La relación interpersonal en el cuidado de enfermeria en tiempos de pandemia: revision integrativa / Interpersonal relationship in nursing care in pandemic times: an integrative review / A relação interpessoal no cuidado da enfermagem em tempos de pandemia: revisão integrativa

RESUMEN La enfermería como profesión, con sus procesos de trabajo directamente afectados por la pandemia, encuentra en tecnologías ligeras la escucha calificada y guiada como estrategias para mejorar la relación interpersonal que se establece con el equipo de salud, la familia y el paciente (Rodrigues, Belarmino, Custódio, & Ferreira Júnior, 2020). Esta comunicación ante la pandemia ha tenido que modificarse, sin embargo, sigue siendo fundamental para el cuidado de enfermería. Objetivo: Describir los beneficios que tiene la relación interpersonal en el cuidado de enfermería. Métodos: revisión integrativa realizada entre el 14 de julio y el 30 de agosto del 2021, y parte de la pregunta estructurada ¿Qué beneficios tiene la relación interpersonal en la satisfacción del cuidado de enfermería en tiempos de pandemia? La línea de investigación: Práctica de Enfermería. Las estrategias de búsqueda utilizadas son las bases de datos MEDLINE con su buscador PUBMED, EBSCO Host, Lilacs, Redalyc y EMBASE; en el idioma inglés y español. La pesquisa de información se realizó por especificidad restringida a términos MESH y DECS y para ampliar la búsqueda se realizaron combinaciones y los motores booleanos. Conclusiones: El proceso de comunicación no es una tarea fácil y requiere mucho esfuerzo entre los involucrados. La comunicación resultó satisfactoria para el paciente y la familia cuando apunta a la calidad de la salud y a los objetivos de seguridad del paciente. Hay comunicación interpersonal de insatisfacción cuando se dan actualizaciones insuficientes sobre la condición del paciente y cuando la familia no es consultada sobre la toma de decisiones de su familiar.

ABSTRACT Nursing as a profession, with its work processes directly affected by the pandemic, finds qualified and guided listening in communication in light technologies as strategies to improve the interpersonal relationship established with the health team, the family and the patient (Rodríguez, Belarmino, Custódio, & Ferreira Júnior, 2020). Although this communication had to be modified in the face of the pandemic, it continues to be essential for nursing care. Objective: To describe the benefits of interpersonal relationships in nursing care. Methods: integrative review, January 2020- July 2021, and starts with the research question, What benefits does the interpersonal relationship have in the satisfaction of nursing care in times of pandemic? The line of research: Nursing Practice. The search strategies used were the MEDLINE databases with its PUBMED search engine, EBSCO Host, Lilacs, Redalyc and EMBASE; in English and Spanish. The information search was done by restricted specificity to MESH and DECS terms and to broaden the search, combinations and Boolean engines were performed. Conclusions: The communication process is not an easy task and requires a lot of effort among those involved. The communication was satisfactory for the patient and the family when it aims at the quality of health and the objectives of patient safety. There is interpersonal communication of dissatisfaction when insufficient updates are given on the patient's condition and when the family is not consulted on the decision-making of their relative.

RESUMO A enfermagem como profissão, com seus processos de trabalho diretamente afetados pela pandemia, encontra em tecnologías ligeiras a escuta qualificada e orientada como estratégia para melhorar a relação interpessoal estabelecida com a equipe de saúde, a família e o paciente (Rodríguez, Belarmino, Custódio, & Ferreira Júnior, 2020). Essa comunicação em face da pandemia teve de ser modificada, no entanto, continua sendo fundamental para o cuidado de enfermagem. Objetivo: Descrever os benefícios da relação interpessoal nos cuidados da enfermagem. Métodos: revisão integrativa, janeiro de 2020 a julho de 2021, e parte da questão estruturada, Quais benefícios tem a relação interpessoal na satisfação do cuidado de enfermagem em tempos de pandemia? A linha de pesquisa: Prática de Enfermagem. As estratégias de pesquisa utilizadas foram os bancos de dados MEDLINE com seus mecanismos de busca PUBMED, EBSCO Host, Lilacs, Redalyc e EMBASE; em inglês e espanhol. A pesquisa de informações foi realizada por especificidade restrita aos termos MESH e DECS e para ampliar foram utilizadas combinações de pesquisa e motores Booleanos. Conclusões: O processo de comunicação não é uma tarefa fácil e requer muito esforço entre os envolvidos. A comunicação foi satisfatória para o paciente e para a família quando abordou a qualidade das metas de saúde e segurança do paciente. Há comunicação interpessoal de insatisfação quando são dadas atualizações insuficientes sobre a condição do paciente e quando a família não é consultada sobre a tomada de decisões de seus familiares.

¿Cómo ayuda la aplicación del proceso enfermero a las mujeres con diagnóstico ansiedad? / How can the application of the nursing process help to women with anxiety nursing diagnosis?

Objetivo: Evaluar las intervenciones grupales de enfermería en mujeres con diagnóstico enfermero ansiedad mediante el resultado NOC autocontrol de la ansiedad. Material y método: Estudio pre-experimental del tipo pretest-postest de un solo grupo realizado en un Centro de Salud Mental de la Región de Murcia a un grupo de 12 mujeres en edad adulta que presentan el diagnóstico enfermero ansiedad. Se realizó a cada paciente la valoración de enfermería por Patrones Funcionales de Salud (PFS) antes y después de la asistencia a las 8 sesiones de intervenciones enfermeras grupales. Al comenzar y al finalizar el grupo, se cumplimentó el criterio de resultado NOC autocontrol de la ansiedad. Las intervenciones enfermeras fueron a) disminución de la ansiedad (5820), terapia de relajación simple (6040), educación sanitaria (5510), enseñanza grupo (5604) y grupo de apoyo (5430). Se tomó como variable independiente las intervenciones enfermeras y como variable dependiente las puntuaciones del resultado NOC, empleándose como instrumento de evaluación. Resultados: El análisis del resultado NOC autocontrol de la ansiedad nos muestra diferencias significativas. Antes de las intervenciones, la media presenta el valor 22.5 y tras las mismas de 37.8 con una desviación típica de 3.22 y 7.11 respectivamente. La mediana antes y después de las intervenciones corresponde con los valores 21 y 37.5. El parámetro del test de los rangos de Wilcoxon corresponde con un valor de Z igual a -2.98 con una p igual a 0.003. Conclusiones: El estado, conducta y percepciones de las pacientes del grupo medido con el resultado autocontrol de la ansiedad, mejora tras recibir las intervenciones enfermeras. La puntuación global de los indicadores empleados en este resultado ha sido apropiada como medida de los efectos de las intervenciones (AU)

Purpose: To evaluate nursing group interventions in women with anxiety nursing diagnosis by self NOC result of anxiety. Methodology: Pre-experimental pretest-posttest study composed by a single group of twelve women in a Mental Health Center of the Region of Murcia. The participants were a group of women in adulthood presenting the nursing diagnosis anxiety. Each patient received 8 group nursing interventions. Before and after the group intervention, a nursing outcome criteria is filled for each patient. The following nursing interventions were used: Anxiety reduction (5820), simple relaxation therapy (6040), health education (5510), group education (5604) and support group (5430). The independent variable was nursing interventions and the dependent variable was NOC punctuations, being used as an assessment tool. Results: The analysis of the NOC result anxiety self-control shows significant differences. Before the intervention, the mean was 22.5 and 37.8 after it with standard deviations of 3.22 and 7.11 for each one. The median was 21 before interventions and 37.5 after them. The Wilcoxon test shows a Z value of -2.98 with p 0.003. Conclusion: The state, behaviour and perception of patients improve with nursing interventions received. The global punctuation of used clinical indicators is a good tool to measure nursing intervention effects (AU)

El don de la aplicación de la terapia de Reiki en pacientes oncológicos / The gif of the application of Reiki therapy in cancer patients

El dolor es una de las consecuencias más temidas del cáncer. Cuando este no se alivia bien contribuye al sufrimiento del paciente y su familia. Ello puede motivarlos a buscar terapias alternativas y complementarias adicionales, tal y como la que nos ocupa en esta revisión bibliográfica. El Reiki es un método de curación que utiliza la energía universal, a través de la imposición de las manos. Es una terapia relativamente nueva en relación con el alivio de los síntomas del cáncer. De hecho, aún existen pocos artículos en este campo. En la actualidad, los autores exploran la evidencia sobre la eficacia del Reiki en relación con el dolor del cáncer y el control de los síntomas. Debido al mayor interés depositado en el Reiki por los profesionales de la salud -en especial por los profesionales de oncología- para el alivio de los síntomas del cáncer, se ha realizado una síntesis de los últimos estudios para ofrecer la evidencia existente hasta el momento. Tras la revisión bibliográfica, se puede concluir que en este momento no existe suficiente evidencia sobre la eficacia del Reiki en el alivio de los síntomas del cáncer debido al reducido tamaño muestral utilizado, la escasez de estudios y el abandono de los participantes de los estudios, entre otras causas (AU)

Pain is one of the most feared symptoms of cancer. Bad pain not properly relieved contributes to the suffering of the patient and family. This may encourage them to seek additional complementary and alternative therapies, such as the one in our literature review. Reiki is understood as a healing method that uses universal energy to achieve balance and harmony of body, mind and soul, through the laying on of hands. Reiki is a relatively new therapy in relation to the relief of the symptoms of cancer. In fact, there are still a few articles in this field. Currently, the authors explore the evidence on the effectiveness of Reiki in relation to cancer pain and symptom control. Due to the increased interest deposited in Reiki by the health professionals -especially for oncology professionals- to relieve the symptoms of cancer, there has been a synthesis of recent studies to provide the evidence so far. After our literature review, we can conclude that there is insufficient evidence on the effectiveness of Reiki in relieving the cancer’s symptoms due to the small sample size used, the paucity of studies and the abandonment of the study participants and others (AU)

Distraction as a technique to control pain in pediatric patients during venipuncture. A narrative review of literature.

INTRODUCTION: Distraction is a non-pharmacological intervention aimed to reduce procedural pain in children. Venipuncture is one of the most widely used diagnostic and therapeutic procedure in pediatric patients. Analgesia during venipuncture may be efficiently achieved with distracting techniques. OBJECTIVE: To describe active and passive distraction techniques to reduce distress in children undergoing venipuncture. METHOD: Data from CINHAL, PubMed, ILISI and Cochrane's databases were used to review existing literature and primary and secondary studies published between 2003 and 2014 were included. Queries were obtained with keywords such as distraction, complementary therapies, pain, pediatric, the Boolean operators AND and OR were used. RESULT: Twenty eligible articles out of the one hundred and forty-three retrieved (20/143) were selected; among these there were 3 systematic and 5 narrative reviews, 11 experimental and quasi-experimental studies and 1 observational study. Active and passive distraction techniques seemed extremely effective to reduce distress and pain in children undergoing venipuncture. Modest evidence of efficacy and absent side effects support this approach. CONCLUSION: Further RCTs are needed to compare the different types of existing active and passive distraction techniques. The presence of parents and the location where painful procedures are administered should be included in the assessment of this approach.

Guided Imagery for Adolescent Post-spinal Fusion Pain Management: A Pilot Study.

Orthopedic surgery for adolescent idiopathic scoliosis entails anxiety and severe postoperative pain. The aim of this pilot study was to investigate an intervention for adolescent post-spinal fusion pain management in patients from a tertiary care hospital in Montreal, Canada. Participants were adolescents and young adults ages 11 to 20 years undergoing spinal fusion. Participants were randomized to standard care or standard care with adjunct intervention. The intervention consisted of a DVD with information and guided imagery/relaxation exercises to practice at least three times a week at home. A nurse screened the DVD with the patient preoperatively and at discharge (T1) and telephoned 2 weeks post-discharge (T2) to reinforce the technique. Both groups completed questionnaires at T1, T2, and T3 (1-month postoperative follow-up). Outcome measures included pain intensity, anxiety, coping mechanisms, and daily activities. From March 2010 to June 2011, we enrolled 40 of 45 eligible participants (n = 20 per group), average age 15 ± 2.1 years, 7 participants were male. Compared with the control group, the experimental group experienced significantly less overall pain at all time points, with moderate to large effect sizes at T2, T3 (p ≤ .007). Worst pain in 24 hours was moderately decreased at T2 (p = .01). State-trait anxiety remained high. On a 10-point scale, a median 2.5-point benefit was seen in eating and sleeping (Mann-Whitney test, p = .002), and 2 points in walking (Mann-Whitney test, p = .003). Coping strategies showed no significant differences. Addition of a guided imagery and relaxation exercise DVD for home use was more effective than standard care alone for postoperative pain. Our nonpharmacologic adjunct looks promising. Larger sample size and longer (6-9 months) follow-up will permit refinement.

The effects of music therapy on pain in patients with neuropathic pain.

The aim of this study was to investigate the effect of relaxing music on pain intensity in patients with neuropathic pain. A quasi-experimental study, repeated measures design was used. Thirty patients, aged 18-70 years, with neuropathic pain and hospitalized in an Algology clinic were identified as a convenience sample. Participants received 60 minutes of music therapy. Classical Turkish music was played to patients using a media player (MP3) and headphones. Participants had pain scores taken immediately before the intervention and at the 30th and 60th minutes of the intervention. Data were collected over a 6-month period in 2012. The patients' mean pain intensity scores were reduced by music, and that decrease was progressive over the 30th and 60th minutes of the intervention, indicating a cumulative dose effect. The results of this study implied that the inclusion of music therapy in the routine care of patients with neuropathic pain could provide nurses with an effective practice for reducing patients' pain intensity.

Optimal timing for initiation of biofeedback-assisted relaxation training in hospitalized coronary heart disease patients with sleep disturbances.

BACKGROUND: Clinical studies have shown that biofeedback-assisted relaxation positively influences the treatment outcomes of sleep disturbance. However, there are only few studies reporting the timing of relaxation training initiation, and the relationships between the timing of initiation and the effectiveness of relaxation remain unclear. OBJECTIVES: The aim of this study was to determine the optimal timing for initiating nurse-led biofeedback-assisted relaxation on hospitalized coronary heart disease patients with sleep disturbance. METHODS: An experimental pretest and repeated posttest design was used to compare the effectiveness of nurse-led biofeedback-assisted relaxation. A total of 128 patients with coronary heart disease were randomly assigned to 1 of 4 groups: morning group, night group, morning-night group, or control group. Outcome measures included self-report of sleep-related indicators, the scores of the Pittsburgh Sleep Quality Index (PSQI) and the Zung's Self-rating Anxiety Scale (SAS), and the dosage of sleep medication used. A 2-way analysis of variance and a simple effect test were used to analyze the differences among the 4 groups. RESULTS: No significant differences could be detected at baseline. Compared with the control group, the nurse-led biofeedback-assisted relaxation yielded a greater benefit for patients in the 3 intervention groups. Group and time factors (pretest-protest) could explain the variation in the effectiveness of this program (main effect P < .01). There were statistical differences among the groups: patients in the night group (FSOL = 33.15, P < .001; FTST = 17.99, P < .001; FSE = 10.26, P = .002; FPSQI = 27.38, P < .001; FSAS = 54.39, P < .001, respectively) and in the morning-night group (FSOL = 33.62, P < .001; FTST = 34.13, P < .001; FSE = 24.04, P < .001; FPSQI = 31.26, P < .001; FSAS = 73.93, P < .001, respectively) had slightly shorter sleep latency, experienced fewer awakenings, reported higher sleep quality, and used significantly fewer sleep medications than the morning group did (F = 32.97, P < .001). CONCLUSIONS: The timing of the initiation of nurse-led biofeedback-assisted relaxation was 1 of the factors affecting the effectiveness of relaxation. Relaxation training either at night or in the morning-night combination could effectively enhance sleep quality and decrease the need for of sleep medications in hospitalized patients with sleep disturbance.

Clinical hypnosis for labour and birth: a consideration.

Labour pain is one of the most important factors in shaping women's experiences of birth. Choice around pharmacological relief can be complex. Clinical hypnosis is a non-pharmacological option which a number of women have chosen to use, often paying privately to do so. Self hypnosis allows women the opportunity to take control of this technique. Research findings relating to the therapy vary; some trials have found positive effects by way of a reduction in use of pharmacological pain relief, oxytocin use and shortened first stage of labour. Inclusion of the therapy as a means to invoke relaxation and counter the effects of stress and anxiety alone may be valid reasons for consideration of its use. This article outlines the framework used in clinical hypnosis and discusses some of the issues relating to the evidence base for it.

[Reclaiming the body through touch-relaxation massage]. / Se réapproprier son corps grâce au toucher-massage.

More than just a simple technique, touch-relaxation massage in the protected haematology unit of Nantes general hospital has become a real personalised act of care, in what are often difficult conditions of hospitalisation. It forms part of the global support of patients suffering from leukaemia.

Estudio cuasi-experimental sobre las terapias de relajación en pacientes con ansiedad / Quasi-experimental relaxation therapies in patients with anxiety

Introducción: Los trastornos de ansiedad son muy frecuentes en atención primaria y especializada. Para reducir la ansiedad se recomienda el uso de terapias de relajación como terapia alternativa a la psicofarmacología. El objetivo del estudio será averiguar si las terapias de relajación benefician a los pacientes con ansiedad. Material y métodos: Se utilizó metodología cuantitativa: estudio cuasi-experimental de antes y después, longitudinal, prospectivo. Sujetos a estudio: pacientes diagnosticados de ansiedad y que acepten participar en la terapia de relajación en el centro de salud mental Infante (Murcia), desde diciembre hasta marzo de 2010. (n=39). Variable independiente: terapia de relajación; variable dependiente: ansiedad. Otras variables: sexo, edad, nivel educativo y tratamiento con psicofármacos. Se utiliza la escala validada: STAI; se comparan puntuaciones pre-post-intervención (se aplica t de student, xi cuadrado (intervalo de confianza p< 0'05). Resultados: Realizan el test STAI pre-post 39 pacientes, 69% mujeres y 31% hombres. La edad media: 39'84 años. Un 77% tomaban medicación y el 23% no. Predominaba claramente el de educación secundaria obligatoria (ESO). La media de ansiedad estado antes fue de 68 y después de 56. STAI estado (antes/después) con un nivel de significación de p< 0'027, por lo que se aceptó la hipótesis nula. Se observó que en los pacientes que no tomaban psicofármacos, el descenso de ansiedad era significativo con una p<0'036. Conclusiones: Los talleres de técnicas de relajación son útiles en la reducción de la ansiedad en atención especializada, además son más eficaces en pacientes con ansiedad que no tomen medicación (AU)

Introduction: Anxiety disorders are highly prevalent in primary and specialty care. To reduce anxiety the use of relaxation therapy is recommended as an alternative therapy to Psychopharmacology. The aim of the study is determine whether relaxation therapies benefit patients with anxiety. Materials and Methods: We used quantitative methodology: a quasi-experimental study before and after a, longitudinal, prospective study. Subjects studied: patients diagnosed with anxiety who agreed to participate in relaxation therapy at the mental health center Infante (Murcia), from December 2009 to March 2010. (N = 39). Independent variable was relaxation therapy and the dependent variable was anxiety. Other variables were sex, age, educational level and treatment with psychotropic drugs. Validated scale used was STAI, scores comparing pre-post-intervention (t student applies, xi square confidence interval (p <0.05). Results: The test was performed by pre-post STAI 39 patients, 69% female and 31% male. The mean age was 39'84 years. 77% were taking medication and 23% were not. There was a clearly dominance of secondary education (ESO). Mean state anxiety before was 68 and after 56. STAI state (before / after) with a significance level of p <0'027, so the null hypothesis was accepted. It was observed that in patients not taking psychotropic drugs, the decrease in anxiety was significant at p <0'036. Conclusions: Workshops in relaxation techniques are helpful in reducing anxiety in specialized care, and are more effective in patients with anxiety who do not take medication (AU)

The effects measurement of hand massage by the autonomic activity and psychological indicators.

This study examined the effects of hand massage on autonomic activity, anxiety, relaxation and sense of affinity by performing it to healthy people before applying the technic in actual clinical practice. Findings were showed below: 1) the significant increase in the pNN50 and the significant decrease in the heart rate meant the intervention of massage increased the autonomic nervous activity, improved the parasympathetic nerve activity and reduced the sympathetic nerve activity. This means the subjects were considered to be in a state of relaxation. 2) Salivary α amylase has been reported as a possible indicator for sympathetic nerve activity. In this study, there was no significant difference in the salivary α amylase despite a decrease after massage. 3) State anxiety score is temporal situational reactions while being in the state of anxiety and this score decreased significantly after massage. 4) The level of willingness to communicate with other person and the sense of affinity toward the massage-performer had a positive change of 70 percent. From this, it can be considered that a comfortable physical contact between a patient and a nursing profession, who are in a supported-supportive relationship, leads to an effect of shortening the gap in their psychological distance.