Dissertações em Teoria e Pesquisa do Comportamento (Mestrado) - PPGTPC/NTPC
URI Permanente para esta coleçãohttps://repositorio.ufpa.br/handle/2011/2333
O Mestrado Acadêmico iniciou-se em 1987 e pertence ao 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).
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Dissertação 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/6600933695027723Diabetes 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.Dissertação 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/6600933695027723Systemic 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.Dissertação 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/6600933695027723In 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.Dissertação 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/6600933695027723Diabetes 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.Dissertação 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/6600933695027723Systemic 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.