The effect of a couple-based posttraumatic growth intervention in supporting couples coping with colorectal cancer: A randomized controlled study.

OBJECTIVES: To promote posttraumatic growth (PTG) in colorectal cancer (CRC) couples, a couple-based PTG intervention was conducted, and the intervention had previously proved be feasible in CRC couples. The current study was conducted to validate the effects of intervention in CRC couples. METHOD: This is a randomized controlled study that included 174 CRC couples. All participants were randomized to either the intervention (usual care plus 5-week PTG intervention, n = 87) or the control group (usual care, n = 87). Data were collected from CRC couple dyads at baseline and immediately post-intervention periods. Primary outcome refers to positive changes, and secondary outcomes include marital satisfaction, quality of life (QOL), and anxiety and depression. Multilevel modeling was applied to analyze the intervention effects. RESULTS: Participants in the program showed increased PTG, marital satisfaction, and QOL both physically and mentally, and decreased levels of anxiety and depression over time. And spousal caregivers showed greater improvement in marital satisfaction and physical QOL compared with patients. In addition, significant intervention effects were shown in the participants' benefit finding, physical health and depressive symptoms. CONCLUSION: The study confirmed the effect of the PTG intervention on CRC couples' benefit finding, physical health and depressive symptoms. However, this study only measured outcome variables at two time-points. Future studies should add follow-up assessments to evaluate long-term effects of the intervention in CRC couples. REGISTRATION NUMBER: ChiCTR2300067809.

Exploring grandparents' psychosocial responses to childhood cancer: A qualitative study.

OBJECTIVE: A childhood cancer diagnosis is a traumatic experience for patients and their families. However, little is known about the effect on grandparents. We aimed to investigate the negative psychosocial impact, coping strategies, and positive outcomes of grandparents of childhood cancer patients in Switzerland. METHODS: We collected data using a semi-structured interview guide and applied qualitative content analysis. RESULTS: We conducted 20 interviews with 23 grandparents (57% female; mean age = 66.9 years; SD = 6.4; range = 57.0-82.4) of 13 affected children (69% female; mean age = 7.5 years; SD = 6.1; range = 1.0-18.9) between January 2022 and April 2023. The mean time since diagnosis was 1.0 years (SD = 0.5; range = 0.4-1.9). Grandparents were in shock and experienced strong feelings of fear and helplessness. They were particularly afraid of a relapse or late effects. The worst part for most was seeing their grandchild suffer. Many stated that their fear was always present which could lead to tension and sleep problems. To cope with these negative experiences, the grandparents used internal and external strategies, such as accepting the illness or talking to their spouse and friends. Some grandparents also reported positive outcomes, such as getting emotionally closer to family members and appreciating things that had previously been taken for granted. CONCLUSIONS: Grandparents suffer greatly when their grandchild is diagnosed with cancer. Encouragingly, most grandparents also reported coping strategies and positive outcomes despite the challenges. Promoting coping strategies and providing appropriate resources could reduce the psychological burden of grandparents and strengthen the whole family system.

Discrepancies in perceived family resilience between adolescents with chronic illness and parents: using response surface analysis to examine the relationship with adolescents' psychological adjustment.

BACKGROUND: This study aimed to explore discrepancies in adolescents with chronic illness and their parents' perceptions of family resilience, as well as the relationship between these differences and the psychological adjustment of adolescents with chronic illness. METHODS: A cross-sectional study was conducted. A total of 264 dyads of parents (77.7% mothers, mean age 41.60 years, SD = 6.17) and adolescents (48.5% girls, mean age 12.68 years, SD = 2.11) with chronic illness were recruited through convenience sampling from three children's hospitals in Wenzhou, Hangzhou, and Shanghai, China between June 2022 and May 2023. The Chinese version of the Family Resilience Scale and the Psychological Adjustment Scale, which are commonly used measures with good reliability and validity, were employed to assess family resilience and psychological adaption, respectively. The data were analyzed using polynomial regression and response surface analysis. RESULTS: Adolescents with chronic illness reported higher family resilience than their parents (t=-2.80, p < 0.05). The correlations between family resilience and adolescents' psychological adjustment reported by the adolescents (r = 0.45-0.48) were higher than parents (r = 0.18-0.23). In the line of congruence, there were positive linear (a1 = 1.09-1.60, p < 0.001) and curvilinear (a2=-1.38∼-0.72, p < 0.05) associations between convergent family resilience and adolescents' psychological adjustment. In the line of incongruence, when adolescents reported lower family resilience than parents, adolescents had a lower level of psychological adjustment (a3=-1.02∼-0.45, p < 0.05). Adolescents' sociability decreased when the perceived family resilience of parent-adolescent dyads converged (a4 = 1.36, p < 0.01). CONCLUSION: The findings highlighted the importance of considering the discrepancies and congruence of family resilience in the parent-child dyads when developing interventions to improve the psychological adjustment of adolescents with chronic illness. Interventions aimed at strengthening family communication to foster the convergence of perceptions of family resilience in parent-adolescent dyads were warranted.

Practitioner perspectives on the use of acceptance and commitment therapy for bereavement support: a qualitative study.

BACKGROUND: There is currently a high demand for bereavement support coupled with inconclusive findings as to the efficacy of existing approaches. Acceptance and Commitment Therapy (ACT) aims to improve human functioning and has shown efficacy across a wide range of conditions. ACT may be a promising means of supporting bereaved people, yet evidence on the use of ACT for bereavement support is lacking. The aim of this study is to explore how ACT is currently used for bereavement support and practitioner perspectives of how it helps following bereavement. METHODS: Semi-structured interviews were conducted online via MS Teams with practitioners experienced in using ACT for bereavement support. Data were analysed thematically guided by a framework approach. RESULTS: Nine participants were recruited. Three themes were identified: (i) creating psychological space around grief; (ii) using psychological space for value-directed action in the midst of grieving, and (iii) adapting ACT for bereavement support. Practitioners indicated that ACT improves clients' relationship with distressing internal experiences. Metaphors and mindfulness techniques were used to encourage acceptance of grief responses, taking perspective on distressing thoughts and images, and contact with the present moment. Better relationships with distressing experiences were regarded as less psychologically taxing, improving coping and well-being, while providing the psychological space to engage in value-directed action. Values exploration, sometimes using metaphors and exercises, was seen as supporting the bereaved person to rediscover a sense of purpose and engage in meaningful activities alongside their grief. Practitioners used ACT flexibly, integrating other interventions, and adapted ACT to the perceived sensitivities of bereaved people, and age-related and developmental factors. CONCLUSION: ACT is used to support people who have been bereaved to live effectively with the difficult thoughts and feelings associated with grieving and to enable them to gradually identify, reconnect with, and act in line with their values after loss.

Trajectories of psychological adaptation to Chinese older internal migrants: a latent transition model.

OBJECTIVES: Little is known about the heterogeneity and transitions between psychological adaptation patterns in Chinese older internal migrants. This study addressed two questions: (a) Do distinct patterns of psychological adaptation exist among Chinese older internal migrants? (b) If so, what factors predict different trajectories? METHOD: The study drew on two waves of data and involved 405 older internal migrants into Nanjing, China. First, a latent transition analysis was performed to visualize the different patterns of psychological adaptation. Second, an ecological model of resilience was used to identify the factors explaining the differences between adaptation patterns. RESULTS: Three main trajectories of psychological adaptation among Chinese older internal migrants over time were: recovery, stability and deterioration. Adaptation trajectories were associated with age, gender, length of stay, psychological resilience, self-esteem, family support, social participation, and living with a spouse. CONCLUSION: Chinese older internal migrants undertake heterogeneous psychological adaptation trajectories, and their positive adaptation is closely associated with coping resources. Our data may provide references for the identification of vulnerable older internal migrants, as well as the making of targeted interventions.

Does self-care improve coping or does coping improve self-care? A structural equation modeling study.

BACKGROUND: Support interventions often address both self-care and coping. Different approaches are used to promote self-care and coping so clarifying the intervention effect can guide clinicians and researchers to provide interventions that achieve benefit. PURPOSE: To compare two models to determine whether self-care improves coping or coping improves self-care. METHODS: We used cross-sectional data from 248 caregivers obtained at enrollment into a randomized controlled trial testing the efficacy of a support intervention. Factor scores for scales measuring caregiver demand, self-care, coping, stress appraisal, and mental health were derived from exploratory factor analysis. Structural equation models were analyzed using the factor scores as estimates of each construct. To control possible spurious effects caregiver age, gender, relationship with the patient, and income adequacy were included. RESULTS: Both models were compatible with the data, but the self-care model was stronger than the coping model. That model had a non-significant chi square and an excellent fit to the data, χ2(4, N = 248) = 2.64, p = .62. The percentage of variance explained by the self-care model was 54 % for mental health, 42 % for stress appraisal, 10 % for avoidance coping, and 6 % for active coping. In the coping model the explained variance of stress appraisal dropped to 33 %, avoidance coping dropped to 0 %, and active coping dropped to 3 %. CONCLUSIONS: The self-care model was strongest, illustrating that self-care decreases stress, promotes coping, and improves mental health. These results suggest that promoting self-care may be more effective in improving mental health than interventions aimed at improving coping.

Resilience, coping and Personal Factors of medical students at a Public University; Karachi, Pakistan.

OBJECTIVE: To assess resilience levels of medical students, identify factors associated with it, and explore association between coping styles and resilience level among medical students. METHODS: The analytical, cross-sectional study was conducted at the Dow Medical College, Dow University of Health Sciences, Karachi, from February to June 2022, and comprised medical students regardless of gender and the academic year. Data was collected using self-administered socio-demographic form, Brief Resilience Scale and Brief Cope. Data was analysed using SPSS 28. RESULTS: Out the 301 participants, 197(65.4%) were females and 104(34.6%) were males. The overall mean age was 20.7±1.849 years. Of the total, 132(43.9%) students had low resilience, with males having better resilience compared to females (p<0.001). Higher resilience was seen in year 1 students compared to those of clinical years (p=0.029). There was a significant positive correlation between high resilience and problem-focussed coping, while a significant negative correlation was found between resilience and avoidant and emotionally focussed strategies (p<0.05). There was a significant negative correlation between resilience levels and age (p<0.025). There was a significant difference in resilience scores with respect to the last grade point average, sleep hours, and hours spent studying (p<0.05). CONCLUSIONS: More than one-third medical students demonstrated low resilience, and the majority reported adopting emotion-focussed coping style.

Medical Error: Using Storytelling and Reflection to Impact Error Response Factors in Family Medicine Residents.

I am a healer, yet sometimes I do more harm than good…David Hilfiker, 1984. Objectives: Medical error is common and significantly impacts patients, physicians, learners, and public perception of the medical system; however, residents receive little formal training on this topic. Research on error response in practicing physicians is limited, and even more so on medical education interventions to improve this. This study evaluates a curriculum developed to foster the sharing of faculty medical error stories, practice of constructive coping strategies, and growth in resident confidence in managing error. Methods: Researchers identified factors related to effective physician error management and recovery to develop a targeted intervention for family medicine residents. The intervention consisted of three one hour didactic sessions in a medium-sized midwestern, urban family medicine residency program over the course of 6 months. Instructional methods included guided reflection after mentor storytelling, small group discussion, role play, and self-reflection. Results: Of the 30 residents, 22 (73%) completed the preintervention survey, and 15 (50%) completed the postintervention survey. While most residents reported having experienced error (55%), fewer than half of the residents reported they knew what to do when faced with medical errors (46%). This increased to 93% after intervention. Personal error stories from mentors were the most desired type of training reported by residents preintervention, but this was surpassed by legal and malpractice concerns in the postintervention survey. Rates of reported error story sharing increased after the intervention. Residents reported self-efficacy (I can be honest about errors) and self-awareness (I acknowledge when I am at increased risk for error) also increased with intervention. However, these changes did not reach statistical significance. Conclusions: Family medicine residents are receptive to learning from peers and mentors about error management and recovery. A brief intervention can impact the culture around disclosure and support. Future research should focus on the impact of targeted interventions on patient-oriented outcomes related to medical error.

The Perceptions and Experiences of Older People Living in the Aftermath of Lombok Earthquakes, Indonesia: A Qualitative Study.

INTRODUCTION: Despite the growing knowledge of people's vulnerability following natural disasters, the perspective of older people has received limited attention. This study aimed to explore the perceptions and experiences of older people encountering the 2018 Lombok earthquakes. METHODS: This exploratory qualitative study involved 16 older people living in one of the villages most affected by the 2018 earthquakes in Lombok Island, Nusa Tenggara Barat, Indonesia. The data were collected in June 2019 using semi-structured interviews. Participants' responses were digitally recorded and transcribed verbatim for analysis. The data were analysed using qualitative content analysis managed in NVivo. RESULTS: From older people's perspectives, three themes were generated: surviving the disaster, dealing with life changes and navigating through challenges and hope. Each theme comprised two categories, which reflected the journey of older people from the early to the later phase of the disaster. CONCLUSIONS: Older people experienced critical conditions and difficulties both physically and mentally. They also experienced various emotional responses before accepting living situations following a disaster. Nurses should play a role in fulfilling the physical and mental health needs of older people in post-disaster conditions. IMPLICATIONS FOR PRACTICE: This study can inform nurses and other key stakeholders about the needs of older people during and after natural disasters. Nurses need to be equipped with the skills and abilities to identify and meet the needs of older people in difficult situations and with limited resources.

Perception of aesthetic impairment in patients with systemic sclerosis determined using a semi-quantitative scale and its association with disease characteristics.

Background: Systemic sclerosis is a fibrotic disease. Body image assessments could be key in optimizing care; however, data are scarce. The main objective was to assess the perception of aesthetic impairment using a visual aesthetic evaluation scale in patients with systemic sclerosis compared with healthy subjects. The secondary objectives were to assess associations between the perception of aesthetic impairment and scores on standardized questionnaires for aesthetic impairment as well as clinical, psychological/quality of life, and functional parameters of patients with systemic sclerosis. Methods: This study evaluated and compared the perception of aesthetic impairment in two populations: patients with systemic sclerosis from a referral center at Lille Hospital, France, and healthy controls. Results: This study included 88 patients (69 (78.4%) women) with a median age of 52 years and 88 controls (49 (55.7%) women) with a median age of 45 years. The perception of aesthetic impairment assessed using the aesthetic evaluation scale was poorer in systemic sclerosis patients than in controls (3.7 ± 0.3 vs 2.8 ± 0.3, p = 0.028) and was statistically correlated with assessments using the adapted satisfaction with appearance, a specific aesthetic impact assessment questionnaire for patients with systemic sclerosis. Patients with anxiety or depressive symptoms had significantly higher aesthetic evaluation scale scores. Systemic sclerosis patients with facial involvement and pitting scars had a worse perception of aesthetic impairment. Compared with healthy controls, systemic sclerosis patients had a worse perception of aesthetic impairment, especially systemic sclerosis patients with anxiety or depression and those with facial and hand involvement. Conclusion: The aesthetic evaluation scale appears to be an easy-to-use tool to evaluate body image. Correlations of the aesthetic evaluation scale score with psychological and quality of life parameters reflect the importance of these parameters for body image evaluation and its complex assessment. Trial registration: Clinical Trial NCT03271320 (Registered 9 January 2017, https://www.clinicaltrials.gov/ct2/show/NCT03271320?term=NCT03271320&cntry=FR&draw=2&rank=1).

Role of Sports Motivation and Basic Psychological Needs in the Relationship Between Child Maltreatment and Psychological Adaptation in Adolescents.

Child maltreatment poses serious consequences, while sports participation among adolescents offers a potential avenue for mitigating such consequences. This study, based on self-determination theory (SDT), examines the associations among child maltreatment, sports motivation (intrinsic and extrinsic), and satisfaction or frustration of basic psychological needs (BPNs). This study also investigated the mediating role of sports motivation in the relationship between child maltreatment and psychological adaptation. Adolescents engaged in sports were derived from the first wave of a large two-wave study (wave 1: n = 1403; wave 2: n = 618) using data on child maltreatment, intrinsic and extrinsic motivation, and satisfaction and frustration of within the sports context. Subsequently, data on psychological adaptation, including self-esteem and satisfaction with life, were collected during the second wave. Path analyses revealed satisfaction and frustration of BPNs as significant mediators in the relationship between child maltreatment and sports motivation. In addition, intrinsic motivation mediated the relationship between child maltreatment and psychological adaptation after 18 months. Specifically, the results indicated that enhancing intrinsic motivation in adolescents with a history of child maltreatment by improving satisfaction of BPNs could be an innovative intervention target.

Difficulties in emotion regulation and well-being in breast cancer.

Objective: Breast cancer is responsible for disruptive changes in women's lives, causing them to experience diverse and intense negative emotions that can affect their perception of well-being. The present study aimed to characterize difficulties in emotion regulation (ER), according to Gratz and Roemer's multidimensional assessment, in women with breast cancer and to relate them with General Well-Being and its different domains: Physical, Social/Familial, Emotional, and Functional. Method: Ninety-five Portuguese women with breast cancer aged between 32 and 75 years answered a sociodemographic and clinical questionnaire and the Portuguese versions of the Difficulties in Emotion Regulation Scale and the Functional Assessment of Cancer Therapy - General. Data were collected in an oncology public hospital. Results: In general, difficulties in ER presented negative correlations with General Well-Being and its domains. The multiple regression analysis findings indicated that two specific types of difficulties, Limited Access to ER Strategies and Lack of Emotional Clarity, play a significant role in predicting well-being, especially in the Emotional domain, which was most compromised in these patients. Conclusions: These difficulties should be approached within psycho-oncological interventions as they are essential contributors to improving emotional and general well-being and fostering psychological adaptation to breast cancer.

Stay strong, stay healthy: exploring a predictive model of psychological adaptation among Macau students studying in Mainland China within the postcolonial context.

The prevailing research on adaptation primarily centers around the settlement of international students and immigrants in different cultural environments. However, there is a notable gap in understanding the intra-cultural adaptation process for individuals from postcolonial areas when relocating to their home country. The primary focus of the current study lies in constructing a predictive model that delineates the psychological adaptation experienced by Macau students studying in Mainland China. In total, two hundred and fifty-five Macau students completed a questionnaire which assessed variables falling into two categories: identity-related variables, such as language proficiency and identity, and intergroup-related variables, including intergroup contact and the quality of contact, and psychological adaptation. The findings from the present study revealed that identity and quality of contact continued to make significant contributions to psychological adaptation in intra-cultural environments as in inter-cultural environments, whereas language proficiency and intergroup contact were unrelated to psychological adaptation in intra-cultural adaptation. The present study extended the adaptation research by transporting hypotheses and findings from inter-cultural adaptation and testing their validity and applicability in postcolonial contexts. The findings also provided practical implications for Chinese education institutions and policy-makers.

An explanatory model of quality of life in high-risk pregnant women in Korea: a structural equation model.

PURPOSE: This study aimed to develop and validate a structural model for the quality of life (QoL) among high-risk pregnant women, based on Roy's adaptation model. METHODS: This cross-sectional study collected data from 333 first-time mothers diagnosed with a high-risk pregnancy in two obstetrics and gynecology clinics in Cheonan, Korea, or participating in an online community, between October 20, 2021 and February 20, 2022. Structured questionnaires measured QoL, contextual stimuli (uncertainty), coping (adaptive or maladaptive), and adaptation mode (fatigue, state anxiety, antenatal depression, maternal identity, and marital adjustment). RESULTS: The mean age of the respondents was 35.29±3.72 years, ranging from 26 to 45 years. The most common high-risk pregnancy diagnosis was gestational diabetes (26.1%). followed by preterm labor (21.6%). QoL was higher than average (18.63±3.80). Above-moderate mean scores were obtained for all domains (psychological/baby, 19.03; socioeconomic, 19.00; relational/spouse-partner, 20.99; relational/family-friends, 19.18; and health and functioning, 16.18). The final model explained 51% of variance in QoL in high-risk pregnant women, with acceptable overall model fit. Adaptation mode (ß=-.81, p=.034) and maladaptive coping (ß=.46 p=.043) directly affected QoL, and uncertainty (ß=-. 21, p=.004), adaptive coping (ß=.36 p=.026), and maladaptive coping (ß=-.56 p=.023) indirectly affected QoL. CONCLUSION: It is essential to develop nursing interventions aimed at enhancing appropriate coping strategies to improve QoL in high-risk pregnant women. By reinforcing adaptive coping strategies and mitigating maladaptive coping, these interventions can contribute to better maternal and fetal outcomes and improve the overall well-being of high-risk pregnant women.

Effect of Training for an Athletic Challenge on Illness Cognition in Individuals with Chronic Disability: A Prospective Cohort Study.

Illness cognitions (IC) influence how a patient adapts to a chronic disease. The aim was (1) to determine if training for a handcycling mountain time trial (HandbikeBattle) improves IC and (2) to identify factors associated with IC change scores. Persons with a chronic disability (N = 220; including N = 151 with spinal cord disorder) trained 5 months and participated in the time trial. The IC Questionnaire measured helplessness, acceptance, perceived benefits and was assessed before training (T1), after training (T2), and four months after the event (T3). Age, sex, body mass index (BMI), time since injury (TSI), disability characteristics, self-efficacy, mental health (MH) and musculoskeletal pain were obtained at T1. Multilevel regression analyses showed that helplessness decreased (from 11.96 to 11.28, p < 0.01) and perceived benefits increased (from 16.91 to 17.58, p < 0.01) from T1 to T2. For helplessness this decrease persisted during follow-up (11.16 at T3). Changes in helplessness were associated with self-efficacy (p = 0.02), MH (p = 0.02) and lesion completeness (p = 0.02), and were independent of disability type (p = 0.66), lesion level (p = 0.30) and demographics such as sex (p = 0.29) and age (p = 0.67). Training with peers may improve helplessness and perceived benefits in individuals with a chronic disability. Especially individuals with MH problems might benefit from training for an athletic challenge with peers to improve illness cognitions, and ultimately, quality of life.

Sense of mastery in caregivers of people living with dementia: translation and cultural adaptation of the Pearlin Mastery Scale / Senso de domínio de cuidadores de pessoas que vivem com demência: tradução e adaptação cultural da Pearlin Mastery Scale

ABSTRACT The sense of mastery is conceptualized as a positive aspect of care targeted at people living with dementia, a coping mechanism to reduce burden, and may represent a protective factor for caregivers' mental and physical health. Objective: To translate and culturally adapt the Pearlin Mastery Scale for Brazil. Methods: A methodological study was conducted at the Federal University of São Carlos in which the initial translation stages were followed; synthesis; back-translation; review by the committee of judges by analyzing the Content Validity Index (CVI); and test of the pre-final version. Results: Two specialists translated the scale into Brazilian Portuguese and defined a consensus version with the researchers. Subsequently, another two specialists back-translated the consensus version, which was reviewed by three judges who are PhDs in the area, considering all scale items as very equivalent (CVI=1.0), and maintaining them in the pre-final version of the instrument. This was tested in a first group of caregivers for them to point out adjustments. The suggestions were accepted by modifying three items and, afterward, the scale was tested in a second group, which did not present difficulties answering the instrument. Conclusion: The Pearlin Mastery Scale was translated and culturally adapted for Brazil, showing equivalence. However, future psychometric analyses of the instrument are required to make it available for use in this population.

RESUMO O senso de domínio é conceituado como um aspecto positivo do cuidado voltado às pessoas que vivem com demência, um mecanismo de enfrentamento para reduzir a sobrecarga e que pode representar um fator protetor para a saúde mental e física do cuidador. Objetivo: Traduzir e adaptar culturalmente a Pearlin Mastery Scale para o Brasil. Métodos: Estudo metodológico conduzido na Universidade Federal de São Carlos, em que foram seguidas as etapas de tradução inicial; síntese; retrotradução; revisão pelo comitê de juízes pela análise do Índice de Validade de Conteúdo (IVC); e teste da versão pré-final. Resultados: Dois especialistas traduziram a escala para o português brasileiro e definiram uma versão consensual com os pesquisadores. Posteriormente, outros dois especialistas retrotraduziram a versão consensual, que foi revisada por três juízes doutores na área, considerando todos os itens da escala como muito equivalentes (IVC=1,0), mantendo-os na versão pré-final do instrumento. Esta foi testada em um primeiro grupo de cuidadores, a fim de se apontarem adequações. As sugestões foram acatadas mediante a modificação de três itens e, depois, a escala foi testada em um segundo grupo, o qual não apresentou dificuldades em responder ao instrumento. Conclusão: A Pearlin Mastery Scale foi traduzida e adaptada culturalmente para o Brasil, demonstrando equivalência. Entretanto, análises psicométricas futuras do instrumento são necessárias para disponibilizá-lo para uso entre essa população.

Estresse e Enfrentamento das Dificuldades em Universitários da Área da Saúde / Stress and Coping with Difficulties in Health University Students / Estrés y Enfrentamiento de Dificultades por Universitarios del Sector Salud

Resumo: Este estudo pretende identificar a percepção de estudantes de uma mesma instituição de ensino superior da área da saúde sobre dificuldades acadêmicas e não acadêmicas, estratégias de coping e identificar a presença de estresse. Foi um estudo transversal utilizando abordagens quantitativa e qualitativa, desenvolvido por meio de questionário estruturado e inventários psicométricos validados ( COPE Breve; inventário de sintomas de estresse ISLL ). Adicionalmente, foram realizadas entrevistas para ampliar a compreensão dos resultados dos instrumentos quantitativos. Na etapa quantitativa, participaram 162 estudantes dos cursos de graduação em Fisioterapia, Fonoaudiologia, Medicina, Nutrição e Terapia Ocupacional. Destes, 60 participaram de entrevista qualitativa. Os dados foram submetidos à análise estatística univariada e análise multivariada por regressão logística. Os estudantes relataram encontrar grande número de dificuldades e utilizar variadas estratégias de coping . A análise estatística univariada demonstrou que não houve diferenças importantes entre cursos e etapas quanto ao número de dificuldades e estratégias utilizadas. A presença de estresse foi identificada em proporções entre 45% e 100% dos estudantes, conforme o curso e a etapa considerada, sem diferenças significativas entre eles. A análise multivariada identificou cinco variáveis independentes como determinantes de estresse: sexo feminino, renda familiar, número de dificuldades acadêmicas/não acadêmicas e número de estratégias de coping voltadas à "emoção" presentes. Esta análise também mostrou que o estresse patológico está relacionado a somente uma variável: o número de dificuldades não acadêmicas. Estes achados reforçam a necessidade de manter ações institucionais de assistência social e apoio psicológico, favorecendo assim um planejamento efetivo de medidas de promoção da saúde mental dos estudantes.

Abstract: This study aimed to find undergraduate students' perceptions about academic and non-academic difficulties and coping strategies and determining the occurrence of stress among them. This was a cross-sectional study using quantitative and qualitative approaches to evaluate students from different health professions in a single institution. Physical therapy, speech therapy, medicine, nutrition, and occupational therapy program students (N=162) answered a structured questionnaire and two validated psychometric inventories (COPE Brief scale and the ISS stress symptoms inventory). Additionally, 60 students underwent a semi-structured interview to better understand the results from the quantitative instruments. Quantitative data underwent univariate analysis to test differences between proportions and stepwise multiple regression analysis to identify the independent determinants of stress. Students reported a large number of academic and non-academic difficulties and a variety of coping strategies. Univariate statistical analysis showed no significant differences between courses and stages regarding the number of difficulties and coping strategies. A large proportion of students showed stress, ranging from 45% to 100%, depending on the course and stage, with no significant differences between them. Multivariate statistical analysis found five independent variables as stress determinants: female gender, low family income, number of academic and non-academic difficulties, and number of emotion-focused coping strategies. This analysis also showed that pathological stress is related to only one variable: the number of non-academic difficulties. These findings reinforce the importance of maintaining institutional actions for student social assistance and psychological support. Results also provide meaningful data for adequately planning more effective measures to promote students' mental health.

Resumen: Este estudio pretende identificar la percepción de los estudiantes del sector salud sobre las dificultades académicas y no académicas, las estrategias de coping y la presencia de estrés. Este estudio transversal, con enfoque cuantitativo y cualitativo, utilizó cuestionarios estructurados e inventarios psicométricos validados (escala Brief COPE; inventario de sintomatología de estrés ISE ); además de entrevistas para ampliar la comprensión de los resultados de los instrumentos cuantitativos. En la etapa cuantitativa participaron 162 estudiantes de los cursos de grado en Fisioterapia, Fonoaudiología, Medicina, Nutrición y Terapia Ocupacional. De estos, 60 participaron en la entrevista cualitativa. Los resultados se sometieron a análisis estadístico univaria nte, para distinguir los grupos y asociaciones entre variables, y a análisis multivariado por regresión logística para identificar variables independientes que determinan el estrés. Los estudiantes reportaron enfrentar muchas dificultades académicas y no académicas, y utilizaban diferentes estrategias de coping. El análisis estadístico univariante no obtuvo diferencias significativas entre cursos y etapas respecto al número de dificultades y estrategias utilizadas. Un 45% y 100% de los estudiantes experimentaron estrés según el curso y la etapa considerada, sin diferencias significativas entre ellos. Se encontraron cinco variables independientes como factores de estrés: sexo femenino, renta familiar, número de dificultades académicas/no académicas y número de estrategias de coping orientadas a la "emoción". El estrés patológico estuvo relacionado solo a la variable número de dificultades no académicas. Se necesita mantener acciones institucionales de asistencia social y apoyo psicológico para favorecer una planificación efectiva de medidas de promoción de salud mental de los estudiantes.

Estrategias de afrontamiento en pacientes oncológicos de un hospital público. Corrientes año 2022 / Coping strategies in cancer patients from a public hospital. Corrientes year 2022

Las estrategias de afrontamiento ante el cáncer representan un proceso mediador ante las repercusiones de la enfermedad. Objetivo: Identificar las estrategias de afrontamiento en pacientes oncológicos que asisten a un hospital público de la ciudad de Corrientes en el año 2022. Metodología: Estudio descriptivo, cuantitativo, transversal, observacional. La población fueron pacientes oncológicos que asistieron a un hospital público. Para la recolección de datos se utilizó cuestionario de modos de afrontamiento, desarrollado por Lazarus y Folkman, versión revisada, adaptado y modificado, compuesto por 67 ítems, asociados a las diferentes estrategias de afrontamiento. Resultados: La muestra se integró con 45 pacientes de 52 años en promedio; el 78% del sexo femenino mayoritariamente amas de casa, 64%; casadas/os el 69%. Niveles obtenidos de las estrategias- centradas en el problema- Nivel Bajo de aplicación el confrontamiento (56%) y Nivel Medio el Distanciamiento (51%). -En las estrategias centradas en la emoción- Nivel Medio de aplicación, la reevaluación positiva (67%) y Planificación 60%, el autocontrol (40%), seguidos por la búsqueda de apoyo social (44%), aceptación de la responsabilidad (44%), huida-Evitación (38%). Conclusiones: El confrontamiento fue la estrategia que presentó el porcentaje más destacado en el nivel bajo aplicación y el distanciamiento el nivel alto más frecuente. Es fundamental destacar la importancia de identificar la estrategia de afrontamiento utilizado por los pacientes oncológicos ya que dichos estados emocionales influyen en la salud de manera directa ya sea en el funcionamiento fisiológico, el reconocimiento de síntomas, la búsqueda de atención oportuna[AU]

Cancer coping strategies represent a mediating process in the face of the repercussions of the disease. Objective: Identify coping strategies in cancer patients attending a public hospital in the city of Corrientes in the year 2022. Methodology: Descriptive, quantitative, cross-sectional, observational study. The population were cancer patients who attended a public hospital. For the data collection, a questionnaire of coping modes was used, developed by Lazarus and Folkman, revised, adapted and modified version, composed of 67 items, associated with the different coping strategies. Results: The sample was made up of 45 patients with an average age of 52; 78% of the female sex, mostly housewives, 64%; 69% married. Levels obtained from the strategies - focused on the problem - Low Level of application of confrontation (56%) and Medium Level of Distancing (51%). -In the strategies focused on emotion- Medium level of application, positive reappraisal (67%) and Planning 60%, self-control (40%), followed by the search for social support (44%), acceptance of responsibility (44%), flight-avoidance (38%). Conclusions: The confrontation was the strategy that presented the most outstanding percentage in the low application level and the distancing the most frequent high level. It is essential to highlight the importance of identifying the coping strategy used by cancer patients since these emotional states directly influence health, be it physiological functioning, recognition of symptoms, the search for timely care[AU]

As estratégias de enfrentamento do câncer representam um processo mediador diante das repercussões da doença. Objetivo: Identificar estratégias de enfrentamento em pacientes oncológicos atendidos em um hospital público da cidade de Corrientes no ano de 2022. Metodologia: Estudo descritivo, quantitativo, transversal, observacional. A população foi pacientes oncológicos atendidos em um hospital público. Para a coleta de dados, foi utilizado um questionário de modos de enfrentamento, desenvolvido por Lazarus e Folkman, versão revisada, adaptada e modificada, composto por 67 itens, associados às diferentes estratégias de enfrentamento. Resultados: A amostra foi composta por 45 pacientes com idade média de 52 anos; 78% do sexo feminino, principalmente donas de casa, 64%; 69% casados. Níveis obtidos das estratégias - focadas no problema - Baixo Nível de aplicação de enfrentamento (56%) e Médio Nível de Distanciamento (51%). -Nas estratégias focadas na emoção- Nível médio de aplicação, reavaliação positiva (67%) e Planejamento 60%, autocontrole (40%), seguido da busca de apoio social (44%), aceitação de responsabilidade (44%), evitação de voos (38%). Conclusões: O confronto foi a estratégia que apresentou maior percentual de destaque no nível baixo de aplicação e o distanciamento o nível alto mais frequente. É fundamental destacar a importância da identificação da estratégia de enfrentamento utilizada pelo paciente oncológico, pois esses estados emocionais influenciam diretamente na saúde, seja no funcionamento fisiológico, no reconhecimento de sintomas, na busca por atendimento oportuno[AU]

O processo de adaptação e desempenho ocupacional de mães de crianças no transtorno do espectro autista / Adaptation process and occupational performance of mothers of children with autism spectrum disorders

Resumo Introdução A adaptação a um filho no Transtorno do Espectro do Autismo (TEA) pode impactar o desempenho ocupacional das mães em razão dos cuidados demandados, que podem dificultar a realização das suas ocupações. Objetivo Investigar a adaptação e o desempenho ocupacional das mães de filhos com TEA. Método Estudo descritivo transversal de abordagem quantiqualitativa com 11 mães de filhos no TEA com idade entre 2 e 9 anos. Os dados foram coletados por meio da Escala Parental de Adaptação à Deficiência (EPAD) e da Medida Canadense de Desempenho Ocupacional (COPM). Os dados da EPAD foram analisados pela soma dos escores de cada participante e cálculo da média geral e os da COPM a partir dos valores atribuídos para o desempenho e satisfação. Resultados As mães estavam em adaptadas a seus filhos; entretanto, avaliaram a presença de problemas funcionais para o desempenho ocupacional após o nascimento deles. Problemas na categoria produtividade, especificamente para trabalhar, por conta das demandas de cuidados com o filho, foram referidos pela maioria das mães. Na categoria autocuidado, algumas mães referiram problemas para ir ao salão de beleza e tomar banho. Na categoria lazer, algumas mães indicaram problemas para realizar leitura, atividade física, viajar e/ou visitar amigos. Conclusão As mães deste estudo demostraram que a adaptação a seus filhos envolve fatores como transmissão do diagnóstico, informação, características dos filhos, condições socioeconômicas, resiliência, crenças e expectativas pessoais. Conclui-se que as mães de filhos no TEA investigadas apresentaram problemas funcionais para o desempenho ocupacional após o nascimento desses filhos.

Abstract Introduction Adapting to a child with Autism Spectrum Disorder (ASD) can impact the occupational performance of mothers because of the care they demand, which can lead to difficulties in carrying out their occupations. Objective To investigate the occupational performance and adaptation of mothers to their children with ASD. Method Cross-sectional, descriptive, quantitative and qualitative study conducted with 11 mothers of children with ASD aged 2-9 years. Data were collected using the Parental Disability Adaptation Scale (EPAD) and the Canadian Occupational Performance Measure (COPM). EPAD data were analyzed by adding the scores of each participant and calculating the general average, whereas COPM data were analyzed from the values ​​assigned to performance and satisfaction. Results The mothers were well adapted to their children; however, they evaluated the presence of functional problems for occupational performance after their birth. Functional problems in the productivity category, specifically in work performance due to the demands of caring for the children, were mentioned by most mothers. In the self-care category, some mothers reported problems related to going to the salon and taking a shower. In the leisure category, some mothers indicated problems with reading, physical activity, traveling and/or visiting friends. Conclusion The mothers in this study reported that adapting to their children with ASD involves factors such as transmission of the diagnosis, information, children characteristics, socioeconomic conditions, resilience, and personal beliefs and expectations. In conclusion, the mothers of children with ASD investigated presented functional problems regarding their occupational performance after the birth of these children.