Loading...
Publication
Contributos do modelo "Empowerment - Comunidade" para a mudança transformativa na saúde mental comunitária : Análise comparativa
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 6.11 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
A presente Tese designada Contributos do Modelo “Empowerment-Comunidade”
para a Mudança Transformativa na Saúde Mental Comunitária: Análise Comparativa é um
estudo transversal usando metodologias e técnicas mistas (quantitativas e qualitativas). A
investigação assentou no pressuposto de que, adoptando processos organizacionais
transformativos, as organizações comunitárias de saúde mental poderão funcionar como
contextos relacionais mediadores do empowerment individual e, consequente facilitadores do
recovery e da integração comunitária.
Com o propósito geral de avaliar os resultados da participação das pessoas com
experiência de doença mental em intervenções de saúde mental consideradas transformativas
foram estabelecidos três objectivos gerais: 1 - adaptar o modelo conceptual dos contextos
comunitários empoderadores para os serviços de saúde mental enquanto recurso para prática
da intervenção e da investigação e testar a validade de aplicação através de um estudo de
caso; 2 - adaptar para a Língua Portuguesa e validar as medidas de empowerment e de
recovery para a utilização no contexto da saúde mental comunitária; 3 - avaliar o impacto do
modelo de intervenção: a) nos resultados individuais de empowerment, recovery e integração
comunitária dos participantes e b) na implementação e envolvimento de participantes em
programas com elevada orientação para o recovery, tais como a habitação independente e o
emprego apoiado.
O desenho misto da investigação foi aplicado através dos seguintes instrumentos de
recolha de dados: Entrevista por Questionário e a Entrevista Qualitativa que podem ser
consultados no Anexo 1 e Anexo 2 da Tese. Em termos da recolha de dados, esta decorreu em
cinco organizações comunitárias de saúde mental com respostas articuladas dos sectores da
saúde e sector social (âmbito do DC nº 407/98), constantes numa lista de organizações filiadas
na entidade representativa das organizações não governamentais (Federação Nacional das
Entidades de Reabilitação de Doentes Mentais) a prestarem serviços de saúde mental na
comunidade à data do estudo.
Os resultados permitiram sustentar a proposição teórica de que os programas de saúde
mental na comunidade podem e devem encetar mudanças transformativas organizacionais
adoptando um funcionamento empoderador e centrado na comunidade (EMP-COM), o qual
tem um efeito transformativo na vida das pessoas com experiência de doença mental. As
análises confirmaram também a validade das medidas de empowerment (ES-P) e de recovery
(RAS-P) para a respectiva utilização no contexto português da saúde mental comunitária. A
investigação realizada permitiu extrair conclusões e implicações para a prática da intervenção
e da investigação no âmbito do sistema de saúde mental.
O relatório de Tese foi composto nas seguintes partes: a Introdução Geral, onde se
apresenta a revisão da literatura geral organizada por temáticas dominantes (o empowerment e
os contextos comunitários empoderadores, a orientação de recovery na saúde mental, a
integração comunitária), os Procedimentos Gerais onde se descreve o desenho geral, os
objectivos gerais); a Secção Empírica, organizada em quatro capítulos relativos às análises
principais desta investigação em formato de artigo; a Discussão Geral, as Conclusões e
Implicações para a Prática, e os Anexos.
The Thesis under consideration, given the title Contributions of the “Empowerment- Community” Model to Transformative Change in Community Mental Health: A Comparative Examination is a cross-sectional study using a number of methodologies and procedures (both quantitative and qualitative). The research is founded on the assumption that, whenever adopting transformative organisational procedures, community mental health organisations can function as mediating relational contexts for individual empowerment and consequently, facilitators of recovery and community integration. With the general aim of evaluating the results of participants with a history of mental illness in so-called transformative mental health interventions, three general objectives were established: 1 – to adapt the conceptual model of empowering community contexts for mental health services as a resource for intervention practice and investigation and to test the validity of its application through a case study; 2 – to adapt into the Portuguese language and to test the validity of the empowerment and recovery measures for their use in the context of community mental health; 3 – evaluate the impact of the intervention model; a) as regards the individual results of levels of empowerment, recovery and community integration among participants and b) the implementation and involvement of participants in programmes with particular emphasis on recovery, as well as independent housing and supported employment. The mixed nature of the study was implemented using the following data collection instruments: Interview conducted by Questionnaire and a Qualitative Interview – which may be consulted in Annexes 1 and 2 of this Thesis. As for the collection of data, this took place in five similar mental health community organisations that carry out their functions for an articulated response to questions of health in the social sector (DC nº 407/98), belonging to a register of organisations affiliated with the entity representing non-governmental organisations (National Federation of Institutions for the Rehabilitation of Mental Patients) that were providing mental health services in the community, at the date of the study. The results sustained the theoretical proposition that mental health programmes in the community can and should instigate transformative organisational change by adopting an empowering process centred on the community (EMP-COM), which would have a transformative effect on the life of people with a history of mental illness. Analyses also confirmed the validity of the empowerment (ES-P) and recovery (RAS-P) measures for their respective implementation in the Portuguese community mental health context. The extent of the investigation undertaken was sufficient to formulate certain conclusions and implications regarding the practises of intervention and investigation in the domain of the mental health system. The main body of the Thesis was organised according to the following sections: a General Introduction, where the revision of general literature is presented, organised by theme (empowering community contexts, recovery-orientation in mental health, community integration), the procedures in which the general structure and objectives are described; an Empirical Section, organised into four chapters according to the main analyses conducted for this investigation; a General Discussion, Conclusions and Implications for Practice, and the Appendices.
The Thesis under consideration, given the title Contributions of the “Empowerment- Community” Model to Transformative Change in Community Mental Health: A Comparative Examination is a cross-sectional study using a number of methodologies and procedures (both quantitative and qualitative). The research is founded on the assumption that, whenever adopting transformative organisational procedures, community mental health organisations can function as mediating relational contexts for individual empowerment and consequently, facilitators of recovery and community integration. With the general aim of evaluating the results of participants with a history of mental illness in so-called transformative mental health interventions, three general objectives were established: 1 – to adapt the conceptual model of empowering community contexts for mental health services as a resource for intervention practice and investigation and to test the validity of its application through a case study; 2 – to adapt into the Portuguese language and to test the validity of the empowerment and recovery measures for their use in the context of community mental health; 3 – evaluate the impact of the intervention model; a) as regards the individual results of levels of empowerment, recovery and community integration among participants and b) the implementation and involvement of participants in programmes with particular emphasis on recovery, as well as independent housing and supported employment. The mixed nature of the study was implemented using the following data collection instruments: Interview conducted by Questionnaire and a Qualitative Interview – which may be consulted in Annexes 1 and 2 of this Thesis. As for the collection of data, this took place in five similar mental health community organisations that carry out their functions for an articulated response to questions of health in the social sector (DC nº 407/98), belonging to a register of organisations affiliated with the entity representing non-governmental organisations (National Federation of Institutions for the Rehabilitation of Mental Patients) that were providing mental health services in the community, at the date of the study. The results sustained the theoretical proposition that mental health programmes in the community can and should instigate transformative organisational change by adopting an empowering process centred on the community (EMP-COM), which would have a transformative effect on the life of people with a history of mental illness. Analyses also confirmed the validity of the empowerment (ES-P) and recovery (RAS-P) measures for their respective implementation in the Portuguese community mental health context. The extent of the investigation undertaken was sufficient to formulate certain conclusions and implications regarding the practises of intervention and investigation in the domain of the mental health system. The main body of the Thesis was organised according to the following sections: a General Introduction, where the revision of general literature is presented, organised by theme (empowering community contexts, recovery-orientation in mental health, community integration), the procedures in which the general structure and objectives are described; an Empirical Section, organised into four chapters according to the main analyses conducted for this investigation; a General Discussion, Conclusions and Implications for Practice, and the Appendices.
Description
Tese de Doutoramento apresentada ao ISPA - Instituto Universitário
Keywords
Saúde mental Integração comunitária Empoderamento Recovery Mental health Community integration empowement Recovery
Citation
Publisher
ISPA - Instituto Universitário das Ciências Psicológicas, Sociais e da Vida