Preditores de Stresse nas Doen?as Neurodegenerativas: dados preliminares sobre o efeito de condi??es cl?nicas e de processos de regula??o emocional

• Autor(a) principal: Costa, Patr?cia Isabel Rodrigues
• Data de Publicação: 2022
• Outros Autores: Carvalho, Teresa (Orientadora)
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://repositorio.ismt.pt/jspui/handle/123456789/1435
• topic: Doen?as neurodegenerativas - Neurodegenerative diseases; Modelo preditivo do stresse - Predictive model of stress; Dor neurop?tica - Neuropathic pain; Incapacidade geral - General disability; Processos de regula??o emocional - Emotion regulation processes

Introdu??o: As doen?as neurodegenerativas (DNs) s?o cr?nicas, progressivas, possuem uma elevada mortalidade e morbilidade e uma relevante e crescente preval?ncia. O stresse coocorre habitualmente com as DNs, podendo contribuir para o seu agravamento. No entanto, estudos sobre preditores de stresse em pessoas com DNs (PcDNs) s?o insuficientes. Objetivos: Disponibilizar dados preliminares sobre um modelo preditivo dos sintomas psicopatol?gicos de stresse em PcDNs, composto pelos seguintes potenciais preditores: dor neurop?tica, fadiga, incapacidade geral ? condi??es cl?nicas frequentes nas DNs ?, fus?o cognitiva, evitamento experiencial e vida comprometida ? processos de regula??o emocional, concetualizados pela Terapia de Aceita??o e Compromisso (ACT). M?todo: Este estudo transversal inclui 93 doentes com DNs e 198 indiv?duos da popula??o geral sem DNs, ambos os grupos sem outras doen?as neurol?gicas. Os participantes responderam aos seguintes instrumentos de autorresposta: Six Item Cognitive Impairment Test, um question?rio sociodemogr?fico e cl?nico, Escala de Stresse da Depression, Anxiety and Stress Scales ? 21, Escalas Anal?gicas Visuais do Pain Detect Questionnaire e da Fadiga, World Health Organization Disability Assessment Schedule ? 12 items, Acceptance and Action Questionnaire ? II, Cognitive Fusion Questionnaire e Engaged Living Scale. Resultados: Os dois grupos diferenciaram-se quanto aos sintomas de stresse e aos seus poss?veis preditores, exceto ? fus?o cognitiva. Por esta raz?o, a fus?o cognitiva foi eliminada como covari?vel do modelo de regress?o linear m?ltipla (RLM). Os restantes potenciais preditores foram selecionados como covari?veis do referido modelo, por tamb?m se terem correlacionado com os sintomas de stresse e predito esta sintomatologia em modelos de regress?o linear simples. O modelo de RLM explicou 53.7% da vari?ncia dos sintomas de stresse e revelou que o evitamento experiencial e a vida comprometida, respetivamente, com valores de beta positivo e negativo, predissessem tais sintomas em PcDNs. Discuss?o: O evitamento experiencial e a vida comprometida revelaram-se fatores de risco e protetores do stresse em PcDNs. Assim, interven??es psicol?gicas destinadas a prevenir/minimizar o stresse na referida popula??o cl?nica e o seu eventual impacto no agravamento das DNs, parecem adequadas para prevenir e/ou reduzir o stresse nos referidos doentes. / Introducion: Neurodegenerative diseases (NDs) are chronic and progressive. They have a high mortality and morbidity rate and a relevant and growing prevalence. Stress usually co-occurs with NDs and may contribute to their worsening. However, studies on predictors of stress in people with NDs (PcDNs) are insufficient. Objectives: To provide preliminary data on a predictive model of psychopathological symptoms of stress in PwDNs, composed of the following potential predictors: neuropathic pain, fatigue, general disability - frequent clinical conditions in DNs -, cognitive fusion, experiential avoidance and engaged life - processes of emotional regulation, conceptualized by Acceptance and Commitment Therapy (ACT). Method: This cross-sectional study includes 93 patients with DNs and 198 individuals from the general population without DNs, both groups without other neurological diseases. The participants answered the following self-report instruments: Six Item Cognitive Impairment Test, a Sociodemographic and Clinical Questionnaire, stress subscale of the Depression, Anxiety and Stress Scales ? 21, Visual Analog Scales of Pain and Fatigue Detection Questionnaire, World Health Organization Disability Assessment Schedule ? 12 items, Acceptance and Action Questionnaire ? II, Cognitive Fusion Questionnaire and Engaged Living Scale. Results: The two groups differed on stress symptoms and their possible predictors, except for cognitive fusion. For this reason, cognitive fusion was eliminated as a covariate from the multiple linear regression (MLR) model. The remaining potential predictors were selected as covariates in this model because they also correlated with stress symptoms and predicted this symptomatology in simple linear regression models. The RLM model explained 53.7% of the variance of stress symptoms and revealed that experiential avoidance and committed living, respectively, with positive and negative beta values, predicted these symptoms in PwDNs. Discussion: Experiential avoidance and impaired living were proved to be a risk and protective factors for stress in PwDNs. Thus, psychological interventions aimed at preventing/minimizing stress in the mentioned clinical population and its possible impact on the worsening of DNs, seem appropriate to prevent and/or reduce stress in these patients.