RESUMO
OBJECTIVE: The aim of the study was to evaluate the relationship of disease characteristics and child anxiety symptoms to family health-related quality of life (FHRQoL) in youth with cyclic vomiting syndrome (CVS). METHODS: Forty-two parents of youth ages 8 to 18 years diagnosed with CVS completed the Family Impact Module of the PedsQL, a measure of the impact of the child's illness on the family. We evaluated the relationship of disease characteristics and child and parent proxy reports of anxiety symptoms on the Screen for Childhood Anxiety and Related Emotional Disorders to FHRQoL. RESULTS: Parent report of child anxiety symptoms and missed school days (meanâ=â11.93, standard deviationâ=â14.62) were the strongest predictors of FHRQoL (râ=â0.33, dfâ=â1.39, Fâ=â8.51, Pâ=â0.006). Other disease characteristics, including frequency, duration, chronicity of CVS episodes, and delay in initial CVS diagnosis were not significantly associated with the FHRQoL total score. Child anxiety symptoms by either parent and/or child report were associated with subscales of the FHRQoL, including family physical functioning, family communication, and family daily activities. CONCLUSIONS: HRQoL for the families assessed in this study was associated with anxiety symptoms to a greater extent than disease characteristics, indexing the importance of a biopsychosocial approach to CVS management. Screening for anxiety symptoms and support for school absences due to illness are indicated to help lessen the impact of CVS on the family as a whole.
Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos do Comportamento Infantil/epidemiologia , Família/psicologia , Qualidade de Vida/psicologia , Vômito/psicologia , Adolescente , Transtornos de Ansiedade/etiologia , Criança , Transtornos do Comportamento Infantil/etiologia , Efeitos Psicossociais da Doença , Saúde da Família , Feminino , Humanos , Masculino , Procurador , Inquéritos e QuestionáriosRESUMO
Emetophobia is an under-researched disorder characterized by a specific fear of vomiting. There is a paucity of research on this impairing condition, with extant examinations being largely limited to adult samples and online communities. The present study examined the incidence, phenomenology, and correlates of emetophobia in 305 Salvadorian youths. Caregivers completed a battery of questionnaires regarding the youth's symptoms of emetophobia, internalizing/externalizing symptoms, health anxiety, and obsessive-compulsive symptoms. Approximately 7.5 % of the sample was elevated on emetophobia symptoms, and higher levels of emetophobia symptoms were correlated with higher levels of internalizing, externalizing, health anxiety, and obsessive-compulsive symptoms, and lower levels of adaptive functioning. Youths meeting the cutoff for elevated emetophobia symptoms versus those who did not demonstrated significantly higher levels of externalizing behaviors, as well as general obsessive-compulsive symptoms, especially doubting/checking and neutralizing behaviors. These findings are hoped to help improve the conceptualization and treatment of this poorly understood disorder.
Assuntos
Ansiedade/diagnóstico , Comportamento Infantil/psicologia , Transtorno Obsessivo-Compulsivo , Transtornos Fóbicos , Vômito/psicologia , Adolescente , Criança , Pré-Escolar , El Salvador/epidemiologia , Emoções , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Isolamento Social/psicologia , Estatística como Assunto , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To evaluate the relationship between anxiety and health-related quality of life (HRQoL) in children and adolescents with cyclic vomiting syndrome (CVS). STUDY DESIGN: Forty children aged 8-18 years diagnosed with CVS and 40 parents completed the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the child and parent forms of the Pediatric Quality of Life Generic Core Scale, a measure of HRQoL. RESULTS: Eleven of the 40 children (27%) by self-report and 6 of 40 (15%) by parent-proxy report met the clinical cutoff for an anxiety disorder on the SCARED. Parent and child SCARED ratings were moderately correlated (intraclass correlation coefficient 0.68; P < .001). Child-rated HRQoL (mean ± SD, 74.3 ± 15.2) and parent-rated HRQoL (mean, 72.1 ± 14.6) were lower than healthy norms (P < .001). Disease severity (mean duration of CVS episodes, 3 ± 2.4 days), annual frequency of CVS episodes (mean, 8.2 ± 15.3), chronicity of CVS (mean, 5.8 ± 3.4 years), and delay in diagnosis (mean, 2.4 ± 1.9 years) were not associated with child-reported HRQoL; however, child SCARED scores accounted for approximately 50% of the variance in child-reported HRQoL (adjusted R(2) = 0.49; df = 1, 38; P < .001). CONCLUSION: Children and adolescents with CVS appear to be at increased risk for anxiety. Anxiety symptoms are a stronger predictor of HRQoL than disease characteristics in children and adolescents with CVS. Assessment and treatment of anxiety in children and adolescents with CVS may have a positive impact on HRQoL.
Assuntos
Transtornos de Ansiedade/diagnóstico , Qualidade de Vida , Vômito/psicologia , Adolescente , Criança , Feminino , Humanos , Masculino , Pais , Análise de Regressão , Autorrelato , Índice de Gravidade de DoençaRESUMO
The aim of this study was to assess the quality of life (QoL) of women with breast cancer during chemotherapy and to identify the incidence of nausea and vomiting during the treatment Data were assessed with the application of the instrument of the European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30 Portuguese version and breast cancer module BR-23, which was applied before, in the middle and in the end of the treatment. The participants were 79 women, of which 93% had nausea and 87% had vomited at least once during the treatment. QoL showed a slight decrease during treatment. Cronbach's alpha for each application of the questionnaires was 0.890492, 0.936392 and 0.937639. The availability of treatment information and guidelines on the management of nausea and vomiting is crucial for the proper management of the toxicities of chemotherapy.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Náusea/induzido quimicamente , Vômito/induzido quimicamente , Adulto , Idoso , Anticorpos Monoclonais Humanizados/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/enfermagem , Neoplasias da Mama/psicologia , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Docetaxel , Epirubicina/administração & dosagem , Epirubicina/efeitos adversos , Feminino , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Humanos , Pessoa de Meia-Idade , Náusea/enfermagem , Náusea/psicologia , Estudos Prospectivos , Qualidade de Vida , Índice de Gravidade de Doença , Fatores Socioeconômicos , Inquéritos e Questionários , Taxoides/administração & dosagem , Trastuzumab , Vômito/enfermagem , Vômito/psicologiaRESUMO
Objetivou-se avaliar a qualidade de vida (QV) de mulheres com câncer de mama em tratamento quimioterápico e identificar a ocorrência de náuseas e vômitos durante o tratamento. Os dados foram coletados com a aplicação do instrumento da Organização Europeia de Pesquisa e Tratamento de Câncer, EORTC-QLQ-C30, na versão em português, bem como do módulo para câncer de mama BR-23, aplicados antes, no meio e ao final do tratamento. Das 79 mulheres incluídas, 93% apresentaram náuseas e 87% vômitos pelo menos uma vez durante o tratamento. A QV apresentou pequena diminuição durante o tratamento. O coeficiente alfa de Cronbach para cada aplicação dos questionários foi de 0,890492, 0,936392 e de 0,937639. A disponibilidade de informações sobre o tratamento e de orientações quanto ao manejo da náusea e do vômito é crucial para o gerenciamento adequado das toxicidades da quimioterapia.
Evaluar la calidad de vida (QOL) de las mujeres con cáncer de mama durante la quimioterapia e identificar el acontecimiento de náuseas y vómitos durante el tratamiento. Se recogieron datos con la aplicación del instrumento de la Organización Europea para la Investigación y Tratamiento del Cáncer, EORTC-QLQ-C30 versión en portugués y módulo para el cáncer de mama BR-23 aplicado antes, en la mitad y al final del tratamiento. Se incluyeron 79 mujeres, el 93% tuvo náuseas, el 87% vómitos al menos una vez durante el tratamiento. La QOL presentó una ligera disminución durante el tratamiento. El coeficiente alfa de Cronbach para cada aplicación de los cuestionarios fue 0.890492, 0.936392 y 0.937639. La disponibilidad de informaciones sobre el tratamiento y directrices sobre el manejo de la náusea y vómito es fundamental para la correcta gestión de las toxicidades de la quimioterapia.
The aim of this study was to assess the quality of life (QoL) of women with breast cancer during chemotherapy and to identify the incidence of nausea and vomiting during the treatment. Data were assessed with the application of the instrument of the European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30 Portuguese version and breast cancer module BR-23, which was applied before, in the middle and in the end of the treatment. The participants were 79 women, of which 93% had nausea and 87% had vomited at least once during the treatment. QoL showed a slight decrease during treatment. Cronbach's alpha for each application of the questionnaires was 0.890492, 0.936392 and 0.937639. The availability of treatment information and guidelines on the management of nausea and vomiting is crucial for the proper management of the toxicities of chemotherapy.
Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Náusea/induzido quimicamente , Vômito/induzido quimicamente , Anticorpos Monoclonais Humanizados/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/enfermagem , Neoplasias da Mama/psicologia , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Epirubicina/administração & dosagem , Epirubicina/efeitos adversos , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Náusea/enfermagem , Náusea/psicologia , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários , Índice de Gravidade de Doença , Fatores Socioeconômicos , Taxoides/administração & dosagem , Vômito/enfermagem , Vômito/psicologiaRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Depurative practices, based on taking emetic plants and the restriction of food intake, are very much used in the traditional medicine of Chazuta (Peruvian Amazon) not only to restore health but also to maintain it. AIM OF THE STUDY: To describe Chazuta's depurative practices, within a theoretical framework that involves the stress system and which defines the role played by the medicinal plants used as medicinal stressors. This biomedical model is more inclusive in relation to the variety of medicinal uses found for these practices. MATERIAL AND METHODS: The information was obtained in the valley of Chazuta from October 2004 to August 2005 through semi-structured interviews to the 6.3% of its rural adult population (i.e., 140 individuals, 75% belonging to the San Martin Quechua's ethnic group). Thereafter, results were analysed and confronted to the existing literature. RESULTS: Overall, 191 depurative practices were reported in Chazuta where 114 different plant species were recorded and identified. Depending on their level of severity and duration, depurative practices can be classified as mild or strict. The wide range of medicinal uses reported supports both the involvement of adaptive stress responses in depurative practices and the consideration of the plants employed in this practices as medicinal stressors. CONCLUSIONS: By inducing moderate stress within safe levels, depurative practices in Chazuta could produce adaptive responses that would protect against the detrimental consequences of chronic stress and stress-related diseases. This hypothesis could help to understand the diversity of the medicinal uses recorded in the field. Thus, plant remedies used in these practices in Chazuta could be considered as "medicinal stressors" as through vomiting the necessary neuroendocrine stress activation would be produced. In addition, other bioactivities that plants may harbour could converge with the whole stress reactivity process.
Assuntos
Eméticos/farmacologia , Medicina Tradicional/psicologia , Plantas Medicinais/efeitos adversos , Estresse Psicológico/psicologia , Vômito/psicologia , Adaptação Psicológica/efeitos dos fármacos , Adulto , Feminino , Humanos , Masculino , Peru , População Rural , Estresse Psicológico/induzido quimicamente , Vômito/induzido quimicamenteRESUMO
This study was designed to determine the effect of a progressive muscle relaxation intervention on nausea and vomiting associated with anticancer chemotherapy. Subjects were 30 hematology patients who were hospitalized and received chemotherapy treatment at a large hospital in the interior of São Paulo, Brazil. The results indicated that progressive muscle relaxation lead to statistically significant changes in physiological and muscle conditions and in nausea and vomiting levels. Therefore, this relaxation technique may be an effective nursing intervention method to allay or alleviate nausea and vomiting in patients receiving chemotherapy. For future studies, we suggest using a control group, a homogeneous sample in terms of antiemetic and chemotherapy type and dosage, and the longitudinal following of subjects during chemotherapy.
Assuntos
Antineoplásicos/efeitos adversos , Náusea/terapia , Neoplasias/tratamento farmacológico , Terapia de Relaxamento , Vômito/terapia , Adolescente , Adulto , Antineoplásicos/uso terapêutico , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Náusea/psicologia , Neoplasias/diagnóstico , Satisfação do Paciente , Projetos Piloto , Resultado do Tratamento , Vômito/induzido quimicamente , Vômito/psicologiaRESUMO
El presente trabajo nos muestra, a través de material clínico de tres momentos distintos, la evolución del proceso analítico de una adolescente que consulta a los 12 años de edad. Presenta una estructura de personalidad limítrofe, con componentes sadomasoquistas y obsesivos, con síntomas fóbicos, impulsividad, angustia difusa y conductas auto agresivas. A través del material, especialmente una serie de dibujos, podemos seguir el proceso terapéutico a lo largo de un período de cuatro años, hasta la actualidad. Esta paciente requirió la intervención de un equipo multidisciplinario, con farmacoterapia, intervenciones vinculares con la madre, supervisiones para la analista. Destaca en el trabajo analítico, el uso de la contratransferencia como herramienta fundamental para ubicar el nivel de las intervenciones de la analista, permitiéndole una contención y una comprensión del material, que va determinando un progreso lento pero sostenido en la expresión de la ansiedad, desde acting out hacia la aparición de un espacio para el pensamiento.
Assuntos
Humanos , Feminino , Criança , Psicanálise/classificação , Terapia Psicanalítica/métodos , Transtorno da Personalidade Borderline/psicologia , Vômito/psicologiaRESUMO
Nausea and vomiting of pregnancy, "morning sickness", is a common contemporary complaint. Many pregnant patients note alterations in smell and taste which can precipitate "morning sickness", symptoms that characterize early gestation. Epidemiologic studies suggest that pregnancies accompanied by "morning sickness" have better outcomes than asymptomatic pregnancies. The intimate connection between immunogenetic identity, chemoidentity, and chemocommunication by olfactory mechanisms suggests a relationship between maternal symptoms and maternal accommodation of paternal antigens contained in the fetoplacental unit. Most mammalian species utilize olfaction to reduce inbreeding and thus do not require an intimate placental connection between mother and fetus. The evolution of Homo sapiens included prolonged periods of small, genetically homogeneous foraging groups which limited selection of genetically heterogeneous mates. Adaptation to this circumstance included a reduction of olfactory precision in mate selection and a more intimate association between mother and fetus, the hemochorial placenta.
Assuntos
Náusea/etiologia , Complicações na Gravidez/etiologia , Vômito/etiologia , Adaptação Fisiológica , Feminino , Humanos , Troca Materno-Fetal , Náusea/psicologia , Placenta , Gravidez , Complicações na Gravidez/psicologia , Olfato/fisiologia , Paladar/fisiologia , Vômito/psicologiaRESUMO
Os autores revisam a literatura sobre vômito psicogênico, mostrando as dificuldades de unificaçäo do conceito desta entidade psiquiátrica, e como ela pode ser relacionada a outros distúrbios psiquiátricos, particularmente bulimia nervosa e anorexia nervosa. Tendências atuais sobre a fisiopatologia e tratamento säo feitos, com o propósito de um diagnóstico seguro