CON CEPTS OF MEN TAL HEALTH AN D CARE ACCORDI N G TO
MENTALLY- I LL PATI ENTS AND THEI R RELATI VES
1Ver a Lucia Mendiondo Osinaga2
Ant onia Regina Fer r eir a Fur egat o3 Jair Licio Fer r eir a Sant os4
Osinaga VLM, Fur egat o ARF, Sant os JLF. Concept s of m ent al healt h and car e accor ding t o m ent ally- ill pat ient s and t heir r elat iv es. Rev Lat ino- am Enfer m agem 2005 m aio- j unho; 13( 3) : 332- 8.
This st udy aim ed at 1) ident ifying social, dem ogr aphic and clinical char act er ist ics of m ent ally- ill pat ient s an d t h eir r elat iv es an d 2 ) an aly zin g t h eir con cep t ion s con cer n in g m en t al illn ess an d p sy ch iat r ic car e. Th e At t it ude Measur em ent Scale ( AMS) w as used. Quant it at iv e and qualit at iv e analy ses of t he dat a w er e car r ied out . The 104 st udy subj ect s com pr ised 35 pat ient s and 69 r elat ives ( n= 104) . The Mann- Whit ney Test w as used f or com par in g t h e opin ion s of pat ien t s X r elat iv es an d t h e Wilcox on Test f or com par in g Con cept an d Car e. Th er e w as h om ogen eit y in t h e dist r ibu t ion of t h e su bj ect s’ scor es for bot h Con cept an d Car e. No qu est ion s st ood out or w er e concent r at ed in eit her gr oup. The subj ect s’ pr ofile show s t he t r ansit ion fr om asylum car e t o in n ov at iv e ex p er ien ces, alt h ou g h t h er e is st ill a con cen t r at ion of d r u g t r eat m en t s an d d ep en d en ce on t h e psy chiat r ic inst it ut ion.
DESCRI PTORS: m ent al healt h; psy chiat r y ; nur sing car e
CON CEPCI ON ES SOBRE EN FERMEDAD MEN TAL Y ATEN CI ÓN
SEGÚN EN FERMOS MEN TALES Y SUS FAMI LI ARES
Est e est udio t uv o com o obj et iv o: 1) ident ificar las car act er íst icas socio- dem ogr áficas y clínicas de los en f er m os m en t ales y su s f am iliar es y 2 ) an alizar su s con cep cion es sob r e en f er m ed ad m en t al y asist en cia psiquiát r ica. Se aplicó la Escala de Medida de Opinión ( EMO) . Fuer on r ealizadas análisis cuant it at ivos y cualit at ivos de los dat os. Los 104 suj et os incluyen 35 por t ador es y 69 fam iliar es ( n= 104) . Las pr uebas est adíst icas fuer on el Test de Mann- Whit ney com par ando dos poblaciones independient es ( Por t ador es X Fam iliar es) , y el Test de Wi l co x o n , co m p ar an d o d os p ob l aci on es r el aci on ad as ( Con cep t o y Asi st en ci a) . Hu b o h o m o g en ei d ad en l a dist r ibu ción de los escor es de los su j et os t an t o par a Con cept o com o par a At en ción . Por lo t an t o, n o h u bo cu est ion es sobr esalien t es o con cen t r adas en n in gu n o de los dos gr u pos est u diados. El per f il de los su j et os r et r at a la t r ansición de la at ención m anicom ial par a exper iencias innovador as, aún t odavía hay la concent r ación de los t r at am ient os m edicam ent osos y la dependencia de la inst it ución psiquiát r ica.
DESCRI PTORES: salud m ent al; psiquiat r ía; at ención de enfer m er ía
CON CEPÇÕES SOBRE DOEN ÇA MEN TAL E ASSI STÊN CI A
SEGUNDO DOENTES MENTAI S E SEUS FAMI LI ARES
Est e est udo obj et ivou: 1) ident ificar as car act er íst icas sociodem ogr áficas e clínicas de doent es m ent ais e seu s f am iliar es; 2 ) an alisar su as con cepções sobr e doen ça m en t al e assist ên cia psiqu iát r ica. Aplicou - se a Escala de Medida de Opinião ( EMO) . For am r ealizadas análises quant it at iv as e qualit at iv as dos dados. Os 104 su j eit os con st it u em - se em 3 5 por t ador es e 6 9 f am iliar es ( n = 1 0 4 ) . As pr ov as est at íst icas f or am o t est e de Mann- Whit ney , com par ando duas populações independent es ( Por t ador es x Fam iliar es) , e o Test e de Wilcox on, com p ar an d o d u as p op u lações r elacion ad as ( Con ceit o e Assist ên cia) . Hou v e h om og en eid ad e n a d ist r ib u ição dos escor es dos su j eit os t an t o par a Con ceit o com o par a Assist ên cia. Por t an t o, n ão h ou v e qu est ões qu e se sobr essaíssem ou que se concent r assem em nenhum dos dois gr upos. O per fil dos suj eit os r et r at a a t r ansição d a a ssi st ên ci a m a n i co m i a l p a r a ex p er i ên ci a s i n o v a d o r a s, em b o r a h a j a a co n cen t r a çã o d o s t r a t a m en t o s m edicam ent osos e a dependência da inst it uição psiquiát r ica.
DESCRI TORES: saú de m en t al; psiqu iat r ia; cu idados de en fer m agem
I NTRODUCTI ON
T
h e Br a zi l i a n a d v a n ce s i n m e n t a l h e a l t h c a r e , w h i c h r e s u l t f r o m t h e g l o b a l t e n d e n c y t oo v e r co m e t h e a sy l u m m o d e l , a r e sl o w l y m o v i n g
ah ead( 1 - 3 ). Th e in st it u t ion on w h ich t h is st u d y w as
based is no different from t he gener al pict ur e of m ent al
healt h car e in Br azil and m any ot her count r ies.
The m ent ally - ill pat ient s r epor t difficult ies in
r elat ion t o m en t al h ealt h ser v ices an d t h eir social
r elat ion sh ip s. Th ey r ep or t t h eir con t act w it h g r ief,
pr ej udices, r ev olt , hat r ed and guilt as w ell as cr it ical
m om en t s su ch as t h e sear ch f or t h e cau ses of t h e
pr oblem t hey ar e faced w it h( 4- 5).
These account s r einfor ce t he need t o r e- t hink
t h e r elat ion sh ip bet w een pr of ession als an d pat ien t s
an d t h eir r elat iv es, set t in g aside pow er r elat ion s t o
m ak e r oom for r elat ions am ong cit izens.
Th er e is an ag r eem en t t h at t h e p sy ch iat r ic
car e pr ocess m ust m ov e aw ay fr om healing t o daily
assist ance, pr ov iding t he possibilit y of t r ansfor m at ion
in t heir lives( 6- 7).
Ther efor e, it w as invest igat ed w hat m ent
ally-ill people and t heir r elat iv es t hink about t he disease
and t he car e offer ed in t his ar ea( 8- 10).
I n analy zing t he r esult s of t he applicat ion of
an At t it ude Measurem ent Scale w it h pat ient s, relat ives
and pr ofessionals( 11) and it s r eapplicat ion w it h nur ses
st u d e n t s( 9 ), t h e y o b se r v e d t h e n e e d t o ca r r y o u t
st u d i e s i n o r d e r t o i m p r o v e t h e e f f i ci e n cy o f t h e
inst r um ent t hat m easur ed t heir k now ledge about t he
illness and m ent al healt h car e.
The crit ical analysis of t he st at em ent s as w ell
as of t he r elev ance of each quest ion w it h a v iew t o
reform ulat ing t he At t it ude Measurem ent Scale allow ed
f o r t h e e x c l u s i o n o r r e f o r m u l a t i o n o f v a r i o u s
st at em en t s f r om t h e or igin al scale. On t h e basis of
t h e t h eor et ical f r am ew or k , t h e r esu lt of t h is cr it ical
a n a l y s i s , a s w e l l a s t h e c o r r e l a t i o n a n a l y s e s ,
sign ifican ce t est s, v alidat ion an d r eliabilit y t est s led
t o t h e d ef in it ion of an At t it u d e Measu r em en t Scale
w it h 34 st at em ent s.
The st at ist ical analyses of a new apply of t his
i n st r u m en t w i t h 2 0 6 su b j ect s al l o w ed f o r t h e l ast
cor r ect ions in t he scale. On t he occasion of t he dat a
collect ion , all pat ien t s an d r elat iv es assist ed in t h e
i n s t i t u t i o n a n s w e r e d q u e s t i o n s r e g a r d l e s s t h e i r
d iag n oses: 1 0 2 cases of ch em ical d ep en d en cy an d
104 psy chiat r ic pat ient s and t heir r elat iv es.
Th e a u t h o r s a n a l y zed t h e co n cep t s a b o u t
m e n t a l h e a l t h a n d c a r e a c c o r d i n g t o t h e 1 0 2
d ep en d en t s an d r el at i v es( 1 2 ) an d n o w p r esen t t h e
analysis of t he concept s of m ent al healt h and care as
display ed by t he ot her gr oup ( 104 subj ect s) .
OBJECTI VES
Th e o b j e ct i v e s o f t h i s st u d y w e r e : 1 ) t o
i d e n t i f y t h e s o c i a l , d e m o g r a p h i c a n d c l i n i c a l
ch ar act er ist ics of m en t ally - ill in d iv id u als an d t h eir
r elat iv es at t ending a psy chiat r ic inst it ut ion and 2) t o
a n a l y z e t h e c o n c e p t i o n s o f m e n t a l i l l n e s s a n d
p sy ch iat r ic car e, com p ar in g t h e op in ion of p at ien t s
and t heir r elat iv es.
METHODOLOGY
Sit e
The r esear ch w as car r ied out at t he Hospit al
Espír it a de Pelot as ( HEP) - Rio Gr ande do Sul, Br azil.
This is a philant hr opical inst it ut ion, w hich assist s t he
Br azilian populat ion as w ell as t hat fr om neighbor ing
count ries. I t is locat ed in t he east ern part of Pelot as,
at 230 Km fr om t he st at e capit al Por t o Alegr e.
This hospit al covers t he field of m ent al healt h,
applies all conv ent ional t y pes of t her apy and adopt s,
under a new per spect iv e, a holist ic focus on car e. I t
r eceiv es pat ien t s of all social classes, r egar dless of
t heir et hnical, polit ical or r eligious or igins.
I n st r u m en t s
Du r in g t h e r ev ision p r ocess of t h e At t it u d e
Measu r em en t Scale- AMS, w h ich w as r ed u ced f r om
56 t o 34 st at em ent s on m ent al illness and car e, t he
Pa t i en t Pr o f i l e Qu est i o n n a i r e- MD PPQ a n d Rel a t i v e
Pr of ile Qu est ion n air e- MDRPQ w er e in clu d ed t o g et
social, dem ographic and clinical dat a: a) ident ificat ion
of subj ect s, b) t he com plaint t hat m ade t hem consult
t h e ser v ice, c) in f or m at ion con cer n in g t h e d isease,
t h e pat ien t an d t h e t r eat m en t con du ct ed as w ell as
specificat ions r egar ding t he diagnoses and t r eat m ent s
ex pect at ions in r elat ion t o t he car e t o be giv en.
Th e AMS, co n si st i n g o f 3 4 st a t em en t s o n
Healt h, Ment al I llness and Care, allow s t he subj ect t o
dem onst r at e his lev el of agr eem ent or disagr eem ent
w it h t h e ex pr essed con t en t in accor dan ce w it h a 5
-point Lik er t scale.
U p o n r e c o r d i n g h i s o p i n i o n , t h e p e r s o n
indicat es t he ext ent of his agr eem ent or disagr eem ent
acco r d i n g t o a g r ad ed scal e r an g i n g f r o m “ I f u l l y
ag r ee, I ag r ee I n eit h er ag r ee n or d isag r ee” t o “ I
disagr ee or I fully disagr ee”.
Sa m p l e
The 104 st udy subj ect s w er e select ed am ong
t h e 2 0 6 in t er v iew ees ( psy ch iat r ic pat ien t s an d t h eir
r elat ives) w ho w er e given som e sor t of car e pr ovided
by t he inst it ut ion ( HEP) in July 2002 ( Pilot st udy) .
As t h e m ain p u r p ose of t h is st u d y w as t o
know individuals w it h psychiat ric pat hologies’ concept s
about healt h, m ent al illness and car e, w er e ex clude
t h e 1 0 2 s u b s t a n c e - d e p e n d e n t s . A l t h o u g h t h i s
populat ion is assist ed in psy chiat r ic inst it ut ions, t his
g r o u p ’ s ch a r a ct er i st i cs a r e m o r e r el a t ed t o so ci a l
pr oblem s t h an psy ch iat r ic disor der s.
Et h ical pr ocedu r es
Th is st u dy w as su bm it t ed t o t h e ev alu at ion
of t he Medical Et hics Com m it t ee of t he Hospit al Espírit a
at Pelot as ( RS) , w h ich ap p r ov ed it s r ealizat ion . All
pat ient s and t heir r elat iv es w er e pr ev iously infor m ed
abou t t h e obj ect iv es an d pr ocedu r es t o be adopt ed
a n d s i g n e d a n i n f o r m e d c o n s e n t d o c u m e n t .
I dent ificat ion dat a did not show nam es or infor m at ion
t h at cou ld in div idu alize t h e su bj ect s, t h u s en su r in g
t h eir an ony m it y.
Dat a collect ion
Th e s u b j e c t s w e r e a p p r o a c h e d b y t h e
r esear cher, w ho explained t he obj ect ives of t he st udy.
Those incapable of providing infor m at ion ( unconscious,
confused or under m edicat ion effect s w hich pr event ed
t heir int er act ion) w er e ex cluded.
Social an d d em og r ap h ic d at a ( g en d er, ag e,
m ar it al st at u s, addr ess an d pr of ession ) an d clin ical
dat a w er e obt ained t hr ough infor m at ion pr ov ided by
pat ient s and t heir r elat iv es.
To apply t he t est , t he r esear cher r ead each
st at em en t f o r t h e su b j ect t o ch o o se o n e o f t h e 5
opt ions, t hus expr essing t heir opinion r egar ding m ent al
healt h and car e concept s in t his field.
Th er e w a s f r ee i n t er l o cu t i o n b et w een t h e
r esear cher and t he subj ect s w it h a v iew t o det ect ing
m ist ak es an d im per fect ion s in bot h t est for m u lat ion
and cont ent .
Dat a an aly sis
Qu an t it at iv e an d q u alit at iv e an aly ses w er e
car r ied out on t he basis of t he cont ent ex pr essed by
t h e r esear ch su bj ect s.
Th e AMS dat a pr ov ided in f or m at ion f or t h e
st at ist ical an aly sis, in w h ich t h e scor es r ef er r in g t o
t h e con cept s w er e com par ed w it h t h ose con cer n in g
car e b y ap p l y i n g t h e Man n - Wh i t n ey an d Wi l co x o n
t est s. The aim of t he t est s w as t o ascert ain st at ically
significant differ ences bet w een t he gr oups.
RESULTS AND DI SCUSSI ON
Th e 1 0 4 s t u d y s u b j e c t s c o m p r i s e d t w o
g r o u p s : 3 5 m e n t a l l y - i l l p e o p l e a n d 6 9 r e l a t i v e s
( n = 1 0 4 ) .
Social and dem ogr aphic charact er ist ics of pat ient s and
r elat iv es
O u t o f 3 5 i n t e r v i e w e d p a t i e n t s , g e n d e r
d i st r i b u t i o n w a s b a l a n ce d w i t h 1 7 m a l e s a n d 1 8
fem ales, 40% of w hom w er e up t o 40 y ear s old and
4 8 . 5 7 % w er e bet w een 4 1 an d 6 0 y ear s old. I t w as
o b ser v ed t h a t 2 8 . 5 7 % w er e si n g l e, 5 4 . 2 8 % w er e
m ar r ied an d 1 7 . 1 4 % w er e separ at ed.
Most of t h em ( 6 5 . 7 1 % ) liv ed in t h e cit y of
Pelot as. I t w as also obser ved t hat one of t hem could
n o t p r o v i d e i n f o r m a t i o n co n ce r n i n g h i s p l a ce o f
r esidence and anot her w as a st r eet dw eller.
Th e 3 5 m en t ally - ill pat ien t s did n ot h av e a
p r o f essi o n w h i ch i n v o l v ed sch o o l i n g o r r eq u i r ed a
colleg e d eg r ee. Th ey w er e all classif ied as h av in g
sim ple occupat ions ( housew or k - 8 ; agr icult ur e - 3 ;
gener al ser v ices - 7; t echnical j obs - 5; ar t - 3 and
Sex No. Age No. Relationship No. Profession No.
F 49 Up to 40 23 Parents 22 General services 18
M 20 41-60 30 Spouses 16 Housewife 18
Total 69 Over 60 16 Sibling 13 Techni. services 11
Total 69 Child 5 Retired 10
Reason to seek the service No. Another relative 11 Self-employed 5
Companion 40 Others 2 Student 3
Visit 19 Total 69 Agriculture 2
Medical prescription 4 Marital Status No. Artist 1
Declaration 2 Married 42 Residence No. Unemployed 1
Change appointment 2 Single 11 In the city 52 Total 69
Hospitalization 1 Separated 2 Out of the city 16
Discharge 1 Widowed 14 Do not know 1
Total 69 Total 69 Total 69
Sex No. Age % Complaint No. No. of Hospitalizations %
F 18 Up to 40 40 No complaint 20 Up to 10 77
M 17 41-60 48.6 Depression/suicide 11 Over 10 8.6
Total 35 Over 60 1.4 Nervousness 4 Were never hospitalized 11.4
Total 35 Do not know 2.8
Marital Status % Profession No. Illness Duration (years) %
Married 54.3 Retired 8 0-10 40 Diagnoses (reported) No.
Single 28.6 Housewife 8 11-20 28.6 Confused/Nervous/Anxious/Stress 15
Separated 17.1 General Services 7 Over 20 25.7 Depression/Suicide attempt 15 Technical Jobs 5 Do not know 5.7 Mental Disorder/Mad/Hallucinations 6
Agriculture 3 Do not know 3
Residence % Artist 3 Treatment Conducted No. Epilepsy/Spasm 2
In the city 65.7 Self-employed 1 Drugs 33 Total 41
Out of the city 28.6 Total 35 Psychotherapy 0
Do not know 2
Total 35
Table 1 - Social, dem ographic and clinical char act er ist ics of t he 35 psychiat r ic pat ient s
Am ong 69 r elat ives, t her e w er e 20 m ales and
4 9 f em ales u p t o 4 0 ( 2 3 ) , f r om 4 1 t o 6 0 ( 3 0 ) an d
ov er 60 ( 16) ; 62. 32% of t hese could be gr ouped in
t he age r ange bet w een 30 and 60 year s old.
I t is im por t ant t o em phasize t hat one of t hem
w as y ounger t han 20 y ear s old ( son) and t hat t her e
w as a high per cent age of r elat ives over 50 year s old
( 40. 98% ) , 14 ( 20. 28% ) of w hom w er e w idow ed. All
r ep o r t s o f h a v i n g a p a r t n er w er e i n cl u d ed i n t h e
m ar r ied cat eg or y.
Consider ing t hat 71% of t hese r elat ives w er e
fem ale, it is not sur pr ising t hat 18 r epor t ed t o w or k
only as housew ives ( 26.08% ) and t hat 9 w er e m aids.
Th is g r ou p in clu d ed a lar g e n u m b er of p en sion er s
( 1 4 . 4 8 % ) a n d 3 4 p e o p l e w h o p e r f o r m e d si m p l e
act iv it ies, su ch as in ag r icu lt u r al w or k an d g en er al
ser v ices, as w ell as t ech n ical j obs ( 3 1 . 8 8 % ) ( Table
2 ) .
Table 2 - Social and dem ographic char act er ist ics of 69 r elat ives of psy chiat r ic pat ient s
Th e p a t i e n t s ’ s o c i a l a n d d e m o g r a p h i c
ch ar act er ist ics in f or m ed by t h e 6 9 r elat iv es did n ot
d if f er m u ch ( p r op or t ion ally ) , alt h ou g h t h e su b j ect s
w er e not pair ed ( pat ient and r elat iv e) .
Th e 6 9 r elat iv es did n ot ex act ly cor r espon d
t o t he 35 pat ient s, since dat a collect ion w as conduct ed
independent ly, alt hough it t ook place sim ult aneously
in t he sam e per iod of t im e.
The m ost fr equent ly found r elat ionships w er e
t hat of par ent s ( 31.88% ) and spouses ( 23.19% ) , w hich
r epr esent ed m or e t han fift y per cent of t hese r elat ives.
Childr en ( 7.24% ) and siblings ( 18.84% ) cor r esponded
t o 26.08% .
Th e s e r e l a t i v e s w e r e a c c o m p a n y i n g t h e
pat ient s dur ing an appoint m ent ( 57.97% ) , had com e
t o collect a pr escr ipt ion or declar at ion or t o ch an ge
t he dat e of an appoint m ent ( 11.71% ) or w er e visit ing
t he pat ient ( 27.54% ) . One of t hem had com e t o pick
up her son, w ho had been dischar ged.
Th e r elat iv es r ep or t ed t h at 6 3 . 7 7 % of t h e
p a t i e n t s w e r e m a l e . Th e s e s u b j e c t s ’ a g e s w e r e
at t r ibut ed as follow s: 42.35% in t he r ange of 20 t o 40
year s old, 46.38% in t he r ange of 41 t o 60, w hile only
11.9% w er e ov er 60 y ear s old ( Table 3) .
Clin ical ch ar act er ist ics
c l i n i c a l c h a r a c t e r i s t i c s r e p o r t e d b y t h e s u b j e c t s
t h em selv es allow ed f or som e r ef lect ion s, b ased on
Table 1 .
W i t h r e sp e ct t o cl i n i ca l p r o b l e m s, i t w a s
obser v ed t hat 20 subj ect s r epor t ed not t o hav e any
com p lain t s. Th is r ep r esen t s 5 7 . 1 4 % of t h e r ep lies,
w her eas t he ot her s only infor m ed depr ession, suicide
or n er v ou sn ess.
An analysis of t his indicat or show ed t hat t he
quest ion had not been w ell for m ulat ed, because t he
su b j ect u n d er st ood “ com p lain t ” as r ef er r in g t o t h e
ser v ice and not as t heir clinical pr oblem . Ther efor e,
t his result m ust be disregarded as a clinical indicat or.
I n r elat ion t o w hen t he disor der had begun,
it w as ob ser v ed t h at 4 0 % of t h e su b j ect s h ad h ad
t h eir f ir st sy m pt om s less t h an 1 0 y ear s bef or e an d
28.57% had pr esent ed t hem bet w een 10 and 20 year s
ago. On e qu ar t er of t h e 3 5 su bj ect s ( 2 5 . 7 1 % ) h ad
had t he disor der for ov er 20 y ear s.
These dat a cor r espond t o t he infor m at ion t hat
7 7 % h ad u p t o 1 0 h osp it alizat ion s an d 8 . 5 7 % h ad
ov er 2 0 .
I t is r elevant t o not ice t hat 11.42% had never
been hospit alized. These pat ient s infor m ed t hat t hey
did t heir best in or der t o av oid hospit alizat ions, t hus
k eeping t heir social int egrat ion ( w or k , school, fam ily,
et c) .
Co n c e r n i n g t h e i n f o r m a t i o n g i v e n b y 6 9
r el at i v es ab o u t t h e p at i en t s, i t w as r ep o r t ed t h at
6 3 . 7 6 % w er e m ales w it h a h ig h er con cen t r at ion in
t h e ag e r an g e f r om 4 1 t o 6 0 y ear s old ( 4 6 . 3 7 % ) .
Regarding t he beginning of t he disorder, t he relat ives
also r epor t ed t h at 2 3 . 1 8 % h ad been ill f or ov er 2 0
y e a r s a n d t h a t 5 9 . 4 2 % h a d p r e se n t e d t h e i r f i r st
sy m pt om s less t h an 1 0 y ear s bef or e. On t h e ot h er
h a n d , t h e y i n f o r m e d t h a t 7 7 % h a d u p t o 1 0
h o s p i t a l i z a t i o n s a n d 1 5 . 9 4 % h a d o v e r 2 0
hospit alizat ions, as show n in Table 3.
Table 3 - I nfor m at ion fr om t he 69 r elat ives concer ning t he psychiat r ic pat ient
Most of t he pat ient s ( 85.72% ) classified t heir
disease as m ood disorder s or confusion, ner vousness,
an x iet y, st r ess, an d p r ob lem s in t h e h ead . On ly 6
( 17. 14% ) denom inat ed t hem selv es as m ent ally - ill or
m ad and r epor t ed t o hav e hallucinat ions ( Table 1) .
Am on g t h e r elat iv es, 1 0 . 1 4 % did n ot k n ow
a b o u t t h e p a t i e n t ’ s d i a g n o s i s , w h e r e a s 3 1 . 8 8 %
classified it as m ent al illness, 20.28% as a problem in
t h e h ead / n er v ou s b r eak d ow n , 1 0 . 1 4 % as p sy ch
o-or g an ic d iseases an d 2 7 . 5 3 % as d ep r ession ( Tab le
3 ) .
Con cer n in g t h e t r eat m en t s applied, 9 4 . 2 8 %
of t he pat ient s only r epor t ed t r eat m ent s w it h dr ugs,
2 of t hem did not know and none of t hem r efer r ed t o
psy ch ot h er apy ( Table 1 ) .
36.23% of t he r elat ives could not pr ovide any
i n f o r m a t i o n a b o u t t h e t r e a t m e n t s a p p l i e d t o t h e
pat ien t s; t h e ot h er s r epor t ed t h at dr u gs w er e u sed
for 59. 42% and psychot her apy for 4. 34% ( Table 3) .
These subj ect s’ pr ofile r eveals t he m ovem ent
of gr adual t r ansit ion fr om asy lum car e t o innov at iv e
ex p er i en ces, a l t h o u g h t h e co n cen t r a t i o n o f d r u g
-b a sed t r ea t m en t s a n d d ep en d en ce o n p sy ch i a t r i c
inst it ut ions ar e st ill char act er ist ic.
St at ist ical r esult s of t he Opinion Measur em ent Scale
( AMS)
Th e com p ar ison s b et w een g r ou p s ( Pat ien t s
a n d Rel a t i v es) a n d b et w een a r ea s ( Co n cep t s a n d
Car e) w er e con d u ct ed t h r ou g h t h e m ean scor e p er
indiv idual in each ar ea.
The st at ist ical t est s used w ere carried out w it h
t y pe- I er r or pr obabilit y fix ed at 5% .
I n t h e Ma n n - W h i t n e y s t a t i s t i c a l t e s t f o r
com par in g t w o in depen den t popu lat ion s ( Pat ien t s x
I n t h e Table 4 , it s possible t o obser v e t h at
significant differ ences bet w een Pat ient s and Relat iv es
occurred neit her in relat ion t o m ent al healt h concept s
nor in relat ion t o care, according t o t he Mann- Whit ney
Test .
How ever, w hen com par ing Concept s and Car e
according t o t he Wilcoxon Test , a significant difference
w as obser v ed for bot h Pat ient s and Relat iv es.
W i t h r e sp e ct t o t h e m e a n Pa t i e n t sco r e s
r egar ding Concept s, t he r esult w as 2. 73 for pat ient s
a n d 2 . 7 1 f o r r e l a t i v e s, w h i ch co n f i g u r e s a n o n
-si g n i f i ca n t d i f f e r e n ce . Si m i l a r l y, t h e m e a n sco r e s
r egar ding Car e ( 1. 73) for Pat ient s do not differ v er y
m u ch fr om t h e r esu lt of t h e m ean scor es r egar din g
Car e for Relat iv es ( 1. 65) ( Table 5) .
Tab le 5 - Mean scor es of m en t ally - ill p at ien t s an d
relat ives in relat ion t o Ment al healt h concept s and care
I n t h e i n d i v i d u a l a n a l y s i s , 1 0 o u t o f 3 5
subj ect s pr esent ed a m ean v alue t hat v ar ied ov er 3.
I n t h e ot h er cases, t h e m ean f or Con cep t s v ar ied
f r o m 2 t o 3 . I n r e l a t i o n t o ca r e , o n e i n d i v i d u a l
p r e s e n t e d a m e a n o v e r 3 a n d s e v e n s u b j e c t s
displayed a m ean bet w een 2 and 3, w her eas t he ot her s
w er e below 2.
Regar ding t he r elat ives, 18 pr esent ed a m ean
ov er 3 for Concept and none had a m ean ov er 3 for
Ca r e .
St andar d deviat ion w as 1.73 for pat ient s and
1 . 7 3 f or Relat iv es in q u est ion s r elat ed t o Con cep t ,
and 1 . 3 7 for pat ient s and 1 . 2 9 for Relat iv es r elat ed
t o Ca r e , w h i c h i n d i c a t e d h o m o g e n e i t y i n t h e
dist r ibut ion of t he subj ect s’ scor es for bot h Concept
and Car e. Ther efor e, no quest ions st ood out or w er e
concent r at ed in eit her gr oup.
CONCLUSI ONS
To ar r ive at t his analysis, an inst r um ent w as
con st r u ct ed in accor d an ce w it h t h e m et h od olog ical
pr ecept s in dicat ed for t h ese pr ocedu r es.
I n t he elaborat ion of psychological scales, t he
r esear ch er sh o u l d f o l l o w 3 p r i n ci p l es: t h eo r et i cal ,
em p ir ical an d an aly t ical( 1 4 ). Th eor et ical p r oced u r es
f o cu s o n t h e su b j e ct t o b e e x a m i n e d ; e m p i r i ca l
p r o c e d u r e s d e f i n e t h e s t e p s a n d t e c h n i q u e s f o r
a p p l y i n g t h e e l a b o r a t e d i n s t r u m e n t ; a n a l y t i c a l
pr ocedu r es est ablish w h at st at ist ical an d qu alit at iv e
analyses w ill be realized on t he basis of t he obt ained
d at a.
Th e an aly sis of t h e social an d dem ogr aph ic
ch ar act er i st i cs o f p at i en t s an d r el at i v es sh o w ed a
populat ion of user s t hat w as not differ ent fr om t hose
found in pr ev ious st udies.
The st at em ent s r elat ed t o m ent al healt h and
p sy ch iat r ic car e t h at w er e p r esen t ed in t h is st u d y
con t ain con cep t u al q u est ion s, w h ich v er if y w h at is
under st ood as m ent al healt h, char act er ist ic behav ior
of m ent al pat ient s, t heir insert ion in societ y and beliefs
and ex pect at ions about cur e, t her apeut ic pr ocedur es
and t he car e sy st em .
Th e st at ist ical r esu lt s f r om t h e op in ion s of
p at ien t s an d t h eir r elat iv es on con cep t s r eg ar d in g
m e n t a l h e a l t h c a r e s h o w e d t h a t t h e r e w e r e n o
significant differences bet w een t he opinions of pat ient s
an d r elat iv es, ex cep t in t h e com p ar ison of con cep t
and car e bet w een t he t w o gr oups of subj ect s. t w o- t ail t est( 1 3 ). I n t h e Wilcox on t est f or com par in g
t w o dependent populat ions, t he alt er nat ive hypot hesis
w as t h at t h e scor es r elat ed t o con cep t s su r p assed
t hose r elat ed t o car e.
Table 4 - Result s of Mann-Whit ney and Wilcoxon Test s for gr oups of Pat ient s and Relat ives concer ning Concept s
an d Psy ch iat r ic Car e
Not e: cr it ical value for t he t est s: 1.64
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