Após as férias estamos de volta para continuar a incluir no nosso blog informação que consideramos importante ter em conta nas intervenções que são feitas pelo nosso país.
Queremos mais uma vez recordar que mais importante que intervir em qualquer que seja a situação, é fundamental saber o que andamos a fazer, lembrem-se que "PIOR QUE NÃO INTERVIR É UMA INTERVENÇÃO MAL FEITA".
Cada pessoa é um ser único e como tal tem reacções únicas perante as situações de stress, compete-nos a nós, enquanto técnicos de saúde mental, adaptar as técnicas às pessoas que temos à nossa frente, e não aplicar as técnicas a torto e a direito como se fosse a única forma de actuar.
Para efectuar um bom trabalho é preciso ter em conta todas as ferramentas que possuímos enquanto técnicos mas também aquelas que aprendemos com os bombeiros com quem trabalhamos, pois é um grupo de trabalho específico e com características próprias.
Não se esqueçam NUNCA que antes de intervir precisam perceber o que aconteceu e qual o impacto que a situação está a ter nos seus diversos elementos, portanto, OBSERVEM - regra de intervenção n.º 1.
Continuem a ler o nosso blog e a participar com posts ou mails.
domingo, outubro 02, 2005
Basic Principles of Emergency Care
It is helpful to remember several basic principles or objectives of emergency care.
1. Provide for basic survival needs and comfort (e.g., liquids, food, shelter, clothing).
2. Help survivors achieve restful and restorative sleep.
3. Preserve an interpersonal safety zone protecting basic personal space (e.g., privacy, quiet, personal effects).
4. Provide nonintrusive ordinary social contact (e.g., a "sounding board," judicious uses of humor, small talk about current events, silent companionship).
5. Address immediate physical health problems or exacerbations of prior illnesses.
6. Assist in locating and verifying the personal safety of separated loved ones or friends.
7. Reconnect survivors with loved ones, friends, and other trusted people (e.g., AA sponsors, work mentors).
8. Help survivors take practical steps to resume ordinary daily life (e.g., daily routines or rituals).
9. Help survivors take practical steps to resolve pressing immediate problems caused by the disaster (e.g., loss of a functional vehicle, inability to get relief vouchers).
10. Facilitate resumption of normal family, community, school, and work roles.
11. Provide survivors with opportunities to grieve their losses.
12. Help survivors reduce problematic tension, anxiety, or despondency to manageable levels.
13. Support survivors' local helpers through consultation and training about common stress reactions and stress management techniques.
1. Provide for basic survival needs and comfort (e.g., liquids, food, shelter, clothing).
2. Help survivors achieve restful and restorative sleep.
3. Preserve an interpersonal safety zone protecting basic personal space (e.g., privacy, quiet, personal effects).
4. Provide nonintrusive ordinary social contact (e.g., a "sounding board," judicious uses of humor, small talk about current events, silent companionship).
5. Address immediate physical health problems or exacerbations of prior illnesses.
6. Assist in locating and verifying the personal safety of separated loved ones or friends.
7. Reconnect survivors with loved ones, friends, and other trusted people (e.g., AA sponsors, work mentors).
8. Help survivors take practical steps to resume ordinary daily life (e.g., daily routines or rituals).
9. Help survivors take practical steps to resolve pressing immediate problems caused by the disaster (e.g., loss of a functional vehicle, inability to get relief vouchers).
10. Facilitate resumption of normal family, community, school, and work roles.
11. Provide survivors with opportunities to grieve their losses.
12. Help survivors reduce problematic tension, anxiety, or despondency to manageable levels.
13. Support survivors' local helpers through consultation and training about common stress reactions and stress management techniques.
Mental-Health Intervention for Disasters
Factors that Facilitate Positive Outcomes and Prevention
There is much evidence to suggest that a number of factors help to facilitate positive outcomes and prevention1. These include:
It is crucial to recognize people's strengths as well as the suffering they have experienced. While survivors' suffering must be acknowledged, and compassion and empathy conveyed to them, it is also important that those who care for them believe in and support their capacity to master this experience.
Information and education help people's understanding and should be an integral part of the support and care systems. Preparation prior to disaster, information about what has happened, education about normal responses to such events, training in what to do to help psychological recovery, information centers and ongoing information feedback to affected communities, all help people's mastery and recovery.
Sharing the experience. Many people may display a need to tell the story of their experience, to give testimony, both to externalise it and obtain emotional release, and to gain understanding and support from others. This varies enormously. It may occur spontaneously as natural groups come together after the disaster. However, there will be others who may not feel ready or who may choose not to talk about their experience. Those involved in the mental health response should be aware of these variable needs and be supportive of what the survivor wants.
Supportive networks are critical and should be retained, reinforced and rebuilt. These networks help people in the ongoing recovery process, both through the exchange of resources and practical assistance, and through to the emotional support they provide to deal with the disaster and its aftermath. Community groups may develop to facilitate support, and should be encouraged.
Possible Obstacles to Seeking Help
Several studies have pointed out that following a disaster or terrorist event, such as the Oklahoma City bombing, many of those in closest proximity to the disaster do not believe they need help and will not seek out services, despite reporting significant emotional distress2. Sprang lists several potential reasons for this:
* Some people may feel that they are better off than those more affected and that they, therefore, should not be so upset.
* Some may not seek help because of pride or because they think that distress indicates weakness of some sort.
* Some individuals may not define services they receive as mental-health intervention, especially if such intervention is unsolicited (e.g., lectures, sermons, discussions, community rituals). Indeed, because the goal of many disaster mental-health workers is to have interventions be a seamless, integrated part of an overall disaster effort, those who receive these services may not recognize them as mental-health interventions.
* Many individuals are more apt to seek informal support from family and friends, which may not be sufficient to prevent long-term distress for some.
It is critical to address this hesitance about seeking help. Nearly half of the individuals studied who were directly exposed to the Oklahoma City bomb blast had an active postdisaster psychiatric disorder, with PTSD being diagnosed in 1/3 of the respondents3. Major Depression was the disorder most commonly associated with PTSD. No new cases of substance abuse were observed, which is consistent with previous findings. Symptom onset of PTSD was rather immediate, usually within one or two days, and few other cases developed after the first month.
There is much evidence to suggest that a number of factors help to facilitate positive outcomes and prevention1. These include:
It is crucial to recognize people's strengths as well as the suffering they have experienced. While survivors' suffering must be acknowledged, and compassion and empathy conveyed to them, it is also important that those who care for them believe in and support their capacity to master this experience.
Information and education help people's understanding and should be an integral part of the support and care systems. Preparation prior to disaster, information about what has happened, education about normal responses to such events, training in what to do to help psychological recovery, information centers and ongoing information feedback to affected communities, all help people's mastery and recovery.
Sharing the experience. Many people may display a need to tell the story of their experience, to give testimony, both to externalise it and obtain emotional release, and to gain understanding and support from others. This varies enormously. It may occur spontaneously as natural groups come together after the disaster. However, there will be others who may not feel ready or who may choose not to talk about their experience. Those involved in the mental health response should be aware of these variable needs and be supportive of what the survivor wants.
Supportive networks are critical and should be retained, reinforced and rebuilt. These networks help people in the ongoing recovery process, both through the exchange of resources and practical assistance, and through to the emotional support they provide to deal with the disaster and its aftermath. Community groups may develop to facilitate support, and should be encouraged.
Possible Obstacles to Seeking Help
Several studies have pointed out that following a disaster or terrorist event, such as the Oklahoma City bombing, many of those in closest proximity to the disaster do not believe they need help and will not seek out services, despite reporting significant emotional distress2. Sprang lists several potential reasons for this:
* Some people may feel that they are better off than those more affected and that they, therefore, should not be so upset.
* Some may not seek help because of pride or because they think that distress indicates weakness of some sort.
* Some individuals may not define services they receive as mental-health intervention, especially if such intervention is unsolicited (e.g., lectures, sermons, discussions, community rituals). Indeed, because the goal of many disaster mental-health workers is to have interventions be a seamless, integrated part of an overall disaster effort, those who receive these services may not recognize them as mental-health interventions.
* Many individuals are more apt to seek informal support from family and friends, which may not be sufficient to prevent long-term distress for some.
It is critical to address this hesitance about seeking help. Nearly half of the individuals studied who were directly exposed to the Oklahoma City bomb blast had an active postdisaster psychiatric disorder, with PTSD being diagnosed in 1/3 of the respondents3. Major Depression was the disorder most commonly associated with PTSD. No new cases of substance abuse were observed, which is consistent with previous findings. Symptom onset of PTSD was rather immediate, usually within one or two days, and few other cases developed after the first month.
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