Distinct experiences and care needs of advanced cancer patients with good ECOG performance status: a qualitative phenomenological study.

BACKGROUND: Advanced cancer patients with good Eastern Cooperative Oncology Group (ECOG) performance status (score 0-1) are underrepresented in current qualitative reports compared with their dying counterparts. AIM: To explore the experiences and care needs of advanced cancer patients with good ECOG. DESIGN: A qualitative phenomenological approach using semi-structured interview was employed. Data was analyzed using the Colaizzi's method. SETTING/PARTICIPANTS: Purposive sample of terminal solid cancer patients on palliative care aged 18-70 years with a 0-1 ECOG score were recruited from a tertiary general hospital. RESULTS: Sixteen participants were interviewed. Seven themes were generated from the transcripts, including experiencing no or mild symptoms; independence in self-care, decision-making, and financial capacity; prioritization of cancer growth suppression over symptom management; financial concerns; hope for prognosis and life; reluctance to discuss death and after-death arrangements; and use of complementary and alternative medicine (CAM) and religious coping. CONCLUSIONS: Advanced cancer patients with good ECOG have distinct experiences and care needs from their dying counterparts. They tend to experience no or mild symptoms, demonstrate a strong sense of independence, and prioritize cancer suppression over symptom management. Financial concerns were common and impact their care-related decision-making. Though being hopeful for their prognosis and life, many are reluctant to discuss death and after-death arrangements. Many Chinese patients use herbal medicine as a CAM modality but need improved awareness of and accessibility to treatment options. Healthcare professionals and policy-makers should recognize their unique experiences and needs when tailoring care strategies and policies.

Exploring Social Work professionals' Experiences of the Mindfulness-Based Social Work and Self-Care Programme: A Focus Group Study.

The evidence for the potential of mindfulness-based programmes to support improved social work practice and self-care is growing. The aim of this focus group study was to explore social workers' (n = 13) experiences of the Mindfulness-based Social Work and Self-care programme (MBSWSC). Thematic analysis highlighted two superordinate themes: benefits to direct social work practice and coping with the social work role. Four subordinate themes highlighted the different social work practice components that were enhanced through MBSWSC participation: social work assessment, service user engagement and team working, working to social work values, and social work skills. Three subordinate themes identified improvements in individual processes which supported enhanced stress coping: moving from avoidant to approach coping, improved boundaries, increased emotional awareness and reduced negative thinking. Our findings indicate that the MBSWSC programme can have a multi-faceted positive effect on social work practice, and on social work professional's capacity to cope with their role.

A mindful approach to physician self-care.

There has been an increasing awareness of the importance of physician mental health. Several South African studies show a high prevalence of burnout among doctors. Burnout is characterised by three components: exhaustion, depersonalisation, and a sense of a lack of efficacy. Burnout is a result of both external and internal pressures. While lifestyle modification is essential, mindfulness-informed programmes promote self-regulation and resilience. Mindfulness programmes comprise three components: present moment awareness, perspective-taking and wisdom, and compassion. Physician wellness begins with individuals recognising the need of self-care and giving themselves permission to prioritise this. Ongoing identification of self-care needs and acting compassionately to address these needs is essential.

Understanding the diabetes self-care behaviour in rural areas: Perspective of patients with type 2 diabetes mellitus and healthcare professionals.

BACKGROUND: Diabetes self-care behaviour plays a crucial role in managing the diabetes effectively and preventing complications. Patients with type 2 diabetes mellitus (T2DM) and health care professionals (HCPs) of rural areas often face unique challenges when it comes to diabetes self-care practices (SCPs). Therefore, this study aim to explore the perspectives of patients with T2DM and HCPs on diabetes SCPs. METHODS: Eight focus group discussions (FGDs) among individuals with T2DM and In-depth interviews (IDIs) with 15 HCPs were conducted in rural areas of Punjab, North India. Capability, Opportunity, Motivation, and Behaviour model (COM-B) was employed for thematic framework analyses. RESULTS: The study participants perceived that a limited understanding of diabetes mellitus (DM), beliefs in alternative therapies, drug side effects, attitudes towards DM (psychological capability), comorbidities (physical capability), family support (social opportunity), financial and time constraints, and weather conditions (physical opportunity) contributed to lack of DM SCPs. Physicians' guidance and support were motivating them to adhere to SCPs, especially when aligned with their sense of self-efficacy (reflective motivation). HCPs constraints in providing patient-centred care are due to training limitations (psychological capability) and a lack of essential resources (physical opportunities). Participants expressed need for comprehensive diabetes care (automatic motivation) through structured diabetes education intervention to improve diabetes SCPs. CONCLUSIONS: The study findings indicate that various factors influence diabetes SCPs from the perspectives of both patients with T2DM and HCPs and emphasizes the need for a multi-faceted approach to improve diabetes SCPs in rural areas. Implementing a structured diabetes self-care intervention strategy in rural areas may help for preventing and mitigating the impact of diabetes-related complications in rural areas.

Living with schizophrenia and type 2 diabetes and the implication for diabetes self-care: A qualitative study.

AIM: To achieve an in-depth understanding of the challenges associated with diabetes management when having both schizophrenia and type 2 diabetes, while also identifying the needs for improved diabetes self-care. DESIGN: The study employed a qualitative explorative design utilizing a phenomenological-hermeneutic inspired approach, involving field observations and individual semistructured interviews. METHODS: Data were collected during 2020-2021 through 17 field observations of outpatient consultations and 13 individual semistructured interviews. Data, including field notes and verbatim transcribed interviews, underwent analysis following Ricoeur's interpretive philosophy, encompassing three levels: naïve reading, structural analysis and critical interpretation and discussion. This study adheres to the COREQ guidelines for qualitative research. RESULTS: Three key themes emerged: 'Diabetes when life is noisy', 'Sacrifices and compromises in life' and 'The double silence'. Everyday life is significantly affected when having both schizophrenia and T2D. The mental health state dominates in relation to diabetes self-care and individuals experience challenges balancing between the two conditions. However, there exists a general acknowledgement for diabetes and its long-term complications as a serious medical condition demanding careful attention and treatment. CONCLUSION: Self-managing two such complex conditions can be overwhelming and make it difficult for the individual to differentiate symptoms and prioritize diabetes care. Moreover, the existing fragmentation within healthcare systems poses communication challenges, resulting in disjointed patient pathways. IMPLICATIONS FOR PATIENT CARE: The study emphasizes the need for a holistic re that addresses the physical, emotional and social challenges. There is also a need for increased awareness and education among informal caregivers and healthcare professionals to foster better understanding and support.

Effectiveness of Person-Centered Health Education in the General Practice of Geriatric Chronic Disease Care.

Objective: This study assesses the impact of personalized health education on elderly patients with chronic diseases in a general practice setting. The rationale behind the incorporation of personalized health education stems from the growing recognition of the need for patient-centered care approaches, particularly in geriatric populations, where such interventions could lead to improved health outcomes. Our study aims to evaluate the effects of personalized health education on elderly patients with chronic diseases in a general practice context. The initiation of this study is grounded in the increasing acknowledgment of patient-centered care's significance, especially in geriatric demographics. We hypothesize that personalized health education interventions could significantly enhance health outcomes in this patient group. Methods: We conducted a randomized controlled trial involving 126 elderly patients with chronic diseases, assigning them equally to receive either standard care or standard care supplemented with personalized health education. The effectiveness of this education was measured through outcomes related to cognition, self-care, health literacy, psychological and physical health, quality of life, and prognosis. In our study, we executed a randomized controlled trial encompassing 126 elderly patients diagnosed with a range of chronic diseases. These participants were evenly divided into two groups: one receiving standard care and the other receiving standard care enhanced with personalized health education. The study spanned over a specified period, during which the impact of the personalized health education was meticulously evaluated. To comprehensively measure the effectiveness of the personalized health education, we employed a variety of tools and scales. These instruments were specifically chosen to assess changes in cognition, self-care abilities, health literacy, and psychological and physical health. Additionally, we evaluated the quality of life and prognosis of these patients, aiming to capture the holistic impact of the intervention. This approach ensured a thorough and nuanced understanding of how personalized health education influences the health outcomes of elderly patients with chronic diseases. Results: The intervention group demonstrated significant improvements across all measured outcomes compared to the control group, highlighting the efficacy of personalized health education in enhancing comprehensive health parameters in geriatric patients with chronic conditions. In our study, the intervention group, which received personalized health education, exhibited notable improvements in several key areas compared to the control group. Specifically, there was a marked enhancement in cognition and health literacy, with patients showing improved understanding and management of their conditions. Additionally, significant gains were observed in the quality of life, indicating that the tailored health education effectively addressed the holistic needs of geriatric patients with chronic diseases. These specific findings underscore the substantial impact of personalized health education in improving critical health outcomes in this patient population. Conclusion: Personalized health education in geriatric chronic disease management significantly betters disease comprehension, health literacy, self-care, psychological well-being, and physical health while also lowering the risk of adverse events. This study underscores the value of patient-centered educational strategies in chronic disease care for the elderly.Our study conclusively demonstrates that personalized health education plays a pivotal role in managing chronic diseases among the elderly. It significantly improves disease comprehension, health literacy, self-care capabilities, psychological well-being, and physical health. Furthermore, it contributes to a reduced risk of adverse health events. These findings emphasize the critical importance of integrating patient-centered educational strategies into general practice care for the elderly. By doing so, we can enhance their overall well-being and quality of life, making personalized health education an essential component in the holistic care of elderly patients with chronic conditions. This approach not only aligns with the principles of modern geriatric care but also sets a benchmark for the future of chronic disease management in older populations.

Effectiveness of ITHBC-Based Care In COPD Management.

Objective: The objective of this study is to propose and assess the clinical application value of a nursing intervention method based on the Integrated Theory of Health Behavior Change, aiming to address the increasing incidence and mortality of chronic obstructive pulmonary disease (COPD) and enhance the focus on its treatment and nursing in clinical practice. Methods: The study included 120 COPD patients admitted to the respiratory department, using random number table method randomly assigned to a control group (Ctrl group, receiving routine nursing management) and an observation group (Obs group, receiving Integrated Theory of Health Behavior Change (ITHBC)-based nursing management), each comprising 60 cases. Self-management, recovery of lung function and clinical symptoms, and quality of life (QOL) of patients were compared in two groups. Results: In summary, the study demonstrated significant improvements in specific parameters among COPD patients receiving Integrated Theory of Health Behavior Change (ITHBC)-based nursing management compared to routine nursing management. After 2 months of intervention, the COPD self-management scale scores indicated noteworthy enhancements in symptom management (Obs: 29.12±4.01 vs. Ctrl: 26.53±3.66), daily living management (Obs: 53.77±4.78 vs. Ctrl: 45.21±4.02), emotional management (Obs: 46.56±5.83 vs. Ctrl: 34.10±4.83), information management (Obs: 29.83±5.33 vs. Ctrl: 25.37±5.83), self-efficacy (Obs: 34.32±4.78 vs. Ctrl: 28.38±3.33), and overall self-management (Obs: 184.18±24.03 vs. Ctrl: 170.88±22.66), all with statistical significance (P < .05). The 6-minute walk test (6MWT) demonstrated improved exercise endurance for the observation group after 1 and 4 months of intervention, with scores (380.03±52.47) significantly higher than the control group (351.73±51.26) at T3 (P < .05). Dyspnea scores were notably lower in the observation group, indicating reduced respiratory severity, and the comprehensive evaluation using the CAT scale showed significantly lower symptom scores in the observation group (Obs: 15.57±4.21 vs. Ctrl: 19.25±4.63) (P < .05). Finally, the WHOQOL-BREF scores reflected a higher quality of life for patients receiving ITHBC-based nursing management (Obs: P < .05), highlighting the substantial impact of ITHBC-based interventions in significantly enhancing self-management, lung function, exercise endurance, dyspnea, symptom recovery, and overall quality of life in COPD patients compared to routine nursing management. Conclusion: In conclusion, the study underscores the effectiveness of Integrated Theory of Health Behavior Change (ITHBC)-based nursing management in significantly improving the self-management capabilities of COPD patients, leading to enhanced prognosis. The findings suggest that ITHBC holds promise as a valuable approach in nursing management for COPD and potentially extends its applicability to other chronic conditions. This study not only contributes to the understanding of effective interventions for COPD but also opens avenues for broader applications of ITHBC-based nursing management in the context of various chronic health conditions.

[Complementary Therapy: Application of Photobiomodulation in Self-Care and Patient Care].

Photobiomodulation (PBM), also known as low-level laser therapy, is a non-invasive light therapy that applies near-infrared light sources near target tissues. PBM allows photons to penetrate tissues and interact with cells, promoting photophysical and chemical changes that result in desired changes at the molecular, cellular, and tissue levels (Oliveira et al., 2022; Shetty et al., 2023). This complementary therapy has garnered significant research attention both domestically and internationally. The results of recent research indicate non-invasive transcranial light stimulation can enhance high-frequency oscillations such as α and ß waves, leading potentially to improved cognitive and neurological functions, memory, attention, and emotional status in healthy adults (Shetty et al., 2023). This mode of therapy is recommended as a non-pharmacological intervention for pain relief (Ross, 2022) and has been found to improve oral pain and quality of life in patients with burning mouth syndrome and in those undergoing hematopoietic stem cell transplantation (Camolesi et al., 2022; Chan et al., 2023). Also, PBM has been promoted as a method of enhancing wound healing (Oliveira et al., 2022) and of reducing the respiratory disturbance index in patients with obstructive sleep apnea (de Camargo et al., 2020). Researchers in Taiwan have also applied PBM to alleviate the pain associated with heel prick blood sampling in newborns and suggested using low-level laser therapy as a pain relief measure for full-term newborns undergoing invasive procedures (Wu et al., 2023). For the column in this issue, we have invited domestic nursing and optoelectronic scholars who have conducted extensive research in the field of PBM to explain the related mechanisms, share research findings, and introduce PBM devices that may be used in clinical, home, and school settings. Considering the impact of shift work on sleep among healthcare professionals, we also hope to provide nurses with different insights and options for self-care and patient care through the research and product introductions provided. Finally, an article on assessing aging and promoting health from a traditional Chinese medicine perspective is included to offer nursing professionals a holistic approach to self-care and preventive concepts based on natural rhythms.

Older women's perceptions of HPV self-sampling and HPV-sampling performed by a midwife - a phenomenographic study.

BACKGROUND: Cervical cancer is a global disease and it is well established that cervical cancer is caused by human papillomavirus (HPV). In Sweden self-sampling for HPV is now used as a complement to sampling performed by a midwife. However, there is a lack of knowledge on how older women perceive the self-sampling compared to the sampling performed by a midwife. Therefore, the aim of the study was to describe how women, aged 64 years and older, perceived the process of self-sampling and sampling performed by a midwife for HPV-testing. METHODS: Eighteen women were included in a qualitative interview study, and a phenomenographic approach was used for the analysis of the interviews. RESULTS: Three descriptive categories emerged: Confidence in sampling, Facilitating participation and Being informed. Within the categories, eight conceptions emerged describing the variation relating to how the women perceived the process of self-sampling and sampling performed by a midwife. CONCLUSIONS: Women in this study describe confidence in self-sampling for HPV-testing and that the self-sampling was saving time and money, both for themselves and for society. Information in relation to an HPV-positive test result is of importance and it must be kept in mind that women affected by HPV may feel guilt and shame, which health care professionals should pay attention to. This knowledge can be used in education of health care staff. TRIAL REGISTRATION: https://researchweb.org/is/fourol/project/228071 . Reg. no 228,071.

Study on the Application Effect of Nursing Intervention Based on the Transtheoretical Model in the Rehabilitation Treatment of Patients with Chronic Heart Failure.

Objective: To analyze the application effect of nursing intervention based on the Transtheoretical Model in rehabilitating patients with chronic heart failure (CHF). Methods: A retrospective analysis of clinical data was conducted for 156 CHF patients admitted to our hospital from May 2019 to September 2022. All patients met the complete inclusion criteria. They were divided into two groups based on the different nursing interventions provided during their treatment. The control group (n=78) received the routine nursing intervention, while the observation group (n=78) received nursing intervention based on the Transtheoretical Model and the care provided to the control group. The treatment compliance (MMAS-8 scale), quality of life (MLHFQ questionnaire), self-care ability (ESCA scale), cardiopulmonary function [anaerobic threshold oxygen consumption (VO2AT), carbon dioxide ventilation equivalent slope (VE/VCO2), peak VO2], and rehospitalization rates were compared between the two groups. Results: Before the intervention, the two groups had no significant difference in MMAS-8 and MLHFQ scores (P > .05). After the intervention, the MMAS-8 scores in the observation group were significantly higher than those in the control group (7.25±0.64 vs. 6.32±0.98), indicating improved treatment compliance. Additionally, the MLHFQ scores were significantly lower in the observation group compared to the control group (48.61±10.42 vs. 57.43±12.15, P < .05), indicating an enhanced quality of life. Before the intervention, the two groups had no significant differences in self-care skills, self-concept, health knowledge level, and self-care responsibility level (P > .05). However, after the intervention, the observation group showed significantly higher self-care skills (33.89±6.16 vs. 28.56±5.84), self-concept (24.79±3.96 vs. 21.34±4.15), health knowledge level (57.43±6.84 vs. 49.23±7.26), and self-care responsibility level (19.67±3.83 vs. 16.47±3.72) than the control group (P < .05). Before the intervention, the two groups had no significant differences in VO2AT, VE/VCO2, and peak VO2 levels (P > .05). However, after the intervention, the observation group exhibited significantly higher VO2AT (12.79±2.42 vs. 11.68±2.43) and peak VO2 levels (19.58±2.72 vs. 18.15±2.36) compared to the control group. VE/VCO2 levels were significantly lower in the observation group compared to the control group (28.32±3.16 vs. 30.47±3.42, P < .05). The rehospitalization rate in the control group was 35.90%, while it was 10.26% in the observation group. The rehospitalization rate in the observation group was significantly lower than that in the control group (P < .05). Conclusion: The integration of nursing intervention based on the Transtheoretical Model into the rehabilitation treatment of CHF patients exhibited significantly improved treatment compliance, enhanced self-care abilities, and favorable changes in cardiopulmonary function and quality of life. These outcomes carry important implications for CHF patients' overall health and well-being, including improved medication adherence, increased exercise tolerance, and reduced rehospitalization rates. The positive outcomes suggest that integrating nursing interventions based on the Transtheoretical Model into standard care for chronic heart failure patients holds promise, with potential applications in other chronic conditions, paving the way for personalized and effective healthcare strategies.

Application Value of Target Management Mode Based on Chronic Illness Trajectory Framework in Elderly Patients with Diabetes Mellitus and Cardiovascular Diseases.

Background: Diabetes and cardiovascular diseases represent significant global health challenges, leading to organ dysfunction and increased mortality rates. Managing these conditions is complex, especially in the elderly population. The study addresses this pressing issue by exploring the application of the Chronic Illness Trajectory Framework (CITF), aiming to improve self-care and quality of life in elderly patients with diabetes and cardiovascular diseases. Methods: A total of 127 patients with diabetes mellitus and cardiovascular diseases admitted to the hospital were enrolled between January 2020 and January 2022. According to the implementation of CITF management mode, they were divided into a control group (62 cases, non-implementation) and an observation group (65 cases, implementation). The control group was given routine intervention, while the observation group was given CITF-based target management mode for 3 months. The changes in blood glucose, blood lipid, negative emotions, self-efficacy, self-management, compliance, and quality of life before and after intervention in both groups were observed. This study was approved by the Ethics Committee of Zhujiang Hospital. Results: After intervention, levels of fasting plasma glucose (FPG), 2h plasma glucose (2hPG), hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C), scores of self-rating depression scale (SDS), self-rating anxiety scale (SAS) and Diabetes Specific Quality of Life Scale (DSQL) were decreased (P < .05), while scores of General Self-Efficacy Scale (GSES) and Scale of the Diabetes Self-Care Activities Chinese version (SDSCA), and compliance rate were increased in both groups (P < .05). The levels of FPG, 2hPG, HbA1c, TC, TG, and LDL-C, scores of SDS, SAS, and DSQL in the observation group were lower than those in the control group (P < .001), and scores of GSES and SDSCA, and compliance rate were higher than those in the control group (P < .001). These results highlight the positive role of comprehensive intervention in improving the physical and mental health of patients with diabetes and provide strong support for the application of comprehensive intervention strategies in diabetes management. Conclusion: CITF-based target management mode can alleviate negative emotions in patients with diabetes mellitus and cardiovascular diseases, improve self-management, self-efficacy, and compliance, effectively control blood glucose and lipids, and improve quality of life. The study conclusions highlight the importance of CITF management models in improving the management of patients with diabetes and cardiovascular disease. This comprehensive intervention helps reduce negative emotions, improve self-management and compliance, effectively control blood sugar and blood lipids, and improve quality of life. These results have important clinical implications and provide strong support for better care of patients with chronic diseases.

The relationship between perception of COVID-19, fear of COVID-19 and self-care management in individuals with chronic diseases during the pandemic process in Turkey.

AIMS: To determine the relationship between perception of COVID-19, fear of COVID-19 and self-care management in individuals with chronic diseases during the pandemic process. BACKGROUND: Individuals with chronic diseases are a sensitive group during the COVID-19 pandemic process; it is thought that self-care management may be adversely affected as a result of their more intense exposure to the psychological, physiological and economic effects of the pandemic. In the literature, there is no study examining the effect of perception of COVID-19 and fear of COVID-19 on self-care management in individuals with chronic diseases. DESIGN: Descriptive study. METHODS: The study was conducted with 322 individuals who applied to the internal medicine outpatient clinics of a university's Health Practice and Research Center, met the inclusion criteria, agreed to participate in the study and had a chronic disease. Questionnaire form, Perception of COVID-19 Scale (P-COVID-19), The Fear of COVID-19 Scale (FCV-19S) and Self-Care Management Process in Chronic Illness Scale (SCMP-G) were used to collect data. STROBE checklist was used to report the present study. RESULTS: In the study, it can be stated that individuals with chronic diseases had a moderate to the high perception of contagiousness and dangerousness of COVID-19, they had a moderate-high level of fear of COVID-19 and their self-care care management was above moderate level. There was a significant positive correlation between P-COVID-19, FCV-19S and SCMP-G in the study. CONCLUSIONS: It was found that the perception of COVID-19 contagiousness and the fear of COVID-19 had a positive effect on the self-care management of individuals with chronic diseases. RELEVANCE TO CLINICAL PRACTICE: Determining the level of COVID-19 perception and fear of COVID-19 and their effects on the life of the individual, and evaluating self-care management during the difficult pandemic process will increase the success in the holistic nursing care and management of chronic diseases.

Entre zelar e cuidar: sentidos sobre saúde-doença em dirigentes da Umbanda / Entre celar y cuidar: significados sobre salud-enfermedad en los líderes de Umbanda / Between watching over and caring: meanings about health-disease in Umbanda leaders

RESUMO Por meio da antropologia da saúde, podemos compreender o terreiro de umbanda como parte de um sistema popular de cuidado. Este estudo teve por objetivo investigar as concepções de saúde e doença produzidas por zeladores de terreiro de umbanda. Participaram dez zeladores de terreiro da cidade de Uberaba (MG/Brasil), sendo três mulheres e sete homens, com idades entre 40 e 76 anos. O tempo médio de atuação como dirigente foi de 18,4 anos, variando de cinco a 43 anos. Os terreiros chefiados por esses participantes atendem entre 15 e 280 pessoas por dia de funcionamento. Pela análise das entrevistas, destaca-se que o cuidado em saúde oferecido pelos zeladores ultrapassa os limites rituais, nas cerimônias públicas, sendo prestado de modo contínuo nos terreiros. As posturas assumidas pelos entrevistados envolvem ações de escuta, acolhimento e proximidade física no momento da urgência. Pelas narrativas, pode-se concluir que o zelar, no sentido de gerenciar o espaço do terreiro, espiritual e materialmente, não pode ser dissociado do cuidar, significando os zeladores como importantes agentes populares de saúde.

RESUMEN A través de la antropología de la salud podemos entender el terreiro de umbanda como parte de un sistema de atención popular. Este estudio tuvo como objetivo investigar las concepciones de salud y enfermedad producidas por los cuidadores del terreiro de umbanda. Participaron diez cuidadores de terreiro de la ciudad de Uberaba (MG/Brasil), tres mujeres y siete hombres, con edades comprendidas entre 40 y 76 años. El tiempo promedio como gerente fue de 18.4 años, que van de cinco a 43 años. Los terreiros encabezados por estos participantes atienden entre 15 y 280 personas por día de operación. Del análisis de las entrevistas, se destaca que la atención médica ofrecida por los cuidadores va más allá de los límites rituales, en ceremonias públicas, que se brindan continuamente en los terreiros. Las actitudes asumidas por los entrevistados implican escuchar, acoger y proximidad física en el momento de urgencia. A través de las narrativas, se puede concluir que el cuidado, en el sentido de administrar el espacio del terreiro, espiritual y materialmente, no se puede disociar del cuidado, lo que significa que los cuidadores son importantes agentes de salud populares.

ABSTRACT Through health anthropology we can understand the umbanda terreiro (specific place for the religious ritual) as part of a popular system of care. This study aimed to investigate the conceptions of health and illness produced by saint keepers of umbanda terreiro. Ten leaders of the terreiros in the city of Uberaba (MG/Brazil) participated, being three women and seven men, between 40 and 76 years old. The average time of performance as a manager was 18.4 years, ranging from 5 to 43 years. The terreiros led by these participants attend between 15 and 280 people working day. The health care offered by saint keepers exceeds ritual limits in public ceremonies and is provided on a continuous basis in the terreiros. The postures assumed by the interviewees involve actions of listening, welcoming and physical proximity at the moment of urgency. From the narratives, it can be concluded that care, in the sense of managing the space of the terreiro, both spiritually and materially, can not be dissociated from caring, meaning saint keepers as important popular health.

Significados atribuídos por mulheres com câncer de mama ao grupo de apoio / Meanings attributed by women with breast cancer to a support group / Significados atribuidos por las mujeres con cáncer de mama al grupo de apoyo

A sobrevivência ao câncer de mama é um problema de saúde pública que demanda serviços especializados com foco na reabilitação psicossocial. Entre as necessidades identificadas nesse contexto está o incentivo à adoção de estratégias de promoção de autocuidados pelas mulheres. Uma das estratégias adotadas consiste no grupo de apoio psicológico, que auxilia as pacientes a enfrentar a longa jornada do tratamento. Assim, o objetivo deste estudo é compreender os significados produzidos por mulheres com câncer de mama sobre sua participação em um grupo de apoio. Trata-se de um estudo qualitativo, descritivo e exploratório realizado com dez mulheres com câncer de mama usuárias de um serviço de reabilitação para mastectomizadas. Como referencial metodológico foi utilizada a Teoria Fundamentada nos Dados. A coleta de dados foi realizada por meio de entrevista aberta em profundidade e os conteúdos foram transcritos e codificados. A análise indutiva e o método de comparação constante foram aplicados nos processos de codificação aberta, axial e seletiva, que permitiram identificar três categorias nucleares: percepção das atividades realizadas no grupo, identificação de benefícios e barreiras do convívio no grupo e transformações decorrentes da participação. As participantes significaram sua presença no grupo como fonte de acolhimento, apoio, desenvolvimento de recursos pessoais e amizades, contribuindo para promover sua qualidade de sobrevida. Além dos potenciais benefícios, também foram identificadas barreiras que podem dificultar a adesão e continuidade da participação no grupo, o que sugere a necessidade de incorporar no cuidado um olhar para as dimensões subjetivas da saúde da mulher.(AU)

Surviving breast cancer is a public health problem and depends on services focused on psychosocial rehabilitation. Healthcare providers must encourage women to adopt strategies to promote their self-care. The psychological support group is a resource that helps women to face the long journey of treatment. This study aimed to understand the meanings women with breast cancer produced about their participation in a support group. This exploratory cross-sectional study was carried out with 10 women with breast cancer who use a rehabilitation service for mastectomized patients. Grounded Theory was used as a methodological reference. An open in-depth interview was applied for data collection. The contents were transcribed and coded. Inductive analysis and the constant comparison method were applied in the open, axial, and selective coding processes, which enabled the identification of three core categories: perception of the activities carried out in the group, identification of benefits and barriers of living in the group, and transformations resulting from participation. Participants denote their involvement with the group as a source of shelter, support, development of personal resources and friendships that helps promoting quality of life. Besides these potential benefits, participants also evinced barriers that can hinder adherence and continuity of participation in the group, suggesting the importance of incorporating a look at the subjective dimensions of women's health into care.(AU)

Sobrevivir al cáncer de mama es un problema de salud pública que depende de los servicios centrados en la rehabilitación psicosocial. Entre las necesidades identificadas en esta materia se encuentra el uso de estrategias para promover el autocuidado. Uno de los recursos que ayuda a afrontar el largo camino del tratamiento es el grupo de apoyo psicológico. El objetivo de este estudio es conocer los significados que producen las mujeres con cáncer de mama sobre su participación en un grupo de apoyo. Se trata de un estudio cualitativo, descriptivo y exploratorio, realizado con diez mujeres con cáncer de mama usuarias de un servicio de rehabilitación para mastectomizadas. Como referencia metodológica se utilizó la teoría fundamentada en los datos. Se aplicó una entrevista abierta en profundidad para la recogida de datos, cuyos contenidos fueron transcritos y codificados. El análisis inductivo y el método de comparación constante se aplicaron en los procesos de codificación abierta, axial y selectiva, lo que permitió identificar tres categorías centrales: percepción de las actividades realizadas en el grupo, identificación de los beneficios y las barreras de vivir en el grupo y transformaciones resultantes de la participación. Las mujeres denotan su participación en el grupo como una fuente de acogida, apoyo, desarrollo de recursos personales y amistades, que ayuda a promover la calidad de vida. Además de los beneficios potenciales, también se identificaron barreras que pueden dificultar la adherencia y continuidad de la participación en el grupo, lo que sugiere la necesidad de incorporar en la atención una mirada centrada en las dimensiones subjetivas de la salud de las mujeres.(AU)

The role of spirituality, religiosity, and self-care on infection preventionist well-being: Results from a national survey in the United States.

BACKGROUND: The degree to which religiosity, spirituality, and self-care practices can improve well-being among infection preventionists is not well understood. METHODS: We surveyed infection preventionists from a random sample of United States hospitals in 2021. Multivariable logistic regression models were used to examine the associations between measures of spirituality, religiosity, and self-care and well-being. RESULTS: Our response rate was 47% (415/881). A total of 49% of respondents reported burnout, 17% reported increased feelings of uncaring, and 69% would choose to become an infection preventionist again. Most respondents found importance in spiritual well-being (88%), religious beliefs (82%), and self-care practices (87%). Spiritual well-being was associated with increased odds of choosing to become an infection preventionist again (odds ratio = 2.32, 95% confidence interval = 1.19-4.53, P = .01). DISCUSSION: Our national survey provides evidence that spiritual importance is associated with career satisfaction among infection preventionists. Our findings contribute to a general body of evidence suggesting spiritual importance may translate to higher flourishing and well-being via serving a higher purpose. CONCLUSIONS: Promoting spiritual well-being may positively influence career satisfaction and overall well-being among infection preventionists.

Self-care strategies for medical students: an uncontrolled mixed-methods evaluation of a mind-body-medicine group course.

BACKGROUND: High stress during medical education and its detrimental effects on student health is well documented. This exploratory evaluation study assesses a 10-week Mind-Body-Medicine student course, created to promote student self-care at Charité Universitätsmedizin Berlin, Germany. METHODS: During 2012-2019, uncontrolled quantitative and qualitative data were gathered from 112 student participants. Outcomes including changes in perceived stress (PSS), mindfulness (FMI/MAAS), self-reflection (GRAS), self-efficacy (GSE), empathy (SPF), and health-related quality of life (SF-12) were measured between the first (T0) and last sessions (T1). Qualitative data were obtained in focus groups at course completion and triangulated with quantitative data. RESULTS: Quantitative outcomes showed decreases in perceived stress and increased self-efficacy, mindfulness, self-reflection, and empathy. In focus groups, students reported greater abilities to self-regulate stressful experiences, personal growth and new insights into integrative medicine. Triangulation grounded these effects of MBM practice in its social context, creating an interdependent dynamic between experiences of self and others. CONCLUSION: After completing an MBM course, students reported reduced perceived stress, increased self-efficacy, mindfulness, empathy and positive engagement with integrative concepts of doctor-patient relationships. Further research with larger randomized confirmatory studies is needed to validate these benefits.

Impact of Gaming (Gamification) on Diabetes Self-Care Behaviors and Glycemic Outcomes Among Adults With Type 2 Diabetes.

PURPOSE: The purpose of this systematic review was to determine if the use of gaming (gamification) among persons with type 2 diabetes improves diabetes self-management behaviors and diabetes outcomes. METHODS: A systematic review was conducted using electronic databases including MEDLINE, Embase, Web of Science, and CINAHL. Studies reporting on the impact of gaming on at least 1 of the Association of Diabetes Care and Education Specialists self-care behaviors (ADCES7) were included. RESULTS: The review included 9 studies, 8 of which were of strong/high quality. Five of the self-care behaviors were addressed in at least 1 of the included studies. However, taking medications and problem solving were not reported in any of the studies. Physical activity and self-efficacy or quality of life (healthy coping) were the most frequently reported ADCES7 behaviors. Six of the studies used A1C as an outcome measure, with a reduction reported in all the studies except 1. CONCLUSION: Type 2 diabetes affects a person holistically, necessitating a range of self-care behaviors to effectively manage the chronic condition. Novel gaming interventions may improve coping mechanisms, lifestyle behaviors, medication engagement, and monitoring of risks and problems, all of which are essential in facilitating optimal diabetes self-management.

A Group Intervention Combining Self-Hypnosis and Self-Care in Oncology: Implementation in Daily Life and Perceived Usefulness.

Multicomponent mind-body interventions are increasingly studied in oncology to improve patients' quality of life (QOL). However, the respective usefulness of each of their components or their long-term use by the participants are rarely assessed. In this study, 95 women with different cancer diagnoses participated in a self-hypnosis and self-care group. Different questionnaires were administrated before (T1), right after (T2), 3 to 4 months after (T3), and 1 year after (T4) the intervention. After the intervention, 97.5% of the participants regularly practiced any kind of relaxation (vs. 50% at baseline), especially hypnosis. The different components of the intervention (i.e., being in a group, hypnosis exercises during the sessions and at home, self-care tasks, and discussions during the group sessions) were all considered to be very useful (M = 6.91-7.75/10). One year after the intervention, the 10 most used techniques were mainly concrete activities to take care of oneself. This intervention seems very relevant for women who had cancer. Our results allow a first reflection about the mechanisms of action of our intervention.Registration: ClinicalTrials.gov (NCT03144154). Registered on the 1st of May 2017.