Prediction of the Impact of CYP2C19 Polymorphism on Drug-Drug Interaction between Voriconazole and Tacrolimus Using Physiologically-Based Pharmacokinetic Modelling

Abstract Voriconazole increases tacrolimus blood concentration significantly when coadministrated. The recommendation of reducing tacrolimus to 1/3 in voriconazole package insert seems not to be satisfactory in clinical practice. In vitro studies demonstrated that the magnitude of inhibition depends on the concentration of voriconazole, while voriconazole exposure is determined by the genotype status of CYP2C19. CYP2C19 gene polymorphism challenges the management of drug-drug interactions(DDIs) between voriconazole and tacrolimus. This work aimed to predict the impact of CYP2C19 polymorphism on the DDIs by using physiologically based pharmacokinetics (PBPK) models. The precision of the developed voriconazole and tacrolimus models was reasonable by evaluating the pharmacokinetic parameters fold error, such as AUC0-24, Cmax and tmax. Voriconazole increased tacrolimus concentration immediately in all population. The simulated duration of DDIs disappearance after voriconazole withdrawal were 146h, 90h and 66h in poor metabolizers (PMs), intermediate metabolizers (IMs) and extensive metabolizers(EMs), respectively. The developed and optimized PBPK models in this study can be applied to assit the dose adjustment for tacrolimus with and without voriconazole.

The role of Magnetic Resonance Images (MRIs) in coping for patients with brain tumours and their parents: a qualitative study.

BACKGROUND: When children and young people (CYP) are diagnosed with a brain tumour, Magnetic Resonance Imaging (MRI) is key to the clinical management of this condition. This can produce hundreds, and often thousands, of Magnetic Resonance Images (MRIs). METHODS: Semi-structured interviews were undertaken with 14 families (15 parents and 8 patients), and analysed using Grounded Theory. Analysis was supported by the Framework Method. RESULTS: Although the focus of the research was whether paediatric patients and their families find viewing MRIs beneficial, all patients and parents discussed difficult times during the illness and using various strategies to cope. This article explores the identified coping strategies that involved MRIs, and the role that MRIs can play in coping. Coping strategies were classified under the aim of the strategy when used: 'Normalising'; 'Maintaining hope and a sense of the future'; 'Dealing with an uncertain future'; and 'Seeking Support'. CONCLUSIONS: Coping and finding ways to cope are clearly used by patients and their families and are something that they wish to discuss, as they were raised in conversations that were not necessarily about coping. This suggests clinicians should always allow time and space (in appointments, consultations, or impromptu conversations on the ward) for patient families to discuss ways of coping. MRIs were found to be used in various ways: to maintain or adapt normal; maintain hope and a sense of the future; deal with an uncertain future; and seek support from others. Clinicians should recognise the potential for MRIs to aid coping and if appropriate, suggest that families take copies of scans (MRIs) home. Professional coaches or counsellors may also find MRIs beneficial as a way to remind families that the child is in a more stable or 'better' place than they have been previously.

Subjective and objective demands on different types of differential stress inventory.

PURPOSE: To validate the differential stress inventory (DSI) by evaluating the objective and subjective stress differences in the five DSI types in the occupational setting. METHODS: A total of 119 German participants working as medical assistants (n = 40) or in a bank (n = 79) were recruited. They completed the Maslach Burnout Inventory-General Survey, the DSI, and wore ECG measuring devices for 24 h to measure heart rate variability. The DSI was used to group people into one of five types according to how they perceived and coped with stress: normal, overstressed, stress-resistant, low stress/high coping, or high stress/high coping. RESULTS: The overstressed type had significantly more burnout symptoms than the other types. The high stress/high coping type also had more symptoms of emotional exhaustion and total burnout compared to the other types, while the low stress/high coping and the stress-resistant types generally had the lowest levels of burnout. There were no differences on the HRV parameters among the DSI types. CONCLUSION: Categorising people into types like in the DSI can help make workers aware of unhealthy stress and coping patterns before they turn into more severe pathology. Proper application and targeted preventive measures can save the individual's health and the company's budget. While the DSI picked up on differences in burnout symptoms as a long-term consequence of stress, there is evidence that it cannot pick up on short-term stress or physical stress as measured by HRV from the 24 h recording.

Estrés en graduados y técnicos en cuidados auxiliares de enfermería en las áreas quirúrgicas hospitalarias / Stress in nursing graduates and healthcare assistants in surgical areas of hospital

OBJETIVOS: Analizar el nivel de estrés que presentan los Graduados de Enfermería y los Técnicos en Cuidados Auxiliares de Enfermería en las áreas quirúrgicas de los Hospitales Públicos de Gran Canaria. MATERIAL Y MÉTODO: Estudio cuantitativo, descriptivo/observacional de prevalencia transversal, de 143 sujetos (Grado de Enfermería y Técnicos en Cuidados Auxiliares de Enfermería, en adelante T.C.A.E.), en Hospital Universitario de Gran Canaria Doctor Negrín, en adelante H.U.G.C. Dr. Negrín, y Complejo Hospitalario Universitario Insular-Materno Infantil de Canarias, en adelante C.H.U. Insular-Materno Infantil de Canarias, en los servicios de Quirófano, Unidad de Reanimación y Cuidados Críticos (R.E.A.), Unidad de Recuperación Post-anestésica (U.R.P.A.) y Cirugía Mayor Ambulatoria (C.M.A.), durante los años 2016-2019. Mediante una encuesta autocumplimentada de carácter anónimo y voluntario formado por la Escala de estrés percibido (PSS) de Cohen, S., Kamarck, T., y Mermelstein, R. Dispuesta en 14 ítems, además se realizó un cuestionario de 19 ítems de carácter demográfico y sociolaboral, efectuándose cruce de variables dependientes e independientes. RESULTADOS: Presentan un nivel de estrés con una mediana de 22%. La media es 21.79, la desviación típica 7.26, el percentil 25 da como resultado 17%, el percentil 50 es 22% y el percentil 75 es 39%. La fiabilidad total da como resultado 0.86 en el Alfa de Cronbach. CONCLUSIONES: Los trabajadores TCAE y Graduados de Enfermería, de las unidades mencionadas presentan un nivel moderado de estrés, pero las instituciones deberían intervenir para minimizarlo lo máximo posible

OBJECTIVES: To analyse the stress level in Nursing Graduates and Healthcare Assistants in surgical areas of the Public Hospitals in Gran Canaria. MATERIAL AND METHODS: Quantitative, descriptive/observational study of cross-sectional prevalence in 143 subjects (Nursing Degree and Healthcare Assistant, henceforth (H.C.A.), in the University Hospital of Gran Canaria Doctor Negrín, henceforth U.H.G.C. Dr. Negrín and Complejo Hospitalario Universitario Insular-Materno Infantil de Canarias(Children and maternity care hospital of the Canary Islands), henceforth the C.H.U. Insular-Materno Infantil de Canarias, in the surgery services/operating rooms, Trauma Resuscitation Unit (TRU) , Post-Anesthesia Care Unit (P.A.C.U.), and Major Outpatient Surgery (M.O.S.), from 2016 to 2019. By means of an anonymous and voluntary self-completion survey based on the Perceived Stress Scale (PSS) from Cohen, S., Kamarck, T., and Mermelstein, R. It was distributed in 14 items, a questionnaire of 19 demographic and socio-labour items was also carried out, applying a cross-sectional design of dependent and independent variables. RESULTS: They show a stress level with a median of 22%. The mean is 21.79, the standard deviation is 7.26, the 25th percentile results in 17%, the 50th percentile is 22% and the 75th percentile is 39%. Total reliability is 0.86 using Cronbach's Alpha. CONCLUSIONS: H.C.A. workers and Nursing Graduates from the aforementioned units show a moderate level of stress, but institutions should intervene to minimize it as much as possible

Intervenciones de enfermería promotoras de la adaptación del niño / joven / familia a la hospitalización: una scoping review / Intervenções de enfermagem promotoras da adaptação da criança / jovem / família à hospitalização: uma scoping review / Nursing interventions promoting child /youth /family adaptation to hospitalization: a scoping review

OBJETIVO: Identificar el proceso de adaptación del niño y la familia a la hospitalización y mapear las intervenciones de enfermería que promueven la adaptación a la hospitalización del niño/joven/familia. MÉTODO: Elaboración de Scoping Review basado en Joanna Briggs Institute (2014). Criterios de inclusión para Población: Niño, Joven (0-18 años) y Familia; Concepto: Intervenciones promotoras hacia la adaptación y Contexto: Hospitalización. Los estudios considerados fueron estudios cuantitativos, cualitativos y revisiones sistemáticas. Búsqueda de artículos en tres bases de datos electrónicas - PUBMED, MEDLINE y CINAHL. Criterio de selección: datados entre 2012 y 2019 y en régimen full text. Idiomas: inglés y portugués. RESULTADOS: Se analizaron un total de 14 artículos, destacando que el diseño del estudio incluye 2 revisiones sistemáticas de la literatura, 7 estudios cualitativos y 5 cuantitativos. Los resultados del análisis se organizaron por temas: adaptación del niño a la hospitalización, adaptación de los padres y estrategias que promueven la adaptación a la hospitalización. Las intervenciones dirigidas a los niños se centran en el fortalecimiento de los mecanismos para hacer frente a los problemas y en el aumento de la seguridad, y se han clasificado en estrategias de comunicación; actividades recreativas y de relajación; promoción de la esperanza y estrategias de coping. CONCLUSIÓN: Las intervenciones de enfermería promotoras de la adaptación a la hospitalización mapeadas pretenden disminuir la ansiedad y el estrés del niño / familia, aumentando la capacidad para recibir información, participar en el cuidado y en las decisiones. Se destacan el juego terapéutico, informaciones anticipatorias, técnicas de relajación, distracción, humor, musicoterapia, kits de adaptación, grupos terapéuticos y estrategias promotoras de esperanza

OBJETIVO: Identificar o processo de adaptação da criança e família à hospitalização e mapear as intervenções de enfermagem promotoras da adaptação à hospitalização da criança/jovem/família. MÉTODO: Elaboração de uma Scoping Review com base no Joanna Briggs Institute (2014). Critérios de inclusão - População: Criança, Jovem (0-18 anos); Conceito: Intervenções promotoras da adaptação e Contexto: Hospitalização. Os estudos considerados foram estudos quantitativos, qualitativos e revisões sistemáticas. Pesquisa de artigos em três bases de dados eletrónicas - PUBMED, MEDLINE e CINAHL. Critério de selecção: datados entre 2012 e 2019 e em regime full text. Línguas de inclusão: Português e Inglês. RESULTADOS: Foram analisados 14 artigos, salientando-se que o desenho de estudo incluem 2 revisões sistemáticas da literatura, 7 estudos qualitativos e 5 quantitativos. Os resultados da análise foram organizados por temas: adaptação da criança à hospitalização, adaptação dos pais à hospitalização e estratégias promotoras de adaptação à hospitalização. As intervenções dirigidas à criança centram-se no fortalecimento dos mecanismos de enfrentamento e no aumento da segurança, tendo estas sido categorizadas em estratégias comunicacionais; atividades lúdicas/brincar e atividades de relaxamento; promoção da esperança e estratégias de coping. CONCLUSÃO: As intervenções de Enfermagem promotoras da adaptação à hospitalização mapeadas visam diminuir a ansiedade e stress da criança/família, aumentando a capacidade para receber informação, participar nos cuidados e em decisões. Destacam-se a brincadeira terapêutica, informações antecipatórias, técnicas de relaxamento, distração, humor, musicoterapia, kits de adaptação, grupos terapêuticos e estratégias promotoras de esperança

OBJECTIVE: Identify the adaptation process of the child and family to hospitalization and map the nursing interventions that promote the child/youth/family's adaptation to hospitalization. METHOD: Elaboration of a Scoping Review based on the Joanna Briggs Institute (2014). Inclusion criteria - Population: Child, Young (0-18 years old); Concept: Interventions promoting adaptation and Context: Hospitalization. The studies considered were quantitative, qualitative and systematic reviews. Electronic databases used for article search - PUBMED, MEDLINE and CINAHL. Selection criteria: full text articles dated between 2012 and 2019. Languages of inclusion: Portuguese and English. RESULTS: A total of 14 articles were analyzed, including 2 systematic reviews of the literature, 7 qualitative studies and 5 quantitative studies. The results of the analysis were organized by themes: the child's adaptation to hospitalization, the parent's adaptation to hospitalization and strategies promoting adaptation to hospitalization. The interventions aimed at children are focused on strengthening coping mechanisms and on increasing the sense of security. These have been categorized into communication strategies; playful activities and relaxation activities; and promotion of hope and coping strategies. CONCLUSION: The mapped Nursing interventions that promote adaptation to hospitalization intend to decrease the child / family's anxiety and stress, increasing the ability to receive information and to participate in care and decisions. Intervention such as therapeutic play, anticipatory information, relaxation techniques, distraction, humor, music therapy, adaptation kits, therapeutic groups and hope-promoting strategies are emphasized

Occupational adaptation - analyzing the maturity and understanding of the concept through concept analysis.

Background: Occupational adaptation is a key occupational therapy concept, yet lacks clarity and consensus, impacting on its application in practice, theory and research. Concept analysis is a rigorous methodology which enables identification of unique features, gaps in knowledge, and the need for further concept refinement.Aim: This study aimed to determine the conceptual maturity of occupational adaptation, and identify steps needed to understand and use occupational adaptation.Methods: Four databases were searched using the term 'occupational adaptation' and a principle-based concept analysis was conducted from epistemological, pragmatic, linguistic, and logical perspectives. A mapping of the concept's evolution and analysis of the maturity of its structural features also occurred.Results: Seven hundred and fourty-eight papers were identified, which reduced to 161 after abstract and full-text review. A diverse range of applications and two primary theoretical frames of reference were identified. The definition, attributes, preconditions, outcomes, and boundaries of the concept lacked maturity, limiting clinical utility.Conclusions and significance: Occupational adaptation is a concept applied across many practice and research contexts, yet the concept is not fully mature. Concept refinement is required before further applied research is conducted. A shared understanding of occupational adaptation through refinement and research may consolidate its importance and future utility.

Posttraumatic growth and depreciation in people with chronic pain: A profile analysis.

OBJECTIVE: Chronic pain can disrupt everyday life and shatter beliefs about the world. Shattered beliefs may be rebuilt, either positively or negatively, leading to posttraumatic growth (PTG) or posttraumatic depreciation (PTD). According to a transdiagnostic emotion regulation perspective, these phenomena are associated with coping strategies and emotions related to the body, self, others, and the world. Because PTG and PTD can coexist, this study aims to compare different profiles of rebuilt beliefs based on emotions, emotion regulation, and psychopathology. METHOD: People with chronic pain (N = 1,577) completed online self-report questionnaires evaluating PTG and PTD, trauma-related emotions, and reactions regarding pain (guilt, shame, mental defeat, injustice, feeling discounted, sensitivity to pain traumatization, sense of body-self unity), difficulties in emotion regulation, coping strategies, and psychopathological symptoms. RESULTS: Profiles illustrate four ways to experience potentially traumatic and life-challenging circumstances: no disruption, ambivalence, growth, and distress. Differences were found regarding trauma-related emotions and reactions, levels of comorbid psychopathologies, and emotion regulation. CONCLUSIONS: Considering trauma as a genuine dimension of chronic pain experience could provide an important framework to better address the resources and trajectories of people with chronic pain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Identification of Pre-Dominant Coping Types in Patients with Parkinson's Disease: An Abductive Content Analysis of Video-Based Narratives.

BACKGROUND: People with Parkinson's disease suffer from a range of various symptoms. Altered movement patterns frequently represent the prevailing symptom experience and influence the everyday life of the affected persons. OBJECTIVE: This qualitative study explores how persons with Parkinson's disease experience everyday life with a complex symptom profile and how they manage the consequential challenges in their daily life, as well as the motivation and consequences of these coping behaviours. METHODS: Thirty-four patients with Parkinson's disease were interviewed as an integrated part of the method Video-based Narrative. The interviews were analysed by means of qualitative content analysis according to Graneheim & Lundman. RESULTS: The analysis identified six predominant coping types with different behavioural traits: The convincing behaviour, The economizing behaviour, The encapsulating behaviour, The evasive behaviour, The adaptable behaviour, and The dynamic behaviour. The strategies embedded in each of the six types are diverse, but all participants seek to maintain their integrity in different ways leading to the main motivation "To stay the same person". CONCLUSION: Healthcare professionals should be aware of the patients' various coping behaviour in order to offer a person-centred approach. Psychoeducational interventions to promote coping skills may be essential in incorporating disease-related changes in the conduct of everyday life with Parkinson's disease to maintain integrity.

Análisis del grupo terapéutico de fútbol, como herramienta de empoderamiento, dentro de la trayectoria deportiva en una unidad de hospitalización / No disponible

Dentro las diversas unidades de hospitalización del Centro Asistencial Salud Mental (CASM) Benito Menni, desde el aérea de rehabilitación hospitalaria, se trabaja y se promueve la actividad de fútbol como parte implícita dentro de su programa de rehabilitación. Desde el modelo de recuperación y promovida por la visión del Terapeuta Ocupacional, esta actividad implica a la persona como parte activa y en primera persona en su proceso de rehabilitación. La actividad transversal comunitaria de fútbol abarca a un amplio perfil poblacional donde, indistintamente de su condición y situación, se orienta a que la persona aumente su capacidad de vivir una vida satisfactoria según sus intereses, metas, objetivos y posibilidades, que le permita y que le ayude a trazar su proyecto de vida. La actividad terapéutica de fútbol, en un periodo de ingreso de hospitalización permite descubrir o redescubrir un sentido positivo de sí mismo, aceptar y hacer frente a la realidad de cualquier dificultad o incapacidad permanente y encontrar significado a las propias experiencias

Within the various hospitalization units in Benito Menni CASM, the hospital rehabilitation area promotes soccer activity as an implicit part of its rehabilitation program. From the recovery model and promoted by the point of view of the Occupational Therapist, this activity involves patients to be an active part, and in the first person, of their rehabilitation process. The cross-sectional community soccer activity involves a broad population profile, where regardless of their condition and situation, the goal is to increase patients' ability to live a successful life according to their interests, goals, objectives and possibilities, which will allow them to trace their life project. The therapeutic soccer activity, during a hospitalization period, allows patients to discover or rediscover a positive sense of themselves, accept and face difficulties or permanent disabilities and find the meaning of their own experiences

Comparative analysis of clinical, physiological, temperamental and personality characteristics of elderly subjects and young subjects with asthma.

BACKGROUND: Asthma is a heterogeneous disease of a complex etiology in which genetic, environmental and personality variables are important factors determining the development of complicated strategies related to coping with stress and temperament traits. Our thesis is that coping styles in asthmatic patients are modified by the environment (chronic inflammation and stress) which affects individual temperament traits in the course of time. Thus, patient age is one of factors which determine the clinical image of asthma and its natural history. AIM: The aim of the study was to evaluate the variables describing stress coping styles and temperament in young (18 to 35 years old) and elderly asthmatics (aged ≥60 years). MATERIAL AND METHODS: A total of 200 patients, 104 elderly and 96 young asthmatics were enrolled in the study. Apart from medical examination, the following tests were performed in all subjects: the Formal Characteristics of Behavior- Temperament Inventory (FCB-TI), Coping Inventory for Stressful Situations (CISS), Beck Depression Inventory, State-Trait Anxiety Inventory, and Borg Rating of Perceived Exertion (RPE) Scale. RESULTS: Elderly patients with asthma exhibited higher intensity of anxiety as a trait, a higher level of depression and experienced dyspnea, as well as higher levels of stress coping strategies such as Avoidance-Oriented Coping (AOC), Distraction Seeking (DS) and Social Diversion (SD) compared to young asthmatics. In elderly patients, Perseverance and Sensory Sensitivity traits have been observed to decline with the duration and development of asthma at later life stages as opposed to young asthmatics, in whom these temperament characteristics are elevated. CONCLUSIONS: Asthma is a heterogeneous disease of a complex etiopathogenesis that has a complex interplay with mental health. The present study confirms a relationship between age and stress coping strategies as well as temperament traits.

Gestores do RS e TO participam de encontro virtual sobre covid-19

O Instituto de Saúde Coletiva realiza um encontro com gestores estaduais para debater estratégias de enfrentamento à covid-19 nas áreas de Trabalho e Educação em Saúde. Os convidados desta semana são: Teresinha Valduga (Rio Grande do Sul), Fabíola Sandini e Robson José da Silva (Tocantins). Os encontros virtuais fazem parte das atividades de cooperação técnica promovidas pelo ISC/UFBA junto ao Ministério da Saúde. O objetivo é desenvolver uma proposta de monitoramento e avaliação da Educação Permanente em Saúde (EPS) no país. Durante as sessões, os convidados compartilham as experiências em relação ao enfrentamento da covid-19 e respondem perguntas dos internautas sobre as ações de cada estado. A ideia é alcançar gestores, profissionais de saúde, pesquisadores e estudantes, mas também toda a comunidade disposta a participar das discussões.

Satisfacción y fatiga por compasión en personal de enfermería de oncología: estudio descriptivo y correlacional / Compassion satisfaction and compassion fatigue in oncology nursing staff: descriptive and correlational study

OBJETIVOS: (1) Conocer la percepción de Satisfacción y Fatiga por Compasión del personal de Enfermería de oncología; (2) estudiar la correlación entre variables sociodemográficas, profesionales y adaptativas (resiliencia, actitudes ante la muerte y personalidad) y la Satisfacción y Fatiga por Compasión y, (3) identificar variables predictoras para ambas dimensiones. MÉTODO: Estudio descriptivo, correlacional, de corte transversal. 69 enfermeras (62.7%) y 41 técnicos en cuidados auxiliares de Enfermería (37.3%) de los servicios de Oncología de Bizkaia (Servicio Vasco de Salud) dieron respuesta al ProQOL-V, CD-RISC-10, PRAM y NEO-FFI-3. Los datos se recogieron entre septiembre 2018 y marzo 2019. El estudio estadístico con el SPSS.22 implicó pruebas chi cuadrado, comparación de medias, correlación de Pearson y regresión logística multivariante. RESULTADOS: El 66.4% (n=73) presentó alta Satisfacción, y el 41.8% (n=46) se situó en niveles moderados de Fatiga por Compasión. Las personas con estudios previos sobre la muerte y/o duelo se percibieron más satisfechas. La Satisfacción estableció correlaciones más fuertes con resiliencia y extroversión, y la Fatiga lo hizo con neuroticismo y resiliencia. Emergieron 4 variables predictoras para la Satisfacción: edad, formación, resiliencia, y amabilidad; y 4 para la Fatiga: evitación y aceptación de escape ante la muerte, neuroticismo y apertura. CONCLUSIONES: La alta relación hallada entre la formación y la resiliencia con la Satisfacción por Compasión puede servir de guía a las instituciones académicas y asistenciales para orientar estrategias formativas, preventivas e interventivas que permitan dotar a los equipos de enfermería oncológica de recursos que les permitan optimizar la percepción sobre su rol de cuidado

OBJECTIVES: (1) To determine the perception of Compassion Satisfaction and Fatigue of oncology nursing staff; (2) to study the correlation between Compassion Satisfaction and Fatigue and sociodemographic, professional and adaptive variables (resilience, attitudes toward death, personality); and (3) to identify predictors of the two dimensions. METHOD: Descriptive, correlational, cross-sectional study. 69 nurses (62.7%) and 41 auxiliary care technicians (37.3%) from the Oncology Services in Biscay (Basque Health Service) completed the ProQOL-V, CD-RISC-10, DAP-R, and NEO-FFI-3. Data were collected between September 2018 and March 2019. The statistical analysis with SPSS.22 included chi-square tests, comparison of means, Pearson's correlation, and multivariate logistic regression. RESULTS: 66.4% (n=73) showed high Compassion Satisfaction, and 41.8% (n=46) were at moderate levels of Compassion Fatigue. People with prior studies related to death and/or grief were more satisfied. Compassion Satisfaction had stronger correlations with resilience and extroversion, and Compassion Fatigue did so with neuroticism and resilience. Four predictor variables emerged for Compassion Satisfaction: age, prior learning, resilience, and agreeableness; and four for Compassion Fatigue: attitudes of avoidance and escape concerning death, neuroticism, and openness. CONCLUSIONS: The high relationship found between training and resilience with Compassion Satisfaction can serve as a guide for academic and health care institutions to orient training, preventive and interventional strategies to provide oncology nursing teams with resources that allow them to optimize their care role

Correlación entre estrés, niveles de cortisol y estrategias de afrontamiento en pacientes con cáncer sometidos a tratamiento / Correlation between stress, cortisol levels and coping strategies in cancer patients undergoing treatment

INTRODUCCIÓN: El cáncer es una de las principales causas de morbilidad y mortalidad en el mundo, según la Organización Mundial de la Salud (OMS), en 2012 14 millones de casos nuevos y 8,2 millones de muertes. Se demostró que los pacientes en tratamiento, cirugía, quimioterapia y radioterapia tienen niveles altos de cortisol que influye en su calidad de vida. OBJETIVO: Identificar la relación entre el estrés, a nivel de cortisol y las estrategias de afrontamiento en pacientes con cáncer sometidos a tratamiento. MATERIAL Y MÉTODOS: Estudio transversal, descriptivo y correlacional realizado junio a diciembre del 2019. RESULTADOS EPIDEMIOLÓGICOS: 68.2% mujeres 31.8 % hombres, entre 17 y 76 años, con diagnósticos de: Ca mama (30.3%), de próstata (18.3), colon (15.2), pulmón (13.6), cervical (12.1% gástrico (9.1%) cáncer de piel (1.5%). Estadísticos: El 35,3% informaron cortisol a niveles normales y 64.5% niveles altos; el estrés obtuvo un promedio de 13.9 (DE = 4.64). Sobre el nivel de cortisol y el tipo de tratamiento, se observaron diferencias significativas (X2 = 1,546, p = .04), es decir, el paciente que tienen un tratamiento mixto el cortisol es más alto. CONCLUSIONES: Es importante reevaluar las estrategias centradas en el problema, analizar implicaciones y proponer estudios en el contexto en que se desenvuelven, en futuro desarrollar una intervención incluyendo actividades de enfermería en la quimioterapia y radioterapia, apoyando estrategias de afrontamiento efectivas. En este sentido y derivado de la minimización de amenazas centradas en el problema, es importante tener un enfoque integral más profundo

INTRODUCTION: Cancer is one of the leading causes of morbidity and mortality worldwide, according to the World Health Organization (WHO), in 2012 14 million new cases and 8.2 million deaths. (WHO, 2019). Patients in treatment, surgery, chemotherapy and radiation therapy have been shown to have high levels of cortisol that influence their quality of life. OBJECTIVE: to identify the relationship between stress, cortisol level and coping strategies in cancer patients undergoing treatment. MATERIAL AND METHODS: Cross-sectional, descriptive and correlational study conducted June to December 2018. In 65 male and female patients under treatment. RESULTS: 68.2% were women 31.8% men, between 17 and 76 years. With diagnoses Ca breast (30.3%), prostate cancer (18.3), colon (15.2), lung (13.6), cervical (12.1% gastric (9.1%) skin cancer (1.5%). Statistics: 35.3% reported cortisol at normal levels and 64.5% high levels; stress averaged 13.9 (DE s 4.64). On the level of cortisol and the type of treatment, significant differences were observed (X2 X 1,546, p .04), i.e. the patient who has a mixed treatment cortisol is higher. CONCLUSIONS: It is important to reevaluate the strategies focused on the problem, analyze implications and propose studies in the context in which they operate, in the future develop an intervention including nursing activities in chemotherapy and radiotherapy, supporting effective coping strategies. minimizing threats focused on the problem, it is important to have a deeper comprehensive approach

Medición y experiencias de inseguridad alimentaria, hambre y estrategias de afrontamiento en niños y adolescentes de 6 a 17 años en Medellín, Colombia / Measurement and experiences of food insecurity, hunger and coping strategies inchildren and adolescents from 6 to 17 years old in Medellín, Colombia

FUNDAMENTOS: La consecución alimentaria en términos de disponibilidad, acceso, consumo (cantidad y calidad), utilización biológica e inocuidad adecuada representa la seguridad alimentaria y nutricional. Los instrumentos para medir esta problemática en menores de edad no han sido estudiados en Colombia. El objetivo del trabajo es explorar y medir experiencias de inseguridad alimentaria-nutricional y hambre (INSAN) y estrategias de afrontamiento (EA) en niños y adolescentes de 6 a 17 años de Medellín, Colombia. MÉTODOS: Estudio mixto, donde se realizaron entrevistas a niños entre 6 y 17 años en Medellín. Se aplicó dos instrumentos para medir la INSAN y EA. El análisis cualitativo fue manual y el cuantitativo por medio de SPSSV.21. RESULTADOS: Un 6,7% de los niños presenta INSAN severa, 23,3% moderada y 63,3% leve. Las experiencias de INSAN fueron relatadas por los menores reflejando escasez de alimentos, episodios de hambre y estrategias de afrontamiento como: fiar, prestar y darse cuenta del sacrificio de sus padres. CONCLUSIONES: Las experiencias de inseguridad alimentaria expresadas por los niños evidencian sentimientos de preocupación e insatisfacción por la falta de alimentos y menor calidad en su alimentación. Los ítems que miden la INSAN y EA en general fueron comprendidos por los niños, aunque se requieren estudios a mayor escala

BACKGROUND: Food achievement in terms of availability, access, consumption (quantity and quality), biological use and adequate safety represents food and nutritional security. Instruments to measure this problem in minors have not been studied in Colombia. The objective of the work is to explore and measure experiences of food-nutritional insecurity and hunger (INSAN) and coping strategies (EA) in children and adolescents from 6 to 17 years of age in Medellín, Colombia. METHODS: Mixed study, where interviews were conducted with children between 6 and 17 years old in Medellín. Two instruments were applied to measure INSAN and EA. The qualitative analysis was manual and the quantitative through SPSSV.21. RESULTS: 6.7% of children have severe INSAN, 23.3% moderate and 63.3% mild. The experiences of INSAN were related by the minors, reflecting food shortages, hunger episodes and coping strategies such as: trusting, lending and realizing the sacrifice of their parents. CONCLUSIONS: The experiences of food insecurity expressed by the children show feelings of concern and dissatisfaction for the lack of food and less quality in their diet. Items measured by INSAN and EA were generally understood by children, although larger scale studies are required

"Ripple effect": psychological responses and coping strategies of Italian children in different COVID-19 severity areas

COVID-19 has affected learning and the outdoor activities of more than 862 million children or adolescents worldwide. This study investigated the mental health of Italian children and explored their psychological response and coping strategies in different COVID-19 epidemic severity areas, with the aims of alleviating the impacts of COVID-19, promoting targeted intervention, and reducing the risk of future psychological problems. 1074 parents of children aged 6 to 12 years old participated in an ad-hoc online survey. Among them, 40.3% were from the high-risk areas in the North, and 59.7% were from the medium/low-risk areas in the center of Italy. The results showed that, compared to the children in medium- or low-risk areas, children in the North scored significantly higher for symptoms of anxiety, moods, and cognitive changes, showing a "ripple effect" trend. Moreover, children in the northern areas used fewer task-oriented strategies and more emotion- and avoidance-oriented strategies than those in the central areas. Specifically, children in the northern areas were more likely to show acceptance and seek affection from others, while those in the central areas used more humor when their parents talked about quarantine or coronavirus. These findings provide relevant evidence and a reference point for crisis management in children's mental health

El COVID-19 ha afectado el aprendizaje y las actividades al aire libre de más de 862 millones de niños o adolescentes en todo el mundo. Este estudio investigó la salud mental de los niños italianos y exploró su respuesta psicológica y las estrategias de afrontamiento en diferentes áreas de gravedad de la epidemia de COVID-19, con el objetivo de aliviar los impactos de la misma, promover la intervención específica y reducir el riesgo de futuros problemas psicológicos. 1074 padres de niños entre 6 a 12 años de edad participaron en una encuesta ad-hoc online. De ellos, el 40,3% procedían de las zonas de alto riesgo del norte y el 59,7% de las zonas de riesgo medio/bajo del centro de Italia. Los resultados mostraron que, en comparación con los niños de las áreas de riesgo medio o bajo, los niños del norte obtuvieron una puntuación significativamente más alta en cuanto a los síntomas de ansiedad, cambios cognitivos y de estado de ánimo, mostrando una tendencia de "efecto dominó". Además, los niños de las zonas del norte utilizaron menos estrategias orientadas a las tareas y más estrategias orientadas a las emociones - y la evitación - que los de las zonas centrales. Concretamente, los niños de las zonas del norte eran más propensos a mostrar aceptación y a buscar el afecto de los demás, mientras que los de las zonas centrales usaban más el humor cuando sus padres hablaban de la cuarentena o del coronavirus. Estos hallazgos proporcionan evidencia relevante y un punto de referencia para el manejo de crisis en la salud mental de los niños

How Super Skills for Life may help children to cope with the COVID-19: psychological impact and coping styles after the program / Cómo Super Skills puede ayudar a los niños a afrontar el COVID-19: Impacto psicológico y estilos de afrontamiento después de recibir el programa

As this is the first time that a pandemic has occurred in our recent history, preventive interventions for children ́s emotional problems during confinement were not planned. A main goal of Super Skills for Life Program (SSL) is to provide children with skills to build emotional resilience and coping strategies for daily and difficult life situations, so examining how the program may help children to face the COVID-19 situation could be appropriate. The aim of this research was to compare parents' perception of immediate psychological reactions to confinement and coping styles in children who received the SSL program before home confinement (n = 48) with an equivalent sample of children who did not attend the program (n = 48). Another objective was to study the relationship between children's immediate psychological reactions to confinement and their coping styles. Parents (n = 96) completed an online survey providing information on sociodemographic variables, children's immediate psychological reactions (anxiety/activation, mood, sleep, behavioral alterations, eating and cognitive alterations), and children's coping styles (task-oriented, emotion-oriented, and avoidance-oriented strategies). Results indicated that the control group presented more symptoms of anxiety (p ≤ .001), worse mood (p ≤ .001), more sleep problems (p ≤ .01), and more cognitive alterations (p ≤ .01) during home confinement than children who received the program. Children in the control group were also more likely to use emotion-oriented strategies (p = .001), which were associated with presenting more psychological alterations. Although the SSL program was not created specifically for coping with the COVID-19 situation, it seems to provide children with skills to cope with this unexpected event

Puesto que ésta es la primera vez que ocurre una pandemia en nuestra historia reciente, no ha sido posible planificar intervenciones para prevenir los problemas emocionales infantiles durante el confinamiento. Un objetivo principal del programa Super Skills for Life (SSL) es proporcionar a los niños habilidades para desarrollar resiliencia emocional y hacer frente a situaciones diarias y difíciles en su vida, por lo que parece interesante examinar cómo el programa podría ayudar a los niños a afrontar la situación del COVID-19. El objetivo de este estudio fue comparar el impacto psicológico durante el confinamiento y los estilos de afrontamiento de los niños que recibieron el programa SSL antes del confinamiento (n = 48), en comparación con una muestra equivalente de niños que no habían recibido el programa (n = 48). La información se obtuvo a través de los padres (n = 96), quienes respondieron a unos cuestionarios online sobre variables sociodemográficas, reacciones psicológicas de los niños (ansiedad/activación, estado de ánimo, sueño, alteraciones conductuales, cambios en la alimentación y alteraciones cognitivas) y estilos de afrontamiento (orientados a la tarea, a la emoción y a la evitación). Los resultados indicaron que durante el confinamiento el grupo control presentó más síntomas de ansiedad (p ≤ .001), peor estado de ánimo (p ≤ .001), más problemas de sueño (p ≤ .01) y más alteraciones cognitivas (p ≤ .01), que los niños que recibieron el programa. Los niños del grupo control también eran más propensos a utilizar estrategias orientadas a la emoción (p = .001), que se asociaron con más alteraciones psicológicas. Aunque el programa SSL no se creó específicamente para hacer frente a la situación del COVID-19, parece proporcionar a los niños habilidades para hacer frente a este evento inesperado

The symbiotic relationship of vulnerability and resilience in nursing.

Background: Whilst the terms vulnerability and resilience are commonly used within professional nursing discourses, they are often poorly understood. Vulnerability is often framed negatively and linked to being at risk of harm, whilst resilience is often perceived as the ability to withstand challenges. Aim: The aim of this paper is to explore resilience and vulnerability; re-positioning them within the context of contemporary professional nursing practice. Design: Discussion paper. Method: Drawing upon historical and contemporary international literature, both concepts are de-constructed and then re-constructed, examining them from the position of patient care as well as from the perspective of nurses and the nursing profession. Conclusion: Resilience and vulnerability have an interdependent relationship as resilience comes into play in situations of vulnerability. Yet, contrary to the popular discourse they are multi-faceted, complex phenomena based on factors such as individual circumstances, supports, and resources.

Cinco retos psicológicos de la crisis del COVID-19 / Five psychological challanges of the COVID-19 crisis

No disponible

Experiencias de vida y soporte percibido por las enfermeras de las unidades de hemodiálisis hospitalaria durante la pandemia de COVID-19 en España / Life experiences and support perceived by nurses in hospital haemodialysis units during the COVID-19 pandemic in Spain

OBJETIVO: Profundizar en el conocimiento sobre las experiencias de vida y el soporte percibido por las enfermeras/os que atendieron a pacientes con enfermedad de COVID-19 en tratamiento con hemodiálisis hospitalaria durante los meses de mayor prevalencia de la pandemia en España. MATERIAL Y MÉTODO: Estudio cualitativo fenomenológico. El grupo participante fue de diez enfermeras/o de hospitales públicos de España que habían dializado a pacientes con COVID-19. La recolección de los datos se realizó mediante entrevistas semiestructuradas a través del programa Skype©, hasta conseguir la saturación de las unidades de significado. El análisis se hizo mediante el método de Colaizzi-7 pasos. RESULTADOS: Del análisis de los discursos emergieron cuatro dimensiones asociadas a diferentes subcategorías: desconocimiento sobre la enfermedad, sufrimiento del paciente, soporte percibido y capacidad de afrontamiento de los profesionales. CONCLUSIONES: En las enfermeras han coexistido emociones positivas y negativas. En la etapa álgida del brote epidémico las vivencias de las enfermeras de hemodiálisis fueron provocadas por el desconocimiento, por no saber actuar adecuadamente y por el miedo al contagio, agravado por la falta de medios de protección. Las vivencias positivas fueron el crecimiento personal, el apoyo del equipo y de la familia. También cabe destacar el control racional de la situación, debido a que en las unidades de diálisis hay gran experiencia en el control de la trasmisión de enfermedades infecciosas

AIM: To deepen the knowledge about life experiences and support perceived by nurses who attended in-hospital patients with COVID-19 disease on haemodialysis during the months with the highest prevalence of the pandemic in Spain. MATERIAL AND METHOD: Qualitative phenomenological study. The participating group was ten nurses from public hospitals in Spain who had dialyzed patients with COVID-19. Data collection was performed using semi-structured interviews through Skype© program, until the units of meaning were saturated. The analysis was done using the Colaizzi's seven-step method. RESULTS: Four dimensions emerged from the speech analysis associated with different subcategories: ignorance about the disease, patient suffering, perceived support and professionals' ability to cope. CONCLUSIONS: Positive and negative emotions have coexisted in nurses. In the peak stage of the epidemic outbreak, the experiences of hemodialysis nurses were caused by ignorance, not knowing how to act appropriately, and fear of infection, aggravated by the lack of means of protection. The positive experiences were personal growth, the support of the team and the family. It is also worth noting the rational control of the situation, because in the dialysis units there is great experience in controlling the transmission of infectious diseases

Mentoring as a process that promotes emotional competence in nursing: perspectives of students and teachers of the undergraduate course / A mentoria como processo promotor da competência emocional em enfermagem: perspetivas de estudantes e professores do curso de licenciatura

Introduction: Mentoring programs, developed in a close relationship with students, allow for a better academic adaptation, promote the development of emotional and social competencies, and expand the network of academic and professional relationships. Aims: Characterize the emotional experiences of nursing students and understand the importance of mentoring in the process of integrating them in a Lisbon School. Methods: This is a cross-sectional, descriptive and correlational study, with a mixed approach. The emotional competencies survey was applied to 238 students, semi-structured interviews with 12 students and focus groups to 10 teachers. Results: Most students are female and attend the 1st and 2nd year. Female students are associated with a better perception and emotional expression. The student's adaptation to higher education is related to a greater ability to cope with emotions. Lastly, school performance influences the student's ability to manage emotions. As to the findings of the interviews, these revealed: precipitating factors of negative intensity emotional experiences; emotional experiences of negative intensity; emotional management strategies; And the function of mentoring in the development of emotional competence. In the focus groups we assessed that the teachers recognize the emotional experience faced by the students resulting from: events, experiences and academic difficulties that trigger emotions of negative load. The concept of mentoring and mentor are different, with requirements, diffi-culties and barriers to the implementation of the mentoring process. Conclusions: Mentoring is a process that influences both the coping of academic performance and the development of competence related to emotional management, acceptance and communication, which are fundamental for the nursing practice

No disponible