RESUMO
OBJECTIVE: To compare the psychometric performance of the Dermatology Life Quality Index (DLQI-BRA) and Skindex-16 to assess quality of life (QoL) in Brazilian patients with dermatological diseases. METHODS: This was a cross-sectional study carried out in a dermatology outpatient clinic of the São Paulo State University, with 188 patients with dermatological diseases. QoL was evaluated using the Dermatology Life Quality Index (DLQI-BRA) and Skindex-16. Cronbach's alpha and Intraclass Correlation for Perfect Concordance (ICC) were used to analyse the reliability and temporal stability, respectively. RESULTS: A positive correlation was found between the total Skindex-16 score and DLQI-BRA (0.75). Both instruments showed a significant (p< 0.01) reduction in their scores at the second assessment, demonstrating that they were sensitive in detecting changes in responsiveness in cases where there was a clinical change. Cronbach alpha coefficients for the instruments showed satisfactory performance (>0,7), but Skindex-16 displayed the highest Cronbach alpha (0.94; CI = 0.93-0.95). CONCLUSION: Both instruments tested showed a good psychometric performance assessing QoL in patients with skin dermatoses. The instruments displayed reliability and temporal stability as well as responsiveness.
Assuntos
Psicometria , Qualidade de Vida , Dermatopatias/psicologia , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de TempoRESUMO
As doenças de pele apresentam sua complexidade no que tange ao diagnóstico, tratamento e controle, indicando uma forte conexão com os aspectos psicológicos. O interesse por este tema é antigo e foi estudado por diversos profissionais, possibilitando o surgimento de novas áreas. Esta pesquisa teve como objetivo realizar uma revisão de literatura no intuito de identificar a complexidade e as possibilidades que a doença de pele pode apresentar, a partir da contribuição de áreas que convergem quanto a relação da pele e do psiquismo. A metodologia baseou-se em uma revisão de literatura, sendo realizada a partir da base de dados da Biblioteca Virtual em Saúde (BVS). Como critério estabelecido para inclusão nesta pesquisa, inicialmente foi utilizar os termos descritores, dermatopatias e transtornos somatoformes e os termos livres, psicodermatologia e psicossomática para selecionar os artigos. Outro critério de inclusão foi a data estar situada entre 2000 a 2020 e o estudo publicado em português, inglês ou espanhol. A partir dos resultados obtidos, pode-se indicar a inseparabilidade entre as reações do organismo e as emoções. Neste sentido, é válido o fomento de novas pesquisas sobre o tema, assim como, ressaltar a importância de oferecer um atendimento humanizado, com um olhar integral ao paciente. Buscando um melhor enfrentamento da doença e auxiliando o desenvolvimento no aspecto psicológico.
Assuntos
Pele , Dermatopatias/psicologia , Emoções , Adaptação PsicológicaRESUMO
BACKGROUND: The Dermatology Life Quality Index (DLQI) is the most commonly used instrument for clinical evaluation of the impact on health-related quality of life (HRQOL) in dermatological research protocols. The DLQI's classical psychometric properties have been considered adequate in validation studies from several countries. However, the structure of the DLQI is a matter of discussion, especially concerning the dimensionality and informative properties of its questions according to the item response theory (IRT). METHODS: Pooled data from studies in Brazil that utilized the DLQI to assess HRQOL in 14 dermatoses were reanalyzed. Classical psychometrical analysis, dimensionality assessment through parallel analysis and IRT (Samejima's ordinal model) analysis were performed. RESULTS: The sample consisted of 1286 patients with a mean age of 47 years (SD = 16), and the proportion of women was 59% (765). The DLQI scores ranged from 0 to 29, with a median (p25-p75) of 5 (2-11). All items indicated significant correlations with the total DLQI score (rho > 0.54). The Cronbach's alpha result was 0.90 (CI 95% 0.89-0.91). Parallel analysis indicated a unidimensional factor structure. According to IRT analysis, items q6 (sports) and q7 (work/study) exhibited insufficient fit to the model (p < 0.01), while the items that indicated the best discrimination and information functions were q2 (embarrassment), q3 (shopping/gardening), q4 (clothing) and q5 (social/leisure). The ordination of the scores was confirmed for all items. Most items revealed non-uniform behavior according to sex, age and type of disease. CONCLUSIONS: The DLQI exhibits adequate psychometric reliability and a unidimensional structure for assessing HRQOL in Brazilian dermatological patients. The DLQI's performance varies in the assessment of HRQOL in heterogeneous samples.
Assuntos
Qualidade de Vida , Dermatopatias/psicologia , Inquéritos e Questionários/normas , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Reprodutibilidade dos TestesRESUMO
Patients with psychocutaneous disorders often refuse psychiatric intervention in their first consultations, leaving initial management to the dermatologist. The use of psychotropic agents in dermatological practice, represented by antidepressants, antipsychotics, anxiolytics, and mood stabilizers, should be indicated so that patients receive the most suitable treatment rapidly. It is important for dermatologists to be familiar with the most commonly used drugs for the best management of psychiatric symptoms associated with dermatoses, as well as to manage dermatologic symptoms triggered by psychiatric disorders.
Assuntos
Transtornos Mentais/tratamento farmacológico , Transtornos Psicofisiológicos/tratamento farmacológico , Psicotrópicos/uso terapêutico , Dermatopatias/tratamento farmacológico , Dermatopatias/psicologia , Dermatologia , Feminino , Humanos , Masculino , Fatores de RiscoRESUMO
Abstract Patients with psychocutaneous disorders often refuse psychiatric intervention in their first consultations, leaving initial management to the dermatologist. The use of psychotropic agents in dermatological practice, represented by antidepressants, antipsychotics, anxiolytics, and mood stabilizers, should be indicated so that patients receive the most suitable treatment rapidly. It is important for dermatologists to be familiar with the most commonly used drugs for the best management of psychiatric symptoms associated with dermatoses, as well as to manage dermatologic symptoms triggered by psychiatric disorders.
Assuntos
Humanos , Masculino , Feminino , Transtornos Psicofisiológicos/tratamento farmacológico , Psicotrópicos/uso terapêutico , Dermatopatias/psicologia , Dermatopatias/tratamento farmacológico , Transtornos Mentais/tratamento farmacológico , Fatores de Risco , DermatologiaRESUMO
Resumo Objetivo compreender as experiências de adolescentes com doenças crônicas de pele que participaram de acampamento. Método estudo fenomenológico, com seis adolescentes com diagnóstico de doença crônica de pele, participantes de acampamento no Brasil. Coleta de dados: foram realizadas entrevistas fenomenológicas, no período de julho de 2015 a janeiro de 2016. Resultados três categorias temáticas emergiram e possibilitaram a compreensão do fenômeno. Participar do acampamento acarreta mudança na vida dos adolescentes e em seus modos-de-ser no mundo cotidiano. Impulsiona-os a refletir sobre o estigma já vivenciado anteriormente e as novas experiências, após participarem do acampamento, os auxilia no enfrentamento dos desafios da própria vida de maneira mais otimista. Conclusão Para os adolescentes, a experiência de participar do acampamento é transformadora, devido à possibilidade do encontro com pares e de vivenciar um ambiente livre de preconceito, permitindo ao adolescente ser si-mesmo. Implicações para prática Os acampamentos promovem interação entre pares, sendo estratégias acessíveis para profissionais de saúde, especialmente aos enfermeiros. Intervenções que, de fato, promovam assistência integral à saúde de crianças e adolescentes com condições crônicas de saúde e seus familiares, além da articulação entre serviços de complexidades distintas e seus profissionais de saúde, podem garantir o acesso ao cuidado de qualidade.
Resumen Objetivo Comprender las experiencias de adolescentes con enfermedades crónicas de piel que participaron de campamento. Método Estudio fenomenológico con seis adolescentes diagnosticados con la enfermedad, participantes del campamento en Brasil. Recopilación de datos: se realizaron entrevistas fenomenológicas desde julio/2015 hasta enero/2016. Resultados Tres categorías temáticas permitieron la comprensión del fenómeno. Participar de campamento produce cambios en la vida de los adolescentes y en sus modos-de-ser en el mundo cotidiano. Los influye a reflexionar sobre el estigma que han experimentado y las nuevas experiencias, después de participaren del campamento, los ayuda a enfrentar los desafíos de la vida de manera más optimista. Conclusión La experiencia del campamento es transformadora debido a la posibilidad de reunirse con sus compañeros y experimentar un ambiente libre de prejuicios, lo que permite que el adolescente sea si-mismo. Implicaciones para la práctica Los campamentos promueven interacción entre pares y son estrategias accesibles para los profesionales de salud, especialmente las enfermeras. Las intervenciones que, de hecho, promueven la atención integral de la salud para niños y adolescentes con enfermedades crónicas y sus familias, así como la articulación entre los servicios de diferentes complejidades y sus profesionales de salud, pueden garantizar el acceso a una atención de calidad.
Abstract Objective To understand the experiences of adolescents with chronic skin diseases who participated in a camp. Method Phenomenological study with six adolescents diagnosed with chronic skin disease, participants in a camp in Brazil. Data collection: phenomenological interviews were conducted from July 2015 to January 2016. Results Three thematic categories emerged and enabled the understanding of the phenomenon. Participating in the camp brings about change in the lives of adolescents and their ways of being in the everyday world. It encourages them to reflect on the stigma they have experienced before and the new experiences, after attending the camp, help them to cope with life's challenges in a more optimistic way. Conclusion For the adolescents, the experience of participating in the camp is transformative due to the possibility of meeting with peers and experiencing an environment free of prejudice, allowing the adolescent to be him/herself. Implications for practice Camps promote interaction among peers, being accessible strategies for health professionals, especially nurses. Interventions that, in fact, promote comprehensive health care for children and adolescents with chronic health conditions and their families, as well as the articulation between services of different complexities and their health professionals, can guarantee access to quality care.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Dermatopatias/psicologia , Acampamento , Doença Crônica , Pesquisa QualitativaRESUMO
BACKGROUND: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. OBJECTIVE: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. METHODS: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. RESULTS: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). STUDY LIMITATIONS: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. CONCLUSION: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.
Assuntos
Ansiedade/epidemiologia , Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Depressão/epidemiologia , Dermatopatias/epidemiologia , Dermatopatias/psicologia , Adolescente , Adulto , Distribuição por Idade , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Distribuição por Sexo , Fatores Socioeconômicos , Estatísticas não Paramétricas , Escala de Ansiedade Frente a Teste , Fatores de Tempo , Adulto JovemRESUMO
Abstract: Background: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. Objective: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. Methods: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. Results: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). Study limitations: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. Conclusion: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Ansiedade/epidemiologia , Dermatopatias/psicologia , Dermatopatias/epidemiologia , Depressão/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Transtornos Dismórficos Corporais/epidemiologia , Escalas de Graduação Psiquiátrica , Fatores Socioeconômicos , Escala de Ansiedade Frente a Teste , Fatores de Tempo , Modelos Logísticos , Prevalência , Estudos Transversais , Distribuição por Sexo , Distribuição por Idade , Estatísticas não Paramétricas , Nigéria/epidemiologiaRESUMO
BACKGROUND: In recent years, the need for international, objective, patient-reported outcomes measures has grown as international collaboration has increased. As most quality-of-life scales have been developed in English, there is a growing need to adapt them transculturally to obtain equivalence between the original instrument and the adapted scale. OBJECTIVES: To assess the construct and convergent-discriminant validity and responsiveness of the Colombian version of Skindex-29. METHODS: The cross-sectional and longitudinal validity and responsiveness were tested in both healthy and dermatology patients. Construct validity was tested through a confirmatory factor analysis. The convergent-discriminant validity was assessed by examining the Spearman correlation coefficient. Change sensitivity was tested by means of the standardized response mean. The effect size and the minimum detectable change were also assessed. RESULTS: A total of 265 participants were included; 21·1% were healthy individuals, and 78·9% patients had either inflammatory or noninflammatory skin diseases. Confirmatory factor analysis showed an adequate comparative fit index and Tucker-Lewis index adjustment for the root mean square error of approximation. Convergent validity showed moderate correlations between the emotions, functioning and physical function or physical role domains. Discriminant validity showed low correlations between overall domains for both scales. Sensitivity to change at the first and third month showed effect sizes in global Skindex scores of 0·92 and 0·82, respectively. CONCLUSIONS: The Colombian version of Skindex-29 is a valid and clinically sensitive instrument, which can be used for clinical practice and for research to measure the impact of skin diseases on the quality of life of dermatology patients.
Assuntos
Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Dermatopatias/diagnóstico , Adolescente , Adulto , Idoso , Colômbia , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Psicometria/métodos , Reprodutibilidade dos Testes , Dermatopatias/psicologia , Traduções , Adulto JovemRESUMO
BACKGROUND: Disgust is a universal emotion that plays a role in reducing people's exposure to situations with risks of contamination. By the same token, skin diseases could generate aversion in observers. The present study aimed to assess the aversion triggered when viewing skin disease lesions on the face and hands. METHODS: A questionnaire was applied over the Internet containing demographic questions, assessment of personal sensitivity to disgust - by the Disgust Scale-Revised (DS-R) -, and the aversion triggered when viewing eight images of skin diseases using an image aversion score (IAS) ranging from 0 to 10. RESULTS: Six-hundred forty-nine people responded, 49% female, with a median age of 26 (p25-p75: 22-34). A total of 2596 evaluations of images were collected. The overall IAS median was 2 (0-4), and Cronbach's alpha resulted 0.87. There was a significant correlation between DS-R and IAS (Spearman's rho = 0.42; P < 0.01). Seven-hundred twenty-four (28%) evaluations were considered as contagious diseases and received higher IAS: 5 (2-7) × 1 (0-3); P < 0.01. In multivariate analysis, the higher IAS was independently associated with male gender, with no children, not working as a health professional or caregiver, and presenting higher DS-R (P < 0.01). By analyzing the IAS according to morphological characteristics, we identified lower scores for macular dyschromic lesions (P < 0.01). CONCLUSIONS: The aversion triggered by skin lesions varies according to the personal characteristics of the observer and the morphology of the lesion, being lower for macular dyschromic lesions, and associated with disgust sensitivity and the assignment of contagiousness to the lesion.
Assuntos
Asco , Dermatopatias/psicologia , Adolescente , Adulto , Idoso , Conscientização , Crowdsourcing , Transmissão de Doença Infecciosa , Emoções , Face , Feminino , Mãos , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
Las dermatosis autoinfligidas representan un motivo habitual de consulta, así como un desafío diagnóstico y terapéutico. Se caracterizan por la autoprovocación de lesiones cutáneas de manera consciente o inconsciente en el contexto de trastornos psiquiátricos complejos. Comunicamos el caso de una paciente que consultó al Servicio de Dermatología por úlceras irregulares y sobreinfectadas localizadas en rostro, de 2 meses de evolución. El caso representó una dificultad diagnóstica ya que solo a partir del interrogatorio exhaustivo y los exámenes complementarios, que descartaron otras patologías, se arribó al diagnóstico de úlceras autoprovocadas en contexto de patología psiquiátrica que requirió manejo interdisciplinario. (AU)
Self-inflicted dermatoses are a frequent cause for consultation and represent a diagnostic and therapeutic challenge. They are characterized by the conscious or unconscious self-generation of cutaneous lesions in the context of complex psychiatric disorders. We report the case of a patient who consulted at the dermatology department with two months history of irregular and superinfected ulcers located on the face. This case represented a diagnostic difficulty since only from an exhaustive interrogation and complementary examinations, which ruled out other pathologies, we arrived at the diagnosis of self-inflicted ulcers in the context of psychiatric pathology that required interdisciplinary management. (AU)
Assuntos
Humanos , Úlcera Cutânea/psicologia , Transtornos Mentais/complicações , Sinais e Sintomas , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Dermatopatias/patologia , Dermatopatias/psicologia , Dermatopatias/terapia , Úlcera Cutânea/patologia , Úlcera Cutânea/terapia , Traumatismos Faciais/patologia , Traumatismos Faciais/terapia , Avulsões Cutâneas/etiologia , Avulsões Cutâneas/terapiaRESUMO
OBJECTIVE: To describe the social networks of patients with chronic skin damages. METHOD: A qualitative study conducted through semi-structured interviews with nine subjects with chronic skin lesions from June 2016 to March 2017; we used the theoretical-methodological framework of Lia Sanicola's Social Network. RESULTS: The analysis of the relational maps revealed that the primary network was formed mainly by relatives and neighbors; its characteristics, such as: reduced size, low density and few exchanges/relationships, configures fragility in these links. The secondary network was essentially described by health services, and the nurse was cited as a linker in the therapeutic process. FINAL CONSIDERATIONS: Faced with the fragility of the links and social isolation, the primary health care professionals are fundamental foundations for the construction of networks of social support and care for patients with chronic skin lesions.
Assuntos
Dermatopatias/psicologia , Apoio Social , Adulto , Idoso , Brasil , Relações Familiares/psicologia , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Dermatopatias/complicações , Isolamento Social/psicologia , Estigma SocialRESUMO
INTRODUCTION: The aim of this study was to assess the psychometric properties of the Brazilian version of Skindex-16 in patients with various skin diseases. METHODS: Dermatologic assessments were performed for the diagnosis and classification of the severity of skin conditions. The clinical feasibility of Skindex-16 was assessed based on the time required to complete the questionnaire and the number of unanswered items. The participants (n = 110) answered the Hospital Anxiety and Depression Scale (HADS), the Dermatology Life Quality Index (DLQI) and the Skindex-16 (Portuguese/Brazil version) questionnaires. Convergent validity was assessed based on the correlation of the Skindex-16 with the DLQI and HADS subscales. Known-groups validity was assessed based on the comparison of the mild, moderate and severe disease groups using the Kruskal-Wallis test. Internal consistency was assessed using Cronbach's alpha and test-retest reproducibility using the intraclass correlation coefficient (ICC) obtained with 29 participants who answered the Skindex-16 a second time 3 to 10 days after the first assessment. RESULTS: The mean time to answer the questionnaire was 2 min 41 sec. Cronbach's alpha scores were 0.867, 0.930 and 0.888 for the Skindex-16 domains symptoms, emotions and functioning, respectively. The ICCs were 0.947, 0.860 and 0.843 for the Skindex-16 domains symptoms, emotions and functioning, respectively. All three Skindex-16 scales exhibited strong correlations with DLQI. Moderate correlations were found between HADS subscales and the Skindex-16 emotions domain. Known-groups validity showed differences in all three Skindex-16 domains between the mild and moderate skin disease groups (emotions: p < 0.001; symptoms: p = 0.049; functioning: p < 0.001) and between the mild and severe skin disease groups (emotions: p = 0.002; symptoms: p = 0.001; functioning: p = 0.002). CONCLUSION: The Portuguese/Brazil version of Skindex-16 is a valid and reliable instrument to assess the quality of life of patients with skin diseases.
Assuntos
Questionário de Saúde do Paciente , Qualidade de Vida , Dermatopatias/psicologia , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Dermatopatias/diagnóstico , Fatores de Tempo , TraduçõesRESUMO
ABSTRACT Objective: To describe the social networks of patients with chronic skin damages. Method: A qualitative study conducted through semi-structured interviews with nine subjects with chronic skin lesions from June 2016 to March 2017; we used the theoretical-methodological framework of Lia Sanicola's Social Network. Results: The analysis of the relational maps revealed that the primary network was formed mainly by relatives and neighbors; its characteristics, such as: reduced size, low density and few exchanges/relationships, configures fragility in these links. The secondary network was essentially described by health services, and the nurse was cited as a linker in the therapeutic process. Final considerations: Faced with the fragility of the links and social isolation, the primary health care professionals are fundamental foundations for the construction of networks of social support and care for patients with chronic skin lesions.
RESUMEN Objetivo: Describir las redes sociales de portadores de lesión cutánea crónica. Método: Estudio cualitativo realizado a través de entrevistas semiestructuras con nueve sujetos portadores de lesiones cutáneas crónicas en el período de junio 2016 a marzo 2017; se utilizó el referencial teórico metodológico de Red Social de Lia Sanicola. Resultados: El análisis de los mapas relacionales reveló que la red primaria estaba formada principalmente por familiares y vecinos; sus características, como: tamaño reducido, baja densidad y pocos intercambios/relaciones, configuran fragilidad en esos vínculos. La red secundaria fue descrita esencialmente por servicios de salud y la enfermera fue citada como formadora de vínculo en el proceso terapéutico. Consideraciones finales: Ante la fragilidad de los vínculos y del aislamiento social, los profesionales de la atención primaria a la salud son bases fundamentales para la construcción de redes de apoyo social y cuidado al portador de lesión cutánea crónica.
RESUMO Objetivo: Descrever as redes sociais de portadores de lesão cutânea crônica. Método: Estudo qualitativo realizado através de entrevistas semiestruturadas com nove sujeitos portadores de lesões cutâneas crônicas no período de junho de 2016 a março de 2017; utilizou-se o referencial teórico metodológico de Rede Social de Lia Sanicola. Resultados: A análise dos mapas relacionais revelou que a rede primária era formada principalmente por familiares e vizinhos; suas características, como: tamanho reduzido, baixa densidade e poucas trocas/relacionamentos, configura fragilidade nesses vínculos. A rede secundária foi descrita essencialmente por serviços de saúde, e a enfermeira foi citada como formadora de vínculo no processo terapêutico. Considerações finais: Diante da fragilidade dos vínculos e do isolamento social, os profissionais da atenção primária à saúde são alicerces fundamentais para a construção de redes de apoio social e cuidado ao portador de lesão cutânea crônica.
Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Dermatopatias/psicologia , Apoio Social , Dermatopatias/complicações , Isolamento Social/psicologia , Brasil , Entrevistas como Assunto/métodos , Pesquisa Qualitativa , Relações Familiares/psicologia , Estigma Social , Pessoa de Meia-IdadeRESUMO
O universo infantil nos últimos anos vem ganhando visibilidade em diferentes campos. O crescente interesse de pesquisadores em conhecer as percepções das crianças acerca de diversos temas as tem destacado em suas pesquisas. O objetivo deste estudo foi investigar as percepções de crianças, sem e com doença crônica de pele, sobre saúde e envelhecimento. Trata-se de estudo qualitativo. Os participantes foram sete crianças sem doença crônica de pele e sete crianças com doença crônica de pele, onde o primeiro grupo possui vínculo com uma entidade comunitária do município de Gravataí e o outro com um ambulatório de saúde pública na cidade de Porto Alegre. Para a coleta de dados foi utilizado roteiro de entrevista semiestruturada. Para análise de conteúdo, foi utilizada a Análise de Bardin e a perspectiva do modelo biopsicossocial. As narrativas das crianças foram classificadas em três categorias a partir da avaliação de três juízes: Envelhecimento e Processo Saúde-doença, Prevenção e Envelhecimento, Relação entre Gerações. Destaca-se que as percepções dos grupos investigados apresentam semelhanças em relação ao envelhecimento, que representa a passagem do tempo. Sobre saúde, os grupos apresentam diferenças a partir de suas próprias experiências. Faz-se necessário o investimento em intervenções que promovam ações intergeracionais para promover a convivência saudável e a solidariedade entre as diferentes gerações. (AU)
The children's universe in recent years has been gaining visibility in different fields. The growing interest of researchers in understanding children's perceptions of various topics has highlighted them in their research. The objective of this study was to investigate the perceptions of children with and with chronic skin disease on health and aging. This is a qualitative study. The participants were 07 children without chronic skin disease and 07 children with chronic skin disease, where the first group had a link with a community entity in the city of Gravataí and the other with a public health clinic in the city of Porto Alegre. For data collection a semi-structured interview script was used. For content analysis, we used the Bardin Analysis and the perspective of the biopsychosocial model. The children's narratives were classified into three categories based on the evaluation of three judges: Aging and Health-Disease Process, Prevention and Aging, Relationship between Generations. It should be emphasized that the perceptions of the investigated groups present similarities in relation to aging, which represents the passage of time. On health, groups present differences from their own experiences. It is necessary to invest in interventions that promote intergenerational actions to promote healthy coexistence and solidarity between different generations. (AU)
El universo infantil en los últimos años ha ido ganando visibilidad en diferentes campos. El creciente interés de los investigadores para conocer las percepciones de los niños sobre los diferentes temas que han destacado en sus investigaciones. El objetivo de este estudio fue investigar las percepciones de los niños y la enfermedad crónica de la piel en la salud y el envejecimiento. Se trata de un estudio cualitativo. Los participantes fueron 07 niños sin enfermedad crónica de la piel y 07 niños con enfermedad crónica de la piel, donde el primer grupo tiene vínculos con el municipio de Gravataí una entidad comunitaria y el otro con una clínica de salud pública en la ciudad de Porto Alegre. Para la recolección de datos se utilizó entrevistas semiestructuradas. Para el análisis de contenido se utilizó para el análisis de Bardin y la perspectiva del modelo biopsicosocial. Los relatos de los niños se clasificaron en tres categorías en función de la evaluación de tres jueces: Envejecimiento y Proceso Salud-Enfermedad, la prevención y el envejecimiento, las relaciones intergeneracionales. Es de destacar que las percepciones de los grupos investigados tienen similitudes en relación con el envejecimiento, que representa el paso del tiempo. La salud, los grupos difieren de sus propias experiencias. Es necesaria inversión en las intervenciones para promover actividades intergeneracionales para promover la sana convivencia y la solidaridad entre distintas generaciones. (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Dermatopatias/psicologia , Envelhecimento , Criança , Doença Crônica , Saúde , Adolescente , Relação entre GeraçõesRESUMO
The mind-skin connection has been studied since the nineteenth century. The last 40 years have set the development of new research areas which allowed the clarifying of how these two dimensions interact. The diseases that involve skin and mind constitute the field of psychodermatology and require that specialists in dermatology, psychiatry and psychology together and integrated take part in it, since skin, nervous system and mind are simultaneously affected. This paper aims to expose how psychodermatoses are currently conceptualized and the need of integration of these three specialties for conveniently treating the patients.
Assuntos
Equipe de Assistência ao Paciente , Transtornos Psicofisiológicos/psicologia , Transtornos Psicofisiológicos/terapia , Dermatopatias/psicologia , Dermatopatias/terapia , Dermatologistas , Humanos , Psiquiatria , Psicologia Clínica , Psicofisiologia , Estresse Psicológico/fisiopatologia , Percepção do TatoRESUMO
Abstract: The mind-skin connection has been studied since the nineteenth century. The last 40 years have set the development of new research areas which allowed the clarifying of how these two dimensions interact. The diseases that involve skin and mind constitute the field of psychodermatology and require that specialists in dermatology, psychiatry and psychology together and integrated take part in it, since skin, nervous system and mind are simultaneously affected. This paper aims to expose how psychodermatoses are currently conceptualized and the need of integration of these three specialties for conveniently treating the patients.
Assuntos
Humanos , Equipe de Assistência ao Paciente , Transtornos Psicofisiológicos/psicologia , Transtornos Psicofisiológicos/terapia , Dermatopatias/psicologia , Dermatopatias/terapia , Psiquiatria , Psicologia Clínica , Psicofisiologia , Estresse Psicológico/fisiopatologia , Percepção do Tato , DermatologistasRESUMO
The nervous, immune, endocrine and integumentary systems are closely related and interact in a number of normal and pathological conditions. Nervous system mediators may bring about direct changes to the skin or may induce the release of immunological or hormonal mediators that cause pathological changes to the skin. This article reviews the psychological mechanisms involved in the development of skin diseases.
Assuntos
Dermatologia , Fenômenos Fisiológicos do Sistema Nervoso , Psiconeuroimunologia , Dermatopatias/imunologia , Dermatopatias/psicologia , HumanosRESUMO
Dermatological symptoms are explained in medicine in biological terms. Nevertheless, exploring the life history of dermatological patients can lead to seductive, but non-rigorously scientific interpretations which are of associative, or even symbolic nature. Moreover, associations of physical signs and life events, suggest us to consider our patients as subjects pervaded by the will to communicate not only through language, but also through their body and all its functions and malfunctions. Interpreting symptoms and eventually finding a meaning to the disease must not imply a causative attribution, because the very signification of cause and effect is probably beyond our grasp. Hence, aware of our limits, we should know whether we wish to treat the disease as a whole, considering that the observer (the doctor, the patient or the medicine as a theoretical corpus) is not only an observer from outside, but part of the disease that will be treated or described.
Assuntos
Dermatologia , Interpretação Psicanalítica , Dermatopatias/diagnóstico , Dermatopatias/psicologia , Humanos , Relações Médico-PacienteRESUMO
The skin has the distinction of being the largest, visible and accessible part of the human body, and it hides a close and old relationship with the human psyche, and so has been demonstrated in the last years, where more elements of the Mental Health are elucidated playing a role in the pathogenesis of skin diseases, as well as there are some descriptions of the inverse relationship, this is, on how the skin diseases affect Mental Health of the individual. In this paper we propose to emphasize the importance of the issue, to consider a comprehensive approach to everyday Dermatology in Primary Care Medicine.