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心理社会关怀服务中的关怀生产:家访作为一种干预技术,将在该领域使用。

The production of care in psychosocial care services: home visits as an intervention technology to be used in the territory.

机构信息

Centro de Ciências da Saúde, Universidade Estadual do Ceará. Av. Paranjana 1700, Itaperi. 60740-000 Fortaleza CE Brasil.

Hospital e Maternidade Dra. Zilda Arns Neumann. Fortaleza CE Brasil.

出版信息

Cien Saude Colet. 2021 Mar;26(3):1163-1172. doi: 10.1590/1413-81232021263.09102019. Epub 2019 Jun 6.

Abstract

Home visits are a technology used in mental health services to address individuals with mental distress and their families. The intent is to analyze different types of knowledge and professional practices related to home visits, grounded on the analytical framework provided by the Psychiatric Reform's dimensions, namely: theoretical-conceptual, technical assistance, legal-political, and sociocultural. This case study with a qualitative approach was conducted in a Psychosocial Care Center (CAPS) located in Fortaleza, Ceará, Brazil. Observation and semi-structured interviews were held with workers and later analyzed from a critical hermeneutic perspective. The results show the territory covered by the service is acknowledged as a social space in which individuals are allowed to express their experience/suffering and a place where care is produced. Home visits require the reorganization of work processes and the development of deinstitutionalization strategies, which in turn promote the patients' autonomy and contractual power. There are, however, challenges to be overcome, such as insufficient human resources and a lack of material resources. Additionally, workers have to deal with urban violence and impediments to cultural change in the way society deals with mental illness. Home visits are essential within CAPS as a strategy to dismantle the traditional asylum apparatus.

摘要

家庭访视是精神卫生服务中用于解决有精神困扰的个体及其家庭的一项技术。其目的是分析与家庭访视相关的不同类型的知识和专业实践,基于精神科改革维度提供的分析框架,即:理论概念、技术援助、法律政治和社会文化。本案例研究采用定性方法,在巴西塞阿拉州福塔莱萨的一个心理社会保健中心(CAPS)进行。对工作人员进行了观察和半结构化访谈,并从批判解释学的角度进行了分析。结果表明,该服务覆盖的领域被认为是一个社会空间,个体可以在其中表达自己的经历/痛苦,并且是提供关怀的地方。家庭访视需要重新组织工作流程和制定去机构化策略,这反过来又促进了患者的自主权和契约权力。然而,还存在一些挑战需要克服,例如人力资源不足和物质资源匮乏。此外,工作人员还必须应对城市暴力和社会对待精神疾病方式的文化变革的障碍。家庭访视是 CAPS 中心的一项重要策略,可用于拆除传统的庇护所设备。

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