Victor Viana (**)

J. Paulo Almeida (**)

RESUMO

Os autores começam por caracterizar de forma sucinta a psicologia da saúde, realçando o papel do comportamento na saúde e na doença. Em seguida, são apresentados aspectos característicos da intervenção psicológica no âmbito da saúde da criança, denominada desde há alguns anos como psicologia pediátrica. Esta é definida e caracterizada como uma prática psicológica nos serviços médicos de crianças, cujos objectivos são contribuir para a promoção da saúde e prevenção da doença na criança, colaborar no tratamento, recuperação e apoio à criança doente, apoio à família, e participar na investigação aplicada dos factores psicossociais associados à saúde e à doença.

É descrita a orientação predominante e objectivos da intervenção psicológica realizada pelos autores, no serviço pediátrico em que estão integrados desde há alguns anos.

Finalmente é apresentada uma referência crítica e breve à legislação, recentemente publicada no nosso país, que enquadra os psicólogos que trabalham na saúde na carreira dos técnicos superiores de saúde, regulamentando o papel e funções, e a formação destes.

ABSTRACT

The authors caracterize the pediatric psychology witch is defined as a psychology applied to children's medical context, and conceptualized as a health psychology and different from the clinic psychology.

Some aspects of the psychological intervention in this context are discribed such as prevention and promotion of children's health, intervention in children's illness and family, and research directions in the field.

Some relevant aspects of the psychological intervention in a portuguese pediatric service are discribed. Recente portuguese legislation about health psychologist's role definition and trainning is analised.

Key words: Behavior and health, health promotion and prevention, pediatric psychology, infant health psychology.

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REFERÊNCIAS BIBLIOGRÁFICAS

Achterberg-Lawlis, J. (1982). The psychological dimensions of arthritis. Journal of Consulting and Clinical Psychology, 46, 984-992.

Almeida, J. P., & Viana, V. (1990). O desenvolvimento psicológico da criança com doença crónica. In I. Botelho, J. Almeida, M. Geada, & J. Justo (Eds.), A Psicologia nos Serviços de Saúde (pp. 75-85). Lisboa: APPORT.

Bachanas, P., & Roberts, M. (1995). Factors affecting children's attitudes toward health care and responses to medical procedures. Journal of Pediatric Psychology, 20, 261-275.

Bibace, R., & Walsh, M. (1980). Development of children's concepts of illness. Pediatrics, 66, 912-917.

Brownell, K.(1982). Obesity: Understanding and treating a serious, prevalent, and refractory disorder. Journal of Consulting and Clinical Psychology, 50, 820-840.

Contrada, R., Baum, A., Glass, D., & Friend, R. (1991). The social psychology of health. In R. Baron, & W. Graziano (Eds.), Social Psychology (pp. 614-649). Fort Worth: Holt. Rinehart and Winston, Inc.

Crisp, J., Ungerer, J., & Goodnow, J. (1996). The impact of experience of children's understanding of illness. Journal of Pediatric Psychology, 21, 57-72.

Cristoffel, K., Donovan, M., Schofer, J., Willis, K., & Lavigne, J. (1996). Psychosocial factors in childhood pedestrian injury: A matched case-control study. Pediatrics, 97, 33-42.

Delamater, A., Bubb, J., Kurtz, S., Kuntze, J., Smith, J., White, N., & Santiago, J. (1988). Physiological responses to acute psychological stress in adolescents with type I diabetes mellitus. Journal of Pediatric Psychology, 13, 69-86.

Dietz, W. (1994). Critical periods in childhood for the development of obesity. American Journal of Clinical Nutrition, 59, 955-959.

Drotar, D. (1994). Impact of parental health problems on children: Concepts, methods, and unanswered questions. Journal of Pediatric Psychology, 19, 525-536.

Drotar, D. (1994a). Psychological researsh with pediatric conditions: If we specialize, can we generalize? Journal of Pediatric Psychology, 19, 403-414.

Engel, G. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129-136.

Fiese, B., & Sameroff, A. (1989). Family context in pediatric psychology: A transactional perspective. Journal of Pediatric Psychology, 14, 293-314.

Gustafsson, P., Cederblade, M., Ludvigsson, J., & Lundin, B. (1987). Family interactions and metabolic balance in juvenile diabetes mellitus: A prospective study. Diabetes Research and Clinical Practice, 4, 7-14.

Hamburg, B., & Inoff, G.(1982). Relationships between behavioral factors and diabetic control in children and adolescents: A camp study. Psychosomatic Medicine, 44, 321-339.

Jessor, R. (1991). Risk behavior in adolescence: A psychosocial framework for understandingand action. Journal of Adolescent Health, 12, 597-605.

Johnson, S., & Birch, L. (1994). Parents' and children adiposity and eating style. Pediatrics, 94, 653-661.

Johnson, S. B. (1994). Health behavior and health status. Journal of Pediatric Psychology, 19, 129-141.

La Greca, A. (1994). Assessment in pediatric psychology: Wath's a researcher to do? Journal of Pediatric Psychology, 19, 283-290.

La Greca, A., & Lemanek, K. (1996). Assessment as a process in pediatric psychology. Journal of Pediatric Psychology, 21, 137-151.

Lemanek, K. (1994). Research on pediatric chronic illness: New directions and recurrent confounds. Journal of Pediatric Psychology, 19, 143-148.

Levy, M. L. (1995). Adolescência e Adolescentes. Acta Pediátrica Portuguesa, 26, 255-258.

Matarazzo, J. (1980). Behavioral health and behavioral medicine. frontiers for a new health psychologist. American Psychologist, 35, 807-817.

Matarazzo, J. D. (1982). Behavioral health's challenge to academic, scientific, and professional psychology. American Psychologist, 37, 1-14.

McAuley, E. (1994). Physical activity and psychosocial outcomes. In C. Bouchard, R. Shephard, & T. Stephans (Eds.), Fisical Activity Fitness, and Health: International Proceedings and Consensus Statment (pp. 551-568). Human Kinectics Publishers.

Mesibov, G., & Johnson, M. (1982). Intervention techniques in pediatric psychology. In J. Tuma (Ed.), Hanbook for the Practice of Pediatric Psychology (pp. 110-164). New York: Wiley & Sons.

Minuchin, S., Baker, L., Rosman, B., Liebman, D., Milman, L., & Todd, T. (1975). A conceptual model of psychosomatic illness in children. Archives of General Psychiatry, 32, 1031-1038.

Olson, D., Portner, J., & Lavee, Y. (1985). Faces III: Family adaptability and cohesion evaluation scales. In D. Olson, H. McCubbin, H. Barnes, A. Larsen, M. Muxen, & M. Wilson (Eds.), Family Inventories: Inventories Used in a National Survey of Families Across the Family Life Cycle (pp. 18-42). St. Paul: Family Social Science, University of Minnesota.

Parmelee, A. (1986). Children's illness: Their beneficial effects on behavioral development. Child Development, 57, 1-10.

Patterson, J. (1995). Promoting resilience in families experiencing stress. Pediatric Clinics of North America, 42, 47-63.

Perrin, E., & Guerrity, P. (1981). Ther's a demon in your belly: Children's understanding of illness. Pediatrics, 67, 841-849.

Peterson, L., & Lewis, K. (1988). Preventive intervention to improve children's discrimination of the persuasive tactics in televised advertising. Journal of Pediatric Psychology, 13, 163-170.

Pires, A., & Pires, A. P. (1995). Psicologia Pediátrica. Análise Psicológica, 13 (1-2), 123-130.

Roberts, M. (1994). Prevention/promotion in America: Still spitting on the sidewalk. Journal of Pediatric Psychology, 19, 267-281.

Roberts, M., La Greca, A., & Harper, D. (1988). Journal of Pediatric Psychology: Another stage of development. Journal of Pediatric Psychology, 13, 1-5.

Roberts, M., McNeal, R., Randall, C., & Roberts, J. (1996). A necessary reenphasis on integrating explicative research with pragmatics of pediatric psychology. Journal of Pediatric Psychology, 21, 107-114.

Roma Torres, A., Almeida, J. P., Viana, V., Barbosa, M. C., Correia, M., Vilas-boas, A., Norton, L., &Lima Reis, I. (1995). Reuniões de grupo de pais de crianças leucémicas: Repercussões sistémicas na família e na unidade de tratamento. Arquivos de Medicina, 9, 283-286.

Routh, D.(1982). Pediatric psychology as an area of scientific research.. In J. Tuma (Ed.), Handbook for the Practice of Pediatric Psychology (pp. 290320). New York: Wiley & Sons.

Sargent, J. (1983). The sick child and the family. Journal of Pediatrics, 102, 982-987.

Schor, E. (1995). The influence of families on child health: Child behaviors and outcomes. Pediatric Clinics of North America, 42, 89-102.

Spieth, L., & Harris, C. (1996). Assessment of health-related quality of life in children and adolescents: An integrative review. Journal of Pediatric Psychology, 21, 175-193.

Sussman, S., Dent, C., Stacy, A., Burton, D., & Flay, B. (1995). Psychosocial predictors of health risk factors in adolescents. Journal of Pediatric Psychology, 20, 91-108.

Taylor, W., & Calfas, K. (1994). Effects of physical activity on psychological variables in adolescents. Pediatric Exercise Science, 6, 406-423.

Teixeira Santos, N., Viana, V., Almeida, J. P., & Guerra, A. (1987). Atitudes dos estudantes de medicina face à pediatria. In Actas do IV Congresso Nacional de Educação Médica (pp. 299-306). Lisboa: Faculdade de Medicina.

Tinsley, B. (1992). Multiple influences on the acquisition and socialization of children's healh attitudes and behavior: An integrative review. Child Development, 63, 1043-1069.

Tuma, J. (1982). Pediatric Psychology: Conceptualization and definition. In J. Tuma (Ed.), Handbook for the Practice of Pediatric Psychology (pp. 1-27). New York: Wiley & Sons.

Ungerer, J., Horgan, B., Chaitow, J., & Champion, D. (1988). Psychosocial functioning in children and young adults with juvenil arthritis. Pediatrics, 81, 195-203.

Van Dongen-Melman, J., De Groot, A., Hahlen, K., & Verhulst, F. (1996). Potencial pitfalls of using illness-specific measures. Journal of Pediatric Psychology, 21, 103-106.

Viana, V. (1992). Adaptação psicossocial da criança com artrite crónica juvenil. Arquivos de Reumatologia, 14, 315-323.

Viana, V., & Almeida, J. P. (1987). Psicologia pediátrica: Intervenção psicológica em pediatria. Jornal de Psicologia, 6, 10-13.

Viana, V., & Almeida, J. P.(1991). Psicologia pediátrica no Hospital S. João: Análise retrospectiva. In I. Botelho, J. Almeida, M. Geada, & J. Justo (Eds.), A Psicologia nos Serviços de Saúde (pp. 69-73). Lisboa: APPORT.

Walker, E. (1988). The future of pediatric psychology. Journal of Pediatric Psychology, 13, 465-478.

Wankel, L., & Sefton, J. (1994). Physical activity and other lifestyle behaviors. In C. Bouchard, R. Shephard, & T. Stephans (Eds.), Fisical Activity Fitness, and Health: International Proceedings and Consensus Statment (pp. 530-550). Human Kinectics Publishers.

Willis, D., Elliot, C., & Jay, S. (1982). Psychological effects of physical illness and its concomitants. In J. Tuma (Ed.), Handbook for the Practice of Pediatric Psychology (pp. 28-66). New York: Wiley & Sons.

Wilson, D., Williams, Z., Arheart, C., Bryant, E., Alpert, B. (1994). Race and sex differences in Health locus of control beliefs and cardiovascular reactivity. Journal of Pediatric Psychology, 19, 769-778.

Wood, B. (1993). Beyond the «psychosomatic family»: A biobehavioral family model of pediatric illness. Family Process, 32, 261-278.

Wright, L. (1967). The pediatric psychologist: A role model. American Psychologist, 22, 323-325.

Young, B. (1987). Sugar, children and television advertising. Research Report N.º 15. Health Education Authority: University of Salford.

(*) Toda a correspondência relativamente a este artigo deve ser enviada para Victor Viana, Hospital de S. João, Departamento de Pediatria, Alameda Prof.Hernâni Monteiro, 4200 Porto.

(**) Psicólogos da Unidade de Psicologia do Departamento de Pediatria do Hospital S. João - Porto.