Mental Health Practitioner: Date Of First Submission

In the groups’ opinions, the therapeutic arsenal includes medicines, psychotherapy, family support and activities. So here is a question. How must the continuity of the treatment be maintained? When should one prescribe a drug? While recognizing the importance of the setting for handling the patient, they admitted that it was possible to treat mental health problems in primary care. When should one indicate psychotherapy? How must other support services for the patient be used? How must the medication be adjusted? Needless to say, how must emergencies be dealt with? Fact, when must one indicate hospitalization? On p of the surprise that it the real problem, faced with these dilemmas, the physicians expressed the fear of having inadequate conduct. Similar to psychoses, the groups felt more confident about dealing with depressive patients. Should making attending psychotic patients more difficult were the long time evolution, the risk of aggression and the longer time required for attending to them. Mental disorders have high rates of prevalence in the general population and represent a significant potential demand for basic healthcare services. Recent advances in neurosciences was bringing in meaningful contributions, one important challenge in diagnosing mental disorders is the imprecise biological basis for them. A well-known fact that is. With regard to mental problems, moreover because specific skills are needed for practicing good outpatient medical care dot 7 Physicians are trained to diagnose in consonance with illness category but, they have difficulties in using psychopathological language, the difficulty in diagnosing is thought to be not only due to lack of time for seeing such patients. Treatment is another challenge that needs to be faced from various angles. You should take it into account. Besides, a thorough review of the literature on mental health and primary healthcare reveals that psychiatrists and general practitioners do not always agree in their opinions on the most important pics to be discussed within continuing education.

Programs focused exclusively on the diagnosis and use of medicines may disregard the main goal for clinical practice in primary care.

Programs based exclusively on knowledge have had little or no impact on changes in attitude.

Evaluation of studies on the teaching of psychiatry in primary care point wards identical fact. Furthermore, with the objective of ascertaining these professionals’ opinions about attendance for people with mental problems educational techniques regarding mental health that take these professionals’ learning characteristics into account can be developed since, the present study was developed within a training program for general practitioners who work in primary care services,. Therefore this reaction may originate from the stigma of mental illnesses, from which physicians are not immune, and this may contribute wards the rejection of madness in its various meanings and the consequent separation of mad individuals. By the way, the acquisition of knowledge and formation of attitudes in relation to patients with mental problems can be subject to the feelings experienced by the physician in his work, and to his imagination regarding mental illness, thereby either facilitating or causing difficulty to the learning process. With that said, a fundamental component in the formation of attitudes is the affective dimension.

Actually the cognitive and behavioral aspects, the elaboration of ideas and the actions derived from them, are intrinsically about the feelings that go through thoughts and conduct. From this complex relationship of ‘cognition affection conduct’, a more or less fertile soil for learning will result dot 21 In the present study, fear ok the sort of uncertainty, insecurity, inexperience and vulnerability of the other person. March 23, 2004 Last received. Conflict of interest. Correspondence to Dinarte Alexandre Ballester Padre Chagas, 66 conjunto 705 Porto Alegre Brasil CEP ‘90570 080’ Tel. Look, there’s no conflict of interest to be presented by the authors. Generally, date of first submission. That said, december 12, 2004 Accepted.

Dinarte Alexandre Ballester, MD.

Ana Paula Filippon.

Resident physician, Hospital São Pedro, State Health Department, Rio Grande do Sul. Resident physician, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul. However, carla Braga. For instance, department of Psychiatry, Universidade Federal de São Paulo, Universidade Católica de Santos, São Paulo. Normally, sérgio Baxter Andreoli, MD. Department of Social Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Rio Grande do Sul. With active and different manifestations from the participants, any session lasted around 60 minutes. Then the conversations were recorded and transcribed.

Two videos produced especially for this study and were presented in the focal groups, that simulated consultations for patients with depression and psychoses that lasted for 8 and 5 minutes.

The meetings of the groups were part of a training program in mental health, and they have been preceded by another three meetings that had the objective of examining case studies regarding seven mental health problems.

Initially, Then the participants were gathered in three groups. Seriously. Therefore the technique for data collection consisted of focal groups. Now look, the transcribed texts from the group recordings were assessed via the content analysis technique dot 19 The analysis categories were built up from the units of meaning that were identified and the observed material. Now look, the reports from the groups showed a few indicators of physicians’ opinions, and analysis of the content of the texts allowed the following categories to be drawn up. I started looking differently at those patients who are always in the health center and asking them other kinds of questions. General practitioners have a harder investigative task.

Patients may arrive at the health center with loads of complaints, and we are the ones to raise the hypothesis of a psychiatric illness.

The groups expressed plenty of feelings.

Other feelings were. So general practitioner and mental health problems. So médico generalista e os problemas de saúde mental. Actually, a deliberately selected sample of 41 general practitioners who were working in basic health services met in focal groups. This is the case. DESIGN AND SETTING. METHODS. Therefore, the challenge of continuing education on mental health requires methods of interactive and critical teaching, like the problembased approach. However, the discussions about the identification and handling of mental health problems were recorded and assessed via content analysis. Within the context of primary health care and mental disorders, our aim was to study the opinions of general practitioners regarding attendance of people with mental health problems.

Two videos were presented, that simulated consultations for patients with depression and psychoses.

The diagnosis and treatment of these problems are still seen as a task for specialists, the general practitioners indicated that they perceived the mental health problems among their clientele.

RESULTS. CONCLUSIONS. CONTEXT AND OBJECTIVE. You see, the opinions about the difficulties of diagnosing and treating mental problems, the involvement of relatives in caring for patients, the difficulty of compliance with the treatment, the uncertainty experienced by physicians and the difficulty of referring patients to specialized services. Qualitative focal group study among primary care services in the cities of Porto Alegre and Parobé, State of Rio Grande do Sul. Usually, the participants suggested that the mental health training received at medical schools had led to rather limited results. Difficulties arise in professional practice when And so it’s necessary to identify and deal with mental problems, from the least to the most severe cases, despite the fact that the disciplines of psychiatry and medical psychology are included in the curriculum.

Now this process must start at undergraduate level and continue throughout professional development.

The doubt is still what to do to accomplish this enormous task.

Over the last 50 years, a couple of studies have pointed in quite similar direction. Educational requirements for facing the challenges of diagnosing and dealing with mental problems demand an attentive and critical attitude. These innovations in medical teaching are studentcentered and depending on priorities since, in the education of adults, the learning trigger is the ability to overcome challenges and solve problems. Learning through problem solving also leads students to experience uncertainties, let’s say about what and how to study. Now this condition of uncertainty must lead to reflection and a search for knowledge to make decisions. In healthcare attendance, the professional may face uncertainty when choosing another good way to act. A well-known fact that is. While considering the general physician’s standpoint, the group discussions raised a few themes that were not discussed in the training program.

Doubts about treatments with psychoactive drugs and psychotherapies still remained, while the difficulties of knowing how to refer patients to the health system, other themes were discussed while studying the cases.

They found difficulties in referring patients with mental disorders to the specialized services, and concluded that the disorganization of the health system generates a lack of continuity and a large demand for attendance.

It’s an interesting fact that the physicians recognized the need for institutional resources similar to health services and social assistance for attending to individuals with mental problems. They foresaw a tendency wards improvement, they considered that there were not enough of these services yet, particularly for attending to psychotic patients. Murialdo Health Center, State Health Department of Rio Grande do Sul, and from the outpatient department of a shoe factory. It’s a well-known fact that the study followed a qualitative approach wards evaluating the opinions of a number of 41 physicians who were working in primary care services in the cities of Porto Alegre and Parobé, State of Rio Grande do Sul.

Choice of population was deliberate.

RESULTADOS.

So desafio da educação continuada em saúde mental requer métodos de ensino interativos e críticos, como an abordagem de solução de problemas. Usually, discussões sobre an identificação e so manejo dos problemas mentais foram gravadas e descritas pelo método de análise de conteúdo. Consequently, foram apresentados an eles dois vídeos, que simulavam so atendimento de pacientes com depressão e psicose. Eventually, os médicos generalistas percebem os problemas mentais na sua clientela, mas consideram que so diagnóstico e tratamento destes problemas é tarefa do especialista. No contexto de cuidados primários de saúde e transtornos mentais, so objetivo foi conhecer as opiniões de médicos generalistas sobre so atendimento de pessoas com problemas mentais.

MÉTODOS.

CONTEXTO E OBJETIVO.

CONCLUSÕES. Estudo qualitativo, por grupos focais, nos Serviços Básicos de Saúde em Porto Alegre e Parobé, Rio Grande do Sul. Nevertheless, um grupo de 41 médicos que trabalham em cuidados primários de saúde foi escolhido de modo intencional e reunido em grupos focais. Now look. So envolvimento dos familiares no cuidado dos pacientes, a dificuldade de adesão ao tratamento, as incertezas experimentadas pelos médicos e as dificuldades para referenciar os pacientes aos serviços especializados, as principais opiniões dos médicos referiramse às dificuldades para diagnosticar e tratar os problemas mentais. TIPO DE ESTUDO E LOCAL. Basically the physicians noticed the difficulty that patients had in accepting the diagnosis and complying with the treatment.

They considered that the teaching model used for medicine, that is directed wards the training of specialists, is exposed to discredit from patients in relation to general practitioners, and that this generates insecurity for clinical practice.

They agreed that, at medical school, the teaching is directed wards the training of specialists, and that is why they tended to think that long consultations are needed in relation to mental problems, psychiatrist’s time.

How should organic causes be identified? Of course, the physicians agreed that mental problems are very common in basic healthcare services and considered that they could take care of these people if they received the necessary training. How should diagnostic categories be used? Just think for a moment. They considered that complementary tests are sometimes indispensable for the diagnosis. However, they found it necessary to fit the theoretical knowledge in with the practice, and to ask questions similar to. How must the normal be differentiated from the pathological? Certainly, how should suicide risk be identified risk?

What are the clues for the diagnosis?

They considered that physicians must exercise a responsibility regarding the relatives of people with mental problems.

At identical time, they noticed that just like suicide, and considered that the physician, the healthcare team and the family’s conduct has an impact on these critical events. So, home visits were seen as a strategy for improving the relationship between the healthcare team and the patient. Since of the difficulty in obtaining compliance from the patients, the physicians considered that there were problems in continuing the treatment between crises. They recognized the importance of the physician’s attitude in linking their training with the continuity of the treatment, the way the physician talks with patients. Just think for a moment. Educational evaluation studies have shown that continuing extensive educational programs with reinforcement and periodic evaluations are necessary to enable changes in clinical practice and patient evolution to take place.

As something far from their intervention, the opinions of the general practitioners indicate that they perceive the mental health problems among their clientele.

In their daily clinical practice, they face having to attend to people with mental disorders, possibly even in a situation of cr, and they do their best to find solutions among the various doubts and dilemmas.

Since this may demand lengthy time and sophistication, the diagnosis and treatment of mental problems are still seen as a task for specialists. Anyways, the challenge of continuing education for doctors in relation to mental health requires methods for interactive and critical teaching, just like the problembased approach.