Made available in DSpace on 2016-04-04T18:27:34Z (GMT). No. of bitstreams: 1 Ana Paula FPregnolatto.pdf: 230365 bytes, checksum: f0f9540c03031709a2d9741c1eaeeda4 (MD5) Previous issue date: 2005-02-11 / The chronic renal failure is a disease that evolves slowly, gradually and irreversibly causing physical and emotional damage. Studies on the emotional aspects of patients undergoing hemodialysis procedures emphasize that they are a special group among chronic disease patients, because the procedure itself and the individual s dependence on the equipment involved assume great importance on the individual s life. These stressful aspects can, therefore, cause special effects on the emotions and behavior of these patients, overloading the depressive symptoms caused by uremia itself. Among the pathologies and conditions related to emotions, alexithymia stands out. The term been applied to an individual s difficulty to express emotions and affection. Alexithymia and its psychopathological symptoms are considered to have influence on diagnosis, prognosis, and the way a patient can cope with the different forms of treating renal failure. That being so, the evaluation and identification of these aspects can provide a better understanding of them in order to identify and offer to these patients more adequate psychological treatment and a program of prevention and mental health involving patients and the health team. For this study the sample include 48 patients who have been receiving hemodialysis at the hospital of the University School of Medicine in the state of S?o Paulo, Brazil. The sample was stratified according to the type of renal disease presented. The tools used were Identification Form, The Toronto Alexithyimia Scale (TAS) and the Symptoms Evaluation Scale (EAS-40). The sample was distributed like the following: men (60,4%); age between 40 and 59 years of age (58,3%); basic education (50%); retired or on sick leave (47,9%). High blood pressure (41,6%); diabetes mellitus (31,3%); chronic glomerule nephritis (27,1%). Regarding alexithymia 52% of the patients presented scores equal or superior to 74, and 4,2% presented scores equal or inferior to 62. 43,8% of the subjects are on the range between 63 and 73 points. The average score of the sample was 74 and DP 7,52. The results show that patients undergoing hemodialysis present high scores on TAS, regardless of sex, level of education, marital status, occupation, age or diagnosis, and the differences between these variables were not significant. Concerning the psychopathological symptoms, the average score was 0,63 and DP 0,37 , and there were no significant differences between the social and demographic variables. Regarding the association between alexithymia and psychopathological symptoms the results show significant relation between the total scores of TAS and EAS-40; and also between the total score of TAS and Factors 1, 2 and 3 of EAS-40, which fulfill the theoretical expectations. Although further research is needs to identify how these aspects believe in other groups, our finding confirm that alexithymia is related to psychopathological symptoms. / A insufici?ncia renal cr?nica (IRC) ? a uma doen?a de instala??o lenta, gradativa e irrevers?vel das fun??es renais, levando o indiv?duo a ter altera??es f?sicas e emocionais. Estudos sobre os aspectos emocionais de pacientes em hemodi?lise enfatizam que estes comp?em um grupo especial entre os portadores de doen?a cr?nica, pois o tratamento, e a depend?ncia dos equipamentos utilizados assume grande import?ncia na vida da pessoa. Assim, estes aspectos podem acentuar caracter?sticas especiais na sua afetividade e no seu comportamento, salientando que a pr?pria uremia pode produzir sintomas depressivos. Dentre as altera??es e patologias relacionadas ?s emo??es destaca-se a alexitimia, que designa a dificuldade de expressar afetos ou emo??es. Considera-se que a alexitimia e os sintomas psicopatol?gicos podem influenciar no diagn?stico, no progn?stico e na forma de rea??o do sujeito ? modalidade de tratar a insufici?ncia renal. Desta maneira a avalia??o e identifica??o destes aspectos possibilitam uma melhor compreens?o destes visando um tratamento psicol?gico mais adequado a esta popula??o e um trabalho de preven??o e promo??o da sa?de mental com estes pacientes e tamb?m com a equipe. Para este estudo a amostra ? composta de 48 pacientes em hemodi?lise de um hospital escola no interior de S?o Paulo. Esta foi estratificada em fun??o da doen?a renal apresentada. Os materiais utilizados foram ficha de Identifica??o, a Escala de Alexitimia de Toronto (TAS) e a Escala de Avalia??o de Sintomas (EAS-40). Amostra ficou distribu?da com um predom?nio de: pacientes do sexo masculino (60,4%), casados (50%), na faixa et?ria entre 40 e 59 anos de idade (58,3%), com ensino b?sico (50%), aposentados ou afastados do trabalho (47,9%). Quanto ao diagn?stico, 41,6% t?m hipertens?o arterial sang??nea, 31,3% diabetes mellitus e 27,1%, glomerunefrite cr?nica. Quanto ? alexitimia, observou-se que 52% dos participantes apresentaram pontua??o igual ou maior que 74 e que 4,2% obtiveram escore igual ou inferior a 62. E, 43,8% dos sujeitos encontram-se na faixa de 63 a 73 pontos. J? a m?dia geral da amostra foi 74 e DP 7,52. Verificou-se que pacientes submetidos a hemodi?lise apresentam altos escores na TAS, independentemente do sexo, n?vel de escolaridade, estado civil, atividade profissional, idade e hip?tese diagn?stica e que n?o houve diferen?as significantes entre estas vari?veis.Em rela??o aos sintomas psicopatol?gicos a pontua??o m?dia foi de 0,63 e DP 0,37 e tamb?m n?o houve diferen?as significantes nas categorias segundo as vari?veis s?cio-demogr?ficas. Em rela??o ? associa??o entre alexitimia e sintomas psicopatol?gicos averiguou-se correla??o significantes entre os escores totais da TAS e EAS_40 e entre o escore total da TAS e os fatores 1, 2 e 3 da EAS-40, que correspondem a expectativa te?rica. Logo, os resultados deste trabalho confirmam que para esta popula??o a alexitimia se associa com os sintomas psicopatol?gico e a necessidade de futuras pesquisas para conhecermos como estes aspectos se comportam em outras popula??es.

Made available in DSpace on 2016-04-04T18:27:54Z (GMT). No. of bitstreams: 1 Maria Claudia Roberta Tombolato.pdf: 377189 bytes, checksum: 92c0bdaaa746d0e98588e70e405599c4 (MD5) Previous issue date: 2005-02-14 / Brazil has registered more than three millions of undergraduate students, prevailing private schools. A growing demand for this population has been to conciliate studies and work regularly. This search is focused on evaluation of quality of life, psychopathologic symptoms and social-demographic factors of a group of college students that also work. For this, 122 undergraduate student workers and 18 non-workers, of a night Business Administration faculty of a private university, from S. Paulo State, answered three questionnaires: social-demographic questionnary, WHOQOL-bref (Fleck & et al.,2000), and EAS-40 / Symptoms Evaluation Scale (Laloni, 2001). Results showed, in general, differently than expected, that work was not a variable that would distinguish undergraduate worker from non-worker concerning to quality of life level and severity of psychopathologic symptoms, in general. Exceptions were: for women and age between 18 and 22 categories, on physical and ambient domain, and obsessive/compulsive psychopathologic symptom, that showed significant differences. Quality of life and psychopathologic symptoms were negatively correlated among the workers as far as for the non-workers, except on domain 4, in which the correlation coefficient did not reach significant levels although it was negative (r=0,36, p>0,05). So, women and youngers showed to be more susceptible to work, but, in general, work did not show to be a problem for quality of life and psychopathologic symptoms manifestation among undergraduate students. This suggests further studies with these groups to clear up about it. / O Brasil registra mais de tr?s milh?es de estudantes no ensino superior, com presen?a dominante de escolas privadas. Conciliar cotidianamente estudo e trabalho tem sido uma demanda crescente nesta popula??o. Este estudo realizou uma avalia??o de grupos de universit?rios-trabalhadores com respeito ? qualidade de vida, sintomas psicopatol?gicos e alguns fatores s?cio-demogr?ficos. Para isso, 122 estudantes universit?rios trabalhadores e 18 n?o trabalhadores da faculdade noturna de Administra??o de Empresas de uma institui??o privada de ensino superior, no interior do Estado de S?o Paulo, responderam a tr?s instrumentos: Question?rio socio-demogr?fico, WHOQOL-bref (Fleck et al.,2000), e EAS-40/Escala de Avalia??o de Sintomas (Laloni, 2001). Os resultados indicaram que o trabalho, ao contr?rio do que era esperado, n?o se mostrou vari?vel que discrimina universit?rio trabalhador de n?o trabalhador, quanto ? qualidade de vida nem a sintomas psicopatol?gicos, no geral. Apenas nas categorias mulheres e idade entre 18 e 22 anos, os dom?nios f?sico, meio ambiente e sintomas obsessivos/compulsivos apresentaram diferen?as que foram significantes. Uma avalia??o do grau de associa??o da qualidade de vida com sintomas psicopatol?gicos mostrou correla??es negativas significantes tanto para os trabalhadores como para os n?o trabalhadores, exceto pelo dom?nio 4 Ambiente no qual o coeficiente de correla??o n?o chegou a ser significante embora negativo (r=0,36, p>0,05). Enfim, as mulheres e os mais jovens apontaram ser mais suscet?veis ao trabalho que, por?m, n?o se mostrou ser um problema para a qualidade de vida e manifesta??o de sintomas psicopatol?gicos do universit?rio de uma maneira geral, sugerindo que se realizem futuras pesquisas com estes grupos que possam trazer maior esclarecimento a respeito.

Made available in DSpace on 2016-04-04T18:29:32Z (GMT). No. of bitstreams: 1 Jena Hanay Doutorado.pdf: 721081 bytes, checksum: 65f8d839cf686774d38170e56199f048 (MD5) Previous issue date: 2006-12-18 / Evaluates depression, anxiety, psychopathologic symptoms, alexithymia and defensive style of grade III obese patients, before and after bariatric surgery, as well as estimates the level of association among such variables. Methodological study design was correlational crosssectional type. 65 patients took part in the study (Group 1: surgical candidates vs. Group 2: postoperative patients), mainly females (92,3%), who answered the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Symptoms Assessment Scale (EAS- 40), and the version in Portuguese of The Toronto Alexithymia Scale (TAS-26) and of the Defensive Style Questionnaire (DSQ-40). Gr 1 showed mild anxiety and depression levels and Gr 2 minimum level (respectively, p< 0,001 e p< 0,01). The total average score for EAS- 40 and F2 and F3 (obesity-compulsion and somatization) were higher in Gr 1 when compared to Gr 2 (repetitively, p< 0,005, p< 0,005 e p< 0,001). On TAS, the total average score for F1 (ability to identify and describe feelings and distinguish them from bodily sensations) were higher in Gr 1 than in Gr 2 (respectively, p< 0,01 e p< 0,005). According to DSQ-40, there was a tendency for an immature defensive style in Gr 1 in comparison to Gr 2 (p< 0,02). In relation to the association between the variables and BMI, the correlations were negative for Gr 1 and F2 of TAS (daydreaming, p < 0,05) and for the mature factor of DSQ- 40 and Gr 2 (p < 0,05), which shows a trend towards a more mature and adaptive style in Gr 2. Correlations were positive and significant in relation to immature defenses - acting out (Gr 1: p<0,005 and Gr 2: p<0,05) and in the autistic fantasy in Gr 1 (p<0,05). The results show the psychological status of the participants, who are apt for bariatric surgery and point to a decrease in psychopathological symptoms proportional to weight loss after surgery. / Avalia depress?o, ansiedade, sintomas psicopatol?gicos, alexitimia e o estilo defensivo de pacientes obesos grau III, antes e depois de cirurgia bari?trica, e estima o grau de associa??o entre essas vari?veis. O delineamento metodol?gico foi correlacional de tipo cross-sectional. Participaram do estudo 65 pacientes (Gr 1: pr?-cir?rgico vs. Gr 2: p?scir?rgico), predominantemente do sexo feminino (92,3%), que responderam o Invent?rio de Depress?o de Beck (BDI), o Invent?rio de Ansiedade de Beck (BAI), a Escala de Avalia??o de Sintomas (EAS-40), a Vers?o em Portugu?s da Escala de Alexitimia de Toronto (TAS-26) e a Vers?o em Portugu?s da Defensive Style Questionnaire (DSQ-40). O Gr 1 apresentou n?vel de depress?o e ansiedade leve e o Gr 2 n?vel m?nimo (respectivamente, p< 0,001 e p< 0,01). O escore m?dio total da EAS-40 e de F2 e F3 (obsessividade-compulsividade e somatiza??o) foram mais elevados no Gr 1 quando comparados aos do Gr 2 (respectivamente, p< 0,005, p< 0,005 e p< 0,001). Na TAS, o escore m?dio total e de F1 (habilidade de identificar e descrever sentimentos e distingui-los de sensa??es corporais) foram maiores no Gr 1 do que no Gr 2 (respectivamente, p< 0,01 e p< 0,005). De acordo com o DSQ-40, houve tend?ncia a um estilo defensivo imaturo no Gr 1 quando comparado ao Gr 2 (p< 0,02). Em rela??o ? associa??o das vari?veis com o IMC, as correla??es foram negativas no Gr 1 e o F2 da TAS (sonhar acordado, p < 0,05) e no fator maduro do DSQ-40 e o Gr 2 (p < 0,05), apontando uma propens?o de estilo mais maduro e adaptativo no Gr 2. As correla??es foram positivas e significantes nas defesas imaturas acting out (Gr 1: p<0,005 e Gr 2: p<0,05) e na fantasia aut?stica no Gr 1 (p<0,05). Os resultados mostram o modo de funcionamento psicol?gico dos participantes aptos ? cirurgia bari?trica e assinalam uma diminui??o da sintomatologia psicopatol?gica na propor??o da perda de peso ap?s a cirurgia.