Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-08T20:36:43Z No. of bitstreams: 1 LuciaMariaDeOliveiraSantos_DISSERT.pdf: 1117679 bytes, checksum: b534802cf25f161fce0c6edc89f67851 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-07-11T19:00:00Z (GMT) No. of bitstreams: 1 LuciaMariaDeOliveiraSantos_DISSERT.pdf: 1117679 bytes, checksum: b534802cf25f161fce0c6edc89f67851 (MD5) / Made available in DSpace on 2016-07-11T19:00:00Z (GMT). No. of bitstreams: 1 LuciaMariaDeOliveiraSantos_DISSERT.pdf: 1117679 bytes, checksum: b534802cf25f161fce0c6edc89f67851 (MD5) Previous issue date: 2015-05-25 / O L?pus Eritematoso Sist?mico (LES) ? uma doen?a autoimune cr?nica, rara, multissist?mica, com um padr?o muito heterog?neo de manifesta??es cl?nicas e sorol?gicas. O paciente, al?m de sofrer agravos f?sicos e no funcionamento fisiol?gico, tamb?m pode enfrentar uma s?rie de problemas psicossociais. Pesquisas apontam que o LES pode acarretar danos importantes no ?mbito psicol?gico, principalmente com presen?a de ansiedade e depress?o. O American College of Rheumatology (ACR), em 1999, prop?s a defini??o de 19 s?ndromes cl?nicas neuropsiqui?tricas atribu?das ao LES. A depress?o, portanto, encontra-se entre os transtornos de humor e ? uma das manifesta??es psiqui?tricas mais comuns nesse grupo, sendo encontrada com maior frequ?ncia nesses pacientes do que na popula??o em geral. Estudos tamb?m sugerem que o apoio social desempenha um papel importante no desenvolvimento de estrat?gias de enfrentamento, na gest?o do LES e na depress?o. Assim, este estudo tem como objetivo geral verificar a associa??o entre sintomas depressivos e apoio social percebido em pacientes com LES. Os objetivos espec?ficos voltaram-se ?: investigar a preval?ncia de sintomas depressivos; investigar o apoio social percebido e verificar se h? associa??o entre a depress?o, o apoio social e vari?veis sociodemogr?ficas. Utilizou-se um question?rio sociodemogr?fico, a Escala de Depress?o de Beck e a Escala de Apoio Social Percebido. A an?lise foi realizada atrav?s das estat?sticas descritiva e inferencial. A amostra final foi de 79 mulheres com LES, com uma m?dia de idade de 35,7 anos. Destas, 44 (55,7%) eram casadas. Apenas 6 (7,59%) haviam terminado o ensino superior e 32 (40,51%) ainda n?o finalizaram o ensino m?dio. Setenta e uma (89,87%) tinha renda abaixo de tr?s sal?rios m?nimos e 71 (89,87) praticavam alguma religi?o, sendo a cat?lica (67,71%) a mais mencionada pelas participantes. Do total da amostra, 37 (46,74%) j? haviam sido diagnosticadas h? mais de 7 anos, sendo que 25 (31,65%) tinham LES h? mais de 10 anos. Apenas 19 (24,05%) desenvolviam alguma atividade laboral. Quarenta e duas (53,17%) apresentaram n?veis de sintomas depressivos de leve a grave e 51 (64,46%) referiram n?veis de dor igual ou acima de 5. Encontrou-se associa??o significativa entre sintomas depressivos e dor (p=0,013) e sintomas depressivos e atividade laboral (p=0,02). Quando se verificou a percep??o de apoio social, os resultados mostraram n?veis altos pelas participantes do estudo. Atrav?s do teste de correla??o de Spearman, encontrou-se forte correla??o entre sintomas depressivos e apoio social (p= 0,000037) de modo que quanto maior a frequ?ncia de apoio menor os escores de depress?o. Esses achados s?o relevantes porque sintomas depressivos nos pacientes com LES t?m um car?ter multicausal e multifatorial e podem permanecer despercebidos, pois muitos deles se confundem com as manifesta??es da doen?a. Tal fato exige dos profissionais uma avalia??o cuidadosa, n?o apenas no ?mbito cl?nico, mas tamb?m considerando outros fatores de ordem psicossociais que podem estar atuando no surgimento ou mesmo agravamento dos sintomas. Esses resultados tamb?m corroboram com outros estudos, os quais n?o apenas confirmam o papel preditivo do apoio social nos aspectos f?sicos, mas tamb?m psicol?gicos. Nesse sentido, os profissionais de sa?de que atuam nesta ?rea, podem desenvolver a??es que fortale?am as dimens?es de apoio social, pautando-se em interven??es bem-sucedidas j? em curso ou, a partir da fala dos pacientes com LES, construir pr?ticas de cuidado que estejam de acordo com as necessidades, peculiaridades e disponibilidade desse grupo. / Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease, rare, multisystem, with a very heterogeneous clinical and serological manifestations standard. The patient, in addition to suffering injuries on his physical and physiological functioning, may also face a number of psychosocial problems. Research indicates that SLE can cause significant damage to the psychological realm, especially with the presence of anxiety and depression. In 1999, the American College of Rheumatology (ACR), proposed the establishment of 19 neuropsychiatric clinical syndromes attributed to SLE. Depression lies between mood disorders and is one of the most common psychiatric manifestations in this group, being found more frequently in these patients than in the general population. Studies also suggest that social support plays an important role in the development of coping strategies, in SLE management and depression. This study has as main objective verify the association between depressive symptoms and perceived social support in patients with SLE. The specific objectives turned to: investigte the prevalence of depressive symptoms; investigate the perceived social support and verify if there is an association between depression, social support and sociodemographic variables. We used a sociodemographic questionnaire, the Beck Depression Scale, and the Perceived Social Support Scale. The analysis was performed through descriptive and inferential statistics. The final sample could count with 79 SLE women, with an average age of 35.7 years. 44 (55.7%) of the participants were married. Only 6 (7.59%) had completed higher education and 32 (40.51%) have not finished high school. Seventy-one (89.87%) had an income below three minimum salaries and 71 (89.87) practiced a religion, and the Catholic (67.71%) was the most mentioned by them. Of the total sample, 37 (46.74%) had been diagnosed SLE more than 7 years before, and 25 (31.65%) had the disease for more than 10 years. Only 19 (24.05%) had some work activity. Forty-two of them (53.17%) had depressive symptoms levels from mild to severe, and 51 (64.46%) reported pain levels of 5, or above. The study found a significant association between depressive symptoms and pain (p = 0.013) and depressive symptoms and work activity (p = 0.02). When we examined the perception of social support, the results showed high levels among participants. Using the Spearman correlation test we found a strong correlation between depressive symptoms and social support (p= 0,000037). It means that the higher the frequency of support, the lower the score of depression. These findings are relevant because depressive symptoms in patients with SLE have a multicausal and multifactorial character and may remain unnoticed, since many of them are confused with the manifestations of the disease. This fact requires a careful assessment from professionals, not only in the clinical setting, but also considering other psychosocial reasons, that may be influencing the emergence or worsening of symptoms. These results also corroborate other studies, which not only confirm the predictive role of social support in the physical wellbeing, but also in the psychological.

Made available in DSpace on 2014-12-17T15:38:57Z (GMT). No. of bitstreams: 1 MariaAMO_DISSERT.pdf: 1764108 bytes, checksum: b91b0f5edc0ee2890324733c58bfdc95 (MD5) Previous issue date: 2012-04-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The subjective well- being (SWB) is formed by global judgments of satisfaction with life, or with peculiar domains the positive and the negative emotional experiences. The perception in turn, is the process of interpretive process of sensory data with cognitive or informative sense, absorbed in function of a context. From this perspective, the research aimed to evaluate SWB and the perception of advanced age pregnant women. Participated in the survey 80 pregnant with 35 years old or older (Group A or older) and 80 pregnant aged between 20 and 34 years old (Group B or young adults). The instruments used were: the scale of subjective well-being and a questionnaire, that included sociodemographic informations, items about pregnancy and a statement based on the Free Association of Words Technique (FAWT) to approach the perception of pregnancy. The data from the questionnaire and scale, in order to compare the data between groups suffered descriptive and inferential statistical analyzes. The analyzes performed with chi-square test among groups, which had values that were statistically significant, with the sociodemographic variables the type of contraceptive and health problems. The indicators of the SWB had further more by means in groups. The results of the Wilcoxon's test that there were no differences between the groups referred above. In the relation indicators of well being with variables age, education and income, some associations were significant. In addition, the words derived from the (FAWT) were analyzed using the software Programmer s Permenttant l?Analyse des Evocation (EVOC2000) and categorized according to content analysis of Bardin in three thematic categories (positive and negative affects, perception of gestation and implications of pregnancy) discussed as a group, since most of words were common. The study highlights shown how similar were the presented data by pregnant women surveyed. It is supposed about this fact the similarity is related to the social context. The relevance of this study for the health care network is to help with proposals aimed at specific improvements to the public and the sector, beside demonstrate that advanced age pregnant women and young adulst in the researched context showed no differences in the most of the studied characteristics / O Bem-estar Subjetivo (BES) ? formado por julgamentos globais de satisfa??o com a vida, ou com dom?nios peculiares - as experi?ncias emocionais positivas e negativas. A percep??o, por sua vez, ? o processo interpretativo dos dados sensoriais dotado de sentido cognitivo ou informativo, assimilado em fun??o de um contexto. Sob essa perspectiva, a pesquisa objetivou avaliar o BES e a percep??o da gravidez em gestantes tardias. Participaram da pesquisa 80 gr?vidas com 35 anos ou mais de idade (grupo A ou tardias) e 80 gr?vidas com idade entre 20 e 34 anos (grupo B ou adultas jovens). Os instrumentos usados foram: a escala de BES e um question?rio; este contemplou informa??es sociodemogr?ficas, itens sobre a gravidez e uma afirmativa baseada na T?cnica de Associa??o Livre de Palavras (TALP) para abordar a percep??o da gesta??o. Os dados oriundos do question?rio e da escala, objetivando comparar os dados de intergrupos, sofreram an?lises estat?sticas descritivas e inferenciais. As an?lises realizadas com o teste qui-quadrado apresentaram valores estatisticamente significativos com as vari?veis sociodemogr?ficas tipo de anticoncepcional e problemas de sa?de. Os indicadores do BES apresentaram m?dias pr?ximas nos grupos. Al?m disso, por meio do teste de Wilcoxon, percebeu-se que n?o houve diferen?as dos aspectos supracitados intergrupos. Ao relacionar os indicadores do BES com as vari?veis idade, escolaridade e renda, algumas associa??es foram significativas. Em adi??o, as palavras oriundas da afirmativa (TALP) foram analisadas com o aux?lio do software Programmes Permettant l analyse des Evocations (EVOC2000), e categorizadas segundo a an?lise de conte?do de Bardin que resultaram em 3 categorias tem?ticas (afetos positivos e negativos, percep??o da gesta??o e implica??es da gravidez), discutidas de forma agrupada, pois a maioria das palavras foram comuns. Frisa-se o qu?o semelhantes foram os dados apresentados pelas gestantes pesquisadas. Sup?e-se, acerca dessa considera??o, que a similitude esteja relacionada ao contexto social. A relev?ncia desse estudo para a rede assistencial de sa?de reside em auxiliar em propostas que visem a melhorias espec?ficas para o p?blico e para o setor, al?m de demonstrar que gestantes tardias e adultas jovens, no contexto pesquisado, n?o apresentaram diferen?as em boa parte das caracter?sticas estudadas

Made available in DSpace on 2014-12-17T14:14:04Z (GMT). No. of bitstreams: 1 SimoneNB.pdf: 1450571 bytes, checksum: 491d3f4e3cfc42edec5aafb00ea04f6a (MD5) Previous issue date: 2004-09-15 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Purpose: assess the frequency of stress and anxiety levels in infertile women, correlate these aspects with risk factors and qualitatively analyze feelings resultant from the inability to conceive, in order to obtain data for specific psychological guidance. Methods: the case-control study included a total of 302 women, 152 being infertile (case group: 30.3 ? 5.4 years), and 150 non-fertile (control group: 25.7 ? 7.9 years). The quantitative approach involved the application of Lipp s Stress Symptoms Inventory (LSSI) and State-Trait Anxiety Inventory (STAI), whereas the qualitative approach consisted of a semi-structured interview. Response variables considered were: stress frequency and anxiety scores (State and Trait). Statistical analysis compared frequencies and medians between groups, by means of qui-squared and Mann-Whitney tests, respectively, and constructed logistical regression models to test associations between response variables and risk factors considered. Qualitative data were analyzed descriptively and categorized in order to perform correspondence analysis. The level of significance was 5%. Results: in the study sample, stress frequency was higher in the case group than in the control(61.8 and 36.0%, respectively), however, significant differences were not observed between groups in relation to stress phases and predominant symptomology type. With respect to anxiety, there were no significant differences between case and control groups as to median state scores [39.5 (35.0 46.0) and 41.0 (35.7 47.0 ); respectively) and anxiety trait scores [44.0 (34.0 51.0) and 42.0 (36.0 49.2); respectively). Risk factors significantly associated with greater risk for high anxiety scores in the case group were: primary infertility, unawareness of the causal factor, diagnostic phase investigation, religion, lack of children from other marriages and the fact that the woman was previously married. The qualitative approach demonstrated that infertility provokes emotional responses, such as sadness, anxiety, anger, fear and guilt. Conclusions: it can be concluded that infertile women are more vulnerable to stress; however, they are capable of adapting to stressful events without serious physical or psychological compromising / Objetivo: avaliar a freq??ncia de estresse e n?veis de ansiedade em mulheres inf?rteis, correlacionar esses aspectos com fatores de risco e analisar, qualitativamente, os sentimentos advindos da incapacidade de conceber, de forma a obter subs?dios para uma orienta??o psicol?gica espec?fica. M?todos: o estudo incluiu um total de 302 mulheres, sendo 152 inf?rteis (grupo caso: 30,3 ? 5,4anos), e 150 n?o-inf?rteis (grupo controle: 25,7 ? 7,9 anos). A abordagem quantitativa envolveu a aplica??o do Invent?rio de Sintomas de Estresse de Lipp (ISSL) e Invent?rio de Ansiedade Tra?o-Estado (IDATE), ao passo que a abordagem qualitativa consistiu de uma entrevista semi-estruturada. As vari?veis resposta consideradas foram: freq??ncia de estresse e escores de ansiedade (Estado e Tra?o). A an?lise estat?stica compreendeu a compara??o de freq??ncias e medianas entre os grupos, por meio dos testes qui-quadrado e Mann-Whitney, respectivamente, assim como a constru??o de modelos de regress?o log?stica para testar associa??es entre as vari?veis resposta e os fatores de risco considerados. Os dados qualitativos foram analisados de forma descritiva e categorizados para realiza??o de an?lise de correspond?ncia. O n?vel de signific?ncia adotado foi de 5%. Resultados: na amostra estudada, a freq??ncia de estresse foi maior no grupo caso do que no controle (61,8 e 36,0%; respectivamente), no entanto, n?o foram observadas diferen?as significativas entre os grupos com rela??o ?s fases do estresse e tipo de sintomatologia predominante. Em rela??o ? ansiedade, n?o houve diferen?as significativas entre os grupos caso e controle quanto ?s medianas dos escores de estado (39,5 e 41,0; respectivamente) e tra?o (44,0 e 42,0; respectivamente) de ansiedade. No grupo caso, os fatores de risco associados significativamente com estresse ou ansiedade foram: infertilidade prim?ria, desconhecimento do fator causal, fase de investiga??o diagn?stica, religi?o e aus?ncia de filhos advindos de outros casamentos. Na abordagem qualitativa, as mulheres inf?rteis expressaram as seguintes respostas emocionais predominantes: tristeza, ansiedade, raiva, medo e culpa. Conclus?es: os resultados permitem concluir que as mulheres inf?rteis est?o mais vulner?veis ao estresse, no entanto, s?o capazes de responder aos eventos estressores de forma adaptativa, sem comprometimentos mais s?rios nas ?reas f?sica e psicol?gica

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-05-03T22:17:31Z No. of bitstreams: 1 MarceloVialRoehe_TESE.pdf: 789282 bytes, checksum: 93718bb6b26136140c1beeb25d2bafae (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-05-04T19:19:57Z (GMT) No. of bitstreams: 1 MarceloVialRoehe_TESE.pdf: 789282 bytes, checksum: 93718bb6b26136140c1beeb25d2bafae (MD5) / Made available in DSpace on 2016-05-04T19:19:57Z (GMT). No. of bitstreams: 1 MarceloVialRoehe_TESE.pdf: 789282 bytes, checksum: 93718bb6b26136140c1beeb25d2bafae (MD5) Previous issue date: 2015-06-05 / A cr?tica ao modelo biom?dico ? um tema recorrente em publica??es de psicologia sobre sa?de. O modelo ? rejeitado devido ? sua ?nfase (1) na doen?a (2) como disfun??o corporal. A posi??o presente nos trabalhos de psicologia que tratam do assunto ? de que o modelo ? reducionista, limitando a sa?de a ser aus?ncia de doen?a. As implica??es da abordagem biom?dica para o pensamento em sa?de s?o o materialismo (corp?reo) de vi?s biol?gico e o mecanicismo fisiol?gico. Como contraponto ? biomedicina e com o objetivo de apresentar uma vis?o ampliada do fen?meno, os trabalhos de psicologia revisados, conforme um m?todo de leitura, destacam os aspectos contextuais e o papel do comportamento e do estilo de vida no processo sa?de-doen?a. Nesta discuss?o, ? poss?vel vislumbrar a presen?a de uma concep??o subjacente de homem, refor?ada com a refer?ncia, em alguns trabalhos, ao pensamento de Descartes como sendo a origem das ideias inspiradoras do modelo biom?dico. A argumenta??o das publica??es de psicologia a respeito de sa?de destaca caracter?sticas do fen?meno que implicam um modo de conceber o ser humano, a quem a sa?de diz respeito. Esta tese desenvolve o entendimento de que a concep??o de ser humano elaborada pelo fil?sofo alem?o Martin Heidegger em sua Anal?tica do Dasein ? compat?vel com as propostas dos trabalhos de psicologia acerca da sa?de. Ou seja, o que as publica??es de psicologia discutem a respeito da compreens?o da sa?de ? relativo, de modo subjacente, a uma concep??o de homem que possibilita o (novo) olhar sobre o fen?meno. O Dasein heideggeriano ? uma vis?o de ser humano que se coaduna com a posi??o sobre sa?de presente nos trabalhos de psicologia que estabelecem uma discuss?o a respeito do fen?meno, entendendo-se que a maneira como se concebe um fen?meno humano ? coerente, ainda que de modo impl?cito, com um modo de compreender o homem. A considera??o dos aspectos contextuais - como sociedade, ambiente e cultura - na abordagem da sa?de remete ? quest?o da rela??o entre homem e mundo, para a qual Heidegger desenvolveu a no??o de ser-no-mundo. A aten??o ao papel do comportamento na sa?de aponta para a participa??o da pr?pria pessoa em sua sa?de, permitindo que se estabele?a um paralelo com o pensamento heideggeriano sobre a rela??o que o ser humano tem com seu pr?prio ser. / A reading method (Cervo & Bervian, 1983) was applied to select psychology publications on health. The rejection of the biomedical model is a recurring theme in these publications. Its point of view is that the model is reductionistic because it emphasizes (1) the disease (2) as a body dysfunction and by consequence health is understood as the absence of disease. The implications of the biomedical model for health are biological materialism and physiological mechanicism. Psychology publications counterpoint to biomedicine is to include attention to life contexts and consider the role of individual behavior and lifestyle in the health-disease process. Those thoughts about the nature of health imply a conception of man, especially when some articles claim that Descartes? ideas are the ground to biomedicine development. Psychology publications reviewed highlight health characteristics related to a different view of the human mode of being. The thesis presented develops an understanding that Martin Heidegger?s Dasein Analytic is a conception of human being consistent with the selected psychology works? view of health. It means psychology?s discussion about what is health is based on an implicit approach to the human being, one that allows the rethinking of health. The heideggerian Dasein is a vision of man in tune with the comprehension of health presented in the selected publications. It is understood that the manner a human phenomenon is conceptualized is related even implicitly to a conception of man. To take into account health?s contextual aspects like society, environment, and culture call attention to the man world relationship to which Heidegger calls being in the world. To highlight the role of behavior on one?s own health makes a point of the relationship man has with her/his own being, which Heidegger calls mineness.

Made available in DSpace on 2014-12-17T15:38:41Z (GMT). No. of bitstreams: 1 RemersonRM.pdf: 448865 bytes, checksum: 14cbfed29d38210302974844ec6adb11 (MD5) Previous issue date: 2008-07-11 / Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (?13,25 years) and 22,04 years (?4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ?18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work / Introdu??o: Este trabalho busca caracterizar indicadores comportamentais de ader?ncia ao tratamento hemodial?tico por meio do Invent?rio Millon de Estilos de Personalidade em uma amostra de pacientes portadores de insufici?ncia renal cr?nica (IRC) na grande Natal/RN. A ader?ncia terap?utica representa o grau de concord?ncia entre o comportamento do paciente e as prescri??es da equipe de sa?de. A IRC ? a perda progressiva e irrevers?vel da fun??o renal, sendo o tratamento hemodial?tico uma importante alternativa para auxiliar ou substituir os rins. M?todo: A amostra consistiu de 80 pacientes renais cr?nicos em tratamento hemodial?tico em dois centros cl?nicos localizados na regi?o da grande Natal, RN. Utilizaram-se como instrumentos (a) um protocolo de coleta de dados cl?nicos, (b) o invent?rio Millon de estilos de personalidade (MIPS) e (c) um roteiro de entrevista semi-estruturada. Resultados: Os resultados mostram que houve equil?brio entre os sexos (51% do sexo feminino e 48,8% do sexo masculino), idade m?dia e tempo m?dio de di?lise respectivamente iguais ? 43,4 anos (?13,25 anos) e 22,04 anos (?4,24 anos). O estado civil de metade da amostra ? casado, predominando o ensino fundamental (43,6%) e uma renda familiar at? um sal?rio m?nimo (43,8%). Definiram-se seis indicadores cl?nico-laboratoriais para avaliar a ader?ncia terap?utica, mais o uso da avalia??o da equipe de sa?de e do pr?prio paciente. Desse modo, observou-se uma ader?ncia m?dia em torno de 55,97% da amostra (?18,37%). Contudo apenas entre a auto-avalia??o do paciente acerca da ader?ncia e a avalia??o feita atrav?s da press?o arterial p?s-di?lise indicou-se uma associa??o significativa (p=0,029, teste qui-quadrado). Por outro lado, houve uma associa??o significativa (p<0,05, teste qui-quadrado) entre os crit?rios de ader?ncia ao tratamento e aspectos investigados na entrevista a percep??o da qualidade dos servi?os de sa?de prestados aos pacientes, as dificuldades no seguimento da dieta prescrita, a caracteriza??o dos dias entre as sess?es de di?lise e a percep??o dos pacientes acerca das sess?es de di?lise. Tamb?m se observou uma associa??o significativa (p<0,05, teste de Levene) entre a ader?ncia terap?utica e as escalas que constituem o MIPS. A equipe de sa?de caracterizou o comportamento do paciente mais aderente como uma postura de aceita??o do tratamento, buscando ativamente pela sua realiza??o, por informa??es e mais conhecimento, al?m de estabelecer uma comunica??o positiva com a equipe e com os demais pacientes. Resultados semelhantes foram confirmados pela avalia??o do MIPS. Segundo essa avalia??o os pacientes mais aderentes adotam uma atitude mais otimista, buscando agir ou adaptar-se ao seu meio, processando cognitivamente tanto informa??es concretas e objetivas, como informa??es mais especulativas e simb?licas. Al?m de estabelecer um padr?o de relacionamento interpessoal greg?rio, cooperativo, submisso e flex?vel ?s demandas sociais. Estas caracter?sticas conseguiram explicar 55,7% da varia??o da ader?ncia definida segundo a equipe de sa?de e 23,3% da varia??o da ader?ncia segundo o indicador laboratorial CaxP. Conclus?es: O MIPS demonstrou ser capaz de identificar os pacientes mais e menos aderentes. O uso de diferentes indicadores de ader?ncia ? importante para uma avalia??o que abarque as diferentes facetas desse processo. Os n?veis de ader?ncia observados est?o dentro do registrado pela literatura pertinente. H? a necessidade de outros estudos com uma amostra maior para aprofundar os dados achados nesse trabalho