{"id":3852,"date":"2021-03-28T19:50:08","date_gmt":"2021-03-28T19:50:08","guid":{"rendered":"https:\/\/curesz.org\/?p=3852"},"modified":"2023-08-14T12:05:27","modified_gmt":"2023-08-14T16:05:27","slug":"telemedicine-and-schizophrenia-a-brave-new-world","status":"publish","type":"post","link":"https:\/\/curesz.org\/pt_pt\/2021\/03\/28\/telemedicine-and-schizophrenia-a-brave-new-world\/","title":{"rendered":"Telemedicina e esquizofrenia: um admir\u00e1vel mundo novo"},"content":{"rendered":"
\"\"

Dr. Craig Chepke, Membro do Conselho de Administra\u00e7\u00e3o da Funda\u00e7\u00e3o CURESZ, Psiquiatra de Pr\u00e1tica Privada e Professor Assistente Adjunto de Psiquiatria, Escola de Medicina da Universidade da Carolina do Norte<\/p><\/div>\n

Em mar\u00e7o de 2021, faz um ano que os Estados Unidos declararam a pandemia de COVID-19 uma emerg\u00eancia nacional e o mundo dos cuidados de sa\u00fade ainda est\u00e1 a tentar perceber os pormenores. Num instante, a telemedicina passou de um servi\u00e7o de nicho a uma expetativa b\u00e1sica para os prestadores de cuidados de sa\u00fade em todos os contextos, desde os grandes sistemas de sa\u00fade aos consult\u00f3rios privados.<\/p>\n

Ao contr\u00e1rio de muitos outros especialistas, a maioria dos psiquiatras n\u00e3o requer uma quantidade significativa de equipamentos para fazer seu trabalho, ent\u00e3o algu\u00e9m poderia pensar que o campo seria ideal para uma transi\u00e7\u00e3o suave para a telemedicina. No entanto, muitos psiquiatras o fizeram de m\u00e1 vontade - inclusive eu. Em quase todas as facetas da minha vida, sou um usu\u00e1rio \u00e1vido de toda tecnologia que consigo. No entanto, em minha pr\u00e1tica cl\u00ednica, insisti em consultas presenciais e em escrever minhas anota\u00e7\u00f5es \u00e0 m\u00e3o para manter o contato visual o m\u00e1ximo poss\u00edvel. Mas tempos desesperados exigiam medidas desesperadas, ent\u00e3o me tornei um telepsiquiatra tempor\u00e1rio da noite para o dia. No in\u00edcio, havia duas preocupa\u00e7\u00f5es comuns que ouvi de colegas: que as pessoas com esquizofrenia teriam dificuldade em usar a tecnologia necess\u00e1ria para a telemedicina ou que del\u00edrios ou alucina\u00e7\u00f5es atrapalhariam demais as consultas.<\/p>\n

A minha experi\u00eancia, no entanto, tem sido diferente. De um modo geral, tenho verificado que as pessoas com esquizofrenia se sentem muito \u00e0 vontade a navegar na tecnologia. Mais preocupante tem sido o chamado \"fosso digital\", que se refere ao facto de nem toda a gente no pa\u00eds ter igual acesso a liga\u00e7\u00f5es r\u00e1pidas e est\u00e1veis \u00e0 Internet e a hardware adequado para tirar partido delas. Tamb\u00e9m n\u00e3o vi a psicose apresentar uma fonte de problemas que n\u00e3o fosse igualmente desafiadora se a pessoa estivesse na mesma sala. No entanto, pode ser mais dif\u00edcil para um m\u00e9dico avaliar o \u00e2mbito e a gravidade da psicose virtualmente, pelo que recomendo aos doentes que tentem ser mais pr\u00f3-activos na express\u00e3o dos sintomas que est\u00e3o a sentir. Muitas pessoas tamb\u00e9m consideram \u00fatil fazer uma lista de t\u00f3picos que querem discutir com anteced\u00eancia. Claro que a esquizofrenia \u00e9 muito mais do que apenas os sintomas positivos. Tenho notado que algumas pessoas que t\u00eam sintomas cognitivos mais proeminentes de esquizofrenia s\u00e3o um pouco mais distra\u00eddas. Por outro lado, muitas pessoas com sintomas negativos mais proeminentes parecem mais \u00e0 vontade nas nossas intera\u00e7\u00f5es virtuais do que presenciais.<\/p>\n

A telemedicina tamb\u00e9m demonstrou ser \u00fatil como complemento dos cuidados presenciais e n\u00e3o como substituto. Um dilema para as pessoas a quem s\u00e3o prescritos antipsic\u00f3ticos inject\u00e1veis de a\u00e7\u00e3o prolongada (AIL) na pandemia \u00e9 o facto de estes exigirem absolutamente uma administra\u00e7\u00e3o presencial. Acredito que os AIL s\u00e3o interven\u00e7\u00f5es que salvam vidas, pelo que tive de descobrir como continuar a oferecer injec\u00e7\u00f5es e, ao mesmo tempo, fazer a minha parte para manter todos saud\u00e1veis. Desde cedo, fiz a transi\u00e7\u00e3o das pessoas para as IALs que podem ser injectadas no ombro, para permitir que as pessoas conduzam e recebam a inje\u00e7\u00e3o enquanto permanecem no seu carro. \u00c0 medida que ganh\u00e1mos confian\u00e7a na nossa capacidade de utilizar m\u00e1scaras e distanciamento para reduzir o risco de infe\u00e7\u00e3o, comecei a trazer para o consult\u00f3rio as pessoas que necessitavam de LAIs administradas no m\u00fasculo da anca. Depois de administrar a inje\u00e7\u00e3o, realiz\u00e1mos o resto da consulta virtualmente para reduzir a possibilidade de transmiss\u00e3o do v\u00edrus.<\/p>\n

Tamb\u00e9m houve claros pontos positivos no uso generalizado da telemedicina. A elimina\u00e7\u00e3o do tempo de viagem tornou mais f\u00e1cil para as pessoas agendar compromissos em torno de outras obriga\u00e7\u00f5es. Como resultado, consegui atender as pessoas com mais rapidez quando elas precisavam de um compromisso com urg\u00eancia, as pessoas que moram longe do escrit\u00f3rio puderam agendar reuni\u00f5es mais frequentes e o n\u00famero de compromissos perdidos diminuiu. A telemedicina tamb\u00e9m capacitou as pessoas a irem al\u00e9m de sua geografia local para buscar atendimento especializado. \u00c9 mais f\u00e1cil do que nunca para as pessoas que vivem em \u00e1reas rurais acessar tratamento ou uma segunda opini\u00e3o de um especialista em esquizofrenia em todo o estado ou al\u00e9m.<\/p>\n

Dizem que a necessidade \u00e9 a m\u00e3e da inven\u00e7\u00e3o. Embora a urg\u00eancia da transi\u00e7\u00e3o tenha feito com que err\u00e1ssemos em algumas coisas, tanto os m\u00e9dicos quanto os pacientes se adaptaram rapidamente. O resultado transformou a sa\u00fade de uma forma que n\u00e3o nos vejo abandonando. Qualquer que seja a apar\u00eancia da telepsiquiatria, uma coisa \u00e9 certa: \u00e9 o futuro da medicina de uma forma ou de outra.<\/p>","protected":false},"excerpt":{"rendered":"

March 2021 marks a year since the United States declared […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3852","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"acf":[],"yoast_head":"\nTelemedicine and Schizophrenia: A Brave New World - CURESZ Foundation<\/title>\n<meta name=\"description\" content=\"March 2021 marks a year since the U.S. declared the COVID-19 pandemic a national emergency, and the healthcare world is still trying to sort out the details. 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