Nuevo índice de desempeño global de una prueba diagnóstica: el índice T / New global performance index of a diagnostic test: the T index

Introducción. En el presente artículo se propone un nuevo índice de desempeño global de una prueba diagnóstica: el índice T, que corresponde a la proporción de aciertos (Pa) menos la proporción de error (Pe) dividido entre la proporción de aciertos (Pa). Métodos. Describir los fundamentos teóricos y prácticos del índice T. Comparar el índice T frente al índice de Youden para poder establecer si dos o más modalidades diagnósticas difieren en su capacidad de discriminar, correctamente, entre los individuos verdaderamente enfermos de los sanos. Comparar el índice T frente al índice de Youden para poder establecer si el índice T puede ser utilizado para escoger "el mejor punto de corte" cuando la prueba diagnóstica de interés expresa sus resultados en forma cuantitativa continua.Resultados. Comparado frente al índice de Youden, el índice T permite distinguir entre las pruebas diagnósticas con alto desempeño diagnóstico de aquellas con pobre desempeño diagnóstico. Además, el índice T, de manera confiable, permite escoger "el mejor punto de corte" cuando una prueba diagnóstica utiliza una variable cuantitativa continua para expresar sus resultados.Conclusiones. Al contrastar los resultados del índice T versusel índice de Youden y los resultados del índice T versus la curva COR, podemos afirmar que el índice T es un índice exacto y eficiente.

Introduction. In this article, a new global performance index of a diagnostic test is proposed: the T Index, which corresponds to the proportion of the hit ratio (Hr) minus the error ratio (Er) divided by the hit ratio (Hr).Methods. To describe the theoretical and practical foundations of the T index; to compare the T index against the Youden index in order to establish whether two or more diagnostic modalities differ in their ability to correctly discriminate between truly ill and healthy individuals; and to compare the T index with the Youden index in order to establish whether the T index can be used to choose the "best cut-off point" when the diagnostic test of interest expresses its results in a continuous quantitative way.Results. Compared with the Youden index, the T index allows us to differentiate between diagnostic tests with high diagnostic performance and those with poor diagnostic performance. In addition, the T index, reliably, allows choosing "the best cut-off point" when a diagnostic test uses a continuous quantitative variable to express its results.Conclusions. By contrasting the results of the T index versus the Youden index and the results of the T index versus the COR curve, we can affirm that the T index is an accurate and efficient index.

Psicodrama como terapia en trauma y estrés postraumático / Psychodrama as a Therapy in Trauma and Posttraumatic Stress

Resumen Objetivo: Evaluar la evidencia disponible de la eficacia del psicodrama como terapia para el manejo del trauma psicológico, trastorno por estrés agudo y postraumático. Método: Se realizó una búsqueda sistemática de la literatura en MEDLINE, EMBASE, Cochrane Central, Scopus, LILACS y Ovid hasta abril de 2019. Se incluyeron los términos: (1)Psychodrama, (2)Role-playing, (3)Stress disorders, Acute, posttraumatic, y (4)Psychological trauma (MeSH). Se seleccionaron revisiones sistemáticas de la literatura, metaanálisis, ensayos clínicos aleatorios, cuasi aleatorios y estudios observacionales en inglés y español. Se seleccionaron los trabajos que incluyeran una descripción de las intervenciones con técnicas del psicodrama. Resultados: 14 trabajos cumplieron criterios de inclusión. Conclusión: No se encontró una asociación fuerte de la eficacia del psicodrama ante los síntomas de estrés postraumático. Se requieren más investigaciones con diseño metodológico ajustado para este tipo de intervenciones.

Abstract Objective: To evaluate the available evidence in regarding the efficacy of psychodrama in patients with acute and posttraumatic stress disorder and psychological trauma- Methods: Systematic review. Terms: (1)Psychodrama, (2)Role-playing, (3)Stress disorders, Acute, posttraumatic, and (4)Psychological trauma (Mesh), were searched in Pubmed, EMBASE, Cochrane Central, Scopus, Lillacs and OVID, until April 2019. Systematic reviews of the literature, meta-analysis, randomized clinical trials, quasi-randomized and observational studies in English and Spanish were selected. The works should have described interventions with psychodrama techniques. Results: 14 papers met the inclusion criteria. Conclusions: There is no evidence of the psychodrama response to the symptoms after traumatic stress. Research should be carried out with a more rigorous methodological design.

El rol del cuidador a distancia de personas con enfermedad crónica: scoping review / The role of the distance caregiver of people with chronic disease: scoping review / Papel do cuidador à distância de pessoas com doenças crônicas: scoping review

Introducción: Se ha explorado poco sobre el rol del cuidador a dis-tancia o cuidador secundario de las personas con enfermedad cró-nica, por ello se hace necesario conocer el avance de la evidencia científica sobre este tipo de cuidadores, con el fin de determinar los aportes y los vacíos presentes en la literatura. Metodología: Revi-sión descriptiva tipo scoping review, en la que se realizó una bús-queda en las siguientes bases de datos: de Embase, Science direct, Pubmed, Medline, Academic search complete y Scopus, limitando el tiempo entre 2005 ­ 2020. Se utilizaron los términos: DeCS y MeSH de Long distance caregiver, distance caregiver, secondary caregiver y chronic disease. Además, se seleccionaron 20 artículos originales, una vez realizado el proceso de crítica con CASPe. Re-sultados. Emergieron 4 núcleos temáticos: experiencias y percep-ciones del cuidador a distancia, características del rol del cuidador a distancia, soporte social del cuidador a distancia por medio de Tec-nologías de la información y la comunicación TICs y estrategias de afrontamiento del cuidador a distancia. Conclusión: es un fenómeno poco explorado, por lo que son amplios los vacíos que existen, em-pezando por su autoreconocimiento en el desempeño de su rol hasta las intervenciones específicas que lo favorezcan.

Introduction: Little has been explored about the role of remote caregiver or secondary caregiver of people with chronic disease, so it is relevant to know the progress of scientific evidence on remote or secondary family caregivers, in order to determine the contributions and knowledge gaps present in the literature. Metodology: Descriptive review type scoping review, in which a search was performed in databases of Embase, Science direct, Pubmed, Medline, Academic search complete and Scopus, limiting between 2005 - 2020 using the terms DeCS and MeSH de Long-distance caregiver, distance caregiver, secondary caregiver and chronic disease, selected 20 original articles after completing the review process with CASPe. Results: 4 thematic nuclei emerged that were Experiences and perceptions of the remote caregiver, Characteristics of the role of the remote caregiver, Social support of the remote caregiver through information and communication technologies, ICTs and coping strategies of the remote caregiver. Conclusion: this is a phenomenon little explored, so the gaps that exist are wide, starting with their self-rec-ognition in the role performance up to the specific interventions that favor their performance.

Introdução: Tem se explorado pouco sobre o papel do cuidador à distância ou cuidador secundá-rio das pessoas com doenças crônicas, por isso, faz-se necessário conhecer o avanço da evidência científica sob este tipo de cuidadores, com o intuito de determinar os aportes e os vazios presentes na literatura. Materiais e Métodos: Revisão descritiva tipo Scoping review, realizou-se a busca nas seguintes bases de dados: Embase, Science direct, Pubmed, Medline, Academic search com-plete e Scopus, limitando o tempo entre 2005 ­ 2020. Usaram-se os descritores: DeCS e MeSH "Long distance caregiver, distance caregiver, secondary caregiver" e "chronic disease". Alem disso, selecionaram-se 20 artigos originais, uma vez realizado o processo de crítica com CASPe. Resultados: Surgiram 4 núcleos temáticos: experiências e percepções do cuidador à distância por meio de tecnologias da informação e a comunicação e estratégias de afrontamento do cui-dador à distância. Conclusão: é um fenômeno pouco explorado, pelo que são amplos os vazios existentes, começando pelo auto reconhecimento no desempenho do seu papel até as interven-ções específicas que o favorecem.

Protagonismo juvenil e medidas socioeducativas em meio aberto: experiência em oficinas temáticas / Protagonismo juvenil y medidas socioeducativas en un ambiente abierto: experiencia en talleres temáticos / Youth protagonism and socio-educational measures in open environment: experience in thematic workshops

Resumo O objetivo deste relato é apresentar uma experiência sobre o desenvolvimento do Protagonismo Juvenil dos adolescentes e jovens que estão em cumprimento de medidas socioeducativas em meio aberto, a partir de Oficinas Temáticas realizadas no Centro de Referência Especializado de Assistência Social (CREAS). Para o desenvolvimento das oficinas foi construído um jogo de interpretação de personagem que teve a missão de revitalizar uma quadra de esportes. Partindo de um tema de interesse e de um jogo criado a partir da realidade concreta dos jovens, foi possível perceber o papel protagônico e o envolvimento dos jovens, que fomentou discussões sobre os serviços públicos e como poderiam se articular para modificar a realidade da quadra esportiva. Além disso, foi possível ampliar as discussões sobre outros direitos, como o direito ao esporte e ao lazer. Assim, trabalhar o protagonismo juvenil é reafirmar os adolescentes e jovens como sujeitos de direitos.

Resumen El propósito de este informe es presentar una experiencia sobre el desarrollo del Protagonismo Juvenil de adolescentes y jóvenes que están cumpliendo medidas socioeducativas en ambiente abierto, a partir de talleres temáticos realizados en el Centro de Referencia Especializado de Asistencia Social (CREAS). Para el desarrollo de los talleres se construyó un juego de rol con la misión de revitalizar una cancha deportiva. A partir de un tema de interés y un juego creado a partir de la realidad concreta de los jóvenes, se pudo percibir el papel protagonista y la implicación de los jóvenes, lo que propició discusiones sobre los servicios públicos y cómo se podían articular para cambiar la realidad de la cancha deportiva. Además, fue posible ampliar los debates sobre otros derechos, como el derecho al deporte y al esparcimiento. Así, trabajar con el protagonismo juvenil significa reafirmar a los adolescentes y jóvenes como sujetos de derechos.

Abstract This report aims to present an experience on the development of youth protagonism of teenagers and young people who are in compliance with socio-educational measures in open environment, based on Thematic Workshops held at the Specialized Reference Center for Social Assistance (CREAS). For the development of the workshops, a role-playing game was built with the mission of revitalizing a sports court. Starting from a topic of interest and a game created from the concrete reality of young people, it was possible to perceive the leading role and involvement of young people, which fostered discussions about public services and how they could articulate themselves to change the reality of the sports court. In addition, it was possible to expand discussions on other rights, such as the right to sport and leisure. Thus, working with youth protagonism means reaffirming adolescents and young people as subjects of rights.

Self-care related to the performance of occupational roles in patients under antineoplastic chemotherapy treatment / O autocuidado relacionado ao desempenho de papéis ocupacionais em pacientes sob tratamento quimioterápico antineoplásico / Autocuidado relacionado con el desempeño de roles ocupacionales en pacientes bajo tratamiento de quimioterapia antineoplásica

Objective: to analyze and correlate occupational roles, symptoms and self-care capacity in oncologic patients seen at the chemotherapy service of a university hospital. Method: cross-sectional study, in which the instruments were applied sociodemographic and clinical questionnaire, M.D Anderson's Symptom Inventory - core, Appraisal of Self Care Agency Scale-Revised and Occupational Paper Identification List to oncologic patients seen in the chemotherapy service of a university hospital. Data analysis included absolute and relative frequency tables and multiple linear regression, adopting a significance level of α=0.05. Results: the sample showed capacity for self-care operationalized with an average of ̄X=57.8. In the correlation between the degree of importance of the occupational papers and the scores of the evaluation instrument for self-care was found statistical significance in the papers of volunteer (r=0.26; p=0.02) and friend (r=0.33; p= <0.001). The linear regression showed that the greater the interference of symptoms in life activities (β=0.20; p=0.05) and greater the importance of the role of friend (p=0.001; p=0.43), the higher the rates of self-care. Conclusion: the operationalization of self-care can be directly related to the degree of importance attributed to the performance of social roles.

Objetivo: analisar e correlacionar os papéis ocupacionais, os sintomas e a capacidade de autocuidado em pacientes oncológicos atendidos no serviço de quimioterapia de um hospital universitário. Método: estudo transversal, no qual foram aplicados os instrumentos questionário sociodemográfico e clínico, Inventário de Sintomas do M.D Anderson - core, escala de avaliação da capacidade do autocuidado Appraisal of Self Care Agency Scale-Revised e Lista de Identificação de Papéis Ocupacionais em pacientes oncológicos atendidos no serviço de quimioterapia de um hospital universitário. A análise dos dados incluiu tabelas de frequências absolutas e relativas e regressão linear múltipla, adotando nível de significância de α=0,05. Resultados: a amostra apresentou capacidade para o autocuidado operacionalizada com média de ̄X=57,8. Na correlação entre o grau de importância dos papéis ocupacionais e os escores do instrumento de avaliação para o autocuidado foi encontrada significância estatística nos papéis de voluntário (r=0,26; p=0,02) e de amigo (r=0,33; p= <0,001). A regressão linear mostrou que quanto maior a interferência dos sintomas nas atividades de vida (β=0,20; p=0,05) e maior a importância do papel do amigo (p=0,001; p=0,43), maiores os índices de autocuidado. Conclusão: a operacionalização do autocuidado pode estar diretamente relacionada ao grau de importância atribuído ao desempenho de papéis sociais.

Objetivo: analizar y correlacionar los roles ocupacionales, los síntomas y la capacidad de autocuidado en pacientes oncológicos atendidos en el servicio de quimioterapia de un hospital universitario. Método: estudio transversal, en el que se aplicaron los instrumentos cuestionario sociodemográfico y clínico, Inventario de Síntomas de M.D. Anderson - core, escala de evaluación de la capacidad de autocuidado Appraisal of Self Care Agency Scale-Revised y Lista de Identificación de Roles Ocupacionales en pacientes oncológicos atendidos en el servicio de quimioterapia de un hospital universitario. El análisis de los datos incluyó tablas de frecuencias absolutas y relativas y regresión lineal múltiple, a un nivel de significancia de α=0,05. Resultados: la muestra ha mostrado capacidad para el autocuidado operacionalizada, con un promedio de ̄X=57,8. En la correlación entre el grado de importancia de los roles ocupacionales y las puntuaciones del instrumento de evaluación para el autocuidado, se encontró significancia estadística para los roles de voluntario (r=0,26; p=0,02) y de amigo (r=0,33; p= <0,001). La regresión lineal mostró que cuanto mayor es la interferencia de los síntomas en las actividades de la vida (β=0,20; p=0,05) y cuanto mayor la importancia del rol del amigo (p=0,001; p=0,43), más altos son los índices de autocuidado. Conclusión: la operacionalización del autocuidado puede estar directamente relacionada con el grado de importancia atribuido al desempeño de los roles sociales.

Development and Effects of a Hand-washing Program using Role-playing for Preschool Children

PURPOSE: A hand-washing program using role-playing was developed for preschool children and tested to verify its usefulness. METHODS: The participants were 46 preschool children (experimental group, 23; control group, 23). Data were collected from August 7, 2017 to September 20, 2017. The first posttest was carried out on the day after the initial intervention was completed, and the second posttest was performed after a month. Data were analyzed using the χ² test, Fisher exact test, Shapiro-Wilk test, Mann-Whitney test, and Friedman test. RESULTS: In the experimental group, the frequency of practicing hand-washing was significantly higher than in the control group on the next day (z=−4.94, p<.001) and after a month (z=−3.15, p=.002). The accuracy of hand-washing was significantly higher in the experimental group than in the control group on the next day (z=−4.02, p<.001) and after a month (z=−3.86, p<.001). CONCLUSION: The hand-washing program developed in this study was found to be an effective intervention strategy for improving the frequency and accuracy of hand-washing among preschool children.

Investigating the effects of interprofessional communication education for medical students / 한국의학교육

PURPOSE: Interprofessional communication skills are an essential competency for medical students training to be physicians. Nevertheless, interprofessional education (IPE) is relatively rare in Korean medical schools compared with those overseas. We attempted to evaluate the effectiveness of the first IPE program in our school. METHODS: In the first semester of the school year 2018, third-grade medical students (N=149) at the Seoul National University College of Medicine participated in ‘communication between healthcare professionals in the clinical field’ training, which consisted of small group discussions and role-play. To evaluate the effectiveness of this training, we conducted pre- and post-training questionnaire surveys. Comparing paired t-tests, we evaluated the students' competency in interpersonal communication and their attitude towards the importance of IPE before and after the training. The Global Interpersonal Communication Competence Scale (GICC-15) was used to evaluate competency in interpersonal communication. RESULTS: Out of 149 students, 144 completed the pre- and post-training questionnaires. The total GICC-15 scores before and after training were 55.60±6.94 (mean±standard deviation) and 58.89±7.34, respectively (p=0.000). All subcategory scores of GICC-15 after training were higher after training and were statistically significant (p<0.05), except for two subcategories. The importance of IPE score also improved after training but was not significant (p=0.159). The appropriateness of content and training method scores were 3.99±0.92 and 3.94±1.00, respectively. CONCLUSION: From the results, our school's IPE program demonstrated a positive overall educational effect. Deployment of systematic and varied IPE courses is expected in the future, with more longitudinal evaluation of educational effect.

Avaliação do processo ensino e aprendizagem no ambiente de simulação realística na graduação em enfermagem / Evaluation of the teaching-learning process in a realistic simulation environment for undergraduate nursing

Objetivo: Avaliar o processo ensino-aprendizagem no ambiente de simulação realística na percepção de estudantes de graduação em enfermagem. Método: Estudo transversal descritivo com 59 estudantes. Foram aplicadas duas escalas: Experiência com o debriefing e design de Simulação. Dados analisados com Software Statistical Package for the Social Sciences, versão 24.0, o The R Project for Statistical Computing versão 3.3 e Office Excel 2007. Empregaram-se o Alpha de Cronbach e teste Qui-quadrado considerando p<0,05. Resultados: para as duas escalas, demostrou-se concordância entre 62% e 93% correspondentes ao somatório dos parâmetros: concordo com a afirmação e concordo com afirmação totalmente. A confiabilidade interna da escala de experiência com debriefing foi 0.972 e da escala do design de simulação 0.964. Associando-se dimensões da escala de debriefing, obtiveram-se p-valores significativos de (0-0,0006) e para a escala de design, p-valores (0-0,0050). Conclusões: consolidou-se a simulação como estratégia de ensino-aprendizagem evidenciada pela avaliação satisfatória dos estudantes. (AU)

Objective: To evaluate the teaching-learning process in a realistic simulation environment according to the perception of undergraduate nursing students. Method: Descriptive cross-sectional study with 59 students. Two scales were applied: Debriefing Experience Scale and Simulation Design Scale. Data were analyzed using the Software Statistical Package for Social Sciences, version 24.0, The R Project for Statistical Computing version 3.3, and Microsoft Office Excel 2007. Cronbach's Alpha and Chi-square test were used considering p<0.05. Results: Both scales showed agreement between 62% and 93%, corresponding to the sum of the parameters: I agree with the statement and I totally agree with the statement. The internal reliability was 0.972 for the debriefing experience scale and 0.964 for the simulation design scale. The association between the dimensions of the debriefing scale showed significant p-values (0-0,0006); the simulation design scale showed p-values of (0-0,0050). Conclusion: Simulation was evidenced as a teaching-learning strategy, as demonstrated by the satisfactory evaluation of the students. (AU)

Objetivo: Evaluar el proceso de enseñanza y aprendizaje en un ambiente de simulación realística en la percepción de los estudiantes de enfermería. Método: estudio descriptivo de corte transversal con 59 estudiantes. Se aplicaron dos escalas: experiencia con el informe y diseño de simulación. Las pruebas alfa y chi-cuadrado de Cronbach se utilizaron considerando p <0.05. Resultados: Dos escalas mostraron un acuerdo entre 62% y 93% correspondiente a la suma de los parámetros: estoy de acuerdo con la declaración y estoy totalmente de acuerdo con la declaración. La confiabilidad interna de la escala de experiencia informativa 0.972 y la escala de diseño de simulación 0.964. La combinación de las dimensiones de la escala de informes mostró valores con p significativos (0-0,0006) y para los valores p de la escala de diseño (0-0,0050). Conclusiones: la evaluación de simulación consiste en mejorar la calidad de la educación en enfermería, contribuyendo para la seguridad del paciente y al avance científico. (AU)

A dramatização como estratégia facilitadora no processo ensino aprendizagem dos estudantes de enfermagem / The dramatization as a facilitating strategy in the process of teaching nursing student learning / La dramatización como estrategia facilitadora en el proceso de enseñanza aprendizaje de los estudiantes de enfermería

A necessidade de fundamentar as práticas educativas para uma ação transformadora impulsiona o educador\r\nna busca de métodos de ensino inovadores e assim sendo, a dramatização favorece a aprendizagem do\r\nestudante de forma ativa e participativa. Objetivos: Levantar os estudos sobre a utilização da dramatização\r\ne verifi car os resultados na aprendizagem do estudante de Enfermagem. Metodologia: Revisão sistemática\r\nda literatura, norteada pela questão: "Quais os resultados da aplicação da dramatização na aprendizagem\r\ndo estudante de Enfermagem?". Resultados: 64 estudos incluídos, 100% indicaram resultados positivos\r\ncom a utilização da dramatização, 77% evidenciaram melhora na aquisição de conhecimento teórico, 66%\r\nna associação entre teoria e prática, 45% no pensamento crítico e 30% no relacionamento interpessoal. Em\r\n13% estudos a dramatização foi associada com difi culdades do aluno no estabelecimento de prioridades\r\ne embaraço pelo medo de exposição no grupo. Conclusão: A dramatização contribuiu na construção das\r\ncompetências profi ssionais estimulando a aprendizagem, o desenvolvimento de habilidades técnicas e\r\ncomunicacionais, a criatividade, o pensamento crítico e o relacionamento interpessoal

The need to support education practices, promoting transforming actions, drives the educator in\r\nsearch for innovative teaching methods and the role playing favors students' learning in an active and\r\nparticipative fashion. Objectives: To identify studies related with the use of role playing and to check the\r\nresults of using such strategy in the learning of nursing students. Methodology: Systematic literature \r\nreview guided by the question: "What are the results of the use of role playing in the learning of nursing\r\nstudent?". Results: Included 64 studies, 100% showed positive results with the use of role playing, 77%\r\nassociated positive correlation with acquisition of theoretical knowledge, 66% described improvement in\r\nthe association between theory and practice, 45% related improvement of critical thinking, 30% resulted\r\nin improvement of interpersonal relationship. Difficulties were mentioned in 13% studies, associated with\r\nstudents' embarrassment because of fear of public exposure and to define priorities. Conclusion: The role\r\nplaying increases the professional competences when favors learning, collaborates in the development of\r\ntechnical and communication skills, enhances the perception of human beings within a holistic fashion,\r\nstimulating creativity, critical thinking and interpersonal relationship

La necesidad de fundamentar las prácticas en educación, promoviendo una acción transformadora\r\nimpulsiona el educador por la búsqueda de métodos de enseñanza innovadores y la dramatización\r\nfavorece el aprendizaje del estudiante en forma activa y participativa. Objetivos: Levantar los estudios\r\nrelacionados a la aplicación de la dramatización como estrategia en el proceso de enseñanza-aprendizaje\r\ny verificar los resultados de la utilización en el aprendizaje del estudiante de Enfermería. Metodología:\r\nRevisión sistemática de literatura, orientada bajo la cuestión ¿Cuáles son los resultados de la aplicación\r\nde la dramatización en el aprendizaje del estudiante de Enfermería?. Resultados: Entre los 64 estúdios\r\nincluidos, 100% evidenciaron resultados positivos con la utilización de la dramatización, 77% presentaron la\r\nadquisición del conocimiento en el aspecto teórico, 66% en la asociación entre la teoria y la práctica, 45%\r\nen el pensamiento crítico, 30% en el relacionamiento interpersonal. Las dificultades sobre la proposición\r\nde la actividad dramatizada fueron mencionados en 13% estúdios, asociados a la verguenza del alumno y\r\ndificultades por parte de los estudiantes en establecer prioridades. Conclusión: La dramatización favorece\r\nla construcción de competencias profesionales, colabora en el desenvolvimiento de habilidades técnicas\r\ny de comunicación, estimula la creatividad, el pensamiento crítico y el relacionamiento interpersonal.

Uso do Role-Playing Game no treinamento de habilidade de enfrentamento das situações de risco para o uso de drogas / Use of Role-Playing Game in skills training to cope with situations of risk for drug use / Uso del juego de rol en el entrenamiento de habilidad para enfrentar las situaciones de riesgo para el uso de drogas

O Role-Playing Game (RPG) é uma intervenção lúdica que pode favorecer o treinamento de habilidades de enfrentamento (THE). O objetivo deste estudo foi avaliar a eficácia do uso do RPG no THE das situações de risco para o uso de drogas, mais especificamente, avaliar a autoconfiança do usuário para resistir a esse uso nessas situações. Estudo exploratório, randomizado e constituído por grupos controle e experimental, com cinco usuários em cada. Os participantes estavam internados em uma instituição privada. Os instrumentos utilizados foram: Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) e Brief Situational Confidence Questionnaire (BSCQ). A análise de dados foi realizada por meio da análise de variância com medidas repetidas. A intervenção ocorreu ao longo de quatro semanas, com um encontro semanal e no formato de grupo. Os resultados apontam que o THE proporcionou aumento da autoconfiança dos participantes no enfrentamento de diferentes situações de risco que desencadeiam o uso de drogas, especialmente diante de situações de conflitos pessoais, familiares e sociais; houve também aumento da autoconfiança para recusar o uso de droga em situações que a usava descontroladamente. O RPG pode ser uma ferramenta útil e complementar para THE das situações de risco para o uso de drogas.(AU)

The Role-Playing Game (RPG) is a playful intervention that may favor both through Coping Skills Training (CST), provided by role playing. The aim of this study was to evaluate the efficacy of RPG in CST for drug use risk situations, more specifically, evaluate the user's self-confidence to resist to this use in these situations. It is an exploratory, randomized study and consisted of control and experimental groups with five members each. Participants were admitted to a private institution. The instruments used were: Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and Brief Situational Confidence Questionnaire (BSCQ). Data analysis was performed using analysis of variance with repeated measures. The intervention took place over four weeks, with a weekly meeting and group format. The results indicate that the intervention provided an increase in participants' self-confidence in facing different risk situations that trigger drug use, especially in situations of personal, family and social conflicts; moreover, there was also an increase in self-confidence to refuse drug use in uncontrolled situations. RPG can be an useful and a complementary tool for CST for drug use risk situations.(AU)

El Role Playing Game (RPG) es una intervención lúdica que puede favorecer el entrenamiento de habilidades de enfrentamiento (EHE). El objetivo de este estudio fue evaluar la eficacia del uso del RPG en el EHE de las situaciones de riesgo para el uso de drogas, más específicamente, evaluar la autoconfianza del usuario para resistir ese uso en esas situaciones. Estudio exploratorio, randomizado y constituido por grupos control y experimental, con cinco usuarios en cada uno. Los participantes estaban internados en una institución privada. Los instrumentos utilizados fueron: Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) y Brief Situational Confidence Questionnaire (BSCQ). El análisis de datos fue realizado por medio del análisis de varianza con medidas repetidas. La intervención ocurrió a lo largo de cuatro semanas, con un encuentro semanal y en el formato de grupo. Los resultados apuntan que EHE proporcionó un aumento de la auto-confianza de los participantes en el enfrentamiento de diferentes situaciones de riesgo que desencadenan el uso de drogas, especialmente ante situaciones de conflictos personales, familiares y sociales; hubo también un aumento de la auto-confianza para rechazar el uso de drogas en situaciones que la usaban descontroladamente. El RPG puede ser una herramienta útil y complementaria para EHE de las situaciones de riesgo para el uso de drogas.(AU)

Avosidade nos desenhos animados ocidentais: estilos de avós com netos adolescentes / Grandparenthood in western cartoons: grandparent styles with teen grandchildren

O presente artigo objetivou analisar os tipos de relações entre avós idosos e netos adolescentes exibidos em desenhos animados de longa metragem da filmografia ocidental. Foi realizada a busca dos desenhos nos sites de companhias cinematográficas, lançados no período de 1950 a 2015, que mostrassem essa relação de avosidade. Os filmes foram selecionados através da leitura das sinopses, visualização dos respectivos trailers e, posteriormente, dos filmes escolhidos. Os avós mostrados nos filmes foram analisados através de adaptação da escala de Responsividade e Exigência. Os estilos de avós encontrados foram classificados em quatro tipos: autoritativo, autoritário, indulgente ou negligente. Preencheram os critérios de inclusão 17 desenhos animados. Observou-se predomínio de desenhos animados mostrando estilos de avós indulgentes, seguidos de autoritativo. Não foram encontradas relações autoritárias. (AU)

The present article aimed to analyze the types of relationships between older grandparents and teen grandchildren exhibited in feature film cartoons of the western filmography. The cartoons were searched on film companies' sites, in the period from 1950 to 2015, looking for those who showed grandparenthood relations. The films were selected through the reading of the synopsis, visualization of the respective trailers and, later, of the selected films. The grandparenthoods shown in the films were analyzed by adaptation of the scale of Responsiveness and Requirement, being classified into four types: authoritative, authoritarian, indulgent or negligent. There were 17 cartoons that met the criteria for inclusion. What can be observed is a predominance of cartoons showing indulgent grandparenthood relations, followed by authoritative. No authoritarian relationships were found. (AU)

Percepção de saúde, estilo de vida e comportamento ocupacional de estudantes universitários / Percepción de la salud, estilo de vida y el comportamiento ocupacional de los estudiantes universitarios / Health perception, lifestyle and occupational behaviour of university student

Este estudio tuvo como objetivo analizar la relación entre la percepción de la salud, estilo de vida y el comportamiento ocupacional de universitarios. La percepción de la salud se evaluó mediante una variable categórica con escala que va desde "muy bueno" a "muy malo". El estilo de vida y el comportamiento ocupacional fueron medidos por los instrumentos "Estilo de Vida Fantástico" y "Auto Evaluación del Funcionamiento Ocupacional". Los datos se sometieron a análisis descriptivo y la correlación con el nivel de 5% de confianza. La muestra fue constituida por 56 estudiantes, 87,5% son mujeres, edad media 20 años, y regularmente matriculados en los cursos de salud (85,7%). De estos estudiantes, 38,2% percibe su salud como "regular" a "muy malo" y 10,7% han clasificado su estilo de vida como "buena" y "necesitan mejorar". Se encontró diferencia entre el estilo de vida y la percepción de la salud (p=0,016). La percepción de la salud y el funcionamiento ocupacional tenía diferencia en Hábitos (p=0,028) y Medio Ambiente (p=0,040). Al comparar el funcionamiento ocupacional con el estilo de vida, ocurrió diferencias en la Causalidad Personal (p=0,039), Valores (p=0,001), Intereses (p=0,001) y Funciones (p=0,000). Los resultados del estudio apoyan la conclusión de que existen asociaciones significativas entre la auto percepción negativa de la salud con un peor estilo de vida y el comportamiento en el trabajo entre los estudiantes universitarios.

This current study aimed to anolyze the relationship between perception of health, lifestyle and occupational behavior of college students. The perception of health was evaluated using o categorical variable with sea/e rangingfrom 'Very good to Very bad The lifestyle and occupotional behavior were evaluated from the instruments "'Fantastic Lifestyle" for young adults and "Self-Assessment of Occupational Functioning". The data underwent descriptive analysis and correlation, having a 5% level of confidence. The sample was composed of 56 college students predominantly of women (87.5%) with mean age of 20 and enrolled in health courses (85.7%). Of these students, 38.2% perceive their health as being from "Regular to Real/y bod" and 10.7% have lifestyle classifted from 'it needs improvement to good There was difference between lifestyle and health perception (p=O.076),indicating that students who perceive their health as "very had to regular" have lifestyle "good improvement need". The perception of health and occupational functioning was different for the components: habits (p=0.028) and environment (p=O.040). When comparing occupational functioning with the lifestyle, was no difference in causality staff (pmO.039), values(p-0.007),interests (p=O.007)and roles (pm0,000).Signiftcant associations were found between negative self-perception of health with a worse lifestyle and occupational hehavior.

A Literature Review of the Studies on Cultural Competency of Nurses and Nursing Students in Korea

PURPOSE: The purpose of this study is to identify trends in research on cultural competency of nursing students and nurses in Korea and to provide suggestions for future studies. METHODS: A literature search was conducted with 432 papers published between 1985 and 2016 from five electronic databases and other sources using such key words as ‘cultural competency’, ‘cultural nursing’, ‘multi-cultural competency’, ‘nursing students’, ‘nurses’, etc. RESULTS: The research design of 86 nursing researches on the cultural competence of nurses and nursing students analyzed in this study was 90.7% in quantitative research, 9.3% in qualitative research, and 2.3% in mixed research. Cultural competence was the most measured concept. A total of 41 papers (47.7%) out of 86 papers were used to measure cultural competence. Ten different tools were used various instruments of cultural competency were used in 41 papers. In 11 experimental studies, new methods such as role playing, case study, four stage 3D puzzle model, newspaper reading, and writing reflection note were used other than traditional method of lecture. CONCLUSION: The overall findings of this study suggest that future research should include more well-designed experimental studies, qualitative studies and repeated studies to confirm the effects of findings from previous studies. Development of effective and highly diverse teaching methods is recommended to increase cultural competency. Supporting systems and funding are required to help activate research of nurses.

The effects of an empathy role-playing program for operating room nursing students in Iran / 보건의료교육평가

PURPOSE: The purpose of this study was to investigate the effects of a role-playing training program conducted among operating room nursing students on empathetic communication with patients through measurements of empathy scores. METHODS: This study was carried out among 77 operating room nursing students from the first to the fourth years studying at the School of Nursing and Midwifery of Isfahan University of Medical Sciences in the academic year 2017–2018. The intervention administered to the experimental group included a 12-hour training program on expressing empathy to patients that incorporated role-playing. The Jefferson Scale of Empathy-Health Profession Student version was completed by the participants before, immediately after, and 1 month after the intervention. A comparative analysis of these 3 time points was conducted. RESULTS: No significant difference was found in the total pre-intervention mean empathy scores before the intervention between the control group and the experimental group (P=0.50). However, the total mean empathy scores in the experimental group immediately after and 1 month after the intervention were higher than those in the control group (P<0.001). CONCLUSION: Empathy training through a role-playing technique was effective at improving the empathy scores of operating room nursing students, and this finding also underscores the fact that empathy can be promoted by education. Changing the educational curriculum of operating room nursing students is suggested in order to familiarize them with the concept of empathy in the operating room.

Effects of Module Development and Role Play Course on Clinical Practice Examination Scores during a 4th Year Clerkship / 가정의학회지

BACKGROUND: After introduction of clinical skills assessment in the Korean Medical Licensing Examination, medical schools have reinforced both experiential learning with real patients and preparatory programs. This study was conducted to investigate whether a clinical practice examination (CPX) preparation program improves students' CPX score in terms of case specificity. METHODS: One hundred and thirteen senior students in a medical school participated in this study. During the fourth-year clerkship, 28 students (24.8%) from three rotation groups took a 3-day CPX preparation course consisting of module development, role play, and comprehensive physical exam skills training. Eleven rotation groups (n=85) were compared as control. Both the intervention and control group took two comprehensive CPXs before and after the clerkship was completed. RESULTS: There was no significant difference in age, sex, and school type between the two groups. On pre-test CPX, there was no significant difference in total and sectional scores between the two groups. On post-test CPX, total scores of the intervention group were higher than those of the control groups (69.5±4.3 vs. 67.5±4.4, P < 0.05). History taking scores were higher in intervention groups (70.0±6.0 vs. 66.0±6.6, P=0.01). The station scores of vaginal discharge with case similarity were higher in the intervention groups (73.0±6.3 vs. 68.9±9.3, P=0.03). CONCLUSION: A short CPX preparation course improved history taking ability, but its effect was greater only in a specific case, similar to the pre-course case. Whether this effect was due to the test experience or true improvement in competency requires further investigation.

Role-playing: teaching strategy that encourages reflections on nursing care / Role-playing: estrategia de enseñanza que propicia reflexiones sobre la atención de enfermeira / Role-playing: estratégia de ensino que propicia reflexões sobre o cuidado de enfermagem

ABSTRACT Objective: Describe the reflections of nursing students on nursing care through the use of role-playing. Method: Qualitative research with descriptive-exploratory approach and documentary base. The data were collected from portfolios of 32 students from an undergraduate course in the Southern Brazil. The analysis of the data followed the steps of sorting, classification in structures of relevance, synthesis and interpretation. Results: Two empirical categories were obtained: (1) Feelings in the act of taking care and receiving care and (2) Reversing roles: benefits to the nurse in the act of caring. Final considerations: The use of role-playing as a strategy for teaching the theme of care to undergraduate students encouraged reflections about the skills and abilities necessary for the act of taking care and favored the students' self-perception as nurses, appropriating the essence of their future profession: care.

RESUMEN Objetivo: Describir las reflexiones de estudiantes de enfermería sobre la atención de enfermería a partir del uso del role-playing. Método: Investigación cualitativa con enfoque descriptivo-exploratorio y de base documental. Los datos fueron recolectados a partir de los portafolios de 32 alumnos de un curso de graduación de la región Sur. El análisis de los datos siguió las etapas de ordenación, clasificación en estructuras de relevancia, síntesis e interpretación. Resultados: Se obtuvieron dos categorías empíricas: (1) Sentimientos en el acto de cuidar y ser cuidado; y (2) Inversión de papeles: beneficios en ser enfermero en el acto de atención. Consideraciones finales: El uso del role-playing como estrategia de enseñanza para alumnos de la graduación en la temática del cuidado colaboró para despertar reflexiones acerca de las competencias y de las habilidades necesarias para el acto de cuidar, así como para que los alumnos pudieran "percibirse" como enfermeros, apropiados de la esencia de su futura profesión: la atención.

RESUMO Objetivo: Descrever as reflexões de estudantes de enfermagem sobre o cuidado de enfermagem a partir do uso do role-playing. Método: Pesquisa qualitativa com abordagem descritivo-exploratória e de base documental. Os dados foram coletados a partir dos portfólios de 32 alunos de um curso de graduação da região Sul. A análise dos dados seguiu as etapas de ordenação, classificação em estruturas de relevância, síntese e interpretação. Resultados: Obtiveram-se duas categorias empíricas: (1) Sentimentos no ato de cuidar e ser cuidado e (2) Invertendo papéis: benefícios para o ser enfermeiro no ato de cuidar. Considerações finais: O uso do role-playing como estratégia de ensino para alunos da graduação na temática do cuidado colaborou para despertar reflexões acerca das competências e habilidades necessárias para o ato de cuidar, como também para que os alunos pudessem se "perceber" como enfermeiros, apropriados da essência de sua futura profissão: o cuidado.

Effect of Stepwise Communication Education Program using SBAR among Nursing Students: Focusing on Scenarios and Nursing Case-based Role Playing / 한국간호교육학회지

PURPOSE: This study intends to examine the effects of a stepwise communication education program among nursing college students, focusing on scenarios and nursing case-based role playing. METHODS: The study design was a one-group repeated measure ANOVA. Participants were 27 nursing students in practice. Students participated in 5-week stepwise communication education program using SBAR; including 1 week of lecture education, 4 weeks of scenarios and nursing case-based role playing. The data were collected at each level of the education process: pre-education, after 1 week of lectures, and after completion of scenarios and nursing case-based role playing. Repeated measures ANOVA was used to determine changes in SBAR technique knowledge and communication self-efficacy. RESULTS: The stepwise communication education program using SBAR was effective in increasing SBAR technique knowledge, and communication self-efficacy. The lecture-based education was effective only in the area of SBAR technique knowledge and its subscale, attitudes towards SBAR. However, scenarios and nursing case-based role playing was broadly effective across communication self-efficacy, SBAR technique knowledge, and its subscale, knowledge of the SBAR. CONCLUSION: Based on this study, we propose that it is necessary to confirm the effect of long-term SBAR communication education using scenarios and nursing case-based role playing in nursing students' practice.

O eu em cena: o jogo no psicodrama e os jogos eletrônicos / The self in action: the game in psychodrama and electronic games / El yo en escena: el juego en el psicodrama y los juegos electrónicos

A partir de ensaio gerado durante a dissertação de Mestrado "Atores em ação: O jogo no Psicodrama e os jogos eletrônicos", retratamos as mutualidades entre os enredos que fluem no palco psicodramático e as teias que emanam da plataforma digital. Nas articulações entre os jogos psicodramáticos e eletrônicos encontramos entrelaçamentos dos contextos de representação da fantasia-realidade em cenários lúdicos de dramatização, em que protagonistas, egos auxiliares e objetos intermediários são equivalentes a atores de papéis, avatares e objetos não humanos.

Based on an essay "Actors in Action: The Game in Psychodrama and Electronic Games" wrote in a Master's Degree dissertation, we have shown the mutuality between the plots that take place on a psychodrama stage and the networks that arise from a digital platform. In the articulations between psychodrama and electronic games, we have found the interlacement of the contexts of fantasy-reality representations in ludic scenarios of dramatisation, in which the protagonists, the supporting egos and the intermediate objects are equivalent to the role players, the avatars and the non-human objects.

A partir del ensayo producido durante la disertación del máster "Actores en Acción: El Juego en el Psicodrama y los Juegos Electrónicos", retratamos las mutualidades entre los enredos que fluyen en el escenario psicodramático y las telas que emanan de la plataforma digital. En las articulaciones entre los juegos psicodramáticos y electrónicos, encontramos entrelazamientos de los contextos de representación de la fantasía-realidad en los escenarios lúdicos de dramatización a los cuales los protagonistas, los egos auxiliares y los objetos intermediarios equivalen a los actores de papeles, los avatares y los objetos no-humanos.

Acurácia das características definidoras do diagnóstico de enfermagem Desempenho do Papel Ineficaz / Accuracy of defining characteristics of the nursing diagnosis Ineffective Role Performance

A pesquisa tem o objetivo de verificar a acurácia das características definidoras do diagnóstico de enfermagem Desempenho do Papel Ineficaz em puérperas. Trata-se de um estudo de acurácia diagnóstica realizado com 58 mulheres atendidas em Unidades de Saúde da Família (USF). Utilizou-se uma escala de rastreamento de Depressão Pós-parto para a identificação das características definidoras do referido diagnóstico. Foram calculadas as medidas de sensibilidade, especificidade e seus respectivos intervalos de confiança. O Desempenho do Papel Ineficaz esteve presente em 50,0% das participantes. As características definidoras Adaptação inadequada à mudança, Autocontrole insuficiente e Percepção de papel alteradas apresentaram, simultaneamente, sensibilidade e especificidade significantes, em termos estatísticos. Portanto, tais indicadores clínicos mostraram-se mais acurados para a verificação do diagnóstico de enfermagem Desempenho do papel ineficaz em puérperas.

The study objective was to verify the accuracy of the defining characteristics of the nursing diagnosis Ineffective Role Performance in pregnant women. This is an accuracy diagnosis study conducted with 58 women attended in Family Health Units (FHU). We used a tracking scale for Postpartum Depression to identify the defining characteristics of the referred diagnosis. We calculated sensitivity, specificity measures, and their respective confidence intervals. The Ineffective Role Performance was present in 50.0% of participants. The defining characteristics Inadequate adaptation to change, Insufficient self-management, and Alteration in role perception simultaneously presented, significant sensitivity and specificity, in statistical terms. Therefore, such clinical indexes were more accurate to verify the nursing diagnosis Ineffective Role Performance in pregnant women.

Effects of a Cognitive Rehearsal Program on Interpersonal Relationships, Workplace Bullying, Symptom Experience, and Turnover Intention among Nurses: A Randomized Controlled Trial

PURPOSE: This research aimed to investigate the effects of a cognitive rehearsal program (CRP) on workplace bullying among nurses. METHODS: A randomized controlled trial was performed. Participants were 40 nurses working in different university hospitals in B city, South Korea. The experimental group was provided with a 20-hour CRP comprising scenarios on bullying situations, standard communication, and role-playing. To evaluate effects of the CRP, we measured interpersonal relationships, workplace bullying, symptom experience, and turnover intention at preand post-intervention. Follow-up effect was measured in the experimental group only at 4 weeks after the intervention. RESULTS: After the intervention, there were significant differences in interpersonal relationships (F=6.21, p=.022) and turnover intention (F=5.55, p=.024) between experimental and wait-list groups. However, there was no significant difference in workplace bullying or symptom experience between the 2 groups. The beneficial effects on interpersonal relationships and turnover intention lasted at least up to 4 weeks after CRP. CONCLUSION: The CRP for workplace bullying improves interpersonal relationships and decreases turnover intention. So it can be utilized as one of the personal coping strategies to reduce the the turnover among nurses. Further studies on the effects of unit- or hospital-based CRP and on the long-term effects of CRP are necessary.