Impact of doula's continuous support on serotonin release in parturients: a pilot randomized clinical trial

Abstract Objective: To evaluate whether the continuous support provided by doulas influences the endogenous release of serotonin in parturients. Methods: This pilot study included 24 primigravidae at term. Of these, 12 women received continuous doula support (Experimental Group), whereas the other 12 received the usual assistance without doula support (Control Group). Blood samples were collected from all the women at the active and expulsion stages of labor and at the fourth period of labor (Greenberg period) for evaluation of their serotonin levels using high-performance liquid chromatography. Results: The average serotonin concentrations in the control and experimental groups were respectively 159.33 and 150.02 ng/mL at the active stage, 179.13 and 162.65 ng/mL at the expulsion stage, and 198.94 and 221.21 ng/mL at the Greenberg period. There were no statistically significant differences in serotonin concentrations between the two groups at the active and expulsion stages of labor. By contrast, within the experimental group, a significant increase in serotonin concentration was observed in the Greenberg period compared with the levels in the active and expulsion stages (p < 0.05). Conclusion: The novelty of this study relies on the ability to correlate the influence of the continuous support offered by doulas with the release of serotonin in parturients, with the results suggesting that the assistance received during labor can modulate the levels of hormone release in the Greenberg period. Brazilian Registry of Clinical Trials: RBR-4zjjm4

Genetic Counseling Outcome Scale (GCOS-24): cultural adaptation and validation to Brazilians in process of Genetic Counseling

Profissionais de saúde, atuantes em serviços que oferecem aconselhamento genético (AG), carecem de instrumentos objetivos para avaliar os desfechos do AG e para \"dar voz\" aos usuários desses serviços. O desconhecimento desses desfechos pode impactar diretamente na efetividade e nos benefícios do aconselhamento, na qualidade de vida, na promoção da saúde e no empoderamento dos aconselhados. Tais instrumentos são escassos na maioria dos países e inexistentes no Brasil. Nesse contexto, o presente estudo teve como objetivo adaptar culturalmente e validar a Genetic Counseling Outcome Scale/GCOS-24, originalmente elaborada no idioma inglês britânico. Após aprovação pelo Comitê de Ética em Pesquisa das instituições participantes, conduzimos uma investigação metodológica, que incluiu 204 usuários (pacientes, acometidos ou em risco para doenças genéticas, ou um de seus familiares/cuidadores) do Serviço de Genética Médica de um hospital universitário do interior paulista, durante o período de outubro de 2014 a dezembro de 2015. O processo de adaptação e validação da GCOS-24 compreendeu as fases de tradução e retrotradução, comitê de especialistas, validação semântica, estudo piloto e estudo de campo, por meio de análise estatística apropriada. A validação semântica demonstrou que a GCOS-24 é composta por itens considerados relevantes para a condição de saúde dos participantes do estudo, os quais foram facilmente compreendidos pelos mesmos. A versão adaptada apresentou confiabilidade satisfatória (?Cronbach=0,71) e estabilidade moderada (ICC=0,52), mensuradas, respectivamente, pelo Coeficiente Alfa de Cronbach e Coeficiente de Correlação Intraclasse. O processo de adaptação e validação da GCOS-24 para brasileiros foi finalizado. O produto final deste trabalho, a EDAG-24 (Escala de Desfechos do Aconselhamento Genético/EDAG-24), foi considerada válida e fidedigna à sua versão original, com potencial para mensurar os desfechos do aconselhamento genético, realizado em serviços de genética clínicaHealth professionals working in services that offer genetic counseling (GC) lack objective instruments to measure the GC outcomes and to give voice to the users of these services. The unawareness of these outcomes can directly impact the effectiveness and benefits of counseling, life quality, health promotion and the empowerment of the patients. Such instruments are scarce in most countries and nonexistent in Brazil. In this context, this paper aimed to culturally adapt and validate the Genetic Counseling Outcome Scale /GCOS-24, originally made in British English. After the approval of the Research Ethics Committee of the participating institutions, we conducted a methodological investigation, which included 204 users (patients, affected or at risk for genetic diseases, or one of their relatives/caregivers) from the Medical Genetics Service of a university hospital in the countryside of the state of Sao Paulo, during the period from October 2014 to December 2015. The process of adaptation and validation of the GCOS-24 comprehended the phases of translation and back-translation, committee of experts, semantic validation, pilot test and field study, through appropriate statistical analysis. The semantic validation revealed that GCOS-24 consists of items that were considered relevant to the health condition of the study participants, which were easily understood by them. The adapted version presented satisfactory reliability (?Cronbach=0,71) and moderate stability (ICC=0,52), measured, respectively, by the Cronbach\'s Alpha Coefficient and Intraclass Correlation Coefficient. The adaptation and validation process of the GCOS-24 to Brazilians was finalized. The final product of this paper, the EDAG-24 (Escala de Desfechos do Aconselhamento Genético/EDAG-24), was considered valid and reliable to its original version, with potential to measure the genetic counseling outcomes conducted in Clinical Genetics Service

Adaptation and preliminary validation of the genetic counseling outcome scale (GCOS-24) in a Brazilian genetic counselling setting

Health professionals working in services providing genetic counseling need objective instruments to assess genetic counseling outcomes and also to “give a voice” to those using these services. Lack of knowledge regarding such outcomes may directly impact the effectiveness and the potential benefits of counseling, quality of life, health promotion, and empowerment of those receiving counseling. There are very few instruments available for most countries, however there are none in Brazil. In this context, this study aimed to adapt and preliminarily validate the Genetic Counseling Outcome Scale (GCOS-24), a Patient-Reported Outcome Measure (PROM), originally developed in British English. This methodological study recruited 278 individuals attending a medical genetic service at a Brazilian university hospital. We performed the translation, back-translation, semantic validation, pilot study and field study for testing of some psychometric properties. The instrument's internal consistency and test-retest reliability (stability) were assessed using Cronbach's alpha coefficient and Intraclass Correlation Coefficient, respectively. The Brazilian version of the GCOS-24 presented face and content validity, satisfactory internal consistency (Cronbach's α = 0.71), and moderate stability (ICC = 0.52). It was considered reliable, easily understood and relevant to assessing the genetic counseling outcomes for the study participants. Its construct validity still needs to be assessed to verify the instrument's internal structure and its potential use to measure change in empowerment following genetic counseling provided by Brazilian clinical genetics services

SÍNDROME DE BURNOUT EM TRABALHADORES DA ONCOLOGIA: UMA REVISÃO INTEGRATIVA

O estudo teve como objetivo identificar, na literatura, os principais fatores geradores da síndrome de burnout em profissionais de saúde, sobretudo em enfermeiros que atuam em unidades de oncologia. Trata-se de uma revisão integrativa, a qual utilizou as etapas metodológicas de Ganong. Realizamos uma busca eletrônica por artigos indexados nas bases de dados Web of Science, PubMed Central e Biblioteca Virtual de Saúde, publicados entre 2010 a 2015. Nós utilizamos, em diferentes combinações, os descritores controlados: esgotamento profissional, enfermagem e oncologia. A amostra final foi composta por 18 artigos. O maior número de publicações, quatro artigos (22,2%) em cada ano, ocorreu em 2010 e 2013, principalmente nos Estados Unidos (n=5, 27,8%) e na Austrália (n=3, 16,6%). Lidar com o agravamento da doença do paciente e a morte foi considerado o principal fator gerador da síndrome de burnout. A implementação de programas de valorização profissional e de grupos de apoio psicossocial para equipe de enfermagem tem potencial para auxiliar na elaboração de mecanismos para suportar as situações difíceis que permeiam o cotidiano da enfermagem oncológica

Self-reported cancer family history is a useful tool for identification of individuals at risk of hereditary cancer predisposition syndrome at primary care centers in middle-income settings: a longitudinal study

Abstract Analysis of cancer family history (CFH) offers a low-cost genetic tool to identify familial cancer predisposition. In middle-income settings, the scarcity of individual records and database-linked records hinders the assessment of self-reported CFH consistency as an indicator of familial cancer predisposition. We used self-reported CFH to identify those families at risk for hereditary cancer syndromes in community-based primary care centers of a low-income Brazilian area. We also evaluated the consistency of the information collected by reassessing CFH five years later. We interviewed 390 families and constructed their pedigrees for genetic cancer risk assessment. We found 125 families affected by cancer, 35.2% with moderate to high risk of familial susceptibility to cancer, a number that represents a relatively high prevalence of potential hereditary cancer syndromes in the overall study sample. Upon reassessment of CFH in 14/20 families that were previously identified as having at least one first-degree and one second-degree relative affected by cancer, and presented moderate to high risk for developing cancer, 90% of initial pedigrees were confirmed. These results demonstrate the reliability of self-reports as a means of early identification of healthy individuals at risk, encouraging the wider use of this method in low- and middle-income primary care settings