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Master's Dissertation
DOI
10.11606/D.22.2004.tde-08092004-165526
Document
Author
Full name
Ana Maria Sertori Durão
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2004
Supervisor
Committee
Souza, Maria Conceicao Bernardo de Mello e (President)
Carswell, Wendy Ann
Pela, Nilza Teresa Rotter
Title in Portuguese
"Grupo de acompanhamento de pacientes e familiares de portadores de esquizofrenia medicados com clozapina: o impacto sobre o cotidiano de suas vidas"
Keywords in Portuguese
clozapina
esquizofrenia
família
grupo
Abstract in Portuguese
Trata-se de uma pesquisa de avaliação, de natureza qualitativa,do tipo descritivo exploratório. Que teve como proposta descrever o cotidiano do portador de esquizofrenia em três momentos: antes do uso da clozapina; após o uso da clozapina; após o uso da mesma e o acompanhamento em grupo. A população foi constituída por todos os portadores de esquizofrenia que participaram do grupo de medicações atípicas (GRUMA) em uso de clozapina e um familiar que os acompanhavam com maior freqüência ao grupo. Para coleta dos dados foram realizadas entrevistas semi-estruturadas, com pacientes e familiares, guiadas por roteiros pré-elaborados. As mesmas foram gravadas e, posteriormente, transcritas na íntegra pelo próprio pesquisador.Foi utilizada a análise qualitativa a qual embasou-se nos passos propostos por Minayo (1996). Obteve-se como resultados que antes do uso da clozapina e acompanhamento em grupo, a imprevisibilidade de comportamento e a demonstração de agressividade eram constantes no cotidiano dos pacientes e seus familiares, gerando grande sofrimento psíquico para ambos, além do desconhecimento sobre a doença. A manifestação dos sintomas constituía causa de isolamento social, perdas de relações com as pessoas mais próximas, prejudicando de maneira significativa às atividades de trabalho, estudo e de convívio social. Após o uso da clozapina, antes de realizarem acompanhamento em grupo, os pacientes apresentaram expressiva melhora dos sintomas positivos da doença, principalmente no que se refere à agressividade. Entretanto, verificamos que as dificuldades nos relacionamentos, no trabalho, no estudo, nas atividades de convívio social e em outras atividades do cotidiano dos pacientes permaneceram. Foi possível verificar que após o uso da clozapina e acompanhamento em grupo houve melhora do relacionamento, antes difícil, diminuição da ansiedade e da agressividade, aumento da a auto-estima, da tolerância e força de vontade bem como fortalecimento dos vínculos familiares. O grupo em questão possibilitou que pacientes e familiares fossem orientados a reconhecer os sintomas da doença e os sinais prévios de efeitos colaterais concernentes ao tratamento. Evidencia-se, também, a importância do acolhimento, da amizade e do conforto encontrado no grupo, além do clima de solidariedade e segurança. Constatou-se, assim, que apesar das adversidades de um sistema de saúde ainda incipiente, profissionais parecem ainda investir nas possibilidades de encontro, buscando meios para a criação de novas realidades no cotidiano pacientes e seus familiares.
Title in English
FOLLOW UP GROUP OF PATIENTS AND RELATIVES OF SCHIZOPHRENIA SUFFERERS MEDICATED WITH CLOZAPINE: the impact on their daily lives.
Keywords in English
clozapine
family
group
schizophrenia
Abstract in English
This descriptive, exploratory, assessment study of a qualitative nature has as it’s aim, to describe the daily life of the schizophrenic sufferer in three moments: before the use of clozapine; after clozapine use and after clozapine use and group follow-up. The population was made up of all the schizophrenia sufferers using clozapine and the most frequently accompanying relative that participated in the atypical medication group (GRUMA).Data was collected through tape recorded, semi structured interviews with patients and relatives using a previously prepared guideline. Afterwards the recorded interview was hand written by the researcher and a qualitative analysis based on the steps proposed by Minayo (1996) was carried out. The results obtained, showed that before the use of clozapine and group followup, unpredictable behaviour and overt aggressiveness were constant in the daily lives of the patients and their families, causing, in both, great psychological suffering as well as lack of know ledge about the disease. The manifestation of symptoms constituted cause for isolation, loss of relationships with close people affecting in a significant manner work, study and social living. After the use of clozapine, before beginning the folowup group, the patients presented expressive improvement of the positive and negative symptoms of the disease, principally in as far as agressiveness was concerned. However, it was found that the difficulties continued in relationships at work, in study pursuits, in social living activities as well as in the patient’s other daily talks. It was possible to verify that after the use of clozapine with the support of the followup group, there was an improvement in relationships that were difficult before, reduction of anxiety and agressiveness, thus increasing self respect, tolerance, willpower, as well as, the strenghthening of family ties. The group in question allowed the patients and relatives to be guided to recognize the symptoms of the disease and the previous signs of the collateral effects of the treatment. The importance of acceptance, of friendship and the comfort encountered in the group was also verified, as well as solidarity and security. It was also ascertained that inspite of the adversities of the still incipient health system, professionals still seem to invest in the possibilities of finding, looking for and of creating new realities in the daily lives of patients and their families.
 
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Publishing Date
2004-09-13
 
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