Bullying is a concept commonly used to describe situations in which an individual is persistently treated in an abusive manner over a period of time, with a feeling of not being able to counterattack or defend him-or herself against the abuse. In this study we investigated both the prevalence of bullying in Portuguese nurses and the relationship between the symptoms of burnout and mental health in nurses who report being bullied. Participants were 107 nurses of the Portuguese Public Health System. We concluded that one out of six (13%) nurses had experienced bullying in the past six months. The three most common types of bullying behaviour experienced by the nurses were doing tasks below their level of competence, having areas of responsibility removed or replaced with more trivial or unpleasant tasks, and being exposed to unmanageable levels of workload. Bullied nurses had significantly higher levels of emotional exhaustion and lowered levels of mental health compared with non-bullied colleagues.

Our aim was to identify factors that contribute to a better outcome in drug users and to understand the effectiveness of nursing interventions, by applying "Nursing Role Effectiveness Model" (NREM). It's a correlational, cross-sectional study with 180 drug users in a methadone program, randomly selected from three community services. We identified that treatment time, lower co-morbidities, less poly-drug use, family support and being employed contribute to a better quality of life, better mental health, less substance addiction consequences and more satisfaction with nursing care (p < 0.05). Those data were also related with nursing interventions using Structural Equation Model and we found that nursing care contributes 29% to health outcome improvement. The model revealed itself adequate to assess the effectiveness of nursing interventions (X: 82.51/(34) = 2.426; p < 0.01, NFI = 0.927, CFI = 0.955, RFI = 0.903, GFI = 0.917, PGFI = 0.567, PCFI = 0.722, PNFI = 0.700, RMSEA = 0.089). Compared with the NREM original model, our findings reveal new relationships between the users' structural variables and the health outcomes and also relationship between units' structural variables and nurses' structural variables.

Our aim was to contribute to the clinical validation of "Substance Addiction Consequences" (SAC) derived from the nursing outcomes classification (NOC), and to analyse psychometric properties. To that purpose, we applied a methodological design. The study's outcome comprises 16 nursing-sensitive indicators, within four different consequence factors: psychological and family; physical and cognitive ability; self-care; economic and work. The psychometric properties were considered good. We concluded that the scale can be used as a valid tool to measure the consequences of substance addiction and to assess the health status as a nursing sensitive outcome. The scale is considered valid to monitor nursing interventions in the clinical setting; being a comprehensive tool it allows the nurse to understand better this complex health problem.

Resumo Objetivo: Identificar a prevalência do diagnóstico de enfermagem ansiedade relacionada à morte da NANDA-I em cuidadores familiares de doentes paliativos; e validar as características definidoras associadas. Métodos: Estudo transversal, exploratório e descritivo utilizando o Modelo de Validação Clínica de Fehring, em uma amostra de 111 cuidadores familiares de doentes paliativos. Foi calculada a sensibilidade, especificidade e valor preditivo das características definidoras. As questões formuladas para operacionalizar as características definidoras foram validadas por um painel de peritos. Resultados: A prevalência do diagnóstico foi de 38,7% na amostra estudada. Foram alvo de validação clínica 17 características definidoras, oito delas emergiram de uma prévia revisão da literatura. Nove características foram classificadas como principais e oito secundárias. Conclusão: O diagnóstico foi validado em cuidadores familiares de doentes paliativos. A validação clínica de novas características definidoras confirmou a necessidade da sua revisão de modo a estar adequado à clínica. A prevalência do diagnóstico na amostra estudada, indica que este é um fenômeno relevante a que os profissionais devem estar particularmente atentos, de modo a implementar intervenções específicas para minimizar a ansiedade relacionada à morte dos cuidadores familiares de doentes paliativos.

A 52-year-old woman was referred to the gynecology outpatient clinic with a 2 months history of vaginal bleeding with intercourse, and no other symptoms. Vaginal examination revealed a firm, non-tender, mass in the posterior vaginal wall. The initial clinical impression was that of a vaginal carcinoma and a biopsy under local anesthesia was performed, but the result was inconclusive. A deeper biopsy, under general anesthesia, was performed and a histological diagnosis of non-Hodgkin’s lymphoma was done. The staging workup permitted to exclude any other site of the body affected by the malignancy. Hematologists reviewed the patient and recommended chemotherapy. A complete tumor regression was observed and the patient has now a disease-free survival of 72 months. This case report intends to create awareness of this rare clinical entity. Although the gynecologist will rarely be faced to extranodal lymphoma, it should be included in the differential diagnosis of gynecologic malignancies.

Social support plays an important role in these families, especially in the impact of the disease on healthy siblings. Nurses should identify the support systems that families have available, as well as their family functionality and the implications for healthy siblings.

No abstract

RESUMO CONTEXTO:As demências causam grande impacto no seio familiar, aumentando a sobrecarga emocional, de todos os membros do agregado familiar, mas principalmente do cuidador e gerando conflitos na dinâmica familiar. Como tal, torna-se emergente a necessidade de implementação de programas de apoio para os cuidadores familiares. OBJETIVO: Avaliar qual a eficácia dos programas psicoeducacionais na sobrecarga dos cuidadores de pessoas com demência. MÉTODOS: Revisão integrativa da literatura sobre programas psicoeducacionais para cuidadores, publicados entre janeiro de 2010 e dezembro de 2015 nas bases de dados PubMed e b-on, utilizando as seguintes palavras-chave: "psychoeducation, dementia, caregiver, burden", "psicoeducação, cuidador, demência, sobrecarga". RESULTADOS: Foram analisados 9 artigos que avaliam os efeitos da aplicação de um programa psicoeducacional na sobrecarga dos familiares de cuidadores de pacientes com demência. Verifica-se que existe uma melhoria substancial do bem-estar dos cuidadores; um aumento da aquisição de estratégias de resolução de problemas e de técnicas de gestão de stress; aumento do conhecimento acerca dos recursos na comunidade e de como lidar com situações de crise nas diferentes fases da doença. CONCLUSÃO: Os resultados sugerem que a aplicação de programas psicoeducacionais em cuidadores familiares de pessoas com demência tem resultados positivos na sobrecarga do cuidador e na melhoria do seu bem-estar. BACKGROUND: Dementias have a major impact on the family, increasing the emotional overload of all household members, but mainly the caregiver and generating conflicts in the family dynamics. As such, the need to implement support programs for family caregivers emerges. Caregiver overload is understood as a set of physical, psychological, emotional, social and financial problems experienced by caregivers of patients with some type of impairment. AIM: To evaluate the effectiveness of psychoeducational programs in the overload of caregivers of people with dementia. METHODS: Integrative review of the literature on psychoeducational programs for caregivers, published between January 2010 and December 2015 in the PubMed and b-on databases, using the following keywords: "psychoeducation, dementia, caregiver, burden". RESULTS: We analyzed 9 articles that evaluate the effects of the application of a psychoeducational program on the overload of family members of caregivers of patients with dementia. There is a substantial improvement in the well-being of caregivers; An increase in the acquisition of problemsolving strategies and stress-management techniques; Increase knowledge about resources in the community and how to deal with crisis situations in the different phases of the disease. PALAVRAS-CHAVE: CONCLUSION:The results suggest that the application of psychoeducational programs in family caregivers of people with dementia has positive results in the caregiver's overload and in the improvement of their wellbeing.