Evidence of validity and accuracy for the Mindful Self-Care Scale-Brief among family caregivers of people with cancer in Brazil: A cross-sectional study.

OBJECTIVES: This study aimed to evaluate the evidence of validity and accuracy for the Mindful Self-Care Scale-Brief (B-MSCS) in Brazil among family caregivers of people with cancer. METHODS: This was a cross-sectional study with a sample of 203 family caregivers of people with cancer. The instruments used in this study were the following: B-MSCS, Brief Resilience Scale, and Brief Scale for Spiritual/Religious Coping. Exploratory factor analysis was carried out using the principal axis factoring method and direct oblimin oblique rotation, and confirmatory factor analysis using the robust weighted least squares means and variance adjusted estimation method and GEOMIM oblique rotation. The internal consistency of the latent factors was measured using Cronbach's alpha coefficients. RESULTS: The 6-factor model showed good fit to the data, with satisfactory reliability indices and adequate representation of the scale's internal structure. The results that can support arguments in favor of validity evidence based on internal structure for the B-MSCS-Brazilian version (BR) relate to a 19-item version which, grouped into 6 latent factors, explained 46.47% of the variance. The factor solution reproduced 79.2% of the theoretically expected structure and 5 items were excluded. The Cronbach's alpha coefficient of the factors in the B-MSCS-BR ranged from 0.58 to 0.84. Positive religious/spiritual coping had a direct association with the B-MSCS-BR factors, with the exception of the Physical Care factor (r = 0.033, p = 0.635). Negative spiritual/religious coping was inversely associated with the Mindful Relaxation (r = -0.160, p = 0.023), Supportive Relationships (r = -0.142, p = 0.043), and Mindful Awareness factors (r = -0.140, p = 0.045). There were no associations between the B-MSCS-BR factors and resilience. SIGNIFICANCE OF RESULTS: The findings reveal that the B-MSCS (19-item) is a valid, reliable, and culturally-appropriate instrument to examine the practice of mindful self-care by family caregivers of people with cancer in Brazil.

Development and Validation of an Auricular Acupuncture Protocol for the Management of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients.

Auricular acupuncture (AA) has been used to manage chemotherapy-induced nausea and vomiting (CINV). However, the application of the technique varies widely among the clinical trials that test its effectiveness. The aim of the present study was to develop and clinically validate an AA protocol for the management of CINV in cancer patients. This study was carried out in two stages: (1) development of the AA protocol for the management of CINV and (2) clinical validation of the protocol. The content validity of the protocol was determined by a panel of specialists, with an agreement rate ranging from 85.7% to 100%. In the clinical validation, when administered to cancer patients, the protocol developed has been shown to reduce the incidence, frequency, severity, and length of nausea and vomiting following chemotherapy, as well as the severity of nausea and anticipatory nausea following chemotherapy. This protocol needs to be tested in future studies, including a pilot study with a sham group and a randomized clinical trial, in order to further evaluate its feasibility, acceptability, safety, and clinical usefulness for the management of CINV.

The expectations of metastatic cancer patients regarding palliative chemotherapy: A Brazilian-German qualitative study.

OBJECTIVE: To explore the expectations of Brazilian and German patients regarding metastatic cancer and palliative chemotherapy. METHODS: Interviews with 48 metastatic cancer patients from Brazil and Germany were conducted. The interviews were transcribed and analyzed using the thematic analysis approach to identify common themes. The sociodemographic data were collected using an instrument developed by the authors. RESULTS: A total of 48 patients participated in the study (58% were Brazilian and 42% were German). Of all participants, 35% were men and 65% were women. The participants' mean age was 41 years. The general idea captured from the interviewees' speech was that their diseases were curable or "while there is chemotherapy, there is life"; thus, the data analysis enabled the elaboration of the central theme, entitled "Mistaken expectations of metastatic cancer patients regarding palliative chemotherapy: While there is chemotherapy, there is life," with 5 subthemes, namely: (1) communication and expectations; (2) normal life; (3) the person behind the disease; (4) religiosity and spirituality; and (5) the fortitude to choose between continuing or discontinuing treatment. SIGNIFICANCE OF RESULTS: Regardless of cultural aspects, patients with metastatic cancer on palliative chemotherapy tend to believe in the healing potential of treatments. Dividing expectations only into curable or incurable is insufficient, as even patients who have acknowledged the incurability of their disease expect to live, as long as they remain under treatment as if the disease did not exist.

Spiritual Well-Being Among Users and Non-Users of Psychedelics: A Cross-Sectional Study.

This study evaluated the psychometric properties of the Spiritual Well-Being Scale (SWBS) in a Brazilian sample. We analyzed spiritual well-being, defined as existential well-being (EWB) and religious well-being (RWB), among individuals with varying religious and spiritual experiences, both users and non-users of psychedelics. The online cross-sectional survey was conducted in Brazil, from April to June 2022. The psychometric analyses demonstrated reliability and validity based on the internal structure and the relationship with satisfactory external variables concerning the RWB and EWB factors of the SWBS. Validity evidence was shown for both factors (RWB, EWB) with adequate reliability ratings. However, the RWB factor, which was entirely replicated, demonstrated the best group differentiation and internal consistency. Although both factors showed validity, the RWB factor exhibited superior psychometric indices for validity, group discrimination, and reliability. Regarding psychedelics, the association with RWB and EWB demonstrates a U-shaped pattern, as participants who never use these substances typically exhibit higher RWB and EWB indices, succeeded by frequent users. This finding underscores the need for additional studies to further explore the intricate interplay between psychedelics and spiritual well-being.

Translation, Cultural Adaptation, and Analysis of the Psychometric Properties of the Death Transcendence Scale for the Brazilian Context.

The study of the coping strategies used by humans to cope with their finitude has been the center of attention of several researchers throughout the history of psychology. The present study aimed to translate, culturally adapt, and validate the Death Transcendence Scale (DTS) for the Brazilian context. This was a cross-sectional study with a sample of 517 Brazilians. The European Organisation for Research and Treatment of Cancer - Quality of Life Group Translation Procedure protocol was used for the translation and the cultural adaptation process. The results of parallel analyses indicated the relevance of extracting up to five factors, which explained 58.23% of the scale's total variance. The Brazilian version of the DTS, with validity evidence, consisted of 21 items, considering that items 13, 17, 20, and 21 were excluded according to exploratory factor analysis. As far as we know, the version of the DTS developed in this study is the only instrument available in the Brazilian context that allows the measurement of a theory dedicated to understanding how humans cope with their finitude, beyond death denial.

Demoralization and spirituality in oncology: an integrative systematic review.

OBJECTIVE: To synthesize the scientific findings on demoralization and spirituality in the oncology context. METHODS: This is an integrative systematic review, in line with the PRISMA 2020 guidelines, as proposed by Whittemore and Knalf (2005). The MEDLINE via PubMed, Scopus, Web of Science, APA PsycNet, CINAHL, Cochrane Library, EMBASE, and LILACS databases were searched without limitations regarding language or year of publication. The studies were screened for inclusion according to the predefined eligibility criteria. Data extraction and evidence quality assessment were performed. RESULTS: Out of the 1587 articles evaluated, 10 studies were included in this review. In general, it was found that demoralization tends to increase with the proximity of death and seems to be inversely related to spirituality, with spiritual well-being being a protective factor against demoralization, while the non-fulfillment of spiritual needs is related to increased demoralization in people with cancer. Furthermore, even among caregivers of people with advanced cancer, demoralization seems to be associated, among other factors, with spiritual suffering. These results should be analyzed with caution, considering that the studies included in this review are all observational studies, which prevents establishing cause and effect relationships. CONCLUSIONS: Demoralization tends to increase with growing frailty and the proximity of death in people with cancer, and it seems to be inversely related to spirituality, both in these patients and in their caregivers.

Palliative Sedation at Home: A Scoping Review.

Palliative Sedation (PS) is an effective measure for the relief of refractory symptoms in end-of-life patients. This intervention can be performed at home, respecting the patients' and their families' decisions. A scoping review was performed to map the available evidence in the literature on the performance of PS at home. This review included 23 studies. Most were conducted in European countries with adult cancer patients. Patients, family members and healthcare providers participated in the decision making regarding the use of PS at home. PS was used primarily to manage refractory symptoms (pain, delirium, dyspnea, and others), and in 1 of the studies PS was mentioned as a possible intervention for shortening life. The most commonly used medication was midazolam and the average duration ranged from 4 h to 7 days. There are few reports on adverse events related to PS. This intervention seems to be a feasible possibility for the management of refractory symptoms in patients at the end of life, despite the fact that it can represent specific challenges for healthcare providers, patients and families. However, the literature is limited regarding PS in children and in people with diseases other than cancer, as well as on the evaluation of possible adverse effects related to this intervention. Furthermore, it is essential to have a broad ethical, clinical and legal debate on whether to consider the use of PS for the purpose of shortening life in specific cases.

Gestão e Práticas em Saúde Coletiva: da política à ação / Management and Practices in Public Health: from policy to action

Este livro que você tem em mãos é fruto de uma longa trajetória de pesquisas, debates, reflexões e trabalho árduo de um grupo de pessoas que se encontraram no Núcleo de Pesquisa em Política, Gestão e Avaliação em Saúde Coletiva (Nupgasc), grupo esse vinculado à Pós-graduação em Saúde Coletiva da Universidade Federal do Espírito Santo (PPGSC/UFES). Formado por pesquisadoras e pesquisadores com experiências diversas, são muitas as marcas que (re)conduziram a trajetória desse coletivo, sempre em defesa da saúde pública de qualidade, universal, integral e acessível para todas, todos e todes. O livro revela um pouco dos "processos-passos" desse coletivo que há mais de duas décadas tem aberto as portas despretensiosamente para a esperança, a curiosidade pelo aprender, o diálogo e a vontade de saber. Os frutos gerados por esse "bom encontro" surpreenderam com uma linda trajetória repleta de projetos, eventos, reflexões construídas a muitas mãos e mentes. Esse "pensar-coletivo", ou seja, "pensar-político", buscou contribuir com a gestão e as práticas da Saúde Coletiva no Espírito Santo e no Brasil por muitas vias e modos, abrindo espaço para novas linhas de pesquisa que acolhessem o diferente, o singular, tirando das sombras aquilo que a generalização, os estereótipos e preconceitos mantem obscurecido. Neste momento, em que todos os esforços estão voltados para a recuperação do violento impacto oriundo do período pandêmico, esta obra se apresenta como possibilidade para ampliar as nossas perspectivas a fim de promover o pensamento e a reflexão coletiva sobre a saúde da população brasileira. Nesse contexto de precarização de vidas insistimos na crença de que saúde não é mercadoria e sim democracia, portanto direito para toda a população. Por fim, ressalta-se que esse livro não tem a pretensão de colocar ponto final em nenhuma discussão, muito pelo contrário. Trata-se de uma obra em aberto, em constante (re)construção já que o que se pretende é uma troca de sentidos que convertam essa obra num testemunho de um contexto histórico, social, cultural coletivo. Espera-se que você, leitor(a), continue a escrever essa história, tornando-se coautor dessa obra, e contribuindo para que as produções do Nupgasc tenham vida longa!

Mindful Self-Care, Self-Compassion, and Resilience Among Palliative Care Providers During the COVID-19 Pandemic.

CONTEXT: Given the adverse impact of COVID-19 on the wellbeing of palliative care providers, there is a growing need to better understand protective variables, such as self-care, mindfulness and self-compassion, as they relate to resilience. OBJECTIVE: To investigate mindful self-care, self-compassion, and resilience as reported by palliative care providers during the COVID-19 pandemic. METHODS: Descriptive, cross-sectional survey. An electronic questionnaire captured data from validated instruments measuring each study variable, as well as participant demographics and perceived impacts of COVID-19 on professional quality of life. RESULTS: Positive, statistically significant correlations were found between mindful self-care, self-compassion, and resilience. These variables were also associated with greater satisfaction with professional life and perceived lessened impairment in physical and/or mental health due to a decrease in self-care activities stemming from altered routines during COVID-19. Those with higher resilience had worked in palliative care longer and also reported higher levels of self-compassion and mindful self-care, explaining 50% of variance. Self-compassion, satisfaction with professional life, and changes in self-care routine due to professional activities in the pandemic explained 44.3% of variance in mindful self-care. Self-compassion, female gender, and working as a frontline responder to the COVID-19 pandemic accounted for 35% variance in resilience levels. CONCLUSIONS: Results from this study extend the currently limited knowledge of self-care, mindfulness and self-compassion, as protective variables related to resilience in palliative care providers during the COVID-19 pandemic. Further longitudinal studies into causal effects on health and wellbeing over time are needed.

The Therapeutic Potential of Psychedelic-assisted Therapies for Symptom Control in Patients Diagnosed With Serious Illness: A Systematic Review.

CONTEXT: People affected by serious illness usually experience suffering in its various dimensions, not only in the physical but also in the psychosocial and spiritual aspects. The interest in psychedelic-assisted therapies as a potential new therapeutic modality has increased since evidence suggests a significant impact of their use on the outcomes of patients with serious illness. OBJECTIVES: To systematically review the available evidence on the effects of psychedelic-assisted therapies for symptom control in patients diagnosed with serious illness. METHODS: The protocol of this systematic review has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. This review included randomized and non-randomized controlled trials published in peer-reviewed scientific journals. A comprehensive search for studies was carried out in the main scientific databases, including Web of Science, Scopus, Cochrane Library, PsycINFO, PubMed, CINAHL, and EMBASE. There were no limitations regarding the year or language of publication. RESULTS: The sample was composed of 20 studies. The results suggest positive effects of psychedelic-assisted therapies for symptom control in patients diagnosed with serious illness, with considerable safety of use. Most studies have been conducted with lysergic acid diethylamide, psilocybin, and N,N-dipropyltryptamine in cancer patients. The adverse effects reported were of physical and/or psychological nature and of mild to moderate intensity, transient, and self-resolutive. CONCLUSION: The evaluated evidence suggests positive effects of psychedelic-assisted therapies for symptom control in patients diagnosed with serious illness, especially regarding symptoms of psychological and spiritual nature.

Gestão e Práticas em Saúde Coletiva: no contexto da pandemia de COVID19 / Management and Practices in Public Health: in the context of the COVID19 pandemic

Este é um livro escrito em meio a um dos momentos mais desafiadores da história, um evento que, certamente, deixará marcas em nós e nas próximas gerações e que, possivelmente, reconduzirá a forma como organizamos nossas vidas e sociedades. Outros diriam que é um livro escrito no olho do furacão, cuja visibilidade se torna difícil, pois, além das emoções que afloram, existem muitos obstáculos carregados pela força do vento que bloqueiam a visão. Mas será que isso realmente impede nossa observação? Lançar um olhar para a pandemia, enquanto a experienciamos, requer um compartilhamento de olhares, desvelando uma profusão de perspectivas que podem nos ajudar a clarear, ou melhor, ampliar a visibilidade. Não estamos em busca de um olhar totalizante ou generalista, muito menos em busca de uma verdade absoluta sobre um fato ou fenômeno, uma vez que todo conhecimento é transitório e processual. Este livro, fruto das reflexões dos mestrandos, doutorandos e pesquisadores do Núcleo de Pesquisa em Política, Gestão e Avaliação em Saúde Coletiva (Nupgasc), contextualiza e, mais importante, compartilha um olhar implicado com a defesa de uma saúde para todos(as) em um país que vitimiza as populações mais vulneráveis. É um livro em defesa das vidas que são manipuladas, segregadas ou eliminadas por serem consideradas perigosas ou não se ajustarem a um mercado cada vez mais corporativo, global e automatizado. Que o encontro com estas páginas possa produzir afetos e nos permita aumentar a potência e a capacidade para existir-resistir-insistir. E que as marcas resultantes desse furacão nos permitam construir novas formas de sentir/pensar/agir em saúde pública que estejam conectadas a um exercício de reflexão e esperança.

Roleplay as an Educational Strategy in Palliative Care: A Systematic Integrative Review.

INTRODUCTION: Simulation activities, such as roleplay, have become established in undergraduate and graduate education in several subjects of healthcare. The objective of this study was to synthesize the evidence available in the literature on the use of roleplay as an educational strategy in palliative care. METHODS: Using the method proposed by Whittemore and Knafl, this integrative systematic review was carried out based on the following guiding question: "What is the available evidence in the literature on the use of roleplay as an educational strategy in the teaching of palliative care?" The databases used for the selection of articles were the following: Web of Science, Scopus, Cochrane Library, PubMed, CINAHL, EMBASE, and LILACS. There were no limitations regarding the year of publication or language. RESULTS: The articles (n = 34) were grouped into 3 categories, according to the purpose of roleplay use: 1) Use of roleplay as an educational strategy to teach communication in palliative care; 2) Use of roleplay as an educational strategy to teach the communication of bad news, and 3) Use of roleplay as an educational strategy to teach end-of-life care. CONCLUSION: Roleplay has been employed in the teaching of palliative care in order to develop skills related to communication and to the provision of end-of-life care. These educational activities have mainly been directed to healthcare students and professionals. Future investigations should further evaluate the efficacy of this teaching strategy, based on studies with more robust designs that allow the establishment of cause-and-effect relationships.

Translation, cultural adaptation, and validation of the mindful self-care scale among Brazilian palliative care providers.

OBJECTIVE: This study aimed to translate, culturally adapt, and validate the Mindful Self-Care Scale (MSCS, 33-item) in a Brazilian hospice and palliative care context. METHOD: This was a cross-sectional study with a sample of 336 Brazilian hospice and palliative care providers. The European Organisation for Research and Treatment of Cancer - Quality of Life Group Translation Procedure protocol was used for the translation and the cultural adaptation process. Psychometric properties supporting the use of the MSCS were examined through confirmatory factor analysis (CFA) and correlation analysis with other instruments to assess congruence to related constructs (resilience and self-compassion). The reliability of the Brazilian-Portuguese version of the MSCS was assessed using Cronbach's α and composite reliability coefficients. RESULTS: The six-factor (33-item) model showed a good fit to the data, with satisfactory reliability indices and adequate representation of the scale's internal structure. Further validity is evidenced in the significant, positive correlations found between the MSCS, and similar well-being constructs, namely the Self-Compassion and Resilience scales. SIGNIFICANCE OF RESULTS: The findings reveal that the MSCS (33-item) is a valid, reliable, and culturally appropriate instrument to examine the practice of mindful self-care by hospice and palliative care providers in Brazil. More broadly, it represents a promising instrument for future research into self-care practices and well-being among Brazilian healthcare providers.

Escala para Avaliação de Náuseas e Vômitos Relacionados à Quimioterapia: Tradução e Adaptação Transcultural / Scale for the Assessment of Chemotherpy-Induced Nausea and Vomits: Translation and Transcultural Adaptation / Escala de Evaluación de Náuseas y Vómitos Relacionados con la Quimioterapia: Traducción y Adaptación Cultural

Introdução: Náuseas e vômitos induzidos por quimioterapia acometem cerca de 70-80% dos pacientes com câncer. Assim, é importante a utilização de um instrumento para avaliar melhor esses sintomas, visando a um tratamento mais adequado. Objetivo: Traduzir e adaptar culturalmente a escala Morrow Assessment of Nausea and Emesis para o contexto brasileiro. Método: Estudo correlacional do tipo survey, com tradução e adaptação cultural da escala segundo o protocolo da European Organization for Research and Treatment of Cancer ­ Quality of Life Group (EORTC-QLG). A amostra foi constituída por 160 pacientes em tratamento quimioterápico em uma clínica de oncologia. No processo de validação, realizaram-se análises de correlação multimétodos entre os itens da escala Morrow Assessment of Nausea and Emesis e os escores das escalas visuais numéricas de náusea e vômito com nível de p<0,05. Resultados: O autor da escala autorizou a tradução. A escala Morrow Assessment of Nausea and Emesis e as escalas numéricas apresentaram correlações significativas (p<0,01; p<0,05), sendo que os itens que apresentaram correlação mais forte das escalas numéricas foram os que se referiram à avaliação de náusea e vômito pós-quimioterapia. Já os itens destinados à avaliação desses sintomas no momento pré-quimioterapia e ao uso da medicação antiemética e sua eficácia apresentaram associações fracas com as escalas numéricas. Conclusão: A escala Morrow Assessment of Nausea and Emesisapresentou-se adequada para a avaliação de náuseas e vômitos induzidos por quimioterapia no contexto brasileiro

Introduction: Chemotherapy-induced nausea and vomiting affects nearly 70-80% of patients with cancer. To achieve a better treatment it is important to utilize an adequate instrument to assess these symptoms. Objective:To translate and culturally adapt the Morrow Assessment of Nausea and Emesis Scale to the Brazilian context. Method: Survey and correlational study, with the translation and cultural adaptation of the scale according to the protocol of the European Organization for Research and Treatment of Cancer ­ Quality of Life Group (EORTC-QLG). The sample consisted of 160 patients undergoing chemotherapy treatment in an oncology clinic. In the validation process, multimethod correlation analyses were carried out among the items of the Morrow Assessment of Nausea and Emesis Scale items and the scores of the numerical visual scales of nausea and vomits at the level of p<0.05. Results: The author of the scale approved the translation process. The Morrow Assessment of Nausea and Emesis scale and the numerical scales presented significant correlations (p<0.01; p<0.05), considering that the items presenting stronger correlation with the numerical scales were those addressing post-chemotherapy assessment of nausea and vomit. On the other hand, the items for pre-chemotherapy assessment of these symptoms and use of the antiemetic drugs and their efficacy presented weak associations with the numerical scales. Conclusion: The Morrow Assessment of Nausea and Emesis scale was adequate for the assessment of chemotherapy-induced nausea and vomiting in the Brazilian context

Introducción: Las náuseas y vómitos inducidos por la quimioterapia afectan aproximadamente al 70-80% de los pacientes con cáncer. Por lo tanto, es importante utilizar un instrumento para evaluar mejor estos síntomas, con el objetivo de un tratamiento más adecuado. Objetivo: Traducir y adaptar culturalmente la escala de Morrow Assessment of Nausea and Emesisal contexto brasileño. Método: Estudio correlativo del tipo de encuesta, con la traducción y adaptación cultural de la escala según el protocolo de la European Organization for Research and Treatment of Cancer ­ Quality of Life Group (EORTC-QLG). La muestra consistió en 160 pacientes sometidos a quimioterapia en una clínica oncológica. En el proceso de validación, se realizaron análisis de correlación multimétodos entre los elementos de la escala de Morrow Assessment of Nausea and Emesis y las puntuaciones de las escalas visuales numéricas de náuseas y vómitos con nivel de p<0,05. Resultados: El autor de la escala autorizó la traducción. La Morrow Assessment of Nausea and Emesis y las escalas numéricas mostraron correlaciones significativas (p<0,01; p<0,05), y los elementos que presentaron una correlación más fuerte de las escalas numéricas fueron los que se refirieron a la evaluación de las náuseas y los vómitos después de la quimioterapia. Por otro lado, los elementos destinados a la evaluación de estos síntomas en el momento anterior a la quimioterapia y el uso de medicamentos antieméticos y su eficacia presentaron asociaciones débiles con escalas numéricas. Conclusión: La Morrow Assessment of Nausea and Emesis fue adecuada para la evaluación de náuseas y vómitos inducidos por quimioterapia en el contexto brasileño

Burden and social support in informal caregivers of people undergoing kidney dialysis: a mixed study.

OBJECTIVES: to analyze the burden and the social support of the informal caregivers of people undergoing kidney dialysis. METHODS: mixed study, based on the Theory of Stress and Overload, using instruments of sociodemographic characterization, the Social Support Survey from the Medical Outcomes Study, Zarit's Burden Scale, and guiding questions. Analysis of data used statistical and thematic inferences. RESULTS: 55 caregivers were evaluated, most were women, from 31 to 50 years old, married, and having worked in care for more than three years. A high level of affective and material support was observed, with a light overload on the caregiver. The central theme of the discourses was: "Experiences of the caregiver: between the burden of responsibility and the search for meaning". CONCLUSIONS: a small overload was found in the participants, with a high median in the dimensions of affective and emotional support, in the relations between positive social interactions and the burden of the caregivers, in addition to the duality or responsibility and the meaning of care.

Burden and social support in informal caregivers of people undergoing kidney dialysis: a mixed study.

OBJECTIVES: to analyze the burden and the social support of the informal caregivers of people undergoing kidney dialysis. METHODS: mixed study, based on the Theory of Stress and Overload, using instruments of sociodemographic characterization, the Social Support Survey from the Medical Outcomes Study, Zarit's Burden Scale, and guiding questions. Analysis of data used statistical and thematic inferences. RESULTS: 55 caregivers were evaluated, most were women, from 31 to 50 years old, married, and having worked in care for more than three years. A high level of affective and material support was observed, with a light overload on the caregiver. The central theme of the discourses was: "Experiences of the caregiver: between the burden of responsibility and the search for meaning". CONCLUSIONS: a small overload was found in the participants, with a high median in the dimensions of affective and emotional support, in the relations between positive social interactions and the burden of the caregivers, in addition to the duality or responsibility and the meaning of care.

Self-compassion In Hospice and Palliative Care: A Systematic Integrative Review.

Those involved with hospice and palliative care, including nurses, will inevitably experience or be exposed to suffering. Self-compassion represents a personal resource and support for self-care, ensuring that needs are not neglected particularly during times of suffering. However, the empirical evidence for self-compassion in hospice and palliative care is yet to be reviewed systematically. To synthesize the evidence on self-compassion in hospice and palliative care patients, their relatives, and health care professionals, we conducted a systematic integrative review using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. For patients, self-compassion was associated with reduced stress, anxiety, shame, depressive symptoms, fear of cancer recurrence, and loneliness. It was also associated with increased social capital, self-soothing, mindfulness, compassion, causal reasoning ability, psychosocial and spiritual well-being, legacy, courage, and commitment. For health care professionals, self-compassion was associated with increased capacity for self-care, mindfulness, and professional quality of life and a decrease in perceived burnout risk and secondary traumatic stress. No studies were found to involve patients' relatives. Self-compassion seems to be an important resource in hospice and palliative care. It supports self-care and alleviates suffering by improving the social, psychosocial, and spiritual well-being of patients and health care professionals, including hospice and palliative care nurses. Future research should include care patients' relatives.

Quality of life, self-compassion and mindfulness in cancer patients undergoing chemotherapy: A cross-sectional study.

PURPOSE: We investigated whether self-compassion and mindfulness are associated with quality of life in patients undergoing antineoplastic chemotherapy. METHODS: A cross-sectional survey of 183 patients (100% response rate) undergoing chemotherapy was conducted at a Brazilian hospital between August and December 2019. A questionnaire was administered by the research team, collecting clinical and demographic data as well as responses to the Self-compassion scale, Mindful Attention Awareness Scale, and the Functional Assessment of Cancer Therapy-General instrument. Data analysis comprised descriptive and inferential statistics, with multiple regression and Spearman's rank-order correlation testing for associations between quality of life, self-compassion and mindfulness. RESULTS: Mean scores for the study variables were 4.23 (SD = 0.63) for self-compassion, 69.05 (SD = 13.27) for mindfulness, and 80.25 (SD = 12.62) for quality of life. Significant positive correlations were observed between quality of life and self-compassion (r = 0.466, p < 0.001), as well as for quality of life and mindfulness (r = 0.325, p < 0.001). Higher levels of self-compassion and mindfulness were associated with better quality of life. CONCLUSIONS: This research suggests merit in further studies of self-compassion and mindfulness either as predictor variables or for direct causal effect on quality of life in cancer patients undergoing antineoplastic chemotherapy. We recommend that future studies incorporate an intervention and experimental design.

Bullying, physical activity, and body image among Brazilian students.

To determine the prevalence of bullying in Brazilian schools and analyze its association with physical activity and body image, data were collected from 51.192 students. Boys are more frequently bullied (7.2%) and they also bully more than girls (p ⩽ 0.01). Regarding body image, 26 percent of the girls considered themselves thin or very thin (p ⩽ 0.01). For boys, we observed associations between the variable of being treated well by classmates and race. Bullying was associated to mother's education. The data show the need for cross-sector actions based on educational policies and practices that can reduce and prevent bullying in schools.