Abordagem dos aspectos psicológicos da mulher infértil :um estudo quali-quantitativo

Purpose: assess the frequency of stress and anxiety levels in infertile women, correlate these aspects with risk factors and qualitatively analyze feelings resultant from the inability to conceive, in order to obtain data for specific psychological guidance. Methods: the case-control study included a total of 302 women, 152 being infertile (case group: 30.3 ± 5.4 years), and 150 non-fertile (control group: 25.7 ± 7.9 years). The quantitative approach involved the application of Lipp s Stress Symptoms Inventory (LSSI) and State-Trait Anxiety Inventory (STAI), whereas the qualitative approach consisted of a semi-structured interview. Response variables considered were: stress frequency and anxiety scores (State and Trait). Statistical analysis compared frequencies and medians between groups, by means of qui-squared and Mann-Whitney tests, respectively, and constructed logistical regression models to test associations between response variables and risk factors considered. Qualitative data were analyzed descriptively and categorized in order to perform correspondence analysis. The level of significance was 5%. Results: in the study sample, stress frequency was higher in the case group than in the control(61.8 and 36.0%, respectively), however, significant differences were not observed between groups in relation to stress phases and predominant symptomology type. With respect to anxiety, there were no significant differences between case and control groups as to median state scores [39.5 (35.0 46.0) and 41.0 (35.7 47.0 ); respectively) and anxiety trait scores [44.0 (34.0 51.0) and 42.0 (36.0 49.2); respectively). Risk factors significantly associated with greater risk for high anxiety scores in the case group were: primary infertility, unawareness of the causal factor, diagnostic phase investigation, religion, lack of children from other marriages and the fact that the woman was previously married. The qualitative approach demonstrated that infertility provokes emotional responses, such as sadness, anxiety, anger, fear and guilt. Conclusions: it can be concluded that infertile women are more vulnerable to stress; however, they are capable of adapting to stressful events without serious physical or psychological compromising

Mudanças climáticas globais e o compromisso pró-ecológico de adolescentes natalenses

In recent years, much has been discussed about global climate changes (GCCs), popularly known as global warming. The scientific evidences point out to the influence of human actions for its drastic intensification. Therefore, studies of the psychological aspects involved become relevant. This study aimed at the investigation of the views of adolescents concerning GCCs, and the possible relations between those views and their pro-ecological commitment. Such commitment is measured by willingness for engagement in pro-environmental behaviors; environmentalism attitudes, like ecocentric and anthropocentric; consideration of future consequences; and ecological worldviews. Participants were 348 adolescents who answered a questionnaire containing questions about socio-demographic data, open questions about the practice of environmental care, and about GCCs, and the scales of Ecocentric and Anthropocentric Environmentalism, the Consideration of Future Consequences and the Ecological Worldviews assessment scale. From the inter-relationships between variables, procedures carried out by means of descriptive and correlacional statistics, it was observed that 55% of teenagers said that they did not engage in actions of environmental care, which was associated with apathyanthropocentric, immediatism, and individualism. The consideration of future consequences joined the practice of environmental care, corroborating evidence from the literature. It was evident that views concerning GCCs were superficial; adolescents perceive it as a generic environmental problem, and are confused with other problems such as pollution. This study found no association between views about GCCs and the indicators of pro-ecological commitment, perhaps due to the conceptual confusion about the subject. However, the lack of environmental care actions and other indicators of non-commitment (apathy-anthropocentric, individualism and immediatism) were associated with conceptually poor or incomplete responses (with no indication of cause, consequence or responsibility for the problem), demonstrating diminished knowledge and the failure to consider these issues

Práticas institucionais/discursivas acerca dos cuidados com os bebês prematuros e/ou de baixo peso: o programa canguru

The Kangaroo Program was implemented in Brazil in 2000 through the Unified Health System (Sistema Único de Saúde SUS) sustained with a humanized rethoric of health care assistance. This program adopts the skin-to-skin contact contributing to the mother-infant bond, breastfeeding and promoting security in mother s care. The users of SUS are encouraged to live in the maternity ward to follow the baby health improvement. However, it was verified in previous observations that mothers participation in the Kangaroo Program has been done through an imposed practice. Therefore, this study intended to understand the texts that permeate the kangaroo practice. This research was developed through two studies: 1) an historic exploration of motherhood concept and an analysis of how the motherhood is presented in the official document that orients the program; 2) an analysis of institutional dynamic of Kangaroo Program, emphasizing the study about the health workers everyday practice, the mothers view about their life in the maternity wards, and the attendance practice. It is highlighted that the relation between this two studies allowed the comprehension abouthow the official discourses can influence the health workers behaviors and how their viewpoint and position can shape the everyday work in a public health program. This research, supported by Institutional Ethnography, considers that people s practices and experiences are socially organized and shaped by broad social forces. The discourse method was used in the documental analysis and in the analysis of qualitative data from empiric research. The research showed that the kangaroo program has been an excellent way to save resources and to improve some baby s biologic and psychological aspects. However, this program has failed to consider the social, economic and cultural complexity of mothers and the structural limitation of the health care system. The official document uses the economic and medical approach, following the hegemonic biomedical model and the life style of the people that don t use the public health system. Consequently, the program has not been successful because it is planned without people participation. On the other hand, it was verified that although some professionals are committed with their work, the mainly does not consider mothers participation as an active process, using the institutional power as a social control to keep mothers uninformed about the possibility to leave the maternity wards. As a result, the research also showed that mothers perceive the program as mandatory and not as option that can improve pleasure moments. It is, therefore, necessary to consider the complex social determinants of health that can increase mothers participation in the Kangaroo Program. Bringing these issues into debate can be a reflective exercise on citizenship and governance, allowing spaces for the improvement of public health programs

Características psicológicas do paciente obeso grave e suas implicações pós-operatórias na cirurgia bariátrica

Obesity is a chronic disease that has multi-factorial aetiology, characterized by high degree of body fat; the degree of obesity will vary according to the Body Mass Index (BMI=m2 /kg). The severe degree of obesity is characterized by BMI>40 and it is regularly associated to endocrine-metabolic or mechanic clinical alterations, and to psychological disorders. Binge Eating (BE) results were overly high for this population. The Bariatric Surgery has been the treatment chosen by those diagnosed with severe obesity as this intervention provides prompt outcomes for loss of weight and clinical improvement conditions. However, recent research has acquiesced that after two years between 20% and 30% of people subject to this intervention gained weight. The main objective of this research is to assess the psychological and behavioral characteristics of those diagnosed with severe obesity that have been subject to Gastric Bypass Surgery in the past 24 months. Specific aspects were investigated: (1) characteristics of different personalities and diagnose of clinic and personality disorders; (2) BE and its relation with loss of weight; (2) the difference between the groups regarding post-surgery care, e.g. physical activity, psychological and dietician input. Method: 40 adults (women and men) aged 23 and 60 year-old who went through a bariatric surgery in the past 24 months, in the city of Natal-RN (Brazil); they were assembled in two groups n=20, Gain group displaying loss of < 50% of their initial surplus of weight, and the Loss group displaying loss of >50%. The research protocol is made of a socio-demographic questionnaire and 3 psychometric instruments: Rorschach – Comprehensive System; Millon Personality Inventory (MCMI-III); and the Binge Eating Scale (Escala de Compulsão Alimentar Periódica (ECAP). Through Rorschach significant differences between these groups were verified according to the kind of personality (EB) - more EB Extratensivo in Gain group and Intratensivo in Loss group – and the lack of control to express affect, increasing the answer for Color Pure at Group I. Concerning the people standardization, the sample as a whole tends to show psychic pain, denigrated selfperception, high levels of self-criticism, distorted perceptions, vulnerability to develop mood disorders and high scores regarding Suicide. MCMI-III results showed more clinic and personality disorders in Group I: Depressive Disorder and Schizotypal, Anxiety, Dysthymia, Major Depressive Disorder; Thought Disorder, Bipolar- Manic and Posttraumatic Stress Disorder. In relation to ECAP, the results indicated significant differences, showing increased BE results in Gain group. There were found significant differences between BE severity and the presence of clinic and personality disorders. Concerning the post-surgery care, the observed differences are statistically significant regarding physical activities with median-increased differences in Loss group. There is a difference between the initial weight and the time post-surgery, indicating that the higher the initial weight and the time after the surgery the higher the re-gain of weight post-surgery. Finally, the results show that the participants with more than 3 years of surgery will have Clinic and Major Depressive Disorders; Somatoform Disorder; Dysthymia. These results confirm prior studies related to BE post-surgery and re-gain of weight as well as the proneness of clinic disorders in severe obesity people. That means the results reinforce that the surgery process is a facet of the severe obesity treatment. The post-surgery process needs to be the main focus of attention and have a long-term input to sustain the care of the surgery results and the quality of life of the patients.