[Post-traumatic stress disorder symptoms among professionals during humanitarian aid in Haiti after the earthquake in 2010]. / Sintomas de estresse pós-traumático em profissionais durante ajuda humanitária no Haiti, após o terremoto de 2010.

The scope of this article is to screen the symptoms of Post-Traumatic Stress Disorder (PTSD) among the professionals who provided humanitarian aid for the Haitian population after the 2010 earthquake. It involvess a cross-sectional study. The Impact of Event Scale - Revised (IES-R) was used for screening symptoms of PTSD. The participants included 32 Brazilians (mean age = 37.58 +/-7.01), 22 Americans (mean age =33.67 +/-8.03) and 12 Ecuadorians (mean age = 44.80 +/- 15.88). The professionals did not have PTSD symptoms. The relationship between prior experience variables in disaster situations and the total score of the IES-R (F (2) = 4.34, p = 0.017), as well as prior experience in disaster situations and the intrusion subscale (F (2) = 3.94, p = 0.024) were significant in linear regression models. The number of prior experiences was revealed as a significant predictor for the total score of IES (p < 0.05). The results showed that current experiences can be exacerbated by memories of prior experiences, increasing the likelihood of developing PTSD. Therefore the mental health care of the professionals should foster the early identification of prior experience risk factors, thereby not permitting voluntary initiative to transcend selective criteria and specific care.

Sintomas de estresse pós-traumático em profissionais durante ajuda humanitária no Haiti, após o terremoto de 2010 / Post-traumatic stress disorder symptoms among professionals during humanitarian aid in Haiti after the earthquake in 2010

O artigo tem por objetivo rastrear sintomatologia de transtorno de estresse pós-traumático (TEPT) em profissionais que prestaram ajuda humanitária à população haitiana, após o terremoto de 2010. Estudo transversal. A sintomatologia de TEPT foi avaliada pela Escala Impacto do Evento - Revisada (IES-R). Os participantes foram 32 brasileiros (idade m = 37.58 +/- 7.01), 22 estadosunidenses (idade m = 33.67 +/- 8.03) e 12 equatorianos (idade m = 44.80 +/- 15.88) e não apresentaram sintomatologia de TEPT. A relação entre as variáveis experiência prévia em situação de desastre e escore total da IES-R [F(2) = 4.34, p = 0.017] bem como experiência prévia em situação de desastre e subescala intrusão [F(2) = 3.94, p = 0.024] foram significantes nos modelos de regressão linear. Experiência prévia se mostrou preditor significante para escore total da IES-R (p < 0,05). Os resultados demonstraram que vivências atuais podem ser potencializadas pelas memórias de experiências anteriores, aumentando a probabilidade de desenvolvimento de TEPT. Portanto, o cuidado com a saúde mental dos profissionais deve favorecer a precoce identificação do fator de risco experiência prévia, não permitindo que a iniciativa voluntária se sobreponha aos critérios seletivos e aos cuidados específicos.

The scope of this article is to screen the symptoms of Post-Traumatic Stress Disorder (PTSD) among the professionals who provided humanitarian aid for the Haitian population after the 2010 earthquake. It involvess a cross-sectional study. The Impact of Event Scale - Revised (IES-R) was used for screening symptoms of PTSD. The participants included 32 Brazilians (mean age = 37.58 +/-7.01), 22 Americans (mean age =33.67 +/-8.03) and 12 Ecuadorians (mean age = 44.80 +/- 15.88). The professionals did not have PTSD symptoms. The relationship between prior experience variables in disaster situations and the total score of the IES-R (F (2) = 4.34, p = 0.017), as well as prior experience in disaster situations and the intrusion subscale (F (2) = 3.94, p = 0.024) were significant in linear regression models. The number of prior experiences was revealed as a significant predictor for the total score of IES (p < 0.05). The results showed that current experiences can be exacerbated by memories of prior experiences, increasing the likelihood of developing PTSD. Therefore the mental health care of the professionals should foster the early identification of prior experience risk factors, thereby not permitting voluntary initiative to transcend selective criteria and specific care.

[Cross-cultural adaptation of the Brazilian version of the Impact of Events Scale-Revised (IES-R)]. / Adaptação transcultural da versão brasileira da Escala do Impacto do Evento-Revisada (IES-R).

The Impact of Events Scale-Revised (IES-R) is used to screen for post-traumatic stress disorder (PTSD). The aim of this study was to assess the cross-cultural adaptation of the IES-R. The scale was translated into Brazilian Portuguese and culturally adapted. Reliability and validity were evaluated in 45 individuals divided into three groups of 15 (without PTSD, with PTSD, and treated for PTSD). Reliability was evaluated using intraclass correlation coefficient - ICC and Cronbach's alfa. Discriminant validity was evaluated by comparing mean IES-R scores in the three groups. The area under the ROC curve (AUC) was evaluated to determine cut-offs with higher sensitivity (s) and specificity (e) using the clinical interview (DSM-IV) as reference. The IES-R showed good reliability (ICC = 1; alfa from 0.75 to 0.93). The mean IES-R scores (p < 0.05) and ROC curve had good discriminant validity for a cut-off of 5.6 (s = 0.80, e = 0.70 and AUC = 0.81). The Brazilian version of IES-R showed good properties and can be a useful screening tool for PTSD.

Adaptação transcultural da versão brasileira da Escala do Impacto do Evento - Revisada (IES-R) / Cross-cultural adaptation of the Brazilian version of the Impact of Events Scale-Revised (IES-R)

A Escala de Impacto do Evento - Revisada (IES-R) é utilizada no rastreio de transtorno de estresse pós-traumático. O objetivo do estudo foi avaliar a adaptação transcultural da IES-R. Realizou-se a tradução e adaptação da escala para o português do Brasil. Confiabilidade e validade foram avaliadas entre 45 sujeitos distribuídos em 3 grupos de 15: sem transtorno, com transtorno e tratados para transtorno. A confiabilidade foi avaliada pelo Coeficiente de Correlação Intraclasse (ICC) e pelo alfa de Cronbach (α). A validade discriminante foi calculada pela comparação dos escores médios de IES-R nos 3 grupos. A área sobre a curva ROC (AUC) foi avaliada para determinar os pontos de corte com maiores sensibilidade (s) e especificidade (e), utilizando-se a entrevista clínica (DSM-IV) como referência. A IES-R exibiu boa confiabilidade (ICC = 1; α entre 0,75 e 0,93). Os escores médios da IES-R (p‹0,05) e a curva ROC mostraram boa validade discriminante para o ponto de corte de 5,6 (s = 0,80, e = 0,70 e AUC =0,81). A versão brasileira da IES-R apresentou boas propriedades e mostrou-se eficiente no rastreio de transtorno de estresse pós-traumático.

The Impact of Events Scale-Revised (IES-R) is used to screen for post-traumatic stress disorder (PTSD). The aim of this study was to assess the cross-cultural adaptation of the IES-R. The scale was translated into Brazilian Portuguese and culturally adapted. Reliability and validity were evaluated in 45 individuals divided into three groups of 15 (without PTSD, with PTSD, and treated for PTSD). Reliability was evaluated using intraclass correlation coefficient - ICC and Cronbach's alfa. Discriminant validity was evaluated by comparing mean IES-R scores in the three groups. The area under the ROC curve (AUC) was evaluated to determine cut-offs with higher sensitivity (s) and specificity (e) using the clinical interview (DSM-IV) as reference. The IES-R showed good reliability (ICC = 1; alfa from 0.75 to 0.93). The mean IES-R scores (p < 0.05) and ROC curve had good discriminant validity for a cut-off of 5.6 (s = 0.80, e = 0.70 and AUC = 0.81). The Brazilian version of IES-R showed good properties and can be a useful screening tool for PTSD.

Transtorno de estresse pós-traumático em pacientes de unidade de terapia intensiva: [revisão] / Post-traumatic stress disorder in intensive care unit patients: [review]

O transtorno de estresse pós-traumático tem sido descrito em pacientes após tratamento em unidade de terapia intensiva. O objetivo foi revisar estudos sobre os aspectos psicológicos e as intervenções terapêuticas destes pacientes após internação em unidade de terapia intensiva. Trinta e oito artigos foram incluídos. A prevalência de transtorno de estresse pós-traumático variou de 17 por cento a 30 por cento e a incidência de 14 por cento a 24 por cento. Os fatores de risco foram: história prévia de ansiedade, depressão ou pânico, ter memórias traumáticas ilusórias (memórias derivadas de formações psíquicas como sonho e delirium), tempo de ventilação mecânica, experiências estressantes, crenças e comportamentos de característica depressiva. Doses altas de opióides, sintomas na retirada da sedação ou analgesia e o uso de lorazepam foram relacionados ao aumento de delirium e de memória ilusória. A sintomatologia do transtorno pode ser reduzida com a administração de hidrocortisona, com a interrupção diária da sedação e não foram encontrados estudos de efetividade de intervenção psicológica.

Post-traumatic stress disorder has been detected in patients after treatment in intensive care unit. The main goal of this study is to review the psychological aspects and therapeutic interventions on those patients after their treatment on intensive care unit. Thirty eight articles have been included. The prevalence of post-traumatic stress disorder has varied from 17 percent up to 30 percent and the incidence from 14 percent to 24 percent. The risk factors were: previous anxiety historic, depression or panic, having delusional traumatic memories (derived from psychic formations as dreams and delirium), belief effects, depressive behavior, stressing experiences and mechanical ventilation. High doses of opiates, symptoms caused by sedation or analgesia reduction and the use of lorazepam were related with the increase of delirium and delusional memory. The disorder sintomatology can be reduced with hydrocortisone administration, with daily sedation interruption. No other effectiveness psychological intervention study was found.

Post-traumatic stress disorder in intensive care unit patients. / Transtorno de estresse pós-traumático em pacientes de unidade de terapia intensiva.

Post-traumatic stress disorder has been detected in patients after treatment in intensive care unit. The main goal of this study is to review the psychological aspects and therapeutic interventions on those patients after their treatment on intensive care unit. Thirty eight articles have been included. The prevalence of post-traumatic stress disorder has varied from 17% up to 30% and the incidence from 14% to 24%. The risk factors were: previous anxiety historic, depression or panic, having delusional traumatic memories (derived from psychic formations as dreams and delirium), belief effects, depressive behavior, stressing experiences and mechanical ventilation. High doses of opiates, symptoms caused by sedation or analgesia reduction and the use of lorazepam were related with the increase of delirium and delusional memory. The disorder sintomatology can be reduced with hydrocortisone administration, with daily sedation interruption. No other effectiveness psychological intervention study was found.

[Quality of life in chronic renal disease patients submitted to hemodialysis evaluated with SF-36 instrument]. / Qualidade de vida de pacientes com insuficiência renal crônica em hemodiãlise avaliada através do instrumento genérico SF-36.

UNLABELLED: Quality of life is a new concept in the health area and controversies exist about its application to clinical practice. Studies carried out in Brazil in the nephrology area have indicated the need for further investigations. OBJECTIVE: To analyze the quality of life of patients with different times of hemodialysis. METHODS: The study consisted of application of the questionnare SF-36, collection of demographic, socioeconomic and biochemical data, as well as of the clinical characteristics. RESULTS: The study was conducted on 184 patients, 63% of them males, aged 46 15 years (X SD), with a hemodialysis time of 30 36 months; 48% had up to 4 years of schooling and 53% belonged to the economic-social classes D and E. Impairment of the different dimensions analyzed was observed, with the poorest results being obtained for Physical Aspects and Vitality. A negative correlation was detected between Age and Functional Capacity, Physical Aspects, Pain, and Vitality, and between Hemodialysis Time and Emotional Aspects. A positive correlation was observed between Schooling and Emotional Aspects and between Hemoglobin and Vitality. We observed that diabetic patients were older than non-diabetic patients and presented lower values for the Functional Capacity and General Health condition dimensions. CONCLUSION: SF-36 proved to be a good instrument for the assessment of the quality of life of hemodialysis patients. The presence of a chronic disease, the need for continuous treatment over a long period of time, advanced age, and the presence of co-morbidities were factors that might interfere with the quality of life of this population.

Qualidade de vida de pacientes com insuficiência renal crônica em hemodiálise avaliada através do instrumento genérico SF-36 / Quality of life in chronic renal disease patients submitted to hemodialysis using the SF-36 health survey

RESUMO: Qualidade de vida é um conceito novo na área de saúde e existem controvérsias na aplicaçäo da prática clínica. No Brasil, trabalhos foram realizados na área de nefrologia, indicando a necessidade de maiores estudos. OBJETIVOS: Analisar a qualidade de vida dos pacientes com diferentes tempos de hemodiálise. MÉTODOS: O estudo constou de uma entrevista com aplicaçäo do SF-36, coleta de dados demográficos e socioeconômicos, obtençäo das principais características clínicas e coleta de dados bioquímicos. RESULTADOS: Foram estudados 184 pacientes, sendo 63 por cento do sexo masculino, com idade de 46±15anos (X±DP), tempo em hemodiálise 30±36 meses, 48 por cento com escolaridade até quatro anos e 53 por cento pertenciam às classes D e E. Constatou-se comprometimento nas diferentes dimensöes analisadas, sendo que os menores resultados foram nos aspectos físicos e vitalidade. Verificou-se correlaçäo negativa entre idade e capacidade funcional, aspectos físicos, dor e vitalidade; entre tempo de hemodiálise e aspectos emocionais. Por outro lado, constatou-se correlaçäo positiva entre escolaridade e aspecto emocionais e entre hemoglobina e vitalidade. Além disso, observou-se que os pacientes diabéticos, quando comparados aos näo diabéticos, eram mais idosos e apresentavam menores valores nas dimensöes capacidade funcional e estado geral de saúde. CONCLUSÕES: O SF-36 foi um bom instrumento para avaliar qualidade de vida de pacientes em hemodiálise. A populaçäo estudada apresentou comprometimento em várias dimensöes analisadas. A presença de doença crônica, a necessidade de tratamento contínuo por um longo período, idade avançada, assim como a presença de co-morbidades säo fatores que podem interferir na qualidade de vida dessa populaçäo

Intervenção psicológica para familiares de pacientes críticos

O contexto de internação na Unidade de Terapia Intensiva provoca nos familiares do paciente reações emocionais acompanhadas de quadros de ansiedade e implicações no contato com os profissionais de saúde. Tal contexto sugere a necessidade de intervenção psicológica junto a esses familiares. Esse estudo apresenta, através de uma breve revisão da literatura, propostas de intervenções psicoterapêuticas de suporte ou aconselhamento que apontam para a diminuição do nível de ansiedade dos familiares e a melhoria no relacionamento dos mesmos com a equipe de saúde. (AU)