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2002, Número 4

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Salud Mental 2002; 25 (4)


Autodeterminación y calidad de vida en salud mental: dos conceptos emergentes

Verdugo MA, Martín M

Idioma: Español
Referencias bibliográficas: 93
Paginas: 68-77
Archivo PDF: 380.86 Kb.


RESUMEN

Autodeterminación y calidad de vida son dos conceptos que en los últimos años han sido objeto de numerosos estudios que han tratado de encontrar la relación existente entre ambos, a fin de mejorar las condiciones de vida de los enfermos mentales y sus familiares. A partir de la reforma psiquiátrica se comenzó a ver, desde la perspectiva del paciente, la necesidad de mejorar su calidad de vida mediante una mayor participación suya en los servicios de salud mental, así como en las decisiones y la planificación del tratamiento.
Evaluar la satisfacción del paciente con la atención prestada por los dispositivos socioasistenciales permitió ver la necesidad de mejorar su autonomía. Para conseguir este objetivo, se tuvieron en cuenta sus opiniones, deseos y necesidades, y se promovió además su integración a la comunidad. La percepción del paciente acerca de su calidad de vida y de su propia realidad es una variable que ya forma parte de muchos programas de rehabilitación psicosocial diseñados en los últimos años.
Los modelos de calidad de vida que más importancia han dado al concepto de autodeterminación han sido los comunitarios, así como el modelo propuesto por Schalock, validado por la revisión de la investigación publicada en el periodo 1985-1999. Estos modelos multidimensionales consideran que la percepción subjetiva del paciente debe tenerse en cuenta al diseñar las distintas intervenciones o los programas de rehabilitación.
El concepto de autodeterminación se utilizó inicialmente en la evaluación de programas como principio de garantía de bienestar y calidad de vida. A partir de la reforma psiquiátrica, se empleó como indicador de los modelos comunitarios y, en los últimos años, como una dimensión importante dentro de los programas de rehabilitación psicosocial.
Debido al cambio de paradigma, la atención en salud mental se centró más en los usuarios y familiares, y menos en los profesionales. Este cambio se reflejó en el uso de diseños de evaluación longitudinales, cuantitativos y cualitativos. El objetivo de este artículo es analizar el impacto del concepto de calidad de vida y autodeterminación en salud mental. Para ello, nos centramos en la investigación sobre calidad de vida y autodeterminación efectuada entre 1985-1999, que indica cuándo comenzaron a utilizarse ambos conceptos, por qué y de qué manera. En un segundo momento, analizaremos su empleo en las prácticas profesionales y su influencia en el cambio de paradigma. Para finalizar, ofreceremos una serie de propuestas y pautas de acción, dirigidas a todas las personas interesadas en mejorar la calidad de vida y autodeterminación en salud mental.


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