Oppositionality and sympathetic skin response in adolescents : specific associations with the headstrong/hurtful dimension

Oppositionality encompasses distinct dimensions, and few studies have investigated the validity of such distinctions from a pathophysiological perspective. Our aim was to investigate the association between sympathetic skin responses (SSR) and distinct oppositional dimensions in a community sample of adolescents. Forty adolescents aged 13.84 ± 1.46 years participated in this study. Oppositionality was measured by externalizing behavior and bullying scores (dependent variables), while SSR was recorded by electrical changes at the skin level (independent variables). Results showed that increased SSRs were associated with oppositionality; however, these associations were specific to the headstrong/hurtful dimension. Further exploratory analyses demonstrated that increased SSRs were associated with several types of headstrong/hurtful behaviors and underscore the importance of the first aversive stimuli to differentiate groups with low and high headstrong/hurtful behaviors. There were no differences between groups regarding time until habituation. This study provides insights about how dysfunctions in autonomic balance may contribute to the emergence of oppositional behavior among adolescents

Resultados de la Nursing Outcomes Classification/NOC para pacientes con trastorno obsesivo-compulsivo

Objetivo: Analisar a aplicação de resultados e indicadores de enfermagem selecionados na Nursing Outcomes Classification (NOC) para avaliar pacientes com Transtorno Obsessivo-Compulsivo (TOC) em acompanhamento ambulatorial. Método: Pesquisa de resultados. Primeiro, realizou-se consenso entre enfermeiros especialistas em saúde mental (SM) e em processo de enfermagem para seleção de resultados e indicadores da NOC, seguido da elaboração das suas definições conceituais e operacionais. Depois, construiu-se um instrumento com estes, que foi testado em grupo piloto de seis pacientes atendidos em ambulatório de SM. O instrumento foi aplicado aos pacientes com TOC submetidos a Terapia Cognitivo-Comportamental em Grupo (TCCG). Estudo aprovado pelo Comitê de Ética em Pesquisa da instituição. Resultados: Foram selecionados quatro resultados e 17 indicadores NOC. Observou-se modificação significativa dos escores de nove indicadores após a TCCG. Conclusão: O estudo apontou viabilidade de avaliação dos sintomas de pacientes com TOC através dos resultados e indicadores da NOC em cenário ambulatorial.Objective: To analyze the application of nursing outcomes and indicators selected from the Nursing Outcomes Classification (NOC) to evaluate patients with obsessivecompulsive disorder (OCD) in outpatient follow-up. Method: Outcome-based research. First, a consensus was achieved between nurses specialized in mental health (MH) and in the nursing process to select NOC-related outcomes and indicators, followed by the elaboration of their conceptual and operational definitions. Then, an instrument was created with these, which was tested in a pilot group of six patients treated at a MH outpatient clinic. The instrument was applied to patients with OCD undergoing Group Cognitive Behavioral Therapy (GCBT). The study was approved by the Research Ethics Committee of the institution. Results: Four NOC outcomes and 17 indicators were selected. There was a significant change in the scores of nine indicators after CBGT. Conclusion: The study showed feasibility for evaluating symptoms of patients with OCD through NOC outcomes and indicators in an outpatient situation.Objetivo: Evaluar la aplicación de resultados e indicadores de enfermería seleccionados en la Nursing Outcomes Classification (NOC) para examinar a los pacientes con Trastorno ObsesivoCompulsivo (TOC) en seguimiento ambulatorio. Método: Investigación de resultados. Primeramente, se realizó un acuerdo entre enfermeros expertos en salud mental (SM) y en proceso de enfermería para seleccionar los resultados e indicadores de la NOC, seguido de la elaboración de sus definiciones conceptuales y operativas. Después, se construyó un instrumento con las informaciones recolectadas, y lo aplicaron a un grupo piloto con seis pacientes, que recibían atención en el ambulatorio de SM. Se aplicó el instrumento a los pacientes con TOC, sometidos a Terapia Cognitivo-Conductual en Grupo (TCCG). Estudio aprobado por el Comité de Ética en Investigación de la institución. Resultados: Se seleccionaron cuatro resultados y 17 indicadores NOC. Se observó una modificación significativa de los puntajes de nueve indicadores después de la TCCG. Conclusión: El estudio apuntó la viabilidad de evaluación de los síntomas de pacientes con TOC por medio de los resultados e indicadores de la NOC en el ámbito ambulatori

Instruments of pain evaluation in elderly with cognitive impairment : systematic review

O objetivo deste estudo foi realizar uma revisão sistemática sobre instrumentos para avaliação da dor em idosos com prejuízo cognitivo. Buscaram-se artigos na base de dados Isi Web of Knowledge. Foram selecionados artigos originais, com delineamentos transversais ou ensaio clínico no período de 2000 a 2012. Dos 920 resumos encontrados, 55 artigos foram acessados na íntegra e 29 preencheram os critérios de inclusão. Os instrumentos utilizados em maior número de estudos foram o Pain Assessment in Advanced Dementia (PAINAD) e o Doloplus, ambos apresentando níveis variados de consistência interna, confiabilidade e correlação interavaliadores. Ainda que a maioria dos instrumentos tenha demonstrado níveis psicométricos aceitáveis, não houve consenso sobre a aplicabilidade de instrumentos para avaliação da dor em idosos com prejuízo cognitivo.The objective of this study was to conduct a systematic review about instruments to evaluate pain in elderly with cognitive impairment. The Isi Web of Knowledge was used to select articles. Original cross-sectional studies and clinical trials conducted from 2000 to 2012 were included. Of the 920 abstracts found, 55 could be accessed in full, and 29 met the inclusion criteria for final assessment. Pain Assessment in Advance Dementia (PAINAD) and Doloplus were tested in most studies, and both results revealed variable levels of internal consistency, reliability and interrater correlation. Although most instruments have demonstrated acceptable psychometric levels, there was no consensus on the applicability of instruments for assessing pain in elderly with cognitive impairment