Coercive measures are a highly controversial issue in mental health. Although scientific evidence on their impact is limited, they are frequently used. Furthermore, they lead to a high number of ethical, legal, and clinical repercussions on both patients, and professionals and institutions. This review aims to assess the impact of the main alternative measures to prevent or limit the use of coercive measures with restraints in the management of agitated psychiatric patients. The research was conducted following the guidelines recommended by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) in Medline, Cochrane Library, CINAHL, Web of Science, PsycInfo, LILACS, and Health Database of records between 2015 and 2020. After a critical reading, 21 valid articles were included. Both simple interventions and complex restraint programs were evaluated. Training in de-escalation techniques, risk assessment, and implementation of the “six core strategies” or “Safewards” program were the most assessed and effective interventions to reduce aggressive behaviors and the use of coercive measures. According to the revised literature, it is possible to reduce the use of restraints and coercive measures and not increase the number of incidents and violent behaviors among the patients through a non-invasive and non-pharmacological approach. However, further research and further randomized clinical trials are needed to compare the different alternatives and provide higher quality evidence.
Background and objectives: Chemotherapy does not only affect cancer cells; it also affects, to a greater or lesser degree, all other cells in the body. This toxicity should be assessed according to its severity, frequency, and duration, taking into account objective and subjective dimensions in its assessment. This assessment is a highly relevant aspect when providing care to chemotherapy patients, mainly due to the impact of the treatment on the patient's quality of life, as well as the vital risk it may imply under certain circumstances. For all this, the objective of this study was to assess the relationship between chemotherapy-associated adverse reactions and health-related quality of life in breast cancer patients. Materials and methods: With this purpose, a descriptive cross-sectional study was developed on 110 breast cancer patients who were treated with docetaxel, epirubicin, and cyclophosphamide. Results: It is worth highlighting the negative effect of nausea, dysgeusia, peripheral neuropathy, loss of appetite, myalgia, and peripheral edema on the quality of life. Likewise, it is worth mentioning peripheral neuropathy as the toxicity that affects a greater number of quality-of-life indicators. Conclusions: To sum up, it would be necessary to make health professionals aware of the importance of chemotherapy-associated adverse reactions.
BackgroundCOVID-19 has caused a series of economic, social, personal, and occupational consequences that may affect the mental health of healthcare workers (HCWs), with the consequent risk of developing suicidal ideation and behaviors.ObjectivesThe aim of this study was to identify the main risk factors that may predispose HCWs to suicidal ideation and suicide attempts during the COVID-19 pandemic.MethodsA systematic review of studies published between January 2020 and August 2022 was conducted following the PRISMA guidelines in the following electronic databases: Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO. Methodological quality was assessed using the critical appraisal tools for non-randomized studies of the Joanna Briggs Institute (JBI). The followed protocol is listed in the International Prospective Register of Systematic Reviews (PROSPERO) with code CRD42022340732.ResultsA total of 34 studies were included in this review. There are a number of underlying factors such as higher rates of depression, anxiety, pre-pandemic lifetime mental disorders or previous lifetime suicide attempt, living alone, having problems with alcohol and/or other drugs, etc. that favor the emergence of suicidal tendencies and ideation in times of COVID-19. Similarly, the pandemic may have precipitated a series of factors such as economic concerns, assessing one's working conditions as poor, having family members or friends infected, changes in services or functions, and feeling discriminated against or stigmatized by society. Other factors such as age, sex, or type of healthcare worker show differences between studies.ConclusionOrganizations should ensure the adoption of strategies and programmes for early detection of suicides as well as increased attention to the mental health of professions with a high workload.Systematic review registrationPROSPERO, identifier CRD42022340732.
Objetivo: Analizar las técnicas de catarsis empleadas en los trabajadores que atienden situaciones de emergencias y catástrofes. Métodos: Revisión sistemática realizada en 7 bases de datos bibliográficas Medline-Pubmed, Web of Science, Cochrane Library, CINAHL, Scopus, PsycINFO y otras fuentes secundarias, para artículos publicados entre 2008 y 2017, con los términos «catarsis», «emergencias», «debriefing» y «estrés post-traumático». Resultados: Los criterios de inclusión fueron cumplidos por 5 artículos. Los estudios muestran que es común entre el personal sanitario la exposición al sufrimiento y a las experiencias traumáticas, suponiendo repercusiones negativas manifestadas a nivel físico, psicológico y cognitivo tras situaciones de emergencias y catástrofes. Para algunos autores, el debriefing ofrece un lugar para descargar las emociones y reducir el impacto del estrés en la vida de los trabajadores de emergencia actuando como una red de apoyo para que dichos trabajadores puedan reconstruir sus experiencias y verbalizar sus pensamientos y sentimientos, así como reducir el impacto en sus vidas. Para otros en cambio, esta técnica no es eficaz para todos los profesionales y su uso puede conllevar consecuencias negativas. Conclusiones: El debriefing es una intervención breve que promueve la catarsis. Sin embargo, existe una gran controversia sobre su eficacia y la manera de aplicar esta intervención. Este estudio pone de manifiesto la heterogeneidad existente en la aplicación de técnicas de catarsis en los trabajadores que atienden situaciones de emergencia y catástrofes.
Breast cancer is the most common malignant tumour in women around the world. The objective of this study was to quantify the number of non-haematological adverse reactions associated with chemotherapy, as well as to assess the effect of the sense of coherence, optimism-pessimism and the quality of the doctor-patient relationship on the quality of life of breast cancer patients. To this end, a cross-sectional descriptive study was conducted involving 110 breast cancer patients who were treated with docetaxel, epirubicin, and cyclophosphamide during the period 2012-2014. The difference in the quality of life in patients who have five or fewer toxicities compared to those with more than six is highlighted. This difference is not as important when comparing patients with 6 to 10 toxicities and those with more than 10. The multivariate model used in this study corroborates the direct implication of the sense of coherence on the quality of life and adds the number of adverse reactions as a new construct. This has virtually the same impact on the quality of life of these patients, but in reverse. In conclusion, to improve the quality of life of breast cancer patients it would be necessary to have an impact on the number of adverse reactions involved in chemotherapeutic treatment, as well as on psychological interventions, with the sense of coherence as a possible starting point.
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