6 research outputs found
Family Health Strategy Professionals Facing Medical Social Needs: difficulties and coping strategies
Professionals of Family Health Strategy (FHS) work in communities where there are complex medical social problems. These contexts may lead them to psychological suffering, jeopardizing their care for the users, and creating yet another obstacle to the consolidation of FHS as the primary health care model in Brazil. The study investigated the difficulties and coping strategies reported by health professionals of the FHS teams when they face medical social needs of the communities where they work. Focus groups and semi-structured interviews were carried out with 68 professionals of three primary care units in the city of Sao Paulo (Southeastern Brazil). Drug dealing and abuse, alcoholism, depression and domestic violence are the most relevant problems mentioned by the study group. Professionals reported lack of adequate training, work overload, poor working conditions with feelings of professional impotence and frustration. To overcome these difficulties, professionals reported collective strategies, particularly experience sharing during team meetings and matrix support groups. The results indicate that the difficulties may put the professionals in a vulnerable state, similar to the patients they care for. The promotion of specialized and long term support should be reinforced, as well as the interaction with the local network of services and communities leaders. That may help professionals to deal with occupational stress related to medical and social needs present in their routine work; in the end, it may as well contribute to the strengthening of FHS
Contribution des techniques projectives à l'étude du fonctionnement psychique des enfants dialysés et asthmatiques
André Jacquemin, Patricia Lacerda Bellodi and Renata Sarti, Contribution of projective techniques in study of psychical functioning of dialysed and asthmatic children.
In this work, various projective techniques - drawing, drawing story, Rorschach and CAT- A- were used to study 2 groups of children - dialysed and asthmatic - how they integrate their disease and organize psychically for themselves. The dialysed children (n=10), were evaluated by the drawing story and Rorschach. The group feels intensitily and suffering their limitation on the psychological growth's level. The children subjected to hemodialysis (HD) present a self image decreased and inferiori- zed, with serious difficulties in react and interact with the other, whereas those wich reçoivent processing CAPD (Continuous Ambulatory Peritoneal Dialysis) introduce the other into their relations but their emotions are lived in more restrictive way. The asthmatic children (n=20) evaluated by drawing of the human figure and CAT- A, show feelings of threa tening and primitive conflicts. They allot to the external world the dissatisfaction of their needs and have great difficulties in control the aggressiveness. The parental figures are perceived negatively. The results suggest a bad interaction between mother-child and an antagonistic family situation wich can contribute significantly for the asthmatic manifestation of crises. The techniques used made it possible to visualize the children's reactions with their disease. The results obtained show the need of an interdisplinaire therapeutic for better treatment evolution. It is important as for the dialysed as for the asthmatic ones.
Key-words : Dialysis - Asthma - Children - Rorschach - CAT - Projective Techniques.Dans ce travail, diverses techniques projectives - dessin, dessin-histoire, Rorschach et CAT - ont été utilisées pour comprendre comment deux groupes d'enfants - dialyses et asthmatiques- intègrent leur maladie et s'organisent psychiquement. Les enfants dialyses (N=10) ont été évalués par le dessin-histoire et le Rorschach. Le groupe ressent avec intensité et souffrance son retard de croissance physique. Les enfants soumis à l'hémodialyse (HD) présentent une image de soi diminuée et infériorisée, avec de sérieuses difficultés de réaction et interaction avec l'autre, alors que ceux qui reçoivent le traitement CAPD (dialyse intrapéritonéale continue) introduisent l'autre dans leurs relations, mais vivent leurs émotions de manière plus restrictive. Les enfants asthmatiques (N=20), évalués avec le dessin de la figure humaine et le CAT, souffrent de conflits menaçants et primitifs. Ils attribuent au monde externe l'insatisfaction de leurs besoins et ont de grandes difficultés à contrôler l'agressivité. Les figures parentales sont perçues négativement. Les résultats suggèrent un dysfonctionnement de la dyade mère-enfant et une situation familiale antagoniste qui peut jouer un rôle dans la survenue des crises asthmatiques. Les techniques utilisées ont permis de saisir les réactions des enfants à leur maladie. Les résultats obtenus montrent la nécessité d'une prise en charge interdisciplinaire pour une meilleure évolution du traitement de la maladie, tant chez les dialyses que chez les asthmatiques. Mots-clés : Dialyse - Asthme - Enfant - Rorschach - CAT - Techniques Projectives.André Jacquemin, Patricia Lacerda Bellodi and Renata Sarti, Contribución de las técnicas proyectivas al estudio del funcionamiento psÃquico de niños dialisados y asmáticos.
En este trabajo, diversas tecnicas proyectivas - dibujo, dibujo-historia, Rorschach y CAT- han sido utilizadas para comprender cómo dos grupos de niños - dialisados y asmáticos - integran su enfermedad y se organizan psÃquicamente. Los niños dialisados (N=10) han sido evaluados por el dibujo-historia y el Rorschach. El grupo resiente con intensidad y sufrimiento su retraso en cuanto a su crecimiento fÃsico. Los niños sometidos a la hemodiálisis (HD) presentan una imagen de sà mismos disminuÃda e inferiorizada, con serias dificultades de reacción e interacción con el otro, cuando aquellos que reciben el tratamiento CAPD (diálisis intraperitoneal continua) introducen al otro en sus relaciones pero viven sus emociones de forma más restrictiva. Los niños asmáticos (N=20) evaluados con el dibujo de la figura humana y el CAT, sufren de conflictos amenazadores y primitivos. Ellos atribuyen al mundo externo la insatisfacción de sus necesidades y tienen grandes dificultades para controlar la agresividad. Las figuras parentales son percibidas negativamente. Los resultados sugieren un disfuncionamiento de la dualidad madre-niño y una situación familiar antagonista que puede jugar un roi en la irrupción de las crisis asmáticas. Las técnicas utilizadas han permitido percibir las reacciones de los niños a su enfermedad. Los resultados obtenidos muestran la necesidad de tomar a cargo la situación en forma interdisciplinaria para que el tratamiento de la enfermedad mejore evolutivamente, tanto en los dialisados como en los asmáticos.
Palabras-clave : Diálisis - Asma - Niño - Rorschach - CAT - Técnicas proyectivas.Jacquemin André, Lacerda Bellodi Patricia, Sarti Renata. Contribution des techniques projectives à l'étude du fonctionnement psychique des enfants dialysés et asthmatiques. In: Psychologie clinique et projective, vol. 6, 2000. Organisation et désorganisation psychiques chez l'enfant. pp. 63-75
Contribution des techniques projectives à l'étude du fonctionnement psychique des enfants dialysés et asthmatiques
André Jacquemin, Patricia Lacerda Bellodi and Renata Sarti, Contribution of projective techniques in study of psychical functioning of dialysed and asthmatic children.
In this work, various projective techniques - drawing, drawing story, Rorschach and CAT- A- were used to study 2 groups of children - dialysed and asthmatic - how they integrate their disease and organize psychically for themselves. The dialysed children (n=10), were evaluated by the drawing story and Rorschach. The group feels intensitily and suffering their limitation on the psychological growth's level. The children subjected to hemodialysis (HD) present a self image decreased and inferiori- zed, with serious difficulties in react and interact with the other, whereas those wich reçoivent processing CAPD (Continuous Ambulatory Peritoneal Dialysis) introduce the other into their relations but their emotions are lived in more restrictive way. The asthmatic children (n=20) evaluated by drawing of the human figure and CAT- A, show feelings of threa tening and primitive conflicts. They allot to the external world the dissatisfaction of their needs and have great difficulties in control the aggressiveness. The parental figures are perceived negatively. The results suggest a bad interaction between mother-child and an antagonistic family situation wich can contribute significantly for the asthmatic manifestation of crises. The techniques used made it possible to visualize the children's reactions with their disease. The results obtained show the need of an interdisplinaire therapeutic for better treatment evolution. It is important as for the dialysed as for the asthmatic ones.
Key-words : Dialysis - Asthma - Children - Rorschach - CAT - Projective Techniques.Dans ce travail, diverses techniques projectives - dessin, dessin-histoire, Rorschach et CAT - ont été utilisées pour comprendre comment deux groupes d'enfants - dialyses et asthmatiques- intègrent leur maladie et s'organisent psychiquement. Les enfants dialyses (N=10) ont été évalués par le dessin-histoire et le Rorschach. Le groupe ressent avec intensité et souffrance son retard de croissance physique. Les enfants soumis à l'hémodialyse (HD) présentent une image de soi diminuée et infériorisée, avec de sérieuses difficultés de réaction et interaction avec l'autre, alors que ceux qui reçoivent le traitement CAPD (dialyse intrapéritonéale continue) introduisent l'autre dans leurs relations, mais vivent leurs émotions de manière plus restrictive. Les enfants asthmatiques (N=20), évalués avec le dessin de la figure humaine et le CAT, souffrent de conflits menaçants et primitifs. Ils attribuent au monde externe l'insatisfaction de leurs besoins et ont de grandes difficultés à contrôler l'agressivité. Les figures parentales sont perçues négativement. Les résultats suggèrent un dysfonctionnement de la dyade mère-enfant et une situation familiale antagoniste qui peut jouer un rôle dans la survenue des crises asthmatiques. Les techniques utilisées ont permis de saisir les réactions des enfants à leur maladie. Les résultats obtenus montrent la nécessité d'une prise en charge interdisciplinaire pour une meilleure évolution du traitement de la maladie, tant chez les dialyses que chez les asthmatiques. Mots-clés : Dialyse - Asthme - Enfant - Rorschach - CAT - Techniques Projectives.André Jacquemin, Patricia Lacerda Bellodi and Renata Sarti, Contribución de las técnicas proyectivas al estudio del funcionamiento psÃquico de niños dialisados y asmáticos.
En este trabajo, diversas tecnicas proyectivas - dibujo, dibujo-historia, Rorschach y CAT- han sido utilizadas para comprender cómo dos grupos de niños - dialisados y asmáticos - integran su enfermedad y se organizan psÃquicamente. Los niños dialisados (N=10) han sido evaluados por el dibujo-historia y el Rorschach. El grupo resiente con intensidad y sufrimiento su retraso en cuanto a su crecimiento fÃsico. Los niños sometidos a la hemodiálisis (HD) presentan una imagen de sà mismos disminuÃda e inferiorizada, con serias dificultades de reacción e interacción con el otro, cuando aquellos que reciben el tratamiento CAPD (diálisis intraperitoneal continua) introducen al otro en sus relaciones pero viven sus emociones de forma más restrictiva. Los niños asmáticos (N=20) evaluados con el dibujo de la figura humana y el CAT, sufren de conflictos amenazadores y primitivos. Ellos atribuyen al mundo externo la insatisfacción de sus necesidades y tienen grandes dificultades para controlar la agresividad. Las figuras parentales son percibidas negativamente. Los resultados sugieren un disfuncionamiento de la dualidad madre-niño y una situación familiar antagonista que puede jugar un roi en la irrupción de las crisis asmáticas. Las técnicas utilizadas han permitido percibir las reacciones de los niños a su enfermedad. Los resultados obtenidos muestran la necesidad de tomar a cargo la situación en forma interdisciplinaria para que el tratamiento de la enfermedad mejore evolutivamente, tanto en los dialisados como en los asmáticos.
Palabras-clave : Diálisis - Asma - Niño - Rorschach - CAT - Técnicas proyectivas.Jacquemin André, Lacerda Bellodi Patricia, Sarti Renata. Contribution des techniques projectives à l'étude du fonctionnement psychique des enfants dialysés et asthmatiques. In: Psychologie clinique et projective, vol. 6, 2000. Organisation et désorganisation psychiques chez l'enfant. pp. 63-75
Mentors also need support: a study on their difficulties and resources in medical schools
CONTEXT AND OBJECTIVE: Mentors have been recognized as important elements in the personal and professional development of medical students. However, few investigations have sought to understand their development, needs and difficulties. Our objective was to investigate the perceptions of a group of mentors regarding difficulties experienced over time and the resources used to face up to them. DESIGN AND SETTING: Qualitative exploratory study on mentors at Faculdade de Medicina da Universidade de São Paulo (FMUSP). In the FMUSP Mentoring Program, mentors follow and guide students throughout the course, and are responsible for heterogeneous group of students, in relation to the academic year. METHOD: Semi-structured interviews were conducted with 14 FMUSP mentors. RESULTS: For many of the mentors, the difficulties related to initial doubts about the role, frustration with the students' attendance and overloading of daily tasks. To address such difficulties, these mentors used external resources and their own life experience and personal way of dealing with situations. Some mentors did not perceive difficulties for themselves or for students. CONCLUSIONS: Like in other mentoring programs, many difficulties perceived by mentors seem to be derived from the context of medical education itself. However, unlike in other experiences, FMUSP mentors do not feel that there is lack of support for their role, since this is regularly provided in the structure and dynamics of the program. The "difficulty in perceiving difficulties", presented by some mentors, demands further investigation for better and greater understanding