Avaliação das habilidades de vida independente e comportamentosocial de pacientes psiquiátricos desospitalizados

Abstract

ARTICLE 1Objective: The aim of this article is to show the more relevant aspects of psychiatric reform and the community insert of psychiatric patients around the world and in Brazil. It will be detached the procedures of discharge occurred in the city of Barbacena, emphasizing the residential services and the psychosocial approaches. Methods: A non-systematic search in Medline database was made between 1990 and 2006using keywords deinstitutionalization, psychiatric reform, community-based treatment, psychosocial rehabilitation.Results: Review and follow-up studies were selected. The most of the studies indicate that the patients have better autonomy, social interaction, global behavior and life quality when they live in community settings. Nevertheless, the authors emphasize the importance of community support, professional staff and rehabilitation programs as a condition forgood outcomes. Discussion: In despite of difficulties in the psychiatric reform process, the communitybased treatment and psychosocial rehabilitation approach are the principal models of psychiatric care presently, and the residential services play an important role in thisprocess. Key-words: psychiatry, deinstitutionalization, psichiatric reform, residential service.ARTICLE 2Objective: The aim of this study was to assess the Social Behaviour and Independent Living Skills in a sample of psychiatric patients before their discharge from a mental hospital and after two years living in the community facilities. Methods: Cross-sectional study carry out in two stages using the Independent Living Skills Survey (ILSS) and the Social Behaviour Scale (SBS). Results: The most of patients was male(58,7%). The means of age and time of hospitalization are 57,5±11,8 e 29,8±10,2 years respectively. 54,6% were schizophrenic, 25,3% had mental retardation and the remainder were of other diagnosis. There were asignificant improvement in the social behavior and in the level of autonomy (p<0,05), as evidenced by their scores in the two stages. The more consistent association with the evolution scores were the time of hospitalization, age and the baseline score. Conclusion: The patients impairments in the social role functioning and in the autonomylevels before their discharge from a mental health hospital were not incompatible with living in society. The patients showed a great improvement in the social behavior and in the level of autonomy after two years. Key-words: deinstitutionalization, social behaviour, independent living skills, autonomy.