Youth psychosocial adjustment in the context of parental illness: risk and protective factors

Young carers might experience both psychological distress and positive changes from living with their chronically ill parent. However, little is known about why some young carers do well with their situation and experience positive outcomes, whereas others do not. In this regard, this dissertation aims to investigate how parental chronic illness affects young carers’ psychosocial adjustment through risk (i.e., unmet needs) and protective factors (i.e., benefit finding, emotion regulation). This main goal has been addressed by conducting three studies presented in Chapters 2–4. Chapter 2 has examined the mediating role of unmet needs on the relationship between illness unpredictability and youth psychosocial adjustment (i.e., quality of life and internalizing problems). In this regard, it has been found that levels of unmet needs significantly mediated the relationship between illness unpredictability and offspring health-related quality of life. In the systematic review with meta-analysis presented within Chapter 3, it has been sought to investigate the mediating role of the protective factors (i.e., benefit finding and emotion regulation) in the relationship between caregiving components and youth psychosocial adjustment in young carers. This study has shown the significant associations between caregiving components and psychosocial adjustment in young carers not only directly, but also indirectly through protective factors. Finally, to expand on previous findings, a qualitative study in Chapter 4 has examined the unique experiences of young carers, as well as the effects of the COVID-19 global pandemic. This study has yielded a deeper understanding of how protective factors may be operated during young carers’ lived experiences before and during the COVID-19 global pandemic. Overall, this dissertation has shed light on the pivotal role played by risk and protective factors in caregiving components that serve as key determinants that can enhance positive psychosocial outcomes as well as concurrently mitigate adverse psychosocial consequences among young carers.

The Consequences Of Refractory Epilepsy And Its Treatment.

Seizures in some 30% to 40% of patients with epilepsy fail to respond to antiepileptic drugs or other treatments. While much has been made of the risks of new drug therapies, not enough attention has been given to the risks of uncontrolled and progressive epilepsy. This critical review summarizes known risks associated with refractory epilepsy, provides practical clinical recommendations, and indicates areas for future research. Eight international epilepsy experts from Europe, the United States, and South America met on May 4, 2013, to present, review, and discuss relevant concepts, data, and literature on the consequences of refractory epilepsy. While patients with refractory epilepsy represent the minority of the population with epilepsy, they require the overwhelming majority of time, effort, and focus from treating physicians. They also represent the greatest economic and psychosocial burdens. Diagnostic procedures and medical/surgical treatments are not without risks. Overlooked, however, is that these risks are usually smaller than the risks of long-term, uncontrolled seizures. Refractory epilepsy may be progressive, carrying risks of structural damage to the brain and nervous system, comorbidities (osteoporosis, fractures), and increased mortality (from suicide, accidents, sudden unexpected death in epilepsy, pneumonia, vascular disease), as well as psychological (depression, anxiety), educational, social (stigma, driving), and vocational consequences. Adding to this burden is neuropsychiatric impairment caused by underlying epileptogenic processes (essential comorbidities), which appears to be independent of the effects of ongoing seizures themselves. Tolerating persistent seizures or chronic medicinal adverse effects has risks and consequences that often outweigh risks of seemingly more aggressive treatments. Future research should focus not only on controlling seizures but also on preventing these consequences.

[factors Associated With Satisfaction With Life Among Elderly Caregivers And Non-caregivers].

This article seeks to investigate associations between satisfaction with life and sociodemographic variables, health conditions, functionality, social involvement and social support among elderly caregivers and non-caregivers, as well as between satisfaction and the intensity of stress in the caregiver group. A sample of 338 caregivers was selected according to two items of the Brazilian version of the Elders Life Stress Inventory. A comparison-group of elderly non-caregivers was selected at random, with a similar gender, age and income profile. Data were derived from self-reported questionnaires and scales. Elderly caregivers with low levels of satisfaction and high levels of stress revealed more symptoms of insomnia, fatigue, diseases and worse IADL performance. Those with greater satisfaction and less stress revealed a good level of social support. Insomnia, depression and fatigue were associated with low satisfaction among caregivers, and with fatigue, depression and low social support among non-caregivers. It was considered relevant that instrumental, psychological and informative support can improve the quality of life and the quality of care provided by elderly caregivers, especially if they are affected by unfavorable health and psychosocial conditions and low satisfaction with life.

Burnout Syndrome In Nursing Assistants Of A Public Hospital In The State Of São Paulo.

The burnout syndrome is a psychosocial phenomenon that arises as a response to chronic interpersonal stressors present at work. There are many aspects that make nursing assistants vulnerable to chronic stress situations that may lead to burnout, highlighting the low degree of autonomy in the healthcare staff and spending more in direct contact with patients. To assess the prevalence of the burnout syndrome in nursing assistants in a public hospital, as well as its association with socio-demographic and professional variables. A socio-demographic and professional questionnaire and the Maslach Burnout Inventory (MBI-SS) were applied to 534 nursing assistants. The prevalence of burnout syndrome among nursing assistants was 5.9%. High emotional exhaustion was observed in 23.6%, 21.9% showed high depersonalization, and 29.9% low professional achievement. It was found statistically significant associations between emotional exhaustion, job sector and marital status; depersonalization, having children and health problems; low professional achievement and job sector and number of jobs. There was association between job satisfaction and the three dimensions. Professionals working in the health area must pay intense and extended attention to people who are dependent upon others. The intimate contact of the nursing assistants with hard-to-handle patients, as well as being afraid to make mistakes in healthcare are additional chronic stress factors and burnout syndrome cases related in this study.

Aesthetic And Functional Rehabilitation Of The Primary Dentition Affected By Amelogenesis Imperfecta.

The objective of this case report was to describe the oral rehabilitation of a five-year-old boy patient diagnosed with amelogenesis imperfecta (AI) in the primary dentition. AI is a group of hereditary disorders that affects the enamel structure. The patient was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of AI. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms. The main objectives of the selected treatment were to enhance the esthetics, restore masticatory function, and eliminate the teeth sensitivity. The child was monitored in the pediatric dentistry clinic at four-month intervals until the mixed dentition stage. Treatment not only restored function and esthetic, but also showed a positive psychological impact and thereby improved perceived quality of life. The preventive, psychological, and curative measures of a young child with AI were successful. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, and resin-filled celluloid forms to reestablish the oral functions and improve the child's psychosocial development.

Burden Of Focal Cryoablation Versus Brachytherapy Versus Active Surveillance In The Treatment Of Very Low-risk Prostate Cancer: A Preliminary Head-to-head Comprehensive Assessment.

Focal cryoablation (FC), brachytherapy (B) and active surveillance (AS) were offered to patients diagnosed with very low-risk prostate cancer (VLRPC) in an equal access protocol. Comprehensive validated self-report questionnaires accessed patients' erectile (IIEF-5) and voiding (IPSS) functions, Beck scales measured anxiety (BAI), hopelessness (BHS) and depression (BDI), SF-36 reflected patients' quality of life added to the emotional thermometers including five visual analogue scales (distress, anxiety, depression, anger and need for help). Kruskal-Wallis or ANOVA tests and Spearman's correlations were obtained among groups and studied variables. Thirty patients were included, median follow-up 18 months (15-21). Those on AS (n = 11) were older, presented higher hopelessness (BHS) and lower general health perceptions (SF-36) scores than patients opting for FC (n = 10) and B (n = 9), P = 0.0014, P = 0.0268 and P = 0.0168 respectively. Patients on B had higher IPSS scores compared to those under FC and AC, P = 0.0223. For all 30 included patients, Spearman's correlation (rs ) was very strong between BHS and general health perceptions (rs  = -0.800, P < 0.0001), and weak/moderate between age and BHS (rs  = 0.405, P = 0.026) and age and general health perceptions (rs  = -0.564, P = 0.001). The sample power was >60%. To be considered in patients' counselling and care, current study supports the hypothesis that even VLRPC when untreated undermines psychosocial domains.

Questionário de qualidade de vida na epilepsia: resultados preliminares

Seizures happen for brief periods of time, but the feelings of anxiety and helplessness, adaptation to the restrictions impose by the life-style and variety of other problems affect more the quality of life in epilepsy. This study proposes a protocol that regards the objectives of a quality of life assessment in health and is applied to a population that attends a university hospital. It contains 65 items and assesses the psychosocial performance, physical limitation, cognitive aspects, perception of control, self-concept, as well as perception of health and quality of life. The results of reliability and validity are discussed.

Gênero e estresse em trabalhadores de uma universidade pública do estado de São Paulo

The aim of this paper was to identify, according to gender, the indexes of Mental Health and the Psychosocial Risk Factors in workers at a state University. A sample of 400 was randomly selected, 253 female and 147 male. They were assessed by means of The Questionnaire SWS Survey (Self, Work and Social) (Ostermann & Gutiérrez, 1992), validated in Brazil by Guimarães and Macfadden (1999). Univariate, bivariate, multivariate statistics were assessed. Significant associations emerged from Mental Health and Gender, and Psychosocial Risk Factors and Gender. Women showed greater Psychosocial Risk Factors, Work and Social Stress, worst mental health than men (p < 0.05), which place them at greater risk for developing physical and/or mental illness.

Equitação e volteio com crianças carentes : uma proposta educacional

Universidade Estadual de Campinas. Faculdade de Educação Física

Tradução, adaptação cultural e validação da escala Moorong Self-Efficacy Scale (MSES) para o português no Brasil = : Translation, cultural adaptation and validation of Moorong Self-Efficacy Scale (MSES) into Brazilian Portuguese

Universidade Estadual de Campinas . Faculdade de Educação Física

Beneficios da atividade fisica para pessoas com deficiencia visual : contribuições a partir da teoria de Erik Erickson

Universidade Estadual de Campinas . Faculdade de Educação Física

Laços mal-atados como efeito de funcionamento falso-self em tempos de desconfiança

A contemporaneidade contempla formas de estruturação da subjetividade amplamente perpassadas por condições de existência socioculturais e econômicas. Estas, por sua vez, têm promovido laços intersubjetivos frágeis, cujo funcionamento psíquico pode ter uma organização de base "falso-self". Autores também demonstram que diversas instituições atuais se tornaram "fluidas" na passagem da modernidade para a "modernidade líquida". Isto contribuiu para a perda de referências sólidas que, outrora, davam sentido e direcionamento para o ser humano. Em decorrência há uma interferência direta na construção da "confiança madura", visto que os sinais de angústia da contemporaneidade podem ser um desorganizador do funcionamento psíquico, além de promoverem o isolamento, a desconfiança no ambiente e no outro, laços mal-atados e funcionamentos de base "falso-self".

Ateliê de desenho e Rorschach: estudo fenômeno-estrutural

A produção de desenhos em grupo e o método de Rorschach foram utilizados ao longo do tratamento de um paciente com esquizofrenia, acompanhado em Centro de Atenção Psicossocial. O referencial proposto para a compreensão do caso é o método fenômeno-estrutural que busca acessar o modo de ser e de vivenciar a doença que afeta o paciente, a partir do que ele revela nas imagens e na linguagem. Aos desenhos de cores acromáticas e conteúdos humanos deformados, o paciente insere cores, representantes da expressão afetiva, e figuras humanas integradas, denotando disponibilidade nas relações. O Rorschach indica contato mais adequado com a realidade, dado a diminuição da distorção da percepção da forma e de figuras fantasiosas. Após diminuição da sintomatologia persecutória e isolamento social, o paciente recebeu alta. O uso desses instrumentos tem contribuído na difícil tarefa diagnóstica e no acompanhamento da evolução de pacientes, nos cuidados interdisciplinares em saúde mental.

Inconsciente e cotidiano na prática da atenção psicossocial em saúde mental

O objetivo deste artigo é analisar as concepções sobre o inconsciente ligadas ao cotidiano da prática terapêutica de rede, como contribuição à clínica em saúde mental. A pesquisa participante foi realizada em um Centro de Atenção Psicossocial (CAPS) na cidade de São Paulo. Os resultados mostraram as concepções mais frequentes: o inconsciente como inconsciência, o inconsciente como desconhecimento e o inconsciente como método de escuta do sujeito e das relações na instituição. Demonstram uma flexibilidade teórica que pode permitir articulações complexas nas diversas intervenções no cotidiano da equipe referentes às subjetividades e saberes sobre o inconsciente, psicanalíticos ou não. Conclui-se que a elucidação desse saber prático sobre o inconsciente contribui para o aprofundamento dessa temática no campo da reforma psiquiátrica.

Ambiente de desenvolvimento e início da vida reprodutiva em mulheres Brasileiras

Modelos teóricos inspirados na teoria da história de vida têm avaliado padrões de reprodução humanos em países desenvolvidos, com resultados ainda não conclusivos. Em vista das condições de vida na população brasileira, foram investigadas relações entre marcos da carreira reprodutiva feminina, condições ambientais e variáveis psicossociais relacionadas às condições de criação. Foram entrevistadas 606 mulheres em seis estados. Os resultados apóiam a teoria da história de vida, mostrando associações entre condições de vida na infância e início da vida sexual e da reprodução, mas não com a idade da menarca. Sugerimos que diferentes marcadores da vida reprodutiva podem estar sob controle de diferentes fenômenos e que a diversidade de condições da população brasileira oferece contextos alternativos para testar hipóteses.