Revista Cuidarte最新文献

Introduction: Caregivers provide assistance to people with physical, emotional, and cognitive problems; however, they often do not receive the necessary support, leading to the occurrence of Caregiver Role Strain.

Objective: To analyze the concept of caregiver role strain theoretically and operationally to favor the instrumentalization of its use in research and clinical practice.

Materials and methods: This is an analysis of the concept of Caregiver Role Strain based on the Afaf Meleis model (2018). Operationalized in the following steps: (1) definition; (2) differentiation; (3) outlining of antecedents; (4) outlining of consequences; (5) modeling; (6) analogy, and (7) synthesis. A scoping review was performed to enable the execution of the four initial steps.

Results: The literature review identified 67 studies capable of integrating the final sample. Based on its findings, a theoretical definition and empirical references of the concept were evidenced, in order to instrumentalize clinical inference. Furthermore, 29 antecedents and 21 consequences of the concept were recognized. Some attributes that differentiate Caregiver Role Strain from other similar concepts were also highlighted, such as a stressor that contributed to the suffering, the degree of extension of the patient's disabilities, the caregiver's perception of the patient's suffering, and the quality and quantity of the care burden to be provided.

Discussion: Caregiver Role Strain can provide outcomes for informal caregivers and care recipients, manifesting worsening of symptoms, cognitive impairment, decreased quality of life, and physical, psychological, social, and financial aspects of both.

Conclusion: A theoretical definition for Caregiver Role Strain emerges as a complex and multidimensional construct that includes subjective and objective factors, in which the demands of care, the impact of the patient's disease process, and the physical, psychological, social, and financial implications accompany a negative reaction to care-related activities. The analysis is useful in the process of inference and distinction of the concept of Tension and its similarities with synonymous terms, with the aim of adequately addressing the instruments used to observe the phenomenon, in an accurate and comprehensive manner, and the distinction from other commonly used definitions.

Introduction: Suicidal behavior is an important health problem, frequently studied from a risk perspective. Evidence that transcends this hegemonic view is required.

Objective: To identify the structural and intermediate social health determinants associated with attempted suicide and completed suicide in Latin American adolescents and youth, according to published literature.

Materials and methods: Systematic review following PRISMA recommendations, performed in LILACS, Google academic and Pubmed using keywords. Primary ecological studies performed in Latin America were included, which were evaluated for confounding bias, data quality and ecological fallacy.

Results: Initially, 23,770 documents were located, and 10 were finally included. The structural determinants associated with suicide include being male, aged 15-24 years, having a high Gini index, having a low Gross Domestic Product (GDP) per capita, and being Catholic or Evangelical. While the suicide attempt was due to educational backwardness, being a woman, and living in the municipal seat. The intermediate determinants for suicide attempts were tobacco and alcohol consumption, violent episodes, and depression.

Discussion: The proposed theoretical model offers a novel view of the problem, moving away from individual responsibility and giving an active role to lifestyle-related conditions contributing to health inequities.

Conclusion: Social determinants offer a novel view for developing new prevention actions; however, empirical evidence from Latin America remains contradictory, and half of the studies reviewed were affected by confounding bias. Therefore, these associations should be interpreted with caution.

Introduction: The rising prevalence of overweight and non-communicable chronic diseases (NCDs) represents a serious public health problem for young people in countries across the Americas.

Objective: To analyze the nutritional status of students at a higher education institution in Medellín, Colombia, 2022.

Materials and methods: A cross-sectional descriptive study was conducted with 352 students. Sociodemographic information, nutritional status, and lifestyle habits were collected through surveys. Validated instruments were used to measure nutritional indicators. Data analysis included frequency distributions, summary measures, and statistical tests applied based on the assumption of normality.

Results: 31.82% of students were overweight, 22.16% had a high body fat percentage, and 19.32% were at cardiovascular risk. A statistical association was observed between BMI and both academic programs and age. While the consumption of natural foods was common, there was also a high intake of ultra-processed foods. Additionally, 62.78% of students engaged in adequate physical activity, yet 95.17% displayed sedentary behavior, and 39.77% had low handgrip strength. A potential positive correlation was identified between BMI, waist circumference, body fat percentage, and handgrip strength.

Discussion: The study revealed a concerning nutritional profile among university students, marked by overweight, increased adiposity, and sedentary behavior, aligning with findings from similar studies conducted in this population across various regions. Although the frequent consumption of natural foods and engagement in adequate physical activity are positive aspects, they contrast with the high intake of ultra-processed foods and prevalent sedentary lifestyles-patterns consistent with research in Latin America.

Conclusion: The university environment often increases students' risk of metabolic disorders, high consumption of ultra-processed foods, excess adiposity, and low physical activity levels, contributing to a nutritional profile that calls for attention and implementing preventive educational strategies.

Introduction: The emergence of hospital networks requires nursing models to guide practice and research.

Objective: To develop a professional practice model to guide nursing care practice, teaching, and research in a teaching hospital network.

Materials and methods: This study involved Nursing Methodology Research conducted within an academic-service partnership over three years in a hospital network in Colombia. It followed a humanistic theoretical framework and a collective construction technique with guideline-based development and analysis. It included four consecutive phases: 1) Identification of the need for the model within the Hospital Network, 2) recognition of nursing metaparadigm concepts for practice, 3) formulation and prioritization of the assumptions required to achieve nursing mission and vision, and 4) consolidation, sharing, and validation of the model. A total of 156 out of the 185 nurses in the organization participated.

Results: The model developed for the Hospital Network consists of three essential components: compassion, safe care, and nursing leadership.

Discussion: The collective participation of the nursing staff and the work made within the academic-service partnership facilitated the adoption of the model. This development responds to the Hospital Network's strategic guidelines for quality of care, includes internal and external validation, and adheres to international standards.

Conclusion: The "Leadership in Compassionate and Safe Care" nursing practice model guides, facilitates, and makes visible teaching and care practice and nursing research inside and outside of the Hospital Network.

Introduction: The Covid-19 pandemic has posed a significant challenge to public health worldwide, leading to the collapse of healthcare institutions and professionals, particularly nursing technicians, who provide direct patient care.

Objective: To investigate nursing technicians' perceptions of their technical-scientific experiences while caring for Covid-19 patients.

Materials and methods: An exploratory and descriptive study with a qualitative approach was conducted in a university hospital. The Iramuteq software was used to analyze the data, applying the Descending Hierarchical Classification Method alongside Bardin's Content Analysis Technique.

Results: It was identified that the participants' technical-scientific skills are associated with previous ICU experience and active participation in training sessions, both facilitating factors for performing the procedures. Additionally, the negative effects of care practices were observed, leading to physical and mental exhaustion.

Discussion: Work overburden, fear of contagion, high mortality rates, and social isolation were identified as causes of stress and mental exhaustion among professionals, making resilience a crucial factor in adapting to these adversities.

Conclusion: Identifying the nursing professionals' prior knowledge is an important tool for assessing the quality of care provided and the professionals' safety in care delivery. Moreover, implementing health policies that offer psychological support for health professionals is essential.

Introduction: Sociodemographic factors such as geographic location are associated with high cardiovascular risk. Urban areas are characterized by densely populated areas with access to services, while rural areas have fewer people and limited services.

Objective: To determine the factors associated with high cardiovascular risk according to the area of patients enrolled in a chronic care program in Putumayo.

Materials and methods: Analytical cross-sectional study. The population was selected through simple random sampling. Information on the main risk factors was collected and included in a multivariate logistic regression model.

Results: A total of 1,190 patients were included (median age 59.5 years [IQR 53-66], 68.74% women). 86.22% of the patients had high cardiovascular risk, with a similar distribution between urban (87.95%, n=628) and rural (83.61%, n=398) areas and a statistically significant difference compared to low/moderate risk (p=0.033). The factors related to cardiovascular risk in this population were primary education (OR: 0.68, CI 95%: 0.38-1.24), secondary education (OR: 0.88, CI 95%: 0.42-1.83), higher education (OR: 0.33, CI 95%: 0.13-0.82), ethnicity (none) (OR: 2.13, CI 95%: 0.98-4.63), rural area (OR: 0.66, CI 95%: 0.47-0.94), and contributory health affiliation (OR: 6.58, CI 95%: 2.75-15.72).

Discussion: This study revealed that factors such as education level, ethnicity, type of health affiliation, and area were related to cardiovascular risk.

Conclusion: The results showed a high proportion of individuals with elevated cardiovascular risk in Putumayo, with statistically significant differences between areas.

Introduction: The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set the 95-95-95 targets. It is expected that 95% of HIV-positive individuals will know their HIV status and of these, 95% will be on antiretroviral therapy (ART) and 95% will achieve viral suppression.

Objective: To analyze the distribution and spatial autocorrelation of the 95-95-95 targets among children and adolescents living with HIV/AIDS in Latin America and the Caribbean.

Materials and methods: An epidemiological ecological study using data from AIDSinfo by the Joint United Nations Programme on HIV/AIDS (UNAIDS) on the 95-95-95 targets among children and adolescents between 2015 and 2022. The analysis was performed using Moran's spatial autocorrelation coefficient (global and local), considering a 5% significance level.

Results: A total of 52,000 and 42,000 cases of HIV/AIDS among children and adolescents in Latin America and the Caribbean were analyzed, respectively, for the period from 2015 to 2022. Disparities in the targets were identified between countries, with significant spatial autocorrelation for the second target of 95, showing a value of 0.375 (p-value 0.017).

Discussion: Among the 27 countries included in the study, only Guatemala met the first 95 target. To reach the goal, strategies are needed to increase access to HIV testing, with more accessible counseling and testing services.

Conclusion: There are discrepancies between countries in Latin America and the Caribbean in meeting and increasing the percentage of the 95-95-95 targets. The study allowed the identification of priority areas for attention, highlighting the need for new strategies and policies tailored to each locality, assisting in the achievement of the targets.

Introduction: Military police officers daily face stressful and potentially traumatic situations, resulting in a high prevalence of occupational stress and mental comorbidities within this group. Despite this, the pursuit of mental health services by these professionals encounters structural challenges that are still insufficiently discussed.

Objective: To determine the factors that most influence the search for, provision of, and utilization of mental health services by police officers through an integrative literature review.

Materials and methods: The search for articles was conducted using the following databases: Virtual Health Library (VHL), MEDLINE, Scopus, and Embase. After the selection process, 23 articles were included for analysis in this review.

Results: The main findings indicate that social stigma, lack of knowledge on the subject, and organizational deficiencies are critical aspects that hinder the pursuit of psychological well-being services in the police field.

Discussion: Despite the many barriers to police officers seeking mental health care, it was highlighted that family support and professional development are positively related to help-seeking behavior.

Conclusion: Further research is needed to evaluate mental health programs and better understand the difficulties in implementing these services. Promoting the search for psychological help is essential to improving police officers' health and population's safety.

Introduction: The COVID-19 pandemic led to a high prevalence of anxiety and depression among healthcare personnel.

Objective: To assess the prevalence and independent risk factors associated with anxiety and depression symptoms among healthcare staff working in Intensive Care Units (ICUs) during the COVID-19 pandemic in Bucaramanga and its metropolitan area.

Materials and methods: This was an analytical cross-sectional study. Anxiety and depression were measured using the Hopkins Symptom Checklist-25 (HSCL-25). Bivariate and multivariate analyses were conducted using linear regressions to investigate associated factors.

Results: A total of 288 people were included in the study. The prevalence of anxiety and depression symptoms was 8.34% (95% CI: 5.41-12.14%). In the bivariate analysis, six factors were associated with depression and anxiety symptoms; however, only three remained in the multivariate analysis: female sex (β=0.085, 95% CI: 0.019 - 0.151), experiencing COVID-19 symptoms in the past 14 days (β= 0.115, 95% CI: 0.024 - 0.205), and having worked in general ICUs and COVID-19 ICUs (β =0.009, 95% CI: 0.025 - 0.173).

Discussion: The prevalence of anxiety and depression symptoms was considerably lower than reported in the scientific literature.

Conclusion: In the studied population, although the prevalence of depression and anxiety symptoms was low, three independent factors were found to be statistically associated with the presence of these mental symptoms.

Introduction: Hospitalised adults often have essential emotional needs during their hospital stay, highlighting the importance of incorporating emotional mobilisation therapies.

Objective: To evaluate the effect of laughter therapy with healthcare clowns on the mood of 40 adults hospitalised in internal medicine.

Materials and methods: This quasi-experimental study used the transculturally adapted Scale for Mood Assessment (EVEA-H) to assess the intervention's effects.

Results: Findings revealed significant improvements in participants' mood. There was a considerable reduction in levels of sadness/depression (p <0.00), anxiety (p <0.00) and anger/hostility (p < 0.00), while a significant increase in joy (p < 0.00) was observed after laughter therapy.

Discussion: Current evidence supports laughter therapy with healthcare clowns as a tool to foster positive emotions, reduce negative psychological symptoms, and improve emotional well-being in various contexts, highlighting the importance of collaborative implementation with medical staff to strengthen well-being in healthcare settings.

Conclusion: Laughter therapy can be an effective strategy to improve the emotional well-being of hospitalised adults by reducing negative moods and promoting positive emotions.