Cancer is a life-changing disease that introduces an abundance of psychosocial stress into patient's lives. Exposure to psychosocial stress over periods of weeks or more has a maladaptive effect on the human immune system. Chronic psychosocial stress means elevated activates the hypothalamic-pituitary-adrenal (HPA) and the sympathetic-adrenomedullary (SAM) axes which over time induce deleterious physiological effects in the form of glucocorticoid resistance, chronic low-level inflammation, and inhibition of leukocyte telomerase activity. Because these down-stream physiologic effects of psychosocial stress have oncogenic implications, the effective management of chronic stress inherent to a cancer diagnosis should positively impact the efficacy of current cancer therapies. Mindfulness is an age-old concept that has recently gained traction in the medical community for its utility as a cognitive therapy in treating patients with mental health disorders. Although the study of mindfulness as a complementary cancer therapy is in its relative infancy, other examples of mind-body medicine have already been documented to help treat many psychological side effects of cancer including anxiety, depression, sleep deprivation, and pain. It has been theorized that mindfulness acts by providing a cognitive strategy to buffer the harmful effects of psychosocial stress. Mindfulness elicits discrete effects on human psychology and physiology that are conducive to the efficacy of current cancer treatments. Mindfulness techniques have shown promise in providing relief for many of the psychological side effects of a cancer diagnosis. In this thesis, we explore the psychological and physiological effects of mindfulness practice that counter-act many of the harmful consequences of chronic stress exposure specifically immunosuppression, chronic inflammation, and telomerase activity.

Background The incidence of hypertension is increasing in developing countries such as Thailand (Chaiteerapan et al 1997; Ministry of Public Health 2001; National Library of Thailand Cataloguing in Publication Data 2001) as a result of sociological, political and economic changes. These changes are producing enormous alterations in people�s lifestyles, following similar trends in western countries (National Economic and Social Development Board 1997). Negative changes in food consumption, alcohol consumption, level of physical activity, smoking, stress and tension have led to an increase in chronic health problems for Thai people (National Economic and Social Development Board 1997). Age, gender, ethnicity, genetic background, family health history and hyperlipidaemia are likely to influence hypertension (Kaplan, Lieberman & Neal 2002; Mancia et al 2002; Manger & Gifford 2001; National Heart Foundation of Australia 2003). It has been found that health care professionals and patients with chronic disease have increased their use of complementary therapies to help relieve uncomfortable symptoms and suffering (Long, Huntley & Ernst 2001). Foot reflexology is a well known complementary therapy which claims to help the body achieve homeostasis (Byers 2001; Dougans 2002). It is believed that pressing specific areas on the feet related to specific glands or organs of the body can help these glands and organs to function at their peak, allowing the body to heal itself (Byers 2001; Dougans 2002). The principle difference between massage or touch and foot reflexology is that foot reflexology provides not only the relaxation effect obtained from massage or touch is said to also improve body�s immunity contributing to healing process (Byers 2001;Dougans 2002). Foot reflexology has been scientifically researched in many studies to explore the claimed benefits (Bishop 2003; Kohara et al 2004; Oleson & Flocco 1993; Siev-Ner et al 2003; Yang 2005). Some studies have supported its ability to reduce anxiety and pain (Gambles, Crooke & Wilkinson 2002; Launso, Brendstrup & Arnberg 1999; Stephenson, Dalton & Carlson 2003; Stephenson, Weinrich & Tavakoli 2000). However, there has been little scientific evidence to support the claim that foot reflexology can reduce blood pressure and serum lipids, and can improve the quality of life in patients with hypertension (Hodgson 2000; Milligan et al 2002; Park & Cho 2004). The purpose of this study was to begin to fill this gap by investigating the influence of foot reflexology on blood pressure, serum lipids and quality of life. Aim The aim of this study was to investigate the effect of foot reflexology on reducing blood pressure in patients with hypertension. To this end, patients receiving reflexology were compared with patients receiving a light foot massage, thus controlling for any effects contributed by massage or touch alone. Null hypotheses 1. There is no difference in mean blood pressure level between the foot reflexology group and the light foot massage group at the end of four weeks of treatment. 2. There is no difference in mean low density lipoprotein (LDL) cholesterol and triglyceride levels between the foot reflexology group and the light foot massage group at the end of four weeks of treatment.3. There is no difference in mean quality of life scores between the foot reflexology group and the light foot massage group at the end of four weeks of treatment. Sample A sample size of 128 was required to yield a power of 80%, if the difference in mean diastolic blood pressure between the two groups was 5 mmHg. One hundred twenty eight patients with hypertension who attended the hypertensive clinic in the medical outpatients department of Phramongkutklao Hospital, Bangkok, Thailand were enrolled and participated in the study. Methods Data collection This study used a randomized controlled trial design. Participants were randomly allocated into one of two groups � 64 participants in the foot reflexology group (intervention) and 64 in the light foot massage group (control). Data collection took place over 4� months between 26 July and 9 December 2004. Ethics approval was obtained from both the university and hospital ethics committees. Prior to randomization, participants were asked to complete a demographic data questionnaire and the World Health Organization Quality of Life-BREF (WHOQOLBREF) (World Health Organization 1996) questionnaire. Blood was drawn to test LDL cholesterol and triglyceride levels. Using an intervention protocol based on previous literature (Byers 2001), participants in the foot reflexology group received their usual medical treatment and a 50-minute foot reflexology treatment twice a week for four weeks. Participants in the light foot massage group received their usualmedical treatment and a 30-minute light foot massage session without pressure on specific reflexology areas twice a week for four weeks. Blood pressure was recorded before and after each treatment. At the end of the study, participants were asked to complete the WHOQOL-BREF (World Health Organization 1996) again and blood was once more drawn to test LDL cholesterol and triglyceride levels. Data analysis An independent samples t-test followed by analysis of covariance was used to test for difference in mean diastolic blood pressure between treatment groups both unadjusted and adjusted for baseline values respectively. Descriptive statistics were used to present the demographic data. Results Demographic data Control and intervention groups were similar in gender, age, educational background, economic factors, lifestyle characteristics, co-morbidities and medical treatments. Demographic data which were substantially different between groups were marital status, the length of time experiencing hypertension and the length of time having treatment for hypertension. The study showed that fewer participants in the foot reflexology group (57.8%) were married than in the light foot massage group (70.3%). The foot reflexology group also had a higher rate (32.8%) of �divorced/separated/widowed� compared with the light foot massage group (20.3%). Participants in the light foot massage group had almost nine times the number of participants who had had hypertension for more than 15 years, and almost eight times the number of participants who had been having treatment for hypertension for more than 15 years, compared with those in the foot reflexology group. Outcome variables For both the unadjusted and adjusted analyses, there was no statistically significant difference between treatment groups post-intervention. Conclusions The results from this study did not support the claim that foot reflexology can decrease blood pressure, LDL cholesterol and triglyceride levels. Similarly, there was no evidence that it could improve the quality of life in patients with hypertension.

Background: Breast cancer is the most common cancer in the world with approximately 1.7 million new cases diagnosed in 2012. While women with breast cancer are treated with a multitude of different therapies, these treatments can lead to long-term effects that impact quality of life (i.e. fatigue, pain, lymphedema, anxiety, depression, osteoporosis). With more people looking into complementary and alternative medicine (CAM), research on yoga’s effect on quality of life in breast cancer survivors is vital. Methods: This literature synthesis used PsychINFO, MEDLINE, and CINAHL explore current research on yoga’s effects on quality of life in breast cancer survivors. Search terms included: breast cancer, survivor, quality of life, lifestyle, wellbeing, clinical trial, and controlled trial. Literature was excluded if it included men, women under cancer treatment and if yoga was included in a mindfulness intervention. Results: Eleven articles met the inclusion criteria. Yoga was shown to have a positive impact on fatigue, pain, anxiety, depression, and breast cancer survivors’ quality of life. A majority of the studies measured quality of life using the FACT-B and FACT-G scale. Others used similar measurement tools and qualitative journal entries. Specific studies indicated improvements in aromatase-inhibitor associated arthralgia, diurnal salivary cortisol levels, and menopausal symptoms. Conclusions: Yoga appears to be beneficial in improving breast cancer survivor’s quality of life. More research is needed. However, nurses can use this information to educate clients about the benefit of yoga in survivorship. This research may promote further utilization of CAM in improving quality of life.

nÃo hà / Este trabalho tem como temÃtica central os conhecimentos e prÃticas ancestrais africanas desenvolvidas no Centro de AtenÃÃo Psicossocial â Caps Iracema da cidade de Fortaleza, no Estado do CearÃ, no Brasil. A pesquisa objetivou compreender as significaÃÃes produzidas pelos usuÃrios da saÃde mental que realizam tratamento complementar com plantas e ervas, chÃs e benzeduras, escuta e acolhimento com as terapeutas de tradiÃÃo religiosa de matriz africana, as mÃes de santo. Para o estudo investigativo, utilizamos a metodologia de pesquisa com entrevistas individuais e observaÃÃo participante, onde optamos em conhecer e ouvir a histÃria de pacientes estabilizados (sem o contexto da crise) e pacientes em vivÃncias sintomatolÃgicas evidentes de crise, totalizando o nÃmero de 4 usuÃrias. TambÃm foram ouvidas as terapeutas de matriz africana, que sÃo as mÃes de santo e os profissionais do Caps responsÃveis pelo acompanhamento do plano terapÃutico dos usuÃrios. A observaÃÃo participante possibilitou o acompanhamento dos usuÃrios durante as sessÃes terapÃuticas numa convivÃncia semanal. Os dados coletados demonstraram que no campo da saÃde mental, o referencial bio-mÃdico posta-se ainda com hegemonia, sendo considerado por familiares e usuÃrios, como tratamento imprescindÃvel. Apesar de existir desde 2006 a PolÃtica Nacional das PrÃticas Integrativas e Complementares no MinistÃrio da SaÃde, constatou-se que o Caps Iracema implementou-a em 2011 e, por parte dos usuÃrios, somente apÃs a participaÃÃo na primeira sessÃo de terapia de base ancestral africana com ervas e plantas, à que a resistÃncia comeÃa a diminuir e hà uma posterior aceitaÃÃo geradora de confianÃa e afinidade com a forma de acolhimento e cuidado dessa terapÃutica. A anÃlise dos dados coletados nos permitiu concluir que: os usuÃrios das terapias de base ancestral africana entrevistados revelam diminuiÃÃo dos sintomas de ansiedade, tristeza, angustia, desejo de morte, alucinaÃÃo e delÃrios, conjuntamente com uma disposiÃÃo de re-aprender a lidar com âseus fantasmas e sofrimentosâ, descaracterizando o estigma de loucos e doentes mentais. ConcluÃmos tambÃm que a inserÃÃo de outros referenciais de acolhimento, cuidado e tratamento em saÃde sÃo fundamentais para o fortalecimento dos direitos humanos e de cidadania dos usuÃrios de saÃde mental e potencializam compreender o processo saÃde-doenÃa para alÃm da dimensÃo bio-mÃdica ou psicoterapÃutica. / The central theme of this work is the knowledge and African ancestry practices developed at Centro de AtenÃÃo Psicossocial â Caps Iracema (Center of Psychosocial Atention â Caps) in the city of Fortaleza, Ceara State, Brazil. The researchâs objective is to comprehend the significations produced by the patients of mental health who attended complementary treatment based on plants, herbs, teas and sacred procedures as well as being treated by the African-based religious tradition of the âmÃes de santoâ (mother of saints) who are religious leaders. The research methodology utilized for this investigative study is based on individual interviews and participative observations in order to get acknowledge and listen to the stories told by stabilized patients (with no symptoms of crisis) and also those who present evident symptoms of mental crisis, totalizing a universe of 6 patients. African-based therapists, the âmother of saintsâ, as well as professional therapists of Caps responsible for accompanying the patientâs therapy plan were also heard. The participative observations permitted the patientâs accompaniment during the therapy sessions in a weekly gathering. The collected data shows that in the mental health field the biomedical referential still plays a hegemonic role being considered an irreplaceable treatment by patients and their family. Despite the existence of the âPolÃtica Nacional das PrÃticas Integrativas e Complementares no MinistÃrio da SaÃdeâ (Ministry of heatlhâs National Policy of integrative and complementary practices) since 2006, it was notified that Caps Iracema implemented this policy in 2011. According to the patients, after the first session of the African-based ancestry therapy using plants and herbs the resistance among the patients decreased. A posterior and trustful acceptance geared toward affinity as a way of caring was also notified within this therapy. The analysis of the collected data allowed us the following conclusions: the patients who were treated on African-based ancestry therapy revealed decreasing symptoms of anxiety, sadness, anguish, killing desires, hallucinations and deliriums as well as to re-adapt their coping with their own âghosts and sufferingsâ. That itself mischaracterizes the stigma of being insane and mentally ill people. We also conclude that the application of other referential such as refuge, caring and health treatment are fundamental for the strengthening of Human Rights and citizenship of mental-health patients. It also allows the comprehension of the health-illness process going beyond the biomedical and psychotherapy dimensions.

There has been little research to date specifically addressing counselors' experiences with complementary therapy. The objective of this exploratory survey was to assess counselors' professional practice, knowledge and training, and personal experience with complementary therapy. The study design was a web-based, random sample survey of American Counseling Association members. Results indicated the typical respondent was female, Caucasian, holds a Master's degree and works in a private practice/self-employed or community agency setting as an outpatient counselor. Few respondents asked about or had clients volunteer use of complementary therapy. Anxiety and depression were the most common client concerns for which respondents recommended or referred for complementary therapy. Respondents agreed that client referrals should be to licensed or certified practitioners. Respondents reported that complementary therapy provided clients with at least some positive benefits and few negative consequences. The majority of respondents included complementary therapy in counseling during the past year and thought that complementary therapy should be included in addition to counseling. Although respondents considered themselves qualified to discuss a variety of complementary therapies, few possessed licensure or certification. The majority of respondents used informal, self-study to gain knowledge of complementary therapy. Most respondents have personally experienced at least one complementary therapy, primarily "To improve overall wellness". Respondents reported they received some to large benefits from this experience. A number of respondents descriptors had moderately positive associations with client usage, recommendation and referral, inclusion, and knowledge factors. These descriptors were those respondents who worked in a private practice/self-employed setting, as an outpatient counselor, were licensed as an LPC, provided individual, family/couples, or alcohol/substance abuse counseling, and had a psychodynamic orientation. There were moderately negative associations between respondents who worked in a K-12 setting, did not possess mental health licensure and were a Master's student and client usage, recommendation and referral, and inclusion factors. The data provide support for the idea that counselors are beginning to embrace a post-modern approach, which gives consideration to complementary therapy interventions. However, the findings also suggested that the counseling profession still has a good deal of work to do before it can be considered truly holistic. / Ph. D.

Orientador: Henrique Luiz Monteiro / Banca: Angelina Zanesco / Banca: Elisa Harumi Kozasa / Resumo: A prática de exercícios de Yoga pode proporcionar inúmeros benefícios à saúde, atuando como terapia complementar em patologias como a hipertensão arterial. O objetivo deste estudo foi descrever os efeitos de uma combinação de seqüências de práticas de yoga realizadas durante quatro meses sobre os parâmetros hemodinâmicos (frequência cardíaca e pressão arterial), bioquímicos (concentração plasmática de colesterol e suas frações, triglicerídeos e glicemia) e a percepção da qualidade de vida em pacientes portadores de hipertensão arterial. Trinta e três voluntários (64±9 anos) participaram do estudo. Três homens e 14 mulheres (68±7 anos) realizaram aulas de yoga durante quatro meses (GY), enquanto dois homens e 14 mulheres (58±8 anos) constituíram o grupo controle (GC), sem intervenção. Os alunos do GY compareceram nas aulas três vezes por semana e realizaram exercícios de yoga em uma seqüência composta por alongamentos, exercícios de respiração, posturas do yoga, relaxamento e meditação. Durante o experimento foram observadas a pressão arterial sistólica e diastólica, frequência cardíaca e respiratória, perfil bioquímico (glicemia de jejum, colesterol total, LDL-colesterol, HDL-colesterol e triglicerídeos) e qualidade de vida (SF-36). Os dados foram submetidos a análise estatística para verificar a normalidade (Shapiro Wilk), a diferença entre os grupos (Mann-Whitney) e entre momentos pré e pós intervenção (Wilcoxon); a variação ao longo dos meses (ANOVA para medidas repetidas) e correlação entre valores iniciais e diferenças finais (Sperman). Foi adotado nível de significância de p<0,05. Os resultados apontaram melhora significativa no valor médio de pressão arterial sistólica final do GY comparado com o valor inicial (113,8±7,7 versus 120,7±7,9; p<0,05), enquanto a pressão arterial diastólica não apresentou diferenças... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The practice of Yoga exercises can provide numerous health benefits, acting as a complementary therapy in diseases like hypertension. The aim of this study was to describe the effects of a combination of yoga sequences carried out during four months, on the hemodynamic parameters (heart rate and blood pressure), biochemical (plasma cholesterol concentrations and its fractions, triglycerides and glucose) and the perception of quality of life in hypertension patients. Thirty-three volunteers (64 ± 9 years) participated in the study. Three men and 14 women (68 ± 7 years) conducted yoga classes for four months (YG), while two men and 14 women (58 ± 8 years) constituted the control group (CG) without intervention. The yoga goers attended the YG classes three times a week and did yoga exercises in a sequence consisting of stretching, breathing exercises, yoga postures, relaxation and meditation. During the experiment it was measured systolic and diastolic blood pressure, heart rate and respiratory rate, biochemical profile (fasting glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) and quality of life (SF-36). Data were subjected to statistical analysis to ensure normality (Shapiro Wilk), the difference between the groups (Mann-Whitney test) and between pre and post intervention (Wilcoxon), the variation over the months (repeated measures ANOVA) and correlation differences between initial and final values (Spearman). The significance level was p <0.05. The results showed significant improvement in the average of final systolic blood pressure compared with the initial value (113.8 ± 7.7 versus 120.7 ± 7.9, p <0.05) in the YG, while diastolic blood pressure did not showed differences between times. In the CG the initial and final mean of systolic and diastolic blood pressure showed no difference statistically significant. Regarding the biochemical profile, we found... (Complete abstract click electronic access below / Mestre

BACKGROUND: Anxiety and pain are prevalent symptoms experienced by inpatients in acute, long-term and rehabilitation care settings. There is a need for effective relief from these symptoms without increasing the risks as a result of the intervention. Empirical evidence supports the use of music as a complementary therapy for the management of anxiety and pain. However, there is limited knowledge of nurses’ awareness of and intention to use music therapy in clinical practice. AIMS: This study examined nurses’ awareness of and intention to use music therapy for the management of anxiety and pain, and factors that influenced nurses’ intention to implement music therapy in practice. A conceptual framework incorporating elements of the Theory of Planned Behaviour and Triandis’ Theory of Interpersonal Behaviour guided the study. METHOD: A correlational, survey-type design was used. The sample consisted of 161 Registered Nurses who were currently providing direct care to patients in acute, rehabilitation and long-term care settings in Ontario. Data were collected using adapted instruments that were pilot tested. RESULTS: Attitudes, subjective norms, perceived behavioural control, moral norms, and awareness were positively and moderately (all β > 0.20, p < .05) associated with nurses’ intention to use music therapy for the management of anxiety and pain. Role beliefs, selected demographic and professional characteristics were not significantly related to nurses’ intention to use music therapy for either anxiety or pain management. Nurse, client and unit factors were additional factors reported by nurses as affecting their use of music therapy in practice. IMPLICATIONS: The findings suggested the need for strategies to educate nurses about music therapy to facilitate its implementation in clinical practice. Research exploring why nurses are unaware of music therapy as an intervention and revisions to the current conceptual framework to incorporate additional factors influencing intervention use are required.

BACKGROUND: Anxiety and pain are prevalent symptoms experienced by inpatients in acute, long-term and rehabilitation care settings. There is a need for effective relief from these symptoms without increasing the risks as a result of the intervention. Empirical evidence supports the use of music as a complementary therapy for the management of anxiety and pain. However, there is limited knowledge of nurses’ awareness of and intention to use music therapy in clinical practice. AIMS: This study examined nurses’ awareness of and intention to use music therapy for the management of anxiety and pain, and factors that influenced nurses’ intention to implement music therapy in practice. A conceptual framework incorporating elements of the Theory of Planned Behaviour and Triandis’ Theory of Interpersonal Behaviour guided the study. METHOD: A correlational, survey-type design was used. The sample consisted of 161 Registered Nurses who were currently providing direct care to patients in acute, rehabilitation and long-term care settings in Ontario. Data were collected using adapted instruments that were pilot tested. RESULTS: Attitudes, subjective norms, perceived behavioural control, moral norms, and awareness were positively and moderately (all β > 0.20, p < .05) associated with nurses’ intention to use music therapy for the management of anxiety and pain. Role beliefs, selected demographic and professional characteristics were not significantly related to nurses’ intention to use music therapy for either anxiety or pain management. Nurse, client and unit factors were additional factors reported by nurses as affecting their use of music therapy in practice. IMPLICATIONS: The findings suggested the need for strategies to educate nurses about music therapy to facilitate its implementation in clinical practice. Research exploring why nurses are unaware of music therapy as an intervention and revisions to the current conceptual framework to incorporate additional factors influencing intervention use are required.

Made available in DSpace on 2014-06-11T19:22:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-12-17Bitstream added on 2014-06-13T19:49:08Z : No. of bitstreams: 1 mizuno_j_me_rcla.pdf: 1272357 bytes, checksum: 1cd5b2fb9250513c2c65f7d1e2e82154 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A prática de exercícios de Yoga pode proporcionar inúmeros benefícios à saúde, atuando como terapia complementar em patologias como a hipertensão arterial. O objetivo deste estudo foi descrever os efeitos de uma combinação de seqüências de práticas de yoga realizadas durante quatro meses sobre os parâmetros hemodinâmicos (frequência cardíaca e pressão arterial), bioquímicos (concentração plasmática de colesterol e suas frações, triglicerídeos e glicemia) e a percepção da qualidade de vida em pacientes portadores de hipertensão arterial. Trinta e três voluntários (64±9 anos) participaram do estudo. Três homens e 14 mulheres (68±7 anos) realizaram aulas de yoga durante quatro meses (GY), enquanto dois homens e 14 mulheres (58±8 anos) constituíram o grupo controle (GC), sem intervenção. Os alunos do GY compareceram nas aulas três vezes por semana e realizaram exercícios de yoga em uma seqüência composta por alongamentos, exercícios de respiração, posturas do yoga, relaxamento e meditação. Durante o experimento foram observadas a pressão arterial sistólica e diastólica, frequência cardíaca e respiratória, perfil bioquímico (glicemia de jejum, colesterol total, LDL-colesterol, HDL-colesterol e triglicerídeos) e qualidade de vida (SF-36). Os dados foram submetidos a análise estatística para verificar a normalidade (Shapiro Wilk), a diferença entre os grupos (Mann-Whitney) e entre momentos pré e pós intervenção (Wilcoxon); a variação ao longo dos meses (ANOVA para medidas repetidas) e correlação entre valores iniciais e diferenças finais (Sperman). Foi adotado nível de significância de p<0,05. Os resultados apontaram melhora significativa no valor médio de pressão arterial sistólica final do GY comparado com o valor inicial (113,8±7,7 versus 120,7±7,9; p<0,05), enquanto a pressão arterial diastólica não apresentou diferenças... / The practice of Yoga exercises can provide numerous health benefits, acting as a complementary therapy in diseases like hypertension. The aim of this study was to describe the effects of a combination of yoga sequences carried out during four months, on the hemodynamic parameters (heart rate and blood pressure), biochemical (plasma cholesterol concentrations and its fractions, triglycerides and glucose) and the perception of quality of life in hypertension patients. Thirty-three volunteers (64 ± 9 years) participated in the study. Three men and 14 women (68 ± 7 years) conducted yoga classes for four months (YG), while two men and 14 women (58 ± 8 years) constituted the control group (CG) without intervention. The yoga goers attended the YG classes three times a week and did yoga exercises in a sequence consisting of stretching, breathing exercises, yoga postures, relaxation and meditation. During the experiment it was measured systolic and diastolic blood pressure, heart rate and respiratory rate, biochemical profile (fasting glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) and quality of life (SF-36). Data were subjected to statistical analysis to ensure normality (Shapiro Wilk), the difference between the groups (Mann-Whitney test) and between pre and post intervention (Wilcoxon), the variation over the months (repeated measures ANOVA) and correlation differences between initial and final values (Spearman). The significance level was p <0.05. The results showed significant improvement in the average of final systolic blood pressure compared with the initial value (113.8 ± 7.7 versus 120.7 ± 7.9, p <0.05) in the YG, while diastolic blood pressure did not showed differences between times. In the CG the initial and final mean of systolic and diastolic blood pressure showed no difference statistically significant. Regarding the biochemical profile, we found... (Complete abstract click electronic access below

Orientadores: Joel Sales Giglio, Cibele Andrucioli de Matos Pimenta. / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-05T19:18:30Z (GMT). No. of bitstreams: 1 Elias_AnaCatarinadeAraujo_D.pdf: 2016555 bytes, checksum: fc9eb54fe87d798e109996a98478e447 (MD5) Previous issue date: 2005 / Resumo: Em dissertação de mestrado, desenvolvemos o estudo da Intervenção Terapêutica Relaxamento, Imagens Mentais e Espiritualidade (RIME) para re-significar a Dor Espiritual de pacientes terminais. A continuidade da pesquisa no Doutorado consistiu na operacionalização de um Curso de Capacitação sobre o uso da RIME por profissionais da saúde (Fase 1), na análise da vivência destes profissionais na sua aplicação e na avaliação do uso desta Intervenção junto aos doentes (Fase 2). Os sujeitos foram uma enfermeira, uma médica, três psicólogos e uma terapeuta alternativa voluntária, todos eles experientes ou estudiosos em Cuidados Paliativos, selecionados por convite e que atenderam onze pacientes terminais internados em hospitais públicos das cidades de Campinas, Piracicaba e São Paulo. Este estudo teve como base teórica metodológica a Pesquisa-Ação e a Fenomenologia. Os resultados qualitativos foram colhidos através da Entrevista Semi-Estruturada, do Questionário Estruturado e do Diário, e foram analisados pelo método Análise do Conteúdo através da técnica Análise Temática. Os resultados quantitativos foram analisados pelo método Descritivo através dos dados colhidos pelo instrumento Escala Visual Analógica de Bem-Estar ¿ EVA modelo expressões faciais coloridas, utilizando-se o Teste de Wilcoxon. Na análise da vivência dos profissionais foram encontradas cinco categorias e quinze subcategorias. Na análise da natureza da Dor Espiritual foram encontradas seis categorias e onze subcategorias. Na aplicação da RIME observamos diferença estatisticamente significativa (p<0,0001) isto é, no final das sessões os doentes relataram maior nível de Bem-Estar do que no início da sessão, o que indica que a RIME favoreceu a re-significação da Dor Espiritual dos pacientes terminais. O Programa de Treinamento proposto mostrou-se eficaz para preparar profissionais de saúde para o uso da Intervenção RIME, capacitando-os para o processo de cuidar e para prestar assistência espiritual dentro de uma perspectiva acadêmica / Abstract: In this essay of mastership we developed the study of the Therapeutical Intervention ¿Relaxation, Mental Images and Spirituality¿ (RIME) applied for terminal patients. The continuity for the research in the Doctorship consisted in operating a Course of Capacitance on the RIME Intervention usage by the health area professionals (Phase1) and on the analysis of the living experiences of these professionals in the application and evaluation of the RIME use in the patients (Phase2). The participants were a nurse, a female doctor, three psychologists and an alternative volunteer therapist, all experienced ones or scholars at Palliative Cares, they were selected by invitation and were in charge of caring of eleven terminal outpatients in public hospitals of Campinas, Piracicaba and São Paulo. This study had as a theory methodological base the Action-Research and the Phenomenology. The qualitative results were caught through the Semi-Structured Interview, the Structural Questionnaire and the Diary, and they were analyzed by the Contents Analysis method through the Thematically Analysis techniques. It is descriptive through the data, which were caught by the Analogical Visual Scale instrument of Welfare-AVS, in-color faces model, by using the Wilcoxon test. In the analysis of the professionals experiences were found five categories and fifteen sub-categories. In the analysis of the Spiritual Pain constitution, six categories were found with eleven sub-categories. In the application of the RIME was observed statistically expressive difference (p<0,0001) that is, at the end of each session the patients reported a greater level of welfare than at the beginning, indicating that the RIME favors the re-signification of the Spiritual Pain in the terminal patients. The purposed training program showed itself effective in preparing health area professionals for the use of the RIME Intervention, qualifying them to care and give spiritual assistance inside an academic perspective / Doutorado / Ciencias Biomedicas / Doutor em Ciências Médicas