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O luto pré morte como mediador da relação entre vinculação ansiosa e sintomas psicopatológicos no cuidador informal
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Abstract(s)
A vivência de luto antecipatório pode ser sentida de forma muito distinta consoante a influência de variáveis intrapessoais como a vinculação. A vinculação insegura está mais associada a sintomas de ansiedade e depressão, bem como a luto complicado. O diagnóstico de uma doença grave e as perdas múltiplas derivadas da mesma são fatores contextuais que podem impactar a saúde mental da pessoa cuidada e do cuidador. Pretende-se explorar, neste estudo, o papel mediador dos sintomas de luto pré-morte e a sua relação com a vinculação e os sintomas psicopatológicos de ansiedade e depressão dos cuidadores familiares. Os participantes foram 129 cuidadores informais de pacientes com doença grave ou crónica. O questionário foi difundido através das redes sociais junto de associações de cuidadores informais. Adicionalmente, alguns cuidadores da clínica de São João D`Ávila responderam ao questionário presencialmente. A avaliação incluiu um questionário sociodemográfico; Escala de Vinculação do Adulto (EVA); Questionário de Perturbação de Luto Prolongado - pré-morte (PG-12) e Escala Hospitalar de Ansiedade e Depressão (HADS). Os resultados revelaram que existe uma correlação significativa forte entre a vinculação ansiosa, luto pré morte e sintomas de ansiedade e depressão. A análise de mediação permitiu concluir que o luto pré morte é um bom mediador da relação entre a vinculação ansiosa e os sintomas de ansiedade no cuidador porque quando existe uma ameaça à vida do outro significativo, os sintomas de luto pré-morte potenciam o efeito adverso da vinculação ansiosa, criando mais ansiedade. Estes resultados demonstram a necessidade de intervir precocemente nos sintomas de luto.
The living experience of anticipatory grief can be felt in many distinctive ways according to the influence of different intrapersonal variables, like attachment. Insecure attachment styles are more related to symptoms of anxiety and depression, as well as complicated grief. The diagnostic of a severe illness and the derived loss from it, are contextual factors that can impact the mental health of the caregiver, and the person cared for. The aim of this study is to explore the mediator effect of predeath grief symptoms and its relation between anxious attachment and psychopathological symptoms of anxiety and depression in caregivers of patients. The participants were 129 informal caregivers of patients with a chronic or severe condition. The questionnaire was widespread through social media at informal caregivers’ associations. Additionally, some informal caregivers of Saint John of Avila clinic answered the questionnaire in a face-to-face meeting. The evaluation includes a Sociodemographic Questionnaire, the Adult Attachment Scale (AAS), the Prolonged Grief Disorder Questionnaire - Predeath (PG-12) and the Hospital Anxiety and Depression Scale (HADS). The results showed a significant and strong correlation between anxious attachment, pre death grief and symptoms of anxiety and depression. The analysis of the mediation model allowed the conclusion that pre death grief is a good mediator in the relation between anxious attachment and anxiety symptoms in the informal caregiver because when there is a threat to the life of a significant other, pre death symptoms increase the adverse effect of anxious attachment, creating more anxiety. This findings demonstrate the need to an early intervention in grief symptoms.
The living experience of anticipatory grief can be felt in many distinctive ways according to the influence of different intrapersonal variables, like attachment. Insecure attachment styles are more related to symptoms of anxiety and depression, as well as complicated grief. The diagnostic of a severe illness and the derived loss from it, are contextual factors that can impact the mental health of the caregiver, and the person cared for. The aim of this study is to explore the mediator effect of predeath grief symptoms and its relation between anxious attachment and psychopathological symptoms of anxiety and depression in caregivers of patients. The participants were 129 informal caregivers of patients with a chronic or severe condition. The questionnaire was widespread through social media at informal caregivers’ associations. Additionally, some informal caregivers of Saint John of Avila clinic answered the questionnaire in a face-to-face meeting. The evaluation includes a Sociodemographic Questionnaire, the Adult Attachment Scale (AAS), the Prolonged Grief Disorder Questionnaire - Predeath (PG-12) and the Hospital Anxiety and Depression Scale (HADS). The results showed a significant and strong correlation between anxious attachment, pre death grief and symptoms of anxiety and depression. The analysis of the mediation model allowed the conclusion that pre death grief is a good mediator in the relation between anxious attachment and anxiety symptoms in the informal caregiver because when there is a threat to the life of a significant other, pre death symptoms increase the adverse effect of anxious attachment, creating more anxiety. This findings demonstrate the need to an early intervention in grief symptoms.
Description
Dissertação de Mestrado apresentada no ISPA – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Clínica.
Keywords
Vinculação Luto antecipatório Cuidadores informais ansiedade e depressão Attachment Anticipatory grief Informal caregivers Anxiety
Citation
Costa, S. C. (2024). O luto pré morte como mediador da relação entre vinculação ansiosa e sintomas psicopatológicos no cuidador informal [Dissertação de Mestrado]. ISPA – Instituto Universitário.