Adaptação cultural e validação da reason of using face masks cale para brasileiros / Adaptación cultural y validación de la reason of using face mask scale para brasileños / Cultural adaptation and validation of the reason of using face mask scale for brazilians

RESUMO Objetivo: realizar a tradução, adaptação cultural e validação da Reason of Using Face Mask Scale entre brasileiros. Métodos: estudo metodológico realizado entre abril e maio de 2020 mediante as seguintes etapas: tradução; síntese das traduções; retrotradução; comitê de juízes; pré-teste e avaliação das propriedades psicométricas. A coleta dos dados foi online a partir de mensagens enviadas por meio de mídias sociais. O questionário foi disponibilizado a partir de um link e os dados armazenados no Google Forms. Utilizou-se a Análise Fatorial Exploratória, testes de Kaiser-Meyer-Olkin e de Esfericidade de Bartlett para constatar se a amostra era adequada e passível de fatoração. Resultados: a escala foi traduzida para o português, avaliada por cinco especialistas, pré-testada com 20 adultos e aplicada em 500 pessoas da população brasileira. O índice de validade de conteúdo para a escala como um todo foi de 0,92. Os valores de Kaiser-Meyer-Olkin (0,639) e teste de esfericidade de Bartlett (p=0,000) indicaram que os itens eram fatoráveis. A variância explicada foi de 62,18%. Na validade de construto por grupos distintos, obteve-se resultado satisfatório (p<0,05). Conclusão: a Versão Brasileira da escalafoi adaptada para a cultura brasileira, sendo válida para avaliar os motivos para o uso de máscaras entre brasileiros.

RESUMEN Objetivo: realizar la traducción, adaptación cultural y validación de la Reason ofUsingFaceMaskScale entre brasileños. Métodos: estudio metodológico realizado entre abril y mayo de 2020 a través de las siguientes etapas: traducción; síntesis de las traducciones; retrotraducción; evaluación por jueces; pretest y evaluación de las propiedades psicométricas. La recolección de datos se realizó online a partir de mensajes enviados a través de redes sociales. La encuesta se hizo disponible a partir de un enlace y los datos almacenados en Google Forms. Se utilizó el Análisis Factorial Exploratorio, pruebas de Kaiser-Meyer-Olkin y de Esfericidad de Bartlett para determinar si la muestra era adecuada y susceptible a la factorización. Resultados: la escala fue traducida al portugués, evaluada por cinco especialistas, pre-testada con 20 adultos y aplicada en 500 personas de la población brasileña. El índice de validez del contenido para la escala como un todo fue de 0,92. Los valores de Kaiser-Meyer-Olkin (0,639) y test de esfericidad de Bartlett (p=0,000) indicaron que los ítems eran susceptibles a la factorización. La varianza explicada fue de 62,18%. En la validez de constructo por grupos distintos se obtuvo resultado satisfactorio (p<0,05). Conclusión: la Versión Brasileña de la escala fue adaptada para la cultura brasileña yes válida para evaluar los motivos para el uso de máscaras entre brasileños.

ABSTRACT Objective: to carry out the translation, cultural adaptation and validation of the Reason of Using Face Mask Scale among Brazilians. Methods: methodological study conducted between April and May 2020 using the following steps: translation; synthesis of translations; back-translation; committee of judges; pre-test and evaluation of psychometric properties. Data collection took place online from messages sent through social media. The questionnaire was made available from a link and the data stored in Google Forms. Exploratory Factor Analysis, Kaiser-Meyer-Olkin and Bartlett's Sphericity tests were used to check if the sample was adequate and factorable. Results: the scale was translated into Portuguese, evaluated by five experts, pre-tested with 20 adults and applied to 500 people from the Brazilian population. The content validity index for the scale as a whole was 0.92. The Kaiser-Meyer-Olkin (0.639) and Bartlett's Sphericity test (p=0.000) values indicated that the items were factorable. The explained variance was 62.18%. In the construct validity for different groups, a satisfactory result was obtained (p<0.05). Conclusion: the Brazilian Version of the scale was adapted to the Brazilian culture and is valid to evaluate the reasons for the use of masks among Brazilians.

Perioperative nurses' experiences of caring for donation after cardiac death organ donors and their family within the operating room.

Background: Worldwide, operating rooms have seen the re-emergence of donation after cardiac death organ donors to increase the number of available organs. There is limited information on the issues perioperative nurses encounter when caring for donor patients after cardiac death who proceed to organ procurement surgery. Objectives: The purpose of this paper is to report a subset of findings derived from a larger study highlighting the difficulties experienced by perioperative nurses when encountering donation after cardiac death organ donors and their family within the operating room during organ procurement surgery from an Australian perspective. Methods: A qualitative grounded theory method was used to explore perioperative nurses' (n = 35) experiences of participating in multi-organ procurement surgery. Results: This paper reports a subset of findings of the perioperative nurses' experiences directly related to donation after cardiac death procedures drawn from a larger grounded theory study. Participants revealed four aspects conceptualised as: 'witnessing the death of the donation after cardiac death donor'; 'exposure to family'; 'witnessing family grief' and 'stepping into the family's role by default'. Conclusion: Perioperative nurses' experiences with donation after cardiac death procedures are complex, challenging and demanding. Targeted support, education and training will enhance the perioperative nurses' capabilities and experiences of caring for the donation after cardiac death donor and their family with the operating room context.

Relación entre afrontamiento y problemas externalizados e internalizados en hermanos de niños con autismo / Relation between coping and externalized and internalized problems in siblings of children with autism

Introducción: El trastorno del espectro autista es un problema del neurodesarrollo caracterizado por la presencia de dificultades en la comunicación social e interacción y en el comportamiento, el cual suele ser estereotipado y con intereses restringidos. El impacto que tiene la presencia de un niño con este trastorno en los hermanos, tiene diferentes matices. Objetivo: Identificar las estrategias de afrontamiento que utilizan los hermanos de niños con trastorno del espectro autista y analizar su relación con problemas externalizados e internalizados. Resultados: Participaron 23 niños (15 niños y 8 niñas) de 8 a 12 años de edad (edad promedio: 9.8; DE= 1,5). Se aplicó una ficha sociodemográfica para niños, la escala infantil de afrontamiento y el cuestionario de problemas internalizados y externalizados para niños. Los resultados indican que el factor disfuncional se utiliza con mucha frecuencia y que existen correlaciones positivas entre el afrontamiento disfuncional con problemas externalizados e internalizados y entre los factores centrado en la emoción y el evitativo con problemas internalizados. Conclusiones: En este grupo de hermanos de niños con trastorno del espectro autista, la correlación significativa entre el afrontamiento disfuncional y los problemas externalizados e internalizados, indica la necesidad de una evaluación profunda de posibles problemas de conducta y emocionales, la necesidad de aprender a responder de manera funcional ante las situaciones cotidianas, así como de una intervención para desarrollar estrategias de afrontamiento funcionales(AU)

Introduction: Autism Spectrum Disorder (ASD) is a neuro-developmental disorder characterized by the presence of difficulties in social communication, social interaction and behavior, which is usually stereotyped and with restricted interests. The impact of the presence of a child with ASD in the siblings has different connotations and it has been found that these children have more positive than negative aspects. Objective: To identify the coping strategies used by siblings of children with ASD, and analyze their relation with externalized and internalized problems. Results: Participants were 23 children (15 boys and 8 girls) from 8 to 12 years old (average age: 9.8, D.E = 1.5). A socio-demographic index card for children was used in addition to the Children Coping Scale and the Questionnaire on Internalized and Externalized Problems for Children (EIA and CPIEN, by its acronyms in Spanish, respectively). The results indicate that the dysfunctional factor is very frequently used and that there are positive correlations between dysfunctional coping with externalized and internalized problems, and also between the factors focused on emotion and the avoidance with internalized problems. Conclusions: In this group of siblings of children with Autism Spectrum Disorder, the significant correlation between disfunctional coping and externalized and internalized problems indicates the need of a deep assesment of possible behavioral and emotional problems, the need to learn how to respond in a functional way to daily life situations, as well as the need of an intervention to develop functional coping strategies(AU)

Características de los cuidadores principales de niños y adolescentes con fibrosis quística / Characteristics of main caregivers of children and adolescents with cystic fibrosis

Introducción: Las investigaciones sobre los cuidadores han tomado importancia por los efectos negativos que provoca en las esferas físicas, psicológicas y sociales de estas personas, debido a su dedicación prolongada a la atención de enfermos cuyas dolencias les impiden totalmente su autocuidado. Objetivos: Referir las características de los cuidadores principales de pacientes pediátricos con fibrosis quística. Métodos: Estudio descriptivo de corte transversal realizado en el segundo semestre del 2016, con 54 cuidadoras principales de pacientes menores de 19 años, atendidos en los hospitales Pediátrico de Centro Habana, Juan Manuel Márquez, de Marianao, y el William Soler, de Boyeros. Resultados: Las cuidadoras son mujeres, madres en su mayoría, sin vínculo laboral, con nivel educativo medio superior, dedicadas al cuidado de los enfermos a tiempo completo, lo que interfiere su vida personal y social. Ante estas situaciones responden con mediana capacidad de afrontamiento y adaptación ante las situaciones que les generan estrés. Conclusiones: Las estrategias de afrontamiento utilizadas por las cuidadoras están afectadas pues no generan respuestas efectivas que les permita adaptarse y responder a las situaciones de forma óptima, por lo que se requiere reforzar los recursos que están utilizando. La meta de enfermería como ciencia y como disciplina es un factor muy importante para obtener esos recursos necesarios para mejorar la calidad de vida de los niños, adolescentes y sus cuidadores(AU)

Introduction: Research on caregivers has become important because of the negative effects this activity causes in the physical, psychological and social aspects of these people due to their prolonged dedication to the care of patients, whose illnesses prevent them from fully looking for themselves. Objective: To describe the characteristics of the main caregivers of pediatric patients with cystic fibrosis. Methods: A cross-sectional descriptive study conducted in the second semester of 2016, with 54 main caregivers of patients under 19 years old that were attended in Centro Habana Pediatric Hospital, Juan Manuel Márquez (Marianao´s municipality Pediatric Hospital), and William Soler (Boyeros municipality´s Pediatric Hospital). Results: Caregivers are women, mostly mothers, with no employment, with a medium superior level of education, who are devoted to caring for the sick patients full-time, and this interferes with their personal and social life. Given these situations, they respond with a medium capacity for coping and adapting to situations that generate stress. Conclusions: Coping strategies used by caregivers are affected because they do not generate effective responses that allow them to adapt and respond to situations in an optimal way, so it is necessary to reinforce the resources they are using. The goal of nursing as a science and as a discipline is a very important factor in obtaining those necessary resources to improve the quality of life of children, adolescents and their caregivers(AU)

The association between fear of cancer recurrence and quality of life among Chinese cancer survivors: main effect hypothesis and buffering hypothesis.

PURPOSE: The aim of the present study is to examine whether fear of cancer recurrence (FCR) is related to health-related quality of life (HRQOL) among Chinese cancer survivors, an understudied population (i.e., main effect hypothesis). Also, we investigated whether the FCR-HRQOL link is moderated by two coping strategies, avoidance and positive reappraisal (i.e., buffering hypothesis). METHODS: This is a cross-sectional study conducted among 238 Chinese cancer survivors in Beijing. Participants completed a set of questionnaires including FCR, coping, and HRQOL. RESULTS: FCR was related to lower physical, psychological, social, and spiritual well-beings, even when demographics, cancer-related factors, and coping were taken into account. There was only one moderation effect between FCR and avoidance coping. Surprisingly, the detrimental effect of FCR on spiritual well-being was lessened among those with high avoidance coping such that the negative association between FCR and spiritual well-being was only found in those with low avoidance coping and not among those with high avoidance coping. CONCLUSIONS: Findings largely supported the main effect hypothesis. FCR was associated with diverse domains of HRQOL among Chinese cancer survivors. The buffering hypothesis was largely not supported in this population. Rather, in some cases, the effects of FCR and coping strategies on HRQOL were independent. Thus, ways to attenuate the harmful effects of FCR on HRQOL among Chinese cancer survivors remain unresolved. It is urgent and timely that future studies focus on FCR and HRQOL in this population.

Acceptance of dying: a discourse analysis of palliative care literature.

The subject of death denial in the West has been examined extensively in the sociological literature. However, there has not been a similar examination of its "opposite", the acceptance of death. In this study, I use the qualitative method of discourse analysis to examine the use of the term "acceptance" of dying in the palliative care literature from 1970 to 2001. A Medline search was performed by combining the text words "accept or acceptance" with the subject headings "terminal care or palliative care or hospice care", and restricting the search to English language articles in clinical journals discussing acceptance of death in adults. The 40 articles were coded and analysed using a critical discourse analysis method. This paper focuses on the theme of acceptance as integral to palliative care, which had subthemes of acceptance as a goal of care, personal acceptance of healthcare workers, and acceptance as a facilitator of care. For patients and families, death acceptance is a goal that they can be helped to attain; for palliative care staff, acceptance of dying is a personal quality that is a precondition for effective practice. Acceptance not only facilitates the dying process for the patient and family, but also renders care easier. The analysis investigates the intertextuality of these themes with each other and with previous texts. From a Foucauldian perspective, I suggest that the discourse on acceptance of dying represents a productive power, which disciplines patients through apparent psychological and spiritual gratification, and encourages participation in a certain way to die.

End-of-life care education for psychiatric residents: attitudes, preparedness, and conceptualizations of dignity.

OBJECTIVE: The authors examined psychiatric residents' attitudes, perceived preparedness, experiences, and needs in end-of-life care education. They also examined how residents conceptualized good end-of-life care and dignity. METHODS: The authors conducted an electronic survey of 116 psychiatric residents at the University of Toronto. The survey had a mix of qualitative and quantitative questions. RESULTS: Eighty-two of 116 invited psychiatric residents participated for a response rate of 71%. With favorable attitudes, residents felt least prepared in existential, spiritual, cultural, and some psychological aspects of caring for dying patients. Trainees conceptualized dignity at the end of life in a way very similar to that of patients, including concerns of the mind, body, soul, relationships, and autonomy. Residents desired more longitudinal, contextualized training, particularly in the psychosocial, existential, and spiritual aspects of care. CONCLUSION: This is the first study to examine the end-of-life educational experience of psychiatric residents. Despite conceptualizing quality care and the construct of dignity similarly to dying patients, psychiatric residents feel poorly prepared to deliver such care, particularly the nonphysical aspects of caring for the dying. These results will inform curriculum development in end-of-life care for psychiatric residents, a complex area now considered a core competency.

Transferências produtivas e consultas terapêuticas: afeto e intensidade na experiência psicanalítica / Productive transferences and therapeutic consultations: affection and intensity in the psychoanalytic experience

O presente trabalho procura examinar a experiência psicanalítica através das consultas terapêuticas de Winnicott, levando-se em conta sua realização em instituições públicas de saúde brasileiras e buscando uma leitura não-ortodoxa da construção do dispositivopsicanalítico. Para isto, propõe-se, em um primeiro momento, o estudo sobre a questão do afeto e da intensidade na experiência analítica a partir das teorizações iniciais sobre transferência na obra freudiana. Em seguida discute-se a contribuição ferencziana com relação à noção de tato e a intensidade própria de sua prática clínica, priorizando-se a fase final de suaobra, momento em que o foco de seu trabalho dirigia-se mais agudamente às questões referentes ao lugar do analista, aos sentimentos contratransferenciais e à elasticidade datécnica. Num terceiro momento, propõe-se um exame das idéias de Winnicott a respeito do manejo e o uso do objeto e as suas implicações na teorização sobre a transferência. Finalmente, pretende-se pensar o campo de afetação que se dá na clínica psicanalítica a partirdos conceitos de introjeção em Ferenczi, o surgimento dos sensos de eu e afetos de vitalidade na teoria de Stern e a relação de tais conceitos com alguns dos pressupostos winnicottianos, para fundamentar a possibilidade de transferências produtivas nas consultas terapêuticas.

Balancing dual roles in end-of-life research.

Ethical and practical issues are sure to arise from the majority of research studies done with palliative populations. Whether it is feeling opportunistic, being emotionally available, or struggling with witnessing a gap in service and needs of the participants receiving care, nurses involved in research find a way to balance both roles to meet the needs of the participants as well as the study (McIlfatrick, Sullivan, & McKenna, 2006). This paper highlights some of the practical and ethical issues that arise when frontline nurses also take on the role of research assistant for studies with palliative populations. Specifically, the authors highlight their personal experiences based on their research assistant work on a study examining family caregiver coping in end-of-life cancer care. The authors discuss the "balancing act" of taking on these dual roles and offer recommendations on how to be with and approach people when doing research at the end of life using a framework based on Swanson's Theory of Caring (1991).

Ethical dilemmas and moral distress in oncology nursing practice.

Although ethical values and principles guide oncology nursing practice, nurses often are challenged to fulfill every professional core duty and responsibility in their everyday practice. Nurses commonly encounter clinical situations that have ethical conflicts, and they often have difficulty recognizing and articulating them. Unresolved conflicts can cause feelings of frustration and powerlessness, which can lead to compromises in patient care, job dissatisfaction, disagreements among those in the healthcare team, and burnout. This article reviews the ethical principles and values individual nurses bring to their practice as well as those basic to the profession of nursing. This article also discusses ethical conflicts in oncology practice and describes how nurses, especially students and novice nurses, may react to such situations with moral uncertainty or distress. In addition, a process for analyzing and resolving ethical problems in clinical situations is outlined. Increasing awareness and dialogue about ethical issues is an important first step in the process. Additional resources in the clinical setting may encourage nurses to actively participate in ethical decision making and take deliberate action as moral agents.

The palliative care nurse's role in supporting the adolescent child of a dying patient.

The aim of this article was to critically evaluate the author's role as a hospital-based palliative care nurse in supporting the adolescent child of a dying parent. The approach taken and the resources that were available have been reflected upon. The article explores whether it was possible to adapt the theory of bereavement support for those working with adults within the constraints of a busy acute hospital. It was found that although there were limitations to the amount of support the author could give within her role, there remains a window of opportunity for all healthcare professionals within this field to support parents in preparing their children for bereavement.

Experience of dealing with moral responsibility as a mother with cancer.

This study explored how women with a diagnosis of cancer (lymphoma) deal with moral concerns related to their responsibility as parents. Ten women with cancer and who had children living at home were interviewed. The interviews were analysed according to the constant comparative method used in grounded theory. In order to provide a focus for the analysis, the ethics of care and the concept of mothering were used as sensitizing concepts. The core concept 'experience of dealing with moral responsibility of being a parent with cancer by redefining oneself as a mother was identified. The processes involved were: interrupted mothering; facing the life-threatening illness and children's reactions; striving to be a good mother; attempting to deal with moral responsibility; and coming to terms with being a mother.