Navegando por Autor "Silva, Breno Augusto Ferreira"

Agora exibindo 1 - 1 de 1

Impacto do exame clínico objetivo estruturado sobre a ansiedade e parâmetros cardiovasculares
(Faculdade Ciências Médicas de Minas Gerais, 2022-12-13) Silva, Breno Augusto Ferreira; Lima, Isabela Maria Magalhães; Machado, Maria da Glória Rodrigues
Introduction: Arterial stiffness (AS) is a set of alterations that refer to the material properties of the arterial wall that generate functional consequences for the artery. Mental stress can be the trigger for a cardiac or cerebrovascular event. One of these is test anxiety. A well-known mental stressor in academic settings is the Objective Structured Clinical Examination (OSCE), the gold standard in assessing clinical aptitude and practical skills. On the other hand, it is considered an important cause of anxiety in an academic environment. Objectives: To evaluate the association between changes in cardiovascular parameters and degrees of anxiety in OSCE participants. To assess vascular, hemodynamic parameters and AS indices in OSCE participants. To assess the degree of anxiety of OSCE participants and to analyze whether there is an association with the degree of mindfulness and with personality traits. Material and Methods: Eighty-one OSCE participants from the medical course in the second semester of 2021 were evaluated. Baseline data were collected 30 days before the OSCE (T1). The second collection (T2) took place on the day of the OSCE, with 25 minutes left for the participant to start his exam. Cardiovascular parameters were non invasively assessed using the Mobil-O-Graph® – the Pulse Wave Analysis Monitor. Anxiety was measured using the State Trace Anxiety Inventory (STAI), short version. Mindfulness was measured using the Mindful Attention Awareness Scale (MAAS). Personality traits were assessed using the Big Five Personality Factors Inventory (BIG 5). Results: Peripheral vascular pressures (systolic, diastolic, mean and pulse blood pressure) and central (systolic, diastolic and pulse pressure) and hemodynamic parameters (systolic volume, cardiac index and heart rate) were significantly higher in the T2 moment of OSCE completion. Similarly, the AS parameters: global peripheral and central AS indices (pPP/SVi and cPP/SVi), reflection coefficient, augmentation index (AIx@75), pulse wave velocity (PWV) and pressure amplification pulses increased significantly at T2. The degree of state anxiety and total anxiety increased significantly at T2. Trait anxiety and total anxiety were negatively associated with mindfulness. Conclusion: The present study showed, for the first time, the elevation of the AR indexes AIx@75, PWV, PPp/iVS and PPc/iVS of the participants, suggesting xiii that the OSCE significantly altered the main AS parameters. Such alterations were measured both in the parameters that are associated with hemodynamics, and those that are related to the AS indices and arterial compliance of the great arteries. The study also suggested that the OSCE caused an increase in the degree of anxiety in its participants. There was no association between anxiety and personality traits, suggesting that personality is not a predictor of anxiety for the OSCE. Associations found between mindfulness and anxiety suggest that OSCE participants who perceive themselves more physically and mentally have less anxiety. No association was found between changes in cardiovascular parameters and degrees of anxiety at T1 and T2.