Estressores e coping de crianças e adolescentes usuários de dispositivos auditivos implantáveis e seus cuidadores
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Data
2021-09-03
Autores
Campos, Lara Sessa
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Universidade Federal do Espírito Santo
Resumo
Hearing impairment (HI) is a type of sensory deprivation that is characterized by the atypical reaction to sound stimuli, causing damage to the individual's communication, which can generate emotional, social, psychological and intellectual damage. After diagnosis, the rehabilitation process begins, which may culminate in cochlear implant (CI) surgery or bone-anchored hearing aids (BAHA). Surgery is only one step that unfolds in systematic follow-up for activation, mapping and speech therapy. It is a complex process, which can add stressors to those already related to AD, namely: exposure to invasive procedure, change of appearance, difficulty in social interaction, adaptation to the device, frequent trips to the treatment center, among others. The child and the family need to deal with these stressors, seeking to adapt to the situation to obtain the benefits that implantable hearing devices can bring. This study aimed to verify and describe how children using implantable hearing devices and their parents deal with stressors related to the rehabilitation process. A sample of nine children and adolescents who use CI/BAHA, aged between six and 12 years, and their family caregivers were constituted. Family caregivers answered the instruments for recording sociodemographic and clinical characteristics of children and adolescents (Brazil Economic Classification Criterion - ABEP), psychosocial risk assessment instrument (Psychosocial Assessment Instrument - PAT), child/adolescent behavioral indicators (Strengths and Difficulties Questionnaire [SDQ]), stressors and expectations in relation to CI/BAHA (semi-structured interview), coping (Coping Scale). For the interview with the adolescent child, an instrument was elaborated with drawings of stressful situations and questions for the evaluation of coping. Data from standardized instruments and sociodemographic and clinical characteristics were submitted to descriptive statistics, while data from the interview and instrument elaborated were submitted to content analysis. The results showed that, from the psychosocial point of view, there was a predominance of mild and moderate psychosocial risk classification, and in all cases there is a perception of social support. The behavioral indicators of the children comprised clinical and non-clinical groups for behavioral problems, but most children have prosocial behavior. Caregivers perceive common stressors for them and for the children, such as surgery and child communication, with the exception being the management of the device for the child and the access to the service for parents. In the face of stressors, caregivers reported sadness and fear, but there was a predominance of coping families related to the perception of the stressor as a challenge, with emphasis on "information search" and "problem solving". About the coping of children/adolescents, the emotional reaction to the stressors was sadness and the coping behaviors that were mentioned are related to adaptive strategies. Despite the limitation in the verbal report of some children, resulting from the heterogeneity of the history of HI and rehabilitation, the preliminary analysis of the adequacy of the proposed instrument is favorable to the use in child care, in order to obtain its self-perception, which is placed as innovative. It is concluded that the integration of psychosocial and behavior data with data on perception and coping on the auditory rehabilitation process through implantable devices helped to understand the process of each child/adolescent and their families, contributing to a more focused care and the possibility for the children to reach their full potential.
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Palavras-chave
Deficiência auditiva , implante coclear , coping , estratégias de enfrentamento , desenvolvimento da criança , desenvolvimento do adolescente , cuidador familiar