Clinical-qualitative Method Research Articles

P-1172 - Psychological meanings given by Brazilian clinical-school’ users about outcomes of psychoanalytic psychotherapy: a qualitative study

Introduction Since the Freudian construction of Psychoanalytic purposes, the foundations for the psychotherapy treatment have suffering profound transformations. However the understanding of the outcomes for patients in the therapeutic strategies used in the psychotherapeutic relationship need to be better discussed. Although the technique has been used in various contexts and submitted to a technical theoretical-structure, it lacks elements that help to evaluate both whether pedagogical actions employed to this education to potentize the professional actuation and whether they are effectives for the establishment of pillars for this practice. Objective To discuss the psychological meanings of outcomes of a psychoanalytic psychotherapeutic process for young and adults ex-patients who has used a clinical-school of a Brazilian federal university. Method Clinical-qualitative method whose sample was closed by information of saturation. The data was collected through semi-directed interviews, registered and transcribed for further Qualitative Content Analysis of Enunciation, based on a psychoanalytic theoretic framework. Results Preliminary data have emerged three thematic categories: the treatment as an escape from a death the life generates, expressed by pain of the overload's life; the maternal function attributed to the therapist and demonstrated through idealizations; and the pain felt by him/herself regarding perceptions of being a different one. Conclusion These categories support the reflection of treatment goals currently in public services and they permit to improve the approach to these users and to explore constitutive elements of the teaching-learning process.

P01-253 - Meanings of life experiences during manic episodes as reported by outpatients in remission in the Southeast Brazil: A clinical-qualitative study

BackgroundPsychosocial representations about the manic episode may constitute personal difficulty factors in dealing with the disorder, to relate socially and compromise satisfactory adherence to clinical treatments. It was elected to recall the experiences of manic episode due to its social and individual stigma.PurposeTo discuss the meanings of life experiences regarding manic episodes as reported by outpatients with bipolar affective disorder in remission.MethodResearch methodology from the Humanities employed to health settings, using clinical-qualitative method, with the technique of semi-directed interview with open-ended questions. The sample was closed by the criterion of theoretical saturation of information. Eight interviews were conducted in a university psychiatric clinic. Data were treated through the qualitative content analysis, with free-floating readings of the corpus - the set of the transcribed interviews - in order to categorization in core's discussion.ResultsPatients whom experienced manic episodes use unique adaptive mechanisms to deal with their psychosocial experiences and emotions. The highlights were the recognized strategies of bargaining, denial, rationalization and escaping when facing the experienced problems.ConclusionThe recognition of the management of patients’ experiences of mental disorder by the healthcare team can better harmonize the professional-patient relationship and develop strategies for greater adherence to the therapeutic and preventive measures for recurrence of the episodes.

P02-297 - Psychological meanings of life experiences during postpartum depression as reported by outpatients seen at a university hospital in the Southeast Brazil: A clinical-qualitative study

BackgroundThe object of this study have covered the psychological and sociocultural experience in context of depression occurred in postpartum period. The research assumes that pregnant women have the expectation that the motherhood is one of the most important moments of their lives and thus need to feel happy in face of childbirth, while women who had postpartum depression can experience feelings of anxiety and guilt. In addiction, there could be limitations on the child care and support or false sense of support felt by these women in relation to her partners, relatives, doctors, nurses and others.PurposeThe aim was to discuss what the perceptions and points of view brought by the women about this health problem represent or represented, emotionally and socio-culturally.MethodWe used the clinical-qualitative method, employing the technique of semi-directed interview with open-ended questions and we close the sample using the theoretical saturation of information, were sought on issues that could support better ways of managing such patients by health professionals. The researchers paid attention to the emic perspective, that is, the insider’s point of view or the reasons for certain interviewees’ customs/beliefs.ResultsIn processing the data through both qualitative content analysis and free-floating readings, it emerged the following discussion categories:(1) the escape the feeling of guilt brought by the difficulty of caring for the child;(2) how to deal with family support upon arrival in the home;(3) to learn to manage the strong sadness;(4) the need for baby care.

P02-293 - Psychological meanings of silence for Brazilian working women with urinary incontinence about their health problem: A clinical qualitative study

ObjectiveTo interpret the meanings of the silence from Brazilian working women about their urinary incontinence (UI).MethodA clinical-qualitative method was used with semi-directed interviews with open-ended questions. The sample consisted of eight women aged 30 to 45 from low-income brackets of the population with complaints of UI and who had never sought treatment. The resulting data was analyzed according to the thematic content analysis technique, based on psychosocial and psychodynamic approaches. The authors were aware of the polysemic character from the speeches in Human Science research.ResultsThe difficulty that women with urinary incontinence face in talking about the problem is an indication of the anxiety involved. They generally avoid discussing it due to embarrassment and from fear of being judged and misunderstood. In addition, their underprivileged social, economic and cultural situation may have aggravated their limitations in expressing their feelings. In terms of psychic processes, these women’s silence can be seen as a way for them to contain the physical symptom that their UI has brought on. Since it is so hard to express themselves in words, everything remains “unsaid,” but this silence can be interpreted as a way of expressing painful and unnameable feelings.ConclusionThe silence of Brazilian women with urinary incontinence proved to be an essential element of communication about this disorder and was as important as the words they uttered. Their silence evidenced the pain and anxiety they experienced, and it emerged as an adaptive psychosocial mechanism.

Metodologia clínico-qualitativa na produção científica no campo da saúde e ciências humanas: uma revisão integrativa

doi: 10.5216/ree.v12i4.5840 A pesquisa qualitativa vem ascendendo sua utilização, por profissionais de saúde, principalmente nas últimas décadas. Desta forma, o objetivo deste estudo foi caracterizar as pesquisas produzidas nas diversas áreas da saúde e ciências humanas, utilizando especificamente a metodologia clínico-qualitativa. Trata-se de uma revisão integrativa que abarcou as publicações nacionais de 2000 a 2010, nas bases de dados Cinahl, PubMed e nas bibliotecas virtuais Bireme e SciELO, utilizando as palavras-chave pesquisa qualitativa, método clínico-qualitativo, metodologia clínico-qualitativa. Foram identificados 55, dos quais 33 compuseram a amostra do estudo. Os resultados apontaram crescimento nas publicações nos últimos anos. A aplicação deste referencial metodológico apresentou-se pertinente, especialmente nas pesquisas vinculadas aos settings de saúde, porém percebemos deficiências na produção de alguns destes artigos, sobretudo em relação a abordagem metodológica. Por tratar-se de um método de recente utilização, sua aplicação ainda carece de melhor entendimento e desenvolvimento, por parte de alguns autores. Descritores: Pesquisa Qualitativa; Literatura de Revisão como Assunto; Técnicas de Pesquisa.

Content analysis in studies using the clinical-qualitative method: application and perspectives

Content analysis comprises a set of techniques for organizing communication/information - a procedure used with qualitative data to make themes/topics and concepts/knowledge emerge. Communication content, considering human written or spoken discourse, is complex and presents valuable polysemous characteristic. With the dissemination of the clinical-qualitative method, the use of content analysis, considered an important methodological tool, raises theoretical-practical issues that need to be taken into consideration for its academically precise use. Thus, this article aimed to enumerate specific elements of the content analysis technique and discuss its suitability for the clinical-qualitative method that combines generic qualitative methods from Human and Cultural Sciences with the area of Health Sciences. Concepts were selected due to their pertinence, use and eventual adaptation to the method focused on.

The Psychology of Bariatric Patient: What Replaces Obesity? A Qualitative Research with Brazilian Women

Obesity has serious implications on a woman's quality of life and body image. We propose a qualitative investigation aimed at understanding the postoperative significance of bariatric surgery for women suffering from morbid obesity and how these factors influence the outcomes, with an emphasis on body image and on the possible psychological complications that may jeopardize the operation's success. This study uses a clinical qualitative method, through a semidirected interview with open-ended questions in an intentional sample, closed by saturation, with seven women operated in a period of 1.5-3years, following the definition of emergent categories and qualitative content analysis. Bariatric surgery is a procedure that brings about rapid physical, social, and emotional changes, and it is seen by patients as a possibility of being reinstated and accepted socially. The reencounter with the feminine body after surgery is experienced as a means of reinstatement but also with a feeling of defenselessness, which may lead to the development of phobic symptoms. Imbalance in family and conjugal relationships may be factors that discourage the continuation of the treatment. The patient sees the skin folds, flaccidity, and the scars as therapeutic failures, which can lead to a constant quest for plastic surgery. We observe the necessity of studies that allow the health team to identify those aspects of a patient's psychological makeup which would be expected to improve or worsen their prognosis and to provide the necessary preoperative and postoperative psychosocial interventions.

Understanding the Life Experiences of Brazilian Women after Bariatric Surgery: a Qualitative Study

The increase in bariatric surgeries has called into question the aspects that contribute to or impair the results. Psychosocial factors directly influence the results of the surgery, but a lot of controversy exists in relation to the degree of influence of these factors. We propose a qualitative investigation to understand the significance of the surgery for women and how these factors influence the outcomes. This study is a clinical-qualitative method, through the semi-directed interview with open-ended questions in an intentional sample, closed by saturation, with seven women operated in a period of 1.5-3 years, following the definition of emergent categories and qualitative content analysis. The experience of acceptance and social reinsertion is a motivating factor to keep up the challenge of weight loss; social discrimination is a risk factor leading to losing the stimulus to continue the process; the recuperation of self-esteem and personal identity is a factor that improves the quality of life and psychopathological symptoms; disillusionment is an important risk factor, linked principally to the experiences of failure. We observe the necessity of qualitative studies that serve the health team in the handling of these patients, aiming for a greater understanding of their psychological dynamics and of the meanings that weight loss has for them.

As redes pessoais significativas como instrumento de intervenção psicológica no contexto comunitário

Este artigo visa apresentar proposta de sistematização do trabalho com redes significativas pessoais em torno de um paciente, e sua ressonância nas pessoas participantes do processo de intervenção psicológica. Buscou-se gerar condições para que os envolvidos na situação de intervenção pudessem ser co-construtores das mudanças, frente à visão do problema da pessoa que procurou atendimento. O método foi o clínico-qualitativo proposto pela "Grounded Theory". A análise dos casos estudados mostrou a eficácia da intervenção de rede no atendimento a famílias com pacientes psiquiátricos, para os participantes possibilitando entrar em contato com seu potencial de ajuda, para o psicoterapeuta distribuindo a responsabilidade no cuidado da pessoa identificada. O trabalho com a rede pessoal significativa não implica em desistência de outras ações de intervenção ou olhares teóricos, constituindo-se em aporte qualitativo, tanto para o profissional, como para o potencial de ação clínica da psicologia, em variados contextos de atuação.

A equipe de saúde, a pessoa com doença renal em hemodiálise e suas relações interpessoais

Na literatura científica, discussões amplas sobre a relação entre equipe de saúde e doentes renais apresentam singularidades relativas à formação profissional e ao tratamento. Analisamos do ponto de vista do doente em hemodiálise, o atendimento dos profissionais de saúde e suas relações interpessoais. Utilizando o método clfnicoqualitativo, realizamos entrevistas semiestruturadas com sete pacientes de uma unidade de hemodiálise, escolhidos numa amostragem intencional. Tratamos os dados coletados através da técnica de análise de conteúdo temática. Concluímos que os pacientes desejam ser mais ouvidos pela equipe em seus anseios, os quais vão além das expectativas de ordem fisica. A assistência clínica mostrou-se mais voltada aos aspectos biológicos do paciente e aos procedimentos mecãnicos, ocorrendo certa indiscriminação entre relacionamento humano e competência técnica.