Taking into consideration issues such as stigma and the mental health gap, this study explores narratives of anxious and depressed women treated in a community-based primary care service in a Rio de Janeiro favela about their suffering and care. We analysed 13 in-depth interviews using questions from Kadam's study. Framework analysis studied Access, Gateway, Trust, Psychosocial Issues, and Primary Mental Health Care, as key-concepts. Vulnerability and accessibility were the theoretical references. Thematic analysis found "suffering category", highlighting family and community problems, and "help seeking category", indicating how these women have coped with their emotional problems and addressed their needs through health services, community resources and self-help. Women's language patterns indicated links between implicit social rules and constraints to talk about suffering, especially if related to local violence. High medical turnover and overload are barriers for establishing a positive relationship with family physicians and continuity of care is a facilitator that promotes trust, security and adherence. Concluding, to plan community-based primary mental health care of this population, cultural and social factors must be comprehended as well as the work health teams conditions.

译文

:考虑到耻辱感和心理健康差距等问题,本研究探讨了在里约热内卢贫民窟的社区初级保健服务机构中接受治疗的焦虑和沮丧妇女的叙述,介绍了她们的痛苦和照料。我们使用Kadam研究中的问题分析了13次深度访谈。框架分析研究了访问,网关,信任,社会心理问题和初级精神卫生保健等关键概念。漏洞和可访问性是理论参考。专题分析发现“遭受苦难的类别”,突出家庭和社区问题以及“寻求帮助的类别”,表明这些妇女如何通过健康服务,社区资源和自助来应对自己的情感问题并满足其需求。妇女的语言模式表明,内隐的社会规则与谈论苦难的约束之间存在联系,特别是在与地方暴力有关的情况下。较高的医疗流失率和超负荷工作是与家庭医生建立积极关系的障碍,而护理的连续性则可促进信任,安全性和依从性。最后,要计划此人群的社区初级精神卫生保健,必须理解文化和社会因素以及工作健康团队的条件。

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