Habilidades sociais e adesão ao tratamento em adolescentes com lúpus eritematoso sistêmico juvenil

Abstract

Juvenile Systemic Lupus Erythematosus (JSLE) is an autoimmune disease characterized by the production of antibodies, formation and deposition of immune complexes, inflammation in diverse organs and tissue damage diagnosed in individuals under 17 years old. It is likely that adolescents affected by JSLE undergo experiences that compromise the acquisition of social skills (SS) expected for this stage of life, compromising their quality of life, since such skills can help in adherence to treatment. This research aims to characterize the behavior repertoire corresponding to SS and the level of adherence to treatment in teenagers with JSLE through two studies. In the first one, a descriptive study with a cross - sectional design was carried out, aiming to characterize behaviors corresponding to SS and adherence to treatment in teenagers with JLSE. Nineteen adolescents with SLE, attended at the rheumatology department of a University Hospital (HU) located in the city of Belém-PA, participated. Data collection was carried out in seven steps: (a) analysis of patients' records; (b) invitation and reading of the Free and Informed Consent Form 1 and of the Term of Assent 1 to the caretakers and participants, respectively; (c) follow-up of the participant's consultation with the rheumatologist; (d) medical evaluation of disease activity; (e) and application of the Social Skills Inventory for Teenagers(SSIT), followed by the application of the 24-hour Recall (R24h); (f) Reapplication of the R24h; and (g) feedback interview. The results indicated that the participants had deficits in SS and low IATs and significant correlation between the frequency of affective approach skills with better adherence to treatment. In Study 2, we verified the effects of the use of self-monitoring training in the installation of behaviors corresponding to SS and their relationship with the adherence to the treatment by teenagers with JSLE. Participants were four adolescents selected from among those who participated in Study 1. These were distributed by order of entry into the survey under two conditions. In Condition number 1, two participants were submitted to social skills training (SST). In Condition number 2, two participants underwent routine consultations and were evaluated at the beginning and at the end of the study. The study was done in 6 steps: (a) invitation and reading of the Free and Informed Consent Form 2 and of the Term of Assent 1 to the caretakers and participants, respectively; (b) application of the R24h, baseline survey of behaviors corresponding to adherence to treatment; (c) Intervention with the participants of Condition number 1 from the elaboration of the hierarchy of behaviors that indicated a deficit and self-monitoring record training, with application of the R24h; (d) Interview for reapplication of IHAS and R24h conducted individually with the four participants; (e) Feedback interview with application of the final interview script for feedback. The results indicate that the participants submitted to SST presented a strengthening and expansion in the repertoire of SS and better results of the IAT when compared to the results obtained with the participants of Condition 2. The importance of social skill repertoires in the promotion of adherence to the treatment of JSLE is discussed.