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Master's Dissertation
DOI
10.11606/D.47.2008.tde-12022009-121121
Document
Author
Full name
Luciane de Rossi
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2008
Supervisor
Committee
Campos, Elisa Maria Parahyba (President)
Lúcia, Mara Cristina Souza de
Rodrigues, Avelino Luiz
Title in Portuguese
Gritos e sussurros: a interconsulta psicológica nas unidades de emergências médicas do Instituto Central do Hospital das Clínicas - FMUSP
Keywords in Portuguese
Hospitais de Emergência
Psicanálise
Psicologia hospitalar
Abstract in Portuguese
Situações críticas e emergenciais permeiam todos os setores do hospital, mas ocorrem prioritariamente no Pronto-Socorro e nas Unidades de Terapia Intensiva. Estes cenários são marcados por sofrimento físico e emocional intensos; limites de diversas ordens; imprevisibilidade; vivências de perdas e morte. Vivências que geram uma angústia que pode ultrapassa o limiar de contenção dos atores nesse cenário pacientes, familiares e equipe de saúde e implicam a necessidade de intervenção psicológica. A interconsulta psicológica é uma modalidade de intervenção que permite considerar a demanda institucional, que inclui a subjetividade nas relações da equipe, e a assistência psicológica aos pacientes e a seus familiares. O presente trabalho utilizou o método da pesquisa clínico-qualitativa para descrever o serviço de interconsulta psicológica nas unidades de emergências médicas do Instituto Central do Hospital das Clínicas FMUSP. São apresentados cinco relatos de interconsulta, a partir das intervenções junto aos pacientes e junto aos profissionais envolvidos no caso (médicos, auxiliares de enfermagem, enfermeiros e assistentes sociais). Os casos foram analisados por meio do referencial psicanalítico freudiano e evidenciaram que nas unidades de emergência existem urgências físicas e subjetivas, cujo impacto atinge o paciente, seus familiares e os profissionais que se relacionam com ele. A relação pacienteprofissional de saúde aparece repleta de conteúdos inconscientes e transferenciais A equipe vivencia sofrimentos psíquicos relacionados a identificações com o paciente e principalmente ao sentimento de impotência. Observa-se que esse sofrimento interfere na conduta do profissional e, conseqüentemente, na assistência que ele oferece. A intervenção da psicóloga interconsultora permitiu a explicitação de conflitos inconscientes e a intermediação das relações entre pacientes e equipe de saúde.
Title in English
Shouts and whispers: interconsultation psychological in the units of medical emergencies of the Central Institute of the Hospital of Clinics - FMUSP
Keywords in English
Hospitals psychological aspects
Hospitals-Packaged
Psychoanalysis
Abstract in English
Critical situations and emergencies are present in all the areas of the hospital, however, they do occur at the emergency rooms and Intensive Care Units. The core traits of these pictures are physical and mental suffering, several ways of limitations, unpredictability as well as loss and death experiences. Such exposures engender anguish which can get out of control of the people involved in the situations patients, their families, hospital staff therefore psychological intervention is necessary. Psychological consultation-liaison is a way of intervention which takes into account the institutional demand, the subjectivity among the team relationships and the psychological assistance to the patients and their families. The present work makes use of a clinic-qualitative study describing the consultation-liaison psychology service in emergency medical units of the Central Institute of Hospital das Clínicas FMUSP. There are five reports described resulting from the intervention in patient and other staff members involved in the case (doctors, nurses, nurse assistants and social workers).The cases were analyzed through the Freudian frames of reference and showed that there are subjective and physical urgencies which impacts the patients, theirs families and the staff in contact with them. The relationship hospital staff-patient presents itself to be full of unconscious and transferential contents. The team experiences mental suffering which is related to their identification with the patient and, mainly, to their feeling of impotence. It was noticed that this suffering influences the professional behavior and consequently the assistance he will offer. The intervention made by the interconsulting psychologist enabled the disclosure of unconscious conflicts and the intermediation of the relationship between the hospital staff and the patients.
 
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rossi_me.pdf (340.30 Kbytes)
Publishing Date
2009-04-06
 
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