*This dissertation is a compound document (contains both a paper copy and a CD as part of the dissertation). The CD requires the following system requirements: Windows MediaPlayer or RealPlayer. / Aim. The aim of this study was to examine the effects of preoperative therapeutic play on the immediate preoperative and postoperative outcomes of Hong Kong Chinese children undergoing surgery, and their parents in a day surgery unit. / An intervention study was conducted in the second phase of the study. A randomized controlled trial, two-group pretest and repeated posttest, between subjects design was employed. Hong Kong Chinese children (7-12 years of age; N = 203) admitted for elective surgery in a day surgery unit during a 13-month period, were invited to participate in the study along with their parents. By using a simple complete randomisation method, 97 children with their parents were assigned to the experimental group receiving therapeutic play intervention, and 106 children with their parents were assigned to the control group receiving routine information preparation. / Background. Surgery causes considerable stress and anxiety that can have a profound effect on both children and their parents. Therefore, they need to be well prepared before surgery to minimize their anxiety, enhance their feeling of control, and promote positive post-operative outcomes. With the increasing number and complexity of paediatric surgery being performed in day surgery units, there is a compelling need for nurses to develop and evaluate appropriate interventions tailored to the needs of children and parents so as to enhance their ability to cope with surgery. / Conclusion. The first phase of this study confirmed the psychometric properties of the Chinese version of the State and Trait Anxiety Scales for Children, and the Children's Emotional Manifestation Scale. The results also support the appropriateness of these instruments as clinical research tools in evaluating the effectiveness of preoperative nursing interventions. / Methods. The study was conducted in two phases. The first phase consisted of developing and testing the psychometric properties of three instruments that were used in the second phase of the study. These instruments included the Chinese version of the State Anxiety Scale for Children, the Chinese version of the Trait Anxiety Scale for Children, and the Children's Emotional Manifestation Scale. / Results. The results showed that both children and parents in the experimental group reported statistically significant lower state anxiety scores than the control group in both pre- and post-operative periods. Children in the experimental group also exhibited statistically significant fewer instances of negative emotional behaviours, displayed lower heart rates and mean arterial blood pressures. Additionally, parents in the experimental group reported significantly higher level of satisfaction with the preoperative nursing preparation given. The results, however, did not find statistically significant differences in children's postoperative pain scores and post-hospital adjustment between the two groups. / Significance of the study. It is anticipated that this study could increase nurses' understanding of the emotional responses of children undergoing surgery and enrich their experience in using child-sensitive research tools in evaluating the effectiveness of preoperative nursing interventions. Most importantly, this research provides empirical evidence of the benefits of incorporating therapeutic play in the preoperative preparation of children and parents thus charting a path towards promoting holistic and quality care.* / The second phase of this study had addressed a gap in the literature by empirically testing the effectiveness of the therapeutic play intervention in preparing children for surgery, and their parents, which had been under-researched. It also provides empirical evidence that therapeutic play, using preoperative tour visit to the operating theatre, doll demonstration and return demonstration on the procedure of anaesthesia, is more effective in improving immediately pre- and post-operative outcomes of children and their parents than information-based preparation alone. / Therapeutic play has been used as a psychological preparation for helping children cope with the stress of hospitalisation. However, the majority of previous studies into the effect of therapeutic play were based only on theories and clinical observations. The lack of empirical evidence makes it difficult to determine precisely the effectiveness of therapeutic play. Therefore, there is vital need for more rigorous empirical scrutiny. / Li Ho Cheung William. / "July 2005." / Advisers: Violeta Lopez; Chung Kwong Yeung. / Includes supplementary digital materials. / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6309. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 335-354). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Made available in DSpace on 2017-06-01T18:08:52Z (GMT). No. of bitstreams: 1 gabriela_nunes_catarino.pdf: 507365 bytes, checksum: 4fc758346d9198724d8fa4fbf606c4d3 (MD5) Previous issue date: 2014-03-25 / This dissertation aimed, in general, analyze the action of the clinical psychologist in the preparation and psychological care of people undergoing bariatric surgery process. Specifically seeks to identify the elements that can interfere positively and / or negatively, in relation therapist - patient, analyze the resonances that therapeutic monitoring exercises on patients undergoing bariatric surgery. Sought to both the theoretical contributions about the body in Merleau Ponty and psychoanalysis Winnicott. Mainly addressed the relationship therapist - patient by Winnicott's approach and within the context of psychologists working with the theme of obesity. This is a qualitative study, whose participants seven clinical psychologists who develop activities in the field of bariatric surgery, both in the private and public sectors and two included patients aged 33 to 56 years, who underwent surgery and continue in psychological counseling. Semistructured interview used to psychologists and for both patients through a different starter question. The analysis of the narrative was taken from the thematic analysis, which identified themes related to the issue of professional practice and theoretical concepts used by psychologists, especially axes as the nature of the bond established relationship therapist and patient, the importance of family participation in the process and especially body image experienced by the patient before, during and after surgery. O care that the psychologist should have to take into account in its therapeutic relationship , the promotion of self-knowledge and understanding about a body experienced by the patient and therefore a body guy, not objectified ; constituted themselves as elements of fundamental importance , reminding us that policies accompanying attitudes are necessary but not sufficient for successful treatment. For these reasons, we point out that intrapsychic issues and the internal resources of the patient are sufficiently worked out, thus avoiding that the same replace the symptom of obesity by another symptom of compulsion. / Esta dissertação objetivou, de forma geral, analisar a ação do psicólogo clínico no processo de preparação e acompanhamento psicológico das pessoas que se submetem à cirurgia bariátrica. De forma específica pretendeu-se identificar os elementos que podem interferir positivamente e/ou negativamente, na relação terapeuta - paciente; analisar as ressonâncias que o acompanhamento terapêutico exerce sobre os pacientes que se submetem à cirurgia bariátrica. Para tanto buscou as contribuições teóricas a respeito do corpo na filosofia de Merleau Ponty e na psicanálise de Winnicott. Sobretudo, abordou o relacionamento terapeuta paciente pela abordagem winnicottiana e dentro do contexto dos psicólogos que trabalham com o tema da obesidade. Trata-se de uma pesquisa qualitativa, que tem como participantes sete psicólogas clínicas que desenvolvem atividades na área de cirurgia bariátrica, tanto no setor privado como público e duas pacientes compreendidas na faixa etária de 33 e 56 anos, que se submeteram à cirurgia e continuam em acompanhamento psicológico. Utilizamos a entrevista semidirigida tanto para as psicólogas como para as pacientes, através de uma questão disparadora diferenciada. A análise das narrativas foi feita a partir da análise temática, que permitiu identificar eixos temáticos ligados à questão da prática profissional e às concepções teóricas utilizadas pelas psicólogas, destacando-se eixos como a natureza do vinculo estabelecido na relação terapeuta e paciente, a importância da família na participação do processo e, sobretudo, a imagem corporal vivida pelo paciente antes, durante e depois do procedimento cirúrgico. O cuidado que o psicólogo deve ter para levar em consideração no seu relacionamento terapêutico, a promoção do autoconhecimento e a compreensão a respeito de um corpo vivido pelo paciente e, portanto, um corpo sujeito, não coisificado; constituíram-se como elementos de fundamental importância, lembrando-nos que, atitudes explicativas diretivas são necessárias, mas não suficientes para o sucesso do tratamento. Por essas razões, apontamos que questões intrapsíquicas e os recursos internos do paciente sejam suficientemente trabalhados, evitando, assim, que o mesmo substitua o sintoma da obesidade por outro sintoma de compulsão.