Complementary and Alternative Medicine to Treat Fibromyalgia Symptoms. A Systematic Review.

This study aims to investigate the current evidence for the use of complementary and alternative medicine (CAM) in fibromyalgia (FM). A systematic review was conducted searching for PubMed, Scopus, CINAHL, PsycInfo, and Web of Science databases. Randomized controlled trials published up to December 2023 in peer-reviewed journals were included. Methodological quality was assessed by the Quality Assessment of Controlled Intervention Studies tool. A total of 216 articles were identified and 15 constituted the final sample. The type of CAM most used was traditional Chinese medicine (60%), and the most common instrument used was the Fibromyalgia Impact Questionnaire (60%). Our review was grouped into four themes based on the origin of the therapies: 1) Traditional Chinese Medicine; 2) Japanese natural harmonization (eg, Reiki); 3) Ayurvedic Medicine; and 4) Other non-drug therapies. Our systematic review showed that there is a wide range of CAMs used to treat FM. Most of the clinical trials have shown significant results for the effectiveness of these interventions in both physical and mental health outcomes of FM as compared to control groups. However, the heterogeneity of the interventions and outcomes warrants further studies on this topic.

Violence on social networks related to the body image of young women and its repercussions on health.

INTRODUCTION: Social networking sites perpetuate gender stereotypes, inequalities, and gender violence, generating adverse health effects. METHODS: This study aimed to analyze the relationship between Instagram, alcohol consumption and effects on health, through interviews and discussion groups involving adolescents (high school or university students and workers), during the period from the third to the sixth wave of the COVID-19 pandemic. RESULTS: A total of 118 individuals participated in the study. Three coding clusters were identified: (1) Inequality in the representation of men and women on SNSs; (2) Violence towards women's bodies and sexual violence on SNSs; and (3) Health problems derived from violence against women's body image on SNSs. The main focus of our analysis was the exhibition of the female body, in which eroticization of the body prevails and gender roles are perpetuated. Violence is generated towards women in the form of misogynistic attacks for daring to challenge conventional stereotypes. Many interviewees coincide that the main health effects include low self-esteem, anxiety and eating disorders. CONCLUSIONS: The institutional response to the abuses and violence committed on SNSs against women is weak, and public policies are needed to protect women in these environments where they are especially vulnerable.

Ecospirituality and Health: A Systematic Review.

Environmental changes are affecting human health. A renewal of the way we understand and relate to the planet is needed. Ecospirituality brings together the terms spirituality and environment and is born as a means of solution to this dilemma. This systematic review aimed to find out the influence of ecospirituality on global health. A search of scientific literature was carried out in the main health science databases. A review was conducted to critically evaluate the studies that identified relevant ecospiritual aspects regarding health care for communities. After a systematic search and screening, and following specified methodological criteria, a total of 14 articles were selected in the review. The findings of the review suggest that a new perspective in our worldview such as ecospirituality will provide us with the necessary keys to improve health. To understand ecospirituality, we must keep in mind the indigenous way of life, which is the clear example to follow to achieve environmental health and global health. Ecospirituality leads to a healthier environment, and as this is directly related to health, there is also an improvement in global health.

The Spiritual Aspect of Pain: An Integrative Review.

Pain is an unpleasant sensory and emotional experience that affects individuals in various ways involving biological, psychological, social, and spiritual aspects. There is currently no comprehensive treatment that effectively addresses all aspects of pain. This integrative review aimed to analyze the spiritual aspect of pain relief. Following the specified methodological criteria, a total of 20 articles were selected. There evidenced a lack of spiritual care provided by healthcare professionals, even though its correlation with pain and its potential benefits have been widely demonstrated in the literature. Fortunately, some patients put into practice existential and religious tools to self-control and cope with their pain, although not always with a successful response.

Dosage of Physical Activity to Avoid Impairment of Activities Due to Pain: Analysis of Population-based Conditional Processes.

BACKGROUND: Physical activity's established health benefits include pain control, yet there is no consensus on the required dosage according to the literature. AIM: To test the influence of exercise on perceived health in patients whose daily activities are limited due to pain. Besides, analyze the possible moderating effect of age and find a formula for exercise dosage based on the perceived level of health. METHODS: Cross-sectional study based on the 2017 Spanish National Health Survey with 4,123 participants reporting activity limitations in their daily activities due to pain. The International Physical Activity Questionnaire (short version) was used to calculate energy expenditure. Data included age, sex, leisure-time physical activity, sitting time, pain-related impairments, pain medication, and perceived health. Mediation regression analysis was conducted using the SPSS PROCESS 4.0 macro. RESULTS: Results indicate a decline in perceived health with age. The relationship between exercise (energy expenditure) and perceived health was highly significant (d=-0.224, p<0.001). Age moderated the association between pain and energy expenditure up to 75.61 years (0.1568, p=0.05) and between energy expenditure and perceived health up to 75.74 years (-0.289, p=0.05), but this effect diminished afterwards. A formula was developed to estimate energy expenditure based on the desired level of health. CONCLUSIONS: The perception of health in people who are limited in their daily activities due to pain (moderate to very much) is mediated by the amount of physical activity they perform. Besides, this perception is moderated by age, up to 76 years.

The use of complementary and traditional medicine for the treatment of patients with COVID-19: A systematic review.

OBJECTIVE: The aim of this study was to evaluate the use and effectiveness of non-pharmacological therapies as part of the treatment of COVID-19 and its complications, either combined or not with the usual treatment. METHODS: A systematic review was conducted between August and October 2021 using PubMed, Scopus, CINAHL and Web of Science databases. From a total of 204 articles identified, 33 were included in the final sample (15 clinical trials and 18 quasi-experimental studies). The methodological evaluation was carried out using STROBE and CONSORT guidelines. RESULTS: There is a growing literature on the use of CAM for COVID-19. Most studies have shown positive findings, particularly for the use of TCM, other herbal therapies and acupuncture. Nevertheless, most studies were carried out in Asia and relied on quasi-experimental designs. The current evidence is available for physical outcomes (mortality rate, pneumonia resolution and other symptoms, negative PCR test, and hospitalization and ICU admissions) and for mental health outcomes. CONCLUSION: Despite a positive role of CAM on COVID-19 outcomes, the evidence is still mostly based on quasi-experimental studies. More robust clinical trials are needed in order to generate better evidence in this area.

"More Spiritual Health Professionals Provide Different Care": A Qualitative Study in the Field of Mental Health.

In recent years, there has been an exponential increase in studies demonstrating the positive effects of the religiosity/spirituality (R/S) approach on patients' physical and mental health. In mental health units, patients want professionals to be sensitive to their spiritual and/or religious needs, which is a fundamental aspect of a holistic approach to patients. Qualitative research with an exploratory and descriptive design with an ethnographic-phenomenological approach through in-depth interviews with sixteen professionals from Spanish mental health units. There is no consensus on the definition of spirituality; however, all of them believe that R/S has a positive influence on the health of patients in coping with illness. They believe that their own R/S may interfere with the professional-patient relationship and their attention to spiritual needs. Few professionals address these needs, citing limitations such as lack of time and lack of specific training in spiritual care. More research is needed on the spiritual care of mental health professionals to define the framework, professional training, and associated challenges in the spiritual care of patients.

Spiritual needs during COVID 19 pandemic in the perceptions of Spanish emergency critical care health professionals.

OBJECTIVES: To investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic. METHODS: A qualitative investigation was carried out using in-depth interviews. SETTING: Emergency and emergency and ICU health professionals from different regions of Spain. FINDINGS: The sample consisted of 47 nursing and one nursing assistant. The qualitative analysis yielded four main themes that reflect the following categories: "the experience with spirituality in clinical practice"; "resources and barriers to provide spiritual care"; "the COVID pandemic and spiritual care" and "training in spiritual care". In addition, two subdeliveries were also obtained: "ethical dilemma" and "rituals of death". CONCLUSIONS: The majority of emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients' spiritual needs. During the COVID-19 pandemic in Spain, professionals felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of health professionals is that more training and resources are needed on this topic. IMPLICATIONS FOR CLINICAL PRACTICE: Health professionals in emergency intensive care must provide nursing care that meets the spiritual needs of their patients to improve care in crisis situations such as the one suffered by the COVID-19 pandemic. For this, emergency services professionals must work and participate in the development of measures to overcome certain barriers present in emergency services, such as lack of time, lack of training and misconceptions that make it difficult to approach emergency services these needs.

Instagram, risky drinking and main health effects in Spanish adolescents in the COVID-19 pandemic. A qualitative study.

INTRODUCTION: The aim of this study was to analyze the relationship between Instagram, alcohol consumption and the impact on adolescent health during the COVID-19 pandemic. DESIGN AND SAMPLE: A qualitative study was carried out with 13 focus groups, involving 38 interviews. The fieldwork was conducted between January and December 2021 using a semi-structured script with three main categories. The research was carried out by a team specialized in adolescent risks and qualitative research. RESULTS: Three main categories were established: (1) The COVID-19 pandemic, Instagram and Risky Drinking, (2) Risk prevention and control strategies and (3) Effects on health. The participants (n = 118) reported greater alcohol consumption among Instagram users, either because this social media platform was used to spread the practice of alcohol consumption, or because they were affected by the content posted by digital marketers, Instagrammers, and/or contacts on Instagram. More than half of the sample (67.8%) had health problems (loss of control, headaches, difficulty in breathing, trembling, anxiety attacks, vomiting, tiredness, blackouts, and absence seizures), of whom 35% required urgent attention from their parents and/or the health services. CONCLUSIONS: Further research is needed to prevent risky drinking related to the use of social networking sites (SNSs) and its main health effects.

Spiritual Dimension in Neurological and Neurodegenerative Diseases: A Systematic Mapping Review.

Previous studies have shown the benefits of spirituality/religiosity with regard to health and quality of life for people. The high prevalence of neurological disorders, which are the main diseases that cause disability and dependency around the world, makes neurological disorders especially relevant. This systematic mapping review aimed to map the knowledge of spirituality experienced by people with neurological/neurodegenerative disorders and its influence on outcomes and the ability to cope with the disease. Following specified methodological criteria, a total of 13 articles were selected. The spiritual dimension should be considered a fundamental component of the quality of life and well-being of neurological patients as it can significantly influence their ability to cope with their disease.

"The COVID 19 pandemic worsened my living and working conditions". A qualitative research study of female Brazilian immigrants in Oporto.

Immigrant women face a double vulnerability, being a woman and an immigrant, a situation that hinders their entry into the labor market and worsens their working conditions and occupational health with respect to the native population. The objective of these women is to seek employment or educational opportunities and improving their own lives and those of their families. All this is affected by the axes of gender, ethnicity, migration and socioeconomic level, as well as being confronted with the patriarchal structure of exercise of power and domination. These situations of inequality have aggravated due to the COVID-19 pandemic, worsening working conditions and their occupational health. This study aims to explore the working conditions of the female Brazilian immigrant population living in Porto (Portugal) and how these conditions may affect their health. Qualitative research through semi-structured interviews conducted during the second wave of the COVID-19 pandemic was used. The results show of them had work overload, manifesting anxiety and stress. Physical affectations related to poor work ergonomics and the lack of occupational health examinations in working immigrant women is highlighted. The importance of strengthening migration policies related to occupational health is highlighted. In pandemic situations, the vulnerability of these women increases, worsening their overall health.

Knowledge, Attitudes and Practices towards Sexual and Reproductive Health and Rights of Girls among Colombian Healthcare Professionals.

This research aims to determine knowledge and attitudes towards sexual and reproductive health and rights of adolescent girls among healthcare professionals working at Café Madrid and Colorados health centers, which are highly vulnerable neighborhoods in Bucaramanga, Santander. To this end, in-depth interviews were conducted with a total of eight healthcare professionals from the above health centers using a script based on WHO recommendations on adolescent sexual and reproductive health and rights and recommendations by the DAPRE-Presidential Council for Women's Equity-CedaVida Foundation. Healthcare professionals were found to have proper technical and legal knowledge, especially regarding comprehensive care packages for survivors, as well as a gender perspective in their professional practice aimed at achieving equity. Knowledge and experience with sexual and reproductive health and rights provide insight into women's health from unrestrained choice of contraceptive methods to procedures such as abortion within the current legal framework. Their professional work is also affected by potential barriers that may limit their actions when putting their knowledge into practice.

The efficacy of religious and spiritual interventions in nursing care to promote mental, physical and spiritual health: A systematic review and meta-analysis.

BACKGROUND: Spiritual interventions have proved to alleviate suffering, help the patient to prepare for end of life issues, improve quality of life, and well-being. OBJECTIVE: This study aims to investigate the efficacy of religious and spiritual interventions in nursing care to promote mental, physical and spiritual health as compared to control groups not receiving such care. METHODS: This is a systematic review and meta-analysis of clinical trials from SCOPUS, PUBMED, Web of Science and CINAHL databases. The searches were carried out between May and July 2020 without restrictions concerning the date of publication. Peer-reviewed articles published in English, Portuguese or Spanish, focusing on nurses were included. This study followed the PRISMA guidelines. In addition, the CONSORT and The Cochrane Collaborations tool for assessing risk of bias were followed. RESULTS: The search process identified 1308 publications, 18 randomized controlled trials were included for the systematic review and 9 for the meta-analysis. The meta-analyses revealed that spiritual interventions were associated with lower mental health symptoms (SMD = -6.91 [-9.83,-3.98], p < 0.001, I2 = 99 %), greater well-being (SMD = 1.26 [0.58, 1.93], p < 0.001, I2 = 94 %) and higher levels of spirituality (SMD = 0.48 [0.29, 0.67], p < 0.001, I2 = 31 %) as compared to individuals in the control group. CONCLUSIONS: Spiritual interventions seem to be effective to promote health, as seen for mental health, spirituality, well-being and physical outcomes. Nevertheless, more than half of the studies have a high risk of bias in any of the dimensions evaluated and there is an important heterogeneity among interventions and outcomes. This is particularly important to nurses and nurse managers who want to provide a holistic care to their patients.

Effects of an educational intervention on nursing students' attitudes towards gypsy women: A non-randomized controlled trial.

BACKGROUND: The cultural differences between health professionals and patients, together with the ethnocentric opinions that some health professionals sometimes hold, generate prejudice and negatively influence the experiences of these groups, for example, the Gypsy population. METHODS: We set up a quasi-experimental study to test the efficacy of an educational intervention among 40 nursing students in Spain based on the use of positive references in order to improve the students' attitude towards gypsy women receiving health care. Analysis of comparison of means and correlation analysis were carried out according to the type of variable compared. RESULTS: The score in all the items that make up the Prejudicial Attitude Scale (PAT) decreased after the test, which demonstrated that their attitudes had become less prejudiced. The Stereotype Content Model (SCM), the perception of the outgroup and the stereotypes regarding the Roma population as "trustworthy" all improved showing a statistically significant difference between the periods (pre and post educational intervention). CONCLUSION: Nursing educators have the opportunity, through theoretical and practical exposure to positive references, to explore the students' experience and perceptions, analyze interventions and change their perceptions of threat, thus contributing to a more inclusive group identity.

The Role of Spirituality and Religiosity in Healthcare During the COVID-19 Pandemic: An Integrative Review of the Scientific Literature.

The pandemic caused by the new coronavirus SARS-CoV-2 has been affecting populations globally since the end of 2019. Previous studies have indicated that spirituality in these times of crisis serves as a source of hope and well-being that helps people get through the day. This study investigated the role of spirituality and religiosity in healthcare during the COVID-19 pandemic. An integrative review of the scientific literature available on PubMed, Scopus, and Web of Science databases and a review of the gray literature in the Information System on Gray Literature in Europe (OpenGrey) were carried out. From a total of 1,338 articles searched; 25 articles were included in this review (22 quantitative observational, 2 qualitative and one randomized controlled trial). Our findings revealed the importance of including spirituality in clinical practice for both health professionals and patients. On the one hand, spirituality can be considered a good coping strategy used by healthcare professionals to promote mental health and well-being during the COVID-19 pandemic and resulting in greater patient satisfaction with the care given. On the other hand, addressing spiritual needs of individuals leads to a reduction in stress, anxiety, depression, and an increase in resilience and hope among patients.

How Does Confucianism Influence Health Behaviors, Health Outcomes and Medical Decisions? A Scoping Review.

The aim of this study is to analyze the influence of Confucianism on health behaviors, health outcomes and medical decisions. The research was conducted using the following databases: PubMed, Scopus, CINHAL, PsycINFO and Web of Science, without restrictions of language and year of publication. The search process identified 833 publications matching the search criteria, and after the review process, 40 articles were included. Family is a central aspect of Confucianism, and it seems to affect participation in medical decisions, taking care of relatives, ethical dilemmas and mental health problems. Although most Confucianist influence seems to be positive, some ways of thinking could increase suffering, burnout and a delay in healthcare seeking. Understanding these values could help health professionals to deal with the growing contingent of patients with different cultures and religious beliefs.

The influence of spirituality and religion on critical care nursing: An integrative review.

BACKGROUND: Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed. AIMS AND OBJECTIVES: To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing. METHODS: An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included. RESULTS: Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinical practice. Nurses are encouraged to increase their knowledge and awareness towards spiritual issues.

The Use of Spiritual and Religious Interventions for the Treatment for Insomnia: A Scoping Review.

Insomnia is a common problem, affecting individuals' health and quality of life. Among several therapies used to treat this condition, spiritual interventions are suggested to have beneficial outcomes on sleep disturbances. Nevertheless, a systematic compilation of the evidence available is still needed in the literature in order to scientifically investigate the topic. To examine the most common spiritual interventions proposed to treat sleep disorders and to assess the scientific evidence of these interventions. This is a scoping literature review conducted by independent researchers on the following databases: PubMed, SCOPUS, Web of Science, Cochrane Library and OpenGrey. A boolean expression was used, and all studies published in the last 5 years investigating the role of spiritual or religious interventions on insomnia were included. From a total of 3257 articles retrieved in our search, ten studies were included in the final analysis. There is a wide array of techniques used to treat insomnia or the mental disorders associated with insomnia, such as mantra, yoga, mindfulness, praying/meditation, daily spiritual experiences, psycho-religious training and intervention. The included studies showed a positive influence of spiritual/religious interventions on insomnia directly and indirectly. However, there is a scarcity of clinical trials and most studies have small sample sizes and used only subjective measures, resulting in a low evidence. The results of the present review point to a promising role of spirituality and religion on better sleep outcomes, particularly in the improvement in insomnia. However, the heterogeneity and the quality of these studies suggest caution while interpreting these findings. More clinical trials are needed in this area to provide a recommendation of these methods in clinical practice.

Spiritual care in critically ill patients during COVID-19 pandemic.

INTRODUCTION: Spiritual care has a positive influence when patients are subjected to serious illnesses, and critically ill situations such as the case of the COVID-19 pandemic. PURPOSE: The purpose of this study was to investigate the perceptions and attitudes of nurses working at critical care units and emergency services in Spain concerning the spiritual care providing to patients and families during the COVID-19 pandemic. METHODS: A qualitative investigation was carried out using in-depth interviews with 19 ICU nursing professionals. FINDINGS: During the pandemic, nurses provided spiritual care for their patients. Although they believed that spirituality was important to help patients to cope with the disease, they do not had a consensual definition of spirituality. Work overload, insufficient time and lack of training were perceived as barriers for providing spiritual healthcare. DISCUSSION: These results support the role of spirituality in moments of crisis and should be considered by health professionals working in critical care settings.

Burnout and spirituality among nurses: A scoping review.

OBJECTIVE: To investigate the relationship between spirituality / religiousness and Burnout Syndrome in nurses, as well as to examine the current evidence for spiritual/religious interventions to alleviate their symptoms. DATA SOURCES: A scoping review was conducted using CINAHL, SCOPUS, Web of Science, Pubmed databases, and grey literature, between January and July 2020. STUDY SELECTION: Two researchers performed the searches with a 95% agreement rate for the inclusion and exclusion of the studies. Both quantitative and qualitative studies published in peer-reviewed journals, using Spanish, Portuguese or English language were included. Restriction on publication date was not applied. DATA EXTRACTION: A total of 1143 articles were identified and 18 were included in the final analysis. Quality assessment was performed, following CONSORT, STROBE, PRISMA and COREQ guidelines. Finally, the following data were extracted: authors, year, country, study design and sample characteristics, purpose of the study, and major findings. DATA SYNTHESIS: The results of the present review show that spirituality / religiousness is a common strategy used by nurses when coping with stress and burnout. Most studies reveal that spiritual and religious beliefs are correlated with lower levels of burnout, exhaustion and depersonalization in different settings. Nevertheless, two studies have not found any relationship and one study has found worse outcomes. CONCLUSIONS: There is a lack of experimental studies trying to examine if spiritual interventions could modify burnout levels in clinical practice. Health managers should be aware of the spirituality / religiousness of their nurses and provide the appropriate spiritual support.