Orientador: Ana Cláudia Bortolozzi Maia / Banca: Paulo Rennes Marçal Ribeiro / Banca: Sandro Caramaschi / Resumo: Compreender as reações que as doenças apresentam em virtude de emoções, sensações e sentimentos, faz-se hoje um dos maiores desafios da medicina. Uma dessas enfermidades que desperta o interesse de pesquisadores diversos é a hanseníase. No entanto, o tema da sexualidade ainda é escasso nas pesquisas com pessoas atingidas pela hanseníase. Diante disso, este estudo teve por objetivo investigar como pessoas atingidas pela hanseníase relatam sobre sua sexualidade, descrevendo os aspectos da vida social, sexual e afetiva. As questões que permeiam a percepção relacionada à própria sexualidade, bem como as relações afetivas dessas pessoas, além de todas as implicações emocionais desses aspectos na qualidade de vida desses indivíduos foram objeto de nosso estudo. Utilizou-se de um questionário de duas partes: Sexualidade e hanseníase - para verificação da autopercepção da possível influência na sexualidade dos indivíduos e Escala de Satisfação Sexual para avaliar o grau de satisfação pessoal em relação aos aspectos da vida sexual do indivíduo. Os resultados mostram a dificuldade existente na autoaceitação de si enquanto pessoa com hanseníase e que a mesma acaba por repercutir na forma do indivíduo se relacionar não só consigo mesmo, mas inclusive com os outros. Observou-se, ainda, que as relações afetivas se tornam fragilizadas e inconstantes e que há dificuldades na expressão da sexualidade. Novos estudos podem ampliar a compreensão dessa temática, ampliando o número de pessoas atingidas pela hanseníase ou o uso de entrevistas mais aprofundadas / Abstract: Understand the reactions that have diseases because of emotions, sensations and feelings, it is now of the greatest challenges of medicine. One such disease that arouses the interest of many researchers is leprosy. However, the issue of sexuality is still scarce in research with people affected by leprosy. Thus, this study aimed to investigate how people affected by leprosy report about his sexuality, describing aspects of social life, sexual and emotional. The questions related to perceptions related to their sexuality and affective relations of these people, besides all the emotional implications of these aspects of quality of life of these individuals were the object of our study. A questionnaire of two parts was used: Sexuality and leprosy - to verify the perception of possible influence on the sexuality of individuals and Sexual Satisfaction Scale for assessing the degree of personal satisfaction in relation to aspects of sexual life. The results show the difficulty in autoaceitação of himself as a person with leprosy and that it ends up impacting the way the individual relates not only himself but also with others. It was noted also that the affective relations become fragile and unstable and that there are psychological problems in the expression of sexuality. Further studies may enhance understanding of the subject, increasing the number of people affected by leprosy or the use of more in-depth interviews / Mestre

Ser cuidador informal de pacientes com doenças crônicas pode implicar em sobrecarga e sofrimento psicológico significativo, potencialmente prejudiciais para a própria saúde física e mental e para a recuperação do paciente. Pouco se sabe sobre as experiências e características psicossociais dos cuidadores de pacientes portadores de Cardioversor Desfibrilador Implantável (CDI), principalmente na população brasileira, de forma que o presente estudo (quantitativo descritivo transversal) teve por objetivos caracterizar demográfica e psicossocialmente uma amostra não probabilística de cuidadores informais de pacientes portadores de CDI que se encontravam em tratamento médico em um hospital-escola do interior do Estado de São Paulo. As variáveis estudadas incluíram: características sóciodemográficas, qualidade de vida, ansiedade, depressão e percepção de sobrecarga. Participaram da pesquisa 60 cuidadores, entrevistados entre setembro de 2010 a maio de 2011. Para a coleta dos dados foram usados: Roteiro de Entrevista Semiestruturada, elaborado para esta pesquisa, Questionário de Avaliação de Saúde SF-36, Escala Hospitalar de Ansiedade e Depressão e a Zarit Burden Interview. Os dados foram analisados quantitativamente de forma descritiva. Posteriormente verificou-se associação estatisticamente significativa (p<=0,05) entre algumas variáveis de interesse, por meio do Teste Exato de Fisher. Os resultados mostraram que a média de idade dos cuidadores foi de 52,5 anos (DP=14,76), eram em sua maior parte do sexo feminino (n=45, 75%), o cônjuge do(a) paciente (n=39, 65%), com escolaridade predominante de até quatro anos (n=28, 46,67%), sendo a maioria (45, 75%) portadora de problemas de saúde. Vinte e cinco cuidadores (41,67%) apresentaram sintomas indicativos de ansiedade e 13 (21,67%) de depressão. Na avaliação da qualidade de vida, a média de escore mais elevado foi no domínio Aspectos Sociais (Média=78,12, DP=27,48) e o mais baixo em Vitalidade (Média=60,25, DP=26,03). O escore médio relacionado à percepção de sobrecarga foi de 19,93 (DP=12,51, Mediana= 18,5). Os participantes relataram alterações significativas em suas vidas após o implante do CDI, preocupações com a saúde do paciente e funcionamento do dispositivo, dificuldades relacionadas ao papel de cuidador, além de dúvidas sobre o desfibrilador implantável. Os resultados confirmaram que o implante do CDI no paciente impactou significativamente na vida de seus cuidadores informais, sendo necessário o oferecimento de apoio emocional e orientações específicas por parte dos profissionais da saúde para auxiliá-los na adaptação e enfrentamento adequado dessas situações. Dada a escassez de estudos brasileiros nesta população e alguns fatores metodológicos limitantes, é necessário que mais investigações sejam realizadas para comparar estes resultados. / Being an informal caregiver of patients with chronic diseases may imply significant psychological burden and suffering, potentially harmful to caregiver\'s own physical and mental health and patient\'s recovery. Little is known about the psychosocial experiences and characteristics of caregivers of patients with Implantable Cardioverter Defibrillator (ICD), mainly in the Brazilian population, so that the purpose of the present study (transversal descriptive quantitative) was to characterize, both demographically and psychosocially, a nonprobabilistic sample of informal caregivers of patients with ICD undergoing treatment in a university hospital in the interior of the State of São Paulo. The studied variables comprised: sociodemographic characteristics, life quality, anxiety, depression and perception of burden. Sixty caregivers took part in the survey, and they were interviewed between September, 2010 and May, 2011. Data collection used the following instruments: Semi-structured Interview Script prepared for this survey, SF-36 Health Evaluation Questionnaire, Hospital Anxiety and Depression Scale and the Zarit Burden Interview. Data was analyzed quantitatively in a descriptive way. Subsequently, statistically significant association (p<=0,05) was verified between some variables of interest through Fisher\'s Exact Test. Results describe that the average age of caregivers was 52.5 years (DP=14.76), they were mostly female (n=45, 75%), and patient\'s spouses (n=39, 65%), predominantly with up to four years of education (n=28, 46.67%), and most (45, 75%) with health problems. Twenty-five caregivers (41.67%) presented symptoms related to anxiety and 13 (21.67%) to depression. In life quality evaluation, the highest average score was in the Social Aspects dominion (Average=78.12, DP=27.48) and the lowest in Vitality (Average=60.25, DP=26.03). The average score regarding burden perception was of 19.93 (DP=12.51, Median= 18.5). Participants reported significant changes in their lives after ICD implant, concerns about patient\'s health and device operation, difficulties concerning their role as caregivers, in addition to doubts about the implantable defibrillator. Results confirm that the ICD implant had a significant impact in the life of their informal caregivers, requiring provision of emotional support by healthcare professionals in order to help them adapt and properly cope with these situations. Due to the scarcity of Brazilian studies in this population and some limiting methodological factors, further investigation is required to compare these results.

Background: We are facing a global lack of working nurses since nurses end their carrier earlier than their planned retirement. The psychosocial work environment is a big problem in the nursing field and affects the nurses´ health status, suffering and stress level. Aim: The aim with this study was to describe nurses´ perceptions of factors that affects their psychosocial working environment. Method: A literature overview Results: The collegial relationships, the workplace manager, the structure of the working hours and the organization and staffing makes the ground for however the nurses will appreciate and stay at their workplace, or if they are going to dislike the work and leave either the workplace or the nursing-field entirely. Conclusion: Adequate staffing, good relations with the co-workers, a manager that sees and appreciates the nurses is work environmental factors that increase the chances that the nurses is going to appreciate their work, and remain at their workplace. To achieve a good work environment there should be enough time for the nurses´ to take good care of the patients and colleagues. There should also be a supporting management at the work place and a good cooperation in the working team. A mean manager, understaffing, bad relationships with colleagues, and a lack of trust and independence increases the risk that the nurses will leave both the workplace and the entire nursing field.

The goal of this study was to explore the psychosocial aspects within the workplace of people with visual impairment, after mobility training at Optima College Pretoria. The objectives of this study were: To build up a theoretical framework by means of a literature study as well as consultation with experts on the psychosocial aspects of people with visual impairment within the workplace after mobility training at Optima College. To conduct an empirical study of the psychosocial aspects of people with visual impairment within the workplace after mobility training at Optima College. To come to conclusions and to make recommendations for improved adaptation of people with visual impairment within the workplace. This qualitative study endeavoured to answer the following research question: What are the psychosocial aspects experienced by people with visual impairment within the workplace and what are the viewpoints of supervisors and colleagues in this regard? By answering this question, the researcher aimed to document these experiences to understand the phenomenon and to make recommendations for improved adaptation within the workplace. Non-probability sampling methods were used to select the five respondents. Data was gathered by conducting interviews, using semi-structured interview schedules with five people with visual impairment, as well as a supervisor and colleague for each of the five respondents. These interviews were taped and transcribed and subsequently analysed, extracting themes as well as sub-themes. The study was feasible, as it was within the financial and practical means of the researcher. She had access to the target group and she had permission from Optima College to conduct the study, using their resources, clients and data. Five main themes emerged from the data analysis, namely: 1.The adaptation at Optima College and the experience of the training 2.Adaptation at the workplace and investments made by the employers 3.Psychosocial aspects experienced within the workplace as well as in the community 4.The experiences of the supervisor of the person with visual impairment 5.The experiences of the colleague of the person with visual impairment. From the research findings, recommendations were made on micro, macro and meso-levels. On micro-level, people with visual impairment can play a role by telling supervisors and colleagues about their needs and problems. On macro-level, recent employers of people with visual impairment can motivate other employers to employ people with visual impairment. When stigmatization as well as prejudices are removed from society, employers will be more motivated to employ people with visual impairment. On meso-level, Optima College, the South African National Council for the Blind, as well as public media, can play a leading role in publishing positive articles regarding people with visual impairment in the workplace. Optima College must continue with the training of people with visual impairment. / Dissertation (MSD (Health Care))--University of Pretoria, 2006. / Social Work and Criminology / Unrestricted

Bakgrund Till följd av stroke kan förändringar samt förlust av kroppsliga funktioner uppstå. Förändringar kan på olika sätt påverka personens förmåga att äta och upplevelse av måltiden. Måltiden utgör en integrerad del av det sociala livet och är förknippad med kultur, livsstil, samhörighet och välbefinnande. Ätsvårigheter efter stroke kan därmed få flera psykosociala konsekvenser och inverka på det dagliga livet och välbefinnandet. Syfte Syftet var att belysa psykosociala aspekter av måltidssituationen hos personer med ätsvårigheter till följd av stroke. Metod En icke-systematisk litteraturöversikt utfördes baserat på 15 vetenskapliga originalartiklar med kvalitativ och kvantitativ design. Artiklarna inhämtades från databaserna PubMed och CINAHL med hjälp av utvalda relevanta sökord för syftet. Alla artiklar granskades utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet. Resultatet sammanställdes och analyserades med en integrerad dataanalys.  Resultat I sammanställningen av resultatet identifierades tre huvudkategorier; En förändrad tillvaro, Främmande känslor och Samspelet med omgivningen. Resultatet visade att ätsvårigheter orsakade olika former av begränsningar i måltidssituationer och det sociala livet. Det krävdes anpassningar för att hantera nya situationer och för det användes olika strategier. Ätsvårigheter framkallade negativa känslor vilket berörde den egna självbilden. Det fanns en strävan att passa in bland omgivningen och interaktionen med omgivningen upplevdes olika. Slutsats Ätsvårigheter hade flera psykosociala konsekvenser vilket inverkade på känslomässiga och sociala processer i det dagliga livet. Ätsvårigheterna orsakade begränsningar i måltiden och måltidsrelaterade aktiviteter där förhållandet till måltiden som en social, kontextuell och njutbar aktivitet kom att förändras. Resultatet tyder på att ätsvårigheter är mycket komplext eftersom det påverkar flera aspekter av att leva och att vara människa. / Background As a result of stroke, changes and loss of bodily functions can occur. The changes can affect the person's ability to eat and the experience of the meal in different ways. The meal is an integrated part of social life and is associated with culture, lifestyle, togetherness and well-being. Eating difficulties after stroke can therefore have several psychosocial consequences and affect daily life and well-being. Aim The aim was to shed light on psychosocial aspects of the mealtime situation in people with eating difficulties following stroke. Method A non-systematic literature review was performed based on 15 original scientific articles with a qualitative and quantitative design. The articles were retrieved from the databases PubMed and CINAHL using selected relevant search terms for the aim. All articles were reviewed based on Sophiahemmet University's assessment basis for scientific classification and quality. The results were compiled and analyzed using an integrated data analysis.  Results In the compilation of the results, three main categories were identified; A changed existence, Unfamiliar emotions and The interaction with the surroundings. The results showed that eating difficulties caused various forms of limitations in meal situations and social life. Adaptations were required to deal with new situations and for that different strategies were used. Eating difficulties evoked negative feelings, which affected one's own self-image. There was a desire to fit in with the surroundings and the interaction with the surroundings was experienced differently. Conclusions Eating difficulties had several psychosocial consequences, which affected emotional and social processes in daily life. The eating difficulties caused limitations during the meal and meal-related activities where the relationship to the meal as a social, contextual and enjoyable activity came to change. The results suggest that eating difficulties are very complex because they affect several aspects of living and being human.

No description available.

The study focused on the occurrence of dyslexia among the convicted in the Czech Republic. On the ground of plentiful research results from various countries that refer to a connection between dyslexia and criminality, a research was conducted in Czech penitentiary environment (specifically the Horní Slavkov prison). The research sample comprised of 113 respondents aged 22 - 65 in the first round of data collection. All respondents met the research criteria: Czech citizenship, Czech nationality and Czech as a mother tongue. The data were collected via the Raven's standard progressive matrixes, personal questionnaire, interview, assessment battery including tests on specific learning disabilities among adolescents and adults and a rapid naming test. The research results have proven a several times higher occurrence of dyslexia among the sample population than in common population, which is 34 % dyslexic individuals in the sample. The research results are comparable to research results from abroad. On top of that, up to 84 % of the respondents spontaneously demonstrated dyslexic difficulties during the interview. Reading and writing skills in the sample are comparable to those in common population and intelligence is slightly higher than standard. The research hypothesis that there is a connection...

No contexto da Oncologia, define-se recidiva como o reaparecimento do câncer após um período de remissão da doença, o que acarreta menor possibilidade de cura e necessidade de reorganização do paciente e de sua família para lidarem com a situação de tratamento. Considerando o elevado nível de ansiedade associado ao diagnóstico de recidiva e o reduzido número de investigações disponíveis na literatura nacional e internacional sobre seus aspectos psicossociais no âmbito da Oncologia Pediátrica, o presente estudo teve como objetivo compreender as vivências de crianças e de seus cuidadores-familiares diante dessa fase do tratamento. Participaram da pesquisa crianças com idades entre cinco e 12 anos incompletos, em tratamento de recidiva de câncer em um centro de referencia brasileiro para atenção em onco-hematologia infantil, e seus cuidadores principais. Trata-se de um estudo descritivo e exploratório, com enfoque na abordagem clinico-qualitativa. A fim de atender aos objetivos propostos, foi realizada uma entrevista, guiada por um roteiro semiestruturado, com o familiar responsável pelo cuidado do paciente e duas sessões de aplicação do procedimento de Desenhos-Estórias com a criança. As verbalizações foram audiogravadas mediante o consentimento dos participantes. Os relatos extraídos das entrevistas e as narrativas obtidas nas sessões com as crianças foram transcritos na integra e literalmente e, posteriormente, submetidos a analise de conteúdo temática, sendo os conjuntos de Desenhos-Estórias analisados de acordo com as recomendações da literatura. Os resultados mostraram que o diagnostico de recidiva remeteu os participantes ao período inicial de investigação e diagnóstico, porém com maior mobilização e intensidade afetiva. Emergiram sentimentos de frustração em relação as expectativas de cura, vivências de ameaça e perda de controle diante do adoecer e do prognóstico, favorecendo o confronto com a possibilidade da morte. Tal situação prejudicou a projeção para a temporalidade da cura, de forma a trazer implicações para a atribuição de sentidos da existência. A necessidade de recomeço do tratamento foi acompanhada pela necessidade de reorganização da dinâmica familiar e pelo fortalecimento afetivo para enfrentamento das vicissitudes do cotidiano terapêutico. Observaram-se relações entre as vivências parental e infantil, abrangendo questões como a comunicação e os significados atribuídos ao adoecer. A religiosidade e a busca de senso de controle foram recursos importantes utilizados pelos cuidadores para o enfrentamento das situações desafiadoras, ao passo que as crianças buscaram manter a proximidade afetiva com os cuidadores e fortalecer o sentimento de segurança. Compreender as vivências da criança e de seu cuidador-familiar pode oferecer subsídios para o planejamento de intervenções psicológicas que favoreçam o enfrentamento das peculiaridades da situação de adoecimento introduzidas pelo diagnóstico de recidiva do câncer infantil, contribuindo para a implementação dos cuidados paliativos. / In the context of Oncology, relapse is defined as the reappearance of cancer after a remission period of the disease, which entails a lesser possibility of cure and the need for patients and families to get reorganized in order to cope with the treatment situation. In view of the high level of anxiety associated with the relapse diagnosis and the limited number of studies available in Brazilian and international literature about its psychosocial aspects in the Pediatric Oncology context, the aim in this research was to understand the experiences of children and their family caregivers in view of this treatment phase. The research participants were children between five and 12 incomplete years of age, undergoing cancer relapse treatment at a Brazilian referral center for childhood onco-hematology, as well as their primary caregivers. A descriptive and exploratory research with a clinical-qualitative approach was carried out. To achieve the objectives, an interview was held with the relative responsible for patient care, guided by a semistructured script, and two application sessions of the Drawing-And-Story Procedure with the child. The interviews were audio-recorded with the participants consent. The reports taken from the interviews and the narratives collected during the sessions with the children were fully and literally transcribed and then submitted to thematic content analysis, while the Drawings-Histories were analyzed in accordance with literature recommendations. The results showed that the relapse diagnosis returned the participants to the initial investigation and diagnosis period, but accompanied by greater mobilization and affective intensity. Feelings of frustration emerged with regard to the cure expectations, feelings of threat and loss of control in view of the disease and prognosis, favoring the confrontation with the possibility of death. This situation negatively affected the projected timing of cure, influencing the attribution of meanings to existence. The need to restart the treatment was accompanied by the need to reorganize the family dynamics and the need for affective strengthening to cope with the vicissitudes of daily treatment. Relations between parents and childrens experiences were observed, comprising issues like communication and the meanings attributed to the disease. Religiosity and the search for a sense of control were important resources the caregivers use to cope with these challenging situations, while the children attempted to maintain their affective proximity with the caregivers and strengthen their feeling of security. Understanding the experiences of the children and their family caregivers can support the planning of psychological interventions that favor coping with the peculiarities of the disease situation introduced by the relapse diagnosis of child cancer, contributing to the implementation of palliative care.

A depressão pode ser considerada um problema de saúde pública devido aos agravos e perdas sociais conseqüentes. É um problema que por si já debilita a pessoa, levando a pior evolução, se assim estiver associada a alguma doença clínica. Freqüentemente é negada pelo próprio indivíduo por questões de preconceito social, visto provocar queda na produtividade pessoal, perda de iniciativa e de interesse. Este estudo objetivou conhecer a presença de depressão entre usuários de plantão noturno em unidade de emergência de uma instituição privada, relacionando esse fato aos condicionantes clínicos e biopsicossociais. Metodologia: A pesquisa foi realizada com 62 pacientes adultos que passaram por atendimento durante o período noturno, em casos que não envolviam situação de risco iminente de vida, no Pronto Socorro do Hospital Irmãos Penteado, uma instituição privada de assistência em saúde no município de Campinas-SP, nos meses de outubro e novembro de 2007. Foram aplicados dois instrumentos durante a entrevista: a) Identificação, informações clínicas e contextualização psicossocial; b) Inventário de Depressão de Beck. Os dados foram analisados estatisticamente por análise bivariada e multivariada pelo teste de Fisher. Os resultados mostraram que a amostra era composta por maioria de mulheres (75%), solteiras, brancas, com predomínio de faixa etária entre 18 e 30 anos, bom nível educacional, com mais de 20% em nível superior e nenhum analfabeto; todos declaravam alguma ocupação, sendo destaque para comércio e administrativo, boa satisfação com moradia e salienta-se que todos os pacientes possuem convenio de saúde, seja pela empresa em que trabalham, seja porque pagam paralelamente. Entre as queixas clínicas mais comuns apareceram cefaléia como sintoma prevalente e problemas do sistema digestivo. Mais de 12% já tiveram diagnóstico anterior de depressão. Maioria pratica atividade física. Mais de 23% apresentavam hipertensão leve, moderada ou severa durante o atendimento. Mais de 77% relataram dormir entre 6 e 8 horas diárias, mas quase metade alega problemas de sono. Estresse no trabalho e problemas relacionados a ele apareceram com certa freqüência. Álcool também chamou atenção, pois 45,2% alegavam fazer uso, mesmo que socialmente, enquanto que problemas com álcool ou drogas na família foram relatados para quase 20 %. A depressão apareceu em 21% dos entrevistados, sendo 8,1% moderada, 12,9% leve e não houve depressão grave. O Inventário de Beck mostrou-se eficaz e chamou a atenção negativamente nos itens prazer, autocrítica, irritabilidade, sono, cansaço e preocupação com a saúde. Os dados mostraram correlação negativa para os itens hábito de fumar (p=0,021), insônia (p=0,005) e problemas econômicos (p<0,000). Conclui-se que sintomas depressivos estavam aumentados se comparados à amostra não diagnosticada e insuspeita, mas em acordo com os dados de depressão associadas a outras doenças clínicas em hospital geral, qualquer patologia pode aumentar a prevalência de sintomas depressivos e vice versa. Essas informações permitem conhecer melhor o cliente atendido neste serviço de saúde e demonstra que ações de enfermagem em Emergência e Pronto Socorro podem e precisam ser pensadas a fim de garantir a integridade da pessoa que sofre psíquica e fisicamente, tendo em vista que cabe ao hospital geral atender as descompensações antes designadas exclusivamente aos serviços manicomiais. Sugerem-se estudos mais detalhados a fim de elucidar melhor a relação entre \"estresse no trabalho\", manifestação clínica e/ou somática e sintomas depressivos, bem como o fator \"problemas econômicos\" e impacto econômico, a fim de despertar o interesse das grandes empresas privadas de assistência a saúde para com a temática da saúde mental e incentivar a melhoria da assistência de pacientes, sejam conveniados ou não. / Depression may be considered a public health problem due to consequential aggravation and social losses. It is a problem by its own and it weakens the person, leading to worse development, if associated with any clinical disease. Often it is denied by the individual himself for social prejudice issues, since it provokes drop in personal productivity, loss of initiative and interest. This study aimed to know the presence of depression among night call users at a private institution emergency unit, relating this fact to clinical and biopsycho- social indicators. Method: The research was conducted with 62 adult patients who have undergone care during the night time, in cases not involving imminent risk of life situations, in the Emergency Unity of Hospital Irmãos Penteado, which is a health care private institution, in the city of Campinas-SP, in October and November 2007. Two instruments were applied during the interview: a) Identification, clinical information and psychosocial contextualization b) Beck Depression Inventory. Data were statistically analyzed by bivariate analyses and multivariate by Fisher test. The results showed that the sample was composed by a majority of women (75%), single, white, with predominance of age between 18 and 30 years, good educational level, with more than 20% with third degree and no illiterate; all declared any occupation, emphasizing trade and administrative jobs, good housing satisfaction and noting that all patients have health care insure, by the company where they work, or because they pay in parallel. Among the most common clinical complaints appeared headache as prevalent symptom and digestive system problems. More than 12% have had previous diagnosis of depression. Majority practices physical activity. More than 23% had mild, moderate or severe hypertension during care. More than 77% reported sleeping between 6 and 8 hours a day, but nearly half claims sleep problems. Stress at work and problems related to it appeared with some frequency. Alcohol also drew attention because 45.2% claimed to use, even if socially, while alcohol or drugs problems in the family were reported to almost 20%. The depression appeared in 21% of interviewees, with 8.1% moderate, 12.9% mild and no severe depression. Beck Inventory proved to be effective and drew attention negatively on items pleasure, self-criticism, irritability, sleep, tiredness and health concern. Data showed negative correlation for items smoking habit (p = 0021), insomnia (p = 0005) and economic problems (p <0000). It is concluded that depressive symptoms were increased when compared to the undiagnosed and unsuspected sample, but in accordance with data of depression associated with other clinical diseases in general hospital, any pathology can increase the prevalence of depressive symptoms and vice versa. This information allows to better know the client attended at this health care service and demonstrates that nursing actions in Emergency and First Aid can and must be designed in order to ensure the integrity of the person who suffers psychically and physically, facing that it is up to the general hospital to attend the decompensations once exclusively designated to asylum services. More detailed studies are suggested to better clarify the relationship between \"stress at work,\" clinical and/or somatic manifestation and depressive symptoms, and the factor \"economic problems\" in economic impact, in order to arouse the interest of large health care private companies in the mental health issue and to encourage the improvement in caring of patients, are they insured or not.

No contexto da Oncologia, define-se recidiva como o reaparecimento do câncer após um período de remissão da doença, o que acarreta menor possibilidade de cura e necessidade de reorganização do paciente e de sua família para lidarem com a situação de tratamento. Considerando o elevado nível de ansiedade associado ao diagnóstico de recidiva e o reduzido número de investigações disponíveis na literatura nacional e internacional sobre seus aspectos psicossociais no âmbito da Oncologia Pediátrica, o presente estudo teve como objetivo compreender as vivências de crianças e de seus cuidadores-familiares diante dessa fase do tratamento. Participaram da pesquisa crianças com idades entre cinco e 12 anos incompletos, em tratamento de recidiva de câncer em um centro de referencia brasileiro para atenção em onco-hematologia infantil, e seus cuidadores principais. Trata-se de um estudo descritivo e exploratório, com enfoque na abordagem clinico-qualitativa. A fim de atender aos objetivos propostos, foi realizada uma entrevista, guiada por um roteiro semiestruturado, com o familiar responsável pelo cuidado do paciente e duas sessões de aplicação do procedimento de Desenhos-Estórias com a criança. As verbalizações foram audiogravadas mediante o consentimento dos participantes. Os relatos extraídos das entrevistas e as narrativas obtidas nas sessões com as crianças foram transcritos na integra e literalmente e, posteriormente, submetidos a analise de conteúdo temática, sendo os conjuntos de Desenhos-Estórias analisados de acordo com as recomendações da literatura. Os resultados mostraram que o diagnostico de recidiva remeteu os participantes ao período inicial de investigação e diagnóstico, porém com maior mobilização e intensidade afetiva. Emergiram sentimentos de frustração em relação as expectativas de cura, vivências de ameaça e perda de controle diante do adoecer e do prognóstico, favorecendo o confronto com a possibilidade da morte. Tal situação prejudicou a projeção para a temporalidade da cura, de forma a trazer implicações para a atribuição de sentidos da existência. A necessidade de recomeço do tratamento foi acompanhada pela necessidade de reorganização da dinâmica familiar e pelo fortalecimento afetivo para enfrentamento das vicissitudes do cotidiano terapêutico. Observaram-se relações entre as vivências parental e infantil, abrangendo questões como a comunicação e os significados atribuídos ao adoecer. A religiosidade e a busca de senso de controle foram recursos importantes utilizados pelos cuidadores para o enfrentamento das situações desafiadoras, ao passo que as crianças buscaram manter a proximidade afetiva com os cuidadores e fortalecer o sentimento de segurança. Compreender as vivências da criança e de seu cuidador-familiar pode oferecer subsídios para o planejamento de intervenções psicológicas que favoreçam o enfrentamento das peculiaridades da situação de adoecimento introduzidas pelo diagnóstico de recidiva do câncer infantil, contribuindo para a implementação dos cuidados paliativos. / In the context of Oncology, relapse is defined as the reappearance of cancer after a remission period of the disease, which entails a lesser possibility of cure and the need for patients and families to get reorganized in order to cope with the treatment situation. In view of the high level of anxiety associated with the relapse diagnosis and the limited number of studies available in Brazilian and international literature about its psychosocial aspects in the Pediatric Oncology context, the aim in this research was to understand the experiences of children and their family caregivers in view of this treatment phase. The research participants were children between five and 12 incomplete years of age, undergoing cancer relapse treatment at a Brazilian referral center for childhood onco-hematology, as well as their primary caregivers. A descriptive and exploratory research with a clinical-qualitative approach was carried out. To achieve the objectives, an interview was held with the relative responsible for patient care, guided by a semistructured script, and two application sessions of the Drawing-And-Story Procedure with the child. The interviews were audio-recorded with the participants consent. The reports taken from the interviews and the narratives collected during the sessions with the children were fully and literally transcribed and then submitted to thematic content analysis, while the Drawings-Histories were analyzed in accordance with literature recommendations. The results showed that the relapse diagnosis returned the participants to the initial investigation and diagnosis period, but accompanied by greater mobilization and affective intensity. Feelings of frustration emerged with regard to the cure expectations, feelings of threat and loss of control in view of the disease and prognosis, favoring the confrontation with the possibility of death. This situation negatively affected the projected timing of cure, influencing the attribution of meanings to existence. The need to restart the treatment was accompanied by the need to reorganize the family dynamics and the need for affective strengthening to cope with the vicissitudes of daily treatment. Relations between parents and childrens experiences were observed, comprising issues like communication and the meanings attributed to the disease. Religiosity and the search for a sense of control were important resources the caregivers use to cope with these challenging situations, while the children attempted to maintain their affective proximity with the caregivers and strengthen their feeling of security. Understanding the experiences of the children and their family caregivers can support the planning of psychological interventions that favor coping with the peculiarities of the disease situation introduced by the relapse diagnosis of child cancer, contributing to the implementation of palliative care.