Urgência e emergência psiquiátrica: assistência de enfermagem e perfil de pacientes atendidos em Unidade de Pronto Atendimento
DOI:
https://doi.org/10.11606/issn.1806-6976.smad.2025.225483Palavras-chave:
Enfermagem, Cuidados em saúde mental, Urgência e emergência psiquiátrica, Serviços de Saúde MentalResumo
Objetivo: descrever a percepção e a compreensão dos profissionais de enfermagem sobre os cuidados em urgência e emergência psiquiátrica; e conhecer o perfil dos pacientes atendidos em Unidade de Pronto Atendimento. Metodologia: pesquisa multimétodos, por complementaridade das abordagens qualitativa e quantitativa. Realizou-se busca de dados em prontuários de pacientes com diagnóstico de problemas de saúde mental e entrevistas com 16 profissionais de enfermagem. Dados quantitativos foram analisados por frequência bruta e relativa; dados qualitativos por Análise Temática. Resultados: a maioria dos pacientes com problemas de saúde mental foram homens entre 25-29 anos (25,6%) e mulheres entre 14-19 anos (25%), sem estratificação de risco (59,2%; 54,2%), permaneceram na unidade entre 1h-5h59m (43,3%; 37,5%) com necessidade de atendimento continuado. Os motivos para buscar atendimento foram crise depressiva e ansiedade entre mulheres; abuso de substâncias e agitação psicomotora entre homens. Emergiram três categorias temáticas: Reconhecendo a urgência e emergência psiquiátrica; (Des)cuidado ao paciente com transtorno psiquiátrico em serviços de emergência; (Des)continuidade da atenção ao indivíduo com transtorno psiquiátrico. Conclusão: os profissionais de enfermagem compreendem conceitos de urgência e emergência psiquiátrica, porém, sentem-se inseguros e requerem estrutura adequada para o atendimento. Articulação com a rede psicossocial poderia garantir cuidados mais eficazes a esta população.
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Referências
Carrijo MVN, Silva LS, Nascimento VF, Rocha EM, Basso TQS, Volpato RJ, et al. Profile of psychiatric emergency care in an urgent and emergency health service. Enferm Bras. 2022;21(4):413-29. https://doi.org/10.33233/eb.v21i4.5049
Homercher BM, Volmer A. Interlocution between reception and psychic crisis: perception of an Emergency Care Unit workers. Physis. 2021;31(3):1-22. https://doi.org/10.1590/S0103-73312021310312
Rotoli A, Silva MRS, Santos AM, Oliveira AMN, Gomes GC. Mental health in primary care: challenges for the resoluteness of actions. Esc Anna Nery. 2019;23(2):e20180303. https://doi.org/10.1590/2177-9465-EAN-2018-0303
Ribeiro, ABA, Reis, RP. Nursing care in psychiatric assistance. Rev Saude Desenvolv [Internet]. 2020 [cited 2024 May 22];14(17):18-29. Available from: https://revistasuninter.com/revistasaude/index.php/saudeDesenvolvimento/article/view/918
Zetterberg J, Visti E, Holmberg M, Andersson H, Aléx J. Nurses’ experiences of encountering patients with mental illness in prehospital emergency care – a qualitative interview study. BMC Nurs. 2022;21:89. https://doi.org/10.1186/s12912-022-00868-4
Seens H, Modarresi S, Fraser J, MacDermid JC, Walton DM, Grewal R. The role of sex and gender in the changing levels of anxiety and depression during the Covid-19 pandemic: a cross-sectional study. Womens Health (Lond). 2021;17:17455065211062964. https://doi.org/10.1177/17455065211062964
Jaeger VS, Camatta MW, Calixto AM. Interpersonal relationships between health professionals and psychoactive substance users: an integrative review. SMAD, Rev Eletrônica Saúde Mental Álcool Drog. 2024;20:e-212178. https://doi.org/10.11606/issn.1806-6976.smad.2024.212178
Sampaio ML, Bispo JP Junior. Network of Psychosocial Care: evaluation of the structure and process of mental healthcare linkage. Cad Saude Publica. 2021;37(3):e00042620. https://doi.org/10.1590/0102-311X00042620
Sabeh ACB, Cecilio HPM, Campos CJG, Reis HFT, Wisocki AD, Santos EM. Social representations of nurses of the Emergency Care Unit towards people with mental disorder. Rev Esc Enferm USP. 2023;57:e20220298. https://doi.org/10.1590/1980-220X-REEUSP-2022-0298pt
Lima LB, Mendes DCO, Silva GCL, Scorsolini-Comin F, Vedana KGG, Silva RA et al. Psychiatric urgencies and emergencies: perceptions of the nursing teamin an Emergency Care Unit. Observatorio Economía Latinoam. 2023;21(7):6674-96. https://doi.org/10.55905/oelv21n7-046
Brewer J, Hunter A. Foundations of multimethod research: synthesizing styles. 2. ed. Thousand Oaks, CA: Sage; 2006. 206 p.
Hong QN, Pluye P, Fàbregues S, Bartlett G, Boardman F, Cargo M, et al. Mixed methods appraisal tool (MMAT), version 2018. User guide [Internet]. Montreal: McGill University; 2018 [cited 2024 May 22]. Available from: http://mixedmethodsappraisaltoolpublic.pbworks.com/w/file/fetch/127916259/MMAT__criteria-manual_2018-08-01_ENG.pdf
Brasil. Ministério da Saúde. Portaria nº 10 de 3 de janeiro de 2017. Redefine as diretrizes de modelo assistencial e financiamento de UPA 24h de Pronto Atendimento como Componente da Rede de Atenção às Urgências, no âmbito do Sistema Único de Saúde. Diário Oficial da União [Internet]. 2017 Jan 04 [cited 2024 May 22];Seção 1:34-7. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2017/prt0010_03_01_2017.html
Saunders MNK, Lewis P, Thornhill A. Research Methods for Business Students. 8. ed. Vancouver Island, CA: Pearson Education; 2019. 833 p.
Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 14. ed. São Paulo: Hucitec-Abrasco; 2014. 416 p.
World Health Organization. World mental health report: transforming mental health for all [Internet]. Geneva: WHO; 2022 [cited 2024 May 22]. Available from: https://www.who.int/publications/i/item/9789240049338
Rocha DM, Oliveira AC, Reis RK, Santos AMR, Andrade EMLR, Nogueira LT. Suicidal behavior during the COVID-19 pandemic: clinical aspects and associated factors. Acta Paul Enferm. 2022;35:eAPE02717. https://doi.org/10.37689/acta-ape/2022AO02717
World Health Organization. Mental health of adolescents [Internet]. Geneva: WHO; 2021 [cited 2024 Mar 05]. Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
Goulart SMS. Suffering and pandemic: an existential-phenomenological reflection on ways of life and “psychic” suffering in the Covid-19 pandemic. Aoristo [Internet]. 2022 [cited 2024 Mar 20];5(2):126-39. Available from: https://e-revista.unioeste.br/index.php/aoristo/article/view/29828
Moura BR, Matsukura TS. Attention to the crisis of children and adolescents: care strategies of Psychosocial Care Centers for Children and Adolescents from the perspective of managers and family members. Physis. 2022;32(1):e320113. https://doi.org/10.1590/S0103-73312022320113
World Health Organization. Coronavirus disease 2019 (COVID-19): situation report – 78 [Internet]. Geneva: WHO; 2020 [cited 2024 Mar 5]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200407-sitrep-78-covid-19.pdf
Ministério da Saúde (BR). Plano de contingência nacional para infecção humana pelo novo Coronavírus COVID-19. Centro de operações de emergências em saúde pública (COE COVID-19) [Internet]. 3. ed. Brasília: MS; 2021 [cited 2024 Mar 15]. Available from: https://www.gov.br/saude/pt-br/assuntos/covid-19/publicacoes-tecnicas/guias-e-planos/livreto-plano-de-contingencia-espin-coe-26-novembro-2020
Centers for Disease Control and Prevention - COVID-19 Response Team. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) - United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):343-6. https://doi.org/10.15585/mmwr.mm6912e2
Faro A, Bahiano MA, Nakano TC, Reis C, Silva BFP, Vitti LS. COVID-19 and mental health: the emergence of care. Estud Psicol (Campinas). 2020;37:e200074. https://doi.org/10.1590/1982-0275202037e200074
Carvalho CN, Fortes S, Castro APB, Escalante JC, Rocha TAH. The covid-19 pandemic and hospital morbidity due to mental and behavioral disorders in Brazil: an interrupted time series analysis, from January 2008 to July 2021. Epidemiol Serv Saude. 2023;32(1):e2022547. https://doi.org/10.1590/S2237-96222023000100016
Nunes SAN, Silva MC, Silva LC, Fernandes MG. Effects of the pandemic on anxiety, controlling for the effects of age, gender and physical exercise. Plural Saude Ment. 2024;12(2):124-38. https://doi.org/10.55388/psicofae.v12n2.445
Musse FCC, Castro LS, Mestre TF, Pelloso SM, Poyares D, Musse JLL, et al. Mental violence: anxiety and depression during COVID-19 pandemic in Brazil. Saude Pesq. 2022;15(1):e9684. https://doi.org/10.17765/2176-9206.2022v15n1.e9684
Goularte JF, Serafim SD, Colombo R, Hogg B, Caldieraro MA, Rosa AR. COVID-19 and mental health in Brazil: psychiatric symptoms in the general population. J Psychiatr Res. 2021;132:32-7. https://doi.org/10.1016/j.jpsychires.2020.09.021
Braga RB, Pegoraro RF. Psychiatric Hospitalization: What do Families Think about It? Rev Psicol Saude. 2020;12(1):61-73. https://doi.org/10.20435/pssa.v12i1.820
Brito KMM, Santos JE, Lima JM Junior, Silva TN, Lino DCSF, Souza RC. Experiences in the substitutive network, meanings and therapeutic itineraries of women with a history of psychiatric hospitalization. SMAD, Rev Eletrônica Saúde Mental Álcool Drog. 2023;19:e196190. https://doi.org/10.11606/issn.1806-6976.smad.2023.196190
Dias MK, Ferigato SH, Fernandes ADSA. Attention to the Crisis in mental health: centralization and decentralization of practices. Cien Saude Colet. 2020;25(2):595-602. https://doi.org/10.1590/1413-81232020252.09182018
Refosco ALM, Buriol D, Machado KC, Ilha S, Zamberlan C, Cesar MP. Care for psychiatric patients in the emergency service: potentialities and fragilities of nursing. Rev Pesq Cuid Fundam Online. 2021;13:324-9. https://doi.org/10.9789/2175-5361.rpcfo.v13.8599
Lopes PF, Toledo VP. Nurses' feelings when accommodating an agitated and aggressive psychiatric patient. J Nurs UFPE Online. 2020;14:e244485. https://doi.org/10.5205/1981-8963.2020.244485
Baldaçara L, Diaz AP, Leite V, Pereira LA, Santos RM, Gomes VP Júnior, et al. Brazilian guidelines for the management of psychomotor agitation. Part 2. Non-pharmacological approach. Braz J Psychiatry. 2019;41(2):153-67. https://doi.org/10.1590/1516-4446-2018-0177
Daggenvoorde TH, van Klaren JM, Gijsman HJ, Vermeulen H, Goossens PJJ. Experiences of Dutch ambulance nurses in emergency care for patients with acute manic and/or psychotic symptoms: a qualitative study. Perspect Psychiatr Care. 2021;57(3):1305-12. https://doi.org/10.1111/ppc.12691
Ministério da Saúde (BR), Secretaria de Atenção à Saúde, Departamento de Atenção Especializada e Temática. Centros de Atenção Psicossocial e Unidades de Acolhimento como lugares da atenção psicossocial nos territórios: orientações para elaboração de projetos de construção, reforma e ampliação de CAPS e de UA [Internet]. Brasília: MS; 2015 [cited 2024 Mar 28]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/centros_atencao_psicossocial_unidades_acolhimento.pdf
Ramos TSS, Ramalho MA, Souza TS, Medeiros CM, Sthal HC, Leite GR. Percepção de profissionais do atendimento pré-hospitalar na assistência à urgência e emergência (crise) em psiquiatria. Res Soc Dev. 2021;10(11):e275101119423. https://doi.org/10.33448/rsd-v10i11.19423
Andersson H, Carlsson J, Karlsson L, Holmberg M. Competency requirements for the assessment of patients with mental illness in somatic emergency care: a modified Delphi study from the nurse’s perspective. Nord J Nurs Res. 2020;40(3):162-70. https://doi.org/10.1177/2057158520946212
Schick B, Mayer B, Jäger M, Jungwirth B, Barth E, Eble M, et al. Emergency medical care of patients with psychiatric disorders – challenges and opportunities: Results of a multicenter survey. BMC Emerg Med. 2022;22(1):173. https://doi.org/10.1186/s12873-022-00722-5
Ngune I, Hasking P, McGough S, Wynaden D, Janerka C, Rees C. Perceptions of knowledge, attitude and skills about non-suicidal self-injury: a survey of emergency and mental health nurses. Int J Ment Health Nurs. 2021;30(3):635-42. https://doi.org/10.1111/inm.12825
Veloso ES, Pereira LS, Silva MV, Lage RDF, Silva RMCA, Silva MVG, et al. Violencesuffered by nursing professionals in the emergency service. Res Soc Dev. 2022;11(10):e239111032426. https://doi.org/10.33448/rsd-v11i10.32426
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