Religious faith in coping with terminal cancer: what is the nursing experience?

This qualitative study describes nurses' reports on the role played by religious faith in the care of patients with terminal cancer. Using Gadamer's philosophical hermeneutics and C. Roy's adaptation model as a base, in-depth interviews were carried out with 23 nurses who had cared for patients with terminal cancer for at least 6 months. Three main themes emerged when a Gadamerian-based hermeneutic research method was applied: faith facilitates the coping process in cases of terminal cancer, faith hinders the coping process in cases of terminal cancer and terminal illness impacts faith. The lack of univocal results indicates that the role of faith in coping with death is essentially practical, individualised and changeable. The nurse-patient relationship can help to determine the spiritual needs of cancer patients at the end of life. This source of knowledge held by the nurse, together with the rest of the multidisciplinary team, can help to improve end-of-life care.

Psychometric properties of the QuickPIPER: a shortened version of the PIPER Fatigue scale.

This paper proposes 'QuickPIPER', a 15-item, validated one-dimensional model representing cancer-related fatigue, based on factor analysis testing of the Piper Fatigue Scale-revised (R-PFS). One hundred and eleven breast cancer survivors participated in this prospective, observational study of the QuickPIPER validation. Participants completed the R-PFS and the Profile of Mood States (POMS) Fatigue and Vigor subscales. The questionnaires were tested concurrently before and after a multimodal exercise programme trial. Psychometric characteristics assessed from the sample included internal consistency and factor analysis, concurrent criterion validity and predictive ability. The results shows that the correlation matrix for the QuickPIPER questionnaire was determined as suitable with the Kaiser-Meyer-Oklin values (0.89) and Bartlett's Test of Sphericity (P < 0.001). The total cumulative variance explained was 65.32%. The goodness-of-fit indices of confirmatory factor analysis were satisfactory (normed fit index = 0.91 and comparative fit index = 0.92). Test-retest reliability was very good (r = 0.947, P < 0.001). The QuickPIPER scores correlated with POMS Fatigue (r = 0.800) and POMS Vigor (r = -0.352) subscales. Predictive ability showed that the area under the curves for the screening questionnaires was 0.743 (95% confidence interval 0.579-0.906). The 15-item QuickPIPER possesses similar properties to the 22-item R-PFS and offers the important advantage of brevity.

Strategies to develop the nursing process and nursing care plans in the health system in Bolivia.

BACKGROUND: Care plans provide guidelines to offer all patients the same quality assistance. Care plans constitute a base where every stage of the nursing process can be recorded, which will save time when handling documentation. Bolivian nurses are very keen to participate in this global trend in order to grasp the opportunity offered by the international cooperation programmes carried out between Spain and South America. AIMS: To identify obstacles and enablers encountered when implementing the nursing process and to set clear strategies and actions so as to develop the nursing process and care plans in Santa Cruz department (Bolivia) both in hospitals and universities. METHODS: The participatory action research was conducted between the Autonomous University of Gabriel René Moreno (Bolivia) and the University of Almería (Spain). The procedure for data collection included meetings with key informants, interviews, observation and workshops. Data were analysed using the constant comparison and categorized by common themes. RESULTS: Lack of time and instruments, shortage of resources and the need for continuous training came up as obstacles, whereas enablers were the nurses' involvement, the university-hospital coordination and the support given by institutions. Actions taken were the creation of a care plan unit, the implementation of a training programme, design of instruments and meetings held with authorities and institutional representatives. CONCLUSIONS: Conducting action research schemes within international cooperation programmes signifies an excellent opportunity for the nursing system in less-developed countries to be included in international plans with the aim of standardizing the nursing practice.

Electroterapia, hiperhidrosis y enfermedades neurovasculares / Electrotherapy, hyperhidrosis and neurovascular diseases

Los síndromes vasoespásticos son alteraciones vasculares que afectan a las extremidades, principalmente las superiores; tienen carácter funcional y, como denominador común, su sintomatología está producida por un aumento de la capacidad vasoconstrictiva de etiología poco conocida. Entre los factores precipitantes se encuentran la exposición al frío y los estímulos emocionales. La exploración generalmente muestra, entre las crisis, dedos fríos y lividez con hiperhidrosis. Los objetivos de nuestro estudio son exponer la evolución antes y después del tratamiento del cortejo sintomático acompañante de la hiperhidrosis palmar, como la hipotermia y la lividez en los pacientes que la sufren. Para cumplir los objetivos, se planteó un estudio experimental con sendos grupos: control normal de 10 pacientes sin tratamiento y experimental con un total de 60 pacientes con hiperhidrosis, distribuidos en 6 subgrupos y sometidos a tratamiento de iontoforesis con agua corriente. Los resultados obtenidos indican que, aunque la terapéutica aplicada suprimió en el 100% de los casos el problema de la hipersudación palmar que presentaban los pacientes, no se obtuvo un paralelismo en los resultados del cortejo clínico acompañante, lo que confirma cierta idiosincrasia evolutiva en los pacientes con hiperhidrosis y problemas vasomotores en partes acras(AU)

Vasospastic syndromes are vascular alterations affecting the limbs, mainly the upper ones. They have a special function, that is, they are functional and have a common denominator that is produced by their symptoms due to an increase in vasoconstrictor capacity whose etiology is little known. Exposure to cold and emotional stimuli is among its precipitating factors. The examination generally shows cold fingers and lividness with hyperhidrosis among the episodes. The goals outlined in our study are exposing the pre and post therapeutic course of the main symptoms accompanying the palmar hyperhidrosis, such as hypothermia and lividness in patients with osteoporosis. In order to fulfill the objectives, a pilot study was proposed with two groups: control group of 10 patients without normal and experimental treatment and a total of 60 patients with hyperhidrosis, divided into 6 subgroups who underwent treatment with tap water iontophoresis. The results obtained suggest that although the therapy applied eliminated the problem of palmar hyperhidrosis presented by the patients in all of the cases, a parallel result was not obtained in the main accompanying symptoms, confirming some evolutionary idiosyncrasy in patients with hyperhidrosis and acral vasomotor problems(AU)

Disminución de la presión arterial en pacientes con arteriopatía periférica mediante el masaje reflejo del tejido conjuntivo / Decrease in blood pressure in patients with peripheral arterial disease by connective tissue reflex massage

Objetivos: Evaluar la eficacia del masaje reflejo del tejido conjuntivo en la presión arterial sistólica y diastólica en pacientes con enfermedad arterial periférica. Metodología: Participaron en el estudio 26 pacientes con enfermedad arterial periférica del Distrito Sanitario de Granada durante un período de intervención de 15 semanas. La muestra de estudio se dividió de forma aleatoria en grupo experimental y grupo control. Los criterios de exclusión fueron los siguientes: insuficiencia arterial periférica en estadios más avanzados, insuficiencia venosa periférica, insuficiencia cardíaca, renal o hepática. La variable independiente considerada ha sido la aplicación del masaje reflejo del tejido conjuntivo según el método de Elizabeth Dicke. Asimismo, la variable dependiente estudiada ha sido la evaluación de la presión arterial sistólica y diastólica en ambas extremidades superiores. Resultados: Se observan diferencias significativas entre la valoración basal y las valoraciones posbasales, entre los dos grupos de estudio, en la presión arterial diastólica derecha (basal, p<0,043; primera valoración, p<0,041; segunda valoración, p<0,047) y la presión arterial sistólica izquierda (basal, p<0,042; primera valoración, p<0,04; segunda valoración, p<0,049). Conclusiones: El masaje reflejo del tejido conjuntivo genera un descenso de la presión arterial en pacientes con enfermedad arterial periférica en estadio I(AU)

Aims: Evaluate the effectiveness of connective tissue reflex massage on systolic and diastolic blood pressure in patients with peripheral arterial disease. Methodology: Twenty-six patients with peripheral arterial disease from the Health District of Granada participated in the study during a 15-week intervention period. The study sample was randomly divided into an experimental group and a control group. Exclusion criteria were peripheral arterial insufficiency at more advanced stages, peripheral venous insufficiency, cardiac, renal or hepatic insufficiency. Application of the connective tissue reflex massage according to the method of Elizabeth Dicke was regarded as the independent variable. The dependent variable was evaluation of systolic and diastolic blood pressure in both upper limbs. Outcomes: Significant differences could be observed between the baseline and post-baseline evaluations between the two study groups in the right diastolic blood pressure (baseline, p<0.043; 1st evaluation, p<0.041; 2nd evaluation, p<0.047), and left systolic blood pressure (basal, p<0.042; 1st evaluation, p<0.04; 2nd evaluation, p<0.049). Conclusions: Connective tissue reflex massage causes a blood pressure decrease in patients with stage I peripheral arterial disease(AU)

[Screening of scoliosis in a school population of 8 to 12 years in the province of Granada (Spain)]. / Cribado de la escoliosis en una población escolar de 8 a 12 años de la provincia de Granada.

The scoliosis is a disease that affects the three-dimensional shape of the spine, which may occur at any stage of life but mainly arises from 10 years of age, and it is everyone's job (doctors, physiotherapists and teachers) responsible for managing the schoolchild to detect this spinal deformity. Therefore, we included a number of objectives in our study; first to detect the spinal disorder (scoliosis) in the school population from 8 to 12 years of Granada province; to establish the relationships between age groups and gender in people with scoliosis in the province of Granada; and finally to determine whether the occurrence of such changes have a greater impact on certain geographical areas in Granada province. Thus, this is a descriptive and cross-sectional study of a school population (n=2,956) in the province of Granada analyzed the positive clinical signs using the Adams Test on individuals with scoliosis. Of the 16 % (n=472) of schoolchildren who had scoliosis, 57.6 % (n=272) were male. The distribution of children from 8 to 12 years is fairly homogeneous with no differences seen (p=0.62) and highlight areas of higher incidence of scoliosis in zone 5 (Alpujarra-Valle of Lecrín). We conclude that there are no significant differences in scoliosis as regards age group (8 to 12 years), but there is an increasing trend towards the male gender. Differences can also be observed in the seven areas of study defined by work, environmental, genetic and consanguinity factors.

Cribado de la escoliosis en una población escolar de 8 a 12 años de la provincia de Granada / Screening of scoliosis in a school population of 8 to 12 yearsin the province of Granada (Spain)

La escoliosis es una enfermedad que altera la columna vertebral de forma tridimensional; puede producirse en cualquier etapa de la vida, aunque la mayoría de las veces surge a partir de los 10 años de edad. Es tarea de los estamentos encargados cuidar de los escolares (médicos, fisioterapeutas y docentes) detectar esta deformidad del raquis. Son varios los objetivos planteados en este estudio. En primer lugar, detectar la alteración raquídea (escoliosis) en la población escolar de 8 a 12 años de la provincia de Granada; en segundo, establecer las relaciones entre los grupos de edad y sexo en la población con escoliosis de la provincia de Granada y, por último, determinar si la aparición de dicha alteración tiene mayor incidencia en determinadas zonas geográficas de Granada y su provincia. Por tanto, se realiza un estudio de carácter descriptivo y transversal de la población escolar (n=2.956) de la provincia de Granada analizándose las manifestaciones clínicas positivas mediante el método del test de Adams de los individuos con escoliosis. Un 16 % (n=472) de escolares presentó escoliosis, de los cuales el 57,6 % (n=272) eran varones; la distribución de niños y niñas de 8 a 12 años es bastante homogénea y no se aprecian diferencias significativas (p=0,62). Por zonas destaca una mayor incidencia de escoliosis en la zona 5 (Alpujarra-Valle de Lecrín). Se llega a la conclusión de que en la escoliosis no se aprecian diferencias significativas en función de los grupos de edad (8 a 12 años), que existe una tendencia mayor hacia el sexo varón y que se aprecian diferencias en cuanto a las siete zonas de estudio definidas por componentes laborales, ambientales, genéticos y de consanguinidad (AU)

The scoliosis is a disease that affects the three-dimensional shape of the spine, which may occur at any stage of life but mainly arises from 10 years of age, and it is everyone's job (doctors, physiotherapists and teachers) responsible for managing the schoolchild to detect this spinal deformity. Therefore, we included a number of objectives in our study; first to detect the spinal disorder (scoliosis) in the school population from 8 to 12 years of Granada province; to establish the relationships between age groups and gender in people with scoliosis in the province of Granada; and finally to determine whether the occurrence of such changes have a greater impact on certain geographical areas in Granada province. Thus, this is a descriptive and cross-sectional study of a school population (n=2,956) in the province of Granada analyzed the positive clinical signs using the Adams Test on individuals with scoliosis. Of the 16 % (n=472) of schoolchildren who had scoliosis, 57.6 % (n=272) were male. The distribution of children from 8 to 12 years is fairly homogeneous with no differences seen (p=0.62) and highlight areas of higher incidence of scoliosis in zone 5 (Alpujarra-Valle of Lecrín). We conclude that there are no significant differences in scoliosis as regards age group (8 to 12 years), but there is an increasing trend towards the male gender. Differences can also be observed in the seven areas of study defined by work, environmental, genetic and consanguinity factors (AU)

Fisioterapia en la reconstrucción mamaria posmastectomía: a propósito de un caso / Physical therapy in postmastectomy mammary reconstruction: with regard to a case

La reconstrucción mamaria posmastectomía, se considera actualmente parte integral del tratamiento multidisciplinario del carcinoma de mama, pues contribuye a restaurar de una forma objetiva, la imagen corporal de la paciente y revierte las secuelas psicológicas negativas, ocasionadas por la mastectomía. Las técnicas reconstructivas de la mama consisten en la aplicación de una serie de técnicas quirúrgicas con posibilidades de aplicación selectiva o adyuvantes, en función de las necesidades y posibilidades de la paciente. En este trabajo se destaca las modalidades de intervención del fisioterapeuta, en las distintas etapas del proceso quirúrgico, como miembro del equipo multidisciplinar de la Asociación de Mujeres Andaluzas Mastectomizadas (AMAMA). Así mismo, se establece una valoración de los resultados mediante el Cuestionario de Calidad de Vida para Cáncer de Mama

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Rol del fisioterapéuta en las opciones quirúrgicas de reconstrucción postmastectomía / Physical therapy role in the surgical options of postmastectomy reconstruction

En la actualidad, aproximadamente el 40 % de las pacientes portadoras de cáncer de mama, son sometidas a mastectomía. En este grupo, un alto porcentaje de mujeres son menores de 65 años, con enfermedades locorregionalmente controladas y sobrevidas prolongadas, que se ven mutiladas por el tratamiento quirúrgico al que han sido sometidas. En el presente trabajo de revisión se exponen las distintas modalidades de reconstrucción quirúrgicas opcionales en cada mujer, relacionándolas no solo con los requisitos previos para su aplicación, sino también con las ventajas e inconvenientes observados tras la misma. Los beneficios del proceso reconstructivo quirúrgico, requieren la intervención del fisioterapeuta, considerándose fundamental en la obtención de los resultados esperados, no solo la especificidad de los procedimientos, sino también el ajuste a las interfases quirúrgicas

At the present time, approximately 40 % of the carrier patients of breast cancer are subjected to mastectomy. In this group, a high percentage of women are < 65 years, with diseases locally controlled and prolonged overlife, they are mutilated by the surgical treatment. In the present review work are exposed the different optional surgical modalities of reconstruction in each woman, it related not only to previous requirements for their application but also with the advantages and disadvantages observed after the same. The benefits of the surgical reconstructive process require the physiotherapy intervention, he is considered very important in the obtaining of the awaited results not only the specificity of the procedures but also the adjustment to the surgical interphases

Prevalencia del Síndrome de Burnout en Fisioterapia / Prevalence of Burnout Syndrome in Physiotherapy

El síndrome de Burnout es un tipo de estrés laboral que puede tener repercusiones psicosomáticas, conductuales, emocionales, familiares y sociales, que pueden ser motivo de bajo rendimiento laboral. El objetivo de este trabajo es conocer la prevalencia del síndrome de Burnout en los Fisioterapeutas, pertenecientes al Servicio Andaluz de Salud, que desarrollan su actividad profesional en hospitales y centros de salud de Granada (capital). Material y métodos: Se diseñó un estudio observacional transversal sobre una muestra de 46 fisioterapeutas, a los que se les administró el Maslach Burnout Inventory para medir el grado de Síndrome de Burnout. Resultados: El 37 % de los encuestados presentó un porcentaje elevado en el grado de Burnout para el cansancio emocional, el 17,40 % presentó una alta despersonalización, y un 69,50 % presentó una baja realización personal. El Síndrome de Burnout se encuentra en el 10, 87 % (n = 5) de la muestra. Conclusiones: En general, la prevalencia del síndrome de Burnout es relativamente baja, en base al siguiente criterio: elevado agotamiento emocional, baja realización personal y alta despersonalización

Burnout Syndrome refers to a kind of occupational stress that can have psychosomatic, behavioural, emotional, familial, and social repercussions; it can also cause loss of effeciancy at work. The aim of this study is to determine the prevalence of Burnout syndrome in physiotherapists, who belong to Servicio Andaluz de Salud and redeem their professional activity in hospital and health centres from Granada (city). Material and methods: A cross-sectional study was designed in a sample of 46 physiotherapists, who were given the Maslach Burnout Inventory to measure the degree of Burnout syndrome. Results: The 37 % of the staff interviewed presented a high percentage in the degree of Burnout for the emotional exhaustion, the 17.40 % presented a high depersonalization, and 69.50 % presented a low personal execution. The Burnout Syndrome is in the 10.87 % of the staff. Conclusion: In general the prevalence of Burnout syndrome is relatively low in base to following criteria elevated emotional exhaustion, low personal execution and high depersonalization

Modificaciones del índice tobillo/brazo mediante dos modalidades fisioterapéuticas: bindegewebsmassage/ cinesiterapia sublesional / Modifications ankle/braquial index by means of two physiotherapeutic modalities: bindegewebsmassage/sublesional kinesitherapy

Objetivos: Evaluar la acción del bindegewebsmassage y de un programa de cinesiterapia sublesional sobre el índice tobillo/brazo. Metodología: estudio experimental en su modalidad pretest/postest. La muestra de estudio ha estado compuesta por 40 alumnos. Los criterios de exclusión han sido los de presentar insuficiencia arterial periférica, diabetes, obesidad, hipertensión arterial y ser fumador). Las variables independientes consideradas han sido las dos modalidades de intervención (bindegewebsmassage y cinesiterapia sublesional). Asimismo, las variables dependientes estudiadas han sido: pulso tibial posterior, pulso pedio, presión sistólica en miembro superior e inferior (índice tobillo/brazo). Resultados: En el análisis de los resultados se ha realizado, previa descripción de la distribución de frecuencias, un análisis de la varianza (ANOVA). Entre las valoraciones realizadas se han observado diferencias significativas para todas las variables dependientes excepto a nivel de la presión sistólica en tobillo (p < 0,98). No existen diferencias significativas entre los efectos producidos por cada una de las modalidades terapéuticas. Conclusiones: Ambas modalidades terapéuticas aplicadas se producen modificaciones en el índice de tobillo/brazo, pulso tibial posterior y pulso pedio

Aims: To evaluate the action of bindegewebsmassage and a sublesional kinesitherapy programme on the ankle/brachial index. Methods: Experimental study on its modality pre-test/post-test. The study's sample has been composed by forty pupils. Every group of treatment has been constituted by a sample of twenty pupils from "Escuela Universitaria Ciencias de la Salud" (Granada). The exclusion criteria have been to present (peripheral arterial disease, diabetes, obesity, arterial hypertension and to be smoker). The independent considered variables have been the modalities of intervention (bindegewebsmassage and sublesional kinesitherapy). Likewise, as dependent variables have been studied: posterior tibialis pulse, pedis pulse, systolic pressure in upper and lower members (ankle/brachial index). Results: In the analysis of the results previous description of the frequency distribution has been made an analysis of variance (ANOVA). Between the valuations, significantives differences for all the dependent variables have been observed except on the systolic pressure in ankle (p < 0,98). No significant differences between the effects produced by each one of therapeutic modalities. Conclusions: Both therapeutic modalities produced modifications in the ankle/brachial index, posterior tibialis pulse and pedis pulse