Cliente com enfermidade psiquiátrica crônica: reconstrução sociocognitiva no contexto do processo de cuidado institucional [Chronic psychiatric client: socio-cognitive reconstruction in the institutional care process] [Cliente con enfermedad psiquiátrica crónica: reconstrucción socio-cognitiva en el contexto del proceso de atención institucional]

Objetivo: analisar a reconstrução sociocognitiva dos profissionais de saúde acerca do cliente com enfermidade psiquiátrica crônica, contextualizando com a sua permanência institucional e o processo assistencial. Método: estudo qualitativo, com abordagem estrutural das representações sociais, realizada em 2013, em dois hospitais do Rio de Janeiro - Brasil, com 159 profissionais. Projeto aprovado pelo Comité de Ética em Pesquisa, pareceres nº 13/2009 e 53/2010. Utilizou-se a técnica de evocações livres e a análise com o software Ensemble de Programmes Permettant L’analyse des Évocations. Resultados: foram evocadas 795 palavras, com frequência mínima 9 e média 17. O rang das ordens médias de evocação alcançou 2.99. Foram construídas cinco dimensões, a saber: imagética; afetividade positiva; assistencial-institucional; afetividade mista; necessidade. Conclusão: compreendeu-se a representação social dos profissionais de saúde mental sobre os clientes que envelheceram nos espaços manicomiais, vítimas de uma assistência estigmatizante e excludente.ABSTRACTObjective: to analyze health personnel’s socio-cognitive reconstruction about chronic psychiatric clients, contextualizing it with their time in the institution and the care process. Method: qualitative study conducted in 2013 with 159 participants at two hospitals in Rio de Janeiro, Brazil, applying a structural approach to social representations, using the free evocations technique and the software Group of Programs for the Analysis of Evoked Responses (Ensemble de Programmes Permettant L’analyze des Évocations, EVOC). Approved by the research ethics committee (opinions 13/2009 and 53/2010). Results: 795 words were evoked, the minimum frequency was 9, the mean was 17. The ranking of mean orders of evocation was 2.99. Five dimensions were constructed: imagery; positive affectivity; institutional care; mixed affectivity; and need. Conclusion: the study afforded an understanding of mental health personnel’s social representations about clients who have aged in asylum spaces, victims of stigmatizing, exclusionary care. RESUMEN Objetivo: ananalizar la reconstrucción socio-cognitiva de los profesionales de salud acerca del cliente con enfermedad psiquiátrica crónica, contextualizando con su permanencia institucional y el proceso asistencial. Método: estudio cualitativo, con enfoque estructural de las representaciones sociales, realizado en 2013, en dos hospitales de Río de Janeiro-Brasil, con 159 participantes. Aprobado por el Comité de Ética en Investigación, dictámenes 13/2009 y 53/2010. Se utilizó la técnica de evocaciones libres y el análisis con el software Ensemble de Programmes Permettant L’analyse des Évocations. Resultados: fueron evocadas 795 palabras, la frecuencia mínima fue 09, la media fue de 17. El rango del orden promedio de evocación fue de 2.99. Se construyeron cinco dimensiones, a saber: imagética; afectividad positiva; asistencial-institucional; afectividad mixta; necesidad. Conclusión: el alcance del objetivo posibilitó la comprensión de la representación social que los profesionales de salud mental poseen respecto a los clientes que envejecieron en los espacios manicomiales, víctima de una asistencia estigmatizante y excluyente. DOI: http://dx.doi.org/10.12957/reuerj.2017.31073

PERBANDINGAN TINGKAT KEMAMPUAN MEKANISME KOPING SEBELUM DAN SESUDAH PEMBERIAN BIMBINGAN INDIVIDU PADA MAHASISWA PROFESI DI RUMAH SAKIT JIWA

AbstrakPenelitian ini bertujuan mengetahui peningkatan kemampuan mekanisme koping dalam berinteraksi mahasiswa program profesi Keperawatan Jiwa sebelum dan sesudah pemberian bimbingan individu di Rumah Sakit Jiwa. Jenis penelitian adalah penelitian deskriptif dengan rancangan cross sectional. Populasi penelitian adalah total populasi mahasiswa program profesi Keperawatan Jiwa laki-laki dan perempuan. Data primer diperoleh dari 60 responden dengan menggunakan kuesioner. Hasil penelitian didapatkan ada peningkatan kemampuan koping mahasiswa program profesi dari menghindar untuk berinteraksi (sebelum diberikan bimbingan individu) hingga dapat berinteraksi dengan klien gangguan jiwa (setelah diberikan bimbingan individu) dengan peningkatan nilai mean sebesar 5,15. Sedangkan hasil uji statistik didapatkan ada peningkatan yang signifikan kemampuan mekanisme koping mahasiswa sebelum dan sesudah pemberian bimbingan individu (p value 0.003). Kesimpulan penelitian adalah mahasiswa yang akan praktik di RS Jiwa diharapkan mempersiapkan diri terlebih dahulu dengan cara mempelajari pengetahuan dalam merawat klien gangguan jiwa melalui studi literatur, studi lapangan, dan diskusi dengan pembimbing juga kemampuan analisis diri dalam berinteraksi dengan klien gangguan jiwa. Sedangkan pembimbing diharapkan dapat melakukan pendampingan pada mahasiswa berupa bimbingan individu (bedside teaching) dalam berinteraksi dengan klien gangguan jiwa secara terjadual. AbstractThe aim of thus research is to know about increasment in ability of coping mechanism and interaction of the student’s in psychiatric nursing programme on clinical studies, before and after the bedside teaching. The descriptive research with cross sectional method is used in this research. The research population is both female and male students in psychiatric nursing programme on clinical studies. Primary data was got from 60 respondences using questioner. The result of study found that there is an increase of coping ability of proffession programe students from avoid to inteeact to be come able to interact with psychiatric client (after the students is given the beside teaching), with an increase of mean score about 5.15. Where as the result of statistical analysis found tjat there is a significant rise of students coping mecanism ability before and after the beside teaching is given (p value 0.003). The summary of this study is the student should prepare themselfbefore going to the psychiatric hospital by learning how to take care the psychiatric client through literature study, field study, and in interaction with psychiatric client. Likewise/meanwhile the facililator should be able to accompany the student like beside teaching when interact with psychiatric client using a schedule.

She Looks so Beautiful

This article offers a story that illustrates how the medium of music is able to provide comfort, even in extreme cases of hopelessness, when all other efforts seem futile. I will relate how the creative act of music-making within an institutional setting, was able to provide comfort to a self-injurious female psychiatric client, who had been institutionalised all her life, to restore a sense of beauty and dignity which had been lost. The music that was created in the moment was also able to carry and support all the individuals who were creating it - even in the most desperate moments where those that were supposed to be "in command" were experiencing a sense of uncertainty. The story further demonstrates how a client, a care-worker and a therapist, three individuals from very diverse backgrounds and life circumstances, were able to transcend their different histories to come together and connect on a level which they have not been able to do outside the music therapy room.