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Análise Psicológica

versão impressa ISSN 0870-8231

Aná. Psicológica v.18 n.4 Lisboa nov. 2000

 

Elementos psicoterapêuticos na reabilitação dos sujeitos com incapacidades físicas adquiridas

 

Rui Aragão Oliveira (*)

 

 

RESUMO

O autor aborda as principais questões inerentes ao processo psicoterapêutico dos sujeitos com incapacidades físicas adquiridas, salientando por um lado a dimensão dos processos relacionais na evolução da doença física, e por outro lado definindo as questões do suporte social como um recurso importante para a promoção da saúde, influenciando temáticas como a mortalidade, a morbilidade e o isolamento social; este último especificamente desencadeado pela incapacidade física adquirida.

São realçados os aspectos psicológicos envolvidos nos casos particulares dos doentes hemiplégicos, vítimas de Acidente Vascular Cerebral, e dos sujeitos que sofreram amputações, procurando simultaneamente oferecer uma panorâmica geral dos contributos dos múltiplos autores que, nas últimas duas décadas, têm de uma forma mais ou menos exaustiva, tomado este assunto como objecto de investigação.

Palavras-chave: Psicoterapia, suporte social, hemiplégia, amputação.

 

 

ABSTRACT

The psychotherapeutic aspects of people with disabilities are the main aim of this paper. Relational process and social support are discussed as two main topics of this specific population. Relational dimensions of physical handicap people are discussing as well as social support, mortality, morbidity and heath improvement.

Psychological variables are considered in the case of stroke patients and amputees. The main studies of the last decades are discussed.

Key words: Psychotherapy, social support, stroke, amputees.

 

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

 

REFERÊNCIAS BIBLIOGRÁFICAS

Aloni, R., Schwarts, J., & Ring, H. (1994). Sexual function in post-stroke patients of both sexes. Comunicação no 7th World Congress of the International Rehabilitation Medicine Association, IRMA VII, Washington, USA, 9-16 de Abril de 1994.        [ Links ]

American Heart Association (1994). Family guide to stroke: treatment, recovery and prevention. USA: Times Books.         [ Links ]

Anderson, G., Vestergaard, K., Ingemann-Nielsen, M., & Lauritzen, L. (1995). Risk factors for post-stroke depression. Acta Psychiatryc Scandinave, 92, 193-198.         [ Links ]

Astrom, M., Asplund, K., & Astrom, T. (1992). Psychosocial function and life satisfaction after stroke. Stroke, 23 (4), 527-531.         [ Links ]

Astrom, M. (1996). Generalised anxiety disorder in stroke patients: a 3-year longitudinal study. Stroke, 27, 270-275.         [ Links ]

Berkman, L., & Syme, S. (1979). Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda Country residents. American Journal of Epidemiology, 109, 186-204.         [ Links ]

Bradway, J. K., Mclone, J. M., Ravy, J., Leal, J. M., & Poole, J. (1984). Psychological adaptation to amputation: an overview. Orthotics and Prosthetics, 38, 46-50.         [ Links ]

Chatain, M., Campech, M., Marque, P., & Roques, C. F. (1993). Sexual activity of hemiplegic patients. Comunicação apresentada no International Congress on Stroke Rehabilitation, Berlim, 21-24 Novembro, 1993.         [ Links ]

Christensen, J., Wiebe, J. S., Smith, T. W., & Turner, C. W. (1994). Predictors of survival among hemodialysis patients: effect of perceived family support. Health Psychology, 13 (6), 521-525.         [ Links ]

Codine, P., Maitre, M., & Brun, V. (1996). Facteurs conditionnant a la réinsertion socio-professionnelle des amputés dú membre inférieur. In P. Codine, V. Brun, & J. M. André (Eds.), Amputation du membre inférieur appareillage et rééducation (pp. 429438). Paris: Masson.         [ Links ]

Davison, K. P., Pennebaker, K. W., & Dickerson, S. S. (2000). Who talks? The social psychology of illness support groups. American Psychologist, 55 (2), 205-217.         [ Links ]

Evans, R. L., & Northwood, L. K. (1983). Social support needs in adjustment to stroke. Archives Physical Medicine and Rehabilitation, 64, 61-64.         [ Links ]

Evans, R. L., Matlock, A-L., Bishop, D. S., Stranahan, S., & Pederson, C. (1988). Family intervention after stroke: does counselling or education help? Stroke, 19 (10), 1243-1249.         [ Links ]

Evans, R. L., Noonan, W. C., Bishop, D. S., & Hendricks, R. D. (1989). Caregiver assessment of personal adjustment after stroke in a veterans administration medical center outpatient cohort. Stroke, 20 (4), 483-487.         [ Links ]

Farzan, D. (1991). Reintegration for stroke survivors - home and community considerations. Nurs. Clinics North America, 26 (4), 1037-1048.         [ Links ]

Glass, T. A., Matchar, D. B., Belyea, M., & Feussner, J. R. (1993). Impact of social support on outcome infirst stroke. Stroke, 24 (1), 64-70.         [ Links ]

Goplerud, E. N. (1980). Social support and stress during the first year of graduate school. Professional Psychology, 2, 283-290.         [ Links ]

Grzesiak, R., & Hicok, D. A. (1994). A brief history of psychotherapy and physical disability. American Journal of Psychotherapy, 48 (2), 240-250.         [ Links ]

Joffres, M., Reed, D., & Nomura, A. (1985). Psychosocial processes and cancer incidence among Japanese men in Hawaii. American Journal of Epidemiology, 121, 488-500.         [ Links ]

Kajanne, A. (1995). A study of women without relapse after breast cancer diagnosis. In Jesús Rodríguez-Marín (Ed.), Health psychology and quality of life research (pp. 416-429). Alicante (Spain): Health Psychology Department.         [ Links ]

King, K. B., Reis, H. T., Porter, L. A., & Norsen, L. H. (1993). Social support and long-term recovery from coronary artery surgery: effects on patients and spouses. Health Psychology, 12, 56-63.         [ Links ]

King, R. (1996). Quality of life after stroke. Stroke, 27 (9), 1467-1472.         [ Links ]

Laíns, J., & Paixão, R. (1989). Algumas considerações sobre os factores psicológicos da amputação. Arquivos Reumatologia, 11, 393-402.         [ Links ]

Laíns, J., Oliveira, R. A., Caldas, J., Azenha, A., & Keating, J. (1993). Depressão e ansiedade nos hemiplégicos crónicos. Revista de Medicina Física e Reabilitação, 1, 13-17.         [ Links ]

Laíns, J., Oliveira, R. A., Oliveira, C., Pratas, G., Coelho, S., & Paixão, R. (1995). O impacto do hemiplégico no meio familiar. In J. Pinheiro, J. Laíns, P. Lemos, & L. André (Eds.), Medicina Física e de Reabilitação (pp. 41-43). Coimbra: Serviço Medicina Física Reabilitação, Hospitais Universidade Coimbra.         [ Links ]

Laíns, J., Oliveira, R. A., Caldas, J., Azenha, A., Guedes, A., & Paixão, R. (1998). A sexualidade dos hemiplégicos - um estudo sobre hemiplégicos de causa vascular. Arquivos Fisiatria, 5, 27-36.         [ Links ]

Lambert, M. (1992). Social support systems in practice. Washington, DC: Nasw Press.         [ Links ]

Langer, K. G. (1994). Depression and denial in psychotherapy of persons with disabilities. American Journal of Psychotherapy, 48 (2), 181-191.         [ Links ]

Levy, S., & Heiden, L. A. (1990). Personality and social factors in cancer outcome. In H. S. Friedman (Eds.), Personality and disease (pp. 254-279). New York: John Wiley & Sons.         [ Links ]

Li, L., & More, D. (1998). Acceptance of disability and its correlates. The Journal of Social Psychology, 138 (1), 13-25.         [ Links ]

Maitre, M., Rouyer, A., Enjalbert, M., & Pélissier (1996). Approche épidémiologique des amputés du membre inférieur. In P. Codine, V. Brun, & J. M. André (eds.), Amputation du membre inférieur appareillage et rééducation (pp. 1-7). Masson: Paris.         [ Links ]

Marshall, M., Helmes, E., & Deathe, A. B. (1992). A comparison of psychosocial functioning and personality in amputee and chronic pain patients. Clinical Journal of Pain, 8, 351-357.         [ Links ]

Mikorey, M. (1959). Fantômes et doubles. Paris: Doin.         [ Links ]

Miller, S. (1986). Patients - perceptions of their adjustment to disability and social support in a community-based teaching hospital. In S. Walker, F. Z. Belgrave, A. M. Banner, & R. W. Nicholls (Eds.), Equal to the challenge-Perspectives, problems, and strategies in the rehabilitation of the non-white disabled. Washington, DC: Bureau of Educational Research, Howard University.         [ Links ]

Monga, T. N., Lawson, J. S., & Inglis, J. (1986). Sexual dysfunction in stroke patients. Archives Physical Medicine and Rehabilitation, 67, 19-22.         [ Links ]

Morgan, M., Patrick, D. L., & Charlton, J. R. (1984). Social networks and psychosocial support among disabled people. Social Science and Medicine, 19 (5), 489-497.         [ Links ]

Morris, P. L. P., Robinson, R. B., & Bishop, D. (1991). Social support and post-stroke depression. Psychiatry, 54, 305-315.         [ Links ]

Oliveira, R. A. (1994). Transformar o impossível - contributo para o estudo dos factores psicológicos dos doentes hemiplégicos vítimas de Acidente Vascular Cerebral. Tese de Mestrado à Universidade de Coimbra.         [ Links ]

Oliveira, R. A., & Laíns, J. (1995). Reacções à situação de doença no síndrome do hemiplégico. Medicina Física e de Reabilitação, 3 (2), 17-20.         [ Links ]

Oliveira, R. A., Laíns, J., & Paixão, R. (1995a). Anxiety and social readjustment of hemiplegics. In J. Rodríguez-Marin (Ed.), Health Psychology and quality of life research (Vol. 1, pp. 304-311). Alicante, Spain: University of Alicante.         [ Links ]

Oliveira, R. A. (1996). Reabilitação, tratamento e aspectos psicossociais: estudo dum grupo de hemiplégicos vítimas de AVC. Psychologica, 13, 5-26.         [ Links ]

Oliveira, R. A. (1998). Do vínculo ao suporte social. Dissertação de doutoramento à Universidade de Coimbra. Não publicado.         [ Links ]

Orr, E., Thein, R. D., & Aronson, E. (1995). Orthopaedic disability, conformity and social support. The Journal of Psychology, 129 (2), 203-219.         [ Links ]

Paradiso, S., Robinson, R., & Arndt, S. (1996). Self-report aggressive behaviour in patients with stroke. The Journal of Nervous Mental Disease, 184 (12), 746-753.         [ Links ]

Pierre, P. (1992). Troubles psychiques des amputés des membres. Journal Reádaptation Médical, 12, 26-30.         [ Links ]

Pierre, P. (1996). Aspects psychologiques et psychiatriques de l'amputation du membre inférieur et de as prise en charge. In P. Codine, V. Brun, & J. M. André (Eds.), Amputation du membre inférieur appareillage et rééducation (pp. 443-450). Paris: Masson.         [ Links ]

Price, T. R. (1990). Affective disorders after stroke. Stroke, 21 (suppl II), 12-13.         [ Links ]

Revenson, T. A., & Majerovitz, S. D. (1990). Spouses support provision to chronically ill patients. Journal of Social Personal Relationships, 34 (7), 575-586.         [ Links ]

Riese, W. (1928). Uber die Sogenannte Phantomhand der amputierten. Deuts. Ztschr. F. Nervenheilk, 101, 270.         [ Links ]

Rybarczyk, B. D., Nyenhuis, D. L., Nicholas, J. J., Schulz, R., Alioto, R. J., & Blair, C. (1992). Social discomfort and depression in a sample of adults with leg amputations. Archives Physical Medicine Rehabilitation, 73, 1169-1173.         [ Links ]

Schilder, P. (1968). L'image du corps: étude des forces constructives de la psyché. Paris: Éditions Gallimard.         [ Links ]

Schubert, D. S. P., Burns, R., Paras, W., & Sioson, E. (1992). Decrease of depression during stroke and amputation rehabilitation. General Hospital Psychiatry, 14, 135-141.         [ Links ]

Schulz, R., & Rau, M. T. (1985). Social support through the life course. In S. Cohen, & L. Syne (Eds.), Social support and health (129-149). New York: Academic Press.         [ Links ]

Schulz, R., & Decker, S. (1985a). Long-term adjustment to physical disability: The role of social support, perceived control, and self-blame. Journal of Personality and Social Psychology, 48, 1162-1172.         [ Links ]

Schulz, R., & Tompkins, C. (1990). Life events and changes in social relationships: examples, mechanisms, and measurement. Journal of Social Clinical Psychology, 9 (1), 69-77.         [ Links ]

Schwarzer, R., & Leppin, A. (1991). Social support and health: a theoretical and empirical overview. Journal of Social and Personal Relationships, 8, 99-127.         [ Links ]

Shukla, G. D., Sahu, S. C., Tripathi, R. P., & Gupta, D. K. (1982a). A psychiatric study of amputees. British Journal of Psychiatry, 141, 50-53.         [ Links ]

Shukla, G. D., Sahu, S. C., Tripathi, R. P., & Gupta, D. K. (1982). Phantom limb: a phenomenologicalstudy. British Journal of Psychiatry, 141, 54-58.         [ Links ]

Spencer, K., Tompkins, C., & Schilz, R. (1997). Assessment of depression in patients with brain pathology: the case of stroke. Psychological Bulletin, 122 (2), 132-152.         [ Links ]

Stephens, M. A. P., Kinney, J. M., Norris, V. K., & Ritchie, S. W. (1987). Social networks as assets and liabilities in recovery from stroke by geriatric patients. Psychology and Aging, 2 (2), 125-129.         [ Links ]

Thompson, D. M., & Haran, D. (1983). Living with na amputation: the patient. International Rehabilitation Medicine, 165-169.         [ Links ]

Tomeno, B. (1996). Amputations pour tumeurs: particularités techniques, aspects psichologiques et psychosomatiques. In P. Codine, V. Brun, J. M. André (Eds.), Amputation du membre inférieur appareillage et rééducation (pp. 41-48). Paris: Masson.         [ Links ]

Tuomilehto, J., Nuottimaki, T., Salmi, K., Aho, K., Kotila, M., Sarti, C., & Rastenytè, D. (1995). Psychosocial and health status in stroke survivors after 14 years. Stroke, 26 (6), 971-975.         [ Links ]

Varni, J. W., Setoguchi, Y., Rappaport, L. R., & Talbot, D. (1992). Psychological adjustment and perceived social support in children with congenital/acquired limb deficiencies. Journal of Behavioural Medicine, 15 (1), 31-44.         [ Links ]

Wade, D., Langton Hewer, R., Skilbeck, C., & David, R. (1986). Stroke - a critical approach to diagnosis, treatment and management. London: Ed. Chapman and Hall.         [ Links ]

Wilcox, V. L., Kasl, S. V., & Berkman, L. F. (1994). Social support and physical disability in older people after hospitalisation: a prospective study. Health Psychology, 13 (2), 170-179.         [ Links ]

Williamson, G., Schulz, R., Bridges, M., & Behan, A. (1994). Social and psychological factors in adjustment to limb amputation. Journal of Social Behavior Personality, 9, 249-268.         [ Links ]

Williamson, G. (1995). Restriction of normal activities among older adult amputees: the role of public self-consciousness. Journal of Clinical Geropsychology, 1, 229-242.         [ Links ]

Williamson, G., & Walters, A. (1996). Perceived impact of limb amputation on sexual activity: a study of adult amputees. The Journal of Sex Research, 33 (3), 221-234.         [ Links ]

 

 

(*) Instituto Superior de Psicologia Aplicada, Rua Jardim do Tabaco, 34, 1149-041 Lisboa. E-mail: raragao@ispa.pt

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