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Estudo caracterizador desenvolvimentista em mulheres com gravidez de alto risco
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Este estudo teve como principal objectivo a caracterização psicológica de uma amostra de grávidas
de alto risco, tendo por base uma perspectiva desenvolvimentísta-construtivista, sustentada no modelo de
psicopatologia do desenvolvimento de Joyce-Moniz (1993). Esta caracterização permitiu reflectir sobre
estratégias de intervenção psicológica que visem a prevenção/redução de respostas emocionais excessivas e
desadaptativas nesta população.
Nesta investigação participaram 49 mulheres com diagnóstico de Gravidez de Alto Risco (GAR)
cujos discursos, através da análise qualitativa de uma entrevista semi-estruturada, foram caracterizadas num
conjunto de áreas: Temas Centrais (significações subjectivas de carácter mais abstracto e inclusivo)
associados à vivência psicológica da GAR; Operações Dialécticas que estruturam as significações associadas
à vivência psicológica da GAR e processos cognitivos subjacentes às atribuições causais da GAR, às
concepções de saúde e às concepções de doença. Simultaneamente, foram ainda avaliados os graus de
sintomatologia emocional (com recurso ao Beck Depression Inventory, para avaliar o grau de sintomatologia
depressiva e ao Siate-Trait Anxiety Inventory para avaliar o grau de sintomatologia ansiosa e a ansiedade-traço)
e as estratégias de confronto com o problema, através do instrumento Coping With Health Injuries and
Problems Scale.
Destas 49 mulheres, cinco participaram num programa de intervenção psicológica com o objectivo
de comparar as medidas de sintomatologia depressiva, ansiosa e dos diferentes estilos de confronto com a
GAR, antes e após a implementação dessa metodologia de intervenção breve.
Foram identificados 24 Temas Centrais representativos e 22 Temas Centrais preponderantes na
vivência psicológica da GAR. As Operações Dialécticas predominantes foram as Operações de Restruturação
deficiente. Relativamente aos processos cognitivos verificou-se uma predominância de processos
característicos dos Níveis 1, 2 e 3. As grávidas de alto risco apresentaram um valor superior de
sintomatologia ansiosa, quando comparadas com população em gerai e mais de metade das mulheres
apresentaram, pelo menos, uma depressão de intensidade suave. Os graus de sintomatologia depressiva e
ansiosa foram mais intensos no grupo de mulheres hospitalizadas e com prescrição de repouso absoluto, e não
se encontraram diferenças em função da satisfação com o apoio social recebido. Relativamente às estratégias
de confronto, predominaram os estilos Instrumental e Distrativo.
This study had as primary goal the psychological characterization of a sample of high-risk pregnant women, based on a developmental-constmctivist approach, sustained in the developmental psychopathology model of Joyce-Moniz (1993). This characterization allowed a reflection on the psychological strategies of intervention that seek the prevention/reduction of excessive and non-adaptative emotional responses in this population. In this investigation participated 49 women with diagnosis of High Risk Pregnancy (HRP) whose discourse, through the qualitative analysis of a semi-structured interview, were characterized in several dimensions: Central themes (subjective meanings/significations of abstract and inclusive nature) associated to the psychological experience of HRP; Dialectic Operations that structure the significations associated with the psychological experience of HRP and underlying cognitive processes of causal attributions of HRP, conceptions of health and conceptions of disease. Simultaneously, there were also assessed the degrees of emotional symptomatology (with resource to the Beck Depression Inventory, to evaluate the degree of depressive symptomatology and to the State-Trait Anxiety Inventory to evaluate the degree of anxious symptomatology and trait -anxiety) and the coping strategies with the problem, through the instrument Coping With Health Injuries and Problems. Of these 49 women, five participated in a program of psychological intervention developed with the aim to compare the measures of depressive and anxious symptomatology and the different styles of coping with HRP, before and after the brief intervention program. 24 representative Central Themes and 22 preponderant Central Themes in the psychological experience of HRP were identified. The predominant Dialectic Operations were faulty Reestructuration. Concerning the cognitive processes, a predominance of characteristic processes of the Levels 1, 2 and 3 was verified. The high risk pregnant presented a higher amount of anxious symptomatology, when compared with the general population and more than half of these women presented, at least, a depression of soft intensity. The degrees of depressive and anxious symptomatology were more intense in the hospitalized women's group and with prescription of absolute bedrest, and no differences were observed as a function of the satisfaction with the received social support. Relatively to the coping strategies, the Instrumental and Distractive styles prevailed.
This study had as primary goal the psychological characterization of a sample of high-risk pregnant women, based on a developmental-constmctivist approach, sustained in the developmental psychopathology model of Joyce-Moniz (1993). This characterization allowed a reflection on the psychological strategies of intervention that seek the prevention/reduction of excessive and non-adaptative emotional responses in this population. In this investigation participated 49 women with diagnosis of High Risk Pregnancy (HRP) whose discourse, through the qualitative analysis of a semi-structured interview, were characterized in several dimensions: Central themes (subjective meanings/significations of abstract and inclusive nature) associated to the psychological experience of HRP; Dialectic Operations that structure the significations associated with the psychological experience of HRP and underlying cognitive processes of causal attributions of HRP, conceptions of health and conceptions of disease. Simultaneously, there were also assessed the degrees of emotional symptomatology (with resource to the Beck Depression Inventory, to evaluate the degree of depressive symptomatology and to the State-Trait Anxiety Inventory to evaluate the degree of anxious symptomatology and trait -anxiety) and the coping strategies with the problem, through the instrument Coping With Health Injuries and Problems. Of these 49 women, five participated in a program of psychological intervention developed with the aim to compare the measures of depressive and anxious symptomatology and the different styles of coping with HRP, before and after the brief intervention program. 24 representative Central Themes and 22 preponderant Central Themes in the psychological experience of HRP were identified. The predominant Dialectic Operations were faulty Reestructuration. Concerning the cognitive processes, a predominance of characteristic processes of the Levels 1, 2 and 3 was verified. The high risk pregnant presented a higher amount of anxious symptomatology, when compared with the general population and more than half of these women presented, at least, a depression of soft intensity. The degrees of depressive and anxious symptomatology were more intense in the hospitalized women's group and with prescription of absolute bedrest, and no differences were observed as a function of the satisfaction with the received social support. Relatively to the coping strategies, the Instrumental and Distractive styles prevailed.
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 Grávidas de alto risco Caracterização psicológica Sintomas depressivos Perspectivas desenvolvimentistas-construtivistas Estratégias de intervenção