Medication Adherence in Adults with Chronic Diseases in Primary Healthcare: A Quality Improvement Project.

(1) Background: Medication adherence is influenced by a variety of intricate factors, presenting hurdles for nurses working to improve it among adults with chronic conditions. Pinpointing the reasons for non-adherence is crucial for customizing interventions. The objective of this quality improvement project was to improve medication adherence among adults with chronic diseases in primary healthcare by promoting evidence-based practices, identifying barriers and facilitators to compliance, and developing strategies to ensure optimal adherence through engaging the nursing team, enhancing knowledge, and evaluating the effectiveness of the implemented strategies. (2) Methods: This study was a quality improvement project that utilized the JBI Evidence Implementation framework, the Practical Application of Clinical Evidence System, and the Getting Research into Practice audit tool across three phases: (i) forming a project team and conducting a baseline audit, (ii) offering feedback via the GRiP tool, and (iii) conducting a follow-up audit to assess best practice outcomes. The study was conducted between September 2021 and March 2022 in the community care unit of Algarve Regional Health Administration, targeting adults with chronic illnesses. (3) Results: A total of 148 individuals were audited, including 8 nurses, 70 baseline patients, and 70 post-implementation patients. Initial compliance with key best practices was low, with several criteria at 0% compliance at baseline. Post-intervention, we observed significant improvements; compliance with key best practices improved dramatically, with many reaching 100%. Notable improvements included enhanced patient education on medication management, regular medication adherence assessments, and increased engagement of healthcare professionals in adherence activities. (4) Conclusions: This quality improvement project demonstrated that structured, evidence-based interventions could significantly enhance medication adherence among adults with chronic diseases. The success of the project highlights the potential of similar strategies to be applied broadly in primary healthcare settings to improve health outcomes.

The Effect of Coping on the Relationship between Work-Family Conflict and Stress, Anxiety, and Depression.

The challenges experienced in the context of the pandemic have required a significant reconciliation between work and family domains due to confinement and the need to spend more time at home, which may have increased the levels of stress, anxiety, and depression, making it necessary to use resilient coping strategies to overcome the difficulties felt. This study examined the effect of resilient coping on the relationship between work-family conflict and stress, anxiety, and depression in this context. Data were collected using a self-report protocol from a sample of Portuguese workers (N = 476). The results indicated that work-family conflict was positively associated with stress, anxiety, and depression. Resilient coping established a negative relationship with stress, anxiety, and depression. The moderation effect was not corroborated; it was found that in the presence of the moderating variable (resilient coping), the relationship between the variables of work-family conflict and stress, anxiety, and depression was strengthened. This study reinforces the importance of appropriate interventions in resilient coping in the work-family context, which helps control stress, anxiety, and resilience levels.

Nursing students' perceptions of spiritual needs at the end of life. A qualitative study.

Spirituality is defined as the meaning of life, being the very essence of life made up of all of the aspects inherent to it. During end-of-life processes, this need is shown to be particularly altered in patients and yet it is an aspect that the health professionals accompanying patients in this situation report being least equipped to address, alongside therapies that could help to meet these needs, such as art therapy. An exploratory qualitative study was conducted, adheres to the guidelines of COREQ (41). The study population were final year students undertaking a nursing degree at the University of Huelva, Spain. The sample was selected via intentional sampling using snowball recruitment from the study population. Stratification according to gender was performed due to the feminised nature of the population. Sample size was determined progressively during the research, with recruitment ceasing at 13 informants once information saturation was achieved. Inclusion criteria required that participants were to be final year students enrolled on a nursing degree who had provided consent to participate voluntarily in the research. The analysis Realized was interpretive phenomenological (IPA) as described by Smith (43-45). The present study revealed that students perceive their training on spiritual care to be deficient. Despite them reporting that they possess the skills and tools to provide end-of-life care, this is not enough to provide effective accompaniment, given that this moment brings them into touch with their own insecurities. Students verbalized the need to learn strategies to address this shortcoming regarding final accompaniment, for instance, through art, with creativity being one of the skills with the potential to uncover the meaning of life.

Prevalence of Polypharmacy of Older People in a Large Brazilian Urban Center and its Associated Factors.

BACKGROUND: With the aging population comes greater risks associated with polypharmacy, a significant public health problem. OBJECTIVE: This study aimed to identify the prevalence of polypharmacy and its associated factors through Comprehensive Geriatric Assessment (CGA) among older adults treated in primary health care (PHC) in a large Brazilian urban center. METHODS: We conducted a cross-sectional study with a random sampling of 400 older adults using primary health care. Polypharmacy was defined as the cumulative use of five or more daily medications. An assessment of a sociodemographic and health survey, fear of falling, and physical disabilities affecting activities of daily living and instrumental activities of daily living was conducted. RESULTS: The mean age was 75.23 (SD: 8.53) years. The prevalence of polypharmacy and hyperpolypharmacy was 37% (n = 148) and 1% (n = 4), respectively. The adjusted logistic regression showed that participants with chronic non-communicable diseases (CNCDs) (OR = 9.24; p = 0.003), diabetes (OR = 1.93; p = 0.003), and obesity (OR = 2.15; p = 0.005) were associated with a greater propensity to use polypharmacy. CONCLUSION: Our results show that older adults with CNCDs, diabetes, and obesity were more likely to use polypharmacy. The results reinforce the importance of using CGA in clinical practice in PHC.

Anxiety and Depression in the Initial Stage of the COVID-19 Outbreak in a Portuguese Sample: Exploratory Study.

BACKGROUND: In previous studies, it was found that the confinement to which the population was subjected during the quarantine of the COVID-19 pandemic increased the risk of anxiety and depression. OBJECTIVE: to analyze the levels of anxiety and depression symptoms in Portugal residents during the quarantine of the COVID-19 pandemic. METHODS: This is a descriptive, transversal, and exploratory study of non-probabilistic sampling. Data collection was carried out between 6th and 31st of May 2020. Sociodemographic and health questionnaires PHQ-9 and GAD-7 were used. RESULTS: The sample consisted of 920 individuals. The prevalence for depressive symptoms (PHQ-9 ≥ 5) was 68.2% and (PHQ-9 ≥ 10) was 34.8%, and for anxiety symptoms (GAD-7 ≥ 5) was 60.4% and (GAD-7 ≥ 10) was 20%. Depressive symptoms were moderately severe for 8.9% of the individuals, and 4.8% presented severe depression. Regarding the generalized anxiety disorder, we found that 11.6% of individuals present moderate symptoms, and 8.4% severe anxiety symptoms. CONCLUSIONS: The prevalence of depressive and anxiety symptoms were substantially higher than those previously found for the Portuguese population and when compared with other countries during the pandemic. Younger individuals, female, with chronic illness and medicated, were more vulnerable to depressive and anxious symptoms. In contrast, participants who maintained frequent levels of physical activity during confinement had their mental health protected.

Effectiveness of Music Therapy in People Living with Dementia: An Umbrella Review Protocol.

BACKGROUND: Dementia stands out as a neurological disorder which constitutes a progressive decline in cognitive, behavioral, emotional, and social functioning. However, non-pharmacotherapy, such as music therapy, can be combined with pharmacological treatment as a possible strategy to improve functionality regarding the cognitive and non-cognitive dimensions of people diagnosed with dementia. OBJECTIVES: To analyze and synthesize published evidence regarding the effectiveness of music therapy in people diagnosed with dementia, concerning cognitive and non-cognitive outcomes. DESIGN: Descriptive study protocol of an umbrella review. METHODS AND ANALYSIS: An umbrella review method will guide this study, focusing on an extensive search of published systematic reviews and meta-analyses reviews that include randomized controlled trials and other types of trials. Databases for the article search include ISI Web of Knowledge, Scopus, and Joanna Briggs Institute (JBI) EBP database, and EBSCO Host platform (Cochrane Database of Systematic Reviews, MEDLINE, and CINAHL). Two reviewers will independently review all titles and abstracts and identify articles considering the inclusion criteria. Afterward, two reviewers will independently extract relevant information from each article for the characterization table, and evaluate the quality of selected articles using the Measurement Tool for Evaluating Systematic Reviews (AMSTAR) 2 guideline. RELEVANCE TO CLINICAL PRACTICE: Data from this study will aid in designing healthcare workers' training courses, clinical intervention guidelines, and specific intervention protocols that support pharmacological interventions in treating dementia.

Pessoa idosa com diabetes mellitus tipo 2: Contributos para a compreensão da gestão do regime medicamentoso / Older adults with type 2 diabetes mellitus: Contributions to understanding medication regimen management / Anciano con diabetes mellitus de tipo 2: Contribuciones a la comprensión de la gestión del régimen de medicación

Resumo Enquadramento: Face ao envelhecimento populacional existe uma crescente prevalência de doenças crónicas entre elas a diabetes mellitus. A complexidade dos regimes medicamentosos destas pessoas e a otimização da sua gestão assume-se desafiante para os enfermeiros. Objetivo: Compreender como a pessoa idosa com diabetes mellitus gere o seu regime medicamentoso. Metodologia: Estudo descritivo, qualitativo e natureza indutiva. Realizadas 12 entrevistas semiestruturadas a pessoas idosas com diagnóstico de diabetes mellitus. O verbatim foi transcrito e analisado através de análise de conteúdo. Resultados: O sucesso terapêutico relaciona-se com o modo como as pessoas lidam com a necessidade de aderir a um regime medicamentoso. Fatores intrínsecos (como sexo e idade) e fatores extrínsecos (como duração do tratamento, sistema de saúde pouco desenvolvido, entre outros) condicionam o sucesso terapêutico, ainda que a toma dos medicamentos seja reconhecida como necessária. Conclusão: Este estudo permitiu compreender como as pessoas gerem o regime medicamentoso, corrobora que baixas taxas de adesão comprometem o sucesso terapêutico e estabelece como prementes intervenções dirigidas às necessidades concretas das pessoas com doença crónica.

Abstract Background: Due to the population's aging, the prevalence of chronic illnesses, including diabetes mellitus, is increasing, and nurses have to face the challenges arising from the complexity of older adults' medication regimens and their optimal management. Objective: To understand how older adults with diabetes mellitus manage their medication regimens. Methodology: This is a descriptive qualitative study using an inductive approach. Twelve semi-structured interviews were conducted with older adults diagnosed with diabetes mellitus. The interviews were transcribed and analyzed using content analysis. Results: Therapeutic success relates to how patients deal with the need to adhere to a medication regimen. Despite patients recognizing the need to take medication, intrinsic factors (such as gender and age) and extrinsic factors (treatment duration, underdeveloped health systems, and others) influence therapeutic success. Conclusion: The study allowed understanding how patients manage their medication regimens. It confirmed that low adherence rates compromised therapeutic success and identified the urgent need for interventions that address the specific needs of chronically-ill patients.

Resumen Marco contextual: Ante el envejecimiento de la población, aumenta la prevalencia de enfermedades crónicas, entre ellas la diabetes mellitus. La complejidad de los regímenes de medicación de estas personas y la optimización de su gestión es un reto para los enfermeros. Objetivo: Entender cómo el anciano con diabetes mellitus gestiona su régimen de medicación. Metodología: Estudio descriptivo, cualitativo e inductivo. Se realizaron 12 entrevistas semiestructuradas a ancianos diagnosticados de diabetes mellitus. El texto se transcribió y analizó mediante un análisis de contenido. Resultados: El éxito terapéutico está relacionado con la forma en que las personas afrontan la necesidad de cumplir un régimen de medicación. Los factores intrínsecos (como el sexo y la edad) y extrínsecos (como la duración del tratamiento, el sistema sanitario poco desarrollado, entre otros) condicionan el éxito terapéutico, aunque las personas reconozcan como necesario tomar medicamentos. Conclusión: Este estudio permitió comprender cómo las personas gestionan su régimen de medicación, corrobora que las bajas tasas de adherencia comprometen el éxito terapéutico y establece la urgencia de llevar a cabo intervenciones dirigidas a las necesidades concretas de las personas con enfermedades crónicas.

Bibliometric Analysis of the Scientific Production on Compassion Fatigue.

BACKGROUND: Compassion fatigue is a common phenomenon among healthcare professionals and includes several concepts that share a direct relationship with quality of life, with consequences on both physical and emotional well-being but also at the economic and organizational levels. OBJECTIVES: To analyze the profile of scientific publications on compassion fatigue, dissecting trends, and highlighting research opportunities. METHOD: Bibliometric analysis based on Donthu's guidelines, data collection from Web of Science (Clarivate Analytics), and analytic techniques (performance analysis and science mapping) with VOSviewer® and CiteSpace®. RESULTS: We obtained 1364 articles and found that the concept emerged in 1995 and is frequently associated with areas of general health. Through analysis, we identified the following research frontiers: "vicarious traumatization", "working", "survivor", "mental health", and "impact". CONCLUSION: There has been a growing interest in this subject among researchers, with an increase in scientific production related to areas of health such as nursing, providing a solid starting point for further investigation. Registration number from the Open Science Framework: osf.io/b3du8.

Mental health, quality of life and optimism during the covid-19 pandemic: a comparison between Brazil and Portugal.

PURPOSE: Although there have been numerous studies investigating the mental health of individuals during the pandemic, a comparison between countries is still scarce in the literature. To explore this gap, the present study aimed to compare the mental health (i.e., anxiety and depression), quality of life (QoL), and optimism/pessimism among individuals from Brazil and Portugal during the COVID-19 pandemic and the associated factors. METHOD: A cross-sectional population-based study was conducted during the COVID-19 pandemic in Brazil and Portugal. Data collection was carried out between May and June 2020, using an online form which was sent through social networks. A total of 2069 participants (1156 from Brazil and 913 from Portugal) were included. Depressive symptoms (PHQ-9), Anxiety (GAD-7), optimism/pessimism (Revised Life Orientation Test - LOT), QoL (WHOQOL-Bref), and sociodemographic, health, and social distancing variables were assessed. Data was analyzed using univariate and multivariate models. RESULTS: There were remarkable differences between Brazil and Portugal in all outcomes during the COVID-19 pandemic, including higher levels of depressive symptoms, anxiety, and optimism for the Brazilian individuals and higher levels of QoL and pessimism for the Portuguese individuals. The following factors were associated with the mental health and QoL in both Brazilian and Portuguese populations: gender, age, being a healthcare professional, and days in social distancing. CONCLUSION: Despite the fact that Brazilians were more optimistic during the COVID-19 pandemic, they had lower levels of mental health and QoL as compared to the Portuguese individuals.

Sentido de humor, bem-estar subjetivo e competências de coping desportivo em atletas / Humor, subjective well-being and sports coping skills in athletes / Humor, bienestar subjetivo y habilidades de afrontamiento deportivo en atletas

Resumo Introdução: O sentido de humor tem sido estudado como uma estratégia para lidar com adversidade, sendo considerado um importante mecanismo de coping, utilizado em situações de stress. Objetivo: Verificar a relação entre sentido de humor, o bem-estar subjetivo e as competências de coping desportivo num grupo de atletas. Métodos: Estudo transversal e correlacional, realizado numa amostra não probabilística de 47 atletas de triatlo e mountain Bike. Os instrumentos utilizados foram: Athletic Coping Skills Inventory-28, Multidimensional Sense of Humor Scale (versão portuguesa), Escala de Felicidade Subjectiva de Lyubomirsky e Lepper e Positive and Negative Affect Schedule. Utilizou-se estatística descritiva e coeficiente de correlação de Spearman e o nível de significância adotado foi p<0,05. Resultados: Produção e Uso Social do Humor e Apreciação do Humor estão positivamente correlacionadas com a Felicidade Subjetiva. O Humor Adaptativo e a Produção e Uso Social do Humor estão positivamente correlacionados com a dimensão Afetividade Positiva e com a dimensão Rendimento sob Pressão da Escala de Competências de Coping Desportivo. Conclusões: O papel do sentido de humor e suas dimensões no bem-estar subjetivo dos atletas e nas suas competências psicológicas, deve ser considerado na conceção de programas de promoção de estratégias de coping e de saúde mental em atletas.

Abstract Background: Sense of humor has been studied as a strategy to deal with adversity and is considered an important coping mechanism used in stressful situations. Aim: To verify the relationship between humor, subjective well-being and sports coping skills in a group of athletes. Methods: Cross-sectional and correlational study. Performed on a non-probabilistic sample of 47 triathlon and mountain bike athletes. The instruments used were: Athletic Coping Skills Inventory-28, Multidimensional Sense of Humor Scale (portuguese version), Lyubomirsky and Lepper's subjective happiness scale and Positive and Negative Affect Schedule. Descriptive statistics and Spearman's correlation coefficient were used, and the significance level adopted was p<0.05. Results: Production and Social Use of Humor and Humor Appreciation are positively correlated with subjective happiness. Adaptive Humor and Production and Social Use of Humor are positively correlated with the positive affect dimension and the performance under pressure dimension of the Athletic Coping Skills Inventory. Conclusions: The role of humor and its dimensions in the subjective well-being of athletes and their psychological skills should be considered in the design of programs to promote coping strategies and mental health in athletes.

Resumen Contexto: El sentido del humor se ha estudiado como una estrategia para enfrentar la adversidad y se considera un mecanismo de afrontamiento importante utilizado en situaciones estresantes. Objetivo(s): Verificar la relación entre el humor, el bienestar subjetivo y las habilidades de afrontamiento deportivo en un grupo de atletas. Metodología: Estudio transversal y correlacional. Realizado en una muestra no probabilística de 47 atletas de triatlón y bicicleta de montaña. Los instrumentos utilizados fueron: Athletic Coping Skills Inventory-28, Multidimensional Sense of Humor Scale (versión portuguesa), Escala de Felicidad Subjetiva de Lyubomirsky y Lepper y Positive and Negative Affect Schedule. Se utilizaron estadísticas descriptivas y el coeficiente de correlación de Spearman y el nivel de significancia adoptado fue p<0.05. Resultados: La producción y el uso social del humor y la apreciación del humor están positivamente correlacionados con la Felicidad Subjetiva. El Humor Adaptativo y la Producción y el Uso Social del Humor se correlacionan positivamente con la dimensión de Afecto Positivo y la dimensión de Rendimiento sobre Presión de la Escala de Habilidades de Afrontamiento Deportivo. Conclusiones: El papel del humor y sus dimensiones en el bienestar subjetivo de los atletas y sus competencias psicológicas deben considerarse en el diseño de programas para promover estrategias de afrontamiento y salud mental en los atletas.

Public and health policy for the aged in Africa to the South of Saara.

OBJECTIVE: to know the social and health responses for the elderly in sub-Saharan Africa. METHODS: An integrative literature review. RESULTS: There is a lack of specialized health care to meet the real needs of the elderly, and the shortage of health professionals does not contribute favorably to this situation. There is a small number of facilities for the elderly and most of them are inadequate. Although there are models of care as well as social and health support policies for the elderly, there are still inequities/inequalities in access to these policies, especially for the most disadvantaged populations. CONCLUSION: Social and health policies for the elderly in Sub-Saharan Africa are below standard and appropriate economic, political and social intervention is required.

Association between stress/anxiety, depression, pain and quality of life in people with chronic kidney disease / Associação entre stress/ansiedade, depressão, dor e qualidade de vida em pessoas com doença renal crónica / Asociación entre estrés/ansiedad, depresión, dolor y calidad de vida en personas con enfermedad renal crónica

BACKGROUND: Chronic kidney disease patients undergoing hemodialysis have a high symptom burden that contributes to increased suffering and diminishes their quality of life. Cardiovascular, musculoskeletal and psychosocial disorders affect their physical and functional capacity anxiety, stress and depression. AIM: To determine the prevalence of stress/anxiety and depression in people with chronic kidney disease and to verify the association between stress/anxiety and depression with pain and quality of life. METHODS: A cross-sectional, descriptive and correlational study; A random sample of 183 patients who underwent hemodialysis; application of the depression and stress anxiety scale (DASS-21), brief pain inventory (BPI), and Medical Outcomes Study Short-Form 12-Item Health Survey (SF-12). RESULTS: The sample consisted mostly of men (59.6%), married (53.8%), Portuguese nationality (78.7%), mean age 59.17 years (SD ± 14.64), hemodialysis treatment 70.9 months (SD ± 54.2). 76% were retired and 24% had a regular job. The prevalence of stress and anxiety was 24% and depression was 37.2%. CONCLUSIONS: Stress / anxiety and depression are prevalent in people with chronic kidney disease. Stress / anxiety and depression are associated with high levels of pain, which impacts on activities of daily living, presenting low levels of quality of life in the physical and mental components.

CONTEXTO: As pessoas com doença renal crónica, em programa de hemodiálise, apresentam sintomas que contribuem para aumentar o sofrimento e diminuir a sua qualidade de vida. Apresentam vários problemas cardiovasculares, músculo-esqueléticos e psicossociais que afetam a sua capacidade física e funcional, podendo aumentar a ansiedade, stresse e depressão. OBJETIVO(S): Determinar a prevalência de stresse / ansiedade e depressão em pessoas com doença renal crónica e verificar a associação entre o stresse / ansiedade e depressão com a dor e a qualidade de vida. MÉTODOS: Estudo transversal, descritivo e correlacional, Amostra aleatória composta por 183 utentes em programa de hemodiálise; aplicação da escala de ansiedade, depressão e stresse (DASS-21), inventário breve de dor e Medical Outcomes Study Short-Form 12-Item Health Survey (SF-12). RESULTADOS: A amostra foi maioritariamente constituída por homens (59,6%), casados (53,8%), de nacionalidade portuguesa (78,7%), com média de idade de 59,17 anos (DP ±14,64), sob tratamento hemodialítico há 70,9 meses (DP ±54,2). 76% estavam reformados e 24% tinham um emprego regular. A prevalência do stresse e ansiedade foi de 24% e da depressão foi de 37,2%. CONCLUSÕES: O stresse/ansiedade e depressão são prevalentes em pessoas com doença renal crónica. O stresse/ansiedade e depressão estão associados a altos níveis de dor, com impacto nas atividades da vida diária, e a baixos níveis de qualidade de vida nos componentes físico e mental.

CONTEXTO: Las personas con enfermedad renal crónica en hemodiálisis presentan una elevada carga de síntomas que contribuyen para aumentar el sufrimiento y disminuir su calidad de vida. Presentan varios problemas cardiovasculares, musculoesqueléticos y psicosociales que afectan a su capacidad física y funcional, pudiendo aumentar la ansiedad, el estrés y la depresión. OBJECTIVO(S): Determinar la prevalencia de estrés / ansiedad y depresión en personas con enfermedad renal crónica y verificar la asociación entre el estrés / ansiedad y la depresión con el dolor y la calidad de vida. MÉTODOS: Estudio transversal, descriptivo y correlacional, Muestra aleatoria compuesta por 183 pacientes en hemodiálisis; aplicación de la escala de ansiedad depresión y estrés (DASS-21), inventario breve de dolor (BPI) y Medical Outcomes Study Short-Form 12-Item Health Survey (SF-12). RESULTADOS: La muestra consistió principalmente en hombres (59,6%), casados (53,8%), de nacionalidad portuguesa (78,7%); con edad media de59,17 años (DP ±14,64), haciendo tratamiento hemodialítico hace 70,9 meses (DP ±54,2). El 76% estaba reformado y el 24% tenía un empleo regular. La prevalencia del estrés y la ansiedad fue del 24% y de la depresión fue del 37,2%. CONCLUSIONES: El estrés / ansiedad y depresión son prevalentes en personas con enfermedad renal crónica. El estrés / ansiedad y depresión están asociados a altos niveles de dolor, que afectan las actividades de la vida diaria, y a bajos niveles de calidad de vida en los componentes físico y mental.

Comparison of Techniques and Solvents on the Antimicrobial and Antioxidant Potential of Extracts from Acacia dealbata and Olea europaea.

Ethnopharmacological use of plant natural extracts has been known since ancient times. The optimization of plant molecule extraction is fundamental in obtaining relevant extraction yields. The main purpose of this study was to understand the role of different extraction techniques (solid-liquid, ultrasound, Soxhlet, and microwave) and solvents (water, methanol, ethanol, acetone, dichloromethane, and hexane) on the antimicrobial and antioxidant activities of extracts from Olea europaea (olive) and Acacia dealbata (mimosa). Crude plant extracts were evaluated for their antimicrobial activity against Staphylococcus aureus and Escherichia coli by the disk diffusion method. The antioxidant capacity of the extracts was determined by ABTS (2,2-azinobis (3-ethyl-benzothiazoline-6-sulfonic acid)) and DPPH (2,2-diphenyl-1-picrylhydrazyl) methods. In terms of extraction yield, ultrasound extraction and the solvents methanol, acetone (O. europaea) or water (A. dealbata) were found to be the best options. However, ethanol and acetone proved to be the best solvents to extract compounds with antimicrobial activity and antioxidant capacity, respectively (regardless of the extraction method employed). Soxhlet and microwave were the best techniques to extract compounds with antimicrobial activity, whereas any of the tested techniques showed the ability to extract compounds with antioxidant capacity. In most of the cases, both plant extracts (mimosa and olive) were more efficient against S. aureus than E. coli. In the present study, both mimosa and olive leaf crude extracts proved to have antimicrobial and antioxidant activities, increasing the demand of these natural products as a source of compounds with health benefits.

Public and health policy for the aged in Africa to the South of Saara / Política pública y de salud para el anciano en África del Sur del Sahara / Política pública e de saúde para o idoso na África ao Sul do Saara

ABSTRACT Objective: to know the social and health responses for the elderly in sub-Saharan Africa. Methods: An integrative literature review. Results: There is a lack of specialized health care to meet the real needs of the elderly, and the shortage of health professionals does not contribute favorably to this situation. There is a small number of facilities for the elderly and most of them are inadequate. Although there are models of care as well as social and health support policies for the elderly, there are still inequities/inequalities in access to these policies, especially for the most disadvantaged populations. Conclusion: Social and health policies for the elderly in Sub-Saharan Africa are below standard and appropriate economic, political and social intervention is required.

RESUMEN Objetivo: conocer las respuestas sociales y de salud para los ancianos en África subsahariana. Métodos: repaso integrador de la literatura. Resultados: hay falta de cuidados de salud especializados y enfocados a las reales necesidades de los ancianos, siendo que la escasez de profesionales de salud no contribuye favorablemente para esta situación. Se observa baja oferta de infraestructura destinadas a los ancianos y la mayoría de ellas son de bajo nivel. Aunque haya modelos de atención, así como políticas de apoyo social y de salud para las personas mayores, aún hay iniquidades/desigualdades en el acceso a ellas, sobre todo para las poblaciones más desfavorecidas. Conclusión: las políticas sociales y de salud para las personas mayores en el África subsahariana están por debajo de sus necesidades, siendo necesario garantizar una intervención económica, política y social adecuada.

RESUMO Objetivo: Conhecer as respostas sociais e de saúde para os idosos na África Subsaariana. Métodos: Revisão integrativa da literatura. Resultados: Há falta de cuidados de saúde especializados e direcionados às reais necessidades dos idosos, sendo que a escassez de profissionais de saúde não contribui favoravelmente para essa situação. Verifica-se baixa oferta de instalações destinadas aos idosos, e a maioria delas são básicas. Apesar de existirem modelos de cuidados para os idosos e políticas de apoio social e de saúde, ainda há iniquidades/desigualdades no acesso a elas, sobretudo para as populações mais desfavorecidas. Conclusão: As políticas sociais e de saúde para os idosos na África Subsaariana estão aquém das necessidades, sendo preciso garantir uma intervenção econômica, política e social adequada.

Effect of humor intervention on well-being, depression, and sense of humor in hemodialysis patients / Efecto del uso del humor en el bienestar, depresión y sentido del humor en pacientes en hemodiálisis

Objective: To evaluate whether visualization of humor movies during hemodialysis sessions improves subjective well-being and sense of humor, while decreasing stress / anxiety and depression levels, in hemodialysis patients. Material and Method: A pre-test / post-test design study with a non-equivalent control group was carried out in patients with chronic kidney disease undergoing hemodialysis, in two hemodialysis units of Diaverum Clinics. The study included 34 patients in the intervention group and 33 patients in the control group. The intervention consisted in the visualization of humor movies during hemodialysis sessions for ten sessions over a four-week period. The control group watched neutral movies. Data were collected using a sociodemographic and health information questionnaire (age, gender, nationality, education, occupation, marital status, dialysis session length, presence of hypertension and diabetes); the Subjective Happiness Scale; the satisfaction with life in general; the Depression Anxiety Stress Scale 21, and the Multidimensional Sense of Humor Scale. Student t-tests and t-tests for paired samples were performed. The response to change was evaluated using: the percentage of change, ceiling effect and floor effect, effect size, and the standardized response mean. Results: The levels of subjective happiness and sense of humor increased in the intervention group, but there were no significant increases in satisfaction with life in general. Only depression levels decreased significantly in the intervention group. Conclusions: The visualization of humor movies as a nursing intervention improved the levels of subjective happiness and sense of humor, while decreasing the perception of depressive symptoms

Objetivo: Evaluar si la visualización de películas de humor durante las sesiones de hemodiálisis mejora el bienestar subjetivo y el sentido del humor, al tiempo que disminuye los niveles de estrés / ansiedad y depresión, en pacientes con hemodiálisis. Material y Método: Se realizó un estudio pre-post intervención con un grupo de control no equivalente, en pacientes con enfermedad renal crónica en hemodiálisis, en dos unidades de hemodiálisis de Diaverum Clinics. El estudio incluyó a 34 pacientes en el grupo de intervención y 33 pacientes en el grupo de control. La intervención consistió en la visualización de películas de humor durante diez sesiones de hemodiálisis en un período de cuatro semanas. El grupo control vio películas neutrales. Los datos se recogieron mediante un cuestionario de información sociodemográfica y de salud (edad, sexo, nacionalidad, educación, ocupación, estado civil, duración de la sesión de diálisis, presencia de hipertensión y diabetes); la escala subjetiva de felicidad; la escala de satisfacción general con la vida; la escala de depresión, ansiedad y estrés (DASS-21) y la escala multidimensional de sentido del humor. Se emplearon pruebas t-Student y pruebas t para muestras pareadas. La respuesta al cambio se evaluó utilizando: el porcentaje de cambio, el efecto pico y el efecto base, el tamaño del efecto y la media de respuesta estandarizada. Resultados: Los niveles de felicidad subjetiva y de sentido del humor aumentaron en el grupo de intervención, pero no hubo aumento significativo en la satisfacción general con la vida. Solo los niveles de depresión disminuyeron significativamente en el grupo de intervención. Conclusiones: La visión de las películas de humor como una intervención de enfermería mejoró los niveles de felicidad subjetiva y de sentido del humor, al tiempo que disminuyó la percepción de los síntomas depresivos

Subjective wellbeing, sense of humor and psychological health in hemodialysis patients

Objective: To investigate the relationship between satisfaction with life in general, sense of humor, and anxiety, depression and stress with subjective happiness in chronic kidney disease patients undergoing hemodialysis. Material and Methods: A cross-sectional and correlational study was developed in two units of the Diaverum dialysis clinic and one hospital unit, with 183 chronic kidney disease patients undergoing hemodialysis. An instrument was used to characterize the sociodemographic and clinical profile of the sample (age, gender, nationality, education, occupation, marital status, dialysis sessions length, presence of hypertension and diabetes): the subjective happiness scale; the satisfaction with life in general; depression, anxiety and stress scale 21; and multidimensional sense of humor scale. Inferential procedures included Spearman correlation coefficients, and multiple linear regression adjusting to age, marital status, professional activity and diabetes. Results: Subjective Happiness was positively correlated with satisfaction with life in general, and the three dimensions of Sense of Humor. Nevertheless, subjective happiness was negatively correlated with stress / anxiety and depression. Satisfaction with life in general, humor production and social use of humor, and attitude towards humor had a positive relationship with subjective happiness. However, depression had a negative relationship with subjective happiness. Conclusions: Higher levels of subjective happiness were associated with higher levels of satisfaction with life in general, and sense of humor, however they were also associated with lower levels of depression in patients undergoing hemodialysis

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Health diagnosis: a responsibility of community health nursing in Angola.

OBJECTIVE: To characterize the health situation of the population in the Imbondeiro neighborhood, sector C (Luanda). METHOD: This is a descriptive, cross-sectional and quantitative study. Families living in the sector were included, included in the sample by "door to door" contact. They accepted to participate through a free and consented form. RESULTS: Health diagnosis of 341 family households was conducted, involving 1,312 people. A total of 46.02% are male and 54.08% are female; from these, 42.62% are children, 15.14% adolescents and 42.24% adults. CONCLUSION: The results obtained and presented are in accordance with the data from the National Institute of Statistics of Angola (INE), revealing that it is necessary to intervene and to promote healthy lifestyle habits, regarding issues such as domestic violence, alcohol consumption, inappropriate eating habits, sexually communicable diseases, among others.

Health diagnosis: a responsibility of community health nursing in Angola / Diagnóstico de salud: una responsabilidad de la enfermería comunitaria en Angola / Diagnóstico de saúde: uma responsabilidade da enfermagem comunitária em Angola

ABSTRACT Objective: To characterize the health situation of the population in the Imbondeiro neighborhood, sector C (Luanda). Method: This is a descriptive, cross-sectional and quantitative study. Families living in the sector were included, included in the sample by "door to door" contact. They accepted to participate through a free and consented form. Results: Health diagnosis of 341 family households was conducted, involving 1,312 people. A total of 46.02% are male and 54.08% are female; from these, 42.62% are children, 15.14% adolescents and 42.24% adults. Conclusion: The results obtained and presented are in accordance with the data from the National Institute of Statistics of Angola (INE), revealing that it is necessary to intervene and to promote healthy lifestyle habits, regarding issues such as domestic violence, alcohol consumption, inappropriate eating habits, sexually communicable diseases, among others.

RESUMEN Objetivo: Caracterizar la situación de salud de la población del barrio Imbondeiro, sector C (Luanda). Método: Estudio descriptivo, transversal, cuantitativo. Se incluyeron las familias residentes en el sector, que aceptaron participar de forma libre, aclarada, a las cuales se tuvo acceso de modo accidental, por contacto «puerta a puerta¼. Resultados: Se realizó el diagnóstico de salud de 341 agregados familiares, lo que implicó a 1321 personas, de las cuales un 46,02 % del sexo masculino y un 54,08 % del sexo femenino. De estos, un 42,62 % son niños, un 15,14 % adolescentes y un 42,24 % adultos. Conclusión: Los resultados obtenidos y presentados están de acuerdo con los datos del Instituto Nacional de Estadística, lo que revela la necesidad de intervenir en la promoción de hábitos de vida saludables, en cuestiones como violencia doméstica, consumo de alcohol, hábitos alimentarios inadecuados, enfermedades sexualmente transmisibles, entre otros.

RESUMO Objetivo: Caracterizar a situação de saúde da população do bairro do Imbondeiro, setor C (Luanda). Método: Estudo descritivo, transversal e quantitativo. Incluídas as famílias residentes no setor, que aceitaram participar de forma livre e esclarecida e acedidas de modo acidental, por contacto "porta a porta". Resultados: Fez-se o diagnóstico de saúde de 341 agregados familiares, envolvendo 1321 pessoas. 46,02% são do género masculino, 54,08% do género feminino; destes, 42,62% são crianças, 15,14% adolescentes e 42,24% adultos. A maioria das famílias é alargada. A alimentação engloba açúcares e hidratos de carbono. Existe consumo de álcool e violência. Conclusão: Os resultados obtidos e apresentados vão de encontro aos do Instituto Nacional de Estatística (INE), no que diz respeito às três faixas etárias estudadas e ao seu diagnóstico de situação de saúde, revelando ser necessário intervir na promoção de hábitos de vida saudáveis, em áreas como violência doméstica, consumo de álcool, hábitos alimentares, doenças sexualmente transmissíveis, entre outras.

Community intervention in the Nursing education: experience report.

OBJECTIVE: To report the implementation and results of community intervention projects used as a strategy for teaching and developing people and communities in the training of community health nursing specialists at the Centro de Formação de Saúde Multiperfil (Multi-profile Health Training Center), Angola. METHOD: Report of experience of the use of community intervention projects in nursing. RESULTS: Community intervention projects have contributed to the learning of students and to the promotion of health, citizenship and the empowerment of individuals and communities. Its implementation is in the fourth year, and 16 projects have already been developed in 2 distinct neighborhoods, and this year the intervention will cover a third. CONCLUSIONS: Nursing teaching should adopt strategies that lead the student not only in the path of professional autonomy, but, above all, in the empowerment of people and communities. Community intervention is undoubtedly important in this area.