Effectiveness of relaxation techniques before diagnostic screening of cancer patients / Efectividad de las técnicas de relajación en oncología antes de realizar pruebas diagnósticas en neuroimagen

Psychophysiological arousal was observed in cancer patients during the application of relaxation techniques prior to a diagnostic scan (PET-CT). The aim of the study is two fold: firstly, it is sought to establish whether such techniques can minimize patient arousal before diagnostic screening begins, and secondly to measure which of them are most effective. The dependent variable is electrodermal activity, recording the attentional level and emotional response, and the independent variable comprises the relaxation techniques used, namely Jacobson, breathing and visualization. The 39 patients were split into experimental groups to whom the relaxation techniques (Jacobson, breathing exercises, and visualization) were applied before they went for the PET-CT. An activity-module procedure was applied to track electrodermal activity during the relaxation sessions, consisting of instructions, time out; wait, task; relaxation and end of the recording session. The control group received no relaxation techniques before the PET-CT. Session-end results show that patients who perform relaxation techniques achieve greater attentional focus using Jacobs on’stechnique(M= .212) and enhanced emotional containment using visualization (M= .206). It is concluded that relaxation techniques minimize the state of activation during the waiting period before a diagnostic scan.

Se registra la activación psicofisiológica en pacientes oncológicos durante la aplicación de técnicas de relajación antes de someterse a una prueba diagnóstica (TEP-TAC). Se plantea un doble objetivo: primero, comprobar si dichas técnicas minimizan el estado de activación de los pacientes antes de realizar pruebas diagnósticas, y en segundo lugar, medir cuáles de estas son más efectivas para relajarse. La variable dependiente es la actividad electrodérmica, registrando el nivel atencional y la respuesta emocional, y la variable independiente son las técnicas de relajación de Jacobson, de respiración y de visualización. Se distribuyen los pacientes (n = 39) en 3 grupos experimentales y se les aplican las técnicas antes de realizar el TEP-TAC: Jacobson, respiración y visualización. Se utiliza un procedimiento para el registro de la actividad electrodérmica durante la relajación por módulos de actividad: instrucciones, tiempo muerto; espera, tarea; relajación, y fin del registro. El grupo control no recibe relajación antes del TEP-TAC. Los resultados indican que los pacientes que realizan relajación consiguen mayor focalización atencional con Jacobson (M = .212) y mayor contención emocional con la visualización (M = .206). Se concluye que las técnicas de relajación minimizan el estado de activación durante el periodo de espera antes de una prueba diagnóstica.

Analysis of the nature of spiritual pain in terminal patients and the resignification process through the relaxation, mental images and spirituality (RIME) intervention / Análisis de la naturaleza del dolor espiritual presentado por pacientes terminales y el proceso de elaboración de un nuevo significado a través de la intervención de relajamiento, imágenes mentales y espiritualidad (RIME) / Análise da natureza da dor espiritual apresentada por pacientes terminais e o processo de sua re-significação através da intervenção relaxamento, imagens mentais e espiritualidade (RIME)

OBJECTIVE: To understand Spiritual Pain and the new meaning it takes on using the RIME intervention. Subjects and methods: Eleven terminally ill patients (n=11), treated at public hospitals, received care from six professionals trained for RIME application. The methods used were both qualitative, through phenomenology, and quantitative, based on the descriptive method, using the Wilcoxon Test. RESULTS: In the qualitative approach, six categories and eleven subcategories were found. The prevailing categories were: fear of dying by denying the severity of the clinical condition (n=5); fear of dying by realizing the severity of the clinical condition (n=5); fear of postmortem due to disintegration or feeling of non-existence, of being affectively forgotten (n=5). In the quantitative analysis, a statistically significant difference (p<0.0001) was noted. CONCLUSION: The results suggested that RIME promoted quality of life in the dying process, as well as more serenity and dignity in the face of death.

OBJETIVO: Estudiar la naturaleza del Dolor Espiritual y el proceso de elaboración de un nuevo significado durante la aplicación de la Intervención RIME. Sujetos y métodos: Once pacientes terminales (n=11), tratados en hospitales públicos, por seis profesionales entrenados para aplicar la RIME. Los métodos utilizados fueron el cualitativo con base en la fenomenología y el cuantitativo, a través del descriptivo, utilizándose la Prueba Wilcoxon. RESULTADOS: En el abordaje cualitativo fueron encontradas seis categorías y once subcategorías. Las categorías que prevalecieron fueron: miedo de la muerte por negación de la gravedad del cuadro clínico (n=5); miedo de la muerte por percepción de la gravedad del cuadro clínico (n=5); miedo de la post-muerte por el sentimiento de desintegración, de dejar de existir, de ser afectivamente olvidado (n=5). En el análisis cuantitativo se observó una diferencia estadísticamente significativa (p<0,0001). CONCLUSIÓN: Los resultados sugirieron que la RIME promovió la calidad de vida en el proceso de morir, así como propició más serenidad y dignidad delante de la muerte.

OBJETIVO: Estudar a natureza da Dor Espiritual e sua re-significação durante a aplicação da Intervenção RIME. Sujeitos e métodos: Onze pacientes terminais (n=11), tratados em hospitais públicos, por seis profissionais treinados para aplicar a RIME. Os métodos utilizados foram o qualitativo com base na fenomenologia e o quantitativo, através do descritivo, utilizando-se o Teste Wilcoxon. RESULTADOS: Na abordagem qualitativa foram encontradas seis categorias e onze subcategorias. As categorias prevalentes foram: medo da morte por negação da gravidade do quadro clínico (n=5); medo da morte por percepção da gravidade do quadro clínico (n=5); medo do pós-morte pelo sentimento de desintegração, de inexistir, de ser afetivamente esquecido (n=5). Na análise quantitativa observou-se diferença estatisticamente significativa (p<0,0001). CONCLUSÃO: Os resultados sugeriram que a RIME promoveu qualidade de vida no processo de morrer, assim como mais serenidade e dignidade perante a morte.

Técnicas de psicoterapia breve en psiquiatría de enlace / Short Psychotherapeutic Techniques in Liaison Psychiatry

Introducción: Los pacientes y las condiciones que trata el psiquiatra de enlace requieren técnicas terapéuticas breves que aporten soluciones a los problemas y que disminuyan la carga que existe sobre las familias y los profesionales de la salud. Objetivo: Hacer una revisión narrativa de algunas técnicas terapéuticas de uso en enlace. Método: Revisión de la literatura. Desarrollo: Se provee una revisión de algunas técnicas de terapia breve, modalidades grupales, técnicas de relajación, hipnosis, terapia de ordalía y otras usadas en los profesionales de la salud, como los grupos Balint, y en los pacientes y sus familias, como la psicoeducación.

Introduction: Liaison psychiatrist treat patients and conditions that require short psychotherapeutic techniques, which will contribute to solve the patient’s problems, and reduce the burden on both family and health professionals. Objective: To do a narrative review of some therapeutic techniques used in liaison psychiatry. Method: Literature review. Development: Some short therapy techniques are reviewed, i.e. group therapy, relaxation techniques, hypnosis, ordalia therapy and others used by health professionals, such as Balint Groups, as well as psychoeducation for the patients and their families.

Programa de treinamento sobre a intervenção terapêutica "relaxamento, imagens mentais e espiritualidade" (RIME) para re-significar a dor espiritual de pacientes terminais / Training program about the therapeutical intervention

CONTEXTO: Neste artigo, apresentamos um programa de treinamento sobre a intervenção terapêutica relaxamento, imagens mentais e espiritualidade (RIME) para profissionais de saúde, que objetiva re-significar a dor espiritual de pacientes terminais. OBJETIVO: Analisar um programa de treinamento por meio da compreensão da experiência de profissionais na utilização da Intervenção RIME e da compreensão da experiência dos doentes na re-significação da dor espiritual, manifestada durante a aplicação do RIME por profissionais treinados. MÉTODOS: Os sujeitos foram uma enfermeira, uma médica, três psicólogos e uma terapeuta alternativa voluntária, todos experientes ou estudiosos em cuidados paliativos, selecionados por convite e que atenderam 11 pacientes terminais internados em hospitais públicos das cidades de Campinas, Piracicaba e São Paulo (SP). A metodologia utilizada teve como base a pesquisa-ação e a fenomenologia. Os resultados qualitativos foram analisados pelo método análise do conteúdo por meio da técnica análise temática e os quantitativos foram analisados pelo método descritivo, utilizando-se o teste de Wilcoxon. RESULTADOS: Na análise da vivência dos profissionais, encontramos cinco categorias e 15 subcategorias. Na análise da natureza da dor espiritual, encontramos como categorias mais prevalentes os medos da morte expresso pela negação e pela percepção do quadro clínico. Na aplicação do RIME, observamos diferença estatisticamente significativa (p < 0,0001), isto é, no final das sessões os doentes relataram maior nível de bem-estar que no início das sessões. CONCLUSÃO: O programa de treinamento proposto mostrou-se eficaz para preparar profissionais de saúde para o uso da intervenção RIME, capacitando-os para o processo de cuidar e prestar assistência espiritual segundo uma perspectiva acadêmica. Os resultados sugeriram que o RIME favoreceu a re-significação da dor espiritual de pacientes terminais.

BACKGROUND: This article presents a training program for a therapeutic intervention involving relaxation, mental images and spirituality (RIME), which can be administered to help terminal patients to resignify their spiritual pain. OBJECTIVE: Analysis of a training program based on the understanding of the experience of professionals in the use of RIME intervention and of patients in their resignification of spiritual pain, as revealed during the administration of RIME by trained professionals. METHOD: The participants were a nurse, a female doctor, three psychologists and a volunteer alternative therapist, all experienced in or studying palliative care; they were invited to participate in the training program and were later in charge of caring for eleven terminal inpatients in public hospitals of Campinas, Piracicaba and São Paulo. The theoretical and methodological basis of the study involves action-research and phenomenology. Qualitative results were analyzed by the content analysis utilizing the thematic analysis technique. Quantitative results were analyzed descriptively using the Wilcoxon Test. RESULTS: In the analysis of the professionals, experiences, five categories and fifteen sub-categories were found. In the analysis of the constitution of spiritual pain, we found the idea of fear of death to be the most prevalent, either expressed by negation of the gravity of the clinical prognosis or by the perception of this gravity. After the administration of RIME, statistically significant differences in perceived level of well being (p < 0.0001) were expressed after sessions of RIME. CONCLUSION: The proposed training program proved to be effective in preparing health area professionals for the use of RIME intervention, qualifying them to provide spiritual assistance within an academic perspective. The results suggested that RIME promoted the resignification of spiritual pain in terminal patients.

Effects of Relaxation Therapy and Exercise Therapy on the ACTH and Cortisol Hormone Level in Workers / 기본간호학회지

PURPOSE: The purpose of this study was to investigate the effect of exercise therapy and relaxation therapy on the level of ACTH and cortisol in workers and to determine, from this information, the effectiveness of applied exercise therapy and relaxation therapy as a nursing intervention method for workers experiencing stress. METHOD: The subjects were divided into an exercise therapy group, a relaxation therapy group, and a control group. The research design was a nonequivalent control group pretest-posttest design (exercise therapy: n=12, relaxation therapy: n=12, control group, the group without exercise or relaxation therapy: n=12). The subjects in the exercise therapy group were given a particular intensity for each kp over 30 min, bicycle ergometer which uses the LX PE training system before and after four weeks of training. The subjects did 60-70% exercise intensity exercise therapy for eight weeks. The relaxation therapy subjects were trained using a modified Jacobson's relaxation technique for eight weeks. The exercise and relaxation therapy groups were trained at the following intensity for eight weeks (3 times/week, 30 min/day). Changes in the levels of ACTH and cortisol were identified. Two-way ANOVA and multiple range test (SNK: Student Newman Keul) were used to examine the effects of exercise therapy and relaxation therapy at four and eight weeks.. RESULT: 1. Changes in the level of ACTH in the relaxation therapy group were statistically significant at .05 level, and were better than that of the exercise therapy group after eight weeks. But there was no significant difference between the exercise therapy group and the control group. 2. Change in the level of cortisol in the relaxation therapy group were statistically significant at .05 level as compared to the exercise therapy group and the control group after four weeks, but not after eight weeks. Also, the relaxation therapy was statistically significant at .05 level after four weeks compared to before treatment, but there was a tendency toward increased cortisol after eight weeks. CONCLUSION: Relaxation therapy was found to be more effective in stress treatment than exercise therapy and as such is a desirable nursing intervention method for stress hormone reduction in workers.

Yogaterapia de la hipertensión arterial esencial

Se evalúa la utilidad práctica de un protocolo de entrenamiento yoga específico, como complemento del tratamiento de 18 pacientes con hipertensión arterial esencial no controlada, procedentes de un consultorio del médico de la familia del municipio Playa. Durante 40 semanas practicaron, con frecuencia de 3 veces semanales, ejercicios sencillos de hatha yoga, combinados con psicología grupal con basamento conductual y yoga tendientes al cambio de hábitos, y principios de atracción y educación para la salud en general. Se logró un decrecimiento significativo de la presión arterial, de los niveles de colesterol sanguíneo y de noradrenalina en orina de 14 horas. También disminuyó la dosis de medicamentos hipotensores en general. Dentro de lo limitado de este pequeño estudio, se concluye que el yoga puede ser beneficioso como coadyuvante en el manejo de los pacientes hipertensos.

The practical usefulness of a protocol of specific yoga training, is assessed as a complement for the treatment of uncontrolled essential arterial hypertension, in 18 patients coming from a family physician's office, at Playa municipe. During 40 weeks they practiced, three times weekly, simple hatha yoga exercises, in combination with behavioural based group psicology and yoga intended for habits changing, and principles of attraction and health education. A significant decrease of arterial pressure, of blood cholesterol levels, and of urine norepinephrine, was achieved. Generally, the dose of hypotensive drugs also decreased. It is concluded, within the limits of this small study, that yoga may be beneficial as a coadyuvant in managing hypertensive patients.