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

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

Prevalência e fatores associados à sintomatologia dolorosa e a qualidade de vida de odontólogos da cidade de Teresina-PI

Objective: Identify the factors associated to the painful symptomatology and the quality of life and in dentists in the city of Teresina-PI. Brazil. Methods It was accomplished a cross-sectional study with 175 dentists registered with the Regional Council of Dentistry-PI from March to May, 2007. For characterization of the dentists we used a multidimensional questionnaire containing sociodemographic (age, sex) and professional information (time of service, journey to work). The evaluation of the presence of pain was performed by the Protocol of Painful Symptoms of McGILL. The WHOQOL-Bref was used to assess quality of life through physical, psychological, social and environmental domains. Results / Conclusions The painful symptomatology was reported in 69,7% of individuals, being observed in 77.3% of women and 60.3% of men. Body regions where pain was prevalent was the regions of neck (69,2%) lower back (69,7%). The dentists had high levels of self-perception of quality of life satisfaction and health. 96,0% of the individuals reported quality of life as very good, and only 16.6% reported dissatisfied with health. The Physical and Environmental domains showed values higher than the psychological and social domains. The painful symptomatology of studied dentists is associated with female sex (RP=1.28; IC95% 1.04-1.58; p<0.01). A multivariate analysis by logistic regression was performed and only the painful symptoms (OR = 2.51, IC95% 1,21-5,21) remained associated with the quality of life of these professionals when adjusted for other variables studied

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

Lócus de controle e conceito de maternidade e paternidade em adolescentes

Locus of control is a construct that seeks to explain people's perceptions about the source of control of events, if the subject's own - internal - or belonging to some element outside of oneself - external. The location of individual s locus of control will suffer influence of their developmental period. During adolescence, individuals turn to the construction of their identity, and the structuring of sexual identity is a relevant part of this process, since the roles of males and females are the most important from the socio-cultural point of view. One of the roles that adolescents can take is the mother or father. We chose to head the adolescents who are not mothers and fathers, and question them about their concepts of parenthood. It is hypothesized that adolescents with internal locus of control will probably develop concepts of maternity and paternity in which they attach to themselves the responsibility for children. The aim of this study was to relate the locus of control s predominant dimension in adolescence and the way that these young people conceptualize parenthood. This is an exploratory analytical cross-sectional study accomplished with 400 adolescents from the classes of the sixth to ninth grade of high school at public schools in Natal / RN. We used as protocols: structured questionnaire involving sociodemographic questions and questions about the concept of parenthood, and the Multifactorial Scale of Locus of Control. Data were analyzed using descriptive and inferential statistics, with the aid of statistical package SPSS 18.0. The results regarding questions about the concept of maternity and paternity were analyzed using the analysis program often ALCESTE 4.7. The results showed that for boys and girls, maternity and paternity were characterized by the acquisition and assumption of responsibilities of adulthood. This concept is supported by the locus of control s classification of individuals, since most of the subjects of this study was characterized as individuals who tend to take responsibility for their life's events. For young people from lower classes (as the subjects of this research), the project of autonomy and social mobility is realized by the constitution of his own family and the ability to sustain it

Vida, experiência, conhecimento : a reforma do sujeito cognoscente em Tsunessaburo Makiguchi

Utilizing a great part of the works by Japanese educator Tsunesaburo Makiguchi and the register of fragments of his life, this thesis affirms that knowledge emerges from peoples` experience as they go about their daily lives. Facts, events, genetic inheritance, cultural patrimony, family history, the place where one was born and lived, and psychological predispositions nurture and form a vision of the world and of life in general. In Makiguchi s case, this multi-causal constellation led him to conceive the system of the value-creating pedagogy of good, gain and beauty; discussing the importance of cognition and evaluation in the experience of the human being. His life is exemplary in demonstrating that these aspects are inter-connected and, in a recursive movement between knowledge and self-knowledge, they can generate creative systems for understanding the world and introducing, essentially, the author into the epistemological problematic of complexity. The Makiguchian system and Edgar Morin s complexity approach suggest a pragmatic, paradigmatic reform of education and a thought reformation in the direction of the complex pedagogy, and that it creates a web that connects master-disciple, subject-object, human-world, local-global and singular-universal

História oral de vida de pessoas com úlcera venosa nos serviços de atenção primária à saúde

The Chronic Venous insufficiency is characterized as a set of physical changes including how most serious complication of venous ulcers, characterized by irregular and progressive loss of continuity of the skin. The occurrence of venous ulcers in people with chronic venous insufficiency generates dependence on them with health services, with long-term treatments that cause limitations and high-impact changes, affecting their quality of life, affecting the physical, psychological, social, cultural and spiritual as an important public health problem. This study aimed to describe the experience of having a venous ulcer, in the scenario of primary health care services to Health, which includes Primary Care Units and Family Health Strategy in the city of Natal / RN, based on the life histories of users. This is a qualitative study, exploratory and descriptive, with the Oral History of Life as a methodological framework. From the ponto zero was the recruitment of participants who formed the network, totaling six employees, of both sexes and aged between 57 and 79 years. After approval by the Research Ethics Committee - UFRN under the Protocol 653 788/2014 and CAAE 30408014.0.0000.5537 was held data collection, between the months of July and August, through interviews, using identification and characterization of the instrument employees and open questions. Interviews were recorded, transcribed, transcriadas and returned to employees for a conference. The narratives were subjected to Content thematic analysis technique, according to Bardin, allowing the construction of three themes that encompass categories, namely: Axis I - Perspectives on the changes: the impact wound in social relations (changes with ulcer venous, venous ulcer and social and family relationships); Axis II - Brands in body and soul: the story of being hurt (conceptions of the body injured; therapeutic itinerary in primary care services); and Axis III - Reconstruction of being hurt: coping mechanisms (redefinition of the wounded body, resilience to chronic wound). The impact of having a chronic venous ulcer generates impact of physical, psychological and social order. As aspects related to changes after the appearance of venous ulcers, survey participants reported the presence of pain, physical limitations, psychological distress, social and emotional isolation, incapacity, aesthetic discomfort and dependency on health services; the family was the aspect thatshowed no significant change after the occurrence of wound for most participants, an ally in the therapeutic process as a support network. The redefinition of the body and the wound are the main coping mechanism of chronic condition. The services in the Primary Care Network play a fundamental role in the rehabilitation of patients with venous ulcers, although there are difficulties in accessing appropriate treatment and need for expanded services, with permanent professional training of health teams and providing the resources managers to strengthen the comprehensive care of people with venous ulcers in Health Primary Care.

Qualidade de vida de pessoas com estomias intestinais

Ostomy is an open surgical origin, when it is necessary to deviate temporarily or permanently, the normal transit of food and / or deletions. The patient with ostomy disposal is faced with changes in their physiology, also emerging on the need to care collection bag. This study aimed to analyze the quality of life (QOL) of people living with ostomy Intestinal (EI), who attended the Pediatric and Adult Rehabilitation Center of Rio Grande do Norte (CRI / CRA-RN). It is an analytical study with cross-sectional design and quantitative approach, accomplished with 89 people who had EI. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), CAAE: 19866413.3.0000.5537. Held data collection in the period January-March 2015 using two instruments: an adapted general questionnaire covering socio-demographic, clinical and self-care and a specific instrument for assessing QOL of people with stoma titled as City of Hope Quality of Life - Ostomy Questionnaire (COH-QOL-Q), validated and adapted to Portuguese in 2010, composed of four areas, namely: Welfare Body (BEF), Welfare Psychological (BEP), Welfare (BES ) and Spiritual Well-Being (BEE). The collected data were entered into a database in Microsoft Excel 2007 spreadsheet application and processed in computerized software for descriptive and inferential analysis. The results showed that 83.1% had a colostomy and ileostomy 16.9%. Sociodemographic characteristics prevailed in males (57.3%), over 50 (57.3%), mulatto (46.1%), with presence of companion / a (57.3%), retired / beneficiaries (50.5%), monthly income above the minimum wage (68.5%) and who have studied up to elementary school (67.4%). Regarding clinical aspects, it was observed that the main cause that led to the making of the stoma was the neoplasm (59.6%) followed by trauma (21.3%). The sample showed people with stoma for more than six months (79.8%) of permanently (57.3%), in use sink equipment piece drainable (68.5%) of flat base (82.0%). With respect to self-care, 93.3% emptied and washed the bag alone (care related to hygiene) and 75.3% fixed the new exchange on the skin during the exchange (care related to the stock). Patients with more than six months of ostomy and had no partner (a) had higher averages of self-care related hygiene and purse. The average of respondents QoL scores was 68.90% for General QOL; 68.03% for the BEF; 68.38% for the BEP; 66.46% for BES and 75.41% for BEE. Among the aspects that influenced QOL included: physical strength, pain, suffering and gases (physical domain); appearance, care of the stoma and adaptation to new condition (psychological domain); isolation, interference in personal relationships and social activities (social domain) and going to church or synagogue, spiritual activities and positive change after ostomy (spiritual realm). Based on these results, it is concluded that this was a predominantly adult sample / elderly (between 50 and 70 years), with low education and the cause motivating the stoma, neoplasms. However, such findings did not pass at low percentage levels on the self-care capacity to deliver even at low QOL scores.

Qualidade de vida de pessoas com estomias intestinais

Ostomy is an open surgical origin, when it is necessary to deviate temporarily or permanently, the normal transit of food and / or deletions. The patient with ostomy disposal is faced with changes in their physiology, also emerging on the need to care collection bag. This study aimed to analyze the quality of life (QOL) of people living with ostomy Intestinal (EI), who attended the Pediatric and Adult Rehabilitation Center of Rio Grande do Norte (CRI / CRA-RN). It is an analytical study with cross-sectional design and quantitative approach, accomplished with 89 people who had EI. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), CAAE: 19866413.3.0000.5537. Held data collection in the period January-March 2015 using two instruments: an adapted general questionnaire covering socio-demographic, clinical and self-care and a specific instrument for assessing QOL of people with stoma titled as City of Hope Quality of Life - Ostomy Questionnaire (COH-QOL-Q), validated and adapted to Portuguese in 2010, composed of four areas, namely: Welfare Body (BEF), Welfare Psychological (BEP), Welfare (BES ) and Spiritual Well-Being (BEE). The collected data were entered into a database in Microsoft Excel 2007 spreadsheet application and processed in computerized software for descriptive and inferential analysis. The results showed that 83.1% had a colostomy and ileostomy 16.9%. Sociodemographic characteristics prevailed in males (57.3%), over 50 (57.3%), mulatto (46.1%), with presence of companion / a (57.3%), retired / beneficiaries (50.5%), monthly income above the minimum wage (68.5%) and who have studied up to elementary school (67.4%). Regarding clinical aspects, it was observed that the main cause that led to the making of the stoma was the neoplasm (59.6%) followed by trauma (21.3%). The sample showed people with stoma for more than six months (79.8%) of permanently (57.3%), in use sink equipment piece drainable (68.5%) of flat base (82.0%). With respect to self-care, 93.3% emptied and washed the bag alone (care related to hygiene) and 75.3% fixed the new exchange on the skin during the exchange (care related to the stock). Patients with more than six months of ostomy and had no partner (a) had higher averages of self-care related hygiene and purse. The average of respondents QoL scores was 68.90% for General QOL; 68.03% for the BEF; 68.38% for the BEP; 66.46% for BES and 75.41% for BEE. Among the aspects that influenced QOL included: physical strength, pain, suffering and gases (physical domain); appearance, care of the stoma and adaptation to new condition (psychological domain); isolation, interference in personal relationships and social activities (social domain) and going to church or synagogue, spiritual activities and positive change after ostomy (spiritual realm). Based on these results, it is concluded that this was a predominantly adult sample / elderly (between 50 and 70 years), with low education and the cause motivating the stoma, neoplasms. However, such findings did not pass at low percentage levels on the self-care capacity to deliver even at low QOL scores.

Does a mandibular RDP and new maxillary CD improve masticatory efficiency and quality of life in patients with a mandibular Kennedy class I arch?

Objectives To evaluate the change in masticatory efficiency and quality of life of patients treated with mandibular Kennedy class I removable partial dentures (RPDs) and maxillary complete dentures at the Department of Dentistry of the Federal University of Rio Grande do Norte. Materials and methods A total of 33 Kennedy class I patients were rehabilitated with maxillary complete dentures, and mandibular RPDs were selected for this non-randomized prospective intervention study. The patients had a mean age of 59.1 years. Masticatory efficiency was evaluated by colorimetric assay using fuchsin capsules. The measurements were conducted at baseline and 2 and 6 months after prosthesis insertion. Quality of life was evaluated using the Oral Health Impact Profile (OHIP-14) at baseline and 6 months after denture insertion. The Kolmogorov-Smirnov normality test was applied. Masticatory efficiency was evaluated by repeated measures ANOVA. Oral health-related quality of life was compared using the paired t test. Results There was no statistically significant difference in masticatory efficiency after denture insertion (p = 0.101). Significant differences were found (p = 0.010) for oral health-related quality of life. A significant improvement in psychological discomfort (p < 0.01) and psychological disability (p < 0.01) was observed. Mean difference value (95 % confidence interval) was 6.8 (3.8 to 9.7) points, reflecting a low impact of oral health on quality of life, considering the 0–56 range of variation of the OHIP-14 and a Cohen’s d of 1.13. Conclusion According to the results of the present study, rehabilitation with Kennedy class I RPDs and complete dentures did not influence masticatory efficiency but improved oral health-related quality of life. Clinical relevance The association between the patient’s quality of life and the masticatory efficiency is important for treatment predictability.