Made available in DSpace on 2016-07-27T14:20:41Z (GMT). No. of bitstreams: 1 Lorena de Melo Mendonca Oliveira.pdf: 963293 bytes, checksum: f42977e9d37ec6e5017a5abdf5e6c001 (MD5) Previous issue date: 2014-11-24 / The present essay is organized in two sections, which main target is studying child depression in institutionalized children. The first section consists of a systematic bibliographic review to examine or analyze the scientific production, concerning the studies where assessments tools were used to evaluate child depression in the last ten years. To make it possible, a search in the following national and international database files was made (September 2003 to August 2013.): Virtual Library in Health- BVS Psi Scielo, Lilacs, Index Psi Magazines and Pepsic, using different combination among keywords. The results showed that the studies were in conducted various areas of knowledge, and that the predominant method of descriptive research with quantitative data analyzes. A total of twenty-eight articles were brought up. The results showed that the studies were in conducted various areas of knowledge, and that the predominant method of descriptive research with quantitative data analyzes. Considerable proportion of articles aimed to investgate the factors that cause childhood depression (N=10; 35,7%) and related to such pathology symptoms (N=7; 25%). Ten different instruments to analyze child depression were found. The Child Depression Inventory CDI was the instrument of major incidence (N=21; 75%) and presented good intern consistency with the selected studies. The second section is about an empiric article which aims at analyzing depressive symptoms in institutionalized sheltered children, compared to children living with their families. Fifty male and female children were part of this study aged between 7 and 11 years old. Twentythree of these children lived in institutions-shelter and twenty-seven lived with their families. To analyze children depressive symptoms, the following instruments or resources were used; CDI, CBCL and the Rorschach-SC. The results showed that institutionalized children reveal more depressive symptoms, present more emotional distress, have affective expression with no modulation, are immature and inopportune, they also have more aggressive behavior and present difficulty in following rules. Significant correlation between depressive symptoms and externalizing behavior was found (r = 0,43; p<0,05). In general, both sections of this dissertation bring up the importance of considering psychological aspects that influence in the appearing, the symptoms and investigation of child depression. / A presente dissertação está organizada em dois capítulos que têm como objetivo principal estudar sintomas depressivos em crianças institucionalizadas. O primeiro capítulo consiste em uma revisão bibliográfica sistematizada a fim de analisar a produção científica acerca dos estudos que fizeram uso de instrumentos de avaliação dos sintomas depressivos em crianças no Brasil, nos últimos dez anos (2004 2013). Para isso, foi realizada uma busca na Biblioteca Virtual de Saúde, na área específica de Psicologia (BVS-PSI), utilizando as seguintes bases de dados: Scielo, Lilacs, Index Psi Revistas e Pepsic, utilizando diferentes combinações entre palavras-chave. Foram levantados, no total, 28 artigos. Os resultados mostraram que os estudos foram realizados por diversas áreas do conhecimento e que predominou o método de pesquisa descritivo com análise quantitativa de dados. Considerável parte dos artigos teve como objetivo investigar os fatores que causam a depressão infantil (N=10, 35,7%) e sintomas relacionados a tal patologia (N=7; 25%). Foram encontrados 10 instrumentos diferentes que foram utilizados para avaliar sintomas depressivos em criança. O Inventário de Depressão infantil CDI foi o instrumento de maior incidência (N=21; 75%) e apresentou boa consistência interna nos estudos selecionados. O segundo capítulo trata-se de um artigo empírico que tem por objetivo analisar sintomas depressivos em crianças em situação de acolhimento institucional comparadas com crianças que vivem com suas famílias. Participaram deste estudo 50 crianças, do sexo masculino e feminino, com idades entre sete e onze anos, sendo que 23 crianças residiam em instituições e 27 crianças residiam com suas famílias. Foram utilizados para avaliar sintomas de depressão infantil os seguintes instrumentos: CDI, CBCL e o Rorschach SC. Os resultados revelaram que as crianças institucionalizadas apresentavam mais sintomas depressivos, desconforto emocional, expressões afetivas mais imaturas e sem modulação, mais comportamentos agressivos e dificuldade em seguir regras. Foi encontrada correlação significativa entre sintomas depressivos e comportamentos externalizantes (r = 0,43; p<0,05). De maneira geral, os dois capítulos da Dissertação realçam a importância de se considerar aspectos psicológicos que influenciam no surgimento, na sintomatologia e na investigação da depressão infantil.

The topic of the diploma thesis is description of care system for unaccompanied minors in the Czech Republic and mapping of special pedagogical methods used within this system. In my own research I show examples of concrete case studies how individual forms of educational and special pedagogical care help unaccompanied minors in successful integration into the major society. The aim of the thesis is not only to describe the current state of care for minors and special pedagogical methods used, but also its evaluation. Based on the critical assessment of the case studies, they try to outline the possibilities of further development of care for unaccompanied minors in the Czech Republic from the perspective of special pedagogy.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-03-14T12:02:20Z No. of bitstreams: 1 Larissa Garcia Ponce.pdf: 1862982 bytes, checksum: 7a2089cfdd5d8fb87cc8113ecf59037c (MD5) / Made available in DSpace on 2018-03-14T12:02:20Z (GMT). No. of bitstreams: 1 Larissa Garcia Ponce.pdf: 1862982 bytes, checksum: 7a2089cfdd5d8fb87cc8113ecf59037c (MD5) Previous issue date: 2018-03-16 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / This study aimed to investigate, through clinical case studies, the strategies and challenges found in the psychotherapeutic care of five children sheltered in an Institutional Shelter in a country town of São Paulo State. The reports of these sessions were analyzed based on psychoanalysis, with a greater emphasis on the contributions of D. Winnicott. Two aspects were examined with special attention: the established clinical management and the evolution of psychotherapy in each history. The instruments used to find and read these data were: life and sheltering history of the patients/participants, presented in the registration form of the institution, and clinical material from playful psychotherapy. In four of the five cases, the time of psychotherapy was short (five to ten sessions), due to an abrupt interruption of the psychotherapeutic processes. In the only case with a longer duration (thirty sessions), there was the possibility of a therapeutic withdrawal performed progressively. Regarding the treatment results, one patient did not show significant achievements; the others demonstrated benefits from the psychotherapeutic process and exhibited improvement in symptoms or thawing of emotional maturation. The role of each action of differentiated clinical management in the setting was listed and some of them served as coping strategies of some of the challenges that were interposed. In addition to these actions, the importance of the management promoted by the social environment to shelters was evidenced. In order for this to be guaranteed, both the sheltering institution and the Judiciary are expected to commit themselves to protect children from future trauma, especially those which could be avoided by a more judicious and realistic analysis of the family circumstances in each case. Finally, it was pointed out the need to implement psychotherapy services in Shelters throughout the country, as well as psychological care programs for those who return home after sheltering. This proposition is corroborated by the obvious importance of a listening, receiving and psychological support space for the recovery of personal maturation of deeply traumatized people, as postulated byWinnicott, in addition to actively collaborating in the construction of a healthy society and, therefore, more prepared to care for their children and adolescents / Este trabalho teve por objetivo investigar, por meio de estudos de caso clínico, as estratégias e desafios encontrados no atendimento psicoterápico de cinco crianças acolhidas em um Abrigo Institucional do interior do Estado de São Paulo. Os relatos das sessões foram analisados com base na psicanálise, com maior ênfase nas contribuições de D. W. Winnicott. Dois aspectos foram examinados com atenção especial: o manejo clínico estabelecido e a evolução da psicoterapia em cada história. Os instrumentos utilizados para conhecer e interpretar os dados foram: história de vida e de abrigamento dos pacientes/participantes, presentes na ficha cadastral da instituição, e o material clínico proveniente da psicoterapia lúdica. Em quatro dos cinco casos, o tempo de psicoterapia foi curto (cinco a dez sessões) por ter ocorrido a interrupção abrupta dos processos psicoterápicos. No único caso com maior duração (trinta sessões), houve a possibilidade do desligamento terapêutico ser realizado progressivamente. No que se refere aos resultados dos atendimentos, uma paciente não apresentou conquistas significativas; os outros demonstraram se beneficiar do processo psicoterápico e exibiram melhora dos sintomas ou descongelamento do amadurecimento emocional. Elencou-se o papel de cada ação de manejo clínico diferenciado no setting, e algumas delas, serviram como estratégias de enfrentamento de alguns dos desafios que se interpuseram. Evidenciou-se, além destas ações, a importância do manejo promovido pelo ambiente social aos abrigados e, para que isto seja garantido, espera-se tanto da instituição de acolhimento quanto do Poder Judiciário que se comprometam a proteger as crianças de futuros traumas, especialmente daqueles que poderiam ser evitados com análises mais criteriosas e realistas das circunstâncias familiares em cada caso. Por fim, assinalou-se a necessidade de implementar serviços de psicoterapia nos Abrigos em todo país, além de programas de atendimento psicológico àqueles que retornam ao lar após o abrigamento. Tal proposição se corrobora pela evidente importância do espaço de escuta, acolhida e sustentação psicológica para a retomada do amadurecimento pessoal de pessoas profundamente traumatizadas, como postulado por Winnicott, além de colaborar ativamente na construção de uma sociedade saudável e, portanto, mais preparada para cuidar de suas crianças e adolescentes

This study attempted to identifj and explore the role the building plays in the organisation culture of nursing homes. To do this a research plan was formulated in which the central plank was a case-study of a seventy-five bed high care nursing home. As part of the case-study, interviews were conducted at the nursing home with ten members of staff, two residents and a daughter of a resident. The study was also informed by interviews with two architects, who specialise in the design of nursing homes and aged care facilities. A theoretical model entitled the 'Conceptual Framework' was developed prior to the case-study. It was tested by applying it to findings related to the physical context and the organisation culture of the case-study venue. The hypothesis that the building does influence the culture of the nursing home environment was explored by studying the manner in which the building influenced the lives of those who work in the nursing home and those who live there. This challenge was met with the use of theoretical contributions from organisation theory and psychodynamics, which together provided a vehicle for analysis of the culture and the building's role in it.

<p>Syftet med föreliggande studie var att med avseende på upplevelser av delaktighet och livstillfedsställelse samt arbetssituation och sjukvårdskonsumtion jämföra två grupper som deltagit respektive inte deltagit i ett Strokescreeningprogram. En strukturerad enkät skickades ut till konsekutivt, retroaktivt utvalda personer. Det inkomna resultatet analyserades med hjälp av Chi2-test, Mann Whitney test, T-test, linjär regressionsanalys och multivariat logistisk regressionsanalys. Några signifikanta skillnader mellan grupperna kunde inte påvisas även om vissa tendenser noterades.</p><p>Gruppen som deltagit i Strokescreeningprogrammet upplevde en mindre delaktighet i den personliga vården än gruppen som ej deltagit i Strokescreeningprogrammet. De strokedrabbade upplevde en signifikant lägre livstillfredsställelse än en referensgrupp bestående av en normalpopulation svenskar. Det fanns en markant skillnad mellan grupperna gällande sysselsättning före strokeinsjuknandet. Vid tillfället för studien var det en högre procent ur gruppen som deltagit i Strokescreeningprogrammet som återgått till arbete. Flera av deltagarna i gruppen som inte deltagit i Strokescreeningprogrammet hade en regelbunden, återkommande kontakt med primärvården. Föreliggande studies resultat väckte en del frågor gällande nyttan med Strokescreeningprogrammet i relation till kostnaden. Eftersom metoden att göra en enkätstudie hade en del svagheter både genom ett relativt högt bortfall och fråga om huruvida frågorna varit adekvata vore en uppföljande studie med intervjuer av studiens deltagare högst intressant. Intressant vore även en undersökning om frekvens av återinsjuknande i stroke i respektive grupp för att se om Strokescreeningprogrammet haft en sekundärpreventiv effekt.</p> / <p>The aim of this study was that, with focus on experiences of participation and life satisfaction, work situation and consumtion of non institutional care, compare two groups that had participated versus not participated in a stroke program for Strokescreening. A questionnaire was sent retrospective to a consequetive group of people. The results were analyzed with Chi2-test, Mann Whitney-test, T-test, linear regression analyzes and multiple logistic analyze. No significant differences could be shown between the groups even though some tendences were noted. The group who participated in the Strokescreening program experienced less participation in personal care than the group who did not participate. The strokepatients that participated in this study experienced a significant lower level of life satisfaction than a reference group of a normal population of Swedes. There was a prominent difference between the groups about occupation before the stroke. In time of this study there where some higher percentes in the group who participated in the Strokescreening program that had returned to work. Several of the participants in the group that had not participated in the Strokescreening program had a regulary contact with the non institutional care. The results of the present study arouse some questions about the benefit with the Strokescreening program related to the expences. The method of a questionnairy study had some weekness, both in a relatively high level of reduction of participants and a question about the relevace of the questions asked. Therefore, it would be of great interest to make an interview study of this population. It would also be of great interest to examin if there are any differences in the frequency of how many of the participants who gets another stroke in respective group. The purpose of that would be to see if the Strokescreening program has any secondary preventive effect.</p>

<p>Sammanfattning</p><p>Ungdomar med antisocial problematik är en svårbehandlad grupp där ingen specifik metod har visat sig råda bot på hela problematiken kring ungdomen. Bäst utgång att behandla ungdomar med beteendeproblem återfinns inom institutioner som har en enighet i personalgruppen kring de teorier som är gällande inom verksamheten, så kallad behandlingsintegritet. Syftet med studien var att granska om personalgruppen på en behandlingsverksamhet för ungdomar har ett gemensamt förhållningssätt utifrån de miljöterapeutiska behandlingsprinciper som vägleder verksamheten. Syftet konkretiserades utifrån följande frågeställningar: 1. Vilka behandlingsprinciper är vägledande inom verksamheten? 2. På vilket sätt kommer dessa principer till uttryck i det praktiska arbetet med ungdomarna? 3. I vilka avseenden är personalen samstämmiga respektive skiljaktiga i sitt utförande av behandlingsprinciperna? 4. Vilka framträdande hinder och möjligheter framkommer när det gäller att arbeta enhetligt och i linje med de terapeutiska målen? 5. Framkommer faktorer som genom att förändra centrala organisationsstrukturer skulle utveckla verksamheten? Uppsatsen har en kvalitativ metodansats. Observationer gjordes på verksamheten vid fem tillfällen och tre intervjuer genomfördes, två med personal i behandlingsgruppen och en med enhetens föreståndare. Det framgår att verksamheten till stor del arbetar enhetligt efter de essentiella behandlingsprinciper som är vägledande för miljöterapi, men att det finns aspekter som skulle kunna förbättras. Det framkommer även såväl möjliggörande som hindrande faktorer för upprätthållande av behandlingsintegritet. I diskussionen förs resonemang kring centrala begrepp såsom ledningens betydelse för en välfungerande organisation, behandlingsintegritet, personalens kompetens och tillgänglighet samt ungdomarnas möjlighet att påverka verksamhetens innehåll.</p> / <p>Abstract</p><p>Young people with antisocial problems are a difficult group to treat where no specific method has proven effectively for solving all the problems surrounding the youth. The best chance to treat youths with behavioral problems is found in institutions where staff members agree on the theories used, so called treatment integrity. The purpose of the Study was to find out whether staff members on a treatment institution for youths have a unanimous way of practicing the milieu therapeutic treatment principles guiding the institution, within the following questions: 1. Which essential principles of treatment guides the institution? 2. In what way do the personell practice these principles in treating the youths? 3. In what area/areas appears unanimous or differences in the way staff members practice the principles? 4. Which prominent problems and possibilities appear in working homogeneous and according to the therapeutic goals? 5. Do factors appear which by chancing prominent structures of the organisation would develop the institution? The Study includes a qualitative approach. Data were collected from five observations at the institution and three semistructured interviews with staff members and the manager. The result shows that the staff members overall are unanimous concerning the practice of the treatment principles, but also indicate that some aspects could be improved. Enabling as well as preventing factors for maintaining treatment integrity emerges. Central aspects of the discussion are the management’s importance for a functioning organization, treatment integrity, competence and availability among staff members and the youth’s ability to influence the content of treatment.</p>

Sammanfattning Ungdomar med antisocial problematik är en svårbehandlad grupp där ingen specifik metod har visat sig råda bot på hela problematiken kring ungdomen. Bäst utgång att behandla ungdomar med beteendeproblem återfinns inom institutioner som har en enighet i personalgruppen kring de teorier som är gällande inom verksamheten, så kallad behandlingsintegritet. Syftet med studien var att granska om personalgruppen på en behandlingsverksamhet för ungdomar har ett gemensamt förhållningssätt utifrån de miljöterapeutiska behandlingsprinciper som vägleder verksamheten. Syftet konkretiserades utifrån följande frågeställningar: 1. Vilka behandlingsprinciper är vägledande inom verksamheten? 2. På vilket sätt kommer dessa principer till uttryck i det praktiska arbetet med ungdomarna? 3. I vilka avseenden är personalen samstämmiga respektive skiljaktiga i sitt utförande av behandlingsprinciperna? 4. Vilka framträdande hinder och möjligheter framkommer när det gäller att arbeta enhetligt och i linje med de terapeutiska målen? 5. Framkommer faktorer som genom att förändra centrala organisationsstrukturer skulle utveckla verksamheten? Uppsatsen har en kvalitativ metodansats. Observationer gjordes på verksamheten vid fem tillfällen och tre intervjuer genomfördes, två med personal i behandlingsgruppen och en med enhetens föreståndare. Det framgår att verksamheten till stor del arbetar enhetligt efter de essentiella behandlingsprinciper som är vägledande för miljöterapi, men att det finns aspekter som skulle kunna förbättras. Det framkommer även såväl möjliggörande som hindrande faktorer för upprätthållande av behandlingsintegritet. I diskussionen förs resonemang kring centrala begrepp såsom ledningens betydelse för en välfungerande organisation, behandlingsintegritet, personalens kompetens och tillgänglighet samt ungdomarnas möjlighet att påverka verksamhetens innehåll. / Abstract Young people with antisocial problems are a difficult group to treat where no specific method has proven effectively for solving all the problems surrounding the youth. The best chance to treat youths with behavioral problems is found in institutions where staff members agree on the theories used, so called treatment integrity. The purpose of the Study was to find out whether staff members on a treatment institution for youths have a unanimous way of practicing the milieu therapeutic treatment principles guiding the institution, within the following questions: 1. Which essential principles of treatment guides the institution? 2. In what way do the personell practice these principles in treating the youths? 3. In what area/areas appears unanimous or differences in the way staff members practice the principles? 4. Which prominent problems and possibilities appear in working homogeneous and according to the therapeutic goals? 5. Do factors appear which by chancing prominent structures of the organisation would develop the institution? The Study includes a qualitative approach. Data were collected from five observations at the institution and three semistructured interviews with staff members and the manager. The result shows that the staff members overall are unanimous concerning the practice of the treatment principles, but also indicate that some aspects could be improved. Enabling as well as preventing factors for maintaining treatment integrity emerges. Central aspects of the discussion are the management’s importance for a functioning organization, treatment integrity, competence and availability among staff members and the youth’s ability to influence the content of treatment.

Syftet med föreliggande studie var att med avseende på upplevelser av delaktighet och livstillfedsställelse samt arbetssituation och sjukvårdskonsumtion jämföra två grupper som deltagit respektive inte deltagit i ett Strokescreeningprogram. En strukturerad enkät skickades ut till konsekutivt, retroaktivt utvalda personer. Det inkomna resultatet analyserades med hjälp av Chi2-test, Mann Whitney test, T-test, linjär regressionsanalys och multivariat logistisk regressionsanalys. Några signifikanta skillnader mellan grupperna kunde inte påvisas även om vissa tendenser noterades. Gruppen som deltagit i Strokescreeningprogrammet upplevde en mindre delaktighet i den personliga vården än gruppen som ej deltagit i Strokescreeningprogrammet. De strokedrabbade upplevde en signifikant lägre livstillfredsställelse än en referensgrupp bestående av en normalpopulation svenskar. Det fanns en markant skillnad mellan grupperna gällande sysselsättning före strokeinsjuknandet. Vid tillfället för studien var det en högre procent ur gruppen som deltagit i Strokescreeningprogrammet som återgått till arbete. Flera av deltagarna i gruppen som inte deltagit i Strokescreeningprogrammet hade en regelbunden, återkommande kontakt med primärvården. Föreliggande studies resultat väckte en del frågor gällande nyttan med Strokescreeningprogrammet i relation till kostnaden. Eftersom metoden att göra en enkätstudie hade en del svagheter både genom ett relativt högt bortfall och fråga om huruvida frågorna varit adekvata vore en uppföljande studie med intervjuer av studiens deltagare högst intressant. Intressant vore även en undersökning om frekvens av återinsjuknande i stroke i respektive grupp för att se om Strokescreeningprogrammet haft en sekundärpreventiv effekt. / The aim of this study was that, with focus on experiences of participation and life satisfaction, work situation and consumtion of non institutional care, compare two groups that had participated versus not participated in a stroke program for Strokescreening. A questionnaire was sent retrospective to a consequetive group of people. The results were analyzed with Chi2-test, Mann Whitney-test, T-test, linear regression analyzes and multiple logistic analyze. No significant differences could be shown between the groups even though some tendences were noted. The group who participated in the Strokescreening program experienced less participation in personal care than the group who did not participate. The strokepatients that participated in this study experienced a significant lower level of life satisfaction than a reference group of a normal population of Swedes. There was a prominent difference between the groups about occupation before the stroke. In time of this study there where some higher percentes in the group who participated in the Strokescreening program that had returned to work. Several of the participants in the group that had not participated in the Strokescreening program had a regulary contact with the non institutional care. The results of the present study arouse some questions about the benefit with the Strokescreening program related to the expences. The method of a questionnairy study had some weekness, both in a relatively high level of reduction of participants and a question about the relevace of the questions asked. Therefore, it would be of great interest to make an interview study of this population. It would also be of great interest to examin if there are any differences in the frequency of how many of the participants who gets another stroke in respective group. The purpose of that would be to see if the Strokescreening program has any secondary preventive effect.

När unga behandlas inom ramen för institutionell tvångsvård finns det några aspekter som är avgörande för behandlingsresultatet; att personalen arbetar samstämmigt och i enlighet med relevanta metoder samt att de upprättar en främjande relation till den unge. Det krävs en kombination av dessa aspekter för att på bästa sätt ge den unge förutsättningar att främja sin utveckling. Föreliggande studie syftar därmed till att undersöka hur personal på tre särskilda ungdomshem, drivna av Statens Institutionsstyrelse, ser på metodtillämpning, relationella aspekter och samstämmighet. Studien bygger på en kvantitativ del som innefattar en enkätundersökning där behandlingspersonalen besvarar hur de ser på dessa aspekter, samt en kvalitativ del där institutionschefer, avdelningsföreståndare och annan personal delger sin syn på hur metodanvändning, samstämmighet och relationella aspekter förhindrar eller möjliggör adekvat behandling. Av materialet framkommer att metodanvändningen uppfattas, av personalen, vara ett hinder för de olika verksamheterna. Detta är även något som påvisas av resultatet i enkätundersökningen där majoriteten av behandlingsassistenterna uppger att de arbetar med metoder som inte ska förekomma vid institutionerna. Relationen ses som viktig men det finns vissa svårigheter i upprättandet av den. Behandlingspersonalen anser sig vara samstämmiga i arbetet men av det kvalitativa materialet framkommer att även denna aspekt innebär vissa svårigheter. Genom att upprätta tydliga riktlinjer kring hur arbetet ska bedrivas vid de olika avdelningarna kan metodtillämpningen och samstämmigheten möjliggöra god vård.

No description available.