Efetividade da prática do Reiki em gestantes diabéticas: protocolo de ensaio clínico randomizado

The aim was to outline the protocol of a randomized clinical trial (RCT) with the objective of identifying the effectiveness of the practice of Reiki in diabetic pregnant women. 150 pregnant women with diabetes were included and randomized into three groups: control/placebo group (mimicking of Reiki therapy), intervention (with face-to-face Reiki therapy technique) and remote intervention (with remote Reiki therapy) in the period of March from 2016 to December 2018. The intervention comprised seven Reiki sessions compared to the simulation of laying on of hands, in person or at a distance. Quality of life and anxiety will be measured, in addition to perinatal outcomes such as: gestational age at birth, Apgar score, birth weight, classification of gestational age at birth (term or preterm), classification of newborn weight by gestational age, type of care (joint accommodation, nursery and NICU) and perinatal death. Statistics will comprise a descriptive analysis with the calculation of mean and standard deviation for quantitative variables and frequencies and percentages for categorized variables. The literature has few works on Reiki in the area of ​​obstetrics, highlighting the need to carry out studies that introduce integrative and complementary therapies in Brazilian public health.Objetivou-se delinear o protocolo de um ensaio clínico randomizado (ECR) com o objetivo de identificar a efetividade da prática do Reiki em gestantes diabéticas. Foram incluídas 150 gestantes diabéticas que foram randomizadas em três grupos, sendo: grupo controle/placebo (mimetização da terapêutica Reiki), intervenção (com a técnica terapêutica Reiki presencial) e intervenção à distância (com a terapêutica Reiki à distância) no período de março de 2016 a dezembro de 2018. A intervenção compreendeu em sete sessões de Reiki em comparação a simulação de imposição das mãos, de forma presencial ou à distância. Serão mensurados a qualidade de vida e ansiedade, além de desfechos perinatais como: idade gestacional ao nascimento, índice de Apgar, peso ao nascer, classificação da idade gestacional ao nascimento (termo ou pré-termo), classificação do peso do recém-nascido por idade gestacional, tipo de atendimento (alojamento conjunto, berçário e UTI Neonatal) e morte perinatal. A estatística compreenderá uma análise descritiva com o cálculo de média e desvio padrão para variáveis quantitativas e frequências e percentuais para as variáveis categorizadas. A literatura dispõe de poucos trabalhos sobre Reiki na área de obstetrícia, evidenciado a necessidade da realização de estudos que introduzam as terapias integrativas e complementares na saúde pública brasileira

Estresse ocupacional e esgotamento profissional em profissionais da enfermagem: revisão integrativa da literatura / Occupational stress and professional exhaust in nursing professionals: integrating literature review

Objetivo: Identificar os fatores desencadeantes do stress ocupacional e mapear se há esgotamento profissional na enfermagem e seus principais fatores. Método: Estudo de revisão integrativa, qualitativo, baseado em dados da literatura científica publicado nas bases de dados LILACS, BDENF e MEDLINE selecionados a partir do DeCS, com os descritores e sinônimos: “Esgotamento Profissional ” e “Equipe de Enfermagem”. A busca nas bases de dados ocorreu em julho de 2020. Para selecionar as produções científicas, os critérios de inclusão foram: artigos completos acerca da temática em língua portuguesa e publicados até a data da busca. Os critérios de exclusão foram: artigos de revisão bibliográfica da literatura, monografias, dissertações, teses, livros, capítulos e resenhas de livros, manuais, relatórios técnicos artigos publicados em outros idiomas. Também foram excluídos artigos que não possuíam relação com a questão norteadora do estudo. Resultados: A análise incluiu 14 estudos publicados de 2008 a 2020 que foram divididos em duas categorias, sendo “fatores geradores de estress ocupacional” que identificou que relacionamento interpessoal, carga de trabalho excessiva gerada pela escassez de tempo adequado, ausência de profissionais treinados e carência de planejamento das atividades são fatores geradores de stress ocupacional. A categoria para “esgotamento profissional” constatou que presença de déficit na valorização profissional, número insuficiente de trabalhadores e risco de acidente de trabalho são os fatores mencionados pela equipe de enfermagem. Conclusão: o stresse ocupacional bem como seu agravamento, o esgotamento profissional está relacionado ao contexto laboral e é resultado do estress crônico, levando a exaustão emocional

Complementary therapies in controlling side-effects during cancer treatment: A systematic review and meta-analysis

This systematic review evaluated whether reiki had an impact on patients undergoing chemo-therapy, with possible improvement of the following outcomes: fatigue, pain, anxiety and quality of life. Method: Systematic review study with meta-analysis conducted at a tertiary care center. The following databases were searched until July 2020: MEDLINE, LILACS and CENTRAL. Two re-viewers independently examined eligible articles, extracted data and assessed the risk of bias using the Cochrane tool. Results: The analyzes included eight studies and showed that there was a sta-tistically significant for anxiety control (MD = -2-09; 95% CI: -3.00 to -1.19; I2 = 51%) and Quality of life (MD = -5.97; 95% CI: -10.70 to -1.25; I2 = 97%) but no statistically significant difference was found for the other outcomes analyzed. An analysis of the risk of bias has uncertain methodological limitations in the studies. Conclusions: Although there is anxiety control and improved quality of life, there is a need for the elaboration of randomized clinical trials with larger populations to verify their real performance in controlling some side effects during chemotherapy

Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis

There is an ongoing discussion regarding abdominal muscle (AbM) and pelvic floor muscle (PFM) synergism. Therefore, this study aimed to investigate the cocontraction between AbMs and PFMs in women with or without pelvic floor dysfunction (PFD). The following databases were searched up to December 21, 2018: MEDLINE, EMBASE, LILACS, PEDro and CENTRAL. We included any study that assessed the cocontraction between PFMs and AbMs in women with and without PFD. Two reviewers independently screened eligible articles and extracted data. The outcomes were extracted and analyzed as continuous variables with random effect models. Twenty studies were included. A meta-analysis did not show differences in women with and without PFD. However, a sensitivity analysis suggested cocontraction of the transversus abdominis (TrA) during PFM contraction in healthy women (standardized mean difference (SMD) 1.02 [95% confidence interval (CI) 1.90 to 0.14], P=0.02; I2 = not applicable; very low quality of evidence). Women with PFD during contraction of PFMs showed cocontraction of the obliquus internus (OI) (SMD 1.10 [95% CI 0.27 to 1.94], P=0.01; I2 = not applicable; very low quality of evidence), and obliquus externus (OE) (SMD 2.08 [95% CI 1.10 to 3.06], Po0.0001; I 2 = not applicable; very low quality of evidence). Increased cocontraction of the TrA may be associated with maximal contraction of PFMs in women without PFD. On the other hand, there is likely an increased cocontraction with the OI and OE in women with PFD

Is reiki or prayer effective in relieving pain during hospitalization for cesarean? A systematic review and meta-analysis of randomized controlled trials

ABSTRACT CONTEXT AND OBJECTIVE: This systematic review compared reiki and prayer with drug use for relieving pain during hospitalization for cesarean, given that the popularity of integrative medicine and spiritual healing has been increasing. It had the aim of evaluating whether reiki or prayer is effective in relieving pain during cesarean section. DESIGN AND SETTING: Systematic review with meta-analysis conducted at Botucatu Medical School, UNESP, São Paulo, Brazil. METHODS: The following databases were searched up to March 2016: MEDLINE, Embase, LILACS and CENTRAL. Randomized controlled trials published in English or Portuguese were included in the review. Two reviewers independently screened eligible articles, extracted data and assessed the risk of bias. A GRADE table was produced to evaluate the risk of bias. RESULTS: There was evidence with a high risk of bias showing a statistically significant decrease in pain score through use of reiki and prayer, in relation to the protocol group: mean difference = -1.68; 95% confidence interval: -1.92 to -1.43; P < 0.00001; I2 = 92%. Furthermore, there was no statistically significant difference in heart rate or systolic or diastolic blood pressure. CONCLUSION: Evidence with a high risk of bias suggested that reiki and prayer meditation might be associated with pain reduction

Is the risk of low birth weight or preterm labor greater when maternal stress is experienced during pregnancy? A systematic review and meta-analysis of cohort studies

<div><p>Antenatal stress is linked to fetal risks that increase the chances of neonatal complications and reduction of child cognitive ability. Therefore, we aimed to evaluate if maternal stress affects fetal, neonatal or child development. The following databases were searched: MEDLINE (1966 to May 2016), Embase (1980 to May 2016), LILACS (1982 to May 2016) and CENTRAL (1972 to May 2016). Observational studies published in English and Portuguese were included whether there was any relationship between fetal and neonatal outcome, such as birth weight, preterm labor, child development with pregnant women that were subjected to any stress type during at least one month of follow-up. Two independent reviewers screened eligible articles, extracted data and assessed the risk of bias. Thus, 8 cohort studies with about 8,271 pregnant women and 1,081,151 children proved eligible. Results suggested a significant association between antenatal stress exposure and increasing rates of low birth weight (Odds ratio (OR) 1.68 [95% Confidential Interval (CI) 1.19, 2.38]). However, there was no statistically significance difference between non-exposed and exposed groups related to preterm labor (OR 1.98 [95% CI 0.91 to 4.31]; I2 = 68%, p = 0.04). Although, results were inconsistent with primary analysis suggesting a significant association between antenatal stress exposure and the occurrence of higher rates of preterm birth (OR 1.42 [95% CI 1.05 to 1.91]; I2 = 68%, p = 0.04) in the sensitivity analysis. Furthermore, the current review has suggested that stress perceived during antenatal negatively influences fetal life and child development. Yet, further studies are necessary with adequate sample size and longer follow-up time to confirm our findings.</p></div

Study characteristics related to number of participants, inclusion and exclusion criteria.

<p>Study characteristics related to number of participants, inclusion and exclusion criteria.</p

Search strategy.

<p>Search strategy.</p

Meta-analysis of low birth weight.

<p>Meta-analysis of low birth weight.</p

Risk of bias assessment.

<p>Risk of bias assessment.</p