Burden and quality of life of family caregivers of Alzheimer's disease patients: the role of forgiveness as a coping strategy.

OBJECTIVES: This study aimed to evaluate the variables that  were associated, contributed and moderated quality of life (QoL) and burden in family caregivers. METHODS: A total of 130 participants were evaluated using the following instruments: Depression, Anxiety and Distress Scale; Index of Family Relations; Heartland Forgiveness Scale; Burden Interview Scale; Short Form Health Survey. RESULTS: Being a younger caregiver, less distress, better family relationships and greater use of forgiveness were associated with more QoL. Also, family caregivers who chosethe caregiving role, less distress, better family relationships and greater use of forgiveness showed lower levels of burden. Age, distress and forgiveness contributed to QoL. In turn, the choice to become a family caregiver, distress, and forgiveness contributed to burden. Forgiveness played a moderating role in the relationship between family relationships and burden. CONCLUSION: Based on the results, there is a need to intervene in older family caregivers, particularly those who did not choose to become a caregiver, who report greater distress, have worse family relationships, and display less use of forgiveness, in order to decrease their burden and promote QoL.

Portuguese Caregivers of Persons With Alzheimer's Disease in the Context of the COVID-19 Pandemic: A Qualitative Study of the Grieving Process.

This study addresses the experiences of informal caregivers caring for elderly family members with Alzheimer's disease (AD) during the COVID-19 pandemic. The study includes a sample of eight informal caregivers who were evaluated through a semi-structured interview six months after the death of a loved one they cared for. A thematic content analysis was applied to the interviews and yielded two higher-order domains: (1) Experiencing the AD and the death of a family member and (2) The grieving process during the COVID-19 pandemic. The results provide valuable insights into family caregivers' experiences regarding the profound emotional impact of caregiving and grief during the COVID-19 pandemic. Caregivers maintain their identity even after loss, underscoring the enduring impact of caregiving. The identity as a caregiver impacted coping and grief responses, highlighting the need for tailored interventions.

The Moderating Role of Self-Care Behaviors in Personal Care Aides of Older Adults during the COVID-19 Pandemic.

The COVID-19 pandemic has brought new challenges and work changes for formal caregivers such as personal care aides with an impact on their quality of life (QoL). This cross-sectional study aims to analyze the relationships and contribution of sociodemographic and psychological variables towards QoL including the moderating role of self-care. This study included 127 formal caregivers from Portugal who were assessed on depression, anxiety and stress (DASS-21); professional self-care (SCAP); quality of life (SF-12); COVID-19 traumatic stress (COVID-19TSC) and preventive COVID-19 infection behaviors (PCOVID-19 IBS). Professional self-care was positively associated with QoL and also moderated the relationship between distress and QoL (p < 0.001). According to results, nursing homes should provide formal caregivers, such as personal care aides, with the professional support they need in order to promote their QoL and prevent burnout.

Dyadic adjustment, family coping, body image, quality of life and psychological morbidity in patients with psoriasis and their partners.

BACKGROUND: Psoriasis is an incurable and chronic disease that includes unpredictable periods of remission and relapse requiring long-term therapy. PURPOSE: This paper focuses on the relationship among family coping, psychological morbidity, body image, dyadic adjustment and quality of life in psoriatic patients and their partners. METHOD: One hundred and one patients with psoriasis and 78 partners comprised the sample. They were regular users of the Dermatology Service of a Central Northern hospital in Portugal and a private dermatology clinic. Patients with psoriasis were assessed on anxiety, depression, body image, quality of life, dyadic adjustment and family coping. Partners were assessed on the same measures except body image and quality of life. RESULTS: A positive relationship among dyadic adjustment, psychological morbidity and family coping in patients and their partners was found. Also, patients with lower levels of quality of life had partners with higher levels of depressive and anxious symptoms. Better dyadic adjustment predicted family coping in the psoriatic patient. High levels of dyadic adjustment in patients and low partners' trait anxiety predicted better dyadic adjustment in partners. CONCLUSION: The results highlight the importance of incorporating family variables in psychological interventions in psoriasis' care, particularly family coping and dyadic adjustment as well as the need for psychological intervention to focus both on patients and partners.

Entrevista motivacional no autogerenciamento de cuidados a adolescentes com diabetes tipo 1: revisão integrativa / Motivational interviewing and self-management among adolescents with type 1 diabetes: an integrative review / Entrevista motivacional en la autogestión de los cuidados a adolescentes con diabetes tipo 1: revisión integradora

Objetivo: analisar evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado do adolescente com diabetes mellitus tipo 1. Método: revisão integrativa cuja busca aconteceu em junho de 2020 nas bases de dados LILACS, PubMed, CINAHL, Scopus e Web of Science para atender a pergunta: Quais evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado ao adolescente com diabetes mellitus tipo 1? Todos os artigos identificados estavam no idioma inglês e publicados entre 2003 e 2020. Resultados: entre os dez estudos incluídos, nove foram realizados nos Estados Unidos e um no Reino Unido. As pesquisas tiveram métodos diversificados na aplicação da entrevista motivacional em circunstâncias diferentes e os resultados mostraram impactos positivos no autogerenciamento dos cuidados de adolescentes com DM1, principalmente em relação ao controle glicêmico e/ou nos níveis de hemoglobina glicada. Conclusão: a entrevista motivacional favorece o autogerenciamento do cuidado e autonomia do adolescente com diabetes.

Objective: this study examined scientific evidence on motivational interviewing and its influence on self-management among adolescents with type-1 diabetes mellitus (DM1). Methods: the survey for this integrative review took place in June 2020 in the LILACS, PubMed, CINAHL, Scopus, and Web of Science databases to answer the question: What scientific evidence is available on motivational interviewing and its influence on self-management among adolescents with DM1? All the articles found were in English and published between 2003 and 2020. Results: of the ten studies included, nine were conducted in the United States and one in the United Kingdom. The studies used different methods for applying motivational interviewing in differing circumstances, and their findings revealed positive impacts on self-management among adolescents with type-1 diabetes, especially on blood glucose monitoring and/or on glycated hemoglobin levels. Conclusion: motivational interviewing is an intervention that favors self-management and autonomy among adolescents with diabetes.

Objetivo: analizar evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1 (DM1). Métodos: revisión integradora llevada a cabo en junio de 2020 en las bases de datos LILACS, PubMed, CINAHL, Scopus y WoS para responder a la pregunta: ¿Cuáles son las evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1? Los artículos encontrados estaban en inglés y fueron publicados entre 2003 y 2020. Resultados: de los diez estudios incluidos, nueve se realizaron en Estados Unidos y uno en Reino Unido. Las investigaciones utilizaron diferentes métodos de aplicación de la entrevista motivacional en diferentes circunstancias y los resultados señalaron impactos positivos en la autogestión de los cuidados de adolescentes con DM1, especialmente cuanto al control glucémico y/o niveles de hemoglobina glucosilada. Conclusión: la entrevista motivacional favorece la autogestión del cuidado y la autonomía de adolescentes con diabetes.

Entrevista motivacional no autogerenciamento de cuidados a adolescentes com diabetes tipo 1: revisão integrativa / Entrevista motivacional en la autogestión de los cuidados a adolescentes con diabetes tipo 1: revisión integradora / Motivational interviewing and self-management among adolescents with type 1 diabetes: an integrative review

RESUMO Objetivo analisar evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado do adolescente com diabetes mellitus tipo 1. Método revisão integrativa cuja busca aconteceu em junho de 2020 nas bases de dados LILACS, PubMed, CINAHL, Scopus e Web of Science para atender a pergunta: Quais evidências científicas sobre entrevista motivacional e sua influência no autogerenciamento do cuidado ao adolescente com diabetes mellitus tipo 1? Todos os artigos identificados estavam no idioma inglês e publicados entre 2003 e 2020. Resultados entre os dez estudos incluídos, nove foram realizados nos Estados Unidos e um no Reino Unido. As pesquisas tiveram métodos diversificados na aplicação da entrevista motivacional em circunstâncias diferentes e os resultados mostraram impactos positivos no autogerenciamento dos cuidados de adolescentes com DM1, principalmente em relação ao controle glicêmico e/ou nos níveis de hemoglobina glicada. Conclusão a entrevista motivacional favorece o autogerenciamento do cuidado e autonomia do adolescente com diabetes.

RESUMEN Objetivo analizar evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1 (DM1). Métodos revisión integradora llevada a cabo en junio de 2020 en las bases de datos LILACS, PubMed, CINAHL, Scopus y WoS para responder a la pregunta: ¿Cuáles son las evidencias científicas sobre entrevista motivacional y su influencia en la autogestión del cuidado de adolescentes con diabetes mellitus tipo 1? Los artículos encontrados estaban en inglés y fueron publicados entre 2003 y 2020. Resultados de los diez estudios incluidos, nueve se realizaron en Estados Unidos y uno en Reino Unido. Las investigaciones utilizaron diferentes métodos de aplicación de la entrevista motivacional en diferentes circunstancias y los resultados señalaron impactos positivos en la autogestión de los cuidados de adolescentes con DM1, especialmente cuanto al control glucémico y/o niveles de hemoglobina glucosilada. Conclusión la entrevista motivacional favorece la autogestión del cuidado y la autonomía de adolescentes con diabetes.

ABSTRACT Objective this study examined scientific evidence on motivational interviewing and its influence on self-management among adolescents with type-1 diabetes mellitus (DM1). Methods the survey for this integrative review took place in June 2020 in the LILACS, PubMed, CINAHL, Scopus, and Web of Science databases to answer the question: What scientific evidence is available on motivational interviewing and its influence on self-management among adolescents with DM1? All the articles found were in English and published between 2003 and 2020. Results of the ten studies included, nine were conducted in the United States and one in the United Kingdom. The studies used different methods for applying motivational interviewing in differing circumstances, and their findings revealed positive impacts on self-management among adolescents with type-1 diabetes, especially on blood glucose monitoring and/or on glycated hemoglobin levels. Conclusion motivational interviewing is an intervention that favors self-management and autonomy among adolescents with diabetes.

Improved endothelial function and reversal of myocardial perfusion defects after aerobic physical training in a patient with microvascular myocardial ischemia.

The objective of this report is to document the effects of an aerobic training program on myocardial perfusion, and endothelial function abnormalities, and on the relief of angina in a patient with microvascular myocardial ischemia. A 53-year-old female patient exhibited precordial pain on effort and angiographically normal coronaries. Her symptoms had been present for 4 yrs despite pharmacologic treatment for the control of risk factors, with myocardial perfusion scintigraphy revealing an extensive reversible perfusion defect. She was submitted to aerobic training for 4 mos, obtaining significant improvement of the anginal symptoms. Additionally, after the aerobic training program, scintigraphy revealed the disappearance of the myocardial perfusion defect, with a marked improvement of endothelium-dependent vasodilatory response and an improved quality-of-life score. These results suggest that aerobic training can improve endothelial function, leading to a reduction of ischemia and an improved quality-of-life in patients with microvascular myocardial ischemia.

Sensibilizando a criança com diabetes para o cuidado de si: contribuição à prática educativa / Sensitizing children with diabetes to self-care: contributions to educational practice / Sensibilizando al niño con diabetes para el cuidado de sí: contribuciones a la práctica educativa

Objetivo: Analisar a aplicabilidade da dinâmica Corpo Saber na sensibilização da criança para o cuidado de si por meio de suas experiências. Métodos: Estudo descritivo e analítico desenvolvido em maio e junho de 2013, com seis crianças diabéticas em idade escolar, atendidas no ambulatório de um hospital de referência em Fortaleza/CE. Resultados: A dinâmica promoveu um ambiente de descontração favorável à expressão de sentimentos e demonstração dos cuidados básicos ao conviver com o diabetes. A sensibilização foi permeada de reflexões sobre o início da doença e o momento atual vivido. Assim, compartilharam com os pares as necessidades de cuidados e aprendizagens no controle metabólico. Conclusão: A aplicação da dinâmica Corpo Saber favoreceu o desenvolvimento de atividades educativas com a participação das crianças em momentos de aprendizagem sobre o cuidado de si.

Objective: To analyze the applicability of Body Knowledge dynamics in sensitizing children, through the expression of theirexperiences, to the practice of self-care. Methods: This descriptive and analytical study was conducted in May and June 2013with six diabetic school-aged children attending the outpatient clinic of a referral hospital in Fortaleza, CE, Brazil. Results: Thedynamics promoted a relaxed environment conducive to the expression of feelings and the reporting of basic care providedfor diabetes. Sensitization was permeated with reflections upon the onset of the disease and current time. Thus, the childrenshared with their peers the need for care actions and learning concerning metabolic control. Conclusion: The application ofBody Knowledge dynamics favored the development of educational activities with the participation of children, which promotedlearning regarding self-care.

Objetivo: Analizar la aplicabilidad de la dinámica Cuerpo Saber en la sensibilización del niño para el cuidado de sí mediantesus experiencias. Métodos: Estudio descriptivo y analítico desarrollado en mayor y junio del 2013, con seis niños diabéticosen edad escolar, atendidas en el ambulatorio de un hospital de referencia en Fortaleza-CE. Resultados: La dinámica promovióun ambiente de relajamiento favorable a la expresión de sentimientos y demostración de los cuidados básicos al convivir conla diabetes. La sensibilización fue permeada de reflexiones sobre el inicio de la enfermedad y el momento actual vivido. Así,compartieron con las parejas las necesidades de cuidados y aprendizajes en el control metabólico. Conclusión: La aplicaciónde la dinámica Cuerpo Saber favoreció el desarrollo de actividades educativas con la participación de los niños en momentosde aprendizaje sobre el cuidado de sí.

Síndrome de Stevens-Johnson: presentación de tres casos / Stevens-Johnson's syndrome: presentation of three cases

Fundamento: el Síndrome de Stevens-Johnson (SSJ) es una enfermedad grave, a menudo fatal, que ha sido considerada como un tipo de eritema multiforme, es causada generalmente por fármacos y de no ser diagnosticado y tratado de forma oportuna puede asociarse a secuelas importantes y la muerte. Objetivo: describir y reseñar el tratamiento y evolución clínica del cuadro clínico de tres casos con diagnóstico de Síndrome de Stevens-Johnson, ingresados en Cuidados Intensivos. Presentación de casos: se presentan tres enfermos, dos pertenecientes al sexo femenino y uno al masculino, con diagnóstico de SSJ asociados al empleo de fármacos. En los tres casos el tratamiento consistió en medidas de cuidados generales para la profilaxis y el tratamiento de complicaciones, esteroides sistémicos y además IgG intravenosa de producción nacional (intacglobin). Los tres pacientes evolucionaron de forma satisfactoria. Resultados: se destaca la utilidad del uso de inmunoglobulina G intravenosa en el tratamiento de estos pacientes, así como su importancia en una unidad de cuidados para enfermos graves. Conclusiones: en la casuística predominó el sexo femenino y el empleo precoz del Intacglobin (IgG IV) que contribuyó a una mejor evolución de los pacientes al detener la progresión de la enfermedad, evitar complicaciones y disminuir la estadía en las unidades de enfermos graves.

Background: Stevens-Johnson’s syndrome (SJS) is a serious disease, fatal most of the time, which has been considered as a type of erythema multiforme. It is generally caused by medicaments. If it is not diagnosed and treated at appropriate time it can be associated to considerable sequelae and death. Objective: to describe the treatment and evolution of the clinical manifestations of three cases with the diagnosis of Stevens-Johnson’s syndrome admitted in the intensive care unit. Cases presentation: the cases of two female patients and a male patient with the diagnosis of SJS, associated to the use of medicaments, are briefly presented. The treatment consisted of measures of general care for the prophylaxis and treatment of complications for the three cases. The patients were treated with intravenous IgG of national production (intacglobin) and systemic steroids. The three patients improved their condition satisfactorily. Results: the use of intravenous immunoglobulin G in the treatment of these patients stands out; as well as the importance of the treatment of seriously ill patients in an intensive care unit. Conclusions: female sex predominated in the casuistics. The early use of Intacglobin (IgG IV) contributed to a better improvement of the patient’s condition arresting the development of the disease, avoiding complications and decreasing the hospital stay of seriously ill patients.

Variáveis individuais e familiares na psoríase: um estudo com doentes e parceiros / Individual and family variables in psoriasis: a study with patients and partners

Este trabalho avalia morbilidade, qualidade de vida, ajustamento de casal, coping familiar e imagem corporal em 101 doentes com psoríase e 78 parceiros. Os resultados revelaram uma relação positiva entre as variáveis dos doentes e parceiros no que diz respeito ao ajustamento, coping e morbilidade. Pior qualidade de vida e imagem corporal no doente estão associadas a mais morbilidade no parceiro. Os doentes em tratamento combinado e fototerapia apresentaram pior qualidade de vida e insatisfação com a imagem corporal. Melhor ajustamento de casal e menor ansiedade no parceiro predizem ajustamento de casal no doente. Satisfação com a imagem corporal prevê melhor qualidade de vida no doente. Os resultados enfatizam a necessidade de envolver os parceiros nos programas de intervenção. As implicações são apresentadas.

In this paper the relationship between morbility, quality of life, marital adjustment, family coping and body image in 101 psoriatic patients and 78 partners was investigated. The results showed a positive relationship between patients and partners variables on dyadic adjustment, coping and morbidity. Negative quality of life and body image in patients are associated to more morbidity in partners. Patients in combined treatment and phototherapy showed lower quality of life and less satisfaction with body image. Better dyadic adjustment and less anxiety in partners predict higher adjustment in patients. Satisfaction with body image predicts better quality of life in patients. The results of this study emphasize the need to involve partners in program´s interventions. Clinical implications of the results are presented.

La hipertensión arterial en la población escolar del Estado Nueva Esparta / Arterial hypertension in the scholar population of the State Nueva Esparta

Como consecuencia de una observación empírica concerniente a lo que parecía una ingesta elevada de sodio en la población neoespartana; los autores nos preguntamos si un fundamento estadístico podía sustentar una correlación entre el consumo elevado de sodio (si realmente existía) y una mayor incidencia de hipertensión arterial. El estudio se dirigió a la población escolar; puesto que es bien conodida la historia natural de esta patología en adultos de la región insular de Venezuela. 299 escolares fueron seleccionados aleatoriamente de tres poblaciones del Edo. Nva. Esparta: El Valle del Espíritu Santo 106 (35,45 por ciento), los Millanes 98 (32,77 por ciento) y la Isla de Coche 95 (35.77 por ciento). Se les realizó una encuesta alimentaria a los representantes de los niños y se controlaron las medidas de tensión arterial con un tensiómetro automático por método oscilométrico. No se encontró diferencia estadísticamente significante en la composición de la muestra (edad, sexo) según el análisis de varianza. En las tensiones arteriales diastólicas se encontró una diferencia estadísticamente significante en la población del Valle del Espíritu Santo con respecto a las otras poblaciones (p<0.01). El consumo de sal no obtuvo diferencia significativa estadísticamente