Pistas para pensar o cuidado no contexto hospitalar / Clues to think about care in the hospital context / Pistas para pensar el cuidado en el contexto hospitalario

O objetivo deste artigo é dar voz a reflexões produzidas entre psicólogas, estudantes de psicologia e professoras e/ou trabalhadoras da saúde durante e após o desenvolvimento de uma experiência cartográfica de cuidado compartilhado, suscitada por rodas de conversa com cuidadores de pacientes internados em um hospital geral no interior do estado do Espírito Santo. Diante do trabalho realizado com as rodas, nos foi possível pensar e repensar a nossa atuação, colocando em análise as práticas da psicologia hospitalar, e como podemos reinventá-las diariamente, principalmente quando nos colocamos disponíveis para as modulações do campo e para os desvios das rotas planejadas. O caminho teórico-metodológico cartográfico, a partir de leituras esquizoanalíticas, possibilitou que colocássemos em xeque o lugar engessado do especialista, além de fortalecer a possibilidade do trabalho com grupos em uma emergência hospitalar. (AU)

The aim of this article is to give voice to reflections produced by psychologists, psychology students, teachers and/or health area workers, during and after the development of a cartographic experience of shared care, raised by circles of conversation with caregivers of patients admitted to a general hospital in the countryside of the state of Espírito Santo. Given the work done with the coterie, it was possible for us to think and rethink our performance, analyzing the practices of hospital psychology, and how we can reinvent them daily, especially when we are available for field modulations and deviations of the planned routes. The theoretical-methodological cartographic path, based on schizoanalytic readings, enabled us to put the specialist's plastered place in check, in addition to strengthening the possibility of working with groups in a hospital emergency. (AU)

El objetivo de este artículo es dar voz a las reflexiones producidas por psicólogas, estudiantes de psicología y maestras y/o trabajadoras de la salud durante y después del desarrollo de una experiencia cartográfica de atención compartida, generada por círculos de conversación con cuidadores de pacientes hospitalizados en un hospital general del interior dela província de Espírito Santo. Dado el trabajo realizado con las ruedas, nos fue posible pensar y repensar nuestro desempeño, analizando las prácticas de la psicología hospitalaria y cómo podemos reinventarlas diariamente, especialmente cuando estamos disponibles para modulaciones y desviaciones de campo. La ruta cartográfica teórico-metodológica, basada en lecturas esquizoanalíticas, nos permitió poner a prueba el lugar enlucido del especialista, además de fortalecer la posibilidad de trabajar con grupos en una emergencia hospitalaria. (AU)

Experiencias del tratamiento metodológico interdisciplinar al tema Historia Psicosocial en la Facultad de Ciencias Médicas Guantánamo / Experiences of the interdisciplinary methodological treatment to the subject Psychosocial History in the Faculty of Medical Sciences Guantánamo

Se realizó una investigación de corte pedagógico, resultado del trabajo metodológico realizado por los docentes de la Disciplina Psicología Médica II para perfeccionar la preparación metodológica del claustro docente en el tratamiento al contenido Historia Psicosocial. Se aprovechó el sistema de contenidos básicos de Psicología Médica II vinculados con la asignatura Propedéutica médica y semiología clínica. Los principales resultados se encuentran en la falta de correspondencia entre el modelo de Historia Psicosocial que se imparte en la asignatura Psicología Médica II con el que reciben los estudiantes en la asignatura Propedéutica, la desactualización de la bibliografía. El sistema de clases metodológicas desarrolladas dio respuesta al problema conceptual metodológico, se actualizaron los contenidos del tema Historia Psicosocial, se reelaboró la guía de la Clase Práctica y modificó la dinámica de la clase, con lo que se logró el incremento de la satisfacción de los profesores y estudiantes(AU)

A pedagogical research, as result of the methodological work carried out by the educational staff of Discipline Medical Psychology II to perfect the methodological preparation of the educational staff in the treatment to the contained Psychosocial History was carried out. It took advantage of the system of basic contents of Medical Psychology II linked with the subject medical Propedeutics and clinical semiology. The main results find in the fault of correspondence between the model of Psychosocial History that gives in the subject Medical Psychology II with which receive the students in the subject Propedeutics, the out-of-date of the bibliography. The system of methodological classes developed gave answer to the methodological conceptual problem, updated the contents of the subject Psychosocial History, rebuilded the guide of the Practical Class and modified the dynamics of the class, with what attained the increase of the satisfaction of the professors and students(AU)

How can psychological science inform research about genetic counseling for clinical genomic sequencing?

Next generation genomic sequencing technologies (including whole genome or whole exome sequencing) are being increasingly applied to clinical care. Yet, the breadth and complexity of sequencing information raise questions about how best to communicate and return sequencing information to patients and families in ways that facilitate comprehension and optimal health decisions. Obtaining answers to such questions will require multidisciplinary research. In this paper, we focus on how psychological science research can address questions related to clinical genomic sequencing by explaining emotional, cognitive, and behavioral processes in response to different types of genomic sequencing information (e.g., diagnostic results and incidental findings). We highlight examples of psychological science that can be applied to genetic counseling research to inform the following questions: (1) What factors influence patients' and providers' informational needs for developing an accurate understanding of what genomic sequencing results do and do not mean?; (2) How and by whom should genomic sequencing results be communicated to patients and their family members?; and (3) How do patients and their families respond to uncertainties related to genomic information?

Dealing with complexity in research processes and findings: how do older women negotiate and challenge images of aging?

The Representing Self-Representing Ageing initiative has been funded by the ESRC as part of the New Dynamics of Ageing cross-council research program. It has consisted of four projects with older women using visual research methods and participatory approaches to enable women to articulate their experiences of aging and to create alternative images of aging. Complex research processes were utilized. Innovative methods included the use of art elicitation, photo diaries, film booths, and phototherapy.

Prática psiquiátrica no hospital geral: interconsulta e emergência / Psychiatric practice in general hospital: referral and emergency

Dez anos após seu lançamento, Prática psiquiátrica no hospital geral: interconsulta e emergência chega à sua terceira edição ampliado e atualizado, abordando tanto elementos da psicologia médica como da psiquiatria. Nos últimos anos, o reconhecimento e o interesse pela psiquiatria como área cada vez mais integrada a outras especialidades da saúde aumentou consideravelmente, assim como o conhecimento a ser dominado pelo psiquiatra de hospital geral. Em decorrência dessa nova realidade, nesta edição, os autores, destacados profissionais brasileiros e estrangeiros da área da saúde, tiveram o cuidadoso trabalho de atualização e de inclusão de novos temas.

Assessing self-efficacy for coping with cancer: development and psychometric analysis of the brief version of the Cancer Behavior Inventory (CBI-B).

OBJECTIVE: The Cancer Behavior Inventory-Brief Version (CBI-B), a 12-item measure of self-efficacy for coping with cancer derived from the longer 33-item version, was subjected to psychometric analysis. METHOD: Participants consisted of three samples: 735 cancer patients from a multicenter CCOP study, 199 from central Indiana, and 370 from a national sample. Samples were mixed with respect to initial cancer diagnosis. Participants completed the CBI-B and measures of quality of life, optimism, life satisfaction, depression, and sickness impact. RESULTS: Exploratory Factor Analysis with oblique rotation yielded four factors in the first sample: (1) Maintaining Independence and Positive Attitude; (2) Participating in Medical Care; (3) Coping and Stress Management; and (4) Managing Affect, which were confirmed in subsequent samples. Cronbach α coefficient for the 12-item CBI-B ranged from 0.84 to 0.88. Validity of the CBI-B was demonstrated by positive correlations with measures of quality of life and optimism, and negative correlations with measures of depression and sickness impact. CONCLUSION: The CBI-B is a valid brief measure of self-efficacy for coping that could be easily integrated into clinical oncology research and practice, and also used in screening patients.

Proposta de uma escala para avaliação de estresse em pacientes atendidos em programa de check-up clínico / Proposal of an evaluation scale for stress in patients attending a clinical check-up program

A prevenção primária em psicologia hospitalar possibilita o estudo dos fatores de risco e proteção para desordens psicológicas e assume um modelo que privilegia a dimensão biopsicossocial. Constata-se que diferentes modelos teóricos relacionam o estresse com o desencadeamento de doenças, possibilitando que esse seja...

[Disease--defence--manipulation: the difficulties in providing forensic-psychiatry opinions]. / Choroba--obrona--manipulacja: trudnosci opiniowania sadowo-psychiatrycznego.

The challenges met by the psychiatrist and the psychologist and the difficulties in providing forensic-psychiatry and forensic-psychology opinions have been reviewed, based on examples. The studied patient was hospitalised 10 times and the forensic-psychiatry opinion passed 15 times during the judiciary process. Different psychiatric diagnoses were made and different soundness of mind were passed. The psychiatric health status were expresses by professors of psychiatry who did not participate directly in passing the forensic-psychiatry opinion. The studied patient was examined by other specialists and assessed by certificating medical doctors with the aim of getting disability pension benefits. The effect of medical certificates and testimonials from different medical doctors were analysed. Analysing this example, revealed the problem of proper formulation of content of medical documents to support the medical diagnosis and declared soundness of mind during the passing of forensic-psychiatry opinion. The doctors treating the patients and doctors passing opinion on the treated patient had a different assessment of the diagnoses and soundness of mind for the studied patients. Irrespective of the immediate aim of the examinations, all professionals providing assessment should mind the consequences of opinions passed by them and especially, the possibility of the opinion being used by the subject to prolong the judiciary process or even avoid legal responsibility. The independence (sovereignty) of the expert requires consideration in the context of prior multiple forensic-psychiatry opinion leaders in the field of psychiatry and the need for the expert to assume an attitude towards these opinions.

[Perspectives on psycho-oncology and tumor-related fatigue]. / Perspektiven in der Psycho-Onkologie und tumorbedingter Fatigue.

Psycho-oncology -- as the diction suggests -- is a multidisciplinary sub-specialty of oncology concerned with the emotional responses of patients at all stages of the disease, their families and staff. Psycho-oncology does not assume the responsibility of cancer cure but attends to the psychological, social and behavioural variables that influence cancer prevention, risk and survival. The psycho-social research domains today contain the screening and management of psycho-social distress as well as experiences with specific psycho-oncological symptoms. Cancer-related fatigue, for example, disturbs patients' quality of life more often than pain. However, all too often doctors fail to pay enough attention to this unknown symptom.

Trasplante cardiopulomar. Presente y futuro / Cardiopulmonary transplantation. Present and future

El trasplante cardiopulmonar se ha transformado en una modalidad terapéutica bien aceptada para pacientes con enfermedad cardiaca y pulmonar en estado terminal. El refinamiento en los criterios del donador y sus cuidados, la selección del receptor incluyendo en forma importante la consideración de los aspectos psicológicos, la terapia inmunosupresora, diagnóstico oportuno y el tratamiento del rechazo así como un entendimiento más preciso de las complicaciones a largo plazo, han mejorado los resultados en el trasplante de corazón y pulmón, con una sobrevida actual a un año del 85 por ciento y 70 por ciento, respectivamente.

Survey of pediatric hospitals' preparation programs: evidence of the impact of health psychology research.

A survey of all 123 nonchronic-care pediatric hospitals in the United States revealed that 75% of hospitals responding had greatly increased the use of effective medical procedure preparation technologies, such as filmed modeling and coping skills instruction, in comparison to the last survey. Respondent characteristics such as position (e.g., nurse, child life worker, physician), degree (e.g., RN, MA, PhD), and length of time in the position failed to predict the type of techniques selected, but higher respondent knowledge and more psychological sources of preparation information did predict the use of preparation techniques used for drawing blood that experts rated as more effective. Challenges for more effective dissemination of research in the future are considered, as is the need for increased study of research-implementation links.

Assessment of self-efficacy and coping with cancer: development and validation of the cancer behavior inventory.

This article reports the development of a measure of self-efficacy for coping with cancer. Items culled from a variety of sources were chosen for inclusion in the Cancer Behavior Inventory (CBI) based on the psychometric properties of the items and the fit of the items in a factor structure. Factor analysis on a group of 502 persons with cancer yielded 6 factors: (a) Maintenance of Activity and Independence (alpha = .89), (b) Coping With Treatment-Related Side Effects (alpha = .88), (c) Accepting Cancer/Maintaining Positive Attitude (alpha = .87), (d) Seeking and Understanding Medical Information (alpha = .88), (e) Affective Regulation (alpha = .75), and (f) Seeking Support (alpha = .77). Cronbach's alpha for the entire measure was .96, and correlations with other measures supported its validity. The CBI may be useful for research and clinical practice.

Construcción semántica del concepto relación médico-paciente, por alumnos del primer año de la carrera de médico cirujano / Semantic construction of the concept doctor-patient relationship by first year students of medical school

La relación médico-paciente, es una transacción, un sistema de interacción recíproca, tanto intelectual como emocional, que incorpora lo que el médico y el enfermo piensan, sienten, hacen y reciben, el uno del otro. El presente estudio pretende conocer los cambios de que desarrollan los alumnos del primer año de la carrera de médico cirujano en la UNAM antes y después de un curso de psicología médica en conexión al concepto "relación médico-paciente", con el fin de vislumbrar las modificaciones congnocitivas que el proceso enseñanza-aprendizaje del tema efectúa en su construcción semántica del concepto. Se utiliza la prueba de Redes Semánticas Naturales en 7 grupos de alumnos seleccionados aleatoriamente. Los resultados muestran que las mujeres tuvieron una mayor asimilación de nuevos términos que el hombre y que ambos sexos mantuvieron un 40 por ciento de sus conocimientos previos a su entrada a la carrera. Se mostraron mayores cambios en consistencia interna que afirma la influencia del proceso de enseñanza de la materia de psicología médica sobre su memoria semántica

Utilización de servicios para problemas de salud mental en población femenina: tres estudios / The use of services for mental health problems among the feminine population: three studies

Se presentan los resultados de tres estudios sobre la utilización de servicios de salud mental. El primero incluye una muestra urbana en la que se compara el uso de servicios de las mujeres en relación con el de los hombres, mientras que en los otros dos se incluyen sólo grupos de mujeres, en un caso rurales y en el otro urbanas. Entre las diferencias importantes en el uso de servicios de las mujeres y de los hombres se enocntró que en los casos de depresión severa, las mujeres acuden menos con amigos o familiares y solicitan más la ayuda profesional, mientras que los hombes indican que no solicitan yuda porque piensan que otra persona los puede ayudar y porque no desean dejar de trabajar por las consecuencias enconómicas que ésto puede ocasionar. Las diferencias encontradas en las personas con depresión moderada se refieren al tipo de ayuda formal a la que acuden: los varones a especialistas privados y a centros de salud mental especializados, mientras que las mujeres para no solicitar ayuda son: por vergüenza, porque nadie podría entender su problema ni podría ayudarla, por pensar que otra persona puede ayudarlas, por falta de disponibilidad del servicio y por no tener quién les cuide los niños. En el segundo estudio se observó que son pocas las mujeres que solicitan ayuda cuando padecen síntomas depresivos mientras que cuando el problema lo presenta alguno de sus hijos acuden más a instancias formales de atención que cuando son ellas quienes lo padecen. En el área rural se encontró que las comunidades carecen de servicios especializados, lo que limita las posibilidades de obtener un tratamiento adecuado. El uso generalizado de servicios alternativos, como la ayuda de amigos, el apoyo de sacerdotes y la utilización de remedios caseros, se presentan como soluciones viables a sus problemas