Matriciamento: uma experiência ambulatorial

Objetivo: comprender la construcción del apoyo matriz en un servicio de atención a dependientes.Método: se trata de una investigación de acción realizada en los últimos siete años, considerandolas experiencias de una terapeuta ocupacional durante sus actividades en el servicio, abarcandoreuniones clínicas, supervisiones, grupos de estudios y capacitaciones. Los materiales utilizados fueron prontuarios, registros de supervisión y reunión y anotaciones personales. Resultados: las demandas de cada sujeto se abordan más allá de las especificidades de cada área. Los saberes se transmiten en los encuentros de equipo, permitiendo a quien está lidiando directamente con el caso, una ampliación en su comprensión, experimentación de instrumentos clínicos construidos junto a los colegas. El proceso de construcción de trabajo con cada sujeto, con apoyo matriz constantemente entre los profesionales, permite al que ofrece la atención, mayor apropiación de la construcción clínica. Tal fenómeno, también ocurre durante capacitaciones ofrecidas por el servicio a otros equipos de salud. Conclusión: los espacios colectivos consideran la comprensión del sujeto por diversas perspectivas, incluso sin contacto directo con el individuo, a partir de las narrativas de uno de los profesionales y de hipótesis de los demás miembros del equipo, amplían posibilidades de cuidado. El trabajo en...Objective: to understand the construction of the dependent care service matrixing. Method: this is an action-research conducted over the past seven years, considering the experiences of an occupational therapist during her service activities, covering clinical meetings, supervision, study groups and training. The materials used were medical records, supervision and meeting records and personal notes. Results: the demands of each subject are addressed beyond the specificities of each area. The knowledge is transmitted in the team meetings, allowing, to those who are dealing directly with the case, an expansion in their understanding and the experimentation of clinical instruments built with colleagues. The process of building work with each subject, constantly matrixed among the professionals, allows, to the one who offers the attention, greater appropriation of the clinical construction. This phenomenon also occurs during training offered by the service to other health care teams. Conclusion: the collective spaces consider the subject’s understanding from different perspectives, even without direct contact with the individual, from the narratives of one of the professionals and from the hypotheses of the other team members, expanding the possibilities of care. The work in therapeutic projects is spread throughout the institution and in training of other teams, allowing ...Objetivo: compreender a construção do matriciamento em um serviço de atenção a dependentes. Método: trata-se de uma pesquisa-ação realizada nos últimos sete anos, considerando as experiências de uma terapeuta ocupacional durante suas atividades no serviço, abrangendo reuniões clínicas, supervisões, grupos de estudos e capacitações. Os materiais utilizados foram prontuários, registros de supervisão e reunião e anotações pessoais. Resultados: as demandas de cada sujeito são abordadas para além das especificidades de cada área. Os saberes são transmitidos nos encontros de equipe, permitindo, a quem está lidando diretamente com o caso, uma ampliação em sua compreensão e a experimentação de instrumentos clínicos construídos junto dos colegas. O processo de construção de trabalho com cada sujeito, matriciado constantemente entre os profissionais, permite, àquele que oferece a atenção, maior apropriação da construção clínica. Tal fenômeno também ocorre durante capacitações oferecidas pelo serviço a outras equipes de saúde. Conclusão: os espaços coletivos consideram a compreensão do sujeito por diversas perspectivas, mesmo sem contato direto com o indivíduo, a partir das narrativas de um dos profissionais e de hipóteses dos demais membros da equipe, ampliando as possibilidades de cuidado. O trabalho em projetos terapêuticos propaga-se pela instituição e em capacitações de outras equipes, permitindo a circulação..

Substance misuse among physicians: a still neglected problem

OBJECTIVE: To evaluate the opinions and attitudes about substance use among clinical physicians. METHOD: A hundred physicians of clinical areas were selected in a public hospital of São Paulo. All of them were asked to answer a questionnaire with some questions about drug use. 83% completed the research protocol properly. RESULTS: 60.2% of the interviewed clinicians think that physicians are more likely to develop substance use disorders than general population. 67.5% of them stated they knew a colleague presenting a substance use disorder and in that in 41.0% of the cases the abused substance was a psychotropic available on the surgery facilities. However, 96.4% of the participants denied they could have a substance use problem, although 16.9% declared they had already used non prescribed psychotropics. Benzodiazepines were the most frequently used substances. In addition, 88.0% of them consider it was difficult to search for medical help. They added that a service exclusive for physicians would make this search easier. Nevertheless, 56.6% are not aware of the existence of such a service. CONCLUSION: Non-prescribed psychotropic use was high. However, most part of the clinicians does not consider this a problem. Most of the professionals do not know programs on substance use disorders specific for physicians, what would be a very positive initiative according to great part of them.OBJETIVO: Avaliar as impressões e as opiniões de médicos de áreas clínicas acerca do uso de drogas entre médicos e, mais especificamente, em ambiente cirúrgico. MÉTODOS: Foram sorteados 100 médicos não-residentes de áreas clínicas, selecionados ao acaso entre os profissionais com vínculo em um hospital público de São Paulo. Destes, 83 concluíram o estudo, respondendo perguntas sobre o uso de drogas entre médicos. RESULTADOS: Declararam conhecer algum colega com problemas relacionados ao uso de substâncias 67,5% dos médicos. Esse índice foi de 41,0% quando a pergunta era acerca de drogas disponíveis em ambiente cirúrgico, visto que 68,6% julgam ser fácil o desvio de psicotrópicos desse local. Além disso, 60,2% acreditam que os médicos são mais suscetíveis ao uso abusivo de psicotrópicos quando comparados à população geral. No entanto, 88,0% do total consideram difícil a procura por ajuda especializada. A porcentagem é de 56,6% dos que não conhecem serviço de atendimento direcionado exclusivamente para esses profissionais, algo que, na opinião de 83,1%, facilitaria a busca por tratamento. Dos participantes, 96,4% declararam não apresentar problemas relacionados ao uso de substâncias, ainda que 16,9% admita já ter feito uso de psicotrópicos sem prescrição. CONCLUSÃO: A freqüência de uso de psicotrópicos sem prescrição foi elevada. No entanto, parcela considerável não considera isso problema. A maioria dos profissionais não conhece serviços de atendimento específico para médicos.Universidade Federal de São Paulo (UNIFESP) Departamento de Psiquiatria Programa de Orientação e Atendimento a DependentesUNIFESP, Depto. de Psiquiatria Programa de Orientação e Atendimento a DependentesSciEL

Translation and validation of the Brown attention-deficit disorder scale for use in Brazil: identifying cases of attention-deficit/hyperactivity disorder among samples of substance users and non-users. Cross-cultural validation study

BACKGROUND: The Brown Attention-Deficit Disorder Scale (BADDS) was developed as a self-report assessment that was designed to screen for presence of symptoms of attention deficit hyperactivity disorder (ADHD). The objective here was to translate and validate the adult self-report BADDS for use in Brazil. DESIGN AND SETTING: Cross-cultural validation study conducted in an addiction unit at a public university hospital. METHODS: This study included a control group (n = 100) and a drug-user group (n = 100). Both groups included subjects aged 18 to 60 years old. The control group had no prior diagnosis of drug addiction and the drug-user group included participants with a diagnosis of addiction. Each participant answered Brazilian Portuguese translations of both the BADDS and the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS) guestionnaires, in paper-and-pencil format. RESULTS: The drug-user group scored higher than the control group on both scales. The mean scores on ASRS were 27.26 (standard deviation, SD 11.99) and 25.85 (SD:8.65) respectively (P > 0.05). The mean scores on BADDS were 79.56 (SD:29.61) and 79.31 (SD:18.09), respectively (P > 0.05) Cronbach's alpha for BADDS was 0.95. BADDS presented fair sensitivity (72% accuracy) and fair specificity (88% accuracy). CONCLUSION: This study provides discriminative validity evidence for use of BADDS among Brazilian adults with substance-use disorders.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Univ Fed Sao Paulo, UNIFESP, Av Prof Ascendino Reis 763, BR-04027000 Sao Paulo, SP, BrazilColumbia Univ, Mailman Sch Publ Hlth, New York, NY USAUniv Fed Sao Paulo, Dept Psychiat, UNIFESP, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, UNIFESP, Av Prof Ascendino Reis 763, BR-04027000 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Psychiat, UNIFESP, Sao Paulo, SP, BrazilCNPq: 122507/2014-2Web of Scienc

Women Crack Users, Pregnancy and Motherhood: Potential Periods for Health Care

This study aimed to understand how women relate their behaviors concerning drug use during pregnancy and breastfeeding. This is a qualitative study, conducted in the Metropolitan Area of Santos. Twelve women who have used crack were interviewed through a semi-structured interview. The interviews were analyzed from the perspective of content analysis. Our data indicate that pregnancy is a critical time to sensitize these women and try to lessen the damage and risks associated with the consumption of crack among them.Esse estudo objetivou compreender como as mulheres reportam seus comportamentos em relação ao uso de drogas durante a gravidez e a amamentação. Trata-se de um estudo qualitativo, realizado na Região Metropolitana de Santos. Doze mulheres usuárias de crack foram entrevistadas por meio de entrevista semiestruturada. As entrevistas foram analisadas a partir da análise de conteúdo. Os dados indicam que a gravidez é um momento crítico para sensibilizar essas mulheres e tentar diminuir danos e riscos associados ao consumo de crack entre elas

Assessing Alcohol Dependence in Hospitalized Patients

Alcohol misuse is generally not detected in hospital settings. the goal of this study was to estimate the prevalence of alcohol abuse and dependence in hospitalized patients in a university hospital in São Paulo (Brazil). Patients were randomly selected from all hospital admissions. the final sample consisted of 169 adult inpatients. Two screening tools were used: the Short Alcohol Dependence Data (SADD) and the CAGE questionnaires. in this sample, 25.4% of patients could be considered alcohol dependent according to the CAGE questionnaire, whereas 32.9% of patients fulfilled the criteria according to the SADD. the only predictor of alcohol dependence was gender; male inpatients were 3.2 times more prone to alcohol dependence with female inpatients. All inpatients should be systematically screened for alcohol use disorders. the choice of the screening tool will depend on whether the goal is to identify inpatients with hazardous drinking behaviors or with established alcohol-related problems. To maximize proper case identification, the CAGE questionnaire should be used as a first-step screening tool, and patients who screen positive on this scale should be subsequently administered the SADD questionnaire to assess the severity of the condition.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, São Paulo Sch Med, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo Sch Med, Dept Psychiat, São Paulo, BrazilWeb of Scienc

Poppers and sexual behavior: an intimate relationship

Fac Santa Marcelina, Sao Paulo, BrazilUniv Fed Sao Paulo, Psychiat, Sao Paulo, BrazilUniv Fed Sao Paulo, Psychiat, Sao Paulo, BrazilWeb of Scienc