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O impacto da doença e tratamento cirúrgico em homens acometidos por câncer de próstata: estudo exploratório da qualidade de vida / The impact of the disease and surgical treatment in men affected by prostate cancer: an exploratory study of quality of lifeAna Cristina de Oliveira Almeida Vieira 09 April 2010 (has links)
O câncer de próstata é o segundo tumor maligno mais prevalente e quarta causa de óbitos no Brasil em homens após 50 anos. Está relacionado ao processo de envelhecimento, uma vez que sua incidência aumenta com a idade. O tratamento cirúrgico, prostatectomia radical, é considerado o método mais eficaz para tumores localizados. Dentre as complicações cirúrgicas mais comuns, destacam-se a disfunção erétil e as perdas urinárias. Este trabalho aborda o sofrimento emocional e impacto da doença e tratamento cirúrgico na qualidade de vida de homens com CaP. Objetivouse, investigar prospectivamente o impacto psicológico da doença e tratamento cirúrgico no pré e pós operatório. Como objetivos específicos: identificar formas de percepção do CaP antes e após PR e avaliar a QV após diagnóstico e tratamento cirúrgico. Foram estudados 52 pacientes antes e após o evento cirúrgico através de entrevista psicológica semidirigida, questionário genérico de qualidade de vida SF-36 (Short-Form Health Survey) e avaliação função erétil através IIEF5 (Índice Internacional de Função Erétil). A análise dos dados se deu de forma quantitativa e qualitativa. Os resultados obtidos apontam que o sofrimento emocional antes da cirurgia está relacionado às representações do CaP e suas associações com a identidade masculina. Vivências subjetivas que envolvem doença e cirurgia se relacionam à morte e perda da identidade masculina. A análise estatística dos escores obtidos na SF-36 não evidenciou diferença significativa nas médias de cada domínio que compõe a referida escala antes e após o evento cirúrgico. O IIEF-5 diagnosticou 60% dos pacientes antes da cirurgia com algum grau de DE. Antes da cirurgia 94% referiram atividade sexual, após cirurgia, 63,5% dos casos estudados relataram ausência de atividade sexual. 63,43% dos homens declararam-se satisfeitos com o tratamento, 34,54% declaram-se insatisfeitos e a queixa principal nos dois grupos referiu-se às sequelas. Conclui o CaP e possíveis sequelas da PR tem impacto significativo na sexualidade masculina e QV em homens acometidos pela doença. O sofrimento emocional e ambivalência antes da PR estão relacionados ao desempenho sexual, visto que a virilidade é um dos aspectos que compõe as representações de masculinidade. A intervenção psicológica e a prática assistencial interdisciplinar são necessárias para abordar as questões que envolvem a saúde do homem / Prostate cancer (PC) is the second most prevalent malignancy and the fourth cause of death in Brazil in men over 50 years of age. It is related to the aging process, since its incidence increases with age. The surgical treatment, radical prostatectomy (RP) is considered the most effective method for localized tumors. Among the most common surgical complications, erectile dysfunction and urinary losses tend to stand out. This study focuses on the emotional distress and impact of the disease and surgical treatment on the quality of life of men with PC. The objective is to investigate prospectively the psychological impact of the disease and surgical treatment before and after surgery. As specific objectives: to identify ways of perception for PC before and after RP and assess QoL after diagnosis and surgical treatment. Weve studied 52 patients before and after the surgical procedure through semioriented psychological interview, the generic quality of life questionnaire SF- 36 (Short-Form Health Survey) and erectile function assessment by IIEF-5 (International Index of Erectile Function). The data analysis was quantitative and qualitative. The results indicate that the emotional distress before surgery is related to representations of PC and their associations with the male identity. Subjective experiences involving the disease and surgery relate to death and loss of male identity. Statistical analysis of scores on SF- 36 showed no significant difference in the averages of each field that make up such a scale before and after the surgical event. IIEF-5 diagnosed 60% of patients before surgery with some degree of erectile dysfunction. Before surgery 94% reported sexual activity, after surgery 63.5% of cases reported lack of sexual activity. 63.43% of men declared they were satisfied with the treatment, 34.54% were unsatisfied and the main complaint for both groups was the sequel. Conclusion is that PC and possible sequel of RP have a significant impact on male sexuality and QoL in men affected by the disease. The emotional distress and ambivalence before the RP are related to sexual performance, as the virility is one of the aspects that make up the representations of masculinity. A psychological intervention and practice interdisciplinary care are needed to address issues involving mens health
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An Assessment of Returning Foreign Terrorist Fighters’ Commitment to Reintegrate : A Case Study of Kwale County, KenyaMykkänen, Tina January 2018 (has links)
The preoccupation in the past decades with theorizing radicalization in order to prevent violent extremism has left deradicalization undertheorized. As the number of returning Foreign Terrorist Fighters (FTFs) is expected to increase as a result of the anticipated military and intelligence advancement on terrorism, the reintegration imperative stresses the urgency to develop comprehensive reintegration and deradicalization strategies. This study seeks to contribute to filling the research deficit begging for empirical data informed by FTFs’ experiences of, and challenges in, reintegration, through qualitative interviews with returning FTFs in Kwale County, Kenya; a county producing a relative majority of Kenyan recruits to Al Shabaab who are now offered amnesty on return to their county of origin. The Life Psychology framework, which assumes an inherent human strive to obtain a good life, i.e. life embeddedness, is adopted for the analysis. The study finds that returnees commit to reintegration in the absence of other alternatives, due to economic incentives and longing for acceptance. It confirms that the process requires the societal motivation in facilitation, but will fail without the sustained commitment of the returning FTF. The study further establishes that returning FTFs are not able to obtain a flow in life embeddedness, which would indicate inability to reintegrate. Yet, many of the interviewed returning FTFs express the contrary, which challenges the concept of life embeddedness as an indicator for reintegration. The study further challenges the general assumption that deradicalization is a precondition for reintegration, as it finds that radicalized individuals are able to reintegrate into communities of origin without deserting held radical beliefs, if those communities share radical sentiments. This study contributes to filling the deficit in empirical data, which when advanced will work to avert security threats posed by returning FTFs and enable utilizing the potential of the phenomenon to counter violent extremism.
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An evaluation of the Amblyopia and Strabismus Questionnaire using Rasch analysisVianya-Estopa, M., Elliott, D. B., Barrett, B. T. January 2010 (has links)
PURPOSE: To evaluate whether the Amblyopia and Strabismus Questionnaire (A&SQ) is a suitable instrument for the assessment of vision-related quality-of life (VR-QoL) in individuals with strabismus and/or amblyopia. METHODS: The A&SQ was completed by 102 individuals, all of whom had amblyopia, strabismus, or both. Rasch analysis was used to evaluate the usefulness of individual questionnaire items (i.e., questions); the response-scale performance; how well the items targeted VR-QoL; whether individual items showed response bias, depending on factors such as whether strabismus was present; and dimensionality. RESULTS: Items relating to concerns about the appearance of the eyes were applicable only to those with strabismus, and many items showed large ceiling effects. The response scale showed disordered responses and underused response options, which improved after the number of response options was reduced from five to three. This change improved the discriminative ability of the questionnaire (person separation index increased from 1.98 to 2.11). Significant bias was found between strabismic and nonstrabismic respondents. Separate Rasch analyses conducted for subjects with and without strabismus indicated that all A&SQ items seemed appropriate for individuals with strabismus (Rasch infit values between 0.60 and 1.40), but several items fitted the model poorly in amblyopes without strabismus. The AS&Q was not found to be unidimensional. CONCLUSIONS: The findings highlight the limitations of the A&SQ instrument in the assessment of VR-QoL in subjects with strabismus and especially in those with amblyopia alone. The results suggest that separate instruments are needed to quantify VR-QoL in amblyopes with and without strabismus.
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Psicodinâmica e qualidade de vida do médico: um estudo transversal em Botucatu-SP / Psychodynamics and physician quality of life: a cross-sectional study in Botucatu-SPSilva, Benedito Carlos Miranda da 24 May 2013 (has links)
INTRODUÇÃO: A Psicodinâmica é o estudo da interação das forças psíquicas que subsidiam o funcionamento mental. A dinâmica mental interfere na qualidade de vida de um indivíduo, na medida em que modifica a percepção que ele tem da própria existência. O papel da psicodinâmica sobre a qualidade de vida ainda é pouco estudado. OBJETIVOS: Estudar, de forma transversal, a relação entre psicodinâmica e qualidade de vida na população de médicos de Botucatu, para testar a hipótese de que quanto melhor a psicodinâmica do médico melhor a sua qualidade de vida. MÉTODOS: Foram enviados questionários, com carta-resposta, para 602 médicos (população referenciada). As variáveis independentes (Psicodinâmica) foram obtidas por meio de duas escalas: a) Defense Style Questionnaire (DSQ-40), que avalia e classifica os mecanismos de defesa do ego em maduros, neuróticos e imaturos; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), que avalia e classifica as relações objetais (alienação, egocentrismo, vinculação insegura e incapacidade social) em normais e patológicas. As variáveis dependentes (qualidade de vida) foram avaliadas pelo World Health Organization Quality of Life (WHOQOL-Abreviado), que fornece escores para os quatro domínios: físico, psicológico, relações sociais e meio ambiente. As variáveis moderadoras foram obtidas por meio de um questionário sóciodemográfico. A análise estatística foi feita por meio dos seguintes testes: Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Coeficiente de Spearman e modelos de regressão linear com resposta Gamma. Foram utilizados os softwares SPSS versão 17, R versão 2.11.0 e Graph Pad versão 5.0. RESULTADOS: Foram respondidos 198 (33%) questionários válidos. Os seguintes resultados foram obtidos: a média (± desvio padrão) de idade foi de 47,6 (± 11,12) anos e o sexo masculino foi de 53,5%. A presença de perfil patológico nas relações objetais do tipo alienação, egocentrismo e vinculação insegura reduziu os escores dos domínios psicológico (p < 0,001) e relações sociais (p < 0,001), da qualidade de vida. A presença do fator imaturo das defesas do ego reduziu os escores dos domínios físico (p < 0,0001) e meio ambiente (p < 0,0001), da qualidade de vida. DISCUSSÃO: Defesas imaturas do ego dificultam a adaptação do indivíduo à vida profissional e conjugal, enquanto que a presença do perfil patológico das relações objetais leva à dificuldade em manter relacionamentos estáveis e à tendência a manipular as pessoas, apresentando-se socialmente inapto. Ou seja, médicos com esse perfil (de defesas e de relações objetais) devem enfrentar dificuldades para conviver com outras pessoas, inclusive com pacientes. Sua qualidade de vida é pior do que a de médicos com defesas maduras do ego e perfil normal de relações objetais. CONCLUSÕES: A psicodinâmica e a qualidade de vida do médico estão significativamente relacionadas. Os escores da qualidade de vida caem à medida que aumentam os escores das defesas imaturas do ego. Médicos com perfil patológico nas relações objetais apresentam menores escores de qualidade de vida, em relação àqueles com perfil normal / INTRODUCTION: Psychodynamics is the study of the psychological forces that underlie mental action. Ego defense mechanisms and object relations are psychodynamic aspects that affect quality of life as they alter people\'s perceptions of their own life. OBJECTIVES: To assess the influence of ego defense mechanisms and object relations on quality of life in a population of physicians, and thus test our hypothesis that mature ego defenses and normal object relations are associated with better physician quality of life. METHODS: In this cross- sectional study, questionnaires and pre-stamped return envelopes were sent to the population of physicians (602 individuals) living in the city of Botucatu, São Paulo. Psychodynamics was evaluated using the following instruments: a) Defense Style Questionnaire (DSQ-40), which assesses and classifies ego defense mechanisms as mature, neurotic, or immature; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), which assesses and classifies object relations (alienation, egocentricity, insecure attachment, and social incompetence) as either normal or pathological. Quality of life was assessed by the World Health Organization Quality of Life (WHOQOL-BREF) that was developed in the context of four domains of quality of life: physical health, psychological health, social relationships, and environment. Demographic data were obtained via a specific questionnaire. Statistical analyses were performed using the tests of Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Spearman\'s coefficient, and Gamma linear regression models with SPSS v. 17, R v. 2.11.0 and Graph Pad v. 5.0 software. RESULTS: A total of 198 questionnaires (33%) with valid responses were obtained. Among respondents, mean age was 47.6 ± 11 years, and the rate of males was 53.5%. High BORRTI scores (pathology) on the alienation, egocentricity and insecure attachment subscales were associated with reduced WHOQOL-BREF scores for the psychological health (p < 0,001) and social relationships (p < 0,001) domains. Immature ego defense mechanisms were associated with lower WHOQOL-BREF scores for the physical health (p < 0,0001) and environment (p < 0,0001) domains. DISCUSSION: Immature ego defenses impair adjustment to professional and marital life, while pathological object relations lead to difficulty in sustaining stable relationships and tendency to manipulate others, hence social ineptitude. Physicians with immature defenses and pathological object relations are, therefore, likely to find it hard to relate with other people, including patients. Their quality of life is worse in comparison with that of physicians with mature ego defenses and normal object relations. In the study population, both immature ego defenses and pathological object relations were associated with lower quality of life. CONCLUSIONS: Among physicians, quality of life is influenced by its psychodynamics, herein assessed through ego defense mechanisms and object relations
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Psicodinâmica e qualidade de vida do médico: um estudo transversal em Botucatu-SP / Psychodynamics and physician quality of life: a cross-sectional study in Botucatu-SPBenedito Carlos Miranda da Silva 24 May 2013 (has links)
INTRODUÇÃO: A Psicodinâmica é o estudo da interação das forças psíquicas que subsidiam o funcionamento mental. A dinâmica mental interfere na qualidade de vida de um indivíduo, na medida em que modifica a percepção que ele tem da própria existência. O papel da psicodinâmica sobre a qualidade de vida ainda é pouco estudado. OBJETIVOS: Estudar, de forma transversal, a relação entre psicodinâmica e qualidade de vida na população de médicos de Botucatu, para testar a hipótese de que quanto melhor a psicodinâmica do médico melhor a sua qualidade de vida. MÉTODOS: Foram enviados questionários, com carta-resposta, para 602 médicos (população referenciada). As variáveis independentes (Psicodinâmica) foram obtidas por meio de duas escalas: a) Defense Style Questionnaire (DSQ-40), que avalia e classifica os mecanismos de defesa do ego em maduros, neuróticos e imaturos; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), que avalia e classifica as relações objetais (alienação, egocentrismo, vinculação insegura e incapacidade social) em normais e patológicas. As variáveis dependentes (qualidade de vida) foram avaliadas pelo World Health Organization Quality of Life (WHOQOL-Abreviado), que fornece escores para os quatro domínios: físico, psicológico, relações sociais e meio ambiente. As variáveis moderadoras foram obtidas por meio de um questionário sóciodemográfico. A análise estatística foi feita por meio dos seguintes testes: Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Coeficiente de Spearman e modelos de regressão linear com resposta Gamma. Foram utilizados os softwares SPSS versão 17, R versão 2.11.0 e Graph Pad versão 5.0. RESULTADOS: Foram respondidos 198 (33%) questionários válidos. Os seguintes resultados foram obtidos: a média (± desvio padrão) de idade foi de 47,6 (± 11,12) anos e o sexo masculino foi de 53,5%. A presença de perfil patológico nas relações objetais do tipo alienação, egocentrismo e vinculação insegura reduziu os escores dos domínios psicológico (p < 0,001) e relações sociais (p < 0,001), da qualidade de vida. A presença do fator imaturo das defesas do ego reduziu os escores dos domínios físico (p < 0,0001) e meio ambiente (p < 0,0001), da qualidade de vida. DISCUSSÃO: Defesas imaturas do ego dificultam a adaptação do indivíduo à vida profissional e conjugal, enquanto que a presença do perfil patológico das relações objetais leva à dificuldade em manter relacionamentos estáveis e à tendência a manipular as pessoas, apresentando-se socialmente inapto. Ou seja, médicos com esse perfil (de defesas e de relações objetais) devem enfrentar dificuldades para conviver com outras pessoas, inclusive com pacientes. Sua qualidade de vida é pior do que a de médicos com defesas maduras do ego e perfil normal de relações objetais. CONCLUSÕES: A psicodinâmica e a qualidade de vida do médico estão significativamente relacionadas. Os escores da qualidade de vida caem à medida que aumentam os escores das defesas imaturas do ego. Médicos com perfil patológico nas relações objetais apresentam menores escores de qualidade de vida, em relação àqueles com perfil normal / INTRODUCTION: Psychodynamics is the study of the psychological forces that underlie mental action. Ego defense mechanisms and object relations are psychodynamic aspects that affect quality of life as they alter people\'s perceptions of their own life. OBJECTIVES: To assess the influence of ego defense mechanisms and object relations on quality of life in a population of physicians, and thus test our hypothesis that mature ego defenses and normal object relations are associated with better physician quality of life. METHODS: In this cross- sectional study, questionnaires and pre-stamped return envelopes were sent to the population of physicians (602 individuals) living in the city of Botucatu, São Paulo. Psychodynamics was evaluated using the following instruments: a) Defense Style Questionnaire (DSQ-40), which assesses and classifies ego defense mechanisms as mature, neurotic, or immature; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), which assesses and classifies object relations (alienation, egocentricity, insecure attachment, and social incompetence) as either normal or pathological. Quality of life was assessed by the World Health Organization Quality of Life (WHOQOL-BREF) that was developed in the context of four domains of quality of life: physical health, psychological health, social relationships, and environment. Demographic data were obtained via a specific questionnaire. Statistical analyses were performed using the tests of Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Spearman\'s coefficient, and Gamma linear regression models with SPSS v. 17, R v. 2.11.0 and Graph Pad v. 5.0 software. RESULTS: A total of 198 questionnaires (33%) with valid responses were obtained. Among respondents, mean age was 47.6 ± 11 years, and the rate of males was 53.5%. High BORRTI scores (pathology) on the alienation, egocentricity and insecure attachment subscales were associated with reduced WHOQOL-BREF scores for the psychological health (p < 0,001) and social relationships (p < 0,001) domains. Immature ego defense mechanisms were associated with lower WHOQOL-BREF scores for the physical health (p < 0,0001) and environment (p < 0,0001) domains. DISCUSSION: Immature ego defenses impair adjustment to professional and marital life, while pathological object relations lead to difficulty in sustaining stable relationships and tendency to manipulate others, hence social ineptitude. Physicians with immature defenses and pathological object relations are, therefore, likely to find it hard to relate with other people, including patients. Their quality of life is worse in comparison with that of physicians with mature ego defenses and normal object relations. In the study population, both immature ego defenses and pathological object relations were associated with lower quality of life. CONCLUSIONS: Among physicians, quality of life is influenced by its psychodynamics, herein assessed through ego defense mechanisms and object relations
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"Mer kultur till folket" : En kvalitativ studie om kulturaktiviteter i arbetslivet / ”More culture to the people” : A qualitative study of cultural activities in working life.Bäckström, Hannes, Lundin, Elin January 2021 (has links)
The purpose of this qualitative master thesis is to investigate the cultural activity experiencesof employees and their meaning for well-being and work satisfaction. The method used inthis study was thematic analysis. The data collection was conducted through eightsemi-structured interviews with employees in a municipal department that participated incultural activities organized by their employer as a part of their ordinary work tasks. In theresult three main themes emerged with appurtenant sub-themes: The experience of increasedsocial interaction in the workplace (Promoting fellowship and cohesion in the workplace,New and deepened relationships with colleagues, and Conversations and discussions withcolleagues), The experience of a changed view of the workplace (Feeling appreciated by theemployer, The experience that cultural activities benefit the workplace, and The experience ofhow the cultural activities have been arranged), and The experience that cultural activitieslead to benefits for the individual (Something out of the ordinary and Enriching for theindividual). The main themes, together with their sub-themes, describe how the culturalactivities have been perceived to have affected social relations, increased well-being in theworkplace and enriched the individuals. The results are largely in line with previous researchand can be linked to established theories. All together, from what has emerged in the resultsand previous research the conclusion can be drawn that cultural activities could be used inwork-life to promote the individuals well-being and job satisfaction. / Syftet med föreliggande kvalitativa studie är att undersöka anställdas upplevelser avkulturaktiviteter som arrangerats av arbetsgivaren och deras eventuella betydelse förvälbefinnande och arbetstillfredsställelse. Metoden som användes i studien var tematiskanalys. Datainsamlingen skedde genom åtta semistrukturerade intervjuer med anställda vid enkommunförvaltning som haft deltagande i kulturaktiviteter organiserade av arbetsgivarensom en del av sina arbetsuppgifter. I resultatet utkristalliserades tre huvudteman medtillhörande underteman: Upplevelsen av en ökad social interaktion på arbetsplatsen(Främjande av gemenskap och sammanhållning på arbetsplatsen, Nya och fördjupaderelationer med kollegor, och Samtal och diskussion med kollegor), Upplevelsen av enförändrad syn på arbetsplatsen (Att känna sig uppskattad av arbetsgivaren, Upplevelsen avatt kulturaktiviteterna gynnar arbetsplatsen, och Upplevelsen av hur kulturaktiviteterna harorganiserats), och Upplevelsen av att kulturaktiviteterna leder till fördelar för individen(Någonting utöver det vanliga för individen, och Berikande för individen). Huvudtemanabeskriver tillsammans med sina underteman hur kulturaktiviteterna upplevs ha påverkatsociala relationer, ökat trivseln på arbetsplatsen samt varit utvecklande för medarbetarna somindivider. Resultatet går till stor del i linje med tidigare forskning och kan kopplas tilletablerade psykologiska teorier. Sammantaget dras slutsatsen utifrån vad som framkommit iresultatet och tidigare forskning att kulturaktiviteter skulle kunna användas inom arbetslivetför att främja individens välbefinnande och trivsel på arbetet.
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