Made available in DSpace on 2016-01-26T12:51:55Z (GMT). No. of bitstreams: 1 vitorgiacominiflosi_dissert.pdf: 403974 bytes, checksum: 58e3ff734a5b2f087e3a861db334258c (MD5) Previous issue date: 2006-06-07 / Introduction: Suicide is self-infringed intentional death. The prevalence of suicidal rates varies from culture to culture and from time to time in the same culture. A growing tendency for female, adolescent and young adult has been observed. The current study attempts to describe the psychosocial profile of 40 patients attended in HB-FAMERP Hospital casualty due to suicide attempts. Method: A combination of measures was used while patients were in hospital. The Attempting Suicide Questionnaire, the Hamilton Depression Scale (Ham-D), the Beck Scale for Suicidal Intention (BSI), Two-question Questionnaire and the Goldberg Scale for Depression. Results: Results demonstrated that the male proportion was 37,5% and the female proportion was 62,5%. Self-poisoning was the most used method (95%): 50,3% by psychotropic drugs and 27,7% by pesticides. The average score for male and female was 9,86 (BSI) and 18,8 (Ham-D), and 15 (BSI) and 28,36 (Ham-D), respectively. Patients who had no history of previous suicide attempts were 52,5%. Affective Disorders with depressive episode were identified as diagnostic hypothesis in 87,5% of sample, in which 54,3% was considered grave, 25,7% considered moderate, and 20% tenuous. Family income was lower than 3 minimum wages for 73,5% and per capita family income was up to a minimum salary for 87,5% of the total. Conclusions: Patients are mainly young women, people from working class and with low intent. Self-poisoning is the commonest method. Affective Disorder is the usual diagnosis and most patients presented depression symptoms. / Introdução: Suicídio é a morte intencional auto-infringida. A prevalência das taxas de suicídio é variável em diferentes culturas e varia com o tempo numa mesma cultura. Tem-se observado consistente tendência de aumento da proporção feminina, adolescente e adulto jovem. O presente estudo pretende descrever o perfil psicossocial de 40 pacientes atendidos na emergência do HB-FAMERP devido à tentativa de suicídio. Casuística: Com os pacientes ainda internados os seguintes instrumentos foram aplicados: Questionário de Tentativa de Suicídio (QTS), Escala de Hamilton para Depressão (HamD), Escala de Intencionalidade Suicida de Beck (BSI), Teste das Duas Questões e Escala de Goldberg para depressão. Resultados: Dos 40 casos 37,5% foram do sexo masculino e 62,5% do sexo feminino. O auto-envenenamento foi o método mais utilizado (95%), desses 50,3% por medicação psicotrópica e 27,7% por pesticidas. As pontuações médias para os sexos masculino e feminino foram 9,86 (BSI) e 18,8 (Ham-D), e 15 (BSI) e 28,36 (Ham-D) respectivamente. 52,5% dos pacientes não haviam tentado suicídio anteriormente. 87,5% da amostra tiveram como hipótese diagnóstica Transtorno Afetivo com episódio depressivo, sendo 54,3%% considerados graves, 25,7% moderadas e 20% leves. 73,5% tinham renda familiar inferior a 3 salários mínimos e 87,5% renda familiar per capita até 1 salário. Conclusão: Os pacientes são predominantemente mulheres jovens, de classe socioeconômica baixa, com baixa intencionalidade e auto-envenenamento é o método preferencial. Transtorno Afetivo foi o diagnóstico mais encontrado e a maioria dos pacientes revelou sintomas de depressão.

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La reconstruction mammaire post-mastectomie améliore le bien-être psychosocial, et l’image corporelle des patientes. Parcontre, la reconstruction mammaire demeure faiblement utilisée et même inaccessible à des patients dû à des facteurs limitants. Les taux de reconstruction et les facteurs qui influencent l’accès à la reconstruction n’ont pas été évalués dans la province du Québec. Avec une revue de dossier rétrospective, l’objectif de notre étude est d’identifier les taux de reconstruction mammaire dans un centre tertiaire à Montréal et les facteurs qui influencent l’accès à la reconstruction, avec un revu de dossier rétrospective. Ensuite, nous avons évaluer directement dans la même cohorte de patientes, leur désire d’avoir une consultation en chirurgie plastique pour discuter d’une reconstruction. Il y avait un taux total de reconstruction mammaire post-mastectomie de 21%, dont 14% était immédiat et 8% tardif. Les patientes qui ont eu une reconstruction étaient plus jeunes, plus de tendance à avoir une plus grande proportion de mastectomie bilatérale, avaient des cancers non-invasifs et habitaient plus loin de l’hôpital (>10km). Environ la moitié des patientes avec une mastectomie sont intéresser à avoir une consultation avec un chirurgien plasticien mais seulement 38% ont eu une reconstruction. Les chances d’avoir subi une reconstruction, augmentent lorsqu’une reconstruction est offerte et expliquée. Présentement, il existe des barrières autres que les désires de la patiente qui empêchent l’accès à la reconstruction mammaire post-mastectomie. / Breast reconstruction post-mastectomy has been shown to improve psychosocial wellbeing, and body image. However, accessibility and acceptance of breast reconstruction is limited, with patients being unequally privileged based a number of limiting factors. To date, no evaluation on the rates of reconstruction and the factors that influence patient access has been performed in the province of Quebec. The objective of the research was two-fold with the first component being to identify the rates of breast reconstruction at a tertiary care center in Montreal and the factors influencing the rates of reconstruction through a retrospective chart review. The second component was to directly evaluate in the same cohort of breast cancer patients; their interest in a consultation with plastic surgery through a telephone questionnaire. There was a total rate of PMBR of 21%, where 14% of patients had an immediate reconstruction and 8% of eligible patients underwent a delayed reconstruction. Patients that received a PMBR were younger, more likely to have bilateral mastectomies, had non-invasive breast cancer and resided further then 10km from the hospital. Approximately half of patients with a mastectomy were interested in consulting a plastic surgeon but only 38% of all patients underwent a reconstruction. The offer and awareness of reconstruction increased the chance of opting to have a reconstruction. There are barriers outside of the patient’s own desires that impede their access to breast reconstruction.