Importância da interação entre comunidade e graduando, para uma formação humanizada: relato de experiência / Importance of interaction between community and undergraduate, for humanized training: experience report

Durante a vivência acadêmica, as universidades conectam seus futuros profissionais para assistência à comunidade, tendo em vista uma formação centrada na humanização dos pacientes. O programa de monitoria para a clínica interdisciplinar no tratamento de feridas, do Centro Universitário do Espírito Santo (UNESC), não se limita apenas ao campo teórico, abrangendo muito a prática com o corpo social e possibilita essa experiência com a comunidade de forma humanizada. Objetivo: Relatar a inter-relação com a sociedade durante o tempo de monitoria, como isso é importante para a capacitação de excelência, e também como essa humanização contribui para tratamento e evolução do paciente. Metodologia: O estudo consiste em um relato de experiência de um dos monitores da clínica de feridas durante um semestre de monitoria, apresentando caráter descritivo. Resultados e Discussão: Durante a vivência notou-se o quão importante é enxergar esse lado humano do paciente, não se preocupando apenas com suas queixas. Agindo desse modo, teve como resultado pacientes mais felizes, engajados com o tratamento e gostando de estar naquele ambiente, por mais doloroso que fosse o real motivo. Considerações finais: É vital para o graduando aprender a lapidar sua abordagem com o paciente, atuando de maneira holística. Essa interação entre universidade e corpo social é de fundamental importância para desenvolver profissionais que saiam ainda mais capacitados para o mercado de trabalho, principalmente quando se trata de profissionais da área da saúde, possibilitando mesclar assistência e atendimento, com o processo de ensino-aprendizado das práticas de saúde.(AU)

During their academic experience, universities connect their future professionals to assist the community, with a view to training centred on the humanization of patients. The monitoring program for the interdisciplinary wound care clinic at the Centro Universitário do Espírito Santo (UNESC) is not just limited to the theoretical field, but also encompasses a lot of practice with the social body and enables this experience with the community in a humanized way. Objective: To report on the interrelationship with society during the monitoring period, how important this is for the training of excellence, and also how this humanization contributes to the treatment and evolution of the patient. METHODOLOGY: The study consists of a report on the experience of one of the wound clinic monitors during a semester of monitoring, and is descriptive in nature. Results and Discussion: During the experience, we noticed how important it is to see the human side of the patient, not just worrying about their complaints. Acting in this way resulted in happier patients, engaged with the treatment and enjoying being in that environment, no matter how painful the real reason.Final considerations: It is vital for undergraduates to learn how to refine their approach to patients, acting in a holistic way. This interaction between the university and society is of fundamental importance for developing professionals who are even more qualified for the job market, especially when it comes to health professionals, making it possible to merge assistance and care with the teaching-learning process of health practices.(AU)

Durante su experiencia académica, las universidades vinculan a sus futuros profesionales con la asistencia a la comunidad, con vistas a una formación centrada en la humanización de los pacientes. El programa de acompañamiento de la clínica interdisciplinaria de cuidado de heridas del Centro Universitario do Espírito Santo (UNESC) no se limita apenas al campo teórico, sino que abarca mucha práctica con el cuerpo social y posibilita esta experiencia con la comunidad de forma humanizada. Objetivo: Informar sobre la interrelación con la sociedad durante el período de seguimiento, cuán importante es esto para la formación de excelencia, y también cómo esta humanización contribuye al tratamiento y evolución del paciente. Metodología: El estudio consiste en un informe sobre la experiencia de uno de los monitores de la clínica de heridas durante un semestre de monitorización, y es de naturaleza descriptiva. RESULTADOS Y DISCUSIÓN: Durante la experiencia, nos dimos cuenta de lo importante que es ver el lado humano del paciente, no sólo preocuparse por sus quejas. Actuar de esta manera resultó en pacientes más felices, comprometidos con el tratamiento y disfrutando de estar en ese ambiente, por más doloroso que sea el motivo real.Consideraciones finales: Es fundamental que los estudiantes universitarios aprendan a perfeccionar su abordaje con los pacientes, actuando de forma holística. Esta interacción entre la universidad y la sociedad es de fundamental importancia para el desarrollo de profesionales aún más cualificados para el mercado de trabajo, especialmente cuando se trata de profesionales de la salud, haciendo posible la fusión de la asistencia y el cuidado con el proceso de enseñanza-aprendizaje de las prácticas de salud.(AU)

Inclusão da espiritualidade do paciente durante o tratamento quimioterápico / Inclusion of the patient's spirituality during chemotherapy

Resumo A relação da espiritualidade com a saúde tem sido estudada e apontada como uma dimensão que traz benefícios na promoção, proteção e recuperação, além de colaborar com o enfrentamento de doenças. Assim, o objetivo deste estudo é relatar uma experiência vivenciada durante um ensaio clínico randomizado, que incluiu a dimensão espiritual do paciente no tratamento contra o câncer, a partir da realização de uma pesquisa que incluiu a espiritualidade do paciente oncológico durante o processo quimioterápico. O ensaio clínico foi composto por 30 pacientes portadores de câncer atendidos em uma Unidade de Assistência de Alta Complexidade em Oncologia. Percebeu-se que eles demonstraram surpresa por terem sua dimensão espiritual incluída, relatando que era uma questão importante para vivenciarem o que estavam passando. Também se notou a importância de incluir estudantes de medicina na coleta dos dados, oportunizando aos futuros profissionais contato com essa temática no contexto do cuidado em saúde. A vivência de experiências que trazem questões tão subjetivas, delicadas, profundas e essenciais sobre o ser humano, como são a espiritualidade e a fé, permitiu ao pesquisador desenvolver uma reflexão sobre a necessidade de mudança de paradigma na forma de prestar cuidado à saúde.

Abstract The relationship between spirituality and health has been studied and pointed out as a dimension that brings benefits in the promotion, protection, and recovery of health, in addition to collaborating with the combat against diseases. Thus, the objective of this study is to report an experience of a randomized clinical trial that included the spiritual dimension of patients in clinical treatment against cancer, resulting from a research that included the spirituality of cancer patients during chemotherapy. This randomized clinical trial consisted of 30 cancer patients treated at a High Complexity Care Unit in Oncology. We noticed that the patients showed surprise for having their spiritual dimension included, reporting that it was an important dimension for experiencing the moment they were going through. We also perceived the importance of including medical students in the data collection, providing opportunities for the future professional to have contact with this issue in the context of healthcare. The experience that brings such subjective, delicate, profound, and essential questions about the human being, such as spirituality and faith, allowed the researcher to develop a reflection on the need for a paradigm shift in the way of providing healthcare.

Os Seis Pilares da Medicina do Estilo de Vida no Manejo de Doenças Não Transmissíveis - As Lacunas nas Diretrizes Atuais / The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases - The Gaps in Current Guidelines

Resumo Fundamento: As doenças crônicas não transmissíveis (DCNT), também conhecidas como doenças crônicas de longa duração, são consideradas a principal causa de morte e incapacidade em todo o mundo, e os seis pilares da medicina do estilo de vida (nutrição, exercício, controle de tóxicos, manejo do estresse, saúde do sono e conexão social) desempenham um papel importante na gestão holística da sua prevenção e tratamento. Além disso, as diretrizes médicas são os documentos mais aceitos com recomendações para o manejo das DCNT. Objetivo: O presente estudo tem como objetivo analisar a ausência de pilares de estilo de vida nas principais diretrizes médicas brasileiras sobre as DCNT e identificar evidências na literatura que possam justificar sua inclusão nos documentos. Método: As diretrizes brasileiras foram selecionadas de acordo com as causas de morte mais relevantes no Brasil, informadas pelo Sistema de Informações sobre Mortalidade publicado pelo Ministério da Saúde em 2019. Os periódicos foram selecionados na biblioteca PUBMED de acordo com a doença e os pilares do estilo de vida não mencionados. Resultados: Causas relevantes de mortes no Brasil são o infarto agudo do miocárdio (IAM), o diabetes mellitus (DM) e as doenças pulmonares obstrutivas crônicas (DPOC). Foram identificadas seis diretrizes relacionadas a essas DCNT e todas abordam aspectos do estilo de vida, mas apenas uma, referente à prevenção cardiovascular, destaca todos os seis pilares. Apesar disso, uma pesquisa bibliográfica envolvendo mais de 50 artigos mostrou que há evidências de que todos os pilares podem ajudar no controle de cada uma dessas DCNT. Conclusão: Raramente os seis pilares do estilo de vida são contemplados nas diretrizes brasileiras para IAM, DM e DPOC. A revisão da literatura identificou evidências de todos os pilares do estilo de vida para oferecer uma abordagem holística para a gestão e prevenção das DCNT.

Abstract Background: Noncommunicable diseases (NCDs), also known as chronic diseases that are long-lasting, are considered the major cause of death and disability worldwide, and the six pillars of lifestyle medicine (nutrition, exercise, toxic control, stress management, restorative sleep, and social connection) play an important role in a holistic management of their prevention and treatment. In addition, medical guidelines are the most accepted documents with recommendations to manage NCDs. Objective: The present study aims to analyze the lack of lifestyle pillars concerning the major Brazilian medical guidelines for NCDs and identify evidence in the literature that could justify their inclusion in the documents. Method: Brazilian guidelines were selected according to the most relevant causes of death in Brazil, given by the Mortality Information System, published by the Brazilian Ministry of Health in 2019. Journals were screened in the PUBMED library according to the disease and non-mentioned pillars of lifestyle. Results: Relevant causes of deaths in Brazil are acute myocardial infarction (AMI), diabetes mellitus (DM), and chronic obstructive pulmonary diseases (COPD). Six guidelines related to these NCDs were identified, and all address aspects of lifestyle, but only one, regarding cardiovascular prevention, highlights all six pillars. Despite this, a literature search involving over 50 articles showed that there is evidence that all the pillars can help control each of these NCDs. Conclusion: Rarely are the six pillars of lifestyle contemplated in Brazilian guidelines for AMI, DM, and COPD. The literature review identified evidence of all lifestyle pillars to offer a holistic approach for the management and prevention of NCDs.

Evaluating a wellness intervention including micro-practices for healthcare professionals before and during COVID-19 / Evaluando una intervención de bienestar con micro prácticas para profesionalesde la salud antes y durante el COVID-19

Abstract Objective: To describe, with a mixed design study, healthcare professionals' pre-post descriptive measures of quality of life (subjective wellness) and prolonged fatigue, as well as an improvement in overall wellness and satisfaction regarding micro-practices as a result of participation in a wellness intervention before and during COVID-19. Material and Methods: This study had a mixed design involving two independent groups of healthcare professionals participating in a wellness intervention with micro-practices before and during COVID-19. The intervention contained multimodal presentations with animated cartoon stories, comics, storytelling, readings, breathing, mindfulness and visualization exercises, adapted from second-order factors in the Indivisible Self model. Pre-post descriptive measures of quality of life (subjective wellness), prolonged fatigue, as well as improvement in overall wellness and satisfaction regarding micro-practices were collected. Results: Attending to either wellness interventions before or during COVID-19 had a positive and, in some cases significant, effect on important indicators of quality-of-life and prolonged fatigue among healthcare professionals. A qualitative analysis indicated a subjective improvement in overall wellness and satisfaction regarding the use of micropractices included in the wellness interventions, regardless of whether these were presented in person or virtually. Most participants subjectively indicated that they improved in the targeted indicators, especially achievement of better wellness. Conclusions: During ordinary and extraordinary circumstances, healthcare professionals require specific interventions that act primarily to provide them with strategies that can improve physical, emotional, and spiritual health. Use of micro-practices in multimodal workshops to improve healthcare practitioner wellness is a successful tool for learning or remembering the importance of pausing during daily clinical activities and refocusing their energy.

Resumen Objetivo: Describir, con un estudio de diseño mixto, la medición descriptiva pre-post sobre la calidad de vida (bienestar subjetivo) y la fatiga prolongada entre profesionales de salud, así como su mejora en el bienestar general y satisfacción respecto al uso de micro-prácticas como resultado de participar en una intervención de bienestar antes y durante COVID-19. Material y métodos: Este estudio tuvo un diseño mixto en el que participaron dos grupos independientes de profesionales del sector salud en una intervención de bienestar con micro-prácticas antes y durante el COVID-19. La intervención consistió en presentaciones multimodales con historias con dibujos animados, cómics, narración de cuentos, lecturas, ejercicios de respiración, mindfulness y visualización, adaptados a partir de los factores de segundo orden del modelo del Yo Indivisible. Se recolectaron medidas descriptivas pre-post de calidad de vida (bienestar subjetivo), fatiga prolongada, así como su mejora en el bienestar general y la satisfacción con respecto a las micro-prácticas. Resultados: La asistencia a cualquiera de las intervenciones para el bienestar antes o durante la COVID-19 tuvo un efecto positivo y, en algunos casos, significativo, sobre importantes indicadores de calidad de vida y fatiga prolongada entre los profesionales del ámbito de la salud. El análisis cualitativo indicó una mejoría subjetiva en cuanto a su bienestar general y satisfacción con respecto al uso de las micro-prácticas incluidas en las intervenciones de bienestar, independientemente de si éstas se presentaron en persona o virtualmente. La mayoría de los participantes indicaron subjetivamente que habían mejorado en los indicadores enfocados, especialmente el logro de un mayor bienestar. Conclusiones: Durante circunstancias ordinarias y extraordinarias, los profesionales de la salud requieren intervenciones específicas que actúen principalmente para proporcionarles estrategias que puedan mejorar la salud física, emocional y espiritual. El uso de microprácticas en talleres multimodales para mejorar el bienestar de los profesionales es una herramienta exitosa para aprender o recordar la importancia que tiene hacer una pausa durante las actividades clínicas diarias y reenfocar su energía.

Efeitos do treinamento resistido sobre indicadores de saúde de sobreviventes de câncer de mama / Effects of resistance training on health indicators in breast cancer survivors

O objetivo deste estudo foi investigar os efeitos do treinamento resistido sobre indicadores de saúde em sobreviventes de câncer de mama. Vinte e duas mulheres com histórico de mastectomia e linfadenectomia completaram 12 semanas de treinamento. Avaliações de força, índice de massa corporal, composição corporal, aspectos hematológicos, bioquímicos e de estabilidade de membrana eritrocitária foram realizadas antes e depois do período de treinamento. Em todos os exercícios, ocorreram ganhos significantes de força máxima e resistência de força. Além disso, houve diminuição do percentual de gordura corporal, aumento do percentual de massa magra, redução de eritrócitos, plaquetas e hemoglobina, bem como mudanças desejáveis para todas as variáveis de perfil lipídico. Em conjunto, esses achados destacam o impacto multidimensional do treinamento resistido sobre a saúde de sobreviventes de câncer de mama e revelam a necessidade de monitoramento constante desse público.

The present study aimed to investigate the effects of resistance training on health indicators in breast cancer survivors. Twenty-two women with a history of mastectomy and lymphadenectomy completed 12 weeks of training. Strength, body mass index, body composition, hematological, and biochemical aspects, and erythrocyte membrane stability were performed before and after the training. In all exercises, there were significant gains in maximal force and force endurance. Moreover, there was a decrease in body fat percentage, an increase in lean mass percentage, a reduction in erythrocytes, platelets, and hemoglobin, as well as desirable changes for all lipid profile variables. Altogether, these findings highlight the multidimensional impact of resistance training on the health of breast cancer survivors and reveal the need for constant monitoring of this public.

Breast Cancer Patients’ Experience of Current Health Services as A Holistic Care: A Qualitative Study

@#Introduction: Breast cancer is now one of the leading causes of death and morbidity worldwide, including in Indonesia. Every health care professional and community member should pay close attention to these issues. Women diagnosed with breast cancer will experience physical, psychological, and social issues. Methods: This study looked into breast cancer patients’ experiences with holistic nursing care. The complexity of the difficulties confronting breast cancer patients will influence their experiences and perceptions, necessitating a holistic approach to nursing services. A qualitative exploratory, descriptive method was adopted in the investigation. During data collection, fifteen participants were recruited and interviewed. Focus Group Discussion (FGD) was utilized to collect data. Result: The study’s findings provide five significant themes: (1) knowledge and understanding of breast cancer; (2) experiences felt at the beginning of breast cancer complaints; (3) non-health breast cancer treatment; (4) perception of nursing services received by breast cancer patients; (5) facts and holistic needs during and beyond treatment; and (6) patients’ expectations of nursing services to help their needs. Conclusion: The findings provide information on how breast cancer patients understand the examination procedure, accept a diagnosis, and proceed to treatments.

A exigência do esporte de alta-competição e o desenvolvimento pleno dos atletas: a necessidade de uma relação simbiótica / The demands of high-competition sport and the full development of athletes: the need for a symbiotic relationship / Las exigencias del deporte de alta competición y el desarrollo pleno de los deportistas: la necesidad de una relación simbiótica

RESUMO O presente ensaio discute a Dupla Carreira (DC) em contexto europeu e a natureza simbiótica das habilidades adquiridas ao longo da vida, contribuindo para uma transição saudável ao mercado de trabalho no final da carreira esportiva. Nessa esteira evolutiva do suporte à DC fica evidente a produção conjunta do conhecimento em nível regional, nacional e internacional entre os Estados-Membros da União Europeia, assim como a proposição de políticas de amparo tanto aos atletas estudantes quanto aos atores que participam do processo de DC. A apresentação das Diretrizes para a DC em conjunto com os programas More Than Gold e EMPATIA ressaltam a importância do suprimento a nível micro, meso e macroestrutural, fornecendo experiências que induzem à ampliação do conceito de atleta estudante para sportsperson.

ABSTRACT This essay discusses the dual career (DC) in a European context and its symbiotic nature present in the skills acquired throughout life that contribute to a healthy transition to the job market at the end of the sports career. In this evolutionary path of DC support, the joint production of knowledge at a regional, national and international level, between the member states of the European Union, is evident, as well as the proposal of policies to support student athletes, and actors who participate in the DC process. The presentation of the Guidelines for DC and the More Than Gold and EMPATIA programs highlight the importance of supply at the micro, meso and macro structural level, experiences that induce the expansion of the concept of student athlete to sportsperson.

RESUMEN Este ensayo analiza la carrera dual (DC) en un contexto europeo y su naturaleza simbiótica presente en las habilidades adquiridas a lo largo de la vida que contribuyen a una transición saludable al mercado laboral al final de la carrera deportiva. Por lo tanto, el apoyo al DC destaca la producción conjunta de conocimiento a nivel regional, nacional e internacional, entre los estados miembros de la Unión Europea, así como la propuesta de políticas para apoyar a los estudiantes deportistas y actores que participan en el proceso de DC. La presentación de los Lineamientos para DC y los programas Más Than Gold y EMPATHY resaltan la importancia de ofrecer a nivel micro, meso y macro estructural, experiencias que induzcan a ampliar el concepto de estudiante deportista a sportsperson.

Multi-disciplinary coordination model in palliative care based on integrated medicine / 中华全科医师杂志

Palliative care is the final link in the whole lifecycle health management and is an important part of promoting a healthy China. In order to further improve service efficiency and the quality of end-of-life care, Shanghai Jiading Yingyuan Hospital has constructed a new interdisciplinary team collaboration model for palliative care from the perspective of integrated medical theory, and applied this model to clinical practice. By elaborating on the theory of team integration, member composition and division of labor, implementation process and preliminary effects, this study aims to provide a theoretical basis and reference for other regions to carry out the integration path and collaborative model of interdisciplinary services in palliative care.

Efficacy of Guanqiao Zhengqi holistic therapy for chronic rhinosinusitis / 中国基层医药

Objective:To investigate the efficacy of Guanqiao Zhengqi holistic therapy in the treatment of chronic rhinosinusitis. Methods:A total of 200 patients with chronic rhinosinusitis who received treatment in the Department of Otolaryngology, Shanxi Provincial Integrated Traditional Chinese Medicine and Western Medicine Hospital ( n = 72) and Shanxi Yishengtang Traditional Chinese Medicine Center ( n = 128) from January 2021 to January 2022 were included in this study. These patients were randomly assigned to undergo treatment either with mometasone furoate nasal spray and levocetirizine hydrochloride tablets (control group, n = 100) or Guanqiao Zhengqi holistic therapy combined with mometasone furoate nasal spray and levocetirizine hydrochloride tablets (observation group). All patients were treated for 4 weeks and followed up for 3 months. Clinical efficacy, modified Visual Analogue Scale score, Lund-Kennedy endoscopy scoring system score, and duration of glucocorticoid and anti-leukotriene use were compared between the two groups. Results:The total response rate in the observation group was significantly higher than that in the control group [92.00% (92/100) vs. 73.00% (73/100), χ2 = 18.45, P < 0.001). There was no significant difference in the modified Visual Analogue Scale score between the two groups before treatment ( Z = 1.37, P = 0.170). There was a significant difference in the modified Visual Analogue Scale score between the two groups after treatment ( Z = -5.27, P < 0.001). Before treatment, there was no significant difference in the Lund-Kennedy endoscopy scoring system score between the two groups ( Z = -1.65, P = 0.098) and the Lund-Kennedy endoscopy scoring system score differed significantly between the two groups after treatment ( Z = -6.03, P < 0.001). The duration of glucocorticoid and anti-leukotriene use in the observation group was significantly shorter than that in the control group [10.00 (10.00, 14.00) days vs. 42.00 (28.00, 70.00) days, 7.00 (7.00, 7.00) days vs. 21.00 (14.00, 26.25) days, Z = -11.27, P < 0.001, Z = -12.31, P < 0.001). Conclusion:Based on the conventional treatment with western medicine, Guanqiao Zhengqi holistic therapy for the treatment of chronic rhinosinusitis can effectively reduce clinical symptoms, reduce the dose of hormones and anti-leukotriene used, shorten the use cycle, and improve the therapeutic efficacy.

Construction of jingjin differentiation system based on holistic concept / 中国针灸

As a diagnostic method to guide the treatment of sinew/fascia diseases, jingjin (muscle regions of meridians) differentiation is an important component of syndrome differentiation system of acupuncture and moxibustion. In clinical practice, because of the limitations of the ideological guidance of the holistic view, the systemic and dialectical thinking and the syndrome element collection, the system of diagnosis and treatment of sinew/fascia diseases is not comprehensive. Through combing the origin of the holistic view of jingjin, the paper expounds the differentiation framework of sinew/fascia diseases from 4 aspects of differentiation, i.e. the location of disease, etiology, nature of disease and condition of disease. It suggests to construct jingjin differentiation system by taking the holistic ideas as the core, the syndrome element research as the common method and the evidence-based medicine as the theoretical basis so that the thinking of syndrome differentiation and the diagnostic approaches based on jingjin theory can be enriched.

2. A Newly Established Quality/Competency "Taking a Multi-Systemic View towards a Patient as a Living Person" / 医学教育

Based on the social context of an aging society and surveys conducted since 2020, the need for comprehensive perspectives and approaches that consider patients'psychosocial background and a cross-organ perspective has been identified. As a result, a new quality and ability, namely comprehensive attitudes toward patients, has been established as part of the core curriculum for medical education in FY2022. Specific learning objectives include "holistic perspectives and approaches," "community perspectives and approaches," "life perspectives and approaches," and "social perspectives and approaches". An educational design that draws on multiple learning theories to enable reflection on one's own way of being has been proposed to integrate abstract and concrete, conceptual and experiential, and self and others perspectives. It is expected that this medical education will lead to improvement in the well-being of individuals, families, and communities.

Memoirs of yesterday: The lived experience of individuals with separated parents

@#Separation issues have been rampant, and a significant rise in union dissolution cases in the Philippines has been observed. This certain occurrence should be given particular attention because it may alter the individual's way of living, particularly in perceiving and dealing with relationships. This study explores the lived experience of individuals who have undergone parental separation. The study utilized a Hermeneutic Phenomenological Design, which involved ten (10) respondents using a semi-structured key informant interview guide. The respondents were selected based on criteria as follows: (1) Have parents who have decided on the dissolution of marriage (annulled or informal) living separately; (2) 18 years of age and above; (3) Residents of Central Visayas; permanent or transient in Cebu City and; (4) Able to understand and express ideas in Cebuano dialect or English language. An Interpretative Phenomenological Analysis anchored on van Manen's six-step interpretive phenomenological approach with management and analysis done manually created a poem titled “Memoirs of Yesterday,” which incorporates three (3) major themes: (1) Into the Tunnel: Etiology of Separation, (2) The Darkness in the Tunnel: effects of the dissolution of marriage to children- emotional, psychological and academic status and (3) The Light After the Tunnel: attitude of the child and parent towards relationships and separation. The study implies that nurses should recognize the importance of assessing family concerns in rendering holistic and individualized client care. Thus, nurses should use assessed needs in advocating for the creation of more programs on awareness and counseling to families and, most especially, children.

Discussion on the construction of holistic nursing based on SWOT in apheresis platelets collection / 中国输血杂志

【Objective】 To explore the application and effectiveness of holistic nursing based on SWOT in platelet collection at blood stations. 【Methods】 SWOT analysis was used to analyze the causes of adverse reactions to blood donation in platelet donors, put forward countermeasures and take holistic nursing measures. Routine nursing was adopted from January to June 2021, and holistic nursing based on SWOT analysis was adopted from July to December 2021. The adverse reactions and the nursing quality before and after the implementation of holistic nursing in the two groups were compared, and the satisfaction of blood donors to the nurses was analyzed. 【Results】 After the implementation of holistic nursing based on SWOT analysis, the incidence of adverse reactions in blood donation was 2%(2/100) in the observation group, significantly lower than 11%(11/100) in the control group(P<0.05). Nursing satisfaction score of the observation group was (93.10±4.97 points), significantly higher than that of the control group (78.12±5.36 points)(P<0.05). 【Conclusion】 The implementation of holistic nursing based on SWOT analysis can significantly reduce the incidence of adverse reactions in platelet donors and improve the satisfaction of blood donors with the nursing work, thus significantly improving the quality of nursing in the department.

Intrinsic "self-consistent" phenomenon based on holistic view of traditional Chinese medicine / 中国中药杂志

The fundamental principle of traditional Chinese medicine(TCM) is holism, and it is crucial for TCM to address the key issue of the "holistic view" of Chinese herbal medicine. While the overall regulatory effects of Chinese herbal medicine have been widely recognized, the holistic internal logic of individual ingredients of Chinese herbal medicines require further clarification. In order to comprehensively understand the mechanism of action of Chinese herbal medicine, this paper combined the holistic view of Chinese herbal medicine with differentiation thinking to explore the intrinsic logical relationships within Chinese herbal medicine. Starting from the perspective of the coexistence of multiple components in Chinese herbal medicine, this paper systematically examined the "self-consistent" phenomenon within single Chinese herbal medicine. This phenomenon refers to the consistent or opposing actions of various components in terms of their physical and chemical properties, pharmacokinetic effects, biological effects, flavors and properties, and TCM efficacy. The paper summarized various logical relationships of syndrome differentiation exhibited by the same Chinese herbal medicine, analyzed the underlying reasons, and focused on analyzing external factors affecting the "self-consistent" phenomenon in the efficacy of Chinese herbal medicine, aiming to better elucidate the theoretical basis of the pharmacological effects of Chinese herbal medicine, further enrich the scientific connotation of the holistic view of Chinese herbal medicine, and provide theoretical guidance for the preparation process, compatibility patterns, and formulation design of Chinese herbal medicine.

Quality control strategy of traditional Chinese medicine based on pharmaceutical product lifecycle management / 中国中药杂志

Quality control is pivotal in the research and development of traditional Chinese medicine, whose connotation is not limi-ted to the qualitative or quantitative detection of an indicator component, but extends to the establishment of a whole process quality control system from the perspective of pharmaceutical product lifecycle management. This study discussed the quality control strategy of Chinese medicine based on the concept of pharmaceutical product lifecycle management, and proposed the following suggestions:(1) to focus on the "holistic view" and "phased" characteristics of quality control and strengthen the establishment of quality control strategy based on top-level design;(2) to strengthen the research on quality control of Chinese medicine based on quality risk management, focus on the correlations of quality control indicators with the safety and effectiveness of traditional Chinese medicine, and establish a quality evaluation system consistent with the characteristics of traditional Chinese medicine;(3) to consider the characteristics of different registration classifications in the establishment of quality control strategy;(4) to highlight the quality correlation research, strengthen the quality transfer research, ensure the quality traceability, and establish a sound quality management system;(5) to strengthen the quality research on marketed drugs to achieve dynamic quality improvement.

Reflexão crítica da teoria de Jean Watson: estudo fundamentado no modelo de Chinn e Kramer / Critical reflection of Jean Watson's theory: a based study on the Chinn and Kramer model / Reflexión crítica de la teoría de Jean Watson: un estudio basado en el modelo de Chinn y Kramer

Objetivo: analisar a teoria do Cuidado Humano de Jean Watson, a partir do modelo de reflexão crítica proposto por Chinn e Kramer. Método: estudo teórico- reflexivo, realizado em abril de 2021, a partir do modelo de reflexão crítica elaborado por Chinn e Kramer, com ênfase nos seguintes componentes: clareza, simplicidade, generalidade, acessibilidade e importância da teoria. Resultados: da análise do modelo proposto, observou-se que a teoria do Cuidado Humano de Jean Watson apresenta relativa clareza semântica devido aos seus elementos complexos, no entanto pode ser classificada como geral, acessível, importante, valiosa e útil, podendo assim, ser empregada como importante subsídio para a atuação profissional por sua abrangência de significados e de valor prático. Conclusão: a Teoria do Cuidado Humano pode ser utilizada nas mais diversas situações de cuidados, independentemente da situação de saúde do indivíduo, permitindo a promoção de um cuidado holístico e com atenção aos aspectos biopsicossocioespirituais.

Objective: to analyze Jean Watson's theory of Human Caring, based on the critical reflection model proposed by Chinn and Kramer. Method: theoretical- reflective study, carried out in April 2021, based on the critical reflection model developed by Chinn and Kramer, with emphasis on the following components: clarity, simplicity, generality, accessibility and importance of the theory. Results: from the analysis of the proposed model, it was observed that Jean Watson's theory of Human Caring presents relative semantic clarity due to its complex elements, however it can be classified as general, accessible, important, valuable and useful, thus being able to be used as an important subsidy for professional performance due to its range of meanings and practical value. Conclusion: the Theory of Human Care can be used in the most diverse care situations, regardless of the individual's health situation, allowing the promotion of holistic care and attention to biopsychosocial-spiritual aspects.

Objetivo: analizar la teoría del Cuidado Humano de Jean Watson, a partir del modelo de reflexión crítica propuesto por Chinn y Kramer. Método: estudio teórico- reflexivo, realizado en abril de 2021, a partir del modelo de reflexión crítica desarrollado por Chinn y Kramer, con énfasis en los siguientes componentes: claridad, sencillez, generalidad, accesibilidad e importancia de la teoría. Resultados: del análisis del modelo propuesto, se observó que la teoría del Cuidado Humano de Jean Watson presenta relativa claridad semántica debido a sus elementos complejos, sin embargo, puede clasificarse como general, accesible, importante, valiosa y útil, pudiendo así ser utilizado como un importante subsidio para el desempeño profesional debido a su variedad de significados y valor práctico. Conclusión: la Teoría del Cuidado Humano puede ser utilizada en las más diversas situaciones de cuidado, independientemente de la situación de salud del individuo, permitiendo la promoción del cuidado holístico y la atención a los aspectos biopsicosociales-espirituales.

Concepção de saúde dos profissionais que usam práticas integrativas e complementares no cuidado / Health conception of professionals using integrative and complementary practices in healthcare

Resumo As práticas integrativas e complementares em saúde (PICS) ampliam o cuidado, dependendo das concepções de saúde. O objetivo deste estudo foi analisar as representações e os significados de saúde dos profissionais que usam PICS e os motivos para inseri-las em suas práticas. Tratou-se de uma pesquisa descritiva com abordagem qualitativa e coleta de dados on-line. Para a análise, utilizou-se a Técnica de Associação Livre de Palavras para as dimensões da saúde, visando embasar as análises das representações sobre saúde e a criação de categorias sobre a motivação. A hermenêutica dialética serviu de referencial teórico para interpretação. Participaram 19 profissionais que utilizavam PICS, cuja maioria era enfermeira. As representações sociais foram descritas em 49 palavras, sendo as mais significativas "bem-estar" e "integralidade". Na motivação para a utilização, revelaram-se dois conjuntos de significados: promoção da saúde e enfrentamento da doença. O primeiro expressou-se como saúde integral; autocuidado individual; equilíbrio e não tratar os sintomas. O segundo tomou a forma de redução da medicação alopática; ineficiência do modelo atual; tratar as patologias biomédicas de outra forma. Emergiram dois paradigmas, o biomédico e o vitalista, entrelaçados no discurso, mostrando o sincretismo de significados nas práticas em saúde dos profissionais.

Abstract The Integrative and Complementary Health Practices broaden care, depending on the conception of health. The research aimed at analyzing the representations and meanings given to health by professionals using Integrative and Complementary Health Practices, and the reasons to include them in their practice. Research data was collected online and the method of free association was used to analyze the dimensions of health, which substantiated the analyses of the representations on health, and the motive categories. Hermeneutics served as the theoretical background for data interpretation. Nineteen professionals, mostly nurses, who use Integrative and Complementary Health Practices, participated in the study. Social representations of health were described in 49 words, and the most significant are "well-being" and "comprehensiveness". Two set of meanings emerged while interpreting the reasons that led professionals to use Integrative and Complementary Health Practices: health promotion and confronting disease. The first expresses Comprehensive Health; Individual Self-care; Balance, and do not treat symptoms. The second includes Reduction of Allopathic Medication; Inefficacy of the Current Model; Treating Biomedical Pathology in different ways. Two paradigms were identified: biomedicine and vitalism, both intertwined in speech, revealing syncretism of meanings in the practices of professionals.

Cuidado espiritual en estudiantes de enfermería: estudio cualitativo / Spiritual Care in Nursing Students: Qualitative Study / Cuidado espiritual em estudantes de enfermagem: um estudo qualitativo

Introducción. La atención de la dimensión espiritual en pacientes y familias es fundamental como parte del papel activo de los profesionales de enfermería en la satisfacción de las necesidades espirituales de los pacientes. Objetivo. Comprender las actitudes frente al cuidado espiritual de los profesionales de enfermería en formación. Metodología. Estudio de abordaje cualitativo, con análisis de contenido, con población de 20 estudiantes de educación superior de Enfermería, con un muestreo por conveniencia. Se realizaron entrevistas semiestructuradas y dos grupos focales para indagar sobre el autoconocimiento espiritual y las concepciones del cuidado espiritual, tomando como referencia los conceptos teóricos propuestos por McSherry. El análisis de los datos inicialmente se hizo de forma inductiva, con ayuda del software Iramuteq. Resultados. La espiritualidad se considera una dimensión intrapersonal donde se reconoce la necesidad de explorar su propia espiritualidad para acercarse a la percepción espiritual del paciente. Aprender de las crisis para el desarrollo de la espiritualidad personal y encontrarse desde la naturaleza fueron parte de las categorías encontradas. Discusión. La concepción del cuidado espiritual para los estudiantes como dimensión intrapersonal, les permite distinguir entre la espiritualidad y la religiosidad. Este es un aspecto que se ha podido ver durante el desarrollo de las prácticas formativas, ya que se han encontrado personas muy religiosas, así como otras que no lo son. Conclusiones. Se hace referencia a la relación entre lo espiritual y lo corpóreo y aunque existe una diferencia entre religión y espiritualidad, los dos conceptos deben ser valorados a nivel personal.

Introduction. Attention to the spiritual dimension of patients and families is fundamental as part of the active role of nursing professionals in satisfying the spiritual needs of patients. Objective. To understand the attitudes towards spiritual care of nursing professionals in training. Methodology. Qualitative study with content analysis, with a population of 20 higher education Nursing students, with convenience sampling. Semi-structured interviews and two focus groups were held to explore spiritual self-knowledge and the conceptions of spiritual care, using the theoretical concepts proposed by McSherry as a reference. Data was initially analyzed inductively, with help from the Iramuteq software. Results. Spirituality is considered an intrapersonal dimension in which the need to explore one's own spirituality in recognized, in order to approach the spiritual perception of the patient. Learning about crises for the development of a personal spirituality and finding oneself through nature were part of the observed categories. Discussion. The conception of spiritual care as an intrapersonal dimension helps students differentiate between spirituality and religion. This aspecto has been observable during educational practice, since there were some very religious people and others who were not. Conclusions. Reference is made to the relationship between that which is spiritual and corporeal, and though there is a difference between spirituality and religion, both concepts must be assessed personally.

Introdução. A atenção à dimensão espiritual em pacientes e familiares é essencial como parte do papel ativo dos profissionais de enfermagem no atendimento às necessidades espirituais dos pacientes. Objetivo. Compreender as atitudes em relação aos cuidados espirituais dos profissionais de enfermagem em formação. Metodologia. Estudo de abordagem qualitativa, com análise de conteúdo, com uma população de 20 estudantes do ensino superior de Enfermagem, com amostragem por conveniência. Foram realizadas entrevistas semiestruturadas e dois grupos focais para indagar sobre autoconhecimento espiritual e concepções de cuidado espiritual, tomando como referência os conceitos teóricos propostos por McSherry. A análise dos dados foi feita inicialmente de forma indutiva, com o auxílio do software Iramuteq. Resultados. A espiritualidade é considerada uma dimensão intrapessoal onde se reconhece a necessidade de explorar a própria espiritualidade para se aproximar da percepção espiritual do paciente. Aprender com as crises para o desenvolvimento da espiritualidade pessoal e encontrar-se com a natureza foram algumas das categorias encontradas. Discussão. A concepção de cuidado espiritual para os alunos como uma dimensão intrapessoal, permite-lhes distinguir entre espiritualidade e religiosidade. Este é um aspecto que se tem visto ao longo do desenvolvimento das práticas formativas, uma vez que foram encontradas pessoas muito religiosas e outras não. Conclusões. É feita referência à relação entre o espiritual e o corpóreo e, embora haja uma diferença entre religião e espiritualidade, os dois conceitos devem ser valorizados a nível pessoal.

Enfermedad renal diabética: puesta al día / Update on diabetic kidney disease

Introducción: La Diabetes Mellitus (DM) es una enfermedad inflamatoria sistémica de alta prevalencia e incidencia a nivel mundial. Dentro de las complicaciones crónicas, la enfermedad renal diabética es una de las más frecuentes y que marca el pronóstico. Objetivos: El objetivo de este artículo es hacer una revisión actualizada de la enfermedad renal diabética, a la luz de los cambios en los paradigmas que se han generado en los últimos años con respecto a sus nuevas definiciones, el papel de la inflamación en su desarrollo, la gestión del riesgo cardiovascular y los nuevos tratamientos. La enfermedad renal diabética puede presentarse en aproximadamente el 30-50% de la población con diabetes mellitus tipo 1 o 2 alrededor del mundo. En la patogénesis y progresión de esta condición se distinguen tres ejes fundamentales el hemodinámico, metabólico e inflamatorio. Es importante siempre hacer gestión del riesgo cardiovascular. El diagnóstico se debe hacer con el cálculo de la tasa de filtrado glomerular y la relación albuminuria / creatinuria en muestra ocasional. Los objetivos en el tratamiento deben ser: el control metabólico, reducir o enlentecer la progresión de la enfermedad renal y disminuir los desenlaces cardiovasculares. Conclusión: El tratamiento de la ERD debe ser holístico, desde intervenciones no farmacológicas, como la modificación de los estilos de vida, hasta los nuevos medicamentos como el uso de inhibidores SGLT-2, Agonistas del receptor GLP-1 y el uso antagonistas selectivos del receptor mineralocorticoide como finerenona. El futuro es promisorio.

Introduction: Diabetes mellitus (DM) is a systemic inflammatory disease of high prevalence and incidence worldwide. Among the chronic complications, diabetic kidney disease is one of the most frequent and determines the prognosis. Objectives: The objective of this article is to make an updated review of diabetic kidney disease, in light of the changes in the paradigms that have been generated in recent years concerning to the new definitions, the role of inflammation-causing disease, cardiovascular risk management, and the new treatments. Diabetic kidney disease can present in approximately 30-50% of the population with diabetes mellitus type 1 or 2 around the world. In the pathogenesis and progression of this condition, three fundamental axes are distinguished: the hemodynamic, the metabolic, and the inflammatory. It is important to manage cardiovascular risk. The diagnosis must be made by calculating the glomerular filtration rate and the albuminuria/creatinuria ratio in a random urine sample. The objectives of the treatment should be: metabolic control, reduce or slow the progression of kidney disease and improve cardiovascular outcomes. Conclusion: The treatment of diabetic kidney disease should be holistic, from non-pharmacological interventions, such as lifestyle changes, to new medications such as the use of SGLT-2 inhibitors, GLP-1 receptor agonists, and the use of selective mineralocorticoid receptor antagonists such as finerenone. The future is promising.

Reflexión bioética sobre especímenes vegetales: trascendencia de los intereses antropocéntricos ligados a las plantas medicinales

Propósito/Contexto. El presente artículo expone el enigma referente a ciertas perspectivas culturales que han abarcado a las plantas medicinales, desde su valor intrínseco y uso en distintos panoramas sociales, teniendo en cuenta dos líneas de acción: la holística y la antropocéntrica. Metodología/Enfoque. Se realizó una revisión de material bibliográfico, desde el enfoque cualitativo del análisis cultural y la técnica del análisis documental, teniendo en cuenta los ejes temáticos ética de la tierra, antropocentrismo y plantas medicinales. Resultados/Hallazgos. Las plantas medicinales han generado una alta incidencia en el campo de la salud, frente a su valor intrínseco, visualizado desde la autopoiesis y su importancia en el ecosistema. Por otro lado, los usos establecidos en diferentes áreas del conocimiento (medicina, biotecnología, agricultura, entre otras) y las prácticas ejercidas (culturales) logran beneficios para el hombre desde las dimensiones físicas, biológicas y del entendimiento. Discusión/Conclusiones/Contribuciones. La posición bioética estuvo apoyada desde los fundamentos ambientales visualizados en la Ética de la Tierra de Aldo Leopold y la Bioética Global de Van Rensselaer Potter, sin dejar de lado autores como Fritz Jahr, Gilberto Cely, entre otros. Los planteamientos analizados enfatizan la necesidad de fomentar el paso del antropocentrismo al ecocentrismo, sobre la base de una interacción responsable entre humanos y no humanos, generando armonía, interrelación y equilibrio que se debe consolidar dentro de un ecosistema, donde es esencial convivir con plantas medicinales y su valor intrínseco.

Purpose/ Context. This article exposes the enigma concerning certain cultural perspectives that have covered medicinal plants, from their intrinsic value and use in different social scenarios, taking into account two lines of action: the holistic and the anthropocentric. Methodology/Approach. A review of bibliographic material was carried out, from the qualitative approach of cultural analysis and the technique of documentary analysis, taking into account the thematic axes land ethics, anthropocentrism and medicinal plants. Results/Findings. Medicinal plants have generated a high incidence in the field of health, due to their intrinsic value, visualized from autopoiesis and their importance in the ecosystem. On the other hand, the uses established in different areas of knowledge (medicine, biotechnology, agriculture, among others); and practices exercised (cultural), achieve benefits for man from the physical, biological and understanding dimensions. Discussion/Conclusions/Contributions. The bioethical position was supported from the environmental foundations visualized in A. Leopold's Earth Ethics and V. Potter's global bioethics; without leaving aside authors such as F. Jahr, G. Cely, among others. The approaches analyzed emphasize the need to promote the transition from anthropocentrism to ecocentrism, based on a responsible interaction between humans and non-humans, generating the harmony, interrelation and balance that must be consolidated within an ecosystem, where it is essential to coexist with medicinal plants and their intrinsic value.

Objetivo/ Contexto. Este artigo expõe o enigma relativo a certas perspectivas culturais que abraçaram as plantas medicinais, a partir de seu valor intrínseco e uso em diferentes cenários sociais, levando em conta duas linhas de ação: a holística e a antropocêntrica. Metodologia/Abordagem. Foi realizada uma revisão do material bibliográfico, a partir da abordagem qualitativa da análise cultural e da técnica de análise documental, levando em conta os eixos temáticos da ética fundiária, do antropocentrismo e das plantas medicinais. Resultados/Descobertas. As plantas medicinais têm gerado uma alta incidência no campo da saúde, devido ao seu valor intrínseco, visualizado a partir da autopoiese e sua importância no ecossistema. Por outro lado, os usos estabelecidos em diferentes áreas do conhecimento (medicina, biotecnologia, agricultura, entre outras); e as práticas exercidas (culturais), obtêm benefícios para o homem a partir das dimensões física, biológica e de compreensão. Discussão/Conclusões/Contribuições. A posição bioética foi apoiada a partir dos fundamentos ambientais visualizados em A. Leopold's Earth Ethics e V. Potter's global bioethics; sem deixar de lado autores como F. Jahr, G. Cely, entre outros. As abordagens analisadas enfatizam a necessidade de promover a transição do antropocentrismo para o ecocentrismo, com base na interação responsável entre humanos e não-humanos, gerando a harmonia, a inter-relação e o equilíbrio que devem ser consolidados dentro de um ecossistema, onde é essencial a coexistência com as plantas medicinais e seu valor intrínseco.