Efeitos da pandemia: percepção de estresse e apoio em famílias com filhos com desenvolvimento atípico / Pandemic' effects: perception of stress and support in families with children with atypical development

A pandemia da COVID-19 exigiu medidas de proteção que repercutiram no modo de vida das famílias. Os impactos podem ter sido mais intensos em famílias com crianças com deficiência ou transtorno global do desenvolvimento (TGD) que necessitam de cuidados e estímulos específicos. O objetivo deste estudo foi analisar o impacto do isolamento social na percepção de estresse, estresse parental e apoio social percebido por mães e pais de crianças com deficiência/TGD. Trata-se de um estudo transversal com 37 participantes, em duas fases independentes de coleta de dados (F1; F2). Utilizou-se instrumentos autoaplicáveis disponibilizados em um Formulário Google: Questionário Sociodemográfico; Questionário sobre percepção da influência do isolamento social na dinâmica familiar; Escala de Estresse Percebido; Escala de Estresse Parental e Escala de Apoio Social. Observou-se que a percepção de estresse em F2 foi significativamente maior que em F1 e em famílias com mais de um filho (p

The COVID-19 pandemic required protect actions with quarantine and social distancing, which had an impact on families' lifestyle. The impacts of the pandemic may have been even more intense in families of children with disabilities or pervasive developmental disorder (PDD) who need specific care. This study aims to analyze the impact of the social distancing situation on the perception of stress, parental stress and perceived social support by mothers and fathers of children with disabilities/PDD with 11 years old or more, and associations between these variables. This is a cross-sectional study with 37 participants in two independent phases. The following self-administered instruments were available in a Google Form: Sociodemographic Questionnaire; Questionnaire on the perception of the influence of social distancing resulting from the pandemic on family dynamics; Perceived Stress Scale; Parental Stress Scale and Social Support Scale. There was a significatively higher stress perception between mothers in Phase 2 (P2>P1) and higher stress among families with more than one child. Most mothers referred social support, an increase in the stress perception with children care and stress comparing the phases. This study demonstrated the importance of social support to parents' adaptation in stress increasing related to pandemic situation

Comparison of the whole slide imaging and conventional light microscopy in the grading of oral epithelial dysplasia: a multi-institutional study

BACKGROUND: Whole Slide Imaging (WSI) is an alternative method to light microscopy (LM). However, few studies have compared the diagnostic agreement between WSI and LM, especially to grade oral epithelial dysplasia (OED). The purpose of this study was to evaluate the variability in grading OED by the World Health Organization grading system, using WSI and conventional LM, and to investigate whether the access to clinical information, and psychologic or physical states of the pathologists could interfere with the diagnosis. MATERIAL AND METHODS: eleven experienced pathologists from seven Brazilian universities independently evaluated twenty-five OED cases. The analyses were performed in duplicate for each method, with an interval of at least 30 days, and the time consumed in each analysis was measured. Physical and psychologic states were evaluated by blood pressure levels, heart rate and two questionnaires: State-Trait Anxiety Inventory and Perceived Stress Scale. Clinical information was provided after the second evaluation using WSI and the pathologist could change their diagnostic decision or not. RESULTS: LM showed a higher inter-examiner agreement (k=0.53) than WSI (k=0.45) and a smaller time consumed by the pathologists (mean of 65.53 seconds compared to 91.02 seconds in WSI). In the first analysis using conventional microscopy, there was a positive correlation between kappa values and anxiety (r=0.47, p = 0.02), and stress (r=0.64, p < 0.01), and an inverse correlation with heart rate (r=-0.48, p = 0.02). In the digital analysis, there was also a positive correlation between kappa values and anxiety (r=0.75, p < 0.001). After clinical information was given, there was a slight change in 11.3% of the cases, and a great discrepancy in 1.1% of the cases, mainly increasing the OED grade. CONCLUSIONS: both microscopy systems had similar results, although LM had slightly higher kappa values, and WSI was more time consuming

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[Integrative review: psychological distress among university students and correlated factors]. / Revisão integrativa: sofrimento psíquico em estudantes universitários e fatores associados.

This review sought to identify risk factors and protection from psychic distress among university students. Empirical studies were analyzed in the Web of Science, Medline and Scopus databases. A total of 1,375 articles were located, and after the exclusion criteria were applied, 37 articles made up the final sample, most of which were cross-sectional studies published in the last five years, in developed countries and with students in the health area. The most frequently used instruments for psychic distress screening were the General Health Questionnaire and the Self Reporting Questionnaire, which identified a prevalence of between 18.5% and 49.1% and, as risk factors, conditions related to academic life (24) and to health (22). Twelve studies identified as protective factors: given coping strategies, sense of coherence, self-efficacy, vigor, self-esteem, resilience, among other psychological conditions. This review singles out directions for possible interventions that could contribute to the well-being of students and to stimulate more positive experiences in the educational environment.

Esta revisão propôs-se a identificar fatores de risco e proteção para sofrimento psíquico em estudantes universitários. Analisaram-se estudos empíricos nas bases de dados: Web of Science, Medline e Scopus. Foram localizados 1375 artigos e, aplicados os critérios de exclusão, 37 artigos compuseram a amostra final, tendo sido a maioria estudos transversais, publicados nos últimos cinco anos, em países desenvolvidos, com estudantes da área da saúde. Os instrumentos mais utilizados para o rastreamento de sofrimento psíquico foram o General Health Questionnaire e o Self Reporting Questionnarie, que identificaram prevalências de 18,5% a 49,1% e, como fatores de risco, condições relativas à vida acadêmica (24) e à saúde (22). Foram identificadas como fatores de proteção, em doze estudos, apresentar determinadas estratégias de coping, senso de coerência, autoeficácia, vigor, autoestima, resiliência, entre outras condições psicológicas. Essa revisão aponta direções para possíveis intervenções que poderiam contribuir para o bem estar dos estudantes e para estimular vivências mais positivas no ambiente educacional.

Revisão integrativa: sofrimento psíquico em estudantes universitários e fatores associados / Integrative review: psychological distress among university students and correlated factors

Resumo Esta revisão propôs-se a identificar fatores de risco e proteção para sofrimento psíquico em estudantes universitários. Analisaram-se estudos empíricos nas bases de dados: Web of Science, Medline e Scopus. Foram localizados 1375 artigos e, aplicados os critérios de exclusão, 37 artigos compuseram a amostra final, tendo sido a maioria estudos transversais, publicados nos últimos cinco anos, em países desenvolvidos, com estudantes da área da saúde. Os instrumentos mais utilizados para o rastreamento de sofrimento psíquico foram o General Health Questionnaire e o Self Reporting Questionnarie, que identificaram prevalências de 18,5% a 49,1% e, como fatores de risco, condições relativas à vida acadêmica (24) e à saúde (22). Foram identificadas como fatores de proteção, em doze estudos, apresentar determinadas estratégias de coping, senso de coerência, autoeficácia, vigor, autoestima, resiliência, entre outras condições psicológicas. Essa revisão aponta direções para possíveis intervenções que poderiam contribuir para o bem estar dos estudantes e para estimular vivências mais positivas no ambiente educacional.

Abstract This review sought to identify risk factors and protection from psychic distress among university students. Empirical studies were analyzed in the Web of Science, Medline and Scopus databases. A total of 1,375 articles were located, and after the exclusion criteria were applied, 37 articles made up the final sample, most of which were cross-sectional studies published in the last five years, in developed countries and with students in the health area. The most frequently used instruments for psychic distress screening were the General Health Questionnaire and the Self Reporting Questionnaire, which identified a prevalence of between 18.5% and 49.1% and, as risk factors, conditions related to academic life (24) and to health (22). Twelve studies identified as protective factors: given coping strategies, sense of coherence, self-efficacy, vigor, self-esteem, resilience, among other psychological conditions. This review singles out directions for possible interventions that could contribute to the well-being of students and to stimulate more positive experiences in the educational environment.

Prevalence and correlates of common mental disorders among dental students in Brazil.

This study aimed to estimate prevalence of common mental disorders (CMD) and associated factors among dental students. In this cross-sectional study, 230 students answered a questionnaire and instruments to assess CMD (Self Reporting Questionnaire-20), hazardous alcohol consumption (Alcohol Use Disorder Identification Test), social support (Social Support Scale), perceptions of academic life (Dundee Ready Education Environment Measure), coping (Ways of Coping Inventory) and resilience (Resilience Scale). Bivariate analysis was conducted using the Chi-Square and Mann-Whitney tests. Logistic regression included all explanatory variableswith p<0.20 in the bivariate analysis, besides sex and academic year. The explanatory variables were analyzed in five successive blocks (backward-stepwise), until all variables presented statistical significance in the final model (p<0.05). The prevalence of CMD was 45.2% (95%CI: 38.7-51.6), with no significant differences between sexes. Students with no extracurricular activities, who had negatively self- assessed their health status and their academic performance, were about four times more likely to present CMD, followed by receiving psychological or psychiatric treatment during university (AOR: 2.65; 95%CI: 1.1-6.1) and those with high scores for confrontive coping (AOR: 1.20; 95%CI: 1.0-1.4). Resilience was a protective factor for CMD among dental students (AOR: 0.93; 95%CI: 0.9-1.0). Aspects related to academic performance, health status and confrontive coping strategies were risk factors to students' mental health. Individuals with high levels of resilience showed lower prevalence of CMD. Further prospective studies could contribute to understanding the role of resilience among this population.

Pacientes em processo diagnóstico de câncer de cabeça e pescoço: aspectos psicológicos, percepções e expectativas / Patients in diagnostic process of head and neck cancer: psychological, perceptions and expectations

O presente estudo identificou características sociodemográficas, da saúde física e mental, percepções e expectativas ao atendimento e diagnóstico de pacientes com suspeita de câncer de cabeça e pescoço. Avaliou-se 49 pacientes de dois centros de diagnóstico oral. O delineamento constou de dois Momentos: pré-biópsia (M1) e pósdiagnóstico (M2). No M1, investigaram-se dados sociodemográficos, apoio social e estilo de vida (questionário), sintomas ansiosos (Inventário de Ansiedade Traço- Estado, IDATE), depressivos (Inventário de Depressão de Beck, BDI) e uso de álcool (Alcohol Use Disorders Identification Test, AUDIT); motivo da consulta, sentimentos, percepção do problema e expectativas sobre diagnóstico e atendimento (entrevista). No M2, reavaliaram-se sintomas ansiosos (IDATE-Estado) e depressivos (BDI), percepções e sentimentos ao diagnóstico, enfrentamento, expectativas e a satisfação com o atendimento (entrevista) dos 29 pacientes com diagnóstico de câncer. As respostas às entrevistas foram categorizadas. Utilizou-se de análises descritivas e bivariadas (chi-quadrado ou exato de Fisher, Goodman e Wilcoxon – p<0.05). Resultados: na amostra total, predominaram: homens (73,4%), idade de 59 anos, 4,5 anos de estudo, ocupação remunerada (40,8%), rendimento de R$ 670,65, viver com companheiro 61,2% e com parentes 87,8%, relatar sentimento de apoio social 83,7%, ter religião 93,9%, tabagismo e etilismo 44,9%, ter problemas de saúde 45,0% e autoavaliação da “saúde boa” 69,4%. O tempo médio de observação da lesão foi de seis meses, sendo a maioria intraoral (83,7%) e encaminhados por dentistas 51,0%. No M1, 53,9% das mulheres foram consideradas caso para ansiedade-Traço, 61,5% para Estado e 46,2% para sintomas depressivos; e 36,1% dos homens apresentaram risco para de uso de álcool...

This study aimed to describe the sociodemographic characteristics, lifestyle, and physical and mental health status of patients with head and neck cancer, as well as identify their perceptions and expectations regarding care and diagnosis. 49 patients were evaluated before and after diagnosis communication as they were submitted to biopsies in two diagnostic oral centers. Before the diagnosis (moment 1), the sociodemographic and lifestyle variables were evaluated using a questionnaire and validated instruments to assess anxiety (State - Trait Anxiety Inventory, STAI), depression (Beck Depression Inventory, BDI) and alcohol abuse (Alcohol Use Disorders Identification Test, AUDIT); reason for examination, feelings, perception of the problem, and expectations were investigated through a structured interview. After cancer diagnosis (moment 2), 29 patients had some aspects reassessed: anxiety, depression levels, perceptions, feelings about the disease, and expectations towards medical and dental care. Were also investigated coping and satisfaction with the service received from dentists. Data collected during the interviews were categorized and a descriptive and bivariate analysis (Qui-square, fisher, Goodman and Wilcoson – p<0,05) to other variables. The initial sample consisted mostly of males (73.4%) (mean age of 59 years), with four and a half years of study, employed (40.8%), low income (53,0%), having a partner (61.2%), living with relatives (87.8%), having feelings of social support (83.7%) and a religion (93.9%), smoking (44.9%) and (45.0%) drinking habits, and classified their health as “good” (69.4%). The mean time between observation of symptoms and seeking for help was six months, which were mostly intraoral lesions (83.7%), referred by dentists (51.1%). Before diagnosis (Moment 1), women had a high prevalence for anxiety-trait (53.9%), state (61.5%) and depressive symptoms (46.2%)...

Dor em oncologia: intervenções complementares e alternativas ao tratamento medicamentoso / Oncology pain: complementary and alternatives interventions to drug treatment

A Organização Mundial da Saúde [OMS] considera a dor associada às neoplasias uma emergência médica mundial. Em oncologia, constitui uma das queixas mais frequentes dos pacientes e uma variável peculiar que requer tratamento adequado. Isso se torna ainda mais relevante na medida em que essa população experiencia impacto emocional adverso e desconfortos desde os exames diagnósticos até os procedimentos terapêuticos convencionais. Além dos tratamentos farmacológicos utilizados para o manejo da dor, como os opioides, terapias complementares e alternativas são indicadas por profissionais de saúde e buscadas pelos pacientes. Para isso, há técnicas físicas, mecânicas e cognitivas, referidas pela OMS e reconhecidas pela literatura. A Psicologia contribui com uma ampla variabilidade de técnicas, como relaxamento, visualização, distração dirigida, biofeedback, respiração profunda, grupos educativos, modelação, sistemas de recompensas (reforço positivo) e ensaio de comportamentos. Intervenções complementares e alternativas ao tratamento medicamentoso visam reduzir o sofrimento relacionado e/ou acentuado pela dor, e promover a qualidade de vida nas diferentes fases do tratamento clínico usual. No entanto, são necessários mais estudos sistemáticos, com grupos controle, que comprovem a eficácia das técnicas sobre o controle da dor e identifiquem eventuais formas de manejo alternativo ou complementar ao tratamento medicamentoso.(AU)

The World Health Organization - WHO considers pain associated with cancer a "worldwide medical emergency." In oncology, it is one of the most frequent complaints of patients with cancer and a peculiar variable that requires treatment. This becomes even more relevant to the extent that people experience discomfort and adverse emotional impact from the diagnostic testing procedures to conventional therapy. In addition to the pharmacological treatments used for pain management, such as opioids, complementary and alternative therapies are provided by health professionals, and sought after by patients. For this, thare are some physical , mechanical and cognitive techniques , cited by WHO and literature. Psychology contributes to a wide variation of techniques such as relaxation, visualization, distraction directed, biofeedback, deep breathing, educational groups, modeling, systems of rewards (positive reinforcement), testing behaviors, etc.. Complementary and alternative therapies aim to reduce the suffering caused and / or sharp pain, and promote quality of life in different stages of treatment concomitantly to clinical usual. However, it is necessary to perform more controlled studies, demonstrating the effectiveness of techniques for pain control in oncology and to identify the best management, so an alternative or complement to drug treatment.(AU)