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People expenencmg chronic pain encounter increases m needs and endure the consequences of failure to satisfy needs. In much of the management of people with chronic pain, chronic pain is considered an abstract phenomenon with little attention given to the human experience. Numerous literature focus on a mechanistic reductionistic approach in management of chronic pain. Most literature is written by medical practitioners, nurses and psychologists from a health-care oriented methodology, whereas minimal research literature was contributed from a pastoral care and counselling perspective. This dissertation explores the needs and feelings of people with chronic pain to identify their needs at the various developmental stages of their pain experience, and within their relevant ecosystems, in order to develop a pastoral response. / Practical Theology / M. Th. (Practical Theology)

People expenencmg chronic pain encounter increases m needs and endure the consequences of failure to satisfy needs. In much of the management of people with chronic pain, chronic pain is considered an abstract phenomenon with little attention given to the human experience. Numerous literature focus on a mechanistic reductionistic approach in management of chronic pain. Most literature is written by medical practitioners, nurses and psychologists from a health-care oriented methodology, whereas minimal research literature was contributed from a pastoral care and counselling perspective. This dissertation explores the needs and feelings of people with chronic pain to identify their needs at the various developmental stages of their pain experience, and within their relevant ecosystems, in order to develop a pastoral response. / Philosophy, Practical and Systematic Theology / M. Th. (Practical Theology)

Com o avanço dos recursos científico-tecnológicos da medicina, a expectativa de vida vem crescendo de forma substancial nas últimas décadas. Doenças, que no passado eram letais, são hoje passíveis de tratamento. Enfermidades que não apresentavam perspectiva de cura tiveram seu curso e evolução alterados assegurando um aumento na sobrevida dos pacientes. A busca pelo prolongamento e manutenção da vida ao longo dos tempos, foi se configurando como esforços de distanciamento e negação da morte, por vezes, através de tratamentos obstinados e fúteis. A ampliação da quantidade de vida passou a ocupar lugar privilegiado na assistência. Diante do aumento de pacientes gravemente enfermos ou fora de possibilidade terapêutica, os embates da comunidade científica acerca da qualidade de vida se voltam para a necessidade de integração de outras dimensões do cuidado ao paciente inserido em programas de cuidados paliativos, além do foco estritamente físico e biomédico. Nesse sentido, a espiritualidade vem sendo apontada como importante aspecto da dimensão existencial, causadora de grandes impactos na saúde física, sobretudo, em doentes no final da vida. Este trabalho tem por objetivo compreender a clínica psicológica e a experiência da espiritualidade de pacientes inseridos em programa de cuidados paliativos em hospital público da cidade do Recife através de pesquisa qualitativa, com recorte de amostra intencional devido às especificidades do tema. Buscou apresentar os princípios dos cuidados paliativos apontando o manejo da equipe de saúde ao paciente fora de possibilidade terapêutica de cura; identificar as reflexões apresentadas pela Psicologia entre a prática psicológica e a experiência de espiritualidade; apresentar contribuições que possibilitem reflexão no cuidado integral oferecido ao paciente gravemente enfermo, tendo em vista a oferta de melhor qualidade de vida / With the advancement of scientific technological resources of medicine, life expectancy has increased substantially in recent decades. Diseases that were once fatal are now treatable. Diseases that had no prospect of cure had changed its course and development ensuring an increase in patient survival. The search for the extension and maintenance of life over time, it was shaping up as efforts of distancing and denial of death, sometimes through obstinate and futile treatments. The expansion of the quantity of life has come to occupy a privileged place on the tour. Given the increase in critically ill patients or out of therapeutic possibilities, the struggles of the scientific community about the quality of life turn to the need to integrate other dimensions of patient care inserted in palliative care programs, and focus strictly physical and biomedical. In this sense, spirituality has been identified as an important aspect of existential dimension, causing great impacts on physical health, especially in patients at the end of life. This work aims to understand the psychological clinic and experience the spirituality of patients enrolled in palliative care program at a public hospital in Recife through qualitative research, purposeful sampling clipping due to the specific theme. Sought to present the principles of palliative care by pointing the management of the health team to the patient without therapeutic possibility of cure; identify the comments made by the practice of psychology and the psychological experience of spirituality; present contributions that enable reflection in the comprehensive care offered to patients seriously patient, in order to offer a better quality of life

Made available in DSpace on 2017-06-01T18:08:41Z (GMT). No. of bitstreams: 1 dissertacao_Waleska_Medeiros.pdf: 1453485 bytes, checksum: 4cc5ac8b2be5d64bac1fa8bc60dfe416 (MD5) Previous issue date: 2012-03-21 / With the advancement of scientific technological resources of medicine, life expectancy has increased substantially in recent decades. Diseases that were once fatal are now treatable. Diseases that had no prospect of cure had changed its course and development ensuring an increase in patient survival. The search for the extension and maintenance of life over time, it was shaping up as efforts of distancing and denial of death, sometimes through obstinate and futile treatments. The expansion of the quantity of life has come to occupy a privileged place on the tour. Given the increase in critically ill patients or out of therapeutic possibilities, the struggles of the scientific community about the quality of life turn to the need to integrate other dimensions of patient care inserted in palliative care programs, and focus strictly physical and biomedical. In this sense, spirituality has been identified as an important aspect of existential dimension, causing great impacts on physical health, especially in patients at the end of life. This work aims to understand the psychological clinic and experience the spirituality of patients enrolled in palliative care program at a public hospital in Recife through qualitative research, purposeful sampling clipping due to the specific theme. Sought to present the principles of palliative care by pointing the management of the health team to the patient without therapeutic possibility of cure; identify the comments made by the practice of psychology and the psychological experience of spirituality; present contributions that enable reflection in the comprehensive care offered to patients seriously patient, in order to offer a better quality of life / Com o avanço dos recursos científico-tecnológicos da medicina, a expectativa de vida vem crescendo de forma substancial nas últimas décadas. Doenças, que no passado eram letais, são hoje passíveis de tratamento. Enfermidades que não apresentavam perspectiva de cura tiveram seu curso e evolução alterados assegurando um aumento na sobrevida dos pacientes. A busca pelo prolongamento e manutenção da vida ao longo dos tempos, foi se configurando como esforços de distanciamento e negação da morte, por vezes, através de tratamentos obstinados e fúteis. A ampliação da quantidade de vida passou a ocupar lugar privilegiado na assistência. Diante do aumento de pacientes gravemente enfermos ou fora de possibilidade terapêutica, os embates da comunidade científica acerca da qualidade de vida se voltam para a necessidade de integração de outras dimensões do cuidado ao paciente inserido em programas de cuidados paliativos, além do foco estritamente físico e biomédico. Nesse sentido, a espiritualidade vem sendo apontada como importante aspecto da dimensão existencial, causadora de grandes impactos na saúde física, sobretudo, em doentes no final da vida. Este trabalho tem por objetivo compreender a clínica psicológica e a experiência da espiritualidade de pacientes inseridos em programa de cuidados paliativos em hospital público da cidade do Recife através de pesquisa qualitativa, com recorte de amostra intencional devido às especificidades do tema. Buscou apresentar os princípios dos cuidados paliativos apontando o manejo da equipe de saúde ao paciente fora de possibilidade terapêutica de cura; identificar as reflexões apresentadas pela Psicologia entre a prática psicológica e a experiência de espiritualidade; apresentar contribuições que possibilitem reflexão no cuidado integral oferecido ao paciente gravemente enfermo, tendo em vista a oferta de melhor qualidade de vida

The purpose of this current study is to examine the impact of non-pharmacologic pain interventions administered by trained Child Life professionals in an emergency department on pain perception in children. Results showed no significant decrease in children's pain report during the medical procedure compared to before the medical procedure. However, pain after the medical procedure is significantly less than pain during the medical procedure.

Indiana University-Purdue University Indianapolis (IUPUI) / Chronic pain, defined as pain lasting more than 3 months, is a common and costly health condition. Thirty-three percent of adults and upwards of 35% of children report experiencing pain due to various diseases, disorders, or accidents. Recent research has identified perceived injustice and anger as important constructs in an adult’s pain experience and a possible focus for intervention efforts. The present study explored the extent to which perceived injustice and anger expression operate similarly in children with chronic pain as in adults. This was a retrospective analysis of data from 122 patients seeking treatment at a pediatric pain clinic. Results supported anger expression as a mediator in the relationship between perceived injustice and pain intensity but not psychological distress, suggesting that anger expression operates similarly in children as in adults with chronic pain. Unlike previous findings in adults with chronic pain, injustice did not moderate the relationship between pain intensity and psychological distress, suggesting that injustice operates differently in children with chronic pain compared to adults. The strong association between injustice and pain outcomes (i.e. pain intensity, quality of life, functional disability) suggests that injustice is an important construct to explore in the chronic pain experience of children.

This research was executed as three separate studies. Study 1 focused on the perception of pain and the semantic aspects of pain. Study 2 focused on the measurement of acute pain and mood states. Study 3 focused on the psychological treatment of cancer pain. In Study 1 a group of 66 Setswana-speaking adults were required to describe what they saw, what happened, and what would be the outcome with respect to three visually presented pain scenes using The Pain Apperception Test (PAT) A qualitative analysis of their responses shows that pain is experienced as an all encompassing experience affecting all aspects of their lives, such as the physical, emotional, social, and economic. This was found to be true, irrespective of gender and age with the exception of economic issues. A qualitative analysis of their responses to the Pain Eliciting Incidents Questionnaire (PEIQ) reveals that the Setswana pain descriptors are classifiable according to the three dimensions of pain namely, the sensory-discriminative, affective-motivational, and cognitive-evaluative. Sludy 2 applied the Profile of Mood States (POMS) preoperatively to a group of 58 female laparotomy (gynaecological) patients. These patients were also tested post-operatively with the Visual Analogue Scale (VAS) and the Wisconsin Brief Pain Questionnaire (WBPQ) as pain measures. The pain measures were taken at no medication and at the peak of medication. Factor analysis could not confirm the validity of the six POMS scales. These scales also did not show correlations with post-operative pain. Correlations between the pain measures showed acceptable reliability and validity of the VAS and the WBPQ. In Study 3 three groups of 15 cancer patients each, suffering from chronic pain, were treated over a period of two weeks with either cognitive behavioural therapy plus medication, reassurance therapy plus medication, or medication only. Comparison of before and after treatment pain measures showed that both cognitive behavioural therapy and reassurance therapy had a beneficial effect. Follow-up results three months later showed that the beneficial effect of reassurance therapy did not persist. Patients treated with cognitive behavioral therapy still showed the beneficial effects thereof. / Psychology / D. Litt. et Phil. (Psychology)

This research was executed as three separate studies. Study 1 focused on the perception of pain and the semantic aspects of pain. Study 2 focused on the measurement of acute pain and mood states. Study 3 focused on the psychological treatment of cancer pain. In Study 1 a group of 66 Setswana-speaking adults were required to describe what they saw, what happened, and what would be the outcome with respect to three visually presented pain scenes using The Pain Apperception Test (PAT) A qualitative analysis of their responses shows that pain is experienced as an all encompassing experience affecting all aspects of their lives, such as the physical, emotional, social, and economic. This was found to be true, irrespective of gender and age with the exception of economic issues. A qualitative analysis of their responses to the Pain Eliciting Incidents Questionnaire (PEIQ) reveals that the Setswana pain descriptors are classifiable according to the three dimensions of pain namely, the sensory-discriminative, affective-motivational, and cognitive-evaluative. Sludy 2 applied the Profile of Mood States (POMS) preoperatively to a group of 58 female laparotomy (gynaecological) patients. These patients were also tested post-operatively with the Visual Analogue Scale (VAS) and the Wisconsin Brief Pain Questionnaire (WBPQ) as pain measures. The pain measures were taken at no medication and at the peak of medication. Factor analysis could not confirm the validity of the six POMS scales. These scales also did not show correlations with post-operative pain. Correlations between the pain measures showed acceptable reliability and validity of the VAS and the WBPQ. In Study 3 three groups of 15 cancer patients each, suffering from chronic pain, were treated over a period of two weeks with either cognitive behavioural therapy plus medication, reassurance therapy plus medication, or medication only. Comparison of before and after treatment pain measures showed that both cognitive behavioural therapy and reassurance therapy had a beneficial effect. Follow-up results three months later showed that the beneficial effect of reassurance therapy did not persist. Patients treated with cognitive behavioral therapy still showed the beneficial effects thereof. / Psychology / D. Litt. et Phil. (Psychology)

Na clínica contemporânea, temos nos defrontado com novas expressões de sofrimento, nas quais o corpo ganha destaque. Entre os fenômenos recorrentes encontramos a dor crônica e as fibromialgias. Os estudos sobre esses assuntos apresentam posições distintas: uns consideram tais dores como fenômenos histéricos, outros, como uma manifestação do corpo deprimido. Pretendemos verificar as especificidades das dores crônicas, desde a possibilidade de uma manifestação histérica ou depressiva, mas avançando na hipótese de que elas possam ser manifestações do quadro melancólico. Tomaremos a teoria de Freud como principal fonte dos nossos estudos sobre a melancolia e cotejaremos também autores mais recentes que tratam do fenômeno da dor, particularmente os da psicossomática psicanalítica. Os pacientes que nos mobilizaram a empreender tais estudos foram aqueles que apresentavam traços curiosos: pouca fluidez pulsional, desânimo, dores em vários pontos do corpo, sintomas psicossomáticos, ansiedade bastante expressiva e, geralmente, marcados por uma falta de sentido, conotando, de um lado, traços melancólicos e, de outro, sintomas somáticos. Na melancolia, trata-se de uma perda na vida pulsional enquanto que no sofrimento decorrente de um luto normal, isso não acontece; a libido se desprende do objeto, devido a uma posição ocupada por esse objeto perdido, em que havia um duplo trabalho a ele dirigido, de amor e ódio, portanto passível de ser elaborado, no nível consciente. Nesse mesmo texto, ele mostra que no luto patológico, o objeto perdido mantém-se investido, libidinalmente, tendo como consequência um apego a ele, sem que ele possa ser elaborado, causando, portanto, uma sombra do objeto sobre o próprio ego do sujeito. Isso significa que há um hiper investimento narcísico no objeto, no qual o sujeito se fixa colando nele. Num mundo voltado para o individualismo, para o narcisismo e sem ideais é provável que se estimule mais esse encapsulamento, impedindo o sujeito de se vincular. Na clínica contemporânea os sintomas são mais dessa natureza: são primários, de caráter narcísico, no qual o sujeito se vê encapsulado num mundo vazio e sem significação. Nesse contexto, pensamos ser mais propício falar de sujeitos melancólicos, distinto dos deprimidos, pois estes fazem uma retirada do investimento libidinal, mas mantém uma relação com objeto.