Impacto psicossocial da hospitalização pediátrica no pai e na mãe

Dissertação de mestrado em Estudos da Criança (área de especialização em Intervenção Psicossocial com Crianças, Jovens e Famílias)A hospitalização pediátrica tende a constituir uma experiência marcante na vida de uma criança/adolescente, podendo afetar o seu desenvolvimento e bem-estar, e várias áreas do funcionamento da família (Jorge, 2004; L. Oliveira, Gabarra, Marcon, Silva, & Macchiaverni, 2009). Entre os protagonistas deste processo, os pais assumem um papel de particular relevância, sendo que as suas reações e recursos para lidar com o quadro clínico, sofrimento e hospitalização do filho, e com as alterações geradas nas rotinas familiares, influenciam a adaptação psicossocial do paciente pediátrico e dos restantes elementos da família (Barros, 2003; Schneider & Medeiros, 2011). Neste processo, apesar de a mãe se assumir, em grande parte dos casos, como o cuidador principal, nos últimos anos o pai tem vindo a assumir um crescente protagonismo em termos de presença e cuidados ao filho hospitalizado (Crepaldi, Andreani, Hammes, Ristof, & Abreu, 2006; Moura & Ribeiro, 2004). Na componente empírica desta dissertação apresenta-se um estudo qualitativo, de natureza exploratória, desenvolvido com o objetivo de auscultar a forma como os pais experienciam a hospitalização de um filho em situação de internamento agudo, e explorar eventuais diferenças no modo como pai e mãe vivem este episódio. O estudo envolveu 16 casais (16 pais e 16 mães), com um filho internado no serviço de pediatria de um hospital do norte de Portugal. Através de uma entrevista, procurou-se conhecer as alterações geradas pela hospitalização de um filho nas várias esferas da sua vida, as dificuldades, preocupações e necessidades experienciadas, e as estratégias de coping utilizadas. Os resultados do estudo, mais do que apontando diferenças significativas nas vivências destes casais, em função de assumirem o papel de pai ou mãe, revelaram que as diferenças observadas se deveram essencialmente ao facto de terem assumido o papel de cuidador principal ou secundário. Tais diferenças podem ser explicadas pelo facto de o cuidador principal permanecer mais tempo com o filho no hospital – um ambiente estranho, que o priva dos seus contextos e papéis habituais, oferecendo condições desajustadas às suas necessidades de conforto, descanso e privacidade, e implicando uma gestão mais exigente (cumulativa e à distância) dos papéis de profissional e de pai/mãe de outros filhos em casa.Pediatric hospitalization tends to be a remarkable experience in the life of a child/teenager, which can affect their development and welfare, and several areas of family functioning (Jorge, 2004; L. Oliveira et al., 2009). Among the protagonists of this process, parents play a particularly important role, and their reactions and resources to deal with the clinical picture, suffering and hospitalization of the child, and with the changes generated in family routines, influence the patient's psychosocial adaptation pediatric and other family members (Barros, 2003; Schneider & Medeiros, 2011). In this process, in spite of the mother assuming herself, in most cases, the main caregiver, in recent years the father has been assuming a growing role in terms of presence and care of the hospitalized child (Crepaldi et al., 2006; Moura & Ribeiro, 2004). The empirical component of this dissertation presents a qualitative study, of exploratory nature, developed with the objective of listening the way parents experience the hospitalization of a child, and to explore possible differences in the way the father and mother experience this episode. The study involved 16 couples (16 fathers and 16 mothers), with a child hospitalized in a pediatric service of a hospital in the north of Portugal. Through an interview, it was sought to know the changes generated by the hospitalization of a child in various spheres of life, the difficulties, concerns and needs experienced, and coping strategies used. The results of the study, rather than pointing out significant differences in the experiences of these couples, as they assume the role of father or mother, revealed that the differences observed were essentially related to their role as a primary or secondary caregiver. Such differences can be explained by the fact that the primary caregiver stays longer with the child in the hospital – a strange environment, that deprives him of his usual contexts and roles, offering conditions that are incompatible with their needs for comfort, rest and privacy, and implying a more demanding (cumulative and to the distance) management of professional and parent roles of other children at home

A Investigação sobre Esquizofrenia em Portugal: uma revisão sistémica

O que na atualidade se entende por Esquizofrenia é fruto de um conceito e de uma definição que sofreu e tem vindo a sofrer alterações. Em aproximadamente 100 anos, muito se evoluiu, sendo hoje claro que estamos perante uma patologia de elevada prevalência, de etiologia diversificada, cujo prejuízo para o indivíduo é grave e incapacitante. A comunidade científica internacional tem realizado grandes investigações, para que se possam promover intervenções fundamentadas que potenciem, à pessoa com esquizofrenia, qualidade de vida e participação plena enquanto cidadãos de direito. Portugal, que sempre esteve atrasado na implementação das políticas de saúde mental internacionais, como tem vindo a estudar esta problemática? Como caminha e se direciona a produção académica nacional, relativa à esquizofrenia? A procura de resposta para estas questões, foi o motor do presente estudo, que tem como objetivo descrever e caracterizar a forma como tem sido estudada, a nível académico, a Esquizofrenia em Portugal. Deste modo, realizou-se uma Revisão Sistemática de todas as Dissertações de Licenciatura, Dissertações de Mestrado e Teses de Doutoramento, até Novembro de 2012, integradas no Repositório Científico de Acesso Aberto de Portugal (RCAAP), relativas ao tema Esquizofrenia, sendo a amostra final composta por 35 trabalhos. A presente revisão permitiu perceber que os estudos de acesso aberto que têm por objeto a Esquizofrenia são, essencialmente, Dissertações de Mestrado, produzidas em pleno século XXI, desenvolvidas maioritariamente no Porto. Tratam-se de estudos primários observacionais que se focalizam na avaliação de doentes com esquizofrenia, escolhidos através de técnicas de amostragem não probabilísticas, em média compostos por 35 pacientes. A análise da amostra permitiu levantar a possibilidade de a Esquizofrenia, em Portugal, ter sido uma doença que, ao longo de largos anos, se encontrou subavaliada. Concluiu-se ainda que existe uma grande diversidade e dispersão de temáticas abordadas, dimensões avaliadas e instrumentos utilizados pelos investigadores que se dedicam ao estudo desta doença. / What we understand today has Schizophrenia is based on a concept and a definition that has changed and is still changing. In approximately 100 years, much has evolved, being clear that this is a disease of high prevalence, of diverse etiology, whose prejudice to the individual is serious and disabling. The international scientific community has made major investigations to promote substantiated interventions for people with Schizophrenia, so that they can potentiate quality of life and full participation as citizens in law. How is Portugal, which has always been delayed on the implementation of international mental health policy, studying this issue? How are national academic studies targeted towards schizophrenia? The search for the answers for these questions was the starter for the present study, which it´s objective is to describe and characterize the way that Schizophrenia has been studied in Portugal. Therefore, we carried out a Systematic Review of all Bachelor, Master´s and PhD Thesis, until November 2012, integrated into the Open Access Scientific Repository of Portugal (RCAAP) related to Schizophrenia, resulting on a final sample of 35 scientific papers. This review led to realize that studies of open access that focus on Schizophrenia are, essentially, Master´s Thesis, produced in the XXI century, developed mainly in Oporto. These are observational primary studies that focused on the evaluation of patients with Schizophrenia, chosen through non probabilistic sampling techniques, in average composed by 35 patients. The study of this sample has shown the possibility that Schizophrenia in Portugal has been an undervalued disease for many years. There is also the conclusion that there is a great diversity and dispersion of topics addressed, dimensions assessed and instruments used by researchers who are dedicated to the study of this disease

Emotional and behavioral problems and psychosocial skills in adolescents in residential care

Research suggests that mental health problems in adolescents in residential care (RC) are more prevalent than for youth in the community, and that psychosocial competencies are protective factors of mental health. This study compared adolescents in RC in Portugal, with a Portuguese community sample on the incidence of mental health problems and psychosocial skills, explored gender differences and the relationships between mental health problems and psychosocial competencies. Four hundred and forty-three adolescents in RC participated. Results showed that the RC adolescents had higher levels of mental health problems lower academic achievement, a poorer social support network, but were more involved in sports and hobbies, household chores than the adolescents in the normative sample. Gender differences were observed. Psychosocial skills were negatively correlated with mental health problems. These findings indicate an urgent need in Portugal for early screening of mental health problems and socio-cognitive interventions for youth in RC.info:eu-repo/semantics/publishedVersio

Saúde mental no acolhimento residencial de crianças e jovens: prevalência, fatores de risco e fatores de proteção

The Residential Care is an extrafamilial promotion and protection measure that aims at placing the child or young person in the care of an entity which has the facilities and permanent equipment and a team of caregivers that guarantees you the care appropriate to their needs and provide them conditions that allow their education, welfare and integral development. In Portugal there are about 8000 children and young people who are in Residential Care, corresponding this number to 0.43% of children and adolescents Portuguese. Several studies have concluded that the prevalence rate and the severity of mental health problems is higher in children and young people institutionalized in relation to the general population. Risk factors for the problems observed are related not only with the family context previous to institutionalization, as well as individual characteristics and contextual variables from their centres. At the same time there is a significant number of clinical cases that are not promptly diagnosed, causing emotional and behavioral problems manifested reveal a risk factor for the psychopathology in adulthood. The main objective of this work focuses on the presentation of the state of the art regarding the prevalence of mental health problems in children and young people in Residential Care, as well as their risk factors and protective factors.info:eu-repo/semantics/publishedVersio

Saúde mental de crianças e adolescentes portugueses em acolhimento residencial

Em Portugal existem mais de 8000 crianças em Acolhimento Residencial (AR). Neste estudo participaram 77 crianças em AR (63,6% rapazes). Através da Bateria ASEBA foi possível observar que os participantes apresentaram níveis clínicos de problemas de saúde mental (maioritariamente as raparigas). Estes estão relacionados com o motivo de acolhimento e com o tipo de apoio recebido. A dimensão da casa medeia a relação entre a sintomatologia e o número de apoios recebidos. Estes resultados apelam à necessidade de instituir procedimentos de avaliação psicológica no momento de admissão da criança, sensibilizar os profissionais das casas de AR para estes sinais e sintomas e implementar programas de prevenção e promoção da saúde mental.In Portugal there are more than 8,000 children in Residential Care (RC). Seventy-seven children in RC (63.6% boys) participated in this study. Using the ASEBA Battery it was possible to observe that the participants presented clinical levels of mental health problems (mainly the girls), which were related to the reasons of being in care and the kind of support received. The RC Centre’s dimension mediated the relationship between the amount of support and the child’s symptomatology. These results reinforce the need to provide psychological assessment procedures at the moment when the child enters care, to sensitize RC professionals for these signs and symptoms, and to implement programs for the prevention and promotion of mental health.Il existe au Portugal plus de 8000 enfants en Accueil Institutionnel (AI). Ont participé à cette étude 77 enfants en AI (63,6% garçons). Utilisant la Batterie ASEBA il a été possible d'observer que les participants présentaient des niveaux cliniques de problèmes de santé mentale (surtout les filles). Ceux-ci sont liés au motif de la mise en accueil et au type d’appui reçu. La dimension du centre d’accueil est médiateur du rapport entre la symptomatologie et le nombre d’appuis. Ces résultats renforcent le besoin d'instituer des procédures d'évaluation psychologique au moment de l'admission de l'enfant, de sensibiliser les professionnels de l’AI à ces symptômes et mettre en œuvre des program- mes de prévention et de promotion de la santé mentale

Fever and Rash: Revisiting Measles

Fever and rash are a common combination of symptoms in the young adult patient. The etiologic investigation is usually oriented towards the most common diseases, but atypical presentations of less frequent conditions should also be recalled. We describe the case of a 44 year-old Portuguese woman who presented with fever, conjunctivitis, cough and rash, rapidly evolving to hepatitis and extensive pneumonia with respiratory failure. Although she claimed to be vaccinated according to the national immunisation schedule, a final diagnosis of primary measles pneumonia was clinically made and confirmed by serology. However, some less typical features mislead us initially. Although the rare form of primary measles pneumonia is more prevalent among immunosuppressed patients, our patient was immunocompetent. Moreover, absence of contagiousness, as was the case, occurs more frequently in atypical measles. This case highlights the need to always confirm the alleged vaccination status in adults and raises attention to some unusual features of typical measles

Conceptual Model of a Federated Data Lake

Valuable insights are frequently only available after combining and analysing data from multiple sources. This paper presents a Conceptual Model of a Federated Data Lake, as a contribution to formalize the required components and their relationships, in order to identify and address them in the implementation of a comprehensive system that supports on-the-fly query processing over multiple heterogeneous sources and provides an adequate data management by highlighting the concepts of a Data Lake and focusing on the Metadata Management domain as an engine to the integration of several Data Lakes