A educação sexual em centro de atenção psicossocial infanto juvenil: revisão de literatura e concepções de profissionais atuantes nesse serviço
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Data
2021-05-28
Autores
Bosco, Mirela
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A saúde e a sexualidade têm seus conceitos modificados ao longo do processo evolutivo da humanidade. Com os conhecimentos adquiridos é possível defini-los a partir de uma perspectiva mais ampla que contemple aspectos múltiplos e que proporcione intervenções a nível de prevenção, promoção e reabilitação. A Educação Sexual (ES), quando sistematizada e organizada, é um formato de ação que pode compor políticas públicas educacionais e de saúde a fim de proporcionar um experienciar da sexualidade mais saudável, coesa e integrativa. Na adolescência, a ES é de extrema importância devido aos riscos e às vulnerabilidades que os adolescentes vivenciam ao desejarem explorar as sexualidades e não terem meios informativos confiáveis para se espelharem e se embasarem. A sexualidade é inerente ao desenvolvimento humano e todos a experienciam – inclusive as subjetividades vistas socialmente como desviantes da norma, como é o caso das crianças e adolescentes com transtorno mental frequentadores do Centro de Atenção Psicossocial Infanto Juvenil (CAPSi). Dessa forma, esta pesquisa, dividida em estudo 1 e estudo 2, teve dois objetivos (a) realizar um estudo de revisão sistemática que identifique a sexualidade como fator integrativo do tratamento em pessoas com transtorno mental nas bases de dados com estudos brasileiros e (b) compreender as concepções de profissionais de saúde mental atuantes no CAPSi sobre a sexualidade e educação sexual nesse serviço. No estudo 1, as bases de dados consultadas foram LILACS, SCIELO E CAPES. Foram localizados 81 artigos, no entanto após a aplicação de critérios de inclusão e da leitura dos resumos, somente 6 foram incluídos. Os resultados mostram uma definição de sexualidade naturalizada, parte do ser humano, bem como, como manifestação do transtorno - hipersexualização dos usuários. Indicam que há maior quantidade de estudos publicados na área de enfermagem que revela a perspectiva biologista aderida e ensinada pela sociedade e pelos dispositivos repressivos existentes e por fim, propõem como resolutiva para a sexualidade da pessoa com transtorno mental tanto a intervenção com as oficinas em sexualidade, quanto às medidas de repressão e controle das manifestações sexuais. No estudo 2, foram sete participantes de nível superior em um CAPSi de uma cidade do interior de São Paulo que responderam a uma entrevista com perguntas abertas elaborada pela pesquisadora e pela orientadora, aplicada no próprio serviço em sessões individuais que duraram aproximadamente 20 minutos. Os dados foram transcritos e analisados com base na análise de conteúdo. Os resultados apontam para uma compreensão maior de sexualidade como uma vivência própria do ser humano e parte do desenvolvimento. A maioria dos participantes entendem a ES como um espaço organizado e sistematizado a fim de orientar sobre práticas saudáveis, como a prevenção de infecções sexualmente transmissíveis e gravidezes não-planejadas e transformações do corpo. Quanto à existência de ES sistematizada no serviço, os entrevistados apontaram para a presença de formas secundárias em orientações quando aparecem demandas dentro dos atendimentos, e se colocam à favor de implementarem um projeto por entenderem ser uma necessidade dos adolescentes que frequentam o serviço. A intervenção poderia ser feita por qualquer profissional atuante em ES desde que tivessem uma capacitação e deveria ser oferecida a depender da demanda dos usuários em formato de oficinas fechadas em consideração a faixa etária de cada usuário, embora os profissionais atentem para as dificuldades em conscientizar os jovens e os familiares sobre a importância da ES. Por fim, relacionam a prática sexual saudável com a saúde mental em pontuar que há sofrimentos originados pela violência sexual e pelo preconceito familiar e a dificuldade de autoaceitação. Conclui-se, assim, a necessidade de investimento de uma Educação Sexual estruturada e emancipatória que auxilie na experiência saudável da sexualidade dos jovens e capacite os profissionais e familiares para educar as crianças e adolescentes no cotidiano.
Health and sexuality have their concepts modified throughout the evolutionary process of humanity. With the knowledge acquired, it is possible to define them from a broader perspective that contemplates multiple aspects and that provides interventions in terms of prevention, promotion and rehabilitation. Sexual Education (ES), when systematized and organized, is an action format that can compose public educational and health policies in order to provide a healthier, more cohesive and integrative experience of sexuality. In adolescence, the ES is extremely important due to the risks and vulnerabilities that adolescents experience when they want to explore their sexualities and do not have reliable informational means to mirror and base themselves on. Sexuality is inherent to human development and everyone experiences it – including subjectivities seen socially as deviating from the norm, as is the case of children and adolescents with mental disorders who attend the “Centro de Atenção Psicossocial Infanto Juvenil” (CAPSi). Thus, this research, divided into study 1 and study 2, had two objectives (a) to carry out a systematic review study that identifies sexuality as an integrative factor in the treatment of people with mental disorders in databases with Brazilian studies and (b ) understand the conceptions of mental health professionals working at CAPSi about sexuality and sexual education in this service. In study 1, the databases consulted were LILACS, SCIELO and CAPES. 81 articles were found, however after applying the inclusion criteria and reading the abstracts, only 6 were included. The results show a definition of naturalized sexuality, part of the human being, as well as a manifestation of the disorder - hypersexualization of service users. They indicate that there is a greater number of studies published in the field of nursing that reveal the biologist perspective adhered to and taught by society and by the existing repressive devices and, finally, they propose intervention with workshops on sexuality as a solution for the sexuality of people with mental disorders as to measures of repression and control of sexual manifestations. In study 2, seven professionals in a CAPSi in a city in the interior of São Paulo responded to an interview with open questions prepared by the researcher and the advisor, applied in the service itself in individual sessions that lasted approximately 20 minutes. Data were transcribed and analyzed based on content analysis. The results point to a greater understanding of sexuality as a human experience and part of development. Most participants understand SE as an organized and systematized space in order to provide guidance on healthy practices, such as the prevention of sexually transmitted infections and unplanned pregnancies and body transformations. As for the existence of systematized sexual education in the service, the interviewees pointed to the presence of secondary forms of guidance when demands appear within the services, and are in favor of implementing a project because they understand it is a need for adolescents who attend the service. The intervention could be made by any professional working in SE as long as they had training and should be offered depending on the demand of users in the format of closed workshops taking into account the age of each user, although the professionals pay attention to the difficulties in raising awareness young people and their families about the importance of sexual education. Finally, they relate healthy sexual practice with mental health, pointing out that there is suffering caused by sexual violence and family prejudice and the difficulty of self-acceptance. Thus, it is concluded that there is a need to invest in a structured and emancipatory Sexual Education that helps in the healthy experience of young people's sexuality and empowers professionals and families to educate children and adolescents in their daily lives.
Health and sexuality have their concepts modified throughout the evolutionary process of humanity. With the knowledge acquired, it is possible to define them from a broader perspective that contemplates multiple aspects and that provides interventions in terms of prevention, promotion and rehabilitation. Sexual Education (ES), when systematized and organized, is an action format that can compose public educational and health policies in order to provide a healthier, more cohesive and integrative experience of sexuality. In adolescence, the ES is extremely important due to the risks and vulnerabilities that adolescents experience when they want to explore their sexualities and do not have reliable informational means to mirror and base themselves on. Sexuality is inherent to human development and everyone experiences it – including subjectivities seen socially as deviating from the norm, as is the case of children and adolescents with mental disorders who attend the “Centro de Atenção Psicossocial Infanto Juvenil” (CAPSi). Thus, this research, divided into study 1 and study 2, had two objectives (a) to carry out a systematic review study that identifies sexuality as an integrative factor in the treatment of people with mental disorders in databases with Brazilian studies and (b ) understand the conceptions of mental health professionals working at CAPSi about sexuality and sexual education in this service. In study 1, the databases consulted were LILACS, SCIELO and CAPES. 81 articles were found, however after applying the inclusion criteria and reading the abstracts, only 6 were included. The results show a definition of naturalized sexuality, part of the human being, as well as a manifestation of the disorder - hypersexualization of service users. They indicate that there is a greater number of studies published in the field of nursing that reveal the biologist perspective adhered to and taught by society and by the existing repressive devices and, finally, they propose intervention with workshops on sexuality as a solution for the sexuality of people with mental disorders as to measures of repression and control of sexual manifestations. In study 2, seven professionals in a CAPSi in a city in the interior of São Paulo responded to an interview with open questions prepared by the researcher and the advisor, applied in the service itself in individual sessions that lasted approximately 20 minutes. Data were transcribed and analyzed based on content analysis. The results point to a greater understanding of sexuality as a human experience and part of development. Most participants understand SE as an organized and systematized space in order to provide guidance on healthy practices, such as the prevention of sexually transmitted infections and unplanned pregnancies and body transformations. As for the existence of systematized sexual education in the service, the interviewees pointed to the presence of secondary forms of guidance when demands appear within the services, and are in favor of implementing a project because they understand it is a need for adolescents who attend the service. The intervention could be made by any professional working in SE as long as they had training and should be offered depending on the demand of users in the format of closed workshops taking into account the age of each user, although the professionals pay attention to the difficulties in raising awareness young people and their families about the importance of sexual education. Finally, they relate healthy sexual practice with mental health, pointing out that there is suffering caused by sexual violence and family prejudice and the difficulty of self-acceptance. Thus, it is concluded that there is a need to invest in a structured and emancipatory Sexual Education that helps in the healthy experience of young people's sexuality and empowers professionals and families to educate children and adolescents in their daily lives.
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Palavras-chave
Sexualidade, Educação sexual, Adolescentes, CAPSi, Sexuality, Sexual Education, Adolescents