Uso de técnicas alternativas o de relajación como terapia al dolor crónico / Use of alternative or relaxation techniques in the treatment of chronic pain

Objetivo: Este trabajo consta de una revisión, dónde tratan el problema del dolor crónico en diferentes ámbitos y terapias alternativas o de relajación como tratamiento a este problema. Material y Método: Se han revisado los trabajos más significativos sobre las intervenciones y terapias de relajación dirigidas a reducir o eliminar el dolor en los pacientes crónicos. Se encuentran; estudios revisiones sistemática observacional, revisiones bibliográficas, estudio experimental, cuasiexperimental, estudios descriptivo transversal. Según los resultados obtenidos de la revisión sistemática realizada en el presente estudio, proceden de los países de España, Colombia, México. Resultados: Según los resultados obtenidos de la revisión sistemática realizada concluimos que las técnicas alternativas o de relajación son efectivas para la disminución del dolor crónico. Conclusiones: Se concluye que todas las intervenciones presentan algún tipo de eficacia y que la elección del tratamiento más adecuado se ha de basar en la evaluación individual de cada paciente. Así mismo se considera la necesidad de continuar la investigación y de considerar las intervenciones multidisciplinares para abordar el problema del dolor crónico. A lo largo de todo el trabajo se pone de manifiesto la utilidad del tratamiento del dolor crónico, destacando el papel que la relajación puede desempeñar a distintos niveles.(AU)

Objective: This work consists of a review, where they treat the problem of chronic pain in different settings and alternative or relaxation therapies as a treatment for this problem. Material and Method: The most significant works on relaxation interventions and therapies aimed at reducing or eliminating pain in chronic patients have been reviewed. They find each other; studies systematic observational reviews, bibliographic reviews, experimental, quasi-experimental studies, descriptive cross-sectional studies. According to the results obtained from the systematic review carried out in the present study, they come from the countries of Spain, Colombia and Mexico. Results: According to the results obtained from the systematic review carried out, we conclude that alternative or relaxation techniques are effective in reducing chronic pain. Conclusions: It is concluded that all the interventions show some type of efficacy and that the choice of the most appropriate treatment must be based on the individual evaluation of each patient. It also considers the need to continue research and consider multidisciplinary interventions to address the problem of chronic pain. Throughout the entire work, the usefulness of chronic pain treatment is highlighted, highlighting the role that relaxation can play at different levels.(AU)

Desenvolvimento, validação e aplicação piloto do Sistema de Observação da Instrução do instrutor de fitness em aulas de pilates / Desarrollo, validación y aplicación piloto del Sistema de Observación de la Instrucción del instructor de fitness en clases de pilates / Development, validation, and pilot application of the Instruction Observation System used by fitness instructors in pilates classes

Considerando as especificidades e princípios do método Pilates, o presente estudo tem como objetivo desenvolver e validar um sistema de observação que permita observar os comportamentos de instrução dos técnicos de exercício físico na atividade de Pilates, (SOIIF-PILATES), a partir da adaptação de um instrumento já existente. Após diversos procedimentos metodológicos para testar a funcionalidade do instrumento, o SOIIF-PILATES demonstrou apresentar validade e fiabilidade, sendo constituído por 2 dois critérios/dimensões (momento e conteúdo) e 15 categorias. Foi também realizada uma aplicação piloto do instrumento numa amostra de 15 técnicos de exercício físico na atividade de Pilates que permitiu caracterizar a sua intervenção assim como compará-la relativamente às fases da aula (aquecimento, parte fundamental e relaxamento/alongamento) e do exercício (antes, durante e após o exercício). Os resultados do estudo piloto demonstraram que a maioria das categorias referidas pelos técnicos de exercício físico estão de acordo com os princípios da modalidade de Pilates, o que pode justificar a sua elevada utilização. Foram encontradas diferenças no total da instrução nas diferentes fases da aula e entre as diferentes fases da aula e do exercício

Considerando las especificidades y principios del método Pilates, el presente estudio tiene como objetivo desarrollar y validar un sistema de observación que permita observar los comportamientos de instrucción de instructores de Fitness en la actividad Pilates, (SOIIF-PILATES), a partir de la adaptación de un instrumento ya existente. Después de varios procedimientos metodológicos para probar la funcionalidad del instrumento, el SOIIF-PILATES creado demostró presentar validez y fiabilidad siendo constituido por dos criterios/dimensiones (momento y contenido) y 15 categorías. Se realizó también una aplicación piloto del instrumento en una muestra de 15 instructores en la actividad de Pilates que permitió caracterizar su intervención, así como compararla con las fases de la clase (calentamiento, parte fundamental y relajación/estiramiento) y del ejercicio (antes, durante y después del ejercicio). Los resultados del estudio piloto demostraron que la mayoría de las categorías mencionadas por las instructoras se ajusta a los principios de Pilates, lo que puede justificar su elevada utilización. Se encontraron diferencias en el total de la instrucción en las diferentes fases de la clase y entre las diferentes fases de la clase y el ejercicio

Considering the specificities and principles of the Pilates method, the present study aims to develop and validate an observation system that allows us to observe the instructional behaviors of Fitness instructors in the Pilates activity (SOIIF-PILATES), based on the adaptation of an instrument that already exist. After several methodological procedures to test the functionality of the instrument, the SOIIF-PILATES proved to be valid and reliable, consisting of two dimensions (moment and content) and 15 categories. A pilot application of the instrument was also carried out in a sample of 15 Fitness instructors of the Pilates activity, which allowed to characterize their intervention as well as to compare it in different phases of the class (warm-up, main part and relaxation/stretching) and in different parts of the exercise (before, during and after the exercise) The results of the pilot study reveal that most of the categories referred by the instructors are following the principles of Pilates, which may justify their high utilization. Differences were found in the total of instruction of the different phases of the class and between the different phases of the class and the different phases of the exercise

Efectividad de un programa estructurado de sofrología durante 4 semanas en pacientes de Atención Primaria con un nivel medio o alto de ansiedad: estudio randomizado controlado / Effectiveness of a 4-week sophrology program for primary care patients with moderate to high anxiety levels: a randomised controlled trial

OBJETIVO: Valorar la efectividad del programa estructurado Bienestar y Sofrología para reducir los síntomas de ansiedad y depresión en pacientes con un nivel medio o alto de ansiedad que acuden a un centro de asistencia sanitaria CAP. MÉTODO: Estudio prospectivo controlado de 70 pacientes, con una puntuación HAD-A > 8 (Escala de Ansiedad y Depresión Hospitalaria), que fueron distribuidos de forma aleatoria en 2 grupos; el grupo de intervención (N = 35) con el programa Bienestar y Sofrología y el grupo control (N = 35) con el programa Hábitos Saludables a nivel Psicocorporal. El HADS y el Inventario de Ansiedad Estado-Rasgo (STAI) fueron apli-cados al inicio y al final de las 12 sesiones de una hora, asignadas en 3 sesiones a la semana durante 4 semanas seguidas. RESULTADOS: Finalizaron el estudio 66 participantes. El abandono fue 2,9 % para el grupo de intervención (N = 1) y 11,4 % para el grupo control (N = 4). El grupo de intervención mostró mejora estadísticamente significativa a nivel intragrupo (p < 0,001) e intergrupal (p = 0,001 a 0,046), en todos los parámetros del HADS y STAI, independientemente del género y edad. El tamaño del efecto, según la (d) de Cohen para la ansiedad y depresión, fue grande para el grupo de intervención (TE = 0,84 a 1,36) y entre pequeño y medio para el grupo control (TE = 0,28 a 0,49). CONCLUSIÓN: El programa estructurado e intensivo de 4 semanas de duración Bienestar y Sofrología ha mostrado eficacia para reducir los síntomas de ansiedad y depresión en pacientes de asistencia primaria con niveles medio o alto de ansiedad

BACKGROUND: The aim of this study is to determine the effectiveness of an intensive four-week structured group re-laxation-training program (sophrology's dynamic relaxation) on anxiety and depression symptoms in primary care patients with moderate and high anxiety levels. Method. In an experimental study, seventy patients, ac-cording to the Hospital Anxiety Depression Scale - Anxiety subscale (HADS-A), cut-off > 8, were randomized to the "well-being and sophrology" or a control program based on physical and mental health recommendations (PMHR). Hospital Anxiety and Depression Scale (HADS) and the State-trait Anxiety Inventory (STAI) ratings were obtained before and after 12 one-hour sessions for 4 consecutive weeks. RESULTS: Sixty-five patients completed the study. The dropout rate was 2.9 % (N=1) for the intervention group and 11.4% (N=4) for the control group. Sophrology showed statistically significant improvements in all HADS and STAI subscales for with-in group (p < 0.001) and be-tween groups analysis (p = 0.001 to 0.046), regardless of gender or age. The pre-post effect sizes (Cohen's d) for anxiety and depression symptoms were large for sophrology (ES=0.84 to 1.36) and small to moderate for the control (ES=0.28 to 0.49). CONCLUSION: An intensive four-week structured group relaxation-training program "well-being and sophrology" is highly effective in reducing anxiety and depression symptoms in primary care patients with moderate and high anxiety levels

Eficacia de dos tratamientos cognitivoconductuales en personas con fibromialgia y afectación emocional / Efficacy of two cognitive-behavioral treatments in people with fibromyalgia and emotional involvement

La fibromialgia afecta en gran medida a la calidad de vida de las personas que la sufren, así como a su funcionalidad, especialmente si la persona presenta síntomas comórbidos de ansiedad y/o depresión, lo que resalta la importancia del tratamiento psicológico. El objetivo del presente trabajo es comparar la eficacia de dos tratamientos cognitivo-conductuales breves en personas con diagnóstico de fibromialgia y con afectación emocional. Participaron un total de 44 personas (42 mujeres y 2 hombres) divididos en dos grupos de tratamiento: uno de ellos elaborado únicamente con componentes convencionales de la terapia cognitivo-conductual (grupo A) y el otro con los mismos componentes más un componente añadido de expresión emocional a través del dibujo (grupo B). Se encontraron puntuaciones significativamente mejores (p < 0,05) después de aplicar cualquiera de los dos tratamientos en las siguientes áreas: funcionalidad, percepción del dolor, ansiedad, depresión, catastrofismo, miedo al movimiento, estrategias de afrontamiento activo y percepción de autoeficacia. Se concluye que los resultados obtenidos apoyan la eficacia de ambos tratamientos cognitivo conductuales para personas con fibromialgia y afectación emocional

Fibromyalgia largely affects the life quality of people suffering from it, as well as its functionality, especially if the person has comorbid symptoms of anxiety and/or depression, which highlights the importance of psychological treatment. The objective of this study is to compare the efficacy of two brief cognitive-behavioral treatments in people with a fibromyalgia diagnosis and emotional involvement. A total of 44 people enrolled in the study (42 female, 2 male), divided within two treatment groups: one of them made only with conventional components of cognitive-behavioral therapy (group A) and the other with the same components plus an added component of emotional expression through drawing (group B). Significantly better scores were found (p < 0.05) after applying any of the two treatments in the following areas: functionality, pain perception, anxiety, depression, catastrophism, fear of movement, active coping strategies and self-efficacy perception. It is concluded that the results obtained support the efficacy of both cognitive-behavioral treatments for people with fibromyalgia and emotional involvement

The effect of Dhikr therapy on anxiety levels in chronic kidney failure patients that have done hemodialysis therapy in Indonesia

Anxiety is a psychological response that is often experienced by patients with chronic renal failure undergoing hemodialysis. The purpose of this study was to determine the effect of Dhikr therapy on anxiety levels in chronic kidney failure patients undergoing hemodialysis at RSUD Dr. Drajat Prawiranegara attack in 2019. This type of research is quasi-experimental without control, with 72 respondents selected using purposive sampling technique. The results of univariate analysis showed that in the first measurement before getting therapeutic intervention Dhikr most respondents condition that is anxious as many as 10 respondents (55.6%). After getting the Dhikr therapy intervention, the condition of the respondents' anxiety level experienced a change to a mild anxiety level of 9 (50%). The result of bivariate analysis is p value 0.000 with α<0.005, so it can be concluded that there is an effect of Dhikr therapy on the level of anxiety in patients with chronic renal failure undergoing hemodialysis at RSUD Dr. drajat prawiranegara attack in 2019. Further researchers are advised to examine the support of family relationships to the level of anxiety in patients with chronic renal failure in the hemodialysis room

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Efecto del relajamiento muscular progresivo en el estrés y bienestar en el trabajo de enfermeros hospitalarios / Effect of progressive muscle relaxation on stress and workplace well-being of hospital nurses / Efeito do relaxamento muscular progressivo no estresse e bem-estar no trabalho de enfermeiros hospitalar

OBJETIVO: Evaluar el efecto del relajamiento muscular progresivo em los niveles de estrés y bienestar en el trabajo de enfermeros hospitalarios. MÉTODO: Estudio de intervención, de tipe antes y después, longitudinal, que ha acompañado 16 enfermeros de una instituición hospitalaria por ocho semanas consecutivas sometidos a un protocolo de relajamiento muscular progresivo. Se han recogido los datos con cuestionario, Escala de Estrés em el Trabajo; Escala de Bienestar en el Trabajo. Se han utilizado las pruebas Shapiro-Wilk, T pareado, Wilcoxon, Sperman y Mann-Whitney. RESULTADOS: Se observó reducción de los promedios de estrés (60/55 p = 0,166) y aumento de los promedios de los factores de bienestar en el trabajo- afecto positivo, afecto negativo y realización (3.22/3,42 p = 0,073; 2,07/2,29 p = 0,094 e 3,71/3,92 p = 0,060), respectivamente. CONCLUSIONES: Hubo evidencias de que el relajamiento muscular progresivo ha reducido los promedios de estrés y ha promovido bienestar en el trabajo entre los enfermeros

OBJECTIVE: To evaluate the effect of progressive muscle relaxation on the levels of stress and workplace well-being of hospital nurses. METHOD: This is an intervention, of the before-after type, longitudinal, which monitored 16 nurses from a hospital institution for eight consecutive weeks submitted to a progressive muscle relaxation protocol. Data were collected by questionnaire, Work Stress Scale and Well-being at Work Scale. Shapiro-Wilk, Wilcoxon, Sperman and Mann-Whitney tests were used. RESULTS: The mean stress level decreased (60/55 p= 0.166) and the mean workplace well-being factors: positive affect, negative affect and fulfillment increased (3.22/3.42 p = 0.073; 2.07/2.29 p = 0.094 and 3.71/3.92 p = 0.060), respectively. CONCLUSION: The study revealed that the progressive muscle relaxation reduced the means of stress and promoted well-being at work among the nurses

OBJETIVO: Avaliar o efeito do relaxamento muscular progressivo nos níveis estresse e bem-estar no trabalho de enfermeiros hospitalar. MÉTODO: Estudo de intervenção, do tipo antes e depois, longitudinal, que acompanhou 16 enfermeiros de uma instituição hospitalar por oito semanas consecutivas submetidos há um protocolo de relaxamento muscular progressivo. Coletou-se os dados com questionário, Escala de Estresse no Trabalho; Escala de Bem-estar no Trabalho. Utilizou-se os testes Shapiro-Wilk, T pareado, Wilcoxon, Sperman e Mann-Whitney. RESULTADOS: Observou-se redução das médias de estresse (60/55 p = 0,166) e aumento das médias dos fatores de bem-estar no trabalho- afeto positivo, afeto negativo e realização (3.22/3,42 p = 0,073; 2,07/2,29 p = 0,094 e 3,71/3,92 p = 0,060), respectivamente. CONCLUSÕES: Houve evidências que o relaxamento muscular progressivo reduziu as médias de estresse e promoveu bem-estar no trabalho entre os enfermeiros

Thought stopping as a strategy for controlling adolescent negative thoughts related to earthquakes

OBJECTIVE: To determine the effect of thought stopping therapy (TS) and nursing intervention (NI) for changes in the ability to control negative thoughts associated with earthquakes. METHOD: The design of this study was used a quasi-experimental study with pretest-posttest control groups and conducted in East Java-Indonesia. 112 respondents divided into intervention and control group. Intervention group were given NI and TS and control groups were given NI only. The questionnaire used in this study was valid and reliable. RESULT: Data analysis included univariate and bivariate. There was a significant increase in the ability of adolescents to control negative thoughts related to earthquakes in both groups (control and intervention). The score of the ability to control negative thoughts in the intervention group increased 5.72 points while the control group only gained 2.82 points. CONCLUSION: NI and TS are recommended as effective strategy for controlling the adolescents negative thought related to earthquake

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The effect of progressive muscle relaxation on stress in diabetes mellitus patient

OBJECTIVE: The purpose of this study is to determine the effect of progressive muscle relaxation exercises on stress level of Diabetes Mellitus Type II patient. METHOD: A quasi-experimental pre post-test with control group design was used in this study. The number of samples amounted to 21 respondents in the treatment group and 21 respondents in the control. The sampling technique simple random sampling. The instrument in this study was a Cohen perceived stress questionnaire. Data analysis was performed by bivariate analysis used t-test independent. RESULTS: The results show that there is no effect of progressive muscle relaxation exercises on the stress value of respondents (p value 0.363). However, PMR exercises have a positive impact on DM Type II patients as complementary nursing therapy in reducing stress. CONCLUSION: It is advisable for patients to do PMR exercises independently after getting nurse assistance during treatment

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The effect of deep breathing relaxation to reduce post operative pain in lower limb fracture

OBJECTIVE: This study was performed to determine the effect of deep breathing relaxation to reduce post operative pain in lower limb fracture. METHOD: This a quasi experiment with a pretest-posttest intervention control group design. Accidental sampling used and consisted of 16 respondents who were divided into two groups (each n=8), intervention and control group. Measurement of pain intensity used Numerical Rating Scale (NRS), in intervention and control group after 4h of analgesic administration. RESULT: Demographic data showed most of respondent were male (43.75%) with age early adulthood (62.5%) and dominan tribe is from Sumatrans (43.75%). There was effect of deep breathing exercise to reduce post operative pain in lower limb fracture, obtained p value=0.000 (p < 0.05). CONCLUSION: Deep breathing relaxation is recommended and suggested intervention to reduce post operative pain in lower limb fracture

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Evaluación del efecto de la terapia de relajación en pacientes con hipertensión arterial / Evaluation of the effect of relaxation therapy in patients with arterial hypertension

Objetivos: Evaluar si la aplicación de una terapia de relajación reduce las cifras tensionales en pacientes hipertensos y si existe mejora en varios parámetros que pueden ejercer influencia sobre la presión arterial tales como ansiedad, calidad de vida y sueño. Métodos: Estudio cuasiexperimental (medidas antes-después). Participaron 25 pacientes de Atención Primaria con hipertensión arterial mal controlada con fármacos. La intervención consistió en terapia de relajación constituida por 3 técnicas: relajación pasiva de Schwartz-Haynes, respiración diafragmática y visualización imaginaria. Se realizaron un total de 14 sesiones grupales (2/semana) de 30 min. Se analizaron los valores de presión arterial sistólica y diastólica al inicio y final del programa de relajación implantado y después de cada una de las sesiones del programa. Para la medición de los parámetros se emplearon los siguientes cuestionarios: Calidad del Sueño de Pittsburgh, Calidad de Vida en Hipertensión Arterial, Ansiedad Estado-Rasgo. Resultados: Tras la intervención, observamos una reducción de la presión arterial sistólica de 20mmHg (p<0,001) y de la diastólica de 8mmHg (p<0,001). En cuanto a los otros parámetros analizados, la calidad del sueño mejoró significativamente (p<0,001), así como la calidad de vida (p<0,001) y la ansiedad estado (p=0,004). Conclusiones: La terapia de relajación tuvo efectos positivos en los parámetros de presión arterial, así como en los demás factores evaluados. En nuestra opinión, estrategias de este tipo deben ser estudiadas de forma más exhaustiva para considerar su inclusión en Atención Primaria

Objectives: To evaluate whether the application of a relaxation therapy reduces the blood pressure in hypertensive patients and whether there is improvement in several parameters which can influence blood pressure such as anxiety, quality of life and sleep. Methods: A quasi-experimental study (measures before-after) was performed in 25 Primary Care patients with hypertension poorly controlled by pharmacological treatment. The intervention consisted of relaxation therapy composed of 3techniques: passive relaxation of Schwartz-Haynes, diaphragmatic breathing and imaginary visualization. A total of 14 group sessions of 30min each (2/week) were conducted. Systolic and diastolic blood pressure were taken at the beginning and end of the relaxation programme implemented and after each of the programme sessions. The Pittsburgh Sleep Quality, Quality of Life Hypertension, State-Trait Anxiety and Perceived Stress questionnaires were used to measure psychosocial parameters. Results: After intervention, a reduction in systolic blood pressure of 20mmHg (p<.001) and of 8mmHg (p<.001) in diastolic blood pressure was observed. Regarding other factors, sleep quality (p<.001), quality of life (p<.001) and state anxiety (p=.004) were significantly improved. Conclusions: Relaxation therapy had positive effects in improving blood pressure parameters, as well as the other factors evaluated. In our opinion, such strategies should be evaluated more thoroughly to consider their inclusion in Primary Care

Técnica de Imaginación Guiada en el manejo de la ansiedad materna durante el embarazo: revisión integradora / A Técnica de Imaginação Guiada na gestão da ansiedade materna durante a gravidez: revisão integrativa / Guided Imagery Technique on managing maternal anxiety during pregnancy: integrative review

Este artículo describe la importancia de la Técnica de Imaginacion Guiada en el manejo de la andiedad materna durante el embarazo.Objetivos: Conocer la evidencia científica sobre la influencia de la Técnica de Imaginacion Guiada en el manejo de la ansiedad materna durante el embarazo.Metodologia: Revisión integradora de la literatura realizada en la base de datos The Cochrane Library y en la plataforma EBSCO Host. Se obtuvieron 30 artículos, de los cuales se incluyeron 10 artículos en el estudio.Resultados/Discusión: Del análisis de la evidencia científica resultaron los siguientes temas: ansiedad; manejo del estrés y su impacto fisiológico; relajación y bienestar; adhesión a la Técnica de Imaginacion Guiada; percepción positiva del embarazo; dificultades en el uso de la Técnica de Imaginacion Guiada. Conclusión: La Técnica de Imaginacion Guiada parece promover la relajación y el bienestar de las mujeres, así como los niveles más bajos de ansiedad y de malestar percibidos durante el embarazo

Este artigo descreve a importância da Técnica de Imaginação Guiada na gestão da ansiedade materna durante a gravidez.Objetivo: Conhecer a evidência científica sobre a influência da Técnica de Imaginação Guiada na gestão da ansiedade materna durante a gravidez.Método: Revisão integrativa da literatura realizada na base de dados The Cochrane Library e através da plataforma EBSCO Host. De um total de 30 artigos obtidos, foram incluídos no estudo 10 artigos.Resultados/Discussão: Da análise da evidência científica resultaram as seguintes temáticas: ansiedade, gestão do stress e impacto fisiológico; relaxamento e bem-estar; adesão à Técnica de Imaginação Guiada; perceção positiva da gravidez; dificuldades na sua utilização.Conclusão: A Técnica de Imaginação Guiada parece promover o relaxamento e bem-estar da mulher, assim como diminuir os níveis de ansiedade e desconfortos percecionados durante a gravidez

This article describes the importance of the Guided Imagery Technique for the management of maternity associated anxiety during pregnancy. Goal: To understand the scientific evidence regarding the Guided Imagery Technique for the management of maternity associated anxiety during pregnancy. Method: Integrative revision of the literature from the Cochrane Library database, using the platform EBSCO Host. From a total of 30 articles on the subject, 10 were included on this articleResults/Discussion: The scientific evidence analysis translates on the following topics: anxiety, stress management and physiological impact; relaxation and well-being; adherence to the Guided Imagery Technique; positive perception of the pregnancy; difficulties to its use. Conclusion: The Guided Imagery Technique seems to promote the relaxation and well being of the women and also, aids with the reduction of anxiety levels and perceived discomfort during pregnancy

Perception of caregivers of persons with schizophrenia about a health education program

The mental health policy of Brazil has been guided by the search for citizenship, social equality and autonomy of the individuals with mental disorders and it star-ted with the deinstitutionalization process. On the other hand, this paradigm shift contributed to making the patients stay in the family environment and thus the need for family members to play the role of caregivers. The attributions of these care functions have contributed to a physical and emotional overload. Using a psychoeducational approach focused on the family member/caregiver of people with schizophrenia, this study proposed to check the caregivers' perception about the importance of the practice of relaxation activities for the promotion of self-care. The intervention was performed during a six-month period. Participants were 31 family caregivers of mental health cohabitation centers in the city of Belo Hori-zonte, Brazil. Using the relatives' reports about the perception of the intervention, categories were listed and treated with the support of the software webQDA. The results revealed through the family members' perception, that the intervention program provided them with contributions such as wellbeing, self-control over impulses, increased self-esteem, and encouragement for self-care. The literature reinforces that the educational practice in health is composed of educational ac-tivities aimed at the development of individual and collective capacities aimed at improving the health and quality of life of people. The intervention program with relaxation exercises contributed to an improved physical and mental health for fa-mily caregivers, awakening them to self-care

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Fundamentos teóricos subyacentes en el diseño de una aplicación móvil de ayuda a personas con sintomatología ansioso/depresiva. Una revisión bibliográfica / No disponible

Las aplicaciones para los teléfonos móviles (Apps) y su utilización en la salud mental, ha ido en rápido aumento. Los objetivos para los que se han diseñado cada una de ellas, son múltiples y variados. El objetivo del presente trabajo es realizar una revisión narrativa, en la que se centra la atención en las bases conceptuales que sustentan el diseño de una aplicación móvil dirigida a personas que puedan experimentar crisis de ansiedad, crisis depresivas o estados emocionales alterados, siguiendo las pautas de trabajo de las terapias cognitivo conductual de tercera generación. Se realiza una búsqueda en las bases de datos: PubMed, MedLine, PsycInfo, Web of Science y en las publicaciones recopiladas en el Directory of Open Access Journal, así como en la revisión de literatura especializada. La búsqueda se centra en los temas del uso de la telefonía móvil en la salud, la eficacia de las Apps en el área de salud mental y las terapias cognitivo conductuales de tercera generación y el modelo Ecological Momentary Assessment (EMA). De los datos recopilados, se puede concluir que las intervenciones a través de las Apps, son potencialmente eficaces en el abordaje de la ansiedad y depresión, reportándose mejora de los síntomas en estos trastornos. Las terapias de tercera generación cuando se realizan a través de los dispositivos móviles, son útiles en el tratamiento de la ansiedad y depresión, sin embargo, la diferencia no es significativa cuando se compara con la terapia cognitivo conductual (CBT), ni con el tratamiento cara a cara. La posibilidad de atender las situaciones de crisis en el momento de su ocurrencia, es una característica que potencia la eficacia de las aplicaciones diseñadas para los dispositivos móviles. Falta mayor cantidad de estudios y estudios más controlados que permitan profundizar en este tema

Mobile phone applications (Apps) and its use in mental health have been growing rapidly. There are a great number of Apps in mental health, which one with multiple and diverse objectives. The objective of this study is doing a narrative review of the literature regarding the use of mobile phone in mental health care. Doing this allows to obtain the theoretical fundaments for the design of a mobile application focused in people who can suffer anxiety crisis, depressant crisis or altered emotional states, following the work guidelines of the third wave of behavioral and cognitive therapies. A search of the databases is performed: PubMed, MedLine, PsycInfo, Web of Science and the publications recollected from the Directory of Open Access Journal, as well as of the review of specialized literature. The research is focused in the use of mobile technology in health, the efficiency of the Apps in the area of mental health care and the third wave of behavioral and cognitive therapies and the model Ecological Momentary Assessment (EMA). The information compiled allows concluding that the interventions by Apps are potentially efficacious in the treatment of anxiety and depression due to the improvements of the symptoms of these disorders. Third wave of behavioral and cognitive therapies are useful in the treatment of anxiety and depression, although the difference is not significant compare with behavioral and cognitive therapies (CBT). The possibility of take care of crisis situations in real time is a characteristic that powers the efficacy of the Apps designed for mobile devices. It is necessary doing more studies in this area of research that allow going deeper into this theme

Efectos de entrenamiento físico específico y técnicas de relajación sobre los parámetros dolorosos de la cefalea tensional en estudiantes universitarios: un ensayo clínico controlado y aleatorizado / Effects of physical therapy and relaxation techniques on the parameters of pain in university students with tension-type headache: A randomised controlled clinical trial

INTRODUCCIÓN: Los tratamientos no farmacológicos consiguen controlar la cefalea tensional, sin embargo, la evidencia es todavía limitada. Esta investigación estudia la eficacia de una intervención fisioterápica, basada en cinesiterapia cervical y pautas de higiene postural, que pretende mejorar los resultados obtenidos únicamente con técnicas de relajación (Entrenamiento Autógeno de Schultz [EA]). MÉTODOS: Se seleccionó a 152 estudiantes universitarios (sector poblacional entre quienes esta patología es muy frecuente), 84 mujeres (55,3%) y 68 hombres (44,7%), con edad media de 20,42 años (DT = 2,36), diagnosticados de cefalea tensional, según criterios de la International Headache Society. Se diseñó un ensayo clínico, no farmacológico, controlado y aleatorizado, con evaluación ciega de las variables respuesta. Se compararon los resultados de 2 muestras paralelas e independientes, aplicando a una el EA y a la otra la combinación de este con un programa de cinesiterapia cervical y educación postural. Se cuantificaron la mejoría en los parámetros dolorosos (frecuencia, intensidad y duración) y la reducción del consumo de fármacos, en diarios de cefaleas, antes de los tratamientos y después, a las 4 semanas y a los 3 meses. RESULTADOS: Los 2 grupos de intervención evolucionaron positivamente, consiguiéndose una reducción más significativa en la frecuencia e intensidad de las cefaleas con el tratamiento combinado (p < 0,01) (d = 0,4). CONCLUSIONES: Las terapias activas, no invasivas, como el EA y la cinesiterapia cervical, y especialmente la combinación de ambos, consiguen reducir la cefalea tensional, al prevenir y controlar las posibles causas psicofísicas de este trastorno. Como futuras líneas de investigación, sería interesante evaluar el mantenimiento de los beneficios a largo plazo

INTRODUCTION: Despite the impact of cerebrovascular disease (CVD) on global health, its morbidity and time trends in Spain are not precisely known. :Objective The purpose of our study was to characterise the epidemiology and trends pertaining to stroke in Aragon over the period 1998-2010. METHODS: We conducted a retrospective, descriptive study using the data of the Spanish health system's Minimum Data Set and included all stroke patients admitted to acute care hospitals in Aragon between 1 January 1998 and 31 December 2010. We present data globally and broken down by stroke subtype, sex, and age group. RESULTS: The number of cases increased by 13% whereas age- and sex-adjusted hospitalisation rates showed a significant decrease for all types of stroke (mean annual decrease of 1.6%). Men and women in younger age groups showed opposite trends in hospitalisation rates for ischaemic stroke. Case fatality rate at 28 days (17.9%) was higher in patients with intracerebral haemorrhage (35.8%) than in those with subarachnoid haemorrhage (26.2%) or ischaemic stroke (13%). CVD case fatality showed a mean annual decline of 2.8%, at the expense of the fatality rate of ischaemic stroke, and it was more pronounced in men than in women. DISCUSSION: Understanding stroke epidemiology and trends at the regional level will help establish an efficient monitoring system and design appropriate strategies for health planning

Development and validation of the relaxation-mindfulness scale for adolescents (eremind-A) / Desarrollo y validación de la Escala de Relajación-Mindfulness para Adolescentes (EREMIND-A)

BACKGROUND: The aim of this investigation was to validate the Relaxation-Mindfulness Scale for Adolescents (EREMIND-A), consisting of 18 items and three factors (Attention-Concentration in the present moment; Relaxation (abilities and attitudes); and Sensory awareness/Contemplation/Interiority). METHOD: The validation was done with a sample of Secondary Education and Baccalaureate students from four different centres in Spain (n = 1.120). EFA and CFA of the EREMIND-A were performed and construct and incremental validities calculated. RESULTS: Initial results confirm the validity and reliability of the scale. CONCLUSIONS: There is a need for a broader conceptualization of mindfulness, as well as the inclusion and analysis of other related and cross-cutting concepts. The research in this sense will propitiate the adaptation of the Mindfulness-Based Interventions to the reality of the adolescents in the educational centers, where relaxation and the interiority are aspects to be taken into consideration

ANTECEDENTES: el objetivo de esta investigación fue validar la Escala de relajación-Mindfulness para Adolescentes (EREMIND-A), que contiene 18 ítems y tres factores (Atención-Concentración en el momento presente; Relajación (habilidades y actitudes); Consciencia Sensorial/Contemplación/Interioridad. MÉTODO: la validación se realizó con una muestra de estudiantes de Educación Secundaria y Bachillerato de cuatro centros diferentes en España (n = 1.120). Se realizaron análisis factoriales exploratorios y confirmatorios de la escala y se calcularon la validez de constructo e incremental. RESULTADOS: los resultados iniciales confirman la fiabilidad y validez de la escala. CONCLUSIONES: es necesaria una conceptualización más amplia de la atención plena, así como la inclusión y análisis de otros conceptos relacionados y transversales. La investigación en este sentido propiciará la adaptación de las intervenciones basadas en mindfulness a la realidad de los adolescentes en los centros educativos, donde la relajación y la interioridad son aspectos a tener en consideración

Caso clínico: cuidados de enfermería a una paciente con enfermedad de Wilson / Clinical case: nursing care to a patient with Wilson's disease

La enfermedad de Wilson o degeneración hepatolenticular es un trastorno congénito de herencia autosómica recesiva del metabolismo del cobre (gen ATP7B) que produce una disminución de su excreción por vía biliar y, como consecuencia, un aumento de la concentración de cobre hepático y en tejidos extrahepáticos como cerebro, riñón y córnea, siendo este acúmulo el responsable de las manifestaciones clínicas. Al ser esta una enfermedad poco común y difícil de diagnosticar, dado su amplio espectro clínico, los facultativos han de sospechar su diagnóstico ante un paciente con hepatopatía de causa no clara. Cuando la detección de la enfermedad es precoz, el tratamiento es farmacológico, pero cuando la detección ocurre en fases avanzadas, o en individuos que no han respondido al tratamiento, la enfermedad puede evolucionar hacia un fallo hepático agudo grave, cuyo tratamiento definitivo es el trasplante hepático. En este artículo se presenta el caso clínico y el seguimiento de una paciente joven con hepatopatía no filiada y en la que se sospecha enfermedad de Wilson. Siguiendo el modelo conceptual de Virginia Henderson, se describen los problemas de colaboración y los diagnósticos de enfermería, presentando un plan de cuidados según la taxonomía NANDA (North American Nursing Asociación), NIC (Nursing Intervention Classification) y NOC (Nursing Outcomes Classification). En este caso, a la vez que se amplían conocimientos sobre la enfermedad, se establece un plan de cuidados que ayuda a la atención individualizada por parte de los profesionales a los pacientes afectos de dicha enfermedad (AU)

Wilson's disease or hepatolenticular degeneration is a congenital autosomal recessive disorder of cooper metabolism (ATP7B gene) which causes a decrease in biliary excretion and consequently, an increase in cooper concentration in hepatic and extrahepatic tissues such as brain, kidney and cornea. This accumulation is responsible for the clinical manifestations. Since this is a rare and difficult disease to diagnose given its wide clinical spectrum, doctors suspect this diagnosis on patients with liver disease of unclear cause. When detection of disease is early, treatment is pharmacological, but when detection occurs in advanced stages, or in individuals who have not responded to treatment, the disease can develop into an acute liver failure, whose definitive treatment is liver transplantation. In this article we present the clinical case and tracking of a young patient with liver disease of unknown origin, which is suspected of having Wilson's disease. Following the conceptual model of Virginia Henderson, collaboration problems and nursing diagnoses are described, presenting a care plan according to the NANDA taxonomy (North American Nursing Association), NIC (Nursing Intervention Classification), and NOC (Nursing Outcomes Classification). In this case, while disease knowledge expands, a care plan that helps individualized attention from professionals to patients affected by the disease is established (AU)

¿Cómo ayuda la aplicación del proceso enfermero a las mujeres con diagnóstico ansiedad? / How can the application of the nursing process help to women with anxiety nursing diagnosis?

Objetivo: Evaluar las intervenciones grupales de enfermería en mujeres con diagnóstico enfermero ansiedad mediante el resultado NOC autocontrol de la ansiedad. Material y método: Estudio pre-experimental del tipo pretest-postest de un solo grupo realizado en un Centro de Salud Mental de la Región de Murcia a un grupo de 12 mujeres en edad adulta que presentan el diagnóstico enfermero ansiedad. Se realizó a cada paciente la valoración de enfermería por Patrones Funcionales de Salud (PFS) antes y después de la asistencia a las 8 sesiones de intervenciones enfermeras grupales. Al comenzar y al finalizar el grupo, se cumplimentó el criterio de resultado NOC autocontrol de la ansiedad. Las intervenciones enfermeras fueron a) disminución de la ansiedad (5820), terapia de relajación simple (6040), educación sanitaria (5510), enseñanza grupo (5604) y grupo de apoyo (5430). Se tomó como variable independiente las intervenciones enfermeras y como variable dependiente las puntuaciones del resultado NOC, empleándose como instrumento de evaluación. Resultados: El análisis del resultado NOC autocontrol de la ansiedad nos muestra diferencias significativas. Antes de las intervenciones, la media presenta el valor 22.5 y tras las mismas de 37.8 con una desviación típica de 3.22 y 7.11 respectivamente. La mediana antes y después de las intervenciones corresponde con los valores 21 y 37.5. El parámetro del test de los rangos de Wilcoxon corresponde con un valor de Z igual a -2.98 con una p igual a 0.003. Conclusiones: El estado, conducta y percepciones de las pacientes del grupo medido con el resultado autocontrol de la ansiedad, mejora tras recibir las intervenciones enfermeras. La puntuación global de los indicadores empleados en este resultado ha sido apropiada como medida de los efectos de las intervenciones (AU)

Purpose: To evaluate nursing group interventions in women with anxiety nursing diagnosis by self NOC result of anxiety. Methodology: Pre-experimental pretest-posttest study composed by a single group of twelve women in a Mental Health Center of the Region of Murcia. The participants were a group of women in adulthood presenting the nursing diagnosis anxiety. Each patient received 8 group nursing interventions. Before and after the group intervention, a nursing outcome criteria is filled for each patient. The following nursing interventions were used: Anxiety reduction (5820), simple relaxation therapy (6040), health education (5510), group education (5604) and support group (5430). The independent variable was nursing interventions and the dependent variable was NOC punctuations, being used as an assessment tool. Results: The analysis of the NOC result anxiety self-control shows significant differences. Before the intervention, the mean was 22.5 and 37.8 after it with standard deviations of 3.22 and 7.11 for each one. The median was 21 before interventions and 37.5 after them. The Wilcoxon test shows a Z value of -2.98 with p 0.003. Conclusion: The state, behaviour and perception of patients improve with nursing interventions received. The global punctuation of used clinical indicators is a good tool to measure nursing intervention effects (AU)

Ejercicio físico, calidad de vida y salud de diabéticos tipo 2 / Physical exercise, quality of life and health of type 2 diabetes / Exercício físico, qualidade de vida e diabetes tipo 2

El objetivo de este estudio fue comparar los efectos de diferentes tipos de ejercicios físicos, desarrollados durante 24 semanas, relacionados con la calidad de vida y salud de individuos con diabetes mellitus tipo 2. Fueron seleccionados 24 individuos inactivos de ambos sexos, con un promedio de edad de 60.41 años. Los individuos fueron divididos aleatoriamente en tres grupos: ejercicio aeróbico, ejercicio resistido y ejercicio de flexibilidad. Los instrumentos utilizados fueron una ficha de registros sobre anamnesis clínica, una ficha de registro de control diario, El Physical Activity Readiness Questionnaire (PAR-Q 1 y 2), cuestionario de calidad de vida relacionada a la salud SF-36 (Medical Outcomes Study 36 - Item Short-Form Health Survey) y las lipoproteínas de alta y baja densidad por medio de análisis bioquímico. Solamente en el ejercicio aeróbico fueron observadas alteraciones significativas en la concentración de lipoproteínas de alta y baja densidad. En relación a la calidad de vida, el ejercicio aeróbico contribuyó de manera significativa en los dominios de capacidad funcional, vitalidad y salud mental. El ejercicio resistido reveló significancia en los dominios de vitalidad y salud mental. Los resultados demostraron que la prescripción de ejercicio físico consiste en una herramienta fundamental en el control de la diabetes, mientras que el ejercicio aeróbico proporcionó un efecto positivo en la calidad de vida y salud de diabéticos tipo 2, siendo fundamental apoyo psicológico para estos pacientes a lo largo de su vida

The aim of this study was to compare the effects of different types of physical exercises developed or 24 weeks-related quality of life and health of individuals with diabetes mellitus type 2. Were selected 24 individuals inactive men and women, with an average of age of 60.41 years. The subjects were randomly divided into three groups: aerobic exercise, resistance exercise and flexibility exercise. The instruments used were a form of records on clinical history, a registration of daily monitoring, the Physical Activity Readiness Questionnaire (PAR-Q 1 and 2), health-related quality of life related to health SF-36 (Medical Outcomes Study 36 - item Short-Form Health Survey) lipoproteins and high and low density by means of biochemical analysis. Only aerobic exercise were observed significant alterations in lipoprotein concentration and higher density. Regarding quality of life, aerobic exercise contributed significantly in the domains of functional capacity, vitality and mental health. The resistance exercise revealed significance in the domains of vitality and mental health. The results showed that the prescription of physical exercise is an essential tool in the management of diabetes, while aerobic exercise provided a positive effect on quality of life and health of type 2 diabetes, and essential psychological support for these patients throughout his life

O objectivo deste estudo foi comparar os efeitos de diferentes tipos de exercício físico desenvolvidos visando 24 semanas de qualidade de vida e saúde para indivíduos com diabetes mellitus tipo 2. Foram seleccionados 24 indivíduos inactivos homens e mulheres, com média de idade de 60,41 anos. Os sujeitos foram divididos aleatoriamente em três grupos: exercício aeróbio, exercício de resistência e exercício de flexibilidade. Os instrumentos utilizados foram uma ficha de registo de história clínica, uma de registo de monitorização diário, o Questionário de Prontidão para a Actividade Física (PAR-Q 1 e 2), um Questionário de Qualidade de Vida relacionada com a saúde SF-36 (Medical Outcomes Study 36 - Item Short-Form Health Survey) e as de alta e baixa densidade por meio de análise bioquímica. Somente no exercício aeróbio foram observadas alterações significativas na concentração e densidade de lipoproteína. Em relação à qualidade de vida, o exercício aeróbio contribuiu significativamente nos domínios da capacidade funcional, vitalidade e saúde mental. O exercício de resistência revelou significância nos domínios da vitalidade e saúde mental. Os resultados mostraram que a prescrição do exercício físico é uma ferramenta essencial no controlo da diabetes, enquanto o exercício aeróbio proporcionou um efeito positivo na qualidade de vida e saúde, bem como um apoio psicológico essencial para estes pacientes ao longo da sua vida

Resilience at information processing level in older adults: maintained attention for happy faces when positive mood is low

Even though ageing is associated with declining cognitive capabilities, research has demonstrated an agerelated improvement in affective well-being. This improvement can be related to increased resilience, developing as changes in emotion regulation at information-processing level. During negative mood, emotion regulation becomes a priority as demonstrated by an increased preference for positive over negative information in older adults. However, the effect of a positive mood on older adult’s attentional preferences has not been established yet. To investigate this, 37 older adults were randomly assigned to a relaxation or a control condition (music). Mood state was assessed before and after the manipulation. Attentional bias was measured by an exogenous cueing task, in which the location of the target was correctly or incorrectly cued by happy, sad or neutral facial pictures. Both groups showed a decrease in negative mood (p < .001, 95% CI [2.73, 5.97], d = .82) without changes in positive mood. The relaxation group showed a significantly bigger increase in feeling relaxed (p = .017, η2 p = .15). No significant group differences were found for attentional bias. However, over the whole group, less positive mood after the manipulation was associated with more maintained attention for positive information (r = -.49, p < .01). These results indicate that older adults deploy emotion regulation strategies in attention during low positive mood. Flexible attentional processing of emotional information might serve as a resilience factor to maintain well-being during later stages of life (AU)

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Mecanismos responsables de la relajación neuromuscular en el tracto gastrointestinal / Mechanisms responsible for neuromuscular relaxation in the gastrointestinal tract

El sistema nervioso entérico (SNE) es responsable de la génesis de los patrones motores que aseguran un correcto tránsito intestinal. Las neuronas entéricas se clasifican en aferentes, interneuronas y motoneuronas, que pueden a su vez ser excitatorias, causando contracción, o inhibitorias, provocando la relajación de la musculatura lisa. Los mecanismos de relajación muscular son claves para entender procesos fisiológicos como la relajación de los esfínteres, la acomodación gástrica o la fase descendente del reflejo peristáltico. El óxido nítrico (NO) y el ATP o una purina relacionada son los principales neurotransmisores inhibitorios. Las neuronas nitrérgicas sintetizan NO a partir del enzima nNOS. El NO difunde a través de la membrana celular uniéndose a su receptor, la guanilil ciclasa, y activando posteriormente una serie de mecanismos intracelulares que provocan finalmente una relajación muscular. El ATP actúa como neurotransmisor inhibitorio junto con el NO y el receptor de membrana purinérgico P2Y1 ha sido identificado como elemento clave para entender cómo el ATP relaja la musculatura intestinal. Aunque probablemente ningún clínico duda de la importancia del NO en la fisiopatología motora digestiva, la relevancia de la neurotransmisión purinérgica es aparentemente mucho menor puesto que el ATP no ha sido todavía asociado a una disfunción motora concreta. El objetivo de esta revisión es mostrar el funcionamiento de ambos mecanismos de relajación para poder establecer las bases fisiológicas de posibles disfunciones motoras asociadas a la alteración de la relajación intestinal (AU)

The enteric nervous system (ENS) is responsible for the genesis of motor patterns ensuring an appropriate intestinal transit. Enteric neurons are classified into afferent, interneuron, and motoneuron types, with the latter two being further categorized as excitatory or inhibitory, which cause smooth muscle contraction or inhibition, respectively. Muscle relaxation mechanisms are key for the understanding of physiological processes such as sphincter relaxation, gastric accommodation, or descending peristaltic reflex. Nitric oxide (NO) and ATP or a related purine represent the primary inhibitory neurotransmitters. Nitrergic neurons synthesize NO through nNOS enzyme activity. NO diffuses across the cell membrane to bind its receptor, namely, guanylyl cyclase, and then activates a number of intracellular mechanisms that ultimately result in muscle relaxation. ATP acts as an inhibitory neurotransmitter together with NO, and the purinergic P2Y1 membrane receptor has been identified as a key item in order to understand how ATP may relax intestinal smooth muscle. Although, probably, no clinician doubts the significance of NO in the pathophysiology of digestive motility, the relevance of purinergic neurotransmission is apparently much lower, as ATP has not been associated with any specific motor dysfunction yet. The goal of this review is to discuss the function of both relaxation mechanisms in order to establish the physiological grounds of potential motor dysfunctions arising from impaired intestinal relaxation (AU)