Ganhos em saúde com a intervenção "humor" em pessoas com doença renal crónica

Introdução: A investigação sobre o humor refere que este contribui para a saúde e bem--estar das pessoas. O humor desempenha uma função importante nas interações humanas, pois, promove a comunicação e o equilíbrio nas relações. Embora tenha existido, ao longo dos anos, um grande investimento no estudo em torno do humor, da sua natureza, fatores que o influenciam, propósitos e benefícios, a sua definição ainda não é consensual. No âmbito da prática clínica esta intervenção está prevista como intervenção na classificação internacional para a prática de enfermagem e na Nursing Interventions Classification. Os estudos têm demonstrado benefícios do humor na saúde das pessoas. Objetivos: Avaliar a qualidade de vida, bem-estar subjetivo, saúde psicológica, interferência da dor e sentido de humor nas pessoas com doença renal crónica em programa de hemodiálise; e avaliar a efetividade da intervenção humor (visualização de filmes de humor) na saúde psicológica, bem-estar subjetivo, interferência da dor e qualidade de vida em pessoas com doença renal crónica durante as sessões de hemodiálise. Materiais e Métodos: Foi efetuado um primeiro estudo, exploratório, correlacional e transversal, onde foram caracterizados os níveis de sentido de humor, bem-estar subjetivo, qualidade de vida, interferência da dor, stresse/ansiedade, e depressão numa amostra aleatória de 171 pessoas com doença renal crónica. O segundo estudo com um desenho quasi-experimental do tipo antes e depois, foi realizado em duas amostras selecionadas aleatoriamente, em dois grupos de pessoas com doença renal crónica. O grupo intervenção tinha 34 pessoas que participaram na visualização de filme de humor durante quatro semanas e o grupo controlo tinha 33 pessoas que assistiram a programas de televisão. Resultados: No estudo exploratório verificaram-se diferenças nas variáveis sociodemográficas e clínicas. O aumento do sentido de humor está associado positivamente a níveis elevados da componente mental da qualidade de vida, bem-estar subjetivo e negativamente com stresse/ansiedade e depressão. No que respeita ao estudo quasi-experimental verificou-se na comparação dos grupos que o grupo intervenção apresentava níveis significativos mais altos na componente física da qualidade de vida, felicidade subjetiva e nas dimensões do sentido de humor, contudo, apresentou níveis mais baixos de depressão. Conclusões: O sentido de humor apresenta diferenças no sexo, nacionalidade, presença de hipertensão arterial e tempo de hemodiálise. Este está relacionado com qualidade de vida, bem-estar subjetivo e saúde psicológica. O estudo quasiexperimental forneceu evidência sobre a visualização de filmes de humor na melhoria do sentido de humor, do bem-estar subjetivo, da qualidade de vida e na diminuição dos sintomas depressivos em pessoas com doença renal crónica durante as sessões de hemodiálise. Esta atividade é acessível e segura, mas requer a presença do enfermeiro para garantir a continuidade e adesão das pessoas. Recomendam-se estudos com desenho experimental, com amostras mais alargadas para verificar o efeito desta intervenção nas variáveis psicológicas e de saúde e bem-estar.Introduction: The research on humor says that it contributes towards the health and well-being of people. Humor plays an important role in human interactions, it promotes communication and balance in relationships. Despite the fact that there has been a great investment in the study of humor over the years, its nature, factors that influence it, its purposes and benefits, its definition has not been consensual. In the context of clinical practice this intervention is taken into account as an intervention in the international classification for nursing practice and in the nursing interventions classification. Studies have shown evidence of the benefits of humor on people's health. Objectives: To evaluate the quality of life, subjective well-being, psychological health, pain interference, and sense of humor in people with chronic kidney disease on hemodialysis and to evaluate the effectiveness of the intervention humor (viewing humor movies) in psychological health, subjective well-being, pain interference, and quality of life in people with chronic kidney disease during dialysis sessions. Materials and Methods: A first study, exploratory, correlational and transversal study, where the levels of sense of humor, subjective well-being, quality of life, pain interference, stress / anxiety, and depression were characterized in a random sample of 171 people with chronic kidney disease. The second study has a quasi-experimental design of the before and after type, performed on two randomly selected samples in two groups of people with chronic kidney disease. The intervention group had 34 people who participated in the viewing of a humorous movie/comedy during four weeks and the control group had 33 people who watched television programs. Results: In the exploratory study differences in sociodemographic and clinical variables were verified. The increased sense of humor is positively associated with high levels of the mental component of quality of life, subjective well-being and negatively with stress / anxiety and depression. In the quasi-experimental study when comparing the groups, it was found that the intervention group showed significantly higher levels in the physical component of quality of life, happiness and in the dimensions: subjective sense of humor, however, exhibited lower levels of depression. Conclusions: The sense of humor differs in regard to sex, nationality, presence of hypertension and dialysis time. It is related to quality of life, well-being subjective and psychological health. The quasi-experimental study provided evidence of the viewing of humorous movies/comedies in improving the sense of humor, subjective well-being, quality of life and in reducing depressive symptoms in people with chronic kidney disease during dialysis sessions. This activity is affordable and safe, but requires the presence of nurses to ensure continuity and commitment of the people. We recommend studies with an experimental design with greater samples in order to verify the effect of this intervention on psychological variables and health and wellness

La intervención humor en la interacción enfermero-paciente

Objective: To describe the factors influencing the use of humor in nursing care, its applicability and benefits. Method: A scoping review was performed using the Arksey and O’Mally methodology. A search for articles published between 2008 and 2018 was performed using the platforms EBSCO Host, Virtual Health Library and Google Scholar. Results: From the initial 465 articles found, 17 were included for final revision. Data allowed to retrieve information on humor definition; its applicability as a nursing intervention; humor as a tool to improve nurse-patient communication and relationship; influence factors; type of humor interventions; humor benefits in health care context and; limitations and precautions of humor intervention. Conclusion: The use of humor promotes both communication and human interaction; it promotes well-being; helps deal/cope with difficult and unpleasant situations, reduces tension, discomfort and stress; and strengthens the immune system. This intervention should be used with caution

Psychological vulnerability, anxiety and personal well-being in athletes

Introduction and objectives: Our preparation for dealing with challenges, either tasks of our daily lives or competing in sports events, may be related to some specific changes in a physiological or cognitive point of view or to broader changes in our well-being. In the context of mental health, the perception of our vulnerability, as well as the indicators of how we function psychologically (dependence, automatic negative thoughts, etc.) can have an impact on our anxiety, both somatic and cognitive, and on our general well-being. Thus, the aim of our study is to verify, in endurance athletes, whether the perception of vulnerability (in mental and psychological health) is related to anxiety and well-being. Methodology: It is a transversal and correlational study in a non-probabilistic sample of 47 endurance athletes (Triathlon/Mountain Bike), 41 men and six women. On average, they are 25 years old, most of them have primary/secondary education, single, non-smokers and without chronic diseases. The instruments used were: Anxiety Scale in Sport, Personal Welfare Index, Psychological Vulnerability Scale and a question on Perception of Vulnerability regarding mental health. The data were collected with the informed consent of the participants who filled out the instruments provided at the beginning of the competition season. Results and Discussion: The results show that psychological vulnerability is positively correlated with somatic anxiety, cognitive (worries) and total anxiety as a trait. It is also negatively correlated with the personal welfare index. Mental health vulnerability perception is positively correlated with psychological vulnerability and with cognitive anxiety (focus disorder). Conclusions: This study is a relevant contribution for mental health technicians, especially for nurses, since it adds information on the biopsychosocial variables associated with athletes’ mental health, providing guidelines to create specific programs to promote Mental Health and to prevent morbidity

Subjective wellbeing, sense of humor and psychological health in hemodialysis patients

Objective: To investigate the relationship between satisfaction with life in general, sense of humor, and anxiety, depression and stress with subjective happiness in chronic kidney disease patients undergoing hemodialysis. Material and Methods: A cross-sectional and correlational study was developed in two units of the Diaverum dialysis clinic and one hospital unit, with 183 chronic kidney disease patients undergoing hemodialysis. An instrument was used to characterize the sociodemographic and clinical profile of the sample (age, gender, nationality, education, occupation, marital status, dialysis sessions length, presence of hypertension and diabetes): the subjective happiness scale; the satisfaction with life in general; depression, anxiety and stress scale 21; and multidimensional sense of humor scale. Inferential procedures included Spearman correlation coefficients, and multiple linear regression adjusting to age, marital status, professional activity and diabetes.Results: Subjective Happiness was positively correlated with satisfaction with life in general, and the three dimensions of Sense of Humor. Nevertheless, subjective happiness was negatively correlated with stress / anxiety and depression. Satisfaction with life in general, humor production and social use of humor, and attitude towards humor had a positive relationship with subjective happiness. However, depression had a negative relationship with subjective happiness. Conclusions: Higher levels of subjective happiness were associated with higher levels of satisfaction with life in general, and sense of humor, however they were also associated with lower levels of depression in patients undergoing hemodialysis

Manter a mobilidade articular no doente crítico: Estudo de Caso

Background: Immobility in critically ill patients is conditioned by the condition of the disease or by the effect of drugs, but in both cases, it emerges as a problem from the perspective of functional recovery. The decrease in muscle mass and joint amplitude delay or hinder the processes of recovery from spontaneous ventilation and self-care. When bed rest is required, safe rehabilitation nursing care is a resource to mitigate the problems associated with immobility. Objective: Evaluate the results of rehabilitation nursing care after the application of a structured passive joint mobilization care intervention in critically ill patients. Methods: Qualitative study, case study type. The case of an adult person in a critical situation is presented and eight joint mobilization sessions were carried out by a rehabilitation nurse. Joint amplitude was evaluated using goniometry before and after the application of a rehabilitation program. Study approved by the ethics committee. Results: It was found that in 26 days of admission to the intensive care unit, the joint amplitude remained in the different segments and there were gains in the supination movements of the forearm, left hand extension and right knee flexion. Passive joint mobilization exercises did not interfere with the stability of physiological parameters or adaptation to the ventilatory prosthesis. Conclusion: The results reveal that there is no decrease in joint amplitude and are sensitive to rehabilitation nursing care, in a structured and regular mobilization plan. There were gains in health and the minimization of complications associated with immobility. Other studies should be carried out in order to parameterize not only the intervention plan but also the evidence of the results obtained.Introducción: La inmovilidad en pacientes críticos está condicionada por la condición de la enfermedad o por el efecto de las drogas, pero en ambos los casos surgen como un problema desde la perspectiva de la recuperación funcional. La disminución de la masa muscular y la amplitud articular retrasan o dificultan los procesos de recuperación de la ventilación espontánea y el autocuidado. Cuando se requiere reposo en cama, la atención de enfermería de rehabilitación segura es un recurso para mitigar los problemas asociados con la inmovilidad. Objetivo: Evaluar los resultados de los cuidados de enfermería rehabilitadores tras la aplicación de una intervención asistencial de movilización articular pasiva estructurada en pacientes críticos. Método: estudio cualitativo, tipo de estudio de caso. Se presenta el caso de una persona adulta en situación crítica y una enfermera de rehabilitación realizó ocho sesiones de movilización conjunta. La amplitud articular se evaluó mediante goniometría antes y después de la aplicación de un programa de rehabilitación. Estudio aprobado por el comité de ética. Resultados: Se encontró que en 26 días de hospitalización en la unidad de cuidados intensivos, la amplitud articular se mantuvo en los diferentes segmentos y hubo ganancias en los movimientos de supinación del antebrazo, la extensión de la mano izquierda y la flexión de la rodilla derecha. Los ejercicios pasivos de movilización articular no interfirieron con la estabilidad de los parámetros fisiológicos o la adaptación a la prótesis ventilatoria. Conclusiones: Los resultados revelan que no hay disminución en la amplitud articular y son sensibles a la atención de enfermería de rehabilitación, en un plan de movilización estructurado y regular. Hubo ganancias en la salud y la minimización de las complicaciones asociadas con la inmovilidad. Se deben realizar otros estudios para parametrizar no solo el plan de intervención sino también la evidencia de los resultados obtenidos.Introdução: A imobilidade no doente crítico é condicionada pela condição de doença ou ainda, pelo efeito de fármacos, mas, em ambos os casos, emerge como um problema na perspetiva da recuperação funcional. A diminuição da massa muscular e da amplitude articular atrasam ou dificultam os processos de recuperação da ventilação espontânea e os autocuidados. Quando o repouso no leito se impõe, os cuidados de enfermagem de reabilitação seguros são um recurso com vista à mitigação dos problemas associados à imobilidade. Objetivo: Avaliar resultados dos cuidados de enfermagem de reabilitação após a aplicação de uma intervenção estruturada de cuidados de mobilização articular passiva em doente crítico. Método: Estudo qualitativo, tipo estudo de caso. É apresentado o caso de uma pessoa adulta em situação crítica á qual foram realizadas oito sessões de mobilização articular por enfermeiro de reabilitação. Avaliada a amplitude articular com recurso a goniometria antes e após a aplicação de um programa de reabilitação. Estudo aprovado em comissão de ética. Resultados: Verificou-se que em 26 dias de internamento em unidade de cuidados intensivos a amplitude articular se manteve nos diferentes segmentos e houve ganhos nos movimentos de supinação do antebraço, extensão da mão esquerda e flexão do joelho direito. A realização de exercícios passivos de mobilização articular não interferiu com a estabilidade de parâmetros fisiológicos ou de adaptação à prótese ventilatória. Conclusões: Os resultados revelam a não ocorrência de diminuição da amplitude articular e são sensíveis aos cuidados de enfermagem de reabilitação, num plano estruturado e regular de mobilizações. Houve ganhos em saúde e a minimização das complicações associadas à imobilidade. Outros estudos devem ser realizados no sentido de parametrizar não só o plano de intervenção bem como a evidência dos resultados obtidos

Relationship between quality of life and alcohol consumption in adolescents

Background: Adolescence is characterized by the development of identity, the desire for autonomy and the exploration of the extra-family world. It is a period in which some additive substances are taken, namely alcohol, which can have consequences on health and quality of life.Objective: to analyze the association between quality of life domains and alcohol consumption in adolescents. Materials and Methods: Cross-sectional, descriptive and correlational study conducted with 316 high school adolescents in three state public schools in Jequié, Bahia, Brazil. A sociodemographic questionnaire, the AUDIT (Alcohol Use Disorders Identification Test) and the WHOQOL-bref were used. Results: The sample is mostly female (56.3%) with an average age of 15.9 years. The results show that 14.6% of participants had a low risk alcohol consumption, 66.1% a risky drink, 17.4% a harmful drink and 1.9% a probable dependence. When comparing the low-risk students with the others, there were statistically significant differences in quality of life in the general domains (t=-2,25, p=0,025), psychological domain (t=-2,57, p=0,011) and social relations domain (t=-2,06, p=0,040). There were statistically significant and positive associations between alcohol consumption and the psychological domain (r=0,24, p<0,0001) and with the social relations domain (r=0,12, p<0,043). Conclusions: The higher the alcohol consumption, the lower the perception of quality of life in the general, psychological and social relations domains. Both health and educational policies are recommended to be reviewed in order to reduce alcohol consumption

Mental health, quality of life and optimism during the covid-19 pandemic: a comparison between Brazil and Portugal

Purpose Although there have been numerous studies investigating the mental health of individuals during the pandemic, a comparison between countries is still scarce in the literature. To explore this gap, the present study aimed to compare the mental health (i.e., anxiety and depression), quality of life (QoL), and optimism/pessimism among individuals from Brazil and Portugal during the COVID-19 pandemic and the associated factors. Method A cross-sectional population-based study was conducted during the COVID-19 pandemic in Brazil and Portugal. Data collection was carried out between May and June 2020, using an online form which was sent through social networks. A total of 2069 participants (1156 from Brazil and 913 from Portugal) were included. Depressive symptoms (PHQ-9), Anxiety (GAD-7), optimism/pessimism (Revised Life Orientation Test – LOT), QoL (WHOQOL-Bref), and sociodemographic, health, and social distancing variables were assessed. Data was analyzed using univariate and multivariate models. Results There were remarkable diferences between Brazil and Portugal in all outcomes during the COVID-19 pandemic, including higher levels of depressive symptoms, anxiety, and optimism for the Brazilian individuals and higher levels of QoL and pessimism for the Portuguese individuals. The following factors were associated with the mental health and QoL in both Brazilian and Portuguese populations: gender, age, being a healthcare professional, and days in social distancing. Conclusion Despite the fact that Brazilians were more optimistic during the COVID-19 pandemic, they had lower levels of mental health and QoL as compared to the Portuguese individuals.info:eu-repo/semantics/publishedVersio

Professional satisfaction of nurses in caring for the patient with chronic disease

Contexto: A satisfação profissional dos enfermeiros no cuidar do doente com doença crónica, seja em ambulatório ou em internamento, influencia a qualidade dos cuidados e a satisfação global dos enfermeiros. Objetivos: Identificar fatores de satisfação profissional do enfermeiro no cuidar do doente com doença crónica. Métodos: Realizou-se uma revisão scoping usando a metodologia proposta por Joanna Briggs Institute. A pesquisa incluiu artigos de pesquisa original publicados entre 2015 a 2018, nas línguas inglesa, portuguesa e espanhola. Resultados: Dos 68 artigos obtidos, foram analisados 23 estudos dos quais apenas 4 correspondiam aos critérios de inclusão. Os fatores de satisfação profissional identificados foram: a influência do ambiente de trabalho na prática de cuidados, as relações interpessoais entre profissionais/doente e família e realização profissional dos enfermeiros. Como fatores de insatisfação profissional observaram-se: as condições de trabalho, a sobrecarga de trabalho associado ao sofrimento e à morte do doente que podem levar a uma exaustão psicológica, e a desvalorização profissional e remuneratória. Conclusões: O enfermeiro gestor pode delinear estratégias adequadas para promover a satisfação profissional junto das equipas e da organização

Diagnóstico de enfermería “deterioro de la deambulación” en el anciano: revisión integradora de la literatura

The impaired walking nursing diagnosis has been included in NANDA International classification taxonomy in 1998, and this review aims to identify the defining characteristics and related factors in elderly patients in recent literature. Integrative literature review based on the following guiding question: Are there more defining characteristics and factors related to the nursing diagnosis impaired walking than those included in NANDA International classification taxonomy in elderly patients? Search conducted in 2007-2013 on international and Portuguese databases. Sample composed of 15 papers. Among the 6 defining characteristics classified at NANDA International, 3 were identified in the search results, but 13 were not included in the classification. Regarding the 14 related factors that are classified, 9 were identified in the sample and 12 were not included in the NANDA International taxonomy. This review allowed the identification of new elements not included in NANDA International Taxonomy and may contribute to the development of taxonomy and nursing knowledge.O diagnóstico de enfermagem deambulação prejudicada integra a NANDA Internacional desde 1998, e o objetivo deste estudo é identificar as características definidoras e os fatores relacionados no paciente idoso na literatura mais atual. Revisão integrativa com a questão: existirão mais características definidoras e fatores relacionados do diagnóstico de enfermagem deambulação prejudicada, além dos que estão descritos na NANDA Internacional, que sejam específicos para o paciente idoso? Pesquisa no período 2007-2013 em bases de dados internacionais e portuguesa. Obteve-se uma amostra de 15 estudos. Entre as 6 características definidoras do diagnóstico na classificação, 3 foram identificadas nos resultados da busca na literatura, contudo, encontram-se outras 13 que não constam da classificação. Relativamente aos fatores relacionados, dos 14 classificados, 9 foram identificados na amostra e 12 não estão na classificação. Essa revisão permitiu identificar novos elementos que não estão classificados na NANDA Internacional e pode contribuir para o desenvolvimento da taxonomia e do conhecimento de enfermagem.El diagnóstico de enfermería deterioro de la deambulación integra la NANDA Internacional desde 1998 y esta revisión tuvo como ob- jetivo identificar las características definidoras y los factores relacionados con el paciente anciano en la literatura más actual. Revisión integrada que surgió de la pregunta: ¿existirán más características y factores relacionados de deterioro de la deambulación, además de aquellas que están descritas en la NANDA Internacional, en el paciente anciano? Búsqueda en el período 2007-2013 en las bases de datos internacionales y portuguesa. Se obtuvo una muestra de 15 estudios. Entre las 6 características de diagnóstico en la clasificación, 3 fueron identificadas 3 en los resultados de la búsqueda, pero, otras 13 no constan en la NANDA Internacional. Con relación a los factores relacionados, 9 en la muestra y 12 no están en la clasificación. Nuevos elementos fueran identificados y no están clasificadas en la NANDA Internacional, ofreciendo así aportaciones para el desarrollo de la taxonomía y del conocimiento en enfermería.info:eu-repo/semantics/publishedVersio

Well-being and spirituality in senior adults

Background: Spirituality contributes to individual well-being as a dynamic process and a personal experience that gives meaning to the human existence.Objective: To characterize spiritual well-being in senior adults and analyse the relationship between spirituality and subjective well-being. Materials and Methods: Descriptive, cross-sectional and correlational study. The participants are mostly female (66.7%), widowed (47.1%) and live alone (40.2%). They are on average 77.3 years old (SD = 7.7) and most have completed primary school (60.8%). Only 11.8% report not having religious beliefs. For data collection the following instruments were used: a Sociodemographic Questionnaire, the Spiritual Well-Being Scale (SWBS) and the Satisfaction with Life Scale (SWLS). Results: There were statistically significant positive correlations between SWBS and Life Satisfaction (r = 0.380; p <0.01), between existential well-being (EWB) and Life Satisfaction (r = 0.515; p <0, 01) and religious well-being (RWB) and Life Satisfaction (r=0,253; p<0,01). On the SWBS scale and on the RWB and EWB subscales between the group of professing religion and non-professing group, statistically significant differences were found. (p<0,05). People who follow a religion, compared to those who do not follow, have better religious well-being, existential, and spiritual well-being. Conclusions: The results confirm that spirituality is related to subjective well-being in the senior adult. Understanding the role of religion and spirituality in this population well-being is critical to better care for and work with these people, and prepare them in advance to meet the challenges of ageing