Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 15.789
Filtrar
1.
Rev. psicanal ; 26(3): http://revista.sppa.org.br/index.php/RPdaSPPA/article/view/465/484, dez. 2019.
Artigo em Português | LILACS | ID: biblio-1049685

RESUMO

O presente artigo apresenta uma intervenção psicanalítica feita na Casa dos Cata-ventos, localizada em Porto Alegre, RS. Esta instituição foi inspirada nas Estruturas Dolto e, assim como a Casa da Árvore, localizada no Rio de Janeiro, trabalha com crianças e adolescentes em território de vulnerabilidade social. A complexidade da intervenção está discriminada no seu processo de invenção, na aposta da palavra como instrumento civilizatório e de abertura simbólica aos silenciamentos provocados pela violência, na escuta transferencial do brincar e das dificuldades escolares e, por último, na formação/ transmissão da Psicanálise presente em todo o projeto


This article presents a psychoanalytical intervention in Porto Alegre city: Casa dos Cata-ventos (Swirl Toy House). It is inspired by Dolto´s Structures and works with children and adolescents in socially vulnerable territories, just as Casa da Árvore (Tree House) in Rio de Janeiro. The complexity of this intervention is associated with its invention process, with the bet on the word as a civilizing instrument, with symbolic opening possibilities to the silence caused by violence, with transferential listening of playing and school difficulties, and lastly with Psychoanalysis formation transmission


El presente artículo presenta una intervención psicoanalítica en Casa dos Catavientos, ubicada en Porto Alegre, RS (Casa de los Molinillos). Se inspira en las Estructuras Dolto y como en la Casa da Árvore (la Casa en el Árbol), de Rio de Janeiro, trabaja con niños y adolescentes en territorios socialmente vulnerables. La complejidad de esta intervención se encuentra en su proceso de invención, por la apuesta en la palabra como instrumento de la civilización y de apertura simbólica en los silencios provocados por la violencia, en la escucha transferencial del jugar y de las dificultades escolares y, finalmente, en la formación/transmisión del Psicoanálisis, presente en todo el proyecto


Assuntos
Serviços Comunitários de Saúde Mental , Entrevista Psicológica
2.
Medicine (Baltimore) ; 98(52): e18515, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876742

RESUMO

Although functional impairment is very common among patients with major depressive disorder (MDD) and is a necessary diagnostic criterion for MDD, clinicians have not directed their attention beyond the mood symptoms of MDD. We aimed to multi-dimensionally assess the functional abilities of patients with MDD using a standardized scale of adaptive function reported by caregivers or parents to identify the nature and degree of functional impairment in patients with MDD.This study was conducted in 40 depressive patients aged 19 to 60 years. Patients were screened according to the DSM-IV-TR and a Hamilton Depression Rating Scale score ≥8. We administered the parent/caregiver rating form of the Korean Vineland Adaptive Behavior Scale to assess functional outcomes in the patients.Patients with MDD showed significant differences in both global and domain-specific functional abilities compared to those of the normal group (all t > -6.35, P < .05) and the patients' premorbid IQ (all t > 4.30, P < .001). The number of episodes among clinical factors was negatively correlated with overall adaptive functioning (r = -0.32, P < .05) and expressive communication (r = -0.42, P < .01).Our present study replicates existing evidence showing impairment in both broad and various functional areas in patients with MDD, suggesting the importance of quantitatively assessing functional outcomes and acquiring information about functioning from informants other than patients.


Assuntos
Atividades Cotidianas/psicologia , Transtorno Depressivo Maior/psicologia , Adaptação Psicológica , Adulto , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Adulto Jovem
3.
BMC Psychol ; 7(1): 67, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651367

RESUMO

BACKGROUND: To bridge the gap between symptoms and treatment, constructing case formulations is essential for clinicians. Limited scientific value has been attributed to case formulations because of problems with quality, reliability, and validity. For understanding, communication, and treatment planning beyond each specific clinician-patient dyad, a case formulation must convey valid information concerning the patient, as well as being a reliable source of information regardless of the clinician's theoretical orientation. The first aim of the present study is to explore the completeness of unstructured psychodynamic formulations, according to four components outlined in the Case Formulation Content Coding Method (CFCCM). The second aim is to estimate the reliability of independent formulations and their components, using similarity ratings of matched versus mismatched cases. METHODS: This study explores psychodynamic case formulations as made by two or more experienced clinicians after listening to an evaluation interview. The clinicians structured the formulations freely, with the sole constraint that technical, theory-laden terminology should be avoided. The formulations were decomposed into components after all formulations had been written. RESULTS: The results indicated that most formulations were adequately comprehensive, and that overall reliability of the formulations was high (> 0.70) for both experienced and inexperienced clinician raters, although the lower bound reliability estimate of the formulation component deemed most difficult to rate - inferred mechanisms - was marginal, 0.61. CONCLUSIONS: These results were achieved on case formulations made by experienced clinicians using simple experience-near language and minimizing technical concepts, which indicate a communicative quality in the formulations that make them clinically sound. TRIAL REGISTRATION: linicalTrials.gov Identifier: NCT00423462 . https://doi.org/10.1007/s00432-018-2781-7 ., January 18, 2007.


Assuntos
Entrevista Psicológica , Transtornos Mentais/terapia , Psicoterapia , Humanos , Linguagem , Transtornos Mentais/diagnóstico , Reprodutibilidade dos Testes
5.
Eat Behav ; 35: 101320, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31445189

RESUMO

Anxiety is highly characteristic of eating disorders (ED). Despite high levels of anxiety, little is known about ED specific fears. The current study developed and tested the psychometric properties of two measures of ED fears in two samples (N = 513 undergraduates; N = 129 clinical EDs): a self-report measure (Eating Disorder Fear Questionnaire; EFQ) and interview (Eating Disorder Fear Interview; EFI). We found strong support for a five-factor EFQ consisting of subscales assessing fear of weight gain, social consequences, personal consequences, physical sensations, and social eating. We found strong support for a six-factor EFI consisting of subscales assessing fear of food, weight gain, physical sensations, personal consequences, social consequences, and exercise-related fears. Both measures had adequate to strong internal consistency and convergent, divergent, incremental, and construct validity. These measures can be used to identify ED fears that can be targeted in personalized treatment. These data show that ED fears are multifaceted and heterogeneous.


Assuntos
Medo , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Entrevista Psicológica , Inquéritos e Questionários , Adolescente , Adulto , Ansiedade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Adulto Jovem
6.
BMC Psychol ; 7(1): 49, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337443

RESUMO

BACKGROUND: Nowadays there is a growing interest in exploring causes of fatigue symptoms and the possible linked aspects in patients with Chronic Kidney Disease (CKD) receiving hemodialysis (HD) treatment. Inflammatory processes were demonstrated to influence motivational systems functioning in chronic conditions. However, there is a lack of connection between quantitative motivational systems measure and patients self-report motivational and fatigue issue. Thus, the aim of this study was to identify an association between HD patients reward mechanisms, fatigue severity and psychosocial variables emerging from semi-structured interviews. METHODS: Interviews were held for a sample of ninety-four patients (54 males, 40 females; Mage = 62.98 ± 17.94; dialytic mean age in months = 76.55 ± 84.89) receiving chronic HD treatment and consequently analyzed by means of quantitative and qualitative analysis. Behavioral motivation systems reflecting inhibition/approach tendency to rewards were measured by Behavioral Inhibition/Activation System (BIS/BAS) scale and the fatigue severity experienced by HD patients was measured with the Fatigue Severity Scale. Scale results were correlated to psychosocial variables and topics derived from the semi-structured interviews. RESULTS: Findings highlight the presence of two effects: one related to the Behavioral Activation System (BAS) as a protective factor against the HD treatment pervasive consequences; the other one deals with the self-reported levels of fatigue that seemed to significantly interfere with patients' daily life, as a function of gender. CONCLUSIONS: Such results encourage the use of a mixed method approach to understand the complexity of the subjective experience of patients' facing chronic disease and treatments.


Assuntos
Atitude Frente a Saúde , Fadiga/psicologia , Entrevista Psicológica/métodos , Qualidade de Vida/psicologia , Diálise Renal/psicologia , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Recompensa , Fatores de Risco , Autorrelato
7.
J Forensic Leg Med ; 66: 113-116, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31277038

RESUMO

Immigration and asylum-seeking are issues that have recently. warranted increased attention and significance. In the aftermath of terrorist attacks, people are more wary of asylum seekers who are usually held in detention centers after fleeing persecution and not for criminal or immigration charges. Asylum seekers may raise suspicions due to inconsistent statements and can be held in detention for the duration of the process and/or denied asylum. Inconsistencies may be influenced by psychiatric symptoms, cognitive abilities, the type of past trauma experienced, the questioning style of the interviewer, and are usually unrelated to dishonesty or malingering making psychiatric consult important in many of these evaluations.


Assuntos
Transtornos de Adaptação/diagnóstico , Entrevista Psicológica , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto , Emigração e Imigração , Feminino , Psiquiatria Legal , Humanos , Texas
8.
J Forensic Sci ; 64(6): 1884-1888, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31287563

RESUMO

In clinical and most forensic evaluations, "diagnosis" connotes the expectation of a DSM-5 or ICD-10 formally labeled mental condition. When the task is to evaluate the security risk a person's psychological makeup presents to an institution, such a molar diagnosis can blind the clinician and elevate the risk to a security agency. When "diagnosis" connotes achieving an understanding of a person's behavior that has raised security concerns, then a different conceptualization of the diagnostic process is required. Unlike the clinical situation, the evaluation is not being performed to benefit the person but for the purpose of assessing risk to an agency. The differences this introduces involve every aspect of the evaluation and changes the type of diagnosis expected. Not appreciating these differences can cause the clinician to fail in the task of assessing psychological tendencies that affect national security.


Assuntos
Emprego , Transtornos Mentais/diagnóstico , Medidas de Segurança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Classificação Internacional de Doenças , Entrevista Psicológica , Transtornos Mentais/psicologia , Testes Psicológicos
9.
Australas Psychiatry ; 27(4): 362-365, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31165642

RESUMO

OBJECTIVE: This study determined the cultural appropriateness of the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) as an acceptable tool for diagnosing mental illness among Indigenous people. METHODS: De-identified qualitative feedback from participants and psychologists regarding the cultural appropriateness of the SCID-I for Indigenous people using open-ended anonymous questionnaires was gathered. Aboriginal Medial Service staff and Indigenous Support Workers participated in a focus group. RESULTS: A total of 95.6% of participants felt comfortable during the 498 questionnaires completed. Psychologists also provided qualitative feedback for 502 (92.3%) interviews, of whom 40.4% established a good rapport with participants. Of the participants, 77.7% understood the SCID-I questions well, while 72.5% did not require any cultural allowances to reach a clinical diagnosis. CONCLUSION: When administered by a culturally safe trained psychologist, SCID-I is well tolerated in this group.


Assuntos
Competência Cultural , Entrevista Psicológica/métodos , Entrevista Psicológica/normas , Transtornos Mentais/diagnóstico , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Austrália/etnologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Retroalimentação , Serviços de Saúde do Indígena/organização & administração , Humanos , Transtornos Mentais/etnologia , Reprodutibilidade dos Testes , Inquéritos e Questionários
10.
J Rehabil Med ; 51(7): 532-538, 2019 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-31161225

RESUMO

OBJECTIVE: Physical activity is an essential part of managing heart failure. However, adherence to activity recommendations is low, especially in female patients. The aim of this study was to investigate the perceptions of healthcare providers regarding sex differences in physical activity, motivation, barriers, and whether adaptations in care based on sex might be meaningful. METHODS: This is a qualitative study; data were collected in semi-structured interviews with healthcare providers. The data were analysed using qualitative content analysis. RESULTS: The major overarching theme was that healthcare providers feel that "Men and women are equal, but different". This theme was explained in terms of 7 sub-themes with associated categories, as follows: "Men and women prefer and perform different physical activity regardless of health status", "Male and female heart failure patients have different motivations for, and barriers to, being active", "Factors related to differences in physical activity and physical capacity between male and female heart failure patients", "Heart failure has more impact on physical activity and physical capacity than patient's sex", and "Tailoring activity advice for heart failure patients based on sex." DISCUSSION: Healthcare providers had clear opinions regarding the existence of sex differences that might affect patients' care. Several differences were identified in male and female heart failure patients in terms of physical activity. There seems to be a conflict between fear of discriminating and the value of personalizing care.


Assuntos
Exercício/fisiologia , Insuficiência Cardíaca/reabilitação , Entrevista Psicológica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Caracteres Sexuais
11.
Turk Psikiyatri Derg ; 30(1): 23-30, 2019.
Artigo em Turco | MEDLINE | ID: mdl-31170304

RESUMO

OBJECTIVE: Activation syndrome (AS), as described by the U.S. Food and Drug Administration (FDA), comprises 10 bipolar associated symptoms which starts after antidepressant therapy. The aim of this study is to investigate whether there is a relationship between lifetime hypomanic symptoms and the development of AS in patients diagnosed with major depressive disorder (MDD).  METHOD: The study was conducted at Hacettepe University Faculty of Medicine Department of Psychiatry. A total of 60 consecutive outpatients diagnosed with MDD were assessed at three time points; before the initiation of antidepressant therapy (baseline), at 2nd week and at 4th week. At the initial interview the patients completed the Hypomania Checklist-32 (HCL-32) in order to assess the lifetime history of hypomanic symptoms. Barnes Akathisia Rating Scale (BARS), Hamilton Rating Scale for Depression (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and Young Mania Rating Scale (YMRS) were utilized to detect the symptoms of AS at each assessment.  RESULTS: AS was detected in 25 (41.7%) patients. The most prevalent symptoms of AS were insomnia (31.7%), anxiety (25%) and irritability (15%). A significant difference was found in the HCL-32 scores of patients with and without AS. A moderate correlation between the number of AS symptoms and HSL-32 test scores were also determined.  CONCLUSION: AS development was more common among the depressed patients with lifetime history of hypomanic symptoms. Given the frequency of misdiagnosis of BPD as MDD, it would be helpful to assess the hypomanic symptoms systematically with scales similar to HSL-32 in depressive patients before prescribing antidepressant medication.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Adulto , Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Diagnóstico Diferencial , Feminino , Humanos , Entrevista Psicológica , Masculino , Pacientes Ambulatoriais , Escalas de Graduação Psiquiátrica
12.
Turk Psikiyatri Derg ; 30(1): 51-56, 2019.
Artigo em Turco | MEDLINE | ID: mdl-31170307

RESUMO

OBJECTIVE: In this study, we aimed to adapt the Structured Clinical Interview for DSM-5-ClinicianVersion into Turkish and to demonstrate its reliability.  METHOD: A total of 185 patients, both inpatient and outpatient, from two different university hospitals were included. Training sessions on the features and use of SCID-5/CV were held before the data collection. During the study, in order to test the diagnostic agreement and accuracy, two psychiatrists remained present at the evaluation of each participant; alternatively being interviewer and the observer. Cohen's kappa coefficient for inter-rater reliability was calculated for every diagnostic category.  RESULTS: The patient group had a mean age of 37.2 (±13.5) years and 55.7% were female. The education status was as follows: 2.7% were illiterate, 1.7% literate with no primary education, 33% had primary education, 23.8% had secondary education and 38.9% had higher education. The calculated kappa value showed excellent agreement for schizophrenia (κ=0.93), bipolar disorder (κ=0.96), major depressive disorder (κ=0.89), dysthymic disorder (κ=0.82), alcohol use disorder (κ=0.96), panic disorder (κ=0.84), agoraphobia (κ=0.85), social anxiety disorder (κ=0.95), generalized anxiety disorder (κ=0.89), obsessive compulsive disorder (κ=0.87), posttraumatic stress disorder (κ=0.89), adult attention deficit and hyperactivity disorder (κ=1.00), specific phobias (κ=0.82) and very good agreement with adjustment disorder (κ=0.78) and somatic symptom disorder (κ=0.65).  CONCLUSION: Similar to the past SCID versions, kappa values were found to be quite high and all were statistically significant. The Turkish version of SCID-5/ CV can be reliably used in both clinical practice and clinical studies.


Assuntos
Entrevista Psicológica , Transtornos Mentais/psicologia , Escalas de Graduação Psiquiátrica , Adolescente , Adulto , Idoso , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Traduções , Turquia , Adulto Jovem
13.
Rev Gaucha Enferm ; 40: e20180062, 2019 Jun 10.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31188983

RESUMO

OBJECTIVE: To understand the motives behind the actions of harm reducers when working with drug users. METHOD: Qualitative research conducted in the municipality in Rio Grande do Sul (RS), Brazil, in May 2017, by means of phenomenological interviews with 17 harm reducers. We analyzed and interpreted the data using the social phenomenology of Alfred Schütz. RESULTS: Data analysis led to the following three categories: expectation of changes in the user's sphere of life, motivation at work from the recognition of their actions, and relationship with others as a life-learning experience. CONCLUSION: The reasons harm reducers work with drug users are related to the family, search for a home, employment, access to health care, rights, and stigma, as well as the positive results of their work, personal satisfaction, and learning with drug users.


Assuntos
Usuários de Drogas , Redução do Dano , Entrevista Psicológica , Motivação , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto , Brasil , Emprego/psicologia , Família , Feminino , Acesso aos Serviços de Saúde , Habitação , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Pesquisa Qualitativa , Estigma Social , Assistentes Sociais/psicologia , Adulto Jovem
14.
BMC Med Educ ; 19(1): 121, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046745

RESUMO

BACKGROUND: Performing a psychiatric interview and documenting the recorded findings in the form of a brief psychiatric report is one of the main learning goals in the psychiatric curriculum for medical students. However, observing and assessing students' reports is time consuming and there are no objective assessment tools at hand. Thus, we applied an integrative approach for designing a checklist that evaluates clinical performance, as a tool for the assessment of a psychiatric report. METHODS: A systematic review of the literature yielded no objective instrument for assessing the quality of written reports of psychiatric interviews. We used a 4-step mixed-methods approach to design a checklist as an assessment tool for psychiatric reports: 1. Development of a draft checklist, using literature research and focus group interviews; 2. Pilot testing and subsequent group discussion about modifications resulting from the pilot testing; 3. Creating a scoring system; 4. Testing for interrater-reliability, internal consistency and validity. RESULTS: The final checklist consisted of 36 items with a Cronbach's alpha of 0.833. Selectivity of items ranged between 0.080 and 0.796. After rater-training, an interrater-reliability of 0.96 (ICC) was achieved. CONCLUSIONS: Our approach, which integrated published evidence and the knowledge of domain experts, resulted in a reliable and valid checklist. It offers an objective instrument to measure the ability to document psychiatric interviews. It facilitates a transparent assessment of students' learning goals with the goal of structural alignment of learning goals and assessment. We discuss ways it may additionally be used to measure the ability to perform a psychiatric interview and supplement other assessment formats.


Assuntos
Lista de Checagem , Transtornos Mentais/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Grupos Focais , Humanos , Entrevista Psicológica , Psicometria , Garantia da Qualidade dos Cuidados de Saúde , Estudantes de Medicina
15.
PLoS One ; 14(5): e0216052, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31042753

RESUMO

OBJECTIVE: To explore experiences among pregnant women diagnosed with a small-for-gestational age (SGA) fetus, and monitored by frequent ultrasounds. METHODS: We performed a qualitative study at the outpatient clinic of the Gynecology and Obstetrics department of a large academic hospital in Amsterdam. Semi-structured interviews were conducted with fifteen women, diagnosed with an SGA fetus during their pregnancy and having had at least two monitoring ultrasounds since. Themes were identified following analysis of the interview transcripts. RESULTS: Most women experienced the frequent ultrasounds as a source of support providing comfort and a feeling of safety. It was considered necessary, in the best interest of the baby, which outweighed the discomfort caused by having to come to the hospital frequently. Women described anxiety building up prior to each ultrasound, but feeling reassured and relieved afterwards. During the ultrasound a continuous explanation was preferred, which provided confirmation and a feeling of security. Women identified the uncertainty of SGA's cause and prognosis as one of the biggest challenges to cope with, for which they used different strategies. Many women expressed a need for more detailed information and counselling, including non-medical aspects of pregnancy and delivery as well. Lastly, many women reported that seeing different doctors negatively influenced the perceived quality of care. CONCLUSIONS: In general, women in this study were satisfied with the ultrasounds for their small-for-gestational age pregnancies. However, women expressed a need for additional information to help cope with a feeling of uncertainty regarding cause and prognosis. Their medical team should preferably provide this in a consistent and continuous manner.


Assuntos
Feto/diagnóstico por imagem , Mães/psicologia , Ultrassonografia Pré-Natal/métodos , Adulto , Ansiedade , Aconselhamento , Emoções , Feminino , Idade Gestacional , Humanos , Entrevista Psicológica , Países Baixos , Gravidez , Gestantes/psicologia , Pesquisa Qualitativa , Incerteza
16.
PLoS One ; 14(5): e0216682, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31067286

RESUMO

Many stroke survivors require care from informal carers such as family members and friends who may experience adverse impacts. This study aimed to qualitatively explore the unmet needs of carers of stroke survivors, and their preferences for interventions and support services. We conducted 24 semi-structured, qualitative interviews with carers of stroke survivors from the Hunter region, Australia. Inductive thematic analysis was used in the context of a needs-led framework to identify key themes of their unmet needs. Key unmet needs identified by carers of stroke survivors in this study centred on four main themes: (1) social relationships and support; (2) adequacy of information; (3) taking care of oneself; and (4) accessing appropriate services. Carers of stroke survivors desired the development of services which provide connectivity to information, training, education and community support; and inclusion in a community with social relationships and other carers of stroke survivors. Ongoing unmet needs often result in adverse health and quality of life outcomes for carers of stroke survivors. Co-designed programs and resources for carers, particularly relating to unmet needs in social, information, self-care and service access domains are needed.


Assuntos
Cuidadores/psicologia , Qualidade de Vida/psicologia , Reabilitação do Acidente Vascular Cerebral/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Família , Feminino , Amigos , Humanos , Entrevista Psicológica/métodos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Autocuidado , Apoio Social , Acidente Vascular Cerebral/fisiopatologia , Sobreviventes/psicologia
17.
Anaesthesia ; 74(10): 1240-1251, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31090927

RESUMO

Anaesthetists experience unique stressors, and recent evidence suggests a high prevalence of stress and burnout in trainee anaesthetists. There has been no in-depth qualitative analysis to explore this further. We conducted semi-structured interviews to explore contributory and potentially protective factors in the development of perceived stress, burnout, depression and low work satisfaction. We sampled purposively among participants in the Satisfaction and Wellbeing in Anaesthetic Training study, reaching data saturation at 12 interviews. Thematic analysis identified three overarching themes: factors enabling work satisfaction; stressors of being an anaesthetic trainee; and suggestions for improving working conditions. Factors enabling work satisfaction were patient contact; the privilege of enabling good patient outcomes; and strong support at home and work. Stressors were demanding non-clinical work-loads; exhaustion from multiple commitments; a 'love/hate' relationship, as trainees value clinical work but find the training burden immense; feeling 'on edge', even unsafe at work; and the changing way society sees doctors. Nearly all trainees discussed feeling some levels of burnout (which were high and distressing for some) and also high levels of perceived stress. However, trainees also experienced distinct elements of work satisfaction and support. Suggested recommendations for improvement included: allowing contracted hours for non-clinical work; individuals taking responsibility for self-care in and out of work; cultural acceptance that doctors can struggle; and embedding wellbeing support more deeply in organisations and the specialty. Our study provides a foundation for further work to inform organisational and cultural changes, to help translate anaesthetic trainees' passion for their work into a manageable and satisfactory career.


Assuntos
Anestesiologistas/psicologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Depressão/epidemiologia , Depressão/psicologia , Satisfação no Emprego , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Adulto , Feminino , Humanos , Entrevista Psicológica , Masculino , Pacientes , Satisfação Pessoal , Relações Médico-Paciente , Autocuidado , Reino Unido/epidemiologia , Tolerância ao Trabalho Programado , Adulto Jovem
18.
An. psicol ; 35(2): 269-279, mayo 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181697

RESUMO

Esta investigación analiza si la estructura (no narrativa o narrativa) que caracteriza a dibujos animados incide en la habilidad narrativa e identificación de valores y contravalores frente a factores personales (edad, curso educativo, sexo y nivel atencional) o contextuales (red e índice socioeconómico y cultural del centro educativo) del alumnado de Educación Primaria. Se ha contado con la participación de 186 estudiantes que han relatado el episodio visionado. El estudio tiene un diseño cuasiexperimental con metodología mixta (cuantitativa y cualitativa). Los resultados obtenidos mediante análisis de regresión confirman que la estructura incide en mayor grado que el resto de factores. Se concluye que conviene considerar el tipo de estructura de los contenidos audiovisuales, y no solo la potencialidad en valores o contravalores, tanto en investigaciones futuras como al diseñar e implementar intervenciones en el ámbito formal e informal


This research analyses whether the structure (non-narrative or narrative) that characterizes cartoons affects the narrative skill and identification of values and countervalues, as opposed to personal (age, school year, gender and attention level) or contextual (school network and socioeconomic and cultural index of the school) factors of Primary Education students. 186 students participated in it, who have reported on the episode watched. The study has a quasi-experimental design with blended methodology (quantitative and qualitative). The results obtained through regression analysis confirm that the structure has a greater effect than the rest of the factors. We conclude that it is advisable to consider the structure of audio-visual content, not just the potential values or countervalues, both in future research and in designing and implementing interventions in formal and informal settings


Assuntos
Humanos , Masculino , Feminino , Criança , Narração , Desenhos Animados como Assunto/psicologia , Valores Sociais , Psicometria/métodos , Percepção , Entrevista Psicológica , Reforço (Psicologia)
19.
Cir Esp ; 97(5): 275-281, 2019 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31010579

RESUMO

INTRODUCTION: The aim of the present study was to examine the diagnostic accuracy of screening tests in detecting cases requiring psychological intervention among patients referred for thoracic surgery. METHODS: Emotional distress was evaluated in 105 patients referred for thoracic surgery by means of a diagnostic psychological interview (criterion variable). The screening ability of the following methods was analyzed: the physician's opinion (Yes/No), Hospital Anxiety and Depression Scale (HADS), single-item interview: «Are you depressed?¼ (Depression Question, ADEP) (1-5) and the single-item interview: «Are you anxious?¼ (Anxiety Question, ANXQ) (1-5). RESULTS: According to the clinical interview, 34% of the patients were clinical cases requiring psychological intervention. The total HADS (cut-off point of 10) showed a sensitivity=0.89, specificity=0.75 and AUC=0.883; the ADEP scale (>1) showed a sensitivity=0.79, specificity=0.74 and AUC=0.795; the ANXQ scale (>1) showed a sensitivity=0.78, specificity=0.41 and AUC=0.690; and the physician's opinion showed a sensitivity=0.47 and specificity=0.86. CONCLUSIONS: A high percentage of patients referred for thoracic surgery required psychological intervention. The best instrument to identify those patients requiring psychological care, taking a psychological interview as the criterion variable, was the total HADS score. This test is brief, simple and well accepted by patients; it is easy to implement within a thoracic surgery service and has a good diagnostic accuracy.


Assuntos
Estresse Psicológico/diagnóstico , Cirurgia Torácica/organização & administração , Procedimentos Cirúrgicos Torácicos/psicologia , Ansiedade/diagnóstico , Depressão/diagnóstico , Feminino , Humanos , Entrevista Psicológica/métodos , Neoplasias Pulmonares/cirurgia , Masculino , Cuidados Pré-Operatórios/métodos , Escalas de Graduação Psiquiátrica , Sensibilidade e Especificidade , Espanha
20.
BMJ ; 365: l1476, 2019 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-30967483

RESUMO

OBJECTIVE: To determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression. DESIGN: Individual participant data meta-analysis. DATA SOURCES: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015). INCLUSION CRITERIA: Eligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level data extracted from primary reports were synthesized. For PHQ-9 cut-off scores 5-15, bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, among studies that used semistructured diagnostic interviews, which are designed for administration by clinicians; fully structured interviews, which are designed for lay administration; and the Mini International Neuropsychiatric (MINI) diagnostic interviews, a brief fully structured interview. Sensitivity and specificity were examined among participant subgroups and, separately, using meta-regression, considering all subgroup variables in a single model. RESULTS: Data were obtained for 58 of 72 eligible studies (total n=17 357; major depression cases n=2312). Combined sensitivity and specificity was maximized at a cut-off score of 10 or above among studies using a semistructured interview (29 studies, 6725 participants; sensitivity 0.88, 95% confidence interval 0.83 to 0.92; specificity 0.85, 0.82 to 0.88). Across cut-off scores 5-15, sensitivity with semistructured interviews was 5-22% higher than for fully structured interviews (MINI excluded; 14 studies, 7680 participants) and 2-15% higher than for the MINI (15 studies, 2952 participants). Specificity was similar across diagnostic interviews. The PHQ-9 seems to be similarly sensitive but may be less specific for younger patients than for older patients; a cut-off score of 10 or above can be used regardless of age.. CONCLUSIONS: PHQ-9 sensitivity compared with semistructured diagnostic interviews was greater than in previous conventional meta-analyses that combined reference standards. A cut-off score of 10 or above maximized combined sensitivity and specificity overall and for subgroups. REGISTRATION: PROSPERO CRD42014010673.


Assuntos
Confiabilidade dos Dados , Transtorno Depressivo Maior/diagnóstico , Programas de Rastreamento/métodos , Questionário de Saúde do Paciente/estatística & dados numéricos , Idoso , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Entrevista Psicológica/métodos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/normas , Sensibilidade e Especificidade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA