Implementing advance care planning in palliative and end of life care: a scoping review of community nursing perspectives.

BACKGROUND: Advance care planninganning (ACP) is a priority within palliative care service provision. Nurses working in the community occupy an opportune role to engage with families and patients in ACP. Carers and family members of palliative patients often find ACP discussions difficult to initiate. However, community nurses caring for palliative patients can encourage these discussions, utilising the rapport and relationships they have already built with patients and families. Despite this potential, implementation barriers and facilitators continue to exist. To date, no research synthesis has captured the challenges community nurses face when implementing ACP, nor the facilitators of community nurse-led ACP. Considering this, the review question of: 'What factors contribute to or hinder ACP discussion for nurses when providing care to palliative patients?' was explored. METHOD: To capture challenges and facilitators, a global qualitative scoping review was undertaken in June 2023. The Arksey and O'Malley framework for scoping reviews guided the review methodology. Six databases were searched identifying 333 records: CINAHL (16), MEDLINE (45), PUBMED (195), EMBASE (30), BJOCN (15), IJOPN (32). After de-duplication and title and abstract screening, 108 records remained. These were downloaded, hand searched (adding 5 articles) and subject to a full read. 98 were rejected, leaving a selected dataset of 15 articles. Data extracted into a data extraction chart were thematically analysed. RESULTS: Three key themes were generated: 'Barriers to ACP', 'Facilitators of ACP' and 'Understanding of professional role and duty'. Key barriers were - lack of confidence, competence, role ambiguity and prognostic uncertainty. Key facilitators concerned the pertinence of the patient-practitioner relationship enabling ACP amongst nurses who had both competence and experience in ACP and/or palliative care (e.g., palliative care training). Lastly, nurses understood ACP to be part of their role, however, met challenges understanding the law surrounding this and its application processes. CONCLUSIONS: This review suggests that community nurses' experience and competence are associated with the effective implementation of ACP with palliative patients. Future research is needed to develop interventions to promote ACP uptake in community settings, enable confidence building for community nurses and support higher standards of palliative care via the implementation of ACP.

Developing a model describing voluntary residency attrition: a qualitative study.

BACKGROUND: Many factors influencing residency attrition are identified in the literature, but what role these factors play and how they influence each other remains unclear. Understanding more about the interaction between these factors can provide background to put the available evidence into perspective and provide tools to reduce attrition. The aim of this study was therefore to develop a model that describes voluntary residency attrition. METHODS: Semi-structured interviews were held with a convenient sample of orthopaedic surgery residents in the Netherlands who dropped out of training between 2000 and 2018. Transcripts were analysed using a constructivist grounded theory approach. Concepts and themes were identified by iterative constant comparison. RESULTS: Seventeen interviews with former residents were analysed and showed that reasons for voluntary attrition were different for each individual and often a result of a cumulative effect. Individual expectations and needs determine residents' experiences with the content of the profession, the professional culture and the learning climate. Personal factors like previous clinical experiences, personal circumstances and personal characteristics influence expectations and needs. Specific aspects of the residency programme contributing to attrition were type of patient care, required skills for the profession, work-life balance and interpersonal interaction. CONCLUSIONS: This study provides a model for voluntary resident attrition showing the factors involved and how they interact. This model places previous research into perspective, gives implications for practice on the (im)possibilities of preventing attrition and opens possibilities for further research into resident attrition.

Examining the role of social relationships on health and health behaviors in African American men with prostate cancer: a qualitative analysis.

PURPOSE: Cancer survivor cohort studies document the positive impact of health behaviors on cancer survivorship by influencing quality of life, comorbidity burden, and cancer recurrence. Social networks can be instrumental in supporting health behavior changes. This study used qualitative interviews to explore how social networks may impact health and health behaviors of African American Prostate Cancer Survivors (AAPCS) enrolled in Men Moving Forward (MMF), a lifestyle intervention designed with and for AAPCS. Specifically, we sought to understand how different relationships within social networks influence health and health behaviors, and to identify potential mechanisms for this influence. METHODS: Eighteen men who completed the MMF intervention participated in a semi-structured interview which explored social connections, health and health behaviors, stress, and the cancer experience. Interviews were recorded and transcribed, and thematic analysis was performed by two coders. RESULTS: Participants described robust social networks of friends and family. Four distinct yet overlapping themes were identified that described how relationships influence health and health behaviors among AAPCS: (1) provision of knowledge, (2) health and behavior history, (3) encouragement and support, and (4) shared behavior. CONCLUSIONS: These results provide initial insight into the types of relationships that influence health, and the intersecting and multifaceted mechanisms through which this influence occurs.

The protective roles of affectionate behaviors and communication on mental quality of life of couples living with fibromyalgia: movement toward a dyadic perspective.

This study assessed the impact of affectionate behaviors and communication problems on the mental quality of life (mQoL) in couples with fibromyalgia. Dyadic multilevel modeling in 204 fibromyalgia couples found that people with fibromyalgia (PwFM) who engaged in high levels of affectionate behaviors with their partner had improved mQoL. There was no significant association between affectionate behaviors and mQoL for their partners. Similarly, when PwFM and their partners had more communication problems within the couple, they had poor mQoL. Both models found that higher levels of pain interference for PwFM were significantly associated with poorer mQoL for both members of the couple. Young partners were significantly more likely to report poorer mQoL. Findings highlight the importance of the interpersonal context of fibromyalgia and the protective roles that affectionate behaviors and positive communication can play. Clinicians should include the partner in the care plan and treat the couple as one unit to better optimize the health of both members.

Sexual Health in Adolescents and Young Adults With Cancer.

Sexual health (SH), an integral aspect of overall health and quality of life, can be negatively affected by cancer and cancer treatment. SH is influenced by biological, psychological, social, and cultural factors, and, for adolescents and young adults (AYAs), developmental factors. The AYA population (age 15-39 years) is diverse in terms of psychosexual development, interpersonal relationships, and varying levels of independence, resulting in unique SH needs for this population. AYAs with cancer are particularly vulnerable to unmet SH needs related to contraception and infection prevention, sexual function, body image, and romantic/sexual relationships. Sexual dysfunction during and after cancer treatment is reported by 30%-100% of AYA cancer survivors. Clinical guidelines recommend discussing SH and screening for dysfunction but currently lack specifics regarding psychosexual interventions and strategies for incorporating screening into clinical care. Research and clinical priorities include improved provider-AYA communication regarding SH, standardization of SH measures and screening tools, infrastructure to support the SH needs of AYAs across pediatric and adult clinical environments, and engagement of sexual and gender minority AYAs in research. As the field of SH in cancer evolves, interventions need to be tailored to the developmental needs that are unique to AYAs and address the multidimensional aspects of SH.

Navigating norms and expectations: the influence of culture on Latino couples and their interpersonal communication and coping post-breast cancer diagnosis.

OBJECTIVES: Cultural norms shape expectations, care, and communication. Effective interpersonal communication is a prominent predictor of patient-partner cancer management, improving the overall quality of life for the dyad by increasing their ability to cope with cancer. However, couples-based cancer interventions often do not consider cultural factors. Additionally, although Latinas have a high incidence of breast cancer, few studies focus on Latino couples and the influence of culture in cancer care interventions. This study focuses on understanding how Latino culture's norms and expectations influence how couples communicate and cope post-breast cancer diagnosis. DESIGN: This study conducted interviews and focus groups with a purposive sample of Spanish-speaking Latina breast cancer survivors (N = 21) and intimate partners (N = 5). In the focus group and interviews, participants were asked about the influence cancer had on their relationship, with specific questions focusing on communication within the dyad. The study team used CARV: Community-Engaged Adaptation with Rapid Analysis and Visualization framework to identify cultural considerations and recurring themes. RESULTS: The cross-cutting cultural considerations and themes found were: the negative influence of gendered and social norms on managing emotions and coping; the silent struggle with physical intimacy; and the inability to discuss the topic - or even say the word 'cancer.' CONCLUSION: Understanding the role of Latino culture in how couples cope with and communicate about cancer post-diagnosis is essential. This understanding will help strengthen the dyad by assisting with positive interpersonal support, which contributes to a better quality of life. These findings will also help providers assist dyads in navigating the cancer diagnosis and journey, helping to lessen the interpersonal stress and tensions that can occur after diagnosis.

The incurable self: Negotiating social bonds and dis/connection with metastatic breast cancer.

As the culture of silence that once surrounded cancer has gradually given way to greater public awareness, normative visions of what cancer survivorship should entail have proliferated. These visions emphasise positivity and perseverance in pursuit of cure. While these visions provide comfort to many, for people with metastatic cancer, the emphasis on cure can undermine their sense of belonging to the broader collective of people living with cancer. Drawing on semi-structured interviews with 38 Australian women living with metastatic breast cancer, we explore how incurable cancer inflects understandings of self and transforms interpersonal relationships. Extending ideas around biosociality and belonging, we explore the tenuousness of social bonds, revealing how (in)visibility, (in)authenticity and (in)validation circulate within the daily lives of women with metastatic breast cancer. We conceptualise accounts according to four social bonds: (1) threatened bonds where a relationship is strained by misunderstanding, (2) severed bonds where a relationship is ruptured due to misunderstanding, (3) attuned bonds whereby a relationship is based on shared identification and (4) flexible social bonds when a relationship is based on mutual understanding. More broadly, we illustrate the persistence of normative visions of cancer survivorship and their enduring effects on those whom such visions exclude.

Couples communication and cancer: Sequences and trajectories of behavioral affective processes in relation to intimacy.

Cancer poses a set of physical and emotional challenges to the patient, spouse, and their relationship. One challenge for couples is discussing cancer-related concerns in a manner that facilitates intimacy. Current couple-based interventions have been shown to have mixed efficacy, and little is known about how they bring about improvements. This study aims to expand our understanding of dyadic communication and intimacy to adapt and/or develop more effective interventions for couples coping with cancer. To accomplish this goal, the present study examined affective and behavioral processes associated with intimacy using the valence-affective-connection (VAC) framework and observational coding methods. Participants were 134 couples in which a patient was diagnosed with breast, colorectal, or lung cancer. Couples completed a battery of questionnaires, including a self-report measure of intimacy. Couples also completed a 15-min videotaped interaction about a cancer topic of their choosing, which was observationally coded for communication behavior and affective expression. Couples coping with cancer who reported higher versus lower intimacy engaged in qualitatively different levels, types, and patterns of communication behavior and affective expression. Specifically, couples who reported lower relationship intimacy used negative approach behavior and hard negative affect more frequently and for longer periods of time and were more likely to use avoidance-based communication. Higher intimacy couples were less likely to sustain the use of negative behavior and affect and displayed more reciprocity of positive joining affect. The study highlights important considerations for couple-based interventions and research in the context of cancer. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Joint action with human and robotic co-actors: Self-other integration is immune to the perceived humanness of the interacting partner.

When performing a joint action task, we automatically represent the action and/or task constraints of the co-actor with whom we are interacting. Current models suggest that, not only physical similarity, but also abstract, conceptual features shared between self and the interacting partner play a key role in the emergence of joint action effects. Across two experiments, we investigated the influence of the perceived humanness of a robotic agent on the extent to which we integrate the action of that agent into our own action/task representation, as indexed by the Joint Simon Effect (JSE). The presence (vs. absence) of a prior verbal interaction was used to manipulate robot's perceived humanness. In Experiment 1, using a within-participant design, we had participants perform the joint Go/No-go Simon task with two different robots. Before performing the joint task, one robot engaged in a verbal interaction with the participant and the other robot did not. In Experiment 2, we employed a between-participants design to contrast these two robot conditions as well as a human partner condition. In both experiments, a significant Simon effect emerged during joint action and its amplitude was not modulated by the humanness of the interacting partner. Experiment 2 further showed that the JSE obtained in robot conditions did not differ from that measured in the human partner condition. These findings contradict current theories of joint action mechanisms according to which perceived self-other similarity is a crucial determinant of self-other integration in shared task settings.

Coabitação durante a pandemia de covid-19: a experiência de casais jovens adultos / Cohabitation during the COVID-19 pandemic: the experience of young adult couples / La cohabitación en el transcurso de la pandemia del covid-19: la experiencia de parejas jóvenes adultas / Cohabitation pendant la pandemie de COVID-19: l'expérience de jeunes couples adultes

Resumo Este estudo qualitativo visou compreender a experiência de oito casais de adultos jovens em coabitação durante a pandemia de covid-19 e as repercussões do período na vida conjugal. Foram realizadas entrevistas semiestruturadas, seis presenciais e duas online, com casais heterossexuais, sem filhos, que coabitavam há menos de três anos. A análise temática reflexiva gerou três temas: desafios e dificuldades na pandemia; aproximação entre o casal; ganhos e aprendizados. Níveis aumentados de estresse, insegurança e ansiedade, sensação de sobrecarga e de privação devido às medidas de distanciamento social, dificuldades na delimitação dos espaços individuais dentro de casa e aumento nos conflitos conjugais foram os principais desafios relatados. Apesar disso, o enfrentamento colaborativo resultou em maior intimidade e no fortalecimento do vínculo conjugal, aumentando o compromisso com a relação. Tais resultados ilustram como um contexto pandêmico pode impactar relacionamentos durante o início da coabitação.

Abstract This qualitative study investigated the cohabitation experience of eight young adult couples during in the pandemic and its repercussions on marital life. Semi structured interviews were conducted, six in-person and two online, with childfree heterosexual couples living together for less than three years. The reflexive thematic analysis generated three themes: pandemic-related challenges and difficulties, couple bonding, gains and learnings. Increased levels of stress, insecurity and anxiety, a sense of of overload and deprivation due to social distancing measures, difficulties in delimiting individual spaces within the home and an increase in marital conflicts were the main challenges reported. Conversely, the ability to collaboratively cope with these challenges resulted in more intimacy and strengthened the marital bond, generating greater couple commitment. These findings illustrate how pandemics can impact relationships during the beginning of cohabitation.

Resumen Este estudio cualitativo tuvo como objetivo comprender las experiencias de ocho parejas de adultos jóvenes en cohabitación en el transcurso de la pandemia del covid-19 y sus repercusiones en la vida conyugal. Se realizaron entrevistas semiestructuradas, seis presenciales y dos en línea, con parejas heterosexuales, sin hijos, que vivían en cohabitación hace menos de tres años. El análisis temático reflexivo generó tres temas: desafíos y dificultades en la pandemia, acercamiento entre la pareja, conquistas y aprendizajes. El aumento de los niveles de estrés, inseguridad y ansiedad, los sentimientos de sobrecarga y privación por las medidas de distanciamiento social, las dificultades para delimitar los espacios individuales dentro del hogar y el aumento de los conflictos conyugales fueron los principales desafíos informados. Además, afrontar estos desafíos de forma colaborativa redundó en mayor intimidad y en el fortalecimiento del vínculo conyugal, repercutiendo en el aumento del compromiso con la relación. Estos resultados muestran cómo el contexto pandémico puede impactar el comienzo de la convivencia de las relaciones de pareja.

Résumé Cette étude qualitative a examiné l'expérience de cohabitation de huit jeunes couples adultes pendant la pandémie et ses répercussions sur la vie conjugale. Des entretiens semi-directifs ont été réalisés, six face-à-face et deux en ligne, auprès de couples hétérosexuels sans enfants vivant ensemble depuis moins de trois ans. L'analyse thématique réflexive a dégagé trois thèmes: les défis et difficultés liés à la pandémie, le lien du couple, les acquis et les enseignements. Des niveaux accrus de stress, d'insécurité et d'anxiété, des sentiments de surcharge et de privation dus aux mesures de distanciation sociale, des difficultés à délimiter les espaces individuels chez eux et une augmentation des conflits conjugaux sont les principaux défis signalés. Cependant, la capacité à faire face ensemble à ces défis a permis d'accroître l'intimité et de renforcer le lien conjugal, générant ainsi un plus grand engagement du couple. Ces résultats illustrent l'impact que les pandémies peuvent avoir sur les relations au début de la cohabitation.

Parents' hope in perinatal and neonatal palliative care: a scoping review.

BACKGROUND: The diagnosis of a life-limiting condition of a child in the perinatal or neonatal period is a threat to parental hopes. Hope is an interactional and multidimensional construct, and in palliative care, it is a determinant of quality of life, survival, acceptance and peaceful death. OBJECTIVE: To map scientific evidence on parents' hope in perinatal and neonatal palliative care contexts. METHOD: a scoping review theoretically grounded on Dufault and Martocchio's Framework, following the Joanna Briggs Institute methodological recommendations. Searches were performed until May 2023 in the MEDLINE, CINAHL and PsycINFO databases. The searches returned 1341 studies. RESULTS: Eligible papers included 27 studies, most of which were carried out in the United States under a phenomenological or literature review approach. The centrality of women's perspectives in the context of pregnancy and perinatal palliative care was identified. The parental hope experience is articulated in dealing with the uncertainty of information and diagnosis, an approach to which interaction with health professionals is a determinant and potentially distressful element. Hope was identified as one of the determinants of coping and, consequently, linked to autonomy and parenthood. Cognitive and affiliative dimensions were the hope dimensions that predominated in the results, which corresponded to the parents' ability to formulate realistic goals and meaningful interpersonal relationships, respectively. CONCLUSION: Hope is a force capable of guiding parents along the path of uncertainties experienced through the diagnosis of a condition that compromises their child's life. Health professionals can manage the family's hope by establishing sensitive therapeutic relationships that focus on the dimension of hope. The need for advanced research and intervention in parental and family hope are some of the points made in this study. PROTOCOL REGISTRATION: https://osf.io/u9xr5/ .

United we thrive: friendship and subsequent physical, behavioural and psychosocial health in older adults (an outcome-wide longitudinal approach).

AIMS: Three factors converge to underscore the heightened importance of evaluating the potential health/well-being effects of friendships in older adulthood. First, policymakers, scientists, and the public alike are recognizing the importance of social relationships for health/well-being and creating national policies to promote social connection. Second, many populations are rapidly aging throughout the world. Third, we currently face what some call a 'friendship recession'. Although, growing research documents associations between friendship with better health and well-being, friendship can also have a 'dark side' and can potentially promote negative outcomes. To better capture friendship's potential heterogeneous effects, we took an outcome-wide analytic approach. METHODS: We analysed data from 12,998 participants in the Health and Retirement Study (HRS) - a prospective and nationally representative cohort of U.S. adults aged >50, and, evaluated if increases in friendship strength (between t0; 2006/2008 and t1; 2010/2012) were associated with better health/well-being across 35 outcomes (in t2; 2014/2016). To assess friendship strength, we leveraged all available friendship items in HRS and created a composite 'friendship score' that assessed the following three domains: (1) friendship network size, (2) friendship network contact frequency and (3) friendship network quality. RESULTS: Stronger friendships were associated with better outcomes on some indicators of physical health (e.g. reduced risk of mortality), health behaviours (e.g. increased physical activity) and nearly all psychosocial indicators (e.g. higher positive affect and mastery, as well as lower negative affect and risk of depression). Friendship was also associated with increased likelihood of smoking and heavy drinking (although the latter association with heavy drinking did not reach conventional levels of statistical significance). CONCLUSIONS: Our findings indicate that stronger friendships can have a dual impact on health and well-being. While stronger friendships appear to mainly promote a range of health and well-being outcomes, stronger friendships might also promote negative outcomes. Additional research is needed, and any future friendship interventions and policies that aim to enhance outcomes should focus on how to amplify positive outcomes while mitigating harmful ones.

Young children's perspectives on treatment and care: A qualitative study using narrative and play-based interviewing.

PURPOSE: To explore young children's (age 3-6 years) own experiences and perceptions of treatment and care when living with a chronic illness. DESIGN AND METHODS: The study employed a qualitative research design using a narrative and play-based interview approach. Individual face-to-face, narrative and play-based interviews were conducted with eight young children age 3-6 years with type 1 diabetes or cystic fibrosis. The play sessions took place at the home of the children and were video recorded. Interpretative phenomenological analysis was used to analyse the data and frame the study. RESULTS: Our analysis identified six main themes: 1. Children understood illness through their bodily experience of treatment and care, 2. Children's experience of care and treatment ranged from a feeling of powerlessness to a sense of agency, 3. Children depended on their parents to provide comfort, advocacy and protection, 4. Children's perceptions of treatment and care were inherently related to their experiences of familiarity, interpersonal relationships and trust, 5. Children with type 1 diabetes did not perceive that they played an active role during consultations, and 6. Children associated medical treatment with receiving tangible rewards or positive feedback. CONCLUSION: Children expressed a need to feel safe and build agency. They experienced this through participation and interpersonal relationships with healthcare professionals. PRACTICE IMPLICATIONS: We should prioritize the establishment and implementation of age-appropriate psychosocial care practices that support young children in participating, forming relationships, and building trust.

Predicting Self-Reported Depression and Health Among Adolescents: Time Spent Online Mediated by Digital Skills and Digital Activities.

Although young people spend increasing amounts of time online, many gaps remain in the literature regarding the effect of time spent online on young people's development of well-being. We focus on the influence of time spent online on feelings of self-reported (a) depression and (b) health of adolescents. We also consider the mediating role of digital skills and digital activities, each of which is broken down into five dimensions. We collected data through a two-wave longitudinal online survey among 3,942 adolescents aged 12-17 years in six European countries (first wave [W1] = 2021; second wave [W2] = 2022). We specifically want to understand how feelings of self-reported depression and health at W2 are affected by the time spent online at W1, and how digital skills and digital activities at W2 mediate these relationships. Findings indicate a significant increase in feelings of depression and a decrease in self-reported health between W1 and W2. Regarding digital skills, information navigation and communication and interaction were linked to greater well-being (lower depression and greater self-reported health). Regarding digital activities, the development of social relationships online was linked to lower self-reported depression and greater health, while frequently using the Internet to look up information on physical or mental health issues was strongly linked to greater depression and lower health. We discuss the implications of these findings for practice and policy on young people's well-being.

A propósito dos dilemas da comunicação / About the communication dilemmas / À propos des dilemmes de la communication

Les règles que nous appliquons et les normes auxquelles nous obéissons dans les activités communicatives sont tellement intériorisées qu'elles sont pratiquement imperceptibles. Adriano Duarte Rodrigues, au cours des trois dernières décades, a cherché les conditions du déchainement de l'activité communicative en tant que processus interactionnel situé. Dans cette critique, je souligne la question centrale présentée dans A natureza da atividade comunicativa (La nature de l'activité communicative), son dernier livre: l'observation du comportement des personnes dans les interactions auxquelles elles participent comme point de départ pour comprendre la communication. Cette attitude émique, fondée sur l'approche ethnométhodologique, cherche à découvrir les méthodes de sens commun utilisées par les individus dans leurs productions et in-terprétations au cours de leurs interactions. Le grand dilemme des études de communication découle, selon l'auteur, de la naturalisation de dispositifs qui ont été internalisés au cours du processus de socialisation et qui échappent à notre perception lorsque nous nous impliquons dans des interactions reglées sur eux.

As regras que aplicamos e as normas a que obedecemos nas atividades comunicativas estão de tal modo in-teriorizadas que são praticamente imperceptíveis. Adriano Duarte Rodrigues tem dedicado as últimas três décadas a tentar equacionar as condições que desencadeiam a atividade comunicativa enquanto processo interacional situado. Nesta resenha, destaco a questão central apresentada em A natureza da atividade comunicativa, seu mais recente livro: a observação dos comportamentos das pessoas nas interações das quais participam como ponto de partida para a compreensão da comunicação. Esta atitude êmica, funda-mentada na abordagem etnometodológica, procura descobrir os métodos do senso comum, usados pelos indivíduos nas produções e interpretações no decurso das suas interações. O grande dilema dos estudos da comunicação decorre, segundo o autor, da naturalização de dispositivos interiorizados ao longo do processo de socialização e que escapam à nossa percepção quando estamos envolvidos nas interações reguladas por eles

The rules we apply and the norms we obey in communicative activities are so internalized that they are practically imperceptible. Adriano Duarte Rodrigues has dedicated the last three decades to trying to equate the conditions that trigger communicative activity as a situated interactional process. In this review, I highlight the central question presented in A natureza da atividade comunicativa (The nature of commu-nicative activity), his most recent book: the observation of people's behavior in the interactions in which they participate as a starting point for understanding communication. This emic attitude, based on the ethnomethodological approach, seeks to discover the commonsense methods employed by individuals in their productions and interpretations in the course of their interactions. The great dilemma of the commu-nication studies stems, according to the author, from the naturalization of devices internalized throughout the socialization process, devices that escape our perception when we are involved in interactions regulated by them

Relações de amizade nos transtornos alimentares: revisão integrativa da literatura / Friendship relationships in eating disorders: an integrative literature review / Relaciones de amistad en los trastornos alimentarios: revisión integradora

Ainda é desconhecido o papel da amizade enquanto constitutiva da rede de apoio social nos transtornos alimentares (TAs). Esta revisão integrativa teve por objetivo analisar a produção científica sobre relações de amizade em pessoas com TAs. Foram consultadas as bases PubMed/MEDLINE, LILACS, PsycINFO, Web of Science e EMBASE, de 2010 a 2020. Dos 1126 artigos recuperados, 15 preencheram os critérios de elegibilidade. A maioria tem abordagem qualitativa e delineamento transversal, sem indicar referencial teórico. Aspectos qualitativos das relações de amizade foram associados com redução da frequência e intensidade de sintomas quando o vínculo era considerado de boa qualidade. Já amizades que envolviam comentários depreciativos e influências negativas acerca do corpo e hábitos alimentares foram considerados fatores de risco para desencadeamento dos transtornos. Investir na qualidade dos relacionamentos entre pares pode contribuir para fortalecer a rede de proteção social e reduzir a vulnerabilidade psicossocial de adolescentes com risco para desenvolver TAs. (AU)

There is still little knowledge about the role of friendship within the social support network in eating disorders (EDs). This integrative review aimed to analyze the scientific production about friendship relationships in people with EDs. The literature review was conducted using the PubMed/MEDLINE, LILACS, PsycINFO, Web of Science, and EMBASE databases in the period from 2010 to 2020. Among the 1126 articles retrieved, 15 met the eligibility criteria, most with a qualitative approach and cross-sectional design, without indicating a theoretical framework. The qualitative aspects of friendship were associated with a reduced frequency and intensity of symptoms when the bond was considered to be of good quality. On the other hand, friendships that involved derogatory comments and negative influences related to body image and eating habits emerged as potential risk factors for triggering disorders. Investing in the quality of peer relationships can contribute to strengthening the social safety net and reducing the psychosocial vulnerability of adolescents at higher risk for developing EDs. (AU)

El papel de la amistad como constitutiva de la red de apoyo social en los trastornos alimentarios (TAs) es aún desconocido. Este estudio tiene como objetivo analizar la producción científica sobre las relaciones de amistad en personas con TAs. Se consultaron las bases PubMed/MEDLINE, LILACS, PsycINFO, Web of Science e EMBASE, entre 2010 y 2020. De los 1126 artículos recuperados, 15 cumplían los criterios de elegibilidad. La mayoría tiene enfoque cualitativo y diseño transversal, sin indicar el marco teórico. Los aspectos cualitativos de las relaciones de amistad se asociaron con una menor frecuencia/intensidad de los síntomas cuando el vínculo se consideraba de buena calidad. Amistades que implicaban comentarios despectivos e influencias negativas sobre el cuerpo y los hábitos alimentarios se consideraron factores de riesgo. Invertir en la calidad de las relaciones entre pares puede contribuir a reforzar la red de protección social y reducir la vulnerabilidad de adolescentes con riesgo de desarrollar TAs. (AU)

Making meaning of everyday life in the context of lung cancer treatment-a qualitative study of outpatients' perspectives.

BACKGROUND: The increasing survival after a lung cancer diagnosis implies that patients live longer with the disease, which means that symptoms and side effects of the treatment become part of everyday life. AIM: The study explored how older adults make meaning of everyday life when undergoing treatment for their lung cancer. MATERIAL AND METHODS: A qualitative study using semi-structured interviews was conducted with 12 older adults with lung cancer undergoing various treatments. The analysis followed Giorgi's phenomenologic five-step method. RESULTS: The analysis revealed three partly overlapping themes: meeting the health care system, losing identity, and struggling for meaning in everyday life. The patients appreciate clear and coherent communication at the oncology clinic. They had different needs for support from organised support groups, friends, communities, or relatives to make meaning of everyday life. CONCLUSION: Creating meaning in everyday life is essential despite the disease and the treatments' side effects. Interpersonal relationships create meaningfulness in everyday life through a salutogenic perspective that makes everyday life comprehensible and manageable. SIGNIFICANCE: The patients need an everyday life perspective on the disease and the side effects, which a salutogenic approach in the encounter with the health care system could support.

Examination of proinflammatory activity as a moderator of the relation between momentary interpersonal stress and suicidal ideation.

INTRODUCTION: Peer-related interpersonal stress can increase risk for suicidal thoughts among adolescents and young adults. However, not all individuals who undergo peer-related interpersonal stressors experience suicidal thoughts. Heightened proinflammatory activity is one factor that may amplify the relation between interpersonal stress and suicidal thinking. METHODS: This pilot study examined the relation between interpersonal stress and suicidal ideation in real time, as well as whether proinflammatory cytokine (IL-6 and TNF-α) activity across a laboratory social stressor moderated this association in a sample of 42 emerging adults with recent suicidal ideation. Participants completed 28 days of 6×/daily ecological momentary assessment that assessed for suicidal ideation (presence vs. absence, ideation intensity), occurrence of negative peer events, and feelings of exclusion. RESULTS: There was a trend for within-person increases in feelings of exclusion to be associated with increases in concurrent suicidal ideation intensity. Additionally, within-person increases in negative peer events were associated with increased odds of subsequent suicidal ideation among individuals with very low IL-6 activity. However, this finding is considered preliminary. CONCLUSION: Interventions targeting perceptions of exclusion and increasing social support may be of benefit. However, findings require replication in larger samples, and thus must be interpreted with caution.

The association between communication behavior and psychological distress among couples coping with cancer: Actor-partner effects of disclosure and concealment.

OBJECTIVE: This study applies the Actor-Partner Interdependence Model (APIM) to explore the associations between disclosure and concealment with depression and anxiety among patients with cancer and their partners. METHOD: 90 patient-spouse dyads completed the Self-Disclosure Index (SDI), the Self-Concealment Scale (SCS), the Couples Illness Self-Concealment (CISC) questionnaire, and anxiety and depression via the Patient-Reported Outcomes Measurement Information System (PROMIS) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: Significant actor effects were found for most variables, showing disclosure is negatively and concealment is positively associated with depression and anxiety (ß between |0.29| to |0.65|, p ≤ .029). Partner's effect showed a negative association between patients' self-disclosure and their spouses' depression (ß = -0.35, p = .043). Patients' anxiety was negatively associated with similarity in all communication variables (ß between -0.21 to -0.22, p = .042). CONCLUSIONS: Dyadic communication is an important correlate of distress among couples coping with cancer. Specifically, concealment behaviors have a positive association with distress, whereas disclosure is related to lower levels of anxiety and depression among both partners. In addition, whereas patients are affected more strongly than their spouses by the dyadic similarity, spouses seem to be more attuned to their partners' behaviors and therefore potentially more related to patients' propensity for sharing.