Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: Results From a Pilot Randomized Controlled Trial.

Be a Mom is a self-guided web-based intervention, grounded in cognitive behavioral therapy, delivered to postpartum women to prevent persistent postpartum depression [PPD] symptoms. We aimed to evaluate Be a Mom in terms of its preliminary efficacy, feasibility, and acceptability. A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention (Be a Mom) or to the waiting-list control group. Participants in both groups completed baseline (T1) and postintervention (T2) assessments. The 194 women presenting risk factors/early-onset PPD symptoms were allocated to the intervention (n = 98) or to the control (n = 96) group. A significant Time × Group interaction effect was found for both depressive and anxiety symptoms, with women in the intervention group presenting a larger decrease in symptoms from T1 to T2 (p < .05). Less than half of the women (41.8%) completed Be a Mom. Most women (71.4%) would use Be a Mom again if needed. Results provide preliminary evidence of the Be a Mom's efficacy, acceptability and feasibility, although further research is needed to establish Be a Mom as a selective/indicative preventive intervention for persistent PPD.

Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: The Enhancement of Self-Regulatory Skills and Its Association With Postpartum Depressive Symptoms.

Aim: Be a Mom is a self-guided, web-based intervention to prevent persistent postpartum depression symptoms [PPD], targeting both at-risk postpartum women and/or women presenting early-onset postpartum depressive symptoms (selective/indicated preventive intervention). Be a Mom is grounded on the principles of Cognitive-Behavior Therapy and incorporates the recent contributions of acceptance and compassion-based approaches (third-wave approaches) applied to the perinatal context. This study aimed to explore the processes underlying therapeutic change in the Be a Mom intervention, by: (1) exploring whether participation in the Be a Mom promotes the enhancement of self-regulatory skills (emotion regulation abilities, psychological flexibility and self-compassion) in comparison with women who did not participate in the program; and (2) exploring whether changes in self-regulatory skills are associated with changes in depressive symptoms, among women who participated in the Be a Mom program. Methods: A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention group (Be a Mom, n = 98) or to the waiting-list control group (n = 96). Participants in both groups completed baseline (T1) and post-intervention assessments (T2), including measures of depressive symptoms, emotion regulation abilities, psychological flexibility and self-compassion. Results: From baseline to post-intervention assessment, women in the intervention group showed a significantly greater decrease in the levels of emotion regulation difficulties (p < 0.001) and a significant greater increase in the levels of self-compassion (p < 0.001) compared to the control group. No significant differences were found concerning psychological flexibility. Moreover, a greater decrease in difficulties in emotion regulation and greater increase in self-compassion levels were significantly associated with a greater decrease in depressive symptoms, among women in the intervention group. Discussion: Be a Mom promotes the enhancement of women's emotion regulation abilities and self-compassion, and this seems to exert a protective effect in the presence of PPD risk factors (or early-onset symptoms) because it led to a reduction of depressive symptoms. By providing some insights into the processes that underlie treatment response to Be a Mom, this study highlights the important role of the targeted third-wave processes applied to the perinatal context.

Factors Associated with Treatment Adherence of Brazilian Patients Undergoing Hemodialysis

To evaluate patients' adherence to hemodialysis (HD) and its relationship to psychosocial variables. Methods: 64 adult patients undergoing HD participated in the study and were assessed in regard to depression, anxiety, social support, disease and treatment knowledge, and adherence. Results: Association between sex and adherence to HD, and to diet and medication was found, as well as between schooling and overall adherence. There is association between disease knowledge and depression, with adherence to fluid restrictions. No association was found between adherence and anxiety. Conclusion: Identifying the determinants of treatment adherence is essential to devise efficacious strategies to improve patients' quality of life.

Objetivo: Evaluar la adherencia de pacientes al tratamiento de la hemodiálisis (HD) y su relación con variables psicosociales. Método: Participaron 64 pacientes adultos con HD, evaluados en cuanto a depresión, ansiedad, apoyo social, conocimiento de la enfermedad y del tratamiento, y la adherencia. Resultados: Hay asociación entre sexo y adherencia a la HD, la dieta y la medicación, así como entre escolaridad y la adherencia general. Hay asociación entre niveles de conocimiento de la enfermedad y depresión con la adherencia a la restricción de líquidos. No se encontró asociación entre la adherencia y la ansiedad. Conclusión: La identificación de los determinantes de la adherencia al tratamiento es esencial para la elaboración de estrategias eficaces para mejorar la calidad de vida de los pacientes.

Women's use of online resources and acceptance of e-mental health tools during the perinatal period.

OBJECTIVES: The women's professional help-seeking rate for perinatal depression is low, despite the prevalent and disabling nature of this condition. Therefore, new approaches should be implemented to increase women's access and utilization of treatment resources, namely e-mental health tools. This study aimed to characterize women's current pattern of use of online resources for mental heal issues and women's acceptance of e-mental health tools during the perinatal period, and to investigate its main determinants. METHODS: This study used an online cross-sectional survey that was completed by 546 women during the perinatal period. RESULTS: 31.3% had prior knowledge of websites targeting mental health illness. Women presenting an actual need for help (i.e., a positive screen for depression) reported greater use of online resources and greater engagement in e-health behaviors related to mental health (d=0.46-0.61), and being more accepting of e-mental health tools, particularly of informative websites. Women's perceptions concerning the e-mental tools were found to predict their intentions to use them. CONCLUSIONS: The results seem to globally support Portuguese women's acceptance of e-mental health tools. To improve the level of acceptance, women should be involved as stakeholders in the development of new e-mental health tools and provided with specific information before their utilization.

Women׳s help-seeking behaviours for depressive symptoms during the perinatal period: Socio-demographic and clinical correlates and perceived barriers to seeking professional help.

OBJECTIVE: This study aims to characterize the help-seeking behaviours of women who were screened positive for perinatal depression, to investigate its sociodemographic and clinical correlates, and to characterize the perceived barriers that prevent women from seeking professional help. DESIGN: Cross-sectional internet survey. SETTING: Participants were recruited through advertisements published in pamphlets and posted on social media websites (e.g., Facebook) and websites and forums that focused on pregnancy and childbirth. PARTICIPANTS: 656 women (currently pregnant or who had a baby during the last 12 months) completed the survey. MEASUREMENTS: Participants were assessed with the Edinburgh Postpartum Depression Scale, and were questioned about sociodemographic and clinical data, help-seeking behaviours and perceived barriers to help-seeking. FINDINGS: Different pathways of help-seeking were found, with only 13.6% of women with a perinatal depression seeking help for their emotional problems. Married women, currently pregnant women, and women without history of psychological problems had a higher likelihood of not engaging in any type of help-seeking behaviour. The majority of women who had not sought professional assistance identified several barriers to help-seeking, particularly knowledge barriers. KEY CONCLUSIONS: Strategies to increase women׳s help-seeking behaviours should be implemented, namely improving mental health literacy, introducing screening procedures for mental health problems in pre/postnatal health care settings, and offering women innovative opportunities (e.g., web-based tools) that allow them to overcome the practical barriers to help-seeking.

Efeitos de Intervenção Cognitivo-Comportamental sobre Fatores de Risco Psicológicos em Cardiopatas / Effects in Cognitive-Behavioral Intervention on Psychological Risk Factors of Cardiac Patients

RESUMODiminuir fatores de risco para cardiopatias pode melhorar a qualidade de vida e reduzir a mortalidade e morbidade relacionadas a elas.O presente estudo avaliou a eficácia de uma intervenção cognitivo-comportamental em grupo sobre ansiedade, depressão, estresse e saúde cardiovascular em cardiopatas. Foram avaliados 91 pacientes antes e após participação nos grupos, com entrevistas semiestruturadas, Inventários Beck (Ansiedade e Depressão) e Inventário de Sintomas de Stress para Adultos de Lipp. Coletaram-se medidas fisiológicas para cálculo do escore de Framingham. A participação no grupo resultou em redução dos sintomas de ansiedade, depressão, estresse e melhora do enfrentamento ao estresse. Não houve diferença no escore de Framingham. A intervenção se mostrou eficaz para a redução dos fatores de risco psicológicos nessa amostra.

ABSTRACTReducing risk factors for cardiovascular diseases may increase quality of life and decrease mortality and morbidity secondary to these disorders.The present study evaluated the efficacy of a cognitive-behavioral group intervention on anxiety, depression, stress and cardiovascular health of cardiac patients. Ninety-one patients were assessed before and after the group intervention by means of semi-structured interviews, the Beck Anxiety and Depression Inventories and the Lipp's Stress Symptoms Inventory for Adults. Cardiovascular status was estimated using the Framingham Score. The intervention decreased anxiety, depression, and stress, and improved coping with stress. No significant differences were seen for the Framingham Scores. The intervention was effective in improving psychological risk factors for the investigated sample.

Cardiovascular profile of defensive hostile women in a real stressful situation / Perfil cardiovascular de mujeres hostiles defensivas en una situación de estrés real

The main objective of this study was to analyze the impact of defensive hostility on cardiovascular response in a stressful situation. By measuring three of the most commonly used cardiovascular indexes (heart rate, systolic blood pressure and diastolic blood pressure) over three experimental phases (adaptation, task and recovery), the evolution of cardiovascular response was analyzed minute by minute throughout the entire experimental session, to check if the defensive hostility influences the cardiovascular function. Two scales were used: the Cook-Medley Composite Hostility Scale and the Marlowe-Crowne Social Desirability Scale. Based on the scores on these scales, there were formed four groups (high hostility and high defensiveness, high hostility and low defensiveness, low hostility and high defensiveness, and low hostility and low defensiveness). The stressful situation which was used in the task phase was a real academic examination (exam of the Psychology degree). The hypothesis was that cardiovascular response, activation and recovery, minute by minute, will be greater in hostile defensive women, with an intra-phase evolution profile characterized by maintenance or sensitization and slow recovery. Results show that defensive hostile individuals present the highest values in the physiological variables recorded, and less adaptive profile

El objetivo del presente estudio ha sido analizar el impacto de la hostilidad defensiva sobre la respuesta cardiovascular en una situación estresante. Mediante la medición de la frecuencia cardiaca, la presión sistólica y la presión diastólica, a través de las tres fases del experimento (adaptación, tarea y recuperación), hemos analizado la evolución de la respuesta cardiovascular minuto a minuto a lo largo de toda la sesión experimental, para comprobar si la hostilidad defensiva influye sobre la función cardiovascular. Se utilizaron dos escalas: la Escala Compuesta de Hostilidad del inventario de hostilidad de Cook-Medley y la escala de deseabilidad social de MarloweCrowne. Basándonos en las puntuaciones de estas escalas, se formaron cuatro grupos (alta hostilidad-alta defensividad, alta hostilidad-baja defensividad, baja hostilidad-alta defensividad, y baja hostilidad-baja defensividad). La situación de estrés utilizada en la tarea fue un examen real. La hipótesis propuesta fue que la respuesta cardiovascular, la activación y la recuperación, minuto a minuto, serían mayores en las mujeres hostiles defensivas, con un perfil de evolución caracterizado por el mantenimiento o la sensibilización y la recuperación lenta. Los resultados muestran que las personas hostiles defensivas presentan los valores más altos en las variables fisiológicas registradas, así como perfiles menos adaptativos

Percepção de homens idosos sobre saúde e os serviços primários de saúde / Perception of elderly men about health and primary health care / Percepción de los hombres ancianos sobre salud y atención primaria de salud

Objetivo: compreender a percepção de homens idosos acerca dos temas: "Saúde", "Unidade de Saúde da Família" (USF) e "Grupos em Saúde". Métodos: estudo exploratório-descritivo, de abordagem qualitativa, com amostra de conveniência. Para selecionar os participantes, utilizou-se uma lista elaborada pela equipe com os nomes dos homens idosos da área de cobertura da USF que utilizavam os serviços de saúde oferecidos pela unidade. Para a coleta de dados realizou-se entrevista semi-estruturada e os dados foram analisados de acordo com a Análise de Conteúdo Temática. Resultados: participaram desse estudo 11 homens idosos. Os entrevistados possuem um conceito ampliado de saúde, abordando aspectos biopsicossociais em suas descrições. Eles apresentaram um bom vínculo com a USF, frequentando-a para consultas e participação em grupos de prevenção e promoção. Os participantes referiram não se engajarem em tantas atividades preventivas quanto as mulheres. Avaliam os Grupos em Saúde como benéficos, com repercussões positivas para a saúde e para a vida. Alguns, no entanto, carregam modelos de grupos de outros contextos, principalmente do mundo do trabalho, os quais não coincidem com os modelos de Grupo em Saúde. Conclusão: os participantes, por serem idosos e terem maior disponibilidade de tempo e vínculo com a unidade, conseguiram se engajar em mais atividades de promoção e prevenção. Observa-se que a unidade de saúde e os grupos atuam como fatores protetores para essa população, favorecendo o cuidado e as relações socias. No entanto, percebe-se que fatores associados ao gênero ainda dificultam um melhor cuidado de saúde por parte de homens.

Objective: to understand the perceptions of elderly men about the following themes: "Health", "Family Health Unit" and "Groups of Health Approaches". Methods: exploratory and descriptive survey with a qualitative approach, using a convenience sample. Participants were selected from a list of elderly men who used the health unit. A semi-structured interview was designed for data collection. The data were analyzed based on a thematic analysis orientation. Results: eleven men were interviewed. They showed a wide conception of health, considering biopsychosocial factors in their descriptions, as well as a good relationship with the Family Health Unit, where they go for medical appointments and to join health prevention and promotion groups. The participants reported that they did not undergo as many preventive activities as women. They evaluated Groups of Health Approaches as beneficial, with positive implications for health and for life. However some participants have group models from other contexts, especially from the work setting, which do not match the models recommended for Groups of Health Approaches. Conclusion: as the participants are elderly and have more available time and a greater relationship with the unit, they are able to engage in more activities of promotion and prevention at the Family Health Unit. This study also showed that the health unit and the groups act as protective factors for this population; elderly men favor receiving care and engaging in social relations. However, factors associated with gender still hinder a better health care for men.

Objetivo: conocer la percepción de los hombres ancianos sobre los temas: "Salud", "Servicios de salud de la familia" y " Grupos de la Salud". Método: estudio exploratorio-descriptivo, con un enfoque cualitativo y muestra de conveniencia. Para la selección de los participantes se realizó una lista de hombres ancianos utilizando de servicios de salud de la unidad. Para la recolección de los datos se realizaron entrevistas semi-estructuradas y los datos fueron analizados según un análisis cualitativo. Resultados: participaron en el estudio 11 hombres ancianos; se observó que tienen un concepto amplio de la salud, abordando los factores biopsicosociales en sus descripciones. Con respecto a los servicios de salud de la familia, tienen un buen vínculo con la unidad, asistiendo a consultas y participando en grupos de promoción y prevención. Los participantes afirman tener un cuidado de la salud diferente de las mujeres, porque ellas realizan actividades de prevención. Sin embargo consideran que los grupos de salud tienen efectos positivos en ellos. Algunos tienen modelos de grupos de otros contextos, principalmente del trabajo, que no corresponden con el modelo de grupo de salud. Conclusión: los participantes al ser ancianos, tener más tiempo disponible y un vínculo cercano con la unidad, son capaces de participar em más actividades de promoción y prevención. También se observó que la unidad y los grupos actúan como factores de protección para esta población. Se advierte que los factores asociados con el género todavía obstaculizan un mejor cuidado de la salud de los hombres.

A 44ª. Reunião anual de psicologia - homenagem aos 50 anos do departamento de psicologia da faculdade de filosofia, ciências e letras de Ribeirão Preto da universidade de São Paulo (FFCLRPUSP) / The 44th annual congress of psychology: homage to the 50th anniversary of the department of psychology, school of philosophy, sciences and language, Ribeirão Preto, university of São Paulo (FFCLRPUSP) / El 44º. Congreso Anual de Psicología: Homenaje al 50º Aniversario del Departamento de Psicología, Facultad de Filosofía, Ciencias e Letras, Ribeirão Preto, Universidad de São Paulo (FFCLRPUSP)

A Diretoria da Sociedade Brasileira de Psicologia (SBP) deliberou realizar a 44ª. Reunião Anual de Psicologia em Ribeirão Preto, SP, cidade onde nasceu a Sociedade de Psicologia de Ribeirão Preto, sua predecessora. Tal decisão teve como motivação realizar uma homenagem ao Departamento de Psicologia da Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto da Universidade de São Paulo, local onde foi criada a SBP. Para descrever os motivos de tal homenagem escrevemos este breve artigo destacando as características da reunião, deste histórico departamento e sua relação com o nascimento da própria Sociedade Brasileira de Psicologia.(AU).

The Board of Directors of the Brazilian Society of Psychology (SBP) decided to organize its 44th Annual Meeting in Ribeirão Preto, city where the Society of Psychology of Ribeirão Preto, SBP's antecessor, was founded. Such decision had as motivation to honor the Department of Psychology, from the School of Philosophy, Sciences and Languages at Ribeirão Preto, São Paulo University, where the SBP was born. In order to describe the reasons for such homage, this short article was written, pointing out the characteristics of the meeting, of this historic department and its relation with the foundation of the Brazilian Society of Psychology itself.(AU).

El Consejo Director de la Sociedad Brasileña de Psicología (SBP) decidió celebrar la 44a. Reunión Anual de Psicología en Ribeirão Preto, SP, lugar donde nasció la Sociedad de Psicología de Ribeirão Preto, su predecesora. Esto fue motivado para realizar un homenaje al Departamento de Psicología de la Facultad de Filosofía, Ciencias y Letras de Ribeirão Preto de la Universidad de São Paulo, donde se creó la SBP. Para describir las razones del tributo fue escrito este breve artículo que destaca las características de este departamento histórico y su relación con el nacimiento de la propia Sociedad Brasileña de Psicología.(AU).

A 44ª. Reunião anual de psicologia - homenagem aos 50 anos do departamento de psicologia da faculdade de filosofia, ciências e letras de Ribeirão Preto da universidade de São Paulo (FFCLRPUSP) / The 44th annual congress of psychology: homage to the 50th anniversary of the department of psychology, school of philosophy, sciences and language, Ribeirão Preto, university of São Paulo (FFCLRPUSP) / El 44º. Congreso Anual de Psicología: Homenaje al 50º Aniversario del Departamento de Psicología, Facultad de Filosofía, Ciencias e Letras, Ribeirão Preto, Universidad de São Paulo (FFCLRPUSP)

A Diretoria da Sociedade Brasileira de Psicologia (SBP) deliberou realizar a 44ª. Reunião Anual de Psicologia em Ribeirão Preto, SP, cidade onde nasceu a Sociedade de Psicologia de Ribeirão Preto, sua predecessora. Tal decisão teve como motivação realizar uma homenagem ao Departamento de Psicologia da Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto da Universidade de São Paulo, local onde foi criada a SBP. Para descrever os motivos de tal homenagem escrevemos este breve artigo destacando as características da reunião, deste histórico departamento e sua relação com o nascimento da própria Sociedade Brasileira de Psicologia.

The Board of Directors of the Brazilian Society of Psychology (SBP) decided to organize its 44th Annual Meeting in Ribeirão Preto, city where the Society of Psychology of Ribeirão Preto, SBP's antecessor, was founded. Such decision had as motivation to honor the Department of Psychology, from the School of Philosophy, Sciences and Languages at Ribeirão Preto, São Paulo University, where the SBP was born. In order to describe the reasons for such homage, this short article was written, pointing out the characteristics of the meeting, of this historic department and its relation with the foundation of the Brazilian Society of Psychology itself.

El Consejo Director de la Sociedad Brasileña de Psicología (SBP) decidió celebrar la 44a. Reunión Anual de Psicología en Ribeirão Preto, SP, lugar donde nasció la Sociedad de Psicología de Ribeirão Preto, su predecesora. Esto fue motivado para realizar un homenaje al Departamento de Psicología de la Facultad de Filosofía, Ciencias y Letras de Ribeirão Preto de la Universidad de São Paulo, donde se creó la SBP. Para describir las razones del tributo fue escrito este breve artículo que destaca las características de este departamento histórico y su relación con el nacimiento de la propia Sociedad Brasileña de Psicología.

Human experimental anxiety: actual public speaking induces more intense physiological responses than simulated public speaking.

OBJECTIVES: a) To perform a systematic and meta-analytic review to verify whether the Simulated Public Speaking Task (SPST) leads to a greater increase in self-rated anxiety than in physiological correlates of anxiety; and b) to compare the results obtained with the SPST with an actual public speaking task involving healthy volunteers. METHODS: a) The PubMed and ISI Web of Knowledge databases were searched for studies involving the SPST prior to 2012. Eleven publications were eligible and provided data from 143 healthy volunteers for meta-analysis; b) 48 university students without somatic or psychiatric disorders were divided into three experimental groups of 16 subjects to undergo one of the following: SPST, real-world public speaking task (real-world), and control situation (control). RESULTS: The meta-analysis showed that the SPST induced a significant increase in the Visual Analogue Mood Scale (VAMS) anxiety factor, but no significant increases in systolic blood pressure or heart rate. The empirical study showed that the real-world public speaking task increased heart rate, systolic blood pressure and diastolic blood pressure significantly more than the control and SPST conditions. CONCLUSIONS: These results suggest that real public speaking might be better than SPST in inducing experimental anxiety.

Human experimental anxiety: actual public speaking induces more intense physiological responses than simulated public speaking

Objectives: a) To perform a systematic and meta-analytic review to verify whether the Simulated Public Speaking Task (SPST) leads to a greater increase in self-rated anxiety than in physiological correlates of anxiety; and b) to compare the results obtained with the SPST with an actual public speaking task involving healthy volunteers. Methods: a) The PubMed and ISI Web of Knowledge databases were searched for studies involving the SPST prior to 2012. Eleven publications were eligible and provided data from 143 healthy volunteers for meta-analysis; b) 48 university students without somatic or psychiatric disorders were divided into three experimental groups of 16 subjects to undergo one of the following: SPST, real-world public speaking task (real-world), and control situation (control). Results: The meta-analysis showed that the SPST induced a significant increase in the Visual Analogue Mood Scale (VAMS) anxiety factor, but no significant increases in systolic blood pressure or heart rate. The empirical study showed that the real-world public speaking task increased heart rate, systolic blood pressure and diastolic blood pressure significantly more than the control and SPST conditions. Conclusions: These results suggest that real public speaking might be better than SPST in inducing experimental anxiety. .

Aspectos psicológicos de pacientes portadores de cardioversor desfibrilador implantável / Psychological aspects of patients with implantable cardioverter defibrillator

Fundamentos: O cardioversor desfibrilador implantável (CDI) é a alternativa mais eficaz na profilaxia de mortes súbitas, entretanto pode gerar dificuldades aos pacientes. Objetivos: Avaliar ansiedade, depressão e qualidade de vida de pacientes com CDI e investigar associações entre essas variáveis e choques. Métodos: Pesquisa descritiva realizada no ambulatório de CDI de hospital público universitário. Participaram 42 pacientes, >18 anos, de ambos os sexos. Utilizou-se roteiro de entrevista semiestruturado, questionário de avaliação de qualidade de vida (SF-36) e escala de ansiedade e depressão para hospital geral. Resultados: Amostra composta por 80,95 % homens; 35,71 % entre 61-70 anos; 64,29 % com escolaridade até ensino fundamental; 66,67 % com renda mensal familiar até quatro salários mínimos . Experimentaram choques 64,29 %; destes, 21,43 % referiram choques-fantasma, com mal-estar físico, dor, medo e sensação de morte. Receberam orientações sobre o CDI, 73,81 % dos pacientes; mas 45,24 % demonstraram conhecimento parcial e 26,19 %, nenhum conhecimento. A maioria (90,48 %) afirmou que houve mudanças relacionadas a aspectos físicos, psicológicos e cognitivos após o implante. Da amostra, 33,33 % apresentaram sintomas de ansiedade e 19,05 % de depressão. As médias do SF-36 foram maiores em aspectos sociais e saúde mental, menores em aspectos físicos e dor. Não foi verificada associação entre a ocorrência de choques e variáveis sociodemográficas e psicológicas.

Effectiveness of psychological intervention for treating symptoms of anxiety and depression among pregnant women diagnosed with fetal malformation.

OBJECTIVE: To determine the effectiveness of a psychological intervention targeting pregnant women with fetal malformation. METHODS: A clinical study was conducted that enrolled 65 pregnant women attending Clinics Hospital at Ribeirão Preto, University of São Paulo, Brazil, between February 2004 and May 2008. Participants were allocated to 1 of 4 groups: normal pregnancy (NP), fetal malformation (FM), fetal or neonatal death (FD), and control (CG). Psychological intervention-including support, empathy, education, and desensitization-was provided to the NP, FM, and FD groups. Women in CG did not receive the intervention and were assessed in the postnatal period only. Anxiety was measured using the Hospital Anxiety and Depression (HAD) scale. Depression was measured by HAD and the Edinburgh Postnatal Depression Scale. RESULTS: Significant reductions from baseline were observed in anxiety and depression scores after psychological intervention in the NP and FM groups. Symptom scores in the postnatal period were also significantly reduced among these groups (P<0.001). CONCLUSION: Psychological intervention was effective in relieving symptoms of anxiety and depression experienced by pregnant women with fetal malformation.

Caracterização psicossocial de pacientes diabéticos de um hospital público universitário / Psychosocial characterization of diabetes mellitus patients of a public university hospital / Caracterización psicosocial de pacientes diabéticos de un hospital público universitario

OBJETIVOS: caracterizar sociodemograficamente pacientes diabéticos adultos de um hospital público universitário, avaliar o conhecimento da doença e seu impacto psicossocial. MÉTODO: realizadas 62 entrevistas, criadas categorias com conteúdos verbais e feita contagem da frequência. RESULTADOS: da amostra, 54,8% eram do sexo feminino, 67,7% casados, 77,4% cursaram o Ensino Fundamental e 88,7% tinham Diabetes Mellitus tipo 2. Sabiam da necessidade de fazer dieta 82,3%, mas 46,8% tinham dificuldade em segui-la. Quanto ao impacto psicossocial, 37,1% deixavam de sair de casa devido à doença, 45,2% referiram prejuízo da capacidade ocupacional e 29%, dificuldade nos relacionamentos. Apresentaram queixa emocional 67,7%. CONCLUSÃO: observou-se alta frequência de queixas emocionais, pouco conhecimento e dificuldade para lidar com a doença. Ressalta-se a importância das ações multidisciplinares, auxiliando o paciente no processo de aceitação da doença e adaptação às mudanças necessárias, favorecendo a adesão ao tratamento.

OBJECTIVE: To characterize diabetic adult patients of a public university hospital, to evaluate their disease's knowledge, and the psychosocial impact of their illness. METHOD: 62 interviews were performed, verbal contents categorized and frequency counted. RESULTS: 54.8% of the patients were female, 67.7% were married, 77.4% with high school educational level and 88.7% with type 2 Diabetes Mellitus. 82.3% of the population knew the importance of a diet, but 46.8% had difficulties in following it. About psychosocial impact, 37,1% gave up on going out because of the disease, 45,2% had affected their ability to work, 29% reported relationship problems. 67.7% presented emotional complaints. CONCLUSION: Patients reported high frequency of emotional complaints, little knowledge and difficulties in dealing with their disease. It is also pointed out the importance of multidisciplinary actions, helping the patient in the disease acceptance process and in the adaptation to the necessary changes favoring treatment adherence.

OBJETIVOS: caracterizar sociodemográficamente pacientes diabéticos adultos de un hospital público universitario, evaluar el conocimiento de la enfermedad y su impacto psicosocial. MÉTODO: se realizaron 62 entrevistas, se crearon categorías con contenidos verbales y se hizo el cómputo de frecuencia. RESULTADOS: el 54,8% de la muestra fueron mujeres, el 67,7% casados, el 77,4% asistió a la escuela primaria y el 88,7% tenían Diabetes Mellitus tipo 2. Sabían de la necesidad de dietas el 82,3%, pero el 46,8% tenía dificultad en seguirla. En cuanto al impacto psicosocial, el 37,1% dejaba de salir de casa debido a la enfermedad, el 45,2% reportó pérdida de capacidad laboral y el 29%, dificultad en las relaciones. Presentó queja emocional el 67,7%. CONCLUSIÓN: hubo una alta frecuencia de quejas emocionales, poco conocimiento y dificultad para hacer frente a la enfermedad. Destacando la importancia de acciones multidisciplinarias, ayudando al paciente en el proceso de aceptación de la enfermedad y adaptarse a los cambios requeridos, alentando la adherencia al tratamiento.

Análise qualitativa do uso de manual informativo para familiares em UTI / Qualitative analysis of the information booklet use on ICU patient's relatives / Análisis cualitativo del uso de manual de información para familiares en UCI

O objetivo deste estudo foi analisar qualitativamente os efeitos do uso de Manual Informativo (MI) sobre a compreensão das informações e comportamentos dos familiares nas visitas aos pacientes. Foram utilizadas entrevista semiestruturadas. Os seis primeiros familiares, Grupo I, não receberam o MI. Os seis seguintes, Grupo II, receberam o MI. Todos foram entrevistados nas primeiras 72 horas de internação. No Grupo I, identificaram-se percepções incompletas sobre UTI e paciente, dificultando a formulação perguntas e acentuando sentimentos de impotência e isolamento. No Grupo II, evidenciaram-se maiores compreensão e coerência das informações, maior domínio de termos técnicos e comportamentos mais ativos dos familiares. A informação escrita sistematizada colaborou para o esclarecimento dos familiares, aumentando segurança em relação aos profissionais/pacientes, diminuindo seu sofrimento.

The aim of this study was to analyse qualitatively the use of Informative Booklet (IB) in order to comprehend information and behaviours of relatives during visits to patients. Semi-structured interviews were held. At first, six relatives, named Group 1, were not analysed with IB. On the other hand, the following six, group 2, were. All of them were interviewed during the first 72 hours of hospitalization. In Group 1, incomplete perceptions were identified on ICU and patients. Thus, not only was it difficult to pose questions, but also feelings of helplessness and isolation have been accentuated. In Group 2, we could perceive a higher comprehension of information, greater use of technical terms, and more active behaviours. Systematised and written information contributed to enlighten relatives, increasing confidence on professionals and patients, thus reducing suffering.

El objetivo de este estudio fue analizar cualitativamente efectos del uso del Manual de Información (MI) sobre la comprensión de las informaciones y los comportamientos de los parientes en las visitas a los pacientes. Se utilizaron entrevistas semi estructuradas. Los primeros seis familiares, Grupo I, no recibieron el MI. Los seis siguientes, Grupo II, recibieron el MI. Todos ellos fueron entrevistados en las primeras 72 horas de hospitalización. En el Grupo I, fueron identificadas percepciones incompletas sobre la UCI y paciente, lo que puede dificultar la formulación de preguntas y acentuar los sentimientos de impotencia y aislamiento. En el Grupo II, los familiares mostraron más comprensión de la información, mayor dominio de términos técnicos y comportamientos más activos. La información escrita y sistematizada parece contribuir para la clarificación de los parientes, para aumentar la seguridad en lo referente a profesionales/pacientes, reduciendo su sufrimiento.

Brief cognitive behavioral intervention in groups in a Brazilian assisted reproduction program.

The study's objective was to assess the effect of a cognitive behavioral group intervention on the pregnancy rates of patients submitted to in vitro fertilization (IVF) techniques or to intracytoplasmic sperm injection (ICSI). The study was conducted on 188 patients, 93 who participated in a group of psychological intervention before the IVF and ICSI procedures and 95 patients submitted to IVF and ICSI during the same period of time, who did not participate in the intervention (control group). Clinical pregnancy was the outcome measure. Demographic and clinical variables were compared between groups in order to assess the group's homogeneity. Participants in the psychological intervention obtained a pregnancy rate of 39.8%, significantly higher than the 23.2% rate of nonparticipants (χ(2) = 6.03, p = .01, odds ratio of 22 (CI: 1.16-4.13). The data suggest that group psychological intervention before IVF and ICSI in order to control stress seems to increase the rate of success of these procedures.

Ansiedade, depressão, dependência nicotínica e consumo de álcool em pacientes com insuficiência cardíaca / Anxiety, depression, nicotine dependence and alcohol consuption in patients with heart failure

As doenças cardiovasculares são as principais causas de morte, morbidade e incapacidade nos países ocidentais, devendo-se atentar para os múltiplos fatores de risco modificáveis como forma de alteração deste prognóstico junto a esta população. Objetivou-se caracterizar os pacientes da Clínica de Insuficiência Cardíaca (CIC) de um hopsital público universitário, identificando fatores de risco modificáveis que permitam criar linha de base para futuras intervenções. Participaram 100 pacientes, acima de 18 ano, escolhidos aleatoriamente. Aplicou-se uma entrevista semiestruturada, HAD (sintomas ansiosos e depressivos), AUDIT (dependência alcoólica) e FIND (dependência nicotínica). A amostra foi composta por 64 homens e 36 mulheres; idade média de 53,35 anos; 67% com ensino fundamental; 61% casados ou amasiados; 43% com renda mensal de 2 a 4 salários mínimos; 79% não trabalham; 49% aposentados; 69% praticam atividades de lazer; 64% são sedentários; 56% apresentam sintomas de ansiedade e 25% de depressão, com associação entre presença de atividades de lazer e ausência de depressão (p = 0,046), bem como entre as duas patologias (p<0,0001), 85% encontram-se na Zona I (Educação para o Álcool) e 13% são tabagistas, havendo associação entre uso de álcool e tabaco (p + 0,0035). Encontrou-se associação entre as classe funcionais I e II da doença e presença de sintomas ansiosos (p = 0,019) e depressivos (p = 0,019). A caracterização da amostra clínica representativa de CIC traz dados importantes para a sistematização de intervenções eficazes, tornando possível o desenvolvimento de estratégias multidisciplinares de cuidado e prevenção, direcionamento do emprego de recursos e melhora de aspectos psicológicos.

Cardiovascular diseases are the leading causes of death, morbidity and disability in western countries, and attention should be paid to the multiple modifiable risk factors as a way to change this prognosis for this population. The aim of this study was to characterize patients in the Heart Failure Clinic (HFC) from a public university hospital, identifying modifiable risk factors to establish a baseline for future interventions. Chosen at random 100 patients over 18 years old participated in this study. A semi-structured interview was made, HAD (anxiety and depression symptoms), AUDIT (alcohol dependence) and FTND (nicotine dependence). The sample had 64 men and 36 women; mean age of 53,35 years; 67% with primary education; 61% married or cohabiting; 43% with monthly income of 2-4 minimum wages; 79% do not work; 49% retired; 69% practice leisure activities; 64% are sedentary; 56% have symptons of anxiety and 25% of depression, with association between leisure activities and absence of depression (p = 0,046), as well as between the two pathologies (p<0,0001). Zone I (Education for Alcohol) 85% and 13% are smokes, there was an association between alcohol consuption and smoking (p = 0,0035). An association was found between the disease funcional classes I and II and presence of anxiety symptoms (p = 0,01) and depression (p = 0,019). The obtained characterization of a clinical sample representative of the CIC, is an important data for the systematization of effective interventions, making possible the development of multidisciplinary strategies for care and prevention, targeting the use of resources and improvement of psychological aspects.

Caracterização psicossocial de pacientes internados em enfermaria de cardiologia / Psychosocial characterization of patients in a cardiac ward

Fundamentos: As doenças cardiovasculares (DCV) sãoresponsáveis por mais da metade da mortalidade mundial. Apesar dos grandes avanços tecnológicos e do conhecimento clínico, os fatores de risco (FR) psicossociais ainda são poucoconhecidos. Objetivo: Descrever a prevalência de alterações psicossociais,a qualidade de vida e o nível de conhecimento dos pacientes sobre fatores de risco para as DCV. Métodos: Estudo descritivo exploratório de corte transversal, em amostra de conveniência, com adultos >18 anos (n=100), de ambos os sexos, com diagnóstico de qualquer doençacardiovascular. Foram utilizados: entrevista semiestruturada (dados sociodemográficos e hábitos de vida), Escala Hospitalar de Ansiedade e Depressão (HAD) e instrumento de avaliação de qualidade de vida (QV) da OMS (WHOQoL-Bref). Realizadaestatística descritiva dos dados coletados. Resultados: Verificou-se leve predominância de mulheres (54%),com idade <60 anos (58%), baixa escolaridade (74%), baixa renda(48%) e aposentados (49%). Afirmam conhecer os FR para DCV 77% dos pacientes; 51% citam com maior frequência os aspectos emocionais; e 32% os consideram de mais difícil controle. Da amostra, 47% são ex-fumantes e 61% são sedentários. Sintomas depressivos aparecem em 39% dos sujeitos e ansiedade em 41%.Quanto à QV, o domínio “relações sociais” foi o melhor avaliado e o “físico” aquele com pior avaliação.Conclusões: O presente estudo demonstrou elevada prevalência de sintomas de ansiedade e depressão na amostra de cardiopatas.

Psicologia na atenção primária: ações e reflexões em programa de aprimoramento profissional / Psychology in primary health care: actions and reflexions on a program of professional training / Psicología en la atención primaria: acciones y reflexiones en programa de perfeccionamiento profesional

A inserção da Psicologia na Atenção Primária exigiu dos profissionais um repensar de suas práticas, ações e condutas, considerando a realidade da população com que se pretende atuar e os objetivos desse nível de atenção. O objetivo deste estudo é retratar a experiência de psicólogos do Programa de Aprimoramento Profissional em Promoção de Saúde na Comunidade em Núcleos de Saúde da Família em Ribeirão Preto, SP. Para o desenvolvimento das intervenções, inicialmente foram realizadas análises das necessidades, a fim de se verificar os padrões de morbimortalidade da população. A atuação dos psicólogos foi dividida em duas frentes de trabalho: uma voltada para o suporte à equipe e outra para realizar ações com a comunidade. Com os usuários, o psicólogo realizou visitas domiciliares, atendimentos individuais, familiares e coordenação de grupos. Os grupos eram abertos ou fechados, podendo ser classificados em educativos/reflexivos e de socialização. Para auxiliar no desenvolvimento das atividades, foram utilizados recursos audiovisuais, técnicas de dinâmica de grupo, discussões em grupos e trocas de experiências. Notase a importância de as ações do psicólogo na Atenção Básica estarem focadas na interferência nos fatores de risco à saúde da população, visando a alcançar mudanças comportamentais que proporcionem melhor qualidade de vida.(AU)

The insertion of Psychology in the primary level of health care demanded professionals to think over their practices, actions and conducts, considering the reality of the population they will work with, as well as the objectives of this level of health attention. This study aims to describe the experience of the psychologists from the Program of Professional Training in Community Health Promotion, in Family Health Units in Ribeirão Preto, SP, Brazil. For the development of the interventions, the assessment was initially performed to check the morbid-mortality patterns of the population. The psychologists' work was divided into two different approaches: one to support the professional team and another to accomplish community actions. Together with the clients, the psychologists did home visits, gave individual and familiar attention and group coordination. The groups were open or closed, being classified as educational/reflexive and socialization groups. In order to develop these activities, they used audio-visual resources, group dynamic techniques, group discussions and experience exchanges. It is noticed that the importance of the psychologist's actions in the primary attention should be focused on the intervention on the population health risk factors, aiming to attain behavior changes which might allow quality of life improvement.(AU)

La inserción de la Psicología en la Atención Primaria exigió de los profesionales un replanteamiento de sus prácticas, acciones y conductas, considerando la realidad de la población con que se pretende actuar y los objetivos de ese nivel de atención. El objetivo de este estudio es retratar la experiencia de psicólogos del Programa de Perfeccionamiento Profesional en Promoción de Salud en la Comunidad en Núcleos de Salud de la Familia en Ribeirão Preto, SP. Para el desarrollo de las intervenciones, inicialmente fueron realizados análisis de las necesidades, a fin de verificar los estándares de morbi-mortalidad de la población. La actuación de los psicólogos fue dividida en dos frentes de trabajo: uno dirigido al soporte al equipo y otro para realizar acciones con la comunidad. Con los usuarios, el psicólogo realizó visitas domiciliarias, atendimientos individuales, familiares y coordinación de grupos. Los grupos eran abiertos o cerrados, pudiendo ser clasificados en educativos/reflexivos y de socialización. Para auxiliar en el desarrollo de las actividades, fueron utilizados recursos audiovisuales, técnicas de dinámica de grupo, discusiones en grupos e intercambios de experiencias. Se nota la importancia de que las acciones del psicólogo en la Atención Básica estén enfocadas en la interferencia en los factores de riesgo a la salud de la población, visando a alcanzar mudanzas de comportamiento que proporcionen mejor calidad de vida.(AU)