A longitudinal study of breastfeeding relationships at home during the COVID-19 pandemic: A grounded theory method.

AIMS: To describe the process of breastfeeding relationships among stay-at-home mother and infant dyads at 1, 3, 5 and 6 months. DESIGN: A longitudinal qualitative online survey design was used. METHODS: Data were obtained at 1, 3, 5 and 6 months from 26 breastfeeding mothers who stayed home with their infants and directly breastfed at least once a day for the first 6 months between June 2022 and August 2023. Mothers' written responses to 3 open-ended questions were analysed to assess breastfeeding experiences at home, thoughts/comments while directly breastfeeding and breastfeeding concerns/problems and strategies they used. Based on grounded theory, inductive content analysis was used to analyse the data. Trustworthiness of results was established by coding to consensus, formal peer debriefing and maintaining an audit trail. RESULTS: 'Breastfeeding Relationships at Home,' the core construct, was identified and organized the process of breastfeeding relationships into 5 domains: (1) mothers' emotional well-being while breastfeeding, (2) infant-led feeding, (3) alternatives to breastfeeding, (4) evaluation of breastfeeding and (5) changes in breastfeeding as infants grow older. CONCLUSION: Breastfeeding is not simply about feeding breast milk but also involves nurturing and developing a relationship between mother and infant. Across the domains, mutual responsiveness, a central element of the breastfeeding relationship was clear. Mothers who were committed to breastfeeding with embedded infant suckling reached emotional well-being in return for their engagement which has potential to reduce maternal stress and prevent postpartum depression. IMPACT: Findings from the current study add to nurses' knowledge about the relationship building process between stay-at-home mothers and their infants in the first 6 months of breastfeeding during the COVID-19 pandemic. Nurses must remain sensitive to aid the development of breastfeeding relationships in the home environment to maximize mutual responsiveness. PATIENT OR PUBLIC CONTRIBUTION: No patients or public involved.

A comparative study among adolescents with cystic fibrosis and primary ciliary dyskinesia and their caregivers: psychological aspects / Estudio comparativo entre adolescentes con fibrosis quística y discinesia ciliar primaria y sus cuidadores: aspectos psicológicos

This work aimed to conduct a comparative study between cystic fibrosis and primary ciliary dyskinesia among adolescents and their caregivers to understand their emotional adaptation to the disease. Thirty-nine dyads of adolescents aged 9-18 years and their primary caregivers were assessed, 69.20 % of whom had a diagnosis of cystic fibrosis. For the adolescents, anxious-depressive symptomatology was assessed using the HADS, perceived threat of disease (B-IPQ) and quality of life (CRQ-SAS). For the caregivers, emotional symptomatology (HADS) and perceived stress levels (PIP) were assessed. Mean comparisons were made according to diagnosis and severity of anxious-depressive symptomatology, relationships between variables were studied, and qualitative comparative analysis models, QCA, were performed. Higher levels of anxiety and depression were found in the caregiver than in the adolescent. Adolescents with primary ciliary dyskinesia have a more significant emotional impact than adolescents with cystic fibrosis. However, no differences were found in caregivers according to diagnosis. The adolescent's emotional state, quality of life and perceived threat of disease were related to and explained by the caregiver's emotional state, and vice versa. Therefore, there appears to be a certain degree of emotional contagion between the dyad members. This is a preliminary study that has not been carried out before and can help to understand the psychological aspects associated with these diseases to favour the patient's adjustment and thereby ensure more effective management of the disease and adherence to treatment. (AU)

El objetivo fue realizar un estudio comparativo entre la fibrosis quística y la discinesia ciliar primaria entre adolescentes y sus cuidadores para comprender su adaptación a la enfermedad. Evaluando 39 díadas de adolescentes de entre 9 y 18 años y sus cuidadores, el 69,20% de los cuales tenían un diagnóstico de fibrosis quística. Para los adolescentes, se evaluó la sintomatología ansioso-depresiva mediante el HADS, la amenaza percibida de la enfermedad (B-IPQ) y la calidad de vida (CRQ-SAS). Para los cuidadores, se evaluó la sintomatología emocional (HADS) y los niveles de estrés percibido (PIP). Se realizaron comparaciones de medias según el diagnóstico y la sintomatología ansioso-depresiva, se estudiaron las relaciones entre variables y se realizaron modelos de análisis cualitativo comparativo. Se encontraron mayores niveles ansioso-depresivos en el cuidador que en el adolescente. Los adolescentes con discinesia ciliar primaria presentan un impacto emocional mayor que los adolescentes con fibrosis quística. No se encontraron diferencias en los cuidadores según el diagnóstico. El estado emocional, la calidad de vida y la percepción de amenaza de la enfermedad del adolescente estaban relacionados con el estado emocional del cuidador y se explicaban por él, y viceversa. Por lo tanto, parece existir cierto grado de contagio emocional entre los miembros de la díada. Se trata de un estudio preliminar que no se ha realizado previamente y que ayuda a comprender los aspectos psicológicos asociados a estas enfermedades favoreciendo el ajuste del paciente y asegurar así un manejo más eficaz de la enfermedad y la adherencia al tratamiento. (AU)

Acoustic and Subjective Basis of Emotional Perception in Comatose Patients: A Comparative Study.

Objective: : The acoustic stimulation in consciousness patients may improve the diagnosis assessment and the effectiveness of rehabilitation procedures. We aimed to investigate the event-related potential (ERP) response to emotional auditory stimuli in comatose patients. Methods: : We measured the nonlinear and linear electroencephalogram (EEG) features, prepared the acoustic analysis of stimuli parameters, and assessed the subjective emotional rates of stimuli characteristics. Results: : Patients with better outcomes had recognizable ERP responses and significant changes of the nonlinear EEG features to emotional sounds, unlike patients with worse outcomes. The response of comatose patients was attributed to acoustical features of emotional sounds, whereas the EEG response of healthy subjects was associated with their subjective feelings. The comatose patients demonstrated the variable EEG activity for neutral and emotional sounds. Conclusion: : Thus, the EEG reactivity followed the better outcome of comatose patients to emotional stimuli. The study assumed the substantial differences of emotional stimuli perception in the healthy and unconscious brain.

Functional and emotional impact of COVID-19 lockdown on older adults with sarcopenia living in a nursing home: A 15-month follow-up.

This study aimed to detect the functional and emotional impact of COVID-19 lockdown on institutionalized older adults with sarcopenia during a 15-month follow-up. A prospective longitudinal cohort study was conducted in a nursing home. Participants were screened for sarcopenia, and those with a score of ≥4 points according to SARC-F questionnaire were included. Assessments were performed pre-lockdown (T1), 12 months (T2) after, and at a 15-month follow-up (T3). Functional measurements included chair stand test, handgrip, biceps brachii and quadriceps femoris strengths, appendicular skeletal mass, gait speed, Short Physical Performance Battery, and Timed Up-and-Go test. Emotional assessments included Short-Form Health Survey, Geriatric Depression Scale-Short Form, and the Mini-Mental State Examination. The analyzed sample showed a reduction in bicep strength, and other upper and lower limb strength variables showed a decreasing trend with no changes regarding muscle mass. Physical performance showed a change, specifically a deterioration in the subtest related to balance. Cognitive and emotional components were affected and quality of life was decreased. It is of paramount importance to focus on sarcopenic older adults since their characteristics can deteriorate when isolation measures are conducted.

Experiences of transition to adulthood and transfer to adult care in young adults with type 1 diabetes: A qualitative study.

AIM: To explore young adults' experiences of living with type 1 diabetes in the transition to adulthood, including experiences of the transfer from paediatric to adult care. DESIGN: A qualitative approach was used. METHOD: Ten young adults, six women and four men, aged 19-29 years, participated. Participants were recruited at their regular diabetes clinic from spring 2021 to spring 2022. Semi-structured interviews were transcribed and analysed using qualitative content analysis. FINDINGS: Dreaming of being nurtured towards self-reliance was the overarching theme. Personal experiences of the transition to adulthood, including the transfer from paediatric to adult care, were described in terms of struggling to find balance in daily life, dealing with feelings of being different, being gradually supported to achieve independence, and wishing to be approached as a unique person in healthcare. CONCLUSION: In healthcare, it is important to emphasize not only diabetes-related factors but also emotional and psychosocial aspects of life connected to the transition to adulthood, including the transfer to adult care. The young adults wished to be seen as unique persons in healthcare during their emerging adulthood and should therefore be supported to achieve self-reliance through personal preparations for new challenges and for the consequences of transitioning to adulthood. Specialist nurses can provide appropriate knowledge and leadership. IMPLICATIONS FOR THE PROFESSION: These findings can guide nurse specialists in support for emerging adults to achieve self-reliance and indicate the importance of person-centred care when experiencing transition and transfer. REPORTING METHOD: The study adhered to EQUATOR guidelines, and the COREQ checklist for qualitative studies was used as the reporting method.

Emotional intelligence on job performance: A study on Malaysian employees.

BACKGROUND: The COVID-19 pandemic has affected the emotional intelligence of employees through the negative effects on their mental health, and led to poor workplace performance. OBJECTIVE: The purpose of this research is to examine the level of EI of Malaysian employees in various sectors affecting their job performance through the mediating influence of psychological capital by using the Schutte Self-Report Emotional Test (SSEIT), 24-item Psychological Capital Questionnaire (PCQ-24) and Role-Based Performance Scale (RBPS) theories. METHOD: A quantitative study was conducted. 350 sets of questionnaires were given out to Malaysian employees, of which 311 were returned. Data were analysed through regression analysis. RESULTS: The results showed that all emotional intelligence subscales, except for utilising emotions, have a significant relationship with job performance through the effect of psychological capital. CONCLUSION: This study offers valuable and insightful implications by combining the SSEIT, PCQ-24, and RBPS models to investigate the effect of emotional intelligence on job performance in Malaysia, which is an unusual combination model to analyse employees' job performance. It helps Malaysian companies, managers, employers, and other related parties to recognise the processes and elements that influence employees' work performance. This research also successfully developed an extended SSEIT model together with PCQ-24 and RBPS and verified their applicability on workplace performance.

Understanding the role of positive emotions in healthcare communication - A realist review.

AIM: To explore how the expression of positive emotions during the interaction between patients and providers can cultivate the patient-provider relationship. DESIGN: We conducted a realist review guided by the Realist and Meta-narrative Evidence Syntheses: Evolving Standards. METHODS: We systematically searched CINAHL, MEDLINE, PsychINFO and Scopus from inception to March 2019. Study selection and data extraction were performed blinded in pairs. From 3146 abstracts blinded in pairs, 15 papers were included and analysed. From each included paper, we extracted contexts, mechanisms and outcomes that were relevant to answer our research questions, creating a configuration between these elements (CMO configuration). RESULTS: Our findings suggest that in the contexts of person orientation and positive outlook, patient-provider relationships improve by communication conveying and eliciting positive emotions. We found six underlying mechanisms for this that form either direct or indirect pathways between the context and the outcome.

Relação entre aspectos psicossomáticos e psoríase / Relationship between psychosomatic aspects and psoriasis / Relación entre aspectos psicosomáticos y psoriasis

Psoríase é uma dermatose de caráter inflamatório ligado a diversas composições do ser, sendo estas a genética, o sistema imune, o ambiente e o estado mental do paciente, apresentando evidências de ser um quadro clínico multifacetado. A composição da medicina psicossomática empenha-se na relação mental e emocional e do corpo, sendo importante mostrar a relação desta com a psoríase. Por isso, busca-se avaliar as evidências disponíveis na literatura sobre a relação entre a psoríase e os aspectos psicossomáticos. Foi realizado uma a revisão de literatura, por meio de seleção de artigos das base de dados Medical Literature Analysis and Retrieval System Online (PubMed/Medline), biblioteca virtual em saúde Scientific Electronic Library Online (SciElo), UpToDate e Google acadêmico. A busca por artigos científicos resultou em 20 artigos selecionados. Foi possível concluir, que há estudos fundamentados correlacionando a medicina psicossomática e a psoríase, além de que diversos fatores que afetam a homeostase corporal, provocam alterações nervosas, e consequentemente afetam as células da pele. Além disso, foi encontrado evidências que a estigmatização que os pacientes sofrem influenciam no aumento da gravidade da doença, sendo necessário a realização de um tratamento psico cognitivo-comportamental juntamente com o tratamento dos sinais e sintomas gerais da doença. Desta forma, o presente trabalho pôde olhar para a patologia com um olhar ampliado relacionado ao aspecto mental e emocional o que promove melhor compreensão e as consequências disto são a maior capacidade de intervenção sobre a psoríase.

Psoriasis is an inflammatory dermatosis linked to several compositions of the being, which are genetics, the immune system, the environment and the patient's mental state, that is, it shows evidence of being a multifaceted clinical picture. Since the composition of psychosomatic medicine is committed to the relationship between the mental, emotional, and body, it is important to show its relationship with psoriasis. Therefore, we sought to evaluate the available evidence in the literature on the relationship between psoriasis and psychosomatic aspects. A literature review was conducted by selecting articles from the Medical Literature Analysis and Retrieval System Online (PubMed/Medline), Scientific Electronic Library Online (SciElo), UpToDate and Google Scholar databases. The search for scientific articles resulted in 20 selected articles. It was possible to conclude that there are well-founded studies correlating psychosomatic medicine and psoriasis, and that several factors that affect the body's homeostasis cause nervous alterations, and consequently affect the skin cells. Moreover, it was found evidence that the stigmatization that patients suffer influences the increase of the severity of the disease, being necessary the realization of a psycho cognitive-behavioral treatment along with the treatment of the general signs and symptoms of the disease. Thus, the present work could look at the pathology with a broader view related to the mental and emotional aspect, which promotes better understanding and the consequences of this are a greater ability to intervene on psoriasis.

La psoriasis es una dermatosis inflamatoria vinculada a varias composiciones del ser, que son la genética, el sistema inmunitario, el medio ambiente y el estado mental del paciente, es decir, muestra evidencias de ser un cuadro clínico multifacético. Dado que la composición de la medicina psicosomática está comprometida con la relación entre lo mental, lo emocional y el cuerpo, es importante mostrar su relación con la psoriasis. Por lo tanto, se buscó evaluar la evidencia disponible en la literatura sobre la relación entre la psoriasis y los aspectos psicosomáticos. Se realizó una revisión bibliográfica seleccionando artículos de las bases de datos Medical Literature Analysis and Retrieval System Online (PubMed/Medline), Scientific Electronic Library Online (SciElo), UpToDate y Google Scholar. La búsqueda de artículos científicos dio como resultado 20 artículos seleccionados. Se pudo concluir que existen estudios bien fundamentados que correlacionan la medicina psicosomática y la psoriasis, y que diversos factores que afectan a la homeostasis del organismo provocan alteraciones nerviosas y, en consecuencia, afectan a las células de la piel. Además, se encontraron evidencias de que la estigmatización que sufren los pacientes influye en el aumento de la gravedad de la enfermedad, siendo necesaria la realización de un tratamiento psico cognitivo- conductual junto con el tratamiento de los signos y síntomas generales de la enfermedad. Así, el presente trabajo pudo contemplar la patología con una visión más amplia relacionada con el aspecto mental y emocional, lo que favorece una mejor comprensión y las consecuencias de ello son una mayor capacidad de intervención sobre la psoriasis.

Subjective psychological impacts during COVID-19 lockdown on older people, risk profiles and coping strategies: Results of an online survey in Spain.

This study explores the psychological impacts of lockdown among older people during the coronavirus disease 2019 pandemic in Spain, and identifies risk profiles and adaptative behaviors. A cross-sectional online survey was disseminated by social networks through snowball sampling (April-June 2020). The survey included ad-hoc questions about psychological impacts on subjective cognitive functioning, emotional distress, and loneliness. Open end-questions were coded according to Lazarus and Folkman's coping strategies framework. Of the 2010 respondents, 76% experienced impact in at least one cognitive function (11% reporting severe effects), 78% frequent sadness and 13% frequent loneliness. Age 80+, women and low education increased the risk of loneliness and severe impact in memory and processing speed. Living alone was an additional risk factor for loneliness and sadness. Lockdown is associated with cognitive impacts, emotional distress, and loneliness being risk profiles related to inequality axes. Coping strategies should inform aging policies to prevent psychological impacts during the lockdown.

Study protocol: Effects of active versus passive recharge burst spinal cord stimulation on pain experience in persistent spinal pain syndrome type 2: a multicentre randomized trial (BURST-RAP study).

BACKGROUND: Spinal cord stimulation (SCS) has shown to be an effective treatment for patients with persistent spinal pain syndrome type 2 (PSPS Type 2). The method used to deliver electrical charge in SCS is important. One such method is burst stimulation. Within burst stimulation, a recharge pattern is used to prevent buildup of charge in stimulated tissues. Two variations of burst waveforms are currently in use: one that employs active recharge and one that uses passive recharge. It has been suggested that differences exist between active and passive recharge paradigms related to both efficacy of pain relief and their underlying mechanism of action. Active recharge has been shown to activate both the medial spinal pathway, engaging cortical sensorimotor areas involved in location and intensity of pain, and lateral pathway, reaching brain areas involved with cognitive-emotional aspects of pain. Passive recharge has been suggested to act via modulation of thalamic neurons, which fire in a similar electrical pattern, and thereby modulate activity in various cortical areas including those related to motivational and emotional aspects of pain. The objective of this randomized clinical trial is to assess and compare the effect of active versus passive recharge Burst SCS on a wide spectrum of pain in PSPS Type 2 patients. METHODS: This multicentre randomized clinical trial will take place in 6 Dutch hospitals. PSPS Type 2 patients (n=94) will be randomized into a group receiving either active or passive recharge burst. Following a successful trial period, patients are permanently implanted. Patients complete the Pain Catastrophizing Scale (PCS) (primary outcome at 6 months), Numeric Pain Rating Scale (NRS), Patient Vigilance and Awareness Questionnaire (PVAQ), Hospital Anxiety and Depression Scale (HADS), Quality of Life (EQ-5D), Oswestery Disability Index (ODI), Patient Global Impression of Change (PGIC) and painDETECT questionnaires (secondary outcomes) at baseline, after trial, 1, 3, 6 and 12 months following implantation. DISCUSSION: The BURST-RAP trial protocol will shed light on possible clinical differences and effectivity of pain relief, including emotional-motivational aspects between active and passive burst SCS in PSPS Type 2 patients. TRIAL REGISTRATION: ClinicalTrials.gov registration:  NCT05421273 . Registered on 16 June 2022. Netherlands Trial Register NL9194. Registered on 23 January 2021.

Genital Herpes Simplex Virus-An Updated Review.

The herpes virus was named by the Greek physician Hippocrates who called it herpes because the lesions appeared near each other and were vesicular. Alphaherpesvirinae, Betaherpesvirinae, and Gammaherpesvirinae are subfamilies of the human herpes virus family. The Alphaherpesvirinae subfamily includes the simplex viruses-HSV-1 and HSV-2-and varicellovirus-varicella zoster virus. There are more than 200 members of the Herpesviridae family capable of infecting different species, 8 of which are known to cause disease in humans. The simplex viruses can cause lifelong genital infections, and despite the prevalence of HSV-1 and HSV-2 infections in the United States decreasing in the past 20 years, infections with these viruses continue to contribute to significant clinical and psychological morbidities.

Edgework emotion management: A constructivist grounded theory of organ donation nurses' experiences and practices.

AIMS AND OBJECTIVES: To explore nurses' experiences when approaching families for organ donation authorisation to guide nursing practice. BACKGROUND: Organ donation after brainstem death implies that bereaved families are approached to discuss organ donation authorisation, and in many countries, specialist nurses do this approach. The literature describes the social, psychological and emotional challenges of health professionals in this role. However, lack of conceptual clarity regarding nurses' experiences on approaching families to guide nursing practice was found. DESIGN: Constructivist grounded theory. METHODS: Between October 2017 and July 2019, seven months of observations were conducted across two large public hospitals in Chile. Field notes, documents (n = 80), interviews (n = 27) and focus groups (n = 14) with 71 participants (51 healthcare professionals and 20 bereaved families) were included. Data collection and analysis followed the principles and practices of Charmaz' constructivist grounded theory. The COREQ checklist was followed in reporting the study. RESULTS: Edgework emotion management of organ donation nurses was developed as a threefold process: 1) being present to recognise inner and family emotions, 2) being on an emotional edge when approaching families and 3) extending the emotional edge to make sense of their experiences. The grounded theory was conceptualised using edgework emotion management by Lois (2003), which allowed to elucidate organ donation nurses' experiences and practices on managing their emotions. CONCLUSIONS: Organ donation nurses develop a sophisticated and complex emotional regulation process to approach and care for families when negotiating organ donation authorisation for transplantation. RELEVANCE TO CLINICAL PRACTICE: The experiences of specialist organ donation nurses entail a sophisticated emotion management process, which may explain the complexities of a critical role within healthcare institutions. Findings can be locally and internationally used to understand, educate and guide nursing practice, in an area of increasing specialisation and staffing shortages such as organ donation and transplantation.

Altas habilidades/superdotação e ambiente escolar: uma revisão de literatura / High abilities/giftedness and school environment: A bibliographic review

Estudos realizados na literatura brasileira mostram o crescimento do número das produções de artigos e pesquisas referentes às crianças com altas habilidades/superdotação no contexto escolar. Este artigo trata-se de uma revisão de literatura de produções em plataformas digitais e, posteriormente, analisados e discutidos, com o intuito de agrupar informações científicas existentes sobre a temática e compreender quais são as lacunas existentes no processo de desenvolvimento das habilidades dessas crianças. Constata-se a existência de barreiras nas relações que permeiam o público pesquisado, principalmente quando se mencionam as interações no ambiente escolar. Pela análise dos resultados, pode-se concluir que os estereótipos e os mitos vinculados às crianças com altas habilidades influenciam na aprendizagem e em suas interações.

The Brazilian literature shows an increase in the number of studies and scientific research on children with high abilities/giftedness in the school context. This paper presents a bibliographic review of research founded in digital platforms, and afterwards, analyzed and discussed in the aim of grouping scientific information to extend the current knowledge on this theme and to understand the missing parts in the development of the abilities of this public. Furthermore, it is verified that these children present difficulties in their social interaction, mostly, in school. These results suggest that the stereotypes and the common sense attached to high abilities' children have influences in their learning and social interactions.

Tackling risk factors for type 2 diabetes in adolescents: PRE-STARt study in Euskadi.

INTRODUCTION: Obesity in the child population and its effect in the development of metabolic diseases are a public health issue. One of the aims of the European Project in a health system, is the evaluation of the effectiveness of a multidisciplinary health promotion program directed at adolescents with risk factors associated with the development of type 2 Diabetes Mellitus (T2DM). PATIENTS AND METHODS: Randomised clinical trial with two groups of 12-14 year-old overweight adolescents. The intervention group took part in a multidisciplinary program for 24 months. This program was based on 11 group sessions (8 main sessions and 3 additional support ones) for adolescents and their guardians. The control group received usual care at primary care level. Longitudinal regression models were adjusted to assess the evolution of anthropometric measures and living habits at baseline, 3, 6, 12, and 24 months in both groups. RESULTS: There were 92 participants, equally distributed by group. Statistically significant differences were observed between intervention and control groups in several results: evolution of the body mass index; increase in the consumption of fruits and vegetables; decrease in the consumption of snacks and sweetened drinks; and increase in the number of days per week with more than one hour of physical activity. CONCLUSIONS: The results confirm the effectiveness of this multidisciplinary program, both in the evolution of the body mass index, and in the improvement of the eating and physical activity habits, all of them risk factors for the future development of metabolic diseases, such as T2DM.

Women's expectations and experiences of labor induction - a questionnaire-based analysis of a randomized controlled trial.

BACKGROUND: Although labor induction is a commonly used procedure in obstetrical care, there are limited data on its psycho-emotional effects on the woman. This study analysed the expectations and experiences of women in different routes of labor induction. The study's primary aim was to compare women's delivery experience if induced by orally administrated misoprostol (OMS) compared with misoprostol vaginal insert (MVI). Secondly, an evaluation of women's general satisfaction with induced labor was made, and factors associated with a negative experience. METHODS: Primiparous women (n = 196) with a singleton fetus in cephalic presentation, ≥ 37 weeks of gestation, with a Bishop's score ≤ 4 planning labor induction were randomly allocated to receive either OMS (Cytotec®) or MVI (Misodel®). Data were collected by validated questionnaires, the Wijma Delivery Expectation/Experience Questionnaire (A + B). The pre-labor part of the survey (W-DEQ version A) was given to participants to complete within 1 hour before the start of induction, and the post-labor part of the questionnaire (W-DEQ version B) was administered after birth and collected before the women were discharged from hospital. RESULTS: It was found that 11.8% (17/143) reported a severe fear of childbirth (W-DEQ A score ≥ 85). Before the induction, women with extreme fear had 3.7 times increased risk of experiencing labor induction negatively (OR 3.7 [95% CI, 1.04-13.41]). CONCLUSION: No difference was identified between OMS and MVI when delivery experience among women induced to labor was analysed. Severe fear of childbirth before labor was a risk factor for a negative experience of labor induction. TRIAL REGISTRATION: Clinical trial register number NCT02918110 . Date of registration on May 31, 2016.

Impact of BMGIM Music Therapy on Emotional State in Patients with Inflammatory Bowel Disease: A Randomized Controlled Trial.

BACKGROUND: Patients with inflammatory bowel disease (IBD) have a high prevalence of emotional disturbances which worsen the symptoms of the disease. As a therapeutic alternative that is part of a comprehensive care alongside medication, the Bonny Method of Guided Imagery and Music (BMGIM) music-assisted therapy has achieved promising emotional improvements in patients with chronic diseases. The objective of the study was to determine the impact of a treatment based on a BMGIM group adaptation on patients with inflammatory bowel disease (IBD) and their emotional state, therefore analyzing state of mind, quality of life, anxiety, depression, immunocompetence as a marker of well-being, and levels of acute and chronic stress. METHODS: Longitudinal, prospective, quantitative, and experimental study including 43 patients with IBD divided into an intervention group (22 patients), who received eight sessions over eight weeks, and a control group (21 patients). A saliva sample was taken from each patient before and after each session in order to determine cortisol and IgA levels. Similarly, a hair sample was taken before the first and after the last session to determine the cumulative cortisol level. All molecules were quantified using the ELISA immunoassay technique. In addition, patients completed several emotional state questionnaires: HADS, MOOD, and CCVEII. RESULTS: An improvement was observed in the following states of mind: sadness, fear, anger, and depression. No significant effect was observed in state of mind in terms of happiness or anxiety, in the levels of cortisol in hair, and in patients' perceived quality of life. A reduction in cortisol was observed in saliva, although this did not significantly affect the IgA titer. CONCLUSIONS: BMGIM seems to improve the emotional state of patients with IBD.

A qualidade de vida relacionada à saúde e os aspectos emocionais de sobreviventes à COVID-19, após alta da Unidade de Terapia Intensiva, sob as perspectivas da psicanálise de orientação lacaniana e das ciências da saúde / The health-related quality of life and the emotional aspects of COVID-19 survivors, after Intensive Care Unit discharge, under the perspectives of lacanian-oriented psychoanalysis and the health sciences

As infecções causadas por Coronavírus, comumente, estão relacionadas ao trato respiratório superior e incluem sintomas como febre, odinofagia, cefaleia e tosse. Alguns(mas) pacientes podem ter infecções do trato respiratório inferior. As manifestações clínicas da Doença do Coronavírus 2019 (Coronavirus Disease 2019, COVID-19) podem se apresentar nas formas leve, moderada ou grave, ou seja, possuem diferentes graus de gravidade. A COVID-19 é caracterizada pela reação inflamatória aumentada, a qual tem a finalidade de eliminar o patógeno. Porém esse mecanismo, que normalmente protege o indivíduo de infecções e elimina substâncias estranhas, é capaz de causar graves danos teciduais e falências orgânicas, como as que são observadas na COVID-19. Embora os resultados do desfecho do quadro clínico a curto prazo, tais como a mortalidade hospitalar, sejam de extrema importância, eles não são capazes de avaliar como a doença e, os cuidados intensivos, afetam a saúde emocional, física e o bem-estar do(a) paciente após a alta hospitalar. Reflexões sobre a qualidade de vida relacionada à saúde (QVRS) e os aspectos emocionais são de particular importância no contexto dos cuidados críticos, pois as intervenções clínicas podem manter a vida, mas o estado de saúde resultante pode ser avaliado como pior do que a morte. Diante do exposto, o objetivo deste estudo foi conhecer a QVRS e os aspectos emocionais de sobreviventes à COVID-19, após alta da Unidade de Terapia Intensiva (UTI), sob as perspectivas da Psicanálise de orientação lacaniana e das ciências da saúde. Participaram deste estudo 15 pessoas, de ambos os gêneros, entre 46 e 63 anos, que ficaram internadas na UTI para COVID-19 (UTI-COVID-19), que atende pacientes que apresentam a evolução mais grave da infecção, do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HC-FMRP-USP). A partir da abordagem de pesquisa de desenho misto com estratégia de triangulação concomitante, os dados foram coletados através de roteiro sociodemográfico, de formulário de caracterização clínica, do instrumento Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) e de roteiro de entrevista semiestruturado, através de ligações telefônicas gravadas, entre o 61º e o 74º dia após a alta hospitalar, nos meses de dezembro de 2020 e janeiro de 2021.Vale ressaltar que o início do projeto aconteceu após as aprovações dos Comitês de Éticas em Pesquisa competentes. Verificou-se predominância de escores inferiores a 50 pontos na avaliação da QVRS dos(as) participantes deste trabalho nos domínios: Capacidade Funcional, Aspectos Físicos, Dor e Aspectos Emocionais do SF-36. Ademais, foi possível aprofundar nos aspectos emocionais dos(as) sobreviventes à COVID-19, escutando como foram atingidos(as), física e emocionalmente e, o que restou dessa experiência, que continua a afetar suas vidas. Espera-se que este estudo possa contribuir na prática clínica multidisciplinar da equipe de saúde

The infections caused by the Coronavirus, commonly, are associated to the upper Respiratory trato and includes symptoms like fever, odynofagy, headache and cough. Some patients can develop infections on the lower respiratory trato. The clinical manifestation of the Coronavirus Disease 2019 (COVID-19) can present in mild, moderated or severe form, in other words, they have different gravity degrees. The COVID-19 is featured by the increased inflammatory reaction, which intends to eliminate the pathogen. However this strategy, that ordinarily protects the person avoiding infections and expunging strange substances, is responsible of several tissue damages and organic failure, as observed in COVID-19. Although the clinical conditions denouements in short term, such as hospital mortality, are extremely important, they can't evaluate how the disease and, the intensive care, effect the emotional health, physics and the welfare of the patient after hospital discharge. Reflections on health-related quality of life (H-RQL) and emotional aspects are particularly important in the critical care context, because the clinical interventions can maintain life, but results of health condition can be as worse than death. The purpose of this study, after the explanation above, was to cognize the H-RQL and the emotional aspects of COVID's-19 survivors, after Intensive Care Unit (ICU) discharge, under the perspectives of lacanian-oriented Psychoanalysis and the health science. 15 peoples participated in this study, of both sex identities, between 46 and 63 years old, which were hospitalized on ICU for COVID-19 (COVID-19-ICU), that attend patients with the highest evolution of the infection, of the General Hospital of the Medical School of Ribeirão Preto of the University of São Paulo (HC-FMRP-USP). From the research approach of mixed drawing with concomitante triangulation strategy, the information were collected using the sociodemographic guide, a clinical characterization formulary, an instrument of Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36) and semi-structured interview script, trough recorded phone calls, between the 61º and 74º day after hospital discharge, in the months of December 2020 and January 2021. It is important to emphasize that the project began after the Research Ethics Committees approvals. Noticed predominance of score below 50 points on the H-RQL appraisal of the participants in this study in the following domains: Functional Capacity, Physics Aspects, Pain and Emotional Aspects of SF-36. Besides, was possible to deepen on the emotional aspects of COVID's-19 survivals hearken how they was effected, physically and emotionally and, what was left of this experience, which continues to affect their lives. This study expected that can contributes on the multidisciplinary clinic practices of the health team.

Sobrecarga e satisfação com curso: há efeito indireto de fatores emocionais dos universitários? / Burden and satisfaction with sourse: Is there an indirect effect of the emotional factors of university students? / Sobrecarga y satisfacción con la carrera: ¿hay un efecto indirecto de los factores emocionales de los estudiantes universitarios?

O presente trabalho avaliou a relação entre a percepção de sobrecarga universitária e a satisfação com cursos de graduação quando analisada de forma independente ou mediada por sintomas depressivos, solidão e resiliência dos estudantes. Participaram do estudo 317 estudantes de graduação, que responderam um questionário e as escalas: Questionário sobre a Saúde dos Pacientes, Escala Brasileira de Solidão UCLA e Escala Breve de Resiliência. Observou-se relação da sobrecarga com a satisfação com os cursos de graduação quando considerada de forma isolada (rho = - 0,13), mas, ao ser analisada como mediada por fatores emocionais (solidão, depressão ou resiliência), a sobrecarga deixou de ser significativa. Conclui-se que a influência da sobrecarga sobre a satisfação dos estudantes pode mascarar efeitos indiretos de outros fatores emocionais. (AU)

The present study evaluated the relationship between the perception of university burden and satisfaction with undergraduate courses when analyzed independently or mediated by the depressive symptoms, loneliness and resilience of students. Study participants were 317 undergraduate students, who responded to the following instruments: Patients Health Questionnaire, Brazilian Loneliness Scale and Brief Scale of Resilience. There was a relationship between burden and satisfaction with undergraduate courses when considered independently (rho = -0.13), however, when the mediation of the emotional factors (loneliness, depression or resilience) was analyzed the burden was no longer significant. It was concluded that the influence of burden on student satisfaction can mask the indirect effects of other emotional factors. (AU)

El presente estudio evaluó la relación entre la percepción de sobrecarga universitaria y la satisfacción con las carreras de grado cuando se analiza de forma independiente o mediada por síntomas depresivos, soledad y resiliencia de los estudiantes. En el estudio participaron 317 estudiantes, quienes respondieron un cuestionario y las escalas: Cuestionario sobre la Salud de los Pacientes, Escala de Soledad Brasileña UCLA y Escala Breve de Resiliencia. Hubo relación entre la sobrecarga y la satisfacción con las carreras de grado cuando se consideró de forma aislada (rho = - 0,13), pero cuando se analizó cómo mediada por factores emocionales (soledad, depresión o resiliencia) la sobrecarga dejó de ser significativa. Se concluye que la influencia de la sobrecarga en la satisfacción del estudiante universitario puede enmascarar efectos indirectos de otros factores emocionales. (AU)

Nursing students' socialisation to emotion management during early clinical placement experiences: A qualitative study.

AIMS AND OBJECTIVES: To explore nursing students' subjective experience of emotions during first-year clinical placements, strategies used to manage their emotions and socialisation to emotion management. BACKGROUND: Emotion regulation is a key source of stress for early career and student nurses. Clinical placement experiences can elicit strong emotions in nursing students; however, they may be unprepared for the challenge of regulating their emotions in real-world practice. How nursing students learn to manage their emotions in the clinical setting, whether they receive support for this, and how they are socialised to manage their emotions during placements are not well known. DESIGN: An exploratory qualitative study. METHODS: Semi-structured interviews (n = 19) were conducted with first-year nursing students, exploring their experiences of emotion management during clinical placement. Interview transcripts were analysed using conventional qualitative content analysis. Reporting adheres to the COREQ Checklist. RESULTS: Interactions with patients and staff often elicited negative feelings. Structured guidance for emotion management by supervising staff was scarce. Students used informal self-reflection and interpretation to guide emotion management. CONCLUSIONS: In the absence of strategic socialisation and formal support for effective emotion management, students used emotional labour strategies that can negatively impact on well-being. A focus on adequately preparing nursing students for emotion work is a necessary component of classroom and clinical learning environments. Structured debriefing during clinical placements may provide a relevant context to discuss emotions arising during clinical work and to learn emotion management strategies. RELEVANCE TO CLINICAL PRACTICE: Emotional competence, a fundamental ability for registered nurses and students, supports personal health maintenance and strengthens professional practice. Students are exposed to clinical environments and interpersonal encounters that evoke strong emotions. They need situated learning strategies and formal support to develop knowledge and strengthen capability for emotion management, as this is essential for promoting professional development and patient care.

The fate of surplus embryos: ethical and emotional impacts on assisted reproduction.

OBJECTIVE: This paper looked into the findings of a survey on the ethical and emotional aspects encircling the fate of surplus embryos in Assisted Human Reproduction (AHR). METHODS: Five staff members of a fertility clinic in the Brazilian State of São Paulo answered a semi-structured qualitative interview. RESULTS: The answers alluded to the different meanings assigned to embryos by medical staff (genetic material) and couples undergoing fertility treatment (potential child). The meaning couples assigned to their embryos, along with inherent uncertainty and distress, affected the choice of what would be done to surplus embryos. CONCLUSION: Psychological support may be helpful to two key groups present in assisted human reproduction: clinic staff, for support in their interactions with couples; and couples in need of support and awareness on surplus embryo donation.