Desenvolvimento de uma tecnologia digital de apoio à terapia cognitivo-comportamental / Development of a digital technology to support cognitive behavioral therapy / Desarrollo de una tecnología digital de apoyo a la terapia cognitivo-conductual

INTRODUÇÃO: Na atualidade, abordagens que se utilizam de aplicativos tecnológicos para solução de problemas psicológicos têm sido cada vez mais comuns, de modo que múltiplos estudos têm evidenciado eficácia bem estabelecida nessa modalidade de intervenção. OBJETIVO: O objetivo do presente trabalho é o de apresentar o projeto-piloto do desenvolvimento de uma ferramenta, com componentes mobile e web, de apoio ao tratamento psicológico via Terapia Cognitivo-Comportamental. De forma específica, será discorrido sobre a metodologia de desenvolvimento da pesquisa e projeto de software, apresentação da solução tecnológica desenvolvida, avaliação da solução e as considerações finais. METODOLOGIA: A metodologia adotada foi o Design Science Research (DSR), que propõe a resolução de problemas por meio de criação de artefatos. RESULTADOS: Como resultado obteve-se uma solução tecnológica centralizada e eficaz, por meio de um Software as a Service (SAAS), composto por um sistema web que permite ao psicoterapeuta gerenciar o tratamento psicológico pela Terapia Cognitivo-comportamental e um aplicativo móvel que possibilita ao paciente o registro preciso de funcionamento cognitivo-comportamental diário, frequência de sintomas, atividades gamificadas, e técnicas de manejo. CONCLUSÃO: A integração entre áreas da psicologia e da tecnologia tem sido cada vez mais comum, contudo é primordial a condução de estudos que descrevam desde sua concepção até a sua aplicação, com vistas a uma validação baseada em evidências científicas.

INTRODUCTION: Currently, psychological perspectives that use technological applications to solve mental health disorders have been increasingly common, in addition multiple studies have shown well-established effectiveness in this type of intervention. OBJECTIVE: The objective of the present work is to present the pilot project of the development of a tool, with mobile and web components, to support psychological treatment via Cognitive-Behavioral Therapy. Specifically, the research development methodology and software design, presentation of the developed technological solution, evaluation of the solution and final considerations will be discussed. METHODOLOGY: The methodology adopted was Design Science Research (DSR), which proposes the resolution of problems through the creation of artifacts. RESULTS: As a result, a centralized and effective technological solution was obtained, through a Software as a Service (SAAS), composed of a web system that allows the psychotherapist to manage psychological treatment through Cognitive-Behavioral Therapy and a mobile application that provide the patient with an accurate record of daily cognitive-behavioral functioning, symptom frequency, gamified activities, and management techniques. CONCLUSION: The integration between areas of psychology and technology has been increasin, however, it is essential to conduct studies that describe from its conception to its application, with the aim to a validation based on scientific evidence.

INTRODUCCIÓN: Actualmente, los enfoques que utilizan aplicaciones tecnológicas para solucionar transtornos mentales son cada vez más comunes, por lo que múltiples estudios han demostrado una efectividad bien establecida en este tipo de intervenciones. OBJETIVO: El objetivo del presente estudio es presentar el proyecto piloto del desarrollo de una herramienta, con componentes móviles y web, para apoyar el tratamiento psicológico a través del uso de Terapia Cognitivo-Conductual. Específicamente, se discutirá la metodología de desarrollo de la investigación y el diseño del software, presentación de la solución tecnológica desarrollada, evaluación de la solución y consideraciones finales. METODOLOGÍA: La metodología adoptada fue Design Science Research (DSR), que propone la resolución de problemas a través de la creación de artefactos. RESULTADOS: Como resultado se obtuvo una solución tecnológica centralizada y eficaz, a través de un Software como Servicio (SaaS), compuesta por un sistema web que permite al psicoterapeuta gestionar el tratamiento psicológico a través de la Terapia Cognitivo-Conductual y una aplicación móvil que permite al paciente un registro preciso del funcionamiento cognitivo-conductual diario, la frecuencia de los síntomas, las actividades gamificadas y las técnicas de manejo. CONCLUSIÓN: La integración entre áreas de la psicología y la tecnología han sido cada vez más comunes, sin embargo es fundamental realizar estudios que describan desde su concepción hasta su aplicación, buscando una validación basada en evidencia científica.

Utilização da técnica do átomo social no processo de psicodiagnóstico / Use of the social atom technique in the psychodiagnostic process / Uso de la técnica del átomo social en el proceso psicodiagnostico

RESUMO A sociometria tem como propósito a investigação/mensuração das relações interpessoais. Uma das técnicas sociométricas para uso na prática individual é o átomo social, que é caracterizado como o conjunto das relações emocionalmente significativas que o indivíduo estabelece e desenvolve. O objetivo do presente artigo é investigar o uso do átomo social para o procedimento de psicodiagnóstico. Fez-se uso de uma abordagem qualitativa, utilizando como método o estudo de caso. A análise do caso clínico serviu para entender como o átomo pode auxiliar na construção de uma avaliação psicológica mais integral, possibilitando a investigação da dinâmica psíquica do indivíduo e da sua demanda de forma mais lúdica e participativa. Também foi interessante constatar que as informações trazidas pelo átomo confirmaram os achados das outras técnicas empregadas.

ABSTRACT Sociometry aims to investigate/measure interpersonal relationships. One of the sociometric techniques for use in individual practice is the social atom, which is characterized as the set of emotionally significant relationships that the subject establishes. The objective of the article was to investigate the use of the social atom for the psychodiagnosis procedure. A qualitative approach was used, using the experience report as a method. The analysis of the clinical case served to understand how the atom can help in the construction of a more comprehensive psychological assessment, enabling the ludic and participatory investigation of the psychic dynamics of the subject and his demand. It was interesting to note that the information brought by the atom collaborated with the findings of the other techniques employed.

RESUMEN La sociometría tiene como objetivo investigar/medir las relaciones interpersonales. Una de las técnicas sociométricas a utilizar en la práctica individual es el átomo social, que se caracteriza como el conjunto de relaciones emocionalmente significativas que establece el sujeto. El objetivo del artículo fue investigar el uso del átomo social para el procedimiento de psicodiagnóstico. Se utilizó un enfoque cualitativo, utilizando como método el relato de experiencia. El análisis del caso clínico sirvió para comprender cómo el átomo puede ayudar en la construcción de una evaluación psicológica más integral, posibilitando la investigación lúdica y participativa de la dinámica psíquica del sujeto y su demanda. Fue interesante notar que la información aportada por el átomo colaboró con los hallazgos de las otras técnicas empleadas.

Plantão psicológico no referencial do psicodrama: encontro com subjetividades desviantes / Psychological emergency attendance in the psychodrama framework: encounter with deviant subjectivities / La guardia psicológica en el marco del psicodrama: encuentro con subjetividades desviadas

RESUMO O presente trabalho relata uma investigação a partir de encontros clínicos com usuários de uma instituição de apoio que apresentam discursos delirantes. O plantão psicológico fundamentado na teoria do Psicodrama foi o referencial adotado. As interações entre plantonistas e usuários foram registradas em diários de campo, buscando-se analisar as experiências e os sofrimentos narrados, além dos impactos no terapeuta. Foi utilizada a metodologia da Teoria Fundamentada nos Dados, de caráter qualitativo. As produções delirantes foram percebidas como modos de existência que deveriam ser acolhidos. Os sofrimentos diante de experiências desestabilizadoras demonstraram conexões entre vivências de fortes intensidades e as subjetividades fragmentadas. Os plantonistas se sentiram convocados a sustentar as tensões presentes no encontro com formas subjetivas desorganizadas e acolher as produções delirantes.

ABSTRACT This work reports an investigation based on clinical encounters with users of a support institution who present delusional discourses. The Psychological counseling based on Psychodrama theory was the reference adopted. The interactions between therapists and patients were registered in research diaries, seeking to analyze the experiences and the suffering narrated, as well as the impact on the therapist. The methodology of the Grounded Theory was used, with a qualitative character. The delusions were perceived as modes of existence that should be accepted. The suffering in the face of destabilizing experiences demonstrated connections between intense experiences and fragmented subjectivities. The therapists were compelled to sustain the tensions present in the encounter with disorganized subjective forms and to welcome the delirious productions.

RESUMEN El presente trabajo relata una investigación basada en encuentros clínicos con usuarios de una institución de apoyo que presentan discursos delirantes. La guardia psicológica basada en la teoría del Psicodrama fue el marco adoptado. Las interacciones entre los profesionales de turno y los usuarios fueron registradas en diarios de campo, buscando analizar los sufrimientos y experiencias narradas y los impactos producidos en el terapeuta. Se utilizó la Grounded Theory, una metodología cualitativa. Las producciones delirantes fueron percibidas como modos de existencia y manejadas como aspectos del sujeto que debían ser abrazados. El sufrimiento frente a experiencias desestabilizadoras han demostrado conexiones entre experiencias de fuertes intensidades y subjetividades fragmentadas. Los enfermeros de turno se sintieron llamados a sostener las tensiones presentes en el encuentro con formas subjetivas desorganizadas y para acoger las producciones delirantes.

Connections between brief psychoanalytic psychotherapy and online psychotherapy / Conexões entre psicoterapia breve psicanalítica e psicoterapia on-line / Conexiones entre la psicoterapia breve psicoanalítica y la psicoterapia en línea

Clinical psychologists have struggled to keep up, within the scope of the provision of psychological services, with the advances that technology has promoted in the daily life of society. In this sense, this theoretical study, carried out through consultation with authors of clinical psychology linked to the legislation and recent national and international literature, presents theoretical and procedural principles of Brief Psychotherapy of Psychoanalytic Orientation (BPPO), reflecting on its application in online psychotherapy. Characteristics of the PBOP were pointed out (focus, limited objectives and time) and also indications (such as specifying the crisis situation that requires treatment). As for the BPPO interfaces and online psychotherapy, the latter has advantages as a clinical action: convenience, time saving and ease of service in transit. This study enabled the development of theoretical contribution of BPPO, expanding its constructs and the practice of online psychotherapy in a consistent manner and not just as an occasional option.

Psicólogos clínicos têm se esforçado para acompanhar, no âmbito da prestação de serviços psicológicos, os avanços que a tecnologia tem promovido no cotidiano da vida em sociedade. Nesse sentido, este estudo teórico, realizado por meio da consulta a autores da psicologia clínica articulados à legislação e à literatura nacional e internacional recente, apresenta princípios teóricos e procedimentais da Psicoterapia Breve de Orientação Psicanalítica (PBOP), refletindo sobre sua aplicação na psicoterapia on-line. Aponta-se características da PBOP (foco, objetivos e tempo limitados) e indicações (como a especificação da situação de crise que requer tratamento). Quanto às interfaces PBOP e psicoterapia on-line, esta última apresenta vantagens como ação clínica: comodidade, economia de tempo e facilidade de atendimento em trânsito. Assim, este estudo possibilitou o desenvolvimento do aporte teórico da PBOP, expandindo seus construtos e a prática da psicoterapia on-line de maneira consistente e não apenas como opção ocasional.

Los psicólogos clínicos han monitoreado, dentro del alcance de la prestación de servicios psicológicos, los avances que la tecnología ha promovido en la vida cotidiana de la sociedad. Este estudio teórico realizado a través de consultas con autores de psicología clínica articulados con la legislación y la literatura reciente nacional y internacional, presenta los principios teóricos y de procedimiento de la Psicoterapia breve psicoanalítica (PBP), reflexionando sobre su aplicación en la psicoterapia en línea. Se señalaron las características de PBP (enfoque, objetivos y tiempo limitados) y indicaciones (como especificar la situación de crisis que requiere tratamiento). En cuanto a las interfaces, la psicoterapia en línea tiene ventajas como acción clínica: conveniencia, ahorro de tiempo y facilidad de servicio en tránsito. Este estudio permitió el desarrollo de la contribución teórica de PBP, expandiendo sus construcciones y la práctica de la psicoterapia en línea de manera consistente y no solo como una opción ocasional.

Reflexões teórico-técnicas sobre processo grupal on-line desenvolvido em contexto pandêmico / Theoretical-technical reflections on online group process developed in a pandemic context

A pandemia acentua perdas em todos os cenários e esferas da vida em sociedade e tem impulsionado movimentações profissionais e acadêmicas para compreender seus impactos. Adaptações e transformações nas estratégias de atenção à saúde mental das pessoas e nas formas de conceber as experiências universitárias também têm sido requeridas. O texto problematiza os conceitos pichonianos de tarefa e emergente grupal, em busca de subsídios para compreender fenômenos grupais mediados pela internet, face ao contexto pandêmico e ao imperativo de afastamento de atividades presenciais que ele impõe. Propomos que recursos artísticos, tidos como mediadores dialógicos na situação de atendimento remoto, sejam apoiados no redimensionamento dos conceitos de tarefa e emergente, por meio dos neologismos e-tarefa e e-mergente. O resultado do processo de reflexão teórico-técnica é ilustrado a partir de uma vinheta recortada de sessão grupal on-line, na qual um(a) participante, caloura(o) de Curso de Psicologia de instituição pública federal, escolhe e propõe diálogo a partir do conto "Venha ver o pôr do sol", de autoria de Lygia Fagundes Telles. O enlace do dispositivo grupal on-line com a linguagem literária apresenta potência transformadora das realidades compartilhadas no grupo e permite que suas(seus) integrantes possam traduzir e, por conseguinte, se apropriar de experiências emocionais difíceis, como as resultantes da suspensão da vida no espaço físico universitário e da consequente imposição do processo de ensino-aprendizagem remoto.(AU)

The pandemic accentuates losses in all scenarios and spheres of life in society and has driven professional and academic movements to understand its impacts. Adaptations and transformations in peoples mental health care strategies and in ways of conceiving university experiences have also been required. The text problematizes the Pichonian concepts of task and group emergent, searching subsidies to understand group phenomena mediated by the internet, in view of the pandemic context and the compulsory departure from face-to-face activities that it imposes. We propose that artistic resources, considered as dialogical mediators in the situation of remote intervention, should be supported in the redimensioning of the concepts of task and emergent, through the neologisms e-task and e-mergent. The result of the reflection process is illustrated from a cut-out vignette of an online group session, in which a participant, beginning student of Psychology Course of federal public institution, chooses and proposes dialogue based on the literary tale "Come and see the sunset", written by Lygia Fagundes Telles. The link between the online group intervention and the literary language presents a transformative power of the realities shared in the group and allows its members to translate and, consequently, appropriate difficult emotional experiences, such as those resulting from the suspension of life in the university physical space and the consequent imposition of the remote teaching-learning process.(AU)

La pandemia acentúa las pérdidas en todos los escenarios y esferas de la vida de la sociedad y ha impulsado a movimientos profesionales y académicos a comprender sus impactos. También se han requerido adaptaciones y transformaciones en las estrategias de atención en salud mental de las personas y en las formas de concebir las experiencias universitarias. El texto problematiza los conceptos pichonianos de tarea y los emergentes grupales, en busca de subsidios para comprender los fenómenos grupales mediados por internet, ante el contexto pandémico y el imperativo de alejarse de las actividades presenciales que él demanda. Proponemos que los recursos artísticos, vistos como mediadores dialógicos en situación de teleasistencia, sean apoyados en el redimensionamiento de los conceptos de tarea y emergente, a través de los neologismos e-tarea y e-mergent. El proceso de reflexión teórico-técnico resultante se ilustra mediante una viñeta recortada de una sesión grupal online, momento en el que un participante, estudiante novato del curso de psicología de una institución pública federal, elige y propone un diálogo a partir del cuento "Ven a ver el atardecer", de Lygia Fagundes Telles. El entrelazamiento del dispositivo grupal en línea con el lenguaje literario presenta un poder transformador de las realidades compartidas en el grupo y permite a sus miembros traducir y apropiarse de experiencias emocionales difíciles, como las resultantes de la suspensión de la vida en el ámbito físico universitario y la consiguiente imposición del proceso de enseñanza-aprendizaje a distancia.(AU)

Plantão psicológico on-line: a experiência da Clínica Psicológica da UEL no contexto da Covid-19 / Online psychological emergency attendance: the experience of UEL's Psychological Clinic in the context of Covid-19

O mundo encontra-se em uma crise sanitária causada pela pandemia da Covid-19 que requer cuidados em todos os âmbitos: social, econômico, ambiental, político, educacional e de saúde, inclusive saúde mental. Por meio de um relato de experiência, este artigo objetivou evidenciar os alcances e limites do uso da tecnologia na oferta do serviço de Plantão Psicológico on-line da Clínica Psicológica da Universidade Estadual de Londrina. Os alcances desta prática se mostraram importantes para a escuta e o acolhimento do sofrimento psíquico ocasionado pela pandemia, principalmente aos estudantes da universidade que estão lidando com inseguranças e frustrações, tendo seus projetos de vida atravessados pelo novo cenário mundial. Alguns limites do Plantão Psicológico on-line foram elencados, principalmente em relação às intercorrências tecnológicas. Espera-se que esta experiência narrada inspire outros serviços a ofertarem esse tipo de atendimento, ou aprimorarem sua oferta, em tempos pandêmicos, a fim contribuir com a saúde mental da população.(AU)

The world is in a health crisis caused by the Covid-19 pandemic that requires care in all areas: social, economic, environmental, political, educational and health, including mental health. Through an experience report, this article aimed to highlight the scope and limits of the use of technology in offering the online Psychological Emergency Attendance service of the Psychological Clinic of the State University of Londrina. The scope of this practice proved to be important for listening to and welcoming the psychological suffering caused by the pandemic, especially to university students who are dealing with insecurities and frustrations, with their life projects crossed by the new world scenario. Some service limits were listed, mainly in relation to technological complications. It is hoped that this experience will inspire other services to offer this type of care, or improve their offer, in times of pandemic, in order to contribute to the mental health of the population.(AU)

El mundo se encuentra en una crisis de salud provocada por la pandemia de Covid-19 que requiere atención en todos los ámbitos: social, económico, ambiental, político, educativo y sanitario, incluida la salud mental. A través de un relato de experiencia, este artículo tuvo como objetivo resaltar los alcances y límites del uso de la tecnología en la oferta del servicio de Guardia Psicológica en línea de la Clínica Psicológica de la Universidad Estatal de Londrina. El alcance de esta práctica resultó ser importante para escuchar y acoger el sufrimiento psicológico provocado por la pandemia, especialmente a los universitarios que enfrentan inseguridades y frustraciones, con sus proyectos de vida atravesados por el nuevo escenario mundial. Se enumeraron algunos límites de la Guardia Psicológica en línea, principalmente con relación a las complicaciones tecnológicas. Se espera que esta experiencia narrada inspire a otros servicios a ofrecer este tipo de atención, o mejorar su oferta, en tiempos de pandemia, con el fin de contribuir a la salud mental de la población.(AU)

Clinical research on the quality of life and emotion symptoms in patients with permanent peripheral facial paralysis / 中国基层医药

Objective@#To investigate the quality of life(QoL) and emotion symptoms(anxiety symptom and depressive symptom), and its influencing factors in patients with permanent peripheral facial paralysis(PPFP).@*Methods@#A case-control trial was conducted to evaluate the QoL status and emotion symptoms of 79 PPFP patients(PPFP group, disease course >12 months) between January 2017 and January 2018 from the Affiliated Hospital of Yangzhou University, and 42 healthy individuals were selected as control group.The generic questionnaire medical outcomes study short-form 36 items health survey(SF-36), Chinese version of facial clinimetric evaluation(FaCE) scale, self-rating depression scale(SDS) and self-rating anxiety scale(SAS) were evaluated.The correlation among SF-36, SDS, SAS and FaCE was evaluated.SPSS 21.0 software was used to analyze the data.@*Results@#By the assessment of SF-36, the score of vitality[(73.23±15.04)points], social function[(72.41±15.46)points], role-emotion[(72.53±15.27)points] and mental health[(73.35±14.54)points] in four dimensions of the PPFP group were lower than those of the control group [(97.56±3.76)points, (96.51±3.32)points, (97.09±2.49)points and (96.63±2.37)points](t=-10.506, -10.144, -10.505, -10.403, all P<0.001), but the scores of physical function, role-physica, bodily pain and general health in four domains of the PPFP group were similar with those of the control group (all P>0.05). By the assessment of FaCE, the total score of the PPFP group was lower than those of the control group [(48.63±17.44)points vs.(100.00±0.00)points, t=-19.281, P<0.05]. The score of SDS in the PPFP group was higher than those of the control group[(48.43±11.57)points vs.(40.63±5.39)points](t=4.174, P<0.001), but the score of SAS had no statistically significant difference between the two groups (P>0.05). According to the assessment of the correlation among SF-36, SDS, SAS and FaCE, the total scores of FaCE in the PPFP group was related only to SF-36 related mental health dimensions and SDS(r=-0.848~0.908, all P<0.001). Multiple linear regression analysis showed that marital status(t=-2.442, P=0.017), occupation(t=-2.377, P=0.020), and age(t=-5.501, P=0.000) were negatively correlated with the SDS scores; with/without synkinesis(t=3.604, P= 0.042), disease course(t=4.152, P=0.000), and the level of House-Brackmann grading system(HBGS)(t=2.116, P=0.038) were positively associated with the SDS of the PPFP group.However, disease course (t=-2.616, P=0.011), HBGS(t=-6.523, P=0.000) were negatively correlated with the total scores of FaCE, and with/without synkinesis(t= 2.767, P=0.000) was positively associated with the total scores of FaCE.@*Conclusion@#The patients with PFPP have a poorer quality of life and experienced greater psychological distress than healthy individuals.The present study suggested that age, gender, occupation, marital status, disease course, with/without synkinesis, the sources of PPFP and the level of HBGS are associated with depression increasing and quality of life decreasing in PPFP patients.

Clinical research on the quality of life and emotion symptoms in patients with permanent peripheral facial paralysis / 中国基层医药

To investigate the quality of life (QoL) and emotion symptoms (anxiety symptom and depressive symptom), and its influencing factors in patients with permanent peripheral facial paralysis ( PPFP). Methods A case-control trial was conducted to evaluate the QoL status and emotion symptoms of 79 PPFP patients (PPFP group,disease course ＞12 months) between January 2017 and January 2018 from the Affiliated Hospital of Yangzhou University,and 42 healthy individuals were selected as control group.The generic questionnaire medical outcomes study short -form 36 items health survey(SF-36),Chinese version of facial clinimetric evaluation (FaCE) scale,self-rating depression scale(SDS) and self-rating anxiety scale (SAS) were evaluated.The correlation among SF-36,SDS,SAS and FaCE was evaluated.SPSS 21.0 software was used to analyze the data.Results By the assessment of SF-36,the score of vitality[(73.23 ±15.04)points],social function[(72.41 ±15.46)points],role-emotion[(72.53 ±15.27) points] and mental health [(73.35 ±14.54) points] in four dimensions of the PPFP group were lower than those of the control group [( 97.56 ±3.76 ) points, (96.51 ±3.32 ) points, (97.09 ± 2.49)points and (96.63 ±2.37) points] (t＝-10.506,-10.144,-10.505,-10.403,all P＜0.001),but the scores of physical function ,role-physica,bodily pain and general health in four domains of the PPFP group were similar with those of the control group (all P＞0.05).By the assessment of FaCE,the total score of the PPFP group was lower than those of the control group [(48.63 ±17.44) points vs.(100.00 ±0.00) points,t＝-19.281,P＜0.05].The score of SDS in the PPFP group was higher than those of the control group [(48.43 ±11.57)points vs. (40.63 ±5.39) points] ( t ＝4.174, P ＜0.001), but the score of SAS had no statistically significant difference between the two groups (P＞0.05).According to the assessment of the correlation among SF -36,SDS,SAS and FaCE,the total scores of FaCE in the PPFP group was related only to SF -36 related mental health dimensions and SDS(r＝-0.848 ～0.908, all P ＜0.001).Multiple linear regression analysis showed that marital status ( t ＝-2.442,P＝0.017),occupation ( t＝-2.377,P＝0.020),and age ( t ＝-5.501,P＝0.000) were negatively correlated with the SDS scores;with／without synkinesis ( t ＝3.604, P ＝0.042), disease course ( t ＝4.152,P ＝0.000),and the level of House-Brackmann grading system(HBGS)(t＝2.116,P＝0.038) were positively associated with the SDS of the PPFP group.However,disease course (t＝-2.616,P＝0.011),HBGS(t＝-6.523,P＝0.000) were negatively correlated with the total scores of FaCE ,and with／without synkinesis (t＝2.767,P＝0.000) was positively associated with the total scores of FaCE.Conclusion The patients with PFPP have a poorer quality of life and experienced greater psychological distress than healthy individuals .The present study suggested that age ,gender, occupation,marital status,disease course,with／without synkinesis ,the sources of PPFP and the level of HBGS are associated with depression increasing and quality of life decreasing in PPFP patients.

Investigation on psychological status of patients with acute pancreatitis and analysis of influencing factors / 中华胰腺病杂志

Objective To investigate the pshcyological status and influencing factors of patients with acute pancreatitis. Methods Acute pancreatitis patients admitted in Changhai Affiliated Hospital of Navy Medical University from December 2018 to February 2019 were enrolled, and 120 patients were selected using random number table method. Self-made general questionnaire, self-rating depressing scale, self-rating anxiety scale and coping style questionnaire were used for investigation and patients′ psychological status was evaluated. Results In this survey, 109 questionnaires were collected and eligible for final analysis. The incidence of depression in patients with acute pancreatitis was 44. 0％, and the incidence of anxiety was 20. 2％. Male patients had significantly lower anxiety and depression than women. The levels of anxiety and depression in the 31-50 age group were significantly lower than those in other age groups. The level of anxiety in patients with pancreatitis with children was significantly lower than in patients without children. The coping style of "solving problem" was significantly negatively correlated with depression and anxiety level. The"self-blame" coping style was significantly positively correlated with depression and anxiety level. The"rationalized"coping style was positively correlated with the level of depression. Conclusions The mental health status of patients with acute pancreatitis was not optimistic. Different coping styles were important factors affecting the level of anxiety and depression.

O modelo cognitivo-comportamental da procrastinação acadêmica: uma revisão da literatura / Cognitive-behavioral model of academic procrastination: a review of literature

Procrastinação é um fenômeno comum entre estudantes, sendo, geralmente, prejudicial à vida acadêmica. As pesquisas sobre procrastinação são relativamente recentes, sendo iniciadas na década de 60 e, desde lá, pode-se considerar que há pouco avanço sobre o tema. Atualmente, considera-se a procrastinação como problema mais grave da educação. O presente estudo buscou descrever as crenças irracionais e distorções cognitivas que levam ao comportamento de procrastinar. Para isto, o método utilizado foi uma revisão integrativa de literatura sobre o modelo cognitivo da procrastinação. A compreensão deste fenômeno sob a perspectiva cognitivo-comportamental busca dar subsídio para a prática clínica com acadêmicos que apresentam prejuízos devido à procrastinação.(Aut)

Procrastinating is a common behavior among students that causes damages in academic life. Researches about this theme are recently, beginning in the 1960s and since there, there is little advance on the literature. Currently, procrastinating is the worst problem of education. This study sought to describe irrational beliefs and cognitive distortions that result in the procrastination behavior. So, it was an integrative review of literature about the cognitive model of procrastination. Therefore understanding this phenomenon should give subsidy to the clinic practice with academics that present procrastination damages.(Aut)

Escala de Eficácia Adaptativa: evidências de validade com base na estrutura interna e normas interpretativas / Adaptive Efficacy Scale: Validity evidence based on internal structure and interpretative norms

Resumo O acúmulo de evidências de validade e precisão traz respaldo aos usuários de instrumentos de avaliação psicológica. Objetivou-se estimar novas evidências de validade da estrutura interna da Escala Diagnóstica Adaptativa Operacionalizada de Autorrelato, assim como avaliar os parâmetros dos itens e características dos participantes e estabelecer normas interpretativas para a escala. A amostra foi composta por 404 estudantes universitários de ambos os sexos (62% mulheres). Análise fatorial confirmatória corroborou a perspectiva teórica de que as escalas Afetivo-Relacional e Produtividade medem facetas complementares do construto eficácia adaptativa. A Teoria de Resposta ao Item, Modelo de Créditos Parciais, forneceu os parâmetros dos itens e características dos participantes: níveis de dificuldades/theta e índices de ajuste. Através dos mapas de pessoas-itens foram estabelecidas normas interpretativas e pontos de corte para a escalas. Considera-se que a Escala Diagnóstica Adaptativa Operacionalizada de Autorrelato seja útil em situações onde entrevistas não sejam possíveis para a avaliação da eficácia adaptativa.

Abstract The accumulation of evidence of validity and reliability provides support to users of psychological assessment instruments. This study aimed to estimate new evidence of internal structure validity of the Escala Diagnóstica Adaptativa Operacionalizada de Autorrelato (Self-Report Adaptive Operational Diagnostic Scale), evaluate the item parameters and participants’ characteristics, and establish interpretative norms for the scale. The sample was composed of 404 undergraduate students of both genders (62% female). Confirmatory factor analysis corroborated the theoretical perspective that the Affective-Relational and Productivity subscales measure complementary facets of adaptive efficacy. The Rasch-Masters Partial Credit Model, an Item Response Theory model, was used to determine the item parameters and characteristics of the participants: item difficulty/theta and adjustment indices. Interpretative standards and cutoff points for the scale were established using item-person maps. The Self-Report Adaptive Operational Diagnostic Scale can be useful to evaluate the adaptive efficacy when interviews cannot be conducted.

Desvios, devires e cartografias da clínica "PSI" na atualidade / Gaps, becomings and cartographies clinic "PSI" in the news

O presente artigo coloca em discussão a problematização da clínica "psi" tradicional, que é calcada no poder absoluto do cientificismo. Suas descobertas foram através da classificação e identificação de doenças em hospitais, dando origem ao diagnóstico nosológico. Em contrapartida desta clínica tradicional, a clínica desviante entende que mudanças criativas nos encontros entre terapeuta e paciente provocam transbordamentos e deslocamentos da dupla. Pensamento e prática não estão dissociados, portanto clínica e psicologia também não estão. A pesquisa ainda problematiza sobre os poucos espaços ocupados por profissionais "psis". O método utilizado para abordar este assunto foi a cartografia, que potencializa tanto a escrita quanto as experiências.

This article calls into question the questioning of "psy" clinic traditional, that is grounded in absolute power. His findings have been through the classification and identification of diseases in hospitals, giving rise to nosological diagnosis. In contrast to this traditional practice, the deviant clinic understands that creative changes in meetings between therapist and patient cause overflows of double shifts. Thought and practice are not separated, so clinical and psychology also are not. The research also discusses about the few spaces occupied by professionals "psis". The method used to notify this issue was the cartography.

Psychological assessment of patients undergoing cardiac transplant in a teaching hospital (2004 to 2012) / Avaliação psicológica de pacientes submetidos a transplante cardíaco em hospital de ensino (2004 a 2012)

Objective: To analyze the psychological evaluations of patients with heart failure waiting for heart transplantation. Methods: The data were obtained from patient records containing pre-surgery psychological evaluations performed by psychologists from the multidisciplinary cardiology team. The evaluation protocol included the Quality of Life Questionnaire (SF-36), Beck Depression Inventory, and an interview script. Results: The results of psychological evaluations performed between 2004 and 2012 for 60 candidates for heart transplantation were analyzed: 43 men and 17 women aged between 16 and 66 years (Mean=45.18; SD=11.91), predominantly from the São José do Rio Preto area (São Paulo state, Brazil) (83%), with incomplete elementary education (68%), and who were in stable relationships (73%). Although women presented higher mean scores for depression (21.41) than men (14.61), there was no significant difference between genders. Women's quality of life was impaired in all domains compared to men (below 50%) and was significantly poorer in the physical functioning (P=0.01), vitality (P=0.00), emotional role functioning (P=0.04), and mental health (P=0.02) domains. Conclusion: Patients with psychosocial vulnerability (e.g., depression) identified before transplantation should receive psychological treatment. .

Objetivo: Analisar protocolos de avaliação psicológica de pacientes portadores de insuficiência cardíaca, candidatos a transplante cardíaco. Métodos: Os dados da avaliação foram obtidos junto ao arquivo de avaliações psicológicas realizadas pré-cirurgia pelos psicólogos que integram a equipe multidisciplinar de Cardiologia. O protocolo de avaliação inclui o Questionário de Qualidade de Vida - SF-36 o Inventário Beck de Depressão e um roteiro de entrevista. Resultados: Foram analisados os resultados das avaliações psicológicas de 60 pacientes candidatos a transplante cardíaco no período entre 2004 e 2012: 43 homens e 17 mulheres, com idade entre 16 e 66 anos (M=45,18 dp=11,91), 83% provenientes da região, com ensino fundamental incompleto (68%) e união estável (73%). Embora as mulheres tenham apresentado escores mais altos para depressão (21,41) em relação aos homens (14,61), não houve diferença significante entre os gêneros. A qualidade de vida das mulheres mostrou-se prejudicada em todos os domínios (abaixo de 50%) e esse prejuízo foi significantemente inferior aos homens na capacidade funcional (P=0,01), vitalidade (P=0,00), aspectos emocionais (P=0,04) e saúde mental (P=0,02). Conclusão: Pacientes com vulnerabilidades psicossociais identificadas no pré-transplante (ex. depressão) devem receber atendimento psicológico. .

Hotsite de psicologia: informações de interesse sobre anomalias craniofaciais / Psychology hotsite: information of interest about craniofacial anomalies

Este artigo teve como objetivo obter dados para elaborar um hotsite de Psicologia, voltado a familiares e pacientes tratados no Hospital de Reabilitação de Anomalias Craniofaciais - Universidade de São Paulo, em Bauru, estado de São Paulo, abordando temas que envolvem malformações labiopalatais e suas consequências psicológicas. Foi realizada entrevista elucidativa com 200 pais/acompanhantes e 100 pacientes em tratamento no Hospital, buscando definir seus interesses e possibilidades de utilizar um hotsite, a caracterização do perfil do usuário, o conhecimento e confiabilidade na atuação do psicólogo, e o levantamento dos temas de interesse. O hotsite foi aceito pelos entrevistados, que não só relataram interesse nesse tipo de serviço, como também acreditam nele para a resolução de suas dúvidas e anseios. Os temas de interesse citados foram a atuação do psicólogo, os aspectos da malformação e o envolvimento psicoemocional. Os resultados indicam que é viável esse tipo de acompanhamento, atendendo às necessidades individuais, momentâneas e, por vezes, emergenciais dos usuários.

The aim of this article was to obtain data to develop a Psychology hotsite addressing issues involving malformation and its psychological consequences in the Hospital for Rehabilitation of Craniofacial Anomalies - Universidade de São Paulo. An informative interview was held with 200 parents/attendants and 100 patients being treated at the hospital, seeking to define their interest in and possibility of using the hotsite; characterize users' profile: knowledge of and reliability?/trust in the psychologist's actions; and survey of topics of interest. The hotsite was accepted by the interviewees, who were interested not only in the type of service but also believed in it for solving their doubts and anxieties. Mentioned Topics of interest were: the psychologist's work; aspects of malformation and its psycho-emotional involvement. The results indicate that this type of monitoring is feasible, meeting momentary individual needs, momentary, and sometimes the users' emergency needs.

A clínica em situações de abuso sexual: aspectos conceituais e atuação interdisciplinar / Clinic in situations of sexual abuse: conceptual aspects and interdisciplinary work

A violência sexual é classificada como grave violação de direitos humanos e importante problema de saúde pública,representando a extrema restrição da autonomia sexual e reprodutiva da mulher. Trata-se de um fenômeno universal de rápido crescimento e elevada prevalência na população. Embora possa comprometer pessoas de ambos os sexos e em todas as idades, as evidências apontam que a violência sexual declina contundentemente sobre as mulheres, particularmente as mais jovens e vulneráveis. O objetivo deste artigo foi descrever a experiência de um serviço de referência para atendimento de pessoas em situação de violência, com ênfase na organização das ações e papel dos profissionais de psicologia na atenção interdisciplinar.

Sexual violence is taken to be a serious violation of human rights and an important problem of public health, representing the extreme restriction of sexual and reproductive autonomy of women. It is a universal increasing phenomenon and a high prevalence in the population. Though it could compromise persons of both sexes and all ages, evidences point that sexual violence affects preponderantly women, particularly the youngest and vulnerable. The objective of this article isto describe the experience of a service of reference for caring people in situations of violence, with an emphasis in the organization of actions and the role of professionals of psychology in interdisciplinary care.

Qualitative study of life events how to influence emotional state of heart transplantation patients / 中华器官移植杂志

ObjectiveTo explore the influence of life events on the emotional state ot heart transplantation patients.Methods All the heart transplantation outpatients were interviewed by a certain psychiatrist in Zhongshan Hospital during Oct.2010 to Oct.2011.The demographic data,life events and the self-reported influenced degree were recorded by the same psychiatrist.A grounded theory-based approach with thematic content analysis of the field notes was used.ResultsEighty-eight patients were enrolled,including 69 males,and19 females.The average age of the patients was 46.5 ±14.3 years old.The average duration after operation was 39.3 ± 39.6 months.The life events were classified into 4 groups,which were medical financial problems,physical condition,family support and future life.The most frequently reported event was physical condition (50.2％ ) and the influenced degree was the highest (9.2 ±1.2),while most patients (96.6％) complained high medical and relevant cost and the influenced degree was (6.5 ± 2.1). Family support was reported by13.6％ patients and its influenced degree was (7.6 ±1.2).The age of the reporter of future life (6.8％) was under 33 years.ConclusionDifferent events have different influence to patients.Improving the social support of patients is helpful to improve quality of life.

Asma não controlada e angústia na adolescência: escutar o paciente? / Uncontrolled asthma and psychological distress in adolescence: hearing the patient?

Este artigo, com base na apresentação do caso clínico de uma adolescente portadora de asma persistente associada a distúrbios psicoafetivos, procura comentar o atual modelo biotecnológico de atendimento que exclui a subjetividade do paciente. Discute, a partir do caso apresentado, as possíveis contribuições da escuta médica de orientação psicanalítica na condução de casos de pacientes portadores de asma não controlada.

This article. through the presentation of a clinical case of a teen-ager with persistent asthma associated to psycho-affective disorders attempts to discuss the current biotechnological model that excludes patients subjectivity and consider possible contributions of a medical practice under psychoanalytical theory orientation in the management of these uncontrolled asthmatic patients.

Validity and reliability of the Structured Clinical Interview for Mood Spectrum: Brazilian version (SCIMOODS-VB) / Validade e confiabilidade da versão brasileira da Entrevista Clínica Estruturada para o Espectro do Humor (SCIMOODS-VB)

OBJECTIVE: The aim of this study was to translate the Structured Clinical Interview for Mood Spectrum into Brazilian Portuguese, measuring its reliability, validity, and defining scores for bipolar disorders. METHOD: Questionnaire was translated (into Brazilian Portuguese) and back-translated into English. Sample consisted of 47 subjects with bipolar disorder, 47 with major depressive disorder, 18 with schizophrenia and 22 controls. Inter-rater reliability was tested in 20 subjects with bipolar disorder and MDD. Internal consistency was measured using the Kuder Richardson formula. Forward stepwise discriminant analysis was performed. Scores were compared between groups; manic (M), depressive (D) and total (T) threshold scores were calculated through receiver operating characteristic (ROC) curves. RESULTS: Kuder Richardson coefficients were between 0.86 and 0.94. Intraclass correlation coefficient was 0.96 (CI 95 percent 0.93-0.97). Subjects with bipolar disorder had higher M and T, and similar D scores, when compared to major depressive disorder (ANOVA, p < 0.001). The sub-domains that best discriminated unipolar and bipolar subjects were manic energy and manic mood. M had the best area under the curve (0.909), and values of M equal to or greater than 30 yielded 91.5 percent sensitivity and 74.5 percent specificity. CONCLUSION: Structured Clinical Interview for Mood Spectrum has good reliability and validity. Cut-off of 30 best differentiates subjects with bipolar disorder vs. unipolar depression. A cutoff score of 30 or higher in the mania sub-domain is appropriate to help make a distinction between subjects with bipolar disorder and those with unipolar depression.

OBJETIVO: Traduzir e validar para o português a Entrevista Clínica Estruturada para Distúrbios do Humor, mensurando sua validade, confiabilidade, bem como definindo os escores para transtornos bipolares. MÉTODO: A entrevista foi traduzida (para o português) e novamente traduzida para o inglês. A amostra incluiu 47 indivíduos com transtornos bipolares, 47 com transtorno depressivo maior, 18 com esquizofrenia e 22 controles. A confiabilidade entre avaliadores foi testada em 20 indivíduos com transtornos bipolares e transtorno depressivo maior. A consistência interna foi mensurada por meio da fórmula de Kuder Richardson. Análise discriminante foi realizada. Escores dos diversos grupos foram comparados; limiares para mania (M), depressão (D) e valores totais foram calculados usando curvas de "receiver operating characteristic" (ROC). RESULTADOS: Coeficientes de Kuder Richardson ficaram entre 0,86 e 0,94. O coeficiente de correlação intraclasse foi de 0,96 (IC 95 por cento 0,93-0,97). Participantes com transtornos bipolares apresentaram escores M e T aumentados, e escores D semelhantes aos do grupo transtorno depressivo maior (ANOVA, p < 0,001). Os subdomínios que melhor discriminaram indivíduos com doença uni ou bipolar foram energia maníaca e humor maníaco. M apresentou a melhor área sob a curva (0,909); valores de M igual ou superiores a 30 associaram-se a sensibilidade de 91,5 por cento e especificidade de 74,5 por cento. CONCLUSÃO: Entrevista Clínica Estruturada para Distúrbios do Humor apresenta boa validade e reliabilidade. Escore de mania igual ou superior a 30 adequadamente diferencia transtornos bipolares de depressão unipolar.

Application of preoperative interview with watching operation video in patients undergoing selective operation / 中国基层医药

Objective To study the effect of psychological factor in patients undergoing selective operation with preoperative interview by watching operation video. Methods 80 patients undergoing selective operation were divided equally into experimental group and control group randomly, the patients in experimental group accepted pre- operative interview with watching operation video, except for usual preoperative interview. The operation stress reac- tion could be identified by observation of change of blood pressure,pulse signal and emotion before operation. Results The emotion tensity in the experiment group was significantly lower than that of control group(P < 0.01 ). The blood pressure and pulse signal were significantly different between two groups(P < 0.05). Conclusion Application of preoperative interview with watching operation video helped patients to adopt to operation, more smoothly, to ele- vate the effect of operation and to boost the postoperative recovery.

Quantitative assessment and intervention of mental status in patients with severe acute respiratory syndrome / 第二军医大学学报

Objective:To quantitively assess the mental status of patients with severe acute respiratory syndrome(SARS) for correct diagnosis of those have serious mental crisis,providing scientific basis for the psychological intervention. Methods:The mental status in 46 SARS patients were analyzed with the Mental Status Scale in Non psychiatric Settings(MSSNS, by Department of Psychology, Second Military Medical University )and compared with that of the common pneumonia patients and the norm of common inpatients. Results:The scores of SARS patients and those of the other pneumonia patients and the norm of common inpatients had no significant difference. The psychological reactions of SARS patients were related significantly with the patient's age, marital status, occupation and the duration of fever. Conclusion:The psychological reactions of SARS patients were accordant with those of the common patients. The results indicated that the patient's personality, such as the emotional stability, was the essential impact factor on the patient's mental status. The level of negative emotional reactions in SARS patients are influenced by whether the patients are young, single, lack of medical knowledge and fever duration. So the effective psychological intervention to the SARS patients should be based on the scientific assessment and influencing factors analysis.