Marina Kohlsdorf

Estratégias de enfrentamento de pais de crianças em tratamento de câncer

This paper is a review of literature in pediatric psychoncology, concerning studies and research published between 1996 and 2007, related to parental coping with disease and treatment. The results highlight that pediatric oncohematology treatment is associated with various changes in family dynamics, personal routine, and changes in the behavior repertoire, as a consequence of extended medical care, hospital admissions, submission to invasive procedures and antineoplasic chemotherapy protocols, as well as experiences of anxiety, doubt, fear and loss. It is still necessary to investigate, in national literature, how different coping strategies are developed by pediatric caregivers, during cancer treatment. International literature suggests that more research is needed into the process of psychosocial changes, psychological adjustment, adaptation, and changes in coping strategies, during the course of the various stages of treatment.

Diferenças individuais na aquisição de leitura com um sistema lingüístico em miniatura

This study reports the use of a miniature linguistic system in order to investigate reading acquisition. Twenty college students, 10 from Natural Sciences and Engineering (NSE) and 10 from Health and Social Sciences (HSS) courses, learned to relate pictures and printed pseudo-words to dictated pseudo-words in conditional discrimination tasks presented by a computer. Teaching sessions were interspersed with tests of reading new words formed by recombination of elements of taught words (generative recombination). Nine students from NSE and four from HSS developed generalized reading after learning 12 relations with pseudo-words. Reading scores of new words increased as number of taught words increased. Both findings could be interpreted as effects of learning experiences with symbolic relations. Differences between the NSE and the HSS students could also reflect motivational factors.

Psychosocial impact of pediatric cancer on parents: a literature review

A diagnosis of childhood cancer represents challenges for patients, family members, and health workers. The parents of a child or adolescent have to play an expanded role because they need to reconcile parental tasks and treatment de- mands. This study presents an integrative literature review concerning difficulties experienced by pediatric caregivers during onco-hematological treatment. The CAPES periodicals portal and the Scientific Library Online (SciELO) were searched for papers published between 1999 and 2009. Relevant themes are highlighted in Brazilian and international studies published in the field, such as psychological disorders experienced by caregivers, the professional and financial impact associated with treatment, changes in educative practices and family dynamics, and the influence of cultural practices on the experience of treatment. Suggestions for further research are presented to support efficient psychosocial interventions and minimize the psychosocial costs experienced by pediatric caregivers over the course of onco-hematological treatments.A diagnosis of childhood cancer represents challenges for patients, family members, and health workers. The parents of a child or adolescent have to play an expanded role because they need to reconcile parental tasks and treatment demands. This study presents an integrative literature review concerning difficulties experienced by pediatric caregivers during onco-hematological treatment. The CAPES periodicals portal and the Scientific Library Online (SciELO) were searched for papers published between 1999 and 2009. Relevant themes are highlighted in Brazilian and international studies published in the field, such as psychological disorders experienced by caregivers, the professional and financial impact associated with treatment, changes in educative practices and family dynamics, and the influence of cultural practices on the experience of treatment. Suggestions for further research are presented to support efficient psychosocial interventions and minimize the psychosocial costs experienced by pediatric caregivers over the course of onco-hematological treatments.

Recombinative reading derived from pseudoword instruction in a miniature linguistic system

A miniature linguistic system was used to study acquisition of recombinative symbolic behavior. Three studies evaluated the teaching conditions of conditional discriminations with printed and spoken pseudowords that could potentially generate recombinative reading. Fifty-four college students across all studies learned to match 12 printed pseudowords to 12 spoken pseudowords. Some also matched pictures to the same spoken words. Each two-syllable pseudoword was formed by symbols from an arbitrarily created alphabet composed of four vowels and four consonants. Letters had univocal correspondence with phonemes. Recombinative receptive reading, comprehensive reading, and textual responding to pseudowords were periodically assessed. Experiment 1 (n  =  20) showed that recombinative reading increased as the number of trained words composed of the same symbols increased. Experiment 2 (n  =  14) showed that overtraining the same two words did not produce recombinative reading for most participants. Experiment 3 (n  =  20), in which training with pictures was omitted, showed that elemental control by within-syllable units can develop even when the trained pseudowords are meaningless (not related to pictures). The present results support the utility of the miniature linguistic system methodology for identifying and controlling environmental determinants of rudimentary reading skills.

Cuidadores de crianças com leucemia: exigências do tratamento e aprendizagem de novos comportamentos

The pediatric cancer represents a context of losses, uncertainties, physical pain and several difficulties to the patient and family. The main goal of this study was to investigate specific demands experienced by 30 pediatric caregivers, as well as favourable behaviors acquired, along the first semester of leukemia treatment, using semi-structured interviews carried out in two moments. The results indicate specific demands, such as the need of more attention and patient monitoring, and the increase of financial costs. There were relevant reports about learning new behavioral patterns, referred as beneficial, such as the acquisition of more adaptative behaviors related to environmental demands, awareness of a higher self-efficacy and a more active role in treatment, learning related to invasive medical procedures and destitution of dysfunctional beliefs related to cancer. This study corroborates data indicated in literature and highlights the importance of more psychosocial interventions concerning pediatric patients and caregivers.

O autorrelato na pesquisa em psicologia da saúde: desafios metodológicos

Diversas areas de conhecimento, como a Psicologia, empregam o autorrelato em pesquisas, sob a forma de entrevistas, questionarios, inventarios e escalas. Neste trabalho, sao apresentadas reflexoes sobre os desafios implicados no uso de autorrelato, em especial no campo de atuacao da psicologia da saude que focaliza processos de enfrentamento e adesao ao tratamento. O comportamento verbal e reforcado pela comunidade social em que o individuo se encontra e o autorrelato somente pode ocorrer a partir da auto-observacao, pois se encontra associado a estimulos e comportamentos aos quais somente o falante tem acesso. O autorrelato nao garante que haja correspondencia exata entre o comportamento real e aquele verbalizado, por algumas razoes: (a) o comportamento relatado difere do comportamento real porque eventos encobertos nao sao reconhecidos de forma legitima; (b) o comportamento relatado nao e o real, mas o comportamento socialmente desejavel, considerando influencias da historia de reforcamento do individuo; e (c) o participante nao compreende inteiramente os itens que compoem o instrumento utilizado, resultando em significacoes distintas para participante e pesquisador. A fim de minimizar a discrepância entre o dado obtido a partir do autorrelato e o comportamento real, e importante que o pesquisador em psicologia da saude invista no treinamento e preparo para a coleta de dados e utilize metodologias combinadas (tais como observacao do comportamento e aplicacao de mais de um tipo de instrumento, entre escalas, inventarios e questionarios), realizando medidas complementares sobre o comportamento ou processo estudado.

Comunicação em pediatria: revisão sistemática de literatura

The quality of Pediatric communication directly influences the treatment success, by promoting satisfactory adherence levels, information retention, and the inclusion of biopsychosocial demands. The main aim of this study was to perform a systematic literature review concerning pediatric communication, with papers published between 2000 and 2010. The selected studies were included in the following databases: PubMed/MedLine, Bireme/BVS and ScienceDirect, Capes Papers Online site, and SciELO. The 61 selected papers indicate the prevalence of descriptive designs and qualitative or quantitative analysis techniques, over experimental studies and the use of mixed data analysis techniques. The literature indicated the need to include the pediatric patient in the communication process and to consider psychosocial demands, highlighting the good results achieved by programs related to better communication patterns. The need is highlighted for systematic studies that can comprehend the factors involved in pediatric communication, and the inclusion of efficient psychosocial programs.

Cuidadores de crianças e adolescentes com leucemia: análise de estratégias de enfrentamento DOI 10.5752/P.1678-9523.2009v15n1p158

Resumo Este estudo teve como objetivo principal investigar mudancas nas estrategias de enfrentamento adotadas por 30 cuidadores ao longo do semestre inicial de tratamento de leucemia de criancas e adolescentes. A escala de modos de enfrentamento de problemas (EMEP) foi aplicada ao diagnostico depois de dois a tres meses, desde o inicio do tratamento, e apos cinco a seis meses de tratamento. Em aplicacoes correspondentes, foi usado o inventario Beck de ansiedade (BAI). Observou-se uma reducao dos niveis de ansiedade no decorrer do tratamento, bem como o predominio de estrategias de enfrentamento focadas em praticas religiosas, problema e busca por suporte social. Sugere-se um maior cuidado das equipes de oncologia pediatrica para a identificacao das necessidades de intervencao psicossocial que envolvem os pacientes e seus cuidadores. Os dados permitem planejar intervencoes preventivas que aumentem a probabilidade da aquisicao e manutencao de estrategias de enfrentamento mais eficientes por parte dos cuidadores. Caregivers of children and adolescents with leukemia: coping strategies analysis Abstract This study aimed to investigate changes in coping strategies adopted by 30 pediatric caregivers during the initial six months of children’s and adolescents’ treatment for leukemia. The Ways of Coping Scale was applied to the diagnosis two to three months after the beginning of the treatment, and then after five to six months of treatment. The Beck Anxiety Inventory (BAI) was applied in corresponding applications. There was a reduction in levels of anxiety during the treatment, and a predominance of coping strategies focused on the problem and the search for spiritual and social support. Better care by pediatric oncology professionals in identifying the psycho-social intervention needs involving patients and their caregivers is suggested. Data allow planning preventive interventions to increase the acquisition and maintenance of pediatric caregivers’ efficient coping strategies. Cuidadores de ninos y adolescentes con leucemia: analisis de las estrategias Resumen Este estudio tuvo como objetivo investigar cambios en las estrategias de enfrentamiento adoptadas por 30 cuidadores a lo largo del semestre inicial de tratamiento de leucemia de ninos y adolescentes. La Escala de Modos de Enfrentamiento de Problemas (EMEP) fue aplicada al diagnostico, despues de dos a tres meses desde el inicio del tratamiento y despues de cinco a seis meses de tratamiento. En aplicaciones correspondientes, fue utilizado el Inventario de Ansiedad de Beck (BAI). Se observo una reduccion de los niveles de ansiedad en el transcurrir del tratamiento, asi como el predominio de estrategias de enfrentamiento focalizadas en el problema y en la busqueda por soporte espiritual y social. Se sugiere un mayor cuidado de los equipos de oncologia pediatrica para la identificacion de necesidades de intervencion psicosocial, que alcancen a los pacientes y sus cuidadores. Los datos permiten planear intervenciones preventivas que aumenten la probabilidad de la adquisicion y mantenimiento de estrategias de enfrentamiento mas eficientes por parte de los cuidadores.

A proposal for a behavioral pre-consultation: Analysis of the use of a protocol during consultations

This study aimed to analyze how physicians, caregivers, and children use protocols regarding estimated issues to medical visits, procedure named pre-consultation lists, along treatment for childhood cancer. Three pediatricians and 24 dyads child-caregiver took part; each pair was interviewed before medical visits in order to report doubts, needs and issues estimated to the consultation. This list was attached to childs medical record as a memo of themes to discuss in the next medical visit. Results show that two physicians included effectively this file in their consultations and discussed a great amount of issues listed by caregivers and patients. Children did not refer to the listed issues, but parents, in smaller amounts, discussed the themes in the protocol. This procedure contributed to insert the child in consultations and it may facilitate the focus on specific themes, however the physicians main role in managing communication during pediatric medical visits is highlighted.

Impacto psicosocial del cáncer en la infancia para padres

A diagnosis of childhood cancer represents challenges for patients, family members, and health workers. The parents of a child or adolescent have to play an expanded role because they need to reconcile parental tasks and treatment de- mands. This study presents an integrative literature review concerning difficulties experienced by pediatric caregivers during onco-hematological treatment. The CAPES periodicals portal and the Scientific Library Online (SciELO) were searched for papers published between 1999 and 2009. Relevant themes are highlighted in Brazilian and international studies published in the field, such as psychological disorders experienced by caregivers, the professional and financial impact associated with treatment, changes in educative practices and family dynamics, and the influence of cultural practices on the experience of treatment. Suggestions for further research are presented to support efficient psychosocial interventions and minimize the psychosocial costs experienced by pediatric caregivers over the course of onco-hematological treatments.A diagnosis of childhood cancer represents challenges for patients, family members, and health workers. The parents of a child or adolescent have to play an expanded role because they need to reconcile parental tasks and treatment demands. This study presents an integrative literature review concerning difficulties experienced by pediatric caregivers during onco-hematological treatment. The CAPES periodicals portal and the Scientific Library Online (SciELO) were searched for papers published between 1999 and 2009. Relevant themes are highlighted in Brazilian and international studies published in the field, such as psychological disorders experienced by caregivers, the professional and financial impact associated with treatment, changes in educative practices and family dynamics, and the influence of cultural practices on the experience of treatment. Suggestions for further research are presented to support efficient psychosocial interventions and minimize the psychosocial costs experienced by pediatric caregivers over the course of onco-hematological treatments.