Acompanhamento terapêutico: estudo exploratório acerca das dificuldades de adesão aos tratamentos

Abstract

Chemical dependence is a public health problem. There is an estimate that subjects who suffer from substance use disorders have difficulties in starting and staying in treatments, with high dropout rates. The objective of this research was to analyze the contributions of Therapeutic Accompaniment in the process of adherence to the treatment of chemical dependence. As for the method, it was a qualitative-exploratory study carried out with six therapeutic companions who had patients with problematic drug use. As an instrument, a semi-structured interview with guiding questions was used. Data were reviewed based on the content analysis proposed by Laville and Dionne. The results of the data analysis of the six interviews were divided into three categories for better understanding. The category hindering dimensions in the adherence process was divided into three units of analysis: emphasis on hospitalizations where there is a more hospitalization-centered bias, medicalization with a greater support in medicating only considering that large doses solve the patient's demand and resistance in healthy or unhealthy points of refusal and, at the same time, possible signs of difficulty in patient adherence. The second category deals with the facilitating dimensions in the adherence process and is divided into the following units of analysis: bond established making treatment possible, flexible setting allowing for the different provisions necessary for the patient, Expansion of their social support network and Teamwork that integrates the different treatment modalities, such as Accompaniment Therapeutic (AT). The last category is the experience and approach with the AT is divided into: training, path and approach, observance of psychiatric reform and harm reduction. All of these are part of a better understanding of patients and offering a better disposition for treatments. It is considered that the research clarifies dimensions that influence, to some extent, adherence and need attention from the therapeutic companion and team to try to reverse any hindering dimensions, even having the possibility of turning them into facilitating dimensions. The facilitating dimensions also provide an update of practices working in the AT through the experience and approach of the therapeutic companion. Greater knowledge is relevant not only for those who practice TA, but for the entire team to provide greater support for the treatments to be performed. In this way, the subject will have the most integral support and will be within their possibilities, potentialities and needs. [resumo fornecido pelo autor]