Efeitos de uma interven??o preventiva nas compet?ncias emocionais e sociais de crian?as em ambiente escolar

Autor: Heinen, Marina
Přispěvatelé: Oliveira, Margareth da Silva
Jazyk: portugalština
Rok vydání: 2019
Předmět:
Zdroj: Biblioteca Digital de Teses e Dissertações da PUC_RS
Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
instacron:PUC_RS
Popis: Nos ?ltimos anos, tem aumentado a preval?ncia de transtornos mentais em crian?as e adolescentes. A literatura aponta que os Transtornos de Ansiedade e o Transtorno Depressivo tem alto predom?nio de forma isolada ou em comorbidade nessa popula??o. A presen?a de sintomatologia psiqui?trica no per?odo infanto-juvenil ? um fator de risco que pode acarretar em preju?zos ao longo do desenvolvimento. As consequ?ncias incluem dificuldades acad?micas e em relacionamentos, maior envolvimento com viol?ncia, drogas e comportamentos de risco e a evolu??o de transtornos mentais na vida adulta. Nessa perspectiva, considerando a alta preval?ncia e a gravidade dos efeitos dos sintomas, torna-se importante prevenir ou reduzir o impacto da sintomatologia e promover sa?de mental em crian?as e adolescentes. O ambiente escolar tem sido apontado como um espa?o favor?vel para o desenvolvimento de sa?de mental atrav?s da implementa??o de programas que objetivam a promo??o de recursos e preven??o de problemas. A escola pode contribuir para o crescimento saud?vel ao integrar a aprendizagem acad?mica, social e emocional contribuindo tamb?m para o aumento na qualidade da educa??o dos alunos. Frente a isso, pode-se pensar que interven??es precoces com foco no desenvolvimento de compet?ncias socioemocionais podem auxiliar a prevenir problemas de comportamento e promover sa?de mental. A Terapia de Regula??o Infantil (TRI) possui uma modalidade preventiva conhecida como Terapia de Regula??o Infantil Preventiva (TRI-P) ou Trabalho de Regula??o Infantil. O modelo preventivo da TRI destina-se ? popula??o universal com o objetivo de desenvolver habilidades socioemocionais, trabalhando t?cnicas de regula??o emocional e habilidades sociais, que s?o consideradas fatores de prote??o para o n?o desenvolvimento de problemas relacionados aos transtornos mentais. A presente disserta??o tem como objetivo geral avaliar os efeitos do protocolo preventivo da Terapia de Regula??o Infantil (TRI-P) nas compet?ncias socioemocionais de crian?as com idade entre 7 e 9 anos, em escolas de uma cidade do interior do Rio Grande do Sul. O presente estudo faz parte de um projeto maior que visa avaliar a efetividade da Terapia de Regula??o Infantil, o qual est? com parecer favor?vel pelo Comit? de ?tica da PUCRS (CAAE: 40658214.6.0000.5336). Inicialmente, ? apresentada uma se??o te?rica com fundamenta??o te?rica sobre a tem?tica da disserta??o, expondo a preval?ncia e as consequ?ncias da presen?a de sintomas de transtornos mentais em crian?as e adolescentes, a implementa??o de programas preventivos no ambiente escolar, o desenvolvimento de compet?ncias socioemocionais e pesquisas com programas preventivos. Ainda nessa se??o, apresenta-se o primeiro estudo intitulado: ?Interven??o baseada em um protocolo de Terapia Cognitivo-comportamental: Um relato de experi?ncia com crian?as no ambiente escolar?, que visa relatar a experi?ncia da aplica??o do protocolo preventivo da Terapia de Regula??o Infantil com um grupo de dezessete crian?as em uma escola particular no interior do Rio Grande do Sul. Descreve-se de forma detalhada os objetivos e atividades de cada encontro do protocolo. Sugere-se que o TRI-P pode ter auxiliado no fortalecimento de habilidades adquiridas durante a interven??o atrav?s do uso de linguagem acess?vel e materiais concretos. Destaca-se que o alto n?mero de participantes pode ter dificultado um maior aprendizado e a participa??o de todos durante as atividades. Infere-se que houve alta ades?o pois que nenhuma crian?a desistiu do programa e houve feedbacks positivos dos respons?veis. Concluiu-se que esse relato apresentou uma possibilidade de interven??o na escola para o desenvolvimento de habilidades que s?o fatores de prote??o para o desenvolvimento saud?vel das crian?as. A se??o emp?rica da disserta??o ? dividida em dois estudos emp?ricos. O primeiro estudo dessa se??o diz respeito ao estudo piloto realizado com o TRI-P e foi intitulado ?Protocolo Preventivo da Terapia de Regula??o Infantil: Estudo piloto no ambiente escolar?. Esse estudo objetiva avaliar os efeitos do TRI-P nas habilidades socioemocionais em crian?as com idade entre 7 e 9 anos. Realizou-se um estudo de base quasi-experimental em que comparou o grupo experimental (n=17) com o grupo controle do tipo lista de espera (n=11), antes e ap?s a interven??o. A divis?o dos grupos deu-se de maneira n?o aleat?ria. Utilizou-se as escalas Social Skills Rating System (SSRS-BR) para a avalia??o de habilidades sociais e comportamentos problem?ticos, e a Emotional Regulation Checklist (ERC) para avaliar regula??o e labilidade emocional. Ambas escalas foram preenchidas pelos respons?veis. O per?odo entre a avalia??o pr? e a p?s foi de, aproximadamente, 3 meses. A pesquisa foi realizada em uma escola particular no interior do Rio Grande do Sul. Os resultados, ap?s interven??o, apontam diminui??o significativa nos n?veis de problema de comportamento [Pr?: 30,2?20,0 vs. P?s: 22,4?15,8; p=0,018] e labilidade do humor [Pr?: 22,2?3,7 vs. P?s: 19,9?3,2; p=0,036], no grupo experimental. Houve aumento, mas n?o significativo, nos escores de regula??o emocional e habilidades sociais, no grupo experimental. Houve diferen?a significativa entre os grupos na subescala que avalia labilidade do humor nas avalia??es pr? e p?s interven??o (Pr?: p=0,055; P?s: p=0,006). Os resultados apontam que a implementa??o do TRI-P mostrou-se eficaz para a redu??o de problemas de comportamento e nos n?veis de labilidade do humor da amostra em quest?o e pode ser uma op??o promissora frente a import?ncia do cuidado com sa?de mental no ambiente escolar. O segundo estudo emp?rico intitulado ?Efeitos de uma interven??o para promover sa?de mental e prevenir problemas de comportamento de crian?as em ambiente escolar? tem como objetivo avaliar os efeitos do TRI-P nas compet?ncias socioemocionais e nos sintomas de ansiedade e depress?o em crian?as com idade entre 7 e 9 anos. Realizou-se um delineamento de base quasiexperimental. Participaram do estudo 39 crian?as, que foram divididas de forma n?o aleat?ria para o grupo experimental e lista de espera. Os respons?veis preencheram o Social Skills Rating System (SSRS-BR) ? Vers?o Pais e a Emotional Regulation Checklist (ERC). J? as crian?as preencheram a Social Skills Rating System (SSRS-BR) ? Vers?o Crian?as, Screen for Child Anxiety Related Emotional Disorders (SCARED) e Children Depression Inventory (CDI). A pesquisa foi realizada em duas escolas, uma particular e uma p?blica, em uma cidade no interior do Rio Grande do Sul. Comparou-se o grupo experimental (n=22), que recebeu a interven??o do protocolo TRI-P, com o grupo controle do tipo lista de espera (n=17) em rela??o aos n?veis de habilidades sociais, problemas de comportamento, labilidade do humor e regula??o emocional, assim como nos escores dos sintomas dos Transtornos de Ansiedade e Transtorno Depressivo, antes e ap?s a interven??o. O per?odo entre a avalia??o pr? e a p?s foi de, aproximadamente, 3 meses. N?o houve diferen?as significativas em rela??o ? compara??o dos dados s?cio demogr?ficos dos participantes entre os grupos. Percebeu-se redu??o significativa dos n?veis de problemas de comportamento [Pr?: 55,22?30,52 vs. P?s: 37,09?30,15; p=0,013] e labilidade do humor [Pr?: 27,73?4,98 vs. P?s: 24,04?5,10; p=0,006], assim como nos n?veis de ansiedade [Pr?: 38,86?8,87 vs. P?s: 28,00?8,02; p= 0,000] e depress?o [Pr?: 11,18?6,48 vs. P?s: 6,68?3,82; p= 0,000], no grupo experimental. Assim como um aumento significativo nos n?veis de regula??o emocional [Pr?: 31,27?3,41 vs. P?s: 34,09?3,23, p=0,000] e nas habilidades sociais a partir da auto avalia??o da crian?a [Pr?: 35,59?30,61 vs. P?s: 59,00?29,29; p=0,002] e na avalia??o dos pais [Pr?: 43,31?25,61 vs. P?s: 58,27?24,87; p=0,001]. Diferentemente do grupo experimental, no grupo controle houve diminui??o significativa nos n?veis de habilidades sociais na auto avalia??o das crian?as (p=0,019). Houve diferen?as estatisticamente significativas entre os grupos na auto avalia??o inicial das crian?as em rela??o ?s habilidades sociais (p=0,044), na auto avalia??o final (p=0,010) e na avalia??o final de regula??o emocional (p=0,011). Essa pesquisa apresenta resultados satisfat?rios com a aplica??o do TRI-P, visto que diminuiu os n?veis de problemas de comportamento e labilidade do humor e aumentou os escores de regula??o emocionais e habilidades sociais nas crian?as submetidas ? interven??o. Assim, apresentou-se como uma proposta eficaz de preven??o de problemas emocionais de comportamento das crian?as no ambiente escolar. In the last couple of years, the prevalence of mental disorders in children and adolescents have increased. Literature indicates that Anxiety Disorders and Depressive Disorder are highly prevalent in an isolated form or in comorbidity in this population. The presence of psychiatric symptoms in children and adolescents is a risk factor that may lead to developmental losses. Consequences include academic and relationship issues, increased involvement with violence, drugs and risky behavior, and the evolution of mental disorders in adult life. From this perspective, considering the high prevalence and severity of the effects of symptoms, it is important to prevent or reduce the impact of symptoms and promote mental health in children and adolescents. The school environment has been pointed as a favorable space for the development of mental health through the implementation of programs that aim to promote resources and prevent problems. School can contribute to the healthy growth by integrating academic, social and emotional learning and contributing to increase quality in student education. In face of what was exposed, it can be thought that early interventions focusing on the development of socio-emotional skills can help prevent behavioral problems and promote mental health. The Terapia de Regula??o Infantil (TRI) has a preventive modality known as Terapia de Regula??o Infantil Preventiva (TRI-P) or Trabalho de Regula??o Infantil. The preventive mode of TRI is intended to the universal population with the aim of developing socio-emotional skills, working on techniques of emotional regulation and social skills, which are considered protective factors for the non-development of problems related to mental disorders. This dissertation aims to evaluate the effects of the preventive protocol of the Terapia de Regula??o Infantil (TRI-P) on the socio-emotional skills of children from 7 to 9 years of age, in schools of a city in the interior of Rio Grande do Sul. This study is part of a larger project aimed to evaluate the effectiveness of Terapia de Regula??o Infantil, which was approved by the Comit? de ?tica da PUCRS (CAAE: 40658214.6.0000.5336). Initially, a theoretical section is presented with theoretical basis on the theme of the dissertation, exposing the prevalence and the consequences of the presence of symptoms of mental disorders in children and adolescents, the implementation of preventive programs in the school environment, the development of socio-emotional skills and researches with preventive programs. This section also presents the first study entitled: ?Intervention based on a protocol of Cognitive-Behavioral Therapy: An experience report with children in school environment?, which aims to report the experience of applying the preventive protocol of Terapia de Regula??o Infantil with a group of seventeen children in a private school in the interior of Rio Grande do Sul. The objectives and activities of each protocol meeting are described in details. It is suggested that TRI-P may have helped in strengthening skills acquired during the intervention through the use of accessible language and concrete materials. Stands out that the high number of participants may have hampered greater learning and participation of all during the activities. It is inferred that there was high adherence because no child dropped out of the program and there were positive feedbacks from those responsible. It was concluded that this report presented a possibility of intervention at school for the development of skills that are protective factors for the healthy development of children. The empirical section of the dissertation is divided into two empirical studies. The first study in this section concerns the pilot study conducted with the TRI-P and was entitled "Preventive Protocol of Terapia de Regula??o Infantil: Pilot Study in the School Environment". This study aims to evaluate the effects of TRI-P on socio-emotional skills in children from 7 to 9 years of age. A quasi-experimental baseline study was performed comparing the experimental group (n=17) with a waiting list control group (n=11) before and after the intervention. The division of the groups was non-randomly. The scales used were the Social Skills Rating System (SSRS-BR) to evaluate social skills and behavior problems, and the Emotional Regulation Checklist (ERC) to evaluate emotional regulation and mood lability. Both scales were filled by those responsible. The period between pre and post evaluation was approximately 3 months. The research was conducted in a private school in the interior of Rio Grande do Sul. Results after intervention indicate significant decrease in behavior problem levels [Pre: 30,2?20,0 vs. Post: 22,4?15,8; p=0,018] and mood lability [Pre: 22,2?3,7 vs. Post: 19,9?3,2; p=0,036], in the experimental group. There was an increase, but not significant, in the emotional regulation and social skills scores in the experimental group. There was a significant difference between the groups in the subscale that assesses mood lability in the pre and post intervention evaluations (Pre: p=0,055; Post: p=0,006). The results point that the implementation of the TRI-P was effective to reduce behavior problems and mood lability levels of the sample and may be a promising option given the importance of mental health care in the school environment. The second empirical study entitled ?Effects of an intervention to promote mental health and prevent children's behavior problems in school environment? aims to evaluate the effects of TRI-P on socio-emotional skills and symptoms of anxiety and depression in aged children. between 7 and 9 years of age. A quasiexperimental base outline was performed. 39 children participated in the study, who were non-randomly assigned to the experimental group and the waiting list. Those responsible completed the Social Skills Rating System (SSRS-BR) - Parents Version and the Emotional Regulation Checklist (ERC). On the other hand, children completed the Social Skills Rating System (SSRS-BR) - Children Version, Screen for Child Anxiety Related Emotional Disorders (SCARED) and Children Depression Inventory (CDI). The research was conducted in two schools, one private and one public, in a city in the interior of Rio Grande do Sul. The experimental group (n=22), which received the intervention of the protocol TRI-P, was compared to the waiting list control group (n=17), regarding to social skills levels, behavior problems, mood lability and emotional regulation, as well as the scores of symptoms of Anxiety Disorders and Depressive Disorder, before and after the intervention. The period between pre and post evaluation was approximately 3 months. There were no significant differences regarding the comparison of participant's demographic data between groups. Significant reduction in behavioral problem levels was noticed [Pre: 55,22?30,52 vs. Post: 37,09?30,15; p=0,013] and mood lability [Pre: 27,73?4,98 vs. Post: 24,04?5,10; p=0,006], as well as anxiety levels [Pre: 38,86?8,87 vs. Post: 28,00?8,02; p= 0,000] and depression [Pre: 11,18?6,48 vs. Pos: 6,68?3,82; p= 0,000], in the experimental group. Also a significant increase in levels of emotional regulation was noticed [Pre: 31,27?3,41 vs. Post: 34,09?3,23, p=0,000] and in social skills based on the self-evaluation of the child [Pre: 35,59?30,61 vs. Post: 59,00?29,29; p=0,002] and in the evaluation of the parents [Pre: 43,31?25,61 vs. Post: 58,27?24,87; p=0,001]. In the control group there was no significant increase or decrease. However, unlike the experimental group, in the control group there was a significant decrease in social skills levels in the self-assessment of children (p=0,019). There were statistically significant differences between the groups in the initial self-assessment of children in relation to social skills (p=0,044), in the final self-evaluation (p=0,010) and in the final emotional regulation evaluation (p=0,011). This research presents satisfactory results with the application of the TRI-P, since it decreased the levels of behavior problems and mood lability and increased the emotional regulation scores and social skills in the children undergoing the intervention. Thus, it was presented as an effective proposal to prevent emotional behavior problems of children in the school environment.
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