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Efic?cia do treinamento de reconhecimento de emo??es na qualidade da intera??o m?e-beb? em mulheres com depress?o p?s-partoRenner, Anelise Meurer 05 March 2018 (has links)
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Previous issue date: 2018-03-05 / Postpartum Depression (PPD) has a negative effect on newborns and their mothers,
and impairments to the mother-infant relationship seem to be harmful to the child?s
development. Despite the high prevalence of PPD in Brazil, there are no evaluation protocols
and interventions recognized by the country?s unified health service. In order to contribute to
an intervention adapted to Brazilian cultural issues and the reality of Brazilian mothers in the
postpartum period, two studies were carried out in this dissertation - a theoretical study and an
empirical study. The theoretical study aimed to describe two intervention protocols and the
respective materials necessary for their execution: a psychoeducation protocol and a training
protocol for facial expression recognition. The methodology applied the following steps: (1)
state of the art review, (2) preliminary proposal preparation, (3) specialized psychologists?
analysis, (4) pilot study. The study?s resulted in a psychoeducational protocol composed by
seven themed primers defining subjects to be addressed with the mothers, in addition to a
facial expression training protocol composed by six instruments. The empirical study?s
objective was to investigate the effectiveness of both interventions (the psychoeducation and
the facial expression training protocol) in the quality of mother-infant interaction. Preliminary
results are described in this study, The sample consisted of 14 dyads in which the mothers
were diagnosed with PPD by both the EPDS (cut-off point ?11) and SCID. Dyads were
assessed between four and twelve weeks postpartum and were randomized into three
conditions: psychoeducation, facial expression training, and waiting list. The results
suggested a significant effects of the training groups in maternal ability to recognize anger
faces, and a significant effect of the Psychoeducation group on mother-child interaction
(proximity and relaxation dimensions). Compared to the waiting list, the two intervention
groups produced positive effects, albeit only the Psychoeducation group had an effect on the
target primary outcome. Therefore, results suggest that psychoeducation was more effective in
increasing the quality of the mother-infant relationship when compared to the other two
groups. Further studies with a larger sample size and longer follow-up period are required to
investigate these effects further. / A Depress?o P?s-Parto (DPP) tem efeitos negativos na sa?de da m?e e do beb? e na
rela??o m?e-beb? e os preju?zos nesta rela??o parecem ser mediadores importantes dos
preju?zos no desenvolvimento infantil. Apesar da alta preval?ncia de DPP no Brasil, n?o
existem protocolos de avalia??o e interven??es reconhecidos pelo Servi?o ?nico de Sa?de.
Buscando contribuir com uma interven??o adaptada ?s quest?es culturais brasileiras e a
realidade das m?es no per?odo p?s-parto, foram realizados dois estudos nesta disserta??o,
sendo um estudo te?rico e um estudo emp?rico. O estudo te?rico visou descrever a elabora??o
de dois protocolos de interven??o e os respectivos materiais necess?rios para a execu??o
destes: um protocolo de psicoeduca??o e um protocolo de treinamento de reconhecimento de
express?es faciais. A metodologia utilizada seguiu os seguintes passos: (1) revis?o da
literatura, (2) elabora??o da proposta preliminar, (3) an?lise de psic?logas especialistas, (4)
estudo piloto. Os resultados deste estudo s?o um protocolo de psicoeduca??o com sete
cartilhas sobre as tem?ticas definidas para serem trabalhadas com as m?es, al?m de um
protocolo de treinamento de express?es faciais composto por seis instrumentos para a
execu??o deste. A partir desta constru??o, o estudo emp?rico teve como objetivo investigar a
efetividade das interven??es, tanto de psicoeduca??o quanto de treinamento de express?es
faciais no implemento da qualidade da rela??o m?e-beb?. A presente proposta apresenta os
dados preliminares do estudo. A amostra foi composta de 14 d?ades, tendo as m?es
diagn?stico de DPP pela EPDS (ponto de corte ?11) e pela SCID. As d?ades iniciaram a
avalia??o entre quatro e doze semanas ap?s o parto e foram randomizadas em tr?s condi??es:
psicoeduca??o, treinamento de express?es faciais e lista de espera. Os resultados apontam
efeitos positivos do aumento da acur?cia do reconhecimento de faces de raiva do grupo de
treinamento, e um efeito positivo nas dimens?es maternas de intera??o proximidade e
descontra??o no grupo de Psicoeduca??o. Em compara??o com a lista de espera, os dois
grupos de interven??o apresentaram efeitos positivos, ainda que apenas o grupo
Psicoeduca??o tenha apresentado efeitos significativos no desfecho prim?rio. Assim, os
resultados preliminares sugerem a psicoeduca??o como mais eficaz no aumento qualidade da
rela??o m?e-beb? ao comparada com os outros grupos de interven??o. S?o necess?rios futuros
estudos com um aumento do tamanho amostral e realiza??o de follow-ups com mais tempo
ap?s as sess?es para ser poss?vel confirmar os efeitos encontrados.
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Fatores associados ao desmame precoce : auto efic?cia no aleitamento materno e depress?o p?s-natalMargotti, Edficher 28 August 2013 (has links)
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Previous issue date: 2013-08-28 / Objective: To determine factors associated with the length of exclusive breastfeeding at two hospitals, a baby-friendly hospital and one general hospital, and relate them to the scores of the Breastfeeding Self Efficacy Scale and the Edinburgh Postnatal Depression Scale. Methods: We conducted a descriptive and analytical cohort study of 300 binomials of mother-babies that were born in two hospitals: one at the general hospital and the other at a baby-friendly hospital. The inclusion criteria were: children with birth weight of 2,500 g or less, gestational age above 36 weeks and residents in urban areas. At the hospitals maternities, data were collected from medical records, questions to mothers were asked and the Breastfeeding Self-Efficacy Scale was applied. Every 15 days, the mother was contacted and asked if she was still exclusively breastfeeding and the Edinburgh Postnatal Depression Scale-EPDS was applied four months after giving birth. Results: Among the births, 53% were male, 52% were at a baby-friendly hospital and 55% were normal deliveries. The mothers had a mean age of 26 years and a mean gestational age of 39 weeks. The average maternal breastfeed score was 36 points while the score for the Edinburgh Scale was that 36% of the mothers had a tendency of depression. Only 34% of the mothers had up to eight years of education, 57% of them worked outside the home, 13% of them were single and 61% had 7-13 prenatal consultations. At 30 days, the frequency of exclusive breastfeeding was of 86% while only 49% of the babies were breastfed exclusively at 120 days of life. In the multivariate analysis, the variables of exclusive breastfeeding at 60 days showing risk factors were the hospital not being baby friendly (p=0,002), the mother's schooling (up to 8 years of study) (p=0,004) and a working mother (p=0,013). The highest Breastfeeding test score (p=0,016) was for the protection factor of exclusive breastfeeding. At 120 days, it was evaluated that the variables shown as protection factors were the mother's age (p=0,039) and the Breastfeed test score (p=0,046). Conclusions: The risk factors associated with exclusive breastfeeding during the 60 days at a hospital that is not baby friendly are the mother's schooling (up to 8 years) and whether she works or not. The highest Breastfeed score was the exclusive breastfeeding protection factor. At 120 days, the variables shown as exclusive breastfeeding protection factors were the mother's age and the Breastfeed test score. / Objetivo: Determinar os fatores relacionados com o tempo de aleitamento materno exclusivo em dois hospitais, um amigo da crian?a e outro hospital geral, e relacionar com os escores da Breastfeeding Self Efficacy Scale e a Edinburgh Postnatal Depression Scale. M?todos: Foi realizado um estudo de coorte descritiva e anal?tica, com 300 bin?mios m?e-beb?, cujos beb?s nasceram em dois hospitais: um hospital geral e o outro amigo da crian?a. Os crit?rios de inclus?o foram: crian?as com peso de nascimento >2.500 gramas, idade gestacional acima de 36 semanas, residentes em zonas urbanas. Na maternidade, foram coletados dados do prontu?rio foram aplicados um question?rio ?s m?es e a Breastfeeding Self Efficacy Scale. A cada 15 dias, contatava-se a m?e, perguntando-lhe se ainda estava em aleitamento materno exclusivo e, ao chegar aos quatro meses p?s-parto, foi aplicada a Edinburgh Postnatal Depression Scale. Resultados: Dentre os nascimentos, 53% era masculino, 52% foi em hospital amigo da crian?a, 55% foi parto normal. A idade m?dia das m?es era de 26 anos e a idade gestacional m?dia foi de 39 semanas. A m?dia materna de escore de Breastfeed foi de 36 pontos. Quanto ao escore de Edinburgh, 36% das m?es apresentava tend?ncia ? depress?o. Apenas 34% das m?es tinha at? oito anos de estudo, 57% trabalhava fora, 13% era solteira, 61% realizou de 7 a 13 consultas de pr?-natal. Avaliando-se a frequ?ncia de amamenta??o exclusiva (AME) aos 30 dias foi de 86%,enquanto apenas 49% das crian?as recebeu amamenta??o exclusiva aos 120 dias de vida. Na an?lise multivari?vel o aleitamento materno exclusivo aos 60 dias, as vari?veis que se mostraram como fatores de risco para a amamenta??o foram, o Hospital N?o amigo da Crian?a (p=0,002),a escolaridade (at? oito anos de estudo) (p=0,004) e a m?e que trabalha ( p= 0,013). J? a maior pontua??o no teste de Breastfeed (p=0,016) foi um fator de prote??o para amamenta??o exclusivo. Ao avaliar o aleitamento materno aos 120 dias, as vari?veis que se mostraram como fatores de prote??o para a amamenta??o foram a maior idade materna (p=0,039) e a pontua??o no teste de Breastfeed (p=0,046). Conclus?es: Os fatores de risco associados com aleitamento materno exclusivo aos 60 dias foram o Hospital N?o credenciado como amigo da Crian?a, a escolaridade (at? oito anos de estudo) e a m?e que trabalha. J? a maior pontua??o no teste de Breastfeed foi um fator de prote??o para amamenta??o exclusiva. Aos120 dias, as vari?veis que se mostraram como fatores de prote??o para a amamenta??o exclusiva foram a maior idade materna e a pontua??o no teste de Breastfeed.
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Depress?o p?s-parto materna : intera??o m?e-beb? e processamento de facesAzambuja, Carolina Viecili 19 January 2017 (has links)
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Previous issue date: 2017-01-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Depression is a very common medical condition with high prevalence among the population. Among the specifiers of the disorder, one of the most prevalent conditions during pregnancy or puerperium is maternal postpartum depression (PPD). Gestation and the postpartum period are considered risky moments for the development or increase of psychiatric disorders in women, and in particular, PPD. The present dissertation is comprised of two empirical studies; The first addresses the impact of maternal postpartum depression on mother-baby interaction considering the dimensions of the mother, baby, and the duo. The study counted on the participation of 27 pairs, of these, nine with symptoms of depression and 18 without the presence of the disorder, recruited in five different cities of Rio Grande do Sul. The women answered the questionnaire of general questions, which was developed especially for this research, EPDS (cutoff ?11 points), BDI, BAI, SCID, WASI, filming and GRS. Descriptive analyzes, correlation analyzes, MANOVAs and MANCOVAs with covariations were performed. Among the main results obtained, it was found that the prevalence of PPD was 33%, which is higher than the literature indicates. Schooling is significantly and positively related to better maternal indexes of interaction. Overall, mothers had moderate rates of interaction, while infants had low and intermediate rates and low rates for double, regardless of the presence of PPD. On the other hand, in all dimensions of the interaction scale, the indices of women with PPD were lower than the results of women without PPD, demonstrating implications in the interaction. In study two, the same one approaches the processing of facial expressions of adults and of babies. The study had the participation of 22 women, 19 of whom answered the task of adult faces and 22 a of babies, of these 08 depressed and 14 controls. Participants were recruited at the same sites of study 1 and same instruments applied - for this study filming was not analyzed as well as the interaction scale, but the task of face recognition was included. For the analysis of the data, the SPSS program was used and ANOVAs, MANCOVAs, correlations and descriptive analyzes were performed. Among the main results, women with PPD presented lower accuracy for the facial expressions of infants and adults and classified the faces with less intensity as the exposure time increased, when compared to the control group. The findings of the study point to the deficits in relation to the recognition of facial expressions in women with PPD, which may lead to a decrease in the quality of the mother-baby relationship, since adequate responses to the baby's demands are hampered by the distortions in the recognition of the emotion expressed by the child. Unsuccessful interactions can lead to problems in the baby's development. The findings of both studies point to the need for more research in the area which seeks to contribute to prevention and intervention / treatment of mediators and moderators of the quality of the mother-infant relationship in cases of PPD. / A depress?o ? uma condi??o m?dica muito comum e com alta preval?ncia entre a popula??o. Dentre os especificadores do transtorno, um dos quadros com maior incid?ncia durante a gesta??o ou puerp?rio ? a depress?o p?s-parto materna (DPP). A gesta??o e o per?odo p?sparto s?o considerados momentos de risco para o desenvolvimento ou aumento de transtornos psiqui?tricos em mulheres e, em especial, a DPP. A presente disserta??o ? composta por dois estudos emp?ricos; o primeiro aborda o impacto da depress?o p?s-parto materna na intera??o m?e-beb?, levando em considera??o as dimens?es da m?e, do beb? e da dupla. O Estudo I contou com a participa??o de 27 duplas e, destas, nove com sintomas de depress?o e 18 sem a presen?a do transtorno, recrutadas em cinco diferentes cidades do Rio Grande do Sul. As mulheres responderam ao question?rio de perguntas gerais, que foi desenvolvido especialmente para esta pesquisa: EPDS (ponto de corte ?11 pontos), BDI, BAI, SCID, WASI, filmagem e GRS. Foram realizadas an?lises descritivas, an?lises de correla??o, MANOVAs e MANCOVAs, com covaria??es. Dentre os principais resultados obtidos, constatou-se que a preval?ncia de DPP encontrada foi de 33%, ?ndice maior do que aponta a literatura. Escolaridade est? relacionada significativa e positivamente a melhores ?ndices maternos de intera??o. Em todas as dimens?es da escala de intera??o, os ?ndices de mulheres com DPP foram inferiores aos resultados das mulheres sem DPP. O Estudo II aborda o processamento de express?es faciais de adultos e de beb?s. A amostra foi composta por parte das m?es do Estudo I. Participaram 22 mulheres, sendo que 19 responderam a tarefa de faces adultas e 22 a de beb?s; destas, 08 deprimidas e 14 controles. Para este estudo, al?m dos instrumentos de dados demogr?ficos e avalia??o materna, foi inclu?da a tarefa de reconhecimento de faces. Para as an?lises dos dados, o programa SPSS foi utilizado e tamb?m ANOVAs, MANCOVAs, correla??es e an?lises descritivas foram realizadas. Dentre os principais resultados, mulheres com DPP apresentaram menor acur?cia para as express?es faciais de beb?s e adultos e classificaram as faces com menos intensidade conforme o tempo de exposi??o aumentava, se comparadas ao grupo controle. Os achados do estudo apontam para os d?ficits em rela??o ao reconhecimento de express?es faciais em mulheres com DPP, o que pode ocasionar na diminui??o quanto ? qualidade da rela??o m?e-beb?, visto que as respostas adequadas ?s demandas do beb? encontram-se prejudicadas pelas distor??es no reconhecimento da emo??o expressa pela crian?a. Intera??es malsucedidas podem acarretar problemas no desenvolvimento do beb?. Os achados de ambos os estudos apontam para a necessidade de mais pesquisas na ?rea, que busquem contribuir para a preven??o e a interven??o/tratamento do mediadores e moderadores da qualidade da rela??o m?e-beb? em casos de DPP.
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Distor??es cognitivas e conflito conjugal na depress?o p?s-parto paternaKoch, Sabrina 20 January 2014 (has links)
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Previous issue date: 2014-01-20 / Depression is a general medical condition with a prevalence ranging between 4 % and 10 %. Postpartum depression is a specific manifestation of the disorder, affecting women and men. However, few studies address the issue of paternal postpartum depression. In this context, the present study aimed to investigate the effect of paternal postpartum depression on father-infant interaction, and the potential mediators effects (face processing, marital conflict and attention). To this end, two studies, one theoretical and one empirical. The theoretical study comprises a systematic review of the prevalence of postpartum depression in fathers and the impact on child development. Few studies related to the father-infant were found prevalence rates of paternal postpartum depression ranged between 1.2 % and 25.5 %. The empirical study, in turn, examined the effect of paternal postpartum depression on father- child interaction For this quantitative research design with two was performed. A total of 61 dyads father-infant (17 fathers with postpartum depression and 44 controls). Results confirmed the effect of postpartum depression on father-infant interaction. Face processing was confirmed as a mediator. / A depress?o ? uma condi??o m?dica geral com preval?ncia variando entre 4% e 10% da popula??o mundial. A depress?o p?s-parto ? uma das formas de manifesta??o da doen?a, atingindo tanto mulheres como homens. Entretanto, faltam estudos que abordem a quest?o da depress?o p?s-parto paterna. Nesse contexto, o objetivo do estudo foi verificar o efeito da depress?o p?s-parto paterna na intera??o pai-beb?, investigando potenciais mediadores (processamento de faces, conflito conjugal e aten??o). Para isso, foram realizados dois estudos, um te?rico e outro emp?rico. O estudo te?rico realiza uma revis?o sistem?tica sobre a preval?ncia da depress?o p?s-parto nos pais e o impacto para o desenvolvimento infantil. Foram encontrados poucos estudos que inclu?am os fatores investigados, especialmente para as vari?veis intera??o pai-beb? e as implica??es da DPP-P no desenvolvimento infantil. As taxas de preval?ncia sobre a DPP-P variaram entre 1,2% e 25,5%. O estudo emp?rico, por sua vez, examinou o efeito da depress?o p?s-parto paterna na intera??o pai-beb?. Para isso foi realizada uma pesquisa quantitativa com delineamento transversal entre um grupo cl?nico e outro controle. Foram investigadas 61 d?ades pai-beb?, sendo 17 pais com depress?o p?s-parto e 44 controles. Os resultados confirmaram o efeito da depress?o p?s-parto na intera??o pai-beb?. O processamento de faces foi confirmado como um mediador deste efeito.
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O sofrimento ps??quico da mulher no p??s-parto: uma express??o de resist??ncia ao modelo tradicional de maternidadeRamos, Fl??via Regina Agra da Silva 08 December 2006 (has links)
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Previous issue date: 2006-12-08 / This study had the aim to reflect on the by the modern woman after giving birth, particularly the one interpreted by the current biomedical paradigm as postnatal depression . On the contrary of the majority of researches about the issue which associate the phenomenon to physiological alterations related to birth and a supposed emotional fragility characteristic of women we prefer to understand this psychic postnatal suffering as one amongst other possible dimensions of the maternity experience. Our approach is based on the ideas of authors who have studied the social and economical aspects which influenced, during the last three centuries, the construction of the notion of bourgeois family, as well as how the model of the good mother (according to Rousseau) was created in history and then, imposed to the modern woman. To complement this bibliographic survey, we conducted a brief field research with Xavante Indians, in order to get to know how women in this tribe experience maternity, given that their cultural context is completely different from the urban one. The parallel between these two cultures allowed us to elaborate a critical discussion of the modern urban values that guide the experience of the contemporary maternity / Esta disserta????o teve como objetivo refletir sobre o sofrimento ps??quico vivenciado por muitas mulheres burguesas modernas no per??odo p??s-parto, nomeado pelo modelo biom??dico por depress??o p??s-parto . Ao contr??rio da maioria das pesquisas realizadas sobre o tema - que associa o fen??meno ??s altera????es fisiol??gicas relacionadas ao parto, a uma suposta fragilidade emocional comum ??s mulheres e a hist??ria familiar e subjetiva da pu??rpera buscamos compreender o sofrimento ps??quico da mulher neste per??odo sob uma perspectiva diferenciada, propondo que tal sofrimento ?? apenas uma das muitas dimens??es poss??veis da viv??ncia da maternidade. Para tanto, investigamos como foi criado o modelo de boa m??e imposto ?? mulher burguesa moderna, a partir de autores que se dedicaram a estudar os aspectos socioculturais e econ??micos que influenciaram, nos ??ltimos tr??s s??culos, a constru????o da fam??lia burguesa. Entramos em contato com a cultura Xavante, na qual as mulheres vivenciam a maternidade em contexto pol??tico, econ??mico, social e cultural bastante distinto daquelas burguesas dos grandes centros urbanos, com a inten????o de relativizar os conceitos da sociedade moderna que tende a universalizar os valores que norteiam a viv??ncia da gesta????o-parto e puerp??rio na sociedade de produ????o. Por fim, propomos que este fen??meno seja compreendido como uma forma da mulher expressar sentimentos banidos pela sociedade simulacral, nos termos que Baudrillard a define, e de resistir ao modelo tradicional de maternidade
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