Spiritual/religious coping strategies and religiosity of patients living with cancer in palliative care.

BACKGROUND: The palliative care provided to cancer patients should also contemplate the psychological and spiritual dimensions of care. AIMS: This study aimed to compare religiosity and spiritual/religious coping (SRC) of cancer patients in palliative care with a group of healthy volunteers and determine whether sociodemographic characteristics affected this association. METHODS: This was a case-control study conducted with 86 patients living with cancer from an outpatient palliative care clinic of the São Paulo State University (UNESP) medical school, Botucatu, Brazil and 86 healthy volunteers. The brief Spiritual/Religious Coping Scale (SRCOPE) and the Duke University Religion (DUREL) Index were used as a brief measure of 'religiosity'. RESULTS: All 172 participants reported to be religious and, overall, made very little use of SRC strategies. DUREL scores were negatively associated with religious practice (P<0.01) and positive SRC (P<0.01). Age was associated with non-organisational religious activities and intrinsic religiosity (P<0.01); and income was associated with intrinsic religiosity (P<0.04). Positive SRC was negatively associated with the palliative group (P=0.03) and DUREL index (P<0.01). Negative SRC was positively associated with the palliative group (P=0.04) and negatively associated with education level (P=0.03) and practice of religion (P<0.01). CONCLUSION: All participants reported to be religious; however, their use of SRC strategies was very low. Positive religious coping was the most prevalent score. Negative religious coping was more common in the palliative care group compared to healthy volunteers. There is an association between religious coping and religiosity in palliative cancer care patients.

Comfort and religious-spiritual coping of intensive care patients' relatives.

OBJECTIVES: To identify the level of comfort and religious-spiritual coping of family members of intensive care unit patients and to analyse the sociodemographic/clinical variables that influence this association. METHODS: Cross-sectional study on the adult and paediatric intensive care units of two public hospitals in the state of São Paulo, between January and September 2016. Participants were divided into two groups: adult (n = 96) and paediatric (n = 70). We used the religious-spiritual coping brief (RSC-Brief) and the comfort scale for relatives of people in critical states of health (ECONF). RESULTS: Comfort was low in both groups and the family members used limited strategies in the RSC-Brief. The multiple linear regression analysis indicated that the variable length of hospitalization (ß = 0.69; p < 0.01) influenced comfort and was also associated with the RSC-Brief (ß = -0.18; p < 0.01). CONCLUSION: Family members' comfort was low in both groups. It increased with the hospitalisation time of the patients' relative and tended to decrease with the severity of the disease.

Resolubility of eye care in a secondary care center: a quantitative approach.

OBJECTIVE: To evaluate the resolubility of ophthalmologic care in an integrated health center. METHODS: This was a cross-sectional study including 816 patients who were attended from November 2013 to November of 2015. Data were collected from a medical consultation database and patients' medical records. RESULTS: The majority of participants were women, non-diabetic, and had high school education. The main cause of referral for ophthalmologic evaluation was the consultation with a specialist, the waiting time for consultation was shorter for non-diabetic patients. CONCLUSION: This Integrated health center presented, partial resolubility conditions to meet the ophthalmologic needs of users of the Brazilian Unified Health System. Eye care needs to be reorganized particularly by consider the priority cases of those at ophthalmological risk, and referrals should be done to the adequate care level and on time to guarantee resolubility.

Resolubility of eye care in a secondary care center: a quantitative approach / Resolubilidade do cuidado oftalmológico em um centro de atendimento secundário: abordagem quantitativa

ABSTRACT Objective To evaluate the resolubility of ophthalmologic care in an integrated health center. Methods This was a cross-sectional study including 816 patients who were attended from November 2013 to November of 2015. Data were collected from a medical consultation database and patients' medical records. Results The majority of participants were women, non-diabetic, and had high school education. The main cause of referral for ophthalmologic evaluation was the consultation with a specialist, the waiting time for consultation was shorter for non-diabetic patients. Conclusion This Integrated health center presented, partial resolubility conditions to meet the ophthalmologic needs of users of the Brazilian Unified Health System. Eye care needs to be reorganized particularly by consider the priority cases of those at ophthalmological risk, and referrals should be done to the adequate care level and on time to guarantee resolubility.

RESUMO Objetivo Avaliar a resolubilidade do cuidado oftalmológico em um centro integrado de saúde. Métodos Trata-se de estudo transversal realizado com 816 pacientes atendidos no período de novembro de 2013 a novembro de 2015. Os dados foram coletados consultando-se o banco de dados institucional e os prontuários. Resultados A maioria dos participantes era não diabética, do sexo feminino, e com Nível Médio de ensino. A principal causa de solicitação de avaliação oftalmológica foi a consulta com o especialista, cujo tempo de espera foi menor para os não diabéticos. Conclusão Este centro integrado de saúde apresentou, em parte, condições de resolubilidade para atender as necessidades oftalmológicas dos usuários do Sistema Único de Saúde, mas notou-se necessidade de reorganização deste cuidado, considerando prioridades baseadas em critérios de risco oftalmológico, conferindo que o encaminhamento ao nível de atenção deve ser capaz de propiciar, em tempo, a resolubilidade.

Perception of cancer patients in palliative care about quality of life.

OBJECTIVE: To understand the perception of cancer patients in palliative care about quality of life and identify propositions for its improvement. METHOD: This is a quantitative research carried out with 96 patients in palliative care, admitted in a public hospital from March 2015 to February 2015. The interviews were transcribed and analyzed by the methodology Discourse of the Collective Subject. RESULTS: Quality of life was tied to meanings of health, well-being, happiness and spirituality; however, family and financial problems also had an impact on the perception of the construct. Interventions aimed at the relief of suffering, possibility of return to work and resolution of problems had suggestions for improvement. CONCLUSION: The results indicate that the concept of quality of life is subjective, tied to personal values and influenced by the repercussions of the health-disease process. In addition, they can guide actions based on interdisciplinary assistance aimed at the real needs of these patients.

Perception of cancer patients in palliative care about quality of life / Percepción de los pacientes con cáncer en cuidados paliativos en la calidad de vida / Percepção de pacientes oncológicos em cuidados paliativos sobre qualidade de vida

ABSTRACT Objective: To understand the perception of cancer patients in palliative care about quality of life and identify propositions for its improvement. Method: This is a quantitative research carried out with 96 patients in palliative care, admitted in a public hospital from March 2015 to February 2015. The interviews were transcribed and analyzed by the methodology Discourse of the Collective Subject. Results: Quality of life was tied to meanings of health, well-being, happiness and spirituality; however, family and financial problems also had an impact on the perception of the construct. Interventions aimed at the relief of suffering, possibility of return to work and resolution of problems had suggestions for improvement. Conclusion: The results indicate that the concept of quality of life is subjective, tied to personal values and influenced by the repercussions of the health-disease process. In addition, they can guide actions based on interdisciplinary assistance aimed at the real needs of these patients.

RESUMEN Objetivo: Comprender la percepción de pacientes oncológicos en cuidados paliativos en relación a la calidad de vida e identificar proposiciones para su mejora. Método: Investigación cualitativa y cuantitativa realizada con 96 pacientes en cuidados paliativos, atendidos en ambulatorio de hospital público, en el período de marzo de 2015 a febrero de 2016. Las entrevistas fueron transcritas y analizadas por la estrategia metodológica del Discurso del Sujeto Colectivo. Resultados: La calidad de vida se ha vinculado a significados de salud, bienestar, felicidad y espiritualidad; pero problemas familiares y financieros también repercutieron en la percepción del constructo. Para mejora de intervenciones dirigidas al alivio del sufrimiento, se sugirió la posibilidad de retorno al trabajo y resolución de problemas. Conclusión: Los resultados del estudio indican que la concepción de calidad de vida es subjetiva, vinculada a valores personales e influenciada por las repercusiones del proceso salud-enfermedad. Además, pueden guiar acciones pautadas en una práctica asistencial interdisciplinaria, dirigida a las reales necesidades de estos pacientes.

RESUMO Objetivo: Compreender a percepção de pacientes oncológicos em cuidados paliativos em relação a qualidade de vida e identificar proposições para melhoria desta. Método: Pesquisa qualiquantitativa realizada com 96 pacientes em cuidados paliativos, atendidos em ambulatório de hospital público, no período de março de 2015 a fevereiro de 2016. As entrevistas foram transcritas e analisadas pela estratégia metodológica do Discurso do Sujeito Coletivo. Resultados: Qualidade de vida foi atrelada a significados de saúde, bem-estar, felicidade e espiritualidade; porém problemas familiares e financeiros também repercutiram na percepção do constructo. Teve como sugestões de melhoria intervenções direcionadas ao alívio do sofrimento, possibilidade de retorno ao trabalho e resolubilidade de problemas. Conclusão: Os resultados do estudo indicam que a concepção de qualidade de vida é subjetiva, atrelada a valores pessoais e influenciada pelas repercussões do processo saúde-doença. Além disso, podem nortear ações pautadas numa prática assistencial interdisciplinar, direcionada às reais necessidades destes pacientes.

Quality of life and religious-spiritual coping in palliative cancer care patients.

Objectives: to compare the quality of life and religious-spiritual coping of palliative cancer care patients with a group of healthy participants; assess whether the perceived quality of life is associated with the religious-spiritual coping strategies; identify the clinical and sociodemographic variables related to quality of life and religious-spiritual coping. Method: cross-sectional study involving 96 palliative outpatient care patient at a public hospital in the interior of the state of São Paulo and 96 healthy volunteers, using a sociodemographic questionnaire, the McGill Quality of Life Questionnaire and the Brief Religious-Spiritual Coping scale. Results: 192 participants were interviewed who presented good quality of life and high use of Religious-Spiritual Coping. Greater use of negative Religious-Spiritual Coping was found in Group A, as well as lesser physical and psychological wellbeing and quality of life. An association was observed between quality of life scores and Religious-Spiritual Coping (p<0.01) in both groups. Male sex, Catholic religion and the Brief Religious-Spiritual Coping score independently influenced the quality of life scores (p<0.01). Conclusion: both groups presented high quality of life and Religious-Spiritual Coping scores. Male participants who were active Catholics with higher Religious-Spiritual Coping scores presented a better perceived quality of life, suggesting that this coping strategy can be stimulated in palliative care patients.

Quality of life and religious-spiritual coping in palliative cancer care patients / Qualidade de vida e coping religioso-espiritual em pacientes sob cuidados paliativos oncológicos / Calidad de vida y coping religioso-espiritual en pacientes bajo cuidados paliativos oncológicos

ABSTRACT Objectives: to compare the quality of life and religious-spiritual coping of palliative cancer care patients with a group of healthy participants; assess whether the perceived quality of life is associated with the religious-spiritual coping strategies; identify the clinical and sociodemographic variables related to quality of life and religious-spiritual coping. Method: cross-sectional study involving 96 palliative outpatient care patient at a public hospital in the interior of the state of São Paulo and 96 healthy volunteers, using a sociodemographic questionnaire, the McGill Quality of Life Questionnaire and the Brief Religious-Spiritual Coping scale. Results: 192 participants were interviewed who presented good quality of life and high use of Religious-Spiritual Coping. Greater use of negative Religious-Spiritual Coping was found in Group A, as well as lesser physical and psychological wellbeing and quality of life. An association was observed between quality of life scores and Religious-Spiritual Coping (p<0.01) in both groups. Male sex, Catholic religion and the Brief Religious-Spiritual Coping score independently influenced the quality of life scores (p<0.01). Conclusion: both groups presented high quality of life and Religious-Spiritual Coping scores. Male participants who were active Catholics with higher Religious-Spiritual Coping scores presented a better perceived quality of life, suggesting that this coping strategy can be stimulated in palliative care patients.

RESUMO Objetivos: comparar a qualidade de vida e o coping religioso-espiritual de pacientes em cuidados paliativos oncológicos com um grupo de participantes sadios; avaliar se a percepção de qualidade de vida está associada às estratégias de coping religioso-espiritual; identificar as variáveis clínicas e sociodemográficas relacionadas à qualidade de vida e ao coping religioso-espiritual. Método: estudo transversal, realizado com 96 pacientes de ambulatório de cuidados paliativos, em um hospital público no interior do Estado de São Paulo, e 96 voluntários saudáveis, por meio de questionário utilizando dados sociodemográficos, o McGill Quality of Life Questionnaire e o Coping Religioso-Espiritual-Breve. Resultados: foram entrevistados 192 participantes que apresentaram boa qualidade de vida e alta utilização do Coping Religioso-Espiritual. Houve maior uso de Coping Religioso-Espiritual negativo no Grupo A, assim como menor bem-estar físico, psicológico e de qualidade de vida. Observou-se associação entre escores de qualidade de vida e Coping Religioso-Espiritual (p<0,01) em ambos os grupos. Sexo masculino, religião católica e escore de Coping Regioso-Espiritual-Breve influenciaram, de forma independente, os escores de qualidade de vida (p<0,01). Conclusão: ambos os grupos apresentaram escores altos de qualidade de vida e de Coping Espiritual-Religioso. Participantes do sexo masculino, praticantes de religião católica e com maiores escores de Coping Espiritual-Religioso apresentaram melhor percepção de qualidade de vida, sugerindo que essa estratégia de enfrentamento possa ser estimulada em pacientes sob cuidados paliativos.

RESUMEN Objetivos: comparar la calidad de vida y el coping religioso-espiritual de pacientes en cuidados paliativos oncológicos con un grupo de participantes sanos; evaluar si la calidad de vida percibida está asociada a las estrategias de coping religioso-espiritual; identificar las variables clínicas y sociodemográficas relacionadas a la calidad de vida y al coping religioso-espiritual. Método: estudio transversal, desarrollado con 96 pacientes de ambulatorio de cuidados paliativos en un hospital público en el interior del Estado de São Paulo, Brasil, y 96 voluntarios sanos, mediante cuestionario utilizando datos sociodemográficos, el McGill Quality of Life Questionnaire y el Coping Religioso-Espiritual-Breve. Resultados: fueron entrevistados 192 participantes que presentaron buena calidad de vida y alta utilización del Coping Religioso-Espiritual. Fue encontrado mayor uso de Coping Religioso-Espiritual negativo en el Grupo A, y también menor bienestar físico, psicológico y de calidad de vida. Fue observada asociación entre los scores de calidad de vida y Coping Religioso-Espiritual (p<0,01) en ambos grupos. Sexo masculino, religión católica y score de Coping Religioso-Espiritual-Breve influenciaron de manera independiente los scores de calidad de vida (p<0,01). Conclusión: ambos grupos presentaron altas puntuaciones de calidad de vida y de Coping Espiritual-Religioso. Participantes do sexo masculino, practicantes de religión católica y con mayores scores de Coping Espiritual-Religioso presentaron mejor percepción de calidad de vida, sugiriendo la posibilidad de estimular esa estrategia de enfrentamiento en pacientes bajo cuidados paliativos.