Intervenções psicossociais para transtornos mentais comuns: percepções e demandas formativas na Medicina de Família e Comunidade

Abstract

The growing prevalence of mental health problems, especially common mental disorders (CMD), has motivated strategies to increase primary care services resolution through the training of human resources at this level of care. The non-pharmacological approach is the main evidence-based therapeutic method for CMD and, although it is considered an essential competence of family physicians, there is insufficient use of psychosocial interventions (PI) by these professionals in the management of these disorders, with insufficient training reported as one of the main reasons. Data that can guide training strategies on this topic are scarce in the literature. This study aimed to investigate the perceptions of second-year Family and Community Medicine residents (R2) of residency programs in Minas Gerais about the use of PI, the learning of these interventions and the training demands around them, in approach to TMC. Therefore, a descriptive, cross-sectional, quantitative study was carried out through an online semi-structured questionnaire aimed at residents. Data were collected between October and November 2020 and analyzed using descriptive statistics. Of the 102 identified R2 residents, 46 (45.1%) participated in the survey and represent 83.3% of the invited programs. Residents are mostly women (67.4%), with an average age of 30 years and graduates from private institutions (62.2%). Almost all of them (93.5%) claim to use PI for the CMD approach, but although the majority (81.4%) perceive improvement in patients, only 53.4% apply them in more than half of the cases of TMC. The majority (69.6%) know and apply from one to six of the 13 reference PIs presented in the questionnaire, and the most applied and in which they perceive themselves as more competent are: clinical communication techniques and active listening; techniques for exploring the experience of illness and techniques for empathic response to emotions. In addition to using little, they reported having little practical skill in: problem solving therapy; behavioral activation; guided meditation/mindfulness and physical relaxation and breathing techniques. More than 78% reported experiencing difficulty in using PI and the main reasons mentioned were not perceiving themselves as having adequate training (74.4%) and their work process hindering or making this use unfeasible (57.6%). The main learning methods reported for the acquisition of skills on the subject were: self-instructional method (69.6%); theoretical classes at the residence (65.2%) and practical work in the residence service (58.7%). Despite this, 45.6% of the residents consider “little” or “none” the contribution of the residence in this learning process. The main interventions they would like to be more empowered about are: guided meditation/mindfulness; community therapy; physical relaxation techniques and breathing and problem solving therapy. The residency had a contribution considered insufficient and the work process in practice scenarios was pointed out as an important barrier in this context. With the results obtained, it was possible to identify the perception of important training gaps on the use of IP in the approach to CMD by Family and Community Medicine residents (R2), which allows to point out paths for the development of improvement strategies.