OBJECTIVE Analyzing the evidence of the effects of dignity therapy onterminally ill patients. METHOD A Systematic review of the literature conducted using the search strategy in six databases. Inclusion criteria were primary studies, excluding literature reviews (systematic or not) and conceptual articles. RESULTS Ten articles were analyzed regarding method, results and evidence level. Dignity therapy improved the sense of meaning andpurpose, will to live, utility, quality of life, dignity and family appreciationin studies with a higher level of evidence. The effects are not well established in relation to depression, anxiety, spirituality and physical symptoms. CONCLUSION Studies with a moderate to high level of evidence have shown increased sense of dignity, will to live and sense of purpose. Further studies should be developed to increase knowledge about dignity therapy.
Objectives: to analyze the prevalence of symptoms and their relationship with the quality of life of cancer patients. Methods: this is a cross-sectional study with 107 patients evaluated using a sociodemographic instrument, the hospital anxiety and depression scale (HADS) and the quality of life scale (EORTC-QLQ-C30). Pearson’s correlation test was used to evaluate the relationship between symptoms and quality of life. Results: prevalence of female patients (56.1%), 55 years as the mean age and 10 years of schooling. Fatigue (76.6%), insomnia (47.7%), pain (42.1%), loss of appetite (37.4%), anxiety (31.8%) and depression (21.5%) were identified. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms. Conclusions: fatigue, insomnia, pain and loss of appetite were the most common and most intense symptoms. Anxiety and depression symptoms presented a negative correlation with quality of life and positive correlation with physical symptoms.
Objective: to understand the perception of dignity of patients in palliative care and to identify factors that may increase or decrease the sense of dignity. Method: an exploratory study with a qualitative approach, carried in a Palliative Care Center in São Paulo (Brazil), with the Chochinov’s Dignity Model as theoretical framework and content analysis as methodological framework. The participants of this study were 20 patients in palliative care, assessed through semi-structured interviews based on three questions: "What is dignity for you?", "What increases your dignity?", "What decreases your dignity?" The interviews were recorded with the patients’ authorization, from September to November 2017, and transcribed for content analysis. Results: the analysis of the perception of dignity allowed the identification of three categories: Correct person, Autonomy/independence and Socio-political factors. The factors that increased the sense of dignity were the following: Care, Independence/autonomy, Leisure/positive thinking/being with friends. And those that decreased it were the following: Behaviors/attitudes, Health status and Economic situation. Conclusion: the perception of dignity of patients in palliative care was influenced by health professionals and caregivers. Being a “correct person”, maintaining autonomy, being cared for and respected has increased the sense of dignity. Urban violence and the lack of compliance with accessibility policies have reduced the sense of dignity among palliative care patients.
Objective: The objective of this study was to assess the effects of a psychoeducational intervention upon symptom control and quality of life (QoL) among cancer patients. Methods: This was an open randomized clinical trial (RCT) conducted at the Cancer Institute of the State of São Paulo. The RCT comprised 107 outpatients in chemotherapy or radiation for malignant neoplasms. Participants were randomized to control group (usual treatment) or intervention group (IG) (psychoeducational intervention) with assessments at baseline and upon completion of the intervention. Sociodemographic information, clinical data, QoL, functionality, and symptoms were assessed. This trial is registered with the Brazilian Clinical Trials Registry number RBR-9337nv. A mixed-effects model was applied to compare the effects of the intervention between the groups. Results: The most frequent symptoms were fatigue (76.6%), insomnia (47.7%), pain (42.1%), and loss of appetite (37.4%). The symptom intensity analysis suggests that insomnia was the strongest symptom, followed by fatigue, loss of appetite, and pain. The IG experienced a significant improvement in terms of loss of appetite ( P = 0.002) and a tendency toward less insomnia ( P = 0.053). Conclusions: The intervention significantly reduced appetite loss in cancer patients. Despite no effects observed in global QoL or functionality, the intervention yielded a tendency to improve insomnia, and this outcome should be investigated in future studies.
Objectives: to analyze prenatal care process in primary health care units and compare the prenatal adequacy in the third trimester with maternal and perinatal outcomes. Methods: a cross-sectional study of 2,404 pregnant women assisted in 2011in twelve primary health care units in the South region of São Paulo city. The data was collected through medical records. The assessment was based on the indicators process of the Programa de Humanização do Pré-natal e Nascimento (PHPN) (Prenatal and Birth Humanization Program). The prenatal adequacy in the third trimester was analyzed according to three criteria (early-onset, minimum of six consultations and puerperal consultation); and the compared maternal and perinatal outcomes were: type of childbirth, gestational age, birth weight and breastfeeding. The analysis was descriptive for the PHPN indicators and comparative for the prenatal adequacy by the chi-square test. Results: early prenatal (82.9%), minimum of six consultations (73.0%) and puerperal consultation (77.9%). In the overall of the PHPN indicators, there was an expressive decrease in the medical records (10.2%). Prenatal care was adequate for 63.6% with a significant difference in relation to gestational age (p=0.037) and birth weight (p=0.001). Conclusions: There were deficiencies in prenatal care. The difference between the groups in the perinatal outcomes reinforcing the need for prenatal care according to national indicators.
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