Sintomas somáticos funcionais na criança e alexitimia materna
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Data
2023-12-11
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Universidade Estadual Paulista (Unesp)
Resumo
Os sintomas somáticos funcionais se caracterizam como manifestações de natureza principalmente somática e do comportamento da criança, sem causa orgânica aparente. Especificamente em relação aos bebês e às crianças pequenas, período em que a capacidade de comunicação verbal é, ainda, limitada, o corpo é fonte privilegiada de comunicação não-verbal e a qualidade de interação entre mãe-bebê pode contribuir para o surgimento dos sintomas somáticos funcionais no início da vida. Dessa forma, para melhor compreensão dos sintomas somáticos funcionais infantis, é necessário considerar também características maternas, como a alexitimia. Sendo assim, o presente estudo teve por objetivo identificar os sintomas somáticos funcionais em crianças de 6 a 36 meses em acompanhamento na Atenção Primária à Saúde (APS), indicadores de alexitimia materna e compreender de que maneira os sintomas somáticos são percebidos por mães com indicadores de alexitimia. Trata-se de um estudo observacional, de corte transversal e abordagem quanti-qualitativa. Foi composta uma amostra de conveniência com 40 díades mãe-criança, tendo como critérios de inclusão: crianças com idade de 6 a 36 meses de idade, em seguimento pediátrico de rotina na Atenção Primária à Saúde (APS) e mães com 18 anos ou mais, que aceitaram participar do estudo, mediante assinatura do TCLE. Para a realização da pesquisa, foram aplicados os instrumentos: Questionário Sociodemográfico, elaborado para o estudo, Questionário de Sintomas Somáticos do Bebê, Escala de Alexitimia de Toronto (TAS-26), em um único encontro, aproveitando a ida da mãe e da criança à unidade de saúde para acompanhamento pediátrico de rotina. Foram realizadas análises descritivas dos distúrbios de comportamento entre as crianças e de indicadores de alexitimia materna. Também foi realizado o estudo de casos múltiplos, considerando as díades cujas mães apresentaram escores indicativos de alexitimia. O estudo de casos múltiplos foi complementado com dados dos prontuários das crianças sobre queixas espontâneas, relatadas pela mãe ao longo do seguimento da criança. Os resultados apontam que a maioria das mães (95%) avalia de forma positiva a saúde geral do(a) filho(a), porém aproximadamente um terço delas (30%) avaliaram a qualidade do sono da criança como razoável ou ruim, seguida por avaliações negativas de respiração (25%), alimentação (22,5%), pele (20%), comportamento (15%) e digestão (10%). Das 40 mães entrevistadas, 10 (26,66%) apresentaram pontuação indicativa de alexitimia no TAS-26. O estudo de casos múltiplos apontou discrepâncias em relação às respostas ao instrumento fechado e o relato materno ao longo da entrevista e permitiu observar que as mães com indicadores de alexitimia apresentaram dificuldade em atribuir significado subjetivo aos sintomas de seus filhos, justificando-os a partir de causas concretas.
Functional somatic symptoms are characterized as manifestations of a mainly somatic nature and of the child's behavior, without an apparent organic cause. Specifically in relation to babies and young children, a period in which the capacity for verbal communication is still limited, the body is a privileged source of non-verbal communication and the quality of interaction between mother and baby can contribute to the emergence of symptoms functional somatics early in life. Therefore, to better understand children's functional somatic symptoms, it is also necessary to consider maternal characteristics, such as alexithymia. Therefore, the present study aimed to identify functional somatic symptoms in children aged 6 to 36 months being monitored in Primary Health Care (PHC), indicators of maternal alexithymia and understand how somatic symptoms are perceived by mothers with indicators of alexithymia. This is an observational, cross-sectional study with a quantitative-qualitative approach. A convenience sample was composed of 40 mother-child dyads, with the following inclusion criteria: children aged 6 to 36 months, undergoing routine pediatric follow-up in Primary Health Care (PHC) and mothers aged 18 years or older , who agreed to participate in the study, by signing the TCLE. To carry out the research, the following instruments were applied: Sociodemographic Questionnaire, prepared for the study, Baby Somatic Symptoms Questionnaire, Toronto Alexithymia Scale (TAS-26), in a single meeting, taking advantage of the mother and child's visit to the health unit for routine pediatric follow-up. Descriptive analyzes of behavioral disorders among children and indicators of maternal alexithymia were carried out. A multiple case study was also carried out, considering dyads whose mothers presented scores indicative of alexithymia. The multiple case study was complemented with data from the children's medical records on spontaneous complaints, reported by the mother throughout the child's follow-up. The results indicate that the majority of mothers (95%) positively evaluate their child's general health, but approximately a third of them (30%) evaluate the child's sleep quality as fair or bad, followed by by negative assessments of breathing (25%), food (22.5%), skin (20%), behavior (15%) and digestion (10%). Of the 40 mothers interviewed, 10 (26.66%) had a score indicative of alexithymia on the TAS-26. he multiple case study highlighted discrepancies in relation to the responses to the closed instrument and the maternal report throughout the interview and allowed us to observe that mothers with indicators of alexithymia had difficulty in attributing subjective meaning to their children's symptoms, justifying them based on concrete causes.
Functional somatic symptoms are characterized as manifestations of a mainly somatic nature and of the child's behavior, without an apparent organic cause. Specifically in relation to babies and young children, a period in which the capacity for verbal communication is still limited, the body is a privileged source of non-verbal communication and the quality of interaction between mother and baby can contribute to the emergence of symptoms functional somatics early in life. Therefore, to better understand children's functional somatic symptoms, it is also necessary to consider maternal characteristics, such as alexithymia. Therefore, the present study aimed to identify functional somatic symptoms in children aged 6 to 36 months being monitored in Primary Health Care (PHC), indicators of maternal alexithymia and understand how somatic symptoms are perceived by mothers with indicators of alexithymia. This is an observational, cross-sectional study with a quantitative-qualitative approach. A convenience sample was composed of 40 mother-child dyads, with the following inclusion criteria: children aged 6 to 36 months, undergoing routine pediatric follow-up in Primary Health Care (PHC) and mothers aged 18 years or older , who agreed to participate in the study, by signing the TCLE. To carry out the research, the following instruments were applied: Sociodemographic Questionnaire, prepared for the study, Baby Somatic Symptoms Questionnaire, Toronto Alexithymia Scale (TAS-26), in a single meeting, taking advantage of the mother and child's visit to the health unit for routine pediatric follow-up. Descriptive analyzes of behavioral disorders among children and indicators of maternal alexithymia were carried out. A multiple case study was also carried out, considering dyads whose mothers presented scores indicative of alexithymia. The multiple case study was complemented with data from the children's medical records on spontaneous complaints, reported by the mother throughout the child's follow-up. The results indicate that the majority of mothers (95%) positively evaluate their child's general health, but approximately a third of them (30%) evaluate the child's sleep quality as fair or bad, followed by by negative assessments of breathing (25%), food (22.5%), skin (20%), behavior (15%) and digestion (10%). Of the 40 mothers interviewed, 10 (26.66%) had a score indicative of alexithymia on the TAS-26. he multiple case study highlighted discrepancies in relation to the responses to the closed instrument and the maternal report throughout the interview and allowed us to observe that mothers with indicators of alexithymia had difficulty in attributing subjective meaning to their children's symptoms, justifying them based on concrete causes.
Descrição
Palavras-chave
Sintomas somáticos funcionais, Alexitimia, Atenção primária à saúde, Sintomas Inexplicáveis
Como citar
PRADO, A. P. do. Sintomas somáticos funcionais na criança e alexitimia materna. 2023. 83 f. Dissertação (Mestrado em Saúde Coletiva) - Faculdade de Medicina de Botucatu, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, 2023.