Cuidar da pessoa com esquizofrenia em processo de reabilitação psicossocial

Este ensino clínico permitiu-nos prestar cuidados de enfermagem especializados a 16 homens com esquizofrenia em processo de reabilitação psicossocial. Na sua maioria são: adultos, solteiros, da região sul de Portugal, com uma média de 9 anos de escolaridade, com história de consumo de substâncias (álcool, tabaco, haxixe, cocaína, heroína e anfetaminas), institucionalizados na Casa de Saúde do Telhal (CST) há mais de 11 anos. Todos apresentam diagnósticos de enfermagem das várias dimensões do adoecer, com exceção da dimensão comportamental excitatória, sendo os de maior prevalência: “Conhecimento sobre Processo de doença/Cuidados na doença/Tratamento, Não Demonstrado”; Cognição, Comprometida”; “Processo Social, Alterado”; “Autoestima, Diminuída”. Foram desenvolvidos 4 programas de intervenção: consulta de enfermagem de saúde mental e psiquiatria (CESMP); atelier de estimulação cognitiva (AEC); programa de desenvolvimento de competência intrapessoais, interpessoais e profissionais (PDCIIP); programa de psicoeducação (SABER+). A satisfação global com os programas foi superior a 7 (numa escala de 1 a 10) e os resultados que foram percebidos pela maioria dos reabilitandos situaram-se acima das suas expectativas iniciais. De uma forma geral, todos registaram ganhos: no desempenho cognitivo (em particular os que beneficiaram do AEC); na adaptação psicossocial – nomeadamente ao nível do insight; os reabilitandos que beneficiaram do programa SABER+ melhoraram ainda os comportamentos demonstrados de aceitação do estado de saúde; no bem-estar psicológico – nomeadamente ao nível da autoestima (sobretudo os que beneficiaram da CESMP e/ou do PDCIIP), dos afetos positivos e dos comportamentos de motivação; nos vários domínios da qualidade de vida (QdV) medidos pelo WHOQOL-Bref em particular o domínio ambiental; todos elevaram o seu nível de conhecimentos nos 3 eixos em que que se estruturou o programa de psicoeducação (processo da doença, cuidados na doença, tratamento da doença); na adesão à medicação, sobretudo os que integraram o programa de psicoeducação, contudo todos tendem a necessitar de ajuda parcial para conseguir demonstrar conhecimento no cumprimento do esquema terapêutico e estão envolvidos em treinos supervisionados de preparação e autoadministração; ABSTRACT: This clinical training allowed us to provide skilled nursing care to 16 men with schizophrenia in a psychosocial rehabilitation setting. Most of these individuals are: adults, singles, from the southern region of Portugal, with an average of 9 years of schooling, with a history of substance abuse (alcohol, tobacco, cannabis, cocaine, heroin and amphetamines), institutionalized in Casa de Saúde do Telhal (CST) for over 11 years. We find nursing diagnoses from all of the disease dimensions with the exception of excitatory behavioral dimension, being the most prevalent: "knowledge about disease process / care / treatment, not stated"; cognition, impaired", "social process, impaired”, “self-esteem, decreased". We developed 4 intervention programs: psychiatry and mental health nursing consultation (CESMP); atelier of cognitive stimulation (AEC); intrapersonal, interpersonal and professional competences training (PDCIIP); psychoeducation (SABER+). The overall satisfaction with the programs was above 7 (on a scale of 1 to 10) and the results noticed by most patients were above their initial expectations. All registered nursing results were: in cognitive performance (particularly those who benefited from the AEC); in psychosocial adaptation - especially in terms of insight; patients who benefited from the SABER+ program demonstrated improved further acceptance of their health condition, psychological well-being, particularly in terms of self-esteem (especially those who benefited from the CESMP and/or the PDCIIP), positive affects and motivation; in the different domains of quality of life (QoL) measured by WHOQOL-Bref in particular the environmental domain; every patients raised their level of knowledge in the 3 axes in which the psychoeducational program (SABER+) was structured (disease process, care and treatment); in medication adherence, especially those who benefited of the psychoeducational program, however all the patients tend to need partial help to demonstrate knowledge in meeting the therapeutic regimen and are involved in supervised training programs for preparation and self administration.

La enseñanza de los niños impedidos

Diagnosis and intervention programs for SEN children: deafness, physical deficiencies, vocational training for mentally retarded.

Effects of dry-land strength and conditioning programs in age group swimmers

Context: Even though dry-land S&C training is a common practice in swimming, there are countless uncertainties over it effects in performance of age group swimmers. Objective: To investigate the effects of dry-land S&C programs in swimming performance of age group swimmers. Participants: A total of 21 male competitive swimmers (12.7±0.7 years) were randomly assigned to the Control Group (n=7) and experimental GR1 and GR2 (n=7 for each group). Intervention: Control group performed a 10-week training period of swim training alone, GR1 followed a 6-week dry-land S&C program based on sets/repetitions plus a 4-week swim training program alone and GR2 followed a 6-week dry-land S&C program focused on explosiveness, plus a 4-week program of swim training alone. Results: For the dry-land tests a time effect was observed between week 0 and week 6 for vertical jump (p<0.01) in both experimental groups, and for the GR2 ball throwing (p<0.01), with moderate-strong effect sizes. The time*group analyses showed that for performance in 50 m, differences were significant, with the GR2 presenting higher improvements than their counterparts (F=4.156; ƿ=0.007; η2=0.316) at week 10. Conclusions: The results suggest that 6 weeks of a complementary dry-land S&C training may lead to improvements in dry-land strength. Furthermore, a 4-week adaptation period was mandatory to achieve beneficial transfer for aquatic performance. Additional benefits may occur if coaches plan the dry-land S&C training focusing on explosiveness.

An intervention program for children with school failure problems.

School failure is a chronic problem in many developing countries and in some developed as Portugal due to factors like cognitive deficiencies of children, an inadequate family environment, low SES and bad teaching methods or school organization. It is important to develop effective and simple intervention strategies able to cope with the problem at an individual level independently of the cause. The general objective of the following study is to develop behavioral training techniques to help children with problems of school failure. 6 - 12 years old children attending ISCED 1, with academic difficulties because of family problems, social exclusion (living in poverty or belonging to an ethnic minority) or poor schooling were trained. Cognitive-behavioral techniques that have been widely used to train persons with intellectual, sensorial, physical or social deficiencies were applied. Results are evaluated in terms of % of attained objectives, time, and (subjective) teacher satisfaction. Some results of individual children are shown. Training programs seem to be successful independently of the (mostly unknown) cause of failure of the trained subject.