Calidad de vida profesional de quienes laboran en cuidados paliativos y su relación con el autocuidado, la atención plena y el sentido de vida / Professional quality of life of palliative care staff and its relationship with selfcare, mindfulness and meaning of life

Introducción: La calidad de vida profesional (que incluye satisfacción y fatiga por compasión) y sus factores asociados, han sido poco explorados en cuidados paliativos (CP) en Latinoamérica. Objetivo: Determinar la calidad de vida profesional en CP y su relación con el autocuidado, la capacidad de atención plena y el sentido de vida. Método: Estudio observacional, de corte transversal. Participaron profesionales laborando en CP en Colombia. Se empleó el PROQOL para evaluar satisfacción por compasión (SC), Burnout y trauma secundario (TS), el PSCS para examinar autocuidado, el MAAS para examinar atención plena y la Escala dimensional de sentido de vida (EDSV). Se realizaron análisis descriptivos, correlacionales y de regresión múltiple. Resultados: participaron 108 profesionales. Edad promedio 38 años, 55% médicos, 73% mujeres, 32,4% reportaron elevada afectación del bienestar por la Covid-19. El 85% obtuvieron puntuaciones medias o altas en SC, el 75,9% en Burnout y el 81,5% en TS (con medianas de 42.5, 21 y 12, respectivamente). Hubo una correlación positiva y significativa entre PSCS, MAAS y EDSV con SC, pero negativa y significativa con Burnout y TS. En conjunto, la SC, el MAAS y el autocuidado social tuvieron un efecto predictivo negativo sobre los niveles de Burnout (R2=0,535). Conclusiones: Aunque la mayoría de participantes están satisfechos con su labor, los índices de Burnout y TS fueron elevados durante el período de pandemia. El en conjunto, la satisfacción por compasión, la atención plena y el autocuidado social predijeron niveles menores de Burnout, indicando potenciales vías de apoyo para quienes ejercen CP (AU)

Introduction. Professional quality of life (involving compassion satisfaction and compassion fatigue) and its related factors have been poorly explored in Palliative Care (PC). Objectives. To determine the professional quality of life of PC practitioners in Colombia and its relationship with self-care, mindfulness and meaning of life. Methods. Observational cross-sectional study. Practicing professionals of PC of Colombia were invited. Compassion Satisfaction (CS), Burnout, and Secondary Trauma (ST) were assessed using PROQOL; selfcare was examined using PSCS; MAAS was used to assess Mindfulness capacity, and the Dimensional Scale of sense of life (EDSV) was also employed. Descriptive correlational, and multiple regression analyses were performed. Results. One-hundred and eight participants participated; mean age of 38 years, 73% women, 32,4% indicated high impact on their wellbeing due to Covid-19; 85% of participants showed medium-high scores on CS, 75,9% on Burnout, and 81,5% on ST (median scores of 42.5, 21, and 12, respectively). Scores on PSCS, MAAS and EDSV positively and significantly correlated with CS, and were negatively and significantly related with Burnout and ST. Altogether, SC, MAAS and social selfcare had a negative predictive effect on Burnout levels (R2=0.538). Conclusion. Although most participants were satisfied with their jobs, scores on Burnout, and TS were high during the Pandemic. Together, compassion satisfaction, mindfulness and social selfcare were predictive of lower levels of Burnout, signaling potential lines of intervention for PC practitioners (AU)

Redox stress in Marfan syndrome: Dissecting the role of the NADPH oxidase NOX4 in aortic aneurysm.

Marfan syndrome (MFS) is characterized by the formation of ascending aortic aneurysms resulting from altered assembly of extracellular matrix fibrillin-containing microfibrils and dysfunction of TGF-ß signaling. Here we identify the molecular targets of redox stress in aortic aneurysms from MFS patients, and investigate the role of NOX4, whose expression is strongly induced by TGF-ß, in aneurysm formation and progression in a murine model of MFS. Working models included aortae and cultured vascular smooth muscle cells (VSMC) from MFS patients, and a NOX4-deficient Marfan mouse model (Fbn1C1039G/+-Nox4-/-). Increased tyrosine nitration and reactive oxygen species levels were found in the tunica media of human aortic aneurysms and in cultured VSMC. Proteomic analysis identified nitrated and carbonylated proteins, which included smooth muscle α-actin (αSMA) and annexin A2. NOX4 immunostaining increased in the tunica media of human Marfan aorta and was transcriptionally overexpressed in VSMC. Fbn1C1039G/+-Nox4-/- mice aortas showed a reduction of fragmented elastic fibers, which was accompanied by an amelioration in the Marfan-associated enlargement of the aortic root. Increase in the contractile phenotype marker calponin in the tunica media of MFS mice aortas was abrogated in Fbn1C1039G/+-Nox4-/- mice. Endothelial dysfunction evaluated by myography in the Marfan ascending aorta was prevented by the absence of Nox4 or catalase-induced H2O2 decomposition. We conclude that redox stress occurs in MFS, whose targets are actin-based cytoskeleton members and regulators of extracellular matrix homeostasis. Likewise, NOX4 have an impact in the progression of the aortic dilation in MFS and in the structural organization of the aortic tunica media, the VSMC phenotypic modulation, and endothelial function.