Un análisis integrado entre la calidad de vida y las necesidades de apoyo de personas adultas con discapacidad intelectual en Chile / An integrated analysis between the quality of life and the support needs of adults with intellectual disabilities in Chile

El paradigma de apoyos y el de calidad de vida se han transformado en guías fundamentales para los avances en el ámbito de la discapacidad intelectual (DI). Con base en una muestra de 93 personas adultas con DI, se analiza, desde un enfoque cuantitativo no experimental, la relación entre la calidad de vida y las necesidades de apoyo, aplicando la escala INICO-FEAPS y la escala de Intensidad de Apoyos (SIS) para cada constructo. Los principales resultados evidencian que existe una relación fuerte e indirecta entre calidad de vida y necesidades de apoyos, y también la relevancia de analizar dichos resultados desde variables como grado de discapacidad, sexo o nivel socioeconómico. La discusión permite inferir la necesidad de discutir nuevas estrategias en torno a categorías como el grado de discapacidad, la autodeterminación e inclusión social, como elementos facilitadores de la calidad de vida y apoyos desde un enfoque integral que contribuya al desarrollo de estrategias de programas sociales para la población con DI. (AU)

The support paradigm and the quality of life paradigm have become fundamental guides for progress in the field of Intellectual Disability (ID). Based on a sample of 93 adults with ID, the relationship between Quality of Life and Support Needs is analyzed from a non-experimental quantitative approach, applying the INICO-FEAPS scale and the SIS Support Intensity scale for each construct. The main results show that there is a strong and indirect relationship between quality of life and support needs, and the relevance of analyzing these results from variables such as the degree of disability, sex or socioeconomic level. The discussion allows us to infer the need to discuss new strategies around categories such as the degree of disability, self-determination and social inclusion, as facilitating elements of quality of life and supporting a comprehensive approach that contributes to the development of social program strategies for the population with ID. (AU)

Un análisis integrado entre la calidad de vida y las necesidades de apoyo de personas adultas con discapacidad intelectual en Chile / An integrated analysis between the quality of life and the support needs of adults with intellectual disabilities in Chile

El paradigma de apoyos y el de calidad de vida se han transformado en guías fundamentales para los avances en el ámbito de la discapacidad intelectual (DI). Con base en una muestra de 93 personas adultas con DI, se analiza, desde un enfoque cuantitativo no experimental, la relación entre la calidad de vida y las necesidades de apoyo, aplicando la escala INICO-FEAPS y la escala de Intensidad de Apoyos (SIS) para cada constructo. Los principales resultados evidencian que existe una relación fuerte e indirecta entre calidad de vida y necesidades de apoyos, y también la relevancia de analizar dichos resultados desde variables como grado de discapacidad, sexo o nivel socioeconómico. La discusión permite inferir la necesidad de discutir nuevas estrategias en torno a categorías como el grado de discapacidad, la autodeterminación e inclusión social, como elementos facilitadores de la calidad de vida y apoyos desde un enfoque integral que contribuya al desarrollo de estrategias de programas sociales para la población con DI. (AU)

The support paradigm and the quality of life paradigm have become fundamental guides for progress in the field of Intellectual Disability (ID). Based on a sample of 93 adults with ID, the relationship between Quality of Life and Support Needs is analyzed from a non-experimental quantitative approach, applying the INICO-FEAPS scale and the SIS Support Intensity scale for each construct. The main results show that there is a strong and indirect relationship between quality of life and support needs, and the relevance of analyzing these results from variables such as the degree of disability, sex or socioeconomic level. The discussion allows us to infer the need to discuss new strategies around categories such as the degree of disability, self-determination and social inclusion, as facilitating elements of quality of life and supporting a comprehensive approach that contributes to the development of social program strategies for the population with ID. (AU)

Experience with the use of the DIALOG+ intervention in patients with severe mental illness in outpatient services in Colombia.

INTRODUCTION: Severe mental disorders can cause significant and lasting distress for patients and their families and generate high costs through the need for care and loss of productivity. This study tests DIALOG+, an app-based intervention to make routine patient-clinician meetings therapeutically effective. It combines a structured evaluation of patient satisfaction with a solution-focused approach. METHODS: We conducted a qualitative study, based on a controlled clinical trial, in which 9 psychiatrists and 18 patients used DIALOG+ monthly over a six-month period. Semi-structured interviews were used to explore the experiences of participants and analysed in an inductive thematic analysis focusing on the feasibility and effects of the intervention in the Colombian context. RESULTS: Experiences were grouped into five overall themes: a) impact of the intervention on the consultation and the doctor-patient relationship; b) impact on patients and in promoting change; c) use of the supporting app, and d) adaptability of the intervention to the Colombian healthcare system. CONCLUSIONS: DIALOG+ was positively valued by most of the participants. Participants felt that it was beneficial to the routine consultation, improved communication and empowered patients to take a leading role in their care. More work is required to identify the patient groups that most benefit from DIALOG+, and to adjust it, particularly to fit brief consultation times, so that it can be rolled out successfully in the Colombian healthcare system.

Comunidad compasiva para la inclusión social y calidad de vida de las personas con esclerosis múltiple y sus cuidadores familiares / Comunidade compasiva pela inclusao social e qualidade de vida de pessoãs com esclerose multipla e seus familiares cuidadores / Compassionate community for the social inclusion and quality of life of people with multiple sclerosis and their family caregivers

Objetivo: Evaluar cualitativamente la experiencia de pacientescon esclerosis múltiple (PEM) y cuidadores familiares (CFPEM)vinculados al programa de esclerosis múltiple del HospitalUniversitario Nacional de Colombia (PrEM-HUNC), durantela formación y consolidación de una comunidad compasiva(CC), para la inclusión social y promoción de calidad de vida.Materiales y Método: estudio cualitativo interpretativo, conentrevistas a profundidad a nueve colaboradores. Con elmétodo de análisis de espiral de Creswell y Poth, emergieroncuatro categorías y un tema.Resultados: el tema “Un nido comunitario de crecimientoytransformación” señala el proceso de conformación de la CCcomo una experiencia que posibilitó cambios de significadosen torno a la enfermedad, la situación personal y familiar;revela un proceso de descubrimiento y aprendizaje deconformación de diferentes relaciones y roles.Conclusiones: La CC es una opción para construcción deredes de apoyo, fortalecimiento de las capacidades personalesy familiares, una forma para hacer frente a los diferentesimpactos y retos que implica vivir con esclerosis múltiple,se constituye en una alternativa para la promoción de lacalidad de vida y la inclusión social.(AU)

Objective: to qualitatively evaluate the experienceof patients with multiple sclerosis (PEM) and familycaregivers (CFPEM) linked to the multiple sclerosisprogram of the National University Hospital ofColombia (PrEM-HUNC), during the formation andconsolidation of a compassionate community (CC),for social inclusion and promotion of quality of life.Materials and Method: qualitative interpretativestudy, with in-depth interviews to nine collaborators.With Creswell and Poth's spiral analysis method,four categories and one topic emerged. Results: the theme "A Community Nest of Growth andTransformation" points out the process of shaping theCC as an experience that made possible changes in themeanings surrounding the disease and the personaland family situation; reveals a process of discovery andlearning of shaping different relationships and roles.Conclusions: The CC is an option for building supportnetworks, strengthening personal and family capacities,a way to address the different impacts and challengesof living with multiple sclerosis; it is an alternative tothe promotion of quality of life and social inclusion.(AU)

Objetivo: avaliar qualitativamente a experiência depacientes com esclerose múltipla (PEM) e cuidadoresfamiliares (CFPEM) vinculados ao programa de esclerosemúltipla do Hospital Universitário Nacional de Colombia(PrEM-HUNC), durante a formação e consolidação deuma comunidade compassiva (CC), para a inclusãosocial e promoção da qualidade de vida.Materiais e Método: estudo qualitativo interpretativo,com entrevistas em profundidade com nove colaboradores.Com o método em espiral de Creswell e Poth, quatrocategorias e um tema emergiram.Resultados: o tema “Um ninho comunitário de crescimentoe transformação” revela o processo de conformação daCC como uma experiência que possibilitou mudanças designificados em torno da doença, da situação pessoal efamiliar; revela um processo de descoberta e aprendizagemde obter diferentes relacionamentos e papéis.Conclusões: a CC é uma opção para a construção deredes de apoio, fortalecendo as capacidades pessoais efamiliares, uma forma de enfrentar os diversos impactose desafios que o viver com esclerose múltipla implica,sendo uma opção para a promoção da qualidade devida e inclusão social.(AU)

ANALYSIS OF THE MEDIATING ROLE OF RESILIENCE IN THE RELATIONSHIP BETWEEN SOCIAL SUPPORT AND BURNOUT IN UNIVERSITY STUDENTS / ANÁLISIS DEL PAPEL MEDIADOR DE LA RESILIENCIA EN LA RELACIÓN ENTRE EL APOYO SOCIAL Y EL AGOTAMIENTO EN ESTUDIANTES UNIVERSITARIOS / ANÁLISE DO PAPEL MEDIADOR DA RESILIÊNCIA NA RELAÇÃO ENTRE APOIO SOCIAL E BURNOUT EM ESTUDANTES UNIVERSITÁRIOS

This research aimed to assess the mediating role of resilience in the relationship between social support and academic burnout. To do so, a cross-sectional study was conducted with undergraduate students enrolled at a public university in Paraná, Brazil, who were participants in the GraduaUEL project - Analysis of Health and Lifestyle Habits of Undergraduate Students at the State University of Londrina, interviewed in the year 2019. The dependent variable of this study was academic exhaustion, measured through the Copenhagen Inventory Burnout questionnaire (CBI-S). The independent variable was social support, measured using the Medical Outcomes Study Social Support Survey (MOS-SSS), and the mediating effect of resilience was assessed using the CD-RISC-1 scale. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to obtain the model with the best fit using Mplus software, with a 95% confidence interval (CI95%). Total social support significantly and positively influenced resilience, while resilience had a significantly negative effect on burnout. It was observed that the direct effect of social support on burnout and the indirect effect of social support on burnout through resilience were significant, with resilience mediating this relationship by approximately 54.9%. In conclusion, social support and resilience have an impact on academic burnout; thus, reducing university students' exhaustion can be achieved by enhancing both social support and resilience among them.

Esta investigación tuvo como objetivo evaluar el papel mediador de la resiliencia en la relación entre el apoyo social y el agotamiento académico. Para ello, se realizó un estudio transversal con estudiantes universitarios inscritos en una universidad pública en Paraná, Brasil, que participaron en el proyecto GraduaUEL - Análisis de la Salud y los Hábitos de Vida de los Estudiantes de Grado en la Universidad Estatal de Londrina, entrevistados en el año 2019. La variable dependiente de este estudio fue el agotamiento académico, medido a través del cuestionario de Inventario de Burnout de Copenhague (CBI-S). La variable independiente fue el apoyo social, medido mediante la Encuesta de Apoyo Social del Estudio de Resultados Médicos (MOS-SSS), y el efecto mediador de la resiliencia se evaluó utilizando la escala CD-RISC-1. Se llevaron a cabo análisis factorial exploratorio (AFE) y análisis factorial confirmatorio (AFC) para obtener el modelo con el mejor ajuste utilizando el software Mplus, con un intervalo de confianza del 95% (IC95%). El apoyo social total influyó significativa y positivamente en la resiliencia, mientras que la resiliencia tuvo un efecto significativamente negativo en el agotamiento. Se observó que el efecto directo del apoyo social en el agotamiento y el efecto indirecto del apoyo social en el agotamiento a través de la resiliencia fueron significativos, con la resiliencia mediando esta relación en aproximadamente un 54,9%. En conclusión, el apoyo social y la resiliencia tienen un impacto en el agotamiento académico; por lo tanto, reducir el agotamiento de los estudiantes universitarios puede lograrse mejorando tanto el apoyo social como la resiliencia entre ellos.

Esta pesquisa teve como objetivo avaliar o papel mediador da resiliência no efeito do suporte social e a relação com o burnout acadêmico. Para tal, foi realizado um estudo transversal com estudantes matriculados em cursos de graduação de uma universidade pública paranaense, participantes do projeto GraduaUEL - Análise da Saúde e Hábitos de Vida dos Estudantes de Graduação da Universidade Estadual de Londrina, entrevistados no ano de 2019. A variável dependente deste estudo foi a exaustão acadêmica, mensurada por meio do questionário Copenhagen Inventory Burnout (CBI-S). A independente foi o apoio social, medido pela escala de apoio Social (MOS-SSS), e o efeito mediador da resiliência foi verificado a partir da escala CD-RISC-1. Foram realizadas análise fatorial exploratório (AFE) e análise fatorial confirmatória (AFC) para obter o modelo com melhores resultados através do software Mplus, com intervalo de confiança de 95% (IC95%). O apoio social total afetou significativamente e positivamente a resiliência, enquanto a resiliência teve um efeito significativamente negativo no burnout. Foi observado que o efeito direto do suporte social no burnout e efeito indireto do suporte social no burnout por meio da resiliência foram significativos, a resiliência medeia essa relação em aproximadamente 54,9%. Em suma, o apoio social e a resiliência têm efeito sobre o burnout acadêmico, dessa forma a exaustão dos estudantes universitários pode ser reduzida ampliando-se o apoio social e a resiliência entre os estudantes universitários. 

Nurses’ perceptions of the obstacles and supportive behaviors of end-of-life care in intensive care units / Percepciones de los enfermeros sobre los obstáculos y comportamientos de apoyo de la atención al final de la vida en unidades de cuidados intensivos

Purpose This study examined the Jordanian registered nurses’ perceptions of the obstacles and supportive behaviors of End-of-Life Care in Intensive Care Units and examined the differences in the concepts based on the samples’ demographics. Methods A cross-sectional and comparative study was conducted using a convenience sample of 230 Intensive Care Unit registered nurses in Jordan. Data were analyzed descriptively, and differences were measured using the independent sample t-test, the one-way Analysis of Variance, and Scheffe’s post hoc test. Results The registered nurses’ scored moderately on obstacles (74.98 ± 14.54) and supportive behaviors (69.22 ± 4.84). The commonly perceived obstacle and supportive behaviors to End-of-Life Care in Intensive Care Units s were reported. The perceived obstacles differ based on the registered nurses’ certification as an Intensive Care Units nurse (3.04 ± 0.58 vs. 2.74 ± 0.49, p = 0.008), type of Intensive Care Unit (3.28 ± 0.34 vs. 2.86 ± 0.62, p < 0.001), type of facility (3.16 ± 0.59 vs. 2.77 ± 0.61, p < 0.001), number of beds in the unit (3.07 ± 0.48 vs. 2.69 ± 0.48, p = 0.020), and the number of hours worked per week (3.06 ± 0.56 vs. 2.81 ± 0.60, p = 0.005). In contrast, supportive behaviors only differ based on the registered nurses’ age (3.22 ± 0.69 vs. 2.90 ± 0.64, p = 0.019). Conclusions The common End-of-Life Care perceived obstacle in Intensive Care Units was the lack of nursing education and training regarding the studies concept, which warrants immediate intervention such as on-job training. The common End-of-Life Care perceived supportive behavior in Intensive Care Units was when family members accepted that the patient was dying when nurses offered support to family members; motivational interventions are needed to sustain such behavior. Differences in the perceived obstacles and supportive behaviors should be leveraged for the benefit of patients, nurses, and hospitals. (AU)

Propósito Este estudio examinó las percepciones de las enfermeras registradas jordanas sobre los obstáculos y comportamientos de apoyo de la atención al final de la vida en las Unidades de Cuidados Intensivos y examinó las diferencias en los conceptos basados en la demografía de las muestras. Métodos Se realizó un estudio transversal y comparativo utilizando una muestra de conveniencia de 230 enfermeras registradas en la Unidad de Cuidados Intensivos en Jordania. Los datos se analizaron descriptivamente y las diferencias se midieron mediante la prueba t de muestra independiente, el análisis unidireccional de varianza y la prueba post hoc de Scheffe. Resultados Las enfermeras registradas obtuvieron una puntuación moderada en obstáculos (74,98 ± 14,54) y comportamientos de apoyo (69,22 ± 4,84). Se informaron los obstáculos comúnmente percibidos y los comportamientos de apoyo a la atención al final de la vida en las Unidades de Cuidados Intensivos. Los obstáculos percibidos difieren según la certificación del enfermero registrado como enfermero de las Unidades de Terapia Intensiva (3,04 ± 0,58 vs. 2,74 ± 0,49, p < 0.001), tipo de Unidad de Cuidados Intensivos (3,28 ± 0,34 vs. 2,86 ± 0,62, p < 0.001), tipo de instalación (3,16 ± 0,59 vs. 2,77 ± 0,61, p < 0.001), número de camas en la unidad (3,07 ± 0,48 vs. 2,69 ± 0,48, p = 0,020), y número de horas trabajadas por semana (3,06 ± 0,56 vs. 2,81 ± 0,60, p = 0,005). En contraste, los comportamientos de apoyo solo difieren según la edad de las enfermeras registradas (3,22 ± 0,69 vs. 2,90 ± 0,64, p = 0,019). Conclusiones El obstáculo común percibido en la Atención al Final de la Vida en las Unidades de Terapia Intensiva fue la falta de educación y capacitación de enfermería sobre el concepto de estudios, lo que justifica una intervención inmediata, como la capacitación en el trabajo... (AU)

Nurses’ perceptions of the obstacles and supportive behaviors of end-of-life care in intensive care units / Percepciones de los enfermeros sobre los obstáculos y comportamientos de apoyo de la atención al final de la vida en unidades de cuidados intensivos

Purpose This study examined the Jordanian registered nurses’ perceptions of the obstacles and supportive behaviors of End-of-Life Care in Intensive Care Units and examined the differences in the concepts based on the samples’ demographics. Methods A cross-sectional and comparative study was conducted using a convenience sample of 230 Intensive Care Unit registered nurses in Jordan. Data were analyzed descriptively, and differences were measured using the independent sample t-test, the one-way Analysis of Variance, and Scheffe’s post hoc test. Results The registered nurses’ scored moderately on obstacles (74.98 ± 14.54) and supportive behaviors (69.22 ± 4.84). The commonly perceived obstacle and supportive behaviors to End-of-Life Care in Intensive Care Units s were reported. The perceived obstacles differ based on the registered nurses’ certification as an Intensive Care Units nurse (3.04 ± 0.58 vs. 2.74 ± 0.49, p = 0.008), type of Intensive Care Unit (3.28 ± 0.34 vs. 2.86 ± 0.62, p < 0.001), type of facility (3.16 ± 0.59 vs. 2.77 ± 0.61, p < 0.001), number of beds in the unit (3.07 ± 0.48 vs. 2.69 ± 0.48, p = 0.020), and the number of hours worked per week (3.06 ± 0.56 vs. 2.81 ± 0.60, p = 0.005). In contrast, supportive behaviors only differ based on the registered nurses’ age (3.22 ± 0.69 vs. 2.90 ± 0.64, p = 0.019). Conclusions The common End-of-Life Care perceived obstacle in Intensive Care Units was the lack of nursing education and training regarding the studies concept, which warrants immediate intervention such as on-job training. The common End-of-Life Care perceived supportive behavior in Intensive Care Units was when family members accepted that the patient was dying when nurses offered support to family members; motivational interventions are needed to sustain such behavior. Differences in the perceived obstacles and supportive behaviors should be leveraged for the benefit of patients, nurses, and hospitals. (AU)

Propósito Este estudio examinó las percepciones de las enfermeras registradas jordanas sobre los obstáculos y comportamientos de apoyo de la atención al final de la vida en las Unidades de Cuidados Intensivos y examinó las diferencias en los conceptos basados en la demografía de las muestras. Métodos Se realizó un estudio transversal y comparativo utilizando una muestra de conveniencia de 230 enfermeras registradas en la Unidad de Cuidados Intensivos en Jordania. Los datos se analizaron descriptivamente y las diferencias se midieron mediante la prueba t de muestra independiente, el análisis unidireccional de varianza y la prueba post hoc de Scheffe. Resultados Las enfermeras registradas obtuvieron una puntuación moderada en obstáculos (74,98 ± 14,54) y comportamientos de apoyo (69,22 ± 4,84). Se informaron los obstáculos comúnmente percibidos y los comportamientos de apoyo a la atención al final de la vida en las Unidades de Cuidados Intensivos. Los obstáculos percibidos difieren según la certificación del enfermero registrado como enfermero de las Unidades de Terapia Intensiva (3,04 ± 0,58 vs. 2,74 ± 0,49, p < 0.001), tipo de Unidad de Cuidados Intensivos (3,28 ± 0,34 vs. 2,86 ± 0,62, p < 0.001), tipo de instalación (3,16 ± 0,59 vs. 2,77 ± 0,61, p < 0.001), número de camas en la unidad (3,07 ± 0,48 vs. 2,69 ± 0,48, p = 0,020), y número de horas trabajadas por semana (3,06 ± 0,56 vs. 2,81 ± 0,60, p = 0,005). En contraste, los comportamientos de apoyo solo difieren según la edad de las enfermeras registradas (3,22 ± 0,69 vs. 2,90 ± 0,64, p = 0,019). Conclusiones El obstáculo común percibido en la Atención al Final de la Vida en las Unidades de Terapia Intensiva fue la falta de educación y capacitación de enfermería sobre el concepto de estudios, lo que justifica una intervención inmediata, como la capacitación en el trabajo... (AU)

[Perceived social support of people over 60 years who care for their grandchildren]. / Apoyo social percibido de personas mayores de 60 años que cuidan de sus nietos.

OBJECTIVE: The role of older people in today's society is important in supporting work-life balance and well-being. The aim of the study was to analyze the perception of the support they receive and the psychosocial well-being of people over 60years of age who take care of their grandchildren. METHODOLOGY: Cross-sectional descriptive observational study. A sample of people over 60years of age, who attended the pediatrics service in three health centers accompanying their grandchildren, during the first four-month period of 2018. They were administered the Duke-UNC questionnaire, with measures of social support and involvement in the care of their grandchildren. RESULTS: The majority cared for their grandchildren between 5 and 14hours per week, performing recreational and maintenance activities. The participants reported a significant relationship of the caregiver's role in their quality of life and well-being; 88% of the subjects perceived a high level of social support. Involvement in weekly caregiving hours did not correlate with worse perceived support. CONCLUSIONS: Older adults who care for their grandchildren and attend the primary care pediatrics service with them perceive an adequate level of social support, regardless of the number of hours spent doing so.

The day-to-day relationship between posttraumatic stress symptoms and social support after sexual assault.

Background: Experiencing sexual assault is associated with a significant increase in risk for developing posttraumatic stress disorder and related concerns (e.g. alcohol misuse). Cross-sectional and longitudinal evidence suggests that social support may be both broadly protective against and eroded by posttraumatic stress symptoms. However, little is known about how different aspects of social support and posttraumatic stress symptoms influence each other in the weeks and months immediately following sexual assault, when posttraumatic stress (PTS) symptoms first emerge.Objective: The present study assessed the day-to-day relationship between social support and PTS in a sample of distressed, alcohol-using, recently-assaulted female survivors participating in a clinical trial of an app-based intervention (N = 41).Method: Participants completed 3 weeks of daily diaries starting within 10 weeks of sexual assault. Mixed-effects models were used to examine prior-day and same-day relationships between PTS and four social support constructs (social contact, emotional support, pleasantness of social interactions, and talking about sexual assault).Results: Results indicate that higher quantity and pleasantness of social interactions over the full sampling period was associated with lower PTS symptoms on any given day. Experiencing better-than-typical social interactions on one day was associated with lower than typical PTS symptoms on that day and the next day. On days when participants discussed their sexual assault with others, they tended to be having higher than usual PTS symptoms.Conclusions: Findings suggest that increasing the quantity and pleasantness of social interactions soon after sexual assault might protect against worsening posttraumatic stress symptoms.Trial registration: ClinicalTrials.gov identifier: NCT03703258.

In N = 41 distressed and alcohol-using female survivors of recent sexual assault, having a higher quantity of social interactions and more pleasant social interactions within 10 weeks of assault was associated with lower posttraumatic stress symptoms.When survivors' social interactions were more pleasant than average on one day, their posttraumatic stress symptoms tended to be lower than average the next day, and recent survivors were more likely to talk about sexual assault on days when their posttraumatic stress symptoms were higher than usual.Interventionists should take note that increasing the quantity and pleasantness of social interactions soon after sexual assault might protect against worsening posttraumatic stress symptoms.

Heightened response to positive facial cues as a potential marker of resilience following childhood adversity.

Background: Childhood maltreatment profoundly influences social and emotional development, increasing psychiatric risk. Alterations in the implicit processing of threat-related cues following early abuse and neglect represent a marker of mental health vulnerability. Less is known about how early adversity influences the perception of positive social cues, despite their central role in establishing and maintaining social interactions and their association with better mental health outcomes.Methods: The sample consisted of 42 children and adolescents with substantiated childhood maltreatment experiences and 32 peers (mean age 13.3), matched on age, pubertal status, gender, socioeconomic status, ethnicity, and cognitive ability. A computerised experimental task assessed the perceived emotional intensity of positive (happy) and negative (fearful) facial expressions. Mental health symptoms were measured via self- and parental reports, and perceived social support was self-reported.Results: The experience of abuse and neglect was associated with heightened perceived intensity of positive facial cues. Cross-sectional post-hoc moderation and mediation analyses, employing a model-building approach, revealed that in maltreatment-exposed participants: (i) their increased response to positive facial cues was associated with lower symptoms; (ii) the presence of social support accounted for their heightened perceived intensity of positive facial cues; (iii) the presence of social support putatively contributed to lower symptoms by increasing the perceived intensity of positive facial cues. No group differences in perceived intensity of negative expressions were observed.Conclusions: These findings provide fresh insight into how positive faces are processed following maltreatment experience in childhood. Maltreatment experience was found to be associated with heightened perceived intensity of happy faces, which in turn was associated with better mental health and greater levels of social support. This suggests that heightened saliency of positive emotions acts protectively in children with maltreatment experience.

The impact of childhood maltreatment on perceiving positive social cues, especially explicit emotional intensity appraisal, is less understood compared to the extensive focus on its role in processing threat-related cues and psychiatric risk.In this study, we found that maltreatment experience was associated with heightened perceived intensity of happy faces, which in turn was associated with better mental health and greater levels of social support.These findings suggest that heightened saliency of positive emotions may act protectively in children with maltreatment experience.

Efecto de la deuda económica sobre el bienestar psicológico de los residentes de cirugía: Resultados de un estudio nacional en Colombia / Effect of financial debt on the psychological well-being of surgery residents: Results of a national study in Colombia

Introducción. La deuda económica durante la residencia en cirugía general puede afectar el desempeño profesional, las decisiones de vida y el bienestar psicológico. La información disponible en Colombia es limitada. El objetivo de este estudio fue cuantificar la deuda económica del residente de cirugía general, identificar los factores asociados y evaluar su efecto en el bienestar psicológico. Métodos. Estudio de corte transversal analítico. Se invitó a 380 residentes a diligenciar una encuesta sobre los aspectos relacionados con su deuda económica y se utilizó el WHO-index para evaluar su bienestar psicológico. Resultados. Un total de 259 residentes participaron en el estudio (67,6 %). El 56 % posee una deuda económica promedio de COP $88.000.000 ((US$21.826)). Un alto nivel de endeudamiento se relacionó con el año de residencia, el tipo de institución (privada) y la solicitud de préstamos. Se identificó algún trastorno mental en 14,7 % y un bajo nivel de bienestar psicológico en 56,4 % de los participantes. No se identificó ninguna asociación entre una elevada deuda económica y el bajo bienestar psicológico. Conclusiones. La deuda económica tiene un efecto sobre los residentes. El endeudamiento de los residentes de cirugía en Colombia es altamente prevalente, y no se correlaciona con un pobre bienestar psicológico. La autodeterminación favorece el bienestar psicológico en el posgrado en cirugía general. Existe la necesidad de educación financiera en los residentes. Se requieren nuevos estudios que evalúen las causas del pobre bienestar psicológico.

Introduction. Financial debt during surgery residency can affect professional performance, life decisions, and psychological well-being. The information available in Colombia is limited. The objective of this study is to quantify the financial debt of the general surgery resident, identify the associated factors and evaluate their effect on psychological well-being. Methods. A cross-sectional study was carried out. A total of 380 residents were invited to complete a survey on aspects related to their financial debt, and the WHO-index to evaluate their psychological well-being. Results. A total of 259 residents participated in the study (67.6%). 56% have an average economic debt of $88,000,000 COP (US$21,826). High debt was related to level of residence, type of institution (private), and loan application. Some mental disorder was identified in 14.7% and a low level of psychological well-being in 56.4% of the participants. No association was identified between high financial debt and low psychological well-being. Conclusions. Economic debt has an effect on residents. Financial debt among surgical residents in Colombia is highly prevalent; however, it does not correlate with poor psychological well-being. Self-determination favors psychological well-being in the postgraduate course in general surgery. Likewise, the need for financial education in residents is imminent. New studies are required that thoroughly evaluate the causes of poor well-being.

'Life should go on': a qualitative inquiry of parental reactions, experiences, and perceived needs following adolescents' recent traumatic exposure.

Background: Parents have a significant role in supporting children who have been exposed to traumatic events. Little is known about parental experiences and needs in the wake of traumatic exposure, which could help in designing tailored early interventions.Objective: This qualitative study explored experiences, perceived needs, and factors impacting those needs being met, in parents of adolescents aged 11-16 years who had been exposed in the past 3 months to a potentially traumatic event, in the city of Montpellier, France.Method: We purposively sampled 34 parents of 25 adolescents aged 11-16 years meeting the inclusion criteria and used semi-structured in-depth interviews. Thematic analysis was applied using a multistage recursive coding process.Results: Parents lacked trauma-informed explanations to make sense of their child's reduced functioning. They experienced stigma attached to the victim label and were reluctant to seek help. School avoidance and lack of collaboration with schools were major obstacles experienced by parents. Parents trying to navigate conflicting needs fell into two distinct categories. Those who experienced distressing levels of shame and guilt tended to avoid discussing the traumatic event with their child, pressuring them to resume life as it was before, despite this perpetuating conflictual interactions. Others adapted by revisiting their beliefs that life should go on as it was before and by trying to come up with new functional routines, which improved their relationship with their child and helped them to restore a sense of agency and hope, but at the cost of questioning their parental role.Conclusions: Key domains of parental experiences could provide potential early intervention targets, such as psychoeducation on traumatic stress, representations about recovery and the victim status, parent-child communication, and involvement of schools and primary caregivers. Further research is needed to validate the impact of these domains in early post-traumatic interventions.

Parents of teenagers exposed to traumatic events struggle to understand trauma and feel isolated.Parents feel pressured to resume life as it was before, leading to conflictual child­parent interaction.Psychoeducation, stigma, and school involvement could be early intervention targets.

Differentiating social environments of high-risk professionals and specialised nurses: a qualitative empirical study on social embeddedness.

Objective: High-risk professionals and specialised nurses in hospitals are frequently exposed to potentially traumatic events. Psychotrauma researchers have extensively studied personal risk factors of traumatisation among high-risk professionals, but it is hard to understand psychological functioning when professionals are decontextualised from their social environment. Generally, it has been well documented that to reduce the risk of posttraumatic stress disorder (PTSD) or other mental health problems related to traumatisation, it is essential to be embedded in a supportive social environment. However, study results among and within these occupational groups show great variety and even inconsistencies as to what is a supportive social environment.Method: This ethnographical research, including participant observation, in-depth interviews, and document analysis, explored the social environment of firefighters, police officers, ambulance paramedics, specialised nurses, and military personnel and aims to explore their social connections and embeddedness. We performed a thematic content analysis of data to identify themes related to social or emotional support, social relationships, and stress or traumatisation.Results: An analysis of the observational field notes, which covered 332 h of participant observation and 71 evenly distributed formal in-depth interviews, identified four themes related to social connections and embeddedness: Family, Hierarchical relations versus autonomy, Group versus individual, and Conditional family 'love'. Results revealed that the military, police, and professional firefighters have family-like hierarchical connections and highly value group unity. Paramedics and most specialised nurses, however, tend to value individuality and autonomy in their work relationships.Conclusion: This research shows noticeable differences in the social environments and social connections of these professionals, which implicates that prevention and mental health treatment might also have to be differentiated among occupational groups.

It is of great importance for high-risk professionals or frontline professionals who are frequently exposed to potential traumatic events, to be embedded in a supportive social environment; to work with the conviction that others 'have your back'. However, their social environments differ so much that we cannot lump them together in one category.The military, police, and professional or career firefighters have family-like hierarchical connections and highly value group unity. Ambulance paramedics and most nurses working in specialised departments, such as emergency rooms, operating rooms, and intensive care units, on the other hand tend to value individuality and autonomy in their work relationships.To be effective, programmes for preventions, such as professional support or formal peer support, as well as mental health treatments might have to be differentiated accordingly between occupational groups.

Influence of social support and stressful life events on adherence to colorectal cancer screening using faecal occult blood test in Spanish medium risk population / Influencia del apoyo social y los acontecimentos vitales estresantes en el cribado de cáncer colorrectal con sangre oculta en heces en población española de riesgo medio

Introduction Colorectal cancer (CRC) is the second cause of cancer-related deaths worldwide. Five-year survival rate in Spain is 57%. The most important prognostic factor is the stage of the tumor at the diagnosis. CRC can be early diagnosed, but the adherence to screening programs is low (<50%). This study aims to ascertain the influence of social support and stressful life events on the adherence to the population screening of CRC with fecal occult blood test in Spanish average risk population. Methods Multicenter case–control study. We conducted a simple random sampling among individuals invited to participate in the colorectal cancer screening program. We analyzed epidemiological and social variables associated with lifestyle and behavioral factors. We performed a descriptive and a bivariant analyses and a logistic regression analysis. Results Four hundred and eight patients (237 cases and 171 controls) were included. Multivariant analyses showed independent association between higher adherence to the screening program and older age (OR: 1.06; 95% CI: 1.01–1.10), stable partner (OR: 1.77, 95% CI: 1.08–2.89) and wide social network (OR: 1.68; 95% CI: 1.07–2.66). Otherwise, lower adherence was associated to perceiving barriers to participate in the program (OR: 0.92; 95% CI: 0.88–0.96). We find a statistically significant association between lower adherence and high impact stressful life events in the bivariant analyses, and the tendency was maintained (OR: 0.63, 95% CI: 0.37–1.08) in the multivariant. Conclusion Social variables decisively influence the adherence to colorectal cancer screening. The implementation of social interventions that improve social support, reduce impact of stressful life events and the design of screening programs that decrease the perceived barriers, will contribute to increase the participation on these programs. Secondary, the colorectal cancer diagnosis will be made in early-stages with the consequent mortality reduction (AU)

Introducción El cáncer colorrectal (CCR) es la segunda causa de muerte por cáncer en el mundo. La tasa de supervivencia a cinco años en España es de 57%. El factor pronóstico más importante es el estadio del tumor en el momento del diagnóstico. El CCR se puede diagnosticar precozmente, pero la adherencia a los programas de cribado es baja (< 50%). Este estudio pretende conocer la influencia del apoyo social y los acontecimientos vitales estresantes en la adherencia al cribado poblacional de CCR con sangre oculta en heces en población española de riesgo medio. Métodos Estudio multicéntrico de casos y controles. Realizamos un muestreo aleatorio simple entre los individuos invitados a participar en un programa de cribado de CCR. Analizamos variables epidemiológicas y sociales asociadas al estilo de vida y factores conductuales. Realizamos un análisis descriptivo, un análisis bivariante y una regresión logística. Resultados Se incluyeron 408 pacientes (237 casos y 171 controles). El análisis multivariante demostró una asociación independiente entre una mayor adherencia al programa de cribado y mayor edad (OR: 1,06; IC 95%: 1,01-1,10), tener pareja estable (OR: 1,77, IC 95%: 1,08-2,89) y disponer de una amplia red social (OR: 1,68; IC 95%: 1,07-2,66). Por el contrario, la menor adherencia se asoció a la percepción de barreras para participar en el cribado (OR: 0,92; IC 95%: 0,88-0,96). Encontramos una asociación estadísticamente significativa entre menor adherencia y acontecimientos vitales estresantes de alto impacto en el análisis bivariante. La tendencia se mantuvo (OR: 0,63, IC 95%: 0,37-1,08) en el análisis multivariante (AU)

Resilience in theface of the COVID-19 Pandemic in Portuguese Adult Athletes / Resiliencia frente a la Pandemia de COVID-19 en los/as Deportistas Adultos/as Portugueses/as / Resiliência face à Pandemia COVID-19 em Atletas Adultos/as Portugueses/as

COVID-19 triggered the most significant global state of emergency since World War II, establishing a long-lasting and challenging transition period in anyone's life. In the case of athletes, some specific challenges arise, particularly those associated with the restrictions in training and competitions imposed by sanitary measures. This exploratory and cross-sectional study aims to understand athletes' resilience in the face of COVID-19. The data was collected between December 2020 and March 2021 from 1016 participants with a mean age of 30 years (SD=12.5), ranging from 18 to 83 years, and an average of 14 years of federated practice (SD=9.55). Resilience was measured through a tripartite assessment of its domains: adversity factors (personal experience with the virus, effects on sports practice, and fear of COVID-19), protection mechanisms (satisfaction with social support and coping strategies), and adjustment (life satisfaction, positive and negative affect, and subjective impact of the pandemic). The results suggest that the drop in training characteristics, time without trainingand lockdown, fear of COVID-19, and behavioral disengagement are negative predictors of positive adjustment. On the other hand, active coping and satisfaction with social support were positively associated with athletes' adaptation. Furthermore, it was found that being female is an additional adversity factor and that external circumstances, such as the severity of the pandemic, seem to interfere with the participants' adjustment. In conclusion, results suggest that sports institutions should prioritizeathletes’ mental health and promote their sports practice as much as possible.(AU)

La COVID-19 desencadenó el mayor estado de emergencia mundial desde la Segunda Guerra Mundial, estableciendo un período de transición duradero y desafiante en la vida de cualquiera. En el caso de los/as deportistas, surgen algunos retos específicos, especialmente los asociados a las restricciones en los entrenamientos y las competiciones, impuestas por las medidas sanitarias. El objetivo principal de este estudio exploratorio y transversal es comprender la resiliencia de los/as atletas frente a la COVID-19.Los datos se recogieron entre diciembre de 2020 y marzo de 2021 de 1,016 participantes con una edad media de 30 años (±12.5), con un rango de 18 a 83 años, y con una media de 14 años de práctica federada (±9.55). La resiliencia se midió a través de una evaluación tripartita de sus dominios: factores de adversidad (experiencia personal con el virus, efectos en la práctica deportivay miedo al COVID-19), mecanismos de protección (satisfacción con el apoyo social y estrategias de afrontamiento) y ajuste (satisfacción vital, afecto positivo y negativo e impacto subjetivo de la pandemia). Los resultados sugieren que el descenso de las características del entreno, el tiempo sin entrenar y en confinamiento, el miedo al COVID-19 y la desvinculación conductual son predictores negativos del ajuste positivo. Por otro lado, el afrontamiento activo y la satisfacción con el apoyo social se asociaron positivamente con la adaptación de los/as deportistas. Además, se encontró que ser mujer es un factor de adversidad adicional y que las circunstancias externas, como la gravedad de la pandemia, parecen interferir en la adaptación de los/as participantes. En conclusión, los resultados sugieren que las instituciones deportivas deberían priorizar la salud mental de los/as atletas y promover su práctica deportiva en la medida de lo posible.(AU)

A COVID-19 desencadeou o maior estado de emergência global desde a Segunda Guerra Mundial, estabelecendo um período de transição duradouro e desafiante na vida de qualquer pessoa. No caso dos atletas federados, surgiram alguns desafios específicos, particularmente associados às restrições nos treinos e competições impostas por medidas sanitárias. O principal objetivo deste estudo exploratório de natureza trasnversal é compreender aresiliência dos/as atletas federados/as face à COVID-19. Os dados foram recolhidos entre dezembro de 2020 e março de 2021 junto de 1016 participantes com uma idade média de 30 anos (DP=12.5), variando de 18 a 83 anos, e com uma média de 14 anos de prática federada (DP=9.55). A resiliência foi medida através de uma avaliação tripartida dos seus domínios: fatores de risco (experiência pessoal com o vírus, efeitos na prática desportiva, e medo da COVID-19), mecanismos de proteção (satisfação com o apoio social e estratégias de coping), e ajustamento (satisfação com a vida, afeto positivo e negativo, e impacto subjetivo da pandemia). Os resultados sugerem que a queda nas características do treino, o tempo sem treino e em confinamento, o medo da COVID-19 e o desinvestimento comportamental são preditores negativos de ajustamento positivo. Por outro lado, o coping ativo e a satisfação com o apoio social foram positivamente associados à adaptação dos/as atletas. Além disso, verificou-se que ser mulher é um fatorde risco adicional e que circunstâncias externas, tais como a gravidade da pandemia, parecem interferir com o ajustamento dos/as participantes. Em conclusão, os resultados sugerem que as instituições desportivas devem dar prioridade à saúde mental dos/as atletas e promovera sua prática desportiva tanto quanto possível.(AU)

Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centre.

Background: Recent practice guidelines strongly recommend evidence-based psychotherapies (EBPs) as the first-line treatment for post-traumatic stress disorder (PTSD). However, previous studies found barriers to the implementation of EBPs and a relatively high dropout rate in clinical settings. After proving the efficacy of prolonged exposure (PE) in Japan [Asukai, N., Saito, A., Tsuruta, N., Kishimoto, J., & Nishikawa, T. (2010). Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study. Journal of Traumatic Stress, 23(6), 744-750. https://doi.org/10.1002/jts.20589], we began implementing PE in a real-world clinical setting at the Victim Support Center of Tokyo (VSCT).Objective: We aimed to investigate the effectiveness and benefit of PE for crime-induced PTSD among VSCT clients and what causes dropout from treatment.Method: Of 311 adult clients who received counselling from clinical psychologists at VSCT due to violent or physical crime victimization from April 2008 through December 2019, 100 individuals received PE and participated in this study. Their PTSD symptoms were evaluated before and after treatment using the Impact of Event Scale-Revised and the Clinician-Administered PTSD Scale for DSM-IV.Results: A total of 93 participants completed PE and seven dropped out after six sessions or less. The completers group improved in PTSD symptoms with significant score differences between pre- and post-treatment in IES-R and CAPS-IV. Participants' symptoms did not exacerbate after treatment. Forty of 49 completers who left their workplace or college/school after victimization returned to work or study shortly after treatment. Compared to the completers, all dropout participants were women and younger. The majority were rape survivors, with significantly shorter intervals between victimization and treatment. The reasons for dropout were difficulty scheduling treatment between work/study schedules and manifestation of bipolar disorder or physical illness.Conclusions: PE can be implemented with significant effectiveness and a low dropout rate in a real-world clinical setting if advantages in the system and policies, local organizational context, fidelity support and patient engagement are fortified.

We conducted prolonged exposure (PE) with a low dropout rate for crime-induced PTSD in a non-Western real-world practice setting.Patient outcomes and low dropout rate of PE for PTSD in this study may be due to advantages in the following areas: system and policies, local organizational context, fidelity support and patient engagement.When introducing PE for PTSD, it is important to confirm that patients can be reasonably engaged with PE, and to carefully assess the status of other psychiatric and physical illnesses.

Social support buffers the impact of pregnancy stress on perceptions of parent-infant closeness during the COVID-19 pandemic.

Pregnant individuals and parents have experienced elevated mental health problems and stress during COVID-19. Stress during pregnancy can be harmful to the fetus and detrimental to the parent-child relationship. However, social support is known to act as a protective factor, buffering against the adverse effects of stress. The present study examined whether (1) prenatal stress during COVID-19 was associated with parent-infant closeness at 6 months postpartum, and (2) social support moderated the effect of prenatal stress on the parent-infant relationship. In total, 181 participants completed questionnaires during pregnancy and at 6 months postpartum. A hierarchical linear regression analysis was conducted to assess whether social support moderated the effect of stress during pregnancy on parent-infant closeness at 6 months postpartum. Results indicated a significant interaction between prenatal stress and social support on parents' perceptions of closeness with their infants at 6 months postpartum (ß = .805, p = .029); parents who experienced high prenatal stress with high social support reported greater parent-infant closeness, compared to those who reported high levels of stress and low social support. Findings underscore the importance of social support in protecting the parent-infant relationship, particularly in times of high stress, such as during the COVID-19 pandemic.

Individuos y progenitores en estado de embarazo experimentan elevados problemas de salud mental y estrés durante el COVID-19. El estrés durante el embarazo puede ser dañino para el feto y perjudicial para la relación progenitor-niño. Sin embargo, es sabido que el apoyo social actúa como un factor de protección, sirviendo como agente amortiguador contra los adversos efectos del estrés. El presente estudio longitudinal examinó si 1) el estrés prenatal durante el COVID-19 se asociaba con la cercanía madre-infante a los seis meses después del parto, y 2) el apoyo social moderaba el efecto del estrés prenatal en la relación madre-infante. Un total de 181 participantes completaron cuestionarios durante el embarazo y a los seis meses después del parto. Un análisis de regresión lineal jerárquico se llevó a cabo para evaluar si el apoyo social moderaba el efecto del estrés durante el embarazo en cuanto a la cercanía progenitor-infante a los seis meses después del parto. Los resultados indicaron una interacción significativa entre el estrés prenatal y el apoyo social sobre las percepciones que los progenitores tenían de la cercanía con sus infantes a los seis meses después del parto (ß = .805, p = .029); los progenitores que experimentaron un alto estrés prenatal con un alto apoyo social reportaron una mayor cercanía progenitor-infante, comparados con aquellos que reportaron altos niveles de estrés y bajo apoyo social. Los resultados subrayan la importancia del apoyo social para proteger la relación progenitor-infante, particularmente en épocas de alto estés, tal como durante la pandemia del COVID-19.

Les personnes enceintes et les parents font l'expérience de plus grands problèmes de santé mentale et de plus de stress durant la crise du COVID-19. Le stress durant la grossesse peut être néfaste pour le foetus et vient au détriment de la relation parent-enfant. Cependant l'on sait que le soutien social est un facteur de protection, faisant tampon face aux effets adverses du stress. Cette étude longitudinale a examiné si 1) le stress prénatal durant le COVID-19 était lié à la proximité mère-nourrisson à six mois postpartum, et 2) le soutien social a modéré l'effet du stress prénatale sur la relation mère-nourrisson. En tout 181 participants ont rempli des questionnaires durant la grossesse et à sic mois postpartum. Une analyse de régression linéaire hiérarchique a été faite pour évaluer si le soutien social a modéré l'effet du stress durant la grossesse sur la proximité parent-nourrisson à six mois postpartum. Les résultats ont indiqué une interaction importante entre le stress prénatal et le soutien social sur les perceptions des parents de la proximité avec leurs nourrissons à six mois postpartum (ß = ,805, p = ,029); les parents qui ont fait l'expérience d'un stress prénatal élevé avec un soutien social élevé ont signalé une plus grande proximité parent-nourrisson, comparé à ceux ayant signalé des niveaux de stress élevés et un faible soutien social. Les résultats soulignent l'importance du soutien social dans la protection de la relation parent-nourrisson, particulièrement en temps de stress élevé, comme durant la pandémie de COVID-19.

Influence of social support and stressful life events on adherence to colorectal cancer screening using faecal occult blood test in Spanish medium risk population.

INTRODUCTION: Colorectal cancer (CRC) is the second cause of cancer-related deaths worldwide. Five-year survival rate in Spain is 57%. The most important prognostic factor is the stage of the tumor at the diagnosis. CRC can be early diagnosed, but the adherence to screening programs is low (<50%). This study aims to ascertain the influence of social support and stressful life events on the adherence to the population screening of CRC with fecal occult blood test in Spanish average risk population. METHODS: Multicenter case-control study. We conducted a simple random sampling among individuals invited to participate in the colorectal cancer screening program. We analyzed epidemiological and social variables associated with lifestyle and behavioral factors. We performed a descriptive and a bivariant analyses and a logistic regression analysis. RESULTS: Four hundred and eight patients (237 cases and 171 controls) were included. Multivariant analyses showed independent association between higher adherence to the screening program and older age (OR: 1.06; 95% CI: 1.01-1.10), stable partner (OR: 1.77, 95% CI: 1.08-2.89) and wide social network (OR: 1.68; 95% CI: 1.07-2.66). Otherwise, lower adherence was associated to perceiving barriers to participate in the program (OR: 0.92; 95% CI: 0.88-0.96). We find a statistically significant association between lower adherence and high impact stressful life events in the bivariant analyses, and the tendency was maintained (OR: 0.63, 95% CI: 0.37-1.08) in the multivariant. CONCLUSION: Social variables decisively influence the adherence to colorectal cancer screening. The implementation of social interventions that improve social support, reduce impact of stressful life events and the design of screening programs that decrease the perceived barriers, will contribute to increase the participation on these programs. Secondary, the colorectal cancer diagnosis will be made in early-stages with the consequent mortality reduction.

Nurses' perceptions of the obstacles and supportive behaviors of end-of-life care in intensive care units.

PURPOSE: This study examined the Jordanian registered nurses' perceptions of the obstacles and supportive behaviors of End-of-Life Care in Intensive Care Units and examined the differences in the concepts based on the samples' demographics. METHODS: A cross-sectional and comparative study was conducted using a convenience sample of 230 Intensive Care Unit registered nurses in Jordan. Data were analyzed descriptively, and differences were measured using the independent sample t-test, the one-way Analysis of Variance, and Scheffe's post hoc test. RESULTS: The registered nurses' scored moderately on obstacles (74.98 ± 14.54) and supportive behaviors (69.22 ± 4.84). The commonly perceived obstacle and supportive behaviors to End-of-Life Care in Intensive Care Units s were reported. The perceived obstacles differ based on the registered nurses' certification as an Intensive Care Units nurse (3.04 ± 0.58 vs. 2.74 ± 0.49, p = 0.008), type of Intensive Care Unit (3.28 ± 0.34 vs. 2.86 ± 0.62, p < 0.001), type of facility (3.16 ± 0.59 vs. 2.77 ± 0.61, p < 0.001), number of beds in the unit (3.07 ± 0.48 vs. 2.69 ± 0.48, p = 0.020), and the number of hours worked per week (3.06 ± 0.56 vs. 2.81 ± 0.60, p = 0.005). In contrast, supportive behaviors only differ based on the registered nurses' age (3.22 ± 0.69 vs. 2.90 ± 0.64, p = 0.019). CONCLUSIONS: The common End-of-Life Care perceived obstacle in Intensive Care Units was the lack of nursing education and training regarding the studies concept, which warrants immediate intervention such as on-job training. The common End-of-Life Care perceived supportive behavior in Intensive Care Units was when family members accepted that the patient was dying when nurses offered support to family members; motivational interventions are needed to sustain such behavior. Differences in the perceived obstacles and supportive behaviors should be leveraged for the benefit of patients, nurses, and hospitals.

Perspectivas de la investigación enfermera en España. Una revisión narrativa / [Perspectives of nursing research in Spain. A narrative review]

En las últimas décadas los avances en la investigación enfermera han supuesto un incremento del consumo, la generación y producción científica, pero todavía son necesarios cambios importantes para una "cultura de la investigación enfermera". El objetivo general es realizar un análisis de la literatura sobre la investigación enfermera desde los conocimientos y motivaciones, barreras y limitaciones y perspectivas de futuro hacia la investigación. Se puede concluir con los datos recientes que existen déficits sobre los conocimientos y motivaciones de los/as enfermeros/as hacia la investigación y que las barreras y limitaciones en la investigación de los cuidados requieren de estrategias y propuestas de cambio para el futuro de la ciencia enfermera. (AU)