Demoralization and spirituality in oncology: an integrative systematic review.

OBJECTIVE: To synthesize the scientific findings on demoralization and spirituality in the oncology context. METHODS: This is an integrative systematic review, in line with the PRISMA 2020 guidelines, as proposed by Whittemore and Knalf (2005). The MEDLINE via PubMed, Scopus, Web of Science, APA PsycNet, CINAHL, Cochrane Library, EMBASE, and LILACS databases were searched without limitations regarding language or year of publication. The studies were screened for inclusion according to the predefined eligibility criteria. Data extraction and evidence quality assessment were performed. RESULTS: Out of the 1587 articles evaluated, 10 studies were included in this review. In general, it was found that demoralization tends to increase with the proximity of death and seems to be inversely related to spirituality, with spiritual well-being being a protective factor against demoralization, while the non-fulfillment of spiritual needs is related to increased demoralization in people with cancer. Furthermore, even among caregivers of people with advanced cancer, demoralization seems to be associated, among other factors, with spiritual suffering. These results should be analyzed with caution, considering that the studies included in this review are all observational studies, which prevents establishing cause and effect relationships. CONCLUSIONS: Demoralization tends to increase with growing frailty and the proximity of death in people with cancer, and it seems to be inversely related to spirituality, both in these patients and in their caregivers.

Mindful Self-Care, Self-Compassion, and Resilience Among Palliative Care Providers During the COVID-19 Pandemic.

CONTEXT: Given the adverse impact of COVID-19 on the wellbeing of palliative care providers, there is a growing need to better understand protective variables, such as self-care, mindfulness and self-compassion, as they relate to resilience. OBJECTIVE: To investigate mindful self-care, self-compassion, and resilience as reported by palliative care providers during the COVID-19 pandemic. METHODS: Descriptive, cross-sectional survey. An electronic questionnaire captured data from validated instruments measuring each study variable, as well as participant demographics and perceived impacts of COVID-19 on professional quality of life. RESULTS: Positive, statistically significant correlations were found between mindful self-care, self-compassion, and resilience. These variables were also associated with greater satisfaction with professional life and perceived lessened impairment in physical and/or mental health due to a decrease in self-care activities stemming from altered routines during COVID-19. Those with higher resilience had worked in palliative care longer and also reported higher levels of self-compassion and mindful self-care, explaining 50% of variance. Self-compassion, satisfaction with professional life, and changes in self-care routine due to professional activities in the pandemic explained 44.3% of variance in mindful self-care. Self-compassion, female gender, and working as a frontline responder to the COVID-19 pandemic accounted for 35% variance in resilience levels. CONCLUSIONS: Results from this study extend the currently limited knowledge of self-care, mindfulness and self-compassion, as protective variables related to resilience in palliative care providers during the COVID-19 pandemic. Further longitudinal studies into causal effects on health and wellbeing over time are needed.

Concept analysis of cancer survivorship and contributions to oncological nursing.

AIM: This study aims to analyse the concept of cancer survivorship using Rodgers' evolutionary concept analysis model. BACKGROUND: The lack of a consensus definition as well as the confusion and debate concerning the definitions of "survivor" and "cancer survivorship" hinder an understanding of the intrinsic needs associated with the latter. DESIGN: Concept analysis. METHOD: A systematic literature search was performed using the following databases: PubMed, CINAHL, Web of Science, LILACS, and PsycINFO with studies published between 2000 and 2014. The final sample contained 39 studies that were analysed on the basis of Rodgers' model and inductive thematic analysis, discussed through the lens of the medical anthropology concept of culture. FINDINGS: Cancer survivorship is a broad concept that can be understood using 8 themes: changes in life plans, positive and negative aspect dualities, life reflections, identity change, individual experiences, symptom control, the need for support, and quality of care. These themes are summarized using 2 attributes: liminality process and culturally congruent care. CONCLUSIONS: This article contributes to understanding of cancer survivorship and the processes that are intrinsic to this concept. It calls for future investigations to enhance cancer survivorship across its 2 domains at the personal (patient's life) and clinical (nursing practice) levels.

[Social representations of women submitted to mastectomy and the implications for self-care]. / Representações sociais de mulheres mastectomizadas e suas implicações para o autocuidado.

The purposes of this research was to identify the social representations of women on breast mastectomy and to analyze the implications of these social representations to care for self-care. This is a qualitative study using the Theory of Social Representations as theoretical reference. For data collection it was employed two techniques: the free association of ideas and observation. For data analysis the thematic analysis was used. The research resulted in two thematic units: the breast and its representations of social change in the body and social representations of women mastectomy: implications for self care. In the study, showed that women objected care of the breasts through the realization of self-examination.

[My dependent body: social representations of diabetic patients]. / Meu corpo dependente: representações sociais de pacientes diabéticos.

This study aims at identifying social representations of diabetic clients on your body after the amputation, and analyze the relationship of these representations to the care of themselves. The research was a qualitative, exploratory, with the use of the social representations theory and case study method. The scenario was a hospital in the city of Belém, Pará, 20 subjects participated. The data collection techniques were: a free association of words and watch free. After examining three categories emerged: the healthy body - term health of living well, the body work - the perfection and beauty in daily life, The body amputated - the limitation caused by amputation; and the amputated body and its relation to the care of themselves. It is clear concern to recover the lost welfare.