Programa de Pós-Graduação em Teoria e Pesquisa do Comportamento - PPGTPC/NTPC

URI Permanente desta comunidadehttps://repositorio.ufpa.br/handle/2011/2332

O Programa de Pós-Graduação em Teoria e Pesquisa do Comportamento (PPGTPC), que integra o Núcleo de Teoria e Pesquisa do Comportamento(NTPC) da Universidade Federal do Pará (UFPA), iniciou suas atividades em 1987 com o curso de Mestrado Acadêmico em Psicologia: Teoria e Pesquisa do Comportamento. O curso de Doutorado passou a ser oferecido a partir do ano 2000.

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Acesso aberto (Open Access)
Adesão ao tratamento anti-retroviral por cuidadores de crianças e adolescentes soropositivos de uma Unidade de Saúde do Estado do Pará
(Universidade Federal do Pará, 2007-02) BRANCO, Caroline Mota; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
The adhesion to treatment has been receiving a lot of attention in Health´s Psychology these years. Studies in this area reveal that the patients who don't take part in the treatment cannot receive benefits of therapeutical intervention. The literature about adhesion in the anti-retroviral´s treatment reveals that is the caretaker who usually has the responsibility for managing soropositive children and teenager´s treatment. This study aims to describe the standard adhesion of caretakers treatment who live in the State of Pará, identifying the variables that interfere in their participation. It still reveals the types of cope strategies used to deal with the adverse conditions of soropositivity. For that, it was carried out a descriptive study, of transverse cut, with 30 caretakers, enrolled in the “Unidade de Referência Materno-infantil e Adolescente do Estado do Pará” (UREMIA), using, as instruments of data collection, an interview with caretakers - which investigated socialdemografic, clinical and psicosocial children and teenager's aspects - and the “Escala Modos of Enfrentamento de Problemas” (EMEP). Concerning to caretakers participation, it was observed that some conditions facilitated the treatment´s adhesion. Those conditions were related to varied of family organization (such as the number of people that lived in a house), to the history of treatment interruption and the self-report of caretakers about the fulfilment standard which should be emitted about the success (or failure) of the adhesion. The influence of those varied demonstrated the influence of behavior control made by rules, because the caretakers emitted the fulfillment standard classified as "adhesion" in order to avoid being in contact with the aversive consequences of the non-continuation of the treatment. Concerning to the cope strategies, it was showed a major grade for Factor 3, emphasizing the use of strategies focused on religious practices and/or imaginative thoughts. This research verified that the caretakers of the sample avoided thinking about the soropositivity problem as it is really constituted, using religious thoughts or "magic" to continue working with the daily routine of the subject coping, which involved the condition of children and teenager’s soropositivity. Based on all this data, this research suggests that more studies should be carried out in order to investigate themes related to the function of social contigences about the behavior of children and teenager’s caretakers from Pará, and also investigate aspects concerned to the diagnosis revealing.
Acesso aberto (Open Access)
Adesão ao tratamento da malária: um estudo em comunidades do entorno da Usina Hidrelétrica de Tucuruí - Pará
(Universidade Federal do Pará, 2008) ROCHA, Maria de Nazaré Almeida; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Malaria, infectious disease, caused by the protozoan Plasmodium, transmitted to humans by the bite of female mosquito of the genus Anopheles. Currently puts at risk 40% of the world population. In Brazil occurs mainly in the Amazon region where they are concentrated 99.7% of cases. In communities located around the lake of Tucuruí the occurrence of malaria is high and the residents do not have efficient services that provide appropriate prophylaxis and therapy. This research has the purpose of examining the occurrence of conduct of accession to drug treatment and prevention of malaria in people living in the surrounding communities of the Tucuruí hydroelectric power, state of Para, through comparison of three conditions for intervention: Timing ( n = 10), Monitoring (n = 9) and Monitoring with information (n = 10). To quantitatively assess the effects of intervention in the conduct adopted three conditions were compared by non-parametric statistical methods: the Chi-square test and Binomial test. It was previously set the significance level alpha = 0.05 to reject the null hypothesis. The adherence to treatment and the conditions Routine Monitoring was marginal, however, in the condition Monitoring with information was found that after the intervention 80% of the participants joined significantly (p <0.05) to treatment, demonstrating, effectiveness of intervention. As to the knowledge of malaria, in the condition Monitoring with information when compared with other conditions, after intervention, was obtained p-value = 0.0466 (significant) indicating that the intervention promoted increase in the level of knowledge of participants on malaria. The analysis of change in the behavioral repertoire was held in thirteen items. Results have been achieved more success in then condition Monitoring with information on nine items was observed significant change of attitude of the participants, highlighting the fact that these nine items the p-value <0.05 was certificate as evidence of statistical significance of this conclusion. The comparison between the conditions Monitoring and Monitoring with information presented significant difference in eight items. There was a statistically significant difference (p <0.05) in the following items: Use mosquito net, notify the officer of health, keep the trees pruned or cut, not bathing in the river in times of danger, Wear clothes suitable for enter the forest, Use appropriate clothing for fishing, not staying at night and Use repellents as andiroba or similar. In summary, the intervention was successful to contribute to effective treatment of malaria and increase the level of knowledge about the disease.
Acesso aberto (Open Access)
Adesão ao tratamento em adolescentes com diabetes tipo 1: dois estudos de caso
(Universidade Federal do Pará, 2011-04-01) SILVA, Ingrid Ferreira Soares da; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Diabetes mellitus type 1 (DM1) is a chronic degenerative disease of major impact on the quality of life of children and adolescents. The DM1 affects predominantly children and young adults under 30 years of age with peak incidence from 10 to 14 years of age. As a chronic disease it involves changes in daily habits, and rule following becomes a key behavior to achieve such changes. This study aimed to examine factors that influenced the behavior of following the rules prescribed for the treatment of adolescents diagnosed with DM1. These rules relate specifically to the measurement of the blood glucose, the usage of the diet plan in choosing the menu and the application of insulin. The study included two adolescents aged 14 and 17 years, diagnosed with DM1, which had difficulties in controlling the disease according to medical evaluation. Also included as participants of this study were those responsible for each adolescent. The following survey instruments were used: 1) Set of interviews with the parents; 2) Inventory of parenting styles; 3) Questionnaire to evaluate the quality of life of adolescents with DM1; 4) Set of interviews with the adolescents; 5) Diabetes social support questionnaire – family version; and 6) Self monitoring forms for Treatment Compliance Behavior. The data collection was performed in the households of the adolescents. The procedure involved the following steps: 1) Selection of participants; 2) Individual interviews with the parents/guardians; 3) Individual interviews with the adolescents, including applications for inventory on their support network, characterization of the baseline behavior of measuring blood glucose, tracking diet plan, and insulin administration, interviews with positive feedback, and final interview. The results from the analysis of compliance behaviors and from the environmental factors reported by each participant throughout the research identified that the participant which emitted compliance behaviors appropriately had a good quality of life, a good level of knowledge about DM1, his parents owned a positive parenting style, perceived support provided by family, besides having a social condition satisfactory to meet the needs of the family. But the participant with a low compliance, although demonstrating a good quality of life, his parents were using a lot of negative practices, despite their parenting style being also positive, the family support perceived by the participant was inconsistent and his social status was insufficient to provide all the tools necessary for his treatment compliance. Thus, it was possible to analyze the factors that influence compliance to treatment, however further research should be conducted using a larger number of participants and also have a longitudinal character, with long-term monitoring to verify the effect of the variables described in the research along the lives of the participants.
Acesso aberto (Open Access)
Adesão ao tratamento por cuidadores de crianças com hipotireoidismo congênito
(Universidade Federal do Pará, 2005-06-03) OLIVEIRA, Fabiana Pereira Sabino de; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Chronic diseases which require attention and continuous evaluations and have called for attention ofhealth professionals, specially those who devote themselves to the area ofPediatric Psychology, who devote themselves to the study of child development, as well as to the relationship between health and sickness and the interferences in the life quality of children and their relatives. This study aims accomplishing a descriptive study to identify variables making easier or more difficult, the adherence to the treatment of caregivers of children with Congenital Hypothyroidism, attended by the Center of Reference in Pará State. Fifty main caregivers ranging between 17 to 55 years of age. Forty mothers, four grandmothers, four fathers and two aunts took part in this study. Variables related to the adherence were identified by means of structured interviews. Program characteristics were analyzed through structured interviews carried out by the team professionals. The analyses of caregivers reports showed that some of the demands to the treatment adherence are not being supplied. Informations about the illness characteristics, etiology, diagnostics, treatment and prognostics are not part of the repertory of most caregivers, independently of age, school degree, degree of relationship with reiatives and time of participation in the Neonatal Selection Programo Significant differences were found regarding the adequate time for the exam accomplishment, which showed the delay of the treatment start. The difficulties described by the professionals as to the adherence to the treatment by the caregivers were attributed not only to the problems showed by the Program structure itselfbut also by the lack of interest to it. The study brings relevant implications to the implantation of more effective and efficacious prevention programs to attend the needs of caregivers and promote the adequate child development.
Acesso aberto (Open Access)
Análise da adesão ao tratamento em mulheres com lúpus eritematoso sistêmico
(Universidade Federal do Pará, 2009-08-14) NEDER, Patrícia Regina Bastos; CARNEIRO, José Ronaldo Matos; http://lattes.cnpq.br/0859417913316803; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Systemic lupus erythematosus (SLE) is a chronic autoimmune, multisystemic connective tissue inflammatory disease, capable of affecting several organs and systems throughout the body. It affects mostly women and presents periods of remission and exacerbation. Even though its etiology still unknown, several factors contribute to the development of the disease, among them hormonal, environmental, genetic and immunological factors. Some clinical manifestations have challenged the specialists, among them the association of SLE with depressive states. This study aimed to identify related variables with adhesion to treatment in women with SLE diagnosis. Correlations were made between socio demographic characteristics, levels of depression, quality of life, coping and adhesion behavior to treatment strategies. The following instruments were used: Itineraries of interview, The Beck Scale, International Quality of Life Assessment Project (SF-36), The Ways of Coping Scale, World Health Organization Quality of Life Assessment (WHOQOL-BREF). The participants formed a group of thirty patients attended at the rheumatology ward of a public hospital. They were distributed in two groups: Adhesion (n=17) and Non Adhesion (n=13). The adhesion group, regardless of age and time of diagnosis, presented lower levels of depression when compared with the non adhesion group. The results suggest that, on both groups, during the first five months of patients’ coexistence with SLE, the physical aspect, pain and the general state of health are found to be difficult factors to deal with. However, it is possible to assert that, in the same period, if the patient does not adhere to the medical prescriptions, the discomfort regarding the mentioned factors is intensified. The correlation between Vitality subscale and the social Aspects (measured by the SF-36) and the adhesion to treatment presented valid results, for the Adhesion group participants also reported that they felt protected as much by their social group as by the health team. The results suggest that depressive behavior can take place for the long period these patients have been living with the uncontrollability of the disease symptoms, and also for the sequelae caused by SLE, which affects them severely, implicating vital organs such as kidneys, heart, lungs, damaging their quality of life. The pros and cons, as well the limitations on the use of instruments for identification of relevant variables in the study of adhesion to the treatment in chronic diseases are also discussed. Longitudinal studies are suggested, with delineation of the subject as its own control to investigate the relation between depressive states, control of symptoms and adhesion to treatment.
Acesso aberto (Open Access)
Análise do comportamento de crianças seus acompanhantes e auxiliares de enfermagem durante a punção venosa em sessão de quimioterapia ambulatorial
(Universidade Federal do Pará, 2007-03-29) LEMOS, Isabela Porpino; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Acesso aberto (Open Access)
Análise dos efeitos de um treino parental sobre comportamentos de crianças com TDAH: comparação entre setting terapêutico e ambiente domiciliar
(Universidade Federal do Pará, 2008-08) NEVES, Maria Elizabete Coelho das; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
This study aims to contribute with the evaluation of the effects of behavioral intervention addressed to parents/guardians of children with Attention Deficit Hyperactivity Disorder – ADHD, investigating the effects of this model on parental training under two conditions, therapeutic setting (Condition 1) and home environment (Condition 2), on the occurrence of hyperactivity behavior versus self-control. The participants were the parents of four children, between five and nine years of age. The following instruments were used: Free Informed Term of Consent - FITC, Parental Style Inventory – PSI, Child Behavior Checklist – Teachers Report Form CBCL/ TRF, teacher’s version of the ADHD rating scale, Initial Interview Guideline, Interview and Evaluation Guideline, Final Evaluation Guideline, Brazilian Economic Rating Criteria-BERC. The research process consisted in: (a) contacting a pediatric neurologist; (b) participants’ triage and invitation; (c) distribution of two participants for each condition of intervention; (d) initial evaluation, including interview with the guardians, application of FTIC, PSI and CBCL; (e) visit to school and application of FTIC, ADHD rating scale and teacher’s versions of TRF; (f) five intervention sessions, taped in audio and video, two baselines, one habituation to rules and two maintenance in behavior and installation of self-observation behavior, which involved situations of interaction in games with rules, with participation of therapist- researcher, the child’s mother, (g) an evaluation interview on the first phase; (h) reversion of context for the participants and (i) final evaluation, done through interviews with the guardians and a repetition of the previously used standard instruments with the parents and teachers, plus the BERC. The data obtained through such standardized instruments received treatment indicated in the manuals. Two systems of categories for behavior analysis were used, one to describe the mothers’ behavior and the other, the children’s behavior. The main results suggest that children in the consulting room environment had a greater occurrence of behavior emission of self-control than in the home environment, which, on the other hand, had prevalence of hyperactivity-impulsivity behavior. Likewise, mothers in the consulting room environment scored better than those in the home environment group. There was an increase in educative practices for most mothers. One discusses the consulting room context as an effective intervention environment, although it is recognized that the difficulties of control of inadequate behavior are greater for parents in the home environment, as a result, intervention in a natural environment must be considered during the therapeutic process. On the other hand, parental training has demonstrated to be effective in the acquisition, enhancement and maintenance of positive educative practices for all mothers, which may influence beneficially the behavior of children with ADHD.
Acesso aberto (Open Access)
Avaliação comportamental de crianças com Síndrome do Respirador Bucal
(Universidade Federal do Pará, 2012-05-03) CASTELO BRANCO, Marília Fontes de; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
The Mouth Breathing Syndrome (MBS) causes physical and behavioral characteristics that interfere on the child’s quality of life. The Attention Deficit Hyperactivity Disorder (ADHD) may be related to mouth breathing in the individual, as well as to the presence of Sleep Disordered Breathing (SDB). Moreover, studies indicate that adenotonsillectomy reduces the occurrence of behavior indicative of ADHD in patients with MBS, and produces significant improvement in SDB. Objectives: (a) characterize the sociodemographic condition and risk indicators of children diagnosed with MBS; (b) analyze behavioral patterns associated with ADHD and sleep habits of children diagnosed with MBS, observed before and after adenoidectomy, tonsillectomy or adenotonsillectomy. The participants were 44 children, of both genders, between two and 12 years of age, seen in the Otorhinolaryngology Department of a university hospital. The sample was also composed by these children’s caregivers and teachers. Data collection was accomplished through: (1) Application of the Child and Family Information Form and the Developmental and Medical History Form with caregivers, followed by the Child Behavior Checklist - Caregiver Version (CBCL) and the criteria for ADHD diagnosis from DSM-IV; (2) Application of the Teacher’s Report Form (TRF); (3) Application of the Sleep Habits Inventory for Preschool Children and Sleep Behavior Questionnaire, for schoolchildren; (4) Post-surgery Behavioral Evaluation, using the CBCL and the sleep inventories, two months after surgery; and (5) Follow-up interview. Mostly, the mouth breathers: a) were school children; b) were 7-9 years old; c) were female; d) their primary caregiver had completed High School; e) his/her family income was around one and two minimum wages; f) had an original family constitution; g) were at a moderate psychosocial risk. It was observed that most participants in this study went through a normal pregnancy, with no events that could cause harm, and their delivery was also performed appropriately, however, part of the mouth breathers in this sample was cyanotic during or immediately after delivery and presented respiratory problems during the first months. Regarding the baby's temper in the first year of life, most of them were hyperactive and had difficulty falling asleep and being kept busy. The majority of the mouth breathers’ developmental milestones in this study happened in a period within the typical patterns of child development. The most frequent health problems were: appetite problems; and sleep problems. A decrease in frequency of ADHD-related behaviors was observed after surgery in both preschoolers and school children, according to data from CBCL (p = 0.723). And most items in the Sleep Habits Inventory for Preschool Children had a reduction in the frequency of inappropriate habits and an increase in the frequency of appropriate behaviors. In the Sleep Behavior Questionnaire, applied to school children, it was seen that few had sleep problems in the post-surgery evaluation and most sleep problems were reduced in frequency. The greatest reductions occurred in moves a lot while sleeping and snores in his/her sleep (p = 1.000). The preventive multidisciplinary assessment of mouth breathing is suggested as well as the incorporation of a control group, composed by nasal breathers, in future studies.
Acesso aberto (Open Access)
Comportamento suicida: sociedade, assistência e relações comportamentais
(Universidade Federal do Pará, 2015-12-14) BRANDÃO, Whashington Luiz de Oliveira; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
This work was built by means of three studies, a theoretical and two empirical ones. The first study aimed at relating the human development indicators (HDI) in the Northern capitals of Brazil, in particular the city of Macapá-AP, with conditioning aspects for suicidal behavior (CS). For that purpose, we accessed national and international publications that described epidemiological aspects of CS and evaluation of HDI. The data indicate that there is a relation between HDI dimensions - income, longevity and education - with suicide rates. The second study aimed at describing the knowledge that 28 psychologists working in assistance to public mental health have on the suicide phenomenon in the city of Macapá-AP, as well as identifying their procedures in the care of the people involved, through application of a self-administered questionnaire. The results indicate that, considering a perspective on CS knowledge, the professionals reported minimal knowledge, but individually incipient compared to what is described in the literature and, in particular, in manuals and public policies that emphasize on prevention and management of cases. In the third study, we aimed at describing the report about the life cycle (childhood, adolescence and current context) besides the suicide attempt episode lived by seven people (five women and two men). It was observed in the report of the life cycle that there are both events involving situations of cohesion and family conflict; sexual abuse situations, difficulty in dealing with the consequences of sexual orientation. Suicide attempt can be analyzed as a self-control strategy with escape and avoidance function. The study of suicidal behavior is a complex and dense area, which can motivate researchers to pursue further efforts in order to provide a better assistance to those involved.
Acesso aberto (Open Access)
Contribuições da análise do comportamento na avaliação e no tratamento de crianças com transtorno do déficit de atenção e hiperatividade
(Universidade Federal do Pará, 2005-11-08) ROBERT, Edila Adriene Maia; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Attention Deficit/Hyperactivity Disorder (ADHD) is a phenomenon studied in many countries. It is characterized by symptoms like inattentiveness, hyperactivity, and impulsivity. It happens in infancy but can persist until adult age. This behavioral disorder causes prejudice in the academical, social, and occupational areas. It reduces self-esteem, can lead to delinquency, to the use of drugs and alcohol. It generates stressful familial relationship and it has a high social and financial impact on the family. Its diagnosis is made by using clinical criteria of DSM IV and its treatment combines pharmacotherapy and psychotherapy. Considering that ADHD is a behavioral disorder related to the development of self-control and also considering that previous studies suggest self-control can be acquired in training conditions, it becomes relevant to make applied research using behavior analytic principles to minimize prejudice and to contribute for a better quality of life of people affected by ADHD. The objective of this study was to verify the efficacy of the use of differential reinforcement of other behaviors (DRO) and of reinforcement delay on the installation and/or increase of self-control behaviors in 9-year-old boy with diagnostic of ADHD and on medication. The participant was submitted to the procedure of self-control training. He performed tasks during which, if his behavior was as previously programmed, he received tokens. At final of every session he traded tokens in for toys. He could choose accumulate more tokens to trade them in later for more valuable toys. The procedure was divided in 7 stages: (1) Interview with a neuropediatric; (2) Analysis of psychological report and convocation; (3) Initial interview with responsibles for child; (4) Visit to the school and interview with teachers; (5) Sessions of direct observation (baseline, habituation to instructions, installation, maintenance, fading and stability evaluation); (6) Follow-up; and (7) Last session. Eighteen sessions of direct observation have been proceeded. These sessions were recorded and their transcriptions were sorted according to categorical system of relevant behaviors to analysis. Results were analyzed through the comparison between interviews, results of standard instruments and classificatory categories extracted from directly observed behaviors. Self-control behaviors were increased and generalization these repertories to others contexts was observed, during sessions and at the childs house, according to description of parents and teacher, and direct observation record of therapist-researcher. It was observed that using DRO schedule with limited hold can help to increase self-control behavior and produce positive generalization of this behavior to new environments in a child with ADHD.
Acesso aberto (Open Access)
Efeito de instruções e de treino parental sobre comportamentos observados em cuidadores e em crianças com câncer durante sessão de punção venosa para quimioterapia ambulatorial
(Universidade Federal do Pará, 2012-04-12) DUARTE, Inaê Benchaya; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Recurrent invasive procedures in children’s cancer treatment have appeared to be the moment of greatest suffering for both the patient and the caregiver. During these procedures, as in venipuncture, a great deal of children present reactions characterized as behavioral distress. Behavioral interventions have been developed in order to reduce distress, being possible to have the children’s own caregivers as agents. This study aimed to analyze the effects of instruction and parental training on behaviors observed in caregivers and children diagnosed with cancer during venipuncture procedure in an outpatient clinic. Nine caregivers of children undergoing chemotherapy in a specialized hospital in Belém – PA were selected. For data collection the following questionnaires were used: An interview form, a Sociodemographic Questionnaire, the Parental Bonding Instrument (PBI), the Child Behavior Checklist (CBLC), the Child’s and Caregiver’s Behavior Direct Observation Protocol, the Behavioral Assessment Scale, a caregiver orientation manual for venipuncture in children and the Parental Training Protocol. Participants underwent one of three conditions: (1) Routine, (2) Orientation Manual, or (3) Parental Training. Data collection was performed through interviews and four behavior direct observation sessions. The children’s behaviors were classified as concurrent and non-concurrent. The caregivers’ behaviors were classified as positive monitoring, negative monitoring and negligence. The results suggest that, in the Routine Condition, caregivers did not vary their behavior during the sessions, with two participants maintaining a high frequency of negligent behaviors and one participant maintaining a positive monitoring. In the Manual Condition, a change in two caregivers’ behavior was observed as an immediate effect of the manual usage, but not in the long term. In the third Condition, in which the caregivers were submitted to the Parental Training Protocol, an increase in the frequency of positive monitoring was observed in the short and long term. Regarding the children, the results indicated a higher frequency of non-concurrent behaviors, regardless of the condition to which the caregiver was submitted. Most caregivers were classified in the PBI with a permissive parenting style, confirming the literature on caregivers of children with chronic diseases. There have been reports of trained skills generalization to settings outside the hospital. It is concluded that the manual use increased venipuncture knowledge acquisition but not enough for the change and maintenance of behaviors (in long term). On the other side, parental training was effective in changing behavior as well as developing new social skills. The importance of parenting style as a protective factor for children with cancer is discussed.
Acesso aberto (Open Access)
Efeito de três procedimentos de intervenção sobre adesão ao tratamento em adultos com diabetes
(Universidade Federal do Pará, 2011-05-19) CASSEB, Mariene da Silva; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723; https://orcid.org/0000-0001-9778-9295
Due to the high prevalence of diabetes, studies have been conducted in an attempt to produce consistent knowledge to minimize this problem and investigate the variables that affect the purchasing adherence behavior. However, it is not clear which educational strategies are more effective, or if the effectiveness is related to a set of these strategies. Aim of this study, we sought to analyze the effect of three interventional procedures based on behavioral technologies to promote the nutrition and physical activity rule-following for adults diagnosed with type 2 diabetes. These procedures relate to: (1) providing information about diabetes, (2) information combined with the provision of feedback for behaviors related to diabetes treatment, and (3) provision of information combined with the self-monitoring training of behaviors related to treatment diabetes. Diet and regular physical activity were the aspects investigated in this study. Participants 12 adults diagnosed with Type 2 diabetes, selected in Hiperdia Program of the two health services in Belém-Pará city. Participants were divided into three conditions: Information Condition, Information and Feedback Condition, Information and Self-Monitoring Condition. Data were collected in the home environment of the participants through interview scripts, test of knowledge about diabetes treatment, feedback protocol, manual of guidelines and protocols on diabetes of nutrition and physical activity self-monitoring. The results show that during the study was improvement in the level of knowledge about diabetes care after using the guidebook, but not enough to ensure adherence on the Information Condition, and Information and Feedback Condition. However, participants in the three conditions showed positive changes in ways that were not the focus of study, such as use of medication and foot care. The provision of information combined with self-monitoring training exerted a greater effect on increasing the quality of reporting of behaviors and the construction and expansion of compliance behaviors class of behavior reported as the lowest adherence was the performance of physical activity, compared eating behavior.
Acesso aberto (Open Access)
Efeitos da automonitoração sobre o comportamento de adesão a dois tipos de regras nutricionais em adultos com diabetes tipo 2
(Universidade Federal do Pará, 2010-12) GOMES, Daniela Lopes; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Diabetes mellitus is a chronic disease of multiple etiology, whose treatment includes changes in lifestyle, which adopting healthy eating habits is very important to control the disease. However, adherence to diet is one of the most challenging aspects for the treatment of this pathology. This study aimed to compare the efficacy of self-monitoring procedures on the behavior of the two types of membership rules Nutrition (Food Plan - BP and Total Carbohydrate Counting - CTC) in adults with Type 2 diabetes. Participated in four adults enrolled in the program HiperDia of a City Health Unit, in Bethlehem, presenting difficulties of adherence to the diet. Data collection took place at the Pathology Laboratory of Nutrition and the participants at their homes. The procedure consisted of: (1) Membership of the sample and interview for confirmation of inclusion criteria, (2) Characterization of baseline (BL) in eating behavior, (3) Intervention: Self-Monitoring Training (AM) with PA to two participants in Condition A (CTA) and CTC for two participants in Condition B (CTb), (4) Reversal of the conditions of training, (5) Follow-up and (6) Final interview. The AM Training includes verifying the correspondence between the record of eating behavior and nutritional rules and the analysis of costs and benefits of emission behaviors of following established rules, functional analysis of the issue or behavior does not follow the rules and planning the actions of membership. The participant was asked to record all meals at intervals of every two days at each home visit by the researcher. We calculated the index of Accession to the Diet (IAD) per day of registration. Results showed that, at baseline the IADs of all participants were below 50%. However, after training in the AM, the mean IADs obtained by participants when subjected to AP was equal to 62.49%, while the CTC was obtained in 75.50%. The absolute values of IADs found in the CTA participants were higher than those of participants from the IADs CTb. All participants, regardless of condition, showed an increase in IADs when compared with the LB, with a decline after discontinuation of AM. At the end of the MA, PA and two participants chose to follow two CTC treatment, however, showed that all retained the wake of BP at follow-up. Inferred that the CTC seems to be more effective in installing appropriate eating behaviors and the AP seems to get good results in terms of behavior installed. All participants were overweight at LB, two participants reduced the weight after the intervention, but all maintained the nutritional diagnosis of LB. As for glycated hemoglobin, all participants had levels above 6% during the LB and after the intervention, three participants reduced their value. It discusses the importance of nutritionists assist the patient to be under the control of the observed changes in its repertoire through the analysis of contingencies, prescribing an individualized treatment beyond the focus on disease.
Acesso aberto (Open Access)
Efeitos de instrução com justificativas sobre seguimento de regras nutricionais em adultos com sobrepeso
(Universidade Federal do Pará, 2014-10-20) BARRADAS, Tania Socorro de Moraes; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
In recent decades, Brazil has undergone several political, economic, social and cultural changes that showed changes in quality of life, especially regarding health. The main diseases affecting the Brazilians no longer became acute and chronic non-transmitted diseases. The modification of nutritional habits accompanied that change, greatly influencing the Brazilians’ diet. The dissemination of propaganda by the Brazilian media and modern labor activities stimulates the consumption of foods high in fats, sugars and carbohydrates, contributing to the increase in the percentage of overweight and obese individuals in the world. According to the Ministry of Health the overweight’s Brazilian population percentage increased from 42.7% to 48.1% in five years. It is considered that Body Mass Index (BMI) between 25.0 and 29.9 means overweight. Studies in Applied Behavior Analysis to the Health emphasizes techniques, especially focused on increasing the rate of adherence to treatment. On the Nutritional area, these techniques help to identify the environmental variables under which feeding behavior is under control. The emphasis on self-observation and self-description provide the analysis and research of control variables by the individual himself. Thus, the present study aimed to evaluate the effectiveness of the presentation of justifications, in the form of a printed manual, on report of adherence to nutritional instructions in overweight adults, as well as observing the maintenance of this report through follow-up. Participated in this sample, nine individuals enrolled in the Multiprofessional Project of Patients with Nutritional Disorders, attended in the Hospital Universitário Bettina Ferro de Souza (HUBFS) of the Universidade Federal do Pará (UFPA). These participants were divided into three study conditions: Condition 1 (weekly monitoring with application of a manual containing justifications for the following nutritional rules), Condition 2 (weekly application with accompaniments 24-hours recall), Condition 3 (inquiry the medical records of patients with unique monitoring by the HUBFS’ nutrition service. Have been associated anthropometric data, body fat percentage and body folds to the Index of Reporting of Adherence (IRA). Results showed that there was no difference in the indexes of Adherence Reports obtained by participants of Condition 1 and condition 2. However, we observed an increase in the IRA after intervention (compared with values observed in baseline) and reduction in monitoring, regardless of the condition to which the participant was exposed. Thus, the rates of reported adherence did not depend specifically on how the allegations were presented, which were in written form and orally.
Acesso aberto (Open Access)
Efeitos de instrução e de automonitorização sobre seguimento de regras para aplicação de insulina em crianças com diabetes Tipo 1
(Universidade Federal do Pará, 2014-08-22) MOREIRA, Alana dos Anjos; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Diabetes mellitus type 1 (DM1) is a metabolic disease characterized by loss of the ability of the pancreas to produce insulin, which causes an increase in blood glucose (blood sugar), leading to acute and chronic complications. This research was conducted in two stages: in Stage 1, the objective was to characterize children with DM1 treated at an university federal hospital (UH) for the treatment of diabetes; and, in Stage 2, the objective was to analyze the effects of instruction and self-monitoring, according to their order of presentation, among the behavior of rule-following for the use of insulin in children with DM1, relating to family support reported by these children. Eleven children with DM1 participated in this study (n = 11) in Stage 1 and two (n = 2) in Stage 2 with their caregivers at this stage, all aged between 9 and 12 years. In Stage 1, the data collection was held in the waiting room of the Endocrinology clinic of the UH, and in Stage 2, it was held at the residence of the child. The instruments used for data collection were: Game of Treatment Adherence (GTA); Interview Guide on Insulin; Inventory of family support for treatment; Protocol for analysis of medical records; 24h recall; Manual with instructions on applying insulin; Game of application of insulin; and forms of selfmonitoring. The results obtained in Stage 1 showed that the sample size was too small and that the majority were female. However, in Stage 2, only two male participants agreed to continue the study. The GTA showed that the most participants learned the correct way to order the images of the game, indicating that these participants had access to the rules for the use of insulin at breakfast. It was also observed that children did not have a good glycemic control, according to data from medical records, since the majority presented results of the examination of glycated hemoglobin above 8%, regardless of the time of diagnosis. The most participants stated that Stage 1 was only using the pen to apply insulin. It was found that the majority (n = 8) of participants reported Stage 1 autonomy regarding the behavior of glycemia and insulin apply. In Stage 2, it was observed that, in both cases, the measurement of blood glucose was monitored by caregivers more than the actual application of insulin. Another result found was that the majority of children (n = 8) learned to measure blood glucose and to apply insulin with a family member - especially the mother. It was noted that family support did not appear to be a variable directly related to to the knowledge about insulin and its form of application by the patient. According to the results of Inventory of family support for treatment, the participants reported that perceived family suport treatment, especially emotional, followed by social support for diet and for taking blood glucose tests. In Stage 2, regarding the use of insulin, it was observed that the values of pre-prandial glycemia were not used by both participants as tips to select the rapid insulin unit to be used before meals. These results suggest that both the Manual with instructions on applying insulin as the forms of self-monitoring, as well as 24h recalls, produced no changes in the behavior of participants on this aspect. In this study, it was observed that the time of diagnosis of the participants of the Stage 2 showed a direct relation with the understanding of treatment rules. Therefore, it is expected that this research has contributed to the literature on treatment adherence in children with DM1 and the rule-following of the application of insulin, suggesting the use of instructions as justifications, followed by forms of self-monitoring as a behavioral technique in promoting behavioral treatment adherence in this population.
Acesso aberto (Open Access)
Efeitos de instruções, treino de relato verbal e treino de automonitoração sobre o seguimento de regras nutricionais em crianças com obesidade ou sobrepeso
(Universidade Federal do Pará, 2012-04-19) MARTINS, Lana Cristina Cardoso de Oliveira; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Obesity is a chronic illness defined as the accumulation of abnormal or excessive fat that can cause harm to people’s health. It has become necessary to fight it and intervene in favour of its prevention, especially among children. The literature in this field indicates that, in general, interventions only with children or caregivers, or both, show favorable results. This study assessed the effects of instructions, verbal report training (VRT) and self-monitoring training (ST), applied with and without the participation of the primary caregiver, on following nutritional rules in obese or overweight children. The participants were two children (9 and 11 years old) and their primary caregivers. The setting was an outpatient clinic in the Psychology department of a university hospital. The patients’ medical records, an initial interview form, the Parenting Style Inventory (PSI), a second interview form, dietary recall, an informative manual on obesity and healthy eating habits, a knowledge test, a nutritional counseling protocol for children, a self-monitoring protocol, a guide for analysis of the self-monitoring protocol, toys and games and a final interview form were used. The collection procedure occurred in 10 sessions distributed in approximately 15 weeks and consisted of medical records analysis; interview at the outpatient clinic with the caregiver and the child for signing the Free and Informed Consent Form, application of the initial interview form and the PSI; participants’ inclusion in one of two conditions (Condition 1, only the child present [P1]; Condition 2, both the child [P2] and his/her primary caregiver [C2] were present); application of the second interview form followed by the dietary recall use (Baseline 1 [BL1]); application of the informative manual on obesity and healthy eating habits and the knowledge test; VRT (Baseline 2 [BL2]); ST; follow-up interview and final interview. As for the effects of instructions, the results indicate that P1 maintained the same classification on all items, while P2 improved his/her performance in the items knowledge and nutritional orientation follow and C2 showed improvement in the knowledge about obesity at the end of the study. Adherence to diet scores obtained by P2 were higher than those obtained by P1 in all phases of the study. Comparing the mean obtained by both participants in BL1 and BL2, an increase of 39.77 % was observed indicating clinically significant change after intervention. The combination of variables in this study was favorable on the participants’ repertoire extension in relation to eating behavior, having the subject himself as reference throughout the study. The results suggest that there is higher effectiveness when children and caregivers are the target of intervention.
Acesso aberto (Open Access)
Efeitos do treino de automonitoração e do treino de relato verbal no estabelecimento e na manutenção de comportamentos de seguir regras nutricionais em adultos com obesidade
(Universidade Federal do Pará, 2010-05-10) NOBRE, Suellen Martins; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Obesity is an epidemic, chronic, multifactorial and high risk disease, which affectsthousands of people and provokes a lot of social, emotional and economic harms. Behavior Analysis tries to comprehend the obese person’s behaviors which cause both the acquisition and maintenance of such condition and the interactions of this individual with the environment. In spite behavioral strategies have been used, such as the self-monitoring register and the verbal report training, research on obesity treatment usually emphasizes non behavioral goals as criteria of success on treatment (e.g. weight loss). However, some authors defend the use of behavioral criteria which may result on benefits on quality of life, emphasizing the construction of healthy behaviors instead of eliminating maladjusted behaviors. Based on Goldiamond’s constructional model, the objective of this study was to verify the effects of self-monitoring and verbal report training on the establishment and maintenance, in the short term, of nutritional rule governed behaviors on obese adults. Two obese and adult women, patients on treatment in a private nutritional clinic, who had problems regarding to adherence to diet, participated of this research. Data were usually collected in participants own residences, on alternated days, on five stages: (1) Base Line Interviews in order to identify the initial nutritional behaviors; (2) Intervention, divided on the subsequent conditions: (I) Self-monitoring Training and (II) Verbal Report Training; (3) Short Term Maintenance; (4) Follow-up; and (5) Closing: Final Interview, in order to assess obtained data. On condition I, self-monitoring and meal planning registers were used, as for the condition II, verbal report was used for planning and access to the goal meal which had happened the day before. On all the intervention interviews, consistence analysis were conducted, confronting register/ goal meal report and the rules described on nutritional plan; following nutritional rules behaviors were also analyzed in terms of costs and benefits and the determinants variables for the emission of nutritional rule governed behaviors were identified. The training was applied to only one meal at each time, until one of the criteria of change for the goal meal was reached. In this case, the main criterion was the occurrence of 60% adherence on three consecutive interviews. On each interview the Diet Adherence Rating (DAR) was calculated for the goal meal. Results indicated that both participants reached the established criteria for all the meals but the afternoon snack. The efficacy of both procedures on installing self-monitoring feeding behavior was observed, however, the results concerning to self-control were few, suggesting that another behavioral strategies are needed, such as a self-control training, in order to maintain the results obtained on obesity treatment. The complexity of the treatment for obesity was also discussed as well as the need to considerer not only the disease focus, but the context in which obesity is inserted.
Acesso aberto (Open Access)
Efeitos do treino de cuidadores sobre comportamentos de apoio à adesão às orientações nutricionais por portadores de diabetes
(Universidade Federal do Pará, 2005-05-13) MALCHER, Michele da Silva; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Health studies have pointed out that social support is one of the factors related to the adherence to diabetes patients treatment. Based on behavior analysis reference and especially on Goldiamonds constructional approach this study aimed to evaluate the effects of training procedure on caregivers support behavior offered to adult patients feeding behavior. Further, it was intended to analyze effects of this training on the patients adherence to dietary prescription. Taking part on this study were three women enrolled in a program for diabetes patients and one family member of each patient, amounting to three caregiver-patient dyads, two of which were allocated on a Training Condition (TC) and one, on a Non-Training Condition (NTC). As information sources, one used the verbal reports of the patients and of the caregivers, direct observation of behavioral interaction and clinical indicators. Using the subject as its own control, the intervention consisted on the training in contingency analysis and behavioral handling, accomplished in home visits by means of self monitoring records. The results showed that caregivers who took part on the Training Condition presented enlargement on the support behavior repertoire, which was not verified regarding the caregiver who took part on the Non-Training Condition. The glycemic levels reduction and the reports presented by the Training Condition patients suggest that the intervention has contributed to improvements on the adherence to nutritional orientations by theses patients.
Acesso aberto (Open Access)
Elaboração de um manual de orientações para crianças e adolescentes com lúpus eritematoso sistêmico juvenil
(Universidade Federal do Pará, 2014-10-17) GUIMARÃES, Maria de Lourdes Leite; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
Systemic Lupus Erythematosus (JSLE) is a chronic inflammatory disease, autoimmune and multisystemic, diagnosed in children and adolescents, which treatment requires the following of complex rules, difficult to adhere. This study describes the process of elaboration and evaluation of a guidelines manual for patients with JSLE. It was attended by eleven healthcare professionals and three children with JSLE and their mothers in four manual evaluation steps, which was prepared after professional literature analysis. In the first step, performed with four rheumatologists, 70% of the text has changed. In the second, carried out with four psychologists, 65.5%. In the third, with three other psychologists, text and illustrations were evaluated together, checking the comprehensibility and clarity of the material. The results showed that five of the 12 subjects (41.66%) achieved 100% agreement among the participants in all evaluated criteria. The data obtained in this step showed good acceptance of the material by the participants, since even in subjects who did not obtain 100% agreement on all items, disagreement percentage was low. In the fourth stage, performed with three children and their caregivers, participants achieved 100% accuracy when answering questionnaire after reading the manual, even demonstrating ignorance of the disease. The result was a final version of the manual with clear and objective text, easy to understand having as target children and adolescents.
Acesso aberto (Open Access)
Habilidades sociais em portadores de anomalia da diferenciação sexual
(Universidade Federal do Pará, 2010-05-25) SARDINHA, Ana Paula de Andrade; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
The term Social Skills (SS) is used to describe a set of behavioral repertoires that involve social interactions satisfactory. Most published studies on this topic include the participation of children and adolescents by addressing situations in the school environment. Few studies have focused on the health area, and, so far, it has not been found surveys on SS conducted with individuals with the Anomaly of Sex Differentiation (ASD). This anomaly is characterized by malformations in the genitals and/or dysfunction of the gonads, causing secondary sexual characteristics which do not correspond to the sex of rearing. Clinical studies with individuals with ASD have highlighted the occurrence of deficits in social skills in these individuals, characterized by the escape-avoidance of aversive social situations. In this study, we sought to characterize the behavioral repertoire corresponding to SS in individuals with ASD treated at an outpatient clinic of a specialized program developed in a public hospital in Belém, through two complementary studies. At first, we performed a cross-sectional study, with the aim of characterizing the behaviors corresponding to SS in individuals with ASD. The participants were 9 adults in treatment for more than six months. Were used: Interview Script, Protocol for review of medical records and Social Skills Inventory - SSI. The results suggest that the participants have social skills deficits in all the factors of the SSI to a lesser or greater degree, so that could benefit from a social skills training as part of the treatment because it is a technique that aims at overcoming and/or reducing the deficits produced by them. In the second part, a study with a single subject design was performed seeking for evaluating the effects of using self-monitoring training in the installation of behaviors corresponding to SS. Attended an adult woman diagnosed with ASD selected among those who participated in Study 1. The intervention procedure was conducted through weekly interviews, according to the following steps: (1) Agreement: signing the consent form and scheduling an appointment, (2) Evaluation: Baseline survey of behaviors corresponding to SS, preparation of the hierarchy of behaviors that indicate a deficit, under the analysis rules of the SSI, and training in self-monitoring record, (3) Intervention: reading a text on social skills, presentation of the list of basic human rights, application of the adapted Goldiamond’s Constructional Questionnaire, and training in self-monitoring record, (4) Re-evaluation of the SS: reapplication of the SSI; (5) Follow-up: assessing the maintenance of the gains to the study, and (6) Closing: return interview in order to explain the results of the study to the participant. The results suggest that the intervention promoted the development of SS in the participant, given the interpretation of the participant’s evolution presented in accordance with the variation of Z score and the graphical representation of reliable change and clinical significance.