Models around the world: Psychological approach in a hemophilia center in Brazil
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conferenceObject
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2012
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WILEY-BLACKWELL
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HAEMOPHILIA, v.18, suppl.3, Special Issue, p.52-52, 2012
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Brazil has 27 states divided into 5 regions, and its estimated population is 196,000,000. The amount of factor units per capita recorded in 2010 was still low; 1.1. Great efforts are made by the local Hemophilia Federation and Ministry of Health to have primary prophylaxis and immune tolerance treatment projects approved for 2012. Management of care and treatment are done according to each hemocentre, which coordinates other smaller ones called hemonucleos. Access to medical and psychosocial support is free of charge. An overall view would show that to date, only 2 states have neither a psychologist nor social worker on their team. Nineteen teams have both, and 6 only a social worker. A social worker in Brazil is not allowed to provide counselling or psychotherapy. Nevertheless, psychologists and social workers are seen as being of major importance. The psychological interventions I started in 1994 are embedded in the context of supporting people with hemophilia (PWH) and their families who receive on-demand treatment. This situation can be compared to patients with moderate and mild hemophilia who are treated in other countries on-demand as well. These interventions focus mainly on primary prevention and psycho-education using different expressive techniques that also assist literacy issues within our population. Flashcards like hemoaction-playing and learning about hemophilia is one of them. Patients caregivers are also given information and psychological support to cope with different phases of living with hemophilia. Short-term psychotherapy is necessary at times when the patients has to face situations regarding their studies, employment, relationships, family dynamics, and in both minor or major orthopedic procedures. Outcomes like early awareness, better self-management of hemophilia, and coping with life events are reported by patients who are followed through the years.