Averiguando os caminhos da psicoterapia domiciliar / Ascertaining the ways of home psychotherapy

A psicoterapia domiciliar é uma prática pouco conhecida que, entretanto, adquire importância junto a pacientes com dificuldade de locomoção ou com presença de patologias que dificultem o acesso à hospitais/ clínicas. Tendo em vista a escassez de estudos sobre o tema, este artigo apresenta os resultados de uma pesquisa exploratória sobre o atendimento psicológico domiciliar, realizado com 21 psicólogos da cidade de Curitiba (PR). O objetivo foi identificar o tipo de clientela atendida, quais as abordagens e quais as principais vantagens e desvantagens relacionadas a esse tipo de atendimento. Identificou-se que essa modalidade é mais cômoda para o cliente, mas nem sempre para o profissional. Há predominância de algumas vantagens na psicoterapia realizada em domicílio como manutenção do vínculo terapêutico, maior acesso a informações importantes advindas da observação do ambiente e dos comportamentos espontâneos devido à familiaridade do paciente com o ambiente, o que possibilita novas referências para análise diagnóstica.

Home psychotherapy is a little-known practice that, however, acquires importance among patients with locomotion difficulties or with the presence of pathologies that make access to hospitals / clinics difficult. Considering the lack of studies on the subject, this article presents the results of an exploratory research on home psychological care, performed with 21 psychologists from the city of Curitiba (PR). The objective was to identify the type of clientele served, which approaches and what are the main advantages and disadvantages related to this kind of service. It was identified that this modality is more comfortable for the client, but not always for the professional. There is a predominance of some advantages in home psychotherapy as maintenance of the therapeutic link, greater access to important information from the observation of the environment and spontaneous behaviors due to the patient’s familiarity with the environment, which makes possible new references for diagnostic analysis.

A formação acadêmica para a integração da religiosidade/espiritualidade na prática do psicólogo / The academic formation for the integration of religiosity and spirituality in the psychologist´s practice

Várias pesquisas apontam que os profissionais de saúde, destacando-se entre eles os/as psicólogos/as, costumam negligenciar a escuta dos aspectos espirituais e religiosos, evitando o tema e no máximo encaminhando o paciente para o serviço da pastoral, quando este é existente. Por intermédio da identificação dos cursos de Psicologia nas diversas instituições da região Sul e Sudeste, efetuou-se uma pesquisa documental. A partir da análise das grades curriculares disponíveis on-line, buscou-se encontrar disciplinas cujo nome sugerisse a abordagem do tema da espiritualidade/religiosidade. Identificou-se que a integração dos aspectos religiosos/espirituais com a prática profissional foi encontrada em apenas 4 (quatro) descrições disciplinares. Este dado comprova o silêncio que reina sobre este tema na formação do profissional psicólogo, bem como a falta de diálogo entre a Psicologia e a Teologia, mesmo nas escolas confessionais. É imperativo que se reveja a postura dos centros de formação, incluindo-se tanto a presença do tema na grade curricular como fomentando a pesquisa interdisciplinar.(AU)

Several studies indicate that health professionals, especially psychologists, tend to neglect listening to spiritual and religious aspects, avoiding the topic and, at best, referring the patient to pastoral service when it exists. Through the identification of Psychology courses in the various institutions of the South and Southeast, a documentary research was carried out. From the analysis of curricula available online, we sought to find disciplines whose name suggested approaching the theme of spirituality/ religiosity. It was found that the integration of religious/ spiritual aspects with professional practice was found in only four subjects. This data proves the silence that reigns on this theme in the formation of the professional psychologist, as well as the lack of dialogue between Psychology and Theology, even in confessional schools. It is imperative to review the posture of training centers, including both the presence of the theme in the curriculum and fostering interdisciplinary research.(AU)

Quality of life in hemodialysis patients and the relationship with mortality, hospitalizations and poor treatment adherence.

INTRODUCTION: Chronic kidney disease (CKD) causes sudden changes in the daily lives of patients, creates limitations to perform activities of daily life and creates a great impact on emotions and quality of life (QOL) of patients. OBJECTIVE: To understand the relationship between QOL of patients on dialysis and mortality rates, hospitalization and absences. METHODS: A prospective descriptive study with 286 patients on hemodialysis, by applying demographic questionnaire, KDQOL SF-36 and electronic medical record analysis Dialsist. RESULTS: The mean age was 54.71 ± 14.12 years, with a mean score of QOL 60.53 having as higher factor encouraging the support team (85.03) and lowest in work status (21.11). The days of hospitalization is negatively correlated to the compounds of the instrument, particularly in physical functioning (p = 0.000), mean score (p = 0.001) and emotional well-being (p = 0.005). Women had lower QOL in physical role scores, symptoms/problems, physical functioning, emotional well-being, energy and fatigue mean score (p ≤ 0.05). The lowest score was found to be related to treatment of patients in 1 year and 7 months and 5 years (59.93) and higher in patients with more than five years and one month (61.39). CONCLUSION: Hospitalizations decrease QV emotional and physical scores and absences are directly related to social support and age. The study looked through the data raise subsidies for the work of the aspects that need stimulation and adaptation in the lives of patients, providing a better balance in the individual's life.

Quality of life in hemodialysis patients and the relationship with mortality, hospitalizations and poor treatment adherence / Qualidade de vida de pacientes em hemodiálise e sua relação com mortalidade, hospitalizações e má adesão ao tratamento

Abstract Introduction: Chronic kidney disease (CKD) causes sudden changes in the daily lives of patients, creates limitations to perform activities of daily life and creates a great impact on emotions and quality of life (QOL) of patients. Objective: To understand the relationship between QOL of patients on dialysis and mortality rates, hospitalization and absences. Methods: A prospective descriptive study with 286 patients on hemodialysis, by applying demographic questionnaire, KDQOL SF-36 and electronic medical record analysis Dialsist. Results: The mean age was 54.71 ± 14.12 years, with a mean score of QOL 60.53 having as higher factor encouraging the support team (85.03) and lowest in work status (21.11). The days of hospitalization is negatively correlated to the compounds of the instrument, particularly in physical functioning (p = 0.000), mean score (p = 0.001) and emotional well-being (p = 0.005). Women had lower QOL in physical role scores, symptoms/problems, physical functioning, emotional well-being, energy and fatigue mean score (p ≤ 0.05). The lowest score was found to be related to treatment of patients in 1 year and 7 months and 5 years (59.93) and higher in patients with more than five years and one month (61.39). Conclusion: Hospitalizations decrease QV emotional and physical scores and absences are directly related to social support and age. The study looked through the data raise subsidies for the work of the aspects that need stimulation and adaptation in the lives of patients, providing a better balance in the individual's life.

Resumo Introdução: A doença renal crônica (DRC) acarreta mudanças repentinas no cotidiano dos pacientes, cria limitações para realizar as atividades de vida diária e gera um grande impacto nas emoções e na qualidade de vida (QV) do paciente. Objetivo: Compreender a relação entre a QV do paciente em hemodiálise e as taxas de mortalidade, hospitalização e faltas. Métodos: Estudo descritivo e prospectivo com 286 pacientes em hemodiálise, mediante aplicação de questionário sociodemográfico, KDQOL SF - 36 e análise de prontuário eletrônico Dialsist. Resultados: Idade média de 54,71 ± 14,12 anos, com escore médio de QV de 60,53, tendo como fator mais elevado o encorajamento da equipe de apoio (85,03) e menor em status de trabalho (21,11). Os dias de hospitalização se correlacionaram negativamente aos compostos do instrumento, principalmente no funcionamento físico (p = 0,000), escore médio (p = 0,001) e bem-estar emocional (p = 0,005). As mulheres apresentaram menor QV em escores de papel físico, sintomas/problemas, funcionamento físico, bem-estar emocional, energia fadiga e escore médio (p ≤ 0,05). O menor escore encontrado foi referente aos pacientes em tratamento entre 1 ano e 7 meses e 5 anos (59,93) e o maior em pacientes com mais de 5 anos e 1 mês (61,39). Conclusão: As hospitalizações diminuem a QV do quesito emocional e físico e as faltas estão diretamente relacionadas ao suporte social e à idade. O estudo buscou, por meio dos dados, levantar subsídios para o trabalho dos aspectos que necessitam de estimulação e adaptação na vida dos pacientes, proporcionando um maior equilíbrio na vida do indivíduo.