Problemas de comportamento em adolescentes portadores de cardiopatias: estudo exploratório em ambulatório de cardiologia pediátrica segundo os questionários Youth Self Report e Child Behavior Checklist
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2013-10-28
Authors
Da Silva, Maria Marta
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Carvalho, Antônio Carlos de Camargo
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Tese de doutorado
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Abstract
Objetivo: Analisar os problemas de comportamento em adolescentes com cardiopatia
congênita e/ou adquirida e, analisá-los em comparação com adolescentes do grupo
controle. A percepção dos pais dos adolescentes cardiopatas também foi avaliada.
Métodos: Foi realizado um estudo de corte transversal em 130 adolescentes com
cardiopatia congênita e adquirida, e 246 controles sem cardiopatia, com idade entre 11 e
18 anos. Foram aplicados à segunda parte do Youth Self Report e uma entrevista
semiestruturada nos adolescentes cardiopatas e nos controles e o Child Behavior
Checklist nos cuidadores primários dos cardiopatas.
Resultados: Os meninos do Grupo-Estudo se perceberam tendo menos problemas de
comportamento quando comparados aos meninos do Grupo-Controle, exceto na
subescala Problema Social (p=0,030). Os meninos do Grupo-Controle apresentaram
resultados significantes nas escalas de Internalização (p=0,006), Externalização
(p=0,005) e na escala de Total de Problemas (p=0,001). No Grupo-Estudo, as meninas
apresentaram mais problemas na subescala Problema Social (p=0,031) em relação às do
Grupo-Controle. Ao comparar-se os cardiopatas por gênero, as adolescentes
apresentaram resultados significantes na escala de Externalização (p=0,030) e na
subescala de Problemas de Atenção (p=0,010). Ao analisar-se os cardiopatas por faixa
etária, as meninas na adolescência Média e Final e os meninos na adolescência Inicial
apresentaram mais problemas. Quanto à comparação dos grupos diagnósticos, nenhuma
diferença significante foi encontrada entre cardiopatia congênita e adquirida e nem entre
cardiopatia congênita acianótica e cianótica. Os cardiopatas operados não diferiram dos
não-operados. Os cardiopatas com defasagem escolar, ou seja, aqueles com atraso
escolar apresentaram resultados significantes nas subescalas Queixas Somáticas
(p=0,020) e Ansiedade/Depressão (p=0,040). Os cardiopatas apresentaram escores
significantemente menores quando comparados aos seus cuidadores primários nas
escalas de Internalização (p=0,001), Total de Problemas (p=0,002), nas subescalas de
Retraimento (p=0,001), Queixas Somáticas (p=0,001) e na subescala de Problemas de
Pensamento (p=0,013).
Conclusões: Os cardiopatas do sexo masculino se perceberam tendo menos problemas
de comportamento quando comparados aos seus pares do Grupo-Controle exceto na
subescala Problema Social. Diferentemente dos adolescentes cardiopatas, não houve
diferença significante entre as adolescentes cardiopatas e os seus pares do Grupo-
Controle, exceto na subescala de Problema Social. No Grupo-Estudo, as meninas
apresentaram mais problemas quando comparados aos meninos. Em relação à faixa
etária e à defasagem escolar, as meninas na Adolescência Final, os meninos na
Adolescência Inicial e os cardiopatas defasados foram os mais problemáticos. Os
grupos diagnósticos não diferiram entre si. Os cardiopatas operados não diferiram dos
não-operados. Os cardiopatas se perceberam tendo menos problemas quando
comparados à percepção dos seus cuidadores.
Aims: To assess behavioral problems in adolescents with congenital and acquired heart disease in comparison with healthy controls. The perception of behavioral problems by the patients’ parents was also assessed and compared. Methods: A cross-sectional study was carried out in 130 adolescents with congenital and acquired heart disease, and 246 healthy controls, age between 11 and 18 years. The second part of the Youth Self Report and a semi-structured interview were applied to the patients and controls, and the Child Behavior Checklist to one of the patients’ parents or primary caregiver. Results: Male adolescents with heart disease showed significantly fewer behavioral problems compared to male controls except on Social Problems subscale. There were no significant differences between female patients and controls except, just as for males with heart disease, for the Social Problems subscale where females scored higher. Healthy male adolescents scored significantly higher in the Internalizing, Externalizing, and in the Total Problems scales. Among the patients, girls scored higher than males on the Externalizing scale and Attention subscale. Girls in middle and late adolescence and boys in early adolescence displayed more behavioral problems. When different diagnostic groups were compared, no significant difference was found between congenital and acquired heart disease, neither between acyanotic and cyanotic heart disease. Operated patients did not differ from the non-operated ones. Adolescents with heart disease that were behind on schooling scored significantly higher on Somatic Complaints and Anxiety/Depression subscales. Patients scored significantly lower than did their parents on the Internalizing and Total Problems scales, and in the Withdrawn, Somatic Complaints and Thought Problems. Conclusions: Male adolescents with heart disease reported fewer behavioral problems when compared to healthy controls except on Social Problems subscale. Female adolescents with heart disease similar to male adolescents with heart disease also displayed significantly more behavioral problems on the Social Problem subscale when compared to controls. Male controls displayed significantly more problems on the Internalizing, Externalizing, and Total Problems scales. Analyzing the patients’ behavioral profile, female patients in middle and late adolescence, male patients in early adolescence, and patients that were behind on their schooling were the most problematic ones. No difference was observed between diagnostic groups neither between operated patients compared to the non-operated ones. Patients displayed fewer behavioral problems compared to their parents’ perception of behavioral problems.
Aims: To assess behavioral problems in adolescents with congenital and acquired heart disease in comparison with healthy controls. The perception of behavioral problems by the patients’ parents was also assessed and compared. Methods: A cross-sectional study was carried out in 130 adolescents with congenital and acquired heart disease, and 246 healthy controls, age between 11 and 18 years. The second part of the Youth Self Report and a semi-structured interview were applied to the patients and controls, and the Child Behavior Checklist to one of the patients’ parents or primary caregiver. Results: Male adolescents with heart disease showed significantly fewer behavioral problems compared to male controls except on Social Problems subscale. There were no significant differences between female patients and controls except, just as for males with heart disease, for the Social Problems subscale where females scored higher. Healthy male adolescents scored significantly higher in the Internalizing, Externalizing, and in the Total Problems scales. Among the patients, girls scored higher than males on the Externalizing scale and Attention subscale. Girls in middle and late adolescence and boys in early adolescence displayed more behavioral problems. When different diagnostic groups were compared, no significant difference was found between congenital and acquired heart disease, neither between acyanotic and cyanotic heart disease. Operated patients did not differ from the non-operated ones. Adolescents with heart disease that were behind on schooling scored significantly higher on Somatic Complaints and Anxiety/Depression subscales. Patients scored significantly lower than did their parents on the Internalizing and Total Problems scales, and in the Withdrawn, Somatic Complaints and Thought Problems. Conclusions: Male adolescents with heart disease reported fewer behavioral problems when compared to healthy controls except on Social Problems subscale. Female adolescents with heart disease similar to male adolescents with heart disease also displayed significantly more behavioral problems on the Social Problem subscale when compared to controls. Male controls displayed significantly more problems on the Internalizing, Externalizing, and Total Problems scales. Analyzing the patients’ behavioral profile, female patients in middle and late adolescence, male patients in early adolescence, and patients that were behind on their schooling were the most problematic ones. No difference was observed between diagnostic groups neither between operated patients compared to the non-operated ones. Patients displayed fewer behavioral problems compared to their parents’ perception of behavioral problems.
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Silva, Maria Marta da. Problemas de comportamento em adolescentes portadores de cardiopatias: estudo exploratório em ambulatório de cardiologia pediátrica segundo os questionários Youth Self Report e Child Behavior Checklist. São Paulo, UNIFESP, 2013. xv, 123f.