Mediação de saberes na sobrevivência ao câncer de laringe: a experiência de pessoas Laringectomizadas Totais / Mediation of knowledge in surviving laryngeal cancer: the experience of Total Laryngectomized persons / Mediación del conocimiento en la supervivencia al cáncer de laringe: la experiencia de las personas sometidas a Laringectomía Total

O presente estudo parte de reflexões acerca da sobrevivência ao câncer e da experiência estigmatizante vivenciada por pessoas diagnosticadas com câncer de laringe no Hospital Nacional do Câncer/Instituto Nacional do Câncer, submetidas à cirurgia de Laringectomia Total e participantes do Grupo de Laringec-tomizados Totais. O objetivo foi compreender as mediações de saberes e de informações produzidas pelos participantes do grupo na interface com os profissionais de saúde, considerando a sua dupla condição de estigma: o câncer e a deficiência. Parte-se de uma abordagem socioantropológica de caráter qualitativo e ex-ploratório que empregou os métodos de entrevista narrativa com cinco participantes. A análise foi realizada pelo método hermenêutico-dialético. Nos resultados destacam-se a busca pelo reconhecimento individual e social e a valorização da experiência frente aos saberes oficiais e o quanto as mediações extrapolam o espaço institucional. A mediação de saberes faz emergirem elementos significativos para o enfrentamento de uma cultura informacional dominante.

This study is based on reflections on surviving cancer and the stigmatizing experience of people diagnosed with laryngeal cancer at the Hospital Nacional do Câncer/Instituto Nacional do Câncer, who underwent Total Laryngectomy surgery and participated in the Total Laryngectomy Group. The goal was to understand the mediations of knowledge and information produced by the group participants, in the interface with health professionals, considering their double condition of stigma: cancer and disability. It is based on a socio-anthropological approach, of qualitative and exploratory nature that employed the narrative interview method with five participants. The analysis was carried out through the hermeneutic-dialectic method. The results highlight the search for individual and social recognition and the appreciation of experience in relation to official knowledge, and how the mediations go beyond the institutional space. The mediation of knowledge brings out significant elements to confront a dominant informational culture.

El presente estudio se basa en las reflexiones sobre la supervivencia al cáncer y la experiencia estigmatiza-dora de personas diagnosticadas de cáncer de laringe en el Hospital Nacional do Câncer/Instituto Nacional do Câncer, que se sometieron a una Laringectomía Total y participaron en el Grupo de Laringectomía Total. Objetivo: comprender las mediaciones de conocimiento e información producidas por los participantes del grupo, en la interfaz con los profesionales de salud, considerando su doble estigma: cáncer y discapacidad. Se basa en un abordaje socioantropológico, cualitativo y exploratorio, que utilizó métodos de entrevista narrativa con cinco participantes. El análisis ocurrió a través del método hermenéutico-dialéctico. Los resultados destacan la búsqueda de reconocimiento individual y social y la valorización de la experiencia en relación con el conocimiento oficial y la medida en que las mediaciones van más allá del espacio insti-tucional. La mediación del conocimiento pone de manifiesto elementos significativos sobre una cultura informacional dominante.

O papel mediador da dependência de mídia social e da qualidade do sono na associação entre tempo de uso de mídia social e sintomas depressivos em universitários / The mediating role of social media addiction and sleep quality in the association between social media usage and depressive symptoms in university students / El papel mediador de la adicción a las redes sociales y la calidad del sueño en la asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos en estudiantes universitarios

Resumo: O aumento do uso de mídias sociais e sua associação com sintomas depressivos, especialmente em jovens adultos, tem gerado a necessidade do entendimento de como ocorre tal associação para subsidiar políticas de redução de danos e agravos. Nesse sentido, este estudo objetivou verificar o efeito mediador da dependência de mídias sociais e da qualidade do sono na associação entre o tempo de uso de mídias sociais e sintomas depressivos em universitários brasileiros. Trata-se de um estudo transversal, realizado com 2.823 universitários, que forneceram informações referentes ao tempo de uso de mídias sociais, à dependência de mídias sociais, aos sintomas depressivos e à qualidade do sono. A análise de mediação, ajustada por fatores de confusão, foi realizada por meio do software PROCESS para SPSS, para obtenção do efeito total (c), direto (c') e indiretos (EI1, EI2 e EI3). Os resultados identificaram associação entre o tempo de uso de mídias sociais e os sintomas depressivos, mediada pela dependência de mídias sociais (EI1 = 20%) e pela qualidade do sono (EI1 = 40%). Os resultados permitem ampliar o conhecimento acerca dos mecanismos que influenciam mutuamente a relação entre o tempo de uso de mídias sociais e os sintomas depressivos, auxiliando na adoção de estratégias de redução de danos decorrentes do uso excessivo de mídias sociais.

Abstract: Increase in time spent on social media and its association with depressive symptoms, especially among young adults, has generated the need to understand how this association occurs in order to support the development of policies to reduce harm and complications. In view of this fact, this study aimed to assess the mediating effect of social media addiction and sleep quality on the association between time spent on social media and depressive symptoms in Brazilian university students. This is a cross-sectional study conducted with 2,823 university students, who provided information regarding time spent on social media, social media addiction, depressive symptoms and sleep quality. The mediation analysis, adjusted for confounding factors, was performed using the PROCESS macro for SPSS to obtain the total (c), direct (c'), and indirect effects (EI1, EI2, and EI3). The results identified an association between time spent on social media and depressive symptoms, mediated by social media addiction (EI1 = 20%) and sleep quality (EI1 = 40%). These findings help expand knowledge about the mechanisms that mutually influence the relationship between time spent on social media and depressive symptoms, supporting the adoption of strategies to reduce harm resulting from excessive social media use.

Resumen: El aumento del uso de las redes sociales y su asociación con síntomas depresivos, especialmente en adultos jóvenes, ha generado la necesidad de comprender cómo se produce esta asociación como una forma de apoyar las políticas de reducción de daños y afecciones. En ese sentido, el presente estudio tuvo como objetivo verificar el efecto mediador de la adicción a las redes sociales y de la calidad del sueño en la asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos en estudiantes universitarios brasileños. Se trata de un estudio transversal, realizado con 2.823 estudiantes universitarios, quienes brindaron información respecto al tiempo de uso de las redes sociales, adicción a las redes sociales, síntomas depresivos y calidad del sueño. El análisis de mediación, ajustado por factores de confusión, se realizó por medio del software PROCESS para SPSS, para obtener el efecto total (c), directo (c') e indirectos (EI1, EI2 y EI3). Los resultados identificaron una asociación entre el tiempo de uso de las redes sociales y los síntomas depresivos, mediada por adicción a las redes sociales (EI1 = 20%) y la calidad del sueño (EI1 = 40%). Los resultados permiten ampliar el conocimiento acerca de los mecanismos que influyen mutuamente en la relación entre tiempo de uso de las redes sociales y los síntomas depresivos, ayudando a adoptar estrategias para reducir los daños resultantes del uso excesivo de las redes sociales.

Orientação sexual e sintomas depressivos: papel mediador da autoestima e satisfação com a vida / Sexual orientation and depressive symptoms: mediating role of self-esteem and life satisfaction / Orientación sexual y síntomas depresivos: papel mediador de la autoestima y la satisfacción con la vida

Objetivo: verificar se autoestima e satisfação com a vida exercem efeitos mediadores na relação entre orientações sexuais minoritárias e sintomatologia depressiva em amostra de pós-graduandos stricto sensu. Método: estudo analítico, transversal, conduzido com 321 pós-graduandos stricto sensu entre março/abril de 2021. Utilizou-se o Patient Health Questionnaire-9 para avaliação de sintomas depressivos, Escala de Autoestima de Rosemberg e Escala de Satisfação com a Vida. Análises de mediação simples foram conduzidas por meio da macro PROCESS. Resultados: pós-graduandos de orientações sexuais minoritárias apresentaram maior severidade de sintomas depressivos e menores indicadores de autoestima e satisfação com a vida do que seus pares heterossexuais. Autoestima e satisfação com a vida mediaram parcialmente a relação entre orientação sexual e severidade de sintomas depressivos em uma proporção de, respectivamente, 48,26% e 37,54%. Conclusão: autoestima e satisfação com a vida apresentaram-se como importantes mediadores da relação entre orientações sexuais minoritárias e sintomas depressivos entre pós-graduandos(AU)

Objective: to verify whether self-esteem and satisfaction with life exert mediating effects on the relationship between minority sexual orientations and depressive symptoms in a sample of graduate students. Method: analytical, cross-sectional study conducted with 321 Brazilian graduate students between March/April 2021. The Patient Health Questionnaire-9 was used to assess depressive symptoms, was used too, Rosemberg´s Self-Esteem Scale and the Life Satisfaction Scale. Simple mediation analyzes were conducted using the PROCESS macro. Results: graduate students with minority sexual orientations had more severe depressive symptoms and lower indicators of self-esteem and life satisfaction than their heterosexual peers. Self-esteem and satisfaction with life partially mediated the relationship between sexual orientation and severity of depressive symptoms in a proportion of, respectively, 48.26% and 37.54%. Conclusion: self-esteem and life satisfaction were important mediators of the relationship between minority sexual orientations and depressive symptoms among graduate students(AU)

Objetivo: verificar si la autoestima y la satisfacción con la vida ejercen efectos mediadores en la relación entre las orientaciones sexuales minoritarias y la sintomatología depresiva en una muestra de estudiantes de posgrado stricto sensu. Método: estudio transversal analítico realizado junto a 321 estudiantes de posgrado stricto sensu entre marzo y abril de 2021. Para evaluar los síntomas depresivos, se utilizó el Patient Health Questionnaire-9, la Escala de Autoestima de Rosemberg y la Escala de Satisfacción con la Vida. Los análisis de mediación simple se realizaron utilizando la macro PROCESS. Resultados: los estudiantes de posgrado con orientaciones sexuales minoritarias presentaron síntomas depresivos más severos y menores indicadores de autoestima y satisfacción con la vida que sus pares heterosexuales. La autoestima y la satisfacción con la vida mediaron parcialmente la relación entre la orientación sexual y la severidad de los síntomas depresivos en una proporción de, respectivamente, 48,26% y 37,54%. Conclusión: la autoestima y la satisfacción con la vida fueron importantes mediadores de la relación entre la orientación sexual minoritaria y los síntomas depresivos entre estudiantes de posgrado(AU)

El médico de familia como mediador en conflictos vinculados a la salud

Introducción: La mediación adquiere elevada significación social, a partir de su vínculo con la prevención y solución de conflictos. Sin embargo, la revisión bibliográfica y la experiencia profesional de los autores indican que el tema es insuficientemente tratado en relación con el desempeño asistencial del médico de familia. El objetivo del artículo consistió en valorar aspectos asociados a este profesional como mediador en conflictos vinculados a la salud. Métodos: Investigación cualitativa comprendida entre febrero de 2023 y junio de 2023 en el área de salud del Policlínico Docente "René Vallejo Ortiz". Se emplearon métodos teóricos como el análisis y síntesis, el histórico-lógico y la sistematización. En el orden empírico se empleó la revisión de documentos y la encuesta a médicos de familia. Resultados: Fueron develados criterios valorativos sobre aspectos legales, curriculares, metodológicos y asistenciales vinculados al tema. También se obtiene, a partir de la autopercepción del médico de familia, valoraciones sobre la preparación para un desempeño mediador. Discusión: Se valoran integralmente aspectos asociados al médico de familia como mediador en conflictos vinculados a la salud y se revela una correspondencia con estudios precedentes respecto a la necesidad de optimizar en la educación médica la mediación como contenido de enseñanza. Conclusiones: Se enfatiza que el desempeño mediador del médico de familia en los conflictos vinculados a la salud, no se reducen a las posibilidades de intervención reconocidas en el ordenamiento jurídico. Se corrobora la pertinencia del tema y la necesidad de introducir trasformaciones en este sentido.

Introduction: Mediation acquires high social significance, based on its link with the prevention and resolution of conflicts. However, the bibliographic review and the professional experience of the authors indicate that the topic is insufficiently addressed in relation to the care performance of the family doctor. The objective of the article was to assess aspects associated with this professional as a mediator in conflicts related to health. Methods: Qualitative research between february 2023 and june 2023 in the health area of ​​the "René Vallejo Ortiz" Teaching Polyclinic. Theoretical methods such as analysis and synthesis, historical-logical and systematization were used. In the empirical order, the review of documents and the survey of family doctors were used. Results: Evaluative criteria on legal, curricular, methodological and healthcare aspects linked to the topic were revealed. Assessments of preparation for mediation performance are also obtained from the family doctor's self-perception. Discussion: Aspects associated with the family doctor as a mediator in conflicts related to health are comprehensively assessed and a correspondence with previous studies is revealed regarding the need to optimize mediation as teaching content in medical education. Conclusions: It is emphasized that the mediating performance of the family doctor in conflicts related to health is not reduced to the possibilities of intervention recognized in the legal system. The relevance of the topic and the need to introduce transformations in this sense are corroborated.

Estrategia pedagógica para la preparación del profesor de Educación Física como mediador de conflictos

El logro de una educación accesible y de calidad para todos los ciudadanos es, en la actualidad, una de las prioridades para la formación de profesionales, puesto que estos contribuyen al desarrollo de un sistema de educación reconocido, tanto a nivel nacional como internacional. De esta manera, el estudio realizado se propuso como objetico diseñar una estrategia pedagógica para la preparación al profesor como mediador de conflictos en la clase de Educación Física, de las escuelas secundarias básicas del municipio La Habana del Este. Para ello, se utilizó un enfoque mixto, con el fin de agrupar los análisis de documentos y las descripciones cualitativas junto a tablas y figuras para complementar y enriquecer el estudio cualitativa y cuantitativamente. Como principal resultado, se evidenciaron los principios, premisas y el procedimiento metodológico para la integración de influencias educativas. En sentido general, la preparación del profesor como mediador de conflictos da respuesta a los programas priorizados del Ministerio de Educación en su agenda de perfeccionamiento hacia el 2030 y del Instituto Nacional de Deporte, Educación Física y Recreación.

A concretização de um ensino acessível e de qualidade para todos os cidadãos é atualmente uma das prioridades para a formação dos profissionais, uma vez que contribuem para o desenvolvimento de um sistema educativo reconhecido, tanto a nível nacional como internacional. Desta forma, o estudo propôs desenhar uma estratégia pedagógica para preparar o professor como mediador de conflitos nas aulas das escolas secundárias básicas do município de La Habana del Este. Para isso, foi utilizada uma abordagem mista, de modo a agrupar a análise de documentos e descrições qualitativas com tabelas e figuras para complementar e enriquecer o estudo, tanto qualitativo como quantitativo. O principal resultado é a integração das influências educacionais, os fundamentos, princípios, premissas e procedimento metodológico. De um modo geral, é evidente a preparação do professor como mediador de conflitos, respondendo aos programas prioritários do Ministério da Educação em aperfeiçoamento para 2030 e do Instituto Nacional de Esportes, Educação Física e Recreação.

The achievement of accessible and quality education for all citizens is, currently, one of the priorities for the training of professionals, since they contribute to the development of a recognized education system, both nationally and internationally. In this way, the objective of the study carried out was to design a pedagogical strategy to prepare the teacher as a conflict mediator in the Physical Education class, in the basic secondary schools of the municipality of La Habana del Este. For this purpose, a mixed approach was used, in order to group document analyzes and qualitative descriptions together with tables and figures to complement and enrich the study qualitatively and quantitatively. As the main result, the principles, premises and methodological procedure for the integration of educational influences were evident. In a general sense, the preparation of the teacher as a conflict mediator responds to the prioritized programs of the Ministry of Education in its improvement agenda towards 2030 and of the National Institute of Sports, Physical Education and Recreation.

Uso pasivo de redes sociales y malestar psicológico. El rol de la comparación social / Passive use of social media sites and psychological distress. The role of social comparison

Resumen La presente investigación se focalizó en los diferentes tipos de uso (activo/pasivo) que hacen los usuarios de redes sociales y los efectos psicológicos que esto puede conllevar, sobre todo en aquellos sujetos tendientes a compararse con los demás. Por un lado, se examinó el poder predictor de variables relacionadas al uso de redes sociales (i. e., tiempo de conexión, tipo de uso -pasivo/activo-, motivaciones de uso) y la comparación social, sobre el malestar psicológico percibido (i. e., depresión, ansiedad, estrés). Por otro lado, se analizó el rol mediador de la comparación social en la relación entre el uso pasivo de redes sociales y la percepción de malestar psicológico percibido. La muestra fue de conveniencia y estuvo compuesta por 420 sujetos de población general (211 hombres, 209 mujeres), con una media de edad de 40.29 años (DE = 14.93). Se utilizaron los siguientes instrumentos de recolección de datos: Motives for SMSs use Scale; Iowa-Netherlands Comparison Orientation Measure (INCOM-E), Depression, Anxiety and Stress Scale (DASS-21) y una escala diseñada ad-hoc para evaluar el uso activo y pasivo que se hace de redes sociales. Los resultados obtenidos mostraron que la comparación social es el principal predictor de malestar psicológico junto con el motivo de uso relacionado con pasatiempo/exhibicionismo. Además, se pudo comprobar un efecto indirecto del uso pasivo sobre el malestar psicológico considerando a la comparación social como variable mediadora. Por lo tanto, usar pasivamente las redes generaría mayor malestar si el usuario tiende a compararse con quienes realizan las publicaciones.

Abstract The present investigation is framed in the field of cyberpsychology. It aimed to analyze the predictive power of variables related to the use of social media sites -SMSs- (i. e., connection time, type of use -passive / active-, motivations for use) and social comparison, on perceived psychological distress (i. e., depression, anxiety, stress). Furthermore, the mediating role of social comparison in the relationship between the passive use of SMSs and the perceived psychological distress, was also analyzed. It is important to study these topics since different international studies have shown inconsistent and contradictory results regarding the effects of SMSs use on individuals' well-being (e. g., Frison y Eggermont, 2015; Kraut et al., 2002; Nie et al., 2015). Consequently, some studies have focused on understanding whether the manner in which people use the networks, whether actively or passively, explains how technology impacts on users' well-being and/or psychological distress (Verduyn et al., 2015). The negative impact of passive use of SMSs can be explained by the Social Comparison Theory (Festinger, 1954), which suggests that people tend to evaluate themselves in comparison with others. These comparisons might generate negative effects on the individual (Giagkou et al., 2018) and, according to Lup et al. (2015), social comparison may be a mediating variable in this association. Regarding participants of the study, a convenience sample of 420 subjects of general population was studied (211 men, 209 women). The mean age was 40.29 years old (SD = 14.93). The majority of the participants (n = 278) lived in Buenos Aires City and surroundings. In terms of variables related to the use of SMSs, when asked about type of SMSs, most participants reported using more than one SMS, mainly Facebook (72 %) and Instagram (57 %). Regarding time spent on SMSs, 60 % of the respondents used their favorite SMS more than three times a day. The mean daily time engaged on all the SMSs exceeded five hours. Data were gathered using the Motives for SMSs use Scale (Lupano Perugini y Castro Solano, 2021a), the Iowa-Netherlands Comparison Orientation Measure (INCOM-E) (Buunk et al., 2005; Gibbons y Buunk, 1999), the Depression, Anxiety and Stress Scale (DASS-21) (Antúnez y Vinet, 2012; Lovibond y Lovibond, 1995). Furthermore, a survey to assess individuals' use of social networks was designed. The first part explored the most frequently used SMSs, the number and type of friends/followers, and the time spent on SMSs. The main SMSs were listed and participants were asked to indicate whether they used them or not, and if they did, they rated the amount of time spent on SMSs daily. The total amount of time per day was also surveyed. The second part of the survey was designed based on The Passive Active Use Measure (PAUM, Gerson et al., 2017) and some users' suggestions. This instrument assesses the frequency of certain activities performed on the networks to find out if participants make active use (e. g., posting information, commenting) or passive use (e. g., viewing profiles and posts, scrolling). The obtained results showed that social comparison is the main predictor of psychological distress. The motivation for use related to pass time / exhibitionism was also a significant predictor. In addition, an indirect effect of passive use on perceived psychological distress could be verified, considering social comparison as a mediating variable. Therefore, using the social networks passively would generate greater discomfort if the user tends to compare themselves with those who make the publications. The results of this study allow both users and healthcare and education providers to have greater knowledge of the consequences of using social media on individuals' overall well-being, and to promote their proper use.

Revisão sistemática sobre resolução de problema e mediação de conflito pela terapia cognitivo-comportamental / Systematic review on problem solving and conflict mediation by cognitive-behavioral therapy

RESUMO Objetivo: Na prática clínica, é importante diferenciar problema e conflito, porque os passos sugeridos na técnica de resolução de problemas costumam não ser suficientes para auxiliar o cliente a lidar com conflitos. Esta revisão sistemática teve como objetivos: investigar como a terapia cognitivo-comportamental (TCC) pode auxiliar na resolução de problemas e na mediação de conflito; sugerir uma estratégia que favoreça a melhor capacidade de mediar conflitos (QPD). Métodos: Foi realizada uma busca nas bases de dados: PubMed, PsycINFO, Web of Science (ISI) e Scopus. O método prisma foi utilizado, e foram selecionados para leitura na íntegra artigos experimentais. Resultados: Trezentos e sessenta e quatro ensaios clínicos aplicaram a resolução de problemas, apontando a eficácia dessa técnica juntamente com outras estratégias/intervenções da TCC. Livros-guias de TCC: não diferenciam problema e conflito; descrevem detalhadamente passos para resolução de problemas, focando na perspectiva do cliente, no momento presente e no uso da razão lógica; não abordam a mediação de conflitos pela TCC. Sugerimos uma estratégia que pode ajudar na mediação de conflitos: auxiliando na coleta/organização de informações; melhorando a comunicação - empática e assertiva; favorecendo escolhas com o intuito de causar o menor dano possível a todas as partes envolvidas no conflito. Conclusões: Para treinar terapeutas para aplicarem a resolução de problemas, há descrição detalhada dos passos a serem seguidos. Entretanto, para capacitar os terapeutas para mediarem conflitos, práticas clínicas que têm sido frequentemente descritas/utilizadas nas terapias cognitivas contextuais podem ser necessárias: aceitação psicológica, mindfulness , entender valores individuais, vivenciar/considerar a emoção em tomadas de decisão, ativar a compaixão/autocompaixão.

ABSTRACT Objective: It is important to differentiate between problem and conflict in clinical practice, because the steps suggested in the problem-solving technique are usually not enough to help patients deal with conflicts. This systematic review aimed to: investigate how cognitive-behavioral therapy (CBT) can help in problem solving and conflict mediation; suggest a strategy that can improve conflict mediate skills (QPD). Methods: A search was performed in the following databases: PubMed, PsycINFO, Web of science (ISI) and Scopus. Prisma flow diagram was used and experimental articles were selected for full reading. Results: Three hundred and sixty four clinical trials applied problem solving, showing the effectiveness of this technique with other CBT strategies/interventions. CBT guide books: do not differentiate between problem and conflict; describe in detail problem solving steps, focusing on the customer's perspective, the present moment and the use of logical reason; do not explore conflict mediation in the CBT. We suggest a strategy that can help in the mediation of conflicts: assisting in the collection/organization of information; improving communication - empathic and assertive; favoring choices that can cause the least possible harm to all parties in the conflict. Conclusions: There is detailed description of the steps to train therapists to apply problem solving. However, to improve therapeutic skills to mediate conflicts, clinical practices that have been frequently described/used in the contextual cognitive behavioral therapies may be necessary: psychological acceptance, mindfulness, understanding personal values, experiencing/considering emotion in decision making, activating compassion/self-compassion.

Atuação do Núcleo de Apoio à Procuradoria Adjunta de Suporte à Saúde no município de Três Rios-RJ: uma estratégia na abordagem da judicialização da saúde / Performance of the Support Core for the Deputy Prosecutor's Office for Health Support in the municipality of Três Rios-RJ: a strategy in addressing health-related judicialization

O fenômeno da judicialização da saúde é uma realidade crescente no Brasil, principalmente nos municípios, culminando com desestruturação no planejamento e na execução orçamentária. Trata-se de estudo de caso, com abordagem qualiquantitativa, desenvolvida em Três Rios, município de médio porte do estado do Rio de Janeiro, que se iniciou em 2009, com a implantação do Núcleo de Apoio à Procuradoria Adjunta de Suporte à Saúde (NAPASS) e a reestruturação da Assistência Farmacêutica no SUS local, para lidar com a intensa judicialização da saúde. O objetivo central da pesquisa foi analisar a atuação desse Núcleo como estratégia na abordagem da judicialização da saúde, bem como descrever as demais estratégias sinergicamente implementadas pela gestão municipal, a partir de 2009. Os resultados dessas estratégias implementadas permitiram observar que, entre os anos de 2008 e 2021, houve importante redução de ações judiciais distribuídas contra o município já no primeiro ano da nova gestão empossada e significativa resolubilidade extrajudicial das demandas oriundas da Defensoria Pública do Estado do Rio de Janeiro. Espaços de melhorias e avanços foram também elencados, a partir de uma análise dos fatores positivos e negativos na abordagem da judicialização da saúde segundo a ótica da Análise SWOT. Como fatores positivos, destacaram a valorização do diálogo interinstitucional e intersetorial com os atores envolvidos na judicialização da saúde; equipe técnica da saúde multidisciplinar e capacitada atuando em conjunto com a Procuradoria Especializada à Saúde (PASS) e a divulgação periódica da Relação Municipal de Medicamentos Essenciais aos prescritores. A pesquisa considera que a estratégia utilizada pode ser replicável em outros municípios de médio porte na abordagem da judicialização da saúde no país. (AU)

The phenomenon of health judicialization is a growing reality in Brazil, especially in municipalities, resulting in disruption in planning and budget execution. This is a case study with a qualitative-quantitative approach conducted in Três Rios, a medium-sized municipality in the state of Rio de Janeiro, which began in 2009 with the implementation of the Supportive Deputy Prosecutor's Office for Health (NAPASS) and the restructuring of Pharmaceutical Assistance in the local Unified Health System (SUS) to address the intense judicialization of health. The main objective of the research was to analyze the role of this Supportive Deputy Prosecutor's Office as a strategy in addressing health judicialization and to describe the other synergistically implemented strategies by the municipal management between 2008 and 2021. The results of these implemented strategies allowed for the observation of a significant reduction in lawsuits filed against the municipality in the first year of the new administration and a substantial extrajudicial resolution of demands originating from the Public Defender's Office of the State of Rio de Janeiro. Areas for improvement and progress were also identified based on an analysis of the positive and negative factors in addressing health judicialization from the perspective of SWOT analysis. Positive factors included the appreciation of interinstitutional and intersectoral dialogue with the actors involved in health judicialization, a multidisciplinary and skilled health technical team working in collaboration with the Specialized Prosecutor's Office for Health (PASS), and the dissemination of the Municipal Essential Medicines List to prescribers. The research suggests that the strategy used can be replicated in other medium-sized municipalities in addressing health judicialization in the country. (AU)

Association between hyperuricemia and hypertension and the mediatory role of obesity: a large cohort study in China

SUMMARY OBJECTIVE: This study aimed to investigate the sex-specific association between hyperuricemia and the risk of hypertension and whether obesity mediates this association. METHODS: This study included 31,395 (47.0% women) adults without hypertension, cardiovascular disease, or cancer at baseline who completed at least one follow-up annual examination between 2009 and 2016. Cox regression models were performed to calculate hazard ratios and 95% confidence intervals. Mediation analysis was conducted to estimate the effect of body mass index on the association between hyperuricemia and hypertension. RESULTS: During a median 2.9-year follow-up, hyperuricemia was significantly associated with a higher risk of hypertension (HR 1.15, 95%CI 1.07-1.24 for all participants; HR 1.12, 95%CI 1.03-1.22 for men; and HR 1.23, 95%CI 1.02-1.48 for women) after adjustment for potential confounders. Additional adjustment for body mass index attenuated this association (HR 1.09, 95%CI 1.08-1.10 for all participants; HR 1.07; 95%CI 0.98-1.16 for men; HR 1.18; 95%CI 0.96-1.44 for women). Mediation analysis showed that BMI partially mediated the relationship between hyperuricemia and incident hypertension (indirect effect HR 1.09, 95%CI 1.08-1.10; direct effect: HR 1.08, 95%CI 1.02-1.15). The percentage of the mediation effect was 53.2% (95%CI 37.9-84.5). CONCLUSION: Hyperuricemia is associated with a risk of hypertension in both sexes, and BMI partially mediates hyperuricemia-related incident hypertension.

Impact of Early Relational Trauma on Psychic Processes: Implications for Treatment of vulnerable Children and Families / Impacto do Trauma Relacional Precoce nos Processos Psíquicos em Famílias Vulneráveis: Implicações para o Tratamento de Crianças e Famílias

ABSTRACT Numerous works and clinical research conducted in various institutions have cast fresh light on the notion of trauma and have contributed to the emergence of the concept of early relational trauma. Early relational trauma is a form of trauma rendered complex by the multiplicity of its sources and its modes of expression. Its main features are often attachment and acting-out disturbances. In families where such trauma occurs, links could sometimes be perverted and form a narcissistic configuration. This mode of functioning, organized around negativity, impacts the plurality of psychic processes and interferes with the treatment approaches of multidisciplinary teams. In order to promote a multifocal approach to care tailored to differences in situations, educational and socio-judicial practitioners.

RESUMO Inúmeros trabalhos e pesquisas clínicas realizados em diversas instituições trouxeram à luz a noção de trauma e contribuíram para o surgimento do conceito de trauma relacional precoce. O trauma relacional precoce é uma forma de trauma complexo pela multiplicidade de suas fontes e seus modos de expressão. Suas principais características são frequentemente distúrbios de apego e atuação. Nas famílias onde ocorre tal trauma que às vezes pode ser pervertido em configurações narcísicas, esse modo de funcionamento organizado em torno da negatividade impacta a pluralidade do psíquico e interfere nas abordagens de tratamento das equipes multidisciplinares. Para promover uma abordagem multifocal de cuidados adaptados às diferenças de situações, profissionais de educação e sócio judiciais.

Mediação de conflitos familiares: uma revisão sistemática / Mediation of family conflicts: a systematic review

Este artigo trata de uma revisão sistemática da literatura. O problema de pesquisa foi verificar como se dá a atuação do psicólogo nos atendimentos de mediação familiar. O objetivo principal foi caracterizar a atuação do psicólogo enquanto mediador de conflitos familiares em processos de disputa de guarda de filhos. Além disso, buscou verificar as técnicas utilizadas para realização da mediação, as características do processo de mediação, quem são os indivíduos atendidos e quem são os mediadores. Foram escolhidos os descritores "mediação familiar" AND "psicologia". As bases de dados utilizadas na pesquisa foram Redalyc, BVS e Scielo. Analisou-se artigos empíricos e documentais na língua inglesa, espanhola e portuguesa, sem restritor de tempo. Dentre 37 artigos encontrados, foram analisados um total final de sete artigos. Observou-se que o trabalho de mediação é realizado de forma multidisciplinar, como preconiza a Lei da Mediação no Brasil. O trabalho do psicólogo é realizado fundamentalmente em parceria com operadores do direito e assistentes sociais, contudo, sem uma clareza quanto às especificidades do trabalho do psicólogo como mediador

This article deals with a systematic review of the literature. The research problem was verified as it gives a psychological performance in the family mediation enterprises. The main objective was to characterize the psychologist's role as a mediator of family conflicts in child custody dispute processes. Also, try to check how techniques used for mediation, as resources of the mediation process, who are the individuals served and who are the mediators. The descriptors "family mediation" AND "psychology" were selected. As database used in the research were Redalyc, BVL and Scielo. Review some empirical articles and documents in English, Spanish and Portuguese without time restriction. Among 37 articles found, analyzed in the fi nal total of seven articles. Observe if the mediation work is done in a multidisciplinary way, as recommended by the Mediation Law in Brazil. The work of the psychologist is performed primarily in partnership with legal enforcement offi cers and Social Workers, however without clarity as to the specifi cs of the psychologist's work as a mediator

Este artículo trata de una revisión sistemática de la literatura. El problema de investigación fue verificar cómo actúa el psicólogo en sesiones de mediación familiar. El objetivo principal fue caracterizar el papel del psicólogo como mediador de conflictos familiares en disputas por la custodia de los hijos. Además, buscó verificar las técnicas utilizadas para realizar la mediación, las características del proceso de mediación, quiénes son las personas asistidas y quiénes son los mediadores. Se eligieron los descriptores "mediación familiar" Y "psicología". Las bases de datos utilizadas en la investigación fueron Redalyc, BVS y Scielo. Se analizaron artículos empíricos y documentales en inglés, español y portugués, sin restricción de tiempo. Entre 37 artículos encontrados, se analizaron un total de siete artículos. Se observó que el trabajo de mediación se realiza de forma multidisciplinar, como lo recomienda la Ley de Mediación en Brasil. El trabajo del psicólogo se realiza fundamentalmente en colaboración con operadores jurídicos y trabajadores sociales, pero sin claridad en cuanto a las especifi cidades del trabajo del psicólogo como mediador

Analysis of causes and prevention of ankle injuries in college basketball / Análise das causas e prevenção contra lesões no tornozelo no basquetebol universitário / Análisis de las causas y la prevención de las lesiones de tobillo en el baloncesto universitario

ABSTRACT Introduction: Basketball is a combative sport, very popular among college students. However, it requires many periods of running, interspersed with emergency breaks, tackling, and other actions prone to ankle injuries. Objective: Investigate the causes of ankle joint injuries in college basketball, raising countermeasures to prevent these sports injuries. Methods: 413 college students who regularly participate in basketball games at 10 colleges and universities were selected as research objects. The causes of ankle joint injuries in the process of this sport were investigated through questionnaires, and the main causes of injuries were analyzed using statistical methods. Results: The causes of ankle joint injuries in college basketball include subjective and objective factors. Subjective factors include inadequate psychological preparation, warm-up exercise, cushioning, and excessive exercise, among others listed; objective factors mainly contemplate local injury and accidental injury. Conclusion: The participation of college students in basketball is beneficial to improve their physical health, requiring effective measures to prevent possible ankle injuries, both related to subjective and objective aspects. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: o basquetebol é uma modalidade esportiva combativa, muito popular entre os universitários. No entanto, necessita de muitos períodos de corrida, intercalados por pausas emergenciais, enfrentamentos e outras ações propensas a lesões no tornozelo. Objetivo: Investigar as causas de lesões nas articulações do tornozelo no basquetebol universitário, levantando contramedidas para prevenir essas lesões desportivas. Métodos: O total de 413 estudantes universitários que participam regularmente em jogos de basquetebol em 10 faculdades e universidades foram selecionados como objetos de pesquisa. As causas das lesões nas articulações do tornozelo no processo desse esporte foram investigadas através de questionários, sendo analisadas as principais causas das lesões através de métodos estatísticos. Resultados: as causas das lesões nas articulações do tornozelo dentro do basquetebol universitário incluem principalmente fatores subjetivos e objetivos. Os fatores subjetivos incluem a preparação psicológica inadequada, o exercício de aquecimento inadequado, o amortecimento inadequado, o exercício excessivo, entre outros listados; os fatores objetivos contemplam principalmente a lesão local e a lesão acidental. Conclusão: A participação dos estudantes universitários no basquetebol é benéfica para melhorar a sua saúde física, requerendo medidas eficazes para prevenir possíveis lesões no tornozelo, tanto as relacionadas aos aspectos subjetivos como objetivos. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El baloncesto es una modalidad deportiva combativa, muy popular entre los estudiantes universitarios. Sin embargo, requiere muchos periodos de carrera, intercalados con pausas de emergencia, enfrentamientos y otras acciones propensas a las lesiones de tobillo. Objetivo: Investigar las causas de las lesiones de la articulación del tobillo en el baloncesto universitario, planteando contramedidas para prevenir estas lesiones deportivas. Métodos: Se seleccionaron como objeto de investigación un total de 413 estudiantes universitarios que participaban regularmente en partidos de baloncesto en 10 colegios y universidades. Las causas de las lesiones de la articulación del tobillo en el proceso de este deporte se investigaron mediante cuestionarios, y las principales causas de las lesiones se analizaron mediante métodos estadísticos. Resultados: Las causas de las lesiones de la articulación del tobillo en el baloncesto universitario incluyen principalmente factores subjetivos y objetivos. Los factores subjetivos incluyen una preparación psicológica inadecuada, un ejercicio de calentamiento inadecuado, una amortiguación inadecuada, un ejercicio excesivo, entre otros enumerados; los factores objetivos contemplan principalmente la lesión local y la lesión accidental. Conclusión: La participación de los estudiantes universitarios en el baloncesto es beneficiosa para mejorar su salud física, requiriendo medidas eficaces para prevenir posibles lesiones de tobillo, tanto las relacionadas con aspectos subjetivos como objetivos. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Evaluative index system in physical training of basketball players / Sistema de índice avaliativo no treinamento físico dos jogadores de basquetebol / Sistema de índice de evaluación en la preparación física de los jugadores de baloncesto

ABSTRACT Introduction: The training should be performed according to the characteristics of basketball by establishing a scientific evaluation index system to fully exploit the potential of its players. Objective: Evaluate the index system for measuring physical training specific to basketball players. Methods: The physical training evaluation indexes of athletes were studied by checking the scientific literature and mathematical statistics, and an evaluation index for the physical training of young basketball players was designed and experimented. Results: The highest proportion of the special fitness score in athletic average was 46.25%; the proportion of the players' general fitness score represented 15% above and 13.75% below. The specific fitness level of basketball players is mainly at the average level. Conclusion: The effects of training can be effectively evaluated by the experienced index system, and it is useful for athletes to find deficiencies, make full use of their potential, improve skills and adapt basketball tactics. It may also provide more reserve talent for professional basketball. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O treinamento deve ser realizado de acordo com as características do basquetebol estabelecendo um sistema de índice de avaliação científica para explorar plenamente o potencial de seus jogadores. Objetivo: Avaliar o sistema de índices de medição do treinamento físico específico para os jogadores de basquetebol. Métodos: Os índices de avaliação do treinamento físico dos atletas foram estudados verificando a literatura científica e estatísticas matemáticas, um índice de avaliação para o treinamento físico de jovens jogadores de basquetebol foi projetado e experimentado. Resultados: A maior proporção da pontuação da aptidão física especial na média atlética foi de 46,25%; a proporção da pontuação da aptidão física geral dos jogadores representou 15% acima e 13,75% abaixo, o nível de aptidão física específica dos jogadores de basquetebol está principalmente no nível mediano. Conclusão: Os efeitos do treinamento podem ser efetivamente avaliados pelo sistema de índice experimentado, sendo útil para que os atletas possam encontrar deficiências, aproveitar plenamente seu próprio potencial, melhorar as habilidades e adaptar as táticas do basquetebol. Também poderá fornecer mais talentos de reserva para o basquetebol profissional. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El entrenamiento debe realizarse de acuerdo con las características del baloncesto estableciendo un sistema de índices de evaluación científica para explotar plenamente el potencial de sus jugadores. Objetivo: Evaluar el sistema de índices de medición del entrenamiento físico específico para jugadores de baloncesto. Métodos: Se estudiaron los índices de evaluación del entrenamiento físico de los deportistas mediante la comprobación de la literatura científica y la estadística matemática, y se diseñó y experimentó un índice de evaluación del entrenamiento físico de los jóvenes jugadores de baloncesto. Resultados: La proporción más alta de la puntuación de la aptitud física especial en la media atlética fue del 46,25%; la proporción de la puntuación de la aptitud física general de los jugadores representó un 15% por encima y un 13,75% por debajo, el nivel de aptitud física específica de los jugadores de baloncesto está principalmente en el nivel medio. Conclusión: Los efectos del entrenamiento pueden evaluarse eficazmente mediante el sistema de índice de experiencia, y es útil para que los deportistas encuentren las deficiencias, aprovechen al máximo su propio potencial, mejoren las habilidades y adapten las tácticas de baloncesto. También puede proporcionar más talentos de reserva para el baloncesto profesional. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Fear of Covid-19 and Burnout Among Healthcare Providers in Malaysia: Is Resilience a Missing Link?

@#Introduction: During the COVID-19 pandemic, healthcare providers have been in great fear due to the high risk of contracting COVID-19 infection at any time. This study aimed to determine the mediating role of resilience on the relationship between fear of COVID-19 and burnout in primary care healthcare providers in Malaysia. Methods: This was an online cross-sectional study involving 1280 healthcare providers aged 18 years and older from 30 government primary care clinics in Malaysia. We used the COVID-19 Fear Scale, the Copenhagen Burnout Inventory Scale, and the Short Brief Resilience Scale to collect data from the respondents. Smart-PLS was used to perform mediation analysis. Results: The mean age of the respondents was 36 years old and mean duration of working experience was 11 years. The majority of the respondents were female (82.4%) and Malays (82.3%). The study population consisted of nurses (47.4%), doctors (26%), medical assistants (11.9), healthcare assistant (7.1%), medical laboratory technicians (6.4%) and drivers(1.3).The results show that fear of COVID-19 positively predicts burnout. According to the results, resilience mediates the relationship between fear of COVID-19 and all the three burnout domains, namely personal burnout (β=0.175,p<0.001), work-related burnout (β=0.175,p<0.001) and client-related burnout (β=0.172,p<0.001). Additionally, resilience reduces the impact of COVID-19 fear on the three domains of burnout. Conclusion: Our study has reported a mediating effect of resilience on the relationship between fear of COVID-19 and burnout.

Effect of diabetes on sepsis in patients with pyogenic liver abscess / 中华肝胆外科杂志

Objective:To study the effect of diabetes mellitus (DM) on sepsis in patients with pyogenic liver abscess (PLA).Methods:The clinical data of 116 patients with PLA treated in the Affiliated Hospital of Jiangnan University from January 2021 to May 2022 were retrospectively analyzed, including 64 males and 52 females, aged (62.3±12.6) years old. Patients were divided into DM group ( n=56) and non-DM group ( n=60), which were also divided into the sepsis group ( n=29) and the non-sepsis group ( n=87). The clinical features were compared among the groups, the risk factors of PLA complicated with sepsis were analyzed by multivariate logistic regression. Mediation model was used to analyze how DM affects the development of sepsis. Results:Compared with the non-DM group, patients in DM group had higher incidences of hypertension and acute physiology and chronic health evaluation II, a higher proportion of blood neutrophil count, a higher serum levels of triglyceride, urea nitrogen, fasting blood glucose and glycated hemoglobin at admission. The DM group also higher incidences of hypoproteinemia, pleural effusion, and sepsis, with longer hospital stay and higher hospitalization cost (all P<0.05). The levels of hemoglobin, albumin and hematocrit were lower in DM group (all P<0.05). Multivariate logistic regression analysis showed that comorbidity of DM ( OR=3.431, 95% CI: 1.245-9.455) and abscess with a larger diameter ( OR=1.664, 95% CI: 1.258-2.220) were associated with a higher risk of developing sepsis (all P<0.05). Mediation model showed that neutrophil count and triglyceride were the mediating variables of sepsis in patients with PLA. Conclusion:Comorbidity of diabetes is an independent risk factor of developing sepsis in patients with pyogenic liver abscess. Diabetes may induce sepsis by affecting the neutrophils and triglyceride.

The effect of disease uncertainty on caregiving burden in major caregivers of stroke:an intermediary model with regulation / 中国实用护理杂志

Objective:To investigate the relationship and intrinsic mechanism between disease uncertainty, coping style, social support and caregiver burden of primary caregivers of stroke, in order to provide a theoretical basis for reducing the burden of care and improving the quality of care for stroke caregivers.Methods:In this study, the main caregivers of 314 stroke patients hospitalized in Xinjiang Uygur Autonomous Region People's Hospital from December 2021 to May 2022 were selected by convenience sampling method, and cross-sectional surveys were conducted using the general data questionnaire, the Family Scale of Disease Uncertainty, the Simple Coping Style Questionnaire, the Social Support Rating Scale, and the Caregiver Burden Scale. Model 4 in Hayes′ SPSS-Process program was used to test the mediation effect, and Model 15 was used to test the mediation effect of social support.Results:The positive predictive effect of disease uncertainty in the primary caregiver of stroke patients on the burden of caregivers was significant ( β=0.665, P<0.01). Active coping played a partial mediating role between disease uncertainty and caregiver burden, with a mediating effect of 0.306 and a mediating effect of 31.8%. The interaction between disease uncertainty and social support had a significant predictive effect on caregiver burden ( β=-0.033, P<0.05), and the interaction item between active response and social support had a significant predictive effect on caregiver burden ( β=-0.019, P<0.05). Conclusions:Positive coping is an important psychological mechanism between disease uncertainty and caregiver burden, and social support can alleviate the influence of disease uncertainty on caregiver′s burden, and can also strengthen the weakening effect of positive coping on caregiver′s burden.

The mediating effect of interdisciplinary cooperation ability on the level of hospice care practice and the degree of difficulty of medical staff / 中国实用护理杂志

Objective:To explore the mediating role of interdisciplinary cooperation ability between the level of hospice care practice and difficulty degree of hospice care for medical staff, in order to improve the quality of hospice care services for medical staff, and to provide evidence for relevant managers to formulate effective measures to reduce the implementation of hospice care difficulties.Methods:This study was a cross-sectional survey. Using convenience sampling method, the general data questionnaire, Palliative Care Difficulties Scale (PCDS), Palliative Care Self-Report Practice Scale (PCPS) and Modified Index of Interdisciplinary Collaboration (MIIC) were used to investigate 362 medical staff in all hospice care institutions of Shiyan City from July to August 2022.Results:The total score of PCDS in 362 medical staff was (40.58±13.44) points, (67.47 ± 12.50) points for PCPS and (108.36 ± 21.46) points for MIIC. There was a positive correlation between the total score of MIIC and PCDS ( r=0.500, P<0.01). The total score of PCPS was negatively correlated with the total score of MIIC ( r=-0.337, P<0.01) and the total score of PCDS ( r=-0.189, P<0.01). The interdisciplinary cooperation ability of medical staff in hospice care had a complete mediating effect between the level of practice and the degree of difficulty (Effect value=-0.190, 95% CI-0.274 to -0.126), and the mediating effect accounted for 98.5% of the total effect value. Conclusions:The practice level of hospice care can not directly affect the implementation of the difficulty degree, but by taking active measures to improve the interdisciplinary cooperation ability, so as to enhance the practice level, and then reduce the implementation of hospice care difficulty degree.

Intermediary effect of benefit finding in the mindfulness level and coping style of acute cerebral infarction patients who received interventional therapy / 中国实用护理杂志

Objective:To observe the level of mindfulness and coping style in patients with acute cerebral infarction (ACI) after interventional therapy, and analyze the intermediary effect of benefit finding between them, so as to provide a theorectical basis of implement mindfulness intervention in clinical practice.Methods:The 130 patients with ACI after interventional treatment in the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2021 were included in this cross-sectional survey study. The general data questionnaire, Five-factor Mindfulness Scale (FFMQ), Benefit Finding Rating Scale (BFS), and Simple Coping Style Questionnaire (SCSQ) were used to analyze the relationship between benefit finding, mindfulness level and coping style, and the intermediary effect of benefit finding between them.Results:The total FFMQ score of 130 ACI patients after interventional therapy was (123.34 ± 5.14) points. The BFS score, positive coping score and negative coping score were (49.73 ± 3.41), (20.35 ± 2.25), (13.18 ± 1.45) points, respectively. The level of mindfulness and benefit were positively correlated with positive coping ( r=0.687, 0.737, both P<0.05). The level of mindfulness and benefit were negatively correlated with negative coping( r=-0.654, -0.779, both P<0.05). It was found that mindfulness level played a partial intermediatory effect on positive coping and negative coping in ACI patients after interventional therapy, with contribution rates of 49.71% and 64.58%, respectively. Conclusions:Benefit finding plays a partial intermediary effect on the level of mindfulness and coping style of patients with ACI after interventional therapy.

Mediating effect of cognitive emotion regulation strategy on stress overload and stress response of palliative care nurses / 中国实用护理杂志

Objective:To explore the current status and correlation between stress overload, different cognitive emotion regulation strategies and stress response in palliative care nurses, and to provide reference for reducing stress reaction of hospice nurses.Methods:A total of 448 palliative care nurses from Beijing City, Jiangsu Province, Hunan Province and Anhui Province were selected as subjects by convenience sampling method in February 2022. The general information questionnaire, Stress Overload Scale, Cognitive Emotion Regulation Questionnaire and Stress Response Questionnaire were used to conduct a cross-sectional survey. After analyzing their scores, correlation analysis and mediating effect analysis were conducted.Results:The stress overload score of palliative care nurses was 66.00 (55.00, 67.00), and the stress response score was 80.00 (63.00, 84.00). The stress overload was positively correlated with the stress response ( r=0.735, P<0.05), and the positive emotion regulation strategy was negatively correlated with the stress response ( r=-0.440, P<0.05), negative emotion regulation strategy was positively correlated with stress response ( r=0.747, P<0.05). The cognitive emotion regulation strategy had a partial mediating effect between the stress overload and the stress response, accounting for 29.6% of the total effect. Conclusions:Cognitive emotion regulation is the mediating variable between stress overload and stress response of palliative care nurses. Managers should pay more attention to the stress level and mental health status of palliative care nurses, and guide them to choose appropriate emotional regulation strategies, so as to reduce stress response and maintain physical and mental health.

The level of mindfulness and fear of recurrence in patients after radical gastrectomy for gastric cancer: the chain mediating effect of illness uncertainty and negative coping styles / 中国实用护理杂志

Objective:To explore the relationship between the level of mindfulness, illness uncertainty, negative coping style and fear of recurrence in patients after radical resection of gastric cancer, and to understand the internal mechanism of how mindfulness affects the fear of recurrence.Methods:This was a cross sectional survey. From January 2019 to March 2021, the convenience sampling method was used to select 227 patients undergoing radical gastric cancer surgery in the Affiliated Hospital of Naval Medial University of Chinese PLA as the research objects. The general information questionnaire, Mindfulness Attention and Awareness Scale, Fear of Disease Progression Simplified Scale, Mishel′s Illness Uncertainty Scale and Simplified Coping Style Questionnaire were used for questionnaire surveys. The relationship between the level of mindfulness, illness uncertainty, negative coping style and fear of recurrence was explored and the model was tested.Results:The returned questionnaires were 207 with a recovery rate of 91.19%(207/227). Pearson correlation analysis showed that the level of mindfulness was negatively correlated with illness uncertainty, negative coping style, and fear of recurrence ( r=-0.176, -0.269, -0.480, all P<0.01). Illness uncertainty, negative coping styles were positively correlated with fear of recurrence ( r=0.433, 0.420, both P<0.01). The mediation model test showed that mindfulness had a significant direct effect on fear of relapse (effect value was -0.220), illness uncertainty and negative coping styles had significant partial mediating effect between mindfulness level and fear of recurrence (effect value were -0.036, -0.030). And the chain mediating effect of illness uncertainty and negative coping style was also significant (effect value was -0.006). Conclusions:The level of mindfulness can not only have a direct impact on the fear of recurrence in patients after radical gastrectomy, but also indirectly affect the fear of recurrence through the chain mediating effect of illness uncertainty, negative coping style, and disease uncertainty→negative coping style.