Marina Bandeira

Sobrecarga de familiares de pacientes psiquiátricos atendidos na rede pública

CONTEXTO: Pesquisas internacionais constataram sobrecarga em familiares cuidadores de pacientes psiquiatricos, mas no Brasil ha poucos estudos nesta area. OBJETIVOS: Descrever a sobrecarga objetiva e subjetiva de uma amostra de familiares e os aspectos mais afetados de suas vidas. METODOS: Estudo descritivo com 150 familiares de pacientes psiquiatricos selecionados aleatoriamente nos Cersams de Belo Horizonte (MG). Utilizou-se a Escala de Sobrecarga dos Familiares de Pacientes Psiquiatricos (FBIS-BR) e um questionario sociodemografico e clinico. RESULTADOS: A maioria dos cuidadores apresentou elevada sobrecarga objetiva relativa a alta frequencia de ajuda aos pacientes nas tarefas cotidianas e elevada sobrecarga subjetiva, referente as preocupacoes com os pacientes, ao elevado grau de incomodo ao supervisionar seus comportamentos problematicos e a percepcao de mudancas permanentes na vida social e profissional dos familiares. As alteracoes diarias na rotina nao acarretaram sobrecarga objetiva aos cuidadores. A media de gastos mensais com os pacientes foi de R

Validação das escalas de habilidades sociais, comportamentos problemáticos e competência acadêmica (SSRS-BR) para o ensino fundamental

153,57. CONCLUSOES: Os resultados confirmaram dados de estudos internacionais com cuidadores de pacientes psicoticos e de estudos nacionais com cuidadores de pacientes idosos com depressao e demencia. Os resultados da presente pesquisa mostram a necessidade de desenvolver programas de informacao, orientacao e apoio aos familiares dos pacientes psiquiatricos.

Habilidades sociais de estudantes de Psicologia: um estudo multicêntrico

Besides the growing interest on social skills, there are few scales available in Brazil. This research validated the SSRS scale, which evaluates social skills, behavior problems, and academic competence of elementary school students. The participants were 416 students (224 boys and 192 girls) from the first to the fourth elementary school grades, from public and private schools of five cities of four Brazilian states as well as 312 parents and 86 teachers of these children. The results showed some components structure explaining 40% to 62% of data variance. The internal consistency analysis, measured by Cronbach coefficients, showed the following values for each scale: social skills (student=0,78; parents=0,86; teachers=0,94), behavior problem (parents=0,83; teachers=0,91), and academic competence (0,98). Concerning on the temporal stability, results showed positive and significant correlations between test-retest applications for the global scores of the social skills (students: r=0,78; parents: r=0,69; teachers: r=0,71), behavior problems (parents: r=0,75; teachers: r=0,80), and academic competence (r=0,73) scales.

Factors associated with low quality of life in schizophrenia

Social skills occurring in a high frequency and low variability can be taken as patterns, suggesting cultural or sub-cultural features which are important when selecting instruments for evaluation and planning interventions. This research aimed to characterize the social skills repertoire among Psychology students from 4 Brazilian places: Sao Paulo (SP), Bahia (BA), Minas Gerais (MG)e Rio de Janeiro (RJ), also examining their differences and the influence of sex and age on their patterns. Five hundred sixty four Psychology undergraduates completed a self-report inventory (IHS-del-Prette) with a structure of 5 factors: F1) coping and assertion; F2) expressing positive affection; F3) talking and self-confidence; F4) dealing with unknown people and new situations; F5) aggressiveness self-control. The samples were compared considering general (GS) and factorial (F1, F2, F3, F4 e F5) scores as well as sex and age influence in each one (ANOVA, followed by t or Scheffe test). The results showed that: a) Psychology students presented higher scores than normative sample in the GS, F1, F3 and F4 and lower in the F2 and F5, but sex differences were similar to the normative pattern; b) place, sex and age significantly affected the scores, with place-sex and place-age interactions; c) samples from MG, BA, RJ and SP presented similar profiles, with higher values for RJ in the F1 and for MG and SP in the F2 and F5; d) students from BA presented the highest sex differences and from RJ the lowest ones; e) age differences occurred in the F4 (favorable to younger students for SP) and in the F5 (favorable to older ones for BA and RJ). The meaning of these differences and similarities are discussed as well as some explanatory hypotheses and questions for further studies.

Qualidades psicométricas do Inventário de Habilidades Sociais (IHS): estudo sobre a estabilidade temporal e a validade concomitante

Interest in quality of life in mental health care has been stimulated by the deinstitutionalization of psychiatric patients as well as a parallel interest in understanding the scope of their daily lives. This study aims to investigate the socio-demographic and clinical variables related to low quality of life, using a cross-sectional design to evaluate quality of life by means of the QLS-BR scale. We interviewed a sample of 123 outpatients from a reference mental health center in Divinópolis, Minas Gerais State, Brazil, clinically diagnosed with schizophrenia. Univariate and multivariate logistic regression analyses were carried out. The results showed that low quality of life is associated with one or more of the following: male gender, single marital status, low income plus low schooling, use of three or more prescribed psychoactive drugs, psychomotor agitation during the interview, and current follow-up care. The study identifies plausible indicators for the attention and care needed to improve psychiatric patient treatment.

Estudo de validade da escala de sobrecarga de familiares cuidadores de pacientes psiquiátricos

Esta pesquisa investiga as qualidades psicometricas do Inventario de Habilidades Sociais (IHS) em termos de sua validade concomitante e de sua fidedignidade ou estabilidade temporal. Participaram desta pesquisa, 104 estudantes de Psicologia que foram submetidos a aplicacao do IHS e da Escala de Assertividade de Rathus. Os resultados mostram uma correlacao significativa entre estas duas escalas de avaliacao. Os dados referentes a aplicacao teste-reteste do IHS, em uma subamostra aleatoria de 39 sujeitos, mostram igualmente um correlacao significativa entre as duas aplicacoes. Estes resultados indicam que o IHS possui validade concomitante e fidedignidade ou estabilidade temporal. Estas conclusoes complementam os resultados de estudos anteriores sobre as qualidades psicometricas do IHS e recomendam a utilizacao desta escala para avaliar as habilidades sociais de estudantes universitarios no contexto brasileiro.

Validação transcultural do Teste de Orientação da Vida (TOV-R)

A sobrecarga de familiares cuidadores de pacientes psiquiatricos tem sido amplamente estudada por pesquisas internacionais, usando escalas validadas, mas raramente no Brasil, talvez devido a carencia de escalas validadas deste construto. OBJETIVO: Esta pesquisa avaliou a validade da versao brasileira da escala Family Burden Interview Schedule (FBIS-BR). METODO: Participaram cem familiares de pacientes psiquiatricos de tres instituicoes psiquiatricas de Minas Gerais, entrevistados com aplicacao de um questionario sociodemografico e tres escalas de medida: FBIS-BR, BI e SRQ-20. RESULTADOS: A validade de criterio da escala FBIS-BR foi analisada pela sua correlacao com a escala BI, ja validada para o Brasil e que avalia o mesmo construto, obtendo-se correlacoes significativas, entre 0,23 e 0,69 (p < 0,01). A validade de construto da escala FBIS-BR foi analisada pela sua correlacao com a SRQ-20, que avalia um construto diferente, de transtornos psicologicos, porem teoricamente relacionado ao de sobrecarga, tendo-se obtido correlacoes significativas (p < 0,01) entre 0,31 e 0,49. CONCLUSAO: A escala FBIS-BR constitui um instrumento de medida valido para avaliar a sobrecarga dos familiares cuidadores de pacientes psiquiatricos, podendo ser utilizada em servicos de saude mental para identificar as dificuldades e as necessidades destes familiares e para direcionar novas intervencoes de orientacao e suporte.

Predictors of subjective burden for families of psychiatric patients treated in the public health care system in Belo Horizonte, Minas Gerais State, Brazil

Transcultural validation of the Life Orientation Test (LOT-R). The transcultural validation of the Revised Life Orientation Test (LOT-R) was implemented and the psychometric properties of this test were examined in the Brazilian context. This test evaluates the construct of dispositional optimism, in terms of outcome expectancies concerning future life events. The LOT-R was first submitted to a back translation and to a pilot study in order to make its transcultural adaptation. Then, a sample of 396 university students answered this test and the Beck Depression Inventory (BDI). A retest was implemented 30 days later in a randomly selected sub-sample of 48 students. Results showed a significant test-retest correlation (r = 0,61) and good internal consistency (α = 0,68). Degree of optimism was predictive of fewer degree of depressive symptoms (r = -0,42). Exploratory factorial analysis identified one factor explaining 39,78 % of variance. The results demonstrated good psychometric properties for the Brazilian version of the LOT.

Reforma psiquiátrica e serviços residenciais terapêuticos

This study investigated the predictors of subjective burden for families of psychiatric patients. We interviewed 150 relatives of patients randomly selected in four mental health care services in Belo Horizonte, Minas Gerais State, Brazil. Subjects were interviewed with the Family Burden Interview Schedule (FBIS-BR) and a standardized socio-demographic questionnaire. Variables were grouped into thematic categories and separately analyzed to determine the relative importance of predictive factors. The results showed that subjective burden is influenced by objective burden and by factors related to the patients clinical condition, the caregivers and patients living and health conditions and financial status, and increased demand for information on mental illness. Subjective burden was less when the caregiver practiced leisure and religious activities, publicly admitted to being the caregiver of a psychiatric patient, and had positive feelings toward the patient. The findings highlight the need to include family follow-up in the community model for psychiatric care.

Qualidade de vida e dimensão ocupacional na esquizofrenia: uma comparação por sexo

OBJECTIVE: The aim of this article is to show the more relevant aspects of psychiatric reform and the community insert of psychiatric patients around the world and in Brazil. It will be detached the procedures of discharge occurred in the city of Barbacena, emphasizing the residential services and the psychosocial approaches. METHODS: Databases Medline and Lilacs were searched between 1990 and 2006 using the following keywords: deinstitutionalization, psychiatric reform, community-based treatment, psychosocial rehabilitation. For the implementation of the residential services, official documents were used. RESULTS: Review and follow-up studies were selected. The most of the studies indicate that the patients have better autonomy, social interaction, global behavior and life quality when they live in community settings. Nevertheless, the authors emphasize the importance of community support, professional staff and rehabilitation programs as a condition for good outcomes. In Barbacena, the procedures of deinstitutionalization began in 2000. Nowadays there are twenty four residential services in this city. DISCUSSION: In despite of difficulties in the psychiatric reform process, the community-based treatment and psychosocial rehabilitation approach are the principal models of psychiatric care presently, and the residential services play an important role in this process.