Denise Ruschel Bandeira

O conceito de coping: uma revisão teórica

O conceito de coping tem sido descrito como o conjunto das estrategias utilizadas pelas pessoas para adaptarem-se a circunstâncias adversas ou estressantes. O presente artigo apresenta os modelos de coping de Folkman e Lazarus, e de Rudolph, Denning e Weisz, bem como suas diferentes posicoes teoricas e metodologicas. As definicoes de estilos e estrategias de coping, sua eficacia e possiveis relacoes com tracos de personalidade sao discutidas. E salientada a necessidade de uma teoria de stress-coping especifica para criancas, tendo em vista as mudancas cognitivas que ocorrem no curso de seu desenvolvimento. Este artigo apresenta tambem questoes controversas sobre o tema e aponta a necessidade de pesquisas sobre coping no Brasil, para auxiliar na compreensao e desenvolvimento deste conceito.

Adaptação e validação de instrumentos psicológicos entre culturas: algumas considerações

The adaptation of psychological instruments is a complex process that requires a high methodological rigor. Because there is no consensus in the literature about its steps, this article discuss some essential aspects regarding the cross- cultural adaptation of psychological instruments and proposes guidelines to the researchers about the different steps of this process. Some considerations regarding the validation of the adapted instrument are also presented. In this stage, we discuss some aspects regarding the factorial structure of the instrument, which might be evaluated through statistical procedures, such as exploratory and confi rmatory factor analysis. More than that, the authors provide some guidelines to the validation of psychological instruments in different cultures.

Qualidade de vida e espiritualidade

CONTEXTO: A espiritualidade tem sido apontada como uma importante dimensao da qualidade de vida. OBJETIVO: Apresentar revisao de literatura sobre qualidade de vida e espiritualidade, sua associacao e instrumentos de avaliacao. METODO: Busca do tema-titulo nas bases de dados PsycINFO e PubMed/Medline entre 1979 e 2005. RESULTADOS: A qualidade de vida e um conceito recente, que engloba e transcende o conceito de saude, sendo composto de varios dominios ou dimensoes: fisica, psicologica, ambiental, entre outras. Considerada a medida que faltava na area da saude, tem sido definida como a percepcao do individuo de sua posicao na vida no contexto da cultura e sistema de valores nos quais vive e em relacao aos seus objetivos, expectativas, padroes e preocupacoes. Ha indicios consistentes de associacao entre qualidade de vida e espiritualidade/religiosidade, por meio de estudos com razoavel rigor metodologico, utilizando diversas variaveis para avaliar espiritualidade (por exemplo: afiliacao religiosa, oracao e coping religioso/espiritual). Tambem existem varios instrumentos de qualidade de vida validos e fidedignos que avaliam a dimensao espiritual/religiosa. CONCLUSOES: Novos estudos sao necessarios, entretanto, especialmente no Brasil. Tais estudos proverao dados empiricos a serem utilizados no planejamento de intervencoes em saude espiritualmente embasados, visando a uma melhor qualidade de vida.

Escala de coping religioso-espiritual (Escala CRE): elaboração e validação de construto

The spiritual/religious coping (SRC) refers to the way people use faith to cope with stress and has been associated with improvements in qu ality o f life a nd phy sical and mental health. The aim of this article was to d escribe the e laboration and construct validation p rocess of the Spiritual/Religious Coping Scale (SRCOPE Scale), the first i nstrument t o measure SRC in Brazil, based on RCOPE Scale (Pargament & cols., 2000). The study comprehended two phases: (1) translation, adaptation and pilot test (N=50); (2) field test (N=616) and construct validation. Factorial, internal consistency and correlation analysis indicated SRCOPE Scale a s a valid and reliable instrument. It assesses both positives and negatives aspects of SRC, resulting in a comprehensive, functional oriented, theoretical and empirically based, and clinically meaningful instrument, useful to different scientific research areas.

Effects of preanesthetic administration of midazolam, clonidine, or dexmedetomidine on postoperative pain and anxiety in children

Background:  A growing interest in the possible influences of pre‐ and postoperative anxiety and pain scores as outcomes of surgical treatment and benefits of anxiety or pain‐reducing interventions has emerged. The aim of this study was to evaluate the influence of three different premedication regimens on postoperative pain and anxiety in children.

Stress, cortisol, and periodontitis in a population aged 50 years and over.

Periodontitis and its relationship with psycho-neuro-immunological variables, such as psychological stress and cortisol, have been little explored. The objective of this study was to evaluate the extent and severity of chronic periodontitis and its association with the levels of salivary cortisol and the scores obtained with a stress questionnaire in a population aged 50 years and over. We studied 235 individuals in a cross-sectional study. They answered the Lipp’s Inventory of Stress Symptoms for Adults, were instructed to collect three saliva samples for cortisol analysis, and were examined for evaluation for periodontitis. Based on logistic regression, cortisol levels were positively associated with the following outcomes: means of clinical attachment level (CAL) > = 4 mm [OR = 5.1, 95%CI (1.2, 20.7)]; 30% of sites with CAL > = 5 mm [OR = 6.9, 95%CI (1.7, 27.1)]; and 26% of sites with probing depth > = 4 mm [OR = 10.7, 95%CI (1.9, 54.1)] after adjustment for confounding variables. The results suggest that cortisol levels were positively associated with the extent and severity of periodontitis.

Coping (enfrentamento) religioso/espiritual

CONTEXTO: O coping religioso/espiritual (CRE), pouco estudado no Brasil, esta associado a saude e a qualidade de vida (QV). OBJETIVO: Apresentar revisao de literatura sobre CRE, enfocando sua base teorica, avaliacao e aplicacao na pratica clinica. METODO: Pesquisa nas bases de dados Medline, PsycINFO, Scielo e Bireme/BVS entre 1979 e 2006. RESULTADOS: O CRE e o uso da religiao, espiritualidade ou fe para lidar com o estresse. Estrategias de CRE, conforme consequencias que trazem para quem as utiliza, podem ser classificadas como positivas ou negativas, estando geralmente associadas, respectivamente, a melhores ou piores resultados de saude fisica/mental e QV. Evidencias apontam que as pessoas utilizam CRE especialmente em situacoes de crise e, tambem, mais CRE positivo que negativo. Existem cinco estilos de CRE: autodirecao, colaboracao, delegacao, suplica e renuncia. CONCLUSOES: Instrumentos como RCOPE e Escala CRE podem ajudar na avaliacao espiritual do paciente, na pesquisa e no planejamento de intervencoes psicoespirituais enfocando o processo de CRE. Estas podem ser efetivas, ajudando os pacientes a mais bem utilizar um importante recurso disponivel, com significativo impacto na saude e na QV populacional, e reduzindos custos de intervencao em termos de saude publica. Assim, o estudo do CRE mereceria ser incluido na formacao dos profissionais da saude.

Anxiety and salivary cortisol levels in patients with burning mouth syndrome: case-control study

OBJECTIVE The objective of this study was to evaluate the anxiety and salivary cortisol levels in patients with burning mouth syndrome. STUDY DESIGN A case-control ed into 2 groups: BMS, with diagnosis of the syndrome, and control, without any complaint of burning mouth. Anamnesis, oral examination, sialometry, the application anxiety inventory, and 3 saliva samples for cortisol analysis were done in every patient. RESULTS Statistical difference for subjective xerostomia was found on the BMS group (P = .01), but salivary flow rate was normal in both groups. BMS group presented higher anxiety (P = .001) and salivary cortisol levels (P = .003) when compared with the control group. CONCLUSION Higher anxiety and salivary cortisol levels were positively associated with the presence of BMS.

Avaliação de apoio social em estudos brasileiros: aspectos conceituais e instrumentos

This study investigated the different ways of evaluating the social support in Brazilian studies. A surveying of scientific Brazilian publications from 1987 to 2007 was done in the Indexpsi, Pepsic, SciELO and Lilacs databases according to keywords social support and social network. Fifty-five studies included some type of assessing social support in Brazilian samples. The results indicated a rise in the number of studies about social support assessment in the last years using interviews to investigate received and perceived support, predominantly. However, the construction was applied without theoretical basis and was associated with many other concepts, sometimes without an appropriate articulation. Besides, there were evidences of lacking reliable, valid and standardized instruments to Brazilian population by considering the instruments currently used and revised by this study.

Association of chronic stress, depression symptoms and cortisol with low saliva flow in a sample of south-Brazilians aged 50 years and older

BACKGROUND Few studies have evaluated the relationship between depression symptoms, chronic stress or physiological measures of stress such as cortisol levels and saliva secretion. OBJECTIVE To evaluate the association of low saliva flow with chronic stress, depression symptoms and cortisol in a population aged 50 years and older. METHODS Participants (n = 227) were recruited from community clubhouses and among dementia caregivers. Stress was assessed using the Lipps Stress Symptoms Inventory and salivary cortisol measurements. In addition, taking care of a relative with dementia was included as a proxy variable for chronic stress. Depression was assessed using the Beck Depression Inventory. Saliva flow rate was assessed by measuring unstimulated and chewing-stimulated saliva flow. Further saliva samples were collected (morning, noon, night) for cortisol analysis by means of radioimmunoassay. RESULTS Gender, being a dementia caregiver, self-reported diabetes and prescriptive medication intake were independently associated with a low stimulated saliva flow. Prescriptive medication intake was also associated with a low unstimulated saliva flow. CONCLUSION Caregiving, a proxy of chronic stress, was associated with low stimulated saliva flow, indicating that stress may have a potential role in salivary gland hypofunction.