Laser auriculotherapy associated with cupping therapy in chronic spinal pain: Randomized controlled clinical trial.

BACKGROUND: Musculoskeletal spine disorders are common causes of chronic pain and impair functionality. Laser auriculotherapy and cupping has played a significant role in the treatment of chronic pain. OBJECTIVE: to evaluate the effect of laser auriculotherapy associated with cupping at systemic acupuncture points on chronic spinal pain. METHODS: Randomized controlled clinical trial. Volunteers underwent three evaluations: an initial evaluation, a final evaluation immediately after the last intervention session, and a 15-day follow-up. The pain was identified using the numeric pain scale. The pain threshold was also evaluated against mechanical stimulation using a Digital Dynamometer at specific points in the cervical, thoracic and lumbar regions. Fifty individuals with chronic spinal pain, randomized into groups: experimental (n = 25), submitted to 10 sessions of auriculotherapy with laser and cupping therapy and control (n = 25). RESULTS: The experimental group achieved pain intensity reduction between pre and post and follow-up moments (p < 0.0001), of greatest pain in the last seven days among all moments (p < 0.0001), of least pain in the pre with post moment (p = 0.006) and follow-up (p = 0.002), and an increased pain threshold between pre and post (p = 0.023). The control group achieved a reduction in the nociceptive threshold between pre and post (p = 0.001) and follow-up (p < 0.0001). The experimental group showed reduced pain intensity (p = 0.027) and greater pain (p = 0.005) after intervention and in pain intensity (p = 0.018), greater (p < 0.0001) and less pain (p = 0.025) at follow-up, compared to the control group. CONCLUSION: Auriculotherapy with laser associated with cupping therapy may effectively reduce pain intensity and increase the nociceptive threshold.

Validação de face, conteúdo e semântica da escala de avaliação do risco de quedas em pessoas idosas que vivem na comunidade / Face, content and semantic validation of the scale for assessing the risk of falls in community-dwelling elderly people / Validación facial, de contenido y semántica de la escala de evaluación del riesgo de caídas en ancianos residentes en la comunidad

Introdução: quedas em pessoas idosas constituem um sério problema de saúde e geram muitas preocupações para estudiosos e clínicos da geriatria e gerontologia. Objetivo: avaliar a validade de face e de conteúdo e a validade semântica de uma escala de avaliação do risco de quedas em idosos que vivem na comunidade. Método: trata-se de um estudo do tipo metodológico, com realização das seguintes etapas: validade de face e de conteúdo e análise semântica. Na análise de validade de face e de conteúdo, foram convidados sete juízes especialistas na área de saúde da pessoa idosa e do método em questão. Concernente à análise semântica, a referida escala foi aplicada em 20 idosos selecionadas por conveniência. Resultados: dos sete juízes contatados, cinco retornaram com os instrumentos. Na análise de aparência, cinco itens receberam concordância inferior a 80%. Na análise semântica, apenas dois itens foram identificados como de difícil compreensão pelas pessoas idosas. A segunda versão da escala apresentava 43 itens e, após avaliação dos juízes, passou a compor 44 itens. Conclusão: a escala apresenta validade de face, de conteúdo e semântica para o contexto atual e para a população-alvo estudada, sendo importante sua revisão e adequação em momentos pósteros a fim de acompanhar os avanços científicos da geriatria e gerontologia.

Introduction: falls in elderly people constitute a serious health problem and generate many concerns for scholars and clinicians in geriatrics and gerontology. Objective: to evaluate the face and content validity and semantic validity of a scale to assess the risk of falls in community-dwelling elderly people. Method: this is a methodological study, with the following stages: face and content validity and semantic analysis. For the face and content validity analysis, seven judges, experts in the area of elderly health and the method in question, were invited. Regarding the semantic analysis, the scale was applied to 20 elderly people selected by convenience. Results: of the seven judges contacted, five returned with the instruments. In the appearance analysis, five items received less than 80% agreement. In the semantic analysis, only two items were identified as difficult to understand by the elderly. The second version of the scale had 43 items and, after the judges' evaluation, it became 44 items. Conclusion: the scale presents face, content and semantic validity for the current context and for the target population studied, being important its revision and adequacy in later moments in order to follow the scientific advances in geriatrics and gerontology.

Introducción: las caídas en ancianos constituyen un grave problema de salud y generan muchas preocupaciones a los estudiosos y clínicos en geriatría y gerontología. Objetivo: evaluar la validez facial y de contenido y la validez semántica de una escala para evaluar el riesgo de caídas en ancianos residentes en la comunidad. Método: se trata de un estudio metodológico, con las siguientes etapas: validez facial y de contenido y análisis semántico. Para el análisis de la validez facial y de contenido se invitó a siete jueces, expertos en el ámbito de la salud de las personas mayores y en el método en cuestión. En cuanto al análisis semántico, la escala se aplicó a 20 ancianos seleccionados por conveniencia. Resultados: de los siete jueces contactados, cinco devolvieron los instrumentos. En el análisis de apariencia, cinco ítems recibieron menos del 80% de acuerdo. En el análisis semántico, sólo dos ítems fueron identificados como difíciles de entender por las personas mayores. La segunda versión de la escala tenía 43 ítems y, tras la evaluación de los jueces, pasó a tener 44 ítems. Conclusión: la escala presenta validez facial, de contenido y semántica para el contexto actual y para la población objetivo estudiada, siendo importante su revisión y adecuación en momentos posteriores para acompañar los avances científicos en geriatría y gerontología.

Ansiedade no período pré-operatório: uma análise bibliométrica / Anxiety in the preoperative period: a bibliometric analysis / Ansiedad en el periodo preoperatorio: un análisis bibliométrico

Objetivo: caracterizar os indicadores bibliométricos da produção científica disponível em periódicos online que abordam a ansiedade no período pré-operatório. Método: Trata-se de uma análise bibliométrica descritiva com abordagem quantitativa de base documental. Para a busca utilizou-se sete bases de dados, com os descritores "ansiedade" e "período pré-operatório". Realizado análise estatística descritiva simples. Resultados: Foram encontrados 10224 artigos e após análises 148 artigos constituíram-se a amostra do estudo. Conclusão: Os indicadores bibliométricos indicam que a produção científica acerca da ansiedade pré-operatória destaca-se no âmbito nacional e internacional, tendo portanto, predomínio as publicações nacionais no idioma inglês, com sistema de produção em coautoria; o Brasil, os EUA e a Turquia foram os países que mais publicaram, sendo a grande maioria no cenário acadêmico das universidades brasileiras. As publicações foram realizadas por diferentes áreas do conhecimento, com destaque para as áreas médica e de enfermagem, o que indica um caráter interdisciplinar acerca da temática.

Objective: to characterize the bibliometric indicators of science available in online journals that address anxiety in the preoperative period. Method: This is a descriptive bibliometric analysis with a document-based quantitative approach. For the search, seven databases were used, with the descriptors "anxiety" and "preoperative period". Simple descriptive statistical analysis. Results: 10224 articles were found and after analysis 148 articles constituted the study sample. Conclusion: The bibliometric indicators indicate that the scientific production about pre-surgical anxiety stands out at the national and international level, having, therefore, domain of national publications in the English language, with a co-authorship production system; Brazil, the USA and Turkey were the countries that published the most, with the vast majority in the academic scenario of Brazilian universities. The publications were carried out by different areas of knowledge, with emphasis on the medical and nursing areas, which indicates an interdisciplinary character regarding the theme.

Objetivo: Caracterizar los indicadores bibliométricos de la producción científica disponible en revistas online que abordan la ansiedad en el periodo preoperato- rio. Método: Se trata de un análisis bibliométrico descriptivo con un enfoque cuantitativo de base documental. Para a busca utilizou-se sete bases de dados, com os descritores "an- siedade" e "período pré-operatório". Se realizó un análisis estadístico descriptivo simple. Resultados: Fueron encontrados 10224 artículos y después del análisis 148 artículos con- stituyeron la muestra del estudio. Conclusión: Los indicadores bibliométricos indican que la producción científica sobre ansiedad preoperatoria se destaca nacional e internacional- mente, con predominio, por lo tanto, de publicaciones nacionales en inglés, con sistema de producción en coautoría; Brasil, EE.UU. y Turquía fueron los países que más publica- ron, y la gran mayoría en el ámbito académico de universidades brasileñas. Las publica- ciones fueron realizadas por diferentes áreas del conocimiento, especialmente las áreas médica y de enfermería, lo que indica un carácter interdisciplinario sobre el tema.

Aquatic Exercise on Brain Activity in Type 2 Diabetic: Randomized Clinical Trial.

BACKGROUND: A water-based physical exercise program is extremely important for the rehabilitation of type 2 diabetes. Little is known about its action on cerebral electrical activity. OBJECTIVE: To evaluate the effect of a water-based physical exercise protocol on electroencephalographic activity, blood glucose levels, and functional capacity, as well as their correlation, in type 2 diabetics. METHODS: Study design: Randomized Clinical Trial. Forty volunteers were randomized into two groups: control (n = 20) and study (n = 20). A water-based physical exercise program comprising 50 min sessions was conducted three times a week for five weeks. Assessments were performed at the pre- and post-intervention and follow-up phases. The qualitative data were compared using the Mann-Whitney test and Chi-Square. Quantitative data were compared using the Kruskal-Wallis, Independent t, and ANOVA mixed tests. The Spearman correlation coefficient was used to correlate the data. RESULTS: The data were similar when comparing the groups. Six-minute walk test data increased in the comparison between times (p = 0.01-PrexPos). EEG data decreased in comparison between times (prexfollow-up-p < 0.05), except AF3. EEG data decreased in the timexgroup comparison (prexfollow-up and postxfollow-up-p < 0.05). CONCLUSIONS: The water-based exercise protocol maintained electroencephalographic activity, glucose levels, and functional capacity in people with type 2 diabetes, and there was no relationship between brain electrical activity and capillary blood glucose.

Effect of Ear Acupuncture plus Dry Cupping on Activities and Quality of Life in the Adults with Chronic Back Pain: a Randomized Trial.

Background: Chronic pain is a complex phenomenon that brings physical and emotional impairments negatively impacting people's quality of life. The adoption of interventions such as ear acupuncture and dry cupping can represent a treatment option for people with chronic back pain. Objectives: To investigate the effects of ear acupuncture combined with dry cupping therapy on the interference of pain with the daily activities and quality of life of adults with chronic back pain. Methods: An open-label, randomized, parallel-group controlled clinical trial. One hundred and ninety-eight adults were randomized into control (CG - ear acupuncture) or experimental (EG - ear acupuncture combined with dry cupping) groups. Interventions were performed in five sessions, once a week, lasting five weeks. Evaluations were performed before the first session, after the last session, and seven days after the second evaluation, using the Brief Pain Inventory to assess the impact of pain on daily activities and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) to assess the quality of life. Results: Between the initial and final sessions, there were significant changes in daily activities , activity, work, mood, relationships, sleep, and in the physical, psychological and social relationships domains for both the control and experimental groups. Improved perception of quality of life and satisfaction with health were observed for the participants in the experimental group. Conclusion: Ear acupuncture combined with dry cupping showed better results in terms of perception of quality of life and satisfaction with health when compared to ear acupuncture by itself.

Effects of ear acupuncture combined with cupping therapy on severity and threshold of chronic back pain and physical disability: A randomized clinical trial.

Background and aim: Chronic back pain causes physical, functional, and emotional disabilities. Traditional Chinese Medicine therapies have been shown as interventions to treat chronic back pain. The present study aimed to clinically evaluate the effects of ear acupuncture combined with cupping therapy on people with chronic back pain. Experimental procedure: We conducted an open-label, randomized, parallel-group controlled clinical trial. Following the CONSORT statement recommendations, 198 participants were randomized into 'ear acupuncture' and 'ear acupuncture and cupping therapy' groups. Data were collected in three different points; before the first session (initial) with the patient, after the last session (final), and seven days after the end of the treatment (follow-up). The Brief Pain Inventory, a digital algometer, and the Rolland Morris Disability Questionnaire were used for data collection. Generalized Estimation Equation model was used to examine the association between the interventions and the primary outcome pain severity. Results: Pain severity, pressure pain threshold, and physical disability improved over time in both groups. However, for the patients being treated with both ear acupuncture and cupping therapy, significant changes were seen in pain severity, pain relief, and physical disabilities between the initial and final sessions. For the 'ear acupuncture and cupping therapy' group, significant changes were also seen for pain relief and physical disability in the follow-up session. Conclusion: Ear acupuncture combined with cupping therapy was shown to be more effective in the treatment of chronic back pain when compared to treatment using only ear acupuncture.

Effects of low-power laser auriculotherapy on chronic spinal pain: Randomized clinical trial.

AIMS AND OBJECTIVES: To evaluate the effect of laser auriculotherapy on chronic spinal pain. It is a randomized controlled clinical trial. METHODS: Volunteers with chronic spinal pain underwent three evaluations: an initial evaluation, a final evaluation immediately after the last intervention session, and a 15-day follow-up. Pain intensity, nociceptive threshold in relation to mechanical stimulus, and degree of pain (the greatest and least pain) in the last seven days were the assessed variables. The experimental group (EG, n = 24) underwent 10 sessions of laser auriculotherapy twice a week, while the control group (CG, n = 23) did not receive any intervention. RESULTS: The EG showed great clinical improvement in relation to the variable pain intensity between pre- and post-interventions (65.2%) and pre-intervention and follow-up (58.62%) compared to the CG. There was a significant increase in the nociceptive threshold for the EG. In contrast, the CG showed a significant reduction in the nociceptive threshold. The intergroup analysis indicated an improvement in pain intensity for the EG (0.006). This result remained at the follow-up (0.012). The nociceptive threshold increased over time for the EG (0.016). In contrast, the CG showed a reduction in this variable with a significant difference over time (<0.001). CONCLUSION: The results of this clinical trial suggest that the proposed intervention may be effective in reducing pain intensity and increasing the nociceptive threshold. The effect of the intervention remained 15 days after the end of the treatment, when the volunteers were re-evaluated.

Relação entre dor crônica nas costas, incapacidade e qualidade de vida após auriculoacupuntura e ventosaterapia e satisfação com o tratamento: estudo transversal / Relationship between chronic back pain, disability and quality of life after auriculoacupuncture and cupping therapy and satisfaction with treatment: across-sectional study / La relación entre el dolor de espalda crónico, la discapacidad y la calidad de vida después de la acupuntura auricular y la terapia con ventosas y la satisfacción con el tratamiento: un estudio transversal

OBJETIVO: avaliar a relação da intensidade da dor, incapacidade física e qualidade devida após tratamento de auriculoacupuntura e ventosaterapia com a satisfação com o tratamento, necessidade dele para controle da dor, percepção de melhora e consumo de medicação. MÉTODO: estudo transversal conduzido com 198 pessoas com dor crônica nas costas. Foram investigadas: intensidade da dor, incapacidade física, qualidade de vida, satisfação com o tratamento, necessidade da intervenção para o controle da dor, percepção de melhora e consumo de medicação. Foi realizada correlação de Spearman a 5% de significância. RESULTADOS: Houve correlações negativas de fraca magnitude da intensidade da dor e da incapacidade física com a satisfação com o tratamento, necessidade da intervenção, percepção de melhora após o tratamento e consumo de medicamentos, e correlações positivas de fraca magnitude da percepção da qualidade de vida com a satisfação com o tratamento, necessidade da intervenção, e percepção de melhora. CONCLUSÃO: A melhora da intensidade da dor, da incapacidade física e da qualidade de vida ocasionou melhor estado geral de saúde, satisfação com o tratamento e menor consumo de medicamentos entre os participantes do estudo.

OBJECTIVE: to evaluate the relationship between pain intensity, physical disability and quality of life after auriculoacupuncture and cupping therapy with satisfaction with treatment, need for it to control pain, perception of improvement and medication consumption. METHOD: cross-sectional study conducted with 198 people with chronic back pain. The following were investigated: painintensity, physical disability, quality of life, satisfaction with treatment, need for intervention to control pain, perception of improvement and medication consumption. Spearman's correlation was performed at 5% of significance. RESULTS: There were low magnitude negative correlations of pain intensity and physical disability with treatment satisfaction, need for intervention, perception of improvement after treatment and medication consumption, and low magnitude positive correlations of quality of life perception with satisfaction with treatment, need for intervention, and perception of improvement. CONCLUSION: The improvement in pain intensity, physical disability and quality of life resulted in better general health status, satisfaction with treatment and lower consumption of medication among study participants.

OBJETIVOS: evaluar la relación de la intensidad del dolor, la discapacidad física y la calidad de vida después de la acupuntura auricular y la terapia con ventosas con la satisfacción con el tratamiento, la necesidad del mismo para controlar el dolor, la percepción de mejoría y el consumo de medicamentos. MÉTODO:estudio transversal realizado con 198 personas con dolor de espalda crónico. Se investigó: la intensidad del dolor, la discapacidad física, la calidad de vida, la satisfacción con el tratamiento, la necesidad de intervención para el control del dolor, la percepción de mejoría y el consumo de medicamentos. Se realizó la correlación de Spearman al 5% de significancia. RESULTADOS: Hubo correlaciones negativas de baja magnitud de la intensidad del dolor y de la discapacidad física con la satisfacción con el tratamiento, necesidad de intervención, percepción de mejoría después del tratamiento y consumo de medicamentos, y correlacion espositivas de baja magnitud de la percepción de la calidad de vida con la satisfacción con el tratamiento, necesidad de intervención y percepción de mejora. CONCLUSIÓN: La mejora en la intensidad del dolor, la discapacidad física y la calidad de vida llevaron aun mejor estado general de salud, satisfacción con el tratamiento y menor consumo de medicamentos entre los participantes del estudio.

Physical and emotional factors associated with the severity of chronic back pain in adults: a cross-sectional study / Factores físicos y emocionales asociados a la gravedad del dolor crónico en adultos: un estudio transversal / Fatores físicos e emocionais associados à severidade da dor crônica nas costas em adultos: estudo transversal

ABSTRACT Objective: determining the multidimensional factors associated with the severity of chronic back pain is essential to design appropriate interventions. The objective of this study was to assess the physical and emotional factors associated with the severity of chronic back pain in adults. Method: a descriptive, analytical and cross-sectional study, carried out between November 2017 and December 2018 in Family Health Strategies, with 198 adults with chronic back pain. Pain severity, assessed by the Brief Pain Inventory, was considered the outcome variable; and the pain interference in daily activities (Brief Pain Inventory), physical disability (Roland Morris Disability Questionnaire), quality of life (World Health Organization Quality of Life-Brief) and pain threshold (digital algometer) variables were considered explanatory. A Multivariate Multiple Linear Regression analysis, using the stepwise method with 5% significance, was preformed to establish an explanatory model of pain severity. Results: the mean age was 48.03 years old (standard deviation: 12.41). Most of the participants were women, married and worked. The variables that had a significant and joint impact on pain severity were pain interference in daily activities (parameter: 0.196; p-value<0.001) and in mood (parameter: 0.054; p-value=0.039) and physical domain of quality of life (parameter: -0.032; p-value<0.001). Conclusion: physical factors (pain interference in daily activities and physical domain of quality of life) and emotional factors (pain interference in mood) play an important role in the severity of chronic back pain, which reinforces its multidimensional character.

RESUMEN Objetivo: determinar los factores multidimensionales asociados a la gravedad del dolor de espalda crónico es esencial para diseñar intervenciones apropiadas. El objetivo de este estudio fue evaluar los factores físicos y emocionales asociados a la gravedad del dolor de espalda crónico en adultos. Método: estudio descriptivo y analítico, de corte transversal, realizado entre noviembre de 2017 y diciembre de 2018, en unidades de la Estrategia de Salud Familiar, con 198 adultos que sufren dolor de espalda crónico. La gravedad del dolor, evaluada por medio del Brief Pain Inventory, se consideró como variable de resultado; y las variables interferencia del dolor en las actividades cotidianas (Brief Pain Inventory), discapacidad física (Cuestionario de Discapacidad de Roland Morris), calidad de vida (World Health Organization Quality of Life-Brief) y umbral de dolor (algómetro digital) se consideraron como variables explicativas. Se realizó un análisis multivariado de Regresión Lineal Múltiple, usando el método stepwise con 5% de significancia, para establecer el modelo explicativo de la gravedad del dolor. Resultados: la media de edad fue de 48,03 años (desviación estándar: 12,41). La mayoría de los participantes fueron mujeres, casadas y con alguna actividad laboral. Las variables que ejercieron un impacto sobre la gravedad del dolor en forma significativa y conjunta fueron las siguientes: interferencia del dolor en las actividades cotidianas (parámetro: 0,196; valor p<0,001) y en el estado de ánimo (parámetro: 0,054; valor p=0,039) y el dominio físico de la calidad de vida (parámetro: -0,032; valor p<0,001). Conclusión: los factores físicos (interferencia del dolor en las actividades cotidianas y el dominio físico de la calidad de vida) y emocionales (interferencia del dolor en el estado de ánimo) desempeñan un rol importante en la gravedad del dolor de espalda crónico, lo que refuerza su carácter multidimensional.

RESUMO Objetivo: determinar os fatores multidimensionais associados à severidade da dor crônica nas costas é essencial para traçar intervenções apropriadas. O objetivo deste estudo consistiu em avaliar os fatores físicos e emocionais associados à severidade da dor crônica nas costas em adultos. Método: estudo descritivo analítico, de corte transversal, realizado entre novembro de 2017 e dezembro de 2018, em Estratégias de Saúde da Família, com 198 adultos com dor crônica nas costas. A severidade da dor, avaliada pelo Brief Pain Inventory, foi considera variável de desfecho; as variáveis interferência da dor nas atividades cotidianas (Brief Pain Inventory), incapacidade física (Questionário de Incapacidade de Rolland Morris), qualidade de vida (World Health Organization Quality of Life-Brief) e limiar de dor (algômetro digital) foram consideradas variáveis explicativas. Análise multivariada de Regressão Linear Múltipla, usando o método stepwise com 5% de significância, foi conduzida para estabelecer modelo explicativo da severidade da dor. Resultados: a média de idade foi de 48,03 anos (desvio padrão: 12,41). A maioria eram mulheres, casadas e que trabalhavam. As variáveis que tiveram impacto na severidade da dor de forma significativa e conjunta foram interferência da dor nas atividades cotidianas (parâmetro: 0,196; valor p<0,001) e no humor (parâmetro: 0,054; valor p=0,039) e domínio físico da qualidade de vida (parâmetro: -0,032; valor p<0,001). Conclusão: fatores físicos (interferência da dor nas atividades cotidianas e domínio físico da qualidade de vida) e emocionais (interferência da dor no humor) desempenham importante papel na severidade da dor crônica nas costas, o que reforça o seu caráter multidimensional.

A intervenção "Ensino do cuidado com os pés" para pessoas com diabetes: ensaio clínico randomizado

Introdução: pessoas com diabetes possuem risco aumentado para o desenvolvimento de morbidades nos membros inferiores, o que está relacionado a amputações. Objetivo: analisar o efeito da intervenção "Ensino do Cuidado com os Pés", realizada por meio de visitas domiciliares, na integridade tissular, no conhecimento sobre as atividades de autocuidado e na intenção de cuidar dos pés. Método: ensaio clínico paralelo, de mascaramento único e randomizado com taxa de alocação de 1:1, desenvolvido com pessoas com Diabetes tipo 2. O desfecho primário está relacionado a avaliação da integridade tissular e o secundário, ao conhecimento sobre as atividades de autocuidado e à intenção em realizar cuidados com os pés. Resultados: Participaram do estudo 72 pessoas, divididas em grupo controle e tratado. O grupo controle apresentou diferença significativa (p=<0,05) nos indicadores de pele e anexo, circulação, sensibilidade, conhecimento e intenção de cuidar dos pés. Conclusão: "Ensino do Cuidado com os Pés" é uma estratégia que pode influenciar os indicadores de comprometimento dos pés. nº 20376013.2.0000.5142

The effect of operative groups on diabetic foot self-care education: a randomized clinical trial. / Efeito do grupo operativo no ensino do autocuidado com os pés de diabéticos: ensaio clínico randomizado.

OBJECTIVE: To evaluate the effect of operative groups on teaching self-care for diabetic foot prevention. METHOD: Controlled, blinded clinical trial with volunteers presenting type 2 Diabetes Mellitus, randomized into treatment (55 subjects) and control (54 subjects) groups. The treatment group received the educational intervention "Teaching foot self-care", whereas the control group was simply evaluated. Feet evaluation was conducted before and after the intervention, as well as 15 days later in a follow-up. The intervention was conducted through an operative group and developed with orientation via writing, explained through dialogue and role-playing. The following tests were used: Shapiro-Wilk, Chi-squared, t-test, Mann-Whitney, McNemar, and paired Wilcoxon. RESULTS: One-hundred and nine volunteers took part in this study. Their sociodemographic variables were homogeneous. In an analysis between groups, an improvement was observed after the educational intervention regarding most variables related to skin annexes, blood flow, foot sensitivity, and foot pressure. Improved scores for risk of diabetic foot in the treatment group were observed. CONCLUSION: The educational intervention through operative group was efficient, for it encouraged self-care and reduced potential risk of diabetic foot. Brazilian Registry of Clinical Trials (Registro Brasileiro de Ensaios Clínicos): RBR- 753 Kcg.

Intercessory Prayer on Spiritual Distress, Spiritual Coping, Anxiety, Depression and Salivary Amylase in Breast Cancer Patients During Radiotherapy: Randomized Clinical Trial.

The goal of this study was to assess the effect of intercessory prayer in the psychological, spiritual and biological scores of breast cancer patients who are undergoing radiotherapy. Double-blind RCT comprising a sample of 31 participants (15 in the Control Group and 16 in the Intervention Group). Data collection was performed in three time points (T0, T1 and T2). Significant changes have been identified in the intra-group analysis, concerning the decrease in spiritual distress score; negative religious/spiritual coping prevailed, while the total religious/spiritual coping increased between the posttest T2 to T0. Intercessory prayer was effective in religious and spiritual scores.

Efeito do grupo operativo no ensino do autocuidado com os pés de diabéticos: ensaio clínico randomizado / Efecto del grupo operatorio en la enseñanza del autocuidado con los pies de diabéticos: ensayo clínico aleatorizado / The effect of operative groups on diabetic foot self-care education: a randomized clinical trial

RESUMO Objetivo Avaliar o efeito do grupo operativo no ensino do autocuidado com os pés para prevenção do pé diabético. Método Ensaio clínico controlado e cego, realizado com voluntários que apresentavam Diabetes Mellitus tipo 2, randomizados em grupo tratado (55 pessoas) e grupo controle (54 pessoas). O grupo tratado recebeu a intervenção educativa "Ensino do autocuidado com os pés" e o grupo controle foi somente avaliado. As avaliações dos pés ocorreram antes e após a intervenção, bem como 15 dias depois desta (follow-up). A intervenção foi realizada por meio do grupo operativo e desenvolvida com orientação escrita, expositiva dialogada e role-playing. Foram utilizados os testes: Shapiro-Wilk, Qui-quadrado, Teste T, Mann-Whitney, McNemar e Wilcoxon emparelhado. Resultados Participaram 109 voluntários. Houve homogeneidade entre os grupos nas variáveis sociodemográficas. Na análise intergrupo, foi observada melhora após a intervenção educativa para: a maioria das variáveis dos domínios pele anexos; circulação sanguínea; sensibilidade plantar; e pressão plantar. Observou-se melhora nos escores do risco do pé diabético no grupo tratado. Conclusão A intervenção educativa por meio do grupo operativo foi eficaz, pois estimulou o autocuidado e reduziu o potencial de risco para o pé diabético. Registro Brasileiro de Ensaios Clínicos: RBR- 753 Kcg.

RESUMEN Objetivo Evaluar el efecto del grupo operativo en la enseñanza del autocuidado de los pies para prevenir el pie diabético. Método Un ensayo clínico controlado y ciego realizado con voluntarios que padecían diabetes mellitus de tipo 2, asignados al azar a un grupo tratado (55 personas) y a un grupo de control (54 personas). El grupo tratado recibió la intervención educativa "Enseñanza del autocuidado de los pies" y el grupo de control sólo fue evaluado. Las evaluaciones de los pies se realizaron antes y después de la intervención, así como 15 días después de la intervención (seguimiento). La intervención se llevó a cabo a través del grupo operativo y se desarrolló con orientación escrita, diálogo expositivo y juego de roles. Se utilizaron las pruebas: Shapiro-Wilk, Chi-cuadrado, T-test, Mann-Whitney, McNemar y Wilcoxon pareado. Resultados 109 voluntarios participaron. Había homogeneidad entre los grupos en las variables sociodemográficas. En el análisis intergrupal, se observó una mejora después de la intervención educativa para: la mayoría de las variables de piel y anexos; la circulación sanguínea; la sensibilidad plantar; y la presión plantar. Se observó una mejora en las puntuaciones de riesgo del pie diabético en el grupo tratado. Conclusión La intervención educativa a través del grupo operativo fue eficaz, porque estimuló el autocuidado y redujo el riesgo potencial para el pie diabético. Registro Brasileño de Ensayos Clínicos (Registro Brasileiro de Ensaios Clínicos): RBR- 753 Kcg.

ABSTRACT Objective To evaluate the effect of operative groups on teaching self-care for diabetic foot prevention. Method Controlled, blinded clinical trial with volunteers presenting type 2 Diabetes Mellitus, randomized into treatment (55 subjects) and control (54 subjects) groups. The treatment group received the educational intervention "Teaching foot self-care", whereas the control group was simply evaluated. Feet evaluation was conducted before and after the intervention, as well as 15 days later in a follow-up. The intervention was conducted through an operative group and developed with orientation via writing, explained through dialogue and role-playing. The following tests were used: Shapiro-Wilk, Chi-squared, t-test, Mann-Whitney, McNemar, and paired Wilcoxon. Results One-hundred and nine volunteers took part in this study. Their sociodemographic variables were homogeneous. In an analysis between groups, an improvement was observed after the educational intervention regarding most variables related to skin annexes, blood flow, foot sensitivity, and foot pressure. Improved scores for risk of diabetic foot in the treatment group were observed. Conclusion The educational intervention through operative group was efficient, for it encouraged self-care and reduced potential risk of diabetic foot. Brazilian Registry of Clinical Trials (Registro Brasileiro de Ensaios Clínicos): RBR- 753 Kcg.

Acupuntura auricular para dor crônica nas costas em adultos: revisão sistemática e metanálise / Acupuntura auricular para dolor crónico en la espalda: revisión sistemática y metaanálisis / Auricular acupuncture for chronic back pain in adults: a systematic review and metanalysis

RESUMO Objetivo Investigar os ensaios clínicos randomizados sobre a ação da acupuntura auricular para a dor crônica nas costas em adultos, identificar os desfechos mais utilizados para avaliar essa condição, o protocolo utilizado para aplicar a intervenção e identificar nos estudos qual o efeito da terapia sobre a intensidade da dor. Método Revisão sistemática e metanálise, conduzidas entre junho de 2017 e maio de 2018, nas bases de dados PubMed, CINAHL, PEDro, Embase, Scopus e na Biblioteca Virtual em Saúde. Listas de referências de revisões sistemáticas também foram exploradas. Resultados Foram localizados 427 estudos, 15 incluídos na análise qualitativa, e sete na análise quantitativa. A acupuntura auricular obteve resultados positivos em 80% dos estudos. Os desfechos mais utilizados foram a intensidade e a qualidade da dor, consumo de medicação, incapacidade física e qualidade de vida. Não há padronização no protocolo de acupuntura auricular para dor crônica nas costas. Os resultados da metanálise apontaram que a acupuntura auricular foi eficaz em reduzir os escores de intensidade da dor (p=0,038). Conclusão A acupuntura auricular é uma prática promissora para o tratamento da dor crônica nas costas em adultos.

RESUMEN Objetivo Investigar los ensayos clínicos randomizados sobre la acción de la acupuntura auricular para dolor crónico en la espalda en adultos, identificar los resultados más utilizados para evaluar dicha condición, el protocolo utilizado para aplicar la intervención e identificar en los estudios cuál es el efecto de la terapia sobre la intensidad del dolor. Método Revisión sistemática y metaanálisis, conducidas entre junio de 2017 y mayo de 2018, en las bases de datos PubMed, CINAHL, PEDro, Embase, Scopus y en la Biblioteca Virtual en Salud. Listas de referencias de revisiones sistemáticas también fueron exploradas. Resultados Se localizaron 427 estudios, 15 incluidos en el análisis cualitativo, y siete en el análisis cuantitativo. La acupuntura auricular obtuvo resultados positivos en el 80% de los estudios. Los resultados más utilizados fueron la intensidad y la calidad del dolor, consumo de fármacos, incapacidad física y calidad de vida. No existe estandarización en el protocolo de acupuntura auricular para dolor crónico en la espalda. Los resultados del metaanálisis señalaron que la acupuntura auricular fue eficaz en reducir los scores de intensidad de dolor (p=0,038). Conclusión La acupuntura auricular es una práctica prometedora para el tratamiento del dolor crónico en la espalda en adultos.

ABSTRACT Objective To investigate randomized clinical trials on the action of auricular acupuncture for chronic back pain in adults, and to identify the most commonly used outcomes for assessing this condition, the protocol used for applying the intervention, and the efficacy of the therapy on pain intensity. Method A systematic review and a metanalysis were carried out between June 2017 and May 2018, based on the PubMed, CINAHL, PEDro, Embase, Scopus, and the Virtual Health Library databases. Reference lists of systematic reviews were also explored. Results 427 studies were located, 15 included in the qualitative analysis, and seven in the quantitative analysis. Auricular acupuncture led to positive results in 80% of the studies. The most commonly used outcomes were pain intensity and quality, medication consumption, physical disability, and quality of life. There is a lack of protocol standardization for auricular acupuncture for chronic back pain. The metanalysis results showed that auricular acupuncture was effective in reducing pain intensity scores (p=0.038). Conclusion Auricular acupuncture is a promising practice for the treatment of chronic back pain in adults.

Religious/spiritual coping and spiritual distress in people with cancer / El coping religioso/espiritual y la angustia espiritual en individuos con cáncer / Coping religioso/espiritual e a angústia espiritual em pessoas com câncer

ABSTRACT Objective: To investigate the relation between the presence of spiritual distress and use of RSC and sociodemographic, clinical and religious/spiritual variables in people with cancer. Method: Cross-sectional study conducted in an association for support to people with cancer. The data obtained with the tools were analyzed using the Spearman's correlation coefficient and the Mann-Whitney Test. Results: 129 volunteers participated in the study, of which 57% showed moderate spiritual distress, 96% used medium and high positive religious/spiritual coping. Spiritual distress showed positive correlation with negative religious/spiritual coping (P<0.001) and inverse correlation with age (p 0.002). The use of positive religious coping was statistically significant in people who have religious practices (p 0.001). Conclusão: Spiritual distress is a phenomenon that is present in the lives of people with cancer and has significant relation with the use, in a negative manner, of religion/spirituality as a way of coping with the disease.

RESUMEN Objetivo: Examinar la relación entre la presencia de angustia espiritual y el uso del coping religioso/espiritual con variables sociodemográficas, clínicas y de aspectos religioso/espiritual en individuos con cáncer. Método: Estudio transversal, realizado en una asociación de apoyo a la persona con cáncer. En el análisis de datos recolectados se utilizó el coeficiente de correlación de Spearman y el test de Mann-Whitney. Resultados: En el estudio participaron 129 voluntarios; el 57% presentó moderada angustia espiritual, y el 96% utilizaba medio y elevado coping religioso/espiritual positivo. La angustia espiritual presentó una correlación positiva con el coping religioso/espiritual negativo (P < 0,001) e inversa con la edad (p 0,002). Se observó que el uso del coping religioso positivo fue estadísticamente significativo en los sujetos que participan en prácticas religiosas (p 0,001). Conclusión: La angustia espiritual es un fenómeno presente en la vida de los individuos con cáncer y tiene una significativa relación con el uso negativo de la religión/espiritualidad como forma de luchar contra la enfermedad.

RESUMO Objetivo: Investigar a relação entre presença de angústia espiritual e uso do coping religioso/espiritual com variáveis sociodemográficas, clínicas e de aspectos religioso/espiritual em pessoas com câncer. Método: Estudo transversal, realizado em uma associação de apoio à pessoa com câncer. Os dados obtidos dos instrumentos foram analisados por meio do coeficiente de correlação de Spearman e do teste Mann-Whitney. Resultados: Participaram do estudo 129 voluntários; 57% apresentaram moderada angústia espiritual, e 96% faziam uso de médio e alto coping religioso/espiritual positivo. A angústia espiritual apresentou correlação positiva com o coping religioso/espiritual negativo (P < 0,001) e inversa com a idade (p 0,002). O uso do coping religioso positivo foi estatisticamente significativo em pessoas que desenvolvem práticas religiosas (p 0,001). Conclusão: A angústia espiritual é um fenômeno presente na vida de pessoas com câncer e tem significativa relação com o uso, de maneira negativa, da religião/espiritualidade como forma de enfrentamento da doença.

Religious/spiritual coping and spiritual distress in people with cancer.

OBJECTIVE: To investigate the relation between the presence of spiritual distress and use of RSC and sociodemographic, clinical and religious/spiritual variables in people with cancer. METHOD: Cross-sectional study conducted in an association for support to people with cancer. The data obtained with the tools were analyzed using the Spearman's correlation coefficient and the Mann-Whitney Test. RESULTS: 129 volunteers participated in the study, of which 57% showed moderate spiritual distress, 96% used medium and high positive religious/spiritual coping. Spiritual distress showed positive correlation with negative religious/spiritual coping (P<0.001) and inverse correlation with age (p 0.002). The use of positive religious coping was statistically significant in people who have religious practices (p 0.001). CONCLUSÃO: Spiritual distress is a phenomenon that is present in the lives of people with cancer and has significant relation with the use, in a negative manner, of religion/spirituality as a way of coping with the disease.

Auriculotherapy to control chemotherapy-induced nausea and vomiting in patients with cancer: protocol of a systematic review.

BACKGROUND: Due to the worldwide rise in cancer incidence, and therefore the rise in the need for antineoplastic chemotherapy, it is important for both healthcare professionals and patients alike that the side effects of chemotherapy, such as chemotherapy-induced nausea and vomiting (CINV), are treated and prevented. Auriculotherapy is a type of acupuncture and may be a low-cost and safe antiemetic measure to control the side effects of chemotherapy. The goal of this systematic review is to synthesize the available evidence in the literature regarding the auriculotherapy effects to treat CINV in people with cancer. METHODS: The review will only include randomized controlled trials (RCTs) that compare the clinical effects of the auriculotherapy intervention (used alone or as an add-on), with sham auriculotherapy, routine treatment with antiemetic drugs, or other non-pharmacological interventions in patients with cancer with CINV who are undergoing chemotherapy. The outcomes to be evaluated are nausea and vomiting: in acute, delayed, or anticipated stages, when induced by chemotherapy. A comprehensive search for studies will be carried out in these databases: MEDLINE via PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, ICTRP, LILACS, CUMED, IBECS, BVS MTCI Americas, Web of Science, Scopus, PEDro, CNKI, and CBMdisc up until December 31, 2018. Only articles in English, Portuguese, and Spanish will be selected. Two independent reviewers will evaluate full texts, extract data, and assess the risk of bias of eligible articles. The quality of evidence will be assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). A meta-analysis will be undertaken to assess the interventions and outcomes' homogeneity, assessing statistical heterogeneity using the Cochran's Q test and quantified using Higgins' inconsistency index. If there is insufficient data for a meta-analysis, a narrative synthesis will be presented. This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. DISCUSSION: The results of this systematic review will summarize the strength of evidence for the use of auriculotherapy in the control of CINV of patients with cancer and will be used to identify evidence gaps. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018117513.

Auricular acupuncture for chronic back pain in adults: a systematic review and metanalysis. / Acupuntura auricular para dor crônica nas costas em adultos: revisão sistemática e metanálise.

OBJECTIVE: To investigate randomized clinical trials on the action of auricular acupuncture for chronic back pain in adults, and to identify the most commonly used outcomes for assessing this condition, the protocol used for applying the intervention, and the efficacy of the therapy on pain intensity. METHOD: A systematic review and a metanalysis were carried out between June 2017 and May 2018, based on the PubMed, CINAHL, PEDro, Embase, Scopus, and the Virtual Health Library databases. Reference lists of systematic reviews were also explored. RESULTS: 427 studies were located, 15 included in the qualitative analysis, and seven in the quantitative analysis. Auricular acupuncture led to positive results in 80% of the studies. The most commonly used outcomes were pain intensity and quality, medication consumption, physical disability, and quality of life. There is a lack of protocol standardization for auricular acupuncture for chronic back pain. The metanalysis results showed that auricular acupuncture was effective in reducing pain intensity scores (p=0.038). CONCLUSION: Auricular acupuncture is a promising practice for the treatment of chronic back pain in adults.

Contribution of Chinese and French ear acupuncture for the management of chronic back pain: A randomised controlled trial.

AIMS AND OBJECTIVES: To compare the efficacy of Chinese and French ear acupuncture in people with chronic back pain. BACKGROUND: Chronic back pain is a common public health problem worldwide. An intervention for this condition is ear acupuncture. Several approaches are used for ear acupuncture, particularly the Chinese and French guidelines. METHODS: An open, randomised and controlled clinical trial, followed the recommendations of the CONSORT Checklist. One hundred and eleven people were selected and randomised into three groups: Chinese ear acupuncture, French ear acupuncture and Control. Evaluations were performed before the first intervention session (initial), 1 week after the fifth session (final) and after a fifteen-day follow-up period (follow-up), using the Brief Pain Inventory, Rolland Morris Disability Questionnaire, and a thermal imaging camera. For data analysis, the Generalized Estimating Equation Model was applied, with significance level set at 5%. RESULTS: Pain severity was significantly decreased by Chinese ear acupuncture throughout intervention period. Both types of ear acupuncture affected pain interference with daily activities. However, in the comparison between initial and final evaluations, only Chinese ear acupuncture produced statistically significant results. A reduction in physical disability was observed in both ear acupuncture-treated groups during the intervention period and, although Chinese ear acupuncture failed to induce significant changes in tissular temperature at individual time points, a significant increase in cutaneous temperature was detected after the follow-up period in the dorsal region of individuals treated with Chinese ear acupuncture. Importantly, at this time point, the mean difference between Chinese and French ear acupuncture revealed a more benefic effect of Chinese procedure on this parameter. CONCLUSIONS: The individualised treatment based on the Chinese precepts showed, in an overall evaluation, better results for management of chronic back pain in the present study. RELEVANCE TO CLINICAL PRACTICE: Ear acupuncture can be implemented in the nurse's clinical practice to assist the treatment of people with chronic back pain.

Effects of auricular acupuncture on chronic pain in people with back musculoskeletal disorders: a randomized clinical trial.

OBJECTIVE: To evaluate the effects of auricular acupuncture on pain intensity, its impact on daily activities, the relief provided by the intervention, and the pain threshold in people with back musculoskeletal disorders. METHODS: Randomized clinical trial carried out with people randomly allocated into three groups: treatment, placebo, and control. Evaluations were performed using the Brief Pain Inventory and a digital algometer before (initial) and after (final) the treatment and after a 15-day follow-up period. RESULTS: The sample was 110 people. There was a decrease in pain intensity in the treatment and placebo groups as revealed by the comparison between the initial and final evaluations (p<0.05), and in the treatment group in the comparison between the initial and follow-up evaluations (p<0.05). A decreased impact of pain on daily activities in the treatment and placebo groups over time was found (p<0.05). At the final evaluation, the impact of pain was lower in the treatment group (p<0.05). Auricular acupuncture did not increase the pain threshold. CONCLUSION: Auricular acupuncture presented positive effects by reducing the chronic pain intensity and its impact on daily activities in people with back musculoskeletal disorders. Brazilian Clinical Trials Registry: RBR-5X69X2.