Concepções sobre transtornos mentais e seu tratamento entre idosos atendidos em um serviço público de saúde mental

Sentidos e Práticas em Saúde Mental em Comunidades Quilombolas no Estado de Rondônia

Resumo O objetivo deste estudo foi compreender como os remanescentes quilombolas de duas comunidades do Vale do Guaporé no estado de Rondônia produzem sentidos sobre saúde mental. A partir de uma abordagem qualitativa foram realizadas entrevistas abertas e rodas de conversas com 18 participantes de ambos os sexos. A análise do material empírico foi realizada de acordo com as propostas de análise do discurso, sob a perspectiva da Psicologia Discursiva. Por meio do recurso teórico-analítico foram identificados três repertórios interpretativos sobre saúde mental: construção do sofrimento mental: reconhecimento e formas de lidar com os sintomas psiquiátricos; recursos utilizados pelos moradores da comunidade no cuidado em saúde mental; e consumo excessivo de bebidas alcoólicas como problema de saúde mental. Esses sentidos apontam para a necessidade de construção e implementação de intervenções e políticas públicas de saúde direcionadas a essa população que levem em consideração seus aspectos sócio-históricos e culturais.

Comportamento sedentário como discriminador dos transtornos mentais comuns em idosos

RESUMO Objetivo Analisar o comportamento sedentário (CS) como discriminador dos Transtornos Mentais Comuns (TMC) entre idosos. Métodos Estudo transversal com amostra composta por 310 indivíduos idosos, residentes no município de Ibicuí-BA. Foi utilizado um questionário contendo informações sobre características sociodemográficas, inatividade física no tempo livre e questões autorreferidas do tempo gasto sentado em um dia habitual da semana e de um dia do final de semana. Para estimar o ponto de corte do Comportamento Sedentário na discriminação dos TMC, utilizou-se a curva Receiver Operating Characteristic (ROC). Resultados A prevalência de TMC foi de 55,8%, sendo maior entre as mulheres (66,7%). Os maiores valores para a área sob as curvas ROC entre CS e TMC foi para o sexo masculino: CS/dia 0,58 (IC 95% = 0,49-0,67). Os pontos de corte propostos para CS/dia foram: homens: > 330 min/dia; mulheres: > 300 min/dia. Conclusão O comportamento sedentário é um indicador válido para identificação de suspeita de TMC em idosos, mostrando-se ser um fator de risco que deve ser observado pelos profissionais de saúde.

[Ways of thinking and acting of the elderly when tackling functionality/disability issues]

Functionality is a crucial dimension of the health of the elderly. The aim of this work is to investigate the elements that comprise the significance of disability for the elderly residents of the city of Bambuí in the state of Minas Gerais. A qualitative approach was adopted in which the model of signs, significance and actions was used in both data collection and analysis. Interviews were conducted with 57 elderly individuals (30 women; 27 men) ranging from 61 to 96 years of age registered in primary care units. The participants interpret functionality/disability (disease) as "being able to cope/not being able to cope" or "being a burden" (illness) to others. "Not being able to cope" refers to the inexorable functional loss inherent to the aging process, while "being a burden" relates to the permanent condition of generating pain and suffering to both patient and care giver. The way to deal with the "not being able to cope" condition is related to resignation. On the other hand, praying is the way to deal with "being a burden." Religion and resignation can help during critical moments, though they also reveal the lack of resources and alternatives for support and intervention in the most severe cases.

Professional competencies in primary health care for attending to older adults

Objective To identify and analyze the necessary competencies in primary health care for attending to older adults. Method An exploratory, descriptive, and quali-quantitative study was developed. Three rounds of the Delphi Technique were conducted with participants from primary health care services and a multidisciplinary committee. The first questionnaire asked participants to indicate the competencies needed for attending to older adults in primary health care. They were compiled into a list and added to a Likert Scale (from 1 to 5) for the second and third questionnaires. A consensus criterion of 70% was adopted. Results Twenty eight competencies were reached by consensus and were classified into twelve domains. Conclusion The competencies reflect Brazilian health care policy and constitute a reference for professional health practice and education when caring for the older adult in primary health care.

[Common mental disorders among elderly individuals: a population-based study in Campinas, São Paulo State, Brazil]

This study analyzed common mental disorders in the elderly according to demographic and socioeconomic characteristics, health-related behavior, and disease history. This was a cross-sectional, population-based study with a cluster sample using data from a health survey conducted in Campinas, São Paulo State, Brazil, in 2008. SRQ-20 was used to evaluate common mental disorders. Adjusted prevalence ratios were estimated using multiple Poisson regression. Prevalence of common mental disorders was 29.7%, and higher rates were associated with female gender, age 80 years or older, lower income, not working, sedentary lifestyle, poor self-rated health, and greater number of chronic diseases. Prevalence ratios were higher in the subscale of depressive thinking. The results provide direct backing for planning interventions focused on health of the elderly, with an emphasis on elderly that work and follow healthy lifestyles. The study highlights the need for attention by health professionals to depressive disorder in the elderly.