Impacto de uma intervenção baseada em Mindfulness nos sinais de estresse e de bem-estar de professores da rede pública de ensino: avaliação psicométrica e inflamatória
Arquivos
Data
2020-09-03
Orientadores
Demarzo, Marcelo Marcos Piva 
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
O mindfulness tem recebido diversas indicações clínicas, e tem sido implicado em diversos
tratamentos. Para um melhor conhecimento da natureza e consequências da intervenção, é
importante que se tenha quantidade e qualidade em informações acerca de seus impactos
psicológicos e biológicos para que se possa tornar o mindfulness um construto robusto e válido
para aplicação em saúde. No presente estudo avaliamos o impacto de uma intervenção baseada
em Mindfulness em um grupo de 65 professores da Rede Pública de Ensino (34 submetidos a
uma MBI, MBHP-Educa; 31 submetidos a um programa-controle, Neuro-Educa), e procuramos
explorar as bases psicológicas em operação durante o Programa de Promoção da Saúde
Baseado em Mindfulness para o Educador (MBHP-Educa), uma intervenção de 16 horas (2
horas/semana). Para tanto, utilizamos as escalas psicométricas EMRI (Escala Multidimensional
de Reatividade Interpessoal), PANAS (Escala de Afetos Positivos e Negativos), PSS (Escala de
Estresse Percebido), CD-RISC (Escala de Resiliência de Connor-Davidson) e PWBS (Escala de
Bem-estar Psicológico). Além disso, avaliamos a memória episódica através da aplicação do teste
cognitivo RAVLT (Teste Auditivo-Verbal de Rey). Investigamos, também, as mudanças nos níveis
das citocinas pró- e anti-inflamatórias circulantes no soro dos sujeitos da pesquisa através da
técnica de citometria de fluxo. Todas as medidas foram coletadas no pré- e pós-intervenção e
utilizamos um grupo controle ativo, denominado de Neurociência para a Educação (NeuroEduca), baseado em atividades psicoeducativas na área da neurociência de 16h. De acordo com
a análise de GEE (Equação de Estimativa Geral), o programa MBHP-Educa reduziu
significativamente os escores de estresse percebido (p <0,0001) e afetos negativos (p<0,0001),
e aumentou os escores de resiliência (p <0,0001). O MBHP-Educa também reduziu os escores
de reatividade interpessoal, Consideração Empática (p<0,0001), Tomada de Perspectiva
(p<0,0001) e uma redução na Angústia Pessoal (p<0,0001). O MBHP-Educa também reduziu a
pontuação no Bem-estar Psicológico, nas dimensões Auto-aceitação (p<0,0001), Propósito de
Vida (p<0,0001) e Autonomia (p <0,0001). Ainda, observamos uma redução dos níveis de IL-6 (p
<0,0001) e IL-8 (p<0,0001), em educadores saudáveis após a intervenção com o programa
MBHP-Educa. Em relação à memória episódica, observamos uma melhora em todas as
dimensões do RAVLT: Memória Imediata (p<000,1), Capacidade de Aprendizado (p<0.0001),
Interferência Proativa (p<000,1), na evocação imediata (p <0,0001), evocação tardia (p <0,0001),
e reconhecimento tardio (p <0,0001)., com uma redução na Interferência proativa (p<000,1). Para
as variáveis analisadas, neste estudo, não encontrados diferenças significativas para os atributos
do grafo analisados (p > 0,05). A análise de mediação das variáveis do estresse percebido, da
resiliência, da memória episódica e IL-6 são mediadoras das mudanças observadas no bemestar psicológico. Tomados em conjunto, esses dados confirmam uma modificação expressiva
naqueles submetidos à intervenção, modificação essa que encoraja novas pesquisas
Mindfulness has received several clinical indications, and has been implicated in several treatments. For a better understanding of the nature and consequences of such an intervention, it is important that one has quantity and quality in informations about its pscyhological and biological impacts in order to make mindfulness a construct which can be both robust and valid for application in health. In the present study we strived to explore the psychological basis at work during the Mindfulness-Based Health Promotion Program for Educators (MBHP-Educa) in 65 teachers of the Public Education Plant (34 receiving na MBI, 31 receivng a control-program, Neuro-Educa), an intervention lasting 16 hours (2 hours/week). For such, we used the psychometric scales IRI (Interpersonal Multidimensional Reactivity Scale), PANAS (Positive and Negative Affects Scale), PSS (Perceived Stress Scale), CD-Risc (Connor-Davidson Resilience Scale), and PWBS (Psychological Well-being Scale). Besides, we measured episodic memory through the application of the cognitive RALVT (Rey Auditive-verbal Test). We also investigated the changes in serum pro and anti-inflamatory cytokines in research subjects through flow cytometry technic. Additionaly, we investigated the relation between the psychometric scales used in the study and computational graph analysis, which was extracted from the spontaneous description of participants. All measures were collected in the pre and post-intervention and we used an active control group, named Neuroscience for Education (Neuro-Educa), based on psyhchoeducational in the realm of neuroscience, also lasting 16 hours. According to the GEE (General Estimate Equation), the MBHP-Educa significantly reduced the scores of perceived stress (p<000,1) and negative affects (p<0,0001), and increased the scores of resilience (p<0,0001). The MBHP-Educa also reduced the scores of interpersonal reactivity: Empathic Concern (p<000,1), Perspective Taking (p<000,1), and a reduction in Personal Distress (p<000,1). MBHP-Educa also reduced the scoring of Psychological Well-being, in dimensions Self-acceptance (p<000,1), Purporse in Life (p<0,0001), and Autonomy (p<0,0001). Still, we noticed a reduction in the levels of IL-6 (p<000,1) and IL-8 (p<0,0001), in healthy educators after the intervention. As to episodic memory, we observed an improvement in all dimensions of RAVLT: Immediate memory (p<0,0001), Learning capacity (p<0,0001), Proactive Interference (p<0,0001), Immediate recall (p<0,0001), Tardive recall (p<0,0001), and Tardive recognition (p<0,0001), with a reduction in Proactive interference (p<0,0001). For the variables analysed in this study, we did not encounter significant changes for the Graph atributes (p<0,05). Mediation analysis of the variables for perceived stress, resilience, episodic memory and IL-6 showed a mediatino effect on the changes observed in Psychological Well-being. Taken all together, these data confirm an expressive change promoted by MBHPEduca on healthy teachers, corroborating similar findings, and encouraging further research.
Mindfulness has received several clinical indications, and has been implicated in several treatments. For a better understanding of the nature and consequences of such an intervention, it is important that one has quantity and quality in informations about its pscyhological and biological impacts in order to make mindfulness a construct which can be both robust and valid for application in health. In the present study we strived to explore the psychological basis at work during the Mindfulness-Based Health Promotion Program for Educators (MBHP-Educa) in 65 teachers of the Public Education Plant (34 receiving na MBI, 31 receivng a control-program, Neuro-Educa), an intervention lasting 16 hours (2 hours/week). For such, we used the psychometric scales IRI (Interpersonal Multidimensional Reactivity Scale), PANAS (Positive and Negative Affects Scale), PSS (Perceived Stress Scale), CD-Risc (Connor-Davidson Resilience Scale), and PWBS (Psychological Well-being Scale). Besides, we measured episodic memory through the application of the cognitive RALVT (Rey Auditive-verbal Test). We also investigated the changes in serum pro and anti-inflamatory cytokines in research subjects through flow cytometry technic. Additionaly, we investigated the relation between the psychometric scales used in the study and computational graph analysis, which was extracted from the spontaneous description of participants. All measures were collected in the pre and post-intervention and we used an active control group, named Neuroscience for Education (Neuro-Educa), based on psyhchoeducational in the realm of neuroscience, also lasting 16 hours. According to the GEE (General Estimate Equation), the MBHP-Educa significantly reduced the scores of perceived stress (p<000,1) and negative affects (p<0,0001), and increased the scores of resilience (p<0,0001). The MBHP-Educa also reduced the scores of interpersonal reactivity: Empathic Concern (p<000,1), Perspective Taking (p<000,1), and a reduction in Personal Distress (p<000,1). MBHP-Educa also reduced the scoring of Psychological Well-being, in dimensions Self-acceptance (p<000,1), Purporse in Life (p<0,0001), and Autonomy (p<0,0001). Still, we noticed a reduction in the levels of IL-6 (p<000,1) and IL-8 (p<0,0001), in healthy educators after the intervention. As to episodic memory, we observed an improvement in all dimensions of RAVLT: Immediate memory (p<0,0001), Learning capacity (p<0,0001), Proactive Interference (p<0,0001), Immediate recall (p<0,0001), Tardive recall (p<0,0001), and Tardive recognition (p<0,0001), with a reduction in Proactive interference (p<0,0001). For the variables analysed in this study, we did not encounter significant changes for the Graph atributes (p<0,05). Mediation analysis of the variables for perceived stress, resilience, episodic memory and IL-6 showed a mediatino effect on the changes observed in Psychological Well-being. Taken all together, these data confirm an expressive change promoted by MBHPEduca on healthy teachers, corroborating similar findings, and encouraging further research.