Sofrimento moral de profissionais de enfermagem em um Centro de Atenção Psicossocial

Abstract

Resumo O sofrimento moral (SM) é vivenciado por uma pessoa e decorrente da contradição existente entre suas ações e convicções. O objetivo foi analisar o sofrimento moral vivenciado pelos profissionais de enfermagem que atuam no CAPS, bem como descrever e identificar os sentimentos decorrentes do SM e mecanismos de enfrentamento. Trata-se de uma pesquisa com abordagem qualitativa, na qual foi utilizado o método de Análise de Conteúdo de Bardin. Participaram da pesquisa sete profissionais de ambos os turnos de funcionamento do CAPS. Na análise temática de conteúdo das falas desses profissionais, emergiram quatro categorias: Ambiente, como fonte de sofrimento moral; Escassez de financiamento e improvisos; Sentimentos que emergiram das vivências de Sofrimento Moral; e Mecanismos de Enfrentamento dos profissionais. Neste estudo observou-se que os profissionais do CAPS Gentileza de Macapá vivenciam o SM em seu cotidiano, associado às questões do ambiente estrutural e insuficiência de recursos (humanos e materiais), que resultaram em sentimentos de impotência, desânimo, desmotivação e luta. Esse SM fez com que os profissionais pudessem construir mecanismos de enfrentamento, dentre eles o diálogo e o compartilhamento das angústias com a equipe.

Situações geradoras de distresse moral em enfermeiros de saúde mental

“…The ethical/moral problems were widely pointed out in the studies selected for this integrative review and emerge as situations that generate moral distress in mental health nurses worldwide (12)(13)(14)(15)(16)(17)(18)(19) .…”

“…Problems such as the shortage of Nursing staff, excessive workloads, absence of institutional protocols and/or evidence-based treatments and ineffective communication among the multi-professional team members, can disarticulate the work process and promote the emergence of ethical/moral conflicts which, in turn, cause harms to users and professionals, affecting their safety | (12)(13)(14)(16)(17)(18)(19) .…”

“…Naturally, irregular working environments, due to lack of interest in the managers, lack of material resources, excessive services, lack of privacy, prolonged hospitalizations and problems in the articulation of the RAPS also favor violations of the users' rights. In this context, the psychiatric condition of the person treated is often acutely intensified, further increasing the length of hospital stay, in addition to directly impacting on public spending (12,15,18) .…”

Cultural Adaptation and Validation of the Moral Sensitivity Questionnaire Among Brazilian Nurses

“…On the other hand, moral distress also leads to the development of coping mechanisms such as dialoguing and sharing difficult situations with team members, favoring approximation among these professionals. 22 Having confidence in medical and nursing knowledge also maintained the same name given to its equivalent subscale in the original questionnaire. It addresses the importance of the knowledge and opinion of multi-disciplinary teams when facing a conflict situation in which it is difficult to identify the ethically sound solution.…”

Estudos de Saúde Mental publicados nos últimos 25 anos na Revista Ciência & Saúde Coletiva

“…Another 40% are comprised between 2013 and 2019. Several points are discussed in this period, such as moral distress of workers 43 , consolidation of a network of specialized services in the SUS for autists 44 , and low state coordination of CAPS, producing discrepant coverage and functioning between the different municipalities 45 . We have evaluative research, on access to services due to drug problems 46 and local RAPS 47 , indicating that evaluations of Mental Health services should transcend the comparison with the hospital-centric model 48 , found a centrality of CAPS-ad in the drug user care network.…”