Qualidade de Vida nas Pessoas com Doen?as Neurodegenerativas: explorando o efeito preditivo de sintomas, incapacidade e processos de regula??o emocional

• Autor(a) principal: Rentes, Andreia Filipa Ventura
• 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/123456789/1427
• topic: Doen?as neurodegenerativas - Neurodegenerative diseases; Qualidade de vida - Quality of life; Modelo preditivo - Predictive model; Condi??es cl?nicas - Clinical conditions; Processos de regula??o emocional - Emotion regulation processes

Introdu??o: As doen?as neurodegenerativas (DNs) s?o incapacitantes, incur?veis e resultam na deteriora??o progressiva dos neur?nios. As DNs apresentam uma preval?ncia crescente e podem comprometer consideravelmente a qualidade de vida (QV) dos doentes. Por?m, ? ainda insuficiente o conhecimento cient?fico acerca dos preditores da QV em pessoas com DNs (PcDNs). Objetivos: Explorar um modelo preditivo multivariado da QV psicol?gica em PcDNs, composto por poss?veis preditores relacionados com condi??es cl?nicas frequentes nas DNs ? dor neurop?tica, fadiga (sintomas) e incapacidade geral ?, e processos relacionados com a inflexibilidade psicol?gica e a regula??o emocional ? fus?o cognitiva, evitamento experiencial e vida comprometida, tal como conceptualizados pela terapia de aceita??o e compromisso (ACT). M?todo: Foram usadas duas amostras independentes de conveni?ncia: 93 PcDNs e 198 participantes sem DNs, O protocolo de avalia??o incluiu os seguintes instrumentos de autorresposta: Six Item Cognitive Impairment Test, um question?rio sociodemogr?fico e cl?nico, Escalas Anal?gicas Visuais do Pain Detect Questionnaire e da Fadiga, World Health Organization Brief Quality of Life Assessment Scale, World Health Organization Disability Assessment Schedule, Cognitive Fusion Questionnaire, Acceptance and Action Questionnaire-II e Engaged Living Scale. Resultados: Todos os potencias preditores apresentaram diferen?as estatisticamente significativas entre os dois grupos, ? exce??o da fus?o cognitiva. Esta ?ltima vari?vel foi eliminada como poss?vel preditor do modelo preditivo multivariado. Na amostra de PcDNs, os restantes poss?veis preditores correlacionaram-se com a QV psicol?gica e predisseram-na em modelos univariados. Estes resultados permitiram selecionar as seguintes covari?veis: dor neurop?tica, fadiga, incapacidade geral evitamento experiencial e vida comprometida. O modelo explicou 66% da vari?ncia da QV psicol?gica das PcDNs e o evitamento experiencial e a vida comprometida revelaram se preditores significativos com valores de beta, respetivamente, positivo e negativo. Discuss?o: Os resultados sugerem que o evitamento experiencial e a vida comprometida s?o, respetivamente, fatores de risco e de prote??o associados ? QV em PcDNs. Interven??es psicol?gicas com o objetivo de melhorar a QV nos referidos doentes, devem focar-se em aumentar a flexibilidade psicol?gica e uma regula??o emocional adaptativa, atrav?s do desenvolvimento de compet?ncias de aceita??o das experi?ncias indesej?veis e de uma vida comprometida com a??es valorizadas. ACT ? eficaz para este fim. / Introduction: Neurodegenerative diseases (NDs) are disabling, incurable, and result in the progressive deterioration of neurons. NDs have an increasing prevalence and can considerably compromise the quality of life (QoL) of patients. However, scientific knowledge about QoL predictors in people with NDs (PwNDs) is insufficient. Objectives: To explore a multivariate predictive model of psychological QoL in PwNDs, composed of possible predictors related to common clinical conditions in NDs - neuropathic pain, fatigue (symptoms) and global disability -, and processes related to psychological inflexibility and emotional regulation - fusion cognitive, experiential avoidance, and engaged living, as conceptualized by acceptance and commitment therapy (ACT). Method: Two independent convenience samples were used: 93 PwDNs and 198 participants without NDs. The following self-response instruments were administed: The assessment protocol was composed of the following sel-report instruments: Six Item Cognitive Impairment Test, a sociodemographic and clinical questionnaire, Pain Detect Questionnaire Visual Analog Scale, Fatigue Visual Analog Scale, World Health Organization Brief Quality of Life Assessment Scale, World Health Organization Disability Assessment Schedule, Acceptance and Action Questionnaire-II, Cognitive Fusion Questionnaire and Engaged Living Scale. Results: All the predictors showed statistically significant differences between the two groups, except for cognitive fusion. Thus, this last variable was eliminated as a possible predictor of the multivariate predictive model. In the PwNDs sample, the remaining possible predictors correlated with psychological QoL and predicted it in univariate models. These results allowed us to select the following covariates: neuropathic pain, fatigue, global disability, experiential avoidance, and engaged life. The model explained 66% of the variance of the psychological QoL in PwNDs, and experiential avoidance and engaged life were significant predictors with beta values positive and negative, respectively. Discussion: The results suggest that experiential avoidance and engaged life are, respectively, risk and protective factors associated with the QoL of PwDNs. Psychological interventions to promote QoL in these patients should encourage them to increase psychological flexibility and make use of adaptive emotional regulation, through the development of skills to accept undesirable experiences and a life committed to valued actions. ACT is effective for this purpose.