Sexual dysfunction, depression, and marital dissatisfaction among Brazilian couples.

BACKGROUND: Health professionals treating sexual dysfunction and relational dissatisfaction recognize that they are multifactorial phenomena, and depression can be bidirectionally associated with both. AIM: The purpose of this study was to investigate sexual dysfunction in heterosexual couples in relation to the quality of their marital relationship and depression symptoms. METHODS: The sample consisted of 100 heterosexual couples recruited in Brazil. Both partners of each couple completed the Golombok-Rust Inventory of Sexual Satisfaction and the Golombok-Rust Inventory of Marital Satisfaction, which were translated and adapted, and the Beck Depression Inventory, which was validated for the Brazilian population. Both partners completed their questionnaires separately, and the couple's surveys were linked to preserve conjugal data for dyadic analysis. The Actor-Partner Interdependence Model was used to understand how sexual dysfunction in couples is related to depression and relationship quality among and between partners. RESULTS: Sexual dysfunction was found to be strongly associated with dissatisfaction in the relationship (husbands, ß = 0.57, P < 0.001; wives, ß = 0.60, P < 0.001), and a positive association was found between depressive symptoms and marital dissatisfaction (husbands, ß = .32, P < .001; wives ß = .40, P < .001). CLINICAL IMPLICATION: The results suggest that it is important for health professionals to be aware of the dyadic impact of struggles with both sex and the relationship and the presence of depression symptoms in patients who seek care for sexual complaints or depression and who are in a marital relationship. STRENGTHS AND LIMITATIONS: The different results found for men and women may shed light on the biopsychosocial dimensions of human sexuality. When treated as a purely physical experience, sex is myopic. In this study we demonstrated psychosocial aspects associated with gender and sexuality, and the partner's variables were found to have a greater impact on women than they did on the men. A limitation of this study is that the sample is not generalizable as it is not demographically representative of all socioeconomic groups in Brazil. Furthermore, the participants in this sample did not have clinical levels of depression, so the results cannot be extended to couples in which one or both spouses have depressive disorder. CONCLUSION: It was found that sexual dysfunction is strongly associated with the quality of the couple relationship, and that the quality of relationship plays a mediating role between depression and marital quality, especially for the women.

Translation and preliminary validation of the Brazilian family resources scale in a sample of parents of children with congenital Zika virus syndrome.

PURPOSE: Family-centered rehabilitative care optimizes outcomes for children with significant developmental disabilities. Family-centered services involve assessing family resources that promote positive developmental outcomes for children. Little is known regarding family resources in the context of caring for a child with developmental disabilities in Brazil due to an absence of validated measures. This study describes the translation and cultural adaptation of the Family Resource Scale and explored the measurement quality of the resulting measure (the Brazilian-Family Resource Scale, or B-FRS). METHODS: A rigorous serial translation process that emphasized linguistic accuracy as well as cultural adaptation was utilized. The resulting 27-item B-FRS was theoretically related and reflected the contextual intent of the original measure. RESULTS: A four-factor scoring approach yielded acceptable internal consistency estimates for the subscales and total scale score. Overall, low levels of family resources were reported by caregivers of children with Congenital Zika Syndrome. Low family resources were associated with parental depressive and stress-related symptoms. CONCLUSION: Confirmatory factor analysis of the B-FRS in a larger sample is recommended. Practitioners in Brazil should broadly consider family needs and resources to provide family-centered care that is effective for the child and engages the family in a way that highlights their strengths and promotes positive developmental trajectories.

Implementation of Participatory Research in Vulnerable Context: Methodological Strategies and Challenges / Implementação de Pesquisa Participativa em Contexto de Vulnerabilização: Estratégias e Desafios Metodológicos / Implementación de la Investigación Participativa en un Contexto de Vulnerabilidad: Estrategias y Desafíos Metodológicos

Abstract Participatory methods contribute to scientific rigor by highlighting the contextual needs, especially of underrepresented populations, making them protagonists in the process of social change. This article aims to present the application of a participatory research method, called Community-Based Participatory Research (CBPR), in a context of social vulnerability in southern Brazil. It seeks to discuss the challenges and strengths of the method, which provides ecological validity for the development of public policies appropriate to the context, while empowering the participants. The research has been carried out since 2019 and, among the inherent challenges, has also faced the difficulties posed by the COVID-19 pandemic. Based on the application of this method in Brazil, the importance of involving participants throughout the research process has been identified, so that policies are developed to meet the needs of the community and are sustained by those most interested.

Resumo Métodos participativos contribuem para o rigor científico ao evidenciarem demandas do contexto, especialmente com populações sub-representadas, tornando-as protagonistas do processo de transformação social. Este estudo objetivou apresentar a aplicação de um método participativo de pesquisa, a Community-Based Participatory Research (CBPR), em um contexto de vulnerabilização social no sul do Brasil. Busca-se discutir os desafios e as potencialidades do método, que oferece recursos de validade ecológica para o desenvolvimento de políticas públicas próprias ao contexto, ao mesmo tempo em que empodera seus participantes. A pesquisa vem sendo realizada desde o ano de 2019 e, dentre os desafios inerentes, também enfrentou as dificuldades impostas pela pandemia de Covid-19. A partir da aplicação deste método em contexto brasileiro, identificou-se a relevância de se envolver os participantes ao longo do processo de pesquisa, a fim de que as ações desenvolvidas sejam desenvolvidas em coerência com as demandas trazidas pela comunidade, e mantidas por aqueles que são seus maiores interessados.

Resumen Los métodos participativos contribuyen al rigor científico al destacar las necesidades del contexto, especialmente de las poblaciones subrepresentadas, haciéndolas protagonistas del proceso de cambio social. Este artículo pretende presentar la aplicación de un método de investigación participativa, denominado Investigación Participativa Basada en la Comunidad (IBCB), en un contexto de vulnerabilidad social en el sur de Brasil. Busca discutir los desafíos y fortalezas del método, con validez ecológica para el desarrollo de políticas públicas, al tiempo que empodera a los participantes. La investigación empezó en 2019 y, entre los desafíos, también se ha enfrentado a las dificultades planteadas por la pandemia de Covid-19. A partir de la aplicación de este método en el contexto brasileño, se ha identificado la importancia de involucrar a los participantes en el proceso de investigación, para que se desarrollen políticas que respondan a las necesidades de la comunidad y sean mantenidas por los más interesados.

Anxiety and depression among caregivers of young children with Congenital Zika Syndrome in Brazil.

PURPOSE: To examine the psychological well-being of primary caregivers of infants and toddlers with Congenital Zika Syndrome (CZS), and the roles of family resources, parenting stress, and coping strategies in caregivers' adaptation. MATERIALS AND METHODS: Family caregivers (N = 50) of children with CZS who were receiving treatment at a rehabilitation hospital in Recife, Brazil participated a cross-sectional survey study. Caregivers completed measures of anxiety and depression, coping strategies, family resources, and parenting stress. RESULTS: Mild to severe symptoms of depression were identified in 40% of caregivers and were a more prominent concern than symptoms of anxiety. Fewer family resources and high levels of parenting stress were significantly associated with both anxiety and depression. The association between parenting stress and depression was moderated by coping, such that parenting stress was associated with higher caregiver depression at low but not high levels of coping strategy use. CONCLUSIONS: Practitioners in Brazil should consider the role of family coping and resources as important resilience promoting factors in the development of new programs designed to promote psychological adaptation in caregivers to children with CZS. It is recommended that caregiver mental health support services be integrated into existing early intervention programs targeting children with CZS.Implications for RehabilitationParents and other primary caregivers are encouraged to take an active role in the care and developmental monitoring of children born with CZS, but their ability to provide care may be compromised by difficulties in psychological adaptation.Moderate and severe symptoms of depression were more prominent in caregivers than moderate and severe symptoms of anxiety (20% versus 6%, respectively).Practitioners should include assessment of coping strategies, parenting stress and family resources conjointly with evaluation of symptoms of depression and anxiety as part of routine CZS family evaluations.A useful approach for caregivers in Brazil may be to more fully integrate caregiver mental health support services into existing early intervention programs for children with CZS.

Validation of vulnerability markers of dysfunctions in the socioemotional development of infants.

OBJECTIVES: to validate the vulnerability markers of dysfunctions in the socioemotional development of infants. METHODS: study with a sequential exploratory mixed-method design. The vulnerability markers elaborated in the qualitative phase were analyzed by experts in the quantitative phase using the Delphi technique with a minimum consensus of 70%. Seventeen judges answered the questionnaire in the first round of analysis and 11 answered in the second round. RESULTS: in the first round, two markers did not reach minimum consensus: the presence of instability in family relationships (66%) and delinquency and/or drug abuse by parents/caregivers (65%). In the second round, all markers were validated, with more than 90% agreement in most of the attributes, and reached the minimum consensus of 73%. CONCLUSION: the eight vulnerability markers reached the minimum consensus for validation, and a relevant instrument for infant care can be developed after assessing the reliability and clinically validating these markers.

Validation of vulnerability markers of dysfunctions in the socioemotional development of infants / Validação de marcadores de vulnerabilidade de lactentes para disfunções em seu desenvolvimento socioemocional / Validación de los marcadores de vulnerabilidad de los lactantes para las disfunciones en su desarrollo socioemocional

ABSTRACT Objectives: to validate the vulnerability markers of dysfunctions in the socioemotional development of infants. Methods: study with a sequential exploratory mixed-method design. The vulnerability markers elaborated in the qualitative phase were analyzed by experts in the quantitative phase using the Delphi technique with a minimum consensus of 70%. Seventeen judges answered the questionnaire in the first round of analysis and 11 answered in the second round. Results: in the first round, two markers did not reach minimum consensus: the presence of instability in family relationships (66%) and delinquency and/or drug abuse by parents/caregivers (65%). In the second round, all markers were validated, with more than 90% agreement in most of the attributes, and reached the minimum consensus of 73%. Conclusion: the eight vulnerability markers reached the minimum consensus for validation, and a relevant instrument for infant care can be developed after assessing the reliability and clinically validating these markers.

RESUMO Objetivos: validar marcadores de vulnerabilidade à disfunções no desenvolvimento socioemocional de lactentes. Métodos: pesquisa de método exploratório sequencial misto. Os marcadores de vulnerabilidade elaborados na fase qualitativa foram analisados por especialistas na fase quantitativa utilizando a técnica Delphi com consenso mínimo de 70%. Dezessete juízes responderam o questionário na primeira rodada de análise e 11 responderam na segunda rodada. Resultados: na primeira rodada, dois marcadores não alcançaram o consenso mínimo: presença de instabilidade nas relações familiares (66%) e situação de delinquência e/ou abuso dos pais/cuidadores (65%). Na segunda rodada, todos os marcadores foram validados, com mais de 90% de concordância na maioria dos atributos, e alcançaram o consenso mínimo de 73%. Conclusão: os oito marcadores de vulnerabilidade alcançaram consenso mínimo para a sua validação e foram habilitados à verificação de confiabilidade e validação clínica para compor um instrumento relevante ao cuidado do lactente.

RESUMEN Objetivos: validar los marcadores de vulnerabilidad de los lactantes para las disfunciones en el desarrollo socioemocional. Método: investigación de método exploratorio secuencial mixto. Los marcadores de vulnerabilidad, elaborados en la fase cualitativa, fueron sometidos a los especialistas en la fase cuantitativa del estudio, por medio de la Técnica Delphi, con el consenso mínimo del 70%. En la primera ronda de análisis, 17 jueces respondieron a la investigación y en la segunda ronda, 11 respondieron a la misma investigación. Resultados: en la primera ronda, dos marcadores no alcanzaron el consenso mínimo: Presencia de inestabilidad en las relaciones familiares (66%) y Situación de delincuencia y/o abuso de los padres/cuidadores (65%). En la segunda ronda, todos los marcadores fueron validados, con más del 90% de concordancia en la mayoría de los atributos, habiendo alcanzado el valor mínimo del 73%. Conclusión: los ocho marcadores de vulnerabilidad alcanzaron consenso mínimo para su validación, estando habilitados a la verificación de confiabilidad y validación clínica, para componer un instrumento relevante al cuidado del lactante.

Rede de apoio social e funcionamento familiar: estudo longitudinal sobre famílias em vulnerabilidade social / Social support and family functioning: longitudinal study of vulnerable families

Este estudo tem o objetivo de verificar se a qualidade da rede de apoio social dos cuidadores das famílias influencia longitudinalmente o funcionamento familiar. Os dados utilizados são parte de uma pesquisa mais ampla, que acompanhou 148 famílias de Porto Alegre por 15 anos. Para este estudo, foram utilizadas a escala Global Assessment of Relational Functioning (GARF) para avaliar funcionamento familiar, e uma escala de cinco pontos atribuída por uma dupla de pesquisadores após observarem aspectos da rede de apoio social dos membros. Análises de qui-quadrado e Generalized Estimating Equation indicaram diferenças na rede de apoio social de acordo com a configuração das famílias. Além disso, a rede de apoio social mostrou-se associada à qualidade do funcionamento familiar. Esta análise também sofreu impacto das diferentes etapas do ciclo vital, mostrando efeito longitudinal desta associação. Os resultados indicaram o papel protetivo da rede de apoio dos cuidadores sobre o funcionamento familiar.(AU)

This study aims to verify if the caregivers' quality of the social support influences family longitudinaly. Data are part of a wider study, which followed 148 families living in Porto Alegre city for 15 years. For this study, it was used the Global Assessment of Relational Functioning Scale (GARF) to assess family functioning, and a five-point scale assigned by a pair of researchers after observing aspects of members' social support. Chi-square and Generalized Estimating Equation analysis indicated differences in social support according to the family configuration. In addition, the social assigned by a pair support was associated to the quality of family functioning. This analysis also was impacted by different stages through the lifespam, showing longitudinal effect of this association. The results indicated the protective role of caregivers' social support on family functioning.(AU)

Depressão pós-parto e satisfação conjugal: impacto longitudinal em uma amostra brasileira / Postpartum depression and marital satisfaction: a longitudinal study in a Brazilian sample / Depresión posparto y satisfacción con la relación de pareja: impacto longitudinal en una muestra brasileña

Objetivo: O objetivo deste trabalho foi verificar a relação entre a satisfação conjugal e a depressão pós-parto e o impacto destas variáveis nos níveis de satisfação conjugal e depressão futuros, em uma amostra brasileira. Estudos revelam que o conflito conjugal é um antecedente importante no desenvolvimento da depressão e que a depressão pós-parto influencia significativamente a satisfação conjugal. Métodos: Este estudo longitudinal com 99 mulheres brasileiras utilizou análises de regressão múltipla para verificar a associação entre a satisfação conjugal e a depressão. A sintomatologia depressiva foi avaliada pelo instrumento Self-Reporting Questionnaire (SRQ-20). A satisfação conjugal foi verificada a partir de itens sobre a percepção de satisfação conjugal das participantes. Os dados foram coletados 4 meses e 2 anos após o parto. Os dados longitudinais possibilitaram a análise cronológica da interação entre as duas variáveis. Resultados e Conclusões: Os resultados indicam que o modelo teórico que estabelece a relação entre conflito conjugal e depressão é também apropriado para casais brasileiros, sugerindo a utilização potencial da terapia de casal no tratamento da depressão pós-parto no Brasil.

Objective: This study examined the relationship between marital satisfaction and postpartum depression as well as the impact of postpartum depression and marital satisfaction on later relational characteristics among Brazilian couples. Studies have shown that marital satisfaction is an important antecedent to depression and that postpartum depression has an influence on marital satisfaction. Methods: A longitudinal study using multiple regression to test the association between marital satisfaction and depression was conducted among Brazilian women. Depressive symptomatology was assessed using the Self-Reporting Questionnaire 20 and marital satisfaction using an instrument developed by the researchers to test the individuals' perception of their marital quality. Data were collected at 4 months and 2 years after childbirth. The longitudinal data allowed researchers to chronologically analyze the interaction of key variables. Results and Conclusions: Results showed that the model established between marital satisfaction and depression is appropriate for Brazilian couples as well as for postpartum women. This study highlights the potential impact of marital treatment on postpartum depression in Brazil.

Objetivo: El objetivo de este trabajo fué verificar la relación existente entre la satisfacción con la relación de pareja y la depresión pos-parto y el impacto de esas variables en los niveles de satisfacción con la relación de pareja y depresión futuros, en una muestra brasileña. Estudios revelan que el conflicto de pareja és un antecedente importante en el desarollo de depresión y que la depresión pos-parto provoca influencia significativa en la relación de pareja. Métodos: Este estudio longitudinal con 99 mujeres brasileñas hizo uso de análisis de regresión multiple para estudiar la asociación entre la satisfacción en la relación de pareja y la depresión. Los sintomas depresivos fueron evaluados por el instrumento Self-Reporting Questionnaire (SRQ-20). La satisfacción con la relación de pareja fué verificada utilizando datos sobre la percepción de satisfacción de las participantes. Los datos fueron obtenidos 4 meses y 2 años después del parto. Resultados y Conclusiones: Los resultados indican que el modelo teórico que establece la relación entre conflicto de pareja y depresión és tambien apropriado para parejas brasileña s y sugiere la posibilidad de utilización de la terapia de pareja en el tratamiento de la depresión pos-parto en Brasil.

Portuguese translation and validation of the Revised Dyadic Adjustment Scale.

The absence of a translated and validated instrument for measuring marital satisfaction in Brazil, the largest country in South America and fifth most populous country in the world, is a significant barrier for research and mental health service delivery. The purpose of this study was to translate and validate a marital satisfaction scale into Portuguese that would have both empirical credibility and cultural relevance in Brazil. A six-step serial approach was used to simultaneously translate and culturally validate the Revised Dyadic Adjustment Scale (RDAS). The translated instrument (RDAS-P) demonstrated good psychometric properties during field testing.

Finding the heart of medical family therapy: a content analysis of medical family therapy casebook articles.

In an effort to identify the essential ingredients of medical family therapy, a content analysis of 15 peer-reviewed case studies in medical family therapy was conducted. The case studies were published from 1996 to 2007 in Families, Systems, & Health. Through a qualitative content analysis, three main themes emerged that describe the essence of the practice of medical family therapy: (1) The patient's multisystemic experience of disease, (2) treatment is about caring, not just caregiving, and (3) elevating the patient as collaborator in the care team.

Marital satisfaction and depression: a replication of the Marital Discord Model in a Latino sample.

The Marital Discord Model of Depression maintains that marital discord is an important antecedent in the development of depression. Although empirical evidence supports this premise, none of this research has been done with Latinos. The purpose of this study was to test the longitudinal relationship between marital satisfaction and depression among 99 Brazilian women. Using structural equation modeling, results indicated that marital satisfaction was a strong predictor of depression 2 years later. Marital satisfaction was also related to cooccurring depression. These results provide evidence that the Marital Discord Model of Depression is an appropriate theoretical model for the conceptualization of marital discord and depression with Latina women and suggest the potential utility of using couples therapy for treating depression among this population.