Role adoption, anxiety, depression and loneliness in family caregivers of patients with chronic diseases.

OBJECTIVE: to describe and explore the relationship of loneliness, anxiety and depression with adoption of the caregiver role among individuals caring for people with chronic diseases in Colombia. METHODS: this was an exploratory and cross-sectional study involving 960 primary caregivers of individuals with chronic diseases. We applied the Caregiver Role Adoption Scale, the University of California at Los Angeles Loneliness Scale, and the Anxiety and Depression Scale. Principal component and multiple correspondence analyses were performed for clustering. RESULTS: among the participating caregivers, 40.8% reported experiencing depression, 59% reported anxiety, 54.6% reported moderate to severe loneliness, and 88.6% reported satisfactory adoption of the caregiver role. Caregivers who presented basic or insufficient role adoption levels tended to have higher scores for anxiety, depression and loneliness. CONCLUSION: adoption of the caregiver role is a mediator in the anxiety, depression and loneliness levels among caregivers. Strategies aimed at supporting caregivers should include training for the caregiver role to mitigate the negative impacts of anxiety, depression and loneliness. (1) More than half of the caregivers reported moderate or severe anxiety and loneliness. (2) Caregivers with low role adoption levels presented more anxiety, depression and loneliness. (3) Satisfactory adoption of the caregiver role reduces anxiety, depression and loneliness. (4) Role adoption should be intervened to reduce the impact on caregivers' mental health.

Comparative Analysis of Quality of Life of Family Caregivers of Patients With Heart Failure and Cancer Who Receive Palliative Care.

BACKGROUND: Quality of life (QoL) is the criterion-standard outcome in palliative care for patients with various illnesses and their family caregivers. There is a need to determine the factors affecting caregivers' QoL in each population and the differences between groups to design differentiated intervention strategies. PURPOSE: The aims of this study were to compare the role adoption, social support, and QoL of family caregivers of patients with heart failure and cancer in palliative care and to examine the determinants of QoL. METHODS: A comparative study was conducted with the family caregivers of patients with cancer (n = 81) and heart failure (n = 80) in palliative care. Quality of life in life-limiting situations, role adoption, and social support questionnaires were also administered. A χ2 test, Student t test, and Mann-Whitney U test were used for between-group comparisons. Multiple linear regression was used to examine the effects of the correlated variables on caregivers' QoL. RESULTS: Caregivers of patients with heart failure had better QoL (P = .006) and lower tangible social support (P = .007) than caregivers of patients with heart failure. No differences were found in caregiver role adoption between the groups. Linear regression indicated that for caregivers of patients with cancer, social support, role adoption, caregiver age, and patient functional status affect caregiver QoL. For caregivers of patients with heart failure, role adoption and patient functional status are predictors of QoL. CONCLUSIONS: Overall, healthcare professionals should focus on improving social support and caregiver role adoption and provide greater attention to the QoL of caregivers of patients with cancer.

Role adoption, anxiety, depression and loneliness in family caregivers of patients with chronic diseases / Adopción del rol, ansiedad, depresión y soledad en cuidadores familiares de pacientes con enfermedades crónicas / Adoção do papel, ansiedade, depressão e solidão em cuidadores familiares de pacientes com doenças crônicas

Objective: to describe and explore the relationship of loneliness, anxiety and depression with adoption of the caregiver role among individuals caring for people with chronic diseases in Colombia. Methods: this was an exploratory and cross-sectional study involving 960 primary caregivers of individuals with chronic diseases. We applied the Caregiver Role Adoption Scale, the University of California at Los Angeles Loneliness Scale, and the Anxiety and Depression Scale. Principal component and multiple correspondence analyses were performed for clustering. Results: among the participating caregivers, 40.8% reported experiencing depression, 59% reported anxiety, 54.6% reported moderate to severe loneliness, and 88.6% reported satisfactory adoption of the caregiver role. Caregivers who presented basic or insufficient role adoption levels tended to have higher scores for anxiety, depression and loneliness. Conclusion: adoption of the caregiver role is a mediator in the anxiety, depression and loneliness levels among caregivers. Strategies aimed at supporting caregivers should include training for the caregiver role to mitigate the negative impacts of anxiety, depression and loneliness.

Objetivo: describir y explorar la relación de la soledad, la ansiedad y la depresión con la adopción del rol de cuidador entre personas que se ocupan de cuidar pacientes con enfermedades crónicas en Colombia. Métodos: se trató de un estudio exploratorio y transversal con la participación de 960 cuidadores principales de personas con enfermedades crónicas. Aplicamos la Escala de Adopción del Rol de Cuidador, la Escala de Soledad de la Universidad de California de Los Ángeles y la Escala de Ansiedad y Depresión. Se realizaron análisis de componentes principales y de correspondencia múltiple para el clustering . Resultados: el 40,8% de los cuidadores que participaron en el estudio informó padecer depresión, el 59% informó ansiedad, el 54,6% indicó soledad de moderada a grave y el 88,6% presentó adopción satisfactoria del rol de cuidador. Los cuidadores que presentaron los niveles básico o insuficiente en términos de adopción del rol tendieron a obtener puntuaciones de ansiedad, depresión y soledad más elevadas. Conclusión: adoptar el rol de cuidador es un mediador de los niveles de ansiedad, depresión y soledad entre los cuidadores. Las estrategias dirigidas a apoyar a los cuidadores deberían incluir preparación para dicho rol a fin de mitigar los efectos negativos de la ansiedad, la depresión y la soledad.

Objetivo: descrever e explorar a relação entre a solidão, a ansiedade e a depressão com a adoção do papel de cuidador entre os indivíduos que cuidam de pessoas com doenças crônicas na Colômbia. Método: trata-se de um estudo exploratório e transversal que envolveu 960 cuidadores primários de indivíduos com doenças crônicas. Foi aplicada a Escala de Adoção do Papel de Cuidador, a Escala de Solidão da Universidade da Califórnia em Los Angeles e a Escala de Ansiedade e Depressão. Foram realizadas análises de componentes principais e de correspondência múltipla para o agrupamento. Resultados: entre os cuidadores participantes, 40,8% relataram ter depressão, 59% relataram ansiedade, 54,6% relataram solidão moderada a grave e 88,6% relataram uma adoção satisfatória do papel de cuidador. Os cuidadores que apresentaram níveis básicos ou insuficientes de adoção do papel tenderam a ter pontuações mais elevadas de ansiedade, depressão e solidão. Conclusão: a adoção do papel de cuidador é um mediador nos níveis de ansiedade, depressão e solidão entre os cuidadores. As estratégias destinadas a apoiar os cuidadores devem incluir o treinamento para o papel de cuidador, a fim de atenuar os impactos negativos da ansiedade, da depressão e da solidão.

Development and content validation of an NOC-based instrument for measuring knowledge and self-care behaviors in hypertensive disorders of pregnancy: CoNOCiTHE.

PURPOSE: The aim of this study is to design and validate the content of an instrument based on the Nursing Outcomes Classification (NOC) "Knowledge: disease process" and "Risk control: hypertension" to measure pregnant women's knowledge and self-care behaviors about hypertensive disorders. METHODS: The study was carried out in three phases: (a) content validity of the indicators, (b) construction, and (c) content validity of the instrument. FINDINGS: The instrument contains 72 items with an average content validity ratio and representativeness of 0.92. The items that did not reach the established values were eliminated or reformulated according to the observations made by the experts. CONCLUSIONS: This study provides the first instrument for perinatal maternal care designed from the NOC that has demonstrated adequate content validity and representativeness of the NOCs on which it is based. The next phase in the development of the instrument is to test its validity and reliability. IMPLICATIONS FOR NURSING PRACTICE: CoNOCiTHE is a tool that can be useful in assessing pregnant women's knowledge and self-care behaviors about hypertensive disorders, contributing to the documentation and quality of maternal perinatal nursing care.

Perceptions of an educational intervention for family caregivers of palliative care patients.

BACKGROUND: Nursing interventions aimed at family caregivers of palliative cancer patients require not only an objective evaluation, but also subjective consideration of their contributions, and a qualitative evaluation that provides an in-depth understanding of these interventions. AIMS: This study aimed to explore the perceptions that family caregivers of palliative cancer patients had of the nursing intervention, PalliActive Caregivers, in reducing the uncertainty associated with illness and improving the caregiver's quality of life. METHODS: A qualitative approach with content analysis was used. Telephone interviews were conducted with 23 caregivers who participated in the intervention. FINDINGS: Five themes emerged from the content analysis: consolidating physical care, adopting a positive attitude, strengthening the support available to the caregiver, strengthening spirituality and strengthening relationships. CONCLUSION: The themes showed a positive impact of the intervention on aspects such as the caregiver's ability to cope, spirituality and social support of caregivers. The results also indicated the possibility of conducting this type of study to identify other assessment variables for future interventions.

From Relational Uncertainty to Interpersonal Sensitivity: A Substantive Grounded Theory for Nursing Education.

AIM: The aim of our study was to understand how nursing students develop interpersonal competencies during a faculty-supervised practicum. BACKGROUND: Researchers have studied the interpersonal competencies of nursing students in a fragmented way. METHOD: A constructivist grounded theory approach was used for the study. RESULTS: Four categories emerged from the data: Coping With Practicum-Related Challenges and Insecurities, Learning to Identify the Interpersonal Dimension of Nursing Care, Pedagogical Influence: Promoting (De)constructive Processes for Learning and Care, and Transforming the Self as a Nurse Through Interpersonal Relationships. A core category, From Relational Uncertainty to Interpersonal Sensitivity: A Transition of the Nursing Self Within Reflective Environments of Practice, also emerged. CONCLUSION: The interpersonal competencies of nursing students develop in reflective environments within practicums because of interactions with patients and under the influence and modeling of the educator. Acknowledging the importance of interactions with the educator and patients within practicums can contribute to promoting more thoughtful follow-up processes from educators.

Escalas en español para valoración de personas en cuidados paliativos y sus familias: revisión sistemática psicométrica / Scales in Spanish for Assessing People in Palliative Care and their Families: Psychometric Systematic Review / Escalas en español para valoración de personas en cuidados paliativos y sus familias: revisão sistemática psicométrica

Introducción: una de las bases de la atención en cuidados paliativos es la valoración regular e integral de síntomas en pacientes y familias. Al respecto, es importante reconocer las escalas usadas en cuidados paliativos en idioma español y sus propiedades psicométricas. Objetivo: identificar las escalas en español para la valoración del paciente en cuidados paliativos y su familia, evaluar sus propiedades psicométricas y calidad metodológica de sus propiedades basados en los estándares Cosmin. Método: revisión sistemática psicométrica. Se realizó una búsqueda de literatura de las escalas de valoración en cuidados paliativos en español y sus propiedades psicométricas de acuerdo con la propuesta Prisma. Se utilizaron los estándares propuestos por Cosmin para la evaluación de propiedades psicométricas. Resultados: se evaluaron 21 escalas de valoración. La escala de calidad de vida EORTC-QLQ fue la que mayor número de propiedades reportó. La consistencia interna, validez de constructo, contenido y fiabilidad fueron las pruebas más reportadas. Ningún estudio reportó pruebas de validez transcultural. Conclusión: los resultados de este estudio indican una gran variedad de instrumentos disponibles en español para valorar al paciente y al cuidador familiar en cuidados paliativos. Sin embargo, un gran número de propiedades psicométricas de los instrumentos aún se encuentran incompletas. Los resultados muestran la necesidad de seguir investigando las propiedades psicométricas de dichas escalas para garantizar la confiabilidad de estos instrumentos, así como su uso en la práctica e investigación.

Introduction: One of the bases of palliative care is the regular and comprehensive assessment of symptoms in patients and families. In this regard, it is important to recognize the scales used in palliative care in Spanish and their psychometric properties. Objective: Identify the scales in Spanish for the assessment of palliative care patients and their families, evaluate their psychometric properties, and the methodological quality of their properties based on the Cosmin standards. Method: Psychometric systematic review. A literature search of the assessment scales in palliative care in Spanish and its psychometric properties was carried out according to the Prisma proposal. The standards proposed by Cosmin for the evaluation of psychometric properties were used. Results: 21 rating scales were evaluated. The EORTC-QLQ quality of life scale was the one that reported the highest number of properties. Internal consistency, construct validity, content and reliability were the most reported tests. No study reported evidence of cross-cultural validity. Conclusion: The results of this study indicate a wide variety of instruments available in Spanish to assess the patient and the family caregiver in palliative care. However, a large number of psychometric properties of the instruments are still incomplete. The results show the need to continue investigating the psychometric properties of these scales to guarantee the reliability of these instruments, as well as their use in practice and research.

Introdução: uma das bases dos cuidados paliativos é a avaliação regular e abrangente dos sicomet em pacientes e familiares. Nesse sentido, é importante reconhecer as escalas utilizadas em cuidados paliativos em sicome e suas propriedades psicométricas. Objectivo: identificar as escalas em sicome para a avaliação de pacientes em cuidados paliativos e suas famílias, avaliar suas propriedades psicométricas e a qualidade metodológica de suas propriedades com base nos sicom Cosmin. Método: revisão sistemática psicométrica. Foi realizada uma pesquisa bibliográfica para escalas de avaliação de cuidados paliativos em sicome e as suas propriedades psicométricas de sicom com a proposta do Prisma. Foram utilizadas as normas propostas pelo Cosmin para a avaliação das propriedades psicométricas. Resultados: Vinte e uma escalas de classificação foram avaliadas. A escala de qualidade de vida EORTC-QLQ relatou o maior número de propriedades. A sicometría interna, validade da construção, conteúdo e fiabilidade foram os testes mais relatados. Nenhum estudo relatou provas de validade transcultural. Conclusão: os resultados deste estudo sicome uma grande variedade de instrumentos disponíveis em sicome para avaliar o paciente e o cuidador familiar em cuidados paliativos. No entanto, um grande número de propriedades psicométricas dos instrumentos estão ainda incompletas. Os resultados mostram a necessidade de mais investigação sobre as propriedades psicométricas destas escalas para sicomet a fiabilidade destes instrumentos, bem como a sua utilização na prática e na investigação.

Impacto de una estrategia educativa para la enseñanza en línea del cuidado paliativo: mediante el análisis de métodos mixtos / Impact of an educational strategy for online teaching of palliative care through mixed methods analysis / Impacto de uma estratégia educativa para capacitação online do cuidado paliativo: mediante a análise de métodos mistos

Resumen Objetivo: medir la aceptabilidad de un curso virtual de cuidados paliativos y el impacto en los conocimientos sobre cuidados paliativos, confort y nivel de tanatofobia en estudiantes de enfermería. Metodología: se utilizó un diseño de métodos mixtos, en el que se incluyeron 39 participantes estudiantes de enfermería de una universidad pública. Para la información cuantitativa, se aplicaron las escalas Palliative Care Quiz for Nursing, confort en cuidados paliativos y la escala de tanatofobia, antes y después de tomar el curso virtual. Para la información cualitativa, se realizaron cinco grupos focales, tres antes de iniciar el curso y dos al terminarlo. Resultados: se encontró que el curso aumentó significativamente el nivel de conocimiento en cuidados paliativos (p = 0,000), el confort en la atención de cuidados paliativos (p = 0,000) y disminuyó los niveles de tanatofobia (p = 0,005). Además, se identificaron cuatro temas que complementaron los resultados cuantitativos: (a) Entender y conectar con las TIC: oportunidades y limitaciones; (b) vivir el proceso de enseñanza de aprendizaje virtual; (c) Percepciones sobre el cuidado paliativo; y (d) Afrontamiento al final de la vida: persona, familia y enfermera. Conclusiones: este curso fue aceptado por los estudiantes y demostró aumentar los conocimientos frente al cuidado paliativo y el confort, además que contribuyó a disminuir la tanatofobia en los participantes. Los resultados evidencian que estrategias como los cursos virtuales, con plataformas y herramientas innovadoras, pueden llenar los vacíos existentes en los currículos frente a la formación en cuidados paliativos en Colombia.

Abstract Objective: to measure the acceptability of a virtual course on palliative care and the impact on knowledge about palliative care, comfort and level of thanatophobia in nursing students. Methodology: a mixed methods design was used in which 39 participating nursing students from a public university were included. For quantitative information, the Palliative Care Quiz for Nursing scales, the Comfort in palliative care and the Thanatophobia scale were applied before and after taking the virtual course. For qualitative information, five focus groups were held, three before starting the course and two after finishing it. Results: It was found that the course significantly increased the level of knowledge in palliative care (p = 0.000), comfort in palliative care (p = 0.000) and decreased levels of thanatophobia (p = 0.005). In addition, four themes were identified that complemented the quantitative results: (a) Understanding and connecting with ICTs: opportunities and limitations; (b) experience the virtual learning teaching process; (c) Perceptions about palliative care; and (d) confrontation at the end of life: person, family and nurse. Conclusions: this course was accepted by the students and proved to increase knowledge about palliative care and comfort, in addition to contributing to reduce thanatophobia in the participants. The results show that strategies such as virtual courses, with innovative platforms and tools, can fill the existing gaps in the curricula regarding training in palliative care in Colombia.

Resumo Objetivo: medir a aceitabilidade de um curso virtual de cuidados paliativos e o impacto nos conhecimentos sobre cuidados paliativos, conforto e nível de tanatofobia em estudantes de enfermagem. Metodologia: Utilizou-se um desenho de métodos mistos, no que se incluíram 39 participantes estudantes de enfermagem de uma universidade pública. Para a informação quantitativa, aplicaram-se as escalas Palliative Care Quiz for Nursing, conforto em cuidados paliativos e a escala de tanatofobia, antes e depois de tomar o curso online. Para a informação qualitativa, realizaram-se cinco grupos focais, três antes de iniciar o curso e dois ao terminá-lo. Resultados: Encontrou-se que o curso aumentou significativamente o nível de conhecimento em cuidados paliativos (p = 0,000), o conforto na atenção de cuidados paliativos (p = 0,000) e diminuiu os níveis de tanatofobia (p = 0,005). Além, se identificaram quatro temas que complementaram os resultados quantitativos: (a) Entender e conectar com as TIC: oportunidades e limitações; (b) viver o processo de ensino de aprendizagem virtual; (c) Percepções sobre o cuidado paliativo; e (d) Afrontamento ao final da vida: pessoa, família e enfermeira. Conclusões: este curso foi aceitado pelos estudantes e demostrou aumentar os conhecimentos frente ao cuidado paliativo e o conforto, além que contribuiu a diminuir a tanatofobia nos participantes. Os resultados evidenciam que estratégias como os cursos online, com plataformas e ferramentas inovadoras, podem encher os vazios existentes nos currículos frente à formação em cuidados paliativos na Colômbia.

Tendencias investigativas de enfermería en personas con cáncer / Nursing Research Trends about People with Cancer

Introducción: El cáncer es una enfermedad prevalente en Latinoamérica. Los profesionales de enfermería deben reconocer las prioridades y desarrollos relacionados con la investigación en torno al cuidado de la persona con cáncer. Objetivo: Describir las tendencias investigativas de enfermería en personas con cáncer de estudios publicados en las 10 mejores revistas de investigación en Enfermería en Latinoamérica. Métodos: Se realizó una revisión de literatura tipo exploratoria. Se buscó información en las 10 mejores revistas clasificadas en Scimago Journal & Country rank para 2020, organizadas en los cuartiles Q1 a Q4, durante el período 2016-2020 usando los términos cancer patients, oncology patient, patients with cancer, cancer. Se seleccionaron 67 investigaciones después de hacerse el proceso de crítica de la evidencia. De la revisión emergieron los siguientes temas: significado de la experiencia del proceso de enfermedad y tratamiento, calidad de vida de la persona con cáncer en Latinoamérica, impacto del cáncer sobre la dimensión física y psicosocial, afrontamiento ante la enfermedad y percepción de la atención del cuidado de enfermería. Conclusiones: Los estudios analizados evidenciaron dos principales tendencias en investigación de enfermería en Latinoamérica relacionadas con el tipo de cáncer y el fenómeno de investigación(AU)

Introduction: Cancer is a prevalent disease in Latin America. Nursing professionals must recognize the priorities and developments related to research about the care of the person with cancer. Objective: To describe the research trends in nursing about people with cancer, based on studies published in the top ten nursing journals from Latin America. Methods: A scoping review of the literature was carried out. Information was sought in the top ten journals according to the Scimago Journal & Country rank for 2020, organized in the quartiles Q1 to Q4, during the period 2016-2020. The terms cancer patients, oncology patient, patients with cancer, cancer were used. Sixty-seven research papers were selected after the evidence critique process was done. The following topics emerged from the review: meaning of the experience of the disease and treatment process, quality of life of the person with cancer in Latin America, impact of cancer on the physical and psychosocial dimension, coping with the disease, and nursing care perception. Conclusions: The analyzed studies showed two main trends in nursing research in Latin America related to type of cancer and the research phenomenon(AU)

El cuidado real frente a la vulnerabilidad del estudiante de enfermería / Real health care in the face of the vulnerability of the nursing student

Introducción: El intercambio de experiencias con pares en la práctica diaria permite al estudiante el aprendizaje del cuidado de enfermería. Objetivo: Comprender las representaciones sociales del cuidado, construidas desde el cotidiano del estudiante de enfermería mexicano. Materiales y métodos: Estudio cualitativo, basado en la teoría de la representación social en 46 estudiantes que realizaban prácticas clínicas, a quienes se les aplicó entrevista semiestructurada, que se analizó a través de la agrupación de categorías empíricas que sustentan la composición de los resultados subsecuentes, comparando los datos con relatos de los informantes. Resultados: La concepción del proceso de cuidado se estructura con rangos que representan lo social de los entrevistados durante su formación, la cual los torna vulnerables en dicho proceso. Las vivencias se construyen y reconstruyen en su afán por descubrir sus experiencias en el cuidar para dar respuesta a los desafíos del ser. Sin embargo, en estas experiencias se altera su mundo, irrumpiendo la paz mental. Conclusiones: Los procesos de interacción posiciona al estudiante frente al mundo social del cuidado a partir de bases filosóficas, a fin de reflexionar con su ser y hacer, acción que orienta sus conductas en el cotidiano del cuidado del otro.

Introduction: The exchange of daily practicing experiences with peers is useful for students to learn about nursing care. Objective: To understand the social representations of health care that are constructed from the daily life experiences of the Mexican nursing student. Materials and methods: A qualitative study based on the social representation theory with 46 students who carried out clinical practices. A semi-structured interview was applied, which was analyzed through grouping of empirical categories that support the composition of the subsequent results, comparing the data with reports from the participants. Results: The conception of the health care process is structured with ranges that represent the social aspects of the students during their training, which in turn makes them vulnerable. The experiences are constructed and re-constructed as a consequence of the students' eagerness to discover their experiences in health care in order to respond to their challenges. However, these experiences affect the students' world, disrupting their peace of mind. Conclusions: Interaction processes position students in the face of the social world of health care based on philosophical bases in order to reflect with their being and doing, an action that guides their behavior in the daily care of the other.

Adopción del rol y calidad de vida de cuidadores de pacientes oncológicos en Medellín, Colombia / Adoção do papel e da qualidade de vida em cuidadores de pacientes com câncer em Medellín, Colômbia / Adoption of the role and quality of life in caregivers of cancer patients in Medellín, Colombia

Objetivo: determinar el nivel de adopción del rol y la calidad de vida de los cuidadores familiares de personas con cáncer. Materiales y métodos: estudio descriptivo transversal que incluyó la participación de 50 cuidadores familiares de pacientes con cáncer en tratamiento activo. Se aplicaron los instrumentos Adopción del Rol del Cuidador Familiar y Escala de Calidad de Vida versión Familiar. También se realizaron análisis descriptivos y comparativos. Resultados: los participantes reportaron una edad promedio de 44,8 años y fueron en su mayoría mujeres (66 %). Frente a la adopción del rol, se encontró un nivel satisfactorio, con una mediana de 86,5 puntos. La calidad de vida presentó una mediana de 165 puntos. Se encontraron diferencias significativas en los puntajes de adopción del rol de acuerdo con la edad, el grado de escolaridad y el nivel socioeconómico de los cuidadores familiares. Conclusiones: esta investigación encontró niveles satisfactorios de adopción del rol y calidad de vida. Con el fin de mejorar la adopción del rol de los cuidadores, los profesionales de la salud deben prestar atención a características del perfil del cuidador tales como su edad, escolaridad y nivel socioeconómico.

Objetivo: determinar o nível de adoção do papel e da qualidade de vida do cuidador familiar da pessoa com câncer. Materiais e métodos: estudo transversal descritivo que incluiu 50 cuidadores familiares de pacientes com câncer em tratamento ativo. Foram aplicados os Instrumentos de Adoção do Papel do Cuidador Familiar e a versão familiar da Escala de Qualidade de Vida. Foram realizadas análises descritivas e comparativas. Resultados: os participantes tinham idade média de 44,8 anos e eram em sua maioria mulheres (66 %). Diante da adoção do cargo, constatou-se uma adoção satisfatória do cargo com mediana de 86,5 pontos. A qualidade de vida apresentou mediana de 165 pontos. Diferenças significativas foram encontradas nos escores de adoção de papéis de acordo com a idade, o nível de escolaridade e o nível socioeconômico dos cuidadores familiares. Conclusões: este estudo encontrou níveis satisfatórios de adoção do papel e da qualidade de vida. Para melhorar a adoção do papel de cuidador, os profissionais de saúde devem estar atentos às características do perfil do cuidador, como idade, escolaridade ou nível socioeconômico.

Objective: To determine the level of adoption of the caregiver role and the quality of life of family caregivers of people with cancer. Materials and methods: Descriptive and cross-sectional study with the participation of 50 family caregivers of cancer patients under active treatment. The instrument Adoption of the Role of the Family Caregiver and the Scale of Quality-of-Life, Family version, were applied. Descriptive and comparative analyzes were also carried out. Results: Participants were 44.8 years on average and most of them were women (66%). Regarding the adoption of the role, a satisfactory adoption level was identified, with a median of 86.5 points. Quality of life presented a median of 165 points. Significant differences were found in role adoption scores according to the age, education level and socioeconomic status of family caregivers. Conclusions: This study found satisfactory levels regarding the adoption of the caregiver role and the quality of life of family caregivers. In order to improve the adoption of such role, health professionals should pay attention to characteristics of the profile of caregivers such as age, education or socioeconomic status.

Validation of the Latin American-Spanish version of the scale 'Quality of Life in Life-Threatening Illness-Family Caregiver Version' (QOLLTI-F).

Measuring the quality of life in family caregivers of people in palliative care is essential to document the impact of care on the caregiver. This study aimed to adapt and validate a Latin American-Spanish version of the QOLLTI-F scale in family caregivers of palliative care patients. This study was conducted between May and November 2019 in Medellin, Colombia. We develop three phases: translation and semantic adaptation (n = 17), face and content validity (n = 21), construct validity, internal consistency (n = 208) and test-retest reliability (n = 35). Main family caregivers of stage-IV cancer patients receiving palliative treatment, participated. In the translation and semantic adaptation, some items were adjusted following the caregivers' recommendations. In face validity, Fleiss' Kappa was over 0.65 for family caregivers. In content validity, Fleiss' Kappa ranged from 0.54 to 1 for experts. In construct validity, the original version seven-factor structure did not show appropriate model fit indices. The data revealed instead a new 3-factor structure related to (1) impact of care-giving, (2) social and healthcare interactions and (3) meaning of life. Cronbach's alpha was 0.83 for the overall scale. Test-retest reliability was 0.87 between measurements 1 and 2. This study found that The Latin American-Spanish version of the QOLLTI-F scale is an understandable, useful, and relevant tool for family caregivers of people with cancer receiving palliative care. Future research is needed to confirm the factor structure identified in this study.

Metodologías para la enseñanza de cuidados paliativos en estudiantes de áreas de la salud: revisión exploratoria / Methodologies for Teaching Palliative Care in Healthcare Students: An Exploratory Review / Metodologias de ensino de cuidados paliativos em estudantes da área da saúde: uma revisão exploratória

Introducción: la necesidad de la enseñanza de los cuidados paliativos a los profesionales de la salud es cada vez más imperante en el mundo y en Latinoamérica. Los educadores deben reconocer los avances para la enseñanza de los cuidados paliativos a través de nuevas formas de aprendizaje. Objetivo: caracterizar las metodologías, contenidos y efectos de la enseñanza del cuidado paliativo en estudiantes del área de la salud en literatura publicada entre los años 2016 y 2020. Métodos: se realizó una revisión de literatura tipo scoping review.Se revisaron artículos publicados en revistas indexadas en las bases de datos Medline, Cuiden, Lilacs, CINAHL durante el periodo 2016-2020 en inglés, español y portugués. Se seleccionaron 25 investigaciones luego de realizar el proceso de crítica de la evidencia. Resultados: los estudios incluidos fueron en su mayoría realizados con metodologías cuantitativas, en Estados Unidos y con poblaciones de estudiantes de enfermería. La información extraída de los artículos se organizó en cuatro temas: 1) cursos educativos en cuidado paliativo, 2) estrategias de simulación, 3) conocimientos en cuidados paliativos de los estudiantes, y 4) actitudes y emociones de los estudiantes ante los cuidados paliativos. Conclusiones: las estrategias encontradas para enseñar los cuidados paliativos incluyen cursos completamente virtuales o en multimodalidad y simulación clínica o en laboratorios. En general, la evidencia muestra el interés que existe por parte de los estudiantes para recibir este tipo de curso y la importancia que tienen en su desarrollo profesional.

Introduction: The need to teach palliative care to health professionals is increasingly prevalent in the world and in Latin America. Educators must recognize advances in the teaching of palliative care through new ways of learning. Objective: Characterize methodologies, contents and effects of teaching of palliative care in health students in literature published between 2016 and 2020. Methods: A scoping review was carried out o articles published in journals indexed in the databases Medline, Cuiden, Lilacs, CINAHL during the period 2016-2020 in English, Spanish and Portuguese. 25 manuscripts were selected after doing the evidence critique process. Results: The studies included were mostly carried out with quantitative methodologies, in the United States and with populations of nursing students. The information extracted from the articles was organized into four themes: 1) educational courses in palliative care, 2) simulation strategies, 3) students' knowledge of palliative care, and 4) students' attitudes and emotions towards palliative care. Conclusions: The strategies found to teach palliative care include completely virtual or multimodality courses and clinical simulation, or in laboratories. In general, the evidence shows the interest that exists on the part of the students to receive this type of course and the importance that they have in their professional development.

Introdução: a necessidade de ensinar cuidados paliativos aos profissionais de saúde é cada vez mais prevalente no mundo e na América Latina. Os educadores devem reconhecer os avanços no ensino dos cuidados paliativos por meio de novas formas de aprendizagem. Objetivo: caracterizar as metodologias, conteúdos e efeitos do ensino de cuidados paliativos em estudantes da área da saúde na literatura publicada entre os anos de 2016 a 2020. Métodos: foi realizada uma revisão da literatura do tipo scoping review. Foram revisados artigos publicados em periódicos indexados nas bases de dados Medline, Cuiden, Lilacs, CINAHL no período 2016-2020 nos idiomas inglês, espanhol e português. 25 investigações foram selecionadas após fazer o processo de crítica de evidências. Resultados: os estudos incluídos foram em sua maioria realizados com metodologias quantitativas, nos Estados Unidos e com populações de estudantes de enfermagem. As informações extraídas dos artigos foram organizadas em quatro temas: 1) cursos educativos em cuidados paliativos, 2) estratégias de simulação, 3) conhecimento dos alunos sobre cuidados paliativos, e 4) atitudes e emoções dos alunos em relação aos cuidados paliativos. Conclusões: as estratégias encontradas para ensinar cuidados paliativos incluem cursos totalmente virtuais ou multimodalidade e simulação clínica ou em importancia. Em geral, as evidências mostram o interesse que existe por parte dos alunos em receber esse tipo de curso e a importancia que eles têm em seu desenvolvimento profissional.

Versión colombiana del quiz de cuidados paliativos: adaptación y validación / Colombian version of the palliative care quiz: adaptation and validation / Versão colombiana do questionário sobre cuidados paliativos: adaptação e validação

Introducción: El Palliative Care Quiz for Nursing (PQCN) es un cuestionario usado a nivel internacional para evaluar el nivel de conocimientos básicos en cuidado paliativo en Enfermería. Existen validaciones del PCQN en Francia, Irán, Corea y España, se requiere validación en Colombia. El objetivo de este estudio fue adaptar y validar el PCQN al contexto colombiano en estudiantes de enfermería. Materiales y métodos: Estudio de validación psicométrica conducido en el segundo semestre de 2022. El proceso de validez de contenido se desarrolló con 13 expertos que evaluaron la claridad, comprensión, precisión, relevancia y coherencia; se calculó el acuerdo entre los jueces con el índice Lawshe modificado. El proceso de validez facial se desarrolló con 17 estudiantes de enfermería a lo que se les indagó sobre la comprensión, recuperación, juicio y adecuación del cuestionario a través de entrevista cognitiva.

Introduction: The Palliative Care Quiz for Nursing (PQCN) is a questionnaire used internationally to assess the level of basic knowledge in palliative care in Nursing. There are validations of the PCQCN in France, Iran, Korea and Spain; validation in Colombia is required. The aim of this study was to adapt and validate the PCQN to the Colombian context in nursing students. Materials and methods: Psychometric validation study conducted in the second semester of 2022. The content validity process was developed with 13 experts who evaluated clarity, comprehension, precision, relevance and coherence; agreement among judges was calculated with the modified Lawshe index. The face validity process was developed with 17 nursing students who were asked about the comprehension, retrieval, judgment and adequacy of the questionnaire through a cognitive interview.

Introdução: O PQCN (Palliative Care Quiz for Nursing) é um questionário utilizado internacionalmente para avaliar o nível de conhecimentos básicos em cuidados paliativos em Enfermagem. Existem validações do PCQCN em França, Irão, Coreia e Espanha; é necessária uma validação na Colômbia. O objetivo deste estudo foi adaptar e validar o PCQCN ao contexto colombiano em estudantes de enfermagem. Materiais e métodos: Estudo de validação psicométrica realizado no segundo semestre de 2022. O processo de validade de conteúdo foi desenvolvido com 13 especialistas que avaliaram clareza, compreensão, precisão, relevância e coerência; a concordância entre os juízes foi calculada com o índice de Lawshe modificado. O processo de validade de face foi desenvolvido com 17 estudantes de enfermagem que foram questionados sobre a compreensão, recuperação, julgamento e adequação do questionário por meio de entrevista cognitiva.

Palliative Care and Oncology in Colombia: The Potential of Integrated Care Delivery.

Palliative care is on the global health agenda, as only approximately 14% of people who require palliative care receive it [...].

Quality of life of family caregivers of people with cancer in palliative care. / Calidad de vida de cuidadores familiares de personas con cáncer que reciben atención de cuidados paliativos.

OBJECTIVE: To describe quality of life and related factors in a sample of Colombian caregivers of people with cancer in palliative care. METHOD: A correlational, descriptive and cross-sectional study conducted with 208 family caregivers of people with cancer in outpatient palliative care in Medellín, Colombia. The Quality of Life in Life-Threatening Illness - Family Caregiver Version (QOLLTI-F) instrument was used. RESULTS: Quality of life obtained scores between 116.36 and 122.35 (95%CI). The dimensions with the lowest scores were Patient condition (2.4-3.2, 95%CI), Caregiver's own state (36.2-39.9, 95% CI) and Environment (14.4-15.7, 95%CI). The patient's and caregiver's ages and the Karnofsky index presented a positive correlation, from weak to moderate and significant with the caregiver's quality of life. The daily hours devoted to care presented a weak correlation, negative and significant, with the overall quality of life and with the Caregiver's own state dimension. CONCLUSION: It is necessary to develop interventions to improve quality of life in caregivers of people with advanced cancer in the palliative phase, considering the importance of relief actions and the management of the patient's functional dependence.

Seeking an Adjustment from the Unnatural to the Supernatural: The Experience of Losing a Child from Cancer in Colombia.

AIMS: The death of a child with cancer can be devastating for his or her parents. This study sought to understand the way in which the process of parental grief develops after the death of a child with cancer. METHODS: The research used a grounded theory approach, in which 18 participants were enrolled including parents whose child died from cancer 5 months to 5 years before. In-depth interviews were conducted, which were analyzed using constant comparisons until theoretical saturation was reached. RESULTS: Fifteen subcategories were identified and grouped into three categories that explain what the grieving process represents to the parents over time (a) crossing a desert, (b) dying while alive, and (c) coming back to life. From the emerging relationships among the categories, the core category "seeking adjustment from the unnatural to the supernatural" arises. The results show that grief begins from the moment of diagnosis until long after the child's death. For parents, it entails understanding the disruption in the natural course of life, going through indescribable pain, and being spiritually reconnected with their child. CONCLUSIONS: These results enable nurses to design comprehensive interventions that meet the described needs of these parents.

Sobrecarga y calidad de vida de cuidadores de personas con cáncer en cuidados paliativos / Overburden and Quality of Life of Caregivers of Patients with Cancer during Palliative Care / Sobrecarga e qualidade de vida de cuidadores de pessoas com câncer em cuidados paliativos

Resumen Introducción El cuidador familiar experimenta en muchos casos sobrecarga relacionada con asumir el cuidado de una persona, esto a su vez puede tener implicaciones para su calidad de vida. El objetivo de este estudio fue describir las asociaciones entre el nivel de sobrecarga del cuidado y la calidad de vida de cuidadores de pacientes con cáncer en cuidados paliativos que asistían a una institución de IV nivel de la ciudad de Medellín, Colombia. Materiales y métodos Estudio descriptivo correlacional de corte transversal desarrollado con 62 cuidadores familiares. Se aplicaron los cuestionarios de caracterización del participante, escala de sobrecarga del cuidador Zarit y calidad de vida del cuidador. Se realizaron pruebas de correlación por coeficiente de Pearson y modelo de regresión simple. Resultados Se encontró un coeficiente de Pearson de r = -0.54 con una p < 0.0001 entre la sobrecarga y la calidad de vida; surgieron además correlaciones negativas entre todas dimensiones de calidad de vida y la sobrecarga del cuidado. Se estableció un modelo de regresión en el que la sobrecarga del cuidador ( β = − 0.556 I C 95 % = − 3.114 − − 1.237) y el ser cuidador casado o en unión libre ( β = 0.258 I C 95 % = 0.907 − 52.99) son variables predictoras de la calidad de vida. Conclusiones Existe una correlación inversa y fuerte entre la sobrecarga y la calidad de vida del cuidador familiar de la persona con cáncer en cuidados paliativos.

Abstract Introduction Family caregivers often experience caregiving overburden, which in turn may have implications for their quality of life. This study is aimed at describing the associations between the level of caregiving overburden and the quality of life of caregivers of patients with cancer during palliative care attending a quaternary healthcare institution in Medellin, Colombia. Materials and Methods A cross-sectional descriptive correlational study was conducted with 62 family caregivers. Participants' characterization, Zarit Caregiver Burden Scale and Caregiver Quality of Life questionnaires were administered. Correlation tests were performed using Pearson's correlation coefficient and simple linear regression model. Results A Pearson's correlation coefficient of r = -0.54 at p < 0.0001 was found between caregiver overburden and quality of life. Negative correlations were also identified across all dimensions of overburden and quality of life in caregivers. A regression model was established in which caregiver overburden ( β = − 0.556 C I 95 % = − 3.114 − − 1.237) and being a married or common-law partnered caregiver ( β = 0.258 I C 95 % = 0.907 − 52.99) are predicting variables of quality of life. Conclusions A strong inverse correlation was found between overburden and quality of life of family caregivers of patients with cancer during palliative care.

Resumo Introdução O cuidador familiar vivencia, em muitos casos, uma sobrecarga relacionada ao cuidado de uma pessoa, isso por sua vez pode ter implicações na sua qualidade de vida. O objetivo deste estudo foi descrever as associações entre o nível de sobrecarga assistencial e a qualidade de vida de cuidadores de pacientes com câncer em cuidados paliativos atendidos em uma instituição de IV nível na cidade de Medellín, Colômbia. Materiais e métodos. Estudo descritivo correlacionado com a seção transversal desenvolvida com 62 cuidadores familiares. Foram aplicados questionários de caracterização dos participantes, escala de sobrecarga do cuidador Zarit e qualidade de vida do cuidador. Os testes de correlação foram realizados por meio do coeficiente de Pearson e modelo de regressão simples. Resultados Encontrou-se coeficiente de Pearson de r = -0.54 com uma p < 0.0001 entre sobrecarga e qualidade de vida; surgiram também correlações negativas entre todas as dimensões da qualidade de vida e a sobrecarga de cuidados. Um modelo de regressão foi estabelecido no qual a sobrecarga do cuidador ( β = − 0.556 I C 95 % = − 3.114 − − 1.237) e o ser cuidador casado ou em união estável ( β = 0.258 I C 95 % = 0.907 − 52.99) são variáveis preditivas de qualidade de vida. Conclusões Existe uma correlação inversa e forte entre a sobrecarga e a qualidade de vida do cuidador familiar da pessoa com câncer em cuidados paliativos. Conclusões Existe uma correlação forte e inversa entre a carga e a qualidade de vida do cuidador familiar da pessoa com câncer em cuidados paliativos.

Sobrecarga y calidad de vida de cuidadores de personas con cáncer en cuidados paliativos / Overburden and Quality of Life of Caregivers of Patients with Cancer during Palliative Care

Introducción. El cuidador familiar experimenta en muchos casos sobrecarga relacionada con asumir el cuidado de una persona, esto a su vez puede tener implicaciones para su calidad de vida. El objetivo de este estudio fue describir las asociaciones entre el nivel de sobrecarga del cuidado y la calidad de vida de cuidadores de pacientes con cáncer en cuidados paliativos que asistían a una institución de IV nivel de la ciudad de Medellín, Colombia. Materiales y métodos. Estudio descriptivo correlacional de corte transversal desarrollado con 62 cuidadores familiares. Se aplicaron los cuestionarios de caracterización del participante, escala de sobrecarga del cuidador Zarit y calidad de vida del cuidador. Se realizaron pruebas de correlación por coeficiente de Pearson y modelo de regresión simple. Resultados. Se encontró un coeficiente de Pearson de r = -0.54 con una p < 0.0001 entre la sobrecarga y la calidad de vida; surgieron además correlaciones negativas entre todas dimensiones de calidad de vida y la sobrecarga del cuidado. Se estableció un modelo de regresión en el que la sobrecarga del cuidador (b = -0.556 IC 95% = -3.114 - -1.237) y el ser cuidador casado o en unión libre (b = 0.258 IC 95%= 0.907-52.99) son variables predictoras de la calidad de vida. Conclusiones. Existe una correlación inversa y fuerte entre la sobrecarga y la calidad de vida del cuidador familiar de la persona con cáncer en cuidados paliativos.

Introduction: Family caregivers often experience caregiving overburden, which in turn may have implications for their quality of life. This study is aimed at describing the associations between the level of caregiving overburden and the quality of life of caregivers of patients with cancer during palliative care attending a quaternary healthcare institution in Medellin, Colombia. Materials and Methods: A cross-sectional descriptive correlational study was conducted with 62 family caregivers. Participants' characterization, Zarit Caregiver Burden Scale and Caregiver Quality of Life questionnaires were administered. Correlation tests were performed using Pearson's correlation coefficient and simple linear regression model. Results: A Pearson's correlation coefficient of r = -0.54 at p < 0.0001 was found between caregiver overburden and quality of life. Negative correlations were also identified across all dimensions of overburden and quality of life in caregivers. A regression model was established in which caregiver overburden (b = -0.556 CI 95% = -3.114 - -1.237) and being a married or common-law partnered caregiver (b = 0.258 IC 95%= 0.907-52.99) are predicting variables of quality of life. Conclusions: A strong inverse correlation was found between overburden and quality of life of family caregivers of patients with cancer during palliative care.

Introdução. O cuidador familiar vivencia, em muitos casos, uma sobrecarga relacionada ao cuidado de uma pessoa, isso por sua vez pode ter implicações na sua qualidade de vida. O objetivo deste estudo foi descrever as associações entre o nível de sobrecarga assistencial e a qualidade de vida de cuidadores de pacientes com câncer em cuidados paliativos atendidos em uma instituição de IV nível na cidade de Medellín, Colômbia. Materiais e métodos. Estudo descritivo correlacionado com a seção transversal desenvolvida com 62 cuidadores familiares. Foram aplicados questionários de caracterização dos participantes, escala de sobrecarga do cuidador Zarit e qualidade de vida do cuidador. Os testes de correlação foram realizados por meio do coeficiente de Pearson e modelo de regressão simples. Resultados. Encontrou-se coeficiente de Pearson de r = -0.54 com uma p < 0.0001 entre sobrecarga e qualidade de vida; surgiram também correlações negativas entre todas as dimensões da qualidade de vida e a sobrecarga de cuidados. Um modelo de regressão foi estabelecido no qual a sobrecarga do cuidador (b = -0.556 IC 95% = -3.114 - -1.237) e o ser cuidador casado ou em união estável (b = 0.258 IC 95%= 0.907-52.99) são variáveis preditivas de qualidade de vida. Conclusões. Existe uma correlação inversa e forte entre a sobrecarga e a qualidade de vida do cuidador familiar da pessoa com câncer em cuidados paliativos. Conclusões. Existe uma correlação forte e inversa entre a carga e a qualidade de vida do cuidador familiar da pessoa com câncer em cuidados paliativos.

Relationship Between Quality of Life of Children With Cancer and Caregiving Competence of Main Family Caregivers.

OBJECTIVE: The purpose of this study was to describe the caregiver's proxy-report of the quality of life (QoL) of children with cancer and the main family caregiver's competence, and to examine the role of said competence and other care-related variables in their proxy-reported QoL of children with cancer. METHOD: This was a cross sectional, correlation design study conducted with 97 main family caregivers of children between the ages of 8 and 12 years with cancer residing in Colombia. The following variables were collected: main family caregiver and child sociodemographic characteristics (Survey for Dyad Care; GCPC-UN-D), The Pediatric Quality of Life Inventory 4.0 Cancer Module, and the Competence Instrument (caregiver version). RESULTS: The mean of the children's QoL was 102.0 points, and the caregivers' competence score was 211.24. Caregiver's competence (t = 5.814, p < .01), marital status (t = 1.925, p < .05), time as a caregiver (t = 2.087, p < .05), number of hours spent caring for the child (t = 2.621, p < .05), and caregiver's previous caring experiences (t = 2.068, p < .05) were found to influence caregiver's proxy-report of the QoL of children with cancer. CONCLUSIONS: High competence in main family caregivers positively influence caregiver's proxy-report of the QoL of children with cancer. Study results also suggest that nurses should consider the caregivers' sociodemographic characteristics such as marital status, time as a caregiver, number of hours spent caring for the child, and caregiver's previous experiences because those aspects influence main family caregivers' proxy-report about their children's QoL.