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Authors
Abstract(s)
O regresso à vida quotidiana após um internamento hospitalar em psiquiatria pode constituir-se como marcadamente difícil no retomar das atividades e relações que constituem a vida, mas também lhe dão propósito. Assim, procurou-se responder à questão: Qual é a experiência vivida do regresso à vida quotidiana após o primeiro internamento num serviço de psiquiatria de agudos? Os objetivos delineados foram: Compreender e Evidenciar os significados experienciais vividos no regresso à vida quotidiana após o primeiro internamento num serviço de psiquiatria de agudos. A metodologia estabelecida fundamentou-se na fenomenologia da prática de Van Manen. A recolha de material experiencial foi conseguida através de entrevistas fenomenológicas, tendo participado 12 pessoas que tiveram um internamento em psiquiatria num hospital geral. Da análise temática e hermenêutica foram captados sete temas: 1) o (des)velar a marca que há em si; 2) o assombro da memória que há em si; 3) da desconexão à assimilação do corpo medicado em si; 4) do reconhecimento à superação da fragilidade que há em si; 5) a relação com os profissionais de saúde: da expectativa à resposta; 6) a relação com os outros: reformular os laços da alteridade; 7) a relação com o mundo: religar-se como sentido de si. Estes revelaram-se num patamar de interação recíproca e penetrante, em que nenhum se destaca ou sobrepõe, mas antes se afetam e potenciam naquilo que se constitui como a complexidade desta experiência vivida. Os resultados obtidos permitem estabelecer o fenómeno em estudo como um evento de cariz transicional que coloca em causa a estabilidade da pessoa e a sua habilidade para ser-bem e ser-mais. Considera-se que esta transição particular deve ser foco de intervenção transversal a todos os doentes por parte dos serviços de saúde, nomeadamente pela enfermagem. Estas intervenções deverão ter uma lógica de redução gradual do suporte dado pelos profissionais de saúde e acautelar a possibilidade de vivências traumáticas do internamento, os limites de iatrogenia que o doente considera capaz de tolerar, e os recursos e pessoas que o doente quer envolver no que é o seu processo de saúde. Sugere-se ainda a reflexão acerca dos espaços de cuidar das pessoas que são acompanhadas pelos serviços de saúde após a alta pelos significados que atribuem ao espaço da consulta, ainda associado ao internamento. Isto pode ser inibidor da sua adesão plena ao plano terapêutico proposto, mas também de procurar ajuda quando se depara numa fase prodrómica da sua doença pelo medo de regressar ao internamento.
Returning to daily life after admission to a psychiatric ward can be markedly difficult when resuming life’s activities and relationships, which constitute life itself and give it meaning. So, we aimed to answer the question: What is the experience of returning to daily life after the first hospitalization in an acute psychiatric ward? The objectives outlined were: to understand and highlight the experiential meanings experienced in the return to daily life after the first hospitalization in an acute psychiatric ward. The established methodology was based on Van Manen's phenomenology of practice. Experiential material was collected through phenomenological interviews, which included the participation of 12 people who had a singular admission to a psychiatric ward in a general hospital. From the thematic and hermeneutic analysis, seven themes were captured: 1) the (un)veiling of the imprint there is in the self; 2) the astonishment of memory in the self; 3) from disconnection to assimilation of the medicated body in the self; 4) from recognition to overcoming the fragility that is in the self; 5) the relationship with health professionals: from expectation to response; 6) the relationship with others: reformulating the ties of otherness; 7) the relationship to the world: reconnecting for a sense of self. These themes revealed themselves in a level of reciprocal and penetrating interaction, in which none stands out or overlaps, but rather are affected and potentiated in what constitutes the complexity of this lived experience. The results obtained allow to establish the phenomenon under study as a transitional event that calls into question the person's stability and ability for being-well and being-more. It is considered that this particular transition should be the focus of intervention by the health services, across all patients, namely by nursing. These interventions should gradually reduce the support given by health professionals, safeguard the possibility of traumatic experiences of hospitalization, acknowledge the iatrogenic limits that the patient considers tolerable, and access the resources and people that the patient wants to involve in his own health journey. It is also suggested a pondering on the spaces for caring for people who are accompanied by health services after discharge due to the meanings they attribute to the appointment setting/consulting, still associated with the hospitalization. This can inhibit their full adherence to the proposed therapeutic plan, but also to seek help when faced with a prodromal stage of their illness for fear of returning to the hospital.
Returning to daily life after admission to a psychiatric ward can be markedly difficult when resuming life’s activities and relationships, which constitute life itself and give it meaning. So, we aimed to answer the question: What is the experience of returning to daily life after the first hospitalization in an acute psychiatric ward? The objectives outlined were: to understand and highlight the experiential meanings experienced in the return to daily life after the first hospitalization in an acute psychiatric ward. The established methodology was based on Van Manen's phenomenology of practice. Experiential material was collected through phenomenological interviews, which included the participation of 12 people who had a singular admission to a psychiatric ward in a general hospital. From the thematic and hermeneutic analysis, seven themes were captured: 1) the (un)veiling of the imprint there is in the self; 2) the astonishment of memory in the self; 3) from disconnection to assimilation of the medicated body in the self; 4) from recognition to overcoming the fragility that is in the self; 5) the relationship with health professionals: from expectation to response; 6) the relationship with others: reformulating the ties of otherness; 7) the relationship to the world: reconnecting for a sense of self. These themes revealed themselves in a level of reciprocal and penetrating interaction, in which none stands out or overlaps, but rather are affected and potentiated in what constitutes the complexity of this lived experience. The results obtained allow to establish the phenomenon under study as a transitional event that calls into question the person's stability and ability for being-well and being-more. It is considered that this particular transition should be the focus of intervention by the health services, across all patients, namely by nursing. These interventions should gradually reduce the support given by health professionals, safeguard the possibility of traumatic experiences of hospitalization, acknowledge the iatrogenic limits that the patient considers tolerable, and access the resources and people that the patient wants to involve in his own health journey. It is also suggested a pondering on the spaces for caring for people who are accompanied by health services after discharge due to the meanings they attribute to the appointment setting/consulting, still associated with the hospitalization. This can inhibit their full adherence to the proposed therapeutic plan, but also to seek help when faced with a prodromal stage of their illness for fear of returning to the hospital.
Description
Keywords
Enfermagem psiquiátrica Pesquisa qualitativa Fenomenologia da prática Experiência vivida pós-alta Internamento Hospitais psiquiátricos Integração comunitária Continuidade da Assistência ao Paciente