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Consulta psicológica da dor em Centro de Saúde : implementação de um programa de intervenção e caracterização desenvolvimentista em 12 estudos de caso
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Orientador(es)
Resumo(s)
Esta tese tem como objectivos principais a caracterização
desenvolvimentista de pacientes com dor crónica, segundo o modelo de
Joyce-Moniz (1993) e a implementação e avaliação de um programa de
intervenção com estes mesmos pacientes, em contexto de Centro de Saúde.
Trata-se de um estudo predominantemente qualitativo no qual participaram
doze pacientes, utentes de dois Centros de Saúde onde foi implementada
uma consulta psicológica da dor.
Neste estudo foram utilizados os seguintes instrumentos de avaliação: a)
uma entrevista semi-estruturada de avaliação inicial; b) narrativas
desenvolvimentistas; c) escalas de valores para o registo da intensidade da
dor; e c) uma entrevista de follow-up. A partir das verbalizações dos
pacientes ao longo de todo o programa de intervenção foi efectuada uma
análise das temáticas predominantes. Através da utilização de narrativas
desenvolvimentistas, procedeu-se à caracterização dos níveis sócio-cognitivos
dos pacientes. As entrevistas e as escalas de valores permitiram
avaliar o programa de intervenção.
Após a fase de avaliação, foram treinadas com cada paciente estratégias
psicológicas de confronto com a dor que incluíam o relaxamento muscular,
o relaxamento respiratório, auto-instrução e técnicas distractivas.
Verificou-se que as temáticas mais predominantes eram aquelas que se
relacionavam com a utilização de estratégias para o confronto da dor, e que
em termos de desenvolvimento sócio-cognitivo, os pacientes com dor
crónica se situavam, maioritariamente, no nível III. O programa de
intervenção implementado mostrou-se eficaz na redução da intensidade das
dores dos pacientes, possibilitando a sua posterior aplicação em
intervenções nesta área.
This thesis has as primary goals the developmental characterization of chronic pain patients applying the Joyce-Moniz (1993) model, and the aplication and avaluation of an intervention program, with these same patients, in an health care centre context. It is essentially a qualitative investigation, in which twelve patients followed in two health care centres attended a chronic pain psychological program. In this study several assessment instruments and procedures were used: a) a semi-structured interview for initial evaluation; b) developmental narratives; c) a rating scales for pain intensity; and d) a follow-up interview. Along with the therapeutic package, a main themes analysis was performed over the patient's verbalizations. Developmental narratives were used in order to characterize the twelve patients' socio-cognitive levels. The therapeutic package was assessed through interviews and rating scales. After the avaluation phase, each patient was trained in the use of several pain coping strategies like muscle relaxation, breathing relaxation, self-instruction and attention-diverting strategies. The resulting main themes concern the use of pain coping strategies. The characterization of socio-cognitive levels shows that most of these chronic pain patients were function at level III. The therapeutic program was effective in reducing the patient's pain intensity, allowing for the possibility of its use in future interventions on this population.
This thesis has as primary goals the developmental characterization of chronic pain patients applying the Joyce-Moniz (1993) model, and the aplication and avaluation of an intervention program, with these same patients, in an health care centre context. It is essentially a qualitative investigation, in which twelve patients followed in two health care centres attended a chronic pain psychological program. In this study several assessment instruments and procedures were used: a) a semi-structured interview for initial evaluation; b) developmental narratives; c) a rating scales for pain intensity; and d) a follow-up interview. Along with the therapeutic package, a main themes analysis was performed over the patient's verbalizations. Developmental narratives were used in order to characterize the twelve patients' socio-cognitive levels. The therapeutic package was assessed through interviews and rating scales. After the avaluation phase, each patient was trained in the use of several pain coping strategies like muscle relaxation, breathing relaxation, self-instruction and attention-diverting strategies. The resulting main themes concern the use of pain coping strategies. The characterization of socio-cognitive levels shows that most of these chronic pain patients were function at level III. The therapeutic program was effective in reducing the patient's pain intensity, allowing for the possibility of its use in future interventions on this population.
Descrição
Tese de mestrado em Psicologia (Psicoterapia e Psicologia da Saúde) apresentada à Universidade de Lisboa através da Faculdade de Psicologia e de Ciências da Educação, 2002
Palavras-chave
Teses de mestrado - 2002 Dor crónica Consulta psicológica Psicologia da saúde