A percepção e os conhecimentos das epilepsias e dos transtornos mentaispelos clínicos atuantes em ambulatórios do sistema de saúde pública de Belo Horizonte

Abstract

The World Health Organization (WHO) has pointed to epilepsy as one of the most common and prevalent neurological chronic diseases, present in 1% of the world population. In developing countries, aggravating factors, such as diseases associated with this condition, bad hygienic practices and poor schooling, contribute to increase the figures. The WHO has always had great concern over the inadequate healthcare dispensed to epileptic patients, and over the stigmas, social issues related to the disease and the education of the population. The contact of this researcher of over three decades with other general practitioners has pointed to their self-determination and concern for the lack of qualification of the personnel caring for patients suffering from epilepsy and its possible associations with mental disorders, which pose a great challenge for them and the institutions they work for. The purpose of the present study was to identify the origins and impediments to this qualification and propose viable paths to the solutions to these problems. This is a transversal study, carried out by mean of a questionnaire,answered by neurologists, psychiatrists, pediatricians, and general practitioners, a total of 107 respondents working in outpatient units of Belo Horizontes SUS (centralized healthcare system), making up a convenience sample. The data collectio n was held between October 2005 May 2007. The questionnaire, with 36 questions, two of which being open questions, investigated the effectiveness of the graduation and post-graduation courses, internship programs and other courses in the field of epilepsy and associated disorders. There was also a space for written statements by the respondents. A descriptive analysis and the quisquare tests were used, and when necessary, the Fisher test, and, as statistical significance limit, the value p<0,005. The time span the respondents had had their university degrees varied from 1 to 38 years. Regarding the teaching of epilepsy and mental disorders, the medical course was considered insufficient by 57.8% of the respondents while 36.85 considered it not sufficient enough. All general practitioners proved to have some difficulty to identify epilepsy. Priority was given, among the diagnoses resources available, to complementary propedeutics, to the detriment of the clinical background. Therapeutic procedure pointed to the inadequacy in the identification of epilepsies, once this procedure iscoupled with the type of crisis. The issues associated with mental disorders and epilepsy were perceived but not measured in terms of their value, adequacy to clinical approach, and neither were the problems of a social nature. Detailed studies similar to the present study were notfound in the literature, however, there are some general studies pointing to the inadequate qualification of these professionals. In view of these findings, the researcher recommends more focused attention to the contents of the subject matters of the undergraduate medical courses, and that they are more geared to the most prevailing pathologies, and that continuous medical education is encouraged.