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Authors
Abstract(s)
Apesar dos avanços legislativos do tratamento involuntário em psiquiatria, a prática
continua a ser intensamente debatida, sendo relevante conhecer a perspetiva de pessoas
com doença mental que viveram esta experiência e avaliar, considerando a sua perspetiva,
se as novas diretrizes da Lei de Saúde Mental tiveram um impacto positivo na prestação de
cuidados de saúde mental.
Este é um estudo de casos no qual participaram nove utentes em tratamento involuntário
Na Unidade Local de Saúde da Cova da Beira, oito do sexo masculino e 1 do sexo feminino,
com idades compreendidas entre 26 e 80 anos, maioritariamente medicados com
antipsicóticos, com diagnóstico de Esquizofrenia e com múltiplos internamentos
psiquiátricos prévios. A recolha de dados foi realizada após a avaliação clínico-psiquiátrica
bimensal realizada por ordem do Tribunal, no mínimo dois meses depois do último
internamento involuntário de cada participante, através de entrevistas semiestruturadas. A
análise dos dados foi efetuada através do método de análise de conteúdo da transcrição
íntegra das entrevistas, extraindo informações sobre a experiência e a perspetiva dos
utentes em relação ao tratamento involuntário.
Após análise dos dados, verificou-se que a maioria dos participantes experienciam
sentimentos contraditórios ao longo do tratamento, com predominância de sentimentos
negativos, especialmente no início do processo e que a perspetiva dos utentes sobre o
tratamento é amplamente influenciada pelas atitudes dos profissionais de saúde, pela
perceção de melhoria do estado de saúde e pelo nível de envolvimento nas decisões
terapêuticas.
Este estudo permitiu identificar lacunas na implementação das implicações legais do
tratamento involuntário na prática clínica e a importância de promover a capacitação dos
profissionais de saúde numa abordagem centrada na pessoa e adequada às necessidades
individuais de cada utente.
Despite the legislative advances in involuntary treatment in psychiatry, the practice continues to be intensely debated, and it is relevant to know the perspective of people with mental illness who have lived through this experience and to assess, from their perspective, whether the new guidelines of the Mental Health Act have had a positive impact on the provision of mental health care. This is a case study in which nine users in involuntary treatment at the Cova da Beira Local Health Unit took part, eight males and one female, aged between 26 and 80, mostly medicated with antipsychotics, diagnosed with schizophrenia and with multiple previous psychiatric hospitalizations. Data was collected after a bi-monthly clinical-psychiatric assessment carried out by order of the court, at least two months after each participant's last involuntary hospitalization, through semi-structured interviews. The data was analyzed using the method of content analysis of the full transcript of the interviews, extracting information about the experience and perspective of the users in relation to involuntary treatment. After analyzing the data, it was found that many participants experience contradictory feelings throughout treatment, with a predominance of negative feelings, especially at the beginning of the process, and that users' perspectives on treatment are largely influenced by the attitudes of health professionals, the perceived improvement in health status and the level of involvement in therapeutic decisions. This study identified gaps in the implementation of the legal implications of involuntary treatment in clinical practice and the importance of promoting the training of health professionals in a person-centered approach that is appropriate to the individual needs of each patient.
Despite the legislative advances in involuntary treatment in psychiatry, the practice continues to be intensely debated, and it is relevant to know the perspective of people with mental illness who have lived through this experience and to assess, from their perspective, whether the new guidelines of the Mental Health Act have had a positive impact on the provision of mental health care. This is a case study in which nine users in involuntary treatment at the Cova da Beira Local Health Unit took part, eight males and one female, aged between 26 and 80, mostly medicated with antipsychotics, diagnosed with schizophrenia and with multiple previous psychiatric hospitalizations. Data was collected after a bi-monthly clinical-psychiatric assessment carried out by order of the court, at least two months after each participant's last involuntary hospitalization, through semi-structured interviews. The data was analyzed using the method of content analysis of the full transcript of the interviews, extracting information about the experience and perspective of the users in relation to involuntary treatment. After analyzing the data, it was found that many participants experience contradictory feelings throughout treatment, with a predominance of negative feelings, especially at the beginning of the process, and that users' perspectives on treatment are largely influenced by the attitudes of health professionals, the perceived improvement in health status and the level of involvement in therapeutic decisions. This study identified gaps in the implementation of the legal implications of involuntary treatment in clinical practice and the importance of promoting the training of health professionals in a person-centered approach that is appropriate to the individual needs of each patient.
Description
Keywords
Estudo de Casos Perspetiva de Utentes Psiquiatria Tratamento Involuntário