ABSTRACT
Abstract Introduction Despite the results of epidemiological and psychometric studies reporting comparable levels of tobacco dependence among males and females, some clinical studies have detected disparities. Some smoking cessation studies based on clinical setting programs reported poorer outcomes among women than men. Methods This retrospective cohort study aimed to compare treatment success and retention between men and women on a smoking cessation program (n = 1,014) delivered at a CAPS-AD unit in Brazil. The psychological intervention lasted 6 weeks for each group of 15 patients. Each patient had to participate in weekly group cognitive-behavioral therapy (CBT) sessions and individual medical appointments during this period. These appointments were focused on the possibility of prescribing pharmacological treatment (i.e., nicotine replacement therapy, bupropion, or nortriptyline) as adjuvants to group therapy. Results The women had lower smoking severity at baseline, more clinical symptoms, and lower prevalence of alcohol and drug use disorders and were older than the men. Females had significantly higher levels of success (36.6% vs. 29.7%) and retention (51.6% vs. 41.4%) than males. Sensitivity analysis showed that female gender was significantly associated with both retention and success, among those without drug use disorders only. Conclusion Depending on the smoking cessation setting (i.e., low and middle-income countries and mental health and addiction care units), females can achieve similar and even higher quit rates than males. Previous drug use disorder was an important confounding variable in the gender outcomes analyses. Future studies should try to replicate these positive smoking cessation effects of CBT-based group therapy plus pharmacotherapy in women.
ABSTRACT
A Entrevista Motivacional (EM) é uma abordagem pautada na empatia, na escuta reflexiva e na resolução da ambivalência para auxiliar no processo de mudança. Desde sua criação, foram realizadas revisões teóricas importantes com o objetivo de aprimorar o método e melhor adequá-lo às diferentes demandas, porém a literatura no Brasil ainda encontra-se desatualizada. Método: Foi realizada uma revisão não-sistemática da literatura sobre a EM buscando sintetizar e apresentar as principais mudanças teóricas realizadas. Resultados e Discussão: Os princípios centrais e as fases da mudança foram algumas das reformulações propostas, que agora melhor refletem a complexidade do processo e oferecem diretrizes mais estruturadas para direcionar o trabalho do terapeuta, esclarecendo também alguns dos conceitos originais. Conclusões: Considerando o aumento da utilidade da EM nos diversos contextos e as mudanças realizadas ao longo dessas últimas décadas, acredita-se que esta atualização favorecerá o ensino, pesquisa e a prática da EM no país.
Motivational Interviewing (MI) is an approach that relies on empathy, reflexive listening and ambivalence resolution to assist people in the process of changing. Since its creation, important theoretical revisions have been made with the aim of improving the method according to different demands, but literature in Brazil is found to be out of date. Method: A non-systematic review of literature on MI was carried out, seeking to synthesize and present the main theoretical changes made. Results and Discussion: The main principals and phases of change were among some of the changes proposed, which now reflect the complexity of the process and provide more structured guidelines for the therapist, also clarifying some of the original concepts. Conclusions: Considering the increase of the MI utility in various contexts and changes made over the last decades, it is believed that this update will favor the teaching, research and practice of MI in the country.
ABSTRACT
Objetivos: promover a redução de estresse em estudantes de medicina por meio do treinamento em habilidades sociais e identificar a relação entre o estresse e o repertório interpessoal. Métodos: foram utilizados os Inventários de Estresse para Adultos de Lipp e o de Habilidades Sociais de Del Prette e Del Prette, para as avaliações antes e depois da intervenção, em doze universitários de uma instituição privada, num programa de sete sessões de vivências construídos com base nas habilidades consideradas deficitárias. Resultados: após a intervenção detectou-se a redução de níveis de estresse em 58% dos participantes. Entre os casos de diminuição de estresse, constatou-se melhoria nas habilidades sociais gerais (57%) relativas à expressão de sentimento positivo (87%) e autocontrole da agressividade (57%). Conclusão: observaram-se efeitos do treinamento na diminuição do estresse, mas como a análise da correlação entre habilidades sociais e estresse não apresentou significância estatística novos estudos devem ser conduzidos.
Aims: To promote stress reduction in medical students through social skills training and to identify the relationship between stress and interpersonal repertoire. Methods: Twelve students from a private educational institution were evaluated using the Lipp Stress Symptoms for Adults and the Del Prette and Del Prette Social Skills inventories before and after the intervention, which consisted in seven sessions of role-play experiences built on the skills deemed as deficient. Results: After the intervention, it was detected a reduction of stress levels in 58% of the participants. Among these, an improvement was found in general social skills (57%), in expression of positive affection (87%) and self-control of aggressiveness (57%). Conclusion: It was observed an effect of the social skills training in reducing stress among students, but as the correlation between these variables was not statistically significant, new studies should be conducted.