Anxiety in candidates for radical prostatectomy in a university hospital

SUMMARY OBJECTIVE: Metabolic changes caused by anxiety can interfere in both the surgery itself and the recovery process. One way to reassure the patient is to clarify how the procedure will be performed and discuss the possible complications. This study aimed to investigate the anxiety level of candidates for radical prostatectomy at a university hospital. METHODS: Thirty-four patients with a diagnosis of prostate cancer were studied prospectively. Data collection involved the administration of the Hospital Anxiety and Depression Scale and a radical prostatectomy knowledge test. RESULTS: The results showed that 94.1% of the patients reported having received clarifications from the physician or healthcare team regarding the surgery and 23.5% reported having received information on the probability of a medical error during surgery. The most cited postoperative complications were sexual impotence and urinary incontinence. A significant association was found between the total Hospital Anxiety and Depression Scale score and the complications cited (p=0.0004); patients who marked a larger number of possible complications had a higher Hospital Anxiety and Depression Scale score. CONCLUSION: The present study demonstrates that the explanations given by the multidisciplinary health team are not achieving their maximum potential in terms of lowering patient anxiety.

Psychosocial Problem and its Associated Factors Among Adolescents in the Secondary Schools in Pasir Gudang, Johor

Introduction: Adolescence is a crucial period with impressive emotional changes. Emotional disorders such as depression, anxiety and stress are high among adolescents worldwide; however the psychosocial changes are often neglected. The aim of the current study was to determine the depression, anxiety and stress symptoms and their associated factors among adolescents. Methods: A cross-sectional study using cluster sampling was carried out among school-going adolescents in 10 secondary schools in Pasir Gudang, Johor, Malaysia. Respondents answered a self-administered questionnaire including socio-demographic, Inventory of Parent and Peer Attachment (IPPA), Depression Anxiety Stress Scale-21 (DASS-21) and Strength and Difficulties Questionnaire (SDQ). Using SPSS-21, chi-square test and binomial logistic regression were conducted to examine the associations between dependent and independent variables. Results: Respondents (52.6% female and 53.9% Malay) had 46.0% prevalence of depression symptoms, 59.1% anxiety, 38.1% stress and 45.6% psychosocial status (internalizing and externalizing problems). Age, father occupation and parental bonding were significantly predicted having moderate to extremely severe depression symptom (p<0.05). Younger adolescents (13-14 years old) were 1.42 times more likely to have anxiety symptom. In addition, respondents with insecure father attachment were 1.5 times more likely to have stress symptom (p<0.05). Respondents with insecure parental attachment were more likely to have psychosocial problem (p<0.05). Conclusions: Depression, anxiety and stress of adolescents were influenced by the sociodemographic of adoleascents and their parents. Age, gender and parental attachment were the significant predictors in the current study which should be the center of attention for the future studies to reduce the psychological disorders among adolescents.

Relação entre ansiedade ao tratamento odontológico e fatores sociodemográficos: estudo com adultos em Santa Catarina (Brasil) / Relationship between anxiety to dentaltreatment and socidemographic factors:a study with adults in Santa Catarina(Brazil)

Introdução: O medo e a ansiedade são emoções preocupantes no consultório odontológico por desencadearem diferentes tipos de comportamento e causarem repercussões somáticas indesejáveis. A reversão do quadro de ansiedade ao tratamento odontológico requer intervenções de diferentes enfoques. Neste sentido, o papel do cirurgião-dentista no processo de redução dos efeitos negativos da ansiedade é essencial. Frente à importância da temática é desejável melhor se conhecer o fenômeno de ansiedade ao tratamento odontológico. Objetivo: identificar a influência de fatores sociodemográficos na determinação de ansiedade ao tratamento odontológico, junto a uma amostra de adultos residentes em Santa Catarina. Métodos: pesquisa descritiva, do tipo transversal, mediante levantamento de dados primários. A população-alvo foi constituída por adultos, residentes em três cidades da região oeste de Santa Catarina (Brasil) e uma cidade do litoral norte catarinense. O plano amostral foi não probabilístico e a obtenção da amostra deu-se por conveniência. A determinação do nível de ansiedade foi efetuada com base numa adaptação da escala de Corah - Dental Anxiety Scale (DAS). Resultados: a amostra constou de 1219 sujeitos, com idades variando de 18 a 87 anos. Os sujeitos classificados entre muito pouco a levemente ansioso (Grupo A - baixo nível) foram os mais frequentes (80 por cento) e 20 por cento eram portadores de moderada a extrema ansiedade (Grupo B - alto nível). A não efetivação de consultas de modo regular foi um pouco mais frequente entre os sujeitos do Grupo B. Conclusão: a maioria do grupo classificado com baixo nível de ansiedade (Grupo A) era de homens, da faixa etária de 50 ou mais anos e com grau de escolaridade superior.

Introduction: Fear and anxiety are disturbing emotions in the dental office for triggering different types of behavior and causing undesirable somatic repercussions. Reversal of anxiety disorders to dental treatment interventions requires different approaches. In this sense, the dentist's role in the reduction process of the negative effects of anxiety is essential. Considering the relevance of the theme it is desirable to understand clearly the anxiety phenomenon to dental treatment. Objective: to identify the influence of socio-demographic factors on the determination of anxiety related to dental treatment, in a sample of adults living in Santa Catarina. Methods: descriptive research, cross-sectional, through primary data collection. The target population consisted of adults living in two cities of the western region and one city of the north coast in Santa Catarina (Brazil). The sampling plan was not probabilistic and obtaining by convenience. To determine the level of anxiety was used an adaptation of Corah Scale - Dental Anxiety Scale (DAS). Results: The sample consisted of 1219 subjects, aged 18-87 years. The subjects rated between very little to look forward slightly (Group A - Low level) were the most common (80 per cent) and 20 per cent suffered from moderate to extreme anxiety (Group B - High level). The non-effective dental appointment was more frequent among subjects with high levels of anxiety (Group B). Conclusion: most in the group rated low anxiety (Group A) were men, older adults (50 or more years) and higher education. In the group with high levels of anxiety (Group B) the majority were women, young adults (18-24 years) and with higher education. The chi-square test revealed a significant association between anxiety and sexy and age.

Intervención psicológica en trastornos temporomandibulares: revisión narrativa / Psychological intervention in temporomandibular disorders: review

Los pacientes con trastornos temporomandibulares (TTM) presentan trastornos psicológicos y psiquiátricos frecuentemente. Estos pacientes frecuentemente muestran somatización, depresión, ansiedad, reacción al estrés y catastrofismo, lo que juega un rol en la predisposición, iniciación y perpetuación de los TTM y en la respuesta al tratamiento. Esta revisión presenta opciones terapéuticas que comprometen al eje psicológico de los pacientes con TTM, las cuales buscan principalmente reducir la ansiedad y la tensión emocional presentes, modificar las distintas percepciones del dolor y cómo afrontarlo. Existen diversas posibilidades, dentro de las cuales se encuentran: educación del paciente, identificación de las situaciones que incrementan esa tensión para evitarlas, enseñanza de técnicas de relajación como biofeedback, hipnosis y yoga. En cuanto al tratamiento psicológico, la que presenta mejor resultado para los TTM, es la terapia cognitiva conductual (TCC). La intervención psicológica adecuada y eficaz puede reducir el dolor de los TTM, disminuyendo la probabilidad de que el cuadro se haga más complejo. Dentro de las alternativas de tratamiento psicológico para los TTM, un tratamiento estándar conservador (educación, instrucción de autocuidado, evitación de movimientos dolorosos, dieta blanda), incluso el más breve, puede ser suficiente a corto plazo para la mayoría de los pacientes que presentan TTM, sobretodo en los casos de cuadros agudos. La adición de una TCC, por parte de un especialista, entrega habilidades de afrontamiento que se sumarán a la eficacia, especialmente en los casos crónicos, obteniendo mejores resultados a largo plazo.

Patients with temporomandibular disorders (TMD) frecuently present psychological and psychiatric problems. These patients often show increased somatization, depression, anxiety, stress reaction and catastrophism, wich plays a role in the predisposition, initiation and perpetuation of TMD and treatment response. This review presents thaerapeutic options that compromise the psychological axis of patients with TMD, wich primarily seek to reduce the anxiety and the emotional stress present, modify different perceptions of pain and coping. There are different posibilities, within wich are: patient education, identifying situations that increase the tension to avoid them, teaching relaxation techniques such as biofeedback, hipnosis and yoga. As for psychological treatment, the most common for chronic orofacial pain is cognitive behavioral therapy (CBT). The appropriate and effective psychological intervention can reduce TMD pain, decreasing the probability that the symptoms become more complex. Within psychological treatment options for TMD, conservative standard treatment (education, self-instruction, avoidance of painful movements, soft diet), even the shortest, may be sufficient in the short term for most patients with TMD, especially in cases of acute conditions. The addition of CBT, by a specialist, gives coping skills that will add to the effectiveness, especially in chronic cases, obtaining better results in the long term.

Relação entre níveis de ansiedade-traço competitiva e idade de atletas de voleibol e análise destes níveis pré e pós-competição / Relationship between levels of competitive anxiety and age of volleyball athletes and analyze of these levels pre and post-competition

O objetivo do estudo foi analisar os níveis de ansiedade traço-competitivo pré e pós- competição em jogadoras de voleibol e ainda, verificar a associação destes níveis com a idade destas atletas. Durante uma competição, 12 atletas de voleibol do sexo feminino (21,5 ± 2,9 (15-24) anos) responderam a Escala de Ansiedade Traço-Competitivo (SCAT) antes do início da partida e imediatamente após o término desta. Os resultados demonstraram que após a competição houve uma redução significativa dos valores de ansiedade traço-competitivo nas atletas de voleibol (p=0,01) e que há uma correlação significativa em que atletas mais jovens apresentaram níveis mais elevados de ansiedade traço-competitivo antes do início do jogo (p=0,001; r=0,76), sugerindo o fator de idade possa predizer os níveis de ansiedade. A análise de regressão múltipla revelou que a idade pode ser um fator significante na análise dos níveis de ansiedade de jogadoras de voleibol (p=0,003; R2=0,82). Estes resultados sugerem que: a) Os níveis de ansiedade traço competitiva apresentaram uma redução significativa após o término da partida que quando comparados na situação pré-competitiva, entretanto, esses níveis ainda são considerados altos segundo os valores de referencia da escala utilizada e; b) Atletas mais jovens apresentam níveis mais altos de ansiedade traço-competitivo, o que permite inferir que esta variável pode ser modulada pela idade e experiência.

The aim of present study was to analyze the levels of competitive anxiety pre and post competitive on volleyball female players and, verify the association between these levels with the age of these athletes. During a competition, 12 female athletes of volleyball with mean of age of 21,5 ± 2,9 (15-24) years answered the Sport Competition Anxiety Test (SCAT) after and immediately before the start of the game. The data were analyzed by non parametric statistics. To verify significant differences on pre and post competition moments were realized a Wilcoxon test. To analyze the association between age and levels of anxiety it was realized the Spearman's correlation and a stepwise multiple regression. The results showed that on post competition moment there was a significant decrease (p=0,01) of competitive anxiety and there is significant correlation (p=0,001; r=0,76) with higher ages and lower levels of competitive anxiety. It suggests that the factor age can predict the levels of anxiety. The multiple regression revealed that the age can be a significant factor on analyze of competitive anxiety of female volleyball players (p=0,003; R2=0,82). These results suggest that: a) Levels of competitive anxiety presented a significant decrease after the end of the game when compared with the begging of the same game; b) Younger athletes presented higher levels of competitive anxiety.