Estrés y espiritualidad relacionado con la sobrecarga en cuidadores de adultos mayores con dependencia total / Stress and Spirituality Related to Overload in Caregivers of Totally Dependent Older Adults

Introducción: La población adulta mayor requiere atención por los cambios del envejecimiento, la atención que los cuidadores otorgan al adulto mayor dependiente suele generar estrés; los cuidadores recurren a la espiritualidad para afrontar la sobrecarga y estresores del cuidado. Objetivo: Relacionar el estrés y la espiritualidad con la sobrecarga en cuidadores de adultos mayores con dependencia total. Métodos: Se realizó un estudio descriptivo y correlacional en una población de cuidadores de adultos mayores de un centro comunitario de jurisdicción sanitaria en Heroica Matamoros, Tamaulipas, México, entre enero y julio del 2021. Muestra de 75 participantes para una población infinita, se aplicó muestreo por conveniencia. Se aplicó una cédula de datos personales, la Escala de Estrés Percibido, el Cuestionario de Espiritualidad y la Escala de Zarit. Los datos se analizaron en el paquete estadístico SPSS versión-21, se utilizó estadística descriptiva y se realizó correlación de Spearman. Resultados: El 56 por ciento de los cuidadores son hijos o hijas del adulto mayor dependiente, en promedio tuvieron 5,21 (DE= 3,68) horas al día dedicadas al cuidado y 7,67 (DE= 2,28) meses. Se encontró relación entre el estrés y la sobrecarga del cuidador (rs= 0,462; p= 0,000), no hubo relación entre la espiritualidad global y la sobrecarga del cuidador (rs= -0,169; p= 0,147). Conclusiones: A pesar de que la relación entre la espiritualidad global y la sobrecarga del cuidador no fue significativa, se observó relación entre el estrés y sobrecarga del cuidador(AU)

Introduction: The older adult population requires attention because of the changes as a result of aging. The caregivers' attention provided to dependent older adults often produces stress. Caregivers turn to spirituality to cope with the overload and stressors of caregiving. Objective: To relate stress and spirituality with overload in caregivers of totally dependent older adults. Methods: A descriptive and correlational study was conducted with a population of caregivers of older adults from a community health jurisdiction center in Heroica Matamoros, Tamaulipas, Mexico, between January and July 2021. Through convenience sampling, 75 participants made up a sample obtained as an infinite population. A personal data questionnaire, the Perceived Stress Scale, the Spirituality Questionnaire and the Zarit scale were applied. The data were analyzed using the statistical package SPSS (version 21), descriptive statistics were used and Spearman's correlation was performed. Results: 56 percent of the caregivers were children to dependent older adults, who were, on average, 5.21 (SD = 3.68) daily hours or 7.67 (SD = 2.28) months dedicated to caregiving. A relationship was found between stress and caregiver overload (rs= 0.462; p= 0.000). There was no relationship between overall spirituality and caregiver overload (rs= -0.169; p= 0.147). Conclusions: Although the relationship between overall spirituality and caregiver overload was not significant, there was a relationship between stress and caregiver overload(AU)

Salud mental y COVID-19 en estudiantes de enfermería / Mental Health and COVID-19 in Nursing Students

Introducción: La salud mental de los estudiantes de enfermería en tiempos de COVID-19 ha tenido diversas afectaciones, lo que implica un desafío para la formación. Por ser un tema emergente, es necesario integrar en una perspectiva unitaria los estudios más relevantes, para vislumbrar los impactos inmediatos de la pandemia y las acciones que se han emprendido. Objetivo: Analizar la evidencia científica disponible sobre la salud mental de estudiantes de enfermería en el contexto de la pandemia por COVID-19. Métodos: Revisión integrativa realizada durante febrero y marzo de 2021, en las bases de datos Scopus, ScienceDirect, Lilacs, PubMed, CINHAL, Web of Science, SciELO y PsycINFO. La ecuación de búsqueda incluyó los términos Medical Subject Headings (MeSH): "Mental Health", "COVID-19" y "Students, Nursing", combinados con el operador booleano AND. Se evaluaron estudios primarios y secundarios con diferentes enfoques o metodologías en idioma español, inglés o portugués, con disponibilidad de texto completo, publicados hasta la fecha de revisión. Se excluyeron artículos de opinión y cartas al editor. De un total de 535 artículos, se incluyeron 25. Se realizó análisis de contenido cualitativo. Conclusiones: Se identificaron impactos inmediatos en las emociones, estados de ánimo y trastornos emocionales como ansiedad, estrés y depresión; todos ellos mediados por determinantes sociales, biológicos y psicológicos. Las acciones emprendidas están relacionadas con estrategias de afrontamiento y respuestas institucionales(AU)

Introduction: The mental health of nursing students in times of COVID-19 has had diverse issues, which implies a challenge for training. Being an emerging matter, it is necessary to integrate in a unitary perspective the most relevant studies, to glimpse the immediate impacts of the pandemic and the actions that have been undertaken. Objective: To analyze the available scientific evidence on the mental health of nursing students in the context of the COVID-19 pandemic. Methods: Integrative review conducted during February and March 2021 in the databases Scopus, ScienceDirect, Lilacs, PubMed, CINHAL, Web of Science, SciELO and PsycINFO. The search equation included the terms Medical Subject Headings (MeSH): "Mental Health", "COVID-19" and "Students, Nursing", combined with the Boolean operator AND. We evaluated primary and secondary studies with different approaches or methodologies in Spanish, English or Portuguese, with full text availability, published up to the review date. Opinion articles and letters to the editor were excluded. From a total of 535 articles, 25 were included. Qualitative content analysis was performed. Conclusions: Immediate impacts on emotions, mood states and emotional disorders such as anxiety, stress and depression were identified; all mediated by social, biological and psychological determinants. Actions taken are related to coping strategies and institutional responses(AU)

Burden, family functioning, and psychological health of older caregivers of older adults: a path analysis / Sobrecarga, funcionalidade familiar e saúde psicológica de idosos cuidadores de idosos: uma path analysis

Objectives: To evaluate an explanatory model of direct and indirect associations regarding the psychological health of older caregivers of functionally dependent older adults. Methods: This is a cross-sectional study performed with older caregivers recruited in contexts of outpatient and home care. We collected information on sociodemographic characteristics, duration of caregiving, physical and cognitive function indicators of the older care recipients, perceived burden, family functioning, and psychological health measures (psychological need satisfaction and depressive symptoms). Results: We evaluated 133 caregivers (76% female, 69.5 ± 6.98 years). Variables that were significantly correlated with psychological health were selected to form an association model to be tested by structural equation modeling via path analysis. Depressive symptom variability was best explained by this model. Caregiver burden remained in the model as a mediator of indirect associations between physical function for instrumental activities of daily living and indicators of family functioning and psychological health. Three associative paths between caregiver burden and depressive symptoms were found ­ one of them was direct and the other two were mediated whether by family functioning or by the level of psychological need satisfaction. Conclusion: Depressive symptoms were the psychological health indicator best explained by the model involving instrumental functional demands that generate burden. Clinical consequences suggested by the model indicate interventions aimed at family functioning and opportunities of psychological need satisfaction as strategies for promoting caregivers' psychological health.

Objetivos: Avaliar um modelo de associações diretas e indiretas explicativo de saúde psicológica de idosos cuidadores de outros idosos funcionalmente dependentes. Metodologia: Estudo transversal realizado com idosos cuidadores recrutados em contexto ambulatorial e de atenção domiciliar. Foram levantadas informações sociodemográficas, tempo de exercício do cuidado, indicadores funcionais físicos e cognitivos dos idosos que recebem os cuidados, percepção de sobrecarga, funcionalidade familiar e medidas de saúde psicológica (satisfação de necessidades psicológicas e sintomatologia depressiva). Resultados: Foram avaliados 133 cuidadores (76% feminino, 69,5 ± 6,98 anos). As variáveis correlacionadas significativamente à saúde psicológica foram escolhidas para a composição do modelo de associações testado por análise de equações estruturais via path analysis. A variabilidade em sintomatologia depressiva foi melhor explicada pelo modelo. Sobrecarga permaneceu no modelo como mediadora das associações indiretas entre funcionalidade física para atividades instrumentais da vida diária e os indicadores de funcionalidade familiar e de saúde psicológica. Três caminhos associativos entre sobrecarga e sintomatologia depressiva foram encontrados ­ um direto e dois mediados, ora pela funcionalidade familiar, ora pelo nível de satisfação de necessidades psicológicas. Conclusão: Sintomatologia depressiva foi o indicador de saúde psicológica mais bem explicado pelo modelo que envolve a presença de demandas funcionais instrumentais geradoras de sobrecarga. Desdobramentos clínicos sugeridos pelo modelo apontam para intervenções com alvo em funcionalidade familiar e de oportunidades de satisfação de necessidades psicológicas como estratégias para promover a saúde psicológica do cuidador.

Hábitos de vida y rendimiento académico en periodo evaluativo en estudiantes de enfermería / Life Habits and Academic Performance during the Examination Period in Nursing Students

Introducción: Los hábitos de vida de los estudiantes universitarios, con poco tiempo para su realización debido al estrés académico, prácticas, horario de clase y estudio, suelen ser poco saludables, por tanto, pueden influir negativamente en el rendimiento académico. Objetivo: Analizar los hábitos de vida en periodo evaluativo y su influencia en el rendimiento académico en estudiantes universitarios del grado en enfermería. Métodos: Estudio observacional descriptivo de tipo transversal realizado en el momento del examen a 488 estudiantes de los cuatro cursos del grado en enfermería de una universidad al sur de España, en el curso académico 2018. Los instrumentos empleados fueron: un cuestionario con datos sociodemográficos y otro cuestionario de hábitos de estilo de vida. El análisis de la información se realizó través de estadísticos descriptivos, pruebas paramétricas y no paramétricas y correlación lineal. Se respetaron las consideraciones éticas para estudios con humanos. Resultados: El 53,30 por ciento de la muestra realizaba ejercicio físico de forma regular, siendo similar en los cuatro cursos evaluados para los hombres mientras que en las mujeres aumentó de 31,11 por ciento en 1º a 61,26 por ciento en 4º curso. No diferencias relevantes en el rendimiento académico según variables de estilo de vida excepto sueño. Conclusiones: Las horas de sueño dormidas, sobre todo la semana previa al examen se relacionan con mayor rendimiento académico. Nuestros resultados sugieren que los estilos de vida menos saludables conllevan a peor rendimiento académico(AU)

Introduction: The life habits of university students, with little time to carry them out due to academic stress, practices, class and study hours, are usually unhealthy; therefore, they can influence academic performance negatively. Objective: To analyze life habits in the evaluation period and their influence on academic performance in university students of the Nursing degree. Methods: Descriptive, cross-sectional and observational study carried out, in the academic year 2018, at the time of examination with 488 students from the four courses of the Nursing degree from a university in southern Spain. The instruments used were a questionnaire with sociodemographic data and another lifestyle habits quiz. Information analysis was carried out through descriptive statistics, parametric and nonparametric tests, and linear correlation. Ethical considerations for human studies were respected. Results: 53.30 percent of the sample did physical exercise on a regular basis, being similar for men in the four courses assessed, while for women it increased from 31.11 percent in first academic year to 61.26 percent in the fourth academic year. There were no relevant differences in academic performance according to lifestyle variables except sleep. Conclusions: The hours of sleep per se, especially during the week before the exam, are related to higher academic performance. Our results suggest that less healthy lifestyles lead to poorer academic performance(AU)

Factors associated with stress, anxiety, and depression during social distancing in Brazil

ABSTRACT OBJECTIVE To estimate the prevalence of clinical signs and symptoms of severe/extreme stress, anxiety, and depression, as well as their associated factors, among Brazilians during social distancing. METHODS This is a cross-sectional study conducted in April/May 2020 with 3,200 Brazilians over 18 years old. Respondents' sociodemographic and clinical data were collected using an online questionnaire, which also included the 21-item Depression, Anxiety and Stress Scale (DASS-21) to assess emotional symptoms. Unadjusted and adjusted prevalence ratios and their respective 95% confidence intervals were estimated using Poisson regression models with robust variance. RESULTS Our results show the prevalence of severe/extreme stress was 21.5%, anxiety 19.4%, and depression 21.5%. In the final model, sociodemographic, clinical, and Covid-19-related factors were associated with severe/extreme stress, anxiety, and depression in Brazilians during social distancing due to the Covid-19 pandemic. We found the main factors associated with severe/extreme depression to be young women, brown, single, not religious, sedentary, presenting reduced leisure activities, history of anxiety and depression, increased medication use, and Covid-19 symptoms. CONCLUSION This study may help develop and systematically plan measures aimed to prevent, early identify, and properly manage clinical signs and symptoms of stress, anxiety, and depression during the Covid-19 pandemic.

Segundas víctimas: calidad de soporte percibido y su relación con las consecuencias del evento adverso / Second victims: perceived support quality and its relationship with the consequences of the adverse event

INTRODUCCIÓN: Las segundas víctimas son aquellos trabajadores de salud que están involucrados en un Evento Adverso (EA) y presentan afección física, emocional, psicológica y/o laboral. Para evitar estas afecciones, es importante recibir medidas de soporte. El objetivo de este artículo es determinar qué relación existe entre las consecuencias de un EA sobre las segundas víctimas y la calidad de las medidas de soporte percibidas en instituciones de salud públicas y privadas de la Región Metropolitana durante el segundo semestre del año 2018. MATERIALES Y MÉTODO: Estudio cuantitativo, exploratorio, descriptivo, correlacional y transversal. A través de una plataforma online se aplicó una encuesta sociodemográfica e instrumento SVEST que consta de nueve dimensiones relacionadas con consecuencias del EA y calidad del soporte percibido (α=0,826). RESULTADOS: Muestra de 301 trabajadores de salud entre institución pública y privada, el 39,2% se involucró en un EA y de estos, el 73,0% manifestó ser Segunda Víctima. De estas segundas víctimas, 69,1% pertenece al sexo femenino y el 45,7% se desempeña como Profesional de Enfermería. Existe una relación negativa entre calidad de soporte percibido y consecuencia psicológica y laboral del EA (Público y Privado p<0,05) y un aumento del riesgo de tener consecuencias graves al recibir una baja calidad de soporte (OR=3,8; IC 95% 1.32-11.47). DISCUSIÓN: Es de gran importancia conocer este fenómeno y entregar medidas de soporte adecuadas a la Segunda Víctima, para disminuir el impacto físico, psicológico, emocional y/o laboral que conlleva involucrarse en un EA. (AU)

INTRODUCTION: The second victims are those health workers who are involved in an Adverse Event (AE) and display physical, emotional, psychological and / or work-related symptoms. To avoid these conditions, it is important to receive supportive measures. The objective of this arti-cle is to determine the relationship between the consequences of an AE on the second victims and the quality of the support measures received in public and private health institutions of the Metropolitan Region during the second semester of 2018. MATERIALS AND METHOD: Quantitative, exploratory, descriptive, correlational and transversal study. Through an online platform, a sociodemographic survey and SVEST instrument was conducted, consisting of 28 items on the Likert scale (1-5) and nine dimensions related to the consequences of the AE and the quality of the perceived support (α = 0.826). RESULTS: Of a sample of 301 health workers in public and private institution, 39.2% were invol-ved in an EA and of these, 73.0% manifested symptoms of Second Victims. Of these second victims, 69.1% were female and 45.7% worked in the Nursing Profession. There is a negative relationship between the quality of perceived support and the psychological and occupational consequence of AD (Public and Private p <0.05) and an increased risk of having serious con-sequences when receiving low quality of support (OR=3,8; IC 95% 1.32-11.47) DISCUSSIONS: It is of great importance to recognize this phenomenon and deliver adequate su-pport measures to the Second Victim, in order to reduce the physical, psychological, emotional and / or work impact involved in being involved in an AD. (AU)

Alteraciones psicológicas de trabajadores en un centro de aislamiento para casos sospechosos de COVID-19 / Alterações psicológicas de trabalhadores em centro de isolamento por casos suspeitos de COVID-19 / Psychological alterations experienced by workers in an COVID-19 quarantine facility

Introducción: A partir del rebrote de COVID-19 que desde el mes de noviembre de 2020 experimentó la nación, el grupo temporal para el enfrentamiento a la epidemia abrió nuevos centros de aislamiento con el objetivo principal de brindar atención médica integral y de enfermería a pacientes que han sido contacto de personas contagiadas con esta enfermedad. Objetivo: Identificar las alteraciones psicológicas más frecuentes experimentadas por médicos, personal de enfermería y estudiantes de Medicina en el centro de aislamiento ubicado en la Facultad de Medicina No. 2 de Santiago de Cuba. Método: Se realizó un estudio descriptivo a 150 trabajadores de la zona roja de este centro de aislamiento en el periodo comprendido desde el 1 de marzo al 31 de mayo de 2021, para lo cual se empleó una metodología mixta, con una estrategia de triangulación de datos en un sentido cuanticualitativo. Resultados: La alteración psicológica de la esfera afectiva que predominó en estos trabajadores fue la ansiedad con un 98 porciento entre los médicos y enfermeros y un 100 porciento entre los estudiantes. En cuanto a la esfera cognitiva se destacó la presencia de imágenes intrusivas en el 72 porciento de los médicos, el 68 porciento del personal de enfermería y el 54 porciento de los estudiantes. Mientras que en la esfera volitiva predominó la incomodidad por el uso de los medios de protección en el 100 porciento de los sujetos encuestados. Conclusiones: En el centro de aislamiento estudiado, se identifican alteraciones psicológicas en el personal médico, de enfermería y estudiantes de Medicina. Destacan como las más frecuentes: la ansiedad, el estrés, imágenes intrusivas, dificultad para concentrase, el consumo de sustancias lícitas y trastornos del sueño(AU).

Introduction: Since the outbreak of COVID-19 that the nation experienced in November 2020, the temporary group to confront the epidemic opened new COVID-19 quarantine facilities with the main objective of providing comprehensive medical and nursing care to patients who have been in contact with people infected with this disease. Objective: To identify the most frequent psychological alterations experienced by doctors, nursing staff and medical students in the isolation facilities located at the Faculty of Medicine No. 2 of Santiago de Cuba. Method: A descriptive study was carried out on 150 workers in the red zone of this facility in the period from March 1st to May 31st, 2021, for which a mixed methodology was used, with a data triangulation strategy in a quantitative sense. Results: The psychological alteration of the affective sphere that predominated in these workers was anxiety, with 98 percent among doctors and nurses and 100 percent among students. Regarding the cognitive sphere, the presence of intrusive images stood out in 72 percent of the doctors, 68 percent of the nursing staff and 54 percent of the students. While in the volitional sphere, discomfort due to the use of means of protection prevailed in 100 percent of the subjects surveyed. Conclusions: In the quarantine center studied, psychological alterations were identified in the medical staff, nursing staff and medical students. The most frequent ones that stand out were: anxiety, stress, intrusive images, difficulty concentrating, the use of legal substances and sleep disorders(AU).

Introdução: A partir do surto de COVID-19 que viveu o país desde novembro de 2020, o grupo temporário de enfrentamento à epidemia inaugurou novos centros de isolamento com o objetivo principal de prestar assistência médica e de enfermagem integral aos pacientes que estiveram em contato com pessoas infectadas com esta doença. Objetivo: Identificar as alterações psicológicas mais frequentes vivenciadas por médicos, enfermeiras e estudantes de Medicina no centro de isolamento localizado na Facultad de Medicina Nº 2 de Santiago de Cuba. Método: Foi realizado um estudo descritivo com 150 trabalhadores da zona vermelha deste centros de isolamento no período de 1º de março a 31 de maio de 2021, para o qual foi utilizada uma metodologia mista, com estratégia de triangulação de dados no sentido quantitativo. Resultados: A alteração psicológica da esfera afetiva que predominou nesses trabalhadores foi a ansiedade com 98 porcento entre médicos e enfermeiras e 100 porcento entre estudantes. Em relação à esfera cognitiva, a presença de imagens intrusivas destacou-se em 72 porcento dos médicos, 68 porcento da equipe de enfermagem e 54 porcento dos alunos. Já na esfera volitiva, o desconforto devido ao uso de meios de proteção prevaleceu em 100 porcento dos sujeitos pesquisados. Conclusões: No isolamento estudado, foram identificadas alterações psicológicas na equipe médica, equipe de enfermagem e estudantes de Medicina. Destacam-se os mais frequentes: ansiedade, estresse, imagens intrusivas, dificuldade de concentração, uso de substâncias lícitas e distúrbios do sono(AU).

Estresse discente em um curso de Fonoaudiologia / Student stress in a speech, language and hearing sciences undergraduate course

RESUMO Objetivo verificar a prevalência de estresse e os fatores associados à sua presença em discentes de um curso de Fonoaudiologia. Métodos participaram 105 discentes, maiores de 18 anos, de ambos os sexos, matriculados no curso de Fonoaudiologia de uma universidade federal. Foram excluídos os discentes que não estavam com a matrícula ativa durante o período da pesquisa. Todos responderam a um questionário sociodemográfico e ao Inventário de Sintomatologia de Stress de Lippi, que identifica os sintomas de estresse, bem como a sua respectiva fase e os sintomas predominantes. Os dados receberam tratamento estatístico, sendo estipulado o nível de significância de 5%. Resultados dentre os participantes, 77,1% apresentaram resultados sugestivos de estresse, sendo que, destes, 77,7% estavam na fase de "resistência", 18,5% na fase de "quase exaustão"; 2,5% na fase de "alerta"; e 1,2% na fase de "exaustão". Quanto à sintomatologia 64,2% apresentaram predominância de sintomas psicológicos, 18,5%, físicos e 17,3%, físicos e psicológicos. A análise estatística mostrou a presença significativamente superior de estresse entre as mulheres e entre os que não trabalhavam e a relação do estresse com o ano de estudo. Conclusão um elevado número de discentes de Fonoaudiologia foi identificado com estresse, sendo a fase de "resistência" a mais frequente, com prevalência de sintomas psicológicos. Os fatores associados ao estresse foram sexo, com maior prejuízo entre as mulheres, o fato de não exercerem atividade remunerada e o ano do curso em que estavam matriculados, sendo que no primeiro ano foi observada menor prevalência de estresse e no último ano, maior.

ABSTRACT Objective To verify the prevalence and factors associated with the presence of stress in students of a Speech, Language, and Hearing Sciences course. Methods 105 students participated, over 18 years old, of both sexes, enrolled in the Speech, Language and Hearing Sciences course at a Federal University. Students who were not active during participation in the research were excluded. All respond to a sociodemographic questionnaire and Lipp's Stress Symptoms Inventory, which identifies the symptoms of stress, as well as their s—pecific phase and the predominant symptoms. The data received statistical treatment being stipulated the significance level of 5%. Results 77.1% showed results suggestive of stress, of which 77.7% were in the "resistance" phase, 18.5% in the "almost exhaustion"; 2.5% in the "alarm"; and 1.2% in the "exhaustion". As for the symptomatology, 64.2% had a predominance of psychological symptoms, 18.5% physical, and 17.3% physical and psychological. The statistical analysis showed a significantly higher presence of stress among women and among those who do not work, and a relationship between stress and the study year. Conclusion A high number of Speech, Language and Hearing Sciences students with stress, was identified, with the "resistance" phase as the most frequent and the prevalence of psychological symptoms. The factors associated with stress were gender, which presented greater damages among women, the fact that students do not engage in paid work, and the year of the course they were enrolled. The first year had the lowest prevalence of stress, while the last year had the highest result.

Psychosocial impact of the COVID-19 pandemic on paediatric healthcare workers

INTRODUCTION@#Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre.@*METHODS@#This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress.@*RESULTS@#The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome.@*CONCLUSION@#A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.

Medición del estrés prequirúrgico en niños y preadolescentes que ingresan para cirugías de urgencia en el Hospital de Niños Sor María Ludovica de La Plata: estudio descriptivo / Measurement of pre-surgical stress in children and pre-adolescents admitted for emergency surgery in the Hospital de Niños Sor María Ludovica de La Plata: descriptive study

Introducción: como profesionales de la salud hemos observado distintas conductas en los pacientes pediátricos, sin psicoprofilaxis, que ingresan para ser intervenidos quirúrgicamente de urgencia; pacientes que, según su edad, su entorno social, familiar y cultural, podrán manifestar dichas conductas interpretadas como estrés, de distintas maneras. Objetivo: se midió el estrés prequirúrgico de los niños que fueron intervenidos quirúrgicamente de urgencia, los sábados y domingos por Guardia, en el Hospital de Niños Sor María Ludovica en la ciudad de La Plata. Materiales y métodos: hemos realizado un estudio piloto de diseño observacional, descriptivo, de corte transversal, aplicando para la recolección de datos la escala de YALE modificada (EAPY-m). Resultados: reclutamos 16 pacientes, de los cuales 10 fueron varones (62,50%), que ingresaron para ser tratados quirúrgicamente por las especialidades de traumatología y cirugía general en partes iguales. La mediana en edad fue de 7 años y la mediana en escolarización obligatoria de 6 años. Dentro de la muestra obtenida, un 56,25% concurrían a la escuela primaria y el 25% se encontraban en la etapa preescolar. La mitad de los niños tomaron como referente a su madre como la persona que lo calma y que les gustaría que estuviese presente en el momento previo a la cirugía. La conjunción de los resultados obtenidos ha superado los valores referenciales mínimos para la medición del estrés prequirúrgico: un 80% de los niños sufría de estrés prequirúrgico. Conclusiones: el estrés prequirúrgico es un hecho presente en los pacientes pediátricos que han sido incluidos en la realización del estudio, quedando en evidencia que la cirugía es un factor estresante para los niños. (AU)

Introduction: As health professionals, we have observed different behaviors in pediatric patients, without psychoprophylaxis, who are admitted for emergency surgery; patients who, according to their age, their social, family and cultural environment may manifest such behaviors interpreted as stress, in different ways. Objective: Therefore, the general objective of our research was to measure the presurgical stress of children who would undergo emergency surgery, on Saturdays and Sundays by guard, at the Sor María Ludovica children's hospital in the city of La Plata. Materials and methods: We have conducted a pilot study of observational, descriptive, cross-sectional design; applying the modified YALE scale (EArPY-m) for data collection. Results: We recruited 16 patients of which 10 were male (62.50%), who were admitted to be treated surgically by the specialties of traumatology and general surgery in equal parts. The median in age was 7 years and the median in compulsory schooling was 6 years. Within the sample obtained 56.25% attended primary school and 25% were in the preschool stage. 50% of the participants indicated that the mother was the one who calms them when they are nervous; while 43.75% was the mother who would like to be present at the time before surgery. The combination of the results obtained has exceeded the minimum reference values for the measurement of presurgical stress, 80% of children suffered from presurgical stress. Conclusions: We conclude that presurgical stress is a fact present in pediatric patients who have been included in the study, making it clear that surgery is a stressful factor for children. (AU)

Respuesta autonómica cardiovascular al estrés mental inducido por la prueba de cálculo aritmético / Autonomic cardiovascular response to mental stress induced by the arithmetic computation test

Introducción: El estrés mental agudo, así como los estados de ansiedad inducidos para influenciar la reactividad psicofisiológica en jóvenes sanos, aportan cambios en los patrones nerviosos que pueden ser medidos mediante la variabilidad de la frecuencia cardiaca. Objetivo: Determinar las diferencias en los parámetros lineales del balance autonómico cardiovascular en individuos jóvenes en estado basal y durante la prueba de cálculo aritmético. Métodos: Se realizó un estudio cuasi-experimental, sin grupo control de tipo antes y después, en el Laboratorio de Ciencias Básicas Biomédicas de la Universidad de Ciencias Médicas de Santiago de Cuba. Población y muestra de 10 sujetos. Se registró el trazado electrocardiográfico (5 min) durante el reposo y luego durante la prueba de cálculo aritmético. Resultados: Existieron diferencias significativas entre ambos estados en las variables frecuencia cardiaca (p = 0,005); mínima (p = 0,007); máxima (p = 0,005); intervalo RR (p = 0,005); stress index (p = 0,028); índice simpático (p = 0,005); bajas frecuencias (p = 0,005); relación LF/HF (p = 0,005); RMSSD (p = 0,007); NN50 (p = 0,008); pNN50 (p = 0,005); índice parasimpático (p = 0,005) y altas frecuencias (p = 0,005). El estrés mental provocó una disminución parasimpática y un predominio simpático uniforme en todos los sujetos participantes en el estudio. Conclusiones: Durante el estrés mental inducido por la prueba de cálculo aritmético la dinámica lineal de la respuesta autonómica cardiovascular experimenta un aumento en la actividad simpática y una disminución del tono parasimpático, traduciendo una respuesta adaptativa en la regulación de la función cardiovascular por el sistema nervioso autónomo(AU)

Introduction: Acute mental stress and states of anxiety induced to influence psychophysiological reactivity in healthy young people, result in changes in nervous patterns which may be measured in terms of heart rate variability. Objective: Determine the differences in linear parameters for autonomic cardiovascular balance in young individuals at baseline and during the arithmetic computation test. Methods: A non-observational quasi-experimental before-after study without a control group was conducted at the Basic Biomedical Sciences Laboratory of the University of Medical Sciences of Santiago de Cuba. The study population and sample was 10 subjects. The electrocardiographic tracing (5 min) was recorded at rest and then during the arithmetic computation test. Results: Significant differences were found between the two states as to the variables heart rate (p = 0.005), minimum (p = 0.007), maximum (p = 0.005), RR interval (p = 0.005), stress index (p = 0.028), sympathetic index (p = 0.005), low frequencies (p = 0.005), LF/HF ratio (p = 0.005), RMSSD (p = 0.007), NN50 (p = 0.008), pNN50 (p = 0.005), parasympathetic index (p = 0.005) and high frequencies (p = 0.005). Mental stress caused a parasympathetic reduction and uniform sympathetic predominance in all the subjects participating in the study. Conclusions: During the mental stress induced by the arithmetic computation test, the linear dynamic of the autonomic cardiovascular response experiences an increase in sympathetic activity and a reduction in parasympathetic tone, displaying an adaptive response in cardiovascular function regulation by the autonomous nervous system(AU)

Estrés y congestionamiento vial en universitarios costarricenses / Stress and Traffic Congestion in Costa Rican University Students

Introducción: Según el estado de la nación 2018, Costa Rica es el tercer país latinoamericano con mayor densidad vehicular; es solo superado por Argentina y México. Objetivo: Identificar los factores asociados al nivel de estrés por el congestionamiento en el traslado a la universidad en los estudiantes y los factores asociados a la presencia o ausencia de estrés por el congestionamiento en el traslado a la universidad. Métodos: Estudio observacional, analítico de corte transversal, donde participaron 420 estudiantes, quienes completaron las encuestas correspondientes, para evaluar el nivel de estrés que genera el congestionamiento vial en dicha población. Las variables asociadas a la presencia o ausencia de estrés fueron edad, rendimiento, traslado de casa a la universidad por la mañana, de casa a la universidad por la tarde, de casa a la universidad por la noche, carro, taxi, tren, bus y moto. Las asociadas al nivel fueron: sexo, cantón de residencia, la forma de traslado en carro, moto y tiempo de traslado. Resultados: Los estudiantes utilizaban como principal medio de transporte el bus. El rendimiento académico reportado por el 83 por ciento de la muestra estaba en el valor de 7. El 90 por ciento de los encuestados dijo presentar estrés asociado al congestionamiento vial. La presencia de estrés no estaba asociada al tiempo de traslado, el nivel de estrés sí lo estaba. Conclusión: El rendimiento académico está asociado a la presencia de estrés, no al nivel, o sea, que su existencia podría estar afectando la situación académica del estudiante(AU)

Introduction: According to the state of the nation 2018, Costa Rica is the third Latin American country with the highest traffic density; it is only surpassed by Argentina and Mexico. Objective: To identify the factors associated with level of stress in students due to congestion during their transit to the university and the factors associated with the presence or absence of stress due to the congestion in the transit to the university. Methods: An observational, analytical and cross-sectional study was carried put, with the participation of 420 students, who completed the corresponding surveys, which allowed assessing the level of stress generated by road congestion in the study population. The variables associated with the presence or absence of stress were age, academic performance, travel from home to university in the morning, from home to university in the afternoon, from home to university at night, car, taxi, train, bus and motorcycle. The variables associated with the level of stress were sex, canton of residence, the way of transportation by car, motorcycle, and travel time. Results: The students used the bus as their main means of transportation. The academic performance reported by 83 percent of the sample was in the value of 7. 90 percent of the respondents expressed that they present stress associated with road congestion. The presence of stress was not associated with travel time; the stress level was. Conclusion: Academic performance is associated with the presence of stress, not with the level of stress; that is, its existence could be affecting the student's academic situation(AU)

Instrumento de identificación de factores estresantes percibidos por pacientes en unidad de cuidados intensivos / An Instrument for Identifying Stressing Factor Perceived by Patients in the Intensive Care Unit

Introducción: Los estresores provocan diferentes respuestas bio-psicológicas. Identificando situaciones que generan estrés en pacientes en unidad de cuidado intensivo, es posible generar intervenciones positivas que mitiguen estos factores y mejoren su calidad de vida. Objetivo: Validar un instrumento de medición para la identificación de factores estresantes en la unidad de cuidados intensivos a partir del Enviromental Stressors Questionnaire en español. Métodos: Investigación psicométrica en tres fases: a) Construcción de un instrumento para identificación de factores estresantes en unidad de cuidados intensivos Enviromental Stressors Questionnaire en español y revisión bibliográfica de los referentes teóricos Cannon, Selye, Lazarus y Folkman, Fleming, Baum, Singer y Shinn para justificar la construcción de ítems 33. b) Validez facial mediante análisis de comprensibilidad con potenciales pacientes de unidad de cuidados intensivos. c) Validez de contenido mediante juicio de expertos y calculada mediante índice Kappa de Fleiss, Lawche modificado y coeficiente V de Aiken. Resultados: Instrumento con propiedades psicométricas: validez facial por análisis de comprensibilidad superior al 90 por ciento y de contenido óptimos determinados por índice de Kappa de Fleiss de 0,80, índice de Lawche modificado de 0,89 y coeficiente V de Aiken de 0,93. Conclusiones: El instrumento de medición creado es válido y permite identificar factores estresantes de pacientes en unidad de cuidados intensivos. Este instrumento se constituye en un valioso aporte que cualifica la práctica de enfermería y plantea alternativas de cuidado que mejoren su calidad(AU)

Introduction: Stressors provoke different bio-psychological responses. By identifying situations that produce stress in patients in the intensive care unit, it is possible to generate positive interventions that mitigate these factors and improve their quality of life. Objective: To validate a measurement instrument for the identification of stressors in the intensive care unit from the Environmental Stressors Questionnaire in Spanish. Methods: Psychometric research carried out in three phases: a) construction of an instrument for identifying stressors in intensive care units from the Environmental Stressors Questionnaire in Spanish and bibliographic review of the theoretical references Cannon, Selye, Lazarus and Folkman, Fleming, Baum, Singer and Shinn, to justify the construction of 33 items; b) facial validity through comprehensibility analysis with potential intensive care unit patients; and c) content validity through expert criteria and calculated using Fleiss' kappa (κ) index, as well as the modified Lawche's and Aiken's V coefficient. Results: An instrument with psychometric properties: facial validity by comprehension analysis greater than 90 percent and optimal contents determined by Fleiss' kappa (κ) index of 0.80, modified Lawche's index of 0.89, and Aiken's V coefficient of 0.93. Conclusions: The measurement instrument created is valid and allows to identify stressors of patients in intensive care units. This instrument constitutes a valuable contribution that qualifies nursing practice and proposes care alternatives that improve its quality(AU)

Apego y estrés en niños con Diabetes tipo 1 y sus madres / Attachment and stress in children with type 1 Diabetes and their mothers

Resumen: Objetivo: Comprender la relación entre apego y diabetes y el rol mediador del estrés en niños con diabetes mellitus tipo 1 (DM1) y sus madres. Material y Método: Se aplicaron Instrumentos de evaluación correspondientes a Escalas de Apego (ECR-R), Estrés percibido (PSS), Seguridad (SS) y Estrés en niños (SiC), como medidas de autoreporte completadas por niños(as) y sus madres. Se analizaron variables demográficas, tiempo de inicio de diabetes, y el promedio de las ultimas 3 medi ciones de Hemoglobina glicosilada HbA1c como parámetro del control metabólico del último año. Resultados: Las estrategias de apego maternas e infantiles y el estrés materno mostraron una asocia ción significativa con los resultados de la diabetes del niño(a), aunque con importantes diferencias de género. Conclusiones: Las estrategias de apego, infantiles y maternas, son relevantes en el curso de la diabetes.

Abstract: Objective: To understand the relationship between attachment and diabetes and the role of stress mediators in children with type 1 diabetes (T1D) and their mothers. Material and Method: The following assessment instruments were applied as self-report measures: Attachment Scale (ECR- R), Perceived Stress Scale (PSS), Security Scale (SS), and the Stress in Children (SiC) questionnaire, which were completed by children and their mothers. We analyzed demographic variables, diabetes onset time, and the average of the last three glycosylated hemoglobin (HbA1c) measurements as a parameter of metabolic control in the last year. Results: Attachment strategies of both mother and child, as well as maternal stress, showed a significant association with the child's diabetes outcomes, although with important gender differences. Conclusions: Both mother and child attachment strate gies are relevant aspects of the T1D course.

Sofrimento moral de profissionais de enfermagem em um Centro de Atenção Psicossocial / Moral Distress of Nursing Professionals of a Psychosocial Care Center

Resumo O sofrimento moral (SM) é vivenciado por uma pessoa e decorrente da contradição existente entre suas ações e convicções. O objetivo foi analisar o sofrimento moral vivenciado pelos profissionais de enfermagem que atuam no CAPS, bem como descrever e identificar os sentimentos decorrentes do SM e mecanismos de enfrentamento. Trata-se de uma pesquisa com abordagem qualitativa, na qual foi utilizado o método de Análise de Conteúdo de Bardin. Participaram da pesquisa sete profissionais de ambos os turnos de funcionamento do CAPS. Na análise temática de conteúdo das falas desses profissionais, emergiram quatro categorias: Ambiente, como fonte de sofrimento moral; Escassez de financiamento e improvisos; Sentimentos que emergiram das vivências de Sofrimento Moral; e Mecanismos de Enfrentamento dos profissionais. Neste estudo observou-se que os profissionais do CAPS Gentileza de Macapá vivenciam o SM em seu cotidiano, associado às questões do ambiente estrutural e insuficiência de recursos (humanos e materiais), que resultaram em sentimentos de impotência, desânimo, desmotivação e luta. Esse SM fez com que os profissionais pudessem construir mecanismos de enfrentamento, dentre eles o diálogo e o compartilhamento das angústias com a equipe.

Abstract Moral Distress (MD) is experienced by individuals from the contradiction existing between their actions and convictions. This study aimed to analyze the moral distress experienced by nursing professionals working at the CAPS and to describe and identify the feelings resulting from MD and coping mechanisms. This is a qualitative research that adopted the Bardin Content Analysis method. Seven Nursing professionals of both CAPS shifts participated in the research. Four categories emerged from the thematic analysis of the statements of these professionals, as follows: Environment as a source of moral distress; Shortage of funding and improvisations; Feelings that emerged from the experiences of Moral Distress and Coping Mechanisms of professionals. In this study, we observed that Macapá's Gentileza CAPS professionals experience MD in their daily life, associated with structural environment issues and insufficient (human and material) resources that resulted in feelings of helplessness, discouragement, demotivation, and struggle. This MD allowed these professionals to build coping mechanisms against moral distress, such as dialogue and sharing anguish with the team.

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

Abstract Objective: To evaluate the stress level of mothers of preterm infants with gestational age ≤34 weeks, hospitalized in neonatal intensive care. Method: A cross-sectional study with 74 mothers of premature infants in neonatal intensive care, who answered the "Parental Stress Scale: Neonatal Intensive Care Unit" instrument, validated in Brazil. Results: 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 "Alteration in parental roles" and other subscales, meaning that mothers were in a very stressful situation. Conclusion: All items in the subscale "Alteration in parental roles" of the "Parental Stress Scale: Neonatal Intensive Care Unit" were identified as the main source of stress experienced by mothers. This study suggests carrying out further studies with other methodologies to increase the knowledge of maternal stress in the national context, applying care interventions involving the parents.

Resumen Objetivo: Evaluar el nivel de estrés de madres de recién nacidos prematuros con edad gestacional ≤34 semanas, internados en terapia intensiva neonatal. Metódo Estudio transversal con 74 madres de recién nacidos prematuros en unidad de terapia intensiva neonatal, que respondieron al instrumento "Parental Stress Scale: Neonatal Intensive Care Unit" validado en Brasil. Resultados: Se obtuvo un promedio de nivel de ocurrencia de estrés 4,41 (± 0,77) y nivel general de estrés del ambiente 4,36 (± 0,76), con diferencia significativa (p <0,001) entre la subescala " Cambio en el papel de padres "y demás subescalas. Significando que las madres se encontraban en una situación muy estresante. Conclusión: Se identificaron todos los elementos de la subescala "Cambio del papel de padres" de "Parental Stress Scale: Neonatal Intensive Care Unit" como la principal fuente de estrés experimentada por las madres. Se sugiere la realización de estudios con otras metodologías para ampliar el conocimiento del estrés materno en el contexto nacional, aplicando intervenciones de cuidado involucrando a los padres.

Resumo 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 74 mães de recém-nascidos pré-termo em unidade de terapia intensiva neonatal, que responderam ao instrumento "Parental Stress Scale: Neonatal Intensive Care Unit", validado no Brasil. Resultados: 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: Identificaram-se todos os itens da subescala "Alteração do papel de pais" da "Parental Stress Scale: Neonatal Intensive Care Unit" 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 os pais.

O uso intensivo da internet por crianças e adolescentes no contexto da COVID-19 e os riscos para violências autoinflingidas / The intensive use of the internet by children and adolescents in the context of COVID-19 and the risks for self-inflicted violence

Resumo O presente ensaio busca discutir as implicações do isolamento social devido à pandemia do COVID-19 para o uso intensivo da internet entre crianças e adolescentes e suas possíveis consequências para a prática de violências autoinflingidas. Discutimos brevemente o potencial ansiogênico e a reprodução de um "medo global" que se consolidam com a exposição maciça e sem mediação dos conteúdos consumidos, que podem aumentar as vulnerabilidades para estresse e ideações suicidas. Centramos nosso debate sobre práticas "recreativas", denominadas de "desafios" com poder autolesivo, realizados por adolescentes no site Youtube. Essa prática revelou-se crescente a partir das medidas de isolamento social. Nossa reflexão sobre esses riscos é feita a partir da perspectiva teórica da sociabilidade digital, e suas implicações nas interações de adolescentes mediadas pela internet.

Abstract This essay aimed to discuss the implications of social isolation due to the COVID-19 pandemic for the intensive use of the internet among children and adolescents and its possible consequences for the practice of self-inflicted violence. We briefly discussed the anxiogenic potential and the reproduction of a "global fear" that are consolidated with the massive and unmediated exposure of the content consumed, which can increase the vulnerabilities to stress and suicidal ideas. We centered our debate on "recreational" practices, called "challenges" with self-harm power, carried out by teenagers on the YouTube website. This practice has been shown to increase with the social isolation measures. Our reflection on these risks builds on the theoretical perspective of digital sociability, and its implications for the internet-mediated interactions of adolescents.