O profissional da APS e as substâncias de abuso: o papel da capacitação na rotina da assistência

Abstract

Introduction: Between 10-20% of patients treated in Primary Health Care (PHC) drink alcohol at levels considered risky. For preventive actions to be developed at this level, it is essential to train the teams, according to the Ministry of Health of Brazil. However, there are many barriers that may prevent the adoption of a procedure in routine practice. Objective: This study sought to evaluate practices of prevention against the risky use of alcohol and other drugs adopted amongst PHC nurses trained in different modalities – present and at a distance and also un-trained professionals, as well as possible obstacles in this process. Method: Data were collected during October and November 2008. Seven nurses were interviewed who were working in the PHC. For this study a content analysis was adopted as the analytical procedure. We followed a semi-structured model of interview which enabled us the analysis of six themes: training, practices, attitudes, beliefs about alcohol and other drugs; feelings involved in dealing with the topics of alcohol and other drugs. Results: The results suggest the need for a permanent forum for discussion subsequent to training that would serve to strengthen, at medium term, for training, contributing then to identification of difficulties of professional exchange of experiences, increasing the sense of self-efficacy for dealing with this demand. However, a possible positive effect of training was felt among the trained groups, since they did not give the problem alcohol and other drugs the moral connotation given by the non-trained group, which may represent an opening to future educative actions. Conclusion: The underutilization of evidence-based practice in relation to alcohol and other drugs is still prevailing among professionals, supporting the literature that points in Brazil, the mental health services as a whole, being decontextualised with the sanitary practice. The logic of referrals, reference and counter reference also proved to be still prevalent.