FACULTAD DE PSICOLOGÍA - UBA / SECRETARÍA DE INVESTIGACIONES / ANUARIO DE INVESTIGACIONES / VOLUMEN XX MANIFESTACIONES DE SÍNTOMAS DEPRESIVOS EN PACIENTES CON DIABETES TIPO 2: UN ABORDAJE CUALITATIVO MANIFESTATIONS OF DEPRESSIVE SYMPTOMS IN PATIENTS WITH TYPE 2 DIABETES: A QUALITATIVE APPROACH N O P Q R O S ^ (QHOPDUFRGHXQSUR\HFWR8%$&\7PiVDPSOLRVHUHD OL]y XQ HVWXGLR H[SORUDWRULR FRQ XQ DERUGDMH FXDOLWDWLYR FRQHOREMHWLYRGH LGHQWL¿FDUODVPDQLIHVWDFLRQHVGHVtQWR PDVGHSUHVLYRVHQHOGLVFXUVRGHORVSDFLHQWHVFRQGLD EHWHVWLSRTXHFRQFXUUHQDFRQVXOWRULRVH[WHUQRVGHXQ KRVSLWDOS~EOLFRGHSHQGLHQWHGHO*RELHUQRGHOD&LXGDG GH%XHQRV$LUHV*&%$ 6HUHDOL]DURQHQWUHYLVWDVHQSURIXQGLGDGDXQDPXHV WUDQRSUREDELOtVWLFDLQWHQFLRQDOGHSDFLHQWHVGHHQWUH \DxRVGHHGDGTXHFRQFXUUtDQDFRQVXOWRULRVH[WHUQRV GH'LDEHWRORJtD\1XWULFLyQ6HUHDOL]yXQDQiOLVLVFDWHJR ULDOEDVDGRHQOD7HRUtD)XQGDPHQWDGD\HOPpWRGRFRP SDUDWLYRFRQWLQXR /DVSULQFLSDOHVFDWHJRUtDVHPHUJHQWHVIXHURQPLHGRV\ SUHRFXSDFLRQHVDQWHODVFULVLVGHODHQIHUPHGDGDQWHODV VHFXHODVDQWHODDSOLFDFLyQGHLQVXOLQD\DQWHODSRVLELOL GDGGHODWUDQVPLVLyQJHQpWLFDDQJXVWLDDQWHHOLPSDFWR LQLFLDOGHOGLDJQyVWLFRHQUHODFLyQDORVFDPELRVGHKiEL WRVTXHLPSOLFDHOWUDWDPLHQWRSRUODSUHFHSFLyQGHIDOWD GHDSR\RIDPLOLDUFRPRFDXVDGHODHQIHUPHGDGGHVJD QRHQUHODFLyQFRQORVYtQFXORVVRFLDOHVDLVODPLHQWR\ HIHFWRVGHODVPDQLIHVWDFLRQHVGHSUHVLYDVHQODDGKHUHQ FLDDOWUDWDPLHQWR /RVUHVXOWDGRVPXHVWUDQHYLGHQFLDVDIDYRUGHOVXSXHVWR GHODFRPRUELOLGDGGHDPEDVSDWRORJtDV T U V U W X U Y Z V U [ \ _ P ` N ^ a ` ,Q WKH IUDPHZRUN RI D EURDGHU 8%$&\7 SURMHFW DQ H[SORUDWRU\ VWXG\ ZDV FRQGXFWHG ZLWK D TXDOLWDWLYH DSSURDFK ZLWK WKH DLP RI LGHQWLI\LQJ PDQLIHVWDWLRQV RI GHSUHVVLYHV\PSWRPVLQWKHVSHHFKRIWKHSDWLHQWVZLWK W\SHGLDEHWHVDWWHQGLQJVXUJHULHVRIDSXEOLFKRVSLWDORI WKH *RYHUQPHQW RI %XHQRV $LUHV *&%$ GHSWK LQWHUYLHZVZHUHPDGHRIDQLQWHQWLRQDOQRQSUREDELOLVWLF VDPSOHRISDWLHQWVDJHGEHWZHHQDQGZKRDWWHQGHG WKHVXUJHULHVRI'LDEHWRORJ\DQG1XWULWLRQ$FDWHJRULFDO DQDO\VLVZDVSHUIRUPHGEDVHGRQWKH*URXQGHGWKHRU\ DQGWKHFRQWLQXRXVFRPSDUDWLYHPHWKRG 7KHPDLQHPHUJHQWFDWHJRULHVZHUHIHDUVDQGFRQFHUQV IDFHWRWKHGLVHDVHCFULVLVIDFHWRWKHVTXHDOVIDFHWRWKH DSSOLFDWLRQ RI LQVXOLQ DQG WKH SRVVLELOLW\ RI JHQHWLFV WUDQVPLVVLRQ DQJXLVK IDFH WR WKH LQLWLDO LPSDFW RI WKH GLDJQRVLVLQUHODWLRQWRFKDQJHVLQKDELWVWKDWLPSOLHVWKH WUHDWPHQW E\ WKH SHUFHSWLRQ RI ODFN RI IDPLO\ VXSSRUW EHFDXVH RI WKH GLVHDVH OLVWOHVVQHVV LQ UHODWLRQ WR WKH VRFLDOOLQNVLVRODWLRQDQGHIIHFWVRIWKHGHSUHVVLRQLQWKH DGKHUHQFH WR WUHDWPHQW 7KH UHVXOWV VKRZ HYLGHQFH LQ IDYRURIWKHFRXUVHRIWKHFRPRUELGLW\RIERWKGLVRUGHUV .H\ZRUGV 'LDEHWHVW\SH'HSUHVVLRQ3XEOLFKRVSLWDO ] ] 'LDEHWHVWLSR'HSUHVLyQ+RVSLWDOS~EOLFR 'UDHQ3VLFRORJtD8%$,QYHVWLJDGRUD$GMXQWD&21,&(73URI$GMXQWD3VLFRORJtD6RFLDO)DFGH3VLFRORJtD8%$'LUHFWRUDGHSUR\HF ! ! " # ! $ % $ & % ! ' ( ) * + , - . / 0 / , / 0 1 1 2 3 4 2 & $ 6 ' ! " ! & 7 & 8 9 : 9 ; , & < 4 = 4 5 & > 5 /LFHQ3VLFRORJtD8%$$\XGDQWHGH3ULPHUDHQ3UiFWLFD3URIHVLRQDO³ÈPELWR&RPXQLWDULR)DPLOLD\HQIHUPHGDGFUyQLFD´)DFGH3VLFR ? 6 @ A & % B 6 & ( ) * C 4 ) B = & > $ & ( ) * + , - % B & B ! > A & D 9 9 E D 5 9 8 D 4 /LFHQ3VLFRORJtD'UDHQ3VLFRORJtD6RFLDO$GMXQWDDFDUJRGHOD3UiFWLFD3URIHVLRQDOGHOD)DFXOWDGGH3VLFRORJtDGHOD8%$,QYHVWL F @ I & % > & % B 6 & + G B % > & % B / ! $ = 6 @ A & H = $ & 6 % B 6 & 3 & = " 6 & % % B / ! $ = 6 @ A & % B 6 & ( ) * 4 J $ = 4 B 7 / ! $ = 6 @ A & K ( ) DE LA PÁGINA 279 A LA 285 * C 4 1 = B 7 B % B / ! $ = 6 @ A & H = $ & 6 K ( ) * C . $ 7 L B ! $ @ & % > & % B M > , B = ! ! " # ! $ % $ & % ! ( ) * + , - , / 0 1 1 2 3 4 279 MANIFESTACIONES DE SÍNTOMAS DEPRESIVOS EN PACIENTES CON DIABETES TIPO 2: UN ABORDAJE CUALITATIVO MANIFESTATIONS OF DEPRESSIVE SYMPTOMS IN PATIENTS WITH TYPE 2 DIABETES: A QUALITATIVE APPROACH Azzollini, Susana; Benvenuto, Analía; Bail Pupko, Vera; Vidal, Victoria A. b S ` N c d Q a a b e S U h i U W \ j \ Y \ Y k n m o p q o l r s o q r UtJLGDVDFHUFDGHODVFRVDVTXHSRGUtDQRFXUULUHLQWHUpV HQORVMXLFLRVGHORVGHPiV:HLVVPDQ\%HFN 6HJ~QVXSUHVHQWDFLyQODGHSUHVLyQSXHGHVHUGHHSLVR GLR~QLFR\UHFLGLYDQWHGHUHPLVLyQGHUHFXSHUDFLyQGH UHFDtGDRGHUHFXUUHQFLD+HLQ]H9LOODPLO\&yUWHV (OSDGHFHUGHSUHVLyQQRVyORDIHFWDHOHVWDGRDQtPLFRGHO SDFLHQWH VLQR TXH DGHPiV LQÀX\H QRWDEOHPHQWH HQ OD DFHSWDFLyQGHFXDOTXLHUHQIHUPHGDG\HQODDGKHVLyQDO WUDWDPLHQWR*DYLULD*yPH] /D GHSUHVLyQ HV XQD UHDFFLyQ HPRFLRQDO TXH WLHQH XQ LPSDFWRTXHYDPiVDOOiGHOSURSLRPDOHVWDUTXHLPSOLFD SXHVWRTXHDIHFWDDODSXHVWDHQPDUFKDRQRGHFRQGXF WDVGHDXWRFXLGDGR\GHFRQWUROGHODHQIHUPHGDG&DQWyQ &KLULYHOOD\'RPLQJR7DUtQ-XVWDPHQWHVHKDHQ FRQWUDGRHQSDFLHQWHVFRQGLYHUVDVSDWRORJtDVFUyQLFDV XQPD\RUQLYHOGHOHVWDGRGHDQVLHGDG\GHSUHVLyQ\XQD UHODFLyQLQYHUVD\VLJQL¿FDWLYDHQWUHHOHVWDGRGHDQVLH GDGGHSUHVLyQ\ODFDOLGDGGHYLGD9HODVFR%DOOHVWHUR ÈOYDUH]3pUH]\6DQ-XDQ0LJXHOVDQ] f ³XQDHQIHUPHGDGHQGyFULQD\PHWDEyOLFD TXH DIHFWD D OD FDSDFLGDG GHO SiQFUHDV SDUD VHJUHJDU LQVXOLQD\FX\DFRQVHFXHQFLDSULQFLSDOHVTXHODJOXFRVD QRSXHGHVHUPHWDEROL]DGDSRUODVFpOXODV´*LO5RDOHV 1LHWRH,EDUUD6DFDUGX\(QODPD\RUtDGHORV SDtVHV GH $PpULFD VH HVWiQ SURGXFLHQGR FDPELRV GH KiELWRVHQODGLHWDTXHVHFDUDFWHUL]DQSRUHODXPHQWRGHO FRQVXPRGHDOLPHQWRVFRQXQGHQVRFRQWHQLGRHQHUJpWL FRMXQWRDODXPHQWRGHORVKiELWRVVHGHQWDULRV\ODIDOWD GHDFWLYLGDGItVLFD(VWRVFDPELRVVRQORVTXHFRQWULEX\HQ DOLQFUHPHQWRHQODVDOWDVWDVDVGHVREUHSHVR\REHVLGDG HQODUHJLyQTXHDVXYH]SURGXFHXQDXPHQWRGHODGLD EHWHV206(Q$UJHQWLQDVHJ~QHVWLPDFLRQHVGHO 0LQLVWHULRGH6DOXG3~EOLFDGHOD1DFLyQKXERHQ HOSDtVGLDEpWLFRVHQHODxR\VHSUHYpTXH HVWHQ~PHUROOHJDUiDHQHODxR/DLP SRUWDQFLDGHOSUREOHPDHVTXHHOULHVJRGHPXHUWHHQORV GLDEpWLFRVHVDO PHQRVGRVYHFHV PD\RUTXHHOGHODV SHUVRQDV VLQ GLDEHWHV 236 /D GLDEHWHV WLSR UHSUHVHQWDDOUHGHGRUGHOGHWRGRVORVFDVRVGHGLD EHWHV\DSDUHFHFRQPD\RUIUHFXHQFLDGHVSXpVGHORV DxRV6HJ~Q$UERL[ODGLDEHWHVWLSRVHDFRPSD xDSRUQRUPDJHQHUDOGHREHVLGDG\UHVLVWHQFLDDODLQ VXOLQD\VHGHVDUUROODHQIRUPDJUDGXDO (Q JHQHUDO H[LVWHQ HOHYDGDV WDVDV GH SUHYDOHQFLD GH FRPRUELOLGDGHVSVLFROyJLFDVHQORVSDFLHQWHVFRQGLDEH WHVPHOOLWXVWLSR-LPpQHV 3RUHMHPSOROD 206VHxDODTXHODUHODFLyQHQWUHODGHSUHVLyQ\OD GLDEHWHVHVGHHVSHFLDOLQWHUpVHQHOVLJOR;;,\DTXH DPEDVFRQGLFLRQHVVRQJUDQGHVFRQWULEX\HQWHVDODFDUJD PXQGLDOGHHQIHUPHGDGHV 6HJ~Q HO PRGHOR GH %HFN OD GHSUHVLyQ SDUHFH PDQWHQHUVHSRUPHGLRGHODSUHVHQFLDGHHVTXHPDVGH VLJQL¿FDGRGHVDGDSWDWLYRV³SURWHJLGRV´\IRUWDOHFLGRVSRU DOWHUDFLRQHVFRJQLWLYDVHQHOPRGRGHSURFHVDUODLQIRU PDFLyQDVXYH]SURYRFDGRVSRUODDFFLyQGHGLFKRVHV TXHPDV/RVFRQWHQLGRVGHHVWRVHVTXHPDVVHH[SUHVDQ DWUDYpVGHXQWLSRHVSHFLDOGHSHQVDPLHQWRGHQRPLQDGR SHQVDPLHQWRDXWRPiWLFR&LHUWDVDFWLWXGHVGLVIXQFLRQD OHVSRGUtDQHVWDUUHÀHMDQGRHVWRVHVTXHPDVRVXSXHVWRV EiVLFRV3RUORWDQWRVHJ~QHVWHPRGHORKD\TXHPHGLU ODVGLVWRUVLRQHVFRJQLWLYDVORVSHQVDPLHQWRVDXWRPiWLFRV \ODVDFWLWXGHVGLVIXQFLRQDOHV6HJ~Q%DV\$QGUpV ´ FLRQHVTXHQRUPDOPHQWHQRVHSXHGHQMXVWL¿FDUFRQOD LQIRUPDFLyQGLVSRQLEOH\TXHDSDUHFHQFRPRUHVSXHVWDV DQWHH[SHULHQFLDVYLWDOHVQHJDWLYDVDPELJXDVRLQFOXVR PDQL¿HVWDPHQWHSRVLWLYDV/DVDOWHUDFLRQHVGHODOyJLFD g t k o u r v t q l q w m o o l r m k c _ t { k s k t u q m n o r t | } o m u ~ o m p m q t l k s x s k l m u q r t k o y x s k p q u b c f R O ` c d c c ^ f H[SORUDWRULRFRQXQDERUGDMHFXDOLWDWLYR VHHQWUHYLVWyDXQDPXHVWUDQR SUREDELOtVWLFDLQWHQFLRQDOGHSDFLHQWHVGHHQWUH\ DxRVGHHGDGTXHFRQFXUUtDDFRQVXOWRULRVH[WHUQRVGH 'LDEHWRORJtD\1XWULFLyQGHXQ+RVSLWDOS~EOLFRGHSHQ GLHQWHGHO*&%$ 7pFQLFDVSDUDODUHFROHFFLyQGHORVGDWRVVHUHDOL]DURQ HQWUHYLVWDVHQSURIXQGLGDGFX\RVHMHVWHPiWLFRVIXHURQ PRPHQWRGLDJQyVWLFRHVWUDWHJLDVGHFXLGDGRVHFXHODV UHODFLyQPpGLFRSDFLHQWHFDPELRVHQODYLGDFRWLGLDQD DSR\RIDPLOLDUIXHQWHVGHLQIRUPDFLyQDFHUFDGHODHQIHU PHGDGHVWUDWHJLDVGHFXLGDGRDQWHRWURVSUREOHPDVGH VDOXGDJXGRV VH UHDOL]y XQ DQiOLVLV FDWHJRULDO EDVDGRHQOD7HRUtD)XQGDPHQWDGD\HOPpWRGRFRPSD UDWLYRFRQWLQXR q x u ~ m t l r | m y r s o k m n m v s m r p k k o l ~ p q r m s t l q } u n q q x m o q t o l p k o y k n r | ~ o p k m o l l r s m o z N O P Q ` ^ d c P f $FRQWLQXDFLyQVHSUHVHQWDQODVFDWHJRUtDVHPHUJHQWHV GHORVGDWRV\IUDVHVTXHHMHPSOL¿FDQFDGDXQDGHHOODV f z YHGDGGHOVXMHWRGHSUHVLYR´S/RVSHQVDPLHQWRV DXWRPiWLFRVQRVRQXQUDVJRGHODSHUVRQDVLQRXQ³HV WDGR´%HFN(VWiQFRPSXHVWRVSRUFXDWURIDFWRUHV SULQFLSDOHV PDO DMXVWH SHUVRQDO \ GHVHRV GH FDPELR H[SHFWDWLYDV\DXWRFRQFHSWRQHJDWLYREDMDDXWRHVWLPD\ GHViQLPRHLQIHOLFLGDG/DVDFWLWXGHVGLVIXQFLRQDOHVFRP SUHQGHQWHPDVWDOHVFRPRDWULEXFLRQHVH[SHFWDWLYDVGH FRQWUROODSUREDELOLGDGGHTXHVHGHQFLHUWRVUHVXOWDGRV GHVHDGRV QRUPDV GH DFWXDFLyQ SHUIHFFLRQLVWDV LGHDV 280 ` n n t o O m ,GHQWL¿FDUODVPDQLIHVWDFLRQHVGHVtQWRPDVGHSUHVLYRVHQ HOGLVFXUVRGHORVSDFLHQWHVFRQGLDEHWHVWLSRTXHFRQ FXUUHQDFRQVXOWRULRVH[WHUQRVGHXQKRVSLWDOS~EOLFRGH SHQGLHQWH GHO *RELHUQR GH OD &LXGDG GH %XHQRV $LUHV *&%$ R q l D t l k n m o u s q o q o p k n m k t { k s | k p m p ³3DUDPLLLLYRVVDEHVTXH\RQROHOOHYDEDPXFKRODDWHQ FLyQDODGLDEHWHVQRVpFyPRWHSXHGRH[SOLFDUSDUDPL QRHUDXQDHQIHUPHGDGGHJUDYHGDGSRUTXHPXFKDJHQWH ODSDGHFH+DVWDTXHPHVXELyD\DKtVt 3UHJXQWD¢TXpVHQWtD" z k o x ~ k o l m y k o l m m | m n n m u m k m | k q m m k o l m n n m s n r o RtGRV WDSDGRV \ HVH VRQLGR TXH WH KDFHQ ORV RtGRV DE LA PÁGINA 279 A LA 285 FACULTAD DE PSICOLOGÍA - UBA / SECRETARÍA DE INVESTIGACIONES / ANUARIO DE INVESTIGACIONES / VOLUMEN XX PPPPPTXHWHKDFHQORVRtGRVPHHPSHFpDGHVFRP x r t k s m p k o u r | x r t k s y p k n m u m o m | k o m u m s r t m n m s m o l s SXHGHSURGXFLUHQHOFXHUSR(QWUHODVTXHPiVDVXVWDQ \SUHRFXSDQVHLGHQWL¿FDQODFHJXHUDODVDPSXWDFLRQHV GHORVPLHPEURVLQIHULRUHV\ODSRVLELOLGDGGHODPXHUWH 0XFKRVHQWUHYLVWDGRVH[SUHVDQTXHFRQRFHU\UHFLELULQ IRUPDFLyQ DFHUFD GH ODV FRQVHFXHQFLDV SRVLEOHV GH OD HQIHUPHGDGORVDVXVWD1RREVWDQWHWDPELpQFUHHQTXH HVWRORVPRWLYDSDUDFXLGDUVHPiV(QHVWRVFDVRVORV SDFLHQWHVHQFXHQWUDQTXHFRQRFHUODVVHFXHODVD~QOD PiV JUDYHV OHV SHUPLWH WRPDU HO FRQWURO GH VX SURSLR FXLGDGR\DTXHFUHHQTXHHVDHVODPDQHUDGHHYLWDUORV HVFHQDULRVPiVWHPLGRV (VQHFHVDULRGHVWDFDUTXHVHLGHQWL¿FDQDOPHQRVGRV IXHQWHVGHLQIRUPDFLyQVREUHODVVHFXHODVGHODHQIHUPH GDGTXHSRVHHQXQDOWRLPSDFWRHPRFLRQDOHQORVSDFLHQ WHVODH[SHULHQFLDGHRWUDVSHUVRQDVDOOHJDGDVFRQGLDEH WHV\ODVH[SOLFDFLRQHVPpGLFDVUHFLELGDVHQODVFRQVXOWDV /RVVLJXLHQWHVH[WUDFWRVGHHQWUHYLVWDVORHMHPSOL¿FDQ z m \PHOOHYDURQDOKRVSLWDOKDVWDTXHPHEDMDURQHOD]~FDU y | k | m t p m s r t m n m u m o m k s r k o k { ~ k k n o ~ o l r | } o v s m t z GHTXHPHDJDUUp´0XMHUDxRVDxRVGHGLDJQRVWL FRSULPDULRLQFRPSOHWRGHVHPSOHDGDWUDPLWDQGRSHQ VLyQSRULQYDOLGH] ³&XDQGRPLPDULGRHVWDEDHQIHUPR\ROOHJXpDWHQHU OOHJXpD'HORVQHUYLRVTXHSDVDEDOOHJXpDWHQHU \PHDSOLFDEDODLQVXOLQD\QREDMDEDVXEtDFDGDYH] PiV8QVXVWRPHSHJXpHVHGtDSRUTXHQXQFDKDEtDWH QLGROOHJXpDWHQHUSHURMDPiV3HQVp TXHPHPRUtD´0XMHUDxRVDxRVGHGLDJQyVWLFR SULPDULRLQFRPSOHWRDPDGHFDVD z (QSULPHUOXJDUVHREVHUYDTXHFRQIUHFXHQFLDORVSD FLHQWHVVLHQWHQPLHGRFXDQGRVXIUHQODVSULPHUDVFULVLVGH ODHQIHUPHGDGVLQHVWDUGLDJQRVWLFDGRV\RDQWHODVSULPH UDVFULVLVGHKLSHUJOXFHPLDRKLSRJOXFHPLD(QWRGRVHVWRV FDVRVORTXHVHHQFXHQWUDHQFRP~QHVTXHHOPLHGR DSDUHFHDQWHORGHVFRQRFLGR/DLPSRVLELOLGDGGHLQWHUSUH WDUORVVtQWRPDVTXHDSDUHFHQHQHOFXHUSRJHQHUDDOWRV PRQWRVGHLQFHUWLGXPEUH$VtHOPLHGRHVSURYRFDGRSRU ODGL¿FXOWDGSDUDFRPSUHQGHUORTXHOHVHVWiVXFHGLHQGR SHUR WDPELpQ SRUTXH HVRV HSLVRGLRV FRQIXVRV R DPEL JXRVVRQYLYLGRVFRPRH[SHULHQFLDVOtPLWHVTXHDFWLYDQ SHQVDPLHQWRV HQ UHODFLyQ D OD SURSLD PXHUWH (Q HVWH VHQWLGRHQRFDVLRQHVORVSDFLHQWHVOHVDWULEX\HQDGL FKDVYLYHQFLDVGHVHQFDGHQDUFDPELRVDQLYHOFRQGXFWXDO HQUHODFLyQDVXVPRGRVGHDIURQWDUHOWUDWDPLHQWR&RPR WRGDFULVLVVRQLGHQWL¿FDGDVFRPRXQSXQWRGHLQÀH[LyQHQ VXH[SHULHQFLDFRQODHQIHUPHGDG\FRPR³XQDQWHV\XQ GHVSXpV´HQVXVFRQGXFWDVGHFXLGDGR E ³<EXHQRDKRUDVHJXtDOSLHGHODOHWUDODGLHWDSRUTXHOD GRFWRUDOHKDEOyDPLPDULGR\OHGLMRTXHVL\RQRPH FXLGDEDVL\RQRKDFLDHVWRPHLEDSDUDDUULEDTXHVL\R QRPHFXLGRHVWRHVDVt7LHQHUD]yQVLXQRQRVHFXLGD ODVDOXGYDHPSHRUDQGRPiVWHTXHGDVFLHJRWHTXHGDV VLQSLHUQD\HVR\RQRTXLVLHUDQXQFDSRUTXHPLPDULGR KDFHDxRVTXHHVWDPRVMXQWRV\QRTXLVLHUDGHMDUOR QXQFDDpOVROR´0XMHUDxRVDxRVGHGLDJQRVWLFR SULPDULRFRPSOHWRFRPHUFLDQWH 3UHJXQWD¢\ HQ TXp OH FDPELR OD YLGD GHVGH TXH WLHQH GLDEHWHV" 5HVSXHVWD ¢HQ TXp"HQ OD SUHRFXSDFLyQ GH TXH PH SXHGHSDVDUGHTXHPHFRUWHQDOJXQDSDUWHGHPLFXHUSR 3UHJXQWD¢HVROHSUHRFXSD" k t l k n m o o k u ~ k n m o ³«WH GLJR TXH \R PH FXLGR SRU PLHGR VL GHVSXpV PH KDFHPDOPHVLHQWRPDO\R$GHPiVQRTXLHURPROHVWDUD PLKLMR¢VDEpV"´0XMHUDxRVDxRVGHGLDJQyVWLFR SULPDULRMXELODGD ³4XpYR\DKDFHU"VLXQRQRVHFXLGD«SRUTXHPXFKRV QROHGDQLPSRUWDQFLDDHVWDHQIHUPHGDGSHURGHVSXpV l k n u r m s | o l k m t l q | m t k p r o n x n ~ q t k k l x q k t k r v l m r k u k | o ~ r s r u n r l m t k l s ~ k k t t o v x p r k l k ~ r p r t k l | o q l m k k u p k r r t { s l k s s l m k t | | r k k l t p m s r p y r p l k l o s m k k z ³«SRUDKtVLYRVHVWDVHQXQOXJDU\YHVSRUHMHPSORDFi o k t l l k k p m m w u k u r k | o r | | k q x k p m q o l r m y w k w r v o k w t m l o k u q t r p t m k v m n t x q p r k u w r m s o l m x p r s k v m ~ t ~ k o l m o o q k o r | k x s k r u ~ x m | ~ u r y u ~ m t p r w k r ³«DOSULQFLSLRWHQtDXQSRFRGHPLHGRSRUTXHPHDVXVWp PXFKRPHDVXVWDURQDFiPHDVXVWDURQGHORTXHPH x r p s m x s r p ~ u q s p k o p k l m x m s n m o m s l k s q m o l k x ~ k p k m { k u l m s ORVULxRQHVWHSXHGHDIHFWDUODYLVWD«´0XMHUDxRV DxR\PHGLRGHGLDJQyVWLFRVHFXQGDULRQLxHUD 'H HVWD PDQHUD XQD HQWUHYLVWDGD GH¿QH D OD GLDEHWHV FRPRXQVXIULPLHQWRSHURTXHQRSRVHHFRUUHODWRHQHO FXHUSRItVLFRVLQRTXHVHWUDWDGHXQVXIULPLHQWRSVtTXLFR 6HREVHUYDFODUDPHQWHHOLPSDFWRHPRFLRQDOTXHSURYR FDQHQHOODODVYLYHQFLDVQHJDWLYDVSHUVRQDOHV\IDPLOLDUHV HQUHODFLyQDODVVHFXHODVGHODHQIHUPHGDG\XQDDFWLWXG QHJDWLYDKDFLDpVWD z WDQGRFyPRYLHQHQODVFRVDV\Vt«WHDVXVWDV´0XMHU DxRVDxR\PHGLRGHGLDJQyVWLFRVHFXQGDULRQLxHUD $VLPLVPRWDPELpQVHHQFXHQWUDTXHH[LVWHQPXFKRVWH PRUHV DVRFLDGRV D ODV FRQVHFXHQFLDV TXH OD GLDEHWHV DE LA PÁGINA 279 A LA 285 x z o <DPHFRPLyORVRMRVVLPHFRPHORVSLHVQRVHTXpKD UtD"´0XMHUDxRVDxRVGHGLDJQyVWLFRSULPDULR LQFRPSOHWRDPDGHFDVD v o XQDSHUVRQDFRQGLDEHWHVTXHOHIDOWDXQDSLHUQDGLJRµQR SXHGHVHUQRKD\TXHOOHJDUDHVR¶3HUR\RQRVpVLHV QRUPDOTXHSRUPiVTXHWHFXLGHVWHOOHJDDSDVDUHVR HVRQRORVp 0XMHUDxRVDxRVGHGLDJQyVWLFR SULPDULRMXELODGD ³/DSDODEUDGLDEHWHVHVHVRVXIULPLHQWRTXHQRGXHOHHV q t p r n r s r n m p q m k l k o t r l k p ~ k n k t m p m 3UHJXQWD¢\SRUTXpVHVXIUH" 5HVSXHVWDKDVWDTXHWHHPSLH]D«QRQRPLSHQVDPLHQ WRHVHOVXIULPLHQWRGHYHUDODSHUVRQDTXHOHIDOWHXQ z 281 MANIFESTACIONES DE SÍNTOMAS DEPRESIVOS EN PACIENTES CON DIABETES TIPO 2: UN ABORDAJE CUALITATIVO MANIFESTATIONS OF DEPRESSIVE SYMPTOMS IN PATIENTS WITH TYPE 2 DIABETES: A QUALITATIVE APPROACH Azzollini, Susana; Benvenuto, Analía; Bail Pupko, Vera; Vidal, Victoria A. PLHPEURTXHOHSDVHFRPROHSDVyDPLKHUPDQRTXHOH FRQVXPLyHOFHUHEURRFRPRDODRWUDKHUPDQDTXHHH« TXHHH«ORVyUJDQRVQROHWUDEDMDEDQWRGDVHVDVFRVDV \RSLHQVR\SDUDPtHVPDODSDODEUDSHUGyQDPHSHUR SDUDPtHVPDODSDODEUD´0XMHUDxRVDxRVGH GLDJQyVWLFRSULPDULRMXELODGD PL PDPi PL DEXHOD SHUR EXHQR <R SLHQVR TXH HVWR YLHQHPiVSRUORHPRFLRQDOODSDUWHPt´0XMHUDxRV DxRVGLDJQyVWLFRMXELODGD $ YHFHV VDEHU TXH OD KHUHQFLD HV XQ IDFWRU GH ULHVJR SDUDWHQHUGLDEHWHVSURYRFDPLHGRHQUHODFLyQDODSRVL ELOLGDG GH OD WUDQVPLVLyQ JHQpWLFD GH OD HQIHUPHGDG D RWURVPLHPEURVGHODIDPLOLD6LQHPEDUJRWDPELpQVH REVHUYDTXHODVFUHHQFLDVDFHUFDGHODFDXVDOLGDGKHUH GLWDULDGHODGLDEHWHVFRQYLYHQFRQODVLGHDVDFHUFDGHOD FDXVDOLGDGHPRFLRQDO\HVWRVHPDQL¿HVWDHQODVHVWUD WHJLDVTXHVHSRQHQHQSUiFWLFDFRPRLQWHQWRVGHHYLWDU HVDKHUHQFLDIDPLOLDUWHPLGD F$QWHODDSOLFDFLyQGHLQVXOLQD ³«\RMDPiVKDEtDWRPDGRQLXQDFD¿DVSLULQD\DKRUD WHQJRTXHWRPDUODVSDVWLOODVSHURSRUORPHQRVQRPH WHQJRTXHLQ\HFWDULQVXOLQDFRPRVHSRQHQRWURV 3UHJXQWD¢SRUTXp"¢QROHJXVWDUtDHVR" 5HVSXHVWD\QRVpVLXQRWHQGUtDTXHYLYLUSLQFKiQGRVH« QRVpTXpKDUtDSRUTXHQRPHJXVWD/RTXHSDVDTXH« SULPHURPHGLHURQODLQ\HFFLyQ\ODXVpXQDYH]\QROD XVpPiV\OHGLMHDODGRFWRUDSHURQRPHGLMRQDGDSRU TXHFRPRYLRTXHWHQJRFRQWURODGDHOD]~FDU<GHVGHHVD YH]PHFXLGRXQPRQWyQSDUDQRWHQHUTXHLQ\HFWDUPH ^ f D$QWHHOLPSDFWRLQLFLDOGHOGLDJQyVWLFR z s m l r p k u r | k s | k t r o p ~ n u k o y r p k o m y ~ t m m u r t { m u l ~ z UDV\WRGR\DKRUDFRPRJDOOHWLWDV´+RPEUHDxRV PHVHV GLDJQRVWLFR SULPDULR H[ HPSOHDGR FHPHQWHULR MXELODGRUHFLHQWHPHQWH ³3RUTXHSRUDKtDPtODLQVXOLQDPHDUUHJODODGLDEHWHV SHURPHHVWiGHVWUX\HQGRRWUDFRVDHVRHVORTXHSDVD WDPELpQ´0XMHUDxRVDxRVGHGLDJQyVWLFRSULPD ULRLQFRPSOHWRDPDGHFDVD ³«FXDQGRPHGLMHURQTXHPHWHQtDTXHDSOLFDULQVXOLQDOR WRPpPDOHOORVPHH[SOLFDURQWRGRFRPRPHWHQtDTXH DSOLFDU\HOGRFWRUPHGHFtDYRVWHLPDJLQDVTXHVLKDFH DxRVTXHHVWDVWRPDQGRSDVWLOODVHVSRUTXHWXSiQ FUHDVDQGDEDPDO\EXHQREDVWDQWHTXHDJXDQWySHUR EXHQRORWRPpDVt´0XMHUDxRVDxRVGHGLDJQyV WLFRSULPDULRMXELODGD z $OJXQDV FDUDFWHUtVWLFDV GHO WUDWDPLHQWR GH OD GLDEHWHV WDPELpQSXHGHQJHQHUDUPLHGR(QSDUWLFXODUVHHQFXHQ WUDTXHHVKDELWXDOHQWUHORVSDFLHQWHVHQWUHYLVWDGRVHO WHPRUDQWHODLQGLFDFLyQPpGLFDGHDSOLFDFLyQGHLQVXOLQD RODSRVLELOLGDGGHDSOLFDFLyQHQXQIXWXUR\XQDDFWLWXG QHJDWLYD KDFLD pVWD $GHPiV VH LGHQWLILFDQ GLVWLQWDV FUHHQFLDVQHJDWLYDVWDOHVFRPR³HVPX\IXHUWH´³GHVWUX \HRWURVyUJDQRV´³QRHVQDWXUDO´TXHGL¿FXOWDQODDGKH UHQFLDDOWUDWDPLHQWR G$QWHODSRVLELOLGDGGHODWUDQVPLVLyQJHQpWLFD ³SRUTXHPLKHUPDQDOHVDOLyDKRUDXQSULQFLSLRSHUR\R WHQJRPLHGRSRUPLKLMR\PLKLMD0LKLMRVHFXLGDpOPH GLFHµSDSiYRVWHWHQpVTXHFXLGDUQXQFDOHGLVWHEROLOOD DQDGD£WHWHQpVTXHFXLGDU¶«´+RPEUHDxRV DxRVGHGLDJQyVWLFRSULPDULRWD[LVWD ³<RYHQJRGHIDPLOLDGLDEpWLFD\VLHPSUHPHGHFtD\RQR YR\DVHUGLDEpWLFDQRYR\DVHUGLDEpWLFD(UDPLPHQWH SRUTXHWHQtDWHUURUGHWHQHUSUREOHPDV«QRTXHUtDWHQHU x s r 282 n k | m o u r | r l ~ w q k s r t l q k t k t l r p m | q { m | q n q m | q o l m o ³«EXHQRFXDQGRPHDWHQGLyODPpGLFDPHGLMRXVWHGHV GLDEpWLFD<IXHFRPRTXHPHSHJDUDQXQFDFKHWD]RIXH ORSHRUTXHPHSRGUtDKDEHUSDVDGR<HQFLPD\R\DYHQtD FRQSUREOHPDVGHWLURLGHVHQWRQFHV\RGHFtDWRGRORTXH DPtPHJXVWDPHORVDFDQ´0XMHUDxRVDxRVGLDJ QyVWLFRSULPDULRMXELODGD ³SDUDWRGRVWRGRVSDUDPLPXMHUPLPDPiSDUDWRGRV IXHXQLPSDFWRPX\JUDQGHSRUTXHWRGRVGHVFRQRFtDPRV ORTXHHUDHVRSRUTXHQRKDEtDQDGLHHQPLIDPLOLD$KRUD VR\HOSURIHVRUGHODIDPLOLDHQDVXQWRVGLDEpWLFRVSRUTXH WXYHTXHDSUHQGHUFRQPLJRPLVPR´+RPEUHDxRV DxRVGHGLDJQyVWLFRVHFXQGDULRWD[LVWD (OPRPHQWRHQTXHVHUHFLEHHOGLDJQyVWLFRGHGLDEHWHV HVVHxDODGRWDPELpQFRPRGHJUDQLPSDFWRHPRFLRQDO\ DVRFLDGRDVHQWLPLHQWRVGHDQJXVWLD(QHVWHSXQWRVH HQFXHQWUDTXHHVHPRPHQWRHVYLYLGRFRQJUDQDQJXVWLD WDQWRSRUTXLHQHVFRQRFtDQGHODHQIHUPHGDGSRUWHQHU DOJ~QPLHPEURGHODIDPLOLDFRQGLDEHWHVFRPRSRUDTXH OORVTXHGHVFRQRFtDQWRWDOPHQWHGHTXpVHWUDWDED E(Q UHODFLyQ D ORV FDPELRV GH KiELWRV TXH LPSOLFD HO l s m l m | q k t l r 3UHJXQWD\TXpPiVOHFDPELyHQVXYLGDGHVGHHOGLDJ QyVWLFR" 5HVSXHVWD\PXFKDVFRVDVVHOHTXLHEUDODYR]VHDQ v ~ o l q m k m | q | k v ~ o l m m k n k u ~ k o l z z m VHJXLU KDEODQGR« OD FRVWLOOD HO OHFKyQ WRGR HVR \ OR GHMpFRPRSHURDODODUJD3RUHVROHGHFtDTXHHVWDED KDFLHQGRELHQORVGHEHUHV3RUTXHWHQJRXQFRPSDxHUR TXH«WRGDYtDWUDEDMD¢QR"\\RORYHtDTXHFRPtDIDFWX UD\WRGR\VLHPSUHPHTXHUtDGHFLUDPLTXpWHQtDTXH KDFHU«´+RPEUHDxRVPHVHVGLDJQyVWLFRSULPD ULRH[HPSOHDGRFHPHQWHULRMXELODGRUHFLHQWHPHQWH z ³«PHVDFDEDQWRGRHUDFRPRGHFLU¢SDUDTXpYLYLUOD YLGD"(UDFRPRVLDXQFKLFROHVDFDVXQMXJXHWHEXHQR HVDVHQVDFLyQIXH0HVDFDEDQODDOHJUtDGHYLYLUSHUR« GHVSXpV OR VXSHUp SHUR PH FRVWy´0XMHU DxRV DxRVGLDJQyVWLFRSULPDULRMXELODGD DE LA PÁGINA 279 A LA 285 FACULTAD DE PSICOLOGÍA - UBA / SECRETARÍA DE INVESTIGACIONES / ANUARIO DE INVESTIGACIONES / VOLUMEN XX (QORVHMHPSORVDQWHULRUHVVHREVHUYDTXHDSDUHFHIUH FXHQWHPHQWHODDQJXVWLDRHOGLVJXVWRDVRFLDGRVDODSUL YDFLyQRUHVWULFFLyQGHDTXHOORTXHOHVSURGXFtDSODFHUOD FRPLGDHMORVGXOFHVDVDGR\RDFWLYLGDGHVUHFUHDWLYDV HMEDLODUDUWHVPDUFLDOHV(VGHFLUTXHORVFDPELRVGH KiELWRVTXHGHEHQUHDOL]DUORVSDFLHQWHVSDUDFXLGDUVH VRQYLYLGRVFRQDOWRVPRQWRVGHDQJXVWLDVREUHWRGRHQ XQDSULPHUDHWDSD3HURFRQIUHFXHQFLDVHSXHGHYHU TXHPiVWDUGHORJUDQXQDPHMRUDFHSWDFLyQGHHVDVPR GL¿FDFLRQHVTXHHOWUDWDPLHQWRVXSRQH(VSRVLEOHSHQVDU TXHHVWRVHGHEHDTXHFRQHOWLHPSRVHSURGXFHQFDP ELRVDQLYHOFRJQLWLYRTXHSHUPLWHQUHVLJQL¿FDUHVDVLQGL FDFLRQHVPpGLFDV n r o t r m x m s k u k t y r l k t v r p r o t q k l r o ~ t r l q k t k ¡ ¢ | m m t ¯ n r m o ° u q u r m s o m o | m ± r m s t m m t k r o w k n r u y ~ m | n x n m o k s m ± k r ~ t o p q r t k k ~ o t | m m k | q z 3UHJXQWD¢<HQTXpOHFDPELyODYLGDSRUWHQHUGLDEHWHV" 5HVSXHVWD\EXHQRSHUR\RORKDJRSRUTXHHOELHQHV SDUDPtSHURPHFDPELDHQHOVHQWLGRGHTXHSRUHMHPSOR k t | m s r y r o ~ k n r q s | k m n m u m o m p k | q u ~ ± m p m k t ² t l s k 5tRVTXHWHQJRXQRVVREULQRVTXHPHTXLHUHQPX\PX FKR\PHHVWiQOODPDQGR¢WtDYDVDYHQLUQRYDVDYHQLU" z y y r w k r n m r n o m p k s k | k p q r o x m s m k n u r n k o l k s r n x m s m HVWRRWUR£¢\DKRUDYR\DDQGDUFRQODVDJXMDVWDPELpQ" (VXQSUREOHPD´0XMHUDxRVDxRVGHGLDJQyVWLFR SULPDULRLQFRPSOHWRMXELODGD y RWUR\DYHFHVFRPRTXHQRPHGHMDQYHUORV\EXHKK« OORUD´0XMHUDxRVDxRVGHGLDJQRVWLFRSULPDULR FRPSOHWRFRPHUFLDQWH ³<\\«DOSULQFLSLRHUDGLItFLOSRUTXHPHDWDFDEDHOKDP /DH[LVWHQFLDGHDSR\RGHSDUWHGHODIDPLOLDSDUDOOHYDU DGHODQWH HO WUDWDPLHQWR HV LGHQWL¿FDGR SRU ORV PLVPRV SDFLHQWHVFRPRXQIDFWRUTXHIDYRUHFHODDFHSWDFLyQGH ODHQIHUPHGDG\ODDGKHUHQFLDDOWUDWDPLHQWR&RPRFRQ WUDSDUWLGDODSHUFHSFLyQGHIDOWDGHDSR\RIDPLOLDUJHQHUD PRQWRV HOHYDGRV GH DQJXVWLD TXH SXHGHQ GL¿FXOWDU OD DGKHUHQFLDDODVFRQGXFWDVGHDXWRFXLGDGR G m z z n m n z ³3HURQRVyORHOQHJRFLRHVPLFRPSOLFDFLyQ\RWHQJRD PLVKLMRVJUDQGHVXQDHVFDVDGD\\RPHVLHQWRFRPR TXHPLVKLMRVPHXVDQ&XDQGRPDPiQRHVWiWHQHFHVL WDQPDPiWLHQHTXHHVWDU\FXDQGR\RHVWR\HQIHUPD n n q JD\ORIHVWHMDHO$QWHVQRVMXQWiEDPRV\pUDPRVFRPR \VLHPSUHVHKDFHQSDUHMDV\VHYDQDSDUWDQGRDO JXQRV<GHMRGHLUSRUTXHPHVLHQWRDFRPSOHMDGR\ODV FKLFDV TXH VDEHQ TXH VR\ EXHQ EDLODUtQ«WHQJR R FKLFDVTXHFXDQGRSDVDEDQVDOVDRPHUHQJXHEDLODEDQ FRQPLJRSRUTXH\RKDJRPXFKDV¿JXUDV«WRGRVKDFH PRVPXFKDV¿JXUDV\EXHQRPHTXHGpFRQHODVXQWR HVWHGHODSLHUQDTXHQRSXHGREDLODU\PHDFRPSOHMRXQ SRFRQRTXLHURTXHPHYHDQDVt«´+RPEUHDxRV DxRVGHGLDJQyVWLFRSULPDULRWD[LVWD F3RUODSHUFHSFLyQGHIDOWDGHDSR\RIDPLOLDU k m s k l s m l m m p k t r o m n q s l s m l m m p k t r q s m n r p k | q k s | z m z QRSRUHMHPSOR+DVWDTXHQRHVWXYHXQSRFRPHMRUHV WDED PiV DLVODGR 'HVSXpV EXHQR FXDQGR PH KH HPSH]DGRDPHMRUDUEXHQRHQHVWHDxRKHFRPLGRXQ SRFRGHUDYLROHVSHURGHHVRVELHQKHFKRVQRHVRVTXH YLHQHQPDOKHFRPLGRXQSRTXLWR«´+RPEUHDxRV DxRGHVGHHOGLDJQyVWLFRHVWXGLRVVHFXQGDULRVHPSOHD GRIHUURYLDULR z £ ¤ r | r u m ~ o m p k n m k t { k s | k p m p (QHVWDVIUDVHVVHSXHGHLGHQWL¿FDUHOGHVJDQRGHORV SDFLHQWHVHQUHODFLyQDORVYtQFXORV\DFWLYLGDGHVVRFLD OHVDSDUWLUGHODHQIHUPHGDG(QPXFKRVSDFLHQWHVHQ WUHYLVWDGRVVHHQFXHQWUDXQDUHVWULFFLyQGHVXYLGDVRFLDO (VWRHQDOJXQRVFDVRVVXFHGHSRUYHUJHQ]DDQWHOD YLVLELOLGDGGHOGHWHULRURItVLFRRODSpUGLGDGHFDSDFLGD GHV2WDPELpQFRPRXQDPDQHUDGHFXLGDGRVHHYLWD FRQFXUULUDHYHQWRVVRFLDOHVGRQGHVHFUHHSXHGHVHUGL ItFLOPDQWHQHUODGLHWDLQGLFDGD(QDPERVFDVRVODHVWUD WHJLDHVODPLVPDODHYLWDFLyQGHDFWLYLGDGHVVRFLDOHVOR TXHFRQGXFHDODLVODPLHQWR ¥ k { ~ q m ~ t m o m n q l m p k m n n } | k q u q k s r t l r p r o n r o m t } n q o q o \PHSUHJXQWyVL\RHUDGLDEpWLFD<OHGLMHQR\RVLHPSUH £ | k u r t l s r n r ~ m t p r | k p k o u ~ s q k s r t l k t m ¢ ¦ § y | k GLMRQRVRVGLDEpWLFD<PHSUHJXQWyWXYRDOJXQDDQ JXVWLDVHSHOHyFRQDOJXLHQTXpPHKDEtDSDVDGR/R ~QLFRTXHPHSDVyHVTXHIDOOHFLyPLSDSi(QWRQFHVGH ODDQJXVWLDWHDJDUUyPHGLMR<DKt\DWHGLJRWHQJRDP PDPiTXHHUDGLDEpWLFDWDPELpQDVtTXHWHQJRGHVFHQ GHQFLD\DGHHOODWDPELpQ´0XMHUDxRVDxRVGH GLDJQyVWLFRSULPDULRLQFRPSOHWRDPDGHFDVD z z (QUHODFLyQDODDQJXVWLDKDVWDDTXtVHVHxDOyODDSDUL FLyQGHpVWDFRPRFRQVHFXHQFLDGHODGLDEHWHVSHURHV SUHFLVRUHVDOWDUTXHWDPELpQH[LVWHQFUHHQFLDVTXHXEL FDQDORVVHQWLPLHQWRVGHDQJXVWLDFRPRFDXVDQWHVGH ODHQIHUPHGDG d ¨ © ¨ ª « ¨ ¨ f ¨ ¬ O ³ ¨ ³ ª ¨ ¬ ­ ´ ¨ f ­ ³\FRPRGRVRWUHVDxRVDWUiV\GHVSXpVFRQODVSDVWLOODV PHVHQWtDELHQSHURKDFHGRVDxRVDWUiVIDOOHFLyPLSDSi \PHDJDUUyDUWURVLVGHURGLOOD\GHVSXpVGHTXHIDOOHFLy PLSDSiKHTXHGDGRPX\GHSUHVLYDGRUPtDHVWDEDWRGR ® ­ k n | 3UHJXQWD¢<HQTXpOHFDPELyODYLGDGHVGHTXHWLHQH GLDEHWHV" 5HVSXHVWD\HQTXpPHFDPELyODYLGD"<\\\\\HQWRGR <RHUDPX\DFWLYRQRPHTXHGDEDTXLHWRFDPLQDEDELHQ DE LA PÁGINA 279 A LA 285 p ~ m u k r t n k m u o l m m | m m | t m n r m u ~ q m t k t q r n m | p q o q k l k m s | t q m t t m r p o m o t k r k t u l k r s | m s m r t TXH\RHVWDEDDVt\PHSDJDURQHOSDVDMHSDUDTXHYLQLH z s m x m s m m u } y ~ k t r m u } k o l r y r s m k o l r y u r t | q k s z PDQRHQ6DQ,VLGUR/DGRFWRUDPHGLMRTXHPHWHQGUtD TXHTXHGDUXQWLHPSRDFiHQ%XHQRV$LUHVSRUTXHDOOi 283 MANIFESTACIONES DE SÍNTOMAS DEPRESIVOS EN PACIENTES CON DIABETES TIPO 2: UN ABORDAJE CUALITATIVO MANIFESTATIONS OF DEPRESSIVE SYMPTOMS IN PATIENTS WITH TYPE 2 DIABETES: A QUALITATIVE APPROACH Azzollini, Susana; Benvenuto, Analía; Bail Pupko, Vera; Vidal, Victoria A. HQ6DQWLDJRGHO(VWHURPHTXHGDPX\OHMRVSDUDYLDMDU´ 0XMHUDxRVDxRVGHGLDJQRVWLFRSULPDULRLQFRP SOHWRGHVHPSOHDGDWUDPLWDQGRSHQVLyQSRULQYDOLGH] ¤ l s m l r p k u m | q t m s q v ~ m n o k m u r | r o k m l s m l r p k u m | q t m s XQSRFRQRPHTXLHURTXHGDUSRUTXHHQFLPDDKRUDPH WLUDPXFKRODFDPDHVFRPRTXHPHTXLHUHDJDUUDUXQD GHSUHVLyQFRQODPXHUWHGHPLPDULGR¢YLVWH"´0XMHU DxRV DxRV GH GLDJQyVWLFR SULPDULR LQFRPSOHWR U µ U h \ Z U Y U ¶ 3RU~OWLPRVHHQFXHQWUDTXHORVSDFLHQWHVWLHQHQVtQWR PDVGHSUHVLYRVFRPRFRQVHFXHQFLDGHRWURVKHFKRVYL WDOHVQHJDWLYRVTXHQRWLHQHQUHODFLyQFRQODHQIHUPHGDG 1RREVWDQWHpVWRVLPSDFWDQGLUHFWDPHQWHHQODDGKHUHQ FLD DO WUDWDPLHQWR GH PRGR GHVIDYRUDEOH (QWUH HVWRV HYHQWRV QHJDWLYRV HO TXH VH PHQFLRQD FRQ PD\RU IUH FXHQFLDHVHOIDOOHFLPLHQWRGHXQVHUTXHULGRKLMRSDGUH RSDUHMD a ¨ HQHOFXUVRGHODHQIHUPHGDGVLQRTXHWDPELpQVHFRQR FHXQDDOWDFRPRUELOLGDGGHODVHQIHUPHGDGHVFUyQLFDV FRQORVWUDVWRUQRVDQVLRVRV\GHSUHVLYRV-LPpQHV\FROV IUHFXHQWHPHQWHFRPRFRQVHFXHQFLDGHOSDGHFL PLHQWRGHODVPLVPDVWDOFRPRPXHVWUDQORVKDOOD]JRV GHOSUHVHQWHHVWXGLR (QHVWHVHQWLGRFDEHVHxDODUTXHVHGHEHSUHYHQLUDORV SURIHVLRQDOHVDFHUFDGHORVSDFLHQWHVGHORVTXHVHVRV SHFKDXQDSHUVRQDOLGDGGHSUHVLYDSUHYLDRTXHSUHVHQWDQ HVWHWLSRGHPDQLIHVWDFLRQHVDSDUWLUGHOGLDJQyVWLFRGH XQD HQIHUPHGDG FUyQLFD \ SRQHU HQ SUiFWLFD HO DSR\R SVLFROyJLFR QHFHVDULR SDUD PRULJHUDU VX LPSDFWR 6H SXHGHSHQVDUFRPRFRQVHFXHQFLDTXHODDGKHVLyQDORV WUDWDPLHQWRVHVXQSURFHVRFRPSOHMRTXHLPSOLFDTXHORV SURIHVLRQDOHVGHEHQHVWDUDOHUWDDQWHVtQWRPDVTXHSXH GHQQRIRUPDUSDUWHGHOVtQGURPHGHOFXDGURGLDEpWLFR SHURTXHWLHQHQUHSHUFXVLRQHVVREUHODVDOXG\ODFDOLGDG GHYLGDGHODVSHUVRQDV f (O LPSDFWR GHO GLDJQyVWLFR GH GLDEHWHV SXHGH SURGXFLU FRQÀLFWRVDQWHODGL¿FXOWDGGHDSUHQGHUDYLYLUFRQODHQ IHUPHGDG/DDFHSWDFLyQHVXQODUJRFDPLQRTXHQRVLHP SUHVHWUDQVLWDFRQp[LWR\PXFKDVYHFHVORVLQGLYLGXRV LQWHUSUHWDQTXHGHEHQDEDQGRQDUYtQFXORVWDUHDV\UROHV TXHKDEtDQGHVHPSHxDGRKDVWDODDSDULFLyQGHODHQIHU PHGDG \ TXH HUDQ LPSRUWDQWHV HQ VXV YLGDV $ YHFHV VLPSOHPHQWHUHVXOWDGLItFLOPRVWUDUVHDQWHORVGHPiVGH XQDIRUPDGLVWLQWDDODDQWHULRU(OUHVXOWDGRSXHGHVHUHO DEDQGRQRGHWDUHDV\GLYHUWLPHQWRVTXHFRPRWRGDSpU GLGDGHUROHVQHFHVLWDQXQGXHOR\XQDSRVWHULRUUHVLJQL¿ FDFLyQ'HDKtODLPSRUWDQFLDGHODGHWHFFLyQGHODFR PRUELOLGDGHQWUHGHSUHVLyQ\GLDEHWHV(QORVGLVFXUVRV DQDOL]DGRVGHORVSDFLHQWHVVHREVHUYDQGLVWLQWDVPDQL IHVWDFLRQHVGHVtQWRPDVGHSUHVLYRVPLHGRVSUHRFXSD FLRQHV DQJXVWLD \ DLVODPLHQWR VRFLDO (VWRV UHVXOWDGRV VRQFRQJUXHQWHVFRQORVKDOOD]JRVGH.DJHHUHD OL]DGRHQXQDFRPXQLGDGHQ6XGiIULFDHQHOFXDOVHWRPy HOLQYHQWDULRGHGHSUHVLyQGH%HFNDSDFLHQWHVFRQGLDEH WHVWLSR\GHWHFWyXQSRUFHQWDMHVLJQL¿FDWLYRGHpVWRV TXHH[SHULPHQWDQGL¿FXOWDGHVSVLTXLiWULFDVSRUODVFXD OHVQRUHFLEHQQLQJ~QWLSRGHWUDWDPLHQWR $VLPLVPR 3LTXHUDV 5RGUtJXH] LQWHQWDURQ PRVWUDUODLQÀXHQFLDGHORVIDFWRUHVHPRFLRQDOHVHVSHFt ¿FDPHQWHODDQVLHGDG\ODGHSUHVLyQHQHOSURFHVRGH VDOXGHQIHUPHGDG(VWRVIDFWRUHVVHKDQDVRFLDGRFRQ ODVHQIHUPHGDGHVFUyQLFDVFRPRYDULDEOHVLQÀX\HQWHVHQ HOLQLFLRGHVDUUROOR\PDQWHQLPLHQWR'HKHFKR3DQHWDO HQFRQWUDURQTXHODDVRFLDFLyQGLDEHWHVGHSUHVLyQ HV ELGLUHFFLRQDO (Q HVWH VHQWLGR VH KDQ KLSRWHWL]DGR EiVLFDPHQWHGRVYtDVH[SOLFDWLYDVJHQHUDOHV/DSULPHUD KDFHUHIHUHQFLDDODLQÀXHQFLDGHODDQVLHGDG\GHODGH SUHVLyQHQODFRQGXFWDGHPDQHUDTXHLQWHU¿HUHQHQORV KiELWRVVDOXGDEOHV\IRPHQWDQHOGHVDUUROORGHFRQGXFWDV LQDGHFXDGDVTXHSRQHQHQSHOLJURODVDOXG(OVHJXQGR PHFDQLVPRVHUH¿HUHDODUHSHUFXVLyQGHODDFWLYDFLyQ SVLFR¿VLROyJLFDHQORVVLVWHPDVRUJiQLFRVDIHFWDQGRDOD LQPXQLGDGSRUHMHPSOR3HURQRVyORH[LVWHXQDUHODFLyQ k 284 l m n DE LA PÁGINA 279 A LA 285 FACULTAD DE PSICOLOGÍA - UBA / SECRETARÍA DE INVESTIGACIONES / ANUARIO DE INVESTIGACIONES / VOLUMEN XX · ¸ ¹ ¸ · ¸ º » ¼ ½ ¾ ¿ ¼ ¿ À ¼ Á  · à ¹ ¼ » ½ ¾ $UERL[0/DGLDEHWHVPDJQLWXGGHODSDQGHPLD 0pGLFD 'LJLWDO 'LVSRQLEOH HQ 85/ KWWSEROODQDEORJVSRW FRPODGLDEHWHVPDJQLWXGGHODSDQGHPLDKWPO %DV)\$QGUpV9³(YDOXDFLyQGH3URFHVRV\&RQVWUXF WRV 3VLFROyJLFRV GH OD 'HSUHVLyQ´ (Q * %XHOD&DVDO 9( &DEDOOR\-&6LHUUDFRPSV0DQXDOGHHYDOXDFLyQHQSVLFR 0DGULG6LJOR;;, %HFN $7 'HSUHVVLRQ FOLQLFDO H[SHULPHQWDO DQG WKHUD 1XHYD<RUN+DUSHUDQG5RZ %HFN$7³&RJQLWLYHWKHUDS\RIGHSUHVVLRQQHZSHUVSHF WLYHV´(Q3-&OD\WRQ\-(%DUHWW(GV SS 1HZ<RUN5DYHQ3UHVV &DQWyQ&KLULYHOOD(\'RPLQJR7DUtQ$'LDEHWHVLQVXOL QRGHSHQGLHQWHV \ GHSUHVLyQ $QiOLVLV GH OD LQYHVWLJDFLyQ UH FLHQWH *DYLULD*yPH]$5LFKDUG0/RQGRxR&9DOGHUUDPD\-DUD PLOOR0,3HUFHSFLyQGHODHQIHUPHGDGDQVLHGDGGLD EHWHVDXWRH¿FDFLDDGKHVLyQDOWUDWDPLHQWRHQSHUVRQDVGLDJ Ä Å Æ Ç È É Ê Ë Ì Í Í È Î Ï Ê Í Ð Ï Ñ Æ Ð Ê Ò Å Í Ó Ê Ô Õ Ê Å Ë Ì Õ Ö Ö Ó Ç Æ Ð Ê Ô Ó Ð Ç Ô Ö × É Ó Ê Ç Ø Ó Ñ Ç È Ù Å Ó É Ó Ô Ì Í Ö Ô Æ È Ñ Ú Û Å Ð ß à È á Ñ Ä Ç É â È ã Ü Ó á à É Ô Æ Ó Ô Ê Ñ Å Ñ Ó Ý Ö Ê É È Ê Ð Þ Ó Ô × Ì Ì Í Í Õ Ö Ñ È Ô Ç Æ Ð Ê Å Ê Ô Ð È Ñ Å Æ Ê ä Ó Ç Ó Ô Ø Ó Æ Ç Ô × Æ È à à å æ ç è é ê ë ç ì ì í 3VLFRORJtD0HGHOOtQ)DFXOWDGGH3VLFRORJtD8QLY&(6 *LO5RDOHV1LHWR-H<EDUUD6DJDUGX\-/³*XtDGHWUD WDPLHQWRV SVLFROyJLFRV H¿FDFHV HQ 'LDEHWHV´ (Q 0 3pUH] -5)HUQiQGH]&)HUQiQGH]H,$PLJRHGV PLHQWRVSVLFROyJLFRVH¿FDFHV,,3VLFRORJtDGHOD6DOXGSS 0DGULG(GLFLRQHV3LUiPLGH +HLQ]H*9LOODPLO9\&yUWHV-5HODSVHDQG5HFXUUHQ FHRIGHSUHVVHGSDWLHQWVDUHWURVSHFWLYHVWXG\ -LPpQH]0*0DUWtQH]30LUy(\6iQFKH]$,%LHQ HVWDUSVLFROyJLFR\KiELWRVVDOXGDEOHV¢HVWiQDVRFLDGRVDOD SUiFWLFD GH HMHUFLFLR ItVLFR" .DJHH$6\PSWRPVRI'HSUHVVLRQDQG$Q[LHW\DPRQJD 6DPSOHRI6RXWK$IULFDQ3DWLHQWV/LYLQJZLWKD&KURQLF,OOQHVV 0LQLVWHULRGH6DOXGGHOD1DFLyQ%ROHWtQHSLGHPLROyJLFR 'LVSRQLEOHHQ85/KWWSZZZPVDOJRYDUKWPVLWHQRWLFLDVB SODQWLOODDVS",G 206 'LVSRQLEOHHQ85/KWWS ZZZZKRLQWPHGLDFHQWUHIDFWVKHHWVIVHVLQGH[KWPO 236 'LVSRQLEOH HQ 85/ KWWS QHZSDKRRUJKTLQGH[SKS"RSWLRQ FRPBFRQWHQWWDVN YLHZ LG ,WHPLG 3DQ$/XFDV06XQ49DQ'DP5)UDQFR2+0DQVRQ -:LOOHWW:&$VFKHULR$\+X)%LGLUHFWLRQDO$V VRFLDWLRQ%HWZHHQ'HSUHVVLRQDQG7\SH'LDEHWHV0HOOLWXVLQ :RPHQ 3LTXHUDV5RGUtJXH]-$0DUWtQH]*RQ]iOH]$(5DPRV/LQD UHV95LYHUR%XUyQ5*DUFtD/ySH]/-2EOLWDV*XDGDOX SH/$$QVLHGDGGHSUHVLyQ\VDOXG6XPD3VLFROyJL 9HODVFR%DOOHVWHUR6ÈOYDUH]3pUH]56DQ-XDQ0LJXHOVDQ] 0 6LQWRPDWRORJtD WUDVWRUQRV HPRFLRQDOHV \ FDOLGDG GHYLGDUHODFLRQDGDFRQODVDOXGHQSDFLHQWHVHQSURJUDPDGH KHPRGLiOLVLV SHULyGLFD 2YLHGR :HLVVPDQ$1\%HFN$7'HYHORSPHQWDQGYDOLGDWLRQ RIWKH'\VIXQFWLRQDODWWLWXGHVFDOHDSUHOLPLQDU\LQYHVWLJDWLRQ &RPXQLFDFLyQSUHVHQWDGDHQODUHXQLyQGHOD 7RURQWR&DQDGi Õ î Ï Ê Å Ó Ç É Ê Ç Í â ð Ó Ü Æ Ô Ç Ê ï Ê Ì Õ Ê Å Í Ó Ñ Ç Ê Í à Í Ê Ñ Å ó Ó ñ Ç Þ ô Ô Ò Ð Þ Í ó Ó È Í Ê Ç Þ Ñ Ç Ó É Ñ Ê Ç Æ È Ñ ñ Õ Ê Í È É Ñ Í Ê È Ù ò Í Æ Ñ Æ Ð Ê Í Ê ô Ô Ò Ð Þ È õ ö Î Ò ÷ È Ú ÷ ö ú Ö ø È Ç Ê Å Ó Ô Ð É Æ Ç Í Æ Ü Ê Í ø ù Õ ú Ö û Æ Ê ä Ó Ç Ó Ô Ø Ó Æ Ç Ô Ç Æ Í ã É Ð Þ Æ Ü Ó Ô È Ù à Ñ Ç Ó É Ñ È ð Ê Ó Å Æ Ð Æ Ñ Ó Ë Ì õ Ð Ê Í ü û Ä ü ý ò È Ñ Î É Ó Ô È ø Ê Ð Æ È Ñ Í Ê Å Ó Ê ï Ä Ì ø Õ ã Ø Ó É Æ Ð Ê Ñ Ä Å Ì Í Ð Ê Ç Æ È Ñ Ê â Ó Ô Ó Ê É Ð Þ ã Ô Ô È Ð Æ Ê Ç Æ È Ñ )HFKDGHUHFHSFLyQGHPD\RGH )HFKDGHDFHSWDFLyQGHDJRVWRGH DE LA PÁGINA 279 A LA 285 285