Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-09-14T21:40:04Z No. of bitstreams: 1 AlyneMatosNapoleaoFariasDissertacao2018.pdf: 1451305 bytes, checksum: 3527c8590821219daf2aad10bf27a157 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-09-14T21:40:19Z (GMT) No. of bitstreams: 1 AlyneMatosNapoleaoFariasDissertacao2018.pdf: 1451305 bytes, checksum: 3527c8590821219daf2aad10bf27a157 (MD5) / Made available in DSpace on 2018-09-14T21:40:19Z (GMT). No. of bitstreams: 1 AlyneMatosNapoleaoFariasDissertacao2018.pdf: 1451305 bytes, checksum: 3527c8590821219daf2aad10bf27a157 (MD5) Previous issue date: 2018-07-05 / In Brazil the number of elderly people is increasing and this transformation in the age structure is taking place without an improvement of the living conditions. With increased life expectancy there is a greater probability of chronic and degenerative diseases, such as Mild Cognitive Disorder (MCD). The use of cognitive stimuli through cognitive stimulation therapies (CST) causes them to regress and / or interfere with advancement. The objective was to analyze changes in cognitive profile, with emphasis on memory, before and after the execution of cognitive stimulation workshops, as well as to identify socioeconomic characteristics of sedentary elderly people who attend the Mixed Health Unit of Taguatinga, Federal District (UMS-DF). It was a descriptive experimental quantitative study, with elderly (≥60 years), diagnosed with MCD. The composite sample of 9 elderly of the OEC in the experimental group (G1) and 10 elderly did not undergo intervention in the control group (G2). The data collection was done by structured interview, application in the first and last meeting of the mini mental state examination, verbal fluency, clock, memory of figures and list of words. The CST offered to the G1, stimulation techniques were used, for one hour, weekly, in 10 meetings. In G2, daily life activities were reported for the same period, without cognitive stimulation. The descriptive data were evaluated by means of descriptive measures: means, standard deviations, median, absolute and relative frequency, with p <= 0,05. The chi-square test and t-test were applied using the SPSS 20.0 program and the R. software. Results showed mean age of 75 ± years, 84.2% female, 89.5% retired and 89.5% widowed. 17 elderly (89.5%) reported better memory a year ago. After CST, 8 (88.9%) elderly of the G1 considered their current memory as good. Although the G1 elderly had higher scores in all tests after the CST, the difference between the tests was not significant (p = 1.0). No significant differences were found in the Miniexame of the Mental State (p = 0.436). The test of the clock design evidenced the low level of schooling. G1 (p> 1) and G2 (p = 0.621), the tests were not statistically significant, affirming no or almost no change in the cognitive profile. In the tests of verbal fluency (p = 0.367), word memory and figures (p = 0.351), G2 showed no recovery in recall, despite reporting an increase in group sociability. It was concluded that although the CST do not have significant results, they have a visible effect on social integration, exchange of experiences and personal empowerment. This method can help nursing to design more effective methods and implementations for the treatment and rehabilitation of not only elderly people with MCD, but with different cognitive conditions. Perhaps longer-term studies can improve such outcomes and encompass the positive aspects of physical activity in the cognitive area. / No Brasil, é crescente o número de idosos e essa transformação na estrutura etária dá-se sem que haja um melhoramento das condições de vida. Com o aumento da expectativa de vida, há maior probabilidade de doenças crônicas e degenerativas, como o Transtorno Cognitivo Leve (TCL). A utilização de estímulos cognitivos, através de oficinas de estimulação cognitiva (OEC), causa seu retrocesso e/ou interfere no avanço. O objetivo foi analisar modificações no perfil cognitivo, com ênfase na memória, antes e após a execução das oficinas de estimulação cognitiva, assim como identificar características socioeconômicas de idosos sedentários que frequentam a Unidade Mista de Saúde de Taguatinga do Distrito Federal (UMST-DF). Foi um estudo quantitativo experimental descritivo, com idosos (≥60 anos), diagnosticados com TCL. A amostra composta de nove idosos das OEC no grupo experimental (G1) e dez idosos que não sofreram intervenção no grupo controle (G2). A coleta de dados foi feita por entrevista estruturada, aplicação no primeiro e último encontro do Miniexame do Estado Mental (MEEM), fluência verbal, relógio, memória de figuras e lista de palavras. As OEC oferecidas ao G1 utilizaram técnicas de estimulação, por uma hora, semanalmente, em dez encontros. No G2, foram feitos relatos das atividades da vida diária, pelo mesmo período, sem estimulação cognitiva. Os dados descritivos foram avaliados pelas medidas descritivas: médias, desvios padrões, mediana, frequência absoluta e relativa, com p<=0,05. Foram aplicados teste de qui-quadrado e teste t pelo programa SPSS 20.0 e software R. Resultados mostraram idade média de 75± anos, 84,2% feminino, 89,5% aposentados e 89,5% viúvos. 17 idosos (89,5%) relataram memória melhor há um ano. Após as OEC, oito (88,9%) idosos do G1 consideraram sua memória atual como boa. Apesar dos idosos do G1 terem pontuações maiores em todos os testes após as OEC, a diferença entre os testes não foram significativas (p= 1,0). No MEEM não surgiu diferença significativa (p=0,436). O teste do desenho do relógio evidenciou o baixo nível de escolaridade: G1 (p>1) e G2 (p= 0,621); os testes não foram significativos, afirmando nenhuma ou quase nenhuma mudança no perfil cognitivo. Nos testes de fluência verbal (p=0,367), de memória de palavras e o de figuras (p=,0,351), o G2 não mostrou recuperação na evocação da memória, apesar de relatar aumento na sociabilidade em grupo. Concluiu-se que, apesar das OEC não terem resultados estatisticamente significativos, possuem efeito visível na integração social, troca de experiências e empoderamento pessoal. Esse método pode auxiliar a enfermagem a traçar métodos e implementações mais eficazes para o tratamento e reabilitação, não só pessoas idosas com TCL, mas com diversas condições cognitivas. Talvez estudos com prazos maiores possam aprimorar tais resultados e abranger os aspectos positivos das atividades físicas na área cognitiva.

Le syndrome de l’imposteur peut être source d’une grande souffrance. Soixante-deux à 70% de la population peuvent être amenés à douter, ne serait-ce qu’une fois, de la légitimité de leur statut. Ces questionnements s’orientent sur l’impression de tromper les autres, sur les attributions de sa situation et sur la peur de voir son incompétence mise à jour. Malgré sa prévalence, peu d’études s’intéressent au caractère pathologique de ce syndrome, et encore moins à chercher des outils d’accompagnement adaptés. Les objectifs de ce travail étaient de valider un outil d’évaluation en français, et d’améliorer la compréhension de la dimension cognitive de ce syndrome.L’étude 1 est une étude quantitative menée auprès de 549 participants. Elle propose la validation du concept du syndrome de l’imposteur et la réalité d’un syndrome pouvant être pathologique. Les résultats démontrent différents profils d’imposteurs pour lesquels les comorbidités et leur vécu se révèlent différents.L’étude 2 est une étude quantitative menée auprès de 1597 participants. Elle a permis la validation de la Clance Impostor Phenomenon Scale (CIPS) dans sa version francophone. Les résultats démontrent des bonnes qualités psychométriques du questionnaire. L’étude 3 est une étude quantitative menée auprès de 694 participants. Elle évalue les manifestations anxieuses inhérentes au syndrome de l’imposteur. Les analyses rendent compte de profils d’imposteurs différents. L’établissement d’un modèle d’émergence de ce syndrome a été suggéré afin d’interroger sa présence lors des périodes de grand stress de la vie. L’étude 4 est une étude quantitative menée auprès de 873 participants. Elle est axée sur l’intégration de l’acceptation inconditionnelle de soi comme outil pertinent de prise en charge des imposteurs. Elle propose de plus un profil cognitif de ces personnes au regard de la représentation de l’échec, des attitudes dysfonctionnelles et d’une faible acceptation inconditionnelle de soi. / The impostor phenomenon can represent a significant distress source. The literature suggests that 60-70% of the population questions their legitimacy at least once in their lives. These doubts focus on feelings of inadequacy or fraud, poor success attribution, and the fear of being exposed as an impostor. Few studies have explored the pathological aspects of the impostor phenomenon despite its prevalence. Moreover, to our knowledge too little research has been conducted to design adequate management tools. The research carried out for this thesis seeks to validate existing impostor phenomenon measures, the Clance Impostor Phenomenon Scale (CIPS), as well as better understand cognitive dimensions related to this syndrome.Study 1 was a quantitative study carried out on a sample of 549 participants. This study deals with the validation of the independent concept of impostor phenomenon as well as potential pathological aspects related to it. Results showed different impostor profiles both in intensity and impacts of this syndrome.Study 2 was a quantitative study carried out on 1,597-strong sample. The main objective was to validate an existing impostor phenomenon scale (CIPS) in French. The results demonstrated good psychometric validity for the French version.Study 3 was a quantitative study carried out on a sample of 694 participants. This study examined anxiety manifestations linked to the impostor phenomenon. The results demonstrated different profiles of impostors. A model was developed to help understand the manifestation of this syndrome during periods of severe stress and change.Study 4 was a quantitative study carried out on a sample of 873 participants. This study focused on unconditional self-acceptance as a useful method of appropriate therapeutic management linked to the impostor phenomenon. A cognitive profile of impostors was developed that helps account for irrational beliefs about failure, dysfunctional attitudes, and low unconditional self-acceptance.

Background. Cognitive therapies are alternative forms of pain management. Despite the extensive approach regarding the associations between cognitive therapies and health, the clinical applicability of this evidence in the management of pain has not yet been fully elucidated. The objective of this study was to evaluate the efficacy of cognitive therapy in the management of pain and associated symptoms, the patterns of brain activation promoted in the modulation of pain, as well as the methodological quality of the selected articles. Methods: Two systematic reviews of literature on cognitive therapies and pain management were performed to search the databases - MEDLINE, Pubmed, EMBASE, CINAHL, PsycINFO, Science Direct and Scopus - randomized controlled trials examining neurophysiological data of cognitive therapies in patients with chronic pain or healthy individuals exposed to experimental pain. The primary endpoint was pain and neurophysiological changes and the secondary outcomes were anxiety, depression, and quality of life. Results: A total of 406 articles were found, of which 14 met the criteria for inclusion. The results revealed that cognitive therapies reduced the intensity and discomfort of pain, as well as improved pain tolerance and expectancy. In addition, there was improvement of physical and mental health, anxiety, depression and catastrophism. Neuroimaging data revealed distinct patterns of activity, but mainly related to the increase of the activation of the prefrontal cortex and limbic system in the chronic pain population; increased activation of the anterior cingulate cortex, anterior insular cortex, and decreased thalamic activation in healthy individuals following cognitive strategies; in addition to increased activity in pre-frontal ventricular regions following prayer-based cognitive therapy. The methodological evaluation showed a moderate risk of bias, with great heterogeneity that made impossible a meta-analysis. Conclusion: Cognitive therapies modulate the intensity and affective experience of pain and may be responsible for altering the functioning of brain regions in an extensive network, including non-predominantly nociceptive regions. The lack of standardization of interventions points to the need for new studies that evaluate the use of cognitive therapies as a complementary approach in health care. / Contexto: As terapias cognitivas são formas alternativas de gerenciamento de dor. Apesar da abordagem extensiva no que concerne às associações entre terapias cognitivas e saúde, a aplicabilidade clínica dessa evidência no manejo da dor ainda não está completamente elucidada. O objetivo deste estudo foi avaliar a eficácia da terapia cognitiva no manejo da dor e sintomas associados, os padrões de ativação encefálica promovidos na modulação da dor, bem como a qualidade metodológica dos artigos selecionados. Métodos: Duas revisões sistemáticas de literatura sobre terapias cognitivas e manejo da dor foram realizadas para buscar nas bases de dados - MEDLINE, Pubmed, EMBASE, CINAHL, PsycINFO, Science Direct e Scopus - ensaios controlados randomizados que examinassem dados neurofisiológicos das terapias cognitivas em pacientes com dor crônica ou indivíduos saudáveis expostos a dor experimental. O desfecho primário foi dor e alterações neurofisiológicas e os desfechos secundários foram ansiedade, depressão e qualidade de vida. Resultados: Foram encontrados 406 artigos e, destes, 14 preencheram os critérios para inclusão. Os resultados revelaram que as terapias cognitivas reduziram a intensidade e o desconforto da dor, bem como melhorou a tolerância à dor e a expectativa. Além disso, houve melhora da saúde física e mental, ansiedade, depressão e catastrofismo. Já os dados da neuroimagem revelaram padrões distintos de atividade, mas principalmente relacionados ao aumento da ativação do córtex pré-frontal e sistema límbico na população de dor crônica; aumento da ativação do córtex cingulado anterior, córtex insular anterior e diminuição da ativação do tálamo em indivíduos saudáveis após estratégias cognitivas; além de atividade aumentada em regiões pré-frontais ventriculares após a terapia cognitiva baseada em oração. A avaliação metodológica mostrou moderado risco de viés, com grande heterogeneidade que impossibilitou uma meta-análise. Conclusão: Terapias cognitivas modularam a intensidade e a experiência afetiva da dor e podem ser responsáveis pela alteração do funcionamento das regiões encefálicas em uma rede extensiva, incluindo regiões não predominantemente nociceptivas. A falta de padronização das intervenções aponta para a necessidade de novos estudos que avaliem o uso das terapias cognitivas como uma abordagem complementar nos cuidados de saúde. / Aracaju