Vera Lúcia Soares Chvatal

Respostas ao adoecimento: mecanismos de defesa utilizados por mulheres com síndrome de Turner e variantes

OBJETIVO:Conhecer as defesas utilizadas por mulheres com sindrome de Turner (ST) ou formas variantes para lidar com a doenca. METODO: Pesquisa qualitativa com desenho exploratorio, nao experimental. O instrumento consistiu em entrevista psicologica semidirigida, aplicada em 13 mulheres, cuja amostragem deu-se por saturacao, as quais fazem acompanhamento semestral no Centro de Atendimento Integral a Saude da Mulher. Os dados foram interpretados utilizando-se da abordagem psicodinâmica, aliada a um quadro ecletico de referenciais teoricos para discussao no espirito da interdisciplinaridade. RESULTADOS: Essas mulheres apresentaram conflitos psicossociais como dificuldades de relacionamento interpessoal; sentimentos de resignacao, raiva, impotencia, desvalia e quadros de depressao. As defesas utilizadas foram: repressao, negacao, anulacao, fantasia, adaptacao e sublimacao. CONCLUSOES:As mulheres com ST ou formas variantes tem de lidar com as intercorrencias orgânicas e psiquicas da enfermidade provocando grande sofrimento que, frequentemente, dificultam uma insercao social mais sadia. Neste caso, os achados deste estudo poderao nortear acompanhamento psicologico ambulatorial concomitantemente ao protocolo clinico de rotina.

Nutrition and self-care practices of patients with chronic Metabolic Syndrome: a qualitative study

OBJETIVO: Analisar aspectos subjetivos das praticas alimentares e autocuidado de pacientes na convivencia com os sintomas cronicos vinculados a Sindrome Metabolica. METODOS: Estudo clinico-qualitativo (exploratorio, nao-experimental), realizado com amostra propositalmente pequena de nove pacientes em tratamento ambulatorial de endocrinologia em hospital universitario do Estado de Sao Paulo, Brasil. O grupo foi fechado por saturacao de dados. As entrevistas foram realizadas em profundidade, com orientacao psicodinâmica na conducao dos dialogos. A categorizacao do discurso foi desenvolvida por meio da analise de conteudo. A abordagem psicodinâmica foi a referencial teorico complementada pela antropologia social. RESULTADOS: Praticas alimentares revelaram-se como mediadoras de autonomia e como fonte de vulnerabilidade na convivencia com o processo de adoecimento cronico. Acolhimento e compreensao dos aspectos psicologicos e culturais da alimentacao sao necessarios no tratamento diante das dificuldades para estabelecer mudancas no comportamento alimentar. CONCLUSAO: Trata-se de uma contribuicao de abordagem interdisciplinar, que valoriza a escuta de subjetividades no tratamento.

P-1172 - Psychological meanings given by Brazilian clinical-school’ users about outcomes of psychoanalytic psychotherapy: a qualitative study

Introduction Since the Freudian construction of Psychoanalytic purposes, the foundations for the psychotherapy treatment have suffering profound transformations. However the understanding of the outcomes for patients in the therapeutic strategies used in the psychotherapeutic relationship need to be better discussed. Although the technique has been used in various contexts and submitted to a technical theoretical-structure, it lacks elements that help to evaluate both whether pedagogical actions employed to this education to potentize the professional actuation and whether they are effectives for the establishment of pillars for this practice. Objective To discuss the psychological meanings of outcomes of a psychoanalytic psychotherapeutic process for young and adults ex-patients who has used a clinical-school of a Brazilian federal university. Method Clinical-qualitative method whose sample was closed by information of saturation. The data was collected through semi-directed interviews, registered and transcribed for further Qualitative Content Analysis of Enunciation, based on a psychoanalytic theoretic framework. Results Preliminary data have emerged three thematic categories: the treatment as an escape from a death the life generates, expressed by pain of the overloads life; the maternal function attributed to the therapist and demonstrated through idealizations; and the pain felt by him/herself regarding perceptions of being a different one. Conclusion These categories support the reflection of treatment goals currently in public services and they permit to improve the approach to these users and to explore constitutive elements of the teaching-learning process.

Los hábitos de alimentación y el autocuidado de los pacientes con Síndrome Metabólico: un estudio cualitativo

OBJETIVO: Analisar aspectos subjetivos das praticas alimentares e autocuidado de pacientes na convivencia com os sintomas cronicos vinculados a Sindrome Metabolica. METODOS: Estudo clinico-qualitativo (exploratorio, nao-experimental), realizado com amostra propositalmente pequena de nove pacientes em tratamento ambulatorial de endocrinologia em hospital universitario do Estado de Sao Paulo, Brasil. O grupo foi fechado por saturacao de dados. As entrevistas foram realizadas em profundidade, com orientacao psicodinâmica na conducao dos dialogos. A categorizacao do discurso foi desenvolvida por meio da analise de conteudo. A abordagem psicodinâmica foi a referencial teorico complementada pela antropologia social. RESULTADOS: Praticas alimentares revelaram-se como mediadoras de autonomia e como fonte de vulnerabilidade na convivencia com o processo de adoecimento cronico. Acolhimento e compreensao dos aspectos psicologicos e culturais da alimentacao sao necessarios no tratamento diante das dificuldades para estabelecer mudancas no comportamento alimentar. CONCLUSAO: Trata-se de uma contribuicao de abordagem interdisciplinar, que valoriza a escuta de subjetividades no tratamento.

Práticas alimentares e autocuidado de pacientes com Síndrome Metabólica: um estudo qualitativo

OBJETIVO: Analisar aspectos subjetivos das praticas alimentares e autocuidado de pacientes na convivencia com os sintomas cronicos vinculados a Sindrome Metabolica. METODOS: Estudo clinico-qualitativo (exploratorio, nao-experimental), realizado com amostra propositalmente pequena de nove pacientes em tratamento ambulatorial de endocrinologia em hospital universitario do Estado de Sao Paulo, Brasil. O grupo foi fechado por saturacao de dados. As entrevistas foram realizadas em profundidade, com orientacao psicodinâmica na conducao dos dialogos. A categorizacao do discurso foi desenvolvida por meio da analise de conteudo. A abordagem psicodinâmica foi a referencial teorico complementada pela antropologia social. RESULTADOS: Praticas alimentares revelaram-se como mediadoras de autonomia e como fonte de vulnerabilidade na convivencia com o processo de adoecimento cronico. Acolhimento e compreensao dos aspectos psicologicos e culturais da alimentacao sao necessarios no tratamento diante das dificuldades para estabelecer mudancas no comportamento alimentar. CONCLUSAO: Trata-se de uma contribuicao de abordagem interdisciplinar, que valoriza a escuta de subjetividades no tratamento.

P02-293 - Psychological meanings of silence for Brazilian working women with urinary incontinence about their health problem: A clinical qualitative study

Objective To interpret the meanings of the silence from Brazilian working women about their urinary incontinence (UI). Method A clinical-qualitative method was used with semi-directed interviews with open-ended questions. The sample consisted of eight women aged 30 to 45 from low-income brackets of the population with complaints of UI and who had never sought treatment. The resulting data was analyzed according to the thematic content analysis technique, based on psychosocial and psychodynamic approaches. The authors were aware of the polysemic character from the speeches in Human Science research. Results The difficulty that women with urinary incontinence face in talking about the problem is an indication of the anxiety involved. They generally avoid discussing it due to embarrassment and from fear of being judged and misunderstood. In addition, their underprivileged social, economic and cultural situation may have aggravated their limitations in expressing their feelings. In terms of psychic processes, these women’s silence can be seen as a way for them to contain the physical symptom that their UI has brought on. Since it is so hard to express themselves in words, everything remains “unsaid,” but this silence can be interpreted as a way of expressing painful and unnameable feelings. Conclusion The silence of Brazilian women with urinary incontinence proved to be an essential element of communication about this disorder and was as important as the words they uttered. Their silence evidenced the pain and anxiety they experienced, and it emerged as an adaptive psychosocial mechanism.

P02-292 - My pregnancy was a flash of lightning! - the impact of birth of premature babies on adolescent mothers in the southeast Brazil: A clinical-qualitative study

Introduction The pregnancy and the motherhood of adolescents are complex phenomena that happen on the trajectory of life of the young persons under physical, psychological and social aspects. Aim To deepen knowledge of the emotional experiences of socially disadvantaged adolescent primiparous with premature babies. Method qualitative-clinical. Criteria of inclusion: age group, to be primiparous with premature baby and acceptance in participating of the inquiry. The intentional sample was made up of five adolescents aged between 16 and 19. The study was carried between June/2008 to October/2009. Semi-directed interviews based on the trigger question “Tell me about your pregnancy and your babys birth”. The data were submitted for thematic analysis and from this the following categories emerged: 1. Late discovery of pregnancy: “Mine was a lightning pregnancy”; 2. The symbolization of the child: “It was a present for me…” discussed within a theoretical framework of reference, with special emphasis on the psychodynamic approach. Results On a psychological perspective, the adolescents had presented feelings of omnipotence, unfamiliarity, shock, surprise, anger, fear, anguish and happiness at the birth of their child. They appeared to use immature, narcissistic and neurotic defence mechanisms such as denial, dissociation, acting out and idealization as well as revealing the desire to be good mothers and to engage in maternity. Conclusion These finds can subsidize the team of health responsible for the service in neonatal intensive care units, developing attitudes more effective of support and giving emotional presence aiming to reduce the fear and anguishes resulting from the situation.

P02-495 - “My pregnancy was a flash of lightning!” the impact of the birth of premature babies on adolescent mothers

Introduction The pregnancy and the motherhood of adolescents are complex phenomena that happen on the trajectory of life of the young persons under physical, psychological and social aspects. Aim To deepen knowledge of the emotional experiences of socially disadvantaged adolescent primiparous with premature babies. Method Qualitative-clinical. Criteria of inclusion: age group, to be primiparous with premature baby and acceptance in participating of the inquiry. The intentional sample was made up of five adolescents aged between 16 and 19. The study was carried between junho/2008 to outubro/2009. Semi-directed interviews based on the trigger question “Tell me about your pregnancy and your babys birth”. The data were submitted for thematic analysis and from this the following categories emerged: 1. Late discovery of pregnancy: “Mine was a lightning pregnancy”; 2. The symbolization of the child: “It was a present for me…” discussed within a theoretical framework of reference, with special emphasis on the psychodynamic approach. Results On the psychological level, the adolescents presented feelings of omnipotence, unfamiliarity, shock, surprise, anger, fear, anguish and happiness at the birth of their child. They appeared to use immature, narcissistic and neurotic defense mechanisms such as denial, dissociation, acting out and idealization as well as revealing the desire to be good mothers and to engage in maternity. Conclusion These finds can subsidize the team of health responsible for the service in the UTIN, developing attitudes more effective of support and giving emotional presence aiming to reduce the fear and anguishes resulting from the situation.

P02-141 - Psychological life experiences facing chronic diseases for patients with metabolic syndrome and impacts reported about health promotion in the Southeast Brazil: A clinical qualitative study

Introduction Receiving and understanding the psychological and sociocultural aspects associated to both health problems and difficulties to make the eating behaviour changes are relevant issues when treating individuals with Metabolic Syndrome. Objective and aims The reports given by chronic individuals in the present study allowed for analyzing the subjective expressions related to food, treatment management and patient adherence to self care propositions. Methods In-depth semi-directed interviews with open-ended questions, with psychodynamic orientation in the conducting dialogues were performed with nine patients from the endocrinology outpatient service of a public university hospital located in Southeast Brazil. From this broader objective, a selection was made of some experiences reported by the subjects, which were related to the process of managing treatment and eating behaviour, implied in chronic metabolic disorders. Results In this work, elements that mediate the process of developing autonomy in eating habits, living with the illnesses and vulnerability factors experiences by Metabolic Syndrome patients are identified in this study. Conclusion The interdisciplinary character of the present study promoted the valorisation of the practice of listening to the psychological and cultural meanings of eating behaviours, hence offering contributions regarding the nutritional care of individuals with Metabolic Syndrome.