Banca de DEFESA: Isabela Castelli

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : Isabela Castelli
DATE: 20/04/2023
TIME: 13:30
LOCAL: encurtador.com.br/fnOU2
TITLE:

Psychological intervention in patients’ victims of traumatic upper limb amputations.

KEY WORDS:

Traumatic amputation, early intervention, psychological intervention

PAGES: 280
BIG AREA: Ciências Humanas
AREA: Psicologia
SUMMARY:

Amputation surgeries refer to the removal total or partial of an organ, greater objective of saving the
patient's life and, subsequently, saving the limb and its function, aiming at the patient's rehabilitation.
Amputation surgeries can cause adverse impacts to the functionality and quality of life of the patient. The
literature distinguishes the causes of amputations from chronic diseases or trauma. Among the causes of
traumatic amputation, the following stand out: car accidents, accidents with firearms or knives, physical
violence and falls from great heights. The experience of an amputation brings with it physical and
psychological changes, such as anguish, anger, uncertainty about the future. Despite the references in the
literature to these symptoms, the number of studies carried out on the psychological implications in the
life course of amputees is still low, especially in the case of traumatic amputations. Considering the
information gap, a systematic literature review was carried out, comprising publications between the years
2000 and 2021, with the descriptors “traumatic amputation”, “psychological trauma” and crisis
intervention”, combined two by two, and their equivalents in English. Of the total of 133 possible articles,
only 16 that mentioned psychological aspects and traumatic amputations were screened: indicating, again,
the low academic production on the subject. A longitudinal study was carried out with traumatic amputees
to evaluate the effects of early psychological intervention (up to 72 hours after amputation) and follow-up
(up to 12 months) of patients treated at a general hospital in the Federal District. This was an
interventional, non-random, qualitative, and descriptive study, based on the Cognitive-Behavioral Therapy
approach. The collection took place between August/2020 and August/2021. The patients underwent early
psychological intervention, being approached by a psychologist within a maximum period of 72 hours
after the amputation. After discharge, patients were invited to undergo five psychological follow-up
sessions, with an average interval of 15 days. Instruments were applied to assess satisfaction with life,
presence of depressive and anxious symptoms, level of impact of the adverse event and use of coping
strategies (Barthel Index, HADS, IES-R, Brief Cope Scale, SWLS, self-report). The Instruments were
applied in the first psychological follow-up session; being reapplied at the end of the five psychological
follow-up sessions; after six and 12 months after amputation. Three patients were followed up; who,
throughout the study, showed improvement in depressive and anxious symptoms; improvement in
functional dependence; reduction of the level of impact of the stressful event; increase in life satisfaction
score. The data indicate the importance of psychological care to the traumatic amputee patient. The main
limitation of the study is due to the small number of participants. It is suggested the technical training of
professionals who work with amputee patients to identify signs that indicate the need for referral and
psychological follow-up. It is also suggested to strengthen the flow and counterflow of references within
the Health Care System so that the rehabilitation process takes place in an integral way. For patients and
family members, psychoeducation is suggested to ensure better adherence to treatment.

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