Rodrigo Fernando Pereira

Quality of Life, Behavioral Problems, and Marital Adjustment in the First Year After Radical Prostatectomy

UNLABELLED Patients submitted for prostatectomy were evaluated regarding their quality of life, behavioral problems, and marital adjustment. Thirty-two patients aged 54-76 years old were included. The results indicated that prostatectomy does not prevent normal psychological functioning, although there is a relationship between smoking and lower quality of life in these patients. INTRODUCTION Different types of monotherapy for prostate cancer leads to impairment in urinary and sexual functions, but prostatectomy seems to have worse results in physical functioning when compared with other treatments. Nevertheless, patients report high quality of life (QOL) levels, even when there are comments about the impact of sexual dysfunction on psychological health. The objectives of this work were to analyze levels of QOL, marital adjustment (MA), and behavioral problems (BP) of patients submitted to prostatectomy. METHODS Thirty-two patients from 54 to 76 years of age who underwent radical prostatectomy were evaluated during their follow-up appointments with the medical staff at the urology department of a private medical school. QOL scores were obtained from the World Health Organization Quality of Life instrument, short version. BP scores of patients younger than 60 years of age were assessed through the Adult Self-Report, whereas patients older than 60 years were assessed through the Older Adult Self-Report. MA scores were obtained by using the Locke-Wallace Marital Adjustment Test. RESULTS The patients reported relatively high levels of QOL and MA, along with low BPs. Marital support was associated with higher levels of QOL. BPs were associated with lower physical and total QOL scores. Smoking habits were associated with lower levels of MA, psychological health, and QOL. Erectile dysfunction was related to lower MA levels and lower QOL scores. CONCLUSIONS Overall, the patients had high self-reported QOL levels, which indicated that physical impairments related to surgery did not prevent patients to return to normal functioning.

Behavioral alarm treatment for nocturnal enuresis

PURPOSES To investigate the efficacy of alarm treatment in a sample of Brazilian children and adolescents with nocturnal enuresis and relate treatment success to age and type of clinical support. MATERIALS AND METHODS During 32 weeks, 84 children and adolescents received alarm treatment together with weekly psychological support sessions for individual families or groups of 5 to 10 families. RESULTS 71% of the participants achieved success, defined as 14 consecutive dry nights. The result was similar for children and adolescents and for individual or group support. The time until success was shorter for participants missing fewer support sessions. CONCLUSIONS Alarm treatment was effective for the present sample, regardless of age or type of support. Missing a higher number of support sessions, which may reflect low motivation for treatment, increased the risk of failure.

Topical betamethasone and hyaluronidase in the treatment of phimosis in boys: a double-blind, randomized, placebo-controlled trial

PURPOSE To compare the efficacy of three different formulations containing Betamethasone Valerate versus placebo in the topical treatment of phimosis. As a secondary goal, we compared the outcomes after 30 and 60 days of treatment. MATERIALS AND METHODS Two hundred twenty boys aged 3 to 10 years old with clinical diagnosis of phimosis were enrolled. Patients were randomized to one of the following groups: Group 1: Betamethasone Valerate 0.2% plus Hyaluronidase; Group 2: Betamethasone Valerate 0.2%; Group 3: Betamethasone Valerate 0.1% or Group 4: placebo. Parents were instructed to apply the formula twice a day for 60 days and follow-up evaluations were scheduled at 30, 60 and 240 days after the first consultation. Success was defined as complete and easy foreskin retraction. RESULTS One hundred ninety-five patients were included at our final analysis. Group 1 (N = 54), 2 (N = 51) and 3 (N = 52) had similar success and improvement rates, all treatment groups had higher success rates than placebo (N = 38). After 60 days of treatment, total and partial response rates for Groups 1, 2 and 3 were 54.8% and 40.1%, respectively, while placebo had a success rate of 29%. Success and improvement rates were significantly better in 60 days when compared to 30 days. CONCLUSIONS Betamethasone Valerate 0.1%, 0.2% and 0.2% in combination with Hyaluronidase had equally higher results than placebo in the treatment of phimosis in boys from three to ten years-old. Patients initially with partial or no response can reach complete response after 60 days of treatment.

Adesão em saúde e psicoterapia: conceituação e aplicação na enurese noturna

Existem diversos estudos sobre preditores da nao adesao, mas poucos mostram estrategias efetivas para lidar com esse problema. Uma revisao da literatura sobre desistencia em psicoterapia mostrou que quase metade dos pacientes que ingressam num atendimento nao o concluem. A medida na psicoterapia em geral e a de nao adesao, ou desistencia do tratamento; no presente trabalho serao apresentados dados relativos a adesao ao tratamento da enurese com alarme de urina. A taxa de desistencia em um grupo de 61 criancas e adolescentes foi levantada considerando tres condicoes: suas familias nao compareceram aos atendimentos, nao responderam ao contato telefonico ou relataram ter abandonado os procedimentos. A desistencia correspondeu a 19,6% da amostra e a idade do grupo dos desistentes era significativamente inferior, quando comparada a daqueles que aderiram ao tratamento. A ja demonstrada associacao entre a intolerância parental e a idade do filho explica os resultados e aponta para a necessidade de trabalho educativo intenso com os pais de adolescentes portadores de enurese.

Supervisão em Serviços-Escola de Psicologia no Brasil: Perspectivas dos Supervisores e Estagiários

In the last 20 years, there has been an increasing interest in the functioning of psychology university clinics, mainly regarding its clientele. However, there has been little interest in the supervision in this context. Clinical supervision is a process that involves aspects from teaching as well from the therapeutic alliance. In this study, an instrument was used that assess the supervision according to the factors empathy, learning enhancement and comprehension. In total, 126 supervisors and 238 psychology students from several Brazilian regions answered an online questionnaire in order to evaluate supervision. In general, the supervision had a good evaluation from both supervisors and students. However, there were some discrepancies in specific points between the two groups.

Adherence in health and psychotherapy: conceptualization and application in nocturnal enuresis

Existem diversos estudos sobre preditores da nao adesao, mas poucos mostram estrategias efetivas para lidar com esse problema. Uma revisao da literatura sobre desistencia em psicoterapia mostrou que quase metade dos pacientes que ingressam num atendimento nao o concluem. A medida na psicoterapia em geral e a de nao adesao, ou desistencia do tratamento; no presente trabalho serao apresentados dados relativos a adesao ao tratamento da enurese com alarme de urina. A taxa de desistencia em um grupo de 61 criancas e adolescentes foi levantada considerando tres condicoes: suas familias nao compareceram aos atendimentos, nao responderam ao contato telefonico ou relataram ter abandonado os procedimentos. A desistencia correspondeu a 19,6% da amostra e a idade do grupo dos desistentes era significativamente inferior, quando comparada a daqueles que aderiram ao tratamento. A ja demonstrada associacao entre a intolerância parental e a idade do filho explica os resultados e aponta para a necessidade de trabalho educativo intenso com os pais de adolescentes portadores de enurese.

La adhesión en la salud y la psicoterapia: conceptuación y aplicación en la enuresis nocturna

Existem diversos estudos sobre preditores da nao adesao, mas poucos mostram estrategias efetivas para lidar com esse problema. Uma revisao da literatura sobre desistencia em psicoterapia mostrou que quase metade dos pacientes que ingressam num atendimento nao o concluem. A medida na psicoterapia em geral e a de nao adesao, ou desistencia do tratamento; no presente trabalho serao apresentados dados relativos a adesao ao tratamento da enurese com alarme de urina. A taxa de desistencia em um grupo de 61 criancas e adolescentes foi levantada considerando tres condicoes: suas familias nao compareceram aos atendimentos, nao responderam ao contato telefonico ou relataram ter abandonado os procedimentos. A desistencia correspondeu a 19,6% da amostra e a idade do grupo dos desistentes era significativamente inferior, quando comparada a daqueles que aderiram ao tratamento. A ja demonstrada associacao entre a intolerância parental e a idade do filho explica os resultados e aponta para a necessidade de trabalho educativo intenso com os pais de adolescentes portadores de enurese.

Acompanhamento presencial e à distância para o tratamento da enurese noturna com alarme

Nocturnal enuresis is defined as natural urination during sleep occurring at least once a month among children aged five years or older. There is a relative consensus in literature regarding possible causes: nocturnal polyuria, difficulties in waking up and a hyperactive bladder. The objective of this work was two compare two treatment protocols which used an alarm to treat enuresis: face-to-face and long distance. Sixty one enuretic children aged between 6 and 17 and their parents or caregivers participated in the study. They all attended two initial face-to-face sessions in which they received information on the treatment based on the full-spectrum programme. Participants were randomly allocated to the face-to-face (n=27) and long-distance (n=34) protocols. The long-distance protocol recorded outcome rates comparable to those cited in literature and thus offered a feasible alternative to the face-to-face protocol.