Post on 14-Apr-2018
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RESUMO
A anestesia, a cirurgia e o internamento hospitalar so acontecimentos de vida
stressantes podendo desencadear medo e ansiedade nas crianas e pais com
repercusses negativas em vrias reas de desenvolvimento e prolongando-se no
tempo. No presente estudo procuramos avaliar, em crianas com idades entre os 7-10
anos, a existncia de consequncias, a curto (peri e 1 ms ps), mdio (2 meses) e
longo prazos (3 meses), do confronto com os stressores anestsico, cirrgico e de
internamento, isolados ou acumulados, sobre reas cognitivas, comportamentais e
rendimento escolar. A amostra foi constituda por um total de 100 crianas, sendo 75
acometidas a quatro grupos experimentais: um grupo submetido a anestesia geral,
cirurgia minore internamento (n=26); um grupo submetido a anestesia geral e cirurgiaminor em regime ambulatrio (n=19); um grupo submetido a anestesia geral para
exames invasivos (n=15) e um grupo submetido s a internamento (n=15) e as
restantes 25 crianas constituram o grupo de controlo. Os grupos experimentais foram
avaliados nos momentos peri e 1, 2 e 3 meses ps confronto em termos de reas
cognitivas e comportamentais e rendimento escolar e o grupo de controlo foi avaliado
num nico momento temporal, sendo a ansiedade das mes e crianas avaliada no
momento peri confronto. Os dados foram tratados com base na anlise das
percentagens de casos situados acima de um ponto de corte clinicamente significativoe com base nos ranks mdios de cada grupo. Os resultados obtidos vo no sentido
dos grupos submetidos a internamento apresentarem percentagens mais elevadas e
com maior durao de casos com significado clnico em problemas comportamentais.
Os grupos sem internamento apresentam maiores percentagens de queixas
somticas, com aumento a partir dos 2 meses. As reas cognitivas no aparecem
grandemente afectadas para nenhum dos grupos e a ansiedade estado das mes
aparece afectada para todos os grupos experimentais. As comparaes intergrupos
com base nos ranks mdios, so menos claras em termos de diferenciao dos
grupos. So discutidas as implicaes dos resultados em termos de prtica clnica e
contributos para o corpo de conhecimentos actuais sobre o tema.
7/29/2019 jose_caldas.pdf
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ABSTRACT
Anesthesia, surgery and hospitalization are stressful life events that may contribute to
fear and anxiety reactions in children and parents that may reverberate on negative
outcomes in various developmental areas and extend beyond the medical encounter.
The present study tried to assess, in 7 to 10 year old children, the existence of short
(peri and post 1 month), medium (post 2 months) and long (post 3 months) term effects
of anesthetic, surgical and hospitalization stressors, either isolated or cumulative, upon
cognitive, behavioral and achievment in academic areas. Our sample had 100 children
75 were commited to four experimental groups: the first one submited to general
anesthesia, minor surgery and short term hospitalization (n=26); the second one
submited to general anesthesia and minor surgery on a day care basis (n=19); the third
one submitted to general anesthesia for obtrusive examinations and the fourth one
submitted to hospitalization alone. The remaining 25 children were the control group.
Children in the experimental groups were assessed just before the medical encounter
in the areas of cognition, behaviour and academic achievment and the control group
was assessed just once in time, being that mothersand children anxiety were
assessed for all groups on the first moment. The collected data were studied, based on
the percentages of cases beyond or behind a clinical cut off point and on mean ranks
obtained for each group. Our results showed a tendency towards higher percentages ofclinical significant cases with extended lenght of time in the hospitalizad groups in
behavioural problems. Non hospitalized groups showed higher percentages on somatic
complains, with hightened values from 2 months on.. Cognitive and academic
achievment areas did not show affection in none of the groups and mothers state
anxiety was affected in all experimental groups. Between group comparisons based on
mean ranks are less clear differentating between groups. We discuss the implications
of our findings in terms of clinical practice and their contribution for the investigation on
this theme.
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RSUM
Lanesthsie, la chirurgie et lhospitalisation sont des vnements de vie stressants qui
peuvent contribuer aux reactions de crainte et danxiet chez les enfants et les parents
et qui peuvent rverbrer sur des rsultats negatifes dans divers secteurs
developpementaux et se prolonger au-del de la rencontre mdicale. Cette tude a
essay devaluer, dans des enfants de 7 10 ans, lexistance deffects court (peri et
post 1 mois), moyen (post 2 mois) et long (post 3 mois) terme, des stresseurs
anesthsique, chirurgique et dhospitalisation, isols ou cumulatifs, sur les secteurs
cognitives, comportamentalles et scolaire. Notre chantillon a eu 100 enfants, 75
taient assaillis quatre groupes experimentaux : le premier soumis lanesthsie
gnerale, la chirurgie mineure et lhospitalisation court terme (n=26); le second
soumis lanesthsie gnerale et la chirurgie mineure sur une base de garde (n=19);
le troisime soumis lanesthsie gnerale pour des examens (n=15); le quatrime
soumis lhospitalization (n=15). Les 25 enfants restants taient le groupe de controle.
Les enfants dans les groupes experimentaux ont t valus juste avant le rencontre
mdicale et 1, 2 et 3 mois aprs, dans des secteurs cognitifes, comportamentales et
scolaires et le groupe controle a t valu seulement une fois. Lanxiet des mres et
des enfants a t value pour tous les groupes le premier moment. Nos donnes on
t tudies bas sur les pourcentages des cas au del ou derrire un point de coupeclinique et sur les rangs moyens obtenus pour chaque groupe. Nos donnes on montr
une tendance vers des pourcentages plus levs de cas avec de la signification
clinique et se prolongeant dans le temps dans les groupes hospitaliss, dans des
problmes comportamentaux. Les groupes non hospitaliss on montr des
pourcentages plus levs de cas dans plaints somatiques, avec des valeurs plus
levs partir de 2 mois. Les secteurs cognitife et scolaire nont pas montr tre
afects pour quelqun des groupes et lanxiet situationale des mres a t affecte
dans tous les groupes experimentales. Les comparaisons entre les groupes bases
dans les rangues moyens, ont t moin claires dans la differentiation des groupes.
Nous discutons les implications de nos rsultats pour la pratique clinique et leur
contribution pour la recherche.