A aplicabilidade das pics na assistencia de enfermagem em pacientes com doença crônica: revisão integrativa / The applicability of pics in nursing care for patients with chronic disease: integrative review / La aplicabilidad de la pics en los cuidados de enfermería a pacientes con enfermedades crónicas: revisión integradora

A implementação das PICs no Brasil é uma realidade, dessa forma, compreende-se que o enfermeiro é o profissional que em tese deve possuir habilidades para aplicar as técnicas em pacientes. Com base nisso, o objetivo do trabalho foi descrever a atuação da enfermagem através de Planos de ações por intermédio das PICs em individuos com diminuição da qualidade de vida em razão do desenvolvimento de doenças crônicas degenerativas. Dessa forma, o presente artigo trata-se de uma revisão integrativa de literatura. Os resultados obtidos mostram que a aplicabilidade das PICs, está consolidada, sendo uma prática bastante utilizada na intervenção terapêutica de indivíduos portadores de doenças crônicas degenerativas, na qual as mais utilizadas são: plantas medicinais, reiki, homeopatia, acupuntura e auricuoterapia, entretanto, em relação a assistência de enfermagem, foi observado impasses em relação a capacitação profissional. Logo, concluímos que com base nas produções cientificas existentes a respeito das PICs, a prática infere em diversos benefícios ao indivíduo, estas que se convergem a promoção de maior qualidade de vida ao paciente com doenças crônicas, porém, a falta de capacitação profissional revela um impasse ainda persistente.

The implementation of PICs in Brazil is a reality, therefore, it is understood that the nurse is the professional who, in theory, must have the skills to apply the techniques to patients. Based on this, the objective of the study was to describe the role of nursing through Action Plans through PICs in individuals with reduced quality of life due to the development of chronic degenerative diseases. Thus, this article is an integrative literature review. The results obtained show that the applicability of PICs is consolidated, being a practice widely used in the therapeutic intervention of individuals with chronic degenerative diseases, in which the most used are: medicinal plants, reiki, homeopathy, acupuncture and auricutherapy, however, in regarding nursing care, impasses regarding professional training were observed. Therefore, we conclude that based on the existing scientific productions regarding PICs, the practice infers in several benefits to the individual, these that converge to the promotion of a better quality of life for the patient with chronic diseases, however, the lack of professional training reveals a stalemate still persistent.

La implementación de los PICs en Brasil es una realidad, por lo tanto, se entiende que la enfermera es el profesional que, en teoría, debe tener las habilidades para aplicar las técnicas a los pacientes. Con base en esto, el objetivo del estudio fue describir el papel de la enfermería a través de Planes de Acción por medio de PICs en individuos con calidad de vida reducida debido al desarrollo de enfermedades crónico degenerativas. Así, este artículo es una revisión bibliográfica integradora. Los resultados obtenidos muestran que la aplicabilidad de los PICs está consolidada, siendo una práctica ampliamente utilizada en la intervención terapéutica de individuos con enfermedades crónicas degenerativas, en la que las más utilizadas son: plantas medicinales, reiki, homeopatía, acupuntura y auricuterapia, sin embargo, en lo que respecta a los cuidados de enfermería, se observaron impasses en cuanto a la formación profesional. Por lo tanto, concluimos que con base en las producciones científicas existentes en relación a las PICs, la práctica infiere en varios beneficios al individuo, estos que convergen a la promoción de una mejor calidad de vida para el paciente con enfermedades crónicas, sin embargo, la falta de formación profesional revela un impasse aún persistente.

Population child health: understanding and addressing complex health needs.

Advances in paediatric care mean that more children with complex medical problems (heart disease, neurodevelopmental problems and so on) are surviving their early years. This has important implications for the design and delivery of healthcare given their extensive multidisciplinary requirements and susceptibility to poor outcomes when not optimally managed. Importantly, their medical needs must also be understood and addressed within the context of the child and family's life circumstances. There is growing recognition that many other factors contribute to a child's complex health needs (CHNs), for example, family problems, fragmentation of health and care provision, psychological difficulties or social issues.To facilitate proactive care for these patients, we must develop accurate ways to identify them. Whole Systems Integrated Care-an online platform that integrates routinely collected data from primary and secondary care-offers an example of how to do this. An algorithm applied to this data identifies children with CHNs from the entire patient population. When tested in a large inner-city GP practice, this analysis shows good concordance with clinical opinion and identifies complex children in the population to a much higher proportion than expected. Ongoing refinement of these data-driven processes will allow accurate quantification and identification of need in local populations, thus aiding the development of tailored services.

Effect of an Educational Intervention Delivered to Senior Nursing Students to Strengthen Spiritual Care for People with Chronic Illness.

This is an experimental, quantitative, parallel design study (control and experimental groups) with pre- and post-intervention assessment without blinding, which aimed to determine the effect of an educational intervention delivered to ninety Colombian senior nursing students to strengthen perceptions of spirituality and spiritual care for people with chronic illness. The Spirituality and Spiritual Care Rating Scale (SSCRS) was used as the instrument of measurement. The Wilcoxon test was used for comparisons between two groups, and the Kruskal-Wallis test for the comparison of global scale scores between the intervention group and the control group. To determine the effect of the intervention, Cohen's d statistic was used. The intervention modified the perceptions of spirituality and spiritual care in the experimental group (median = 80.2, SD = 10.2) compared with their initial perceptions (median = 70, SD = 11.2), p ≤ 0.001. The effect size (ES) of the intervention was 0.63, with a power of 0.80, indicating a moderate and acceptable effect size.

A Metaphor Analysis of Patients' With Chronic Conditions Experiences With Holistic Nurse Coaching.

The purpose of this study was to examine metaphors used by patients with chronic conditions to describe their experience with holistic nurse coaching. A secondary analysis was conducted using Metaphor Identification Procedure to analyze the corpus of 112 pages of typed transcription. Five metaphors emerged: (1) taking personal power back like acquiring a new toolbox; (2) seeing health challenges from different angles like a duck pond race; (3) shifting perception of a chronic condition like a spider turned into a friend; (4) engaging in self-care like caring for a favorite plant; and (5) choosing to focus on the positive like a collage that changed from dark to light. Specific interventions can be developed to address each of these metaphors to help patients live well with chronic conditions.

The role of the geriatric nurse specialist as a key response in the care of the elderly, chronicity, complex chronicity and its consequences on dependence. / La enfermera especialista en geriatría como respuesta clave en la atención a la persona mayor, la cronicidad, la cronicidad compleja y sus consecuencias en la dependencia.

Aging together with multimorbidity, polymedication and various social factors are some of the determinants that lead to increasing complexity of care in the elderly, thus making it difficult for health systems to meet their needs. To approach this new and growing scenario of care for the elderly, the formal health and social care systems must define specific jobs for geriatric nursing specialists trained to address the needs of older people from a perspective of comprehensive care, both for healthy aging, and for the different health problems of this population group, characterized by the consequences of aging and chronicity, towards dependence, and develop the powers established by law in the framework of an interdisciplinary team, for those who have been trained and accredited, thus adding value to the response that health systems have to provide for this growing problem of the 'aging-chronicity-dependence' triad.

Nursing care practices for people with Chronic Noncommunicable Diseases.

OBJECTIVE: To understand care practices for people with Chronic Noncommunicable Disease, developed by Primary Health Care nurses in a municipality in southern Brazil. METHOD: Qualitative study, developed through the Discourse of the Collective Subject. Twenty-three nurses from the Family Health Strategy participated. Data were collected through semi-structured interviews and analyzed by the health promotion framework. RESULTS: Nurses care practices for people with chronic disease present themselves through the home visit, individual care and collective care. These, eventually, have an extended character, advocating the promotion of health, at other times it is restrictive, returning to be a traditional and biologicalist practice. FINAL CONSIDERATIONS: The nurse acts in a diversified way in this field, being present in the lives of people with chronic diseases. However, it is necessary to move forward, especially in the search for the constant and continuous development of an extended and welcoming care practice.

Impact of a nurse-based intervention on medication outcomes in vulnerable older adults.

BACKGROUND: Medication-related problems are common in older adults with multiple chronic conditions. We evaluated the impact of a nurse-based primary care intervention, based on the Guided Care model of care, on patient-centered aspects of medication use. METHODS: Controlled clinical trial of the Comprehensive Care for Multimorbid Adults Project (CC-MAP), conducted among 1218 participants in 7 intervention clinics and 6 control (usual care) clinics. Inclusion criteria included age 45-94, presence of ≥3 chronic conditions, and Adjusted Clinical Groups (ACG) score > 0.19. The co-primary outcomes were number of changes to the medication regimen between baseline and 9 month followup, and number of changes to symptom-focused medications, markers of attentiveness to medication-related issues. RESULTS: Mean age in the intervention group was 72 years, 59% were women, and participants used a mean of 6.6 medications at baseline. The control group was slightly older (73 years) and used more medications (mean 7.1). Between baseline and 9 months, intervention subjects had more changes to their medication regimen than control subjects (mean 4.04 vs. 3.62 medication changes; adjusted difference 0.55, p = 0.001). Similarly, intervention subjects had more changes to their symptomatic medications (mean 1.38 vs. 1.26 changes, adjusted difference 0.20, p = 0.003). The total number of medications in use remained stable between baseline and follow-up in both groups (p > 0.18). CONCLUSION: This nurse-based, primary care intervention resulted in substantially more changes to patients' medication regimens than usual care, without increasing the total number of medications used. This enhanced rate of change likely reflects greater attentiveness to the medication-related needs of patients. TRIAL REGISTRATION: This trial is registered at https://clinicaltrials.gov , trial number NCT01811173 .

[The challenges of time in therapeutic education]. / Les enjeux du temps dans l'éducation thérapeutique.

The notion of temporality is particularly important in the management of a chronic disease. Therapeutic education of the patient represents a holistic care approach in which his life history plays a role. Establishing a context favourable to personalised support requires one to consider one's cultural interactions. Adapted communication will favour an adjustment of behaviour and the improvement of one's quality of life.

Understanding how a palliative-specific patient-reported outcome intervention works to facilitate patient-centred care in advanced heart failure: A qualitative study.

BACKGROUND: Palliative care needs of patients with chronic heart failure are poorly recognised. Policy makers advise a patient-centred approach to holistically assess patients' needs and care goals. Patient-reported outcome measures are proposed to facilitate patient-centred care. AIM: To explore whether and how a palliative care-specific patient-reported outcome intervention involving the Integrated Palliative care Outcome Scale influences patients' experience of patient-centred care in nurse-led chronic heart failure disease management clinics. DESIGN: A feasibility study using a parallel mixed-methods embedded design was undertaken. The qualitative component which examined patients and nurses experience of the intervention is reported here. Semi-structured interviews were conducted and analysed using framework analysis. SETTING/PARTICIPANTS: Eligible patients attended nurse-led chronic heart failure disease management clinics in two tertiary referral centres in Ireland with New York Heart Association functional class II-IV. Nurses who led these clinics were eligible for inclusion. RESULTS: In all, 18 patients and all 4 nurses involved in the nurse-led clinics were interviewed. Three key themes were identified: identification of unmet needs, holistic assessment and patient empowerment. The intervention impacted on processes of care by enabling a shared understanding of patients' symptoms and concerns, facilitating patient-nurse communication by focusing on these unmet needs and empowering patients to become more involved in clinical discussions. CONCLUSION: This Integrated Palliative care Outcome Scale-based intervention empowered patients to become more engaged in the clinical consultation and to highlight their unmet needs. This study adds to the evidence for the mechanism of action of patient-reported outcome measures to improve patient-centred care and will help inform outcome selection for future patient-reported outcome measure research.

'I try to make a net around each patient': home care nursing as relational practice.

BACKGROUND: As a result of restructuring, home care is increasingly defined in a narrow, task-based way, undermining the holistic nature of practice. Recent practice theories can aid us in articulating the nature of this important, yet often invisible practice. AIM: My aim in this article was to enhance our knowledge and understanding of the nature of home care nursing practice. METHOD: The approach was ethnographic, involving extensive fieldwork and formal interviews with members of five home care nursing teams and 15 older persons receiving care at home in a metropolitan area of Iceland. The study was approved by the National Bioethics Committee. FINDINGS: As a net of services, home care was enacted through relational, but often invisible care practices, relating different actors - patient, family and health-care and social-care workers - in doing the work needed for the older persons to live comfortably at home. The work was collective in that it was shared by different actors and motivated by a common understanding that had developed and was preserved in conversations in the teams. LIMITATIONS: Although the findings are limited in that they only reflect home care as practiced in one neighbourhood, they can be seen as providing important insights into what is needed for home care services to work. CONCLUSION: Home care practice can be understood as relational, aimed at creating a net of needed assistance. This work is a collective accomplishment of the teams and shaped by ideals and values shared among team members.

[Care of Korean elderly in need of care : Tendency to strengthen the role of integrated care for the elderly in communities]. / Versorgung der älteren Pflegebedürftigen in Korea : Tendenz zur Verstärkung der Rolle der integrierten Altenpflege in den Kommunen.

Since the introduction of long-term nursing care insurance in 2008, the Korean elderly in need of care are entitled to residential care or home based care services, as in the other welfare states. This article initially introduces the Korean nursing care insurance (PfV) for the elderly to give an overview of the healthcare system. Subsequently, the latest model project "Community based comprehensive care system" is introduced. The confusing care and social services should be networked and provided in a manner customized to the needs of the elderly, so that home based care before residential care can be realized.

Cognitive behavioural therapy and mindfulness for stress and burnout: a waiting list controlled pilot study comparing treatments for parents of children with chronic conditions.

BACKGROUND: Parents of children with chronic conditions often experience a crisis with serious mental health problems for themselves as a consequence. The healthcare focus is on the children; however, the parents often worry about their children's health and future but are seldom offered any counselling or guidance. AIM: The aim of this study was to investigate the effectiveness of two group-based behavioural interventions on stress and burnout among parents of children with chronic conditions. DESIGN, PARTICIPANTS AND SETTING: After a waiting list control period (n = 28), parents were offered either a cognitive behavioural (CBT, n = 10) or a mindfulness program (MF, n = 9). RESULTS: Both interventions decreased significantly stress and burnout. The within-group effect sizes were large in both interventions (CBT, g = 1.28-1.64; MF, g = 1.25-2.20). CONCLUSIONS: Hence, the results of this pilot study show that treating a group using either CBT or mindfulness can be an efficient intervention for reducing stress levels and burnout in parents of children with chronic conditions.

The feasibility and acceptability of nurse-led chronic disease management interventions in primary care: An integrative review.

AIMS: To explore the feasibility and acceptability of nurse-led chronic disease management and lifestyle risk factor reduction interventions in primary care (general practice/family practice). BACKGROUND: Growing international evidence suggests that interventions delivered by primary care nurses can assist in modifying lifestyle risk factors and managing chronic disease. To date, there has been limited exploration of the feasibility and acceptability of such interventions. DESIGN: Integrative review guided by the work of Whittemore and Knafl (). DATA SOURCES: Database search of CINAHL, Medline and Web of Science was conducted to identify relevant literature published between 2000-2015. REVIEW METHODS: Papers were assessed for methodological quality and data abstracted before thematic analysis was undertaken. RESULTS: Eleven papers met the inclusion criteria. Analysis uncovered four themes: (1) facilitators of interventions; (2) barriers to interventions; (3) consumer satisfaction; and (4) primary care nurse role. CONCLUSION: Literature supports the feasibility and acceptability of nurse-led interventions in primary care for lifestyle risk factor modification. The ongoing sustainability of these interventions rests largely on organizational factors such as funding, educational pathways and professional support of the primary care nursing role. Further robust research around primary care nurse interventions is required to strengthen the evidence base.

Estrés, cuidado espiritual y percepción de los comportamientos de cuidado del personal de enfermería / Stress, spiritual care and perception of care behaviors of nursing staff

A través de un abordaje cuantitativo correlacional se determinó la relación entre el estrés, el cuidado espiritual y los comportamientos de cuidado en el personal de enfermería que labora en servicios para la atención de personas con enfermedad crónica no transmisible ECNT. Al observar dicha relación se evidenció la importancia de mejorar el conocimiento en relación al cuidado espiritual del personal de enfermería para ilustrar mejor cómo el cuidado que se brinda a estas personas debe estar basado en la humanización y puedan apoyar actividades que ayuden al personal de enfermería en situaciones que le generen algún grado de estrés. Objetivo: Establecer la relación entre el estrés y el cuidado espiritual con la percepción de los comportamientos de cuidado del personal de enfermería que labora en instituciones de salud que atienden a pacientes con enfermedad crónica. Método: El diseño fue de tipo cuantitativo, no experimental, correlacional, donde se realizó un muestreo intencional no probabilístico de sujetos, teniendo en cuenta la población de enfermeras y auxiliares de enfermería que laboran en instituciones de alta y mediana complejidad, en colaboración con el Centro de Investigaciones Oncológicas Clínica San Diego y la Organización Colegial de Enfermería, Colombia; donde se obtuvo un tamaño total de muestra de 216 personas que cumplieron con el criterio de inclusión de llevar más de un año trabajando con paciente crónico. Se aplicaron los instrumentos Escala de estrés en enfermería (NSS), Escala de evaluación de la espiritualidad y el cuidado espiritual (SCSSR) y la Escala de Comportamientos de cuidado de Sharon Horner (Versión Profesional). Se realizó nueva validación interna de los instrumentos (análisis factorial confirmatorio), análisis descriptivo y prueba de hipótesis sobre correlación no paramétrica, bajo el modelo de ecuaciones estructurales. Resultados: los participantes fueron en su mayoría mujeres, la edad correspondió a un 47.7% de personas que tienen entre 20 y 29 años, y un 35.65 % entre 30 y 39 años. Los servicios que mostraron mayor número de participantes son los de hospitalización con un 44 %. La correlación con la espiritualidad fue positiva lo cual indica que a medida que ésta aumenta, la percepción del comportamiento del cuidado también lo hace; en caso contrario, el estrés tiene un comportamiento inverso; es decir que a medida que este aumenta, la percepción del comportamiento de cuidado disminuye. Sin embargo, dichas correlaciones fueron bajas (cercanas a cero) Dado que valor p < α para espiritualidad, se rechaza H0, por lo tanto, existe evidencia estadística para afirmar que la percepción del comportamiento de cuidado depende del cuidado espiritual. Para el caso del estrés valor p> α, no se rechaza H0, es decir que no existe evidencia estadística para afirmar que la percepción del comportamiento de cuidado depende del nivel de estrés. Conclusión: Al dar respuesta a la relación existente entre las variables del estudio, se pudo determinar que efectivamente el comportamiento del cuidado si depende del cuidado espiritual que tiene la enfermera hacia su paciente por lo tanto, enfermería al ser el sujeto que está en constante relación con esta clase de personas, se convierte en el motor que dinamiza el proceso en sí de enfermedad que lleva la persona con enfermedad crónica y es el cuidado espiritual, el que permite brindar un cambio al cuidado que se brinda.

Through a quantitative correlative approach, the relationship between stress, spiritual care and care behaviors in nursing staff working in services for the care of people with chronic noncommunicable disease (CND). Upon observing this relationship, the importance of improving knowledge in relation to the spiritual care of the nursing staff was evidenced in order to affirm the care provided to this type of patients based on humanization and support activities that help the nursing staff in situations that can generate some kind of stress. Objective: Establish the relationship between stress and spiritual care with the perception of nursing care behaviors that work in health institutions that care for patients with chronic disease. Method: The design is quantitative, not experimental, correlational, where an intentional non-probabilistic sampling of subjects was carried out, taking into account the population of nurses and nursing assistants who work in institutions of high and medium complexity, in collaboration with the Centro de Investigaciones Oncológicas Clínica San Diego and the Organización Colegial de Enfermería, Colombia; where a total sample size of 216 people who met the inclusion criteria of having been working with a chronic patient for more than a year was obtained. The instruments Stress Scale in Nursing, Spiritual Care and Spiritual Assessment Scale from Sharon Horner Care Behavior Scale (Professional Version) were applied. We performed new internal validation of the instruments (confirmatory factor analysis), descriptive analysis and hypothesis testing on non-parametric correlation, under the structural equations model. Results: The participants were mostly women, referring to age: 47.7% are between 20 and 29 years old, and 35.65% between 30 and 39 years old. The services that show the greatest number of participants are those of hospitalization with 44%. The correlation with spirituality is positive, which indicates that as it increases the behavior of care, it also does so, otherwise, stress has an inverse behavior; that is, as it increases, the care decreases. However, these correlations are low (close to zero) Given that p α for spirituality, H0 is rejected, therefore there is statistical evidence to affirm that care behavior depends on spiritual care. In the case of stress value p> α, H0 is not rejected, that is to say that there is no statistical evidence to affirm that behavioral care depends on the level of stress. Conclusion: By responding to the relationship between the variables of the study, it was possible to determine that the care behavior does depend on the spiritual care the nurse has towards her patient. Nursing, has being the subject that is in constant relationship with the patient, and becomes the engine that dynamizes the process itself of illness that leads the person with chronic disease and is spiritual care, which allows you to offer a change to the type of care that is provided

Nursing care practices for people with Chronic Noncommunicable Diseases / Las prácticas de cuidado de los enfermeros a las personas con Enfermedades Crónicas no Transmisibles / Práticas de cuidado dos enfermeiros a pessoas com Doenças Crônicas Não Transmissíveis

ABSTRACT Objective: To understand care practices for people with Chronic Noncommunicable Disease, developed by Primary Health Care nurses in a municipality in southern Brazil. Method: Qualitative study, developed through the Discourse of the Collective Subject. Twenty-three nurses from the Family Health Strategy participated. Data were collected through semi-structured interviews and analyzed by the health promotion framework. Results: Nurses care practices for people with chronic disease present themselves through the home visit, individual care and collective care. These, eventually, have an extended character, advocating the promotion of health, at other times it is restrictive, returning to be a traditional and biologicalist practice. Final considerations: The nurse acts in a diversified way in this field, being present in the lives of people with chronic diseases. However, it is necessary to move forward, especially in the search for the constant and continuous development of an extended and welcoming care practice.

RESUMEN Objetivo: Comprender las prácticas de cuidado a las personas con Enfermedades Crónicas no Transmisibles, desarrolladas por los enfermeros de la Atención Primaria a la Salud de un municipio del sur del Brasil. Método: Estudio cualitativo, desarrollado por medio del discurso del sujeto colectivo. Participaron 23 enfermeros de la Estrategia Salud de la Familia. Los datos fueron recolectados por entrevistas semiestructuradas y analizados por el referencial de la promoción de la salud. Resultados: Las prácticas de cuidado de los enfermeros a las personas con enfermedad crónica se presentan por la visita domiciliaria, la atención individual y la atención colectiva. Estas, eventualmente, tienen un carácter ampliado, preconizando la promoción de la salud. En otros momentos, se revela restrictiva, volviendo a ser una práctica tradicional y biologicista. Consideraciones finales: El enfermero actúa de modo diversificado en este campo, mostrándose presente en la vida de las personas con enfermedades crónicas. Sin embargo, hay que avanzar, principalmente en la búsqueda por el desarrollo constante y continuo de una práctica de cuidado ampliada y acogedora.

RESUMO Objetivo: Compreender as práticas de cuidado a pessoas com Doença Crônica Não Transmissível, desenvolvidas pelos enfermeiros da Atenção Primária à Saúde de um município do sul do Brasil. Método: Estudo qualitativo, desenvolvido por meio do Discurso do Sujeito Coletivo. Participaram 23 enfermeiros da Estratégia Saúde da Família. Os dados foram coletados por entrevistas semiestruturadas e analisados pelo referencial da promoção da saúde. Resultados: As práticas de cuidado dos enfermeiros a pessoas com doença crônica se apresentam pela visita domiciliar, atendimento individual e atendimento coletivo. Estas, eventualmente, têm caráter ampliado, preconizando a promoção da saúde, em outros momentos se revela restritiva, voltando a ser uma prática tradicional e biologicista. Considerações finais: O enfermeiro atua de modo diversificado neste campo, mostrando-se presente na vida das pessoas com doença crônica. Contudo, é preciso avançar, principalmente na busca pelo desenvolvimento constante e contínuo de uma prática de cuidado ampliada e acolhedora.

Influencia de los factores psicosociales en adolescentes con Diabetes Mellitus tipo I / Influência de fatores psicossociais em adolescentes que sofrem de Diabetes Mellitus tipo I / Influence of psychosocial factors in adolescents suffering from Diabetes Mellitus type I

Durante la adolescencia se presentan multitud de factores psicosociales que pueden alterar el proceso de desarrollo hacia la edad adulta. En adolescentes que además padecen Diabetes Mellitus tipo I, este desarrollo se complica muchísimo más, provocando afectación al mantenimiento adecuado de esta enfermedad crónica. Objetivo: Conocer la influencia de los factores psicosociales sobre el control de la Diabetes Mellitus en la adolescencia. Metodología: Se realiza una revisión bibliográfica en las bases de datos PubMed, CINAHL, Scielo, CUIDEN, Índice Médico Español, Dialnet, además de Google Académico y otras web de organizaciones especializadas, seleccionando los artículos de investigación de los últimos 10 años como criterio de inclusión principal. Resultados-Discusión: Como resultados encontramos como resultados ocho factores principales que influyen en el control de la Diabetes en adolescentes, que son la familia, los amigos, la ansiedad y la depresión, la dieta y alimentación, el estrés, el autoestima, el desarrollo cognitivo y la cultura y religiosidad. Conclusión: Obtenemos que se deben tener en cuenta, no sólo los factores físicos y biológicos, sino todos los aspectos psicológicos y sociales que también rodean al adolescente. El enfermero debe tener presentes estos factores al tratar con adolescentes, ya que pueden ser éstos los causantes de su desajuste de glucosa en sangre, por lo que siempre es necesario valorar al paciente desde un punto de vista holístico e intervenir en consonancia (AU)

During adolescence many psychosocial factors that can alter the development process to adulthood are presented. In addition adolescents with diabetes mellitus type I, this development is far more complicated, causing impairment of the proper maintenance of this chronic disease. Objective: To know the influence of psychosocial factors on the control of Diabetes Mellitus in adolescence. Methodology: One literature review was performed on PubMed, CINAHL, Scielo, CUIDEN, Spanish Medical Index, Dialnet, in addition to Google Scholar data and other specialized organizations website, selecting research articles of the last 10 years as the primary inclusion. Results-Discussion: As results are eight main factors that influence the control of diabetes in adolescents, they are family, friends, anxiety and depression, diet and nutrition, stress, self-esteem, cognitive development and culture and religion . Conclusion: Must be taken into account not only the physical and biological factors, but all the psychological and social aspects that also surround the teenager. Nurses should be aware of these factors when dealing with adolescents, since they can be the cause of your imbalance of blood glucose, so it is always necessary to assess the patient from a holistic point of view and to act accordingly (AU)

Durante a adolescência muitos fatores psicossociais que podem alterar o processo de desenvolvimento até a idade adulta são apresentados. Em adição adolescentes com diabetes mellitus tipo I, este desenvolvimento é muito mais complicado, causando comprometimento da manutenção adequada dessa doença crônica. Objetivos: Conhecer a influência de fatores psicossociais no controle do Diabetes Mellitus na adolescência. Metodologia: Uma revisão da literatura foi realizada no PubMed, CINAHL, Scielo, CUIDEN, Índice de Medicina espanhol, Dialnet, além de dados do Google Acadêmico e outras organizações especializadas website, selecionando artigos dos últimos 10 anos de investigação como a inclusão primário . Resultados-Discussão: Como resultados são oito principais fatores que influenciam o controle do diabetes em adolescentes, eles são família, amigos, ansiedade e depressão, dieta e nutrição, stress, autoestima, o desenvolvimento cognitivo e cultura e religião . Conclusão: Em conclusão obtemos que deve ser levado em conta não apenas os fatores físicos e biológicos, mas todos os aspectos psicológicos e sociais que também envolvem o adolescente. Enfermeiros devem estar cientes desses fatores quando se trata de adolescentes, uma vez que podem ser a causa de seu desequilíbrio de glicose no sangue, por isso é sempre necessário avaliar o paciente de um ponto de vista holístico e agir em conformidade (AU)

Diseño de una escala de medida del grado de convivencia en pacientes con un proceso crónico / Design of a measuring scale to evaluate the degree of living wth a chronic illnes, such as Parkinson´disease

INTRODUCCIÓN. Conocer cómo los pacientes conviven con un proceso crónico es necesario para proporcionar un cuidado individualizado e integral. En la actualidad, no existe ninguna escala validada que evalúe la convivencia con un proceso crónico, como es la enfermedad de Parkinson. OBJETIVOS. Los objetivos fueron: 1) definir el concepto Convivencia con un proceso crónico; 2) diseñar una escala de medición del grado de convivencia en pacientes con un proceso crónico, y en concreto, con la enfermedad de Parkinson. METODOLOGÍA. Se llevaron a cabo dos pasos metodológicos. Respecto al primero, se realizó un análisis del concepto Convivencia con un proceso crónico, a través del método evolutivo de Rodgers. El segundo paso metodológico fue el diseño de la escala, a través de la guía propuesta por DeVellis. RESULTADOS. A través del análisis de concepto se identificó que la Convivencia con un proceso crónico es un proceso complejo, dinámico, cíclico y multidimensional compuesto por los atributos de Aceptación, Afrontamiento, Automanejo, Integración y Adaptación. En cuanto a los resultados del diseño de la escala, se desarrolló una medida autocumplimentada, con cinco opciones de respuesta, tipo Likert y 27 ítems. CONCLUSIONES. La escala diseñada, es una medida innovadora y de interés potencial clínico que permite identificar qué factor o factores hacen que la persona conviva mejor o peor con la enfermedad y, consecuentemente, intervenir de manera integral, acorde con las necesidades individuales de cada persona (AU)

INTRODUCTION. Understanding how a person lives with a chronic illness is necessary to provide care according to the individual’s needs. Nowadays, there is no validated scale to measure how the person is living with a chronic condition, such as Parkinson’s disease. OBJECTIVES. The objectives were to: 1) define the concept of Living with a chronic illness; 2) design a measuring scale of the degree of Living with a chronic illness, in particular with Parkinson’s disease. METHODOLOGY. Two methodological steps were carried out. Regarding the first methodological step, a concept analysis of Living with a chronic illness was done using Rodgers’ evolutionary method. The second methodological step was the design of the scale, following DeVellis guideline. RESULTS. Through the concept analysis it was identified that Living with a chronic illness is a complex, dynamic, cyclic and multidimensional process, involving the attributes of Acceptance, Coping, Self-management, Integration and Adjustment. In relation to the design of the scale, it was developed a self-reported measure, with five Likert response options and 27 items. CONCLUSIONS. The designed scale, is an innovative measure with a high potential interest in clinical community to identify with are the factor(s) that make the person have a positive or negative living with the disease. Consequently, nurses could intervene in a holistic way, according to the patient individual needs (AU)