OBJECTIVE:To understand experiences of nurses caring for women who have suffered sexual violence. METHODOLOGICAL PROCEDURES:Qualitative-clinical study in which six nurses from a health care service for women who had suffered sexual violence were interviewed in the city of Campinas, Southeastern Brazil, between April and May 2007. Semi-guided interview technique with open questions was used. Data were analyzed following the content analysis technique, based on a psychodynamic framework. The following analytical categories were produced: what they think about, how they feel, how they act and how they react to the work with sexual violence victims. ANALYSIS OF RESULTS:Interviewees indicated receptiveness as key to provide humanized health care and form a bond with clients. Feelings such as fear, insecurity, impotence, ambivalence, anguish and anxiety were reported, causing behavioral changes and interfering with one's personal life, in addition to feelings of professional achievement and satisfaction. Technical qualifi cation and activities aimed at providing psychological support were mentioned as strategies to help this type of care. CONCLUSIONS:Although dealing with feelings such as impotence, fear and indignation, the nurses' perception of relief when fulfi lling their job tasks and the personal satisfaction felt when helping these women seem to surpass other feelings, as a form of gratifi cation. The desire to "run away" from the health care service and the willingness to do one's best occur simultaneously and are used as inner mechanisms in the sense of minimizing pain and suffering. DESCRIPTORS: Experiences in healthcare of sexual violence Reis MJ et alSexual violence is an underreported crime and a serious health problem due to high rates of female morbidity and mortality. 6 According to the Brazilian Ministry of Health, sexually abused women need humanized care when interacting with health service professionals.a However, while caring for women who have suffered sexual violence, these professionals frequently have to deal with their own anguish, facing human limitations, and somehow show their feelings to others. 3A phenomenological 3 study showed that such professionals feel powerless. Lack of resolvability might lead to a feeling of impotence, because they confuse their objectives and limitations with those of the people cared for. Authors comment that this impotence causes perceptible tension among professionals, along with sadness and anguish.The impact on professionals resulting from caring for people who suffer sexual violence may infl uence the quality of care provided. These professionals start to share the experience that causes a feeling of impotence and to underestimate their own capabilities and knowledge. In addition, they overlook the resources and possibilities of those who have suffered such violence. 3These reactions are not only evident when caring for sexual violence cases. Professionals who care for battered children and adolescents react similarly. They also feel impotent, an...

Adolescent motherhood, in the context of neonatal hospitalization, causes the health professional to need to understand the specificities of this phase of the life cycle and peculiarities of the mother-hospitalized baby dyad. This study aims to analyze life experiences in the puerperium of first-time adolescent mothers with premature babies hospitalized in the neonatal ICU. We use the Clinical-Qualitative Method, with intentional sampling, in 7 adolescents aged between 13-19 years old. Semi-directed interviews were used and the data underwent thematic analysis and are discussed in a psychodynamic approach. We observed that to deal with the conflicting feelings of omnipotence, affliction, ambivalence, estrangement, shock, confusion, surprise, anger, fear, sadness, anguish, pain, guilt, joy and affection, these adolescents used primitive defense mechanisms: denial, dissociation, splitting and idealization, which are inefficient and require great expenditure of psychic energy. Identifying these defense mechanisms is fundamental to an appropriate therapeutic formulation.Keywords: puerperium, adolescent pregnancy, premature birth, defense mechanisms, qualitative research Mecanismos de Defesa Utilizados por Adolescentes com Bebês Prematuros em UTI NeonatalResumo: A maternidade entre adolescentes, no contexto de internação neonatal, traz ao profissional de saúde uma demanda de compreensão sobre especificidades desta fase do ciclo vital e peculiaridades da díade mãe-bebê internado. Este artigo teve por objetivo explorar as vivências no puerpério de adolescentes primíparas com bebês prematuros internados em UTI Neonatal. Utilizamos método clínico-qualitativo com amostragem intencional fechada pelo critério de saturação. Aplicamos entrevistas semi-dirigidas em sete adolescentes entre 13 e 19 anos. Os dados foram tratados por análise temática de conteúdo e discutidos em referencial psicodinâmico. Na composição das categorias constatamos que para lidar com os sentimentos conflitantes de onipotência, aflição, ambivalência, estranhamento, choque, confusão, surpresa, impotência, medo, tristeza, angústia, dor, culpa, afeto e alegria utilizaram mecanismos de defesa de natureza primitiva: negação, dissociação, divisão (splitting) e idealização, que são ineficazes e exigem grande dispêndio de energia psíquica. A identificação desses mecanismos de defesa é fundamental para uma adequada formulação terapêutica.Palavras-chave: puerpério, gravidez na adolescência, nascimento prematuro, mecanismos de defesa, pesquisa qualitativa Los Mecanismos de Defensa Utilizados por Adolescentes con Bebés Prematuros em la UCIResumen: Maternidad adolescente en contexto hospitalario neonatal aporta una comprensión de la demanda de profesionales acerca de características específicas de esta fase del ciclo de vida y peculiaridades de la díada madre-hijo hospitalizados. Este artículo objetivó Analizar las experiencias adolescentes primíparas posparto con bebés prematuros. Utilizamos método Clínico-cualitativo con muestreo intencional cerrado por...

Objective: To analyze subjective aspects of eating habits and self-care of patients living with chronic symptoms linked to metabolic syndrome. Methods: A clinical and qualitative (exploratory, non-experimental) study, conducted with an intentionally small sample of nine patients in treatment at an outpatient endocrinology clinic of a university hospital in São Paulo, Brazil. The sample was closed when data saturation occurred. The in-depth interviews were conducted with a psychodynamic orientation toward the conduct of dialogues. The categorization of the discourse was developed through content analysis. The psychodynamic approach provided a theoretical reference complemented by social anthropology. Results: Eating habits have been revealed as mediators of autonomy and as a source of vulnerability in the process of coping with chronic illness. Reception and understanding of the psychological and cultural aspects of food are needed in treatment faced with the difficulty of establishing changes in eating behavior. Conclusion: This is a contribution of an interdisciplinary approach that values listening subjectivity during treatment. Keywords: Self care; Food habits; Chronic disease; Health promotion; Metabolic syndrome; Qualitative research resumo Objetivo: Analisar aspectos subjetivos das práticas alimentares e autocuidado de pacientes na convivência com os sintomas crônicos vinculados à Síndro-me Metabólica. Métodos: Estudo clínico-qualitativo (exploratório, não-experimental), realizado com amostra propositalmente pequena de nove pacientes em tratamento ambulatorial de endocrinologia em hospital universitário do Estado de São Paulo, Brasil. O grupo foi fechado por saturação de dados. As entrevistas foram realizadas em profundidade, com orientação psicodinâmica na condução dos diálogos. A categorização do discurso foi desenvolvida por meio da análise de conteúdo. A abordagem psicodinâmica foi a referencial teórico complementada pela antropologia social. Resultados: Práticas alimentares revelaram-se como mediadoras de autonomia e como fonte de vulnerabilidade na convivência com o processo de adoecimento crônico. Acolhimento e compreensão dos aspectos psicológicos e culturais da alimentação são necessários no tratamento diante das dificuldades para estabelecer mudanças no comportamento alimentar. Conclusão: Trata-se de uma contribuição de abordagem interdisciplinar, que valoriza a escuta de subjetividades no tratamento. Descritores: Autocuidado; Hábitos alimentares; Doença crônica; Síndrome X metabólica; Pesquisa qualitativa resumeN:Objetivo: Analizar aspectos subjetivos de las prácticas alimenticias y el autocuidado de pacientes en la convivencia con los síntomas crónicos vinculados al Síndrome Metabólico. Métodos: Estudio clínico-cualitativo (exploratorio, no-experimental), realizado con una muestra propositalmente pequeña de nueve pacientes en tratamiento ambulatorio de endocrinología en un hospital universitario del Estado de Sao Paulo, Brasil. El grupo fue determinado por saturación de datos. Las entre...

The silence of Brazilian women with UI is an essential element of communication about incontinence. We believe that the silence used by these women expresses the pain and anxiety they experienced, and it acts as an adaptive psychosocial mechanism.

ResumoObjetivo: Conhecer as defesas utilizadas por mulheres com síndrome de Turner (ST) ou formas variantes para lidar com a doença. Método: Pesquisa qualitativa com desenho exploratório, não experimental. O instrumento consistiu em entrevista psicológica semidirigida, aplicada em 13 mulheres, cuja amostragem deu-se por saturação, as quais fazem acompanhamento semestral no Centro de Atendimento Integral à Saúde da Mulher. Os dados foram interpretados utilizando-se da abordagem psicodinâmica, aliada a um quadro eclético de referenciais teóricos para discussão no espírito da interdisciplinaridade. Resultados: Essas mulheres apresentaram conflitos psicossociais como dificuldades de relacionamento interpessoal; sentimentos de resignação, raiva, impotência, desvalia e quadros de depressão. As defesas utilizadas foram: repressão, negação, anulação, fantasia, adaptação e sublimação. Conclusões: As mulheres com ST ou formas variantes têm de lidar com as intercorrências orgânicas e psíquicas da enfermidade provocando grande sofrimento que, frequentemente, dificultam uma inserção social mais sadia. Neste caso, os achados deste estudo poderão nortear acompanhamento psicológico ambulatorial concomitantemente ao protocolo clínico de rotina.Chvatal VLS, et al. / Rev Psiq Clín. 2009;36(2):43-7 Palavras-chave: Síndrome de Turner, mecanismos de defesa, pesquisa qualitativa, genética. AbstractObjective: To understand the defenses employed by women suffering from Turner syndrome (TS) and different ways of dealing with the disease. Method: Qualitative research with exploratory design, non-experimental. The instrument consisted of semi-conducted psychological interview, involving 13 women, undergoing semestral medical follow-up at the Women's Health Care Center, and whose sampling was determined by saturation. Data was interpreted using the psychodynamic approach along with an eclectic framework of theoretical references for discussion in the spirit of interdisciplinary approach. Results: These women displayed psychosocial conflicts such as difficulties in interpersonal relationships; feelings of resignation, anger, impotence, devaluation and depression symptoms. Defenses used were: repression, denial, annulment, fantasizing, adaptation and sublimation. Discussion: Women suffering from TS or variant forms must deal with the disease's organic and psychic implications that cause great suffering and often hinder a healthier social insertion. In this case, the study's findings can guide ambulatory psychological support concomitantly to the routine clinical protocol.Chvatal VLS, et al. / Rev Psiq Clín. 2009;36(2):43-7

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.

IntroductionReceiving and understanding the psychological and sociocultural aspects associated to both health problems and difficulties to make the eating behaviour changes are relevant issues when treating individuals with Metabolic Syndrome.Objective and aimsThe reports given by chronic individuals in the present study allowed for analyzing the subjective expressions related to food, treatment management and patient adherence to self care propositions.MethodsIn-depth semi-directed interviews with open-ended questions, with psychodynamic orientation in the conducting dialogues were performed with nine patients from the endocrinology outpatient service of a public university hospital located in Southeast Brazil. From this broader objective, a selection was made of some experiences reported by the subjects, which were related to the process of managing treatment and eating behaviour, implied in chronic metabolic disorders.ResultsIn this work, elements that mediate the process of developing autonomy in eating habits, living with the illnesses and vulnerability factors experiences by Metabolic Syndrome patients are identified in this study.ConclusionThe interdisciplinary character of the present study promoted the valorisation of the practice of listening to the psychological and cultural meanings of eating behaviours, hence offering contributions regarding the nutritional care of individuals with Metabolic Syndrome.

IntroductionThe pregnancy and the motherhood of adolescents are complex phenomena that happen on the trajectory of life of the young persons under physical, psychological and social aspects.AimTo deepen knowledge of the emotional experiences of socially disadvantaged adolescent primiparous with premature babies.MethodQualitative-clinical. Criteria of inclusion: age group, to be primiparous with premature baby and acceptance in participating of the inquiry. The intentional sample was made up of five adolescents aged between 16 and 19. The study was carried between junho/2008 to outubro/2009. Semi-directed interviews based on the trigger question “Tell me about your pregnancy and your baby's birth”. The data were submitted for thematic analysis and from this the following categories emerged: 1. Late discovery of pregnancy: “Mine was a lightning pregnancy”; 2. The symbolization of the child: “It was a present for me…” discussed within a theoretical framework of reference, with special emphasis on the psychodynamic approach.ResultsOn the psychological level, the adolescents presented feelings of omnipotence, unfamiliarity, shock, surprise, anger, fear, anguish and happiness at the birth of their child. They appeared to use immature, narcissistic and neurotic defense mechanisms such as denial, dissociation, acting out and idealization as well as revealing the desire to be good mothers and to engage in maternity.ConclusionThese finds can subsidize the team of health responsible for the service in the UTIN, developing attitudes more effective of support and giving emotional presence aiming to reduce the fear and anguishes resulting from the situation.