RESUMO
INTRODUCTION: In October 2019 in Chile, massive protests broke out in the so-called social uprising. The repressive response of the armed forces and Carabineros (Police) resulted in serious and mas-sive violations of human rights, with between 400 and 500 victims of ocular trauma caused mainly by shots from anti-riot shotguns, constituting the largest number of cases in the world linked to a single event. It is proposed to evaluate the different dimensions of the impact of ocular trauma due to state violence, using the concept of psychosocial trauma and a support model that integrates the medical-psychological and social dimensions. METHODS: Human rights violations of the period are described, focusing on cases of ocular trauma, and state and civil society responses. The requests of a survivors' organisations regarding truth, justice and reparation is presented. A clinical case of ocular trauma treated in our centre is analyzed. RESULTS: Survivors of ocular trauma manifest post-traumatic reactions regardless of the severity of their ocular injuries. The impact on the mental health of survi-vors of ocular trauma due to state violence is a phenomenon where the psychic and psychosocial im-pact of trauma due to socio-political violence intersects with the short- and long-term mental health effects. DISCUSSION: The impact of sociopolitical trauma must be understood considering both the in-dividual and social subject, considering their cultural, socioeconomic and political reality. Recovery from traumatic psychological injury must be addressed in its medical, sensory rehabilitation, psycho-logical and psychosocial dimensions, including processes of social recognition, search for justice and comprehensive reparation of damage. In contexts of impunity, a model is proposed that integrates rehabilitation with psycho-legal support, promotion of agency and organisation, within the frame-work of commitment to the movement and principles of human rights.
Assuntos
Traumatismos Oculares , Direitos Humanos , Trauma Psicológico , Humanos , Chile , Traumatismos Oculares/psicologia , Trauma Psicológico/psicologia , Masculino , Adulto , Sobreviventes/psicologia , Violência/psicologiaRESUMO
The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ(2) tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation.
Assuntos
Anoftalmia/reabilitação , Olho Artificial/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ira , Anoftalmia/psicologia , Atitude Frente a Saúde , Criança , Escolaridade , Emoções , Emprego/psicologia , Oftalmopatias/psicologia , Oftalmopatias/reabilitação , Traumatismos Oculares/psicologia , Traumatismos Oculares/reabilitação , Medo , Feminino , Seguimentos , Humanos , Renda , Relações Interpessoais , Masculino , Estado Civil , Pessoa de Meia-Idade , Relações Profissional-Paciente , Qualidade de Vida , Autoimagem , Vergonha , Timidez , Adulto JovemRESUMO
UNLABELLED: Facial integrity is a condition which interferes in the daily life of the individual. The loss of an eyeball has psychological impact, requiring adaptation. Interventions such as prosthetic repair seem to lead to emotional and behavioral change. PURPOSE: The objective of this study was to identify the psychosocial aspects related to unilateral anophthalmic socket and evaluate patient adaptation to prosthesis. METHODS: All participants responded to a semi-structured interview. This was composed of two parts, the first regarding the general data of patient identification and socioeconomic aspects. The second part included information about eye loss and rehabilitation, with 31 questions. Twenty-eight volunteers were interviewed. RESULTS: Most were male (53.57%). Ages ranged between 11 and 67. Trauma was the prevalent etiological factor (60.71%). A significant statistical difference (p<0.05) was found between the scores of the feelings of loss before and after prosthesis (z Wilcoxon=-4.41; p<0.001). CONCLUSIONS: The data showed emotional difficulties in the initial contact with the loss of an eye and the role of the prosthesis as an element of social inclusion, stressing the importance of teamwork and access to fitting services in adapting these patients.
Assuntos
Traumatismos Oculares/psicologia , Olho Artificial/psicologia , Adaptação Psicológica , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Traumatismos Oculares/reabilitação , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto JovemRESUMO
A integridade da face é condição que interfere no cotidiano do indivíduo sendo que a perda do globo ocular tem um impacto psicológico, demandando uma condição de adaptação. Intervenções como a reparação protética parecem produzir mudanças nos âmbitos emocional e comportamental. Objetivo: Identificar os aspectos psicossociais relacionados à ausência unilateral do globo ocular e avaliar a adaptação dos pacientes usuários de prótese ocular. Métodos: Para realização da pesquisa foi utilizado como instrumento de coleta de dados um roteiro de entrevista adaptado aos objetivos desse trabalho. Este foi composto por duas partes, a primeira referente a dados gerais de identificação do paciente e aspectos socioeconômicos. A segunda parte incluiu dados específicos sobre a perda e reabilitação ocular com 31 questões. Vinte e oito pacientes voluntários foram entrevistados. Resultados: A maioria era do gênero masculino (53,57 por cento). A idade variou entre 11 e 67 anos. O trauma foi o fator etiológico prevalente (60,71 por cento). Foi encontrada diferença estaticamente significativa (p<0,05) entre os escores dos sentimentos da época da perda e atualmente (z Wilcoxon=-4,41; p<0,001). Conclusão: Os dados evidenciaram dificuldades emocionais no processo inicial de contato com a condição de perda do olho e o papel da prótese como elemento de inclusão social, ressaltando a relevância do trabalho em equipe e do acesso a serviços de protetização para a adaptação desses pacientes.
Facial integrity is a condition which interferes in the daily life of the individual. The loss of an eyeball has psychological impact, requiring adaptation. Interventions such as prosthetic repair seem to lead to emotional and behavioral change. Purpose: The objective of this study was to identify the psychosocial aspects related to unilateral anophthalmic socket and evaluate patient adaptation to prosthesis. Methods: All participants responded to a semi-structured interview. This was composed of two parts, the first regarding the general data of patient identification and socioeconomic aspects. The second part included information about eye loss and rehabilitation, with 31 questions. Twenty-eight volunteers were interviewed. Results: Most were male (53.57 percent). Ages ranged between 11 and 67. Trauma was the prevalent etiological factor (60.71 percent). A significant statistical difference (p<0.05) was found between the scores of the feelings of loss before and after prosthesis (z Wilcoxon=-4.41; p<0.001). Conclusions: The data showed emotional difficulties in the initial contact with the loss of an eye and the role of the prosthesis as an element of social inclusion, stressing the importance of teamwork and access to fitting services in adapting these patients.
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Traumatismos Oculares/psicologia , Olho Artificial/psicologia , Adaptação Psicológica , Estudos Transversais , Traumatismos Oculares/reabilitação , Entrevista Psicológica , Fatores SocioeconômicosRESUMO
Pesquisa qualitativa convergente assistencial, que objetivou identificar percepções e significados referentes à perda visual de pacientes que apresentavam visão monocular devido ao trauma ocular. Participaram seis vítimas de trauma ocular com visão monocular, de um hospital referência em emergência. Os dados emergiram das falas das pessoas no grupo de convivência e de entrevistas semiestruturadas. Os resultados demonstraram expectativa de voltar a enxergar, dúvida quanto ao diagnóstico e ausência de acompanhamento, o qual despertou sentimento de angústia e situação conflituosa relacionada à perda da independência. O grupo de convivência foi considerado um elemento que contribuiu para um viver mais saudável, ao promover a troca de experiências e o compartilhar de saberes.
Convergent-care qualitative research, that aimed to identify perceptions and meanings related to visual loss in patients with monocular vision due to ocular trauma. Participants were six victims of ocular trauma with monocular vision, from a reference hospital in emergency. Data emerged from the speeches of people in the living group and from semi-structured interviews. The results showed the expectative to see again, the doubt on the diagnosis and lack of monitoring, which arouse the feeling of anguish and conflict situation related to loss of independence. The living group was considered a contributor to a healthier life by promoting the exchange of experiences and knowledge.
Investigación cualitativa convergente asistencial, que tuvo como objetivo identificar percepciones y significados relacionados con la pérdida visual en pacientes con visión monocular debido al traumatismo ocular. Los participantes fueron seis víctimas de trauma ocular con visión monocular, de un hospital de referencia en emergencia. Los datos surgieron de la voz de las personas en el grupo de convivencia y de entrevistas semiestructuradas. Los resultados mostraron espera de volver a ver, duda sobre el diagnóstico y falta de acompañamiento, lo que provocó angustia y situación de conflicto relacionado con la pérdida de la independencia. El grupo de convivencia ha sido considerado colaborador para uno vivir saludable al promover el intercambio de experiencias y conocimientos.
Assuntos
Humanos , Traumatismos Oculares/complicações , Traumatismos Oculares/psicologia , Visão MonocularRESUMO
Convergent-care qualitative research, that aimed to identify perceptions and meanings related to visual loss in patients with monocular vision due to ocular trauma. Participants were six victims of ocular trauma with monocular vision, from a reference hospital in emergency. Data emerged from the speeches of people in the living group and from semi-structured interviews. The results showed the expectative to see again, the doubt on the diagnosis and lack of monitoring, which arouse the feeling of anguish and conflict situation related to loss of independence. The living group was considered a contributor to a healthier life by promoting the exchange of experiences and knowledge.
Assuntos
Traumatismos Oculares/complicações , Traumatismos Oculares/psicologia , Visão Monocular , HumanosRESUMO
Congenital absence or loss of the ocular globe during childhood causes psycho-social and cosmetic disorders and compromise the normal development of the orbital region. The literature relating to congenital or acquired etiology, due to trauma or disease, demonstrates the necessity of prevention and early detection in order to minimize the sequelae and disturbances in orbital growth. Installation of an eye prosthesis is essential to the rehabilitation process, so as to produce satisfactory development of the region. In order to characterize a profile of the child patient with this condition, a survey was carried out at the Prosthetic Eye sector, Out-patient Clinic, Discipline of Maxillofacial Prosthodontics, School of Dentistry, University of São Paulo (FOUSP), during the period from 1988 to 2003. The 124 (14.02%) patients within the age group of 0-13 years registered for ocular prosthesis were divided into a first group of 64 patients (51.62%) with 0-7 years, and a second group of 60 patients (48.38%) with 8-13 years. Fifty nine were girls and 65 were boys. No statistical significance was observed regarding the distribution of genders in the two analyzed age groups (p = 0.069). However, there was statistical significance at the level of 0.01 in relation to etiology, with higher prevalence of congenital and pathological disturbances in the younger group and traumatic occurrences in the older group. The etiology also presented variation according to the gender, at the significance level of 0.05, where girls presented three times less trauma than boys in the older age group. The necessity of prosthetic ocular repair was evenly distributed along the childhood period and the eye losses that required prosthetic treatment equally affected both genders. However, the etiology of eye loss varied according to the considered gender and age bracket.
Assuntos
Traumatismos Oculares/etiologia , Olho Artificial/estatística & dados numéricos , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Traumatismos Oculares/congênito , Traumatismos Oculares/psicologia , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Prótese Maxilofacial , Distribuição por Sexo , Fatores SexuaisRESUMO
Congenital absence or loss of the ocular globe during childhood causes psycho-social and cosmetic disorders and compromise the normal development of the orbital region. The literature relating to congenital or acquired etiology, due to trauma or disease, demonstrates the necessity of prevention and early detection in order to minimize the sequelae and disturbances in orbital growth. Installation of an eye prosthesis is essential to the rehabilitation process, so as to produce satisfactory development of the region. In order to characterize a profile of the child patient with this condition, a survey was carried out at the Prosthetic Eye sector, Out-patient Clinic, Discipline of Maxillofacial Prosthodontics, School of Dentistry, University of São Paulo (FOUSP), during the period from 1988 to 2003. The 124 (14.02 percent) patients within the age group of 0-13 years registered for ocular prosthesis were divided into a first group of 64 patients (51.62 percent) with 0-7 years, and a second group of 60 patients (48.38 percent) with 8-13 years. Fifty nine were girls and 65 were boys. No statistical significance was observed regarding the distribution of genders in the two analyzed age groups (p = 0.069). However, there was statistical significance at the level of 0.01 in relation to etiology, with higher prevalence of congenital and pathological disturbances in the younger group and traumatic occurrences in the older group. The etiology also presented variation according to the gender, at the significance level of 0.05, where girls presented three times less trauma than boys in the older age group. The necessity of prosthetic ocular repair was evenly distributed along the childhood period and the eye losses that required prosthetic treatment equally affected both genders. However, the etiology of eye loss varied according to the considered gender and age bracket.
A ausência congênita ou a perda do bulbo ocular na infância acarretam distúrbios estéticos e psico-sociais e comprometem o desenvolvimento normal da região orbitária. A literatura relacionada à etiologia congênita ou adquirida, devido a trauma ou doença, demonstra a necessidade da prevenção e da detecção precoce para minimizar as seqüelas e os distúrbios de crescimento orbital. A reabilitação implica a instalação de uma prótese ocular visando favorecer o desenvolvimento harmonioso da região. Com o objetivo de caracterizar o perfil do paciente infantil foi realizado um levantamento junto ao Setor de Prótese Ocular do Ambulatório da Disciplina de Prótese Bucomaxilofacial da FOUSP abrangendo o período de 1988 a 2003. As 124 (14,02 por cento) crianças registradas encontravam-se distribuídas em 64 (51,62 por cento) na faixa etária de 0 a 7 anos e 60 (48,38 por cento) na de 8 a 13 anos de idade, sendo 59 meninas e 65 meninos. A análise estatística revelou que a variação das ocorrências dos gêneros masculino e feminino nas faixas etárias não é significante (p = 0.069). Entretanto, a etiologia da perda variou segundo as faixas etárias consideradas, com um nível de significância de 0,01, apresentando uma maior prevalência de distúrbios congênitos e patológicos na faixa etária mais jovem e trauma na mais velha. A etiologia alterou-se de acordo com os gêneros com uma significância de 0,05, tendo as meninas apresentado três vezes menos trauma que os meninos na faixa etária mais velha. A necessidade de tratamento protético apresentou-se igualmente distribuída ao longo da infância e as perdas oculares que implicam reabilitação protética ocorreram igualmente nos gêneros masculino e feminino. Entretanto, a etiologia da perda ocular variou em função do gênero e da faixa etária considerada.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Traumatismos Oculares/etiologia , Olho Artificial/estatística & dados numéricos , Brasil/epidemiologia , Traumatismos Oculares/congênito , Traumatismos Oculares/psicologia , Necessidades e Demandas de Serviços de Saúde , Prótese Maxilofacial , Distribuição por Sexo , Fatores SexuaisAssuntos
Manifestações Oculares , Neoplasias Oculares/etiologia , Olho Artificial/normas , Olho Artificial/tendências , Acidentes de Trabalho/legislação & jurisprudência , Anoftalmia/patologia , Doenças Orbitárias/etiologia , Traumatismos Oculares/patologia , Traumatismos Oculares/psicologia , Traumatismos Oculares/reabilitação , Odontologia Legal , Legislação Trabalhista , Procedimentos Cirúrgicos Oftalmológicos , Procedimentos Cirúrgicos Oftalmológicos/normasRESUMO
Se presenta el caso clínico de autoenucleación unilateral, en un enfermo esquizofrénico, en un brote psicótico agudo. Son frecuentes las mutilaciones bilaterales por cuanto se propone la blefarorrafía del ojo contralateral en forma temporal mientras es dominado el brote psicótico. A los 4 meses de ocurrido el hecho, el otro ojo no mostraba alteraciones campimétricas ni visuales