RESUMO
Medical practitioners are entrusted with the pivotal task of making optimal decisions in healthcare delivery. Despite rigorous training, our confidence in reasoning can fail when faced with pressures, uncertainties, urgencies, difficulties, and occasional errors. Day-to-day decisions rely on swift, intuitive cognitive processes known as heuristic or type 1 decision-making, which, while efficient in most scenarios, harbor inherent vulnerabilities leading to systematic errors. Cognitive biases receive limited explicit discussion during our training as junior doctors in the domain of paediatric cardiology. As pediatric cardiologists, we frequently confront emergencies necessitating rapid decision-making, while contending with the pressures of stress, fatigue, an earnest interest in "doing the right thing" and the impact of parental involvement. This article aims to describe cognitive biases in pediatric cardiology, highlighting their influence on therapeutic interventions for congenital heart disease. Whether future pediatric cardiologists or experienced professionals, understanding and actively combating cognitive biases are essential components of our ongoing medical education. Furthermore, it is our responsibility to thoroughly examine our own practices in our unwavering commitment to providing high-quality care.
RESUMO
INTRODUCTION: Neurofibromatosis type 1 (NF1) is a genetic pathology that can lead to impaired social functioning that has a negative impact on patients' quality of life. To date, although the hypothesis of impaired social cognition has been proposed as a potential explanation for these difficulties, very few studies have focused on theory of mind in children with NF1. Furthermore, other complex sociocognitive abilities have never been investigated. The aim of the present study was to assess theory of mind, moral reasoning, and social information processing in children with NF1 compared with a control group. METHOD: We administered the Paediatric Evaluation of Emotions, Relationships and Socialization® to 38 children with NF1 aged between 8 years and 16 years 11 months (mean = 11.4, SD = 2.3) and 43 control children with comparable sociodemographic characteristics. RESULTS: Patients performed significantly worse than controls on moral reasoning and social information processing tests, but there was no significant difference on theory of mind. CONCLUSIONS: These results seem to confirm the presence of social cognition difficulties in NF1 that could explain, at least in part, their social difficulties, although not all dimensions are concerned. The differences between the processes we assessed are discussed in relation to the methodologies used to measure them, and raises questions about the complementarity of traditional tools and more ecological assessments.
Assuntos
Neurofibromatose 1 , Cognição Social , Teoria da Mente , Humanos , Neurofibromatose 1/complicações , Neurofibromatose 1/psicologia , Criança , Masculino , Feminino , Adolescente , Teoria da Mente/fisiologia , Testes Neuropsicológicos , Princípios Morais , Transtornos Cognitivos/etiologiaRESUMO
OBJECTIVE: The present study is the first to examine theory of mind (ToM) sequelae in a sample of adult survivors of primary brain tumors, and to investigate the assumed relationship between ToM and health-related quality of life (HRQoL). METHOD: Participants were 40 long-term adult survivors of primary brain tumors and 40 matched healthy controls. They completed ToM tests (Faux-Pas test and Advanced ToM task) and two questionnaires assessing HRQoL (36-Item Short-Form Health Survey and EORTC QLQ-C30/QLQ-BN20). Their relatives also completed an observer-rated version of the SF-36 questionnaire. RESULTS: Survivors performed worse than controls only on the Advanced ToM task. Overall, patients and caregivers reported more problems than healthy controls and their relatives regarding both global HRQoL and its social/emotional aspects. No relationship was found between ToM and HRQoL scores. CONCLUSION: Adult survivors of primary brain tumors may exhibit ToM deficits several years after treatment and report more problems on social/emotional HRQoL components. Our findings highlight the need to consider these late effects in survivors' long-term follow-up, even if the clinical involvement of ToM deficits still needs to be elucidated. The assessment of ToM deficits and their potential impact on survivors' everyday life is thoroughly discussed.
Assuntos
Neoplasias Encefálicas , Teoria da Mente , Adulto , Humanos , Qualidade de Vida , Cognição Social , Neoplasias Encefálicas/complicações , Sobreviventes/psicologia , Testes NeuropsicológicosRESUMO
In recent years, a growing number of studies have been associating Developmental dyslexia (DD) with alterations in executive functions (EF). However, the literature still hasn't reached a consensus on this subject. This study objective was to carry out a systematic literature review of the most explored functions and neuropsychological instruments for the assessment of EF on children and teenagers with DD, between the years of 2007 and 2017. Seventy-one different instruments for the assessment of EF in individuals with DD were mapped. The most used tests were the Digit Span Task, the Stroop Test and the Tower of London. The most studied EF was working memory. It was concluded that the recent interest in this research field, the wide variety of instruments employed and of EF models adopted hamper the establishment of a consensus on the influence of the diverse aspects of EF on DD.
Nos últimos anos, crescente número de estudos tem associado à Dislexia do Desenvolvimento (DD) a alterações em funções executivas (FE). No entanto, a literatura ainda não apresenta consenso quanto a esta questão. Este estudo teve como objetivo realizar revisão sistemática da literatura, investigando os instrumentos e as funções neuropsicológicas mais exploradas para avaliar as FE em crianças e adolescentes com DD, entre os anos de 2007 e 2017. Foram mapeados 71 instrumentos para avaliar FE em indivíduos com DD. Os testes mais utilizados foram o Digit Span Task, o Stroop Test e o Tower of London. A FE mais estudada foi a memória de trabalho. Conclui-se que o recente interesse neste campo de pesquisa, a grande variedade de instrumentos empregados e de modelos de FE adotados dificulta o estabelecimento de um consenso sobre a influência dos diversos aspectos das FE na DD.
En los últimos años, un creciente número de estudios asocian la dislexia del desarrollo (DD) a alteraciones en las funciones ejecutivas (FE). Sin embargo, la literatura aún no ha llegado a un consenso sobre este tema. El objetivo de este estudio fue realizar una revisión sistemática de la literatura de las funciones más exploradas y los instrumentos neuropsicológicos más utilizados para la evaluación de las FE en niños y adolescentes con DD, entre los años de 2007 y 2017. Fueron mapeados 71 instrumentos diferentes para la evaluación de EF en individuos con DD. Las pruebas más utilizadas fueron la Tarea de Digit Span, la Prueba de Stroop y la Torre de Londres. La FE más estudiada fue la memoria de trabajo. Se concluyó que el reciente interés en este campo de investigación, la gran variedad de instrumentos empleados y de modelos de FE adoptados dificultan el establecimiento de un consenso sobre la influencia de los diversos aspectos de las EF en la DD.
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Humanos , Criança , Adolescente , Criança , Adolescente , Dislexia/psicologia , Função Executiva , Testes Neuropsicológicos , Cognição , MétodosRESUMO
This study aimed to describe the processes of translation and cross-cultural adaptation to Brazilian Portuguese of the Childhood Executive Functions Battery (CEF-B), designed to evaluate executive functions in children and adolescents from 6 to 16 years of age. Six steps were carried out to ensure the quality of the processes: 1) instrument translation into the new language; 2) synthesis of the translated versions; 3) evaluation of the synthesized version by experts; 4) evaluation by the target population; 5) back-translation and 6) pilot study. We sought to ensure the translation and adaptation properties of the CEF-B in terms of semantic, idiomatic, experiential and cultural equivalence between the instructions in the original language and the target language. Results showed preliminary evidence of cultural adequacy and a satisfactory comprehension of the instrument instructions by the target population. (AU)
Este estudo objetiva descrever os procedimentos de tradução e adaptação transcultural para o português brasileiro do Protocolo Funções Executivas em Crianças (FEC), voltado para a avaliação das funções executivas de crianças e adolescentes de 6 a 16 anos. Para garantir a qualidade do processo, foram realizadas seis etapas: 1) tradução do instrumento do idioma de origem para o idioma-alvo; 2) síntese das versões traduzidas; 3) avaliação por experts; 4) avaliação pelo público-alvo; 5) tradução reversa e 6) estudo piloto. Buscou-se assegurar as propriedades da tradução e adaptação do protocolo FEC, em termos de equivalência semântica, idiomática, experiencial e cultural entre as instruções no idioma original e no idioma-alvo. Os resultados apontaram evidências iniciais de adequação cultural e boa compreensão das instruções do instrumento pelo público-alvo. (AU)
Este estudio objetiva describir los procedimientos de traducción y adaptación transcultural del protocolo Funciones Ejecutivas en Niños (FEN) para el portugués brasileño, dirigido a la evaluación de las funciones ejecutivas de los niños y adolescentes de 6 a 16 años. Para garantizar la calidad del proceso, se realizaron 6 etapas: 1) traducción del instrumento del idioma de origen al idioma de destino; 2) síntesis de las versiones traducidas; 3) evaluación por expertos; 4) evaluación por el público objetivo; 5) traducción inversa y 6) estudio piloto. Se buscó garantizar las propiedades de la traducción y adaptación del protocolo FEN, en términos de equivalencia semántica, idiomática, experiencial y cultural entre las instrucciones en el idioma original y en el idioma de destino. Los resultados apuntaron evidencias iniciales de adecuación cultural y buena comprensión de las instrucciones del instrumento por el público objetivo. (AU)