Transitar doente e a dor crônica: laços e desenlaces entre adolescentes, familiares e instituição hospitalar
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Data
2019
Autores
Rabelo, Maria Tereza Piedade [UNIFESP]
Orientadores
Len, Claudio Arnaldo [UNIFESP]
Tipo
Dissertação de mestrado
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Resumo
Pacientes com o quadro estável de câncer infanto-juvenil, muitas vezes, apresentam dificuldades em seguir com o seu processo de transição para a vida adulta e, em alguns casos, um quadro de dor crônica se instala, o que dificulta ainda mais sua reinserção social. Objetivo geral: compreender a experiência de adoecer na infância e juventude e seu impacto no processo de transição da adolescência para a fase adulta e, também, investigar o lugar que a dor crônica pode ocupar na economia psíquica do adolescente e de sua família ao longo desse processo. Método: Pesquisa do tipo mista. A coleta de dados foi organizada em três etapas: 1) entrevistas semiestruturadas com 12 adolescentes em seguimento no ambulatório de dor de um hospital de oncologia pediátrica; 2) entrevistas semiestruturadas com as 12 mães dos adolescentes participantes da pesquisa; e 3) aplicação do Questionário de Avaliação do Preparo para a Transição (TRAQ); da Escala de Maturidade para a Escolha Profissional (EMEP); do Teste de Morisky, Green e Levine sobre adesão medicamentosa (TMG). A análise dos dados qualitativos foi realizada por meio do método psicanalítico a partir da escuta analítica, e análise dos dados quantitativos, por meio de análise estatística. A tipologia de método misto utilizada foi a “Triangulação”, que visa à corroboração de métodos de diferentes paradigmas. A pesquisa em psicanálise, cujo paradigma é interpretativo, é o método predominante, e a integração dos dados ocorreu no momento da discussão. Resultados e discussão: Dez categorias foram construídas e apresentadas juntamente com os dados dos questionários em três textos: 1) “Transitar doente: laços e desenlaces entre adolescentes, familiares e a instituição hospitalar”; 2) “Experiência de adoecer na infância e adolescência: uma leitura psicanalítica dos fenômenos de Crescimento pós-traumático e resiliência”; 3) “Sobreviventes de câncer infanto-juvenil e dor crônica: “‘Porque dói bem menos ser criança’”. Conclusões: A condição de desejar foi constatada nesta pesquisa enquanto um fator protetivo em relação ao adoecimento. Espera-se, com este estudo, que haja uma abertura para um diálogo entre campos diferentes do saber e que a psicanálise, a partir da especificidade de seu saber, consiga contribuir com um olhar menos patologizante do sofrimento humano para o fenômeno de adoecer na infância e adolescência
Patients with advanced childhood-cancer often present themselves in a tough process of transition to adulthood and in some cases a chronic pain picture appears of the which is even more difficult for their social reinsertion. Objectives: understand the experience of falling ill in childhood and youth and its impact on the process of transition from adolescence to adulthood, as well as to investigate the place that chronic pain can occupy in the psychic economy of adolescents and their families throughout this process. Method: Mixed type search. The data collection was organized in three stages: 1) Semi-structured interviews with twelve adolescents in a follow-up in the pain outpatient clinic of a pediatric oncology hospital; 2) Semi-structured interviews with the twelve mothers of adolescents participating in the research. 3) We’ve applied :The Transition Preparation Assessment Questionnaire (TRAQ); The Maturity Scale for Professional Choice (MSPC); The Morisky, Green and Levine test on drug adherence (TMG). Qualitative data analysis was performed using the psychoanalytic method from analytical listening and analysis of quantitative data by means of statistical analysis. The typology of mixed method used was the “Triangulation” that aims at the corroboration of methods of different paradigms. Research in psychoanalysis whose paradigm is interpretive is the predominant method, and the integration of data occurred at the time of the discussion. Results and discussion: Ten categories were constructed and presented along with the questionnaire data in three texts: 1) “Transit patient: ties and outcomes between adolescents, their families and the hospital institution” 2) “Experience of falling ill in childhood and adolescence: a psychoanalytic reading of the phenomena of posttraumatic growth and resilience”; 3) “Survivors of childhood -cancer and chronic pain:” Because it hurts a lot less to be a child”. Conclusions: The condition of desire was found in this research as a protective factor in relation to illness. It is hoped by this study to open a dialogue between different fields of knowledge and that psychoanalysis based on the specificity of their knowledge can contribute to the phenomenon of becoming sick in childhood and adolescence with a less pathological view of human suffering.
Patients with advanced childhood-cancer often present themselves in a tough process of transition to adulthood and in some cases a chronic pain picture appears of the which is even more difficult for their social reinsertion. Objectives: understand the experience of falling ill in childhood and youth and its impact on the process of transition from adolescence to adulthood, as well as to investigate the place that chronic pain can occupy in the psychic economy of adolescents and their families throughout this process. Method: Mixed type search. The data collection was organized in three stages: 1) Semi-structured interviews with twelve adolescents in a follow-up in the pain outpatient clinic of a pediatric oncology hospital; 2) Semi-structured interviews with the twelve mothers of adolescents participating in the research. 3) We’ve applied :The Transition Preparation Assessment Questionnaire (TRAQ); The Maturity Scale for Professional Choice (MSPC); The Morisky, Green and Levine test on drug adherence (TMG). Qualitative data analysis was performed using the psychoanalytic method from analytical listening and analysis of quantitative data by means of statistical analysis. The typology of mixed method used was the “Triangulation” that aims at the corroboration of methods of different paradigms. Research in psychoanalysis whose paradigm is interpretive is the predominant method, and the integration of data occurred at the time of the discussion. Results and discussion: Ten categories were constructed and presented along with the questionnaire data in three texts: 1) “Transit patient: ties and outcomes between adolescents, their families and the hospital institution” 2) “Experience of falling ill in childhood and adolescence: a psychoanalytic reading of the phenomena of posttraumatic growth and resilience”; 3) “Survivors of childhood -cancer and chronic pain:” Because it hurts a lot less to be a child”. Conclusions: The condition of desire was found in this research as a protective factor in relation to illness. It is hoped by this study to open a dialogue between different fields of knowledge and that psychoanalysis based on the specificity of their knowledge can contribute to the phenomenon of becoming sick in childhood and adolescence with a less pathological view of human suffering.
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Citação
RABELO, Maria Tereza Piedade.Transitar doente e a dor crônica: laços e desenlaces entre adolescentes, familiares e instituição hospitalar. 2019. 118f. Dissertação (Mestrado em Pediatria) – Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2019.