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Print version ISSN 0104-1169
Rev. Latino-Am. Enfermagem vol.16 no.3 Ribeirão Preto May/June 2008
ARTIGO DE REVISÃO
Analysis of scientific production of mental health researcher and psychiatric nursing specialist meetings
Denize Bouttelet MunariI; Nunila Ferreira de OliveiraII; Toyoko SaekiIII; Maria Conceição Bernardo de Mello e SouzaIII
IPh.D. in Nursing, Full Professor, e-mail: firstname.lastname@example.org
IIUndergraduate Nursing Student. Goiás Federal University School of Nursing, Brasil
IIIPh.D. in Nursing, Faculty, University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, Brazil
This literature review was organized on the basis of the Annals of Mental Health Researcher and Psychiatric Nursing Specialists Meetings promoted by the University of São Paulo at Ribeirão Preto College of Nursing. It aimed to describe the history of these events, investigating the scenario and trends through the reading of texts published in these documents. All annals available from 1990 to 2004 were analyzed and read, based on an analysis protocol. The results showed that the published texts reflect the historical momentum of each national mental health policy movement in Brazil, indicating contradictions and advances. The conclusion is that the events provided a privileged forum to discuss and exchange experiences about the future of psychiatric nursing and mental health care, teaching and research in Brazil.
Descriptors: psychiatric nursing; mental health; nursing research
After observing the therapeutic inefficacy instituted by the asylum model, several movements have appeared worldwide to reformulate the treatment provided to mental patients(1-2). Specifically, in Brazil, the Psychiatric Reform triggers the anti-asylum struggle, a political and historical landmark that points towards paradigm changes to assist and train human resources in psychiatry(1-2).
The nationwide movement favored the appearance of non-conventional therapeutic modalities, establishing that persons with mental impairment are entitled to receive treatment and actively involving family and community. Interventions in this new panorama prioritize the patient-therapist relationship mediated by resources which stimulate expression, communication and interchange with society(1).
This proposal values interdisciplinarity when dealing with the disease and the patient. It was fundamental to establish a new way of functioning and relating with health team prefessionals, provided that it was founded on the basis of collective construction.
Brazilian psychiatric nursing has always been present in this process, discussing the possible advances and current contradictions in mental health care, the directions of professional training of people who work in this area and standing as partners when leading change and improvements in care quality(2-5).
In Brazil, this process has taken approximately thirty years and has become a great challenge to clinical and academic professionals. The implementation of public policies, favoring significant advances in the area, hinges on collective effort. A recent survey has discussed the importance of investments in mental health research so as to trigger the development of the country regarding mental health promotion and reduction of injuries related to mental disorders(6).
In the psychiatric nursing history in Brazil, an important group of teachers from the University of São Paulo at Ribeirão Preto College of Nursing (EERP/USP) has influenced health professionals' training, always allied with public and vanguard policies(7). The Graduate Program in Psychiatric Nursing at EERP/USP, in particular, took the initiative of organizing Meetings of Mental Health Researchers (ESPM) and Meetings of Psychiatric Nursing Researchers (EEEP), which have occurred since 1994 and have been a reference for professionals working in the area.
Due to the important historical and relevant scientific contribution of these events in training mental health and psychiatric nursing professionals, the following objectives are proposed here: to describe the historical background of EPSM and EEEP and to investigate the production panorama of the participating researchers and also the trends shown by the annals issued of the above mentioned events.
This study is the result of a partnership between the Study and Research Group in Integral Health at the Nursing School of Goiás Federal University (NEPSI/FEN/UFG) and the Study and Research Group in Psychiatric Nursing and Mental Health at the Department of Psychiatric Nursing and Human Sciences of the University of São Paulo at Ribeirão Preto College of Nursing.
The study was carried out by using all available annals of the EPSM and EEEP from 1990 to 2004 so as to perform an exploratory, bibliographic research, which is the study of print material in order to survey and analyze what was produced on a given topic characterized as the research theme.
The annals were first published in 1990 and were accessed at the library of the NEPSI/FEN/UFG and in the collection of the Psychiatric Nursing and Human Sciences Department of the University of São Paulo at Ribeirão Preto Nursing School.
The material was read and the analysis protocol of published texts was filled out with the following data: year of publication, type of work, number and origin of author, theme, title and a brief content description.
The protocols were read and systematically analyzed. The abstract contents and the published texts were grouped in the following themes: care practices; teaching; historical and political process in mental health and psychiatry and general texts.
To check the authors´ origins, the footnote references were used.
RESULTS AND DISCUSSION
The presentation of the results and the discussion will be divided in two parts. The first contains the historical panorama of the events, their relevance and influence in the country. The second part is dedicated to the analysis of the production published in the annals, showing their trends over the years.
The Meetings of Mental Health Researchers and the Meetings of Psychiatric Nursing Specialists: history, repercussions and relevance in the national setting
The EPSM and EEEP promoted by the Psychiatric Nursing and Human Sciences Department of the University of São Paulo at Ribeirão Preto Nursing School (EERP/USP) are historically important in the development of research, teaching and mental health care in Brazil, especially in nursing.
In the past 22 years, it has systematically gathered psychiatric nurses and other health-related professionals, who have debated the directions of national health policies, the challenges in the implementation of the Psychiatric Reform, psychiatric nursing and mental health teaching and the role of psychiatric nursing. It was the space for an exchange of experiences, information, practices and knowledge production. The proposal of studying the referred events' background was pondered, taking into account their historical background and the impact of this knowledge on the profile of many professionals and nurses working in the field.
In order to understand this background, it is fundamental to understand the genesis of the Graduate Program in Psychiatric Nursing at master's level, which was founded in March, 1975. It was the third stricto sensu graduate course in Nursing created in the country after the 1968 University Reform(9). Professor Maria Aparecida Minzoni was the psychiatric nurse who led the course, with the aid and participation of other faculty members. The course was accredited by the Federal Education Council and received students from other nursing areas than psychiatric nursing(7). The first class group included thirty students, most of them taught at EERP/USP, in line with the institution's demand(9).
With the proposal of innovating and spreading the research performed in the psychiatric nursing and mental health area, the National Meetings of Researchers of Mental Health and Psychiatric Nurses(10) were created. The first meeting, held in December 1994, was called I Meeting of Mental Health Researchers and was presided by a faculty member from the Graduate Area in Psychiatric Nursing. The opening conference of the meeting was "Research in Mental Health", showing the relevance of the research theme in mental health. There were also presentations of faculty members' and graduate students' research from different Brazilian regions.
The first EEEP was added to the second EPSM, due to the fact that the Specialization Course in Psychiatric Nursing, created in 1972, was sponsored by the São Paulo State Secretariat, with the purpose of training nursing professionals at all levels to deliver care to psychiatric patients, update nurses to educate and train nursing assistants in the area and perform research that supports practice(11). This event was held in 1987 and organized by faculty members and a graduate nursing student of the Psychiatric Nursing Program. Part of the program was organized in "Workshops: Human Resources in Psychiatric Nursing", which aimed at discussing the performance of psychiatric nurses in the different areas. There were also courses about several mental health themes involving care, policies, programs, education and mental health research and a space for "Research under Discussion" where researchers and students could disseminate and discuss their productions.
In this meeting, a motion was submitted to the Brazilian Nursing Association - National Section, requesting the inclusion of the "Maria Aparecida Minzoni" prize for the best psychiatric nursing study in the Brazilian Nursing Meetings.
In 1990, the III EPSM and II EEEP was held, and that was when the annals were published for the first time(10).
The strategies used in the event included coordinated lectures to show research and practical experience reports. With the advent of the Psychiatric Reform, a space was created for professionals to share experiences related to "Alternative Therapeutics in Mental Health". This event was a landmark to spread new developments, reflections on care practices, sharing experiences, contributing to the change in paradigms which characterized the historical background of psychiatry in Brazil.
The IV EPSM and III EEEP took place in April, 1995 and was the first event to show the core theme leading the proceedings "Mental Health and/or Psychiatry?" During the opening, the event was said to be important for alumni, friends and faculty members to meet and exchange experiences in several Brazilian regions. During the event, several conferences, round tables, poster presentations, oral communications and exhibition of videos and photos took place.
This meeting opened room for critical reflections by several professionals, both in education and in mental health care, especially regarding changes occurred in and outside the country for the establishment of actions aimed at rescuing citizenship and respecting the human being(12).
The core theme of the V EPSM and IV EEEP, which occurred in 1998, was "Heading for Integral Care". This event was preceeded by the National Reunion of Psychiatric Nursing Teaching, which hosted 50 participants, who discussed the directions of Psychiatric Nursing teaching. During the meetings, themes like "Research as a True Question" and "The Process of Mental Health Approximation and Integration to other Areas" were addressed. The practical experiences in building multidisciplinary care models were discussed in oral presentations about the themes: "Mental Health: integrating efforts", "Building new Practices" and workshops/experiences: "The Group and the Art Perception", "Yoga in your Life: learn the Benefits of this Millenial Practice". After this event, the events' periodicity was established. The meetings were biennial and the annals began to be presented as books(13).
The VI EPSM and V EEEP were held in April, 2000 and had the following central theme "The Use and Abuse of Drugs and Alcohol: a Challenge for Everyone". The objective was to provide an environment for a reflection on health professionals' role in care and research of problems related to the use and abuse of psychotropic substances, and also to discuss basic requirements in the theory-practice of health professionals for health actions towards chemical dependents or population groups more vulnerable to drug use. The event had pre-meeting activities about "Alcohol and Cigarette Dependence" and "Psychosocial Rehabilitation", presentation of scientific papers, videos and two workshops about "The Situation of Care for the Mentally Impaired Nowadays and Nursing's Participation" and "Inserting the Contents of Alcohol and Drugs Use and Abuse in the Nursing Curriculum"(14-15).
In March, 2002, the VII EPSM and VI EEEP was held, and the theme was "Care: so far... so close...". The objective was to reflect about the role of psychiatric nurses nowadays and the challenge of care(16). It was organized mainly with pre-meeting courses, conferences and round tables, with participants from all regions of Brazil and abroad. A significant number of papers was presented orally and through posters.
The VIII EPSM and VII EEEP, held in April, 2004, had the theme "Mental Health in a Changing Society", whose focus was the discussion of change situations society was experiencing with violence, stress and external pressures. The opening conference was given by a psychoanalyst who addressed the theme "Modern Suffering". The event was initiated by work groups so as to discuss the directions of teaching, research and health care in several regions of the country. There were also seminars, round tables and poster presentations of research(17).
The EPSM and EEEP analyses show a history that accompanies public policy trends and also social movements that attempt to improve mental health care. They were initiated with the goal of promoting debate and experience exchange among health professionals. These meetings stand out as a place for reflection on the needs of users and professionals. They were supposed to think of more suitable intervention models after the Psychiatric Reform. There were concerned with finding ways to understand integral care, specific care delivery to alcohol and drugs, care as essence and, more recently, the discussion of the current directions in psychiatric care.
Analysis of papers published in the EPSM and EEEP annals
Six annals were analyzed. Initially there is no regularity concerning peridiocity and format. In some annals, the events were faithfully reproduced with the publication of the proposed activities, such as conferences, round tables, opening lectures and full papers. In one of the annals, the free themes displayed on posters during the event were also published.
Throughout the years, the annals started losing the characteristics of this type of document and acquired a book format, with chapters or parts, grouping studies selected for publication according to theme similarity.
Of the 172 published works, 54.1% were published in full, 22.8% were abstracts and the remaining 23.1% was distributed among the other modalities: conference, round table, coordinated communication, free theme and event presentation. The footnotes of each work published in the annals contained the authors' data, with origin, institution and e-mail. With such data available, the authors were identified in function of the Brazilian regions, totaling 322 authors, representing the Southeast (77.7%), South (9.6%), Northeast (9.1%), Mid-West (2.8%) and North (0.8%).
In the predominance of researchers from the Southeast, initially, the location of the event should be considered, as well as the number of older and more traditional nursing schools in this area, with developed facilities to support scientific production and many professors and people, proportional to the demand of the most populated region in the country.
The analysis of the protocols filled out with data from the analyzed texts permitted grouping them into themes.
The theme distribution can be observed in Figure 1, which shows the predominance of publications focused on care practices performed in psychiatry-oriented services.
Care Practices was the most recurrent theme in the events studied. When these findings are compared with two other bibliographic studies performed about the theme(18-19), performed in other bibliographic sources, the most published theme was the historical process, followed by care practices. It should be pointed out that one of the studies focused on the production of the theme in a given journal and the other one on the nursing production in national journals.
In the historical perspective of Brazilian Psychiatric Nursing, the importance of the studied events is regarded as essential to build awareness, formation of human resources and improvement in mental health care. The remarkable participation of psychiatric nurses at the EPSM and EEEP in the past twenty years maintains the possibility of consolidating spaces to show studies, experience exchange and reflections about care practice.
The historical panorama indicates the evolution of the event, its innovations and trends that marked the historical background of psychiatry and mental health in Brazil. It demonstrates the importance of psychiatric nursing in building a Brazilian psychiatric reform.
The content of the analyzed material revealed the prevalence of papers on nursing care in psychiatry and it reflects the nurses' initiative to describe and disseminate their practices, which contributes to improve this profession and acknowledge its action.
This kind of events contributes to a role definition of psychiatric nurses and their health teams, as well as to the expansion of their actions by publishing innovative experiences and care possibilities.
The analysis of these events shows that organizing such spaces is fundamental for continued professional education, for their integration and for the advancement of teaching, care and research in the area.
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Recebido em: 26.2.2007
Aprovado em: 19.3.2008