ABSTRACT
Abstract Objectives: To evaluate the impact of temporomandibular disorders on the quality of life of patients with dizziness. Methods: An observational, case-control study evaluated 60 individuals with dizziness (20 cases and 40 controls), who were matched for gender and age. The individuals underwent to anamnesis, overall physical and otoneurological examination, tonal and vocal audiometry and impedanciometry, video head impulse test and the dizziness handicap inventory questionnaire. Results: The otoscopy was normal for all patients. There was an association between the presence of temporomandibular disorders and aural fullness (p<0.01) and otalgia (p<0.01). Audiometry was normal in 90% of the patients in the case group, with a significant association between temporomandibular disorders and normal audiometry (p<0.01). The video head impulse test findings were normal in 66% of the patients in the case group and 45% of the control group, and there was no association between having temporomandibular disorders and vestibular alterations at the video head impulse test (p = 0.12). There were significant differences in total dizziness handicap inventory and in the functional and emotional domains (p<0.01), with higher scores in the control group. Conclusion: Aural fullness and otalgia symptoms are associated with temporomandibular disorders in patients with dizziness, and there is an association between normal complementary audiological tests and temporomandibular disorders. Vestibular alterations are not associated with temporomandibular disorders. However, patients with dizziness and without temporomandibular disorders showed greater quality of life impairment. Level of evidence: 3. Original case-control study.
ABSTRACT
RESUMO O brincar é uma ferramenta de extrema importância para todas as crianças e, no hospital, representa uma fuga do ambiente desgastante e dos sintomas da doença. Nesse contexto, o Mediarte: com Amor e Humor é um projeto de extensão que visa à prática da ludoterapia, musicoterapia e palhaçoterapia, no setor de Pediatria do hospital universitário e que, além de transformar a vida das crianças, acredita-se ter potencial para influenciar os voluntários - estudantes de Medicina do curso da Universidade Federal do Rio Grande do Norte. Objetiva-se neste estudo identificar a influência do projeto na vida e formação médica dos estudantes de Medicina, utilizando como referencial teórico as Diretrizes Nacionais do Curso de Graduação em Medicina (DCN). Desse modo, realizou-se uma pesquisa qualitativa mediante entrevistas semiestruturadas e análise de conteúdo proposta por Bardin. Exploraram-se três categorias temáticas: "Por que estou aqui?", "O que aprendi?" e "Que barreiras encontrei?". Destacam-se como resultados: a vontade dos voluntários de se inserir precocemente no ambiente do cuidado e de interagir com crianças, como aspectos atraentes para o projeto; o desenvolvimento das competências de comunicação, humanização e relação médico-paciente durante a participação no Mediarte. Como barreira encontrada, tem-se, por exemplo, a necessidade de adaptação para brincar com crianças doentes, que, embora tenham certas limitações, não perdem o brilho nos olhos a cada brincadeira. O estudo concluiu que o projeto, na vida dos estudantes voluntários, exercita as competências desejadas pelas novas DCN. Tais resultados servem de estímulo à prática do Mediarte como mais uma estratégia educacional interessante, capaz de atender às demandas atuais da formação médica ampliada e complexa, bem como um estímulo à implantação de projetos semelhantes em outras escolas médicas pelo Brasil.
ABSTRACT Play is an extremely important tool for all children and, at the hospital, it represents an escape for young patients from a taxing environment and from the symptoms of their diseases. In this context, "Mediarte: with Love and Humor" is an outreach project which aims to practice play therapy, music therapy and clown therapy in the pediatric ward of a university hospital. In addition to transforming the children's lives (routine), it also has the potential to positively influence the project's volunteers - medical students at the Federal University of Rio Grande do Norte. The purpose of this study is to identify the impact of this project on the medical training and personal development of the volunteers, based on the Brazilian National Guidelines of Medical Training (DCN). Thus, a qualitative study was conducted in the form of semi-structured interviews and the content was analyzed in line with Bardin's proposals. Three themes were analyzed: "Why am I here?" "What have I learned?" and "What barriers have I found?" The results showed that the volunteers are keen to have an early opportunity to be placed in the health care environment and interact with kids, as important aspects that attracted them to the project, as well as the chance to develop abilities such as communication, humanized care and doctor-patient relationship skills. As a challenge, for example, the students described the need to adapt their behavior while playing with ill children, who, despite their own limitations, never lose the sparkle in their eyes during the proposed activities. The study concluded that the project helped the volunteers develop some of the key competencies and skills required by the new DCN. These results can be used to encourage the practice of "Mediarte" as an additional educational strategy to meet the current demands of complex, extended medical training. It also serves as a successful example that may stimulate the implementation of similar projects at other medical schools throughout Brazil.