Eucia Beatriz Lopes Petean

Importance of psychological intervention for the recovery of children submitted to elective surgery

PURPOSE The effects of anxiety on the patient and his/her family are known to be the main factors that influence health recovery in child surgery. When the whole family can be prepared and supported by psychologic intervention, the damage to child behavior and family anxiety is attenuated. METHODS This study was conducted in children between 2 and 6 years old, divided into 2 groups of 10 pairs each. The experimental group received psychologic intervention, whereas the control group did not. One month after the surgery, they were reevaluated and compared with the same instruments used in the beginning of the study. The instruments used were as follows: the State-Trait Anxiety Inventory with the mothers and the Rutters Child Behavior A2 Scale and the Posthospital Behavior Questionnaire with the children. RESULTS The results were compared by the Wilcoxon and Mann-Whitney nonparametric tests for independent samples, both at the P < .05 significance levels. Mothers stated that anxiety was different in the postsurgery period, showing a significant decrease when comparing the experimental and control groups. Both instruments to measure child behavior also showed that prepared children had less habit changes than the control group, which showed increased levels of inadequate behavior. CONCLUSIONS These data confirm reports in literature regarding child preparation before medical intervention and reinforces the importance of specialized presurgery planning procedures by the proper professional interfaced with the surgical colleagues, all aiming toward the best recovery for the children.

Breaking Bad News: Doctors’ Feelings and Behaviors

The announcement about the handicap of a child is communicated to parents by gynecologists or ultrasonographists, in the prenatal period. Often, these professionals are not prepared to communicate this news to the parents, and they have some limitations that lead them to act inappropriately. Therefore, the aims of this research were to identify and to describe the feelings of professionals facing this situation, and to examine their behaviors when they have to inform a couple about the childs anomaly. Ten gynecologists and ultrasonographists were interviewed: five were consultants in Public Health Services and five were private clinicians. Interviews were carried out with a semi-structured script. The results showed that, according to the participants, there is no specific moment, nor a standard behavior, that is most appropriate for making such an announcement. Yet the data show that all the participants feel hurt or frustrated when they must announce this phenomenon, becoming involved with the case. In conclusion, no graduate course has prepared them to deal with this deficiency. Suggestions are made concerning the graduate curriculum in order to improve the preparation of future doctors. A mental health professional is even necessary among the multidisciplinary team formed to deal with the pain produced in the moment of the announcement.

Sobrecarga emocional e qualidade de vida em mães de crianças com erros inatos do metabolismo

This study aims to investigate the perception of women having children with Inborn Errors of Metabolism (IEM) about the experienced emotional burden and their own quality of life. The participants were 21 mothers of children with IEM, with serious neurological injury. The children were of both sexes, up to ten years old. Data collection was accomplished through instruments WHOQOL-Bref and Burden Interview. The data were statistically analyzed and compared. The care of children with IEM interfere in a negative way in the quality of life of the mother, especially in the domain of their social relations, resulting in an emotional burden; the greater the burden, the lower the perceived quality of life.

Genetic counseling follow-up - a retrospective study with a quantitative approach

The impact of genetic counseling (GC) was evaluated in families, who were interviewed at least two and half years and at most seven years after GC at the Genetics Service of the University Hospital, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo (HC, FMRP, USP). The 113 families interviewed in this study were asked 48 questions and all children born after GC were studied clinically. We evaluated the families for spontaneous motivation for GC and understanding of GC information, their reproductive decisions, changes in the family after GC and the health status of new children. The majority of families seen at the Hospital das Clinicas de Ribeirao Preto were not spontaneously motivated to undergo GC. They had a low level of understanding about the information they received during GC. Generally families were using contraceptive methods (even when at low genetic risk) with a consequent low rate of pregnancies and children born after GC. These families also had a very low rate of child adoption and divorces when compared to other studies.

Perda e luto: vivências de mulheres que interromperam a gestação por malformação fetal letal

The scope of this study was to investigate the grieving experiences of women who terminated pregnancies under judicial authorization, due to life-incompatible fetal malformation. Ten women attended in the Fetal Medicine Department of Botucatu Clinical Hospital participated in the study. Data collection was conducted by means of semi-structured interviews forty days after termination. The interviews were recorded and transcribed in full, with the data analyzed from the thematic content analysis perspective. The results revealed that the mothers sought explanations and meanings for the loss, with religious responses and self-blame being very frequent. The reports were marked by feelings of sadness, longing and sensations of emptiness due to the loss of the child, revealing the need of the mothers to dwell on the issue. The mothers were and continued to be linked to their children; the termination of the pregnancy, although being a choice to minimize the pain of an inevitable loss, did not spare the women from experiences of great suffering.>The study includes input for the discussion and planning of health approaches and care for women who terminate their pregnancy due to lethal fetal malformation, by means of judicial authorization.

Deficiência, família e sociedade: um debate contemporâneo

Univ Sao Paulo, Fac Filosofia Ciencias & Letras Ribeirao Preto, Programa Posgrad Psicol, Sao Paulo, Brazil

Paternidade: vivências de pais de meninos diagnosticados com distrofia muscular de Duchenne

This study’s aim was to understand the experience of being the father of a boy diagnosed with Duchenne Muscular Dystrophy (DMD). Eight fathers of 10-year-old or older boys diagnosed with DMD, living in RibeiraoPreto and surrounding cities participated in the study. Interviews included a semi-structured script and data were analyzed according to thematic content analysis. The results show that the confirmation of a DMD diagnosis shocked fathers and was mixed with sorrow, helplessness and hopelessness. Most fathers considered the illness of their child to be a mission sent by God, which helps to alleviate the pain and anguish caused by the disease. As the symptoms started manifesting, the fathers experienced losses that exposed them to great suffering and triggered an anticipatory mourning process. The fathers assigned to the disease the meaning of a mission to be accomplished and considered themselves to be “special fathers”, which positively influenced their adaptation to the disease. Identifying and understanding how fathers experience fatherhood in the presence of a chronic disease/disability is essential to devising psychological counseling and care programs directed to fathers and their families.

Apego materno-fetal, ansiedade e depressão em gestantes com gravidez normal e de risco: estudo comparativo

Este estudo teve como objetivo verificar as possiveis diferencas nos comportamentos de apego materno-fetal, bem como nos niveis de ansiedade e depressao apresentados por gestantes com e sem risco na gravidez, durante o segundo trimestre gestacional. Participaram da pesquisa 25 mulheres com gravidez sem risco e 23 com gravidez de risco, sendo que quatro delas tiveram fetos malformados. A Escala de Apego Materno-fetal e os Inventarios de Ansiedade e Depressao de Beck foram utilizados. Os resultados mostram que nao ha diferencas no nivel de apego materno-fetal entre os dois grupos de gestantes, os quais apresentaram valores maximos. Os indices de ansiedade e depressao mostraram-se mais elevados, mas nao estatisticamente significativos, entre as gestantes de risco, principalmente para aquelas que tinham suspeita de fetos malformados. Conclui-se que a gravidade da realidade vivida por essas maes implica em niveis mais elevados de ansiedade e depressao, porem, nao impede a formacao da relacao de apego entre elas e seus filhos.

Deficiência auditiva: escolarização e aprendizagem de língua de sinais na opinião das mães

Communication is essential for the deaf child and consequently the learning of the Brazilian signals language (LIBRAS). With the objective of knowing the process of deaf schooling and the opinion of mothers about the LIBRAS learning, ten mothers of auditive handicapped were interviewed. It was achieved that 60% of the deaf children started their schooling before 5 years old, all of them having attended special teaching. Mothers insert their children in school aiming their socialization and they are against the LIBRAS learning, since they expect the child to learn how to speak. Schooling is important but bilinguism is not accepted by mothers, reflecting the fact that these mothers ignore the benefits that this kind of education can bring to the development of their kids.