Emotional distress and self-care during the COVID-19 pandemic in women from an indigenous migrant cultural collective in Mexico City / Malestares emocionales y su autoatención durante la pandemia de COVID-19 en mujeres de un colectivo cultural indígena migrante residente en la Ciudad de México

Abstract Introduction During the coronavirus (SARS-Cov-2) pandemic, restrictive measures were implemented to reduce contagion. However, severely decreasing social interaction also negatively impacted the economy, particularly that of indigenous groups. Objective This article seeks to understand the emotional distress identified by a group of indigenous women residents, as well as their self-care practices, during the COVID-19 pandemic in Mexico City. Method A digital qualitative study was undertaken since the fieldwork was conducted in person and online, using various Internet platforms, which served as a field scenario, data collection tool and a means of continuous connection with subjects. Results Anecdotal records were obtained from the subjects, who identified categorizations in the collective organization of the indigenous group, which became a support network for mobilizing official material resources. Information was also obtained on the way the women engaged in the self-care of their emotional distress in a range of ways with a sense of immediacy, through physical, spiritual, herbal, and psychological resources. They observed how women managed to cope with their situation and continue caring for and supporting their families to enable them to get by, distinguishing between those who were providers and those who were dependent on another provider. Discussion and conclusion The pandemic, together with social restrictions, created stressful situations, causing various emotional problems among the indigenous collective. Nevertheless, their capacity for self-management and self-care enabled them to cope with these conditions in the midst of structural contexts of violence, poverty, and social exclusion.

Resumen Introducción Durante la pandemia del nuevo coronavirus (SARS-Cov-2) se instauraron diferentes medidas restrictivas con la finalidad de disminuir los contagios. Sin embargo, al reducir severamente las interacciones sociales también se produjo un impacto negativo en la economía, especialmente en los grupos indígenas. Objetivo Este artículo busca conocer los malestares emocionales identificados por un colectivo de mujeres indígenas residentes, así como sus prácticas de auto-atención, durante la pandemia por COVID-19 en la CDMX. Método Se desarrolló una investigación cualitativa digital ya que el trabajo de campo fue presencial y en línea, así como en diferentes plataformas de la red de internet, las cuales fungieron como escenario de campo, herramienta de recopilación de datos y un dispositivo de conexión constante con los informantes Resultados Se obtuvieron registros anecdóticos de las participantes, que identificaron: categorizaciones en la organización colectiva del grupo indígena, convirtiéndose en red de apoyo que movilizó recursos materiales oficiales; cómo las mujeres practicaron la auto-atención de sus malestares emocionales de manera variada y con un sentido de inmediatez, mediante recursos físicos, espirituales, herbolarios, psicológicos y el saber aguantarse para sobrellevar su situación, y continuar cuidando y apoyando a sus familias a salir adelante, diferenciando entre mujeres proveedoras y las dependientes de otro proveedor. Discusión y conclusión La pandemia junto con las restricciones sociales, generaron situaciones estresantes, desencadenando diversas problemáticas emocionales en el colectivo indígena, pero su capacidad de autogestión y autocuidado les permitió sobrellevar tales condiciones en medio de contextos estructurales de violencia, pobreza y exclusión social.

Perceived academic stress in Mexican medical students. The role of sex emotional distress, burnout, academic-social support, current abuse experiences, and coping strategies / Percepción del estrés académico en estudiantes de medicina mexicanos. El papel del sexo, distrés emocional, burnout, apoyo académico-social, experiencias actual es de abuso y estrategias de afrontamiento

Abstract Introduction Academic stress is a common problem among medical students that has a negative physiological, social, and learning impact. Perceived academic stress indicates how stressed a student is about academic issues over a given period of time and the ability to handle that stress. Objective To determine the prevalence of PAS and evaluate possible risk factors, focusing on sex differences, burnout, emotional distress, academic-social support, and coping strategies. Method A cross-sectional, retrospective, and comparative study was conducted through an online survey with medical students (MS) willing to participate anonymously. Results All students reported PAS and the majority to a moderate-severe degree. Comparing the presence of abuse within the academic environment between men and women, we found differences in the frequency of reporting emotional abuse and sexual. Also, we found differences in perceived academic social support from teachers and family members. Multiple logistic regression analysis showed sex and current sexual abuse inside school had the strongest association with PAS in MS, followed by a family history of depression and perceived less academic social support from family. Discussion and conclusion Timely identification of individuals at-risk will be critical to establish preventive strategies to limit the impact of PAS in MS, stress management programs, training coping skills, and offer prompt therapeutic alternatives when needed.

Resumen Introducción El estrés académico es un problema común entre los estudiantes de medicina que tiene un impacto negativo a nivel fisiológico, social y de aprendizaje. El estrés académico percibido (PAS) indica lo estresado que está un estudiante por cuestiones académicas durante un periodo de tiempo determinado y la capacidad para manejar ese estrés. Objetivo Determinar la prevalencia del PAS y evaluar los posibles factores de riesgo, centrándose en las diferencias por sexo, burnout, el malestar emocional, el apoyo académico-social y las estrategias de afrontamiento. Método Se realizó un estudio transversal, retrospectivo y comparativo a través de una encuesta en línea con estudiantes de medicina dispuestos a participar de forma anónima. Resultados Todos los estudiantes reportaron PAS y la mayoría en un grado moderado-severo. Comparando la presencia de maltrato dentro del ámbito académico entre hombres y mujeres, encontramos diferencias en la frecuencia de denuncia de maltrato emocional y sexual. Asimismo, encontramos diferencias en el apoyo social académico percibido por parte de docentes y familiares. El análisis de regresión logística múltiple mostró que el sexo y el abuso sexual actual dentro de la escuela tenían la asociación más fuerte con PAS, seguidos por antecedentes familiares de depresión y menos apoyo social académico percibido por parte de la familia. Discusión y conclusión La identificación oportuna de las personas en riesgo será fundamental para establecer estrategias preventivas para limitar el impacto de PAS, programas de manejo del estrés, capacitación en habilidades de afrontamiento y ofrecer alternativas terapéuticas rápidas cuando sea necesario.

Análise de validação e confiabilidade do Questionário Emocional da Vertigem-CIEV em versão traduzida para o Português-Brasileiro / Validation and reliability analysis of the Questionnaire on the Emotional Impact of Vertigo-CIEV version translated to the Brazilian Portuguese language

RESUMO Objetivo Determinar a consistência interna e confiabilidade do "Questionário de Impacto Emocional da Vertigem-CIEV" e validar o instrumento em relação ao Dizziness Handicap Inventory (DHI), em uma amostra de pacientes com distúrbio do equilíbrio corporal. Método Participaram 38 sujeitos, idades entre 23 e 85 anos, ambos os sexos, com queixas relacionadas à tontura, desequilíbrios e/ou quedas, atendidos em um ambulatório de Otoneurologia do Hospital Universitário. Foram excluídos sujeitos com queixas auditivas e/ou zumbido sem tontura associada, comorbidades psiquiátricas prévias e/ou comprometimento cognitivo que impedisse a compreensão dos questionários. Foi realizada anamnese, levantamento de prontuário para caracterização da amostra e aplicados os questionários de autopercepção, DHI e CIEV. O alfa de Cronbach verificou a consistência interna do CIEV e a confiabilidade e validade do CIEV em relação ao DHI foram calculadas pelo Índice de Correlação intraclasse (ICC) e teste de Correlação de Pearson, respectivamente. Resultados Houve correlação estatisticamente significante entre os escores obtidos, tanto à análise de confiabilidade quanto de validação (p<0,001). O ICC médio demonstrou moderada correlação para o escore total (0,695) e forte correlação com os domínios físico, emocional e funcional do DHI (0,706 a 0,869) sendo o maior grau para o domínio emocional (0,869). A Correlação de Pearson demonstrou grau forte para o escore total (r=0,820) e variação de moderado a forte para os domínios, com melhor resultado também para o domínio emocional do DHI (r=0,788). Conclusão Os achados representam parâmetros importantes de contribuição para a validação do CIEV para uso clínico na população brasileira, direcionado para a identificação de aspectos emocionais em pacientes com distúrbios do equilíbrio corporal.

ABSTRACT Purpose To determine the internal consistency and reliability of the "Questionário de Impacto Emocional da Vertigem (CIEV)" and to validate the instrument with respect to the Dizziness Handicap Inventory (DHI) in a sample of individuals with balance disorders. Methods 38 subjects participated in the study, males and females, aged from 23 to 85 years, who presented dizziness, vertigo, and/or falls complaints and attended to the Vestibular Disorders clinic at the University Hospital. Individuals with hearing complaints and/or tinnitus unrelated to dizziness, previous psychiatric comorbidities, and/or cognitive impairments were excluded. We performed an anamnesis and collected complementary data from the medical records. After that, the self-perception questionnaires, DHI, and CIEV, were applied. Statistical analysis was performed in which the Cronbach's alpha verified the internal consistency of the CIEV. Reliability and validity of the CIEV related to the DHI were calculated using Intraclass Correlation Index (ICC) and Pearson's correlation test, respectively. Results There was a statistically significant correlation between the scores obtained, for both reliability and validation analysis (p<0.001). The mean ICC showed a moderate correlation between the total scores (0.695) and a strong correlation with the physical, emotional, and functional DHI domains (0.706 to 0.869), being the emotional aspect the highest degree (0.869). Pearson's correlation showed strong correlation between the total scores (r=0.820) and varied from moderate to strong, with strongest correlations to the DHI emotional domain (r=0.788). Conclusion The outcomes illustrate important contribution to validation parameters to consider clinical use of the CIEV in the Brazilian population, aiming to identify emotional aspects in patients with balance disorders.

"Renaciendo": Intervención Narrativa para la Mejora de la Satisfacción Personal y Laboral de Personal de Enfermeras / "Reborn": Narrative Intervention Program to Improve Nurses' Personal and Work Satisfaction

Resumen En la actualidad el sistema de salud se ve afectado por cargas excesivas de trabajo que conllevan el desarrollo de estrés y ansiedad durante la actividad laboral en sus trabajadores. En distintos hospitales de México la prevalencia del estrés laboral va del 22 a 63%, encabezando la lista médicos residentes y enfermeras. Con el objetivo de probar la efectividad del programa "Renaciendo" basado en Terapia Narrativa para la mejora de la satisfacción personal y laboral de enfermeras, se realizó una investigación cuasiexperimental, preprueba-posprueba, teórico-práctica con temporalidad transversal. Se trabajó con grupos intactos, uno de enfermeras profesionales y otro de estudiantes de enfermería realizando su estancia profesional en hospitales. Los resultados confirman la efectividad del programa para la mejora de la eficacia personal y la reducción de síntomas de agotamiento, depresión, ansiedad y estrés. Con puntuaciones más altas en todas las variables, las enfermeras profesionales tuvieron una reducción significativa solamente en estrés y ansiedad, en tanto que las estudiantes de enfermería disminuyeron significativamente el estrés y la depresión y aumentaron su eficacia personal. Programas de intervención sistémico-narrativos son necesarios ya que permiten mejorar la eficacia personal, así como prevenir y disminuir el agotamiento laboral y los estados emocionales displacenteros asociados que afectan personal de enfermería. Las limitaciones de tiempo y alcance son temas prioritarios en el desarrollo de este tipo de intervenciones.

Abstract Currently the health system is affected by excessive workloads, this encourages the development of stress and anxiety during work activity in its workers. In different hospitals in Mexico the prevalence of work stress ranges from 22 to 63%, leading the list of resident doctors and nurses. With the objective to prove the efficacy of the intervention program "Reborn" based on Narrative Therapy for the improvement of personal and job satisfaction of nurses, a quasi-experimental research was conducted, with pre and post-test, theoretical-practical nature with transverse temporality. We worked with intact groups, one group of professional nurses and the other of nursing students completing their professional internship in hospitals. The results confirm the effectiveness of the program for the improvement of personal efficacy and the reduction of symptoms of emotional exhaustion, depression, anxiety and stress. The highest scores initially shown in professional nurses, exposed a significant reduction in stress and anxiety, while nursing students significantly reduced stress and depression and increased personal efficacy. Systemic-narrative intervention programs are necessary since they allow improving personal efficacy as well as preventing and reducing job exhaustion and the associated unpleasant emotional states that affect nursing staff. Time and scope limitations are priority issues in the development of this type of interventions.

Programas de suporte às segundas vítimas e seus impactos: revisão integrativa / Programas de apoyo a segundas víctimas y sus impactos: revisión integradora / Second victim support programs and their impacts: integrative review

OBJETIVO: identificar e avaliar evidências científicas disponíveis na literatura sobre os programas de acolhimento e seus impactos em profissionais de saúde na condição de segunda vítima. MÉTODO: trata-se de uma revisão integrativa baseada na estratégia PICO, realizada com 8 artigos gerados através das bases de dados PubMed, Embase, Cochrane Library, LILACS, CINAHL e PsycINFO entre janeiro e junho de 2021. RESULTADOS: observando-se a existência de um suporte formal de acolhimento, as publicações abordam gestores de risco e segurança, profissionais acolhidos por programas de suporte, profissionais de assistência direta ao paciente e que poderiam ou não estar na condição de segunda vítima e seus impactos. CONCLUSÃO: apesar da presença de estudos que evidenciam a efetividade de alguns programas de suporte às segundas vítimas, ainda há uma lacuna acerca do tipo adequado de atendimento oferecido e os impactos dessas intervenções.(AU)

OBJECTIVE: Identify and evaluate scientific evidence available in the literature about programs and their impacts on health professionals in the condition of the second victim. METHOD: is an integrative review based on the PICO strategy, carried out with 8 articles generated through the PubMed, Embase, Cochrane Library, LILACS, CINAHL and PsycINFO databases between January and June 2021. RESULTS: observing the existence of formal reception support, the publications address risk and safety managers, professionals assisted by support programs, direct patient care professionals and who may or may not be in the condition of a second victim and their impacts. CONCLUSION: despite the presence of studies that show the effectiveness of some support programs for second victims, there is still a gap regarding the appropriate type of care offered and the impacts of these interventions.(AU)

OBJETIVO: Identificar y evaluar la evidencia científica disponible en la literatura sobre los programas y sus impactos en los profesionales de la salud en la condición de segunda víctima. MÉTODO: es una revisión integradora basada en la estrategia PICO, realizada con 8 artículos generados a través de las bases de datos PubMed, Embase, Cochrane Library, LILACS, CINAHL y PsycINFO entre enero y junio de 2021. RESULTADOS: al observar la existencia de apoyo formal de recepción, el las publicaciones se dirigen a gestores de riesgos y seguridad, profesionales asistidos por programas de apoyo, profesionales de atención directa al paciente y que pueden o no estar en condición de segunda víctima y sus impactos. CONCLUSIÓN: a pesar de la presencia de estudios que muestran la efectividad de algunos programas de apoyo a las segundas víctimas, aún existe una brecha en cuanto al tipo de atención adecuada ofrecida y los impactos de estas intervenciones.(AU)

Investigation on the current situation and influencing factors of mood disorders in patients with thoracic and lumbar osteoporotic fractures / 中国实用护理杂志

Objective:To understand the current situation of mood disorders in patients with thoracic and lumbar osteoporotic fractures and to preliminarily explore its influencing factors.Methods:A cross-sectional survey method was used to select 212 patients with thoracic and lumbar osteoporotic fractures from Department of Orthopedics, West China Hospital, Sichuan University, from January 2018 to September 2020 as the research subjects. The general information questionnaire, Huaxi Emotional-distress Index, Pittsburgh Sleep Quality Index (PSQI) and pain Visual Analogue Scale (VAS) were used to investigate them.Results:The incidence of mood disorders in patients with thoracic and lumbar osteoporotic fractures was 10.38% (22/212). The results of multivariate regression analysis showed that age, days of injury, PSQI score and pain VAS score were the influencing factors of emotional disturbance in patients with thoracic and lumbar osteoporotic fractures ( t values were -3.72-7.66, all P<0.05). Conclusions:Patients with thoracic and lumbar osteoporotic fractures have mood disorders. Age, injury days, PSQI score and VAS score are related to the occurrence of mood disorders in patients with thoracic and lumbar osteoporotic fractures. More attention should be payed to the influencing factors of mood disorders in patients,and timely measures should be taken for individualized intervention.

Psychosocial concerns predict longitudinal trajectories of distress in newly diagnosed cancer patients

INTRODUCTION@#Unmet psychosocial concerns are associated with emotional distress among cancer patients. This longitudinal study aimed to identify specific psychosocial concern profiles and trajectories of emotional distress, and examine their association among newly diagnosed adult cancer patients across the first year of diagnosis.@*METHODS@#Adult patients aged 21-64 years were screened to determine their eligibility for this study. Psychosocial concerns and psychological distress were measured using the Problem List and the Distress Thermometer, respectively (n = 221). Latent transition mixture analysis was used to determine specific psychosocial concern profiles and trajectories of emotional distress, and examine associations with adjustments made for demographic and medical variables.@*RESULTS@#Two classes of psychosocial concerns were identified: low (81%) and high (19%) concerns. Two trajectories of distress were identified: low stable (69%) and high stable (31%) trajectories. Patients in the high concerns class were significantly more likely to demonstrate the high stable trajectory of distress.@*CONCLUSION@#Our findings highlight the importance of concurrent assessment of multiple psychosocial concerns and screening of emotional distress throughout a cancer patient's treatment journey. Such assessments can effectively guide interventions to address individual concerns and alleviate emotional distress among newly diagnosed cancer patients.

Síndrome de burnout en los neurólogos colombianos: prevalência y factores asociados / Burnout syndrome in Colombian neurologists: prevalence and associated factors

RESUMEN INTRODUCCIÓN: El síndrome de burnout es una condición de prevalência creciente que afecta la calidad de vida y los resultados laborales de quienes lo padecen. OBJETIVO: Describir la prevalencia y factores asociados del síndrome de burnout en neurólogos colombianos. METODOLOGÍA: Mediante encuesta autoadministrada se obtuvo información de 119 neurólogos laboralmente activos en Colombia. Se incluyeron datos correspondientes a variables sociodemográficas junto con la escala Maslasch Burnout Inventory. Para calcular la correlación estadística de variables se utilizó regresión logística. RESULTADOS: El síndrome de burnout se determinó en el 49,6 % de los entrevistados (afectación de 2 o más dimensiones). Esta condición se correlacionó con el sexo femenino (P=0,036), el número de horas trabajadas por semana (P=0,040) y la frecuencia de satisfacción con el trabajo (P<0,001). La práctica de actividades de esparcimiento fue estadísticamente significativa (P=0,024) como factor protector. CONCLUSIÓN: El síndrome de burnout es una condición prevalente en los neurólogos en Colombia. Esta información es útil para la creación de políticas encaminadas a mejorar las condiciones del ejercicio de esta especialidad en nuestro país.

SUMMARY INTRODUCTION: Burnout syndrome is a condition of increasing prevalence that affects quality of life and labor outcomes. OBJECTIVE: To describe the prevalence and factors related to burnout syndrome in Colombian neurologists. METHODOLOGY: By mean of a self-administered survey we obtained information from 119 neurologists currently working in Colombia. Sociodemographic and Maslasch Burnout Inventory data were collected. To calculate statistical correlation of variables related to the syndrome a logistic regression model was used. RESULTS: Burnout syndrome was determined in 49.6% of interviewed neurologists (2 or more affected dimensions).This condition was related to female gender (P=0.036), number of hours worked weekly (P=0.040) and level of work satisfaction (P<0.001). Having a hobby was determined as protector for burnout (P=0.024). CONCLUSION: Burnout syndrome is a prevalent condition in Colombian neurologists. This information should be considered for designing policies directed to better labor conditions for this specialty in our country.

Emotional distress and its care in empowered indigenous women exposed to domestic violence and the demands of child rearing / Malestares emocionales y su atención en mujeres indígenas empoderadas expuestas a violencia doméstica y exigencias de crianza de los hijos

Abstract Introduction Indigenous girls and women in Mexico suffer emotional distress due to marital violence and adherence to gender roles. They are unlikely to denounce violence or treat their health in a timely manner. Women can cope with their distress by participating in empowerment processes. Objective Describe in indigenous empowered women the emotional distress caused by domestic violence in their childhood and the current demands of raising their children and the actions they take to cope with them. Method Qualitative and phenomenological qualitative research, in-depth interviews, and participant observation were conducted with nine migrant indigenous women to explore experiences during their upbringing, emotional reactions, and current mental health problems. Results The software Atlas. ti V 7 was used to undertake a theoretical categorization of the data. Findings included exposure to violence, the influence of a good mother, and past and present emotional distress overcome through empowerment and professional care. Discussion and conclusion Participating in urban empowerment activities enables participants to reflect on the violence experienced and the attendant distress, identify them as gender violence, and use them in their favor. They are strategic when coping with current distress due to the conflictive upbringing of their children, using psychological services and the urban upbringing prescriptions of children's rights, and incorporating indigenous parenting practices, which encourage community commitment, responsibility, and early self-sufficiency in children. Empowerment is suggested as an effective means of improving the health of indigenous women in Mexico.

Resumen Introducción En México, niñas y mujeres indígenas padecen malestares emocionales por la violencia conyugal y el cumplimiento de roles de género. No es común que se denuncie la violencia o se atienda oportunamente su salud. Las mujeres pueden emprender la atención de sus malestares al participar en procesos de empoderamiento. Objetivo Describir en mujeres indígenas empoderadas los malestares emocionales causados por la violencia doméstica en su niñez; por las exigencias actuales en la crianza de sus hijos/as y las acciones que realizan para atenderlos. Método Mediante una investigación cualitativa situada y fenomenológica, se realizaron entrevistas en profundidad y observación participante con nueve mujeres indígenas migrantes. Con estas herramientas se exploraron experiencias durante su crianza; reacciones emocionales y problemas actuales de salud mental. Resultados Mediante el software Atlas. ti V 7, se realizó una categorización teórica de los datos. Así se encontraron: exposición a la violencia; la influencia de la buena madre; malestares emocionales antiguos y actuales sobrellevados con el empoderamiento y la atención profesional. Discusión y conclusión Participar en actividades urbanas de empoderamiento lleva a las participantes a reflexionar sobre la violencia vivida y sus malestares asociados; resituarlos como violencia de género, y usarlos en su favor. Se muestran estratégicas al enfrentar malestares actuales por la conflictiva crianza de su hijos/as, usando servicios psicológicos y las prescripciones de crianza urbana del derecho infantil, e integrando prácticas de crianza indígenas, que estimulan el compromiso comunitario, responsabilidad y autosuficiencia temprana en los hijos/as. Se sugiere aprovechar la eficacia del empoderamiento para mejorar la salud de las mujeres indígenas del país.

Adaptação transcultural e investigação psicométrica da Escala de Estresse na Alimentação de Salzburg (SSES) para uma amostra de adultos brasileiros / Cross-cultural adaptation and psychometric investigation of the Salzburg Stress Eating Scale (SSES) in a sample of Brazilian adults / Adaptación transcultural e investigación psicométrica de la Escala de Estrés en la Alimentación de Salzburg (SSES) para una muestra de adultos brasileños

Os objetivos deste estudo foram adaptar a Escala de Estresse na Alimentação de Salzburg (SSES) para o português brasileiro, estimar suas propriedades psicométricas para uma amostra de adultos jovens e verificar, separadamente para cada sexo, a relação da idade e do índice de massa corporal (IMC) com a forma de lidar com a alimentação frente ao estresse. A adaptação da SSES para o português foi realizada seguindo protocolo consolidado. As propriedades psicométricas foram estimadas para cada sexo a partir das validades fatorial e convergente e da confiabilidade. A invariância foi testada em subamostras independentes para cada sexo. A relação da idade e do IMC com a alimentação frente ao estresse foi investigada para cada sexo usando a modelagem de equações estruturais. A prevalência dos indivíduos em categorias que representaram manutenção, redução ou aumento da alimentação frente ao estresse foi calculada. Participaram do estudo 1.030 indivíduos (61,8% mulheres) com média de idade de 25,5 (DP = 5,3) anos. O modelo original da SSES apresentou bom ajuste para a amostra feminina, mas, para a masculina, um item foi excluído, e uma correlação residual foi inserida. Esses modelos foram invariantes em subamostras independentes. O IMC elevado influenciou na alimentação frente ao estresse. Os homens mantêm a alimentação habitual, enquanto as mulheres a aumentam frente ao estresse. A versão em português da SSES será útil para investigar a alimentação frente ao estresse no Brasil. Modelos diferentes da SESS foram ajustados para cada sexo. O IMC foi uma variável significativa para avaliar a alimentação frente ao estresse.

The study's objectives were to adapt the Salzburg Stress Eating Scale (SSES) to Brazilian Portuguese, estimate its psychometric properties in a sample of young adults, and verify (separately for each sex) the relationship between age and BMI and dietary intake during stress. Adaptation of the SSES to Portuguese was performed according to the consolidated protocol. The psychometric properties were estimated for each sex based on factor and convergent validities and reliability. Invariance was tested in independent subsamples for each sex. The relationship between age and bod mass index (BMI) and dietary intake during stress was investigated for each sex using structural equation modeling. Prevalence of individuals in categories that represented maintenance, reduction, or increases in dietary intake in the face of stress was calculated. Participation in the study included 1,030 individuals (61.8% women) with a mean age of 25.5 (SD = 5.3) years. The original model of the SSES presented good fit for the female sample, but for the male sample one item was excluded and a residual correlation was inserted. These models were invariant in independent subsamples. High BMI influenced dietary intake in the face of stress. Men maintained their habitual diet, while women increased their dietary intake during stress. The Portuguese version of the SSES will be useful for investigating dietary intake during stress in Brazil. Different models of SESS were adjusted for each sex. BMI was a significant variable for assessing dietary intake in the face of stress.

Los objetivos de este estudio fueron adaptar la Escala de Estrés en la Alimentación de Salzburg (SSES) al portugués brasileño, estimar sus propiedades psicométricas en una muestra de adultos jóvenes y verificar, separadamente para cada sexo, la relación entre edad e índice de masa corporal (IMC) en lo que respecta a la alimentación frente al estrés. La adaptación de la SSES al portugués se realizó siguiendo un protocolo consolidado. Las propiedades psicométricas se estimaron para cada sexo a partir de la validez factorial y convergente, así como de la confiabilidad. La invariancia se probó en submuestras independientes para cada sexo. La relación de la edad e IMC con la alimentación frente al estrés se investigó para cada sexo, usando un modelado de ecuaciones estructurales. Se calculó la prevalencia de los individuos dentro de categorías que representaban: mantenimiento, reducción o aumento de la alimentación frente al estrés. Participaron en el estudio 1030 individuos (61,8% mujeres) con una media de edad de 25,5 (DP = 5,3) años. El modelo original de la SSES presentó un buen ajuste en la muestra femenina, sin embargo, en la masculina, se excluyó un ítem y se incluyó una correlación residual. Estos modelos fueron invariantes en submuestras independientes. El IMC elevado influenció en la alimentación frente al estrés. Los hombres mantienen la alimentación habitual, mientras que las mujeres la aumentan frente al estrés. La versión en portugués de la SSES será útil para investigar la alimentación ante el estrés en Brasil. Se ajustaron modelos diferentes de la SESS para cada sexo. El IMC fue una variable significativa para evaluar la alimentación ante el estrés.

Analysis of preoperative adverse emotion of patients with lung cancer and its effect on postoperative rehabilitation / 中国胸心血管外科临床杂志

@#Objective    To examine the effect of preoperative adverse emotion on rehabilitation outcomes in lung cancer patients undergoing thoracoscopic major pulmonary resection. Methods    We retrospectively analyzed the clinical data of 1 438 patients with lung cancer who underwent thoracoscopic lobectomy and segmentectomy in West China Hospital of Sichuan University from February 2017 to July 2018 including 555 males and 883 females. All patients were assessed by Huaxi emotional-distress index scoring, and were divided into three groups including a non-negative emotion group, a mild negative emotion group, and a moderate-severe negative emotion group. All patients underwent thoracoscopic lobectomy or segmentectomy plus systematic lymph node dissection or sampling. The volume of postoperative chest drainage, postoperative lung infection rate, time of chest tube intubation and postoperative duration of hospitalization were compared among these three groups. Results    There were different morbidities of adverse emotion in age, sex, education level and smoking among patients before operation (P<0.05). Univariate analysis showed that there was no statistical difference in the duration of indwelling drainage tube, drainage volume, postoperative pulmonary infection rate or the incidence of other complications among these three groups, but the duration of hospitalization in the latter two groups was less than that in the first group with a statistical difference (P<0.05). After correction of confounding factors by multiple regression analysis, there was no statistical difference among the three groups. Conclusion    Young patients are more likely to develop bad emotions, women are more likely to develop serious bad emotions, highly educated patients tend to develop bad emotions, and non-smoking patients tend to develop bad emotions. There is no effect of preoperative adverse emotions on the rapid recovery of lung cancer patients after minimally invasive thoracoscopic surgery.

El malestar emocional como síntoma de estrés postraumático / Emotional distress as a symptom of post-traumatic stress

El trastorno por estrés postraumático (TEPT) tiene una importante prevalencia en la población, por lo que conocer los mecanismos psicológicos para la vulnerabilidad y el mantenimiento del trastorno es claramente relevante. Entre dichos mecanismos, se ha postulado el constructo de malestar emocional como transdiagnóstico a diversos trastornos mentales. El objetivo del presente estudio fue poner a prueba un modelo hipotético que analizaba la asociación entre tres variables pertenecientes a dicho constructo (evitación experiencial, tolerancia al malestar e intolerancia a la incertidumbre inhibitoria) y el TEPT. Participaron 328 estudiantes universitarios (74.7% mujeres y 25.3% hombres, con una media de edad de 21 años) que habían experimentado al menos un acontecimiento traumático de acuerdo con los criterios del DSM-5, quienes completaron una batería de cuestionarios. Se efectuó un análisis de ecuaciones estructurales cuyos resultados apoyaron parcialmente el modelo hipotético. La evitación experiencial mostró asociarse positiva y significativamente con la tolerancia al malestar, la intolerancia a la incertidumbre inhibitoria y los síntomas del TEPT. La tolerancia al malestar también se vinculó de forma positiva y significativa con dichos síntomas. Sin embargo, la intolerancia a la incertidumbre inhibitoria no mostró relación con esta sintomatología. En apoyo a la evidencia empírica precedente, los hallazgos de este estudio inciden en el papel de la evitación experiencial y la tolerancia al malestar como variables moderadoras de la sintomatología postraumática. Asimismo, apuntan hacia la necesidad de considerar estas variables en las intervenciones psicológicas para el tratamiento del TEPT

Post-traumatic stress disorder or PTSD has an important prevalence in the population, so knowing the psychological mechanisms of vulnerability and maintenance of this disorder is clearly relevant. Among those mechanisms, the emotional distress construct has been postulated as a trans-diagnostic tool related to different mental disorders. The objective of the present study was to test a hypothetical model for the analysis of the association between three variables of this construct (experiential avoidance, distress tolerance, and inhibitory uncertainty intolerance) and PTSD. The subjects of study amounted to 328 university students (74.7% women and 25.3% men, with a median age of 21) who had experienced at least one traumatic event according to the DSM-5 criteria. They were made to complete a set of questionnaires. A structural equation analysis was carried out, with results partially coincident with the hypothetical model. Exponential avoidance showed a positive and significant association with distress tolerance, inhibitory uncertainty intolerance and PTSD symptoms. Distress tolerance was also associated with these symptoms in a positive and significant way. However, inhibitory uncertainty intolerance was not associated with this symptomatology. Following the preexisting empirical evidence, the findings of this study have an impact on the role of experiential avoidance and distress tolerance, as variables that moderate post-traumatic symptomatology. Furthermore, the findings point to the need to consider these variables in psychological interventions for the treatment of PTSD

Hacia una integración de mindfulness e inteligencia emocional en psicología y educación / Towards the integration of mindfulness and emotional intelligence in psychology and education

Antecedentes: el presente artículo presenta una revisión empírica de la integración de mindfulness e inteligencia emocional. Mindfulness es un modelo de intervención cognitiva que facilita la toma de consciencia con la experiencia en el momento presente, favoreciendo la autorregulación emocional. Igualmente, la inteligencia emocional ha sido conceptualizada como una constelación de habilidades relacionadas con la percepción, entendimiento y un adecuado manejo de las emociones propias y de los demás. Ambos marcos conceptuales están asociados con un buen sentido de bienestar y desarrollo personal. Estado del arte: se presenta una revisión de la evidencia científica preliminar publicada en la literatura psicológica y de educación, examinando los efectos mediadores de ambos constructos en el proceso de regulación emocional y calidad de vida individual. Conclusiones: los reportes de los estudios evaluados indican que la interacción de mindfulness disposicional e inteligencia emocional ofrece beneficios significativos en los estados de bienestar de las personas. De igual manera, se reportó que la inteligencia emocional es un mediador entre mindfulness e incrementos en las emociones positivas. El propósito del presente artículo de revisión es identificar un modelo integrador en la regulación de la emociones, incluyendo los «ingredientes activos¼ que influyen en los estados de bienestar y la forma en que la práctica de mindfulness contribuye al aumento de las habilidades de la inteligencia emocional.

Background: this article presents an empirical review of the integration of mindfulness and emotional intelligence. Mindfulness is a cognitive intervention model that helps people to develop awareness of their experience in the present moment favoring emotional self-regulation. Similarly, emotional intelligence has been conceptualized as a constellation of abilities related to the perception, understanding and adequate management of emotions within and among people. Both conceptual models are associated with a good sense of well-being and personal development. State of the art: this paper reviews the preliminary scientific evidence published in psychology and education literature, and examines the mediating effects of these two constructs in the process of emotional regulation and quality of life of individuals. Conclusions: the study results indicate that the interaction of mindfulness and emotional intelligence offers important benefits for people's well- being. It was also reported that emotional intelligence acts as mediator between mindfulness and greater positive emotions. The purpose of this review article is to identify a model of integration for emotional regulation that includes «active ingredients¼ to influence well-being and the way in which the practice of mindfulness contributes to increase the abilities of emotional intelligence.

Psychometric properties of the Brief Symptom Inventory-18 in a heterogeneous sample of adult cancer patients / Propiedades psicométricas del Inventario Breve de Síntomas-18 en una muestra heterogénea de pacientes de cáncer adulto

Abstract The Brief Symptom Inventory-18 (BSI-18) is a self-reporting screening instrument that is widely used to assess global psychological distress and three kinds of symptoms: anxiety, depression, and somatization. The present study tests the factor structure of the BSI-18 using confirmatory factor analysis (CFA), its reliability, convergent validity, and invariance for both sexes. A heterogeneous sample of 1183 cancer patients completed the BSI 18 and the NCCN Problem List. Hierarchical models of three and four subscales with GSI as a main factor provided an adequate and similar model fit. Nonetheless, the hierarchical three-factor model (the theoretical proposal) was selected for methodological and theoretical reasons. Reliability indexes (Cronbach's alpha and Composite Reliability) were satisfactory. The positive significant associations between BSI-18 (GSI and subscales) and emotional and physical categories of the Problem List showed the suitable convergent validity of the instrument. Finally, multigroup CFA revealed an essentially invariant structure of the BSI-18 for both sexes. The BSI-18 is a short instrument that can be used by researchers and health professionals to assess the psychological distress of cancer survivors.

Resumen El Inventario Breve de Síntomas-18 (BSI-18) es un instrumento de cribado ampliamente utilizado para evaluar distrés emocional (GSI) y tres tipos de síntomas: ansiedad, depresión, y somatización. Este trabajo estudia la estructura factorial del BSI-18, utilizando análisis factorial confirmatorio (AFC), su fiabilidad y validez convergente, así como su invarianza factorial a través del sexo. Una muestra de 1183 pacientes de cáncer completó el BSI 18 y la lista de problemas de la NCCN. Los modelos jerárquicos de tres y cuatro factores proporcionaron ajustes adecuados y similares. Sin embargo, el modelo de tres factores (propuesta teórica) fue seleccionado por razones metodológicas y teóricas. Los índices de fiabilidad (alfa de Cronbach y fiabilidad compuesta) fueron satisfactorios y las correlaciones positivas y significativas entre el BSI-18 (GSI y subescalas) y las categorías emocionales y físicas del listado de problemas evidenciaron la adecuada validez convergente del instrumento. Finalmente, el AFC multigrupo reveló una estructura básicamente invariante del BSI-18 a través del sexo. El BSI-18 es un instrumento breve que puede ser utilizado por investigadores y profesionales de la salud para evaluar el malestar psicológico en la población con cáncer.

Narrativas de sofrimento emocional na Atenção Primária: contribuições para uma abordagem integral culturalmente sensível em Saúde Mental Global / Narrativas de sufrimiento emocional en la Atención Primaria en Brasil: contribuciones para un abordaje integral culturalmente sensible en Salud Mental Global / Narratives of emotional distress in Primary Care in Brazil: contributions to a comprehensive and culturally sensitive Global Mental Health approach

Autores da Saúde Mental Global defendem, de um lado, o aumento do acesso aos cuidados de saúde mental, inclusive com o uso de intervenções padronizadas. De outro lado, na Atenção Primária à Saúde no Brasil, a apresentação sintomatológica do sofrimento emocional pelos pacientes dificulta sua identificação pelos profissionais, comprometendo o cuidado e exigindo uma abordagem culturalmente sensível. Objetivando conhecer a percepção de pacientes sobre o sofrimento emocional e seu cuidado na Atenção Primária, adotou-se método qualitativo de abordagem narrativa, com coleta de dados em grupos em salas de espera e roteiro baseado no instrumento McGill Ilness Narrative Interview. As narrativas foram tratadas por Análise de Conteúdo e revelaram que limitar a comunicação do sofrimento é negar o acesso ao cuidado. Contrapondo tal limitação, apontaram-se estratégias para nortear a estruturação de um cuidado que seja integral e culturalmente sensível.

Autores de la Salud Mental Global defienden, por un lado, el aumento del acceso a los cuidados de salud mental, incluso con el uso de intervenciones estandarizadas. Por el otro, en la Atención Primaria de la Salud en Brasil, la presentación sintomatológica del sufrimiento emocional por parte de los pacientes dificulta su identificación por parte de los profesionales, comprometiendo el cuidado y exigiendo un abordaje culturalmente sensible. Con el objetivo de conocer la percepción de pacientes sobre el sufrimiento emocional y su cuidado en la Atención Primaria, se adoptó el método cualitativo de abordaje narrativo, con colecta de datos en grupos en salas de espera y guion basado en el instrumento McGill Ilness Narrative Interview. Las narrativas se trataron por Análisis de contenido y revelaron que limitar la comunicación del sufrimiento es negar el acceso al cuidado. Contraponiéndose a tal limitación, se señalaron estrategias para nortear la estructuración de un cuidado que sea integral y culturalmente sensible.

Global Mental Health authors advocate on the one hand, for increased access to mental health care, including the use of standardized interventions. On the other, patients' symptomatic expression of emotional distress hampers its identification by Primary Care professionals in Brazil. This affects the provision of care and demands culturally sensitive approaches. In order to understand patients' perception of their emotional distress and of the care provided in Primary Health Care, a narrative qualitative method was adopted, involving data collection in groups in waiting rooms and the use of a script based on the McGill Illness Narrative Interview. We performed content analysis and found out that restricting communication of distress is associated with limited access to care. To face this limitation, strategies are suggested to guide the structuring of care that is both comprehensive and culturally sensitive.

Mundos vitales de palabras: análisis del sufrimiento adolescente mediante narrativas de malestar / Vital worlds of words: an analysis of adolescent through emotional distress narratives / Mundos vitais de palavras: análise do sofrimento adolescente mediante narrativas de malestar

Resumen (analítico): Las elevadas tasas de evitación/infrautilización de los servicios desalud mental adolescente señalan la preferencia de este colectivo por autoatender sus malestares. Integrar los saberes juveniles mediante un enfoque hermenéutico y de interpretación de narrativas permite esclarecer las razones de dicha preferencia pues da a conocer, a partir del análisis de nosologías legas, los modos en los que la juventud percibe, siente y vivencia el malestar. Se empleó metodología cualitativa, realizándose entrevistas semi-estructuradas a una muestra representativa de 105 informantes catalanes y catalanas. Los resultados muestran un continuum nosológico lego que incluye términos coloquiales y biomédicos articulándolos en distintos gradientes de malestar. Normalización y patologización, así como durabilidad y severidad del malestar, devienen conceptos clave en la conformación del continuum. Observándose diferencias por subgrupos de estudio y género.

Abstract (analytical): Avoiding mental health services indicate that adolescents prefer to engage in self-care to treat their emotional distress. In order to clarify the reasons for this preference the author analyzes the lay nosology that adolescents use to name their emotional distress using a hermeneutic and interpretative approach. The study uses a qualitative methodology through 105 semi-structured interviews with a sample of adolescents and young people from Catalonia (Spain). Results show the existence of a lay nosology continuum, articulating the gradient of emotional distress that forms their vital worlds; temporality, normalization and severity are key concepts that shape this suffering. Differences between subgroups and genders were observed. Recognition of these lay nosologies allows better access to the ways in which emotional distress is perceived, felt and lived. This could lead to improvements in the communication between adolescents and professionals.

Resumo (analítico): A evasão dos serviços de saúde mental indica a preferência dos jovens pelo autoatenção de seus desconfortos. Para esclarecer as razões para esta preferência se analisam as nosologias leigas que os jovens usam para nomear aos seus mal-estares a partir de uma aproximação hermenêutica e interpretativa; foram desenvolvidas entrevistas semiestruturadas a uma amostra de adolescentes e jovens na Catalunha (Espanha). Os resultados desvelam a existência de um continuo nosológico que articula os gradientes de mal-estar emocional dos mundos vitais adolescentes sobre aspectos como temporalidade, normalização e severidade. Foram observados diferentes subgrupos de estudo e de gênero. O conhecimento das nosologias leigas permite um acesso aos modos em que o sofrimento é percebido, sentido e vivido e, como consequência, pode implicar numa melhor comunicação entres jovens e profissionais da saúde.

A study on the status quo and its influencing factors of depression and anxiety in postoperative patients with thoracic neoplasms / 中国胸心血管外科临床杂志

@#Objective    To investigate the status quo and influencing factors of depression and anxiety in postoperative patients with thoracic neoplasms. Methods    The general information questionnaire and Huaxi emotional-distress index scale (HEI) were adopted to survey 70 patients after surgery of thoracic neoplasms at the thoracic nursing outpatients from September to November 2016. There were 43 males and 27 females with age of 18-78 (56.20±11.34) years. Results    The prevalence rate of depression and anxiety among postoperative patients with thoracic neoplasms was 50.0%, and moderate to severe negative emotions predominated. There was significant difference in educational levels, postoperative hospitalization and postoperative complications (P<0.05), while no significant difference in age, gender, disease types, complicated diseases, surgical procedures, pathological stages and hospitalization expenditures between patients with unhealthy emotions and normal emotions (P>0.05). Conclusion    There is a high prevalence rate of negative emotion among postoperative patients with thoracic neoplasms. Educational levels, postoperative hospitalization and postoperative complications are important factors for negative emotion.

Investigation of depression and anxiety emotion in perioperative patients with thoracic neoplasms / 中国胸心血管外科临床杂志

@#Objective    To understand the status quo of depression and anxiety emotion in perioperative patients with thoracic neoplasms under the concept of enhanced recovery after surgery. Methods    Huaxi emotional-distress index scale (HEI) was adopted to investigate the mental status of 195 patients with thoracic neoplasms in Department of Thoracic Surgery, West China Hospital, and the nursing outpatients between September and November in 2016. There were 118 males and 77 females at age of 17–80 (55.72±12.66) years. Results    There was significant difference in mental health level between the preoperative patients and the postoperative patients (3.70±3.41 vs. 11.01±9.78, P<0.001). The incidence of depression and anxiety emotion in the postoperative patients was significantly higher than that in the preoperative patients (50.00% vs. 9.60%, P<0.001). Besides, there was significant difference of depression and anxiety degree between the preoperative patients and postoperative patients (P<0.001). Moderate to severe depression and anxiety were mostly found in the postoperative patients while mild to moderate depression and anxiety in the preoperative patients. Conclusion    Patients with thoracic neoplasms have much emotional obstacle in perioperative period. The incidence and severity degree of depression and anxiety emotion in postoperative patients are higher than those in preoperative patients.

Lesson Topics and Emotions That Pained or Saddened Nursing Students Who Had Lost Someone Close to Them in Lectures on Palliative Care

<p>Purpose: This study intended to clarify the lesson topics, lesson content and emotions that painfully saddened nursing students with experience of bereavement taking lectures on palliative care, as well as the emotional changes of these students and the support they expect from teachers. Methods: We conducted semi-structured interviews. Their emotions were analyzed following Krippendorff’s method. Results: Thirty-six nursing students participated in the study. Lesson topics and content included “the state and signs of loved ones near death,” and “general lessons.” Feelings and thoughts presented were “regret,” “remembering,” “emotional upset,” “feeling anxiety,” “feeling dissatisfied,” “experiencing a sense of discomfort”, and “empathizing with the people shown in the teaching material as well as their situations.” With the exception of one subject, all subjects experienced a positive change in their emotions. Regarding to the support, 20 people did not require additional support because of “nothing wrong” or “enough”. Conclusions: Teachers need to specifically explain support content and methods many times, and to face lessons with the strong desire to always support their students.</p>

Exploración del malestar emocional expresado por mujeres que acuden a centros de atención primaria de la Ciudad de México: Un estudio cualitativo / Exploring the emotional distress of women who attend primary health care units in Mexico City: A qualitative study

La presencia de malestar emocional -que se define como el conjunto de sensaciones subjetivas que percibe una persona de que su bienestar sufre una merma y que se manifiesta por síntomas inespecíficos- puede constituir un factor de riesgo para la aparición de enfermedades mentales, sobre todo en personas con vulnerabilidades biológicas y psicosociales. Estudios recientes señalan que los servicios de atención primaria reciben un número, cada vez mayor, de personas con malestares que no cubren los criterios diagnósticos de una enfermedad, ya sea mental o física, fenómeno que es más frecuente en las mujeres. El objetivo de este trabajo es analizar los malestares emocionales de un grupo de mujeres que acude a instituciones de atención primaria de la Ciudad de México, así como sus percepciones y vivencias sobre la atención recibida, con el propósito de identificar necesidades de atención. Para recopilar la información se utilizaron técnicas e instrumentos propios de la metodología cualitativa. La información se codificó y analizó conforme al método de "categorización de significados" propuesto por Kvale. Los resultados mostraron que los principales detonantes de los malestares emocionales en las participantes se asocian con las preocupaciones que enfrentan cotidianamente (como falta de dinero, problemas con los hijos y violencia intrafamiliar) y, en otros casos, con la vivencia de experiencias traumáticas de violencia y abuso sexual, pasadas y presentes. Los datos demuestran también que las mujeres no hablan directamente de su malestar emocional, pero que tampoco lo detecta el personal de salud o que, cuando lo hace, le resta importancia. Lo anterior se relaciona con las condiciones actuales del servicio, que no ofrece una atención integral y adolece de una visión psicosocial.

Emotional distress is the subjective sensation of diminishment in well-being which manifests itself in a number of unspecific symptoms. It might be a risk factor for the development of mental illness, especially among individuals with psychosocial or biological vulnerability. Recent studies show that primary health care services receive a growing number of patients who suffer distress, but do not fulfill the diagnostic criteria of a mental or physical illness. This phenomenon is more frequent among women. The objective of this paper is to analyze the emotional distress experienced by a group of women who attended primary health care institutions in Mexico City, as well as their perceptions and experiences around the attention received, in order to identify their treatment needs. Data was gathered through techniques and instruments pertaining qualitative methodology. The information was coded and analyzed according to the meaning categorization method developed by Kvale. The results show that the main triggers of emotional distress are associated to daily life worries (lack of money, problems with children, domestic violence, among others). In some cases, it is associated as well with traumatic events, such as violence and sexual abuse in the past or at present. Data also suggest that women do not talk about emotional distress directly during medical consultations and that health care professionals do not identify distress or minimize its importance. These aspects are related to the current characteristics of the service, which lacks a comprehensive approach and a psychosocial point of view.