Salud Colectiva最新文献

Medication errors represent one of the main causes of incidents and adverse events during the perioperative period. Therefore, this study analyzes errors before, during, and after the administration of general anesthesia for abdominal surgery at a high-complexity hospital in Bogota, Colombia. A descriptive cross-sectional study was conducted with 390 patients between January and September 2019. Of the 3,677 medication administrations, some type of error was made in 60% of cases, mostly in emergency surgeries. The pharmacological group with the most errors was general anesthetics, with 32%. All identified errors constituted situations with harm potential, indicating the need to promote the standardization of activities involving the use of medications and a culture of healthcare safety in order to avoid adverse events.

The care of people with mental health problems requires health system and service reforms to build up proper mental health care. The challenges of the present moment continue to be immense. The viral pandemic that we are experiencing has exposed the fragility of our health and social services and certified the inequality and precariousness of the living conditions of many people. The collection of articles published in the journal Salud Colectiva as part of the open call for papers "Mental health and human rights: challenges for health services and communities," includes articles from Spain, Brazil, Mexico, and Chile. These papers present conceptual experiences and reflections on community action plans and programs, contributing toward better knowledge and development of mental health in the region.

This study aims to analyze end-of-life care practices carried out at a hospice institution located in the province of Buenos Aires, Argentina. Based on a qualitative research methodology, ethnographic fieldwork was carried out between 2016 and 2020. Fieldwork included participant observation of the day-to-day work of diverse volunteer teams and nursing professionals, which was complemented with informal conversations and two surveys. Additionally, semi-structured interviews with key actors were conducted. The data collected reflect some of the values of hospice care that directly challenge the biomedical model, such as integrality, holism, and respect for the autonomy of the sick person. This article puts forth the hypothesis that care - as a constitutive practice of human interaction - produces and reproduces values that make up the structures of social life. Therefore, analyzing care practices in non-clinical contexts, based on proposals that seek to humanize the context of health care, provides tools to think critically about the values that structure our health system.

As the COVID-19 pandemic has made visible, childhood is the virus's proverbial south: a world where care is not a value chosen from a place of desire, and where children's voices are silenced at the hands of an ancestral epistemic injustice. Thus, the transformation that human societies are undergoing due to COVID-19 has significantly impacted the rights of children, both at the micro and the macro levels. In Spain - a country that has been particularly hard-hit by the pandemic - we find that both infancy (especially through obstetric violence) and childhood at all its stages fall victim to an adultcentric paradigm based on control and epistemic injustice. This essay analyzes and discusses some of the negative consequences observed in this country related to the care for and the confinement of minors and their families - which has occurred as a result of the pandemic - and considers that the crisis triggered by COVID-19 may be an opportunity to shed light on situations of ancestral injustice towards children.

The National Policy on Mental Health for Children and Adolescents is still poorly structured in Brazil. In general, it replicates the policy aimed at adults, which creates problems for its articulation with networks. The objective of this study was to analyze and describe the actions carried out at a 24-hour Child and Adolescent Psychosocial Care Center (CAPSi) with beds in the city of Curitiba, Brazil. This is a descriptive study based on the analysis of medical record data and productivity data between 2016-2017, provided by the Department of Informatics at the Unified Health System (DATASUS). Results show that the center performed 29,449 procedures and attended to 112 children and adolescents through its 24-hour service. Medical records indicate extensive use of the service by the network. Primary care accounted for 52% of demand, while the other half could be attributed to a wide range of services. The variety of actions carried out suggests a high degree of flexibility at the clinic, replacing the classic model of the psychiatric hospital with the principles of the expanded clinic. Furthermore, the existence of beds made it easier to manage crises in a manner more closely linked to the community.

This article analyzes the repercussions of the Return Home Program - a Brazilian cash transfer program - on the lives of people discharged from psychiatric hospitals. Our aim was to ascertain the program's repercussions on the lives of its beneficiaries, particularly with respect to the implications of accessing an income for their everyday life, in addition to highlighting some of the intersections between their life contexts and existential territories: sexuality, gender, aging, and forms of urban violence. An evaluative study was carried out between 2017 and 2018 that focused on the life itineraries of 20 people. Consequently, we were able to observe that access to income was a fundamental aspect of the experience of living outside the hospital, with regards to the exercise of material exchanges and forays into the community. We discuss the challenges of guaranteeing assisted support to beneficiaries on a contractual basis and the evaluation of psychosocial rehabilitation processes, linked to the intersections that mark ways of living.

Mechanical restraint is a coercive procedure in psychiatry, which despite being permitted in Spain, raises significant ethical conflicts. Several studies argue that non-clinical factors - such as professionals' experiences and contextual influences - may play a more important role than clinical factors (diagnosis or symptoms) in determining how these measures are employed. The aim of this study is to understand how the experiences of mental health professionals in training relate to the use of mechanical restraints in Madrid's mental health network. Qualitative phenomenological research was conducted through focus groups in 2017. Interviews were transcribed for discussion and thematic analysis with Atlas.ti. Descriptive results suggest that these measures generate emotional distress and conflict with their role as caregivers. Our findings shed light on different factors related to their experiences and contexts that are important in understanding the use of mechanical restraint, as well as the contradictions of care in clinical practice.

This article aims to analyze public mental health services in the city of Barcelona from a gender-based perspective. We do so through a case study of mental health services for adults in the context of recent community-oriented and transdisciplinary mental health care reforms. Employing a qualitative methodology, we look at the discourses of mental health professionals regarding the ways in which they approach the therapeutic relationship between professional and user, specifically with reference to vulnerability and proposals for addressing it. Between November 2018 and April 2019 we conducted three discussion groups with professionals and another with a group of female users. Data analysis was guided by a categorical content analysis model. The results show a tendency to understand and address vulnerability from an ethics of care based on a community care model, with differences in the discourses of men and women who participated in the research. We conclude that the community-based model promotes the recovery of users' citizenship, as it is based on a notion of interdependence, in contrast to the hospital-based mental health model.

Care for people diagnosed with schizophrenia and delusional disorders involves many challenges, especially in territorial contexts of pronounced social vulnerability. In Rio de Janeiro, the two decades after the passing of Federal Law 10,216 on Psychiatric Reform in 2001 have been characterized by the transition from a hospital-centered model to one based on community services. Taking the case of a community in Rio de Janeiro, data was extracted from the medical records of 94 patients diagnosed with schizophrenia, schizotypal disorders, and delusional disorders (ICD-10 codes F20 to F29) in five public health services. Covering the period from 2003 to 2016, indicators of the quality of treatment provided were analyzed. As a result of this transition, psychiatric hospitals have all but emptied and a low number of currently untreated patients can be observed. In addition, crisis care and long-term hospitalizations have been replaced by territorial care, and clinical comorbidities are monitored and treated at Family Health Units.

Acknowledging dissident bodies of persons with disabilities is an act of continuous resistance, and as such our objective in this article is to analyze the vulnerability and bodily violation of disability activists in Chile. In order to do so, between September 2018 and February 2019 we conducted 11 in-depth interviews using the technique of bodily itineraries, as well as 6 discussion groups. Through qualitative thematic analysis, several categories emerged: the central category of "Bodily change or difference: experiences of medicalized fragility;" and three subcategories, "Bodily diagnosis: the institutional management of differences;" "Medical treatment: correcting bodily and social abnormality;" and "Rehabilitation: to function once again as a normative body." Activists' itineraries reveal the coaptation and bodily violation that they are subjected to by the biomedical apparatus, where they are systematically denied their human rights; however, despite attempts to discipline and control them, they create subversive strategies to validate their corporealities.