Mulheres com lúpus eritematoso sistêmico: sintomas depressivos e apoio social percebido

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease, rare, multisystem, with a very heterogeneous clinical and serological manifestations standard. The patient, in addition to suffering injuries on his physical and physiological functioning, may also face a number of psychosocial problems. Research indicates that SLE can cause significant damage to the psychological realm, especially with the presence of anxiety and depression. In 1999, the American College of Rheumatology (ACR), proposed the establishment of 19 neuropsychiatric clinical syndromes attributed to SLE. Depression lies between mood disorders and is one of the most common psychiatric manifestations in this group, being found more frequently in these patients than in the general population. Studies also suggest that social support plays an important role in the development of coping strategies, in SLE management and depression. This study has as main objective verify the association between depressive symptoms and perceived social support in patients with SLE. The specific objectives turned to: investigte the prevalence of depressive symptoms; investigate the perceived social support and verify if there is an association between depression, social support and sociodemographic variables. We used a sociodemographic questionnaire, the Beck Depression Scale, and the Perceived Social Support Scale. The analysis was performed through descriptive and inferential statistics. The final sample could count with 79 SLE women, with an average age of 35.7 years. 44 (55.7%) of the participants were married. Only 6 (7.59%) had completed higher education and 32 (40.51%) have not finished high school. Seventy-one (89.87%) had an income below three minimum salaries and 71 (89.87) practiced a religion, and the Catholic (67.71%) was the most mentioned by them. Of the total sample, 37 (46.74%) had been diagnosed SLE more than 7 years before, and 25 (31.65%) had the disease for more than 10 years. Only 19 (24.05%) had some work activity. Forty-two of them (53.17%) had depressive symptoms levels from mild to severe, and 51 (64.46%) reported pain levels of 5, or above. The study found a significant association between depressive symptoms and pain (p = 0.013) and depressive symptoms and work activity (p = 0.02). When we examined the perception of social support, the results showed high levels among participants. Using the Spearman correlation test we found a strong correlation between depressive symptoms and social support (p= 0,000037). It means that the higher the frequency of support, the lower the score of depression. These findings are relevant because depressive symptoms in patients with SLE have a multicausal and multifactorial character and may remain unnoticed, since many of them are confused with the manifestations of the disease. This fact requires a careful assessment from professionals, not only in the clinical setting, but also considering other psychosocial reasons, that may be influencing the emergence or worsening of symptoms. These results also corroborate other studies, which not only confirm the predictive role of social support in the physical wellbeing, but also in the psychological.

Irish and Jordanian general student nurses’ attitudes towards people with mental illness (PWMI) and their relationship to cultural and religious beliefs

Background Attitudes held and cultural and religious beliefs of general nursing students towards individuals with mental health problems are key factors that contribute to the quality of care provided. Negative attitudes towards mental illness and to individuals with mental health problems are held by the general public as well as health professionals. Negative attitudes towards people with mental illness have been reported to be associated with low quality of care, poor access to health care services and feelings of exclusion. Furthermore, culture has been reported to play a significant role in shaping people’s attitudes, values, beliefs, and behaviours, but has been poorly investigated. Research has also found that religious beliefs and practices are associated with better recovery for individuals with mental illness and enhanced coping strategies and provide more meaning and purpose to thinking and actions. The literature indicated that both Ireland and Jordan lack baseline data of general nurses’ and general nursing students’ attitudes towards mental illness and associated cultural and religious beliefs. Aims: To measure general nursing students’ attitudes towards individuals with mental illness and their relationships to socio-demographic variables and cultural and religious beliefs. Method: A quantitative descriptive study was conducted (n=470). 185 students in Jordan and 285 students in Ireland participated, with a response rate of 86% and 73%, respectively. Data were collected using the Community Attitudes towards the Mentally Ill instrument and a Cultural and Religious Beliefs Scale to People with Mental Illness constructed by the author. Results: Irish students reported more positive attitudes yet did not have strong cultural and religious beliefs compared to students from Jordan. Country of origin, considering a career in mental health nursing, knowing somebody with mental illness and cultural and religious beliefs were the most significant variables associated with students’ attitudes towards people with mental illness. In addition, students living in urban areas reported more positive attitudes to people with mental illness compared to those living in rural areas.

Estrategias resilientes ante la situación adversa de los desahucios

Los desahucios en España se han convertido en los últimos años en un fenómeno social emergente, de interés tanto para la investigación como para la intervención de los profesionales de la acción social. Aun así, no existen estudios suficientes relacionados con esta situación adversa, y menos aún centrados en las respuestas resilientes que las personas son capaces de ofrecer ante ella. Con el objetivo de identificar los factores internos y externos que se presentan en la experiencia de las familias que viven procesos de desahucios y que les están permitiendo desarrollar estrategias resilientes ante dicha adversidad, se lleva a cabo la presente investigación en la que participan 20 sujetos, pertenecientes a familias que acuden a la Plataforma de Afectados por las Hipotecas (PAH) de Málaga. A los participantes se les realiza una entrevista semi-estructurada y a través de ellas se han podido definir las características socio-familiares de las personas afectadas, las diferentes estrategias de afrontamiento desarrolladas, las principales fuentes de apoyo con las que han contado, así como las preocupaciones que les han acompañado. Los resultados muestran los principales factores internos y externos que están presenten en las estrategias resilientes que han desarrollado las familias afectadas por los desahucios durante el proceso vivido y destacan como fuente de apoyo informacional a la PAH. Se concluye con la necesidad de continuar con esta línea de investigación para tratar de diseñar intervenciones que refuercen y fomenten las estrategias de afrontamiento ante la situación adversa del desahucio.

Acceptance of relapse fears in breast cancer patients: effects of an act-based abridged intervention

Objective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients.Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a ‘defusion’ exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and ‘anxious preocupation’ were also evaluated through standardized questionnaires.Results: The analysis revealed that ‘defusion’ contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity of fear, distress, anxious preoccupation and hypochondria were also observed.Conclusions: Exposure through ‘defusion’ techniques might be considered a useful option for treatment of persistent fears in cancer patients. This study provides evidence for therapies focusing on psychological acceptance in cancer patients through short, simple and feasible therapeutic methods.

De Invloed van Mentale Veerkracht op Copingstrategieën bij Eetproblematiek

Dit onderzoek bestudeerde het verband tussen probleemgerichte- en emotiegerichte coping en eetproblematiek en onderzocht daarnaast of mentale veerkracht de relaties tussen probleemgerichte en emotiegerichte coping enerzijds en eetproblematiek anderzijds beïnvloedt. Het doel van dit onderzoek was het verkrijgen van meer inzicht in de rol van mentale veerkracht als mogelijke moderator van de relatie tussen coping en eetproblematiek. Er is een eenmalige meting verricht bij jong volwassen vrouwen van 18 t/m 30 jaar uit de algemene populatie. Via e-mail en sociale media zijn online vragenlijsten verspreid die bruikbare gegevens opleverden van in totaal 188 vrouwen. Meetinstrumenten. Coping is gemeten middels de Utrechtse Coping Lijst (UCL) (Schreurs, Willige, van de Tellegen & Brosschot, 1988; Schreurs, Willige, van de Tellegen & Brosschot, 1993); mentale veerkracht is gemeten met behulp van de Resilience Scale-Nederlandse versie (RS-nl) (Portzky, 2008); en de mate van eetproblematiek is gemeten met de Eating Disorder Examination Questionnaire (EDE-Q) (Fairburn & Beglin, 1994). De resultaten hebben aangetoond dat er een significant negatief verband bestaat tussen probleemgerichte coping en mate van eetproblematiek en een significant positief verband tussen emotiegerichte coping en eetproblematiek. De negatieve samenhang tussen probleemgerichte coping en eetproblematiek bleek sterker bij een lagere mate van mentale veerkracht. De positieve samenhang tussen emotiegerichte coping en eetproblematiek bleek eveneens sterker bij een lagere mentale veerkracht. Personen met een lage mentale veerkracht en een ineffectieve (emotiegerichte of weinig probleemgerichte) copingstijl bleken de meeste eetproblemen te ervaren, bij een hoge mentale veerkracht werd de minste eetproblematiek gerapporteerd, ongeacht de gehanteerde copingstijl.

Learning to manage complexity through simulation: students' challenges and possible strategies

Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students' challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.Wearing video glasses, participants took part in a simulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as a theoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.Students' challenges in coping with clinical complexity included being: a) unprepared for 'diving in', b) caught in an escalating system, c) captured by the patient, and d) unable to assert boundaries of acceptable practice.Many characteristics of complexity can be recreated in a ward-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a) taking time to size up the system, b) attuning to what emerges, c) reducing complexity, d) boundary practices, and e) working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity.

A qualitative study of the emotional coping and support needs of children living with a parent with a brain injury

Primary objective: To examine emotional coping and support needs in children of persons with acquired brain injury, with a view to understanding what interventions would be helpful for these children. Design: The study was qualitative, using a thematic analysis approach. Methods and procedure: Six children between 9 and 18 years of age, six parents (three with ABI), and three support workers were interviewed either at home or at a support centre, using a semi-structured interview guide. Results: Children reported using a variety of adaptive and maladaptive emotional coping strategies, but were consistent in expressing a need for credible validation, i.e. sharing experiences with peers. The results are presented under four overarching themes: difficulties faced; emotions experienced; coping strategies; and reported support needs. Conclusions: The results reveal an interaction between the child’s experiences of complex loss that is difficult to acknowledge, emotional distancing between parent and child, and the children’s need for credible validation. All children expressed a desire for talking to peers in a similar situation to themselves, but had not had this opportunity. Interventions should set up such peer interaction to create credible validation for the specific distress suffered by this population.

Stress ocupacional e estratégias de coping em fisioterapeutas e terapeutas ocupacionais

Mestrado em Segurança e Higiene no Trabalho

Mental health and suicidal behaviors in adolescents from a Portuguese island

Background: Adolescent suicidal behaviors are a public health priority. Objectives: Suicidal behavior is an understudied field in the Azores, and the few existing research studies with Portuguese adolescents only include young people from Mainland Portugal. This study aims at analyzing the adolescent student population from this island region so as to describe the current situation and plan community intervention projects in this area to meet the identified needs. Methodology: This is a non-experimental, quantitative and descriptive-correlational study with the purpose of describing phenomena and finding associations between variables. Results: The results showed that 17.9% of the 484 sampled adolescents reported self-harm behaviors, with 12.7% reporting self-cutting and 5.2% medication overdose or ingestion of toxic substances. Around 15.5% of the adolescents reported suicidal ideation. Additionally, they showed high levels of depressive symptoms (19.9%), ranging from moderate (12%) to severe (7.9%). Conclusion: Adolescents had more self-harm behaviors, more severe depressive symptoms, a lower self-concept and fewer coping strategies than similar populations in mainland Portugal.

9-vuotiaiden tyttöjen ja poikien luottamus isää ja äitiä kohtaan

Kiintymyssuhdetutkimuksen kentällä on 2000-luvulta lähtien julkaistu enenevässä määrin tutkimuksia koskien lapsen ja vanhempien välistä suhdetta lapsen eläessä keskilapsuuden ikävaihetta. Tulosten mukaan lapsen luottamus vanhempaa kohtaan ei vähene keskilapsuudessa (mm. Kerns, Tomich & Kim, 2006). Lapsen ja äidin välisen luottamuksen lisäksi tutkimuksissa on nähty tarpeelliseksi ottaa mukaan lapsen ja isän välisen luottamuksen tarkastelu, mikä jo itsessään kertoo lapsen ja isän välisen suhteen merkityksellisyydestä lapsen elämässä. Tämän tutkimuksen tavoitteena oli selvittää, kuinka 9-vuotitaat suomalaiset tytöt ja pojat luottavat isään ja äitiin, luottavatko tytöt ja pojat yhtä paljon isään ja äitiin, sekä onko tyttöjen ja poikien välillä eroja luottamuksessa vanhempia kohtaan. Tutkimus toteutettiin käyttämällä kahta itsearviointimenetelmää: turvallisuusasteikkoa (Kerns Security Scale; Kerns, Klepac & Cole, 1996) sekä selviytymisstrategiakyselylomaketta (Coping Strategies Questionnaire; Finnegan, Hodges & Perry, 1996), joiden avulla arvioitiin lapsen luottamusta vanhempiin sekä välttelevää ja vastustavaa käyttäytymistä vanhempia kohtaan. Lapsi arvioi erikseen suhdettaan äitiin ja suhdettaan isään. Suomalaiset 9-vuotiaat tytöt ja pojat luottavat vähintään yhtä paljon vanhempiinsa kuin suomalaiset 11-vuotiaat verrokit (Kouvo. Virtanen & Silvén, 2015) tai samanikäiset pohjoisamerikkalaislapset (mm. Kerns, Tomich, Aspelmeier & Contreras, 2000). Odotusten mukaisesti luottamus äitiin on voimakkaasti yhteydessä siihen, miten lapsi luottaa isään ja toisin päin. Tytöt ja pojat eivät eroa keskenään siinä, kuinka paljon he luottavat isään ja äitiin. Tämä tukee niitä aiempia havaintoja, joissa tytöt ja pojat ovat luottaneet vanhempiinsa yhtä paljon (mm. Booth-Laforce ym., 2006). Tulokset suomalaisten lasten luottamuksesta vanhempia kohtaan voidaan nähdä perhe-elämän kannalta positiivisina ja osoituksena siitä, että Suomessa äideillä, mutta yhtä lailla isillä on aktiivinen rooli lapsen elämässä.

Test Anxiety, Coping, Gender and Academic Performance in English Exams: A Study of Finnish Upper Secondary School Students

In this MA thesis, test anxiety related to English exams among Finnish upper secondary school students was studied. In addition, the ways students try to cope with test anxiety were investigated. The purpose of the study was to investigate gender differences in test anxiety, the effects of test anxiety on academic performance and relationships between test anxiety, academic performance and coping strategies. Test anxiety and coping strategies were analysed as scores of questionnaire responses. Coping strategies comprised of three categories – task-orientation and preparation, seeking social support and avoidance. Academic performance was analysed as teacher ratings of general performance in English exams. In total 67 subjects were studied. The subjects were Finnish general upper secondary school students. The data were collected by using online questionnaires. This data were mainly quantitative, but also qualitative elements were included. The quantitative data were analysed by using statistical methods. The results showed that females experienced statistically significantly more test anxiety than males. In addition, a statistically significant correlation was found between test anxiety levels and academic performance ratings of the subjects: the higher the test anxiety score, the lower the academic performance rating. A meaningful correlation was found between test anxiety and seeking social support as a coping strategy: a higher test anxiety score was related to using social support as a coping strategy. However, no relationships were found between academic performance and the three coping strategies when quantitative and qualitative data were analysed. Therefore, different coping strategies per se did not seem to be related to academic performance, but instead it was assumed that the effectiveness of coping strategies is dependent on individual differences. In order to obtain more generalisable results and to gain more understanding of test anxiety and coping with it, a larger number of subjects form different areas of Finland and of different ages could be examined in future studies. Moreover, cross-national and cross-cultural studies could provide valuable information. As a practical recommendation for educational purposes, the results of this study indicated that a more individualised approach is needed.

Estratégias de coping utilizadas por famílias portuguesas e espanholas para alcançar um equilíbrio trabalho-família

O estudo do equilíbrio trabalho-família não é recente. Em 1985, Greenhaus e Beutell definiram o conflito trabalho-família como um tipo de conflito originado na incompatibilidade da pressão exercida entre diferentes papéis de um indivíduo. Uma das formas de lidar com este é através de estratégias de coping. Assim, o presente estudo procurou comparar diferenças entre as estratégias utilizadas por famílias portuguesas e espanholas. Aplicaram-se as versões adaptadas dos instrumentos SWING e Brief COPE a uma amostra de 409 participantes portugueses e 158 espanhóis, de diferentes estruturas familiares, com ou sem dependentes. Foram corroboradas relações entre o Equilibrio e variáveis sociodemográficas, e foi comprovada a capacidade preditora do equilíbrio sobre as estratégias de coping utilizadas. É essencial que os estudos futuros considerem certos aspectos das variáveis sociodemográficas (ex.: duração do emprego, idade dos dependentes, etc.), e o desenvolvimento de modelos de coping relativos ao conflito trabalho-família; Coping Strategies used by Portuguese and Spanish Families to achieve a Work-Family Balance Abstract: The study of work-family balance is not recent. In 1985, Greenhaus & Beutell defined work-family conflict as a type of conflict originated in the incompatible pressure between the individual’s different social roles. One way to deal with this is through coping strategies. Hence, the present study has sought to compare differences between strategies used by Portuguese and Spanish families. The SWING and Brief COPE adaptations were applied to a sample of 409 Portuguese and 158 Spanish participants, from different family structures, with or without dependents. A relationship between Balance and sociodemographic variables was proven, and balance’s predictive capacity of the strategies used was found. It is essencial for future studies to consider certain aspects of the sociodemographic variables (eg.: duration of employement, dependents’ age, etc.), and the development of coping models directed at work-family conflict.

Stress e coping nos estudantes do ensino básico

Dissertação de mest.em Psicologia, Faculdade de Ciências Humanas e Sociais, Escola Superior de Educação, Univ. do Algarve, 2002

Correlations among Coping Skills and Life Satisfaction in Ethnic Older Caregivers

The purpose of the present study is to extend our current understanding of the effects of caregiver burden on life satisfaction by examining whether or not there are ethnic differences in coping strategies used to manage caregiving. Several specific hypotheses were tested in order to determine the linkages among age, gender, ethnicity (i.e., familism, filial piety), caregiver burden, coping with caregiving, and life satisfaction. A total of 103 Hispanic and Non-Hispanic White participants ages 60 and older were included in this study (mean age was 67.42; 16.5% male; 83.5 % female; 52.4% Hispanic; 47.6% Non-Hispanic White). The results suggest that demographics and certain coping skills can influence levels of life satisfaction and burden experienced by caregivers. The findings from this study shed light on how to structure effective psychoeducational interventions, facilitate adaptive coping, reduce burden, and improve life satisfaction for older adult caregivers.

Dyadic coping e comunicação conjugal: Estudo comparativo de casais com e sem cancro

Dissertação de Mestrado apresentada no ISPA – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Clínica