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1.
Int Nurs Rev ; 71(2): 244-249, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38191271

RESUMO

OBJECTIVE: To contribute to the recognition of psychotherapeutic nursing (PTN) as a regulated advanced clinical practice (ACP) in Spain, as is the case in other countries. BACKGROUND: Nurses are continually evolving to improve overall health outcomes. PTN has become a reality, with several authors describing it as an ACP. In Spain, psychotherapy is not officially regulated, which has led to a significant number of psychiatric nurses adopting an important ACP in this area without recognition. SOURCES OF EVIDENCE: Evidence confirms that PTN possesses the attributes necessary to be considered an ACP. Nurses, like psychotherapists, independently address the complex needs of individuals and families within the context of therapeutic relationships, and there is a pressing need to advance formal processes of regulation and certification. DISCUSSION: PTN has evolved at different rates depending on local initiatives, policies and various professional interests. In Spain, it is crucial to evaluate its outcomes, recognise it as an ACP and develop training plans for its regulation and accreditation. CONCLUSIONS: Mental health nurses in Spain have a strong interest in PTN being recognised as an ACP. To this end, they should join forces with other partners, scientific associations and international bodies such as the International Council of Nurses (ICN) to make PTN an internationally recognised ACP. IMPLICATIONS FOR NURSING PRACTICE: Psychotherapeutic nurses could contribute to improving mental health outcomes, client satisfaction and health system efficiency, and their formal recognition is an opportunity to enhance their professional identity, competence and autonomy. IMPLICATIONS FOR NURSING POLICY: Nursing policy needs to be reoriented towards strengthening psychotherapy as an ACP. Synergies and alliances between international nursing associations and the ICN can promote its development and implementation, while research, education and leadership are essential to achieving official regulation and accreditation.


Assuntos
Enfermagem Psiquiátrica , Psicoterapia , Humanos , Espanha , Prática Avançada de Enfermagem , Papel do Profissional de Enfermagem , Promoção da Saúde , Transtornos Mentais/enfermagem , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Saúde Mental
2.
Epidemiol Infect ; 151: e112, 2023 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-37325911

RESUMO

We analysed the transmission of the human mpox virus in Spain by estimating the effective reproduction number of the disease from official surveillance data. Our computations show that this decreased steadily after an initial burst phase, dropping below 1 on July 12, and thus the outbreak was expected to reduce in the following weeks. Differences in trends were found across geographical regions of the country and across MSM and heterosexual populations.


Assuntos
Mpox , Humanos , Número Básico de Reprodução , Espanha/epidemiologia , Surtos de Doenças
3.
J Neuroophthalmol ; 42(3): 378-383, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35421036

RESUMO

BACKGROUND: To study the effect of greater occipital nerve (GON) block on migraine-associated photophobia levels. Photophobia is one of the most bothersome symptoms reported by migraine patients. Studies investigating the impact of migraine treatment on this symptom are scarce. METHODS: This is an observational prospective case-control study. Patients with migraine and photophobia attending a Headache Clinic were recruited. Cases were defined as patients in whom GON block was performed, following usual clinical practice guidelines. All patients were evaluated with the Hospital Anxiety and Depression Scale, the Migraine Specific Quality of Life Questionnaire, the Utah Photophobia Symptom Impact Scale (UPSIS-12), and the Korean Photophobia Questionnaire (KUMC-8); both in the first visit (V1) and one week after (V2). RESULTS: Forty-one patients were recruited, 28 (68.3%) cases and 13 (31.7%) controls. At V1, there were no significant differences in the median [p25-p75] score of UPSIS-12 in cases vs controls (32.0 [21.0-34.0] vs 30.5 [22.0-37.0], P = 0.497) or KUMC-8 (6.5 [5.5-7.0] vs 7.0 [6.0-8.0], P = 0.463). At V2, cases experimented a significant improvement in UPSIS-12 of -5.5 [-8.8 to -1.3] and in KUMC-8 of -0.5 [-2.0 to 0], whereas there were no significant changes in the control group. Migraine with aura patients presented higher UPSIS-12 score at V1 (33.5 [24.5-37.0] vs 26.0 [16.0-35.0]) and lesser improvement at V2 after GON block compared with migraine without aura patients (-4.0 [-6.0 to -1.0] vs -8.0 [-17.0 to -2.0]), although statistical significance was not achieved ( P = 0.643 and P = 0.122, respectively). There was no significant variation in the remaining scales. CONCLUSIONS: Greater occipital nerve block improves migraine-associated photophobia, measured with UPSIS-12 and KUMC-8. Patients without aura may exhibit a greater improvement. Physicians could consider GON block for management of photophobia in migraine patients.


Assuntos
Transtornos de Enxaqueca , Bloqueio Nervoso , Síndrome de Quebra de Nijmegen , Estudos de Casos e Controles , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/terapia , Síndrome de Quebra de Nijmegen/complicações , Fotofobia/complicações , Qualidade de Vida
4.
Qual Life Res ; 30(10): 2819-2827, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33956312

RESUMO

PURPOSE: We examined the way people assess hospitalized patients' quality of life from what they immediately observe when entering the patient's room, from what they learn by conversing with the patient, and from what they know about the patient's social life. METHODS: A sample of 474 adults (among them 7 physicians, 57 nurses, and 42 nurse's aides) aged 18-90 years was presented with 54 realistic scenarios depicting the situation of a terminally ill patient, and created by orthogonally combining the levels of four factors: chronic pain (e.g., requiring powerful painkillers), social support (e.g., some visits), mental status (e.g., alterations of consciousness), and physical autonomy. In each case, they assessed the patient's health-related quality of life. RESULTS: Through cluster analysis, three different positions related to what is important when judging the quality of life of a hospitalized patient were found. They were labeled Almost Always Low (40%), Depends on Personal and Social Circumstances (49%), and Depends Mainly on Social Support (11%). Health professionals did not differ fundamentally from lay people in their positions regarding what determines the health-related quality of life of their patients. CONCLUSION: Many people take a particularly pessimistic view of the quality of life of people whose health is unlikely to improve. Others think that, in certain circumstances, a certain quality of life can be preserved but for this to happen, the situation must be nearly ideal. A minority expressed a position consistent with the insistence of voluntary patient-visiting associations on the importance of providing hospitalized patients with social support.


Assuntos
Qualidade de Vida , Doente Terminal , Adulto , Atitude do Pessoal de Saúde , Pessoal de Saúde , Humanos , Pacientes , Qualidade de Vida/psicologia
5.
Headache ; 60(10): 2176-2191, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32989732

RESUMO

OBJECTIVE: To describe the semiology of pain and its associated features in patients with coronavirus disease 2019 (COVID-19) and headache presenting to the emergency department who do not require urgent services. BACKGROUND: Headache is one of the most frequent neurological symptoms reported in case series, epidemiological studies, and meta-analyses of COVID-19, with a prevalence ranging from 8 to 71.1%. Studies addressing the semiology of these headaches are lacking. METHODS: We conducted a cross-sectional study in the emergency department of a tertiary hospital. Patients classified according to the Manchester Triage System as standard and non-urgent and those fulfilling the criteria for probable or confirmed COVID-19 according to World Health Organization guidelines who presented with headache were included. A standardized questionnaire was used for data collection. RESULTS: Of the 145 confirmed and probable COVID-19 patients, 99 (68.3%) reported headache. A total of 54/99 (54.5%) were classified with probable COVID-19 and 45/99 (45.5%) with confirmed COVID-19. The mean age (44.7 ± 11.8 vs 40.4 ± 10.7, P = .061), sex distribution (35/54 [64.8%] vs 28/45 [62.2%] female, P = .768), and headache comorbidity (19/54 [35.2%] vs 17/45 [37.8%], P = .789) were similar between the probable and confirmed COVID-19 groups, along with other medical comorbidities and laboratory data. Patients with confirmed COVID-19 showed a higher incidence of anosmia (21/54 [38.9%] vs 28/45 [62.2%], P = .021) and pneumonia (10/54 [18.5%] vs 18/45 [40%], P = .018), headache at onset (32/54 [59.3%] vs 39/45 [86.7%], P = .002), and hospital admission (0/54 [0%] vs 2/45 [11.1%], P = .017). In most cases, the headache appeared simultaneously with other COVID-19 symptoms (57/99, 57.6%). It was bilateral (86/99, 86.9%), frontal or holocranial (34/99, 34.3% each) in location and intense (60/99, 60.6%, reported a visual analog scale [VAS] score ≥7). A total of 39/99 (39.4%) identified triggers, most commonly fever. The most frequent aggravating factors were physical activity (45/99, 45.5%) and coughing (43/99, 43.4%). Patients showed a propensity toward prostration (41/99, 41.4%), photophobia (29/99, 29.3%), and phonophobia (27/99, 27.3%). Partial (53/99, 53.5%) or total (26/99, 26.3%) responses to first-step analgesics were reported. A total of 25/99 (25.3%) patients had a prior history of migraine, presenting with headache different from the usual in 23/25 (92.0%) patients. Individuals with migraine were more likely to have earlier (headache at onset of the respiratory symptoms in 24/25 [96.0%] vs 57/74 [77.0%], P = .023 [95% CI: 0.067, 0.313]), longer (>24 hours of pain in 20/25 [80%] vs 25/74 [33.8%], P < .001 [95% CI: 0.272, 0.652]), and more intense (VAS score ≥5 in 25/25 [100%] vs 63/74 [85.1%], P = .043 [95% CI: 0.057, 0.213]) headaches than patients without migraine. CONCLUSIONS: Headache is a very prevalent COVID-19 symptom among patients presenting to the emergency room, most frequently presenting as holocranial or bifrontal moderate to severe, and pressing quality headache. Individuals with migraine tend to present with earlier, longer, and more intense headaches.


Assuntos
COVID-19/complicações , Cefaleia/epidemiologia , Cefaleia/virologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , SARS-CoV-2 , Espanha/epidemiologia
6.
Cell Physiol Biochem ; 53(6): 910-920, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31769258

RESUMO

BACKGROUND/AIMS: Exposure to heavy metals is today a threat to society. The understanding of the molecular processes related to diseases related to exposure to metals mixture involve changes in the expression of microRNAs. Changes on microRNAs expression may alter several cellular processes, among them, DNA repair inhibition has been described as an essential event leading to the initiation of metal-induced carcinogenesis. METHODS: We evaluate the miR-222 expression in the two-stage transformation Balb/c 3T3 cell assay treated with As-Cd-Pb mixture. RESULTS: We could appreciate that up-regulation of miR-222 reduces the expression both gene and as a protein expression of Rad51c by RT-PCR and immunoblot, respectively. CONCLUSION: Here, we demonstrate that the mixture of As-Cd-Pb at epidemiologically relevant concentrations induces miR-222 up-regulation, which directly negatively regulates Rad51c expression and impairs homologous recombination of DNA during the initiation stage of cell transformation. This inhibition triggers morphological transformation in a murine two-stage Balb/c 3T3 cell assay, suggesting that this small RNA acts as an initiator of the carcinogenesis process.


Assuntos
Transformação Celular Neoplásica/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Metais Pesados/farmacologia , MicroRNAs/metabolismo , Rad51 Recombinase/metabolismo , Animais , Antagomirs/metabolismo , Arsênio/química , Células 3T3 BALB , Cádmio/química , Sobrevivência Celular/efeitos dos fármacos , Quebras de DNA de Cadeia Dupla/efeitos dos fármacos , Proteínas de Ligação a DNA , Chumbo/química , Camundongos , MicroRNAs/antagonistas & inibidores , MicroRNAs/genética , Rad51 Recombinase/genética
7.
BMC Public Health ; 19(1): 441, 2019 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-31029110

RESUMO

BACKGROUND: Inappropriate use of antibiotics is a worldwide issue. In order to help public health institutions and each particular physician to change patterns of consumption among patients, it is important to understand better the reasons why people accept to take or refuse to take the antibiotic drugs. This study explored the motives people give for taking or refusing to take antibiotics. METHODS: Four hundred eighteen adults filled out a 60-item questionnaire that consisted of assertions referring to reasons for which the person had taken antibiotics in the past and a 70-item questionnaire that listed reasons for which the person had sometimes refused to take antibiotics. RESULTS: A six-factor structure of motives to take antibiotics was found: Appropriate Prescription, Protective Device, Enjoyment (antibiotics as a quick fix allowing someone to go out), Others' Pressure, Work Imperative, and Personal Autonomy. A four-factor structure of motives not to take antibiotics was found: Secondary Gain (through prolonged illness), Bacterial Resistance, Self-defense (the body is able to defend itself) and Lack of trust. Scores on these factors were related to participants' demographics and previous experience with antibiotics. CONCLUSION: Although people are generally willing to follow their physician's prescription of antibiotics, a notable proportion of them report adopting behaviors that are beneficial to micro-organisms and, as a result, potentially detrimental to humans.


Assuntos
Atitude Frente a Saúde , Adesão à Medicação/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Adulto , Antibacterianos/uso terapêutico , Feminino , Humanos , Masculino , Autonomia Pessoal , Personalidade , Inquéritos e Questionários
8.
Nanomedicine ; 18: 101-111, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30849549

RESUMO

The usefulness of nanotechnology to increase the bioavailability of drugs and decrease their toxicity may be a tool to deal with multiresistant P. aeruginosa (Mr-Pa) respiratory infections. We describe the preparation and the in vivo efficacy and safety of sodium colistimethate-loaded nanostructured lipid carriers (SCM-NLC) by the pulmonary and intramuscular routes. Nanoparticles showed 1-2 mg/L minimum inhibitory concentration against eight extensively drug-resistant P. aeruginosa strains. In vivo, SCM-NLC displayed significantly lower CFU/g lung than the saline and similar to that of the free SCM, even the dose in SCM-NLC group was lower than free SCM. There was no tissue damage related to the treatments. Biodistribution assessments showed a mild systemic absorption after nebulization and a notorious absorption after IM route. Altogether, it could be concluded that SCM-NLC were effective against P. aeruginosa in vivo, not toxic and distribute efficiently to the lung and liver after pulmonary or intramuscular administrations.


Assuntos
Colistina/análogos & derivados , Portadores de Fármacos/química , Lipídeos/química , Pulmão/microbiologia , Nanoestruturas/química , Pseudomonas aeruginosa/efeitos dos fármacos , Animais , Colistina/administração & dosagem , Colistina/efeitos adversos , Colistina/farmacologia , Feminino , Inflamação/patologia , Injeções Intramusculares , Pulmão/patologia , Camundongos Endogâmicos BALB C , Testes de Sensibilidade Microbiana , Nanoestruturas/toxicidade , Nanoestruturas/ultraestrutura , Distribuição Tecidual/efeitos dos fármacos , Testes de Toxicidade , Resultado do Tratamento
9.
Sensors (Basel) ; 20(1)2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31878093

RESUMO

Techniques based on ultrasound in nondestructive testing and medical imaging analyze the response of the source frequencies (linear theory) or the second-order frequencies such as higher harmonics, difference and sum frequencies (nonlinear theory). The low attenuation and high directivity of the difference-frequency component generated nonlinearly by parametric arrays are useful. Higher harmonics created directly from a single-frequency source and the sum-frequency component generated nonlinearly by parametric arrays are attractive because of their high spatial resolution and accuracy. The nonlinear response of bubbly liquids can be strong even at relatively low acoustic pressure amplitudes. Thus, these nonlinear frequencies can be generated easily in these media. Since the experimental study of such nonlinear waves in stable bubbly liquids is a very difficult task, in this work we use a numerical model developed previously to describe the nonlinear propagation of ultrasound interacting with nonlinearly oscillating bubbles in a liquid. This numerical model solves a differential system coupling a Rayleigh-Plesset equation and the wave equation. This paper performs an analysis of the generation of the sum-frequency component by nonlinear mixing of two signals of lower frequencies. It shows that the amplitude of this component can be maximized by taking into account the nonlinear resonance of the system. This effect is due to the softening of the medium when pressure amplitudes rise.

10.
Support Care Cancer ; 25(9): 2723-2731, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28364172

RESUMO

BACKGROUND: Cancer patients suffer in part because some health professionals prescribe or administer amounts of analgesics, namely opioids, which are too small or too widely spaced to be fully effective. Patients' reluctance to use opioids for pain treatment is often mentioned as a reason not to apply the official guidelines, but very few studies have been conducted on people's attitudes about opioid use to relieve cancer pain. METHODS: One hundred twenty lay participants and 30 health professionals (7 physicians and 23 nurses) were presented with a set of vignettes describing a terminally ill woman with cancer who is in pain. The vignettes were composed according to a four within-subject factor design: (a) level of pain reported by the patient, (b) patient's explicit request for additional administration of analgesics, (c) the physicians' final decision (e.g., to use a stronger analgesic combining paracetamol and codeine), and (d) the way the decision was made (collectively or not). Participants were asked to assess the extent to which the physician's decision was, in their view, acceptable. RESULTS: Seven qualitatively different positions were found among participants. They were called as follows: tend to disagree with any decision (9%), increase the strength of the painkiller in any case (16%), give morphine preferentially (9%), partly depends on pain level (23%), fully depends on pain level (6%), depends on decision process and on pain level (22%), and tend not to disagree with any collective decision (25%). CONCLUSIONS: Overall, 91% of participants agreed with the use of morphine in terminally ill cancer patients when the pain level was high (score of 7) and the decision to increase the strength of the painkiller was taken collectively. This percentage dropped to 69% when the team was not involved in the decision and to 40% when the pain level was lower (score of 4). If opposition to the use of morphine exists, it is not opposition to morphine itself but opposition to the circumstances of its use.


Assuntos
Atitude do Pessoal de Saúde/etnologia , Dor do Câncer/tratamento farmacológico , Morfina/uso terapêutico , Neoplasias/tratamento farmacológico , Adolescente , Adulto , Feminino , França , Humanos , Pessoa de Meia-Idade , Morfina/administração & dosagem , Neoplasias/complicações , Adulto Jovem
11.
Int J Nurs Pract ; 23(2)2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28150417

RESUMO

AIM: We explored the positions of nurses working in hospitals regarding the acceptability of refusing to give a repeat dose of painkiller to a postoperative patient who requested it. These positions were compared with that of lay people, physicians, and other health professionals. DESIGN AND METHODS: Factorial design was used to assess the impact of 6 situational factors: the patient's age, the current level of pain as assessed by the nurse, the number of requests, the level of risk associated with the administration of a repeat dose, the outcome of surgery, and the giving of alternative mild analgesics. We implemented a combination of scenario technique and of cluster analysis. Data were collected from April 2013 to December 2015. PARTICIPANTS: 138 registered nurses, 32 nurse's aides, 33 physicians, 23 psychologists, and 169 lay people participated in the study. RESULTS: We found 4 qualitatively different meaningful positions. A plurality of participants (57% of nurses) considered that refusing was not acceptable, irrespective of circumstances. A substantial minority of participants (but 52% of physicians) considered that refusing was acceptable only if the level of pain was low and the risk was high. Other participants (mostly lay people) considered that refusing was always acceptable each time a risk of side effects, either serious or simply mild, was present.


Assuntos
Atitude do Pessoal de Saúde , Recursos Humanos de Enfermagem Hospitalar/psicologia , Manejo da Dor/ética , Medição da Dor/ética , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise por Conglomerados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia
12.
J Reprod Infant Psychol ; 35(1): 65-76, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-29517291

RESUMO

The aims of the present study were to map French laypersons' views regarding the acceptability of maternal surrogacy and to delineate the circumstances under which surrogacy is considered, by different groups of people, as especially problematic. Participants (N = 236) were presented with a number of scenarios depicting the circumstances in which a couple has contracted with a surrogate mother and were asked to indicate the extent to which such a contract may present a moral problem. The scenarios were created by varying four factors: the type of surrogacy (traditional or gestational), the surrogate mother's level of autonomy, the family context in which the surrogate mother lives, and whether surrogacy was commercial or altruistic. Three qualitatively different personal positions were found: (a) a majority group for which surrogacy always (30%) or often (34%) presents a moral problem, (b) a minority group (14%) for which maternal surrogacy does not systematically present a moral problem, and


Assuntos
Atitude , Contratos/legislação & jurisprudência , Princípios Morais , Mães Substitutas/legislação & jurisprudência , Mães Substitutas/psicologia , Adolescente , Adulto , Altruísmo , Contratos/economia , Feminino , França , Humanos , Masculino , Gravidez , Adulto Jovem
13.
J Reprod Infant Psychol ; 35(5): 524-537, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29517382

RESUMO

OBJECTIVE: The study mapped French people's views regarding the acceptability of posthumous reproduction. BACKGROUND: Posthumous reproduction - the use of a deceased person's gametes for procreative purposes -is a controversial procedure because it involves a series of ethical issues, namely the surviving partner's rights to procreation, the emotional feelings and financial interests of other family members, and the government's interest in maintaining orderly inheritance rules. METHODS: A convenience sample of participants aged 19-68 (104 lay people, 47 health professionals and 15 lawyers) were presented with 48 realistic stories that were composed according to a four-factor within-subject design: marital status (married for about 10 years with children, married for about three years without children, and cohabiting for three years without children) × attitude of the deceased's parents (favourable vs. unfavourable to posthumous procreation) × time elapsed since the partner's death (three months vs. nine months) × deceased's wishes (written consent, oral consent given in front of credible witnesses, unknown wishes, and unfavourable attitude). RESULTS: Through cluster analysis, four qualitatively different positions were found. They were called Never Acceptable (35% of the sample, mostly health professionals, lawyers and regular attendees to the church or temple), Tolerable in a Few Cases (28%), Depends on Deceased's Wishes (22%, mostly lay people) and Quite Acceptable (16%, mostly lay people). CONCLUSIONS: About half of French lay people view the current legislation regarding posthumous assisted reproduction in a country such as the UK as more appropriate than the French legislation.


Assuntos
Atitude , Família/psicologia , Pessoal de Saúde/estatística & dados numéricos , Consentimento Livre e Esclarecido/legislação & jurisprudência , Advogados/estatística & dados numéricos , Concepção Póstuma/legislação & jurisprudência , Adolescente , Adulto , Feminino , França , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Concepção Póstuma/ética , Adulto Jovem
14.
J Med Ethics ; 42(10): 627-31, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27566793

RESUMO

AIM: To study the views on the acceptability of terminal sedation (TS) of laypeople and health professionals in France. METHOD: In November 2013-June 2015, 223 laypeople and 53 health professionals (21 physicians and 32) judged the acceptability of TS in 48 realistic scenarios composed of all combinations of four factors: (a) the patients' life expectancy, (b) their request for sedation, (c) the decision-making process and (d) the type of sedation. In all scenarios, the patients were women with a terminal illness suffering from intractable pain and receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. RESULTS: Five qualitatively different positions were found that were termed TS acceptable if decision taken collectively (15%), TS acceptable if patient explicitly requested it (19%), TS acceptable if patient did not explicitly oppose it (47%), 24-hour sedation not acceptable (6%) and TS always acceptable (13%). The percentage of older participants in the 'always acceptable' cluster was higher than the percentage of younger participants. CONCLUSIONS: Laypeople and health professionals do not appear to be systematically opposed to TS. The most important factors in increasing its acceptability were the patients' request for sedation and the collective character of the decision-making process.


Assuntos
Sedação Consciente , Tomada de Decisões/ética , Dor Intratável/prevenção & controle , Cuidados Paliativos , Médicos , Assistência Terminal/psicologia , Voluntários , Análise de Variância , Atitude do Pessoal de Saúde , Atitude Frente a Morte , Atitude Frente a Saúde , Análise por Conglomerados , Sedação Consciente/ética , Feminino , França , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Expectativa de Vida , Masculino , Dor Intratável/psicologia , Cuidados Paliativos/ética , Médicos/ética , Médicos/psicologia , Assistência Terminal/ética , Voluntários/psicologia
15.
Health Commun ; 30(7): 694-701, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25186427

RESUMO

The objective of this study was to map people's positions regarding the breaking of bad news to patients. One hundred forty adults who had in the past received bad medical news or whose elderly relatives had in the past received bad news, 25 nurses, and 28 nurse's aides indicated the acceptability of physicians' conduct in 72 vignettes of giving bad news to elderly patients. Vignettes were all combinations of five factors: (a) the severity of the disease (severe but not lethal, extremely severe and possibly lethal, or incurable), (b) the patient's wishes (insists on knowing the full truth vs. does not insist), (c) the level of social support during hospitalization, (d) the patient's psychological robustness, and (e) the physician's decision about communicating bad news (tell the patient that the illness is not severe and minimize the severity of the illness when talking to the patient's relatives, tell the full truth to her relatives, or tell the full truth to both the elderly patient and her relatives). Four qualitatively different positions were found. Twenty-eight percent of participants preferred the full truth to be told; 36% preferred the truth to be told but understood that the physician would inform the family first; 13% did not think that telling the full truth is best for patients; and 23% understood that the full truth would be told in some cases and not in others, depending on the physician's perception of the situation. The present mapping could be used to detect the position held by each patient and act accordingly. This would be made easier if breaking bad news was conceived as a communication process involving a range of health care professionals, rather than as a single occurrence in time.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Comunicação , Assistentes de Enfermagem/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Relações Médico-Paciente , Revelação da Verdade , Adulto , Idoso , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Assistentes de Enfermagem/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Preferência do Paciente , Pacientes/psicologia , Médicos/psicologia , Médicos/estatística & dados numéricos , Pesquisa Qualitativa , Apoio Social , Adulto Jovem
16.
Psychol Health Med ; 20(1): 103-13, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-24666233

RESUMO

Research shows that chronic illness patients encounter difficulties in the social sharing of emotions (SSE). Since most SSE studies focus on quantitative aspects, the present study, aimed, among others, to study the associations between the quality of SSE in people living with HIV/AIDS and patients' psychological and physical well-being. A total of 101 HIV/AIDS patients answered a questionnaire (Likert scale items) which assessed: shame, guilt, perceived stigma, reasons for non-disclosure of serostatus, physical health, mental health, SSE and quality of SSE. While no associations were found between quantitative aspects of SSE, physical health and mental health, the quality of SSE was negatively correlated to shame and guilt, and positively correlated to physical and mental health. Furthermore, mediation analyses showed the mediating role of the quality of SSE in the relationship between, on the one hand, shame and guilt; and on the other hand, physical and mental health. Findings suggest the importance of qualitative aspects of SSE in the emergence of positive outcomes linked to emotional expression in people living with HIV/AIDS.


Assuntos
Emoções Manifestas , Infecções por HIV/psicologia , Apoio Social , Adulto , Idoso , República Dominicana , Feminino , Culpa , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Autorrevelação , Vergonha , Estereotipagem , Inquéritos e Questionários , Adulto Jovem
17.
Eur J Contracept Reprod Health Care ; 20(3): 158-69, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25545288

RESUMO

BACKGROUND: Are people's views on abortion as polarised as is suggested by the 'marches for life' that regularly take place in Paris and other capitals? Objective To map French people's positions regarding the acceptability of induced abortion. METHODS: One hundred and fifty-nine participants were presented with stories composed according to a three within-subject design: Reason for abortion (e.g., the woman's life is endangered) × Gestational age × Woman's age. They assessed the extent to which abortion would be, in each case, an acceptable medical/surgical procedure. RESULTS: Five qualitatively different positions were identified: (i) always acceptable, irrespective of circumstances (31% of the sample), (ii) strictly depends on the reason for abortion (27%), (iii) legalist (23%), (iv) depends on the reason and on the gestational age (18%), and (v) always unacceptable (1%). CONCLUSIONS: Only one-fifth of the participants agreed with the part of the French law that permits abortion on request when gestational age does not exceed ten weeks. The others disagreed either because they thought that abortion on demand should never be permitted or because they thought that the age limit should be extended. This divide in people's opinions guarantees that the debate over induced abortions will continue.


Assuntos
Aborto Induzido/psicologia , Aborto Legal/psicologia , Serviços de Planejamento Familiar/organização & administração , Opinião Pública , Saúde da Mulher , Aborto Induzido/legislação & jurisprudência , Aborto Legal/legislação & jurisprudência , Adulto , Atitude Frente a Saúde , Início da Vida Humana , Política de Planejamento Familiar/legislação & jurisprudência , Feminino , França , Humanos , Masculino , Gravidez , Estigma Social , Fatores Socioeconômicos
19.
J Med Food ; 27(2): 97-109, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38381517

RESUMO

The prevalence of diabetes has increased in last decades worldwide and is expected to continue to do so in the coming years, reaching alarming figures. Evidence have shown that patients with type 2 diabetes (T2D) have intestinal microbial dysbiosis. Moreover, several mechanisms link the microbiota with the appearance of insulin resistance and diabetes. Diet is a crucial factor related to changes in the composition, diversity, and activity of gut microbiota (GM). In this review, the current and future possibilities of nutrient-GM interactions as a strategy to alleviate T2D are discussed, as well as the mechanisms related to decreased low-grade inflammation and insulin resistance. A bibliographic search of clinical trials in Pubmed, Web of Science, and Scopus was carried out, using the terms "gut microbiota, diet and diabetes." The data analyzed in this review support the idea that dietary interventions targeting changes in the microbiota, including the use of prebiotics and probiotics, can improve glycemic parameters. However, these strategies should be individualized taking into account other internal and external factors. Advances in the understanding of the role of the microbiota in the development of metabolic diseases such as T2D, and its translation into a therapeutic approach for the management of diabetes, are necessary to allow a comprehensive approach.


Assuntos
Diabetes Mellitus Tipo 2 , Microbioma Gastrointestinal , Resistência à Insulina , Humanos , Diabetes Mellitus Tipo 2/prevenção & controle , Estado Nutricional , Inflamação
20.
J Neurol ; 271(3): 1224-1234, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38197947

RESUMO

BACKGROUND: In the different published studies, there is no consensus on the efficacy of virtual reality as an adjuvant treatment of mood states. AIM: The aim of this study is to evaluate the impact of no immersive virtual reality with the Nintendo Switch device in rehabilitation treatment on mood, anxiety and depression in stroke patients admitted to neurorehabilitation units. METHODS: Fifty-eight patients admitted to neurorehabilitation units underwent a 1:3 multicentre randomised clinical trial. The intervention group consisted of 17 patients and the control group of 41 patients. The intervention group performed 6 virtual reality sessions together with the conventional treatment, and the control group performed only the conventional rehabilitation sessions. Primary and secondary clinical outcomes were measured before and six weeks after the intervention. RESULTS: Comparing the intervention group and control group, the anxiety levels of the intervention group decreased compared to the results observed in the control group (p = 0.01), as did the dependence of the intervention group (0.015). On the other hand, the results obtained after the intervention by the control group for anxiety (0.479) and depression (0.292) were not statistically significant. CONCLUSION: Rehabilitation VR used as an adjuvant treatment to conventional treatment has a beneficial impact on the neurological status and state of anxiety of stroke patients admitted to neurorehabilitation units. TRIAL REGISTRATION: Registered in the https://clinicaltrials.gov/ repository (NTC NCT05143385). Protocol registration date 7 October 2021, retrospectively registered.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Jogos de Vídeo , Humanos , Reabilitação do Acidente Vascular Cerebral/métodos , Depressão/etiologia , Depressão/terapia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/terapia , Ansiedade/etiologia , Ansiedade/terapia
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