Care to mastectomy with axillary lymphadenectomy, lymphedema prevention: An integrative review

Objective: to examine the care provided to women affected by breast cancer and who has performed axillary lymphadenectomy. Method: integrative review conducted in the databases LILACS and PubMed between 2000 and 2012, leaving the question << What care is provided to prevent lymphedema in women who underwent lymphadenectomy? >> Resulting in 18 articles, analyzed under the following variables: author, title, methodology, year, journal, goal, prevention and control of lymphedema therapies and adherence to rehabilitation. Results: three categories are identified for rehabilitation of patient: prevention and control, therapies and adherence. Conclusion: preoperative is poorly addressed by; emphasizes the importance of home visits as part of rehabilitation, which is effective with the accession of the patient who needs information for its follow-up, no need for a guideline for this type treatment.

Interferences and interventions after acute myocardial infarction: an integrative review of the literature

Objective: to identify the interference of acute myocardial infarction (AMI) in the quality of life of affected, interventions and understanding by health professionals. Method: an integrative review, aiming to answer << What are the interference in the quality of life of post-AMI customers? >> and << What are the interventions proposed in order to minimize them? >>. We selected 12 articles available in the LILACS database, between 2000 and 2011, based on the criteria of inclusion and exclusion. Results: we have selected a total of 12 articles selected according to the inclusion and exclusion criteria pre-established. We obtained a classification into two themes (1) interference with quality of life and (2) proposals for interventions to minimize interference. Conclusions: highlights the importance of patient involvement in care plan well structured, multidisciplinary team integration and quantity of publications by heterogeneous country on the subject.

Integrative aspects of the relationship between stress and heart rate variability

The literature indicates stress as a response of the organism to a stimulation that requires enormous efforts to adapt to the changes in the environment and the body. When an individual is subjected to stress, the autonomic nervous system is triggered, the sympathetic pathway is activated, and the parasympathetic system is suppressed, which exerts several effects on the cardiovascular system and affects heart rate variability. This research aimed to conduct a literature review to find and analyze the studies that address clearly the implications of stress on heart rate variability. The methodology employed was an active search in the databases SciELO, PubMed and Lilacs. The results were five articles, most of which suggest a relationship between stress and heart rate variability. We observed that the majority of the studies indicated a strong association between stress and cardiac autonomic activity. The stress is present in the daily activities of the population, especially in labor. The subject is vast, however, were observed in the references the effects of stress on the body making it vulnerable to diseases. Thus, this information may contribute to the aid of preventive strategies against stress and diseases of the cardiovascular system.

Importance of physical therapy in the family health strategy: integrative review

Objective: to analyze the importance of physical therapy in the Family Health Strategy (FHS). Methodology: integrative literature review, guided by the research question << What is the importance of physical therapy in the FHS? >>. The survey was conducted in the Virtual Health Library and in the website Google Scholar in November and December 2012. The inclusion criteria were: fully available scientific study, published between 2007 and 2012, with free access, and having at least one of the DeCS selected in the title. Results: we found out that the importance of physical therapist’s action at the FHS has been recognized both by professionals included in the teams and users of health care units, showing that, by means of the physical therapist’s preventive and clinical action, the costs and demands in the tertiary care can be reduced. Conclusion: the population and the professionals recognize the physical therapist’s positive impact on the FHS.

Does the gastroprotective action of a medicinal plant ensure healing effects? An integrative study of the biological effects of Serjania marginata Casar. (Sapindaceae) in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mastectomy and Sexuality: An Integrative Review

Women affected by breast cancer are faced with the removal of a body part related to sexuality. This study aimed to investigate the impact of breast cancer and mastectomy in women's sexuality through the analysis of scientific literature published from 2000 to 2009. The bibliographic survey was carried out in LILACS, MedLine and PsycINFO databases. Twenty nine articles were selected to constitute the corpus of the analysis. The findings were grouped by means of content analysis. The results showed that after the removal of the breast, sexual performance is compromised, with reduced frequency of sexual intercourse in the early stages of treatment and low sexual desire, interest and satisfaction.

Nursing care practices at an outpatient care center from an integrative perspective

Aim: to analyze nursing care practices at a Specialized Outpatient Care Center from the perspective of an integrative health care activity. Method: Interviews with 24 nursing professionals were undertaken. For data analysis, Thematic Content Analysis as proposed by Bardin was applied, resulting in the following themes: the team size and its commitment to health care; professional practices and activity of the nursing team. Results: The size of the nursing team was considered insufficient, which compromises the quality of care and results in work overload and dissatisfaction of the nursing professionals. On the other hand, they were satisfied with the tasks performed day-to-day and related integrality to individual care, considered it essential and usually practiced it daily. Conclusion: It is considered that the nursing team has the potential and commitment to develop their care practice combined with the integrative perspective, and therefore providing quality health care to the population.

Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability

Abstract Background Tobacco and cannabis use are strongly interrelated, but current national and international cessation programs typically focus on one substance, and address the other substance either only marginally or not at all. This study aimed to identify the demand for, and describe the development and content of, the first integrative group cessation program for co-smokers of cigarettes and cannabis. Methods First, a preliminary study using expert interviews, user focus groups with (ex-)smokers, and an online survey was conducted to investigate the demand for, and potential content of, an integrative smoking cessation program (ISCP) for tobacco and cannabis co-smokers. This study revealed that both experts and co-smokers considered an ISCP to be useful but expected only modest levels of readiness for participation.Based on the findings of the preliminary study, an interdisciplinary expert team developed a course concept and a recruitment strategy. The developed group cessation program is based on current treatment techniques (such as motivational interviewing, cognitive behavioural therapy, and self-control training) and structured into six course sessions.The program was evaluated regarding its acceptability among participants and course instructors. Results Both the participants and course instructors evaluated the course positively. Participants and instructors especially appreciated the group discussions and the modules that were aimed at developing personal strategies that could be applied during simultaneous cessation of tobacco and cannabis, such as dealing with craving, withdrawal, and high-risk situations. Conclusions There is a clear demand for a double cessation program for co-users of cigarettes and cannabis, and the first group cessation program tailored for these users has been developed and evaluated for acceptability. In the near future, the feasibility of the program will be evaluated. Trial registration Current Controlled Trials ISRCTN15248397

Spiritual dimension of children and adolescents with cancer: an integrative review

OBJECTIVE: To review scientific literature relating to the spiritual dimension of children and adolescents with cancer. METHODS: We conducted an integrative literature review in the LILACS, SciELO, PsycINFO and MEDLINE databases in the period between 1990 to 2011. RESULTS: Twenty-one studies were analyzed and grouped into thematic categories: quality of life and elements of spirituality; alternative and complementary therapies: spirituality as a therapeutic resource; spirituality as a coping strategy and spirituality as an attribute of existential transformations. It was found that spirituality is present at different stages of the disease experience and that its forms of expression may vary, according to age and cognitive development. CONCLUSION: There is a scarcity of specific scales for this age range and a need for scientific production relating to the spiritual dimension of children and adolescents with cancer. Descriptors: Neoplasms; Children; Adolescents; Spirituality

Professional competences of nurse to work in Intensive Care Units: an integrative review

This study aimed to identify and analyze nurses' competences to work at Intensive Care Units-ICU. An integrative review method was used, and data were collected in LILACS, SciELO and BDENF, from August to October 2010. Ten articles were identified, published in the last 12 years. Data grouping permitted the construction of thematic units related to nurses' competences: nursing care management, high-complexity nursing care delivery, decision making, leadership, communication, continuing/permanent education, human resource management, material resource management. The professional competences identified can support the outline of guidelines to constitute the profile of nursing working in intensive care units and drive/mobilize the improvement of nursing care practices.

Evaluation of quality of life in a palliative care context: an integrative literature review

The use of scales that have been validated and standardized for different cultures is very useful for identifying demands in the field of Palliative Care and implementing the most appropriate care. This integrative literature review focuses on instruments assessing the Quality of Life of patients under Palliative Care through a journal search in electronic databases. The study consisted of 49 papers identified in Medline/PubMed, of which 18 met the inclusion criteria previously defined. Information concerning the selected studies is presented and later categorized, with a greater emphasis on the analysis of the psychometric properties of validations of the Palliative Outcome Scale, conducted in three countries. This review enabled the identification of instruments already developed and validated for different cultures, increasing the possibility of knowledge in the field.

Perioperative latex hypersensitivity reactions: an integrative literature review

This article characterizes hypersensitivity reactions during anesthetic-surgical procedures. This integrative literature review was conducted in the LILACS, CINAHL, COCHRANE and MEDLINE databases including papers published from 1966 to September 2011. A total of 17 case reports, two prevalence studies and one cohort study were identified. Latex reactions were mainly type III and the primary source of intraoperative reaction was latex gloves. The average time for clinical manifestation was 59.8 minutes after anesthetic induction; 44.4% of patients reported a reaction to latex at the pre-anesthetic evaluation. It was determined that the history of allergic reactions to latex obtained in the pre-anesthetic evaluation does not ensure the safety of patients if the staff is inattentive to the severity of the issue. There is also a tendency to initially attribute the anaphylactic event to the anesthetic drugs.

Integrative Musterbildung kranialer Strukturen

Form und Gestalt kraniofazialer Strukturen sind primär beeinflusst durch die inhärente Integration der unterschiedlichsten Funktionssysteme und externer selektiver Einflüsse. Die Variabilität der Schädel-Morphe ist ein Indikator für solche Einflussfaktoren und damit ein idealer Gegenstand für vergleichende Analysen morphogenetischer Formbildung. Zur Ermittlung morphologisch-adaptiver Trends und Muster wurden sowohl Hypothesen zur morphologischen Differenziertheit als auch zu Korrelationen zwischen modularen Schädelkompartimenten (fazial, neurokranial, basikranial) untersucht. Zusätzlich wurden aus Schichtröntgenaufnahmen (CT) virtuelle Modelle rekonstruiert, welche die Interpretation der statistischen Befunde unterstützen sollten. Zur Berechnung der Gestaltunterschiede wurden mittels eines mechanischen Gelenkarm-Messgerätes (MicroScribe-G2) max. 85 ektokraniale Messpunkte (Landmarks) bzw. dreidimensionale Koordinaten an ca. 520 Schädeln von fünf rezenten Gattungen der Überfamilie Hominoidea (Hylobates, Pongo, Gorilla, Pan und Homo) akquiriert. Aus dem Datensatz wurden geometrische Störfaktoren (Größe, Translation, Rotation) mathematisch eliminiert und die verbleibenden Residuale bzw. ‚Gestalt-Variablen‘ diversen multivariat-statistischen Verfahren unterzogen (Faktoren, Cluster-, Regressions- und Korrelationsanalysen sowie statistische Tests). Die angewandten Methoden erhalten die geometrische Information der Untersuchungsobjekte über alle Analyseschritte hinweg und werden unter der Bezeichnung „Geometric Morphometrics (GMM)“ als aktueller Ansatz der Morphometrie zusammengefasst. Für die unterschiedlichen Fragestellungen wurden spezifische Datensätze generiert. Es konnten diverse morphologische Trends und adaptive Muster mit Hilfe der Synthese statistischer Methoden und computer-basierter Rekonstruktionen aus den generierten Datensätzen ermittelt werden. Außerdem war es möglich, präzise zu rekonstruieren, welche kranialen Strukturen innerhalb der Stichprobe miteinander wechselwirken, einzigartige Variabilitäten repräsentieren oder eher homogen gestaltet sind. Die vorliegenden Befunde lassen erkennen, dass Fazial- und Neurokranium am stärksten miteinander korrelieren, während das Basikranium geringe Abhängigkeiten in Bezug auf Gesichts- oder Hirnschädelveränderungen zeigte. Das Basikranium erweist sich zudem bei den nicht-menschlichen Hominoidea und über alle Analysen hinweg als konservative und evolutiv-persistente Struktur mit dem geringsten Veränderungs-Potential. Juvenile Individuen zeigen eine hohe Affinität zueinander und zu Formen mit einem kleinem Gesichts- und großem Hirnschädel. Während das Kranium des rezenten Menschen primär von Enkephalisation und fazialer Retraktion (Orthognathisierung) dominiert ist und somit eine einzigartige Gestalt aufweist, zeigt sich der Kauapparat als maßgeblich formbildendes Kompartiment bei den nicht-menschlichen Formen. Die Verbindung von GMM mit den interaktiven Möglichkeiten computergenerierter Modelle erwies sich als valides Werkzeug zur Erfassung der aufgeworfenen Fragestellungen. Die Interpretation der Befunde ist durch massive Interkorrelationen der untersuchten Strukturen und der statistisch-mathematischen Prozeduren als hoch komplex zu kennzeichnen. Die Studie präsentiert einen innovativen Ansatz der modernen Morphometrie, welcher für zukünftige Untersuchungen im Bereich der kraniofazialen Gestaltanalyse ausgebaut werden könnte. Dabei verspricht die Verknüpfung mit ‚klassischen’ und modernen Zugängen (z. B. Molekularbiologie) gesteigerte Erkenntnismöglichkeiten für künftige morphometrische Fragestellungen.