Sentimentos de tristeza e desesperança em jovens portugueses / Sadness and hopelessness feelings in Portuguese youngers

Introduction: Sadness as a basic of the human being emotion. It can be associated with the intrinsic of the younger's characteristics and their context. It may manifest as discouragement, unwillingness to perform routine and social activities, low self-esteem or aloneness. Hopelessness arises when there is no sight of possibilities, confi-dence in others or future, enthusiasm for life being. That can inhibit the set goals and energy mobilization. These feelings may be signs of more complex problems, such as depressive disorders when associated with loss of interest or pleasure, changes in appetite, sleep and concentration and suicidal ideation thoughts. Aims: To identify the sadness and hopelessness feelings perceived by the younger ́s and the associations between these feelings and demographic, educational and family characteristics. Method: Descriptive correlational study with 1377 Portuguese younger ́s, which go into high school, aged 14-21 years, average age 17 years and mostly female. Was used the survey "Comportamentos de saúde, comportamentos de risco e envolvimento dos jovens com a escola e a família". Results: Sadness and hopelessness were not noticed by most younger ́s. However, there is a higher risk in younger's with negative school performance, who relate good relationship with colleagues, have never felt threatened by their colleagues, when they become involved with school and family and even if they are perceived the family as functional. Conclusions: Health professionals should identify early, value feelings of sadness and hopelessness in younger ́s and have a transdisciplinary and inclusive practice in health education, in school and family contexts

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Health-related quality of life amongst primary caregivers of children with intellectual disability.

BACKGROUND: Children with intellectual disability (ID) frequently have significant educational, social and health care needs, resulting in caregivers often experiencing a wide range of negative effects. This paper aims to determine the impact of childhood ID on caregivers' health-related quality of life (HRQoL) across co-morbid diagnostic groups. The second aim of this study is to determine the risk factors associated with lower HRQoL in this population. METHODS: Caregivers of a child with ID aged between 2 and 12 years old completed an online survey to determine their HRQoL using the EQ-5D-5L measure. They were also asked demographic questions and about their dependent child's level of behavioural and emotional difficulties. RESULTS: Of the total sample of 634 caregivers, 604 caregivers completed all five questions of the EQ-5D-5L. The mean age of caregivers was 39.1 years and 91% were women. Caregivers spent on average 66.6 h per week caring for their child related to their child's disability. The mean EQ-5D-5L score of caregivers was 0.80 (95% confidence interval: 0.79, 0.82), which is below the estimated Australian population norms (mean utility score of 0.92) for the age-equivalent population. Caregivers of children with autism spectrum disorders reported the lowest HRQoL (0.77, 95% confidence interval: 0.74, 0.79) of the five included co-morbid diagnostic groups. Caregivers with a lower income, a perceived low level of social support and children with higher degree of behavioural and emotional problems were likely to have a statistically lower HRQoL. CONCLUSIONS: This is the first study to produce utility values for caregivers of children with ID. The utility values can be used to compare health states and can be used to inform comparative cost-effectiveness analyses. Demonstrating that caregivers of children with ID have reduced HRQoL and that this is associated with the degree of behavioural and emotional problems has important policy implications, highlighting the potential for policy interventions that target behavioural and emotional problems to improve outcomes for caregivers.

Alteraciones emocionales en niños víctimas de desastres naturales / Emotional disorders in children victims of natural disasters

Los efectos de los desastres sobre la salud física suelen ser bastante conocidos, con secuelas a corto, medio y largo plazo. En cambio, no siempre se han reconocido de igual manera los efectos sobre la salud mental, a pesar de haberse demostrado que, en situaciones de desastre o catástrofe se produce un incremento de los signos de sufrimiento psicológico y aumenta en cierta medida la morbilidad psiquiátrica y otros problemas sociales. Se estima que entre una tercera parte y la mitad de la población expuesta sufre alguna manifestación psicológica. Se ha pensado erróneamente que los niños y los adolescentes no sufren con la misma intensidad las consecuencias de situaciones especialmente traumáticas. De hecho, se presumía que, dadas sus reacciones tan diferentes a las de los adultos, tenían una cierta protección. En la actualidad esto se ha desmentido y los menores se consideran un grupo de alto riesgo en casos de desastres y emergencias. Algunas investigaciones realizadas demuestran que, en niños y adolescentes, las secuelas psicológicas suelen ser frecuentes y afectar de manera directa al desarrollo físico, mental y social. La enfermera de Atención Primaria correspondiente deberá tratar estas secuelas y, en ocasiones, dependiendo de su gravedad y persistencia (mayor de 3 meses), se realizará una derivación a un profesional de la salud mental, teniendo en cuenta una serie de recomendaciones y criterios de valoración. Los padres o tutores, junto con los profesionales sanitarios, desempeñan un papel muy importante en la recuperación de sus hijos, ya que las reacciones de los niños van a estar muy influenciadas por las de estos. En los últimos años, ha aumentado el interés por el impacto de los desastres en la salud mental de las poblaciones afectadas y actualmente se ha hecho evidente la necesidad de un abordaje integral, que trascienda la atención a la enfermedad y la reparación de los daños materiales (AU)

The effects of disasters on physical health tend to be well-known, with short, medium and long term sequelae. On the other hand, not always is have recognized in the same way the effects on mental health, despite having shown that, in situations of disaster or catastrophe there is a psychological signs of suffering increase and increases to a certain extent the psychiatric morbidity and other problem social. It is estimated that between a third and half of the exposed population, it suffers from some psychological manifestation. It has been erroneously thought that children and adolescents, not suffering with the same intensity of especially traumatic situations. In fact it was presumed, given their reactions so different from that of adults, had some protection. Currently, this has denied and minors are considered to be a group of high risk in cases of disasters and emergencies. Investigations carried out, demonstrate that in children and adolescents, the psychological sequels tend to be frequent and affect directly to the physical, mental and social development. Natural disasters are unexpected situations that will produce a serie of emotional reactions of diverse severity in their survivors, especially children, one of the most vulnerable groups due to a less understanding of what happened and difficulty expressing what they feel, having a personality still developing, and so directly affecting their physical, mental and social development. Therefore suffering the emotional scars, they will take longer to resolve and have a lifetime to live with them. These consequences should be treated by a corresponding community nurse and sometimes, depending on the severity and persistence (more than 3 months), a referral will be made to a qualified mental health professional, taking into account a number of recommendation and assesment canons. Parents or tutors with health professionals have an important role in the recovery of their children and their reactions will be very influenced by these firts. In recent years the interest has increased by the impact of the disaster on the mental health of affected populations and currently has become evident the need for a comprehensive approach that transcends disease care and repair of material damage (AU)

Alexithymia: Should This Personality Disorder Be Considered During Treatment of Patients With Mental Illness?

Alexithymia is characterized by impairment of an individual's ability to experience, identify, and express emotions, and is associated with impaired emotional intelligence and an externally oriented cognitive style. There has been increasing interest in the phenomenon, with numerous peer-reviewed articles published recently. Alexithymia may occur in patients with many psychiatric disorders, and more severe alexithymia is related to worse outcome. However, many clinicians remain unaware of the issue. The current article discusses alexithymia and its importance in the field of mental health.

Prevalencia de ansiedad y depresión en pacientes de hemodiálisis / Prevalence of anxiety and depression in hemodialysis patients

Introducción: Los pacientes en hemodiálisis tienen síntomas y trastornos emocionales como ansiedad y depresión. Son pocos los estudios que valoren el diagnóstico mediante la Hospital Anxiety and Depression Scale (HADS); nuestro objetivo es conocer la prevalencia de la ansiedad y depresión en pacientes con enfermedad renal crónica en programa de hemodiálisis. Metodología: Estudio transversal durante el primer trimestre del 2012. Realizado en el servicio de hemodiálisis del hospital de Palamós. Se incluyeron pacientes en programa crónico de hemodiálisis que llevaban como mínimo un mes. Se registró la edad, sexo, talla, peso, índice de masa corporal, índice de Charlson, tiempo en hemodiálisis y número de fármacos. Se utilizó la escala HADS (versión española de Caro-Ibáñez). Resultados: Se analizaron 49 pacientes, 25% fueron mujeres, la edad media 67,2 años, I. Charlson 4,6 (DE:4,5), tiempo en HD 39,9 meses (DE:43,8), IMC 26,9 (DE:4,5), turno de mañana 52,9 % y tarde 50,9 %. La sintomatología depresiva representa 42,9% (IC95% 33,7%-60,6%) y la ansiosa 32,7 % (IC95% 21,2%-46,6%) según la escala HADS. La ansiedad presenta relación estadísticamente significativa con el índice de masas corporal inferior y sexo femenino, la depresión con una edad más elevada, índice de masa corporal inferior y el turno de la mañana. Conclusiones: Existe una alta prevalencia de ansiedad y depresión en pacientes con enfermedad renal crónica en hemodiálisis. Un índice de masa corporal bajo se relaciona con la ansiedad y depresión, la mayor edad con la depresión y la ansiedad es más frecuente en mujeres. Nuestro estudio sugiere que es necesario un mayor control, seguimiento y tratamiento de las alteraciones emocionales en pacientes con enfermedad renal crónica (AU)

Introduction: Hemodialysis patients have symptoms and emotional disorders such as anxiety and depression. There are few studies that evaluate diagnosis using the Hospital Anxiety and Depression Scale (HADS); our aim is to determine the prevalence of anxiety and depression in patients with chronic kidney disease on hemodialysis. Methods: Cross-sectional study during the first quarter of 2012 was carried out. It was conducted in the hemodialysis service of the Palamós Hospital. Patients on chronic hemodialysis with a dialysis vintage at least than a month were included. Age, sex, height, weight, body mass index, Charlson index, time on hemodialysis and number of drugs were recorded. HADS (Spanish version of Caro-Ibanez) scale was used. Results: 49 patients were analyzed, 25% being women. The mean age was 67.2 years, the average Charlson index was 4.6 (SD: 4.5), a dialysis vintage of 39.9 months (SD: 43.8) and an average BMI of 26.9 (SD: 4.5). The patients in the morning shift were 52.9% and in the evening shift were 50.9%. Depressive symptomatology was represented in 42.9% (95% CI 33.7% -60.6%) and anxiety symptoms in 32.7% (95% CI 21.2% -46.6%) according to HADS scale. The anxiety has significant association with lower body mass index and female, while depression is significantly associated with higher age, lower body mass index and the morning shift. Conclusion: There is a high prevalence of anxiety and depression in patients with chronic kidney disease on hemodialysis. A low body mass index is associated with anxiety and depression, older age with depression, and anxiety is more common in women. Our study suggests that greater control, monitoring and treatment of emotional disorders in patients with chronic kidney disease are necessary (AU)

Papel de las enfermeras en reproducción asistida: dimensión emocional / The role of nurses in Assisted Reproduction: the emotional dimensión

OBJETIVO: analizar y actualizar el papel que llevan a cabo las enfermeras en el ámbito de la reproducción humana asistida desde la perspectiva psicosocial. MÉTODO: revisión narrativa mediante búsqueda bibliográfica en las bases de datos PubMed, Cuiden, Red SciELO, Cochrane Plus y Cinahl, con lenguaje libre y controlado (términos MeSH), utilizándolos operadores booleanos y, en algunos casos, el truncado. La búsqueda se limitó a artículos publicados entre 2004 y 2014. Se seleccionaron 10 artículos en total, en función de los criterios de inclusión y exclusión establecidos. RESULTADOS: se identificaron cinco categorías de análisis: el apoyo emocional, la labor educativa y la formación, la continuidad de los cuidados, la relación enfermera-paciente y el trabajo en equipo. Las enfermeras llevan a cabo un rol múltiple, proporcionando cuidados holísticos a las mujeres y parejas que reciben técnicas de reproducción asistida (TRA), siendo un proceso notablemente costoso en el ámbito emocional. CONCLUSIONES: las enfermeras se presentan como unas profesionales imprescindibles en las Unidades de Reproducción Asistida(URA) para proporcionar una asistencia sanitaria de calidad. Es necesario aplicar los últimos avances a la práctica clínica, fomentarla utilización de la metodología enfermera y promover la labor investigadora en esta temática

OBJECTIVE: to review and update the role performed by nurses in the setting of Human Assisted Reproduction from a psychosocial perspective. METHOD: a narrative review through bibliographic search in the following databases: PubMed, Cuiden, Red SciELO, Cochrane Plus and Cinahl, with free and controlled language (MeSH terms),using boolean operators, and truncation in some cases. The search was limited to articles published between 2004 and2014. Ten articles were selected in total, based on the established inclusion and exclusion criteria. RESULTS: five categories were identified for review: emotional support, educational activities and training, continuity of care, nurse-patient relationship, and team work. Nurses conduct a multiple role, providing holistic care to those women and couples who receive Assisted Reproduction Techniques (ARTs), which represents a significantly difficult process in the emotional setting. CONCLUSIONS: nurses appear as indispensable professionals in the Assisted Reproduction Units (ARUs), in order to provide high quality healthcare. It is necessary to implement the latest advances in clinical practice, to encourage the use of nursing methodology, and to promote research work within this subject

An application of Bowen family systems theory.

While nurse practitioners initially work with the identified patient, Murray Bowen maintains it is the reciprocal functioning of all the members of the family which contributes to the emotional intensity of the patient. The emotional symptoms of an individual are an expression of the emotional symptoms of the family, which are often embedded in patterns of behaviors from past generations. The purpose of this paper is to facilitate understanding Bowen's theoretical concepts of family systems theory and apply these concepts to a family in therapy.

Awaiting diagnosis of breast cancer: strategies of enduring for preserving self.

PURPOSE/OBJECTIVES: To explicate the emotional experiences of women undergoing breast cancer diagnosis who are waiting for the results of breast biopsy. RESEARCH APPROACH: Glaserian Grounded Theory. SETTING: Urban area in western Canada. PARTICIPANTS: 37 women aged 32-76 years. The breast cancer diagnosis was positive for 11 women, negative for 24 women, and two results were unclear. METHODOLOGIC APPROACH: Unstructured, recorded telephone interviews. FINDINGS: Undergoing breast cancer diagnosis is a profoundly distressing experience dictated by diagnostic processes and procedures. Women rapidly transitioned from wellness to frightening phases of facing cancer to continuing terror during the testing phase. While waiting to hear results, women controlled their emotions, which enabled them to get through the experience and highlighted the protective function of enduring and its necessity for survival. The basic social psychological process, preserving self, is the outcome of enduring. CONCLUSIONS: A mid-range theory, Awaiting Diagnosis: Enduring for Preserving Self, was developed. This theory explicates the emotional responses of women who were undergoing diagnosis for breast cancer and provides a theoretical behavioral basis for responding to cues and signals of suffering. INTERPRETATION: The Praxis Theory of Suffering enables nurses to recognize and respond according to the behaviors of suffering, and to endure with healthy, adaptive, and normalizing behaviors that enable preserving self.

A randomized trial comparing two low-intensity psychological interventions for distressed patients with cancer and their caregivers.

PURPOSE/OBJECTIVES: To compare the effectiveness of two low-intensity approaches for distressed patients with cancer and caregivers who had called cancer helplines seeking support. Baseline distress was hypothesized as a moderator of intervention effect. DESIGN: Randomized trial. SETTING: Community-based cancer helplines in Queensland and New South Wales, Australia. SAMPLE: 354 patients with cancer and 336 caregivers. METHODS: Participants were randomized to either a single session of nurse-led self-management intervention or a five-session psychologist cognitive behavioral intervention delivered by telephone. Assessments were undertaken at baseline (preintervention) and at 3, 6, and 12 months. MAIN RESEARCH VARIABLES: Psychological and cancer-specific distress and post-traumatic growth. FINDINGS: No significant moderation by baseline cancer-specific distress was noted. For low-education patients, only the psychologist intervention was associated with a significant drop in distress. For all other participants, distress decreased over time in both arms with small to large effect sizes (Cohen's ds = 0.05-0.82). Post-traumatic growth increased over time for all participants (Cohen's ds = 0.6-0.64). CONCLUSIONS: Many distressed patients with cancer and their caregivers may benefit significantly from a single session of a nurse psychoeducation intervention that can be delivered remotely by telephone and supported by self-management materials. Research is needed to develop an algorithm that moves beyond the use of distress as the only indicator for referral to specialist psychological services. Survivors and caregivers with low education and low literacy may require more in-depth and targeted support. IMPLICATIONS FOR NURSING: Brief nurse psychoeducation and stress management for cancer survivors and caregivers should be considered as part of a tiered approach to psychosocial care.

[Pathological gambling and addiction to cannabis: common psychosocial profile?]. / Jeu pathologique et addiction au cannabis profil psychosocial commun?

Addiction can involve substances (heroin, cannabis, cocaine) or be characterised by behaviour (pathological gambling, addiction to sport, etc.). The question is to establish whether or not there is a specific personality profile (character, temperament) and emotional functioning (anxiety, depression, alexithymia) in subjects presenting addictive behaviour with and without substance use. To find some answers, a team from Sainte-Marguerite General Hospital in Marseille carried out a study comparing a group of cannabis addicts and a group of pathological gamblers.

Entre el deseo, el derecho y el miedo a ser madre tras seropositividad del HIV / Entre o desejo, direito e medo de ser mãe após soropositividade para o HIV / Between desire, duty and fear of being a mother after HIV seropositivity

Objetivo: Comprender las representaciones sociales de las mujeres que conocen su condición de VIH positivo en relación con la maternidad. Método: Estudio exploratorio, descriptivo, con abordaje cualitativo. Utilizamos formulario socioeconómico y entrevista abierta en profundidad para la recolección de datos y análisis de contenido para establecer categorías temáticas. El estudio fue aprobado por el Comité de Ética de la Universidad Federal de Minas Gerais (057/03). Resultados: El material fue clasificado y agrupado en tres categorías temáticas: la primera, "El deseo", la segunda "El derecho", y el último, "El miedo". Conclusiones: El período de gestación está marcado por sentimientos ambivalentes de felicidad, debido a la alegría única de la maternidad, y por el miedo, debido a la posibilidad de transmisión vertical. Se podría decir que el significado del embarazo para estas mujeres gira en torno a los elementos relacionados con el deseo, el derecho y las representaciones sociales sobre el embarazo y el SIDA (AU)

Objetivo: conhecer as representações sociais de mulheres conhecedores de seu status positivo para o HIV em relação a maternidade. Método: estudo exploratório, descritivo com abordagem qualitativa. Utilizou-se formulário sócio econômico e entrevista aberta em profundidade para a coleta de dados e análise de conteúdo para estabelecimento de categorias temáticas. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais (057/03). Resultados: o material foi classificado e agrupado em três categorias temáticas: a primeira, "O Desejo"; a segundo, "O Direito" e a última, "O Medo". Conclusões: o período gestacional é marcado por sentimentos ambivalentes de felicidade, por se configurar na alegria ímpar da maternidade, e medo, em razão da possibilidade da transmissão vertical. Pode-se dizer que o significado da gestação, para estas mulheres, gira em torno de elementos referentes ao desejo, ao direito e às representações sociais sobre a gravidez e a Aids

Objective: to understand the social representations of women who know their HIV positive status in relation to motherhood. Method: exploratory, descriptive study with a qualitative approach. We used socioeconomic and form open at depth interview for data collection and content analysis to establish thematic categories. The study was approved by the Ethics Committee of the Universidade Federal de Minas Gerais (057/03). Results: the material was classified and grouped into three thematic categories: the first, "The Desire", the second "The Law" and the last, "The Fear". Conclusions: the gestational period is marked by ambivalent feelings of happiness, is set in the unique joy of motherhood, and fear, because of the possibility of vertical transmission. You could say that the meaning of pregnancy for these women, revolves around elements related to the desire, and the right to social representations about pregnancy and AIDS (AU)

The role of perceived helpfulness in predicting subjective unmet need and the frequency of health care use.

OBJECTIVES: We scrutinize the health care use of divorcees, in order to explain why users of mental health care have a higher risk of perceiving an unmet need. We hypothesize that a perception of low helpfulness of received care heightens the risk of perceiving an unmet need and becoming a less frequent health care user. METHODS: Three subsamples from the Divorce in Flanders survey are selected: those who contacted a general practitioner (n=816), a psychiatrist (n=205), or a psychologist (n=251) because of social or emotional problems. Logistic regressions are used in order to explore the correlates of subjective unmet need and the frequency of contact with a health care provider among each subsample. RESULTS: show that patients who perceived that care was not helpful more often reported an unmet need and made less frequent use of health care. CONCLUSIONS: These findings suggest that people are less inclined to seek further help when they perceive previous help as being ineffective.

A recovery-oriented alternative to hospital emergency departments for persons in emotional distress: "the living room".

Persons with severe mental illness experience episodic crises, resulting in frequent visits to hospital emergency departments (EDs). EDs, however, are not the most effective treatment environments for these individuals who might better be served elsewhere in an environment based on recovery-oriented framework. The purpose of this study is to describe the lived experience of guests (persons in emotional distress) and staff (counselors, psychiatric nurses, and peer counselors) of a community, recovery-oriented, alternative crisis intervention environment-The Living Room (TLR). The total sample is comprised of 18 participants. An existential phenomenological approach was used for this qualitative, descriptive, study. Through non-directive in-depth interviews, participants were asked to describe what stands out to them about The Living Room. Interviews were audio-recorded, transcribed verbatim, and systematically analyzed using descriptive phenomenological methods of analysis by an interdisciplinary and community-based participatory research team. Participants' experiences in hospital EDs and inpatient psychiatric units contextualized the phenomenological experience of TLR environment. The final thematic structure of the experience of TLR included the following predominant themes: A Safe Harbor, At Home with Uncomfortable Feelings, and It's a Helping, No Judging Zone. Findings from this qualitative study of a recovery-based alternative to hospital EDs for persons in emotional distress are supported by anecdotal and empirical evidence that suggests that non-clinical care settings are perceived as helpful and positive.

La muerte y el proceso de morir: sentimientos manifestados por los enfermeros / Death and the dying process: feelings expressed by nurses

El estudio pretende conocer los sentimientos experimentados por los enfermeros frente a la muerte y el proceso de morir. Investigación cualitativa, realizada con siete enfermeros de una UCI de un hospital en Montes Claros, Minas Gerais. Se utilizó entrevista no estructurada para la recolección de datos, que se analizaron mediante la técnica de análisis de contenido. La confrontación de los encuestados frente a la muerte está impregnada de sentimientos tales como: impotencia, angustia, sufrimiento, miedo, que interfieron en la asistencia prestada al enfermo y a su familia. Por otro lado, a pesar de la vivencia constante con la muerte, las enfermeras aún se sensibilizan con el proceso de muerte (AU)

The study aimed to know the feelings experienced by nurses in the face of death and dying process. Qualitative research, conducted with seven nurses of a UTI from a hospital in Montes Claros, Minas Gerais. Unstructured interview was used for data collection, which were analysed using the technique of content analysis. The confrontation of respondents in the face of death is permeated by feelings such as: impotence, distress, suffering, fear, which interfered in the assistance provided to the patient and his family. On the other hand, despite the constant experience with death, the nurses still raise with the process of death (AU)

Experiencias y sentimientos vividos durante una gestación de alto riesgo: un estudio documental 2005-2011 / Experiences and feelings endured during a high-risk pregnancy: a documental study 2005-2011

Objetivo: Acercase a las experiencias vividas por las mujeres frente a una gestación de alto riesgo, reportadas en la literatura científica durante el período de 2005 a 2011. Materiales y métodos: Estudio documental de corte cualitativo. Las unidades de análisis fueron los artículos científicos de todas las nacionalidades en idioma español, inglés y portugués en el período 2005-2011. Los datos se trataron mediante el análisis de contenido. Resultados: La búsqueda bibliográfica dio como resultado veinte artículos que respondían al objetivo del estudio. Todos tenían un enfoque cualitativo, 14 de ellos fueron trabajos realizados en el mundo en desarrollo y el año de mayor publicación fue 2010. Del análisis emergieron dos grandes temas: las experiencias de las mujeres frente a un embarazo de alto riesgo producto de una condición patológica y las que fueron producto de una gestación en una edad reproductiva temprana o tardía. Conclusiones: Se resalta el papel que juegan las redes de apoyo para las gestantes: la familia, otras mujeres en igual condición y los profesionales de la salud; las dificultades durante la hospitalización y el manejo de un lenguaje cargado de tecnicismos por parte de los profesionales. El cuidado de enfermería debe encaminarse a reforzar las redes de apoyo y procurar mejores ambientes de hospitalización. Las experiencias de las gestantes conviviendo con VIH y de las mujeres que tienen un embarazo después de los 35 años, son necesidades aún pendientes por la investigación. El enfoque cualitativo es válido para el abordaje de este tema(AU)

Objective: To explore the experiences endured by women while in a high-risk pregnancy, reported in the scientific literature during 2005-2011. Methods: Qualitative documental study. Analysis units were the scientific papers published worldwide in Spanish, English and Portuguese during 2005 to 2011. Data were treated by contents analysis. Results: Bibliographic search rendered twenty papers dealing with the study objective. All of them had qualitative focus, fourteen of them were papers published in the so-called underdeveloped world; most frequent publication occurred around 2010. From the analysis emerged two main topics: the women´s experiences while in a high-risk pregnancy from a pathologic condition, and those product of a pregnancy in early or late reproductive age. Conclusion: The role of the pregnant support networks is underlined: family, other women sharing their condition and health professionals; also were of note the difficulties during hospitalization and the technical jargon used by those professionals. Nursing care should focus to reinforce the networks and to procure better environment for the inpatients. The experiences endured by pregnant women living with HIV or by those women older than 35-year are still matter of pending research based upon qualitative focus(AU)

Management of borderline personality disorder.

This article gives an overview of personality disorders, with a focus on borderline personality disorder. It also describes the setting up of a trust-wide service to treat people with BPD, led by mental health workers and using guided formulation. The role of guided formulation in the management of BPD is explored. It is suggested that this form of treatment can greatly improve outcomes for patients.

Psychologic and biologic factors associated with fatigue in patients with persistent radiculopathy.

Fatigue is a common symptom associated with neuropathic pain (NP) and can have negative consequences on psychosocial functioning, physical endurance, and quality of life. Recent evidence indicates that immune activation modulated through the increased release of proinflammatory cytokines can predict fatigue in some patient populations. Although earlier studies have shown that immune activation is a pathophysiologic feature of NP, there have been no studies to examine the relationship between immune activation and fatigue in persons with NP. Therefore, the purpose of this exploratory study was to: 1) determine the relationships among fatigue, pain, psychosocial factors, and selected biologic markers of immune activation (interleukin [IL] 6 and soluble IL-6 receptor [sIL-6R]) in participants with persistent radiculopathy; and 2) determine the differences in these variables based on fatigue severity. Participants (n = 80) were classified according to their level of fatigue as low (27.5%), moderate (32.5%), or high (40%), and significant differences were found between fatigue categories (p = .001). Multivariate analyses of variance revealed that individuals with moderate to high levels of fatigue differed from those with the lowest levels of fatigue in psychologic distress, depressive symptoms, IL-6, and sIL-6R, whereas the differences between moderate and high levels of fatigue were significant for psychologic distress and sIL-6R only. The findings suggest that immune activation affects fatigue severity and possibly other behavioral responses, offering important information when providing care to patients with persistent radiculopathy. The integration of biobehavioral nursing interventions in pain management may have a greater impact on quality of life than treatment focused only on pain.