Ações em tecnologia assistiva com mulheres hospitalizadas / Actions in assistive technology with hospitalized women

Resumo Introdução A saúde da mulher pode se tornar mais frágil durante a internação hospitalar por diversos motivos, o que pode afetar sua autonomia e independência. Nesse contexto, intervenções em tecnologia assistiva podem ser realizadas para favorecer o desempenho ocupacional da mulher. Objetivo Identificar quais ações em tecnologia assistiva são realizadas por terapeutas ocupacionais com mulheres no contexto hospitalar. Método Estudo descritivo, retrospectivo e exploratório, de abordagem quantitativa, realizado de agosto a dezembro de 2021, por meio de dados secundários extraídos de 155 prontuários de mulheres que foram assistidas em terapia ocupacional nas enfermarias de Neurologia, Oncologia e Saúde Mental em um hospital universitário do Recife, PE, Brasil. Foram utilizados como instrumentos um questionário estruturado de caracterização e um checklist de rastreamento de ações em tecnologia assistiva. Para análise dos dados, foi utilizada estatística descritiva por meio da planilha eletrônica do Microsoft Excel. Resultados 48 pacientes receberam intervenções dos terapeutas ocupacionais em tecnologia assistiva, contemplando os serviços de avaliação, prescrição, confecção, orientação de uso e treino, tendo como principais dispositivos órteses de membros superiores e de auxílio para atividades de vida diária no setor de neurologia e o coxim no setor de oncologia, apresentando como predominância nos objetivos o favorecimento do desempenho ocupacional. Conclusão Foi identificado o predomínio das ações de tecnologia assistiva nas enfermarias de oncologia e neurologia com produtos de baixo custo; necessidade de melhorar o processo de acompanhamento de uso da tecnologia assistiva e de se investir no serviço de Tecnologia Assistiva; aumento de estudos sobre essa temática para gerar evidências.

Abstract Introduction Hospitalization can render women's health more fragile for a variety of reasons, potentially impacting their autonomy and independence. Within this scenario, interventions using assistive technology can enhance women's occupational performance. Objective To discern the assistive technology actions undertaken by occupational therapists for women in hospital settings. Method This descriptive, retrospective, and exploratory study with a quantitative approach was conducted from August to December 2021. It utilized secondary data from 155 medical records of women who received occupational therapy in neurology, oncology, and mental health wards at a university hospital in Recife, state of Pernambuco, Brazil. Instruments included a structured questionnaire for characterization and a checklist to trace assistive technology actions. Data analysis was performed using Microsoft Excel. Results Out of 155, 48 patients benefited from assistive technology interventions by occupational therapists. These interventions included evaluation services, prescription, manufacturing, use guidance, and training. The primary devices were orthoses for upper limbs and aids for activities of daily living in the neurology sector, with cushions being prominent in the oncology sector. A common goal was the enhancement of occupational performance. Conclusion Most assistive technology actions occurred in the oncology and neurology wards, focusing on low-cost products. There is a recognized need to refine the monitoring process for assistive technology use, invest more in assistive technology services, and promote research in this field to generate further evidence.

Mutually exclusive disorder-dependent hearing discomfort in first-episode psychosis and panic disorder: two experiments using the same auditory stimulus set and two similar musical sequences.

We investigated the level of hearing tolerance in patients with first-episode psychosis (FEP) and panic disorder (PD) as compared to two different groups of healthy controls (HC, HC2), one for each experiment, because we used two distinct psychophysical paradigms. We evaluated auditory discomfort of 28 volunteers (14 with FEP and 14 HC) in the first study and of 42 volunteers (21 with PD and 21 HC2) in the second study. We presented 20 sounds: 16 pure-tone frequency sweeps (specially designed for use with FEP) and 11 s or 13 s musical sequences from the very beginning of the music "Play the Game" (PLAY) from Queen and its reverses. The first procedure used a Likert-like 0-10 scale ranging from "nothing bad" to "too bad" where volunteers made vertical marks along a horizontal line according to their discomfort. The second procedure involved subjective magnitude estimation online due to the SARS-COV-19 pandemic. Sounds were placed online and played by PD and HC2 volunteers themselves after having listened to the standard (the first 8 s from RADIO, "Radio Ga Ga" by Queen). Then, PD and HC2 volunteers were asked to assign values equal to, or multiples of 10 that felt like, or proportional to, their hearing "discomfort" in comparison with Sound 00 (RADIO). Our findings showed that FEP volunteers assign more discomfort to the 16 specially designed frequency sweep stimuli that appear not to affect HC, HC2, and PD. On the other hand, musical sequences from PLAY caused strong discomfort to PD in the reverse mode, but did not seem to affect HC, HC2, and FEP. Further experiments using the exact same paradigm with FEP and PD are needed to explore these findings.

Auditory perceptual discomfort and low-hearing tolerance in the first episode psychosis.

Awareness of perceptual and sensory changes that might occur in visual, auditory, proprioception, and other senses, in the early stages towards the First Episode Psychosis (FEP), and their subsequent sensorial evolution as the disturb progresses deeper into an acute episode, might be a key element for interrupting the process. In the present study, we investigated hearing discomfort/tolerance to 16 given sound streams. Sixteen people diagnosed with FEP, participated in the experiment. Sixteen frequency sweeps varying in modulation envelopes (sawtooth, sine), order (ascending, descending), duration (4s, 8s), and range (50-8000 Hz, 2-8 kHz) were presented randomly, but always in the same sequence, to FEP and healthy controls (HC). The level of discomfort was estimated by the participant by making a mark across a continuous line whose extremes read "nothing bad" (left) and "too bad" (right). Results showed that ascending sine pure frequency sweeps (p < 0.01) and descending sine pure frequencies sweeps (p < 0.01) caused the maximum discomfort in FEP. Other variables also showed differences between FEP and HC, and FEP were always more intolerant to such pure frequency sweeps than HC. We conclude that this might be useful for very early assessment of people at risk, people with FEP, and people with schizophrenia.

Auditory perceptual discomfort and low-hearing tolerance in the first episode psychosis

Awareness of perceptual and sensory changes that might occur in visual, auditory, proprioception, and other senses, in the early stages towards the First Episode Psychosis (FEP), and their subsequent sensorial evolution as the disturb progresses deeper into an acute episode, might be a key element for interrupting the process. In the present study, we investigated hearing discomfort/tolerance to 16 given sound streams. Sixteen people diagnosed with FEP, participated in the experiment. Sixteen frequency sweeps varying in modulation envelopes (sawtooth, sine), order (ascending, descending), duration (4s, 8s), and range (50­8000 Hz, 2­8 kHz) were presented randomly, but always in the same sequence, to FEP and healthy controls (HC). The level of discomfort was estimated by the participant by making a mark across a continuous line whose extremes read "nothing bad" (left) and "too bad" (right). Results showed that ascending sine pure frequency sweeps (p < 0.01) and descending sine pure frequencies sweeps (p < 0.01) caused the maximum discomfort in FEP. Other variables also showed differences between FEP and HC, and FEP were always more intolerant to such pure frequency sweeps than HC. We conclude that this might be useful for very early assessment of people at risk, people with FEP, and people with schizophrenia. (AU)

Pictorial size perception in schizophrenia.

In this study, we compared visual pictorial size perception between healthy volunteers (CG) and an experimental group (EG) of people diagnosed with schizophrenia. We have been using paintings by Salvador Dalí and Rorschach plates to estimate visual pictorial size perception. In this transversal, ex post facto, and quasi-experimental study, we observed differences between EG and CG. Schizophrenic in-patients perceived sizes about 1.3-fold greater than healthy volunteers (p=0.006), implying that pictorial size perception is altered in some way in schizophrenia. Considering the present and previous results, this measurement of diameter size of first pictorial perception may be a useful estimate of some aspects of perceptual alterations that may be associated with psychotic symptoms in prodromal and acute schizophrenic episodes and other related mental states. Eventually, this may help in preventing people from evolving to acute episodes.

Pictorial size perception in schizophrenia

In this study, we compared visual pictorial size perception between healthy volunteers (CG) and an experimental group (EG) of people diagnosed with schizophrenia. We have been using paintings by Salvador Dalí and Rorschach plates to estimate visual pictorial size perception. In this transversal, ex post facto, and quasi-experimental study, we observed differences between EG and CG. Schizophrenic in-patients perceived sizes about 1.3-fold greater than healthy volunteers (p=0.006), implying that pictorial size perception is altered in some way in schizophrenia. Considering the present and previous results, this measurement of diameter size of first pictorial perception may be a useful estimate of some aspects of perceptual alterations that may be associated with psychotic symptoms in prodromal and acute schizophrenic episodes and other related mental states. Eventually, this may help in preventing people from evolving to acute episodes.

Changes in visual size perception in schizophrenia and depression / Alterações na percepção visual de tamanho na esquizofrenia e depressão / Cambios en la percepción del tamaño en la esquizofrenia y la depressión

The objective of this research was to measure possible changes in visual size perception of patients with depression and schizophrenia. Three groups were compared: Control Group (CG), Schizophrenia Group (SchG) and Depression Group (DepG). The diameter of the first figure seen by the participants in each painting was recorded in degrees of visual angle. The SchG perceived images 1.47 larger than CG and the DepG 1.28 larger than CG, whereas SchG selected images 1.15 larger than DepG, F (2, 57) = 17.677, p < .0001. These findings suggest there are changes in visual size perception related to depression and schizophrenia.

O objetivo desta pesquisa foi medir possíveis alterações na percepção visual do tamanho de pacientes com depressão e esquizofrenia. Três grupos foram comparados: Grupo Controle (GC), Grupo Esquizofrenia (SchG) e Grupo Depressão (DepG). O diâmetro da primeira figura vista pelos participantes em cada pintura foi registrado em graus de ângulo visual. O SchG percebeu imagens 1.47 maiores que o GC e o DepG 1.28 maior que o GC, enquanto SchG selecionou imagens 1.15 maiores que DepG, F (2, 57) = 17.677, p < .0001. Esses achados sugerem que há alterações na percepção visual de tamanho relacionadas à depressão e esquizofrenia.

El objetivo de esta investigación fue medir posibles cambios en la percepción del tamaño de pacientes con depresión y esquizofrenia. Se compararon tres grupos: Grupo de control (CG), Grupo de esquizofrenia (SchG) y Grupo de depresión (DepG). El diámetro de la primera figura vista por los participantes se registró en grados de ángulo visual. SchG percibió imágenes 1.47 más grandes que CG y DepG 1.28 más grandes que CG, mientras que SchG seleccionó imágenes 1.15 más grandes que DepG, F (2, 57) = 17.677, p < .0001. Hay cambios en la percepción del tamaño relacionados con depresión y esquizofrenia.

Processamento visual de contraste em pacientes com depressão maior

O presente estudo teve como objetivo investigar possíveis alterações na percepção visual relacionadas à depressão maior. Para tanto, realizou-se medidas de sensibilidade ao contraste (SC), uma das ferramentas mais utilizadas na avaliação teórica e clínica do sistema visual humano. A SC tem se estabelecido como uma técnica que permite estudar e identificar a forma como determinadas patologias acometem a visão e o sistema nervoso central. Participaram deste estudo 33 voluntários, com idades entre 19 e 37 anos e acuidade visual normal ou corrigida. Dentre eles, 11 foram diagnosticados com transtorno depressivo maior, segundo os critérios do DSM-IV e se encontravam devidamente medicados (Grupo Depressão - GD). Os outros 22 eram isentos de patologia neuropsiquiátrica e gozavam de boa saúde (Grupo Controle - GC). A SC foi mensurada através do método psicofísico da escolha forçada entre duas alternativas temporais (2AF). Foram testadas as frequências espaciais lineares de 0,5; 2,5; 10 e 20 ciclos por grau de ângulo visual (cpg) e as angulares de 2, 4, 24, 48 e 96 ciclos/360º. Os estímulos eram circulares e foram apresentados em um monitor de vídeo LG, RGB de 19 polegadas (resolução de tela de 1024 x 768 pixels a 75 Hz) conectado a um microcomputador e um BITS ++ (Cambridge Research Systems). A luminância média da tela foi de 41,05 cd/m² mensurada por um fotômetro ColorCAL (Cambridge Research Systems). As medidas foram realizadas a uma distância de 300 cm da tela do monitor. Os estímulos foram exibidos em pares sucessivos, um com a frequência testada (espaciais lineares ou angulares) e o outro era um círculo cinza com luminância homogênea. (...)

... Os participantes foram orientados a pressionar o botão do lado esquerdo do mouse, quando o estímulo teste fosse apresentado primeiro, e o botão do lado direito, quando fosse apresentado depois do estímulo com luminância homogênea. Os resultados mostraram um efeito de interação para as frequências espaciais lineares [F(3, 93) = 6,0814, p = 0,0008], o test post-hoc Newmann Kels mostrou diferença significante na frequência de 0,5 cpg. Os resultados para as frequências angulares mostraram um efeito de interação marginalmente significante. As análises com post-hoc mostraram uma diferença marginalmente significante para frequência de 2 ciclos/360º. Esses resultados sugerem alterações na SC de pacientes com depressão maior medicados

The present study aimed to investigate potential changes in visual perception related to major depression. Then, we measure of contrast sensitivity (CS), one of the most used tools to study the humans visual system. The CS has established itself as one tool that allows to study and identify how certain diseases affect the vision and the central nervous system. The study included 33 volunteers aged between 19 and 37 years and they are normal or corrected visual acuity. 11 were diagnosed with major depressive disorder according to DSM-IV and were treated with antidepressants (Depression Group - DG). The other 22 were free of neuropsychiatric disease and were in good health (Control Group - CG). The CS was measured using the psychophysical method of forced choice between two temporal alternatives (2AF). Were tested linear spatial frequencies of 0.5, 2.5, 10 and 20 cycles per degree of visual angle (cpd) and the angular frequencies of 2, 4, 24, 48 and 96 cycles/360º. The stimuli were circular and were presented on a video monitor LG 19-inch RGB (screen resolution of 1024 x 768 pixels at 75 Hz) connected to a microcomputer and a BITS + + (Cambridge Research Systems). The average luminance of the display was 41.05 cd / m² measured by a photometer ColorCal (Cambridge Research Systems). The measurements were performed at a distance of 300 cm from the monitor screen. The stimuli were displayed in successive pairs, with a frequency tested (linear or angular) and the other was a gray circle with uniform luminance. Participants were instructed to press the left mouses button when the test stimulus was presented first, and the right button when the stimulus was presented second. The results showed an interaction effect for the linear spatial frequency [F (3, 93) = 6.0814, p = 0.0008], the test post-hoc Newmann Kels showed significant difference in frequency of 0.5 cpd. The results for the angular frequencies showed a marginally significant effect of interaction. The (...)

... analyzes with post-hoc showed a marginally significant difference for frequency of 2 cycles/360º. These results suggest changes in the CS of patients with major depression medicated

Detecção de estímulos concêntricos mesópicos em crianças surdas e ouvintes / Detection of mesopic concentric stimuli in deaf and hearing children

O objetivo deste trabalho foi medir curvas de sensibilidade ao contraste de 10 crianças ouvintes e de 10 crianças com surdez pré-lingual, de 7 a 12 anos, utilizando frequências radiais circularmente concêntricas (FSCr) de 0,25-2,0 cpg em níveis baixos de luminância (0,7 cd/m²). Todos os participantes apresentavam acuidade visual normal e estavam livres de doenças oculares identificáveis. A FSCr foi medida com o método psicofísico da escolha forçada. Os resultados mostraram sensibilidade máxima na faixa de frequência radial de 0,25 cpg para os dois grupos. Os resultados mostraram ainda diferenças significantes entre as curvas de FSCr de crianças ouvintes e de crianças com surdez pré-lingual. Isto é, as crianças ouvintes precisaram de menos contraste do que as crianças surdas para detectar as frequências radiais. Esses resultados sugerem que, em níveis baixos de luminância, a FSCr das crianças ouvintes foi melhor do que a das crianças com surdez pré-lingual.

The aim of this work was to measure contrast sensitivity curves in 10 hearing children and 10 children with prelingual deafness (from 7 to 12 years old), using concentric circular patterns with radial frequencies (rCSF) of 0.25-2.0 cpd at low levels of luminance (0.7 cd/m²). All participants were free from identifiable ocular disease and had normal visual acuity. The rCSF was measured with the psychophysical forced-choice method. The results showed maximum sensitivity in the frequency range of 0.25 cpd for the two groups. The results showed yet significant differences between the rCSF of deaf and hearing children. That is, hearing children needed less contrast than deaf children to detect radial frequencies. These results suggest that at low levels of luminance the rCSF of hearing children was better than the rCSF of children with prelingual deafness.

Detecção de estímulos concêntricos mesópicos em crianças surdas e ouvintes / Detection of mesopic concentric stimuli in deaf and hearing children

O objetivo deste trabalho foi medir curvas de sensibilidade ao contraste de 10 crianças ouvintes e de 10 crianças com surdez pré-lingual, de 7 a 12 anos, utilizando frequências radiais circularmente concêntricas (FSCr) de 0,25-2,0 cpg em níveis baixos de luminância (0,7 cd/m²). Todos os participantes apresentavam acuidade visual normal e estavam livres de doenças oculares identificáveis. A FSCr foi medida com o método psicofísico da escolha forçada. Os resultados mostraram sensibilidade máxima na faixa de frequência radial de 0,25 cpg para os dois grupos. Os resultados mostraram ainda diferenças significantes entre as curvas de FSCr de crianças ouvintes e de crianças com surdez pré-lingual. Isto é, as crianças ouvintes precisaram de menos contraste do que as crianças surdas para detectar as frequências radiais. Esses resultados sugerem que, em níveis baixos de luminância, a FSCr das crianças ouvintes foi melhor do que a das crianças com surdez pré-lingual.(AU)

The aim of this work was to measure contrast sensitivity curves in 10 hearing children and 10 children with prelingual deafness (from 7 to 12 years old), using concentric circular patterns with radial frequencies (rCSF) of 0.25-2.0 cpd at low levels of luminance (0.7 cd/m²). All participants were free from identifiable ocular disease and had normal visual acuity. The rCSF was measured with the psychophysical forced-choice method. The results showed maximum sensitivity in the frequency range of 0.25 cpd for the two groups. The results showed yet significant differences between the rCSF of deaf and hearing children. That is, hearing children needed less contrast than deaf children to detect radial frequencies. These results suggest that at low levels of luminance the rCSF of hearing children was better than the rCSF of children with prelingual deafness.(AU)

Mensuração da sensibilidade ao contraste em criançaspré-escolares com método psicofísico e estímulos radiais / Contrast sensitivity measuring in preschool children with psychophysical method and radial stimuli

O objetivo deste trabalho foi utilizar o método psicofísico da escolha forçada para mensurar a função desensibilidade ao contraste para freqüências radiais (FSCr) na faixa de 0,25-2 cpg em crianças pré-escolares.Foram estimados limiares de contraste para 15 participantes (dez crianças e cinco adultos). Todos os participantesapresentavam acuidade visual normal e se encontravam livres de doenças oculares identificáveis. Osresultados mostraram diferenças significantes entre as curvas de FSCr de crianças de 4 anos, 5 anos e adultos.Os resultados mostram ainda que as curvas de FSCr de crianças de 4 e 5 anos apresentam perfis semelhantesa dos adultos. Estes resultados sugerem que o método psicofísico da escolha forçada pode ser utilizadopara mensurar a FSCr de crianças a partir dos 4 anos.

The aim of this work was to use the psychophysical forced-choice method to measure contrast sensitivityfunction for radial frequencies (rCSF) in the range between 0.25-2 cpd in preschool children. We measuredthe contrast thresholds of 15 participants (ten children and five young adults). All participants had normalvisual acuity and were free from identifiable ocular diseases. The results showed significant differencesamong the curves rCSF of 4 and 5 years old children and adults. The results showed yet that the curves rCSFof 4 and 5 years old children and adults were similar in general profiles. These results suggest that thepsychophysical forced-choice method can be used to measure the rCSF for children over 4 years old.

Mensuração da sensibilidade ao contraste em criançaspré-escolares com método psicofísico e estímulos radiais / Contrast sensitivity measuring in preschool children with psychophysical method and radial stimuli

O objetivo deste trabalho foi utilizar o método psicofísico da escolha forçada para mensurar a função desensibilidade ao contraste para freqüências radiais (FSCr) na faixa de 0,25-2 cpg em crianças pré-escolares.Foram estimados limiares de contraste para 15 participantes (dez crianças e cinco adultos). Todos os participantesapresentavam acuidade visual normal e se encontravam livres de doenças oculares identificáveis. Osresultados mostraram diferenças significantes entre as curvas de FSCr de crianças de 4 anos, 5 anos e adultos.Os resultados mostram ainda que as curvas de FSCr de crianças de 4 e 5 anos apresentam perfis semelhantesa dos adultos. Estes resultados sugerem que o método psicofísico da escolha forçada pode ser utilizadopara mensurar a FSCr de crianças a partir dos 4 anos(AU)

The aim of this work was to use the psychophysical forced-choice method to measure contrast sensitivityfunction for radial frequencies (rCSF) in the range between 0.25-2 cpd in preschool children. We measuredthe contrast thresholds of 15 participants (ten children and five young adults). All participants had normalvisual acuity and were free from identifiable ocular diseases. The results showed significant differencesamong the curves rCSF of 4 and 5 years old children and adults. The results showed yet that the curves rCSFof 4 and 5 years old children and adults were similar in general profiles. These results suggest that thepsychophysical forced-choice method can be used to measure the rCSF for children over 4 years old(AU)