Spirituality in Coping with Pain in Cancer Patients: A Cross-Sectional Study.

Spirituality has been identified as an adaptive coping strategy and a predictor of better quality of life in cancer patients. Despite the relevance of spirituality in the health-disease process, it is noted that the assessment of the impact of spirituality in coping with pain is still incipient. The objective of this study is to assess the impact of spirituality in coping with pain in cancer patients. This quantitative cross-sectional study was carried out in a medium-sized hospital and a cancer patient support institution located in northeastern Brazil. A questionnaire with sociodemographic and clinical variables was used and the following instruments were applied: Visual Analogue Scale (VAS); Short-Form McGill Pain Questionnaire (SF-MPQ); Neuropathic Pain 4 Questions (DN4); Spiritual Wellbeing Scale (SWBS); WHOQOL Spirituality, Religiousness and Personal Beliefs (WHOQOL-SRPB). Most people with no pain had higher scores on the SWBS. Neuropathic pain was identified in 23 patients and was associated with the highest level of spirituality used as a way of coping with pain. As faith increases, pain decreases in intensity by 0.394 points. On the other hand, as inner peace increases, pain increases by 1.485 points. It is concluded that faith is a strategy for coping with pain, in particular neuropathic pain, minimizing its intensity. On the other hand, greater levels of inner peace allow to increase the awareness of the painful sensation. It is expected that these findings may be useful to integrate spirituality care in healthcare facilities as a resource for positive coping for people in the process of becoming ill, contributing to the therapeutic path and favouring a new meaning to the experience of the disease.

Factors associated with knowledge of the disease in people with type 2 diabetes mellitus.

OBJECTIVES: To identify factors associated with the level of knowledge of the disease in people with type 2 Diabetes. METHODS: A cross-sectional study carried out with 412 people with diabetes registered in the Primary Health Care network of a Brazil Northeast municipality. For data collection, we used a questionnaire with sociodemographic and clinical variables and to identify the level of knowledge, we used the Diabetes Knowledge Questionnaire. RESULTS: Insufficient knowledge prevailed in 54.7% of the participants, associated in significant bivariate analysis (p < 0.05) with the sociodemographic variables: age (≥ 60 years old), marital status (without a partner), education (up to complete / incomplete elementary school), family income (≤ 1 minimum wage). For clinical variables, the level of insufficient knowledge was significantly associated with not participating in an educational group, not using insulin, and not practicing physical activity. In logistic regression, we observed that the factors that increase the risk for insufficient knowledge were: never having participated in an educational group (OR=2.0), age ≥ 60 years old (OR=2.2), illiterate and primary education (OR=8.3) and income less than or equal to 1 minimum wage (OR = 2.4). CONCLUSIONS: The level of knowledge of people with type 2 diabetes mellitus about their disease is insufficient, with socioeconomic and educational characteristics being the factors that increase the odds of having this level of knowledge.

Spirituality in coping with pain in oncological patients: systematic review / A espiritualidade no enfrentamento da dor em pacientes oncológicos: revisão sistemática

ABSTRACT BACKGROUND AND OBJECTIVES: The relationship between spirituality and cancer coping is still a challenge for comprehensive health care. Therefore, it is necessary to analyze whether the level of spirituality directly interferes with clinical markers, such as pain intensity in people with cancer. The present study aims to investigate the relationship between spirituality and pain coping and the strategies used in adult cancer patients. CONTENTS: This is a systematic review, registered in the International Prospective Register of Systematic Reviews: CRD42018108835. The search was performed in Pubmed, Medline, LILACS, Scielo, and ScienceDirect databases until May 2019, available in all languages. The search strategy was defined for the PubMed database as a parameter: (neoplasms or cancer) AND (spirituality) AND (pain). Adults patients with cancer of both genders who faced pain were studied. Studies that did not address the pain associated with spirituality were excluded. Of the 588 studies found, 13 were eligible. Among these, nine studies showed that spirituality contributes to positive pain coping. Regarding the level of spirituality, higher spiritual well-being was associated with lower pain intensity in three studies. The spiritual strategies used were mindfulness, meditation, relaxation, prayer, support from religious leaders and members. CONCLUSION: Despite the few studies found, the findings broaden the knowledge about the positive relationship between spirituality and pain coping and underline the spiritual strategies for the management of this health condition in cancer patients.

RESUMO JUSTIFICATIVA E OBJETIVOS: A relação entre espiritualidade e enfrentamento do câncer ainda é um desafio para o cuidado integral em saúde. Portanto, é necessário analisar se o nível de espiritualidade interfere diretamente nos marcadores clínicos, como na intensidade da dor em pessoas com câncer. O presente estudo teve como objetivo analisar a relação da espiritualidade com o enfrentamento da dor e as estratégias utilizadas em pacientes adultos oncológicos. CONTEÚDO: Trata-se de uma revisão sistemática, com registro na base International Prospective Register of Systematic Reviews: CRD42018108835. A busca foi realizada nas bases: Pubmed, Medline, LILACS, Scielo e ScienceDirect até maio de 2019, disponíveis em todos os idiomas. A estratégia de pesquisa foi definida para o banco de dados Pubmed como um parâmetro: (neoplasms or cancer) AND (spirituality) AND (pain). Foram estudados adultos com neoplasias, de ambos os sexos, que enfrentam a dor. Os estudos que não abordaram a dor associada à espiritualidade foram excluídos. Foram encontrados 588 estudos, sendo 13 elegíveis. Entre esses, nove estudos mostraram que a espiritualidade contribuiu no enfrentamento positivo da dor. Com relação ao nível de espiritualidade, o maior bem-estar espiritual esteve associado com menor intensidade da dor em três estudos. As estratégias espirituais utilizadas foram, mindfulness, meditação, relaxamento, oração, suporte de líderes e membros religiosos. CONCLUSÃO: Apesar dos poucos estudos encontrados, os achados ampliam o conhecimento sobre a relação positiva da espiritualidade com o enfrentamento da dor e evidencia as estratégias espirituais para o manejo dessa condição de saúde em pacientes oncológicos.