<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-7026</journal-id>
<journal-title><![CDATA[Psicología, Conocimiento y Sociedad]]></journal-title>
<abbrev-journal-title><![CDATA[Psicol. Conoc. Soc.]]></abbrev-journal-title>
<issn>1688-7026</issn>
<publisher>
<publisher-name><![CDATA[Facultad de Psicología. Universidad de la República]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-70262017000100123</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Funcionamiento psíquico de pacientes con enfermedad pulmonar obstructivo crónica avanzada: Formulación psicodinámica de casos clínicos.]]></article-title>
<article-title xml:lang="pt"><![CDATA[Funcionamento psíquico de pacientes com doença pulmonar obstrutiva crônica: Formulação psicodinâmica de casos clínicos.]]></article-title>
<article-title xml:lang="en"><![CDATA[Psychic functioning in chronic obstructive pulmonary disease patients: Psychodynamic formulation of clinical cases.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Protesoni]]></surname>
<given-names><![CDATA[Ana Luz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>31</day>
<month>05</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>31</day>
<month>05</month>
<year>2017</year>
</pub-date>
<volume>7</volume>
<numero>1</numero>
<fpage>123</fpage>
<lpage>140</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-70262017000100123&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-70262017000100123&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-70262017000100123&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Los pacientes con Enfermedad Obstructiva Pulmonar Crónica (EPOC) tienen una limitación del flujo aéreo progresiva y poco reversible. Presentan permanentemente síntomas con episodios de agudización y pérdidas funcionales irrecuperables con una creciente dependencia. Se investigó con el fin de comprender el funcionamiento psicológico de los pacientes con EPOC y las modalidades vinculares con sus cuidadores. Se utilizó una metodología cualitativa, descriptiva de estudio de casos clínicos de 14 pacientes en estadío avanzado de su EPOC (oxigenodependientes), usuarios de la Red de Atención Primaria (ASSE). Se tomó para el Formulaciones Psicodinámicas de los Casos clínicos (Varela, De Souza, Miller, Villalba, Oyenard, Zytner, &amp; Bernardi, 2014). Se analizaron las categorías: &#8220;experiencia subjetiva de enfermedad&#8221;, &#8220;diagnóstico de relaciones interpersonales&#8221; y &#8220;diagnóstico de conflictos&#8221;. Se encontró que los pacientes utilizan un modelo explicativo de la enfermedad orientado a factores externos, denotando poca capacidad de implicación. Manejan de modo racional y desafectivizado el diagnóstico y pronóstico. Se aferran a la imagen de sí mismos en estado de salud, con poca capacidad adaptativa. Centran su padecimiento en el eje autonomía e independencia. Los conflictos principales giran entorno a la individuación - dependencia; sumisión - control y protección - autarquía. Se encontró un patrón relacional interpersonal con disfuncionalidades en los ejes: control y afiliación. En síntesis el estudio aportó a la comprensión integral del proceso salud - enfermedad y permitió ajustar las intervenciones del equipo asistencial.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo Pacientes com Doença Pulmonar Obstrutiva Crónica (DPOC) têm uma limitação do fluxo de ar progressiva e com pouca reversibilidade. Apresentam sintomas com exacerbações e perdas não recuperáveis, com o aumento da dependência funcional. A finalidade da pesquisa foi compreender o funcionamento psicológico de pacientes com DPOC e as modalidades relacionais com seus cuidadores. Foi utilizada uma metodologia de estudo qualitativo, descritivo de casos clínicos de 14 pacientes em estágios avançados da DPOC (dependente de oxigénio), usuários da rede de cuidados primários (ASSE). Os materiais clínicos obtidos foram analizados segúm as formulações psicodinâmicas de casos clínicos (Varela, De Souza, Miller, Villalba, Oyenard, Zytner, &amp; Bernardi, 2014) . "A experiência subjetiva da doença", "diagnóstico das relações interpessoais" e categorias "Diagnóstico conflito" foram analisados. Verificou-se que os pacientes utilizam um modelo explicativo dos factores externos orientado pela doença, o que implica pouca capacidade de envolvimento. Eles gerenciam diagnóstico e prognóstico de forma racional e desafectivizada, apegam-se à imagem de si mesmos na saúde, mostrando baixa capacidade de adaptação. Eles se concentram a sua condição no eixo autonomia e independência. Os principais conflitos giram em torno da individuação - dependência; submissao-controle e protecção-autarquia. Controle e filiação: identificou-se um padrão de relacionamento interpessoal com disfuncionalidade nestes eixos. Em suma, o estudo forneceu uma compreensão abrangente da saúde - doença e permitiu adequar as intervenções da equipe de saúde.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Patients suffering from chronic obstructive pulmonary disease (COPD) have a progressive and irreversible limitation of the air flow. They have permanent symptoms with worsening periods and irrecoverable losses in function, requiring increasing levels of assistance. The aim of this research was to comprehend the psychic funtioning in COPD patients and their relationship modalities with their caretakers. A qualitative descriptive methodology was implemented to study multiple cases with 14 patients in advanced phases of COPD (oxygen-dependants), belonging to the Primary Level of Care (ASSE). Pychodinamic formulation of clinical cases (Varela, De Souza, Miller, Villalba, Oyenard, Zytner, &amp; Bernardi, 2014) was used for the analysis. The following categories were analized: &#8220;subjective experience of the disease&#8221;, &#8220;interpersonal relationship diagnosis&#8221; and &#8220;conflict diagnosis&#8221;. It was found that patients use an explanatory model of the disease oriented to external factors, showing a limited capacity of involvement. They demonstrate a rational and indifferent disposition regarding their diagnosis and medical prognosis. They hold their self image as it was in a healthy state, showing a lesser adaptive capacity. They focus their suffering in the autonomy and independence axis. Main confict devolps around ideas of individuality-dependence, submissioncontrol and protection-autarchy. An interpersonal relationship pattern with dysfunctionalities in control and afiliation axes was found. Althogether, the study contributed to the comprehensive understanding of the health-illness process and allowed the assistance team to adapt their interventions.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Funcionamiento psíquico]]></kwd>
<kwd lng="es"><![CDATA[Formulación psicodinámica]]></kwd>
<kwd lng="es"><![CDATA[EPOC avanzado]]></kwd>
<kwd lng="pt"><![CDATA[Funcionamento psíquico]]></kwd>
<kwd lng="pt"><![CDATA[Formulação psicodinâmica]]></kwd>
<kwd lng="pt"><![CDATA[DPOC avançada]]></kwd>
<kwd lng="en"><![CDATA[Psychic functioning]]></kwd>
<kwd lng="en"><![CDATA[Pychodinamic formulation]]></kwd>
<kwd lng="en"><![CDATA[Advanced COPD]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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