Exploring the symptoms and psychological experiences among lung cancer convalescence patients after radical lobectomy: A qualitative study.

OBJECTIVE: This study aims to explore the symptom experiences and psychological feelings of lung cancer patients after radical lobectomy in China. METHODS: A qualitative study was conducted using face-to-face semistructured interviews with lung cancer patients who had a radical lobectomy for treatment of their cancer during the convalescence period. Participants (n = 18) were recruited from a general hospital in China, and patients were selected using purposive sampling from September 2021 to February 2022. Interviews were recorded and transcribed verbatim, and Colaizzi's seven-step method of phenomenology was used. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was conducted to report the study. RESULTS: Four themes were extracted from the interview data: physiological dimensions (fatigue, cough or sputum, chest tightness and shortness of breath, daily activities affected, sleep disturbance, lack of appetite); psychological dimensions (negative emotion, fear of cancer recurrence, learning to accept reality, strengthened faith and hope); family dimensions (heavy economic burden, perceived family care, improved health management behavior); and social dimensions (perceived support of medical staff, decreased sense of social value and self-identity, changes in social and working style). CONCLUSION: Lung cancer patients are still troubled by many problems during the postoperative recovery period. Medical staff should design and implement effective evaluations and targeted interventions for patients' physical and mental health as soon as possible to improve patients' physical and mental health, as well as their quality of life.

Estudio de aplicabilidad de la entrevista motivacional para potenciar la rehabilitación en pacientes geriátricos ingresados en una unidad de convalecencia / Feasibility study of motivational interviewing to improve rehabilitation in an Intermediate Care Hospital

Objetivo: La rehabilitación de las personas mayores es una intervención compleja, en la cual intervienen múltiples componentes (clínica, cognitiva, anímica etc.). Nuestro estudio pretende comprobar si la entrevista motivacional (EM) (basada en una atención centrada en la persona), con adaptaciones, es aplicable en pacientes con fractura de fémur o ictus que realizan rehabilitación en una unidad de convalecencia. Metodología: Se realizan entrevistas motivacionales a 20 pacientes > 65 años (10 con fractura de fémur y 10 con ictus). Un geriatra formado en EM realiza dos entrevistas a cada paciente, una inicial en < 72 horas del ingreso y otra de seguimiento la semana siguiente. Para que los pacientes recuerden los ejercicios acordados, se entregan trípticos adaptados. Resultados: Todos los pacientes aceptaron y valoraron satisfactoriamente las dos entrevistas. La segunda entrevista mostraba mejor aceptación si realizada antes del 6è día, porqué se recordaba mejor al profesional y los objetivos acordados. La demanda de esta intervención fue alta (4-5 pacientes/semana). El mejor momento per realizar la entrevista es por la tarde, evitando interferir en el funcionamiento de la planta. La EM en pacientes con deterioro cognitivo leu presenta mayor dificultad, y en 3 ocasiones se incorporó a la entrevista al cuidador principal, con muy buena respuesta. La motivación de los pacientes para realizar rehabilitación fue alta (poca ambivalencia), por ello durante las entrevistas no se trabajó tanto la ambivalencia, sino en empoderar a los pacientes y ayudarlos a encontrar herramientas para aumentar las probabilidades de éxito. Conclusiones: La EM es una herramienta fácilmente aplicable dentro del entorno socio sanitario, realizando algunas adaptaciones. La motivación de los pacientes es alta y la EM se centra sobre todo en empoderar al paciente. Este estudio abre la puerta a evaluar, en un futuro, si la intervención es efectiva en este ámbito

Objective: Our main objective was to test the feasibility of adding a patient centered motivational intervention to the usual rehabilitation in an Intermediate Care (IC) Hospital for patients admitted after a hip fracture or stroke. Methods: 20 patients>65 years (10 hip fracture;10 stroke) participated in the study, receiving two motivational interviewing sessions by a trained geriatrician, the first within the 72 hours after admission, the second one week later. All patients were given leaflets informing about different rehabilitation exercises to perform besides formal physical therapy provided in the hospital, among which they could choose those they felt more suitable. Data collected included socio-demographics, comorbidity, and clinical, cognitive and functional status. Results: The motivational intervention was accepted by all patients and all felt it to be appropriate. Opportunities for this intervention were high,4-5 patients per week, best time for the interventions was in the afternoons, which avoided interferences with hospital activities. In patients with mild cognitive impairment the intervention was harder, and in 3 occasions the primary caregiver was invited to participate, with high acceptance and enthusiasm. Patients at baseline were already highly motivated to do rehabilitation, and ambivalence was not big. Therefore most of the interviews focussed on empowering patients and helping them to identify and set their own goals during rehabilitation. Conclusions: Adding specific motivational interventions to usual rehabilitation treatment in older patients admitted after a hip fracture or stroke, is feasible and acceptable in our IC Hospital. Since patients are quite prone to rehabilitation, interviews tend to focus on empowerment. Further, rigorous research is needed

Evaluación de psicopatología, afrontamiento y apoyo familiar en el cumplimiento de pautas médicas en los 12 meses posteriores a un trasplante cardiaco / Assessment of psychopathology, coping strategies and family support in compliance with medical regimen in the 12 months after heart transplantation

Introducción y objetivos: La falta de cumplimiento de las pautas médicas es uno de los factores de mayor riesgo de morbimortalidad en pacientes trasplantados de corazón. El objetivo del presente trabajo es evaluar la influencia en el cumplimiento de pautas médicas, en pacientes sometidos a trasplante cardiaco, de determinados factores psicosociales como son la presencia de patología psiquiátrica previa al trasplante y las estrategias de afrontamiento y el soporte familiar medidos a los 12 meses. Métodos: Estudio prospectivo observacional que evalúa, a lo largo de 16 meses, 22 sujetos incluidos en un programa de trasplante cardiaco. Se realizó una evaluación pretrasplante y otra al año del trasplante. La valoración recogía los antecedentes clínicos y sociodemográficos, la medición de clínica depresiva y ansiosa, una entrevista psiquiátrica estructurada, las estrategias de afrontamiento, un cuestionario de función familiar y un instrumento propio diseñado para cuantificar el cumplimiento de pautas médicas. Resultados: El 27% de los pacientes mostraron un trastorno psiquiátrico en la evaluación pretrasplante. Las estrategias de afrontamiento más utilizadas fueron las de aceptación y reinterpretación positiva. El análisis de correlación mostró que a menor soporte familiar y a mayor utilización de estrategias de afrontamiento interpersonales se produce un mayor incumplimiento. No se encontró correlación entre patología psiquiátrica y el cumplimiento de pautas. El porcentaje global de incumplimiento fue del 36,6%. Conclusiones: Podemos señalar que el apoyo familiar es un factor que se asocia al cumplimiento de pautas médicas en pacientes con trasplante cardiaco y que, pese a recibir un soporte adecuado, el porcentaje global de incumplimiento de pautas es elevado (AU)

Introduction and objectives: Failure of compliance with the medical regimen is one of the major risk factors associated with morbidity and mortality in heart transplantation patients. The aim of this study is to evaluate the influence of some psychosocial factors, such as the presence of pre-transplant psychiatric disorders, and coping strategies and family support measured after 12 months, in the compliance with the medical regimen in cardiac transplantation patients. Methods: A prospective observational study was conducted over a period of 16 months to evaluate 22 subjects included in a heart transplantation program. Patients were assessed in the pre-transplant period and one year after transplantation. The evaluation collected medical history and sociodemographic data, clinical measurement of depression and anxiety, a structured psychiatric interview, coping strategies, family function questionnaire, and a tool designed to measure the compliance with the medical regimen. Results: More than one-quarter (27%) of patients had a psychiatric disorder in the pre-transplant evaluation. The most frequently used coping strategies were acceptance and positive re-interpretation. Correlation analysis showed that there is a greater non-compliance with less family support and greater use of interpersonal coping strategies. No correlation was found between psychiatric conditions and compliance with guidelines. The overall percentage of non-compliance was 36.6%. Conclusions: It has been shown that family support is an important factor associated with compliance with the medical regimen in patients with cardiac transplantation and, despite receiving adequate support, there is a high rate of non-compliance (AU)

Construcción de un cuestionario de valoración de la salud social de los usuarios en el ámbito sociosanitario / Creating a social health evaluation questionnaire for users in the socio-sanitary area

Introducción: puede definirse salud social como la situación óptima en cada una de las áreas que configuran el entorno social de la persona. Este trabajo presenta los resultados preliminares de la creación del Qüestionari de Valoració de Salut Social (QVSS), que pretende valorar el estado de salud social de los usuarios del ámbito sociosanitario. Material y métodos: partiendo del análisis de contenido de instrumentos conocidos, el equipo de trabajo elaboró los ámbitos que consideraba necesarios para valorar la salud social, determinó las posibles situaciones en que podía encontrarse un individuo dentro de cada ámbito y formuló las preguntas necesarias para poder describirlas. Posteriormente, en una reunión con un grupo de expertos, se consensuaron los ámbitos y preguntas definitivas. Resultados: los ámbitos, que se corresponden a subescalas independientes del QVSS, fueron: soporte informal, soporte formal, situación económica, vivienda e integración familiar y social. El sexo (p < 0,001), los estudios (p = 0,017) y la clase social (p = 0,029) se asocian con la subescala económica. También el estado civil (p = 0,002), que además se asocia con el soporte informal (p = 0,030). El tiempo medio de respuesta fue de 13,5 min. Conclusiones: el QVSS mostró facilidad en su administración. Parece que no existen grandes diferencias en función de quién lo responda, excepto en la subescala de soporte informal. Se hace necesario validarlo y ahondar en el estudio sobre la relación entre el QVSS respondido por el paciente o por el cuidador

Introduction: social health can be defined as the best possible situation for each of the areas that make up a person's social environment. This article presents the preliminary results of the creation of a Social Health Evaluation Questionnaire (SHEV), aimed at assessing the social health status of users of hospitals for the elderly and disabled. Material and methods: the contents of well-known instruments were analysed and the working team selected the areas considered necessary to be able to evaluate social health status. The team then determined the possible situations in which individuals could find themselves in each of these areas and created questions to help them describe these situations. Subsequently, in a meeting with a group of experts, an overall agreement was reached on the scope and content of the final questions to be included in the questionnaire. Results: the distinct areas, which correspond to independent subscales in the SHEV, were: informal support, formal support, economic situation, housing, and social and family integration. Sex (p < 0.001), educational status (p = 0.017) and social class (p = 0.029) were associated with economic situation. Marital status was associated with economic situation (p = 0.002) and informal support (p = 0.030). The mean answering time was 13.5 minutes. Conclusions: the SHEV proved to be an easy tool to administer. No significant differences based upon responders were found, except in the subscale of informal support. Further validation and a more thorough investigation of the relationship between the SHEV as answered by patients or by their carers is required

O cuidado de Enfermagem à mulher com câncer ginecológico: uma aplicação da teoria de Roy / Caring for woman with gynecological cancer: the application of Roy's theory

Objetivou-se, neste estudo de caso, identificar os problemas e os estímulos de adaptação da mulher portadora de câncer de cérvix uterino, relacionando com o modo fisiológico, tomando por base o modelo de Adaptação de Roy (ROY e ANDREWS, 1991) e levantar os diagnósticos de Enfermagem. Os resultados apontaram para problemas de adaptação: anorexia, náuseas, retenção urinária, deambulação, diminuição da habilidade para o autocuidado, edema, estresse, com os seus respectivos diagnósticos: deglutição prejudicada, nutrição alterada, retenção urinária, mobilidade física prejudicada, fadiga, dor aguda, excesso no volume de líquido e síndrome de estresse