Introducao: Esta apresentacao e resultado da discussao sobre “o que e vida sexual ativa?”. A perg... more Introducao: Esta apresentacao e resultado da discussao sobre “o que e vida sexual ativa?”. A pergunta surgiu a partir do trabalho realizado pelo PET Saude Genero e Sexualidade. O cenario de praticas e uma Clinica da Familia do Rio de Janeiro. Participaram desse processo alunos dos cursos da area de saude da UERJ, medicos do PRMFC/HUPE e profissionais do servico. Objetivos: Conhecer a opiniao dos alunos de graduacao participantes do PET Saude Genero e Sexualidade qual o conceito de vida sexual ativa e como este pode ser medido, levando ou nao em consideracao a qualidade e/ou frequencia do ato sexual, bem como o que consideram ser o ato sexual. Metodologia ou Descricao da Experiencia: Relatos de experiencias de natureza descritiva e exploratoria realizada numa Clinica da Familia do Rio de Janeiro. Os participantes do estudo foram 19 alunos da graduacao, sendo 2 de Enfermagem, 6 de Psicologia, 3 de Servico Social e 8 de Medicina. As opinioes foram registradas em audio e video. Cada par...
Background: Community-based primary mental health care is recommended in low and middle-income co... more Background: Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health. Method: In this mixed-method study 18 health managers and 24 professionals were interviewed from different primary and mental health care services in Rio de Janeiro. A semi-structured survey was conducted with 185 closed questions ranging from 1 to 5 and one open-ended question, to evaluate: access, gateway, trust, family focus, primary mental health interventions, mental health records, mental health problems, team collaboration, integration with community resources and primary mental health education. Two comparisons were made: health managers and professionals' (Mann-Whitney non-parametric test) and health managers' perceptions (Kruskall-Wallis non parametric-test) in 4 service designs (General Traditional Outpatients, Mental Health Specialised Outpatients, Psychosocial Community Centre and Family Health Strategy)(SPSS version 17.0). Qualitative data were subjected to Framework Analysis. Results: Firstly, health managers and professionals' perceptions converged in all components, except the health record system. Secondly, managers' perceptions in traditional services contrasted with managers' perceptions in community-based services in components such as mental health interventions and team collaboration, and converged in gateway, trust, record system and primary mental health education. Qualitative data revealed an acceptance of mental health and primary care integration, but a lack of communication between institutions. The Mixed Method demonstrated that interviewees consider mental health and primary care integration as a requirement of the system, while their perceptions and the model of work produced by the institutional culture are inextricably linked. Conclusion: There is a gap between health managers' and professionals' understanding of community-based primary mental health care. The integration of different processes of work entails both rethinking workforce actions and institutional support to help make changes.
Questionnaire Mapping the Integration of Mental Health Interventions in Primary Care. This questi... more Questionnaire Mapping the Integration of Mental Health Interventions in Primary Care. This questionnaire was originally in Portuguese. The English version was based on the original, considering only the items discussed in this original paper. (DOC 180 kb)
Experiências de mulheres ansiosas e deprimidas sobre sofrimento emocional e busca de cuidado em u... more Experiências de mulheres ansiosas e deprimidas sobre sofrimento emocional e busca de cuidado em uma favela do Rio de Janeiro
Introducao: No ano de 2012 foram realizados 3 seminarios transmitidos pelo TELESSAUDE UERJ sobre ... more Introducao: No ano de 2012 foram realizados 3 seminarios transmitidos pelo TELESSAUDE UERJ sobre Saude Mental e Atencao Primaria. Os temas foram: 1)A pratica do matriciamento na ESF (Sandra Fortes e Celina Ragoni),2) Transtornos Mentais Graves e a ESF (Helio Rocha e Renata Cerqueira), e 3)A abordagem do alcoolismo (Sandra Fortes e Joao Antonio dos Santos Neto). Objetivos: Apresentar a experiencia dos seminarios Saude Mental e Atencao Primaria no Telessaude em 2012. Metodologia ou Descricao da Experiencia: Os seminarios foram divulgados em listas de e-mail de profissionais de saude mental e de Atencao Primaria e em sites do Telessaude-UERJ, Comunidades de Praticas e Humanizasus. A transmissao era gratuita. Para participar e obter certificacao era preciso se cadastrar no portal do Telessaude UERJ (www.telessaude.uerj.br/ava). O formato da apresentacao foi de 20 minutos por palestrante, com a presenca de um moderador e de espectadores do seminario em tempo real. Os encontros ficaram re...
Introducao: O PET Saude Genero e Sexualidade constitui uma oportunidade de ampliar as possibilida... more Introducao: O PET Saude Genero e Sexualidade constitui uma oportunidade de ampliar as possibilidades de promocao da saude e prevencao de agravos, atividades de educacao em saude e producao cientifica, com os objetivos focados na formacao multiprofissional em servico, com foco na abordagem das questoes relacionadas ao genero e a sexualidade humana. O presente trabalho pretende relatar esta experiencia. Objetivos: Incorporar o conceito do trabalho em rede da saude, integrando alunos de graduacao, medicos residentes e profissionais de uma Clinica da Familia, desenvolvendo de modelos de construcao compartilhada que atendam as solicitacoes relacionadas ao genero e sexualidade numa perspectiva interdisciplinar. Metodologia ou Descricao da Experiencia: Busca capacitar no trabalho e para o trabalho tanto os estudantes quanto os profissionais. Sao realizadas atividades de Abordagem Comunitaria (atividades educativas e preventivas, prevencao de DST/HIV-aids, diversidade sexual, abuso e violen...
International Journal of Mental Health and Addiction
Heavy drinking, defined as the consumption of five or more doses of alcoholic beverages on a sing... more Heavy drinking, defined as the consumption of five or more doses of alcoholic beverages on a single occasion by men or four for women at least once in the last 2 weeks (Macinko et al. 2015 ), has become a major health issue in Brazil. In primary care settings, screening and brief intervention reduces heavy drinking (Kaner et al. 2018 ; Soares and Vargas 2019 ), yet it is rarely used in Brazil (Macinko et al. 2015 ). This protocol describes a screening and brief intervention implementation feasibility study to be implemented in Rio de Janeiro’s Family Health Strategy primary care units.
Autores da Saúde Mental Global defendem, de um lado, o aumento do acesso aos cuidados de saúde me... more Autores da Saúde Mental Global defendem, de um lado, o aumento do acesso aos cuidados de saúde mental, inclusive com o uso de intervenções padronizadas. De outro lado, na Atenção Primária à Saúde no Brasil, a apresentação sintomatológica do sofrimento emocional pelos pacientes dificulta sua identificação pelos profissionais, comprometendo o cuidado e exigindo uma abordagem culturalmente sensível. Objetivando conhecer a percepção de pacientes sobre o sofrimento emocional e seu cuidado na Atenção Primária, adotou-se método qualitativo de abordagem narrativa, com coleta de dados em grupos em salas de espera e roteiro baseado no instrumento McGill Ilness Narrative Interview. As narrativas foram tratadas por Análise de Conteúdo e revelaram que limitar a comunicação do sofrimento é negar o acesso ao cuidado. Contrapondo tal limitação, apontaram-se estratégias para nortear a estruturação de um cuidado que seja integral e culturalmente sensível.
Taking into consideration issues such as stigma and the mental health gap, this study explores na... more Taking into consideration issues such as stigma and the mental health gap, this study explores narratives of anxious and depressed women treated in a community-based primary care service in a Rio de Janeiro favela about their suffering and care. We analysed 13 in-depth interviews using questions from Kadam's study. Framework analysis studied Access, Gateway, Trust, Psychosocial Issues, and Primary Mental Health Care, as key-concepts. Vulnerability and accessibility were the theoretical references. Thematic analysis found "suffering category", highlighting family and community problems, and "help seeking category", indicating how these women have coped with their emotional problems and addressed their needs through health services, community resources and self-help. Women's language patterns indicated links between implicit social rules and constraints to talk about suffering, especially if related to local violence. High medical turnover and overload are ...
Background: Community-based primary mental health care is recommended in low and middle-income co... more Background: Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health. Method: In this mixed-method study 18 health managers and 24 professionals were interviewed from different primary and mental health care services in Rio de Janeiro. A semi-structured survey was conducted with 185 closed questions ranging from 1 to 5 and one open-ended question, to evaluate: access, gateway, trust, family focus, primary mental health interventions, mental health records, mental health problems, team collaboration, integration with community resources and primary mental health education. Two comparisons were made: health managers and professionals' (Mann-Whitney non-parametric test) and health managers' perceptions (Kruskall-Wallis non parametric-test) in 4 service designs (General Traditional Outpatients, Mental Health Specialised Outpatients, Psychosocial Community Centre and Family Health Strategy)(SPSS version 17.0). Qualitative data were subjected to Framework Analysis. Results: Firstly, health managers and professionals' perceptions converged in all components, except the health record system. Secondly, managers' perceptions in traditional services contrasted with managers' perceptions in community-based services in components such as mental health interventions and team collaboration, and converged in gateway, trust, record system and primary mental health education. Qualitative data revealed an acceptance of mental health and primary care integration, but a lack of communication between institutions. The Mixed Method demonstrated that interviewees consider mental health and primary care integration as a requirement of the system, while their perceptions and the model of work produced by the institutional culture are inextricably linked. Conclusion: There is a gap between health managers' and professionals' understanding of community-based primary mental health care. The integration of different processes of work entails both rethinking workforce actions and institutional support to help make changes.
Introduction: In 2008, the collaboration between mental health and primary care health becomes a ... more Introduction: In 2008, the collaboration between mental health and primary care health becomes a national policy in Brazil (Portaria 154). One of the challenges of this policy is to improve access to mental health care. In 2009, the research Integration of mental health(MH) in primary care (PC) in the city of Rio de Janeiro reviewed Brazilian articles about this in the first decade of the millennium. Objective: a critical review of articles published from 2000 to 2010 about the relation between mental health and primary care in Brazil in view of the practice of matrix support. Methodology or experience description: Review of virtual database in the period in question. The descriptors were: "mental health", "primary care", "matrix support", and analysis categories were constructed from reading the articles. Results: We selected 86 articles divided in three visions: by mental health specialists = 28 From this point of view all the studies referred to only...
Alcohol screening and brief intervention in primary care reduce harmful alcohol use but are rarel... more Alcohol screening and brief intervention in primary care reduce harmful alcohol use but are rarely conducted in Brazil. This study describes health professionals’ perceptions of patients’ harmful alcohol use. A modified grounded theory approach drawing on purposive sampling was used to secure interviews from thirty-three primary care professionals between September and November 2018. Data analysis was iterative; initial coding was developed by the full research team and refined using formative and axial coding. Alcohol symptomology varied and professionals associated harmful alcohol use with patients’ economic hardship. Although health professionals rarely identified alcohol-related problems among their patients, when alcohol problems were identified, it was often through consultations about other symptoms. Compared to drug use, low to moderate alcohol use was not considered harmful, supported in part by a widespread acceptance of alcohol use. Brazil’s universal primary care system ...
Experiências de mulheres ansiosas e deprimidas sobre sofrimento emocional e busca de cuidado em u... more Experiências de mulheres ansiosas e deprimidas sobre sofrimento emocional e busca de cuidado em uma favela do Rio de Janeiro Resumo Considerando o estigma e a lacuna de acesso ao cuidado em saúde mental, o estudo explorou narrativas de mulheres ansiosas e deprimidas, atendidas na Clínica da Família em favela do Rio de Janeiro, sobre sofrimento e cuidado. Analisou-se 13 entrevistas em profundidade a partir das perguntas do estudo de Kadam. Os dados foram dispostos em Framework, tendo Acesso, Porta de Entrada, Confiança, Questões Psicossociais e Saúde Mental na Atenção Primária como conceitos norteadores. Vulnerabilidade e acessibilidade embasaram teoricamente essa leitura. Do estudo temático emergiram as categorias: "sofrimento emocional" onde se destacam os problemas familiares e comunitários e "busca de ajuda" revelando o papel dos serviços de saúde, recursos comunitários e a autoajuda no enfrentamento do sofrimento emocional. Regras sociais implícitas constrangem as mulheres. sendo observados padrões de linguagem específicos ligados à vulnerabilidade e à violência. Alta rotatividade e sobrecarga dos profissionais são barreiras para uma relação positiva com essas mulheres ao passo que a continuidade do cuidado é facilitador da confiança no profissional, gerando segurança e adesão. Conclui-se ser crucial considerar fatores socioculturais e condições adequadas de trabalho das equipes para o cuidado integral dessa população.
Background: Community-based primary mental health care is recommended in low and middle-income co... more Background: Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health.
Introducao: Esta apresentacao e resultado da discussao sobre “o que e vida sexual ativa?”. A perg... more Introducao: Esta apresentacao e resultado da discussao sobre “o que e vida sexual ativa?”. A pergunta surgiu a partir do trabalho realizado pelo PET Saude Genero e Sexualidade. O cenario de praticas e uma Clinica da Familia do Rio de Janeiro. Participaram desse processo alunos dos cursos da area de saude da UERJ, medicos do PRMFC/HUPE e profissionais do servico. Objetivos: Conhecer a opiniao dos alunos de graduacao participantes do PET Saude Genero e Sexualidade qual o conceito de vida sexual ativa e como este pode ser medido, levando ou nao em consideracao a qualidade e/ou frequencia do ato sexual, bem como o que consideram ser o ato sexual. Metodologia ou Descricao da Experiencia: Relatos de experiencias de natureza descritiva e exploratoria realizada numa Clinica da Familia do Rio de Janeiro. Os participantes do estudo foram 19 alunos da graduacao, sendo 2 de Enfermagem, 6 de Psicologia, 3 de Servico Social e 8 de Medicina. As opinioes foram registradas em audio e video. Cada par...
Background: Community-based primary mental health care is recommended in low and middle-income co... more Background: Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health. Method: In this mixed-method study 18 health managers and 24 professionals were interviewed from different primary and mental health care services in Rio de Janeiro. A semi-structured survey was conducted with 185 closed questions ranging from 1 to 5 and one open-ended question, to evaluate: access, gateway, trust, family focus, primary mental health interventions, mental health records, mental health problems, team collaboration, integration with community resources and primary mental health education. Two comparisons were made: health managers and professionals' (Mann-Whitney non-parametric test) and health managers' perceptions (Kruskall-Wallis non parametric-test) in 4 service designs (General Traditional Outpatients, Mental Health Specialised Outpatients, Psychosocial Community Centre and Family Health Strategy)(SPSS version 17.0). Qualitative data were subjected to Framework Analysis. Results: Firstly, health managers and professionals' perceptions converged in all components, except the health record system. Secondly, managers' perceptions in traditional services contrasted with managers' perceptions in community-based services in components such as mental health interventions and team collaboration, and converged in gateway, trust, record system and primary mental health education. Qualitative data revealed an acceptance of mental health and primary care integration, but a lack of communication between institutions. The Mixed Method demonstrated that interviewees consider mental health and primary care integration as a requirement of the system, while their perceptions and the model of work produced by the institutional culture are inextricably linked. Conclusion: There is a gap between health managers' and professionals' understanding of community-based primary mental health care. The integration of different processes of work entails both rethinking workforce actions and institutional support to help make changes.
Questionnaire Mapping the Integration of Mental Health Interventions in Primary Care. This questi... more Questionnaire Mapping the Integration of Mental Health Interventions in Primary Care. This questionnaire was originally in Portuguese. The English version was based on the original, considering only the items discussed in this original paper. (DOC 180 kb)
Experiências de mulheres ansiosas e deprimidas sobre sofrimento emocional e busca de cuidado em u... more Experiências de mulheres ansiosas e deprimidas sobre sofrimento emocional e busca de cuidado em uma favela do Rio de Janeiro
Introducao: No ano de 2012 foram realizados 3 seminarios transmitidos pelo TELESSAUDE UERJ sobre ... more Introducao: No ano de 2012 foram realizados 3 seminarios transmitidos pelo TELESSAUDE UERJ sobre Saude Mental e Atencao Primaria. Os temas foram: 1)A pratica do matriciamento na ESF (Sandra Fortes e Celina Ragoni),2) Transtornos Mentais Graves e a ESF (Helio Rocha e Renata Cerqueira), e 3)A abordagem do alcoolismo (Sandra Fortes e Joao Antonio dos Santos Neto). Objetivos: Apresentar a experiencia dos seminarios Saude Mental e Atencao Primaria no Telessaude em 2012. Metodologia ou Descricao da Experiencia: Os seminarios foram divulgados em listas de e-mail de profissionais de saude mental e de Atencao Primaria e em sites do Telessaude-UERJ, Comunidades de Praticas e Humanizasus. A transmissao era gratuita. Para participar e obter certificacao era preciso se cadastrar no portal do Telessaude UERJ (www.telessaude.uerj.br/ava). O formato da apresentacao foi de 20 minutos por palestrante, com a presenca de um moderador e de espectadores do seminario em tempo real. Os encontros ficaram re...
Introducao: O PET Saude Genero e Sexualidade constitui uma oportunidade de ampliar as possibilida... more Introducao: O PET Saude Genero e Sexualidade constitui uma oportunidade de ampliar as possibilidades de promocao da saude e prevencao de agravos, atividades de educacao em saude e producao cientifica, com os objetivos focados na formacao multiprofissional em servico, com foco na abordagem das questoes relacionadas ao genero e a sexualidade humana. O presente trabalho pretende relatar esta experiencia. Objetivos: Incorporar o conceito do trabalho em rede da saude, integrando alunos de graduacao, medicos residentes e profissionais de uma Clinica da Familia, desenvolvendo de modelos de construcao compartilhada que atendam as solicitacoes relacionadas ao genero e sexualidade numa perspectiva interdisciplinar. Metodologia ou Descricao da Experiencia: Busca capacitar no trabalho e para o trabalho tanto os estudantes quanto os profissionais. Sao realizadas atividades de Abordagem Comunitaria (atividades educativas e preventivas, prevencao de DST/HIV-aids, diversidade sexual, abuso e violen...
International Journal of Mental Health and Addiction
Heavy drinking, defined as the consumption of five or more doses of alcoholic beverages on a sing... more Heavy drinking, defined as the consumption of five or more doses of alcoholic beverages on a single occasion by men or four for women at least once in the last 2 weeks (Macinko et al. 2015 ), has become a major health issue in Brazil. In primary care settings, screening and brief intervention reduces heavy drinking (Kaner et al. 2018 ; Soares and Vargas 2019 ), yet it is rarely used in Brazil (Macinko et al. 2015 ). This protocol describes a screening and brief intervention implementation feasibility study to be implemented in Rio de Janeiro’s Family Health Strategy primary care units.
Autores da Saúde Mental Global defendem, de um lado, o aumento do acesso aos cuidados de saúde me... more Autores da Saúde Mental Global defendem, de um lado, o aumento do acesso aos cuidados de saúde mental, inclusive com o uso de intervenções padronizadas. De outro lado, na Atenção Primária à Saúde no Brasil, a apresentação sintomatológica do sofrimento emocional pelos pacientes dificulta sua identificação pelos profissionais, comprometendo o cuidado e exigindo uma abordagem culturalmente sensível. Objetivando conhecer a percepção de pacientes sobre o sofrimento emocional e seu cuidado na Atenção Primária, adotou-se método qualitativo de abordagem narrativa, com coleta de dados em grupos em salas de espera e roteiro baseado no instrumento McGill Ilness Narrative Interview. As narrativas foram tratadas por Análise de Conteúdo e revelaram que limitar a comunicação do sofrimento é negar o acesso ao cuidado. Contrapondo tal limitação, apontaram-se estratégias para nortear a estruturação de um cuidado que seja integral e culturalmente sensível.
Taking into consideration issues such as stigma and the mental health gap, this study explores na... more Taking into consideration issues such as stigma and the mental health gap, this study explores narratives of anxious and depressed women treated in a community-based primary care service in a Rio de Janeiro favela about their suffering and care. We analysed 13 in-depth interviews using questions from Kadam's study. Framework analysis studied Access, Gateway, Trust, Psychosocial Issues, and Primary Mental Health Care, as key-concepts. Vulnerability and accessibility were the theoretical references. Thematic analysis found "suffering category", highlighting family and community problems, and "help seeking category", indicating how these women have coped with their emotional problems and addressed their needs through health services, community resources and self-help. Women's language patterns indicated links between implicit social rules and constraints to talk about suffering, especially if related to local violence. High medical turnover and overload are ...
Background: Community-based primary mental health care is recommended in low and middle-income co... more Background: Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health. Method: In this mixed-method study 18 health managers and 24 professionals were interviewed from different primary and mental health care services in Rio de Janeiro. A semi-structured survey was conducted with 185 closed questions ranging from 1 to 5 and one open-ended question, to evaluate: access, gateway, trust, family focus, primary mental health interventions, mental health records, mental health problems, team collaboration, integration with community resources and primary mental health education. Two comparisons were made: health managers and professionals' (Mann-Whitney non-parametric test) and health managers' perceptions (Kruskall-Wallis non parametric-test) in 4 service designs (General Traditional Outpatients, Mental Health Specialised Outpatients, Psychosocial Community Centre and Family Health Strategy)(SPSS version 17.0). Qualitative data were subjected to Framework Analysis. Results: Firstly, health managers and professionals' perceptions converged in all components, except the health record system. Secondly, managers' perceptions in traditional services contrasted with managers' perceptions in community-based services in components such as mental health interventions and team collaboration, and converged in gateway, trust, record system and primary mental health education. Qualitative data revealed an acceptance of mental health and primary care integration, but a lack of communication between institutions. The Mixed Method demonstrated that interviewees consider mental health and primary care integration as a requirement of the system, while their perceptions and the model of work produced by the institutional culture are inextricably linked. Conclusion: There is a gap between health managers' and professionals' understanding of community-based primary mental health care. The integration of different processes of work entails both rethinking workforce actions and institutional support to help make changes.
Introduction: In 2008, the collaboration between mental health and primary care health becomes a ... more Introduction: In 2008, the collaboration between mental health and primary care health becomes a national policy in Brazil (Portaria 154). One of the challenges of this policy is to improve access to mental health care. In 2009, the research Integration of mental health(MH) in primary care (PC) in the city of Rio de Janeiro reviewed Brazilian articles about this in the first decade of the millennium. Objective: a critical review of articles published from 2000 to 2010 about the relation between mental health and primary care in Brazil in view of the practice of matrix support. Methodology or experience description: Review of virtual database in the period in question. The descriptors were: "mental health", "primary care", "matrix support", and analysis categories were constructed from reading the articles. Results: We selected 86 articles divided in three visions: by mental health specialists = 28 From this point of view all the studies referred to only...
Alcohol screening and brief intervention in primary care reduce harmful alcohol use but are rarel... more Alcohol screening and brief intervention in primary care reduce harmful alcohol use but are rarely conducted in Brazil. This study describes health professionals’ perceptions of patients’ harmful alcohol use. A modified grounded theory approach drawing on purposive sampling was used to secure interviews from thirty-three primary care professionals between September and November 2018. Data analysis was iterative; initial coding was developed by the full research team and refined using formative and axial coding. Alcohol symptomology varied and professionals associated harmful alcohol use with patients’ economic hardship. Although health professionals rarely identified alcohol-related problems among their patients, when alcohol problems were identified, it was often through consultations about other symptoms. Compared to drug use, low to moderate alcohol use was not considered harmful, supported in part by a widespread acceptance of alcohol use. Brazil’s universal primary care system ...
Experiências de mulheres ansiosas e deprimidas sobre sofrimento emocional e busca de cuidado em u... more Experiências de mulheres ansiosas e deprimidas sobre sofrimento emocional e busca de cuidado em uma favela do Rio de Janeiro Resumo Considerando o estigma e a lacuna de acesso ao cuidado em saúde mental, o estudo explorou narrativas de mulheres ansiosas e deprimidas, atendidas na Clínica da Família em favela do Rio de Janeiro, sobre sofrimento e cuidado. Analisou-se 13 entrevistas em profundidade a partir das perguntas do estudo de Kadam. Os dados foram dispostos em Framework, tendo Acesso, Porta de Entrada, Confiança, Questões Psicossociais e Saúde Mental na Atenção Primária como conceitos norteadores. Vulnerabilidade e acessibilidade embasaram teoricamente essa leitura. Do estudo temático emergiram as categorias: "sofrimento emocional" onde se destacam os problemas familiares e comunitários e "busca de ajuda" revelando o papel dos serviços de saúde, recursos comunitários e a autoajuda no enfrentamento do sofrimento emocional. Regras sociais implícitas constrangem as mulheres. sendo observados padrões de linguagem específicos ligados à vulnerabilidade e à violência. Alta rotatividade e sobrecarga dos profissionais são barreiras para uma relação positiva com essas mulheres ao passo que a continuidade do cuidado é facilitador da confiança no profissional, gerando segurança e adesão. Conclui-se ser crucial considerar fatores socioculturais e condições adequadas de trabalho das equipes para o cuidado integral dessa população.
Background: Community-based primary mental health care is recommended in low and middle-income co... more Background: Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health.
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