Family caregivers of older adults and physical and psychological health conditions and family support in care / Cuidadores familiares de ancianos y condiciones de salud física y psicológica y apoyo familiar en el cuidado / Cuidadores familiares de idosos e condições de saúde física, psicológica e apoio familiar no cuidado

ABSTRACT Objective: to analyze the existence of overload in family caregivers of older adults in the physical and psychological health and family support dimensions. Method: a qualitative study conducted with 23 participants from Dianópolis, Tocantins, Brazil. Data were collected through semi-structured interviews in September 2022. Data analysis was performed using content analysis in Minayo's thematic modality, which includes ordering, classification and final analysis of data. Results: the results show that the exercised role of caregiver is related to social representation, which is enhanced: by the context, cultural and family values; by the naturalization of the role of women as caregivers; by increasing the burden due to excessive responsibility and lack of support from other family members; and by the presence of psychological symptoms overlapping physical symptoms in caregivers. Conclusion: it is concluded that the support of professionals is essential to rethink new practices and ways of producing care through individual or collective activities, with a view to preventing caregivers from becoming ill.

RESUMEN Objetivo: analizar la existencia de sobrecarga de cuidadores familiares de ancianos en las dimensiones de salud física y psicológica y apoyo familiar. Método: estudio cualitativo, realizado con 23 participantes de Dianópolis, Tocantins, Brasil. Los datos fueron recolectados a través de entrevistas semiestructuradas en septiembre de 2022. El análisis de datos se realizó mediante análisis de contenido en la modalidad temática de Minayo, que incluye ordenamiento, clasificación y análisis final de datos. Resultados: los resultados muestran que el ejercicio del rol de cuidador está relacionado con la representación social, que se ve potenciada: por el contexto, los valores culturales y familiares; por la naturalización del rol de la mujer como cuidadora; al aumentar la carga por exceso de responsabilidad y falta de apoyo de otros miembros de la familia; y por la presencia, en los cuidadores, de síntomas psicológicos superpuestos a los físicos. Conclusión: se concluye que el apoyo de los profesionales es fundamental para repensar nuevas prácticas y formas de producir cuidado, a través de actividades individuales o colectivas, con miras a prevenir que los cuidadores se enfermen.

RESUMO Objetivo: analisar a existência de sobrecarga de cuidadores familiares de idosos nas dimensões de saúde física, psicológica e apoio familiar. Método: estudo qualitativo, realizado com 23 participantes de Dianópolis, Tocantins, Brasil. Os dados foram coletados mediante entrevistas semiestruturadas em setembro de 2022. A análise dos dados foi efetuada utilizando-se a análise de conteúdo na modalidade temática de Minayo, que abrange a ordenação, a classificação e a análise final dos dados. Resultados: os resultados evidenciam que o exercício da função de cuidador está relacionado à representação social, a qual é potencializada: pelo contexto, valores culturais e familiares; pela naturalização da função da mulher como cuidadora; pela potencialização da sobrecarga em razão do excesso de responsabilidade e falta de apoio de outros membros da família; e pela presença, nos cuidadores, de sintomas psicológicos sobrepondo-se aos físicos. Conclusão: conclui-se que o apoio dos profissionais é essencial para repensar novas práticas e formas de produzir o cuidado, por meio de atividades individuais ou coletivas, com vistas a prevenir o adoecimento dos cuidadores.

A study on Instinctive Feelings, Perceived Stressors and Factors that helped in reducing Stress during COVID 19 pandemic among Health Care Workers

Background: Healthcare workers at the forefront of the battle against COVID 19 are not only putting their own health and lives at risk but are also fighting to keep their own worries and emotional stress at bay. Aim & Objective: To evaluate emotions, perceived stressors, and factors that helped in reducing stress of healthcare workers who worked during a COVID19 pandemic. Settings and Design: This cross sectional study was conducted among Health Care staff involved in COVID 19 duty in tertiary care hospital of Gujarat. Methods and Material: Google form link was shared though what’s up and mail. The questionnaire was completed online. Consent for voluntarily participation was also obtained through online Google form. Statistical analysis used: Data was entered and analysed through Microsoft Excel 2010. Results: Total 106 participants responded to the questionnaire. It was extremely stressful for health care workers to see their colleagues getting infection, as well as the fear that they could transmit the disease to their families or friends. Main factors that helped to reduce the stress were positive attitude from colleagues, improvement of patients conditions and availability of protective equipment. Conclusions: Personal safety, the protection of family members and unpredictability of pandemic were the main concerns. Hospitals should prioritise stress monitoring for health care workers and provide targeted psychological guidance for HCWs during the pandemic.

O uso das estratégias de coping por pacientes e seu impacto no controle do estresse / El uso de estrategias de afrontamiento por pacientes y su impacto en manejo del estrés / The use of coping strategies by patients and their impact on stress management

Objetivo: avaliar o efeito das estratégias de Coping sobre o estresse de pacientes hospitalizados com Covid. Métodos: A pesquisa aconteceu no período de março a outubro de 2021 e foram utilizados 3 instrumentos de coletas de dados, inicialmente e após 30 dias da alta do paciente. Aplicou-se um questionário para caracterizar os participantes, depois utilizamos a versão em português da Escala de Estresse Percebido e o Inventário de Estratégias de Coping de Folkmann e Lazarus. Foram realizadas orientações sobre o uso das estratégias de coping aos pacientes hospitalizados. Resultados: Após as orientações sobre o uso das estratégias de coping, os pacientes passaram a utilizá-las e também diminuíram a percepção do estresse. Conclusão: A aplicação das estratégias de coping no momento da internação de pacientes com covid-19, contribuíram de forma impar para recuperação dos internados, modificando de forma significativa o estresse, possibilitando o manejo da ansiedade no período de internação e possivelmente colaborando para uma abreviação no período de internação(AU)

Objective: to assess the effect of Coping strategies on the stress of hospitalized patients with Covid. Methods: Three data collection instruments were used, initially and after 30 days of patient discharge. A questionnaire was applied to characterize the participants, after that the Portuguese version of the Perceived Stress Scale and the Folkmann and Lazarus' Coping Strategies Inventory was used. The hospitalized patients were provided with guidelines on the use of coping strategies. Results: After guidance on the use of coping strategies, patients began to use them and also reduced the perception of stress. Conclusion: The application of coping strategies in patients with Covid-19 at the time of hospitalization contributed in a unique way to their recovery, significantly modifying stress, enabling anxiety management during the hospitalization period and possibly contributing to an abbreviation of the hospitalization period(AU)

Objetivo: evaluar el efecto de las estrategias de Coping sobre el estrés de pacientes hospitalizados con Covid. Métodos: Se utilizaron tres instrumentos de recolección de datos, inicialmente y después de 30 días del alta del paciente. Se aplicó un cuestionario para caracterizar a los participantes, posteriormente se utilizó la versión en portugués de la Escala de Estrés Percibido y el Inventario de Estrategias de Afrontamiento de Folkmann y Lazarus. Los pacientes hospitalizados recibieron orientaciones sobre el uso de estrategias de afrontamiento. Resultados: Después de la orientación sobre el uso de estrategias de afrontamiento, los pacientes comenzaron a utilizarlas y también redujeron la percepción de estrés. Conclusión: La aplicación de estrategias de afrontamiento en pacientes con Covid-19 en el momento de la hospitalización contribuyó de manera única a su recuperación, modificando significativamente el estrés, posibilitando el manejo de la ansiedad durante el período de hospitalización y posiblemente contribuyendo a una abreviación del período de hospitalización.(AU)

"Pegar" ou "passar ": medos entre profissionais da linha de frente da COVID-19 / "To Catch" or "to give": fears among frontline professionals at COVID-19

OBJETIVO: Investigar a relação entre a realização de testes para detectar COVID-19 e indícios de sofrimento psíquico, estresse e burnout entre profissionais de saúde da linha de frente da pandemia em um hospital geral. MÉTODOS: Estudo prospectivo de abordagem mista usando SRQ-20, PSS, OBI e entrevistas em profundidade em série de três entrevistas em 2020. RESULTADOS: Prevalências preocupantes de escores elevados de SRQ20, Burnout e Estresse Percebido ocorreram nas três entrevistas, e o registro de testes realizados foi crescente no período estudado, mas não houve associação entre desfechos e realização de testes para detectar COVID-19. Os temores de contrair a doença e de ser transmissor do vírus apareceram como os principais estressores para profissionais de saúde, mantidos apesar da realização de testes. CONCLUSÃO: Nesse grupo, testes realizados não se mostraram suficientes para modificar os efeitos psicossociais da atividade em linha de frente sobre profissionais de saúde.

OBJECTIVE: To investigate the relationship between the performance of tests to detect COVID-19 and signs of psychological distress, perceived stress and burnout among health professionals on the frontline of the pandemic in a general hospital. METHODS: Prospective mixed-approach study using SRQ-20, PSS, OBI and in-depth interviews in a series of 3 interviews throughout 2020. RESULTS: Worrying prevalences of high scores of SRQ20, Burnout and Perceived Stress occurred on the three interviews and the number of tests performed increased during the study period, but there was no association between outcomes and testing to detect COVID- 19. Fear of contracting the disease or being a transmitter of the virus appeared as the main stressors for health professionals, maintained despite testing. CONCLUSION: In this group, tests performed were not sufficient to modify the psychosocial effects of the front line activity on health professionals.

Terapias complementares no enfrentamento do estresse no período puerperal: revisão integrativa da literatura / Terapias complementarias en el afrontamiento del estrés en el período puerperal: una revisión integrador de la literatura / Complementary therapies facing stress in the puerperal period: integrative literature review

Objetivo: Identificar evidências científicas na literatura sobre o uso de terapias complementares no enfrentamento do estresse no período puerperal. Método : A coleta de dados foi realizada de janeiro a março de 2021.Trata-se de uma revisão integrativa da literatura, utilizou-se estratégia PICO para elaboração da pergunta de pesquisa: Quais são as evidências científicas encontradas na literatura sobre o uso de terapias complementares como benefício para enfretamento de estresse no período puerperal? Utilizou-se as bases de dados: SciELO; LILACS; MEDLINE; CINAHL e EMBASE. Os descritores utilizados segundo DESC/ MESH foram: Período Pós-Parto, Terapias Complementares, Estresse Emocional e Estresse Psicológico. Resultados: Encontrados 49 artigos, dos quais 6 selecionados, dentre as práticas utilizadas 6 terapias complementares distintas foram identificadas: biofeedback ou bioenergética; acupressão; reflexologia; musicoterapia e yoga. Conclusão: Os resultados dos estudos confirmaram a existência de evidências de que terapias complementares são benéficas para o enfrentamento do estresse no período puerperal.(AU)

To identify scientific evidence in the literature on the use of complementary therapies in coping with stress in the puerperal period. Method: Data collection was carried out from January to March 2021. This is an integrative literature review, using the PICO strategy to prepare the research question: What is the scientific evidence found in the literature on the use of therapies supplements as a benefit for coping with stress in the puerperal period? The following databases were used: SciELO; LILACS; MEDLINE; CINAHL and EMBASE. The descriptors used according to DESC/MESH were: Postpartum Period, Complementary Therapies, Emotional Stress and Psychological Stress. Results: 49 articles were found, 6 of which were selected, among the practices used, 6 distinct complementary therapies were identified: biofeedback or bioenergetics; acupressure; reflexology; music therapy and yoga. Conclusion: The results of the studies(AU)

Objetivo: Identificar evidencia científica en la literatura sobre el uso de terapias complementarias en el afrontamiento del estrés en el puerperio. Método: La recolección de datos se realizó de enero a marzo de 2021. Se trata de una revisión integradora de la literatura, utilizando la estrategia PICO para preparar la pregunta de investigación: ¿Cuál es la evidencia científica encontrada en la literatura sobre el uso de terapias complementarias como beneficio para el afrontamiento? con estrés en el puerperio? Se utilizaron las siguientes bases de datos: SciELO; LILACS; MEDLINE; CINAHL y EMBASE. Los descriptores utilizados según DESC / MESH fueron: Posparto, Terapias complementarias, Estrés emocional y Estrés psicológico. Resultados: se encontraron 49 artículos, de los cuales se seleccionaron 6, entre las prácticas utilizadas, se identificaron 6 terapias complementarias distintas: biofeedback o bioenergética; acupresión reflexología; musicoterapia y yoga. Conclusión: Los resultados de los estudios confirmaron la existencia de evidencia de que las terapias complementarias son beneficiosas para afrontar el estrés en el puerperio.(AU)

Effect of Qinggan Xiefei Fang on increasing susceptibility of influenza virus caused by "liver fire invading lung" / 药学学报

In this study, chronic emotional stress-induced H1N1 influenza susceptibility model was employed to simulate the states of "emotional stagnation" and "liver fire invading lung", and the protective effect of Qinggan Xiefei Fang on viral pneumonia was investigated. Survival rate and morbidity rate of mice were observed within 21 days after H1N1 infection, the symptoms of viral pneumonia and the level of phospholipid peroxidation were detected in lungs of mice after 6-day infection. The experimental results showed that Qinggan Xiefei Fang could alleviate the decline of survival rate and morbidity rate of mice caused by chronic constraint stress loaded with H1N1, inhibit the replication of H1N1 and the production of inflammatory factors, reduce the level of phospholipid peroxidation, and improve the symptoms of pneumonia in mice. The results also showed that compound-target network of Qinggan Xiefei Fang contained 171 compounds and 260 corresponding targets involved in the signaling pathway of oxidative stress, inflammation and immunity. All the above results indicate that Qinggan Xiefei Fang protecting influenza virus pneumonia was related to the regulation of oxidative stress. The animal experimental protocol has been reviewed and approved by Laboratory Animal Ethics Committee of Jinan University, in compliance with the Institutional Animal Care Guidelines.

Qingre Xiaoyanning inhibits emotional stress-induced reactivation of latent herpes simplex virus type 1 in mice / 药学学报

In this study, according to TCM theory of "liver qi stagnation forming fire", emotional stress mice model was employed to evaluate the protective effects of Qingre Xiaoyanning on herpes simplex virus type 1 (HSV-1) induced reactivation. The animal experimental protocol has been reviewed and approved by Laboratory Animal Ethics Committee of Jinan University, in compliance with the Institutional Animal Care Guidelines. BALB/c mice were divided into six groups, including mock group, HSV-1 latency group, HSV-1 reactivation group (HSV-1 latency + stress), low (0.658 g·kg-1·day-1) and high dose (1.316 g·kg-1·day-1) of Qingre Xiaoyanning groups and positive control group (acyclovir, 0.206 g·kg-1·day-1). Except for the normal group and HSV-1 latency group, all mice in other groups received a daily 12-h restraint stress for 4 days. After 7-day treatment of drugs, body weight and recurrent eye infections of mice were recorded. Brain tissues were harvested to monitor HSV-1 antigen distribution by immunohistochemical staining and detect virus titer by plaque assay. In the meantime, the mRNA and protein levels of infected cell polypeptide (ICP27) and glycoprotein B (gB) in the brain tissues were detected by RT-PCR and Western blot, respectively. The level of 4-hydroxynonenal (4-HNE) and expressions of ferroptosis-related proteins were measured by Western blot. The evaluation of malondialdehyde (MDA) content in the brain tissues was conducted by MDA assay commercial kit. The results showed that Qingre Xiaoyanning significantly retarded the decline of body weight of mice induced by HSV-1 reactivation, reduced the activation rate of HSV-1 and recurrent eye infections, declined virus titer of HSV-1, down-regulated gene and protein expressions of ICP27 and gB, and hindered the distribution of HSV-1 antigen in the brain of mice. Meanwhile, Qingre Xiaoyanning also decreased the protein expression of ferroptosis-related proteins, including DMT1, TFR1 and ALOX15 in the brain tissue of HSV-1 reactivated mice. The levels of lipid peroxidation products, 4-HNE and MDA, were also reduced by Qingre Xiaoyanning treatment. All the above results indicate that Qingre Xiaoyanning significantly inhibited HSV-1 reactivation by restraint stress, which might be related to the regulation of ferroptosis. Our findings provide a theoretical basis for the application of "clearing liver-fire" TCM on treatmenting HSV-1 reactivation-related symptoms.

Efeito das essências florais na redução do estresse em estudantes de enfermagem: ensaio clínico randomizado / Effect of flower essences in the reduction of nursing students stress: randomized clinical trial

Introdução: Dentre os estudantes acadêmicos da área da saúde, os da enfermagem são os que apresentam maiores manifestações psicológicas e fisiológicas de estresse. Em função da formação, durante o período acadêmico, algumas situações podem ser consideradas estressoras como aulas práticas, avaliações de aprendizado, diferenças entre teoria e a realidade da prática assistencial, situações de limites humanos (doenças/morte), horas intensivas de aula, entre outros. A terapia floral, por sua atuação sutil, pode auxiliar a trazer o equilíbrio emocional ajudando na redução dos sinais e sintomas psicoemocionais do estresse. É uma prática integrativa, não farmacológica e de fácil acesso. Objetivo: Analisar o efeito do buquê de essências florais composto pelas essências: Impatiens, Cerato, Elm, White Chestnut, Olive, Cherry Plum, Larch na redução de sinais e sintomas de estresse dos estudantes de enfermagem medidos pelo Teste de Baccaro, Escala de Estresse Percebido e Instrumento de Avaliação de Estresse de Estudantes de Enfermagem. Método: Ensaio clínico randomizado, triplo cego, com dois grupos: Floral (GF) que recebeu um buquê de essências florais composto por: Impatiens, Cerato, Elm, White Chestnut, Olive, Cherry Plum, Larch e grupo Placebo (GP) que recebeu uma fórmula composta somente do veículo sem essência floral. Os grupos utilizaram a fórmula por 60 dias na dosagem de 4 gotas 4 vezes ao dia. A amostra foi composta por 101 estudantes de enfermagem de duas instituições públicas e duas privadas (49 GP e 52 GF) com pontuação acima de 20 pontos pelo Teste de Baccaro. O desfecho primário foi avaliado pelas escalas: Teste de Baccaro, Escala de Estresse Percebido e Avaliação de Estresse em Estudantes de Enfermagem. O desfecho secundário foi avaliado pela percepção do uso da fórmula pelos estudantes ao final do estudo. As escalas de estresse foram aplicadas no início e no final da intervenção. A escala de COPE Breve e o Questionário de Senso de Coerência de Antonovsky foram utilizadas como variáveis moderadoras. A análise utilizou a estatísitca descritiva, comparação dos grupos pelo t-student, teste de Fisher, qui-quadrado e teste Wilcoxon-Mann-Whitney de acordo com o tipo de variável e tamanho de efeito pelo teste d-Cohen. Adotou-se nível de significância =5%. Resultados: Não houve diferença significativa entre os GF e GP na redução do estresse medido pelo Teste de Baccaro e Escla de Estresse Percebido (p>0,05), ambos os grupos tiveram redução nas pontuações das escalas (p<0.001) com tamanho de efeito grande nos dois grupos. Na Avaliação de Estresse do Estudante de Enfermagem não houve redução significativa entre os grupos e para os dois grupos ao longo do tempo. A analise de interação mostrou que houve interferência ao longo do estudo do ano do curso na Escala de Estresse Percebido e o fato de ser aluno USP na Avaliação de Estresse em Estudantes de Enfermagem, e nesta escala também houve uma influência do ano de curso e pandemia. A análise da percepção sobre a utilização do efeito floral mostrou nos relatos do GF efeito terapêutico na mudança de padrões de comportamento, não observados no GP. Conclusão: A intervenção com terapia floral não foi mais efetiva que o placebo na redução de sinais e sintomas de estresse O efeito da terapia floral se evidenciou nos relatos dos estudantes. A fórmula floral contribuiu para a melhora da qualiade do sono, autoconfiança e padrão de comportamento frente a determinadas situações.

Introduction: Among healthcare college students, the nursing ones are those demonstrate the biggest psychological and physiological stress manifestations. On account of the daily academic life, some situations can be considered stressors such as practical classes, learning assessments, differences between theory and reality of care practice, human boundary situations (disease/death), intensive class hours, amongst others. The floral therapy, for its subtle action, can help bring the emotional balance by helping to reduce the psycho-emotional signs and symptoms of stress. It s an integrative practice, no pharmacological and with easy access. Objective: To analyse the effect of a flower essence bouquet composed by the essences: Impatiens, Cerato, Elm, White Chestnut, Olive, Cherry Plum, Larch in the reduction of nursing students signs and symptoms of stress measured by Baccaro s Test, Perceived Stress Scale and Scale of Assessment of Stress Among Nursing Students. Method: Randomized clinical trial, triple blind, with two groups Floral (FG) that received a flower essence bouquet composed of: Impatiens, Cerato, Elm, White Chestnut, Olive, Cherry Plum, Larch and Placebo group (PG) that received a formula composed only of the vehicle without flower essence. The groups used the formula for 60 days in the dosage of 4 drops 4 times a day. The sample was composed of 101 nursing students from two public and two private institutions (49 PG e 52 FG) with score above 20 points by the Baccaro s Test. The primary outcome was rated by the scales: Baccaro s Test, Perceived Stress Scale and Scale of Assessment of Stress Among Nursing Students. The secondary outcome was rated by the students perception of the formula use by the end of the study. The stress scales were applied in the beginning and at the end of the intervention. The Brief COPE scale and the Antonovsky s Sense of Coherence Scale were used as moderators variables. Descriptive analysis of the data was performed, comparing the groups by t-student test, Fisher test, chi-square and Wilcoxon-Mann-Whitney test according to variable type and size effect by d-Cohen test. The significance level = 5% was adopted. Results: There was no significant difference between GF and GP in the stress reduction measured by Baccaro s Test and Perceived Stress Scale (p>0,05), both groups had scale scores reductions (p<0.001) with large effect size in the two groups. In the Scale of Assessment of Stress Among Nursing Students there was no significant reduction between the groups and for the two groups in the long term. The interaction analysis showed that there was interference throughout the academic year study in the Perceived Stress Scale and the fact of being USP student in the Scale of Assessment of Stress Among Nursing Students, and this scale had also an influence in the academic year and pandemic. The perception analysis about the use of the floral effect showed in the FG reports therapeutic effects in the changing behavior patterns, not observed in the PG. Conclusion: The floral therapy intervention was not more effective than placebo in reducing signs and symptoms of stress. The effect of flower essence therapy was evident in the students' reports. The floral formula contributed to an improvement in sleep quality, self-confidence, and behavioral patterns when faced with certain situations.

Associação entre eventos estressores e citocinas inflamatórias e anti-inflamatórias em pessoas idosas longevas / Association between stressor events and inflammatory and anti-inflammatory cytokines in long-lived older people

Resumo Objetivo investigar a associação entre a frequência de eventos estressores e citocinas em pessoas idosas longevas. Métodos os participantes responderam a um questionário constituído de variáveis sociodemográficas, indicaram quais eventos estressores constantes no Inventário de Eventos Estressores de vida ocorreram nos últimos cinco anos e responderam a escala de depressão geriátrica (GDS). Foram dosados por citometria de fluxo: interleucina (IL) 10, IL-6, IL-4, IL-2, fator de necrose tumoral (TNF-α) e interferon gama (IFN-γ). A análise descritiva foi realizada para a caracterização da amostra. Para investigar a associação entre as variáveis foi desenvolvido um modelo de regressão linear múltipla, utilizando o método Backward. Resultados Participaram da pesquisa 91 pessoas idosas com média de idade de 82 anos. Mais da metade da amostra relatou morte de ente querido como o evento estressor mais prevalente (61%). Nessa amostra foi possível perceber que quanto mais eventos estressores foram relatados, menor o nível de IL-4 (p=0,046), da mesma forma que o estado civil viuvez, onde os dados mostraram que quem é viúvo tem menos eventos estressores em comparação a quem é casado (p=0,037). Conclusão Evidenciou-se a importância de um olhar mais cuidadoso dos profissionais de saúde na avaliação multidimensional da pessoa idosa, de forma que se obtenham subsídios para a implementação de programas e intervenções específicos que possam amenizar a percepção dos eventos estressores vivenciados, colaborando com menores danos decorrentes da imunossenescência.

Abstract Objective To investigate the association between the frequency of stressor events and cytokines in long-lived older people. Methods The participants answered a questionnaire consisting of sociodemographic variables, indicated which stressor events included in the Stressor Life Events Inventory occurred in the last five years and answered the Geriatric Depression Scale (GDS). The following were measured by flow cytometry: interleukin (IL) 10, IL-6, IL-4, IL-2, tumor necrosis factor (TNF-α) and interferon gamma (IFN-γ). We carried out a descriptive statistical analysis in order to characterize the sample. To investigate the association between the variables, a multiple linear regression model was developed, using the Backward method. Results 91 older people with an age average of 82 years participated in the research. More than half of the sample reported the death of a loved one as the most prevalent stressor event (61%). In this sample, it was possible to notice that the more stressor events were reported, the lower the level of IL-4 (p=0.046), as well as the marital status of widowhood, where data showed that those who are widowed have fewer stressor events in comparison to who is married (p=0.037). Conclusion The importance of a more careful look by health professionals in older people multidimensional assessment was evidenced, so that subsidies are obtained for the implementation of specific programs and interventions that can ease the perception of the stressor events experienced, collaborating with less resulting damage of immunosenescence.

Family Members’ Satisfaction Levels : Impact Of An Intensive Care Unit Information Leaflet With Verbal Information Compared To Conventional Verbal Information

@#Introduction: Patients admitted to the Intensive Care Unit (ICU) experience intense physical stress. Family members of these patients also experience stress during the admission. Therefore, it is an important task of the ICU staff to provide the family members with appropriate and clear information. There are many methods to do this. This study aimed to compare the impact of two methods of information sharing on the satisfaction levels among families of ICU patients. The novel method being introduced and investigated was a locally designed information leaflet in combination with verbal explanation. This new method was compared with the traditional method of verbal explanation only. Methods: This was a randomized controlled study, conducted at the ICU of Teluk Intan Hospital. A total of 60 participants were enrolled, with 30 participants each in the intervention and control group. The Malay version of the Validated Critical Care Family Satisfaction Survey (CCFSS) was used to measure family satisfaction with the care received during their ICU admission. Results: The intervention group reported significantly higher level of satisfaction in all of the components (Assurance, Proximity, Information, Support and Comfort). Upon further examination of the results of the intervention group, the scores in the Assurance, Proximity and Comfort component were significantly higher compared to the scores in the Information and Support component. Conclusion: Integrating an information leaflet with the traditional verbal method of delivering information has proven to provide a significant difference in satisfaction levels to the family members of patients who were admitted to the ICU.

Qingre Xiaoyanning Capsules alleviate HSV-1 susceptibility induced by emotional stress / 中国中药杂志

In this study, emotional stress-induced herpes simplex virus type 1(HSV-1) susceptibility model was employed to simu-late the pathological state of " depression-induced liver fire", and the protection effect of Qingre Xiaoyanning(QX) in clearing liver fire was investigated. BALB/c mice were randomly divided into a normal group, a HSV-1 group, a restraint stress + HSV-1 group,low-(0. 658 g·kg~(-1)) and high-dose(1. 316 g·kg~(-1)) QX groups, and an acyclovir group. Except for the normal group and the HSV-1 group, the mice in other groups received daily restraint stress for 6 h from day 3 of medication. On day 9 of medication, mice were anesthetized by isoflurane and infected intranasally with HSV-1. Survival rate, weight change, encephalitis symptoms, and eye injury of mice were recorded for 14 d after virus infection. Hematoxylin-eosin(HE) staining and immunohistochemical staining were used to detect pathological changes and HSV-1 antigen distribution. Plaque assay was performed to detect the titer of HSV-1. The protein ex-pression of ICP27 in the mouse brain was detected by Western blot. The experimental results showed that QX could increase the survival rate of HSV-1-infected mice loaded with emotional stress(P<0. 001), reduce the titer of HSV-1 in the mouse brain(P<0. 01), relieve brain inflammation(P<0. 05) and eye injury(P<0. 05), down-regulate the expression of ICP27 related to HSV-1(P<0. 05), and decrease the distribution of HSV-1 antigen in the mouse brain. The results demonstrated that QX significantly reduced the susceptibility to HSV-1 induced by emotional stress, which is expected to provide a theoretical basis for the treatment and preven-tion of HSV-1 infection and promote the clinical development and application of Chinese medicine effective in clearing liver fire.

Social and health-related predictors of family function in older spousal caregivers: a cross-sectional study / Variáveis sociais e de saúde preditoras da função familiar em cuidadores cônjuges idosos: um estudo transversal

ABSTRACT. Given the benefits of adequate family function for the health and well-being of older adults, it is important to understand what factors predict adequate family function in older people who care for their spouses. Objective: Analyse predictors of family function in older spousal caregivers. Methods: A cross-sectional study design was used to investigate a non-probabilistic sample of 298 older spousal caregivers. Home-based face-to-face interviews were used to evaluate sociodemographic variables and care context, family function (Family APGAR), cognitive function, perceived stress, and depressive symptoms. Data were analysed using multiple logistic regression with stepwise forward method for variable section. Results: Older caregivers having some degree of cognitive impairment (OR=-0.160, 95%CI 0.444-0.579), depressive symptoms (OR=-0.848, 95%CI 0.726-0.992) or high levels of stress (OR=-0.955, 95%CI 0.914-0.999) had overall lower levels of family function. Having more children was linked to approximately 1.3 times higher family function (95%CI 1.080-1.057). Conclusion: Stress, depression, cognitive decline, and number of children are predictors of family function and should be considered in social and health care strategies within the family caregiving context.

RESUMO. Dados os benefícios da função familiar adequada para a saúde e o bem-estar de pessoas idosas, é importante compreender quais fatores predizem o funcionamento familiar adequado em pessoas idosas que cuidam de seus cônjuges. Objetivo: Analisar preditores de funcionamento familiar em idosos cuidadores de cônjuges idosos. Métodos: Um estudo transversal foi usado para investigar uma amostra não probabilística de 298 cuidadores cônjuges idosos. Foram realizadas entrevistas domiciliares para avaliar variáveis sociodemográficas e situação de cuidado, funcionamento familiar (APGAR familiar), função cognitiva, percepção de estresse e sintomas depressivos. Os dados coletados foram analisados por meio de regressão logística múltipla com método stepwise forward para seleção das variáveis. Resultados: Idosos cuidadores com algum grau de comprometimento cognitivo (OR=-0,160, IC95% 0,444-0,579), sintomas depressivos (OR=-0,848, IC95% 0,726-0,992) ou altos níveis de estresse (OR=-0,955, IC95% 0,914-0,999) tiveram menores níveis de funcionamento familiar. Ter mais filhos esteve relacionado a maiores níveis de funcionamento familiar em aproximadamente 1,3 vez (IC95% 1,080-1,057). Conclusão: A presença de estresse, depressão, declínio cognitivo e número de filhos são preditores do funcionamento familiar e devem ser considerados como parte de estratégias sociais e de saúde no contexto de cuidado familiar.

Estresse experimentado por mães de recém-nascidos pré-termo em unidade de terapia intensiva neonatal / Stress experienced by mothers of preterm newborns in a neonatal intensive care unit

Introdução: O estresse materno diante do nascimento e internação do recém-nascido prematuro em unidade de terapia intensiva neonatal pode ser intenso. A "Parental Stress Scale: Neonatal Intensive Care Unit - PSS:NICU" é uma escala, validada no Brasil, indicada para avaliar o nível de estresse em pais e mães no contexto da terapia intensiva, norteando ações de enfermagem que auxiliem os pais no enfrentamento da hospitalização de seus filhos. Portanto, considera-se relevante investigar maneiras de identificar e de avaliar o nível de estresse materno na unidade de terapia intensiva neonatal. Objetivo: Avaliar o nível de estresse de mães de recém-nascidos pré-termo com idade gestacional ≤34 semanas, internados em terapia intensiva neonatal. Método: estudo transversal com mães de prematuros internados em terapia intensiva de novembro/2017 a agosto/2018, que responderam, uma única vez, a um questionário formulado para o estudo e ao instrumento PSS:NICU, do 5º ao 14º dia de internação do prematuro. Projeto aprovado pelo comitê de ética da Instituição de origem. Resultados: Foram incluídas 74 mães com seus 85 prematuros. Média de idade materna de 29±7 anos, das quais: 81,08% não tinham companheiro; 33,8% tinham menos de 9 anos de estudo; 70,30% estavam empregadas. Quanto à gestação: 41,89% primigestas; 13,51% gestaram gemelares; 45,95% planejaram engravidar. Quanto à saúde materna, 68,92% adquiriram doenças gestacionais; 23% das mães possuíam experiência prévia com prematuridade e 12,2% com internação em unidade de terapia intensiva neonatal. Obteve-se média de nível de ocorrência de estresse 4,41(±0,77) e nível geral de estresse do ambiente 4,36 (±0,76), com diferença significativa (p<0,001) entre a subescala "Alteração no papel de pais" e demais subescalas. Significando que as mães se encontravam numa situação muito estressante. Conclusão: identificou-se todos os itens da subescala "Alteração do papel de pais" da PSS:NICU como a principal fonte de estresse experimentada pelas mães. Sugere-se a realização de estudos com outras metodologias para ampliar o conhecimento do estresse materno no contexto nacional, aplicando intervenções de cuidado envolvendo as mães.

Introduction: Maternal stress on the birth and hospitalization of the preterm newborn in a neonatal intensive care unit can be intense. The "Parental Stress Scale: Neonatal Intensive Care Unit - PSS: NICU" is a scale, validated in Brazil, indicated to evaluate the level of stress in fathers and mothers in the context of intensive care, guiding nursing actions that assist parents in coping the hospitalization of their children. Therefore, it is considered relevant to investigate ways of identifying and evaluating the level of maternal stress in the neonatal intensive care unit. Objective: To evaluate the stress level of mothers of preterm infants with gestational age ≤34 weeks hospitalized in neonatal intensive care. Method: cross-sectional study with mothers of premature infants admitted to intensive care between November / 2017 and August / 2018, who answered a questionnaire formulated for the study and the PSS: NICU instrument, from the 5th to the 14th day of admission of the premature infant. Research approved by the ethics committee of the Institution of origin. Results: A total of 74 mothers were included with their 85 premature infants. Mean maternal age was 29 ± 7 years, of which: 81.08% had no partner; 33.8% had less than 9 years of schooling; 70.30% were employed. As for gestation: 41.89% primigravida; 13.51% had twin twins; 45.95% planned to become pregnant. Regarding maternal health, 68.92% had acquired gestational diseases; 23% of the mothers had previous experience with prematurity and 12.2% with hospitalization in a neonatal intensive care unit. The mean stress level was 4.41 (± 0.77) and the general stress level was 4.36 (± 0.76), with a significant difference (p <0.001) between the subscale "Parental role alteration" and other subscales. It means that mothers were in a very stressful situation. Conclusion: all items in the subscale "Parental role alteration" of PSS: NICU were identified as the main source of stress experienced by mothers. It is suggested to carry out studies with other methodologies to increase the knowledge of maternal stress in national context, applying care interventions involving the mothers.

Effect of music therapy on stress in chemically dependent people: a quasi-experimental study / Efeito da musicoterapia sobre o estresse de dependentes químicos: estudo quase-experimental / Efecto de la musicoterapia sobre el estrés de dependientes químicos: estudio cuasi-experimental

ABSTRACT Objective: to evaluate the effect of music therapy on the stress of chemically dependent people. Method: quasi-experimental study conducted at a philanthropic institution with 18 chemically dependent people undergoing treatment. Salivary cortisol (stress hormone) was collected in three moments: before, 60 minutes after, and 120 minutes after a music therapy group intervention. Statistical analysis adopted a significance level of p < 0.05 and used the Wilcoxon and Kruskal-Wallis non-parametric tests. Results: after 60 minutes of intervention, there was a statistically significant reduction in mean salivary cortisol levels (p < 0.001). A reduction was also noted after 120 minutes, but without statistical significance (p = 0.139). Conclusion: a single session of 60 minutes of group music therapy was able to reduce stress (salivary cortisol levels) of chemically dependent people.

RESUMO Objetivo: avaliar o efeito da musicoterapia sobre o estresse de dependentes químicos. Método: estudo quase-experimental realizado em instituição filantrópica com 18 dependentes químicos em tratamento. O cortisol salivar (hormônio do estresse) foi coletado antes, 60 e 120 minutos após única intervenção musicoterapêutica realizada em grupo. A análise estatística adotou nível de significância de p < 0,05 mediante aplicação dos testes não paramétricos de Wilcoxon e de Kruskal-Wallis. Resultados: após 60 minutos da intervenção musicoterapêutica, houve redução estatisticamente significante nas médias dos níveis de cortisol salivar (p < 0,001). Após 120 minutos, também houve redução, mas sem significância estatística (p = 0,139). Conclusão: sessão única de 60 minutos de musicoterapia em grupo mostrou-se capaz de reduzir o estresse (níveis de cortisol salivar) de dependentes químicos.

RESUMEN Objetivo: evaluar el efecto de la musicoterapia sobre el estrés de dependientes químicos. Método: estudio cuasi-experimental realizado en institución filantrópica con 18 dependientes químicos en tratamiento. El cortisol salivar (hormona del estrés) fue recogido antes, 60 y 120 minutos después de una única intervención musicoterapéutica realizada en grupo. El análisis estadístico adoptó un nivel de significancia de p <0,05 mediante la aplicación de las pruebas no paramétricas de Wilcoxon y de Kruskal-Wallis. Resultados: después de 60 minutos de la intervención musicoterapéutica, hubo reducción estadísticamente significativa en las medias de los niveles de cortisol salivar (p <0,001). Después de 120 minutos, también hubo reducción, pero sin significancia estadística (p = 0,139). Conclusión: uma única sesión de 60 minutos de musicoterapia en grupo se mostró capaz de reducir el estrés (niveles de cortisol salivar) de dependientes químicos.

Mediating Effects of Emotional Venting via Instant Messaging (IM) and Positive Emotion in the Relationship between Negative Emotion and Depression

PURPOSE: The purpose of this study is to examine the mediating effects of emotional venting via instant messaging (IM) and positive emotion in the relationship between negative emotion and depression.METHODS: Online survey was conducted in Korea between 2 April and 7 April 2019. To obtain samples with representativeness, data were gathered by the professional research firm. A total of 250 Koreans were participated in this study. The collected data were analyzed using descriptive statistics, Pearson's correlation coefficients, and SPSS PROCESS macro to test the mediating effects.RESULTS: This study analyzed the direct/indirect effects of negative emotion on emotional venting via IM, in the relationship between positive emotion and depression. Negative emotion had indirect effects on depression through emotional venting via IM and positive emotion. Both emotional venting via IM and positive emotion had dual mediating effects in the influence of negative emotion on depression.CONCLUSION: These results suggest that it is important to manage negative emotion to prevent depression. Also, this study confirmed that emotional venting via IM is a powerful factor influencing emotional recovery.

Correlations between a Flexible Parental Visiting Environment and Parental Stress in Neonatal Intensive Care Units

PURPOSE: The purpose of this study was to examine the correlation between a flexible parental visiting environment and parental stress in neonatal intensive care units (NICUs).METHODS: The study participants included 60 parents of premature infants in NICUs. Structured questionnaires and interviews, as well as observations by researchers using a caregiving behavior checklist, were used to measure the flexibility of the parental visiting environment and parents' stress levels. Quantitative and qualitative data were collected concurrently and were initially analyzed as separate data sets. Data collection extended from March 11, 2018 to June 30. 2018 and the data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, and Pearson correlation coefficients.RESULTS: There was a negative correlation (r=−.30, p=.021) between parental stress and the total number of visits in 7 days. We also found that the average duration of each visit and the number of caregiving behaviors performed by parents were positively correlated (r=.73, p<.001).CONCLUSION: When designing a flexible visiting environment for parents, parents should be encouraged to visit their babies. By doing so, stress can be reduced both for babies and for parents. Therefore, it is suggested that the related polices and regulations in South Korea should be changed to provide more a flexible visiting environment to promote better parent-child attachment and family adjustment.

Role of Emotional Distress in Prolongation of Dizziness: A Cross-Sectional Study

BACKGROUND AND OBJECTIVES: Dizziness is a common condition in outpatient clinics. Comorbid conditions such as anxiety and/or depression often complicate a patient’s ability to cope with dizziness. The purpose of the present study was to explore the extent of psychiatric distress using the Hospital Anxiety and Depression Scale (HADS) and to compare the results with the subjective severity of dizziness. SUBJECTS AND METHODS: The cross-sectional study included a total of 456 consecutive patients presenting with acute (n=327) and chronic (n=127) dizziness symptoms. The HADS was used to estimate emotional distress and compare between patients with acute and chronic dizziness symptoms. Also, we calculated correlations between subjective dizziness handicap scores and emotional distress using the total and subscale scores of the Dizziness Handicap Inventory (DHI), Disability Scale (DS), and HADS. RESULTS: The HADS total and subscale scores were significantly increased in patients with chronic dizziness (p<0.01) compared with those with acute symptoms. In patients with symptoms of both acute and chronic dizziness, moderate correlations were evident between the DHI and HADS total scores. When we compared DHI subscale scores with the HADS scores, the emotional DHI subscale scores correlated more highly with the HADS total scores and the scores on the anxiety and depression subscales, than did the functional or physical DHI subscale scores. CONCLUSIONS: Increased levels of distress measured using the HADS in patients with chronic symptoms suggest that emotional status of the patients may contribute to prolongation of dizziness symptoms from the acute phase.

Factors Influencing Smoking Behavior in Patients with Pulmonary Tuberculosis / 임상간호연구

PURPOSE: This study was to investigate the factors affecting smoking behavior in patients with pulmonary tuberculosis. METHODS: The participants were 130 pulmonary tuberculosis patients at a national tuberculosis hospital. Using a descriptive survey design, data were collected from January to March in 2016 and were analyzed using binominal logistic regression. RESULTS: As a result of a correlation analysis of the data, depression had a significant positive correlation with smoking (r=.19, p=.030), stress (r=.54, p < .001), respectively. And depression had a significant negative correlation with smoking-related self-efficacy (r=−.20, p=.023). Smokingrelated self-efficacy, smoking (r=−.79, p < .001), and stress (r=−.23, p=.008) had a significant negative correlation with each other, respectively. The factors affecting the smoking behavior were smoking-related self-efficacy (OR=1.46, p < .001), sex (OR=67.36, p=.001), occupation (OR=17.51, p=.014), and depression (OR=1.16, p=.024). Those factors explained 84.7% (Negelkerke's R2=.847) of pulmonary tuberculosis patients' smoking behavior. CONCLUSION: Developing and applying a prevention eduction for reducing depression and enhancing smoking-related self-efficacy may become a venue toward good prognosis of the patients with pulmonary tuberculosis.

Effects of Maternal Empowerment Program on Stress, Anxiety, Depression and Parenting Confidence in Mothers of Preterm Infants in the Neonatal Intensive Care Unit

PURPOSE: This study aimed to evaluate the effects of an empowerment program on maternal stress, anxiety, depression and parenting confidence. METHODS: A total of 44 mothers of preterm infants were assigned into an experimental or a control group (n=22 each). The experimental group received the usual nursing care and 7 sessions of an empowerment program. The control group only received the usual care. The program was implemented from June to December, 2016 in the neonatal intensive care unit of K university-affiliated hospital in Daegu, Korea. The outcome variables measured were parental stress (PSS: NICU), anxiety (STAI), depression (CES-D) and parenting confidence. Data were analyzed using t-test or repeated measures ANOVA. RESULTS: Scores for both parental stress (t=3.07 p=.004) and depression (F=3.76, p=.26) were significantly lower in the experimental group than in the control group. However, there were no significant differences in anxiety between the groups (F=0.79, p=.505). Parenting confidence scores (F=9.05, p=.001) were significantly higher in the experimental group than in the control group. CONCLUSION: A maternal empowerment program can be an effective means of reducing parental stress and depression as well as enhancing parenting confidence, for mothers of preterm infants.

Multiple-victimisation due to armed conflict and emotional distress in the State of Magdalena, Colombia / Polivictimización por el conflicto armado y sufrimiento emocional en el Departamento del Magdalena, Colombia

Abstract Background: Emotional distress is common in Colombian armed conflict victims. Multiple-victimisation is associated with an increase in emotional distress than victimisation due a single event. However, the association between poly-victimisation and emotional distress among victims of the armed conflict in Colombia has not been documented. Objective: To study the association between multiple-victimisation and emotional distress in victims of armed conflict in the State of Magdalena, Colombia. Methods: A cross-sectional study was designed, with a secondary analysis of registration of the Psychosocial Care Program and Victim Integral Health (PAPSIVI) in the State of Magdalena, from 2013 to 2014. The profile formula grouped demographic variables, victimising events, and a set of symptoms of emotional distress (perceived discrimination, depressive and anxiety-stress). Odds ratio (OR, 95%CI) were established as measures of association. Results: A total of 943 people were included, with 67.4% women, and ages between 18 and 94 years (mean 47.9 ±14.2). A total of 109 (11.7%) suffered from multiple victimisation. Multiple victimisation events were associated with more emotional distress, depressive symptoms (OR = 1.5; 95%CI, 1.3-1.8), perceived stigma (OR = 1.3; 95%CI, 1.1-1.5), and anxiety-stress (OR = 1.2; 95%CI 1.0-1.4) than a single event. Conclusions: There are more emotional distress in multiple victimisations than in a single victimisation event during armed conflict in this region of Colombia. Further studies are required on this topic.

Resumen Introducción: El sufrimiento emocional es frecuente en víctimas del conflicto armado colombiano. La polivictimización se asocia a mayor número de sufrimientos emocionales que la victimización debida un único evento. Sin embargo, hasta la fecha no se ha documentado la asociación entre polivictimización y sufrimiento emocional en víctimas del conflicto armado en Colombia. Objetivo: Estudiar la asociación entre polivictimización y sufrimiento emocional en víctimas del conflicto armado del Departamento del Magdalena, Colombia. Métodos: Se diseñó un estudio transversal, un análisis secundario del registro del Programa de Atención Psicosocial y Salud Integral a Víctimas (PAPSIVI) del Departamento del Magdalena, 2013-2014. El formulario de caracterización agrupó variables demográficas, eventos victimizantes y un conjunto de manifestaciones de sufrimiento emocional (discriminación percibida, depresión y ansiedad). Se establecieron razones de disparidades como medidas de asociación. Resultados: Se incluyó a 943 personas, el 67,4% mujeres, con edad de 18-94 anos (media, 47,9 ± 14,2). Un total de 109 (11,7%) presentaron polivictimización. La polivictimización se asoció a mayor sufrimiento emocional que la victimización por un único evento, síntomas depresivos (odds ratio = 1,5; intervalo de confianza del 95%, 1,3-1,8), estigmatización percibida (odds ratio = 1,3; intervalo de confianza del 95%, 1,1-1,5) y ansiedad-estrés (odds ratio = 1,2; intervalo de confianza del 95%, 1,0-1,4). Conclusiones: La polivictimización incrementa el sufrimiento emocional más que la victimización por un único evento en personas víctimas del conflicto armado en esta región colombiana. Es necesario investigar más en esta área.