Saúde Mental na Atenção Básica: agregando aromaterapia e terapia floral à relação terapêutica
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Data
2019-02-26
Autores
Domingos, Thiago da Silva
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Universidade Estadual Paulista (Unesp)
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Introdução: O cuidado em saúde mental na Atenção Básica representa um desafio para o sistema de saúde em suas dimensões políticas, organizacionais e técnico-assistenciais. A transposição do modelo biomédico e da fragmentação do cuidado são condições fundamentais para reverter a lógica de atenção à saúde e compor novos arranjos de cuidado. Essa pesquisa procurou agregar dois recursos terapêuticos, Aromaterapia e Terapia Floral, ao Relacionamento Terapêutico para pluralizar o cuidado aos usuários em sofrimento psíquico no contexto da Estratégia Saúde da Família. Objetivos: Compreender a dinâmica do cuidado formal e informal oferecido aos usuários em uso crônico de psicofármacos no contexto do processo de trabalho da Estratégia Saúde da Família e proporcionar o cuidado em saúde mental por meio da oferta de Aromaterapia e Terapia Floral associadas ao Relacionamento Terapêutico para usuários em uso crônico de psicofármacos. Método: Pesquisa qualitativa realizada em uma Unidade de Saúde da Família de uma município do interior do estado de São Paulo. Ocorreu em duas etapas inter-relacionadas, iniciando pelo referencial microssociológico que incorporou na coleta de dados a observação participante, o diário de campo, as conversas ocasionais, a entrevista etnográfica e a análise documental; foram participantes os trabalhadores de saúde da referida unidade. Na segunda etapa, guiada pelo referencial da pesquisa clínico-qualitativa, participaram usuários da unidade de saúde que faziam uso crônico de psicofármacos devido ao sofrimento psíquico, e consistiu da oferta de Terapia Floral (Rescue Remedy) e Aromaterapia (Lavandula angustifolia e Pelargonium graveolens), ambas associadas ao Relacionamento Terapêutico, desenvolvida por oito semanas. Os dados qualitativos foram tratados segundo a Análise de Conteúdo. Resultados: A fase exploratória desvelou o modelo biomédico operando sobre o processo de trabalho da Unidade Saúde da Família em suas dimensões organizativa e assistencial. Na primeira, a burocratização, a fragmentação, o cuidado individual indiferenciado e centralizado em ações programáticas foram elementos-chave que interferiram no acesso aos serviços que, por sua vez, subordinou-se a um complexo sistema de regulação. As repercussões assistenciais foram observadas na restrição do cardápio de ofertas, guiado pela clínica biomédica, medicalização e medicamentalização, características atribuídas ao cuidado para o usuário em sofrimento psíquico. Nesse contexto, Aromaterapia e Terapia Floral, associadas ao Relacionamento Terapêutico, foram ofertadas e possibilitaram um processo ampliado de autopercepção e autoconhecimento, favorecendo o reconhecimento da consciência corporal e dos padrões emocionais sobre as relações interpessoais dos participantes. Os benefícios comuns às duas modalidades foram resgatar a importância da relação interpessoal para o autodesenvolvimento, acessar um espaço de escuta e reduzir ou interromper o uso de psicofármacos. Considerações Finais: No processo de trabalho da saúde família há um predomínio do modelo biomédico repercutindo sobre as dimensões organizativas e assistenciais. Sob esse modelo, o cuidado em saúde mental para o usuário em sofrimento psíquico é influenciado de modo substancial pela medicalização e prescrição de psicofármacos. As terapia com aromas e florais oferecidas na relação interpessoal constituíram-se em recursos terapêuticos que contribuíram para a efetivação do cuidado em saúde mental baseado na autonomia, corresponsabilidade e vínculo.
Introduction: The care in mental health in Primary Health care represents a challenge to the health system in its political, organizational and technical-supportive dimensions. The transposition of both the biomedical model and the care fragmentation is a fundamental condition to reverse the actual approach of health attention and set new arrangements for the service. This research aimed to aggregate two therapeutic resources, Aromatherapy and Bach Flowers remedies, to the Therapeutic Relationship in order to amplify the care offered to the users under psychological distress in the context of the Family Health Strategy. Objective: To understand the dynamics of formal and informal care provided to the users under chronic use of psychotropic drugs in the context of the working process of the Family Health Strategy and provide mental health care through Aromatherapy and Bach Flowers associated with the Therapeutic Relationship to users under chronic use of psychotropic drugs. Method: Qualitative Research carried out in a Family Health Unit in the countryside of São Paulo State. It was performed in two interrelated phases, beginning with the microsociological model which incorporated the participative observation, the health diary, the occasional talks, the ethnographic interview and the documental analysis in its data collecting; the health care workers of the referred unit took part in this phase. In the second moment, guided by the clinical qualitative research model, the patients of this unit who made chronic use of psychotropic drugs due to their psychological distress participated, and it consisted in the offering of Bach Flowers Therapy (Rescue Remedy) and Aromatherapy (Lavandula angustifolia and Pelargonium graveolens), both associated with the Therapeutic Relationship, developed during eight weeks. The qualitative data were treated under the Content Analysis. Results: The exploratory phase unveiled the biomedical model operating the working process of the Family Health Unit and its organization and assistance dimensions. In the first phase, the bureaucratization, the fragmentation, the non differential individual attention, also centered in programmatic actions were key elements interfering in the access to the service which, therefore, was subordinated to a complex system of regulations. The assistance repercussions were observed in the restriction of the offering possibilities, guided by the biomedical practice, medicalization, characteristics of the attention granted to the patient under psychological distress. In this context, Aromatherapy and Bach Flowers Therapy, associated with the Therapeutic Relationship were offered and made it possible an expanded process of self-perception and self-knowledge, favoring the acknowledgment of their body awareness and the emotional standards under the interpersonal relationships of the participants. The benefits which were common to both modalities were the rescue of the importance of interpersonal relationship for self-development, the access to a space for listening as well as the decrease or interruption of psychotropic drugs use. Final considerations: In the working process of Family Health there is a predominance of the biomedical model affecting the operational and assistance dimensions. Under this model, the mental health care offered to the user under psychological distress is substantially influenced by the medicalization and prescription of psychotropic drugs. The therapy with aromas and flowers offered in the interpersonal relationship constituted therapeutic resources which contributed to an effective care in mental health based on the autonomy, co-responsibility and attachment.
Introduction: The care in mental health in Primary Health care represents a challenge to the health system in its political, organizational and technical-supportive dimensions. The transposition of both the biomedical model and the care fragmentation is a fundamental condition to reverse the actual approach of health attention and set new arrangements for the service. This research aimed to aggregate two therapeutic resources, Aromatherapy and Bach Flowers remedies, to the Therapeutic Relationship in order to amplify the care offered to the users under psychological distress in the context of the Family Health Strategy. Objective: To understand the dynamics of formal and informal care provided to the users under chronic use of psychotropic drugs in the context of the working process of the Family Health Strategy and provide mental health care through Aromatherapy and Bach Flowers associated with the Therapeutic Relationship to users under chronic use of psychotropic drugs. Method: Qualitative Research carried out in a Family Health Unit in the countryside of São Paulo State. It was performed in two interrelated phases, beginning with the microsociological model which incorporated the participative observation, the health diary, the occasional talks, the ethnographic interview and the documental analysis in its data collecting; the health care workers of the referred unit took part in this phase. In the second moment, guided by the clinical qualitative research model, the patients of this unit who made chronic use of psychotropic drugs due to their psychological distress participated, and it consisted in the offering of Bach Flowers Therapy (Rescue Remedy) and Aromatherapy (Lavandula angustifolia and Pelargonium graveolens), both associated with the Therapeutic Relationship, developed during eight weeks. The qualitative data were treated under the Content Analysis. Results: The exploratory phase unveiled the biomedical model operating the working process of the Family Health Unit and its organization and assistance dimensions. In the first phase, the bureaucratization, the fragmentation, the non differential individual attention, also centered in programmatic actions were key elements interfering in the access to the service which, therefore, was subordinated to a complex system of regulations. The assistance repercussions were observed in the restriction of the offering possibilities, guided by the biomedical practice, medicalization, characteristics of the attention granted to the patient under psychological distress. In this context, Aromatherapy and Bach Flowers Therapy, associated with the Therapeutic Relationship were offered and made it possible an expanded process of self-perception and self-knowledge, favoring the acknowledgment of their body awareness and the emotional standards under the interpersonal relationships of the participants. The benefits which were common to both modalities were the rescue of the importance of interpersonal relationship for self-development, the access to a space for listening as well as the decrease or interruption of psychotropic drugs use. Final considerations: In the working process of Family Health there is a predominance of the biomedical model affecting the operational and assistance dimensions. Under this model, the mental health care offered to the user under psychological distress is substantially influenced by the medicalization and prescription of psychotropic drugs. The therapy with aromas and flowers offered in the interpersonal relationship constituted therapeutic resources which contributed to an effective care in mental health based on the autonomy, co-responsibility and attachment.
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Palavras-chave
Aromaterapia, Enfermagem, Saúde mental, Atenção básica, Práticas integrativas e complementares, Relações interpessoais, Terapia floral, Mental health, Primary health care, Complementary therapies, Interpersonal relations, Aromatherapy, Bach flowers therapy, Nursing