RESUMO

The objective of this study is to identify the main motivations and expectations for seeking spiritual treatment (ST) in  spiritist centers. This is a qualitative study developed at two spiritist centers in the state of Mato Grosso, Brazil. ST was considered as the set of activities that use magnetic current as the main treatment method. We observed that most of the participants first sought treatments from health professionals and that, after insufficient results, they went in search of ST. Their treatments take place simultaneously and, for the participants, they complement each other. The motivations that led the participants to ST ranged from physical reasons to mental health complaints and even family conflicts. One possibility for investing in this type of treatment is due to the participants' desire for a more comprehensive approach, and not as a mere solution to the problem that directly afflicts them.

RESUMO

Resumo Fundamento Religiosidade e espiritualidade têm sido associadas a maiores taxas de recuperação, maior adesão a tratamentos e melhores níveis de qualidade de vida em pacientes cardiopatas. Objetivos Avaliar a associação entre espiritualidade, ganho funcional e melhoria de qualidade de vida em pacientes de um programa de reabilitação cardiovascular. Métodos Estudo de coorte prospectiva, no qual foi avaliada a associação entre os ganhos funcional e em qualidade de vida obtidos durante um programa de reabilitação cardiovascular e o índice de religiosidade/espiritualidade a partir de escala validada. Sintomas de depressão, ansiedade e estresse foram rastreados, para fins de controle. Um p < 0,05 foi adotado como padrão significante para todas as análises. Resultados Foram acompanhados 57 pacientes (66 ± 12 anos; 71,7% masculinos, 76% com doença arterial coronariana). O cálculo do coeficiente de correlação de Spearman não evidenciou associações entre incrementos na capacidade funcional e religiosidade organizacional (rs = 0,110; p = 0,421), não organizacional (rs = −0,007; p = 0,421) ou intrínseca (rs = −0,083; p = 0,543). Também não foram detectadas associações entre os resultados de um escore de qualidade de vida e religiosidade organizacional (rs = 0,22; p = 0,871), não organizacional (rs = 0,191; p = 0,159) ou intrínseca (rs = 0,108; p = 0,429). Conclusão Não foi detectada associação entre ganho funcional ou em qualidade de vida e religiosidade organizacional, não organizacional ou intrínseca, nesta amostra de pacientes em reabilitação cardiovascular.

Abstract Background Religiosity and spirituality have been associated with higher recovery rates, greater adherence to treatments, and better levels of quality of life in patients with heart disease. Objectives To evaluate the association between spirituality, functional gain, and improved quality of life in patients in a cardiovascular rehabilitation program. Methods This prospective cohort study evaluated the association between functional and quality of life gains during a cardiovascular rehabilitation program and a religiosity/spirituality index based on a validated scale. Depression, anxiety, and stress symptoms were screened for control purposes. P values < 0.05 were considered significant for all analyses. Results The study followed 57 patients (66 ± 12 years old; 71.7% male; 76% with coronary artery disease). The Spearman correlation coefficient did not show any associations between increases in functional capacity and organizational (rs = 0.110; p = 0.421), non-organizational (rs = −0.007; p = 0.421), or intrinsic (rs = −0.083; p = 0.543) religiosity. Furthermore, no associations were detected between the results of a quality of life score and organizational (rs = 0.22; p = 0.871), non-organizational (rs = 0.191; p = 0.159), or intrinsic (rs = 0.108; p = 0.429) religiosity. Conclusion No association was detected between functional and quality of life gains and organizational, non-organizational, or intrinsic religiosity in this sample of patients undergoing cardiovascular rehabilitation.

RESUMO

Introducción. Existen estudios que dan cuenta del uso extendido de la medicina tradicional (MT) en diversos países. La formación del pediatra es escasa en este campo. Objetivo. Describir las características de la MT utilizada por los pacientes de un hospital pediátrico de la Ciudad Autónoma de Buenos Aires. Población y métodos. Diseño cualitativo, basado en la teoría fundada. Entrevista a cuidadores de niños de 0 a 11 años. Resultados. Se entrevistaron 30 personas de diferentes colectividades, la gran mayoría mujeres amas de casa. Casi la totalidad refirió haber utilizado la MT. La fuente de recomendación más utilizada fue la familia. En general, el uso de la MT precede a la consulta a un médico del sistema de salud. Se acude a la MT por entidades definidas por la medicina convencional, pero también por otras propias, como pata de cabra, ojeo y empacho. Las prácticas terapéuticas incluyen la administración de preparados a base de plantas, infusiones, caldos, como también rituales conducidos por curanderos. Todos los usuarios refirieron una valoración positiva de la MT. Una gran parte de los entrevistados consideró importante que el médico conozca y pregunte sobre ella. Todos refirieron que su uso no fue abordado en consultas previas. Conclusiones. La MT se extiende como conocimiento y/o práctica en toda la población estudiada y forma parte de su vida cotidiana. Los métodos utilizados son muy diversos, así como las situaciones para las que se utiliza; las principales causas son de origen gastrointestinal y respiratoria. No es abordada en la consulta pediátrica, pero sus usuarios desearían que lo fuera.

Introduction. Several studies have reported on the widespread use of traditional medicine (TM) in different countries. Pediatricians receive scarce training in this field. Objective. To describe the characteristics of TM used by patients attending a children's hospital in the City of Buenos Aires. Population and methods. Qualitative design based on grounded theory. Interview with caregivers of children aged 0-11 years. Results. Thirty people from different communities were interviewed, mostly homemakers. Almost all referred having used TM. The most common source of recommendation was the family. In general, TM use precedes the visit to a physician in the health system. TM is used to manage conditions defined by conventional medicine, but also to treat folk illnesses such as Simeon's disease, evil eye, and indigestion. Therapeutic practices include plant-based preparations, infusions, broths, as well as other rituals performed by folk healers. All users had a positive opinion about TM. Most interviewees considered that physicians should know and ask about TM. All participants referred that its use had not been addressed in prior visits. Conclusions. TM spreads as knowledge and/ or practice across the studied population and is part of everyday life. TM methods vary greatly, as well as the conditions for which it is used; the main reasons for use included gastrointestinal and respiratory conditions. It is not addressed in pediatric visits, but users wish it was.

Assuntos

RESUMO

OBJECTIVE: To systematically analyze quantitative data about the effects of religion/spirituality and the well-being/quality of life of cancer patients. The second aim was to hypothesize a neurophysiological model of the association between religion/spirituality and the brain. METHODS: This study met the PRISMA Statement and was registered at PROSPERO database. Randomized and Controlled trials investigating religion/spirituality and well-being/quality of life of cancer patients were included. Based on neuroimaging and neurophysiology studies, a neuroanatomical model was developed to hypothesize the relationship between neuroscience and religion/spirituality. RESULTS: A large effect size was found on the improvement of well-being/quality of life (SMD = 3.90 [2.43-5.38], p < 0.01). Heterogeneity was high among studies (I2 = 98%, p < 0.01). Specific regions of the brain, such as the temporal lobes, amygdalae and hippocampus, regions from the limbic system, were hypothesized to take part in the religion/spirituality phenomena and the well-being/quality of life improvement. CONCLUSION: Religion/spirituality intervention, mainly the Islamic, promotes an improvement on wellbeing/quality of life of cancer patients.

OBJETIVO: Analisar sistematicamente dados quantitativos sobre os efeitos da religião/espiritualidade e o bem-estar/qualidade de vida de pacientes com câncer. O segundo objetivo foi levantar a hipótese de um modelo neurofisiológico da associação entre religião/espiritualidade e o cérebro. MÉTODOS: Este estudo seguiu as recomendações do PRISMA e foi registrado no PROSPERO. Estudos randomizados e controlados investigando religião/espiritualidade e o bem-estar/qualidade de vida de pacientes com câncer foram incluídos. Com base em estudos de neuroimagem e neurofisiologia, um modelo neuroanatômico foi desenvolvido para hipotetizar relações entre neurociência e religião/espiritualidade. RESULTADOS: Um tamanho de efeito grande foi encontrado na melhoria do bem-estar/qualidade de vida (SMD = 3,90 [2,43-5,38], p < 0,01). A heterogeneidade foi alta entre os estudos (I2 = 98%, p < 0,01). Regiões específicas do cérebro, como lobos temporais, amídalas e hipocampo, regiões do sistema límbico, foram hipotetizadas como participantes dos fenômenos religião/espiritualidade e melhoria do bem-estar/qualidade de vida. CONCLUSÃO: A intervenção religiosa/espiritual, principalmente islâmica, promove melhora no bem-estar/qualidade de vida em pacientes com câncer.

Assuntos

RESUMO

Resumen Objetivos: El estudio pretende reconocer la existencia de agentes portadores y reproductores de prácticas y saberes populares en salud, sus dominios y dinámica en el espacio social. Georreferenciar sus dinámicas y establecer su relación con el Plan Básico de Ordenamiento Territorial. Metodología: Estudio cualitativo analítico, que conjuga la geografía crítica y la etnografía. Mediante el uso de técnicas de georreferenciación, -localización y espacialización-, con uso del software QGIS versión 3.6 Nossa. Y mediante el uso de técnicas de entrevistas a profundidad y observaciones documentadas, información que se ordenó y sistematizó por categorías, mediante la implementación del programa ATLAS.ti versión 9. Resultados: Se reconocieron más de 60 agentes y se localizaron 48. Se reconocen dos dominios del saber popular: el mágico religioso, expresado en sobanderos con secreto, y el curanderismo expresado en hierbateros, rezanderos y sobanderos. Se legitiman a través de su presencia en espacios sociales, en sus tres dimensiones: material, al portar una identidad y un dominio, que habitan con objetos; mental, el cual cargan de relaciones y simbolismos; y político, donde reproducen una cadena comercial vinculada a la zona de vocación comercial establecida por el PBOT del municipio. Conclusiones: Los agentes, sus prácticas y saberes se determinan y legitiman, a partir de actos de reproducción social, cultural y política en el territorio como espacio social, y en sus dimensiones, a partir de expresiones culturales, simbolismos y rituales, relaciones materiales a partir del intercambio con objetos y servicios, y su asiento político en las zonas de vocación territorial.

Abstract Objectives: The study aims at recognizing the existence of agents carrying and reproducing popular practices and knowledge in health, their domains and dynamics in the social space and at geo-positioning their dynamics and establishing their relationship with the Basic Plan of Territorial Planning. Methodology: qualitative analytical study that combines critical geography through georeferencing techniques, -localization and spatialization-, using the QGIS Version 3.6 Nossa program, and ethnography through the use of in-depth interview techniques and observations, information that was organized and systematized by categories through the implementation of the ATLAS.ti version 9 program. Results: More than 60 agents were recognized and 48 were located. Two domains of popular knowledge were recognized: the Religious Magic, expressed in massage therapists (sobanderos) with secrecy, and folk medicine (Curanderismo) expressed in shamans, rezanderos and sobanderos. They are legitimized through their presence in social spaces in their 3 dimensions: material by carrying an identity and a domain inhabiting objects; mental which is loaded with relationships and symbolism; and political where they reproduce an overlapping and expanded commercial chain, linked to the area of commercial vocation delimited by the PBOT of the municipality. Conclusions: Agents, their practices and knowledge are determined and legitimized based on acts of social, cultural and political reproduction in the territory as a social space, and in their dimensions based on cultural expressions, symbolisms and rituals, material relationships from the exchange with objects and services and settled politically in the areas of territorial vocation.

Resumo Objetivos: o estudo pretende reconhecer a existência de agentes portadores e reprodutores de práticas e saberes populares em saúde, seus domínios e dinâmica no espaço social. Georreferenciar suas dinâmicas e estabelecer sua relação com o Plano Básico de Ordenamento Territorial. Metodologia: estudo qualitativa analítico, que conjuga a geografia crítica e a etnografia. Através do uso de técnicas de georreferenciação, -localização e espacialização-, com uso do software QGIS versão 3.6 Nossa. E através do uso de técnicas de entrevistas a profundidade e observações documentadas, informação que se arrumou e sistematizou por categorias, através da execução do programa ATLAS.ti versão 9. Resultados: reconhecerem-se mais de 60 agentes e se localizaram 48. Reconhecem-se dois domínios do saber popular: o mágico religioso, expressado em sobanderos (pessoa que sana a través de massagens) com secreto, e o curandeirismo expressado em curandeiros, rezanderos (pessoa que sana a través da oração) e sobanderos. Legitimam-se através de sua presença em espaços sociais, em suas três dimensões: material, ao trazer uma identidade e um domínio, que habitam com objetos; mental, o qual carregam de relaciones e simbolismos; e político, onde reproduzem uma cadeia comercial vinculada à zona de vocação comercial estabelecida pelo PBOT do município. Conclusões: os agentes, suas práticas e saberes se determinam e legitimam, a partir de atos de reprodução social, cultural e política no território como espaço social, e em suas dimensões, a partir de expressões culturais, simbolismos e rituais, relações materiais a partir do intercâmbio com objetos e serviços, e sua posição política nas zonas de vocação territorial.

RESUMO

INTRODUCTION: Several studies have reported on the widespread use of traditional medicine (TM) in different countries. Pediatricians receive scarce training in this field. OBJECTIVE: To describe the characteristics of TM used by patients attending a children's hospital in the City of Buenos Aires. POPULATION AND METHODS: Qualitative design based on grounded theory. Interview with caregivers of children aged 0-11 years. RESULTS: Thirty people from different communities were interviewed, mostly homemakers. Almost all referred having used TM. The most common source of recommendation was the family. In general, TM use precedes the visit to a physician in the health system. TM is used to manage conditions defined by conventional medicine, but also to treat folk illnesses such as Simeon's disease, evil eye, and indigestion. Therapeutic practices include plant-based preparations, infusions, broths, as well as other rituals performed by folk healers. All users had a positive opinion about TM. Most interviewees considered that physicians should know and ask about TM. All participants referred that its use had not been addressed in prior visits. CONCLUSIONS: TM spreads as knowledge and/ or practice across the studied population and is part of everyday life. TM methods vary greatly, as well as the conditions for which it is used; the main reasons for use included gastrointestinal and respiratory conditions. It is not addressed in pediatric visits, but users wish it was.

uso extendido de la medicina tradicional (MT) en diversos países. La formación del pediatra es escasa en este campo. OBJETIVO: Describir las características de la MT utilizada por los pacientes de un hospital pediátrico de la Ciudad Autónoma de Buenos Aires. Población y métodos. Diseño cualitativo, basado en la teoría fundada. Entrevista a cuidadores de niños de 0 a 11 años. RESULTADOS: Se entrevistaron 30 personas de diferentes colectividades, la gran mayoría mujeres amas de casa. Casi la totalidad refirió haber utilizado la MT. La fuente de recomendación más utilizada fue la familia. En general, el uso de la MT precede a la consulta a un médico del sistema de salud. Se acude a la MT por entidades definidas por la medicina convencional, pero también por otras propias, como pata de cabra, ojeo y empacho. Las prácticas terapéuticas incluyen la administración de preparados a base de plantas, infusiones, caldos, como también rituales conducidos por curanderos. Todos los usuarios refirieron una valoración positiva de la MT. Una gran parte de los entrevistados consideró importante que el médico conozca y pregunte sobre ella. Todos refirieron que su uso no fue abordado en consultas previas. CONCLUSIONES: La MT se extiende como conocimiento y/o práctica en toda la población estudiada y forma parte de su vida cotidiana. Los métodos utilizados son muy diversos, así como las situaciones para las que se utiliza; las principales causas son de origen gastrointestinal y respiratoria. No es abordada en la consulta pediátrica, pero sus usuarios desearían que lo fuera.

Assuntos

RESUMO

Nas últimas décadas, tem-se observado um número crescente de estudos evidenciando uma associação positiva do envolvimento espiritual e religioso com melhores indicadores de saúde física e mental. Nesse contexto, espiritualidade e religiosidade se relacionam a menores taxas de suicídio, depressão, ansiedade e uso de substâncias ilícitas; melhor recuperação nos casos de depressão e maior bem-estar geral, dentre outros benefícios que as caracterizam como fonte de força e resiliência para os pacientes. Assim sendo, espiritualidade e religiosidade passam a ser valorizadas como importantes contributos na atenção clínica e na promoção à saúde, sendo de fundamental importância sua incorporação às atividades de ensino, pesquisa e assistência dos currículos acadêmicos das diversas áreas da saúde. Analogamente, pela importância crescente dedicada à correlação entre saúde, espiritualidade e religiosidade, profissionais da saúde devem estar preparados para compreender as demandas espirituais e religiosas de seus pacientes, adquirindo informação e treinamento nos diversos aspectos e abordagens desse vasto campo de conhecimento. Atendendo a esse objetivo, propomos neste projeto de pós-doutorado sistematizar e disponibilizar as contribuições do Espiritismo no entendimento dessa correlação, em vista de ser um sistema ideológico de cunho científico, filosófico e religioso, disseminado mundialmente e seguido por 2% da população brasileira segundo o último censo demográfico (IBGE, 2010).

Objective: In recent decades, there has been an increasing number of studies showing a positive association between spiritual and religious involvement and better indicators of physical and mental health. In this context, spirituality and religiosity are related to lower rates of suicide, depression, anxiety and use of illicit substances; better recovery in cases of depression and greater general well-being, among other benefits that characterize them as a source of strength and resilience for patients. Therefore, spirituality and religiosity are now valued as important contributors to clinical care and health promotion, and their incorporation into teaching, research and assistance activities in the academic curricula of the various areas of health is of fundamental importance. Analogously, due to the growing importance dedicated to the correlation between health, spirituality and religiosity, health professionals must be prepared to understand the spiritual and religious demands of their patients, acquiring information and training in the different aspects and approaches of this vast field of knowledge. In order to meet this objective, we propose in this postdoctoral project to systematize and make available the contributions of the Spiritism in understanding this correlation, in view of being an ideological system of a scientific, philosophical and religious nature, disseminated worldwide and followed by 2% of the Brazilian population according to the last demographic census (IBGE, 2010).

Assuntos

RESUMO

RESUMO Objetivo mapear evidências sobre o cuidado espiritual em pacientes hospitalizados com diagnóstico de COVID-19. Métodos trata-se de uma revisão de escopo, desenvolvida de acordo com os processos metodológicos do Joanna Briggs Institute, realizada com busca nas fontes de dados SCOPUS, Science Direct, MEDLINE, Web of Science, CINAHL, Google® acadêmico e busca reversa nas referências selecionadas. Incluíram-se estudos que abordassem evidências sobre a temática, publicados em qualquer idioma, sem recorte temporal. Resultados foram analisados 19 estudos, com o mapeamento de oito intervenções sobre o cuidado espiritual, a saber: ouvir a dor espiritual do paciente; suporte de luto; ferramentas de vídeos online com conteúdo sobre fé e resiliência; videochamada online para familiares; disposição de representante religioso; triagem espiritual; treinamento dos profissionais para o cuidado espiritual; e musicoterapia como instrumento de espiritualidade. Conclusão este estudo permitiu mapear as evidências sobre o cuidado espiritual em pacientes hospitalizados com diagnóstico de COVID-19, abordando estratégias para a inserção da espiritualidade no cuidado em saúde. Contribuições para a prática o estudo trouxe contribuições para o avanço da prática da Enfermagem relativo à espiritualidade e aos pacientes com COVID-19, fornecendo subsídios para a utilização da espiritualidade como ferramenta de suporte no cuidar, facilitando o enfrentamento de situações difíceis.

ABSTRACT Objective to map existing evidence on spiritual care for patients hospitalized with COVID-19. Methods scoping review developed in accordance with methodological processes developed by the Joanna Briggs Institute, carried out through a search in the data bases SCOPUS, Science Direct, MEDLINE, Web of Science, CINAHL, and Google Scholar®, in addition to a reverse search in the works selected. The review included studies with evidence on the topic at hand, which had been published in any language, in any time frame. Results 19 studies were analyzed, and 8 different spiritual care interventions were mapped, which were: listening to the spiritual pain of the patient; grief support; on-line video tools with content on faith and resilience; on-line calls with relatives; availability of religious representatives; spiritual triage; training professionals to provide spiritual care; and music therapy as an instrument of spirituality. Conclusion this review allowed mapping the evidence about spiritual care in patients hospitalized with a diagnosis of COVID-19, addressing strategies to bring spirituality into health care. Contributions to practice: this study contributes for the advancement of the practice of nursing regarding spirituality and patients with COVID-19, providing subsidies to use spirituality as a tool to support care and facilitate dealing with difficult situations.

RESUMO

Objective: analyze the scientific production in Nursing about spiritual therapies. Method: integrative review with 41 articles, selected from the Virtual Health Library, between January 9 and February 3, 2020, with the descriptors "Spiritual Therapies" and "Nursing" and the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols methodology. Data were collected through a synoptic chart and critical analysis. Results: increasing studies were identified, especially in the United States and Brazil and in a hospital context, in addition to identifying modalities of spiritual therapies and their contexts of use, training and essential role to Nursing care are described. Conclusions: spiritual therapies promote promote benefits in comprehensive nursing care, in chronic health conditions, in disaster situations, such as the coronavirus disease 2019 pandemic, in the daily lives of different clinics and in promoting well-being.(AU)

Objetivo: analisar a produção científica em Assistência de Enfermagem em Terapias Espirituais. Método: revisão integrativa com 41 artigos, selecionados na Biblioteca Virtual da Saúde, entre 09 de janeiro e 03 de fevereiro de 2020, com os descritores "Spiritual Therapies" e "Nursing" e a metodologia Preferred Reporting Items for Systematic review and Meta-Analysis Protocols. Fez-se coleta dos dados por meio de quadro sinóptico e análise crítica. Resultados: identificaram-se estudos crescentes, especialmente, nos Estados Unidos e Brasil e em contexto hospitalar, além de identificar terapias e seus contextos de uso, formação e papel essencial ao cuidado de Enfermagem. Conclusão: terapias espirituais promovem benefícios na assistência integral de enfermagem, em condições crônicas de saúde, em situações de desastre, como a pandemia do coronavírus, no cotidiano de diferentes clínicas e na promoção do bem-estar.(AU)

Objetivo: analizar la producción científica en Asistencia de Enfermería en Terapias Espirituales. Método: revisión integradora, que siguió las pautas de Preferred Reporting Items for Systematic review and Meta-Analysis Protocols. Se seleccionaron 41 artículos en la Biblioteca Virtual en Salud, entre el 9 de enero y el 3 de febrero de 2020, con los descriptores "Spiritual Therapies" y "Nursing". Los datos se recogieron a través de un cuadro sinóptico y análisis crítico. Resultados: se identificaron estudios crecientes, especialmente en los Estados Unidos y Brasil y en contexto hospitalario, además de identificar las terapias espirituales y sus contextos de uso, formación y función esencial a los cuidados de enfermería. Conclusiones: las terapias espirituales promueven beneficios en la atención integral de enfermería, en condiciones crónicas de salud, en situaciones de desastre, como la pandemia de coronavírus, en la vida diaria de diferentes clínicas y en la promoción del bienestar.(AU)

Assuntos

RESUMO

Introducción: Las personas con tratamiento quirúrgico presentan ansiedad, lo cual impide llegar al periodo operatorio en óptimas condiciones. El cuidado espiritual puede resultar efectivo en momentos como este. Objetivo: Evaluar el efecto del cuidado espiritual en el nivel de ansiedad situacional en pacientes quirúrgicos. Métodos: Investigación cuantitativa, preexperimental con pretest postest, en el Hospital Regional de Ayacucho, Perú, durante marzo a mayo de 2016. Población constituida por 123 pacientes quirúrgicos, entre los que se seleccionaron 30 entre 24 y 57 años, con ansiedad y dispuestos a participar en la investigación. La ansiedad se midió con el Test de Zung, las necesidades espirituales con un cuestionario validado por expertos y pilotaje con alfa de Cronbach > 0,75. Para los ejes temáticos y metodológicos de la intervención (cuidados espirituales) se revisó bibliografía sobre el tema, tuvieron en cuenta las necesidades de cuidados y niveles de ansiedad identificada. Se procesó la información con frecuencias absolutas, porcentajes, media, desviación típica, valor mínimo y máximo. Para contrastar hipótesis se utilizó la Prueba no paramétrica de rangos con signo de Wilcoxon. Para la relación entre necesidad de cuidado espiritual y evolución del nivel de ansiedad se utilizó Chi-cuadrada de Pearson (X2), con probabilidad de error del 5 por ciento. Resultados: El nivel de ansiedad situacional previo a la aplicación del cuidado espiritual fue de marcada a severa en 86,66 por ciento, aplicado el cuidado espiritual estuvo ausente en el 96,66 por ciento. Conclusión: La intervención con cuidados espirituales aplicada resultó efectiva en la disminución del nivel de ansiedad situacional en pacientes quirúrgicos estudiados(AU)

Introduction: People who should undergo surgical treatment present anxiety, which keeps them from reaching the operative period in optimal conditions. Spiritual care can be effective at times like this. Objective: To assess the effect of spiritual care on the level of situational anxiety in surgical patients. Methods: Quantitative pre-experimental research with pre- and post-test carried out in the Regional Hospital of Ayacucho, Peru, during March to May 2016. The population was made up of 123 surgical patients, of which 30 aged 24-57, with anxiety and willing to participate in the study were chosen. Anxiety was measured with the Zung test; spiritual needs, with a questionnaire validated by experts; and piloting, with Cronbach's alpha > 0.75. For the thematic and methodological axes of the intervention (spiritual care), a bibliography on the subject was reviewed, taking into account the care needs and levels of anxiety identified. The information was processed with absolute frequencies, percentages, mean, standard deviation, minimum and maximum values. The Wilcoxon signed rank test was used to test hypotheses. Pearson's chi-square (X2) was used for the relationship between need for spiritual care and evolution of anxiety level, with a probability of error of 5 percent. Results: The level of situational anxiety prior to the application of spiritual care was remarkable to severe in 86.66%; applied spiritual care was absent in 96.66 percent.. Conclusion: The intervention with spiritual care applied was effective in reducing the level of situational anxiety in the surgical patients studied.(AU)

Assuntos

RESUMO

AIM: To assess the effects of laying on of hands (LooH) as a complementary therapy to kinesiotherapy, on pain, joint stiffness, and functional capacity of older women with knee osteoarthritis (KOA) compared to a control group. METHODS: In this randomized controlled clinical trial, participants were assigned into 3 groups: LooH with a spiritual component ("Spiritist passe" Group - SPG), LooH without a spiritual component (LooH Group - LHG), and a control group receiving no complementary intervention (Control Group - CG). Patients were assessed at baseline, 8 weeks, and 16 weeks. Primary outcomes were joint stiffness and functional capacity (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and pain (WOMAC and visual analog scale). Secondary outcomes were anxiety, depression, mobility, and quality of life. Differences between groups were evaluated using an intention-to-treat approach. RESULTS: A total of 120 women (mean age = 69.2 ± 5.2 years) with KOA were randomized (40 participants per group). At 8 weeks, SPG differed significantly from the LHG for WOMAC Functional Status (between-group difference in the change = 0.97; 95% CI: 0.35 to 1.59, P = .001); Anxiety levels (between-group difference in the change = 1.38; 95% CI: 0.11 to 2.65, P = .027); and also from the CG for all outcomes with exception of WOMAC Stiffness. After 16 weeks, SPG differed significantly from the LHG only for WOMAC Functional Status (between-group difference in the change = 0.92; 95% CI: 0.32 to 1.52, P = .001]) and also from the CG for all outcomes with exception of WOMAC Stiffness and timed up-and-go. CONCLUSION: Our results suggest that LooH with a "spiritual component" may promote better long-term functional outcomes than both LooH without a "spiritual component" and a control group without LooH.

Assuntos

RESUMO

Diseases that threaten life raise existential questions that can be a source of psychological distress. Studies with psychedelics demonstrate therapeutic effects for anxiety and depression associated with life-threatening illnesses. Ayahuasca has been proposed as a possible therapeutic agent in the treatment of psychiatric disorders. Preliminary studies suggest that ayahuasca could promote therapeutic effects for people with physical illnesses. The aim of this study was to explore how the ritual use of ayahuasca during the treatment of severe physical illnesses (SPI) may influence the way people understand and relate to their illness, using qualitative methods to assess the participants' perspectives. Participants who consumed ayahuasca ritualistically during the period of treatment for SPI were purposely chosen. Data were obtained through semi-structured interviews. A thematic analysis was performed with 14 individuals. The ritual experience with ayahuasca acted on the participants' illness understanding through multiple psychological mechanisms, including introspection, self-analysis, emotional processing and catharsis, recall of autobiographical memories subjectively related to illness origin, illness resignification, and perspective changes. This study suggests that the experience with ayahuasca may facilitate illness acceptance through an influence on the meanings of the illness, life, and death. These changes may favor a more balanced relationship with illness and treatment.

Assuntos

RESUMO

Objetivou-se identificar o uso de práticas integrativas, espirituais e avaliar a qualidade de vida relacionada à saúde de pacientes adultos com câncer durante o tratamento quimioterápico. Pesquisa quantitativa e transversal realizada com 275 pacientes durante quimioterapia em um hospital de Minas Gerais. Instrumentos utilizados: questionário sociodemográfico e clínico e Quality of Life Questionnaire-Core30 (QLQ-C30) com análise de dados pelo software Statistical Packagefor theSocial Sciences (SPSS) (for Windows). A maioria dos entrevistados era mulher, entre 40 a 79 anos, casadas, aposentadas, com baixo nível de escolaridade e baixa renda. Os cânceres mais prevalentes foram colorretal, mama e estômago. Apenas 13 (4,9%) pacientes utilizavam alguma prática integrativa como fitoterapia, homeopatia, meditação, floral e acupuntura. Cerca de 94 (34,2%) indivíduos realizavam terapia espiritual com predominância da oração, passes, água fluidificada e promessa. Houve nível adequado/satisfatório (escores entre 50 e 70) da qualidade de vida e das funções avaliadas

The objective was to identify the use of integrative, spiritual practices and to evaluate the quality of life related to the health of adult cancer patients during the chemotherapy treatment. Quantitative and cross-sectional research conducted with 275 patients during chemotherapy at a hospital in Minas Gerais. Instruments used: Sociodemographic and clinical questionnaire and Quality of Life Questionnaire-Core30 (QLQ-C30) with data analysis by Statistical Package for the Social Sciences software (for Windows). Most of the interviewees were women, between 40 and 79 years old, married, retired, with low education level and low income. The most prevalent cancers were colorectal, breast and stomach. Only 13 (4.9%) patients used some integrative practice such as phytotherapy, homeopathy, meditation, floral and acupuncture. About 94 (34.2%) individuals performed spiritual therapy with predominance of prayer, passes, fluidized water and promise. There was an adequate/satisfactory level (scores between 50 and 70) of quality of life and functions evaluated.

Assuntos

RESUMO

Resumen Introducción: Ante la crisis epistemológica y sistémica que se encuentra en la civilización occidental, el yagé emerge como alternativa que invita a una reponderación axiológica profunda. Asimismo, el ritual del yagé evidencia los límites del conocimiento médico moderno, dando pauta al abordaje transdisciplinario. Por otro lado, se presentan consecuencias de inserción en el libre mercado, implicando problemas de lucro a costa de tradiciones originarias. En este contexto, se explora el concepto «trabajo espiritual¼ como práctica que busca descolocarse del colonialismo mercantil al tiempo que se aleja del modelo médico moderno. Objetivo: Reflexionar la incorporación del ritual de yagé en Occidente y sus posibilidades como alternativa epistemológica y médica. Materiales y métodos: Revisión de artículos de la base de datos especializados Web of Science, con la palabra clave: "ayahuasca". Resultados: Se estructuró la información teniendo en cuenta los aspectos relacionados con: (a) el contexto de incorporación del yagé al occidente, (b) los límites del conocimiento médico moderno y (c) los problemas de inserción al libre mercado. Conclusiones: Se apoya el diagnóstico de la ruptura epistemológica con occidente, pero reconociendo el estado inicial de las investigaciones y la falta de evidencias documentadas para entrar en una etapa más fructífera para el debate.

Abstract Introduction: In the face of epistemological and systemic crisis in Western civilization, yagé emerges as an alternative that invites a deep axiological reponderation. The yagé ritual demonstrates the limits of modern medical knowledge, giving guidance to a transdisciplinary approach. On the other hand, there are consequences of insertion into the free market, involving profit problems at the expense of original traditions. Thus, the concept of "spiritual work" is explored as a practice that seeks to dislodge itself from commercial colonialism while moving away from the modern medical model. Objective: To reflect on the incorporation of the yage ritual in the West and its possibilities as an epistemological and medical alternative. Materials and methods: Review of articles from the specialized Web of Science database, with the keyword: "ayahuasca". Results: The information was structured considering aspects related to: (a) the context of incorporation of yagé into the West, (b) the limits of modern medical knowledge and (c) the problems of insertion into the free market. Conclusions: The diagnosis of the epistemological rupture with the West is supported while recognizing the initial state of the investigations and the lack of documented evidence in order to enter into a more fruitful debate.

Assuntos

RESUMO

Objetivo: describir el cuidado espiritual a partir de la revisión de literatura científica relacionada con el cuidado paliativo y su arti - culación con los componentes del modelo conceptual del manejo de síntomas de Patricia Larson y colaboradores. Metodología: revisión sistemática de la literatura científica sobre cuidado espiritual y paliativo, publicada entre el 2002 y el 2018, siguiendo los lineamientos de Ganong y teniendo en cuenta los componentes del modelo del manejo de síntomas de Patricia Larson y cola - boradores: experiencia del síntoma, estrategia de manejo del síntoma y resultado del manejo del síntoma. Resultados: de los 56 artículos identificados inicialmente, 50 cumplieron con los criterios de selección y se clasificaron según los componentes del modelo del manejo de síntomas. Se encontró conceptualización de espiritualidad, escalas de valoración, intervenciones y beneficios del cuidado espiritual en pacientes con necesidades paliativas. Conclusiones: el cuidado espiritual parte de percibir la experiencia del proceso de enfermedad o etapa de fin de vida, para identificar las necesidades espirituales de las personas a través de la valoración con escalas validadas y el uso de diagnósticos relacionados con la dimensión espiritual. Las estrategias de manejo que incluyen el cuidado espiritual comienzan con el acompañamiento y la escucha activa del paciente, de donde se derivan las intervenciones de segundo y tercer nivel descritas en la literatura. Se requiere preparación de los profesionales en enfermería para orientar planes de cuidado espiritual fundamentados desde el modelo que exponen Larson y colaboradores para el manejo de síntomas.

Objective: To describe spiritual care from the perspec - tive of scientific literature related to palliative care, taking into account the components of the Conceptual Model of Symptom Management, as stated by Patricia Larson and collaborators. Methodology: Systematic review, following Ganong's guidelines, of publications made between 2002 and 2018 that are related to spiritual care and palliative care and articulated with the components of Patricia Larson's Symptom Management Model: symptom experience, symptom management strategy, and result of symptom management. Results: Of the 56 articles initially identified, 50 met the selection criteria and were classified according to the components of the Symptom Management Model. We found conceptualization of spirituality, scales for its assess - ment, interventions and benefits of spiritual care in patients with palliative needs. Conclusions: Spiritual care starts with perceiving the experience during the disease process or end-of-life stage, and includes timely identification of spiri - tual needs, their assessment through validated scales, and the use of diagnoses related to the spiritual dimension. The management strategies involved in spiritual care start from the accompaniment and active listening to the patient, from which the second and third level interventions described by the literature are derived. It is necessary to prepare nursing professionals which guide management strategies through the use of the model of Larson and collaborators, to manage - ment of symptoms in clinical practice.

Objetivo: descrever cuidados espirituais a partir da revisão da literatura científica relacionada aos cuidados paliativos, levando em conta os componentes do Modelo Conceitual de Manejo dos Sintomas de Patricia Larson, e colaboradores. Metodologia: revisão sistemática, seguindo as orientações de Ganong, de publicações realizadas entre 2002 e 2018, relacionadas aos cuidados espirituais e cuidados paliativos, articuladas aos componentes do Modelo de Gerenciamento de Sintomas de Patricia Larson: experiência, estratégia e resultado do manejo do sintoma. Resultados: dos 56 artigos inicialmente identificados, 50 preencheram os critérios de seleção e foram classificados de acordo com os componentes do Modelo de Gerenciamento de Sintomas. Encontramos conceituação de espiritualidade, escalas para sua avaliação, intervenções e benefícios do cuidado espiritual em pacientes com necessidades paliativas. Conclusões: o cuidado espir - itual começa com a percepção da experiência do processo da doença ou do estágio final da vida, e inclui a identificação de necessidades espirituais, sua avaliação através de escalas validadas, e o uso de diagnósticos relacionados à dimensão espiritual. As estratégias de manejo que incluem o cuidado espiritual partem do acompanhamento e da escuta ativa do paciente, a partir dos quais derivam as intervenções de segundo e terceiro nível descrito na literatura. É necessário preparar e capacitar os profissionais de enfermagem que orientam as estratégias de gestão através do o modelo de Larson e colaboradores.

Assuntos

RESUMO

INTRODUCCIÓN: La investigación en el campo de la psicología de enlace se interesa por la esfera espiritual de las personas. Cuando el cuerpo enferma físicamente, el organismo implementaría estrategias que le posibiliten afrontar psicoemocionalmente las circunstancias. El objetivo del estudio fue evaluar las propiedades psicométricas de la escala Estrategias de Afrontamiento Espiritual en personas con enfermedades crónicas no transmisibles en la ciudad de Cuenca - Ecuador. MÉTODOS: Se realizó un estudio transversal. La muestra fue de 147 participantes. El trabajo de campo se desarrolló en tres instituciones de salud: Hospital de Especialidades José Carrasco Arteaga, Instituto del Cáncer SOLCA - Cuenca; y la Fundación al Servicio del Enfermo de Cáncer - Cuenca; durante el periodo de junio a diciembre de 2017. Se utilizó la escala Estrategias de Afrontamiento Espiritual. Los datos se analizaron en el programa SPSS versión 23. RESULTADOS: De los 147 participantes, 100 personas con cáncer, 29 con diabetes mellitus no insulinodependiente, 4 con hipertensión primaria y 14 con otras enfermedades. El 87.1% fueron católicos. El proceso estadístico inicial obtuvo un alfa de Cronbach de 0.820 al analizar los 20 ítems que se reducen a 17 (α=.821), porque 3 de ellos muestran bajas saturaciones. En el análisis factorial exploratorio mediante el análisis de componentes principales con una rotación ortogonal Varimax, la prueba Kaiser-Meyer-Olkin se obtuvo un resultado de 0.794 y la prueba de Bartlett resultó significativa p=< 0.001 (x2 = 810.49; gl = 136). CONCLUSIONES: Los preguntas que conforman los dos dominios de la escala original Estrategias de Afrontamiento Espiritual se redistribuyeron en este estudio agrupándose en cuatro factores. Producto de este proceso de investigación se obtuvo la versión Estrategias de Afrontamiento Espiritual - Cuenca, escala que demostró validez y fiabilidad en una población de participantes con enfermedades crónicas no trasmisibles de Cuenca - Ecuador.

BACKGROUND: Research in the field of liaison psychology is interested in the spiritual sphere of people. When the body becomes physically ill, the organism implements strategies that allow it to deal psycho-emotionally with the circumstances. The objective of the study was to evaluate the psychometric properties of the Spiritual Coping Strategies in people with chronic non-communicable diseases in the city of Cuenca - Ecuador. METHODS: A cross-sectional study a performed from June to December 2017. The sample included 147 participants and the fieldwork was carried out in three health institutions: José Carrasco Arteaga Specialty Hospital, Institute of Cancer SOLCA - Cuenca and Foundation for the Service of Cancer Sick. The scale of Spiritual Coping Strategies was used and data was analyzed in the SPSS program, version 23. RESULTS: Of the 147 participants, 100 people with cancer, 29 with non-insulin-dependent diabetes mellitus, 4 with primary hypertension and 14 with other chronic diseases. The 87.1% were catholics. The initial statistical process obtained a Cronbach's alpha of 0.820 when analyzing the 20 items that are reduced to 17 (α=.821), because three of them show low saturations. In the exploratory factor analysis through the analysis of principal components with a Varimax orthogonal rotation and the Kaiser-Meyer-Olkin test, obtained a result of 0.794 and the Bartlett test was significant p= <0.001 (x2 = 810.49; gl = 136).. CONCLUSIONS: The questions that make up the two domains of the original Scale of Spiritual Coping Strategies were redistributed in this study and grouped into four factors. The Strategies of Spiritual Coping - Cuenca version was obtained, a scale that demonstrated validity and reliability in a population of participants with chronic, non-communicable diseases in Cuenca - Ecuador.

Assuntos

RESUMO

RESUMEN En este artículo nos interesa reconstruir cómo se desarrolla el proceso de institucionalización de un presbiterio de capellanes no católicos para poder adaptarse e interactuar con las instituciones públicas de Argentina, particularmente, las de salud. Para ello, se realizaron entrevistas cualitativas a actores religiosos formados en temas de bioética, observación participante en espacios de formación, congresos y jornadas de bioética y salud y análisis documental de material de estudio y declaraciones de actores religiosos sobre temas de salud y bioética. En un contexto de relaciones de asimetría entre el Estado y las iglesias y pluralización del campo religioso surgen requerimientos de asistencia espiritual diversos en espacios institucionales estatales. En este marco se institucionaliza esta organización de capellanes que desarrolla un ethos propio en búsqueda de reconocimiento, visibilidad y legitimidad social para ofrecer un servicio de capellanía en instituciones donde los únicos capellanes reconocidos y solventados por el Estado pertenecen a la religión católica.

ABSTRACT This article seeks to reconstruct how the process of institutionalization of a presbytery of non-Catholic chaplains developed as a way to adapt and interact with public institutions in Argentina, particularly health care institutions. For this purpose, qualitative interviews with religious actors trained in bioethics were carried out, in addition to participant observation in training spaces and conferences on health and bioethics and documentary analysis of training material and declarations of religious actors on issues of health and bioethics. In a context of relations of asymmetry between the State and the churches and the pluralization of the religious field, diverse needs for spiritual aide in state institutional spaces arise. It is in such a framework that this organization of chaplains gains institutional status, developing its own ethos in search of recognition, visibility and social legitimacy to offer chaplaincy services in institutions where the only chaplains recognized and funded by the State belong to the Catholic religion.

Assuntos

RESUMO

RESUMEN Este trabajo describe y analiza las trayectorias y las estrategias de búsqueda de sanación entre los miembros de un movimiento católico carismático de sanación en Argentina. A partir de una investigación etnográfica realizada entre julio de 2009 y abril de 2015, se focaliza en las concepciones, prácticas y experiencias en torno a la salud-enfermedad-atención. Se señala que el evento de enfermedad requiere una respuesta cognitiva y otra práctica para su gestión e involucra, principalmente, dos recursos terapéuticos: la biomedicina y las terapias religiosas. Asimismo, se postula que cada recurso es referido en momentos específicos de las trayectorias y el pasaje de uno a otro implica el cambio de una noción restringida por una holística del proceso salud-enfermedad-atención.

ABSTRACT This work describes and analyzes the trajectories and strategies in the search for healing among participants of a charismatic Catholic healing movement in Argentina. Using ethnographic research carried out between July 2009 and April 2015, the article focuses on conceptions, practices and experiences surrounding health-disease-care processes. It is highlighted that disease management requires both a cognitive and a practical response, in this case involving two primary therapeutic resources: biomedicine and religious therapies. It is also postulated that each resource is sought at specific moments in the trajectories and the passage from one to another implies a change from a restricted to a holistic notion of the health-disease-care process.

Assuntos

RESUMO

BACKGROUND: Laying on of hands (LooH) is a culturally-accepted therapy in several traditions. In Brazil, "Spiritism" (third-largest religious tradition in number of followers) uses LooH with the name of "Spiritist Passe" (SP). However, there are few studies assessing SP's role in medical outcomes. The present study aims to investigate the effects of LooH, with and without a spiritual context, on pain, joint stiffness, and functional capacity of older women (≥60 years old) with knee osteoarthritis (KOA). METHODS/DESIGN: In this triple-blind, prospective randomized controlled trial, older women with KOA are assigned to three groups: LooH with a spiritual context group, LooH group without a spiritual context, and a control group receiving no intervention. Patients are assessed by a blinded researcher at baseline, 8 weeks, and 16 weeks. Pain, joint stiffness, and functional capacity are assessed using Western Ontario and McMaster Universities Osteoarthritis Index. Other measures such as anxiety, depression, gait speed, and quality of life will also be assessed. To detect differences between groups, a post-intervention comparison between the three groups and a mean change (post-pre) comparison among the three groups will be done using analysis of variance. All statistical analyses will be performed using an intention-to-treat approach and a per-protocol analysis. DISCUSSION: A pragmatic design using SP, LooH without spiritual context, and no LooH may provide further scientific evidence on SP's feasibility and efficacy for KOA patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02917356.

Assuntos