Investigação do impacto psicossocial da paralisia facial periférica na avaliação fonoaudiológica: proposição de uma escala

• Autor(a) principal: Silva, Mabile Francine Ferreira
• Data de Publicação: 2015
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_SP
• Texto Completo: https://tede2.pucsp.br/handle/handle/12014
• topic: Paralisia facial; Avaliação fonoaudiológica; Impacto psicossocial; Facial paralysis; Speech-Language Pathology evaluation; Psychosocial impact; CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA

INTRODUCTION: Peripheral facial paralysis (PFP) is an impacting condition on its physical, psychological and social aspects, for both the subject affected and those around him. Measuring these data is a complex task. Thus, this research had the PURPOSE to investigate the psychosocial impact of PFP in Speech-Language Pathology evaluation. To meet this proposal, this research was divided into two studies: 1. Development of an instrument of psychosocial assessment in peripheral facial paralysis, which surveyed similar instruments and prepared the questions, submitting them to the evaluation of expert judges, and then revised and verified the applicability of the instrument. 2. Evaluation of the sensitivity of the Psychosocial Scale of Facial Appearance in peripheral facial paralysis, which investigated the sensitivity and internal consistency of the instrument based on the comparison between its results and those from facial functional assessment instruments - House-Brackman scale (HBS) and Facial Grading System and the psychosocial implications measured by the Hospital Anxiety and Depression Scale (HADS). METHODS: The research was approved by the Research Ethics Committee, under protocols number 196.977 (PUC-SP) and 230.982 (Irmandade da Santa Casa de Misericórdia de São Paulo). Study 1: The drafting of the Psychosocial Scale of Facial Appearance comprised a literature review, the survey of similar instruments, the development of questions and thematic groups, the evaluation of 18 expert judges (by forms and meetings), and final review. After this stage, a pilot study was conducted. Subjects with PFP were selected based on the established criteria, and the questionnaire was pretested for verification of its applicability and reproducibility. Study 2: Thirty-eight adult subjects with PFP were submitted to closed interviews in order to evaluate the sensitivity of the questionnaire. Statistical analyses were carried out for each stage of this study. Data were entered into an Excel spreadsheet, and analyzed by the SPSS 17.0 for Windows and the AMOS 22.0 for Windows. RESULTS: Study 1 - The judges assessment was essential to the improvement of the questionnaire. The pilot study increased the familiarity with the process of data collection, and helped in procedure modifications, determining that the questionnaire would be applied as closed interview. Study 2 - Participants were 38 subjects with PFP and ages between 19 and 78 years, with predominance of idiopathic paralysis (44.7%). The results of the Cronbach's Alpha showed strong internal consistency among the thematic groups and the questions. However, the confirmatory factor analysis indicates that there were questions with week causal relationship between thematic groups. This was the case for questions 5 and 6 of the thematic group Functional Aspects of Face, and between question 17 of the Social Aspects group and 23 of the Emotional Aspects group. CONCLUSION: This study provided the first steps for the subsidy and support of an instrument designed to investigate the psychosocial aspects associated to PFP, allowing the elaboration of questions and their organization in thematic groups. Further studies are necessary to conclude the validation processes