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Previous issue date: 2017-07-25 / Obesity is considered a worldwide epidemic, while grade III obesity is one of the most deadly diseases in the world. Research shows that the number of obese people in Brazil is 20.8% and reaches 36.9% worldwide. Today there are several treatments for the disease, and bariatric surgery the most effective method to control obesity and its comorbidities. However, weight regain accounts for about 7% to 50% of patients undergoing surgery. According to the systemic perspective, there are mutual influences between the individual and his primary system of development, which is the family. This system can be a context of health and also illness of its members. Thus, it is understood that the family can have influence in the emergence, as well as in the prevention and treatment of several diseases. Consistent with the need for a better understanding of this phenomenon and the search for more effective solutions, the present study had as its main objective: to understand how the family dynamics of adults submitted to bariatric surgery may or may not influence the weight regain after surgery. The specific objectives were: to identify aspects of the family structure, such as rules of relationship, types of borders and communication among its members; Know the family history, regarding the onset and development of obesity, treatments and context of the decision to do surgery and post-surgical period; To describe the family food pattern in the period before and after bariatric surgery, identifying the quality and amount of food and familiar situations involving food. Identify possible influences of other social systems (church, work school, health services) in the regain or not of weight by the women after the bariatric surgery. The qualitative methodology was privileged through the case study. Two families residing in Administrative Regions of the Federal District participated in the study, with adult women who underwent bariatric surgery; One of the patients presented a regain of weight above 10% in relation to the minimum weight reached after bariatric surgery while the other did not. Two meetings were held with each family, using a semi-structured interview script and the construction of the family genogram. The information collected was analyzed according to the interpretive constructive method, and discussed based on the family systemic approach. The results showed that in the patients family who presented a significant weight regain family boundaries and rules are diffuse and there are difficulties in the differentiation in relation to the extended family, and there is ambiguity in understanding the rules; In the patients family who did not have a weight regain there are clear rules of relationship and definition of the roles of their members; In both cases we observed the multifactorial aspect of obesity, since in addition to the genetic factors some characteristics of the family dynamics may have contributed in both cases; Adherence to treatment and family and social support contributed to the current picture of the cases studied. The data presented reinforce the importance of including the family and the social support network in the prevention, treatment and follow-up of obese patients before and after bariatric surgery. / A obesidade ?? considerada uma epidemia mundial, enquanto a obesidade grau III ?? uma das doen??as que mais matam no mundo. Pesquisas mostram que o n??mero de pessoas obesas no Brasil ?? de 20,8% e chega a 36,9% em todo o mundo. Hoje j?? existem v??rios tratamentos para a doen??a, sendo a cirurgia bari??trica o m??todo mais eficazes no controle da obesidade e de suas comorbidades. No entanto, o reganho de peso atinge cerca de 7 a 50% dos pacientes submetidos ?? cirurgia. De acordo com a perspectiva sist??mica, h?? influ??ncias m??tuas entre o indiv??duo e seu sistema prim??rio de desenvolvimento, que ?? a fam??lia. Este sistema pode ser um contexto de sa??de e tamb??m de adoecimento dos seus membros. Assim, entende-se que a fam??lia pode ter influ??ncia no surgimento, bem como na preven????o e tratamento de v??rias doen??as. Consoante com a necessidade de uma melhor compreens??o sobre esse fen??meno e a busca de solu????es mais eficazes, o presente estudo teve como objetivo principal: compreender como a din??mica familiar de adultos submetidos ?? cirurgia bari??trica pode influenciar ou n??o no reganho de peso p??s cirurgia. Os objetivos espec??ficos foram: identificar aspectos da estrutura familiar, como as regras de relacionamento, tipos de fronteiras e comunica????o entre seus membros; conhecer a hist??ria familiar, no que diz respeito ao in??cio e desenvolvimento da obesidade, tratamentos e contexto da decis??o de fazer a cirurgia e per??odo p??s-cir??rgico; descrever o padr??o alimentar da fam??lia no per??odo anterior e posterior ?? cirurgia bari??trica, identificando a qualidade e quantidade de alimentos e situa????es familiares envolvendo a alimenta????o; Identificar poss??veis influ??ncias de outros sistemas sociais (igreja, escola trabalho, servi??os de sa??de) no reganho ou n??o de peso pelas mulheres ap??s a cirurgia bari??trica. Privilegiou-se a metodologia qualitativa por meio do estudo de caso. Participaram da pesquisa duas fam??lias residentes em Regi??es Administrativas do Distrito Federal, com mulheres adultas que foram submetidas ?? cirurgia bari??trica; uma das pacientes apresentou reganho de peso acima de 10% em rela????o ao peso m??nimo alcan??ado ap??s a cirurgia bari??trica enquanto a outra n??o. Foram realizados dois encontros com cada fam??lia, utilizando um roteiro de entrevista semiestruturado e a constru????o do genograma familiar. As informa????es levantadas foram analisadas de acordo com o m??todo construtivo interpretativo, e discutidas com base na abordagem sist??mica da fam??lia. Os resultados mostraram que na fam??lia da paciente que apresentou significativo reganho de peso as fronteiras e regras familiares s??o difusas e h?? dificuldades na diferencia????o em rela????o ?? fam??lia extensa, e existe ambiguidade na compreens??o das regras; na fam??lia da paciente que n??o teve reganho de peso existem regras claras de relacionamento e defini????o dos pap??is de seus membros; em ambos os casos observamos o aspecto da multifatorialidade da obesidade, pois al??m dos fatores gen??ticos algumas caracter??sticas da din??mica familiar podem ter contribu??do nos dois casos; a ades??o ao tratamento e o apoio familiar e social contribu??ram para que o quadro atual dos casos estudados. Os dados apresentados refor??am a import??ncia da inclus??o da fam??lia e da rede de apoio social na preven????o, tratamento e acompanhamento de pacientes obesos antes e ap??s a cirurgia bari??trica.
| Identifer | oai:union.ndltd.org:IBICT/oai:bdtd.ucb.br:tede/2346 |
| Date | 25 July 2017 |
| Creators | Menezes, C??cero Nunes |
| Contributors | Ribeiro, Maria Alexina |
| Publisher | Universidade Cat??lica de Bras??lia, Programa Strictu Sensu em Psicologia, UCB, Brasil, Escola de Sa??de e Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da UCB, instname:Universidade Católica de Brasília, instacron:UCB |
| Rights | info:eu-repo/semantics/openAccess |
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