Evaluación de una intervención grupal basada en mindfulness en pacientes con ansiedad y depresión atendidos en un centro comunitario de salud mental: estudio cuasi experimental / Evaluation of a group intervention based on Mindfulness in patients with anxiety and depression cared for in mental health community center: a quasy-experimental study

Objetivo: Evaluar la efectividad de una intervención grupal basada en mindfulness en pacientes con ansiedad y depresión atendidos en un centro de salud mental comunitario. Secundariamente, valorar la calidad de vida y la adherencia a la intervención. Método: Estudio cuasi experimental con evaluaciones pre y postintervención llevado a cabo entre marzo de 2015 y diciembre de 2019 en personas mayores de 18 años atendidas en el Centro de Salud Mental de Adultos (CSMA) de Les Corts, Barcelona. Como criterios de inclusión se tomaron en cuenta: 1) sintomatología de ansiedad (Escala de Ansiedad de Hamilton [HARS] > 10 puntos) y 2) firma de consentimiento informado. Las variables recogidas fueron 1) ansiedad, 2) depresión (Inventario de Depresión de Beck [BDI]), 3) calidad de vida (EuroQoL [EQ-5D]) y 4) adherencia a la intervención. La intervención fue de nueve sesiones semanales de 75 min y fue realizada por dos enfermeras. Cada grupo estaba formado por 10-15 pacientes. Resultados: Un total de 128 usuarios fueron incluidos, de los cuales 103 eran mujeres con una edad media de 52,23 (desviación estándar [DE] 12,78). Al comparar medidas pre y post, se observaron mejoras en relación con la sintomatología ansiosa, depresiva y la calidad de vida general (p<0,001) y sus dimensiones de ansiedad-depresión (EQ-5D) (p=0,003). La media de sesiones asistidas fue de 6,17 (DE 2,31) y estaban correlacionadas de forma estadísticamente significativa y positiva con una mejora de la sintomatología ansiosa (p<0,001) y depresiva (p=0,021). No se observaron diferencias entre grupos de edad. Conclusiones: La intervención grupal basada en mindfulness mejora la sintomatología ansiosa y depresiva, así como la calidad de vida. Esto se asocia con una mayor adherencia a la intervención.(AU)

Objective: To evaluate the effectiveness of a group intervention based on Mindfulness in patients with anxiety and depression treated in a community mental health center. Secondarily, to evaluate quality of life and adherence to the intervention. Methods: Quasi-experimental study with evaluations pre-post intervention in people over 18 years of age treated at the Les Corts Adult Mental Health Center (AMHC), Barcelona, between March 2015 and December 2019. Inclusion criteria: 1) anxiety symptoms (Hamilton Anxiety Rating Scale > 10 points); 2) sign informed consent. Variables collected: 1) anxiety; 2) depression (Beck Depression Inventory); 3) quality of life (EuroQoL [EQ-5D]) and 4) adherence to the intervention. The intervention (9 weekly sessions; 75 minutes) was carried out by two nurses. Each group consisted of 10-15 patients. Results: 128 patients were included, of which 103 were women with a mean age of 52.23 years (SD 12.78). Comparisons pre and post measures, its showed improvements in relation to anxiety, depressive symptoms and general quality of life (p<0.001) and in its dimensions of anxiety-depression (EQ-5D) (p=0.003). The mean number of sessions attended was 6.17 (SD 2.31), and they were statistically significant and positively correlated with an improvement in anxiety (p<0.001) and depressive symptoms (p=0.021). There were no differences between age groups. Conclusion: The intervention group based on Mindfulness improves anxiety and depressive symptoms, as well as the quality of life. This improvement in the symptomatology is associated with a greater adherence to the intervention.(AU)

Continuous Psychological Nursing Based on Grey Clustering Algorithm in Patients after Transurethral Resection of Prostate.

Objective: To explore the effect of continuous psychological nursing based on the grey clustering algorithm on erectile function, bad psychological emotion, and complications in patients after transurethral resection of prostate (TURP). Methods: 98 patients who underwent TURP were randomly divided into observation and control groups (routine nursing). The observation group first used the grey clustering algorithm to evaluate the psychological intelligence, found patients with abnormal psychological behavior, and then implemented continuous psychological nursing combined with pelvic floor muscle exercise. The patients were followed up for 4 months. The International Index of Erectile Function-5 (IIEF-5), the incidence of complications, the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA) scores, and the nursing satisfaction were analyzed and compared between these two groups. Results: The grey clustering algorithm can accurately reflect the characteristics of patients' psychological changes. After targeted nursing, compared with the control group, the IIEF-5 in the observation group was higher [(24.87 ± 1.85) vs. (22.24 ± 1.47), P < 0.05], the incidence of total complications was lower (10.20% vs. 26.53%, P < 0.05), the score of HAMA was lower [(6.11 ± 2.57) vs. (10.98 ± 2.29), P < 0.05], the score of HAMD was lower [(6.97 ± 2.85) vs. (11.35 ± 2.19), P < 0.05], and the nursing satisfaction was higher (100% vs. 85.71%, P < 0.05). Conclusion: Mental intelligence evaluation based on the grey clustering algorithm combined with pelvic floor muscle exercise can significantly improve the rehabilitation effect of erectile function in patients after TURP, reduce the incidence of postoperative complications, and alleviate patients' anxiety and depression.

Psychological well-being in patients undergoing stem cell transplantation

The aim of the study is to determine the psychological well-being of patients who underwent stem cell transplantation. This cross-sectional study was conducted with 100 patients. Data were collected face-to-face using an introductory information form and the Brief Symptom Inventory.When the results of the patients were examined, the interpersonal sensitivity of the sub-dimensions of the scale was found to be 5.0 ± 4.06, depression 7.60 ± 5.37, and anxiety disorder 7.90 ± 5.34. There was a significant difference between the diagnosistime of the patients and all sub-factors of the scale, except phobic anxiety. It was found that the psychological state of the patients was directly related to the time of first diagnosis. As a result, the importance of following the psychological processof the patients during the treatment process was revealed when planning nursing care.

Limites e possibilidades de agentes comunitários de saúde na identificação de sintomas depressivos / Límites y posibilidades de los agentes comunitarios de salud en la identificación de síntomas depresivos / Limitations and possibilities of community health workers in identifying depressive symptoms

RESUMO Objetivo: avaliar o conhecimento de agentes comunitários de saúde sobre identificação de sintomas depressivos na comunidade. Método: trata-se de pesquisa qualitativa, realizada em Unidade Básica de Saúde, em Teresina, Piauí, Brasil, com 15 agentes comunitários de saúde. Utilizou-se o método da Pesquisa-Ação. A produção dos dados aconteceu em janeiro e fevereiro de 2019, por meio de dois seminários temáticos, pautados no Método Criativo Sensível. Os discursos foram submetidos à análise temática. Resultados: agentes comunitários de saúde reconhecem os sintomas depressivos por tristeza, choro, isolamento, anedonia e solidão, manifestados pelos indivíduos. Os limites para essa identificação, relatados pelos profissionais, foram dificuldade de acesso aos usuários e às famílias e estigma e preconceito com a depressão. Quanto às possibilidades, destacaram-se acesso à informação sobre a temática pela mídia, diálogo/conversa estabelecido entre usuário e profissional e acesso à rede de apoio. Considerações finais: conclui-se que o reconhecimento, as limitações e as possibilidades de identificação de sintomas depressivos por esses profissionais refletem no diagnóstico, planejamento e implementação de ações no cuidado em saúde mental de forma precoce e segura.

RESUMEN Objetivo: evaluar el conocimiento de agentes comunitarios de salud sobre identificación de síntomas depresivos en la comunidad. Método: se trata de investigación cualitativa, realizada en Unidad Básica de Salud, en Teresina, Piauí, Brasil, con 15 agentes comunitarios de salud. Se utilizó el método de Investigación-acción. La producción de los datos tuvo lugar en enero y febrero de 2019, a través de dos seminarios temáticos, de acuerdo con el Método Creativo-sensible. Los discursos fueron sometidos al análisis temático. Resultados: Los agentes comunitarios de salud reconocen los síntomas depresivos por tristeza, llanto, aislamiento, anhedonia y soledad, manifestados por los individuos. Los límites para esa identificación, relatados por los profesionales, fueron dificultad de acceso a los usuarios y a las familias y estigma y prejuicio con la depresión. En cuanto a las posibilidades, se destacaron acceso a la información sobre la temática por los medios, diálogo/conversación establecido entre usuario y profesional y acceso a la red de apoyo. Consideraciones finales: se concluye que el reconocimiento, las limitaciones y las posibilidades de identificación de síntomas depresivos por parte de estos profesionales reflejan en el diagnóstico, la planificación e implementación de acciones en el cuidado en salud mental de forma precoz y segura.

ABSTRACT Objective: to evaluate the knowledge of community health workers about the identification of depressive symptoms in the community. Method: this is a qualitative research, conducted in a Primary Health Care Unit in Teresina, Piauí, Brazil, with 15 community health workers. We used the Action-Research method. Data production took place in January and February 2019, through two thematic seminars, guided by the Creative Sensitive Method.The speeches were submitted to thematic analysis. Results: community health workers recognize the depressive symptoms by means of sadness, crying, isolation, anhedonia and loneliness, manifested by individuals. The limitations to this identification, reported by professionals, were difficulty of access to users and families, as well as stigma and prejudice against depression. As for the possibilities, access to information about the theme through the media, dialogue/conversation established between users and professionals, besides access to a support network, were highlighted. Final considerations: we conclude that the recognition, limitations and possibilities of identification of depressive symptoms by these professionals are reflected in the diagnosis, planning and implementation of actions in mental health care in an early and safe way.

Evaluation of the Effect of Comprehensive Nursing in Psychotherapy of Patients with Depression.

The purpose of this study is to understand the emotional experience and psychological intervention of patients with depression and to explore the intervention effect of nursing intervention in the psychological treatment of patients with depression, so as to provide clinical nursing work recommendations and provide reference for the implementation of intervention methods for patients with depression. In addition, through case analysis, this paper combines controlled trials to study the effect of comprehensive nursing in the psychotherapy of patients with depression and combines mathematical statistics to process data. Through the analysis of controlled trials, it can be known that on the basis of conventional medication, interventional guidance for patients with depression through comprehensive nursing programs can play an ideal effect in improving the depression of patients. Moreover, it can effectively improve the patient's quality of life after intervention and enhance the patient's nursing satisfaction.

Effect of an Oncology Nurse-Led Primary Palliative Care Intervention on Patients With Advanced Cancer: The CONNECT Cluster Randomized Clinical Trial.

Importance: Guidelines recommend early specialty palliative care for all patients with advanced cancer, but most patients lack access to such services. Objective: To assess the effect of CONNECT (Care Management by Oncology Nurses to Address Supportive Care Needs), a primary palliative care intervention delivered by oncology nurses, on patient outcomes. Design, Setting, and Participants: This cluster randomized clinical trial of the CONNECT intervention vs standard care was conducted from July 25, 2016, to October 6, 2020. Participants were adult patients with metastatic solid tumors who were undergoing oncological care and for whom an oncologist would agree with the statement "would not be surprised if the patient died in the next year." The trial was conducted at 17 community oncology practices in western Pennsylvania. Data analyses adhered to the intention-to-treat principle. Interventions: The CONNECT intervention included 3 monthly visits with an existing infusion room nurse who was trained to address symptoms, provide emotional support, engage in advance care planning, and coordinate care. Main Outcomes and Measures: The primary outcome was quality of life. At baseline and 3 months, participants completed assessments of quality of life (Functional Assessment of Chronic Illness Therapy-Palliative care: score range, 0-184, with higher scores indicating better quality of life), symptom burden (Edmonton Symptom Assessment Scale: score range, 0-90, with higher scores indicating greater symptom burden), and mood symptoms (Hospital Anxiety and Depression Scale [HADS]: score range, 0-21, with higher scores indicating substantial anxiety and depression). Linear mixed-effects models were used to estimate adjusted mean differences in 3-month outcomes. Preplanned, intensity-adjusted analyses were conducted. Results: A total of 672 patients were enrolled (mean [SD] age, 69.3 [10.2] years; 360 women [53.6%]). The mean (SD) number of CONNECT visits completed was 2.2 (1.0). At 3 months, no difference in mean (SD) quality-of-life score was found between the CONNECT and standard care groups (130.7 [28.2] vs 134.1 [28.1]; adjusted mean difference, 1.20; 95% CI, -2.75 to 5.15; P = .55). Similarly, there was no difference between groups in 3-month mean (SD) symptom burden (23.2 [16.6] vs 24.0 [16.1]; adjusted mean difference, -2.64; 95% CI, -5.85 to 0.58; P = .11) or mood symptoms (HADS depression subscale score: 5.1 [3.4] vs 4.8 [3.7], adjusted mean difference, -0.08 [95% CI, -0.71 to 0.57], P = .82; HADS anxiety subscale score: 5.7 [3.9] vs 5.4 [4.2], adjusted mean difference, -0.31 [95% CI, -0.96 to 0.33], P = .34). Intensity-adjusted analyses revealed a larger estimated treatment effect for patients who received a full dose (3 visits) of the CONNECT intervention. Conclusions and Relevance: This cluster randomized clinical trial found that a primary palliative care intervention that was delivered by oncology nurses did not improve patient-reported outcomes at 3 months. Primary palliative care interventions with a higher dose intensity may be beneficial for most patients with advanced cancer who lack access to palliative care specialists. Trial Registration: ClinicalTrials.gov Identifier: NCT02712229.

Effect of a Digital Intervention on Depressive Symptoms in Patients With Comorbid Hypertension or Diabetes in Brazil and Peru: Two Randomized Clinical Trials.

Importance: Depression is a leading contributor to disease burden globally. Digital mental health interventions can address the treatment gap in low- and middle-income countries, but the effectiveness in these countries is unknown. Objective: To investigate the effectiveness of a digital intervention in reducing depressive symptoms among people with diabetes and/or hypertension. Design, Setting, and Participants: Participants with clinically significant depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score ≥10) who were being treated for hypertension and/or diabetes were enrolled in a cluster randomized clinical trial (RCT) at 20 sites in São Paulo, Brazil (N=880; from September 2016 to September 2017; final follow-up, April 2018), and in an individual-level RCT at 7 sites in Lima, Peru (N=432; from January 2017 to September 2017; final follow-up, March 2018). Interventions: An 18-session, low-intensity, digital intervention was delivered over 6 weeks via a provided smartphone, based on behavioral activation principles, and supported by nurse assistants (n = 440 participants in 10 clusters in São Paulo; n = 217 participants in Lima) vs enhanced usual care (n = 440 participants in 10 clusters in São Paulo; n = 215 participants in Lima). Main Outcomes and Measures: The primary outcome was a reduction of at least 50% from baseline in PHQ-9 scores (range, 0-27; higher score indicates more severe depression) at 3 months. Secondary outcomes included a reduction of at least 50% from baseline PHQ-9 scores at 6 months. Results: Among 880 patients cluster randomized in Brazil (mean age, 56.0 years; 761 [86.5%] women) and 432 patients individually randomized in Peru (mean age, 59.7 years; 352 [81.5%] women), 807 (91.7%) in Brazil and 426 (98.6%) in Peru completed at least 1 follow-up assessment. The proportion of participants in São Paulo with a reduction in PHQ-9 score of at least 50% at 3-month follow-up was 40.7% (159/391 participants) in the digital intervention group vs 28.6% (114/399 participants) in the enhanced usual care group (difference, 12.1 percentage points [95% CI, 5.5 to 18.7]; adjusted odds ratio [OR], 1.6 [95% CI, 1.2 to 2.2]; P = .001). In Lima, the proportion of participants with a reduction in PHQ-9 score of at least 50% at 3-month follow-up was 52.7% (108/205 participants) in the digital intervention group vs 34.1% (70/205 participants) in the enhanced usual care group (difference, 18.6 percentage points [95% CI, 9.1 to 28.0]; adjusted OR, 2.1 [95% CI, 1.4 to 3.2]; P < .001). At 6-month follow-up, differences across groups were no longer statistically significant. Conclusions and Relevance: In 2 RCTs of patients with hypertension or diabetes and depressive symptoms in Brazil and Peru, a digital intervention delivered over a 6-week period significantly improved depressive symptoms at 3 months when compared with enhanced usual care. However, the magnitude of the effect was small in the trial from Brazil and the effects were not sustained at 6 months. Trial Registration: ClinicalTrials.gov: NCT02846662 (São Paulo) and NCT03026426 (Lima).

[Applying Swanson`s Caring Theory to a Patient With End Renal Stage Disease Experiencing Hopelessness].

This article describes an experience providing nursing care to a patient under hemodialysis with the end-stage renal disease who had developed depression, loathing, and other, negative personal perceptions and gradually gave up on life goals due to hopelessness. The duration of nursing care, from August 23rd through August 29th, 2019, was revisited to identify the patient`s hopelessness in the dimensions of physiology, mental status, society, and spirituality. The author applied Swanson`s Caring Theory to facilitate the process of "knowing" and "being with" while performing direct nursing care and attentive listening to assist the patient to become more open-minded and to express personal perceptions toward the disease with the goal of further engaging the patient to increase self-awareness recognition, sense of loss, and negative perceptions. Through "doing for" and "enabling," the author reinforced infection control and identified the symptoms of fluid-overload, moisture, and salinity to raise the patient`s self-awareness and self-caring techniques and to lower the risk of hospitalization. Meanwhile, by "maintaining the patient`s belief," accompanied by the encouragement and attention from family members and providing linkages to patient-support communities, the patient was guided to identify and aggregate to foster positive thinking and self-worth to increase acceptance of living with the disease. Nursing personnel may apply Swanson`s Caring Theory to better consider the patient`s perspective, provide individual caring schemes, and strengthen the recognition, self-caring techniques and supportive systems of patients, increasing patient perceptions of self-worth, restoring their confidence, promoting their adaption to their disease, and improving attentiveness.

Factors affecting anxiety and depression in young breast cancer survivors undergoing radiotherapy.

PURPOSE: This study examined anxiety and depression, and their relationship with symptom assessment, uncertainty, social support, and stress in young breast cancer patients receiving radiotherapy. METHODS: This is a descriptive quantitative study. The participants were 126 patients under 50 years of age with breast cancer undergoing radiotherapy. RESULTS: The anxiety and depression levels were higher among those who were married (t = -2.318, p = .022), non-religious (t = 4.510, p = .005), and had a higher monthly income (F = 2.840, p = .041). The hierarchical regression analysis model included symptom assessment, uncertainty, social support, and stress, and accounted for about 49% of the variance in anxiety and depression (F = 7.688, p < .001). Additionally, uncertainty (ß = 0.304, p = .001) and stress (ß = 0.308, p = .001) were significant predictors of anxiety and depression. CONCLUSIONS: Based on the results of this study, nursing interventions are needed to reduce uncertainty and stress in order to reduce anxiety and depression in young breast cancer patients undergoing radiation treatment.

Prevalence and factors associated with depression and anxiety in patients with psoriasis.

OBJECTIVE: To identify the prevalence and factors associated with depression and anxiety in patients with psoriasis. BACKGROUND: Psoriasis is a chronic, non-contagious, autoimmune inflammatory skin disease associated with psychological comorbidities. DESIGN: A cross-sectional study conducted between March 2017-December 2018 in a dermatology infirmary and outpatient clinic of a public hospital in the inner State of São Paulo (Brazil). METHODS: We used questionnaires with sociodemographic data and clinical history, the HADS (Hospital Anxiety and Depression Scale), DLQI-BRA (Dermatology Life Quality Index) and PASI (Psoriasis Area Severity Index). The correlations between variables were explored using multivariate techniques. STROBE checklist was applied as the reporting guideline for this study (File S1). RESULTS: A total of 281 participants were included, of which the majority were female 146 (52%), with a mean age of 52.1 years (SD: 13.8), elementary school 154 (55%), married/cohabiting 209 (74%) and with low income 201 (72%). The median (p25-p75) time with the disease was 14 years (7-23). Regarding the quality of life, 31% of respondents reported being little affected by the disease. The prevalence of depression was 19% and that of anxiety was 36%. The multivariate analysis showed that the variables that influenced the anxiety and depression scores were as follows: DLQI-BRA, income, female sex, illness length and age. For the multiple correspondence analysis, the highest levels of anxiety and depression referred to women, middle age, lower income and low PASI. CONCLUSION: The prevalence of anxiety and depression symptoms was low. Female sex, income, age, illness length and quality of life were associated with anxiety and depression scores in patients with psoriasis. RELEVANCE TO CLINICAL PRACTICE: Due to the scarcity of studies in the field of nursing with psoriasis patients, we believe these findings contribute to the reorganisation of the care provided, allowing nurses to timely identify mood disorders such as anxiety and depression and adopt the necessary measures to a service and/or specialised referral.

Effects of Nurse-Delivered Cognitive Behavioral Intervention on Depression and Anxiety for Persons Living With HIV in China: A Clinical Controlled Trial.

ABSTRACT: Depression and anxiety, which may influence antiretroviral therapy (ART) medication adherence, are prevalent among persons living with HIV (PLWH) in China. This parallel two-arm clinical controlled trial aimed to examine the effects of a nurse-delivered cognitive behavioral intervention (CBI) on depression, anxiety, and ART medication adherence in Chinese PLWH. Using in-person and online recruitment, 140 PLWH ages 18 years and older who were undergoing ART and had a Patient Health Questionnaire-4 score of ≥2 were assigned to the 10-week-long CBI group or the routine follow-up group according to their preference. Outcomes were measured at baseline, postintervention, and 6-month follow-up. Results showed significant intervention effects on depression maintained until the 6-month follow-up. Although anxiety and ART medication adherence did not show robust effects between conditions, amelioration trends for these outcomes were also found. Our study demonstrated that the nurse-delivered CBI could help Chinese PLWH ameliorate depression.

Nursing intervention reduces depression for patients with rheumatoid arthritis: A randomized controlled trial protocol.

BACKGROUND: Rheumatoid arthritis (RA) is a kind of chronic disease of inflammatory joint, which can lead to the damage and disability of bone and cartilage. Psychiatric comorbidity is related to the adverse results of RA. Symptoms of depression is associated with the increased disease activity and decreased response to the treatments. Therefore, the depression may be an effective intervention target to improve the life quality and subjective health of the patients with RA. The objective of this experiment is to evaluate the effectiveness of nursing intervention for reducing depression for patients with RA. METHOD: It is a single-center randomized controlled study to be conducted from January 2021 to December 2021. It was admitted via the Ethics Committee of Tianjin Medical University (202018384). One hundred patients are included in the study. The inclusion criteria contains:The exclusion criteria contains:All the patients participating in this study are randomly divided into control group and study group, with 50 patients in each group. The primary result is the severity of depression in the patients with RA, based on the generally utilized questionnaires (Hospital Anxiety and Depression Scale). The secondary outcome is the patients life quality, which is evaluated with the short form 36 questionnaire. The analysis of all the data are conducted with the software of IBM SPSS Statistics for Windows, version 20. RESULTS: Table will show the clinical outcomes after various interventions. CONCLUSION: This paper instructs the nurses to develop protocol based on evidence to improve the clinical efficacy for the RA patients. TRIAL REGISTRATION NUMBER: researchregistry6114.

Depression treatment research in people with cancer does not reflect cancer prevalence: findings from a systematic review.

BACKGROUND: One in six people with cancer will develop depression at some point in their care. Untreated depression affects quality of life, cancer care satisfaction and healthcare expenditure. Treatments for this vulnerable heterogenous population should be evidence based and specific. A common sentiment is that psychiatric research does not reflect the prevalence of patients with cancer and comorbid depression and is biased towards certain cancers, but this has not been empirically shown. STUDY SELECTION AND ANALYSIS: A systematic review of studies on psychological and pharmacological treatments for depression in people with cancer was conducted. Of 4621 papers identified from a search of PubMed and PsycINFO up to 27 June 2020, 84 met inclusion criteria (eg, adults with cancer; depression diagnosis; treatment study) and comprised 6048 participants with depression with cancer. FINDINGS: Cancer types are not proportionally represented in depression research in accordance with their incidence. Breast cancer is over-represented (relative frequency in research 49.3%, but 11.7% of global cancer). Cancers of the head and neck and bone and soft tissue were close to parity. All other cancers are under-represented. Representativeness varied 40-fold across different cancers. CONCLUSIONS: The evidence base for depression treatments is dominated by a single cancer. Given heterogeneity in cancer populations (eg, stage of illness; psychological impact; cancer treatments), it is possible that depression treatments may not have the same benefits and harms across all cancers, impeding the ability to offer people with different cancers the best depression treatment. While the dominant opinion within this research field is that a cancer bias exists, this is the first study to demonstrate as such.

Developing and testing a nurse-led intervention to support bereavement in relatives in the intensive care (BRIC study): a protocol of a pre-post intervention study.

BACKGROUND: When a patient is approaching death in the intensive care unit (ICU), patients' relatives must make a rapid transition from focusing on their beloved one's recovery to preparation for their unavoidable death. Bereaved relatives may develop complicated grief as a consequence of this burdensome situation; however, little is known about appropriate options in quality care supporting bereaved relatives and the prevalence and predictors of complicated grief in bereaved relatives of deceased ICU patients in the Netherlands. The aim of this study is to develop and implement a multicomponent bereavement support intervention for relatives of deceased ICU patients and to evaluate the effectiveness of this intervention on complicated grief, anxiety, depression and posttraumatic stress in bereaved relatives. METHODS: The study will use a cross-sectional pre-post design in a 38-bed ICU in a university hospital in the Netherlands. Cohort 1 includes all reported first and second contact persons of patients who died in the ICU in 2018, which will serve as a pre-intervention baseline measurement. Based on existing policies, facilities and evidence-based practices, a nurse-led intervention will be developed and implemented during the study period. This intervention is expected to use 1) communication strategies, 2) materials to make a keepsake, and 3) a nurse-led follow-up service. Cohort 2, including all bereaved relatives in the ICU from October 2019 until March 2020, will serve as a post-intervention follow-up measurement. Both cohorts will be performed in study samples of 200 relatives per group, all participants will be invited to complete questionnaires measuring complicated grief, anxiety, depression and posttraumatic stress. Differences between the baseline and follow-up measurements will be calculated and adjusted using regression analyses. Exploratory subgroup analyses (e.g., gender, ethnicity, risk profiles, relationship with patient, length of stay) and exploratory dose response analyses will be conducted. DISCUSSION: The newly developed intervention has the potential to improve the bereavement process of the relatives of deceased ICU patients. Therefore, symptoms of grief and mental health problems such as depression, anxiety and posttraumatic stress, might decrease. TRIAL REGISTRATION: Netherlands Trial Register Registered on 27/07/2019 as NL 7875, www.trialregister.nl.

The impact of intense nursing care in improving anxiety, depression, and quality of life in patients with liver cancer: A systematic review and meta-analysis.

BACKGROUND: Liver resection is a major, serious, and very delicate operation that should be done only by specialized, well-skilled, and experienced surgeons. However, the role of nurses, which has often been under-estimated, is also crucial for the success of the intervention or surgery. Intensive nursing care involves high quality nursing modes to achieve the expected goals of treatment smoothly and with less complications. In this analysis, we aimed to show the impact of intense nursing care in improving anxiety, depression, and quality of life in patients with intervention for liver cancers. METHODS: Data sources included EMBASE, MEDLINE, Web of Science, the Cochrane central, Google scholar, and http://www.ClinicalTrials.gov. Three authors independently extracted data from the selected original studies. The statistical analysis was carried out by the Cochrane based RevMan software. For dichotomous data, the number of events and the total number of participants were required and for the continuous data, mean, standard deviation as well as the total number of participants were required in the input for analysis. Odds ratios (OR) with 95% confidence intervals (CI) were used to represent the data following assessment. RESULTS: A total of 1205 participants with liver cancer enrolled between the years 2010 to 2018 were included in this analysis whereby 667 participants were assigned to an intensive nursing care. Our current analysis showed that most of the patients who were assigned to an intense nursing intervention were significantly very satisfied with their quality of life (OR: 4.07, 95% CI: 1.45 - 11.45; P = .008). However, a minor number of patients with liver cancer who were not assigned to intense nursing care were significantly dissatisfied with their quality of life with OR: 0.18, 95% CI: 0.04 - 0.77; P = .02. This analysis also showed that self-rating anxiety score (SAS) and self-rating depression score (SDS) were significantly in favor of the participants with intense nursing care with OR: - 7.66, 95% CI: [(-9.66) - (-5.66)]; P = .00001 and OR: -7.87, 95% CI: [(-8.43) - (-7.26)]; P = .00001 respectively. In addition, physical function (OR: 13.56, 95% CI: 12.39 - 14.74; P = .00001), and total activity score (OR: 16.58, 95% CI: 13.51 - 19.65; P = .00001) were also significantly in favor of an intense nursing care. CONCLUSIONS: Our current analysis showed that intense nursing care significantly improved anxiety, depression, and quality of life following interventions in patients with liver cancers. Most of the patients with liver cancers who were assigned to an intense nursing care were very satisfied with their quality of life. However, this hypothesis should further be confirmed in larger nursing related studies based on patients with liver cancers.

Efectividad de un programa de enfermería en autocuidados y mindfulness, para el abordaje del trastorno mental común, en atención primaria / Effectiveness of a nursing program of self-care and Mindfulness, in the approach to the common mental disorder in primary care

OBJETIVO: Evaluar la efectividad de la implantación de un programa de mindfulness y autocuidados en atención primaria para el abordaje del trastorno mental común. DISEÑO: Estudio cuasiexperimental no controlado, no aleatorizado, con medidas repetidas. EMPLAZAMIENTO: Siete centros de salud del Área V del Principado de Asturias entre 2014 y 2018. PARTICIPANTES: Sujetos entre 18-75 años, con trastornos de ansiedad, depresivos y adaptativos mixtos, sin enfermedad mental grave. Muestreo no probabilístico por conveniencia. Intervención: Nueve sesiones grupales semanales de 90min, práctica diaria y sesiones de refuerzo al mes, 3, 6 y 12 meses. Mediciones principales: Medidas antes-después, evaluadas por cuestionarios validados y autoadministrados, a medio plazo (3-6 meses) y largo plazo (>12 meses) de las variables: ansiedad rasgo/ansiedad estado (Cuestionario de ansiedad estado-rasgo -STAI-); ansiedad/depresión (Escala de Ansiedad y Depresión de Goldberg -GHQ28-), atención plena (Five Facet Mindfulness Questionnaire -FFMQ-), reducción del tratamiento farmacológico (preguntas abiertas). RESULTADOS: Muestra final de 314 sujetos. Se halló una diferencia de medias estadísticamente significativa en los 3 periodos de seguimiento respecto a los valores basales para todas las escalas/subescalas. Hubo una reducción en la toma de medicación basal de ansiolíticos/antidepresivos del 54,3% en el seguimiento a largo plazo (p < 0,001). CONCLUSIONES: Una disminución moderada de los síntomas, junto con la reducción de la medicación, indican que la intervención en mindfulness dirigida por enfermeras de atención primaria puede ser una opción de tratamiento para el trastorno mental común en este nivel asistencial

OBJECTIVE: To evaluate the effectiveness of the implementation of a mindfulness and self-care program to treat common mental health disorders in primary care. DESIGN: Quasi-experimental non-controlled, non-randomised study, with repeated measurements. SETTING: Seven health centres, in area V of the Principality of Asturias, between 2014 and 2018. PARTICIPANTS: Subjects between 18-65 years with mixed anxiety, depressive, and adaptive disorders, with no serious mental disease. Non-probabilistic convenience sampling was used. Intervention: A group intervention was made, consisting of 9 weekly sessions of 90 min, daily practice, and reinforcement sessions at one month, 3, 6, and 12 months. MAIN MEASUREMENTS: Pre-post measurements using validated and self-administered questionnaires; medium-term (3-6 months) and long-term (>12 months) of the variables: trait anxiety/state anxiety (Status-Trait Anxiety Questionnaire -STAI-); anxiety/depression (Goldberg Anxiety and Depression Scale -GHQ28-), mindfulness (Five Facet Mindfulness Questionnaire -FFMQ-), reduction of pharmacological treatment (open questions). RESULTS: The study included a final sample of 314 subjects. A statistically significant difference in means was found in the 3 follow-up periods as regards the baseline values for all the scales/subscales. There was a reduction of 54.3% in the taking of anxiolytic/antidepressant baseline medication in the long-term follow-up (P < .001). CONCLUSIONS: A moderate reduction of the symptoms, together with the reduction of the medication, indicate that the intervention of mindfulness supervised by the primary care nurse can be a treatment option for the mental disorders common in this level of care

Effect of high-quality nursing intervention on anxiety and depression in patients with chronic heart failure companied malnutrition: A protocol for systematic review and meta-analysis.

BACKGROUND: This study will assess the effect of high-quality nursing intervention (HQNI) on anxiety and depression in patients with chronic heart failure companied malnutrition (CHFM). METHODS: We will retrieve electronic databases from the respective dates to February 29, 2020 without language and publication status restrictions: Cochrane Library, Web of Science, MEDLINE, EMBASE, Scopus, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All potential randomized controlled trials (RCTs), which examined the effect of HQNI on anxiety and depression in patients with CHFM will be included. Two team members will separately perform article retrieval, duplicates excluding, scanning, data collection, and study quality assessment. In addition, this study will carry out data analysis by RevMan 5.3 software. RESULTS: This study will provide high-quality synthesis and/or descriptive analysis of the latest evidence to assess the effect of HQNI on anxiety and depression in patients with CHFM. CONCLUSION: The findings of this study will exert evidence to judge whether or not HQNI is effective on anxiety and depression in patients with CHFM. REGISTRATION NUMBER: INPLASY202040069.

Biblical Counseling: An Alternative for Treating Depressive Symptoms.

Despite use of current standards of care-antidepressant medications and psychotherapy-to treat depressive symptoms, results experienced by patients and reported in the literature have been inconsistent. Religiously integrated cognitive behavioral therapy (RCBT) is an evidence-based alternative to cognitive behavioral therapy. A type of RCBT, biblical counseling is a viable option for patients experiencing depressive symptoms. Nurses need an awareness of biblical counseling as a therapeutic option for patients who are open to spiritually based care for depression.