Maria Cristina de Oliveira Santos Miyazaki

Qualidade de vida e estratégias de enfrentamento em pacientes submetidos a transplante renal

Quality of life and coping strategies in patients undergoing renal transplantation. The aim of the present study was to compare patients’ quality of life before and after renal transplantation, and identify coping strategies after surgery. Participants were 17 patients (9 female, and 8 men) with ages ranging from 23 to 55 years old (M: 37.9 years; SD: 8) assessed with the SF-36 Quality of Life Questionnaire, Ways of Coping Questionnaire, and a structured interview (before and after transplant). There was no significant difference in the quality of life assessment before and after the transplantation for the variables assessed by the SF36. Patients’ major concerns were: effects of the medication, medical consultation, changes in corporal appearance, and hospitalization. Patients tended to use more emotion centered coping strategies, i.e., more subjective ways to cope with difficulties. There was no significant change in patients’ quality of life after transplantation.

Quality of Life, Depression, and Psychosocial Characteristics of Patients Awaiting Liver Transplants

BACKGROUND The identification of the psychological issues that impair the quality of life and the adherence to treatment in transplant candidates are important. OBJECTIVE This study evaluated the presence of symptoms of depression and the quality of life of liver transplant candidates. METHODS One hundred liver transplant candidates underwent a psychological analysis using the following instruments: the short form-36 (SF-36) quality of life questionnaire, the Beck depression inventory (BDI), and Structured Interviews for liver transplant candidates. RESULTS Seventy-three (73%) of the patients were males. Interestingly, 63% of the patients were in a domestic partnership. At the time of the evaluation, 55 patients were not working due to illness, 27 patients were actively working, and 11 patients were retired. Importantly, fears related to the transplant (e.g., fear the surgery and of death) were identified in 38% of the patients. The data from this study demonstrated a significant negative correlation between depressive scores (BDI) and seven of the eight areas of quality of life (SF-36), such as functional capacity (r = .317, P = .0013), social aspects (r = -.469, P < .0001), economic aspects (r = -.319, P = .0012), and mental health (r = -.3832, P < .0001). CONCLUSION The data indicated that the psychological aspects related to transplants require psychological intervention because they can affect the recuperation process, the quality of life, and the adherence to treatment for potential transplant patients.

Depression as a risk factor for early and late morbidity after coronary artery bypass surgery

OBJETIVO: Avaliar a presenca de sintomas de depressao no pre-operatorio, no pos-operatorio imediato (POI) e pos-operatorio tardio (POT) de pacientes com indicacao eletiva de cirurgia de revascularizacao do miocardio e seu impacto na morbidade pos-operatoria imediata e tardia. METODO: Cinquenta e oito pacientes internados na Enfermaria de Cirurgia Cardiaca para realizacao de operacao eletiva de revascularizacao do miocardio responderam ao Inventario de Depressao de Beck, antes da operacao (fase I), antes da alta hospitalar (fase II) e tres meses apos a alta (fase III). A media de idade dos pacientes foi 61,2 (34 a 78 anos; DP:10,1), 34 (58,6%) eram homens, 31 (55,4%) com infarto previo, 35 (62,5%) com fracao de ejecao maior que 40% e 19 (33%) diabeticos. RESULTADOS: Doze (20,7%) pacientes apresentaram sintomas de depressao na fase I, 13 (23,6%), na II e 4 (9,8%), na III. Dezoito (31,0%) pacientes apresentaram complicacoes no POI, 17 (34,0%), no POT. Complicacoes no POI ocorreram com maior frequencia em pacientes mais velhos (idade superior a 65 anos; p=0,003), com pelo menos tres vasos revascularizados (p=0,001) e com depressao na fase I (p=0,011). Quando estas variaveis foram associadas as complicacoes presentes no POT, houve significância para o sexo feminino (p=0,006) e depressao na fase II (p=0,008). Pacientes do sexo feminino apresentaram mais sintomas de depressao durante a internacao (p=0,04). CONCLUSAO: Idade superior a 65 anos, sexo feminino, pelo menos tres vasos revascularizados e sintomas de depressao durante a internacao mostraram-se associados a maior numero de complicacoes no pos-operatorio de cirurgia de revascularizacao do miocardio. Pacientes submetidos a cirurgia de revascularizacao do miocardio devem ser avaliados em relacao a depressao e tratados se necessario, uma vez que esta pode estar associada a complicacoes no pos-operatorio.

Itervenção cognitivo-comportamental em violência sexual: estudo de caso

Sexual violence is a serious problem of public health: it reaches all social classes, ethnics, religions and cultures, specially children and adolescents of the female sex. The objective of the present study is to describe the impact of a cognitive-behavior intervention on a 13-year-old adolescent, victim of rape attempt. The process included 45 sessions, distributed in initial evaluation, intervention, final evaluation and follow-up. It also used semi-directed interview, DSM-IV diagnostic criteria, Children’s Depression Inventory (CDI), cognitive-behavior techniques, and mother counseling. On the first interview the therapist identified school and behavior problems, symptoms of pos-traumatic stress disorder and moderate symptoms of depression, intensified by the episode of violence. Transgerational standard repetition was also observed: promiscuous behavior, alcoholism, sexual violence and relationship instability. Results demonstrated reduction of the initial complaints, acquisition of new behavior repertoire, better psicossocial functioning and positive impact of the intervention. The data indicate the need for inclusion of the family in the process.

Efeitos de um programa de orientação em grupo para cuidadores de crianças com transtornos psiquiátricos

The objective was identify changes in children/parents behavior after a group orientation program for parents. Participants were eight parents/caretakers of children seeing at the Hospital de Base (Faculdade de Medicina de Sao Jose do Rio Preto, SP) Psychiatric Outpatient Clinic, selected by interviews. The intervention consisted of 10 sessions (one session per week) that lasted 90 minutes each. A Clinical Interview Schedule, the Social Skills Inventory, Lipp Stress Symptom Inventory and the Children Behavior Checklist were used at the beginning, at the end and two months after the end of the program. Statistically significant changes were observed on parents social skills p=0.013), and parents presented stress symptoms at the beginning, at the end and two months after the end of the program. There was significant reduction on internalizing (p=0.009), externalizing (p=0,001), and total problems (p=0.003) after intervention. Children and parents behavioral changes were observed.

Asma, competência social e transtornos comportamentais em crianças e adolescentes

The aim of this study was to assess social skills and behavioral disorders in children with asthma. Participants included 62 children/adolescents (between 7 and 16 years of age) with moderate and severe asthma and a control group whose parents completed the Brazilian version of the Child Behavior Checklist. Results: There is evidence of an association between asthma and deficiencies in overall social skills related to activities (p=0.001) and school (p=0.01). The severity of the asthma has no clear link to social skills. There is evidence of an association between behavioral disorders and asthma, especially internalizing disorders, such as anxiety and depression, irrespective of sex, age and severity of asthma. Children/adolescents with asthma had more problems with general social skills and skills associated with activities and school, when compared to the control group. They also had more general and internalizing disorders, which may impair their progress, quality of life and the satisfactory management of the illness.

Burnout and coping among football players: before and during the tournament

INTRODUCAO: No contexto esportivo, a falta de estrategias adequadas de enfrentamento e a sindrome de Burnoutpodem ser fatores limitadores do desenvolvimento e desempenho dos atletas.OBJETIVO: Avaliar Burnout e formas de enfrentamento entre jogadores de futebol, profissionais e de categorias de base, durante as fases pre-competicao e competicao.METODOS: Em estudo prospectivo, foram avaliados 73 jogadores de futebol do sexo masculino, sendo 32 profissionais (media de idade = 22 ± 4,14 anos) e 41 amadores (media de idade = 17 ± 0,94 anos), todos integrantes de tres equipes participantes do Campeonato Paulista das Series A-1 e A-2 (categoria profissional) e Copa Sao Paulo de Futebol Junior (categoria amador), Estado de Sao Paulo, Brasil. Para avaliar as variaveis Burnoute estrategias de enfrentamento foram utilizados os instrumentos: escala modos de enfretamento de problema (EMEP) e o questionario de Burnout para atletas (QBA). Utilizou-se estatistica descritiva para analise dos dados, com nivel de significância de 0,05.RESULTADOS: Observou-se que ha diferencas estatisticamente significativas entre as categorias na fase pre-competicao (p = 0,026), mas que nao ha diferencas na fase de competicao (p = 0,468). Isso sugere que amadores e profissionais utilizam estrategias de enfrentamento distintas, que na maioria dos casos, para as duas categorias, foram focalizadas no problema.CONCLUSAO: Durante a fase de competicao os atletas com escores mais elevados de Burnoutreferentes a dimensao reduzido senso de realizacao esportiva estao associados ao modo de enfrentamento focalizado nas praticas religiosas/pensamento fantasioso.

Burnout e enfrentamento em jogadores de futebol: fases pré e durante competição

INTRODUCAO: No contexto esportivo, a falta de estrategias adequadas de enfrentamento e a sindrome de Burnoutpodem ser fatores limitadores do desenvolvimento e desempenho dos atletas.OBJETIVO: Avaliar Burnout e formas de enfrentamento entre jogadores de futebol, profissionais e de categorias de base, durante as fases pre-competicao e competicao.METODOS: Em estudo prospectivo, foram avaliados 73 jogadores de futebol do sexo masculino, sendo 32 profissionais (media de idade = 22 ± 4,14 anos) e 41 amadores (media de idade = 17 ± 0,94 anos), todos integrantes de tres equipes participantes do Campeonato Paulista das Series A-1 e A-2 (categoria profissional) e Copa Sao Paulo de Futebol Junior (categoria amador), Estado de Sao Paulo, Brasil. Para avaliar as variaveis Burnoute estrategias de enfrentamento foram utilizados os instrumentos: escala modos de enfretamento de problema (EMEP) e o questionario de Burnout para atletas (QBA). Utilizou-se estatistica descritiva para analise dos dados, com nivel de significância de 0,05.RESULTADOS: Observou-se que ha diferencas estatisticamente significativas entre as categorias na fase pre-competicao (p = 0,026), mas que nao ha diferencas na fase de competicao (p = 0,468). Isso sugere que amadores e profissionais utilizam estrategias de enfrentamento distintas, que na maioria dos casos, para as duas categorias, foram focalizadas no problema.CONCLUSAO: Durante a fase de competicao os atletas com escores mais elevados de Burnoutreferentes a dimensao reduzido senso de realizacao esportiva estao associados ao modo de enfrentamento focalizado nas praticas religiosas/pensamento fantasioso.

Psychological assessment of patients undergoing cardiac transplant in a teaching hospital (2004 to 2012)

Objective To analyze the psychological evaluations of patients with heart failure waiting for heart transplantation. Methods The data were obtained from patient records containing pre-surgery psychological evaluations performed by psychologists from the multidisciplinary cardiology team. The evaluation protocol included the Quality of Life Questionnaire (SF-36), Beck Depression Inventory, and an interview script. Results The results of psychological evaluations performed between 2004 and 2012 for 60 candidates for heart transplantation were analyzed: 43 men and 17 women aged between 16 and 66 years (Mean=45.18; SD=11.91), predominantly from the São José do Rio Preto area (São Paulo state, Brazil) (83%), with incomplete elementary education (68%), and who were in stable relationships (73%). Although women presented higher mean scores for depression (21.41) than men (14.61), there was no significant difference between genders. Womens quality of life was impaired in all domains compared to men (below 50%) and was significantly poorer in the physical functioning (P=0.01), vitality (P=0.00), emotional role functioning (P=0.04), and mental health (P=0.02) domains. Conclusion Patients with psychosocial vulnerability (e.g., depression) identified before transplantation should receive psychological treatment.

Diagnóstico e intervenção clínica comportamental infantil: uma breve revisão

Some childhood and adolescence disorders are discussed under a behavioral approach, and using DSM-IV diagnosis criteria. data from literature on diagnostic features, prevalence, etiology, and prognosis for the following disorders Provides: autistic disorder, attention- deficit/hyperactivity disorder, mood disorders (dysthymic disorder and major depressive disorder), anxiety disorders (specific phobia and separation anxiety disorder), and elimination disorders (enuresis and encopresis). Intervention strategies under a behavioral approach are also discussed.