Dyadic effects of perceived stress, relationship satisfaction and distress disclosure on emotional distress in colorectal cancer patients and their family caregivers: An actor-partner interdependence mediation model.

Objective: This study adopted a dyadic analysis method to examine the effect of perceived stress on emotional distress and determine whether relationship satisfaction and distress disclosure act as mediators in colorectal cancer (CRC) enterostomy patient-caregiver dyads. Methods: A total of 312 patient-caregiver dyads completed measures assessing perceived stress, relationship satisfaction, distress disclosure, and emotional distress. The data were analyzed using the actor-partner interdependence mediation model. Results: This study found that the perceived stress of patients and caregivers both had direct and indirect actor effects on emotional distress (through relationship satisfaction). Another important finding is that perceived stress had indirect actor-partner effects (through distress disclosure) on emotional distress. Conclusions: This study highlights that perceived stress, relationship satisfaction, and distress disclosure of patients and their caregivers are key factors that can be considered for improving emotional distress. It also partially confirmed the interdependence of patients with CRC and their caregivers.

A Novel Time Use Approach on Daily Active Engagement with Life: The Intersectionality of Race and Gender.

BACKGROUND AND OBJECTIVES: Active engagement with life (AE) is an integral aspect of successful aging. Using time diary data, this study explored how U.S. older adults structure their daily lives involving social participation and productive engagement, and the extent to which these patterns differ by race and gender. RESEARCH DESIGN AND METHODS: We used American Time Use Survey (ATUS) data (n = 17,990) and sequence and cluster analyses to identify distinctive daily AE patterns. Multivariable linear regression models were used to evaluate associations between AE patterns and self-rated health, and the moderating roles of race and gender. RESULTS: Five AE clusters were identified: Low Degree of AE (26%), Moderate Unpaid Work & Light Social Participation (39%), Persistent Unpaid Work (20%), Persistent Paid Work (10%), and Persistent Social Participation (4%). White women were the most likely and Black men the least likely to have any AE. Compared to "Low Degree of AE", all other AE clusters were associated with better self-rated health, with these associations varying by gender and race. The strongest positive association was observed for "Persistent Paid Work", especially among women. Racial differences in the association between AE and health were more prominent among women than men. Differences by AE were less pronounced among Black women in comparison to White women. DISCUSSION AND IMPLICATIONS: We found that the association between AE and self-rated health varies by race and gender. Persistent structural barriers may prevent older adults from historically minoritized backgrounds, particularly Black women, from benefiting from AE.

Artificial intelligence-generated feedback on social signals in patient-provider communication: technical performance, feedback usability, and impact.

Objectives: Implicit bias perpetuates health care inequities and manifests in patient-provider interactions, particularly nonverbal social cues like dominance. We investigated the use of artificial intelligence (AI) for automated communication assessment and feedback during primary care visits to raise clinician awareness of bias in patient interactions. Materials and Methods: (1) Assessed the technical performance of our AI models by building a machine-learning pipeline that automatically detects social signals in patient-provider interactions from 145 primary care visits. (2) Engaged 24 clinicians to design usable AI-generated communication feedback for their workflow. (3) Evaluated the impact of our AI-based approach in a prospective cohort of 108 primary care visits. Results: Findings demonstrate the feasibility of AI models to identify social signals, such as dominance, warmth, engagement, and interactivity, in nonverbal patient-provider communication. Although engaged clinicians preferred feedback delivered in personalized dashboards, they found nonverbal cues difficult to interpret, motivating social signals as an alternative feedback mechanism. Impact evaluation demonstrated fairness in all AI models with better generalizability of provider dominance, provider engagement, and patient warmth. Stronger clinician implicit race bias was associated with less provider dominance and warmth. Although clinicians expressed overall interest in our AI approach, they recommended improvements to enhance acceptability, feasibility, and implementation in telehealth and medical education contexts. Discussion and Conclusion: Findings demonstrate promise for AI-driven communication assessment and feedback systems focused on social signals. Future work should improve the performance of this approach, personalize models, and contextualize feedback, and investigate system implementation in educational workflows. This work exemplifies a systematic, multistage approach for evaluating AI tools designed to raise clinician awareness of implicit bias and promote patient-centered, equitable health care interactions.

The relationship between attitudes towards professional autonomy and nurse-nurse collaboration: A cross-sectional study.

AIM: This study aimed to determine the relationship between attitudes towards professional autonomy and nurse-nurse collaboration among nurses. BACKGROUND: Professional autonomy is crucial for nurses in today's complex and ever-changing healthcare environment. Therefore, attitudes towards professional autonomy may result in effective collaboration among nurses, one of the nursing roles and responsibilities. METHODS: This descriptive, cross-sectional study was conducted with 685 nurses in four private hospitals affiliated with a university. Descriptive tests, correlation analysis and hierarchical regression analysis were used. An ethics committee approved this study, and the STROBE Statement guidelines for cross-sectional studies were followed. RESULTS: Significant predictors for nurse-nurse collaboration were identified as job-related independence, autonomous clinical judgement and working unit from control variables. CONCLUSION: This study's results provided valuable insights for nurse managers to enhance nurses' attitudes towards professional autonomy and foster collaborative work environments. IMPLICATIONS FOR NURSING: Nurse managers can increase nurses' participation in decision-making processes and allow them to recognize their autonomy and that of their colleagues.

Evaluation of the Let's Focus! (Posem el Focus) Socioeducational Intervention: Promoting Healthy and Equitable Relationships in High Schools.

INTRODUCTION: Gender-based violence is a worldwide problem. School-based socio-educational interventions could be effective in preventing gender-based violence. We assessed the effectiveness of the Let's focus! program, aimed at health and equitable interpersonal relationships among high school students. METHODS: We conducted a quasi-experimental study in an intervention group (IG, n = 560) and a comparison group (CG, n = 366) of secondary school students in Terrassa, Spain between 2019 and 2021. Specifically, we performed an online questionnaire on sexism, acceptance of violence and machismo at baseline and after the intervention. We calculated multivariate linear regression models including satisfaction with the intervention, to evaluate the change in the variables' mean between CG and IG. RESULTS: In comparison to the CG, in the IG hostile and benevolent sexism, and acceptance of violence decreased from baseline to after-intervention, in the group of participants highly satisfied with the intervention (42.4%); machismo did not vary. The multivariate regression analyses showed that the intervention was effective in reducing hostile sexism (ß = -6.40; CI95% (-11.92; -0.88)), benevolent sexism (ß = -5.57; CI95% (-10.52;-0.61)), and acceptance of violence (ß = -4.79; CI95% (-9.50; -0.09)) in highly satisfied students from the IG, in comparison to the ones from the CG, regardless of their age or gender. DISCUSSION: Let's Focus! was effective in reducing sexism and decreasing acceptance of violence among students that were highly satisfied with the intervention.

Desafios relacionados ao clima organizacional da equipe de enfermagem de um hospital público - percepção dos enfermeiros / Challenges related to the organizational climate of the nursing team in a public hospital - nurses' perception

Resumo O ambiente organizacional está relacionado com o grau de motivação de seus colaboradores. Essa percepção é essencialmente sentida, não se vê e nem se toca, mas tem uma existência real. Este estudo objetiva identificar as dificuldades e potencialidades relacionadas ao clima organizacional dos servidores de enfermagem de um hospital público do Distrito Federal. Metodologicamente foi realizado um estudo descritivo e exploratório caracterizado por uma abordagem qualitativa. A análise de conteúdo temática conduziu a três dimensões interpretativas: ambiente e condições de trabalho; comunicação, relacionamento interpessoal e fluxos de trabalho; e motivação para a melhoria do ambiente de trabalho. Os resultados apontam para um déficit de recursos humanos, escassez de recursos materiais, insumos, estrutura física precária, além de problemas de relacionamento interpessoal, como a (des)valorização do profissional enfermeiro e da enfermagem. Os desafios postos para os gestores estão para além da dimensão técnica e estrutural, da complexidade tecnológica dos equipamentos sem manutenção, desdobra-se pela dimensão humana, pelos sentimentos e pelas necessidades não atendidas (de valorização) da enfermagem, que precisa ser cuidada, valorizada, ouvida e vista no seu processo de cuidar.

Abstract The organizational climate is related to the degree of motivation of its employees. This perception is essentially felt, it is neither seen nor touched, but it is real. This study aims to identify difficulties and potentialities related to the organizational climate of the nursing staff at a public hospital in the Federal District. Methodologically, a descriptive and exploratory study was carried out characterized by a qualitative approach. The thematic content analysis led to three interpretative dimensions: environment and working conditions; communication, interpersonal relationship and work flows; motivation to improve the work environment. The results indicate a deficit of human resources, scarcity of material resources, supplies, precarious physical structure, in addition to interpersonal relationship problems, such as the (de)valuation of professional nurses and nursing. The challenges posed to managers go beyond the technical and structural dimension, the technological complexity of equipment without maintenance, as it unfolds through the human dimension, feelings and unmet needs (of appreciation) of nursing, which needs to be cared for, valued, heard and seen in their care process.

Nursing students' perceptions of the qualities of clinical instructors in a public university in Jordan: A qualitative study.

Background: Nursing clinical education is a key to developing nursing students' knowledge, skills, and competencies. Few studies have attempted to explore students' perceptions regarding the qualities of effective clinical instructors. Objective: The current study aims to explore nursing students' perceptions of effective clinical instructors' qualities in Jordan. Methods: A qualitative exploratory approach was used to deepen our understanding of nursing students' perceptions of effective clinical instructors' qualities. A total of 21 nursing students were involved, and data were collected from June to August 2023. Data were analyzed using the thematic analysis approach. Results: The thematic analysis revealed two main themes. The first theme was professional qualities, comprising four subthemes: professional knowledge and experience, acting as a role model, performing as a caring one, and assembling effective communication. The second theme was building a good rapport. The findings demonstrated that clinical instructor qualities impacted how students perceived their teaching effectiveness, and they identified professional knowledge and competence as crucial qualities of an effective clinical instructor. It was acknowledged that caring behaviors and effective communication skills were essential behavioral attributes for clinical instructors. Conclusion: Nursing students have valued particular characteristics of effective clinical instructors. These characteristics were knowledge, caring, relationships, role models, and communication. Further research is needed to validate the study's findings.

Improving Spiritual Well-Being of Polish Pain Outpatients: A Feasibility Mixed Methods Study.

Introduction: A physician in a chronic pain treatment clinic must recognize that the relationship between pain and spirituality is bidirectional. Chronic pain can decrease the level of spiritual well-being, and low spiritual well-being can also significantly intensify the perception of pain and worsen coping with it. Currently, for many scientific and medical communities, it is evident that spiritual care is an indispensable element of holistic medicine. Objective: The authors developed a non-religious spiritual care model provided by a physician at a chronic pain treatment clinic from May 2022 to February 2024. Method: The study utilized a mixed-method approach to conduct the research. The analysis consisted of twelve patients. A FACIT-Sp-12 questionnaire evaluated the individual's spiritual well-being before the intervention. The intervention involved asking patients open-ended questions about their life history, experiences, and spiritual beliefs and the physician's use of active listening and empathetic responses to what patients shared (relationship-building activities). The intervention aimed to assist patients in accepting the limitations of an incurable chronic disease, affirming the value of their lives, enhancing inner harmony, and increasing their sense of belonging to something greater. After the intervention, a re-assessment of the patient's spiritual well-being was conducted using the FACIT-Sp-12 questionnaire. Researchers collected qualitative data through a confidential survey that included the following instructions: "Please express an anonymous opinion on how you perceive the spiritual care provided by the physician". Results: There was an increase in spiritual well-being, assessed using the FACIT-Sp-12 scale, in 9 out of 12 patients. The median, as well as the average, level of spiritual well-being increased in a statistically significant way after the intervention (p < 0.05). This was primarily due to the higher value of the peace subscale of the questionnaire. Qualitative analysis revealed benefits reported by patients (personal development, gratitude, satisfaction, support, hope) resulting from physician's actions. Conclusions: Both qualitative and quantitative data showed that establishing a relationship with the doctor improves the spiritual well-being of patients. Therefore, this model can be recommended for physicians in chronic pain treatment clinics.

Mediating Effect of Digital Information Utilization Ability and Interpersonal Contact on the Relationship between Cognitive Function and Depression in Korean Older Adults.

Background: As Korea rapidly enters a super-aged society, interest in depression, a change in psychological function that occurs with aging, is increasing. Although previous studies have suggested a relationship between depression and cognitive decline in older adults, they have not clarified how cognitive decline leads to depression. We aimed to examine the mediating effects of digital information utilization ability (DIUA) and interpersonal contact (IC) in the relationship between cognitive function and depression in older adults. Methods: This descriptive cross-sectional study used data from the 2020 Korean Elderly Survey. The participants were 9,920 seniors aged 65 years and older. Descriptive statistics, t-test, and one-way ANOVA correlation analysis were performed using SPSS 24.0 and the dual mediation effect was analyzed using PROCESS Macro for SPSS v.3.5 model 6. Results: Depression had a negative correlation with cognitive function (r=-.26, P<.001), DIUA (r=-.20, P<.001), and IC (r=-.13, P<.001). Cognitive function was positively correlated with DIUA (r=.40, P<.001) and IC (r=.08, P<.001). There was a positive correlation between DIUA and IC (r=.10, P<.001). Finally, the mediating effect of cognitive function on depression through the dual parameters of DIUA and IC was also statistically significant (B=.-001, 95% CI [-.002, -.001). Conclusion: The depression caused by cognitive decline can be reduced by improving older adults' ability to use digital information and interact with others. Therefore, social interventions to increase the interpersonal contact of older adults is required, and education programs for improving older adults' ability to utilize digital information may be developed to increase indirect contact using digital devices as well as direct contact.

Evaluating the patient sociodemographic factors affecting dental students' clinical communication skills using a three-perspective approach.

OBJECTIVE: This study aimed to assess undergraduate dental students' communication skills in relation to patient sociodemographic factors using a three-perspective approach; the student, the patient, and the clinical instructor perspective. MATERIALS AND METHODS: A cross-sectional study was conducted using validated modified-communication tools; Patient Communication Assessment Instruments (PCAI), Student Communication Assessment Instruments (SCAI), and Clinical Communication Assessment Instruments (CCAI). Moreover, 176 undergraduate clinical year students were recruited in this study whereby each student was assessed by a clinical instructor, a patient, and self-evaluation. RESULTS: The clinical communication skills domains were not significantly influenced by patient sociodemographic factors, including sex, educational background, and the number of visits (p > .05). However, this study revealed a statistically significant difference in the domain of "caring and respectful" of the SCAI between the low- and middle-income groups. CONCLUSIONS: Overall, most of the patient sociodemographic factors did not affect clinical communication skills. However, patient income groups played a significant role in one of the communication domains.

Clinicians navigating moral accountability when discussing parental behaviors in the care of the child in the hospital.

OBJECTIVE: The purpose of this study was to explore how moral accountability is navigated when clinicians talk about parental behaviors to support the health of the hospitalized child. METHODS: We conducted a secondary data analysis of 74 conversations during daily rounds video recorded as part of a randomized controlled trial of an intervention to advance family-centered rounds in one children's hospital. Conversations involving children under the age 18 who were cared for by a pediatric hospitalist service, pulmonary service, or hematology/oncology service were recorded. We used conversation analysis to analyze sequences in which physicians engaged in talk that had implications for parent behavior. RESULTS: Two phenomena were apparent in how physicians and parents navigated moral accountability. First, physicians avoided or delayed parental agency in their references to parent behaviors. Second, parents demonstrated and clinicians reassured parental competence of parents caring for their children. CONCLUSION: Physicians appeared to be oriented toward the potential moral implications of asking about parental behavior. PRACTICE IMPLICATIONS: Avoiding attributions of agency and moral accountability as well as providing reassurance for the parents' competence may be useful for clinicians to maintain a good relationship with the parents of children in their care in the hospital setting.

BACK TO THE FUTURE WITH SENECA'S PRACTICAL PHILOSOPHY IN MIND.

This paper regards Seneca's practical philosophy as ancestor to psychoanalytically informed psychotherapy and as a progenitor of ongoing contemporary praxis in applied ideas of mind. Facing forward into the Anthropocene, as psychoanalysis encounters Artificial Intelligence, the convergence with contemporary psychoanalytic psychotherapy of value concepts developed from Antiquity is discussed. Drawn from Seneca's Letters on Ethics, constellations of significant ideas present in ancient practical philosophy resonate with similar configurations developed two millennia later, and central to the practice of contemporary psychotherapy.

Qualified Listening to Relatives of Users at a Psychosocial Care Center / La escucha calificada a familiares de usuarios en un Centro de Atención Psicosocial

Abstract Introduction The Psychiatric Reform introduced a new people-centered care model to replace psychiatric hospitals: the Psychosocial Care Center. Qualified listening can be used to achieve the integrality and humanization of the health care provided. It allows for the appreciation of content, the respect of its uniqueness, empathy, and the promotion of a space in which freedom of expression is provided. Objective To identify the understanding of qualified listening from the perspective of the relative of a person with a mental disorder at a Psychosocial Care Center. Method Qualitative, descriptive, exploratory study. Ten relatives over the age of 18 participated, contributing to the production of information. Data was obtained through the triangulation method, through semi-structured individual and collective interviews, observation, and field diary records. Results For relatives, qualified listening translates into clarifying the illness, understanding the family's painful situation and providing help and support during the psychosocial rehabilitation process. Discussion and conclusion Listening constitutes a means of consolidating care networks, through the strengthening of bonds and co-responsibility, in a centered and expanded family-user logic model.

Resumen Introducción La Reforma Psiquiátrica introdujo un nuevo modelo de atención, reemplazando a los hospitales psiquiátricos y centrado en la persona, el Centro de Atención Psicosocial. Para lograr la integralidad y humanización del servicio de salud brindado, se puede utilizar la escucha calificada. Permite la valorización del contenido dicho, el respeto a su singularidad, la empatía y la promoción de un espacio en el que se brinda la libertad de expresión. Objetivo Identificar la comprensión de la escucha calificada desde la perspectiva del familiar de una persona con trastorno mental en un Centro de Atención Psicosocial. Método Estudio cualitativo, descriptivo y exploratorio. Participaron 10 familiares mayores de 18 años, aptos para contribuir a la producción de información. Datos obtenidos a través del método de triangulación, a través de entrevistas individuales y colectivas semiestructuradas, observación y registro en diario de campo. Resultados Para el familiar, la escucha calificada se traduce en brindar aclaraciones sobre la enfermedad, comprender la situación de dolor de la familia y brindar ayuda y apoyo durante el proceso de rehabilitación psicosocial. Discusión y conclusión El dispositivo de escucha constituye una forma de consolidación de las redes de cuidado, a través de la afirmación de los vínculos y la corresponsabilidad, en una lógica familia-usuario centrada y ampliada.

Detecção precoce dos sinais de alerta de autismo em crianças na atenção primária à saúde sob a perspectiva das relações interpessoais / Early detection of warning signs of autism in children in primary care from the perspective of interpersonal relationships

Introdução: os transtornos do espectro do autismo (TEA) são uma condição de início precoce, cujas dificuldades estão relacionadas à ausência ou limitações no uso da linguagem, na interação social e das atividades imaginativas, bem como padrões restritos/repetitivos de comportamento. Geralmente, as primeiras manifestações dos TEA aparecem antes dos 36 meses de idade, o que envolve a adoção de medidas de detecção precoce dos sinais de alerta já nesses primeiros meses de vida. No âmbito da Atenção Primária à Saúde (APS), práticas de Enfermagem podem ser empreendidas para a detecção precoce desses sinais de alerta, partindo-se da premissa de que o enfermeiro possui papel estratégico neste processo, cujas ações podem impactar positivamente na qualidade de vida e bem estar de crianças e de suas famílias. Objetivos: descrever a participação de enfermeiros no processo de detecção precoce dos sinais de alerta dos TEA em crianças de até três anos de idade, no âmbito da Atenção Primária à Saúde; e analisar as relações interpessoais enfermeiros e familiares dessas crianças no processo de detecção precoce dos sinais de alerta dos TEA. Método: estudo de abordagem qualitativa, descritivo, desenvolvido por meio de entrevistas semiestruturadas com enfermeiros de cinco unidades de Clínica da Família (CF) do município do Rio de Janeiro. Para tratamento dos dados foi utilizado o software IRaMuTeQ®. As interpretações e teorização foram orientadas pela aplicação da Teoria das Relações Interpessoais, de Hildegard Peplau. A pesquisa foi aprovada por Comitês de Ética em Pesquisa (Pareceres nº 5.370.466 e nº 5.443.956). Resultados: participaram 27 enfermeiros, com idades variando entre 25 e 50 anos (média de 36,3 anos). A área predominante de formação em especialização/residência foi a de Saúde da Família (22 enfermeiros). O tempo de graduação entre os entrevistados obteve média de 9,5 anos; o tempo de trabalho na CF obteve média de 2,9 anos; e o tempo de trabalho na assistência a crianças, com média de 7,2 anos. O corpus advindo das entrevistas foi processado por meio de classificação hierárquica descendente, cuja estruturação se deu em dois blocos temáticos e cinco classes. O bloco I (composto pela classe 2) reuniu 229 segmentos de texto (ST), o que representou 20,3% do corpus textual; e o bloco II (composto pelas classes 1, 3, 4 e 5) contemplou 866 ST, ou seja, 79,7% do corpus textual. A análise lexical foi estruturada a partir dessas cinco classes, que abordaram os seguintes temas: classe 2) as relações interpessoais nas consultas puericultura; classe 1) capacitação de enfermeiros para a detecção dos sinais de alerta dos TEA; classe 3) papéis dos enfermeiros na atenção a familiares de crianças com sinais de alerta dos TEA; classe 4) a comunicação e o vínculo na relação interpessoal terapêutica; e classe 5) o trabalho multidisciplinar na suspeição precoce dos TEA. Considerações Finais: a participação dos enfermeiros no processo de detecção precoce dos sinais de alerta dos TEA revelou-se essencial, estratégica e necessária, a despeito das dificuldades constatadas em relação às demandas de trabalho, problemas de fluxos de atendimento, demoras nos acompanhamentos subsequentes pelo sistema de regulação, desconhecimento sobre aplicabilidade de escalas e protocolos de avaliação, e ainda autorreconhecimento precário de seus papéis e questões relacionadas à treinamento e capacitação. As implicações para a Enfermagem estão centradas no fortalecimento das relações interpessoais família-criança-enfermeiro, com vistas a melhorar a qualidade de vida futura, proporcionando suporte adequado e oportuno desde os primeiros passos do desenvolvimento. A articulação do conhecimento técnico-científico com a sensibilidade humana pode ser compreendida como o caminho para uma prática de Enfermagem mais efetiva, libertadora e inclusiva.

Introduction: autism spectrum disorders (ASD) are an early-onset condition, whose difficulties are related to the absence or limitations in the use of language, social interaction and imaginative activities, as well as restricted/repetitive patterns of behavior. Generally, the first manifestations of ASD appear before 36 months of age, which involves adopting measures to detect early warning signs in the first months of life. Within the scope of Primary Health Care (PHC), Nursing practices can be undertaken for the early detection of these warning signs, based on the premise that nurses have a strategic role in this process, whose actions can positively impact quality of life and well-being of children and their families. Objectives: to describe the participation of nurses in the process of early detection of warning signs of ASD in children up to three years of age, within the scope of Primary Health Care; and analyze the interpersonal relationships between nurses and families of these children in the process of early detection of warning signs of ASD. Method: qualitative, descriptive study, developed through semi-structured interviews with nurses from five Family Clinic (CF) units in the city of Rio de Janeiro. The IRaMuTeQ® software was used to process the data. The interpretations and theorization were guided by the application of Hildegard Peplau's Theory of Interpersonal Relations. The research was approved by Research Ethics Committees (Opinions nº 5,370,466 and nº 5,443,956). Results: 27 nurses participated, with ages ranging between 25 and 50 years (average of 36.3 years). The predominant area of specialization/residency training was Family Health (22 nurses). The time since graduation among those interviewed had an average of 9.5 years; working time at CF averaged 2.9 years; and time working in childcare, with an average of 7.2 years. The corpus arising from the interviews was processed through descending hierarchical classification, which was structured into two thematic blocks and five classes. Block I (composed of class 2) brought together 229 text segments (ST), which represented 20.3% of the textual corpus; and block II (composed of classes 1, 3, 4 and 5) included 866 ST, that is, 79.7% of the textual corpus. The lexical analysis was structured based on these five classes, which addressed the following themes: class 2) interpersonal relationships in childcare consultations; class 1) training nurses to detect the warning signs of ASD; class 3) nurses' roles in caring for family members of children with warning signs of ASD; class 4) communication and bonding in the therapeutic interpersonal relationship; and class 5) multidisciplinary work in the early suspicion of ASD. Final Considerations: the participation of nurses in the process of early detection of warning signs of ASD proved to be essential, strategic and necessary, despite the difficulties observed in relation to work demands, problems with care flows, delays in subsequent follow-ups by the regulation system, lack of knowledge about the applicability of assessment scales and protocols, and also precarious self-recognition of their roles and issues related to training and qualification. The implications for Nursing are centered on strengthening family-child-nurse interpersonal relationships, with a view to improving future quality of life, providing adequate and timely support from the first steps of development. The articulation of technical-scientific knowledge with human sensitivity can be understood as the path to a more effective, liberating and inclusive Nursing practice.

Introducción: los trastornos del espectro autista (TEA) son una condición de aparición temprana, cuyas dificultades están relacionadas con la ausencia o limitaciones en el uso del lenguaje, la interacción social y las actividades imaginativas, así como con patrones de conducta restringidos/repetitivos. Generalmente, las primeras manifestaciones del TEA aparecen antes de los 36 meses de edad, lo que implica adoptar medidas para detectar signos precoces de alerta en los primeros meses de vida. En el ámbito de la Atención Primaria de Salud (APS), se pueden emprender prácticas de enfermería para la detección temprana de estos signos de alerta, partiendo de la premisa de que el enfermero tiene un papel estratégico en este proceso, cuyas acciones pueden impactar positivamente la calidad de vida y el bienestar. ser de los niños y sus familias. Objetivos: describir la participación del enfermero en el proceso de detección temprana de signos de alerta de TEA en niños de hasta tres años de edad, en el ámbito de la Atención Primaria de Salud; y analizar las relaciones interpersonales entre enfermeras y familias de estos niños en el proceso de detección precoz de signos de alerta del TEA. Método: estudio cualitativo, descriptivo, desarrollado a través de entrevistas semiestructuradas con enfermeros de cinco unidades de Clínica de la Familia (CF) de la ciudad de Río de Janeiro. Para procesar los datos se utilizó el software IRaMuTeQ®. Las interpretaciones y teorización estuvieron guiadas por la aplicación de la Teoría de las Relaciones Interpersonales de Hildegard Peplau. La investigación fue aprobada por los Comités de Ética en Investigación (Dictamen nº 5.370.466 y nº 5.443.956). Resultados: Participaron 27 enfermeros, con edades comprendidas entre 25 y 50 años (promedio de 36,3 años). El área de formación de especialización/residencia predominante fue Salud de la Familia (22 enfermeros). El tiempo de egreso entre los entrevistados tuvo un promedio de 9,5 años; el tiempo de trabajo en CF fue de 2,9 años en promedio; y tiempo trabajado en guarderías, con una media de 7,2 años. El corpus surgido de las entrevistas fue procesado mediante clasificación jerárquica descendente, la cual se estructuró en dos bloques temáticos y cinco clases. El bloque I (compuesto por la clase 2) reunió 229 segmentos textuales (ST), que representaron el 20,3% del corpus textual; y el bloque II (compuesto por las clases 1, 3, 4 y 5) incluyó 866 ST, es decir, el 79,7% del corpus textual. El análisis léxico se estructuró a partir de estas cinco clases, las cuales abordaron los siguientes temas: clase 2) relaciones interpersonales en las consultas de puericultura; clase 1) formación de enfermeras para detectar las señales de alerta del TEA; clase 3) funciones de las enfermeras en el cuidado de familiares de niños con signos de advertencia de TEA; clase 4) comunicación y vinculación en la relación interpersonal terapéutica; y clase 5) trabajo multidisciplinar en la sospecha temprana de TEA. Consideraciones finales: la participación de los enfermeros en el proceso de detección temprana de signos de alerta de TEA resultó esencial, estratégica y necesaria, a pesar de las dificultades observadas en relación a las demandas laborales, problemas con los flujos de cuidados, retrasos en los seguimientos posteriores por parte de los sistema de regulación, desconocimiento sobre la aplicabilidad de escalas y protocolos de evaluación, y también precario reconocimiento de sus roles y cuestiones relacionadas con la formación y la cualificación. Las implicaciones para la Enfermería se centran en fortalecer las relaciones interpersonales familia-niño-enfermero, con miras a mejorar la calidad de vida futura, brindando apoyo adecuado y oportuno desde los primeros pasos del desarrollo. La articulación del conocimiento técnico-científico con la sensibilidad humana puede entenderse como el camino hacia una práctica de Enfermería más eficaz, liberadora e inclusiva.

Affective Trust in the Supervisor and Innovative Work Behavior: The Effects of Proactive Skill Development and Learning Goal Orientation.

The main objective of this study was to examine the relationship between affective trust in the supervisor and innovative work behavior. In addition, this paper investigated the mediating role of proactive skill development in the affective trust - innovative work behavior relationship and the moderating role of learning goal orientation in the affective trust - proactive skill development relationship. Data for this study were collected from 220 employees drawn from four FMCG (fast moving consumer goods) companies based in Pakistan. Multiple regression analyses and the bootstrapping procedure were used to test the research hypotheses. Results revealed that proactive skill development partially mediated the effects of affective trust in the supervisor on innovative work behavior. Furthermore, we found that learning goal orientation strengthened the direct effect of affective trust in the supervisor on proactive skill development and also strengthened its indirect effect on innovative work behavior. The theoretical and practical implications of our results and the limitations of this research are discussed.

Non-violent communication as a technology in interpersonal relationships in health work: a scoping review.

BACKGROUND: Working in healthcare environments is highly stressful for most professionals and can trigger problems in interpersonal relationships that can result in horizontal violence. In order to prevent violence and improve the working environment, some strategies can be implemented to provide well-being for all those involved, whether directly or indirectly in health care, such as non-violent communication. The aim of this study was to map and synthesize the available scientific evidence on the use of Nonviolent Communication as a technology for a culture of peace in interpersonal relationships in healthcare. METHODS: This is a scoping review carried out in the National Library of Medicine (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Excerpa Medica DataBASE (Embase), PsycINFO - APA/ PsycNET (American Psychological Association) and Latin American and Caribbean Health Sciences Literature (LILACS) databases between March and August 2023. The eligibility criteria used were studies that addressed the topic of NVC in the area of health, published in Portuguese, Spanish or English, with no time restrictions. RESULTS: 53 studies were found in the databases. Two additional studies were extracted from of primary research. In the first exclusion phase, 16 texts were removed due to being duplicated. 39 articles were potentially relevant, and full-texts were reviewed for eligibility along with the inclusion and exclusion criteria Thus, seven studies were included in this review, published in English (five) and Portuguese (two), two of which were carried out in Brazil, one in the United States of America, one in South Korea, one in France, one in Canada and one in Thailand. In terms of the type of study/publication, two studies were reflections, one was a review, one was a mixed study, one was an experience report and two were experimental. The studies were predominantly of high and moderate methodological quality (85.7%). The total number of participants in the studies was 185. The studies showed that NVC is a technology that has made it possible to improve interpersonal relationships between health professionals. Training programs or educational intervention projects on the subject are useful for familiarizing professionals with the subject and demonstrating situations in which the technique can be included. CONCLUSION: The global scientific literature indicates that Nonviolent Communication is a significant resource for improving interpersonal relationships in healthcare work. This approach can be adopted as a strategy by managers and decision-makers, both to resolve conflicts and to prevent aggressive situations between health professionals, especially when it comes to moral or psychological aspects.

Aggressive Humor and Social Connectedness: The Moderating Roles of Subjective Social Status and Gender.

Aggressive humor has been conceived as a maladaptive humor style that jeopardizes social relationships. However, past studies have yielded inconsistent findings regarding the detrimental effects of aggressive humor on social relationships. This study attempts to advance the existing literature by examining the gender difference in the moderating role of subjective social status in the association between aggressive humor and social connectedness. Participants were 228 (53.1% female) adults aged from 18 to 53 years (M = 23.19, SD = 6.43). The hypothesized moderated moderation effect was significant, suggesting that gender significantly moderated the moderating effect of subjective social status on the association between aggressive humor and social connectedness. Subjective social status significantly moderated the association between aggressive humor and social connectedness for men but not for women. For men, aggressive humor was negatively associated with social connectedness when subjective social status was low or medium, but the association was not significant when subjective social status was high. For women, aggressive humor was not associated with social connectedness regardless of subjective social status. Implications of the findings are discussed.

Preliminary investigation of objective and subjective experiences of relatives of individuals with hoarding behaviors.

OBJECTIVE: Families of individuals with hoarding symptoms report substantial burden; however, there has been no investigation of potential positive experiences. The objective of this study was to examine the experiences reported by individuals with a relative with elevated hoarding symptoms using a cross-sectional design. The current investigation expands on the literature in this area by incorporating a detailed interview of experiences in conjunction with validated measures of hoarding symptomology. METHODS: Twenty-nine adults with relatives with elevated hoarding symptoms completed self-report measures of hoarding severity for themselves and their relative and a clinician-administered assessment of their experiences with their family member with hoarding symptoms. RESULTS: Participants endorsed significant burden across a range of areas, including permanent changes in their daily routine. The majority (93%) of participants reported at least one positive experience, with 69% endorsing companionship as a benefit of the relationship. Greater symptom severity of the relative with hoarding symptoms was associated with greater subjective burden and decreased positive experiences. CONCLUSION: Our results add further evidence to the potential for interpersonal psychotherapy to lead to a reduction in hoarding symptomology.

The relationship between academic stress and depression among college students during the COVID-19 pandemic: a cross-sectional study from China.

BACKGROUND: The COVID-19 pandemic is a global public health crisis. During the COVID-19 pandemic, mental health has attracted great attention. However, there is a lack of research on the relationship between academic stress and depression in Chinese college students and its mechanisms. Therefore, this study investigated the mechanisms of coping style, sleep quality, and interpersonal relationship in academic stress and depression among college students. METHODS: The cross-sectional study was conducted from May to June 2022 through face-to-face questionnaires with college students in Anhui Province, China. The questionnaires included sociodemographic information, the Simplified Coping Style Questionnaire, and the Self-Rating Depression Scale. Ordered logistic regression model was used to study the relationship between academic stress and depression of college students during the COVID-19 pandemic through the mechanism analysis of coping style, sleep quality and interpersonal relationship. RESULTS: Two thousand thirty-three Chinese college students participated in the study, including 1,285 female and 748 male college students, with an average age 19.81 years old (SD = 1.22 years old). The results showed that (1) Academic stress had a significant impact on depression in college students under the background of COVID-19 (p < 0.01); (2) The influence of academic stress on depression had a difference in work experience as student cadres, which showed that college students who had served as student cadres were less affected by academic stress (p < 0.10), college students who had not served as student cadres were greatly affected by the academic stress (p < 0.05); (3) College students' attitudes toward COVID-19 significantly affected depression (p < 0.01); (4) Counselors' concern had a significant impact on college students' depression (p < 0.01); (5) Positive coping style, high quality sleep and good interpersonal relationship were the important mechanisms of the impact of academic stress on college students' depression. CONCLUSIONS: This study provides new findings for in-depth understanding of the relationship between academic stress and depression among college students in China during the COVID-19 pandemic, which is conducive to the provision of targeted intervention measures for the mental health of college students.

'To loosen up and talk': Patients´ and facilitators´ experiences of discovery group sessions from the Tidal Model as an introduction before engaging in a person-centred group intervention.

WHAT IS KNOWN ABOUT THE SUBJECT: Treatment groups in Mental Health Service is cost-effective, increases patients´ self-understanding and stimulate change Research shows that people with mental illness have different barriers to attend group sessions which often originates from a lack of trust in other people, but it is known that the possibility to build gradual trust among the participants encourages attendance. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: This study is based on the experience from outpatients and illuminates how discovery groups from the Tidal Model can be used as introductory sessions to build gradual trust among people with mental illness before engaging in a person-centred group intervention. The study fills a research gap in methods to create a safe and trusting environment in treatment groups for people with mental illness working with recovery-oriented person-centred interventions. WHAT ARE THE IMPLICATIONS FOR PRACTICE: This study emphasizes the importance of meeting concerns about social interactions in persons with mental illness when joining treatment groups. It presents a recovery-oriented method which meets this requirement and is easy to implement in practice. ABSTRACT: INTRODUCTION: Recovery-oriented interventions delivered individually or in groups are more and more common within mental health nursing. However, persons with mental illness may be cautious about engaging in groups. Therefore, it is important to provide a trusting basis in the group to allow for the best opportunities to promote engagement, attendance and impact of treatment. AIM: The aim was to explore how discovery group sessions were experienced as introductory sessions from the perspectives of participants and facilitators before engaging in a person-centred group intervention. METHOD: A qualitative interview study was conducted, involving four group facilitators and 16 participants with mental illness from five completed groups. Data were analysed with Ricoeur's theory of interpretation. RESULTS: The findings showed that the two discovery group sessions were experienced as useful and meaningful to all and created a safe atmosphere and a trusted relationship among group participants and facilitators. DISCUSSION: Feeling safe and sharing experiences and emotions contribute to the relational climate in a group. IMPLICATION FOR PRACTICE: Addressing concerns about social interactions in persons with mental illness is important in group treatment. This study proved that engaging patients in designing or adapting interventions for mental health services is important to improve quality.