Hope, comfort and quality of life of palliative patients: correlation to the place of care

Background: Maintaining hope has been referred to as a way to endure suffering among people living with a life-limiting disease. Reports about comfort and well-being in palliative care have indicated that hope is an indicator of the quality of life (QoL)and the quality of dying. This study aimed to characterise hope, comfort and QoL of palliative patients, and correlate these variables to the place of care. Methods: A cross-sectional observational study was conducted to test the hypothesis that hope is positively correlated to comfort and QoL and that patients in palliative care units had higher levels of hope, comfort, and QoL than other settings. Participants were recruited from daycare hospital, palliative care units and communitary palliative care in Portugal. Patients answered the Portuguese versions of Herth Hope Index, McGill Quality of Life Questionnaire and Hospice Comfort Questionnaire, a VAS for pain, two-item screening for depression and socio-demographic information. All ethical procedures were considered according to the Helsinki declaration. Results: A total of 205 palliative patients participated in the study (mean age 64.5, range 28–89). Most patients were diagnosed with metastatic cancer (85.4%). Palliative care patients in the sample experienced good level of hope, comfort and QoL. A strong correlation was noted between hope and QoL (0.65; p<0.001) and hope and comfort (0.58; p<0.001). QoL of patients attending daycare unit were higher compared to other settings (p<0.05). Patients experienced higher comfort at home (p<0.05). There were no differences in hope regarding the place of care. Conclusions: Palliative patients reported good levels of hope, comfort and QoL. As hope is dynamic and correlated to comfort and QoL, hope fostering interventions should be implemented in palliative care settings to increase the QoL and quality of death. Further research should address the causative relations among these variables.info:eu-repo/semantics/publishedVersio

Effect of hope-based program on the hope of people with palliative needs: a RCT pilot study in Portugal

Background: Some studies have demonstrated the effectiveness of interventions in the levels of hope, however the relationship between these interventions and the results is still limited. The aim of the study was to evaluate the efficacy of a hopebased program in nursing on Portuguese adult outpatients with advanced and progressive chronic illness. Methods: A single-blind RCT was conducted to test the hypothesis that outpatients in the intervention group, who participated in the Hope Promotion Program (HPP), have higher levels of hope than those who did not participate in the program. Participants were recruited from Day Hospitals of two medical institutions. Following the individuals’ agreement to participate, they were thoroughly screened for eligibility by the main researcher. Inclusion criteria: (1) adults diagnosed with advanced and progressive chronic disease; (2) accompanied by a health care team; and (3) ability to speak and comprehend Portuguese. Hope is measured by the Portuguese version of Herth Hope Index for chronic conditions. The time frames for assessment were at baseline (T1), follow-up (T2 15 days after) and post-test (T3 30 days after). Results: A total of 56 patients were enrolled in the study. They were randomized assigned to either the intervention group [IG] (n=28) or to control group [CG] (n=28). Over time the hope indexes in the IG compared to the CG, suggest a positive effect of HPP in the increase of hope over time. The most expressive effect was observed in the total hope level and in the gains in positive interior disposition and expectations, with significant differences in each of the data collection points in time. Conclusions: Further research should create training programs for nurses and nursing students within the scope of the promotion of hope, in order to promote the development of personal and professional skills.info:eu-repo/semantics/publishedVersio

ENVIRONMENT IMPACT ON CHILDREN’S HEALTH

SAŽETAK Cilj: U proteklih nekoliko godina, u porastu je zabrinutost zbog izloženosti djece kemikalijama koje se nalaze u okruženju. Malo se zna o učincima tih kemikalija na organizme u razvoju. Cilj je ovog istraživanja bio proučiti noviju medicinsku literaturu o opasnostima kemikalija koje se nalaze u okruženju, te njihovu utjecaju na zdravlje djece. Metode: Proučavanje literature provedeno je korištenjem baze podataka MEDLINE, te neposrednim istraživanjem, pri čemu su uzeti u obzir jedino radovi objavljeni u proteklih osam godina. Rezultati: Djeca su izloženija onečišćivačima koji se nalaze u okruženju od odraslih, jer su zbog svojih metaboličkih potreba i ponašanja izloženi posebnu riziku vezanom uz kontakt s kemikalijama dok dišu, jedu, piju ili se igraju. Teški metali, pesticidi, postojani organski onečišćivači, te kod kuće sekundarni cigaretni dim, dovedeni su u vezu sa sve većim brojem bolesti u djece poput astme, neuroloških razvojnih poremećaja, ili raka. Zaključak: Pedijatrima i ostalim zdravstvenim djelatnicima koji liječe djecu i adolescente, povjerena je zadaća prepoznavanja opasnosti koje mogu prouzročiti kemijska sredstva koja se nalaze u okruženju.ABSTRACT Aim: There has been a growing concern in the last few years with the exposure of children to environmental chemicals. There is little knowledge regarding their effects on developing organisms. The objective of this study was to investigate the recent medical literature on environmental chemical hazards to child health. Methods: The bibliographic research was conducted using the MEDLINE database, as well as through direct research, limiting the scope to articles published within the past 8 years. Results: Children have a greater exposure to environmental pollutants than adults, because their metabolic needs and behaviors put them at special risk of contact with chemicals when they breathe, eat, drink or play. Heavy metals, pesticides, persistent organic pollutants and, at home, environmental tobacco smoke have been associated with the increasing number of diseases such as asthma, neurodevelopmental disorders and childhood cancer. Conclusions: Pediatricians and other health professionals who treat children and adolescents are entrusted with the task of recognizing the hazards that environmental chemical agents may pose

"Velhos são os Trapos": do positivismo clássico à nova era

For human beings to fulfil their right to live a full and dignified life, to completely justify the quest for longevity, it must be socially possible for that greater life to be also a better one. For this to occur, something needs to change in the representations of old age, in the respect for its particularities, and in the supply of specific structures. Old age is a stage of life that has been socially devalued, being represented in a negative way. This reflects on the quality of life of older people. This reflexive essay shall explore the main cultural debates regarding old age by analysing two dichotomic ideological structures on aging and old age. The results defend the need to build positive images regarding aging in order to fight the traditional models of decline and depersonalization. Noteworthy is the complexity and heterogeneity of the phenomena being analysed, highlighting the application of new strategies in order to build a new era for old age anchored on the social paradigms of citizenship and plurality.Para que o ser humano consiga concretizar o direito à vida plena e digna, para que se justifique completamente a procura pela longevidade, deve socialmente permitir-se que essa vida maior seja igualmente melhor. Para que isso aconteça algo tem que mudar nas representações da velhice, no respeito pelas particularidades que a envolvem e pela oferta de estruturas específicas. A velhice é uma fase da vida que tem sido socialmente desvalorizada, negativamente representada, o que se reflete na qualidade de vida dos idosos. Esse ensaio reflexivo pretende desvelar os principais debates culturais sobre a velhice, ao analisar duas estruturas ideológicas dicotômicas sobre o envelhecimento e a velhice. Os resultados são defensores da necessidade de construção de imagens positivas sobre o envelhecimento, para combater os tradicionais modelos de declínio e de despessoalização. Realça-se a complexidade e a heterogeneidade dos fenômenos em análise sublinhando a aplicação de novas estratégias destinadas à construção de uma nova era sobre a velhice, ancorada nos paradigmas de cidadania e pluralidade sociais

El modelo multidimensional de la esperanza mientras práctica dirigida por el recovery en enfermería de salud mental

Funding: This work is funded by national funds through FCT – Fundação para a Ciência e a Tecnologia, I.P (UIDB/05704/2020 and UIDP/05704/2020) and under the Scientific Employment Stimulus - Institutional Call – [CEECINST/00051/2018].Objective: To analyze the theoretical dimensions of hope as a recovery-oriented practice in mental health nursing. Method: This is a reflective and discursive study based on theoretical and experiential aspects of hope in the recovery process of people facing mental health disorders. Results: Maintaining hope in adverse situations, especially while facing mental suffering, requires skills to manage the factors that promote and inhibit hope. This balance can be tricky to reach without the presence of high-skilled professionals. The study presents the concept of hope-inspiring competence and its main dimensions. The nurse’s hope-inspiring competence is recognized as a crucial advanced practice that optimizes mental health by providing motivational resources. Final Considerations: Hope-inspiring competence should be a core principle for recovery-oriented mental health professionals. Despite this recognition, the promotion of hope in mental health nursing specialized practice lacks evidence and visibilityinfo:eu-repo/semantics/publishedVersio

Esperanza en un grupo terapéutico de pacientes deprimidos: Un estudio de caso cualitativo

To understand the perceptions of hope for people with depression in the context of a therapy group. Methods: using a qualitative case study approach, a semi-structured in-depth interview and a self-report questionnaire were conducted with seven women with depression integrated in a therapy group at a Portuguese day-care psychiatric unit. Data collection and analysis used triangulation of sources. Results: the participants evidenced hope founded on the positive experiences of the past with a strong affiliation component. Hope management is done fundamentally through the interpersonal relationships established between the members of the group, based on communicational patterns that are established on a regular basis, mediated by the group therapist. Conclusion: the therapy group functioned towards the reinforcement of hope in people who experience depression, and it works as a motivation to manage the implications of illness in the participants’ life and health project. Descriptors: Case Study; Depression; Hope; Interpersonal Relations; Self-Help Groups.info:eu-repo/semantics/publishedVersio

Le phénomène de l'intimidation en milieu scolaire : pistes d'intervention pour le counseling de carrière.

De façon générale, l'école se veut source d'enrichissement, de belles découvertes et de création de nouvelles amitiés. Cependant, pour grand nombre d'élèves qui sont victimes d'intimidation en milieu scolaire, ce parcours scolaire se vit dans la peur, l'anxiété et la solitude. Les conséquences vécues auront aussi un impact sur l'orientation professionnelle de ces jeunes, dont l'altération du concept de soi, qui aurait une influence sur le développement de carrière (Super, 1963, dans Bujold, et Gingras, 2000). On parle aussi de l'anxiété qui occuperait un rôle dans l'indécision vocationnelle (Forner, 2007), ainsi que la destruction de relations sociales essentielles pour l'exploration de soi et l'exploration de son environnement (Bluestein et Felsman, 1999), et l'absence de sentiment de sécurité pouvant influencer la prise de décision (Blusstein, Préziozo et Schultheiss, 1995; Hall, Moradi, Tokar et Withrow, 2003, dans Savard, 2008). Par cette analyse, la question de recherche suivante est formulée : quelles sont les pistes d'intervention possibles pour les conseillères et les conseillers d'orientation qui interviennent auprès des élèves victimes d'intimidation en milieu scolaire? Le deuxième chapitre est consacré à la définition des concepts étudiés pour parvenir à répondre à la question de recherche. Au troisième chapitre, la méthodologie permettant d'effectuer le parallèle entre les concepts étudiés et l'intervention en counseling de carrière est présentée. Au quatrième chapitre, les pistes d'intervention possibles pour les conseillères et les conseillers d'orientation sont identifiées. Finalement, en guise de conclusion, il y a l'identification des limites de cet étude et des éléments qu'éclaire cette recherche sur le plan de l'orientation et de la recherche en général, ainsi que les études pouvant s'ensuivre

Intervenções de esperança na doença crónica: uma revisão integrativa à luz de Nightingale

Objective: To identify the available evidence in the scientific literature about the strategies or interventions used to promote hope in people with chronic diseases. Method: An integrative literature review of literature published between 2009-2019, which was conducted in online browsers/databases: b-On, EBSCO, PubMed, Medline, ISI, SciELO, PsycINFO, Google Scholar. Forty-one studies were found, of which eight met the inclusion criteria. Results: Most studies used a quantitative approach. There was a predominance of studies from Asia and America, addressing patients with multiple sclerosis, diabetes, congestive heart failure, and cancer. Hope-based interventions were categorized by the hope attributes: experiential process, spiritual/transcendence process, rational thought process, and relational process. Conclusion: Hope-based interventions, in its essence, are good clinical practices in the physical, psychological, social and spiritual domains. This is congruent with the vision of nursing, first proposed by Florence Nightingale. There seem to be gaps in the literature regarding specific hope promoting interventions.Objetivo: Identificar as evidências disponíveis na literatura científica sobre as estratégias ou intervenções utilizadas para promover a esperança em pessoas com doença crônica. Método: Revisão integrativa da literatura (2009 a 2019), realizada em navegadores/bases de dados on-line: b-On, EBSCO, PubMed, Medline, ISI, SciELO, PsycINFO, Google Scholar. Foram encontrados 41 estudos, 8 dos quais preencheram os critérios de inclusão. Resultados: A maioria dos estudos utilizou abordagem quantitativa. Predominaram trabalhos da Ásia e América, abordando pacientes com esclerose múltipla, diabetes, insuficiência cardíaca congestiva e câncer. As intervenções foram categorizadas pelos atributos da esperança: processo experiencial, processo espiritual/transcendente, processo de pensamento racional e processo relacional. Conclusão: As intervenções baseadas na esperança, em sua essência, são boas práticas clínicas nos domínios físico, psicológico, social e espiritual. Isso é congruente com a visão da enfermagem holística proposta por Florence Nightingale. Parece haver lacunas na literatura relativas a intervenções específicas de promoção da esperança.info:eu-repo/semantics/publishedVersio

Pickles of fruits and flavored vinegars: new products development in the UIIPS-ESAS vinegar technology project

A aptidão tecnológica do vinagre permite desenvolver múltiplos produtos. Neste projecto (2009 -) criaram-se processos de aromatização múltipla e de conservação ácida de frutos doces em vinagre, incomuns na indústria vinagreira. Articulando ensaios tecnológicos, analíticos e provas sensoriais, desenvolveram-se dois vinagres vínicos com adições (com mirtilo e com mel e especiarias), dois vinagretes aromatizados (de laranja, de physalis) e por tecnologia de piclagem fresh pack (não fermentativa), dez pickles agridoces: pêra-abacaxi, pêra “bêbeda” (cinco variantes), com physalis (simples, com murta ou mirtilo) e de abóbora com pêra e pequenos frutos. Todos os protótipos cumprem os requisitos de estabilidade. Possuem, em comum, inovação e conveniência: novos produtos, com longo tempo de vida de prateleira, são alternativas para a preservação de frutos caros/sazonais/excedentários.Vinegar technological ability enables the development of multiple products. In this project (2009 -) were developed unusual processes in vinegar industry, such as multiple flavoring, and acid preserving of sweet fruits in vinegar. Articulating technological, laboratory and sensory tests, two wine vinegars with additions (with blueberries and with honey and spices) and two flavored vinaigrettes (with orange or physalis) were developed. Ten sweet and sour pickles were also developed by fresh pack pickling technology (without fermentation): pear-pineapple, "drunk" pear (five versions), with physalis (simple and mixed with myrtle or blueberry), and last, pumpkin with pear and berries. The prototypes fulfill the stability requirements and were designed to provide innovation and convenience: new products with long shelf life, aims the preservation of expensive/seasonal/surplus fruit.info:eu-repo/semantics/publishedVersio