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The Service is currently divided into two areas of expertise: Hospital Clinical Psychology and Neuropsychology. Our Service helps inpatients and/or outpatients, ICU patients, as well as their family members handle the stresses and challenges imposed by an illness.
General information Hospital Clinical Psychology is a comprehensive support for the ongoing day-to-day challenges patients have to face when suffering from a serious or terminal illness.The psychologist guides, comforts, and supports the patients and their relatives during the difficult times they must endure while at the hospital.
The Clinical Psychology Service at Instituto de Neurologia and Cardiologia de Curitiba invests on the development of patient welfare activities, education and scientific research.It also contributes to improve professional standards, ethical and scientific principles of Health Psychology. It operates as a specialty in psychology that works with the cognitive-affective and emotional dimensions of wellness, making available to patients, families and health staff , the necessary psychological knowledge and support that enables the multidisciplinary team to not only understand, but also respect the patient's uniqueness, emotions, beliefs and values.
At INC, the Clinical Psychology Service works with the following medical specialties: - Anesthesiology
- Clinic and Surgical Cardiology
- Pain Management
- Multidisciplinary Nutritional Therapy
- Orthopedics
- Psychopedagogy
- Adult and Pediatric ICU
Department of Anesthesiology
In almost all human activities is good practice to properly analyze the scope of work to be developed prior to starting it.However, in the field of anesthetic, it is crucial to deeply analyze each case.The person in charge must access the current situation, the best development options , prospects of success and risks. Negative outcomes can be avoided with a preliminary assessment that has to be performed accurately and comprehensively. If all processes are structured, and the risks are properly outlined and planned, the course of anesthesia goes smoothly with no surprises, and no other results than those that would be desirable.
The work of the psychologist in the Department of Anesthesiology aims to: - All outpatient and/or bedside patients go through preoperative and pre-anesthetic Psychological Evaluation;
- Assess the patients' degree of information about the surgery;
- Assess what the patient knows about anesthesia, which source of information;
- Check whether the patient had previous experiences with anesthesia;
- Guidance on anesthetic and surgical risks;
- Clarify the anesthetic technique in a clear and understandable way;
- Support patients in the acceptance and understanding of their condition;
- Patients receive ongoing evaluation until the post-anesthetic discharge
Department of Cardiology
The patient who undergoes a heart surgery live with different feelings: fear about physical or emotional loss,fear of death, etc.. Since surgeries in general may pose a threat to life, we highlight the importance of psychological support along with the interdisclipinary work of other professionals to assist patients before the procedure.
The work of the psychologist in the Department of Cardiology aims to:
Identify behavioral changes because of the illness; Identify pre-existent patterns of inappropriate behaviors; Identify inappropriate behavior associated with hospital environment and make the necessary changes to help the patient adjust to his new health condition;
Chronic Pain Management Service
Pain expresses an uneasiness, it warns us about possible problems.Chronic Pain sufferers, usually have lived with chronic pain for a number of years, and have been treated and medicated by several physicians. Many have become dependent on medications and have acquired a constellation of disabling symptoms that are eroding the quality of their lives.
Chronic Pain (long term) requires specialized medical treatment because it can seriously affect someone's whole life, causing several problems. Our program aims to diagnose the syndrome properly, reduce the subjective experience of pain, assist with medication management, improve the individual’s ability to control pain and improve physical and emotional functioning.
At INC, we follow the most modern international concepts in the Chronic Pain treatment,not only treating the symptoms but upholding the holistic concept that all aspects of people's needs, psychological, physical and social, and mentally should be taken into account and seen as a whole. The work of the psychologist at Chronic Pain Management Service aims to: Stress the importance of patients participation in assessment, treatment, and self-management Help the patient thoroughly understand the Chronic Pain Syndrome Develop a plan to manage the pain and improve the quality of life
Multidisciplinary Nutritional Therapy Service
The intervention of clinical psychologist at hospitals is necessary to provide emotional relief to the patients because diseases can cause anxiety, depression, among other problems.Besides fearing the disease, patients can become very anxitious before a hospitalization, surgery, and the prospect of the need for nutritional therapy. In these cases, the psychologist is available to speak with the patient about their general fears and the impact that it may cause on their families. Whereas often the family is powerless about the situation and also need more support.
Our team works assessing the following information: Identify behavioral changes toward the disease (lack of understanding of the diagnosis, prognosis) and hospitalizations (difficulty in adapting to routine, procedures and manipulations mainly related to NT).
Identify previous patterns of inappropriate behaviors (non-acceptance of drugs, non-acceptance of NT, lack of interaction with the team, refusal to follow the routines and procedures in the ward).
Identify and modify the contingencies in the hospital environment that may influence the increase of inappropriate behavior which impact the patient’s and family adjustment to the new situation.
Orthopaedics Service - Hip and knee Arthroplasty
Patients typically obtain a functional amount of motion following hip and knee replacement surgery; however the
limits of motion cannot be exceeded. Patient education and understanding of the limitations, especially regarding
the potential for dislocation and range of motion restrictions, can help minimize the occurrence of complications.
Patients are encouraged to discuss specific limitations and activity restrictions with their surgeons prior to treatment. The initial patient psychological evaluation will investigate the following emotional aspects: Self - image (the perception that the patient has of himself)
Daily living (interference in social , family and professional Life)
Emotions (anger, depression, fear, frustration, doubt.)
Life Plans (perspective and interests that drive the patient's life)
Emotional baggage from previous surgeries (coping behavior learned in similar past situations)
Patients quality of life
Once the evaluation is finished, the psychologist in charge, shares the information with the multidisciplinary team to enable them to have a comprehensive view of the patient, thus facilitating communication between physicians, patients and staff.
The follow-up evaluation will focus on the following aspects: - Surgical intervention (questions about the procedure);
- Adherence to treatment plan (acceptance of surgery);
Doubts about the hospitalization; - Long-term treatment ( contract with the rehabilitation unit)
Adult ICU Care
The Intense Care Unit is a highly stressful environment for patients and their families. Most ICU patients are
unconscious or incapacitated. Their care involves constant vigilance by skilled clinicians, complex technologies,
and unfamiliar and often frightening medical interventions, and the outcome is always uncertain. The families, on the
other hand, experience stress, fear, anxiety and sometimes depression watching what is happening to their loved
ones, especially when death is imminent. The hospital psychologist is a source of support, helping the family
members better understand the situation and be involved with the decisions.
At INC, the role of the psychology team at the Intensive Care Unit is: - Provide support and counseling for the family;
- Encourage the patient to understand the dynamics in the ICU, and operating guidelines as
necessary;including information on its characteristics, working and what is expected of the family;
- Evaluate the proper understanding of the clinical prognosis,
- Teach psychological strategies for the management of anxiety, fear, hopelessness,low spirits;
- To ease and promote collaboration behaviours of the family with the medical team: decision making,
organization of functions, adjustment of evaluation to the patient’s real condition;
- Promote better quality of the interaction between medical personnel and patients, family and colleagues
NEUROPSYCHOLOGY SERVICE
Neuropsychology is a specialized service focused on the evaluation and rehabilitation of neurological patients,
involving cognitive dysfunction associated with various diseases affecting the central nervous system, such as:
Parkinson's disease, epilepsy, hydrocephalus, and multiple sclerosis, Stroke Brain, Alzheimer’s disease, and
Traumatic Brain Injury. These diseases can affect intellectual functions and their vectors resulting in several
problems, such as: memory disorders, language, attention, behavior control, spatial orientation, among other
disorders. The service provides specialized care focused on recovery and rehabilitation of these patients, as well
as support and guidance to the patient’s family members.
INC Special Programs in Neuropsychology Parkinson's disease - Medical and Surgical Care Group Epilepsy - Epilepsy Surgery Program Hydrocephalus - Therapy for Patients with NPH (Normal Pressure Hydrocephalus) Stroke - Stroke Care Unit Multiple Sclerosis- Neuromuscular Clinic (Evaluation and Clinical Care) ADEMEC- Center for Memory and Behavioral Disorders The Psychological Service directed to specific departments operates since January 2007, but its present at INC since the hospital opening, developing several activities such as:
Inpatients & Outpatients Care
Service Weekly Meetings
Monthly Clinical Meetings
Activities Directed to Patients' Family members
Consultations in the ICU
Nursing staff orientation
Thematic groups
Therapeutic workshops
Orientation Groups: Nutritional Therapy Discharge, Preoperative & Postoperative Cardiology
Clinical Psychology Staff Clinical Psychology Coordinator of Anestesiology, Cardiology and Nutritional therapy Services Elis Regina Charello Psychologist Health Psychologist Specialist Certified Psychodramatist
Clinical Psychology Administrative Coordinator
Samantha Fabrício Blattes da Rocha CRP
Psychologist
Adult and Children Neuropsychology Specialist
Farmachology Specialist - UFPR
Master's Degree in Cell Biology- UFPR
Clinical Psychology Pain Management Coordinator Silvana Aquim – CRP Nº Pain Management Clinical Psychology Coordinator
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