciências da Saúde) - Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFSP). São Paulo, 2024.