Comunicación interpersonal de médicos-docentes en las prácticas formativas de un pregrado de medicina

Introducción: La comunicación es una competencia esencial en los currículos médicos, y es fundamental en modelos de atención centrados en el paciente. Las prácticas clínicas, eje en la formación médica, son escenarios de interacciones docente-estudiantes-pacientes; en ellas, los estudiantes aprenden a comunicarse con el paciente de la mano de sus profesores. El objetivo del estudio fue comprender la comunicación de médicos-docentes en prácticas clínicas de un pregrado de medicina. Metodología: Investigación cualitativa desde el marco interpretativo del interaccionismo simbólico y el análisis bajo los lineamientos de la teoría fundamentada. Se entrevistaron quince médicos docentes de cursos clínicos. Las entrevistas se grabaron, transcribieron y codificaron por unidades de sentido. Resultados: Del análisis emergen diferentes visiones del estudiante e interés por los elementos comunicativos con este y el paciente y la reflexión de la práctica docente. Los docentes son conscientes del rol de modelaje para el aprendizaje de los estudiantes; consideran a los pacientes como seres vulnerables, generosos, agradecidos, que representan el recurso más valioso para la enseñanza; con ellos desarrollan su doble misión de resolver problemas de salud y enseñar. Conclusiones: Los docentes, en la interacción con los estudiantes y pacientes, transforman una práctica más instruccional y disciplinar a una centrada en los sujetos y sus necesidades. La regulación del currículo y la normativa de las instituciones de salud genera tensiones a los docentes entre el quehacer médico y el deseo de enseñar.

Introduction: Communication is an essential skill in medical curricula and crucial in patient-centered care models. Resident experience is fundamental in medical training. These experiences offer teacher-student-patient interactions where students learn about doctor-patient communication directly from their preceptors. The objective of the study was to understand doctor-teacher communication during clinical practices in an undergraduate medical program. Methodology: Qualitative research undertaken from the interpretive framework of Symbolic Interactionism andanalysis under Grounded Theory guidelines. Fifteen (15) clinical-course medical doctors were interviewed. The interviews were recorded, transcribed, and coded by meaning units. Results: Different student views emerged, including student interest in student-patient communicative aspects as well as their own thoughts on teaching. Teachers are aware of their role as models in student learning; they see patients as vulnerable, generous, grateful people that represent the most valuable asset in their teaching endeavor; with them, teachers develop their dual mission, that is, solving health-related problems and teaching. Discussion and conclusions: During their interaction with students and patients, teachers transform an essentially instructional and disciplined practice into one centered on the patient and their needs. The stress doctors face when addressing the medical task itself versus their desire to teach is compounded by curriculum guidelines and health agency norms. This is, in fact, part of the hidden curriculum that influences student learning

Gênero e violência nos relacionamentos afetivo-sexuais entre adolescentes / Gender and violence in affective-sexual relationships among adolescents

O objetivo deste estudo foi compreender as relações entre gênero e violência nos relacionamentos afetivo-sexuais de adolescentes. Para tanto, foram realizados grupos focais com 29 adolescentes, estudantes do 9o ano do ensino fundamental e EJA de três escolas públicas de uma cidade no interior do Rio Grande do Sul. Os participantes tinham entre 13 e 17 anos de idade. Os dados coletados foram submetidos à Análise Temática Reflexiva, o que possibilitou a elaboração de dois temas. No primeiro, a violência apresentou-se como ferramenta para a construção das masculinidades. A violência física ocupa um lugar central no imaginário desses jovens, sendo uma via de descarga para agressividade, bem como uma prática sujeita a sanções legais. No segundo tema, a violência evidenciou-se como um dispositivo de coerção e amedrontamento das meninas adolescentes. Foi possível observar que as situações de violência são onipresentes nas vivências das adolescentes, sendo mais intensas no contexto dos relacionamentos e após o término. Conclui-se que a violência é um importante marcador das desigualdades de gênero nos relacionamentos entre adolescentes, colocando as meninas adolescentes em situação de desvantagem em relação aos meninos.

The aim of this study was to understand the relationship between gender and violence in adolescents' affective-sexual relationships. Focal groups were carried out with 29 adolescents, students of the 9th year of elementary school and EJA from three public schools in a city in the interior of Rio Grande do Sul. The participants were between 13 and 17 years old. The collected data were submitted to Reflexive Thematic Analysis, which allowed the elaboration of two themes. In the first theme, violence was a tool for the construction of masculinities. Physical violence particularly occupies a central place in the imagination of these adolescents, being a way of discharge for aggression, as well as a practice subject to legal sanctions. In the second theme, violence was a tool of coercion and intimidation of adolescent girls. It was possible to observe that situations of violence are omnipresent in the experiences of adolescents, being more intense in the context of relationships and after the breakup. We conclude that violence is an important marker of gender inequalities in relationships between adolescents, placing adolescent girls at a disadvantage compared to boys.

Ethics in Clinical Orthopedic Surgery.

Introduction: Orthopedic surgeons, owing to their specialized role, have a set of medical and moral responsibilities that span beyond the confines of the operating room. The primary objective of this exploration is to emphasize the pivotal ethical and professional standards that these surgeons should uphold. Methodology: We derived key ethical and professional aspects by reviewing standard medical practices, professional guidelines, and through consultations with senior orthopedic professionals. These aspects covered both the conduct inside the surgery room and the interpersonal relations outside. Results: Several core areas of conduct were identified.Patient-Centered Care: Prioritizing the holistic well-being of the patient.Communication: Ensuring that all communications are both transparent and respectful.Informed Consent: Properly securing consent after ensuring the patient is adequately informed.Confidentiality: Taking measures to safeguard patient information.Professional Behavior: Upholding the highest standards of professional conduct.Continuous Learning: Remaining committed to updating skills and enhancing competence.Interpersonal Relations: Building healthy and constructive relationships with industry representatives, professional peers, and hospital staff.Personal Life Balance: Recognizing the importance of a balanced personal and professional life for holistic well-being. Conclusion: For Orthopedic surgeons, strict adherence to the outlined ethical and professional principles is essential. Such commitment not only ensures the trust and safety of patients but also serves to maintain and elevate the prestigious standing of the orthopedic community in the broader medical landscape.

The Moderating Role of University Students' Humor Styles on the Association between General Mental Health and Subjective Well-Being.

This study investigated the associations among humor styles, general mental health (GMH), and subjective well-being (SWB) in a non-clinical sample of 662 university students (Mage = 21.35, SD = 4.14; 66.3% females) attending Greek public universities, via an online survey. In addition, it investigated possible moderating effects of humor styles in the association between GMH and SWB as well as gender differences. Positive correlations emerged between GMH and SWB, as well as among GMH, SWB, and benign humor styles. Malignant humor styles had a negative correlation with both GMH and SWB. The use of aggressive and self-defeating humor moderated the association between GMH and SWB in that at low levels of these humor styles the link between GMH and SWB was stronger. Finally, males scored higher on self-enhancing and aggressive humor than females. The findings expand previous research and are discussed in terms of their implications.

Composição de grupo de diálogo sobre o tema gênero e sexualidade nas escolas / Composition of a dialogue group on the theme of gender and sexuality in schools / Composición de un grupo de diálogo sobre el tema de género y sexualidad en las escuelas

Considerando-se os desafios da composição de grupos de diálogos em temas socialmente polêmicos, este estudo teve como objetivo apresentar as estratégias utilizadas para compor um grupo de diálogo a partir da metodologia do Projeto de Conversações Públicas entre pessoas com distintas opiniões sobre a abordagem do tema da diversidade sexual e de gênero nas escolas brasileiras. As transcrições das audiogravações das conversas preparatórias e dos encontros grupais e as anotações de diário de campo compuseram o corpus de análise deste estudo. A análise temática de conteúdo serviu para o destaque das seguintes estratégias consideradas úteis para a composição grupal: 1) Reconhecendo as pessoas envolvidas no conflito; 2) Entrando em contato com pessoas-chave; 3) Recrutando participantes reservas; 4) Pensando formas alternativas de presença no grupo; 5) Reconhecendo quem precisaria estar na conversa; 6) Flexibilidade com relação a entrada de novas/os participantes; 7) Lidando com os estereótipos com relação as/aos facilitadoras/es; 8) Co-construindo estratégias para maior adesão grupal. Esses eixos analíticos foram discutidos a partir da literatura da área.

Considering the challenges of composing dialogue groups in polemic issues, this study aimed to present the strategies used to compose a dialogue group based on the methodology of the Public Conversations Project among people with different opinions on the approach to the topic of sexual and of gender in Brazilian schools. Transcripts of audio recordings of preparatory conversations and group meetings and field diary notes composed the corpus of analysis of this study. The thematic content analysis served to highlight the following strategies considered useful for group composition: 1) Recognizing the people involved in the conflict; 2) Contacting key people; 3) Recruiting reserve participants; 4) Thinking about alternative forms of presence in the group; 5) Recognizing who would need to be in the conversation; 6) Flexibility regarding the entry of new participants; 7) Dealing with stereotypes regarding facilitators; 8) Co-building strategies for greater group membership. The selected material was discussed based on the literature in the area.

Considerando los desafíos de la composición de grupos de diálogo, este estudio tuvo como objetivo presentar las estrategias utilizadas para la composición de un grupo de diálogo basado en la metodología del Proyecto Conversaciones Públicas entre personas con opiniones diferentes sobre el abordaje del tema sexual y de género en las escuelas brasileñas. Transcripciones de grabaciones de audio de conversaciones preparatorias y reuniones grupales y notas del diario de campo componen el corpus de análisis de este estudio. El análisis de contenido temático sirvió para resaltar las siguientes estrategias consideradas útiles para la composición del grupo: 1) Reconocimiento de las personas involucradas en el conflicto; 2) Ponerse en contacto con personas clave; 3) Reclutamiento de participantes de reserva; 4) Pensar en formas alternativas de presencia en el grupo; 5) Reconocer quién debería estar en la conversación; 6) Flexibilidad en la entrada de nuevos participantes; 7) Abordar los estereotipos sobre los facilitadores; 8) Estrategias de co-construcción para una mayor membresía del grupo. El material seleccionado se discutió con base en la literatura en el área.

Active for Life after Cancer: Association of Physical Activity with Cancer Patients' Interpersonal Competence, Quality of Life, and Survival Beliefs.

This study aimed to examine the relationship between physical activity and cancer patients' survival beliefs and constructed a mediation model involving the mediating effects of interpersonal competence and quality of life. We conducted 252 questionnaire surveys on multiple chat groups for cancer patients using the WeChat software, and assessed physical activity, survival beliefs, interpersonal competence, and quality of life using standard scales. Data were analyzed using SPSS and AMOS. There were positive correlations between physical activity and quality of life (ß = 0.393, p < 0.001), physical activity and interpersonal competence (ß = 0.385, p < 0.001), interpersonal competence and quality of life (ß = 0.455, p < 0.001), and quality of life and survival beliefs (ß = 0.478, p < 0.001). In addition, a significant mediating effect between physical activity and survival beliefs was observed between interpersonal competence and quality of life (standardized indirect effect = 0.384, p < 0.001). The study revealed that effective physical activity led to higher interpersonal competence, more excellent quality of life, and improved survival beliefs in cancer patients, and that the association of physical activity with improved survival beliefs was fully mediated through interpersonal competence and quality of life. The findings suggest that the relevant government should increase policy support and publicity to improve cancer patients' participation in physical activity.

Estratégia saúde da família como espaço de insatisfação e satisfação profissional / Family health strategy as a place for job dissatisfaction and satisfaction / La estrategia de salud familiar como espacio de insatisfacción y satisfacción profesional

Os fatores que interferem na satisfação e insatisfação dos profissionais que atuam na Estratégia Saúde da Família são diversos e de inúmeras características. O objetivo do estudo foi identificar os fatores de satisfação e insatisfação de profissionais da Estratégia de Saúde da Família do município de Forquilhinha/SC. Trata-se de um estudo de métodos mistos, descritivo e exploratório, realizado com 15 profissionais da saúde de três Unidades de Saúde por meio de entrevista semiestruturada. Os dados foram analisados segundo a análise de conteúdo temática com o auxílio do software Atlas.ti. Os resultados geraram 72 categorias, vinculados a cinco subcategorias, associados a duas categorias. Os grupos fatores de insatisfação e satisfação encontrados envolvem a atuação na rotina diária, estrutura e serviços das unidades e do sistema de saúde, os direitos trabalhistas, a organização dos elementos de atuação, e as relações interpessoais com os colegas, usuários e gestores. A satisfação é indicada, principalmente, pela relação com os colegas e pela divisão de tarefas entre os profissionais. Em contrapartida, a falta de reconhecimento e desvalorização, além da sobrecarga trabalho, são os principais motivos de insatisfação. Os aspectos geradores de satisfação e insatisfação dos profissionais são múltiplos e até mesmo ambíguos e podem colaborar para prejuízo ou melhoria da prestação do cuidado a saúde.

The factors that interfere with the satisfaction and dissatisfaction of professionals working in the Family Health Strategy are diverse. The objective of the study was to identify the factors of satisfaction and dissatisfaction of professionals of the Family Health Strategy in the municipality of Forquilhinha (SC). This is a mixed-methods, descriptive and exploratory study, carried out with 15 health professionals from three health units by means of semi-structured interviews. The data were analyzed according to thematic content analysis, with the help of the Atlas.TI 9.0 software. The results generated 72 codes, linked to five subcategories, associated with two categories. The groups of dissatisfaction and satisfaction factors found involve: the performance in the daily routine, structure and services of the units and the health system, labor rights, the organization of the performance elements, and the interpersonal relationships with colleagues, users and managers. Satisfaction is indicated mainly by the relationship with colleagues and the division of tasks among professionals. On the other hand, the lack of recognition and the devaluation, besides the work overload, are the main reasons for dissatisfaction. The aspects that generate satisfaction and dissatisfaction among professionals are multiple and even ambiguous and can contribute to hinder or improve health care delivery.

Los factores que interfieren en la satisfacción o en la insatisfacción de los profesionales que actúan en la Estrategia de Salud Familiar son diversos. El objetivo de este estudio fue identificar los factores de satisfacción e insatisfacción de los profesionales de la Estrategia de Salud Familiar del municipio de Forquilhinha (Santa Catarina, Brasil). Se trata de un estudio de métodos mixtos, descriptivo y exploratorio, realizado con 15 profesionales sanitarios de tres unidades de salud mediante entrevistas semiestructuradas. Los datos se analizaron según el análisis de contenido temático con la ayuda del software Atlas.TI 9.0. Los resultados generaron 72 categorías, vinculadas a cinco subcategorías, asociadas a dos categorías. Los factores de insatisfacción y satisfacción encontrados tienen que ver con la actuación en la rutina diaria, la estructura y los servicios de las unidades y del sistema de salud, los derechos laborales, la organización de los elementos de actuación y las relaciones interpersonales con los compañeros, los usuarios y los gestores. La satisfacción está indicada principalmente por la relación con los compañeros y el reparto de tareas entre los profesionales. Por otro lado, la falta de reconocimiento y la desvalorización, además de la sobrecarga de trabajo, son los principales motivos de insatisfacción. Los aspectos que generan satisfacción e insatisfacción de los profesionales son múltiples, incluso ambiguos, y pueden perjudicar o mejorar la prestación de la asistencia sanitaria.

Health professionals' experiences of rapport during telehealth encounters in community palliative care: An interpretive description study.

BACKGROUND: Despite the reported importance of rapport, there are knowledge gaps in the ways rapport is developed and experienced by health professionals during telehealth calls in palliative care. AIM: To gain an understanding about developing rapport during telehealth calls by exploring the experiences of health professionals in community palliative care. DESIGN: A qualitative Interpretive Description study was conducted with semi-structured interviews and focus groups between November 2020 and May 2021. Data was audio recorded, transcribed, and analysed using Reflexive thematic analysis. A COREQ checklist was completed. SETTING/PARTICIPANTS: Thirty-one palliative care professionals who had participated in telehealth calls were recruited from four hospice locations in Aotearoa, New Zealand. RESULTS: There were two themes identified: (1) 'Getting on together', which included how rapport shows up in telehealth, with examples of calls with rapport and without rapport, and (2) 'Rapport is a soft skill', which identified health professionals using body language and listening in specific ways in telehealth, while being aware of the privacy of calls, and lack of training concerns. CONCLUSION: Based on health professionals experiences of rapport it was determined that rapport is vitally important in telehealth calls, as it is in-person interactions. Rapport is a soft skill that can potentially be learned, practiced and mastery developed, although rapport in each interaction is not guaranteed. Patient and family experiences of rapport in the palliative telehealth area warrants further research and there is some urgency for health professional training in telehealth interpersonal skills.

Benchmarking Social Isolation, Loneliness, and Smoking: Challenges and Opportunities for Public Health.

Over the past decade, the health implications of social isolation and loneliness garnered global attention due in part to a widely cited meta-analysis that benchmarked associations between cigarette smoking and mortality with associations between several social-relationship measures and mortality. Leaders in health systems, research, government, and popular media have since claimed that the harms of social isolation and loneliness are comparable to that of cigarette smoking. Our commentary examines the basis of this comparison. We suggest that comparisons between social isolation, loneliness, and smoking have been helpful for raising awareness of robust evidence linking social relationships and health. However, the analogy often oversimplifies the evidence and may overemphasize treating social isolation or loneliness at the individual level without sufficient attention on population-level prevention. As communities, governments, and health and social sector practitioners navigate opportunities for change, we believe now is time to focus greater attention on the structures and environments that promote and constrain healthy relationships.

Calidad de vida relacionada con la salud en personas con úlcera venosa / Health-related quality of life of people with venous ulcer / Qualidade de vida relacionada à saúde em pessoas com úlcera venosa

Introducción: la úlcera venosa es la heridade origen vascular que más se presentaen la población adulta; afecta la calidad de vida,por loque se requiereun abordajeinterdisciplinarioparala atenciónde las personas que la padecen. Objetivo:describir las variables clínicas y sociales que interfieren en la calidad de vida relacionada con la salud de un grupo deadultosconúlcera venosa.Métodos:estudio observacional de tipo cohorte; incluyó 80 personas evaluadas en tres clínicas de Medellín(Colombia), en quienes seaplicó elinstrumento de evaluaciónCharing Cross Venous Ulcer Questionnaire. Se describieron las variablessociodemográficas y la evolución de la calidad de vidahasta la cicatrización y se construyó un modelo de regresión logística para explicar las variables asociadas a tener lapeorcalidad de vida. Resultados:el 28,8%de los participantes obtuvieron 64 o más puntos, es decir, grado de afección alto durantela primera mediciónde la calidad de vida;en el 68,8%el puntaje fue63o menos, lo que significó afecciónmoderadaysolo el 2,4%tuvo baja afección.Laspeores puntuaciones se registraron enmujeres,participantes de mayor edad y quienes tenían mayor compromiso de la herida; la afección involucró las dimensiones Estado emocional, Estética, Función social y Actividades domésticas,aunque hubo evolución favorablede la calidad de vidamientrasiba cicatrizandola úlcera. Conclusiones:lacalidad de vida relacionada con la saludestá altamente afectada en las personasque tienen úlcera venosa, siendo más frecuente en quienes tienen dolor constante,heridas más grandes, de mayor tiempo de antigüedad y aquellos con mala percepción desusalud; por tanto,se requiere oportunamentela intervención profesional e interdisciplinaria en salud para el logro de la cicatrizacióny del bienestary para mejorar la calidad de vida.

ntroduction: Venous ulcers are the most common vascular injury in the adult population. They affect the quality of life, so people who suffer from venous ulcers require an interdisciplinary approach to their care. Objective: To describe clinical and social variables that affect the health-related quality of life of a group of adults with venous ulcers. Methods: Observational cohort study carried out with 80 people examined in three medical centers in Medellín (Colombia) and who were given the Charing Cross Venous Ulcer Questionnaire to answer. Sociodemographic variables and the quality-of-life evolution until scarring were described. A logistic regression model was built to explain the variables associated with having the poorest quality of life. Results:There were28.8% of the participants who scored 64 or more points on the first quality of life measurement, which indicates a highly affected quality of life; 68.8% scored 63 or less, indicating a moderately affected quality of life, while only 2.4% indicated a slightly affected quality of life. The worst scores were seen among women, older participants, and those with greater ulcer severity. The dimensions of emotional status, cosmesis, social interaction, and domestic activities were affected, although there was a favorable evolution of the quality of life while the ulcer was healing. Conclusions: Health-related quality of life is highly affected in people with venous ulcers and is more common in those with constant pain, larger and older sores, and those with poor health perceptions. Therefore, timely professional and interdisciplinary healthcare interventions are required to achieve wound healing and wellness and improve quality of life

Introdução:a úlcera venosa é a ferida de origem vascular que ocorre mais frequentemente na população adulta e afeta a qualidade de vida, por isso é necessária uma abordagem interdisciplinar para o cuidado das pessoas que a sofrem. Objetivo:descrever as variáveis clínicas e sociais que interferem na qualidade de vida relacionada à saúde de um grupo de adultos com úlcera venosa.Métodos:estudo de coorte observacional; incluíram-se 80 pessoas avaliadas em três clínicas em Medellín (Colômbia), nas quais foi aplicado o instrumento de avaliação Charing Cross Venous Ulcer Questionnaire. Descreveram-se as variáveis sociodemográficas e a evolução da qualidade de vida até a cicatrizaçãoe construiu-se um modelo de regressão logística para explicar as variáveis associadas à pior qualidade de vida.Resultados: 28,8% dos participantes obtiveram 64 ou mais pontos, ou seja, alto grau de condição na primeira mensuração da qualidade de vida; em 68,8% a pontuação foi de 63 ou menos, o que significa condição moderada e apenas 2,4% em condição baixa. As piores pontuações foram registradas em mulheres, participantes mais velhos e naqueles com maior complicação da ferida; a afecção,envolvia as dimensões Estado Emocional, Estética, Função Social e Atividades Domésticas, embora houvesse evolução favorável da qualidade de vida enquanto a úlcera cicatrizava. Conclusões:a qualidade de vida relacionada à saúde é altamente afetada em pessoas com úlcera venosa, sendo mais frequente naquelas com dor constante, feridasmaiores, mais antigas e com má percepção de saúde; portanto, é necessária intervenção oportuna profissional e interdisciplinar em saúde para alcançar a cicatrização e o bem-estar e melhorar a qualidade de vida

Imigração de haitianos: enfoque na comunicação em saúde / Haitian immigration: focus on health communication / Inmigración haitiana: enfoque en la comunicación de salud

Pesquisa sobre a adaptação dos imigrantes haitianos à realidade brasileira e ao Sistema Único de Saúde (SUS) e a forma como se processam as relações interpessoais no ambiente de saúde. O objetivo foi compreender como os imigrantes haitianos, usuários do sistema de saúde, se apresentam e são percebidos nas relações estabelecidas com os profissionais de saúde em uma Unidade Básica de Saúde (UBS) da Região Metropolitana de Curitiba. Foi uma etnografia com observação participante, com utilização de diário de campo. Resultados apontam dificuldades por parte dos imigrantes haitianos ao acesso ao sistema de saúde, pelas peculiaridades de sua cultura, e por parte dos profissionais de saúde, a língua e a cultura se tornam as principais barreiras para os atendimentos, permeada por preconceitos, decorrentes de falta de preparo de alguns profissionais. Contudo, tais dificuldades podem ser contornadas por meio de estratégias eficazes e uma melhor preparação para acolher essa população.

Research on the adaptation of Haitian immigrants to the Brazilian reality and to the Brazilian Public Health System (SUS) and on the way interpersonal relationship is processed in the health environment. The objective was to understand how Haitian immigrants, users of the health system, present themselves and are perceived in the relationships established with health professionals in a Primary Health Unit in the Metropolitan Region of Curitiba. It was an ethnography with participant observation, using a field diary. Results indicate difficulties for Haitian immigrants to access the health system, due to the peculiarities of their culture, and for the health professionals, as language and culture become the main barrier to care, being permeated by prejudice resulting from lack of training of some professionals. However, such difficulties can be overcome through effective strategies and better preparation to embrace this population.

Investigación sobre la adaptación de los inmigrantes haitianos a la realidad brasileña y al Sistema Único de Salud y la forma en que se procesan las relaciones interpersonales en el entorno de la salud. El objetivo fue comprender cómo los inmigrantes haitianos se presentan y son percibidos en las relaciones establecidas con los profesionales de salud en una Unidad Básica de Salud de la Región Metropolitana de Curitiba. Fue una etnografía con observación participante utilizando un diario de campo. Resultados señalan dificultades por parte de los inmigrantes haitianos para acceder al sistema de salud, por las peculiaridades de su cultura, y por parte de los profesionales de la salud, el idioma y la cultura se convierten en la principal barrera para la atención, permeada por prejuicios, derivados de la falta de formación de algunos profesionales. Tales dificultades pueden superarse mediante estrategias eficaces y una mejor preparación para acoger a esta población.

Patient-Caregiver Dyads' Prognostic Information Preferences and Perceptions in Advanced Cancer.

CONTEXT: Prognostic information is considered important for advanced cancer patients and primary informal caregivers to prepare for the end of life. Little is known about discordance in patients' and caregivers' prognostic information preferences and prognostic perceptions, while such discordance complicates adaptive dyadic coping, clinical interactions and care plans. OBJECTIVES: To investigate the extent of patient-caregiver discordance in prognostic information preferences and perceptions, and the factors associated with discordant prognostic perceptions. METHODS: We conducted secondary analyses of a cross-sectional study (PROSPECT, 2019-2021). Advanced cancer patients (median overall survival ≤12 months) from seven Dutch hospitals and caregivers completed structured surveys (n = 412 dyads). RESULTS: Seven percent of patient-caregiver dyads had discordant information preferences regarding the likelihood of cure; 24%-25% had discordant information preferences regarding mortality risk (5/2/1 year). Seventeen percent of dyads had discordant perceptions of the likelihood of cure; 12%-25% had discordant perceptions of mortality risk (5/2/1 year). Dyads with discordant prognostic information preferences (P < 0.05) and dyads in which patients reported better physical functioning (P < 0.01) were significantly more likely to perceive the one-year mortality risk discordantly. CONCLUSION: Physicians should be sensitive to discordant prognostic information preferences and prognostic perceptions among patient-caregiver dyads in advanced cancer care.

Technology-Mediated Support Among Siblings of Children with Cancer.

Purpose: A diagnosis of pediatric cancer can leave healthy siblings with limited access to support. Technology-mediated interpersonal interactions have been noted among adolescent and young adults with cancer and may be an effective source of support for adolescent siblings of children with cancer. In this study, we understand how adolescent siblings use technology to connect with their support network and how their technology use changes after their sibling's cancer diagnosis. Methods: Participants included a national sample (N = 24) of adolescents aged 12-17 who had a sibling diagnosed with cancer in the last 2 years (up to 3 years if still receiving curative-focused treatment). Ecomaps were cocreated with participants to identify sources of social support and modality of interactions. Interviews were transcribed, coded, content analyzed, and descriptively summarized. Results: Adolescent siblings (mean = 14.2 years) perceived technology as a tool to maintain support from their established personal network, rather than a way to expand sources of social support. Most did not seek support or information about cancer outside their known network, preferring information to come from parents or trusted network members. Siblings identified video calls as an important resource for connecting with parents, their sick brother or sister, and others to receive emotional support and companionship. Conclusions: Findings suggest that adolescent siblings of children use technology to connect with their established network for support, an important finding for designing assessments and interventions for this population. Future inquiry should explore these differences, identify unmet needs, and inform acceptable, effective interventions to augment support.

Spouse caregivers' identification of the patient as their primary support person is associated with better patient psychological well-being.

Examine the impact of the primary-support person (PSP) role on advanced cancer patient and spouse caregiver psychological well-being, above and beyond the effects of relationship satisfaction.Secondary analysis of cross-sectional questionnaire data.88 advanced cancer patient/spouse-caregiver dyads.Patients and caregivers independently completed measures assessing depression, anxiety, perceived stress, and relationship satisfaction, and identified their PSP. Patient and caregiver psychological well-being outcomes were regressed on patient and caregiver PSP variables in an actor-partner interdependence model.Half of patients identified their caregiver as PSP; 9% of caregivers identified their patient as PSP. When caregivers identified their patient as PSP, the patient reported better outcomes. No associations were seen for patient identification of caregiver as PSP or caregiver well-being.Clinicians can encourage patients to find ways to continue to focus on their relationship with the caregiver and help caregivers connect with other sources of support.

Impactos da percepção comunicacional e da timidez autorreferidos na avaliação ao falar em público de estudantes universitários / Impacts of self-reported communication perception and shyness on the public speaking assessment of university students

RESUMO Objetivo comparar a autoavaliação ao falar em público, por meio da Escala para Autoavaliação ao Falar em Público, com a percepção comunicacional e timidez autorreferidos, de estudantes universitários. Método tratou-se de um estudo observacional transversal prospectivo. Foram convidados a participar deste estudo, estudantes universitários do Brasil de diferentes áreas de conhecimento, sendo incluídos os que assentiram em participar. Os participantes receberam convite eletrônico e preencheram um formulário elaborado na plataforma Google Forms que continha questões sociodemográficas, sobre autopercepção como bom falante, sobre facilidade para se expressar, sobre timidez, e a Escala para Autoavaliação ao Falar em Público. Foram comparadas as médias da Escala de Autoavaliação ao Falar em Público com a autopercepção como bom falante, com a facilidade para se expressar e com a timidez. Resultados os participantes que se consideravam bons comunicadores, os que acreditavam ter facilidade para se expressar e os que não eram tímidos apresentaram melhor autopercepção sobre as suas habilidades de fala em público. Conclusão a autopercepção comunicacional positiva, bem como a autopercepção de menor timidez estão relacionadas a uma autoavaliação mais favorável em relação a apresentações em público.

ABSTRACT Purpose To compare self-assessment when speaking in public, using the Self-Statements During Public Speaking scale, with the communicational perception and self-reported shyness of university students. Methods This was a prospective cross-sectional observational study. University students from different areas of knowledge in Brazil were invited to participate in this study. Those who agreed to participate were included. Participants received an electronic invitation and filled out a form created on the Google Forms platform that contained sociodemographic questions, on self-perception as a good speaker, on ease of expression, on shyness, and the Self-Statements During Public Speaking scale. The means of the Self-Statements During Public Speaking scale were compared with the self-perception as a good speaker, the ease of expressing oneself, and shyness. Results Participants who considered themselves to be good communicators, those who believed they had an ease to express themselves, and those who were not shy had better self-perception of their public speaking skills. Conclusion positive communicational self-perception, as well as less shyness self-perception, are related to a more favorable self-assessment in relation to public presentations.

Influencia de los tipos de agrupamiento en la competencia social de futuros docentes de educación física al implementar el aprendizaje cooperativo / Influência dos tipos de agrupamento na competência social dos futuros professores educação física na implementação da aprendizagem cooperativa / Influence of the types of grouping on the social competence of future physical education teachers when implementing cooperative learning

Resumen El objetivo de esta investigación fue comprobar la incidencia del aprendizaje cooperativo (AC) en la competencia social en función de los tipos de agrupamiento del alumnado. Participaron 53 estudiantes de tercer curso del Grado de Magisterio Educación Primaria de la mención de Educación Física (EF). Se utilizó un diseño cuasi-experimental donde se implementó una intervención durante cuatro meses con medidas pre-test y post-test a través de un cuestionario sociométrico. El tratamiento de datos se realizó mediante el software Sociomet. Los resultados obtenidos indican que los seminarios que han utilizado agrupamientos libres y heterogéneos han obtenidos mejores puntuaciones de percepción de competencia social que el seminario organizado en subgrupos homogéneos. Así pues, se considera que el criterio de homogeneidad debe ser descartado a la hora de implementar el AC en EF. (AU)

Resumo O objetivo desta pesquisa foi verificar a incidência da aprendizagem cooperativa (LC) na competência social em função dos tipos de agrupamento de alunos. Participaram 53 alunos do terceiro ano do Ensino Fundamental da Licenciatura da menção à Educação Física (EF). Foi utilizado um desenho quase experimental onde foi implementada uma intervenção durante quatro meses com medidas pré-teste e pós-teste através de um questionário sociométrico. O processamento dos dados foi realizado por meio do software Sociomet. Os resultados obtidos indicam que os seminários que utilizaram agrupamentos livres e heterogêneos obtiveram melhores pontuações para a percepção de competência social do que o seminário organizado em subgrupos homogêneos. Assim, considera-se que o critério de homogeneidade deve ser descartado na implementação da AC em EF. (AU)

Abstract The objective of this research was to verify the incidence of cooperative learning (CL) in social competence depending on the types of grouping of students. Fifty-three (53) third-year students of the Primary Education Teaching Degree participated with the mention of Physical Education (PE). A quasi-experimental design was used where intervention was implemented for four months with pre-test and post-test measures through a sociometric questionnaire. Data processing was performed using Sociomet software. The results obtained indicate that the seminars that have used free and heterogeneous groupings have obtained better scores for the perception of social competence than the seminar organized in homogeneous subgroups. Thus, it is considered that the homogeneity criterion should be discarded when implementing CA in PE. (AU)

Educational intervention in social skills for Primary Care nurses / Intervención educativa en habilidades sociales para enfermeras de Atención Primaria / Intervenção educativa em habilidades sociais para enfermeiros da Atenção Básica

ABSTRACT Objective: to assess an educational intervention on social skills for nurses who work in Primary Health Care. Method: a qualitative research-intervention study, carried out in the municipalities covered by the 17th Health Regional of Paraná. It was developed in three interrelated stages: exploratory, where meetings were held with the managers to define the groups and logistics for running the course; intermediate, developed in meetings with different groups of nurses, addressing selected topics; assessment, in which the nurses developed a personal plan to improve their social skills. Results: participants were 57 nurses who acted as coordinators of Primary Care. They considered the educational intervention in social skills fundamental for positive changes in their professional performance. Final considerations: the educational intervention in social skills was assessed as an important strategy to strengthen the development of nurses' managerial and care skills.

RESUMEN Objetivo: evaluar una intervención educativa sobre habilidades sociales para enfermeros que actúan en la Atención Primaria de Salud. Método: se trata de una investigación cualitativa del tipo investigación-intervención, realizada en los municipios de actuación de la 17ª Regional de Salud de Paraná. Se desarrolló en tres etapas interrelacionadas: exploratoria, donde se realizaron reuniones con los directivos para definir los grupos y la logística para la operación del curso; intermedio, desarrollado en encuentros con diferentes grupos de enfermeros, abordando temas seleccionados; evaluativo, en el que las enfermeras desarrollaron un plan personal para mejorar sus habilidades sociales. Resultados: participaron 57 enfermeros que actuaban como coordinadores de Atención Primaria. Consideraron la intervención educativa en habilidades sociales fundamental para cambios positivos en su desempeño profesional. Consideraciones finales: la intervención educativa en habilidades sociales fue evaluada como una estrategia importante para fortalecer el desarrollo de habilidades gerenciales y asistenciales de los enfermeros.

RESUMO Objetivo: avaliar uma intervenção educativa em habilidades sociais para enfermeiros que atuam na Atenção Básica à Saúde. Método: trata-se de uma investigação qualitativa do tipo pesquisa-intervenção, realizada nos municípios de abrangência da 17ª Regional de Saúde do Paraná. Foi desenvolvida em três etapas inter-relacionadas: exploratória, onde foram realizadas reuniões com os gestores para definição dos grupos e logísticas de funcionamento do curso; intermediária, desenvolvida nos encontros com os grupos distintos de enfermeiros, abordando os temas selecionados; avaliativa, na qual os enfermeiros elaboraram um plano pessoal para aprimorarem suas habilidades sociais. Resultados: os participantes foram 57 enfermeiros que atuavam como coordenadores da Atenção Básica. Consideraram a intervenção educativa em habilidades sociais fundamental para mudanças positivas na sua atuação profissional. Considerações finais: a intervenção educativa em habilidades sociais foi avaliada como uma estratégia importante para fortalecer o desenvolvimento das competências gerencias e assistenciais do enfermeiro.

Cuidado centrado na pessoa na atenção psicossocial: desafios para a relação terapêutica na perspectiva de profissionais / El cuidado centrado en la persona en la atención psicosocial: desafíos para la relación terapéutica en la perspectiva de los profesionales / Person-centered care in psychosocial care: challenges for the therapeutic relationship from professionals' perspective

Resumo Objetivo analisar os desafios para a relação terapêutica na perspectiva do cuidado centrado na pessoa. Método pesquisa social modalidade estratégica, de abordagem qualitativa, realizada com 17 profissionais de dois Centros de Atenção Psicossocial (CAPS) da região central do Brasil. Os dados foram coletados por meio de entrevistas individuais online com roteiro semiestruturado e anotações em diário de campo. Foram organizados com o auxílio do software ATLAS.ti, submetidos à análise temática. Resultados emergiram quatro categorias sobre os desafios para a relação terapêutica que abordaram aspectos relacionados às equipes de saúde, aos usuários, à família e aos processos de trabalho dos serviços estudados. Conclusão e implicações para a prática foram identificados desafios que interferem no estabelecimento da relação terapêutica entre os profissionais dos CAPS, usuários e seus familiares que inviabilizam a concretização do modelo de cuidado centrado na pessoa. Relações interpessoais frágeis se configuram empecilhos para a construção de vínculo, o que demanda processos de educação continuada e permanente para a transformação dessa realidade.

Resumen Objetivo analizar los desafíos para la relación terapéutica desde la perspectiva del cuidado centrado en la persona. Método investigación social estratégica, con abordaje cualitativa, realizada con 17 profesionales de dos Centros de Atención Psicosocial (CAPS) del centro de Brasil. Los datos fueron recolectados a través de entrevistas individuales en línea con un guión semiestructurado y notas en un diario de campo. Fueron organizados con la ayuda del software ATLAS.ti, sometidos a análisis temático. Resultados surgieron cuatro categorías sobre los desafíos para la relación terapéutica que abordaron aspectos relacionados con los equipos de salud, los usuarios, la familia y los procesos de trabajo de los servicios estudiados. Conclusión e implicaciones para la práctica se identificaron desafíos que interfieren en el establecimiento de la relación terapéutica entre los profesionales del CAPS, los usuarios y sus familias que imposibilitan la implementación del modelo de atención centrado en la persona. Las relaciones interpersonales frágiles constituyen obstáculos para la construcción de vínculos, lo que exige procesos de educación continua y permanente para transformar esta realidad.

Abstract Objective to analyze the challenges for the therapeutic relationship from the perspective of person-centered care. Method strategic social research, with a qualitative approach, carried out with 17 professionals from two Psychosocial Care Centers (CAPS) in central Brazil. Data were collected through individual online interviews with a semi-structured script and notes in a field diary. They were organized with the help of the ATLAS.ti software, submitted to thematic analysis. Results four categories emerged on the challenges for the therapeutic relationship that addressed aspects related to health teams, users, family and work processes of the services studied. Conclusion and implications for practice challenges were identified that interfere with the establishment of the therapeutic relationship between CAPS professionals, users and their families that make it impossible to implement the person-centered care model. Fragile interpersonal relationships constitute obstacles to bond building, which demands continuing and permanent education processes to transform this reality.

"We want to hug a friend": the covid-19 pandemic among low-income adolescents / "A gente quer abraçar o amigo": a pandemia de covid-19 entre adolescentes de baixa renda

ABSTRACT OBJECTIVE To examine the perceptions of adolescent students from a public school, of both sexes, living in a peripheral region of the city of São Paulo, Brazil, in relation to the covid-19 pandemic, with a special focus on their experiences regarding education and sociability. METHODS This study is part of the Global Early Adolescent Study. Seven face-to-face focus groups were conducted with adolescents between 13 and 16 years old (19 girls and 15 boys) in 2021. RESULTS The experience of remote teaching was frustrating for the adolescents, without the daily and personalized monitoring of the teacher(s). In addition to the difficult or impossible access to devices and the lack of support from schools, there is also the domestic environment, which made the schooling process more difficult, especially for girls, who were forced to take on more household and family care tasks. The closed school blocked an important space for socialization and forced family interaction, generating conflicts and stress in the home environment. The abrupt rupture brought feelings of fear, uncertainty, anguish and loneliness. The iterative evocation of the words "stuck", "alone" and "loneliness" and the phrase "there was no one to talk to" shows how most of the adolescents experienced the period of distancing. The pandemic aggravated the objective and subjective conditions of preexisting feelings, such as "not knowing the future" and the prospects of a life project. CONCLUSION It has been documented how pandemic control measures implemented in a fragmented way and without support for the most impoverished families have negative effects on other spheres of life, in particular for poor young people. The school is a privileged territory to propose/construct actions that help adolescents to deal with problems aggravated in/by the pandemic.

RESUMO OBJETIVO Examinar as percepções de adolescentes estudantes de uma escola pública, de ambos os sexos, moradores de uma região periférica da cidade de São Paulo, Brasil, em relação à pandemia de covid-19, com especial enfoque em suas experiências quanto à educação e sociabilidade. MÉTODOS Este estudo faz parte do Global Early Adolescent Study. Foram conduzidos sete grupos focais presenciais com adolescentes entre 13 e 16 anos (19 meninas e 15 meninos),em 2021. RESULTADOS A experiência do ensino remoto foi frustrante para as/os adolescentes, sem o acompanhamento cotidiano e personalizado de professoras(es). Ao acesso difícil ou impossível aos dispositivos e à ausência de suporte das escolas é acrescido o ambiente doméstico, que dificultou o processo de escolarização, em especial para as meninas, obrigadas a assumir mais tarefas de cuidado da casa e da família. A escola fechada bloqueou espaço importante de socialização e forçou o convívio familiar, gerando conflitos e estresse. A abrupta ruptura trouxe sentimentos de medo, incerteza, angústia e solidão. A evocação iterativa das palavras "presa/o", "sozinha/o" e "solidão" e da frase "não teve ninguém pra conversar" mostra como grande parte das/os adolescentes experienciou o período de distanciamento. A pandemia agravou as condições objetivas e subjetivas de sentimentos preexistentes, como "não saber o futuro" e as perspectivas de projeto de vida. CONCLUSÃO Foi documentado como medidas de controle da pandemia implementadas de forma fragmentada e sem suporte às famílias mais empobrecidas têm efeitos negativos em outras esferas da vida, em particular para jovens pobres. A escola é um território privilegiado para se propor/construir ações que auxiliem as/os adolescentes a lidar com problemas agravados na/pela pandemia.

Vulnerabilities of Venezuelan refugee women: violence and intersectional social relations / Vulnerabilidades de las mujeres refugiadas venezolanas: violencia y relaciones sociales interseccionales / Vulnerabilidades de mulheres venezuelanas refugiadas: violências e relações sociais interseccionais

ABSTRACT Objective: To analyze the vulnerabilities of Venezuelan women considering their experiences of violence in refugee situations. Method: Qualitative study, developed with ten (10) Venezuelan refugee women in the southern region of Brazil, through individual in-depth interviews. The theoretical framework of analysis was Vulnerability, Human Rights, and Intersectionality. Results: The greater the intensity of the intersection of social markers present, such as sex, racial, nationality, generation, cultural, bodily, territorial and other relations, the greater the range of vulnerable experiences in the social relations of these women, producing exclusions and violation of rights. Conclusion: The situations of vulnerabilities of refugee women are enhanced as more or less social markers intersect in their life experiences and established social relationships, causing impacts that allow the transition from 'vulnerable to violated subjects'. Thus, intersectional relationships were formed, either promoting oppression or producing resilience and resistance.

RESUMEN Objetivo: Analizar las vulnerabilidades de las mujeres venezolanas considerando sus experiencias de violencia en la situación de refugiados. Método: Estudio cualitativo, desarrollado con diez (10) mujeres venezolanas refugiadas en la región sur de Brasil, a través de entrevistas individuales en profundidad. El marco teórico de análisis fue Vulnerabilidad, Derechos Humanos e Interseccionalidad. Resultados: Cuanto mayor es la intensidad de la intersección de marcadores sociales presentes, como género, raza, nacionalidad, generación, relaciones culturales, corporales, territoriales y de otro tipo, mayor es el rango de experiencias vulnerabilizantes en las relaciones sociales de estas mujeres, produciendo exclusiones y violaciones de derechos. Conclusión: Las situaciones de vulnerabilidad de las mujeres que se refugian se acentúan a medida que marcadores más o menos sociales se cruzan en sus experiencias de vida y relaciones sociales establecidas, provocando impactos que posibilitan la transición de 'sujetos vulnerables a vulnerabilizados'. Así, se formaron relaciones interseccionales que a veces promovían la opresión y a veces producían resiliencia y resistencia.

RESUMO Objetivo: Analisar as vulnerabilidades de mulheres venezuelanas considerando suas experiências de violências na situação de refúgio. Método: Estudo qualitativo, desenvolvido com dez (10) mulheres venezuelanas refugiadas na região sul do Brasil, por meio de entrevistas individuais em profundidade. O quadro teórico de análise foi Vulnerabilidade, Direitos Humanos e Interseccionalidade. Resultados: Quanto maior a intensidade da intersecção dos marcadores sociais presentes, como as relações de gênero, raciais, de nacionalidade, geração, culturais, corporais, territoriais e outras, maior a amplitude das experiências vulnerabilizantes nas relações sociais dessas mulheres, produzindo exclusões e violação de direitos. Conclusão: As situações de vulnerabilidades das mulheres que se refugiam acentuam-se à medida que mais ou menos marcadores sociais se interseccionam nas suas experiências de vida e nas relações sociais estabelecidas, provocando impactos que viabilizam a transição de 'sujeitos vulneráveis para vulnerados'. Conformaram-se assim, relações interseccionais que ora promoveram opressão, ora produziram resiliência e resistência.