Effect of Foot Reflexology Protocol on Premenstrual Syndrome Symptoms in Nursing Students: a Pre-Post Pilot Study.

BACKGROUND: Premenstrual syndrome is a highly prevalent cyclical disorder among women of childbearing age which interferes with daily activities, mood, and quality of life. PURPOSE: To evaluate the effects of a foot reflexology protocol on relieving premenstrual syndrome symptoms in nursing students. SETTING: Nursing School, São Paulo University, Brazil. PARTICIPANTS: A convenience sample of 17 nursing students, diagnosed with moderate-to-severe premenstrual syndrome as assessed by the Premenstrual Symptoms Screening Tool (PSST). RESEARCH DESIGN: A pre-post pilot intervention study. INTERVENTION: The intervention consisted of eight reflexology sessions lasting 30 minutes for eight weeks. MAIN OUTCOME MEASURE: Evaluation of the participants by the PSST applied at the beginning and at the end of the study. RESULTS: The participants had an average age of 21.7 (±2.6) years, ranging from 19 to 28 years; all were single, and most were in the third year of the course (58.8%); 75.6% lived with their family; 82.4% do not use contraceptives; 64.7% reported regular menstrual flow with an average duration of 5.1 (±1.1) days, and an average menstrual cycle interval of 29.3 (±4.9) days. The intervention significantly reduced the premenstrual symptoms assessed by the PSST (p<.017) with a pre-post difference of 10.2 points in the overall score, and the items score decreased between 1.2 to 3.4 for difficulty concentrating, insomnia, hypersomnia, feeling overwhelmed, muscle/ joint pain, bloating, weight gain; and between 3.5 to 5.2 to anger/irritability, anxiety/ tension, tearful, depressed mood, decreased interest in daily activities, fatigue, overeating, and breast tenderness. There was a significant decrease regarding the functional impact of premenstrual symptoms domain in the overall score with a pre-post difference of 10.7, and between 1.7 and 3.0 for all of the items (p<.04), except for the item "your home responsibilities". CONCLUSION: Foot reflexology has shown promising results in reducing premenstrual syndrome symptoms.

Florais de Bach em paciente com histórico de abuso sexual: um relato de caso / Flower remedies in patient with a history of sexual abuse: case report

Introduction: According to the World Health Organization (WHO), child sexual abuse is regarded as one of the greatest public health problems. Psychological and emotional effects of sexual abuse can be devastating to the survivors and social and relationship problems arising from this abuse can persist well into adulthood4. Objective: This case study reports on the treatment effects of Bach's flower remedies on a 21 years old, female patient with a history of sexual abuse living in Brazil. Methods: Treatment consisted of remedies comprised of six flower essences that were selected each month over a four-month time period. Data were collected using two open-ended questions that explored the effect of the remedies on the patient's physical, cognitive, emotional and spiritual health as well as her perceptions about the positive and negative aspects of using Bach's flower remedies. Qualitative content analysis was conducted. Results: Over the course of the intervention, the patient reported a significant improvement in her emotional well-being, being able to have a "good laugh" and no longer feeling ashamed of being happy. Also she started pursuing dating relationships throughout the period of treatment. Conclusion: Bach's flower remedies may be a promising intervention for individuals who have experienced childhood sexual abuse and have experienced difficulties in developing relationships. In this case study, a female sexual abuse survivor reported Bach's flower remedies as having beneficial effects with regards to her willingness to engage in dating behaviour and pursue the possible establishment of intimate relationships.(AU)

Introdução: Segundo a Organização Mundial da Saúde (OMS), o abuso sexual infantil é considerado como um dos maiores problemas de saúde pública. Os efeitos psicológicos e emocionais do abuso sexual podem ser devastadores e os problemas sociais e de relacionamento decorrentes podem persistir até a vida adulta. Objetivo: Este estudo de caso relata os efeitos do tratamento com os remedios florais de Bach em uma paciente de 21 anos, do sexo feminino, de nacionalidade Brasileira com um histórico de abuso sexual. Métodos: O tratamento consistiu em remédios compostos por seis essências florais que foram selecionados a cada mês, durante um período de quatro meses. Os dados foram coletados por meio de duas perguntas abertas que exploraram o efeito dos remédios na saúde física, cognitiva, emocional e espiritual da paciente, bem como suas pecepções sobre os aspectos positivos e negativos do uso de remédios florais de Bach. Foi realizada uma análise quantitativa. Resultados: Ao longo da intervenção, o paciente relatou uma melhora significativa no seu bem-esstar emocional, onde se sentiu capaz de dar uma "boa risada" e não sentir mais vergonha de ser feliz. Além disso, ela se permitiu iniciar um namoro durante o período de tratamento. Considerações: Os remédios florais de Bach podem ser uma intervenção promissora para indivíduos que sofreram abuso sexual na infância. Nesse estudo de caso, uma vítima de abuso sexual relatou resultados positivos com o tratamento com os florais de Bach, principalmente no que diz repeito a á criação de relacionamentos íntimos.(AU)

[Patient readmission for surgical site infection: integrative review]. / Reingreso por infección de sitio quirúrgico: una revisión integradora.

BACKGROUND: Surgical site infections (SSI) represent an inherent risk after surgical procedures associated both to the surgical procedure and to the patient clinical conditions. AIM: To analyze in an integrative review the studies related to patient readmission due to SSI. MATERIAL AND METHOD: The review was carried out by LILACS, CINHAL, MEDLINE and COCHRANE databases and articles published from 1966 to 2010 were selected. RESULTS: It was analyzed 13 studies classified as transversal (7), cohort (4) and longitudinal (2). Few studies analyzed only the readmissions related to the SSI. Time to define the readmission ranged from 28 to 90 days after surgery and studies related to orthopedic procedures were more frequent. The ISS readmission rates were lower than 5%. The main aetiological agents isolated from ISS were Staphylococcus aureus and coagulase-negative staphylococci. CONCLUSION: Monitoring readmissions due to SSI could contribute to dimension the occurrence of ISS post-discharge, once about half of the SSI post-discharge was diagnosed at the readmission moment.

Reingreso por infección de sitio quirúrgico: una revisión integradora / Patient readmission for surgical site infection: integrative review

Background: Surgical site infections (SSI) represent an inherent risk after surgical procedures associated both to the surgical procedure and to the patient clinical conditions. Aim: To analyze in an integrative review the studies related to patient readmission due to SSI.Material and Method: The review was carried out by LILACS, CINHAL, MEDLINE and COCHRANE databases and articles published from 1966 to 2010 were selected. Results: It was analyzed 13 studies classified as transversal (7), cohort (4) and longitudinal (2). Few studies analyzed only the readmissions related to the SSI. Time to define the readmission ranged from 28 to 90 days after surgery and studies related to orthopedic procedures were more frequent. The ISS readmission rates were lower than 5%. The main aetiological agents isolated from ISS were Staphylococcus aureus and coagulase-negative staphylococci. Conclusion: Monitoring readmissions due to SSI could contribute to dimension the occurrence of ISS post-discharge, once about half of the SSI post-discharge was diagnosed at the readmission moment.

Introducción: Las infecciones de sitio quirúrgico (ISQ) representan un riesgo inherente a la realización de cualquier acto quirúrgico, asociado a factores propios del procedimiento, así como a condiciones del paciente. Objetivo. Analizar, en una revisión integradora, los estudios que abordaran aspectos epidemiológicos relacionados con el reingreso de pacientes por ISQ. Método: Se efectuó una revisión en las bases LILACS, SCOPUS, COCHRANE e MEDLINE con selección de artículos publicados desde 1966 hasta 2010. Resultados: Se analizaron 13 estudios, siendo siete estudios transversales, cuatro de cohortes y dos longitudinales. Escasos estudios se restringieron a analizar exclusivamente los reingresos relacionados a la ISQ. El tiempo para definir el reingreso varió de 28 a 90 días después de la cirugía y hubo un mayor número de estudios relacionados con procedimientos ortopédicos. La tasa de reingreso por ISQ en los estudios fue inferior a 5%. El principal agente aislado en las ISQ fue Staphylococcus aureus y Staphylococcus coagulasa negativas. Conclusión: La vigilancia de los reingresos por ISQ podría contribuir a dimensionar la ocurrencia de ISQ post-alta, ya que aproximadamente la mitad de las ISQ post-alta originaron reingresos a centros hospitalarios.

Infecção hospitalar e causas múltiplas de morte / Nosocomial infection and multiple causes of death

Objetivo: este estudo se propôs a avaliar a possibilidade de se obter informações de infecção hospitalar por meio da declaração de óbito. Material e métodos: foi feita revisão de prontuários de crianças que faleceram com mais de 48 horas de internação num hospital pediátrico, para coleta de dados sobre as causas múltiplas de morte. Também foram revistas as declarações de óbito, para verificar sua qualidade de preenchimento. Os atestados de óbito foram refeitos segundo as informações do prontuário, utilizando-se a classificação suplementar de causas externas de lesões e envenenamentos da Classificação Internacional de Doenças -9ºrevisão, para codificar as infecções hospitalares e procedimentos associados. Resultados: após refazer os atestados, observou-se concordância da causa básica de morte entre atestados originais e refeitos de 69,9por cento, com índice de Kappa de 0,65. No atestado médico original, identificou-se somente uma infecção hospitalar, enquanto pelo atestado refeito recuperaram-se 88,9 por cento de todas as infecções hospitalares, ocorridas nas crianças, até 15 dias antes do óbito. Conclusão: a qualidade de preenchimento dos atestados de óbito não permite utilizar as declarações de óbito como fonte de dados de infecção hospitalar, a não ser que haja capacitação dos profissionais médicos para identificar e registrar as infecções hospitalares no prontuário, bem como preencher os atestados adequadamente

[Nosocomial infection and multiple causes of death]. / Infecção hospitalar e causas múltiplas de morte.

OBJECTIVE: The purpose of this study was to evaluate the possibility for collecting data on nosocomial infections by means of death certificates. METHODS: The medical charts of children who died after 48 hours of their admission to a pediatric hospital were revised to get information about the causes of death. Death certificates were also revised to verify whether they were properly filled out. The death certificates were redrafted according to the data obtained from patients' medical charts. Nosocomial infections and procedures related to them were codified using the Supplementary External Causes of Injury and Poisoning codes of the International Disease Classification-9th Revision. RESULTS: The causes mentioned on medical death certificates compared with revised causes obtained after revision of patients' charts showed an agreement of 69.9%, with a Kappa coefficient of 0.65. Only one case of nosocomial infection was found on original death certificates, whereas the redrafted certificates revealed 88.9% of nosocomial infections in the study population up to fifteen days before death. CONCLUSION: Death certificates are not a good source of information on nosocomial infection because they are often filled out inadequately. The solution to this is to qualify physicians so that they can identify and record nosocomial infections on the patient's medical chart and complete death certificates accordingly.