Abstract Introduction & Background: One of the most common and debilitating side effects of cancer is fatigue. Fatigue is a general feeling of tiredness or weakness that can greatly impact a patient’s quality of life. It can have a profound impact on a patient’s ability to perform day to day activities and cause emotional distress leading to anxiety and depression. In recent years, there has been an increase in research to look at the effectiveness of non-pharmacological interventions on improving cancer patients’ fatigue. Purpose Statement: The purpose of our research is to look at the effectiveness of different types of non-pharmacological interventions on improving fatigue in lung cancer patients. Literature Review: The ETSU Library Database was used to locate the articles reviewed for this research. Only articles that were peer reviewed, open access, and available online were used. Articles that were published in 2016 or before were eliminated in the search to ensure the research’s relevancy. A total of five articles were selected to be reviewed. Findings: Progressive muscle relaxation therapy, physical therapies such as acupressure, acupuncture, and transcutaneous electrical acupoint stimulation, psychological intervention using the PERMA framework, and light exercise and balance programs consisting of walking in place showed an improvement in cancer patients’ level of fatigue. Conclusions: Non-pharmacological interventions for fatigue, compared to traditional pharmacological treatments, prove to have fewer adverse side-effects and risks for the patient. Therefore, these interventions are a safer and effective option in managing the distressing symptoms like fatigue that many lung cancer patients face while undergoing treatment.

No description available.

Aim: The aim of this study was to develop and evaluate an evidence-based creative expression therapy for Chinese people with dementia in hospitals, LTC settings and household. Background: Creative expression (CE) has been shown to be effective for engagement of both people with dementia and carers to communicate in the USA. However, there are limited cross-cultural studies of psychological therapy of people with dementia in China. Method: The overall research strategy is a mixed method. To develop standard CE programme, action research was conducted by three sequential sessions in the geriatric wards, long term care institution and patients’ homes respectively. 7rounds of action research cycle including plan, action, observation, reflective discussion was complemented and 31 people with dementia received CE intervention and evaluating by means of observation, semi-structure interview. The following evaluation research is a controlled trial for people with dementia in LCT settings and hospitals. 91 cases of people with dementia were recruited and divided into two groups. While a series of social contact activities were conducted on the 48 cases control group, the revised CE intervention carried out on the 43 cases test group, both twice weekly for 6 weeks. The primary outcome was measured by MMSE、QOL-AD、CSDD and SFACS in week 0, week 7, week 10. Findings For the social communication and communication of basic needs in SFACS score, pleasure and general alertness mood by OERS, the test group presented significantly better effect than the control group (P < 0.05). Although both group had a decline effect on CSDD score, the test group were maintaining lower 1month after intervention (P < 0.05). Thus the revised CE programme may improve the communication ability and alleviate depression of people with dementia significantly .However, although the quality of life is less affected, it showed a rising tendency after CE programme. Conclusions: This study added trans-cultural evidence on dementia treatment and developed a standard and effective creative expression intervention on Chinese people affected by dementia.

O presente estudo teve por objetivo avaliar a eficácia de uma intervenção não-farmacológica de distração no alívio de dor aguda em crianças hospitalizadas submetidas a procedimentos dolorosos por demanda clínica, controlando variáveis de estresse e catastrofização de dor. O delineamento do estudo foi um ensaio clínico randomizado cruzado (cross-over). A amostra do estudo foi composta por 40 crianças na fase escolar (6 a 11 anos), que estavam internadas na Enfermaria de Pediatria do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP e que foram submetidas a procedimento de punção venosa ou arterial prescrito por demanda clínica. Os participantes foram randomizados em dois grupos, sendo que todas as crianças receberam a intervenção e foram controles de si mesmas, mas em dois períodos distintos. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do hospital. Inicialmente, avaliações do estresse e catastrofização de dor foram processadas, utilizando-se, respectivamente, a Escala de Estresse Infantil (ESI) e a Escala de Catastrofização de Dor para Crianças (PCS-C), a fim de controlar essas variáveis. Para avaliação da intensidade de dor foram utilizados os seguintes instrumentos: Escala Visual Analógica (VAS) e Escala de Faces Revisada (FPS-R). Na coleta de dados, o Grupo 1 recebeu a intervenção de distração audiovisual antes e durante um procedimento de punção realizado pela enfermeira e, em outro dia um segundo procedimento de punção foi realizado sem intervenção. No Grupo 2, por sua vez, o procedimento ocorreu de forma inversa, sendo primeiramente sem intervenção e posteriormente com intervenção. A intervenção constituiu-se na distração audiovisual com o direcionamento da atenção da criança antes e durante o procedimento doloroso para filmes de curta metragem com temáticas infantis. Após a conclusão dos procedimentos de punção eram aplicadas as duas escalas de dor para avaliar a percepção da intensidade de dor pelas crianças. A análise de variância ANOVA 2 X 2 com comparação entre- e intra-grupos foi processada com a finalidade de atender ao objetivo do estudo. O nível de significância adotado em todas as análises realizadas no presente estudo foi de 5%. Os resultados mostraram que os dois grupos foram semelhantes nas medidas basais de estresse e catastrofização de dor; não houve diferenças estatisticamente significativas nessas variáveis. Verificou-se que houve diferença estatisticamente significativa entre os grupos nos períodos com e sem intervenção da distração; os escores em ambas as escalas FPS-R e VAS mostraram-se menores no período com distração em comparação ao período sem intervenção. Além disso, a sequência de exposição da distração nos grupos e o período em que foi realizada a distração também interferiram significativamente no efeito da intervenção de distração. A análise do efeito carry-over mostrou que aproximadamente 30% dos efeitos estimados no alívio de dor foram atribuídos exclusivamente à intervenção de distração. Em conclusão, a intervenção de distração audiovisual foi eficaz na redução da percepção da intensidade de dor durante o procedimento doloroso agudo em crianças hospitalizadas. A técnica de distração pode ser recomendada como uma estratégia não-farmacológica simples e eficaz para alívio da dor aguda, podendo ser implementada na prática clínica em ambientes de cuidados pediátricos. / The present study was aimed to evaluate the efficacy of a non-pharmacological intervention of distraction for acute pain relief in hospitalized children undergoing painful procedures by clinical demand, controlling variables of stress and pain catastrophizing. The study design was a crossover randomized controlled trial. The sample was composed of 40 children at school age (6-11 years), who was admitted in the pediatric ward of the Hospital of Clinics of Ribeirão Preto Medical School-USP and who underwent venipuncture or arterial puncture prescribed by clinical demand. Participants were randomized into two groups and all children that received the intervention were themselves controls, in two different periods. The study was approved by the Committee of Ethics on Research of the Hospital. Initially, the stress and pain catastrophizing assessments were performed using The Child Stress Scale (CSS) and Pain Catastrophizing Scale for Children (PCS-C), respectively, aiming to control these variables. The instuments used for pain assessment were the following: The Visual Analog Scale (VAS) and The Faces Pain Scale Revised (FPS-R). In the data collection, the Group 1 received the audiovisual distraction intervention before and during the puncture performed by the nurse and in another day a second puncture was performed without intervention. Contrarily, in Group 2 the procedure was first without intervention and subsequently with intervention in another day. The intervention consisted in audiovisual distraction by focusing the child\'s attention before and during the painful procedure to short films about infant thematics. The two pain scales were applied after the puncture procedures to assess the childrens perception of pain intensity. An ANOVA 2 X 2 analyses of variance was performed including between- and within-groups comparisons. The level of significance adopted in all analyzes of the present study was 5%. The results showed that the two groups were similar in the baseline of stress and pain catastrophizing outcomes; there were no significant differences between the groups in these variables. There was a statistically significant difference between groups in the periods with and without distraction intervention; the scores in both scales FPS-R and VAS were lower during distraction compared with the no intervention period. Furthermore, the sequence of exposure of the distraction in the groups and the period that distraction was performed also significantly interfered in the effect of distraction intervention. The analysis of the carry-over effect showed that around 30% of the estimated effects on pain reliefing were attributed to the distraction intervention. In conclusion, the intervention of audiovisual distraction was efficacy in reducing the perception of pain intensity during routine acute painful procedure in hospitalized children. The findings of the present study endorse that distraction is a simple and efficacious non-pharmacological management for acute pain relief, which could be implemented in clinical practice of pediatric care settings.

O presente estudo teve por objetivo avaliar a eficácia de uma intervenção não-farmacológica de distração no alívio de dor aguda em crianças hospitalizadas submetidas a procedimentos dolorosos por demanda clínica, controlando variáveis de estresse e catastrofização de dor. O delineamento do estudo foi um ensaio clínico randomizado cruzado (cross-over). A amostra do estudo foi composta por 40 crianças na fase escolar (6 a 11 anos), que estavam internadas na Enfermaria de Pediatria do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP e que foram submetidas a procedimento de punção venosa ou arterial prescrito por demanda clínica. Os participantes foram randomizados em dois grupos, sendo que todas as crianças receberam a intervenção e foram controles de si mesmas, mas em dois períodos distintos. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do hospital. Inicialmente, avaliações do estresse e catastrofização de dor foram processadas, utilizando-se, respectivamente, a Escala de Estresse Infantil (ESI) e a Escala de Catastrofização de Dor para Crianças (PCS-C), a fim de controlar essas variáveis. Para avaliação da intensidade de dor foram utilizados os seguintes instrumentos: Escala Visual Analógica (VAS) e Escala de Faces Revisada (FPS-R). Na coleta de dados, o Grupo 1 recebeu a intervenção de distração audiovisual antes e durante um procedimento de punção realizado pela enfermeira e, em outro dia um segundo procedimento de punção foi realizado sem intervenção. No Grupo 2, por sua vez, o procedimento ocorreu de forma inversa, sendo primeiramente sem intervenção e posteriormente com intervenção. A intervenção constituiu-se na distração audiovisual com o direcionamento da atenção da criança antes e durante o procedimento doloroso para filmes de curta metragem com temáticas infantis. Após a conclusão dos procedimentos de punção eram aplicadas as duas escalas de dor para avaliar a percepção da intensidade de dor pelas crianças. A análise de variância ANOVA 2 X 2 com comparação entre- e intra-grupos foi processada com a finalidade de atender ao objetivo do estudo. O nível de significância adotado em todas as análises realizadas no presente estudo foi de 5%. Os resultados mostraram que os dois grupos foram semelhantes nas medidas basais de estresse e catastrofização de dor; não houve diferenças estatisticamente significativas nessas variáveis. Verificou-se que houve diferença estatisticamente significativa entre os grupos nos períodos com e sem intervenção da distração; os escores em ambas as escalas FPS-R e VAS mostraram-se menores no período com distração em comparação ao período sem intervenção. Além disso, a sequência de exposição da distração nos grupos e o período em que foi realizada a distração também interferiram significativamente no efeito da intervenção de distração. A análise do efeito carry-over mostrou que aproximadamente 30% dos efeitos estimados no alívio de dor foram atribuídos exclusivamente à intervenção de distração. Em conclusão, a intervenção de distração audiovisual foi eficaz na redução da percepção da intensidade de dor durante o procedimento doloroso agudo em crianças hospitalizadas. A técnica de distração pode ser recomendada como uma estratégia não-farmacológica simples e eficaz para alívio da dor aguda, podendo ser implementada na prática clínica em ambientes de cuidados pediátricos. / The present study was aimed to evaluate the efficacy of a non-pharmacological intervention of distraction for acute pain relief in hospitalized children undergoing painful procedures by clinical demand, controlling variables of stress and pain catastrophizing. The study design was a crossover randomized controlled trial. The sample was composed of 40 children at school age (6-11 years), who was admitted in the pediatric ward of the Hospital of Clinics of Ribeirão Preto Medical School-USP and who underwent venipuncture or arterial puncture prescribed by clinical demand. Participants were randomized into two groups and all children that received the intervention were themselves controls, in two different periods. The study was approved by the Committee of Ethics on Research of the Hospital. Initially, the stress and pain catastrophizing assessments were performed using The Child Stress Scale (CSS) and Pain Catastrophizing Scale for Children (PCS-C), respectively, aiming to control these variables. The instuments used for pain assessment were the following: The Visual Analog Scale (VAS) and The Faces Pain Scale Revised (FPS-R). In the data collection, the Group 1 received the audiovisual distraction intervention before and during the puncture performed by the nurse and in another day a second puncture was performed without intervention. Contrarily, in Group 2 the procedure was first without intervention and subsequently with intervention in another day. The intervention consisted in audiovisual distraction by focusing the child\'s attention before and during the painful procedure to short films about infant thematics. The two pain scales were applied after the puncture procedures to assess the childrens perception of pain intensity. An ANOVA 2 X 2 analyses of variance was performed including between- and within-groups comparisons. The level of significance adopted in all analyzes of the present study was 5%. The results showed that the two groups were similar in the baseline of stress and pain catastrophizing outcomes; there were no significant differences between the groups in these variables. There was a statistically significant difference between groups in the periods with and without distraction intervention; the scores in both scales FPS-R and VAS were lower during distraction compared with the no intervention period. Furthermore, the sequence of exposure of the distraction in the groups and the period that distraction was performed also significantly interfered in the effect of distraction intervention. The analysis of the carry-over effect showed that around 30% of the estimated effects on pain reliefing were attributed to the distraction intervention. In conclusion, the intervention of audiovisual distraction was efficacy in reducing the perception of pain intensity during routine acute painful procedure in hospitalized children. The findings of the present study endorse that distraction is a simple and efficacious non-pharmacological management for acute pain relief, which could be implemented in clinical practice of pediatric care settings.

Patienter med kronisk obstruktiv lungsjukdom (KOL) upplever ofta oro relaterat till dyspné. Syftet med studien var att undersöka vilka icke-farmakologiska åtgärder som kan vidtas för att lindra patienters oro relaterat till dyspné vid KOL.  En litteraturstudie genomfördes där vetenskapliga artiklar granskades och sammanställdes. Resultatet visade att det finns ett flertal icke-farmakologiska åtgärder så som andningstekniker, fysisk träning, avledning, nutrition och kommunikation som sjuksköterskan kan undervisa och informera om för att lindra oro relaterad till dyspné. Åtgärderna bör vara individanpassade, eftersom varje patient är unik. Sjuksköterskan bör själv eller tillsammans med andra vårdinstanser försäkra sig om att patienten får den information och utbildning om sin sjukdom som krävs för att lindra patientens oro i möjligast mån. Informationen och utbildningen bör vara omfattande, för att patienten ska kunna finna de strategier och hjälpmedel som hjälper just dem vid oro. Lungrehabiliteringsprogram visade sig vara av betydelse för patienternas möjlighet att finna strategier för att lindra oro relaterad till dyspné. Ytterligare forskning men även utbildning av sjuksköterskor behövs angående specifika icke-farmakologiska åtgärder som kan lindra oro relaterad dyspné. Det behövs även forskning om vilka icke-farmakologiska åtgärder som bör ingå i ett lungrehabiliteringsprogram. / Patients with chronic obstructive pulmonary disease (COPD) often experience anxiety related to dyspnea. The purpose of this study was to investigate the non-pharmacological interventions that can be performed to alleviate patients' anxiety related dyspnea. A literature review was conducted and scientific articles were reviewed and summarized. The results showed that there are several non-pharmacological interventions that nurses can conduct to relieve anxiety related dyspnea, such as breathing techniques, physical exercise, diversion, nutrition and communication. Every patient is unique and therefore should the nurse interventions be individualized. It is the nurse task together with other health care professionals to ensure that the patients receives and understands the information that is given. The information and education should be extensive so that the patient will be able to find the right strategies that will help them to alleviate their anxiety. Pulmonary rehabilitation programs proved to be of great importance to patients' ability to find strategies to relieve anxiety related to dyspnea. Further research and education to nurses are needed on specific non- pharmacological interventions that can relieve anxiety related dyspnea. Research is also needed on which non-pharmacological interventions that should be part of a pulmonary rehabilitation program.

No description available.

No description available.

OBJECTIVES: The Enriched Opportunities Programme (EOP) is a multi-level intervention focussing on improved quality of life for people with dementia. This study compared the experience of people living with dementia and other mental health problems in extra care housing schemes that utilised EOP with schemes that employed an active control intervention. METHOD: Ten extra care housing schemes were cluster randomised to receive either the EOP intervention or an active control intervention for an 18-month period. Residents with dementia or other significant mental health problems (20-30 per scheme) were assessed on a number of outcome measures at baseline, six months, one year and 18 months. The primary outcome measure was quality of life. Self-reported depression was an important secondary outcome. RESULTS: The EOP-participating residents rated their quality of life more positively over time (4.0 (SE 0.6) units; 14% p < 0.001) than the active control (1.3 (SE 0.6) units; 4% p = 0.003). There was also a significant group-time interaction for depressive symptoms (p = 0.003). The EOP-participating residents reported a reduction of 25% at both six and 12 months and a 37% reduction at 18 months (all p's < 0.001). EOP residents were less likely than residents in the active control sites to move to a care home or to be admitted to a hospital inpatient bed. They were more likely to be seen by a range of community health professionals. CONCLUSION: The EOP had a positive impact on the quality of life of people with dementia in well-staffed extra care housing schemes.

El TDAH és un trastorn neuroevolutiu de l’atenció i la impulsivitat de naturalesa crònica que afecta un 4% de la població i que freqüentment s’associa amb altres trastorns, com els problemes de conducta i les dificultats en l’aprenentatge. Actualment hi ha base empírica sobre el seu origen genètic i biològic, encara que el seu curs evolutiu i el seu pronòstic estan molt influenciats per factors ambientals. És per això que un abordatge adequat del procés d’avaluació i d’intervenció d’aquest trastorn ha de contemplar de forma primerenca els contextos en què el nen es desenvolupa (escola, família i comunitat) i ha de comptar amb un equip multidisciplinari. En aquesta línia, las modalitats d’intervenció que han evidenciat ser més efectives són les medicacions psicoestimulants, les intervencions psicosocials i els tractaments que combinen ambdues modalitats terapèutiques. L’estimulant més utilitzat per al TDAH, el metilfenidat, és el fàrmac més prescrit en psiquiatria infantil i s’ha constatat la seva efectivitat de forma reiterada. No obstant això, s’ha d’administrar amb cautela perquè presenta limitacions que a vegades no en compensen l’administració, com el efectes no desitjats, el desconeixement sobre els efectes a llarg termini o els escassos estudis sobre eficàcia i seguretat en nens preescolars. Aquests troballes ens fan considerar les intervencions psicosocials, que també són una bona opció terapèutica. Les intervencions psicosocials validades empíricament serveixen d’entrenament a pares i mestres per manejar el trastorn, com també al mateix nen, tot i que en menor mesura, per exercitar les seves habilitats socioemocionals. La finalitat d’aquestes teràpies és que paral•lelament o tres la formació, s’implementen intervencions conductuals, cognitiu-conductuals, escolars i sòcio-emocionals en els contexts naturals del nen. Encara que està provada la eficàcia d’aquestes modalitat d’intervenció de forma aïllada, s’han trobat millores superiors amb els tractaments combinats o multimodals, que cobren un ampli ventall de dificultats i plànols de funcionament, permetent en ocasions reduir la dosi de medicació amb un manteniment dels efectes positius. Però, malauradament, encara s’observa una relativa carència d’estudis que incloguin tractaments combinats per al TDAH infantil, si més no a España. En el millor del casos, les intervencions han estat breus i intensives. Tanmateix, no s’han publicat estudis sobre l’eficàcia d’aquestes intervencions per millorar variables com el clima escolar i familiar d’aquests nens. L’objectiu, doncs, d’aquest projecte és analitzar l’eficàcia relativa i diferencial d’un tractament combinat (medicació estimulant + entrenament a pares i mestres) versus un de farmacològic, durant un curs escolar, per millorar diverses variables relacionades amb el nen hiperactiu, com també amb els seus mestres i pares (símptomes, rendiment acadèmic, clima escolar i familiar, autoeficàcia percebuda i coneixements sobre TDAH). / El TDAH es un trastorno neuro-evolutivo de la atención, la actividad y la impulsividad de naturaleza crónica, que afecta a un 4% de la población, asociándose frecuentemente con otros trastornos, como los problemas de conducta y las dificultades de aprendizaje. En la actualidad, hay evidencia empírica sobre su origen genético y biológico, aunque su curso evolutivo y pronóstico están enormemente influidos por factores ambientales. De ahí que un adecuado abordaje del proceso de evaluación e intervención de este trastorno deba contemplar de forma temprana los contextos donde el niño se desenvuelve (escuela, familia y comunidad), contando con un equipo multidisciplinar. En esta línea, las modalidades de intervención que han mostrado ser más efectivas son las medicaciones estimulantes, las intervenciones psicosociales y los tratamientos que combinan ambas opciones terapéuticas. El estimulante más utilizado para el TDAH, el metilfenidato, es el fármaco más prescrito en psiquiatría infantil y se ha constatado reiteradamente su efectividad. Pero se debe administrar con cautela porque presenta limitaciones que en ocasiones no compensan su administración, como sus efectos indeseados; el desconocimiento sobre sus efectos a largo plazo; y los escasos estudios sobre su eficacia y seguridad en niños preescolares. Estos hallazgos nos instan a considerar las intervenciones psicosociales, que son también una buena opción terapéutica. Las intervenciones psicosociales validadas empíricamente son el entrenamiento a padres y a maestros en el manejo del trastorno, y en menor medida el entrenamiento en habilidades socio-emocionales al propio niño. La finalidad de estas terapias es que paralelamente o tras la formación, se implementen intervenciones conductuales, cognitivo-conductuales, escolares y socio-emocionales en los contextos naturales del niño. Sin embargo, a pesar de la eficacia de estas modalidades de intervención de forma aislada, se han mostrado mejoras superiores con los tratamientos combinados o multimodales, que cubren un amplio abanico de dificultades y planos de funcionamiento, permitiendo en ocasiones reducir la dosis de medicación con un mantenimiento de los efectos positivos. Pero desafortunadamente, aún se observa una relativa carencia de estudios que incluyan tratamientos combinados para el TDAH infantil, al menos en España. Y en el mejor de los casos, las intervenciones han sido muy breves e intensivas. Asimismo, no se han publicado estudios sobre la eficacia de estas intervenciones para mejorar variables como el clima escolar y familiar de estos niños. Precisamente, el objetivo de este proyecto es analizar la eficacia relativa y diferencial de un tratamiento combinado (medicación estimulante+entrenamiento a padres y maestros) versus farmacológico, durante un curso escolar, para mejorar diversas variables relacionadas con el niño hiperactivo, sus maestros y sus padres (síntomas, rendimiento académico, clima escolar y familiar, autoeficacia percibida y conocimientos sobre TDAH). / ADHD is a neuro-developmental disorder of attention, impulsivity and activity of a chronic nature, affecting 4% of the population, frequently associated with other disorders such as behavioral problems and learning disabilities. Today, there is empirical evidence on genetic and biological origin, although its clinical course and prognosis are greatly influenced by environmental factors. Hence, an adequate management of the process of assessment and intervention for this disorder should contemplate early contexts where the child develops (school, family and community), with a multidisciplinary team. In this stratum, the interventions that have proven most effective are stimulant medications, psychosocial interventions and treatments that combine both options. The stimulant used for ADHD, methylphenidate, is the most prescribed drug in child psychiatry and has been found repeatedly to be effective. But it should be administered with caution, because it has limitations, like its side effects, the lack of long-term effects, and the few studies on efficacy and safety in preschool children. These findings urge us to consider psychosocial interventions, which are also a good option. Empirically valid psychosocial interventions are parent training and teachers in the management of the disorder, and less training in socio-emotional skills the child itself. The purpose of these therapies is that, - parallel or after the training -, behavioral, cognitive-behavioral, and socio-emotional interventions would be implemented in the child's natural settings. However, despite the effectiveness of these modalities of intervention in isolation, greater improvement has been shown with combined or multimodal treatments covering a wide range of problems, allowing sometimes to reduce the dose of medication, with a maintenance of positive effects. But unfortunately there is still a relative lack of studies involving combined treatments for childhood ADHD, at least in Spain. And in most cases, interventions have been very brief and intensive. Also, there are no published studies on the effectiveness of these interventions to improve variables such as school and family environment of these children. The precise purpose of this project is to analyze the relative and differential efficacy of combined treatment (stimulant medication + training for parents and teachers) versus drug, during a school year, in order to improve various variables related to the hyperactive child, their teachers and their parents (symptoms, academic performance, school and family evironment, self-efficacy and knowledge about ADHD).