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Clin Ter ; 172(4): 264-267, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34247207


Abstract: In the modern era, when prolonging life is not an option, the end-of-life discussions are unavoidably influenced by Neuroethics. Despite this, it is interestingly evident how the sentiments of a terminal patient of 1885 and a physician of 2020, are still comparable. This paper pre-sents the arguments behind the so-called "Therapeutic Misconception" and the aim of palliative care to provide dying patients support. It is essential to address priorities of informed consent, signed before any remedy is provided. A key component of the newest Neuroscience research is the analysis of motivation and free will. So, it is necessary to comprehend if the patient struggles to feel at peace with these aspects of his "right to die": Is he free to choose or is he influenced by the doctors? Is this confusion an example of "Therapeutic Misconception"? Is his Informed Consent totally "Informed"? In order to broaden our understanding, we account for many critical situations, such as the mentally impaired Psychiatric patients or the famous Italian case of Eluana Englaro. In addition, we suggested some current approaches such as Artificial Intelligence, useful in preserving some cognitive functions the patient may have lost. Furthermore, research in this field is very critical and in some Catholic countries like Italy, people faced difficulties accepting the idea of the "Anticipated directives". In general, whatever the mental status and whatever the terminal state, the patients seem still far from handling their own auto-determination and their Consent, even if the ultimate goal is to die with dignity.

Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/legislação & jurisprudência , Direitos do Paciente/ética , Direitos do Paciente/legislação & jurisprudência , Direito a Morrer/ética , Direito a Morrer/legislação & jurisprudência , Assistência Terminal/ética , Assistência Terminal/legislação & jurisprudência , Adulto , História do Século XIX , História do Século XXI , Humanos , Consentimento Livre e Esclarecido/história , Consentimento Livre e Esclarecido/psicologia , Itália , Masculino , Direitos do Paciente/história , Autonomia Pessoal , Médicos/ética , Médicos/psicologia , Direito a Morrer/história , Federação Russa , Assistência Terminal/história , Assistência Terminal/psicologia
J Emerg Manag ; 19(3): 307-315, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34195983


Using the Conservation of Resources Theory and the Self-Determination Theory1-3 as theoretical frameworks, a model for this study was tested, which considers firefighters' autonomous motivation, work-family conflict, and well-being. The hypothesized model was tested using a sample of 201 firefighters from the Special Civil Protection Force in Portugal. Results revealed that autonomous work motivation was significantly related to both work-family conflict and satisfaction with life. In addition, work-family conflict was negatively related to satisfaction with life. More interestingly, the results showed that work-family conflict acted as a mechanism that helped to explain the relationship between autonomous motivation and satisfaction with life. These results underline the importance of understanding the mechanisms through which higher satisfaction with life occurs, with a view to the creation of appropriate -interventions.

Bombeiros , Motivação , Conflito Familiar , Humanos , Autonomia Pessoal , Satisfação Pessoal
Artigo em Inglês | MEDLINE | ID: mdl-34204539


There is convincing evidence on the effects of sport and exercise on mental health and well-being. Less evidence is provided about how to achieve these benefits in the context of grassroots sport coaching. We systematically reviewed the scientific literature of three databases to narratively synthesize the current knowledge about which coaching-related factors influence well-being or ill-being, and how to promote mental health in adult athletes through sport coaches. The review includes 52 studies with different methodological and theoretical approaches and mental health outcomes. The wide range of themes were mapped and synthesized within two clusters, i.e., coaching behavior, antecedents, and context; and coach-athlete relationship and social support. The results highlight the importance of the promotion of empowering environments, autonomy-supportive coaching behavior, and coach-athlete relationship quality that relate to the satisfaction of basic psychological needs. The review also calls for a critical perspective, in the sense that the coaching context and working environment may not be empowering and supportive to the well-being of coaches and consequently to the athletes, and that coaches who want to provide autonomy-supportive environments may face various obstacles. Finally, the review synthesizes recommendations for the training of coaches, as one piece of a holistic mental health promotion.

Tutoria , Esportes , Adulto , Atletas , Humanos , Relações Interpessoais , Saúde Mental , Autonomia Pessoal
Comunidad (Barc., Internet) ; 23(1): 0-0, mar.-jun. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-201953


OBJETIVO: Conocer los cambios percibidos por las mujeres participantes de un grupo de empoderamiento sobre su estado físico, psíquico y social. DISEÑO: Metodología cualitativa mediante grupos focales. EMPLAZAMIENTO: Centro de salud (CS) urbano. PARTICIPANTES Y7O CONTEXTOS: Mujeres incluidas en alguna edición del Programa de Grupo de Empoderamiento del CS, dirigido por la trabajadora social desde 2012. MÉTODO: Grupos focales audiograbados durante 60-70 minutos. Transcripción literal, codificación y triangulación de los datos, comprobando saturación de la información. Análisis con MaxQDA. RESULTADOS: Desde el punto de vista psicológico, la situación previa de las participantes presentaba una baja autoestima, sintiéndose por lo general relegadas al último lugar en la jerarquía familiar. Las herramientas adquiridas durante las sesiones les ha permitido reivindicar un papel de mayor protagonismo. Respecto a su estado de salud físico, no perciben cambios importantes, excepto la menor dependencia farmacológica y la mayor capacidad para afrontar sus problemas de salud. A su vez, este programa les ha proporcionado la oportunidad de crear nuevas relaciones fuera de su entorno habitual. En contraposición, se comprueba una gran dependencia a la pertenencia al grupo. CONCLUSIONES: Destaca que el aprendizaje y la adquisición de nuevas herramientas, la mejora y ampliación de la red social, así como los cambios en la percepción de su propio yo, han dotado a las mujeres de mayor autonomía y ha mejorado su autoestima globalmente. En los aspectos negativos destaca la gran dependencia del grupo hacia la figura dinamizadora, que dificulta su propia autonomía

OBJECTIVE: To ascertain the changes perceived by the women participating in an empowerment group on their physical, mental and social state. DESIGN: Qualitative methodology by means of focus groups. LOCATION: Urban Health Centre (HC). Participants and/or backgrounds. Female sex, included in an edition of the HS Empowerment Group Programme, which has been supervised by the social worker since 2012. METHOD: Audio-recorded focus groups 60-70 minutes long. Literal transcription, coding and triangulation of the data guaranteeing information saturation. Analysis with MaxQDA. RESULTS: From the psychological point of view, the previous situation of the participants presented a low self-esteem, feeling in general relegated to the last place in the family hierarchy. The tools acquired during sessions enabled them to claim a role of greater prominence. Regarding their state of physical health, they do not perceive important changes except lower pharmacological dependence and greater capacity to tackle their health problems. In turn, this programme has provided them with the opportunity to create new relationships outside their usual environment. In contrast, a major dependence on belonging to the group was revealed. CONCLUSIONS: It is notable that learning and the acquisition of new tools, improvement and expansion of the social network, as well as changes in the perception of their own selves, have given women greater autonomy and have improved their self-esteem globally. In terms of negative aspects, the major dependence of the group on the dynamic figure, which hinders its own autonomy, stands out

Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Empoderamento para a Saúde/métodos , Nível de Saúde , Saúde Mental , Qualidade de Vida , Empoderamento para a Saúde/organização & administração , Grupos Focais , Educação em Saúde/organização & administração , Autonomia Pessoal , Pesquisa Qualitativa , Transtornos de Ansiedade/epidemiologia , Depressão , Autoimagem , Relações Interpessoais
Barbarói ; (58): 141-153, jan.-jun. 2021. ilus
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1150774


O objetivo desse estudo é analisar e investigar a qualidade de vida em pessoas com lesão medular, através de uma revisão sistemática. Buscaram-se os principais trabalhos publicados no período de 2006 a 2019, nas bases de dados CAPES e Scielo. Todos os estudos utilizaram medidores quantitativos sobre qualidade de vida, os quais são: o WHOQOL-Bref e o SF-36. Os resultados de forma geral mostraram que o sujeito com lesão medular avalia sua qualidade de vida como boa e sua saúde de forma geral satisfatória. O domínio físico e do meio ambiente foram os domínios mais citados nas pesquisas como um fator negativo, sendo ele relacionado com a questão da acessibilidade. Verificou-se que estudos futuros são de extrema importância, para compreender a qualidade de vida desses indivíduos, assim como para a melhoria de políticas públicas para questão de acessibilidade e autonomia desses sujeitos.(AU)

The aim of this study is to analyze and investigate the quality of life in people with spinal cord injury, through a systematic review. The main studies published in the period 2006 to 2019 were searched in the CAPES, Scielo. All the studies used quantitative measure about quality of life, which were the WHOQOL-Bref and the SF-36. The results generally showed that the subject with spinal cord injury evaluates their quality of life as good and their health in a general satisfactory manner. The physical and environmental domains were the most cited domains in the researches as a negative factor, being related to the issue of accessibility. It was found that future studies are extremely important to understand the quality of life of these individuals, as well as for the improvement of public policies for the question of accessibility and autonomy of these subjects.(AU)

Humanos , Qualidade de Vida , Traumatismos da Medula Espinal , Pessoas com Deficiência , Política Pública , Autonomia Pessoal
Barbarói ; (58): 95-121, jan.-jun. 2021.
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1150759


Objetivo: analisar na literatura científica global o tema protagonismo do usuário no serviço de saúde mental. Método: revisão integrativa da literatura, a partir de artigos em português, inglês e francês nas bases de dados da Biblioteca Virtual em Saúde, CINAHL, SCOPUS e PubMed com palavras-chave e MESH, sem determinação temporal. Elegeram-se 21 artigos pelo fluxograma de seleção no período de agosto de 2017 a abril 2020. Resultados: o protagonismo na área da saúde mental é descrito como uma prática transformadora e humanitária pautada nas necessidades do usuário, os artigos nacionais e internacionais trouxeram concepções e ações sobre o protagonismo. Conclusão: o Modelo da Maré, as oficinas terapêuticas, o Projeto Terapêutico Singular, o Psicodrama e o teatro são ferramentas que se apresentam essenciais para o protagonismo do usuário na assistência em saúde mental, pois demarcam tecnologias e dispositivos de produção que permeiam a autonomia, a valorização e subjetividade da pessoa assistida.(AU)

Objetivo: analizar en la literatura científica global el tema del protagonismo del usuario en el servicio de salud mental. Método: revisión bibliográfica integradora, basada en artículos en portugués, inglés y francés en las bases de datos de la Biblioteca Virtual en Salud, CINAHL, SCOPUS y PubMed con palabras clave y MESH, sin determinación temporal. El diagrama de flujo de selección eligió 21 artículos de agosto de 2017 a abril de 2020. Resultados: el protagonismo en el área de salud mental se describe como una práctica transformadora y humanitaria basada en las necesidades del usuario, los artículos nacionales e internacionales aportaron conceptos y acciones sobre protagonismo. Conclusión: el Modelo Maré, los talleres terapéuticos, el Proyecto Terapéutico Singular, el Psicodrama y el teatro son herramientas esenciales para el papel del usuario en la atención de la salud mental, ya que delimitan tecnologías y dispositivos de producción que impregnan la autonomía. La valoración y subjetividad de la persona asistida.(AU)

Objective: to analyze in the global scientific literature the theme of user leadership in the mental health service. Method: integrative literature review, based on articles in Portuguese, English and French in the databases of the Virtual Health Library, CINAHL, SCOPUS and PubMed with keywords and MESH, without temporal determination. 21 articles were chosen by the selection flowchart from August 2017 to April 2020. Results: the leadership in the mental health area is described as a transformative and humanitarian practice based on the needs of the user, national and international articles brought concepts and actions on leadership. Conclusion: the Tidal Model, the therapeutic workshops, the Singular Therapeutic Project, Psychodrama and the theater are tools that are essential for the role of the user in mental health care, as they demarcate technologies and production devices that permeate autonomy, the valuation and subjectivity of the assisted person.(AU)

Humanos , Pacientes , Saúde Mental , Autonomia Pessoal , Assistência à Saúde Mental , Serviços de Saúde Mental
Afr J Reprod Health ; 25(s1): 26-35, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34077142


Academic women in the Arab world, especially Saudi women, have numerous barriers inhibiting their leadership power at the workplace. The current study explores the perceived and real barriers to workplace empowerment among women at Saudi universities. A descriptive cross-sectional study was carried out at 15 Saudi governmental universities. A multistage cluster sampling technique was followed to select (5587 participants) The data collection started from the beginning of April to the beginning of September 2020. SPSS 23.0 was used to analyze data using descriptive statistics. Multiple linear regression was used to identify the real barriers to women empowerment at the workplace. The study showed that 52.1% of the study participants had moderate workplace empowerment, and only 10.2% have a low level. Regarding perceived barriers to workplace empowerment, 42.6% of the participants agree that male dominance was a barrier. Moreover, 36.2% of the participants agreed and strongly agree that the customs and traditions are a barrier to women empowerment at the workplace. Multiple linear regression showed that age, followed by years of experience (p <0.000), were the most significant demographic predictors of women empowerment at the workplace. Moreover, positive attitude, high self-esteem, and good knowledge (p <0.000) were considered other variables that positively predict women's empowerment at the workplace. The experience of gender-based violence (p <0.000) was a negative predictor of women empowerment at the workplace. The study concluded that around 62.3% of Saudi female academics and administrative staff have moderate or low workplace empowerment at Saudi Universities. Male dominance is perceived as the highest barrier.

Empoderamento , Autonomia Pessoal , Poder Psicológico , Local de Trabalho/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Arábia Saudita , Universidades
Afr J Reprod Health ; 25(s1): 50-59, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34077144


The KSA 2030 vision makes special reference to women's empowerment as an important strategy for Saudi community transformation. Studies related to women's empowerment, especially in the Saudi context, are still not enough and unclear. The current study explored the predictors of women empowerment knowledge and attitudes among Saudi academic and administrative staff. A cross-sectional study was conducted at 15 Saudi government-owned universities. A multistage cluster sampling technique was used to select 5587 participants during the period April to September 2020. The study instrument consisting of three main parts; basic demographic data, questionnaire assessed the knowledge regarding women's empowerment, and women empowerment attitude scale. The results showed good knowledge of empowerment among the women with 75.5% of the participants demonstrating good knowledge. The total women empowerment attitude was positive among 65.9% of the participants. The association between demographic data and women empowerment knowledge and attitude showed a significant association with marital status, residence, education, and occupation (p <0.05). Linear regression on marital status, education, residence, and occupation, are confirmed as significant predictors of women empowerment knowledge and attitude (p <0.05). Mother's education level is shown as a predictor for women empowerment attitude (p>0.005). Three-quarters of Saudi academic and administrative staff have a good women empowerment knowledge score, and more than two-thirds have a positive attitude. Demographic characteristics are important predictors for women empowerment knowledge and attitude. The results of this study will help decision-makers to design and implement goal-directed women empowerment programs.

Pessoal Administrativo/psicologia , Empoderamento , Docentes/psicologia , Poder Psicológico , Mulheres Trabalhadoras/psicologia , Adulto , Atitude , Estudos Transversais , Feminino , Humanos , Conhecimento , Pessoa de Meia-Idade , Autonomia Pessoal , Arábia Saudita , Fatores Socioeconômicos , Inquéritos e Questionários , Universidades
Afr J Reprod Health ; 25(s1): 60-68, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34077145


Women in Saudi Arabia constitute nearly 50% of the population, but their participation in economic and social activities are far below the kingdom's potential. According to the 2030 vision, women empowerment is an essential requirement for community transformation and development. The study aims to explore women empowerment among academic and administrative staff in Saudi Universities. A cross-sectional research design was conducted at 15 Saudi governmental universities. A multistage cluster sampling technique was followed to select 5587 participants. The data collection starts from April to September 2020. The current study results illustrate statistically significant differences between academic and administrative staff in the total women empowerment score and all of its dimensions (p <0.05). The majority of academic staff (84.4%) have high personal empowerment compared to 73.7% of the administrative staff. The study concluded that women empowerment is higher among academics compared to administrative staff in Saudi Universities.

Pessoal Administrativo/psicologia , Empoderamento , Docentes/psicologia , Poder Psicológico , Mulheres Trabalhadoras/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Autonomia Pessoal , Arábia Saudita , Autoimagem , Fatores Socioeconômicos , Inquéritos e Questionários , Universidades
JAMA ; 325(21): 2155-2156, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34061141
Rev Bras Enferm ; 74(3): e20200723, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34161499


OBJECTIVE: To reflect on autonomy in health care, its perspective on the lives of the elderly, and its meaning for the practice of nursing care. METHODS: Theoretical essay on the practice of nursing care to promote autonomy and self-care for the elderly. RESULTS: It is necessary to qualify the practice of nursing care to consider the aging process and maintain the autonomy of the elderly. Three parts emerged: "The autonomy of the elderly and the care plan", "Nursing in the self-care process", and "Challenges to the practice of caring for the elderly in nursing". FINAL CONSIDERATIONS: There is still a deficiency in promoting autonomy for the elderly due to the need for a review of the practice of nursing care, which, considering aging in Brazil, needs to undertake new actions in order to encourage self-care and autonomy in this population.

Cuidados de Enfermagem , Idoso , Envelhecimento , Brasil , Atenção à Saúde , Humanos , Autonomia Pessoal
Am J Bioeth ; 21(7): 40-42, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34152909
Recent Results Cancer Res ; 218: 219-232, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34019171


There are undoubtedly sick people who suffer terribly, and of course this should not be. No patient with incurable cancer is to be so tortured for months or years that they want only to die and lack the means to do so. Being unable to die can be worse than death, one might say or think. But until we ourselves have crossed that frontier, we do not know this for certain. To die could be worse than not being able to die. One case is difficult to distinguish from the other. But we pretend we can distinguish them if we praise assisted suicide and euthanasia as solutions to a problem that we not only do not solve, but make worse. Do we need assisted suicide in the face of non-dying skills? The author's answer is no: we do not need euthanasia, neither in that nor in any other case. The logic of euthanasia itself decrees that it cannot be restricted to exceptional cases, based as it is on the idea that the patient's autonomy is to be valued more highly than their actual illness. But if autonomy were of absolute value, it could not be limited to cases of severe disease. The reasons which supporters of euthanasia cite for limiting assisted suicide to the most serious cases of illness, therefore, speak against euthanasia in general. Once the first step has been taken, the application can no longer be limited if, on the one hand, the 'autonomous' desire for death is superior to any counter-argument, and on the other hand, no state of illness is conceivable that could call into question the alleged autonomy.

Eutanásia , Suicídio Assistido , Humanos , Autonomia Pessoal
Harefuah ; 160(5): 328-331, 2021 May.
Artigo em Hebraico | MEDLINE | ID: mdl-34028227


INTRODUCTION: It is generally understood that Jewish law requires every effort to be made to extend the life of a terminally ill patient using routine treatments, whether he is conscious or not, and whether he wants his life prolonged or is opposed to it. The "Law for Patients Wishing to Die" proposes this approach with slight variations. This article discusses the patient who wishes to die from a Jewish viewpoint, illustrating that this is not the only Jewish approach. The role of the doctor is to cure and not to extend a life of suffering in any case. If the doctor cannot cure him, he should respect the wishes of the patient who does not wish to continue to suffer, by stopping life-prolonging treatment and providing only pain-reducing treatment. This law is correct not only in cases where the patient is aware of his situation but also in cases where the patient is comatose and has no realistic chance of returning to life. Ideas from the Talmud, from the Shulchan Aruch, and from the rulings of many poskim (rabbis) confirm that Judaism places great emphasis on personal autonomy and on limiting medical intervention to situations of need. The authors of the article call for the law to be changed in this respect.

Judaísmo , Autonomia Pessoal , Humanos , Judeus , Masculino
Age Ageing ; 50(3): 664-667, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33951154


BACKGROUND AND OBJECTIVES: during the coronavirus disease 2019 pandemic in Israel, people residing in continuing care retirement communities (CCRC) found themselves under strict instructions to self-isolate, imposed by the CCRC managements before, during and after the nationwide lockdown. The present study explored the personal experiences of CCRC residents during the lockdown. RESEARCH DESIGN AND METHODS: in-depth interviews were conducted with 24 CCRC residents from 13 different CCRCs. Authors performed a thematic analysis of interview transcripts, using constant comparisons and contrasts. RESULTS: three major themes were identified: (i) 'Us vs. them: Others are worse off'. Older residents engaged in constant attempts to compare their situation to that of others. The overall message behind these downward comparisons was that the situation is not so bad, as others are in a worse predicament; (ii) 'Us vs. them: Power imbalance'. This comparison emphasised the unbalanced power-relations between older adults and the staff and management in the setting and (iii) 'We have become prisoners of our own age'. Interviewees described strong emotions of despair, depression and anger, which were intensified when the rest of society returned back to a new routine, whilst they were still under lockdown. DISCUSSION AND IMPLICATIONS: the measures imposed on residents by managements of CCRCs during the lockdown, and the emotional responses of distress among some of the residents, revealed that CCRCs have components of total institutions, not normally evident. This underscores the hidden emotional costs of the lockdown among those whose autonomy was compromised.

COVID-19/psicologia , Solidão/psicologia , Assistência de Longa Duração , Paternalismo , Isolamento Social , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Israel/epidemiologia , Autonomia Pessoal , Aposentadoria , SARS-CoV-2