The experience of the illness and of the treatment for the person with systemic arterial hypertension: an ethnographic study

OBJECTIVE: to interpret the meanings of the experience of the condition and of the treatment among people with arterial hypertension. METHOD: the authors adopted the frames of reference of interpretive and medical anthropology and of the ethnographic method. 22 people with arterial hypertension, and 10 Family Health Strategy health workers, all from Minas Gerais, participated. The authors used interviews, participant observation, focus groups, field diaries and analysis of medical records. Ethical precepts were respected. RESULTS: two nuclei of meaning emerged: "The condition as an expression of way of living", and "The perspective of the cure of the condition". Nervous problems represent the nosological and symptomatic categories, caused by the urban way of living. The participants are supported by the belief of the curing of the problem. The family, spirituality and religion constitute social support networks. The therapeutic routes interpenetrate for the cure of the problem. The 'folk' health subsystem constitutes an important route because it provides better well-being and remission of the symptoms. CONCLUSION: the gaps evidenced between the points of view of the health professionals and the interviewees allow one to re-think the praxis so as to provide comprehensive, contextualized and humanized care, which encourages the people's potential for living, for empowerment, and for self-care.OBJETIVO: interpretar los significados de la experiencia de la enfermedad y del tratamiento en personas con hipertensión arterial. MÉTODO: adoptamos los marcos teóricos de la antropología interpretativa y médica y del método etnográfico. Participaron 22 personas con hipertensión arterial y 10 trabajadores de la salud de la Estrategia de la Salud de la Familia del estado de Minas Gerais. Utilizamos entrevistas, observación participante, grupo focal, diario de campo y análisis de ficha médica. Fueron respetados los preceptos éticos. RESULTADOS: surgieron dos núcleos de significados: "La enfermedad como expresión del estilo de vida" y "La perspectiva de cura de la enfermedad". El problema nervioso representa la categoría nosológica, sintomática, causada por el estilo de vida urbano. Se apoyan en la creencia de la cura del problema. La familia, la espiritualidad y la religión constituyeron redes de apoyo social. Los itinerarios terapéuticos se entrelazan para la cura del problema. El subsistema de salud popular constituye un importante itinerario por proporcionar mejor bienestar y alivio de los síntomas. CONCLUSIÓN: los vacíos evidenciados entre el punto de vista de los profesionales de la salud y él de los deponentes propician repensar la praxis para proveer cuidados integrados, contextualizados y humanizados, lo que estimula la potencialidad de las personas para el vivir, para el empoderamiento y para el autocuidado.OBJETIVO: interpretar os significados da experiência da doença e do tratamento entre pessoas com hipertensão arterial. MÉTODO: foram adotados os referenciais da antropologia interpretativa e médica e do método etnográfico. Participaram 22 pessoas com hipertensão arterial e 10 trabalhadores em saúde da Estratégia de Saúde da Família, de Minas Gerais. Utilizaram-se entrevistas, observação participante, grupo focal, diário de campo e análise de prontuário. Os preceitos éticos foram respeitados. RESULTADOS: emergiram dois núcleos de significados: "a doença como expressão do estilo de vida" e "a perspectiva de cura da doença". Problema de nervoso representa a categoria nosológica, sintomática, causada pelo estilo de vida urbano. Os sujeitos apoiam-se na crença da cura do problema. A família, a espiritualidade e a religião constituíram redes de apoio social. Os itinerários terapêuticos se interpenetram para a cura do problema. O subsistema de saúde popular constitui importante itinerário por proporcionar satisfatório bem-estar e a remissão dos sintomas. CONCLUSÃO: as lacunas evidenciadas entre o ponto de vista dos profissionais de saúde e dos depoentes propiciam repensar a práxis para prover cuidados integrados, contextualizados e humanizados, o que estimula a potência das pessoas para o viver, para o empoderamento e para o autocuidado

Symptoms of depression in patients with cancer of the head and neck undergoing radiotherapy treatment: a prospective study

This study aimed to investigate the frequency of symptoms of depression in patients with cancer of the head and neck undergoing radiotherapy treatment, in the initial, middle and final stages of the treatment. This is a prospective exploratory quantitative study of 41 patients with head and neck cancer, undergoing radiotherapy treatment in the Oncology Outpatient Clinic of the Beneficencia Portuguese Hospital of Ribeirao Preto. Data were collected through the Beck Depression Inventory instrument, and analyzed quantitatively by means of the Statistical Package for the Social Sciences. Symptoms of dysphoria were found to increase throughout the treatment, as well as the number of patients with depression. The results show the importance for the healthcare professionals to detect the prevalence and the levels of the symptoms of depression, since these symptoms tend to increase and may lead to consequences such as a lack of adherence to treatment and a decrease in the quality of life of these patients.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq

Depression, fatigue, and health-related quality of life in head and neck cancer patients: a prospective pilot study

To assess the prevalence of depression and fatigue symptoms in head and neck cancer patients during radiotherapy treatment and relate them symptoms with these patients' quality of life. This is a prospective study. The Beck Depression Inventory (BDI), Piper Fatigue Scale-revised and Functional Assessment Cancer Therapy Head and Neck (FACT-H&N) were applied to 41 head and neck cancer patients at three times: at the start of treatment (T1), approximately 15 days after the start of treatment (T2) and at the end of treatment (T3), approximately 30 days after the start of the radiotherapy. The mean BDI and PIPER increased during the radiotherapy treatment. BDI scores did not demonstrate the presence of depression, although the number of symptoms increased, and the presence of fatigue rose as treatment advanced. The mean FACT H&N decreased in the middle and at the end of treatment, indicating worsening in these patients' Quality of Life. Depression and fatigue symptoms increased during radiotherapy treatment, while QoL levels decreased. This demonstrates that these symptoms are strongly correlated and that their presence negatively influenced QoL. At the start of treatment, nurses need to advise patients and plan care, offering interventions to decrease these symptoms and improve QoL

The Outcomes of Visualization and Acupuncture on the Quality of Life of Adult Cancer Patients Receiving Chemotherapy

Background: The use of complementary and alternative medicine (CAM) to treat cancer patients has increased around the world, and its benefits have been described. These therapies represent an important theme in oncology and have been used in parallel with conventional therapies. Objective: This study aimed to assess the outcomes of using relaxation with visualization and acupuncture on the quality of life of cancer patients undergoing chemotherapy treatment and to compare these outcomes with patients who did not choose to receive the intervention. Methods: Participants chose to be in either the intervention group (IG) or control group (CG). They completed the Quality of Life Questionnaire-Core 30 at the start and end of chemotherapy. The IG was chosen by 38 patients with different types of cancer who completed weekly relaxation with visualization and acupuncture sessions, whereas the CG was composed of 37 patients who did not receive the intervention. Results: Statistically significant results evidenced an increase in global health and emotional and social functions and a decrease in fatigue and loss of appetite for the IG, and an increase in global health for the CG (P <= .05). A highly significant difference was found when comparing the post-chemotherapy scores of the Quality of Life Questionnaire-Core 30 in the global health domain between the CG and the IG (P <= .001), indicating positive outcomes of the CAM intervention. Conclusion: Adults with cancer are able to choose between involvement or not with this kind of CAM intervention. Global health could be improved by participating in this type of intervention. Implications for Practice: Choosing whether to be involved may be assisted by knowing the positive outcomes for some patients