Grupo Hospitalar Conceição (GHC), Porto Alegre , RS , Brazil .
Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre , RS , Brazil .
Trends Psychiatry Psychother. 2020 Oct-Dec;42(4):329-339. doi: 10.1590/2237-6089-2019-0053.
Specialized psychosocial care centers (Centros de Atenção Psicossocial [CAPS]) are mental health services focused on social rehabilitation and reducing hospitalization of patients with severe and persistent mental illness. Collective multiprofessional activities (CMPA) are the main therapeutic tools used at CAPS. This study aimed to determine rates of adherence to CMPA and identify factors associated with adherence.
This is a cross-sectional study in which 111 CAPS users were evaluated using questionnaires covering patient characteristics, clinical status, and treatment and incorporating the Functioning Assessment Short Test (FAST), the Clinical Global Impression - Severity scale (CGI-S), and the Clinical Global Impression - Improvement scale (CGI-I). Adherence was defined as attendance at 50% or more CMPA during the previous 3 months. Data were analyzed using descriptive statistics, bivariate analysis, and Poisson logistic regression with robust variance to estimate prevalence ratios.
CPMA adherence was 43%. Having children aged 14 years or younger was significantly associated with non-adherence (71%, p = 0.001). Poor or partial adherence to psychotropic drugs tended to be associated (p = 0.066) with poor adherence (33% higher risk), as was the number of psychiatric hospitalizations during CAPS (p = 0.076), with a cumulative association of 5% non-adherence per hospitalization.
CMPA adherence was low in the study. It is necessary to consider the environment in which the individual lives and invest in support networks, providing patients and family members with explanations about the importance of CMPA to rehabilitation and attempting to tailor the care provided to each patient's needs. There was an association between greater number of psychiatric hospitalizations and non-adherence, suggesting that CAPS are fulfilling a preventive role.
专门的心理社会保健中心（Centros de Atenção Psicossocial [CAPS]）是专注于社会康复和减少严重和持续性精神疾病患者住院治疗的精神卫生服务。集体多专业活动（Colaborativa Multiprofissional [CMPA]）是 CAPS 中使用的主要治疗工具。本研究旨在确定 CMPA 的依从率，并确定与依从性相关的因素。
这是一项横断面研究，其中评估了 111 名 CAPS 使用者，使用涵盖患者特征、临床状况和治疗的问卷进行评估，并纳入功能评估简短测试（Functioning Assessment Short Test [FAST]）、临床总体印象 - 严重程度量表（Clinical Global Impression - Severity scale [CGI-S]）和临床总体印象 - 改善量表（Clinical Global Impression - Improvement scale [CGI-I]）。依从性定义为在过去 3 个月内参加 50%或更多 CMPA。使用描述性统计、双变量分析和泊松逻辑回归（带有稳健方差）分析数据，以估计患病率比。
CMPA 的依从率为 43%。有 14 岁或以下的孩子与不依从（71%，p = 0.001）显著相关。精神科住院次数（p = 0.076）与药物治疗依从性较差（p = 0.066）也存在趋势性相关，每次住院的依从性风险增加 33%，具有累积性，每住院一次不依从率增加 5%。
本研究中 CMPA 的依从率较低。有必要考虑个人所处的环境，并投资于支持网络，向患者及其家属解释 CMPA 对康复的重要性，并尝试根据每位患者的需求调整护理。精神科住院次数与不依从之间存在关联，表明 CAPS 发挥了预防作用。
