DSpace Collection:http://repository.usmf.md:80/handle/20.500.12710/8622024-03-28T23:26:27Z2024-03-28T23:26:27ZAspectele bioetice ale securității și siguranței în Sănătatea mintalăDorosevici, Alexandrhttp://repository.usmf.md:80/handle/20.500.12710/242972023-05-19T15:16:34Z2018-01-01T00:00:00ZTitle: Aspectele bioetice ale securității și siguranței în Sănătatea mintală
Authors: Dorosevici, Alexandr
Abstract: Introducere: Securitatea umană are un cadru vast și universal iar calitatea sa
bioetică se dovedește prin plasarea acesteia cu ușurință în sistemele etice precum
morala și binefacerea. Asigurarea securității este una din necesitățile primordiale
ale ființei umane conform multcunoscutei piramide a nevoilor lui A.Maslow.
Securitatea ca și dimensiune bioetică consta dintr-un set vital de siguranțe realizate
ca și nivelurile de profunzime a aplicării măsurilor de securitate;
Siguranța fizică bazată pe nevoie fiziologică de mediu prietenos și sigur, care
exclude violența fizică, harțuire și abuzul, acces la servicii de sănătate de calitate
,care exclud malpraxisul inclusiv neglijența , siguranța de mediu sănătos și
prietenos,siguranță societală care include lipsa atitudinilor negative(stigmatizare,
stereotipuri, prejudecăți, discriminări,izolarea, ) sau chiar ostile față de beneficiarii
serviciilor de Sănătate mintală, siguranța economică – accesul la un loc de trai
sigur, cald și salubru, siguranța lingvistică și discursivă- lipsa discriminărilor și
abuzurilor verbale, siguranța politică și publică- prezența mecanismelor,
legislației și politicilor pentru prevenirea crizelor și situațiilor sus numite.
Scopul cercetarii; Studiul a urmărit o analiza normativă a conceptului de
Securitate în domeniul Sănătății mintale, care a stabilit că Securitatea în sănătate
mintală este un set de măsuri întru prevenirea acțiunilor negative a oamenilor din
jur asupra beneficiarilr, precum bulling, mobbing, stigma, abuz, malpraxis,
neglijarea și izolare socială, iar Siguranța în Sănătatea mintală se exprimă prin
nivelurile de aplicare a securității pentru a preveni accidente și crize involuntare sau independente de factorul uman și nu au caracter intenționat. Astfel siguranța în
sănătate mintală este protecția de posibilele situații de criză, prin elaborare și
aplicare politici îndreptate spre evitarea factorilor de vulnerabilitate și consolidarea
factorilor de protecție
În ultimii ani, în Republica Moldova s-au efectuat puține cercetări care
evaluează Securitatea umană prin prisma bioetică, iar în Sănătate mintală nu a fost
descrisă anterior.
Materiale și metode: Analiza și sinteză a literaturii relevante, desk-review.
Rezultate: Studiul arată că Dimensiunea etică a Securității în Servicii de
sănătate mintală, se pronunță prin implicarea multilaterală a valorilor personale ale
beneficiarului,, precum dreptul la liberă alegerea și la consimțămînt, mobilitatea și
liberă circulație indiferent de diagnostic, la mediu sănătos, inclusiv în staționare de
psihiatrie și prietenos precum în servicii de Sănătate mintală, alte servicii de
sănătate, instituțiile statului și comunitate.
Concluzii: Studiul a evidențiat că Securitatea individului este prioritară
securității colectivității , societății sau statului astfel invocarea ,,binelui colectiv și
faptului precum că beneficiarii serviciilor de Sănătate mintală ar trebui să fie
izolați, este total irelevantă și nefondată pe teoriile etice și nu este nimic altceva
decât o metodă de manipulare nebazată pe dovezi.2018-01-01T00:00:00ZУязвимость пациентов с психическими расстройствами в контексте соблюдения биоэтических принциовДоросевич, А. А.http://repository.usmf.md:80/handle/20.500.12710/242962023-05-19T15:04:28Z2016-01-01T00:00:00ZTitle: Уязвимость пациентов с психическими расстройствами в контексте соблюдения биоэтических принциов
Authors: Доросевич, А. А.2016-01-01T00:00:00ZA cross-sectional study of service user needs in the Republic of Moldova first step of implementation of mental health reformChihai, J.http://repository.usmf.md:80/handle/20.500.12710/196162022-01-24T12:29:39Z2019-01-01T00:00:00ZTitle: A cross-sectional study of service user needs in the Republic of Moldova first step of implementation of mental health reform
Authors: Chihai, J.
Abstract: The Republic of Moldova has been undergoing a comprehensive national reform of its mental health system since 2014 in an effort to deinstitutionalize mental health care. The central aim was to implement a continuum of mental health care provided through family doctors, community mental health care teams and mental health care specialists in acute psychiatric wards and general regional hospitals. The current research was conducted in the context of an ongoing reform of mental health services in the Republic of Moldova since 2014, where efforts have been devoted to creating community-based mental health services. This paper presents a snapshot of the needs of mental health service users in the Republic of Moldova and helps to understand how and with which services their needs can be addressed in line with the triage and care pathway modifications made as part of the ongoing reform of the mental health services in the country. This cross-sectional study compared the levels of needs, quality of life, mental health status and functioning among mental health service users consecutively admitted to the psychiatric hospital in Chisinau, Moldova. All service users resided in one of the project’s pilot districts where community mental health services were being developed. Conclusions – There was a high number of unmet needs among this inpatient population, particularly social needs and service-related needs, which helps to guide future service delivery reform efforts in Moldova. A continuum of inpatient and outpatient care, and individual treatment plans can help address the different needs of different patients. Individual treatment plans for patients, and the choice of the appropriate treatment for patients could be guided successfully by an assessment of service users’ (unmet) needs of care and level of functioning.2019-01-01T00:00:00ZComprehensive medical and functional assessment of patients with severe mental illnesses receiving care in period of reforming mental health system 2017-2020 in Republic of MoldovaCosulean, R.Chihai, J.http://repository.usmf.md:80/handle/20.500.12710/196132022-01-24T12:29:25Z2021-01-01T00:00:00ZTitle: Comprehensive medical and functional assessment of patients with severe mental illnesses receiving care in period of reforming mental health system 2017-2020 in Republic of Moldova
Authors: Cosulean, R.; Chihai, J.
Abstract: Introduction: Prior to initiation of the mental health reform in August 2014, people with mental
health problems were provided the bulk of their care in psychiatric hospitals or residential
institutions. While care in institutions was central, a number of people with mental health
problems quality for care in community-based settings, either in: a) primary care services led by
family doctors and nurses; b) community mental health centers staffed by a multidisciplinary
community mental health team, or c) short-term inpatient admission to an acute inpatient ward
in a regional general hospital. To understand how many and which patients qualify for shifting to
services in community settings, this study aims to carry out a psychological and functional
assessment of patients that are residents of the MENSANA project’s 4 pilot rayons (Orhei, Soroca,
Cahul and Cimislia), and after the assessment, applying a referral/indication algorithm for the
more appropriate mental health services that fits their needs. This study carries potential benefits
for people with mental health problems, as they can be re-directed, if necessary, to care that may
be a better fit for their needs and enable them to lead a more fulfilling life in their communities.
Depending on the outcome of the individual assessment, some patients may stay in the service in
which they already receive care (i.e. a psychiatric hospital). This study will have an impact on the
patient flow in the mental health care system in Moldova, particularly for mental health services
in the 4 pilot rayons.
Objective: To conduct a comprehensive diagnostic and functional (psychological and social)
assessment of the patients receiving mental health care that reside in the districts of Orhei, Soroca,
Cimislia or Cahul, in order to determine their further needs for mental health services. A number
of countries have documented the shift in care from psychiatric hospital care to community-based
settings (e.g. England, Canada, Australia). Within these processes, the most frequently assessed
outcomes are social functioning, psychiatric symptoms, and quality of life.
Materials and methods: In order to have a comprehensive assessment to build a patient profile,
the survey developed is a comprehensive assessment consisting of several validated tools and
outcome measures that assess the following dimensions:
• Diagnostic assessment (medical psychiatric assessment);
• Psychological assessment (symptoms and functioning);
• Functional assessment (social functioning, daily life functioning, quality of life).
The first part of the assessment obtains patient-level information which can either be completed
by a ward staff member or CMHC employee and corroborated by the patient. Demographic and
socioeconomic data such as (1) gender, (2) age, (3) partner status, (4) presence or absence of
children under age 18, (5) housing status: independent living (yes/no), (6) occupational status
(paid job yes/no; if yes, how many hours per week). In addition, we like to have some clinical
information: (1) ICD-10 diagnosis, (2) psychiatric and somatic comorbidities, (3) WHO DAS 2
disability level, (5) EQ-5D quality of life.
Conclusions: Often during the course of a mental health problem in Moldova, patients will rotate
in and out of different kinds of services (e.g., hospital-based or community-based) and receive
different kinds of health care interventions (e.g., pharmacological). Given these changes in service
utilization patterns, it is important to capture the types of treatments and services received by
patients to be able to compute the economic costs of offering these treatments and services.2021-01-01T00:00:00Z