Labor pain: Non-pharmacological measures preferred by parturient

Background: Labor pain is a legacy given by bipedalism, sendentarism and greater fetos robustness. It is expected that nurses mostly apply non-pharmacological methods of pain relief, putting the account of the mother to your preferences. Aim: To describe the women preferences about pain relief no-pharmacological measures. Method: Convenience sample of 180 parturients, with mean age of 30.81 years (SD = 5.31), ranging from 17 to 43 years. Results: all positions are valued as a pain relief way. The most valued, classified as "strongly relief" is the lateral decubitus in bed (45.7%), followed by walking (40.4%) and sitting swing (38.9%). Conclusion: Mothers show preference for traditional measure as lateral position on the bed. A greater familiarity with other relief measures could facilitate labor experience.

Abordagem terapêutica de enfermagem ao doente depressivo: o uso da psicoeducação no tratamento da sintomatologia depressiva

A depressão é uma doença, é necessário reconhece-la como tal e procurar capacitar as pessoas que com ela convivem a procurar ajuda e precocemente iniciar o seu tratamento. Dos indivíduos que receberam tratamento para um episódio depressivo apresentaram recaídas, muitas vezes devido à não adesão ao tratamento. Nesse contexto, o tratamento medicamentoso combinado com intervenções psicossociais torna-se cada vez mais utilizado, sendo a Psicoeducação uma das intervenções mais eficazes. O desenvolvimento de um programa Psicoeducativo nesse sentido teve como base e metodologia o processo de relação de ajuda. Pretende-se criar as condições necessárias para que a própria pessoa reconheça a sua patologia, os sintomas que dela decorrem, a importância da adesão terapêutica e a necessidade de suporte por parte da família na pessoa com depressão. No final, procura-se desenvolver e refletir as competências inerentes ao enfermeiro especialista em enfermagem de Saúde Mental e Psiquiatria, no diagnostico, intervenção e avaliação na pessoa com sintomatologia depressiva; Abstract: Therapeutic approach to nursing depressive patient – the use of psychoeducation in the treatment of depressive symptomatology Depression is a disease, it is necessary to recognize it as such and seek to enable people to live with her to seek help early and start your treatment. Of individuals who received treatment for a depressive episode had relapses, often due to non-adherence to treatment. In this context, drug treatment combined with psychosocial interventions becomes increasingly used, the Psychoeducational one of the most effective interventions. The development of a program accordingly Psychoeducational was based on the methodology and process aid relationship. It is intended to create the necessary conditions so that the person recognize their disease, the symptoms resulting from it, the importance of adherence and the need for support by the family in person with depression. In the end, we seek to develop and reflect the skills inherent to the nurse specialist in nursing Mental Health and Psychiatry in the diagnosis, intervention and evaluation in people with depressive symptoms.

A low fermentable oligo-di-mono saccharides and polyols (FODMAP) diet reduced pain and improved daily life in fibromyalgia patients

Fibromyalgia (FM) is a chronic, rheumatic disease characterized by widespread myofascial pain, of unknown aetiology, having a major impact on quality of life (QOL). Available pharmacotherapy for FM is marginally effective. FM is associated with co-morbidities of gastrointestinal (GI) disorders and Irritable Bowel Syndrome (IBS). There is growing evidence that diets low in FODMAPs, “fermentable oligo-, di- or mono-saccharides and polyols” [Low FODMAP Diet (LFD)], are effective in treating IBS. The aim of this pilot study was to examine the effects of LFDs on symptoms of FM, especially with regard to pain, QOL and GI disorders. Methods A longitudinal study using LFD intervention was performed on 38, 51 ± 10 year-old, female patients diagnosed with FM for an average of 10 years, based on ACR (American College of Rheumatology) 2010 criteria. The study was conducted from January through May, 2015, using a four-week, repeated-assessment model, as follows: Moment 0 – introduction of the protocol to participants; Moment 1 – first assessment and delivery of individual LFD dietary plans; Moment 2 – second assessment and reintroduction of FODMAPs; Moment 3 – last assessment and final nutritional counselling. Assessment tools used were the following: RFIQ (Revised Fibromyalgia Impact Questionnaire), FSQ (Fibromyalgia Survey Questionnaire), IBS-SSS (Severity Score System), EQ-5D (Euro-QOL quality of life instrument), and VAS (Visual Analogue Scale). Daily consumption of FODMAPs was quantified based on published food content analyses. Statistical analyses included ANOVA, non-parametric Friedman, t-student and Chi-square tests, using SPSS 22 software. Results The mean scores of the 38 participants at the beginning of the study were: FSQ (severity of FM, 0–31) – 22 ± 4.4; RFIQ (0–100) – 65 ± 17; IBS-SSS (0–500) – 275 ± 101; and EQ-5D (0–100) – 48 ± 19. Mean adherence to dietary regimens was 86%, confirmed by significant difference in FODMAP intakes (25 g/day vs. 2.5 g/day; p < 0.01). Comparisons between the three moments of assessment showed significant (p < 0.01) declines in scores in VAS, FSQ, and RFIQ scores, in all domains measured. An important improvement was observed with a reduction in the severity of GI symptoms, with 50% reduction in IBS scores to 138 ± 117, following LFD therapy. A significant correlation (r = 0.36; p < 0.05) was found between improvements in FM impact (declined scores) and gastrointestinal scores. There was also a significant correlation (r = 0.65; p < 0.01) between “satisfaction with improvement” after introduction of LFDs and “diet adherence”, with satisfaction of the diet achieving 77% among participants. A significant difference was observed between patients who improved as compared to those that did not improve (Chi-square χ2 = 6.16; p < .05), showing that the probability of improvement, depends on the severity of the RFIQ score. Conclusions Implementation of diet therapy involving FODMAP restrictions, in this cohort of FM patients, resulted in a significant reduction in GI disorders and FM symptoms, including pain scores. These results need to be extended in future larger studies on dietary therapy for treatment of FM. Implications According to current scientific knowledge, these are the first relevant results found in an intervention with LFD therapy in FM and must be reproduced looking for a future dietetic approach in FM.