Margareth da Silva Oliveira

Qualidade de vida e gravidade da dependência de tabaco

CONTEXTO: A qualidade de vida e um constructo que vem ganhando importância como uma forma de acessar o impacto tanto de uma patologia quanto de uma estrategia terapeutica na vida dos sujeitos. Este parâmetro tem sido pesquisado nas mais variadas areas, entre as quais o tabagismo. OBJETIVO: Avaliar a associacao entre a qualidade de vida e a gravidade da dependencia do tabaco. METODO: Foi realizado um estudo transversal, com uma amostra por conveniencia de 276 dependentes de tabaco da populacao geral, sem doencas tabaco-relacionadas. Os instrumentos utilizados foram: World Health Organization Quality of Life Instrument (WHOQOL-BREF), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Fagerstrom Test for Nicotine Dependence e ficha com dados sociodemograficos. RESULTADOS: Foi verificada associacao entre a gravidade da dependencia de tabaco e piores escores em todos os dominios da qualidade de vida, avaliada por WHOQOL-BREF, tendo sido esse resultado influenciado por sintomas de ansiedade e depressao. CONCLUSAO: Os tabagistas mais graves tem mais prejuizos na qualidade de vida, no entanto esse grupo e o que apresenta os escores mais elevados de sintomas depressivos e de ansiedade, sendo importante realizar mais estudos a esse respeito.

Craving e dependência química: conceito, avaliação e tratamento

O craving ou fissura, cuja definicao mais comum e o desejo intenso por uma substância, e um conceito controverso entre os pesquisadores da area da dependencia quimica. OBJETIVO: Realizar revisao teorica a respeito do craving nos bancos de dados PsycInfo, Medline, ProQuest e Science Direct. METODO: As palavras-chave utilizadas foram craving, dependence e drug e o periodo pesquisado foi entre 1995 e 2007. RESULTADOS: Os resultados demonstraram que sao encontrados diversos significados para o craving, alguns se restringindo a desejo, e outros, considerando-o nao so como desejo, mas como antecipacao do resultado positivo do uso da substância, alivio dos sintomas de abstinencia ou afeto negativo e intencao de fumar, o que reflete uma visao multidimensional deste construto. A etiologia do craving pode ser explicada por intermedio dos modelos: comportamental, cognitivo ou psicossocial e neurobiologico, porquanto a opcao por um destes influencia a avaliacao e o manejo. CONCLUSAO: Conclui-se quanto a multidimensionalidade do craving e quanto a necessidade de que seja utilizado um modelo biopsicossocial que integre os diversos modelos no tratamento de dependentes quimicos. Destaca-se a importância da realizacao de mais estudos para a compreensao do craving em funcao deste ser um dos principais riscos de recaida.Craving is usually defined as an intense desire for a substance. This is a rather controversial concept among the researchers on the chemical dependence area. OBJECTIVE: The objective of this study was to carry out a theoretical review concerning craving at PsycInfo, Medline, ProQuest, Portal Capes and Science Direct Data Bases. METHODS: The keywords used were craving, dependence and drug, and the searching period was between 1995 and 2007. RESULTS: The results showed that many different meanings can be found for craving, some relate it only to desire, while others consider it not only as desire, but also as the anticipation of the positive result from the use of the substance, the relief of abstinence symptoms or negative affect and intention to smoke, which reflects a multidimensional view of this construct. The ethimology of craving can be explained by the following Models: Behavioral, Cognitive or Psychosocial and Neurobiological, being the option for one of them a factor that influences evaluation and usage. CONCLUSION: As a conclusion, we are in favor of craving multidimensionality, as well as the need to use a Biopsychsocial Model that integrates the various models for treating chemical dependent patients. It is also necessary to highlight the importance of carrying out more studies in oder to understand craving, for it is one of the principal risks of relapse.

Estudo dos estágios motivacionais em sujeitos adultos dependentes do álcool

The general aim of this work was to trace the motivational stages of interned clients in specialized units, based on Prochaska and Diclementes Transtheorical Model. This work also examines if there is a correlation between the motivation stages of this group of alcohol-addicted patients and their level of drug dependence. The sample was composed of 120 alcoholics male patients, with dependence levels between moderate and critical. The instruments used were: Short-form Alcohol Dependence Data to identify the dependence level and the University of Rhode Island Change Assessment Questionnaire to evaluate the motivational stages. The results show positive and low-intensity correlation (r s = 0,197; p=0,031) between the level of drug dependence and the Maintenance stage. It is still under discussion the importance of the scales used in order discussion, in order to judge and choose better techniques to be adopted during the therapeutic process.

Habilidades sociais e abuso de drogas em adolescentes

RESUMO O presente estudo propoe uma revisao bibliografica sobre habilidades sociais e abuso de substâncias. Este artigo foi elaborado a partir de pesquisa nas Bases de Dados Pschynfo, Web of Science, Cochrane Library, Proquest, Medline e Lilacs, entre 1996 e 2006. Os descritores foram: social skills, social skills training, social competence, assertiveness, adolescents, teeenagers, substance abuse, drug abuse, cannabis e marijuana. Nas bases de lingua portuguesa, foram: habilidades sociais, treinamento em habilidades sociais, assertividade, adolescentes, abuso de substâncias, drogas e maconha. Os estudos, a maioria de lingua inglesa, apontaram a existencia de deficits, principalmente a dificuldade em resistir as drogas e dizer nao. Conclui-se que a construcao de habilidades de resistencia ao oferecimento de drogas, a autoeficacia e o estimulo a capacidade de tomada de decisoes pode reduzir o uso de substâncias. Poucos estudos brasileiros foram encontrados abordando esta tematica.

A validação brasileira do Questionnaire of Smoking Urges

This study was designed to validate the Brazilian version of the Questionnaire of Smoking Urges (QSU). The design was experimental, and participants were randomly distributed in groups of zero, 30, and 60 minutes of tobacco abstinence. The total sample was 201, with 67 males and 134 females, age ranging from 18 to 65 (M = 38.15). The instruments applied, besides QSU, were the Social and Demographic Data Form, Visual Analogue Scale to evaluate craving, Fagerström Test for Nicotine Dependence, and Beck Anxiety and Depression Inventories. Total variation in the two-factor factorial analysis was 57.76%, with a high inter-correlation (r = 0.726; p = 0.000). Factor 1 represented the anticipated relief of negative affect, nicotine abstinence symptoms, and urgent and overwhelming desire to smoke. Factor 2 represented the desire to smoke and the anticipation of smoking pleasure. Such results are contrary to those found in the original QSU. The Brazilian version proved to be an adequate and reliable instrument that can be used in both research and patient treatment.

Adaptação brasileira da University of Rhode Island Change Assessment (URICA) para usuários de substâncias ilícitas

This study presents the validation of the University of Rhode Island Change Assessment (URICA) for illici t psychoactive substances users in Brasil. The sample was of 214 persons of the masculine (n=194) and feminine sex (n=20) between 13 and 44 years old (M=22,93; DP=7,94). The collection happened in Porto Alegre, in ambulatories for treatment of the chemical dependence (n=89), as much as in internment places (n=125). The statistical analysis had evidenced a good internal consistency of the 24 itens scale ( =0,657). From statistical analysis was constructed the score T, carrying through the Brazilian standardize of URICA for illicit drugs, wich presented good psicometric results, being able to be used in studies that investigate motivation for behavior-problem change.

Efeitos da entrevista motivacional em adolescentes infratores

Abstract The motivational interview is a brief intervention that aims to stimulate behavioral changes, and it has been applied in this research toadolescent drug users, and identifying the changes after the motivational interviewing. The sample group consisted of 50 adolescent drugusers who had committed offenses. All of them were evaluated by means of a standard protocol, then they received five motivationalinterview sessions and were subsequently reevaluated. The findings of the follow-up were: definitive increases in the number of days of abstinencefrom marijuana and alcohol, a reduction in the usage of alcohol, tobacco and marijuana, abstinence from cocaine, crack and solvents. Therewere also significant changes in the pre-contemplation motivational stage as well as the cognitive beliefs regarding substance use. The datashows that, after motivational interviewing, there were changes in the patterns of drug consumption, in the motivational stages and in thecognitive beliefs of the drug-using adolescent offenders.Uniterms

A terapia multifamiliar no tratamento da dependência química: um estudo retrospectivo de seis anos

INTRODUCTION: the systematic inclusion of interventions focused on the family through unifamily and/or through multi-family group therapy (MFGT) has been growing as a way to face such a serious and complex problem as drug addiction. OBJECTIVE: To investigate and evaluate factors associated with the joining of drug addicted patients to a multi-family treatment. METHOD: the research is a cross-sectional retrospective study, with a sample of 672 families taking part in MFGT for six years (from March, 1997 to July, 2003). A study about sociodemographic factors such as age, gender, time and predominant type of substance used was made, which also looked into the relation between which family members took part in the program and the number of patients joining the multi-family treatment. 672 inpatient files were researched. The reports of the meetings described by the coordinating therapist of the group were also researched. RESULTS: a relation between family participation and patients joining the treatment was found. DISCUSSION: the results suggest that the inclusion of a higher number of family members can promote greater treatment commitment in drug addicted patients.

WHOQOL-BREF psychometric properties in a sample of smokers

OBJECTIVE To study the World Health Organization Quality of Life Instrument Bref psychometric properties in a sample of smokers. It is a self-administered instrument to evaluate quality of life. It contains 26 questions allocated to 4 domains: Social, Psychological, Physical and Environmental, there are 2 questions related to the Global domain. METHOD The sample was formed by 276 tobacco users selected at random. The instruments applied were: World Health Organization Quality of Life Instrument Bref, Fagerström Test for Nicotine Dependence, and Medical Outcomes Study Short-Form 36-item. The statistical analysis was accomplished up by ANOVA, Cronbachs alpha, Pearsons Coefficient and Multiple Regression. RESULTS The World Health Organization Quality of Life Instrument Bref presented good reliability (Cronbachs alpha 0.9207), converging validation (0.382<r<0.753; p<0.001), discriminant validation and criterion validation (0.554<r<0.778; p<0.001). CONCLUSION The World Health Organization Quality of Life Instrument Bref proved to be an adequate instrument, with a good level of reliability, being easily and quickly administered.

Estudo das habilidades sociais em adolescentes usuários de maconha

The present study intends to evaluate the social skills of adolescent marijuana users comparing their performance with non users. The instruments were: Inventory of Social Skills - IHS; Cognitive Screening of the WISC-III and the WAIS-III and Inventories of Anxiety and Depression of Beck. The sample consisted of 98 adolescents, 49 marijuana users and 49 non users, aged between 15 and 22. The results showed higher impairments in the group of marijuana users at the cognitive screening and in the presence of symptoms of anxiety and depression. The findings indicate significant statistical differences in the group of users, with a more impaired performance in Factor 4, Self-exposition to strangers or to new situations and Factor 5, Self-control of aggressiveness in aversive situations. The study concluded that adolescent marijuana users present more impairment in the social skills than adolescent non marijuana users.The present study intends to evaluate the social skills of adolescent marijuana users comparing their performance with non users. The instruments were: Inventory of Social Skills IHS; Cognitive Screening of the WISC-III and the WAIS-III and Inventories of Anxiety and Depression of Beck. The sample consisted of 98 adolescents, 49 marijuana users and 49 non users, aged between 15 and 22. The results showed higher impairments in the group of marijuana users at the cognitive screening and in the presence of symptoms of anxiety and depression. The findings indicate significant statistical differences in the group of users, with a more impaired performance in Factor 4, Self-exposition to strangers or to new situations and Factor 5, Self-control of aggressiveness in aversive situations. The study concluded that adolescent marijuana users present more impairment in the social skills than adolescent non marijuana users.