The results indicate that the concept of quality of life is subjective, tied to personal values and influenced by the repercussions of the health-disease process. In addition, they can guide actions based on interdisciplinary assistance aimed at the real needs of these patients.

Objectives:to compare the quality of life and religious-spiritual coping of palliative cancer care patients with a group of healthy participants; assess whether the perceived quality of life is associated with the religious-spiritual coping strategies; identify the clinical and sociodemographic variables related to quality of life and religious-spiritual coping. Method:cross-sectional study involving 96 palliative outpatient care patient at a public hospital in the interior of the state of São Paulo and 96 healthy volunteers, using a sociodemographic questionnaire, the McGill Quality of Life Questionnaire and the Brief Religious-Spiritual Coping scale. Results:192 participants were interviewed who presented good quality of life and high use of Religious-Spiritual Coping. Greater use of negative Religious-Spiritual Coping was found in Group A, as well as lesser physical and psychological wellbeing and quality of life. An association was observed between quality of life scores and Religious-Spiritual Coping (p<0.01) in both groups. Male sex, Catholic religion and the Brief Religious-Spiritual Coping score independently influenced the quality of life scores (p<0.01). Conclusion:both groups presented high quality of life and Religious-Spiritual Coping scores. Male participants who were active Catholics with higher Religious-Spiritual Coping scores presented a better perceived quality of life, suggesting that this coping strategy can be stimulated in palliative care patients.

This study's aim was to identify the main difficulties faced by caregivers of patients receiving comfort care at home and how they perceive the support provided by the Family Health Strategy. Qualitative research involving 50 caregivers providing comfort care to patients cared for by the Family Health Strategy in a city in the State of São Paulo, Brazil. The interviews were transcribed and analyzed using the Collective Subject Discourse methodological strategy. The results show that countless difficulties are experienced, which are linked to a lack of support, of equipment and financial resources and a lack of preparation to deal with death in the context of terminal illness. The program actions are limited and sporadic. The difficulties caregivers experience reflect unpreparedness combined with social and economic instability experienced in the home context. Additionally, caregivers are confronted with restricted and discontinued care provided by the program. DESCRIPTORS:Family health program. Palliative care. Primary health care. Caregivers. DIFICULDADES DE CUIDADORES DE PACIENTES EM CUIDADOSPALIATIVOS NA ESTRATÉGIA DA SAÚDE DA FAMÍLIA RESUMO: Objetivou-se desvelar as principais dificuldades enfrentadas pelos cuidadores de pacientes em cuidados paliativos no domicílio e compreender a percepção dos mesmos em relação ao suporte oferecido pela Estratégia da Saúde da Família. Pesquisa qualitativa realizado com 50 cuidadores de pacientes em cuidados paliativos, atendidos pela Estratégia da Saúde da Família em município do interior de São Paulo. As entrevistas foram transcritas e analisadas utilizando-se a estratégia metodológica do Discurso do Sujeito Coletivo. As dificuldades vivenciadas pelos cuidadores são inúmeras e atreladas à falta de rede de apoio, de recursos humanos, materiais, financeiros e ao despreparo para lidar com a morte no contexto da terminalidade. As ações desenvolvidas pela Estratégia da Saúde da Família são limitadas e pontuais. As dificuldades sentidas pelos cuidadores refletem o despreparo pessoal aliado à precariedade social e econômica vivenciadas no contexto domiciliar. Além disso, defrontam-se com a atenção restrita e descontinuada prestada pelo programa. DESCRITORES:Programa saúde da família. Cuidados paliativos. Atenção primária à saúde. Cuidadores. DIFICULTADES DE CUIDADORES DE PACIENTES EN CUIDADOS PALIATIVOS EN LA ESTRATEGIA DE SALUD DE LA FAMILIARESUMEN: Se intentó desvelar las principales dificultades enfrentadas por los cuidadores de pacientes en cuidados paliativos en domicilio y comprender su percepción del soporte ofrecido por la Estrategia de Salud de la Familia. Investigación cualitativa con 50 cuidadores de pacientes en cuidados paliativos, atendidos por la Estrategia de Salud de la Familia en un municipio del interior de São Paulo. Las entrevistas fueron transcritas y analizadas mediante la estrategia del Discurso del Sujeto Colectivo. Las dificultades vividas son innúmeras y vinculadas a la falta de red de apoyo, de recursos humanos, materiales, financieros y de ...

Fatores de risco para lesão renal aguda em pacientes clínicos intensivosRisk factors for acute renal injury in intensive clinical patients Factores de riesgo para lesión renal aguda en pacientes clínicos intensivos Cariston Rodrigo Benichel https://orcid.org/0000-0003-2781-0292 1 Silmara Meneguin https://orcid.org/0000-0003-3853-5134 1 ¹Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brasil.Confl itos de interesse: nada a declarar. ResumoObjetivo: Identifi car prevalência e fatores associados à lesão renal aguda em pacientes clínicos intensivos, e compará-los com um grupo controle; analisar se a coexistência de fatores constitui preditor de risco para o desenvolvimento de lesão renal aguda.Métodos: Estudo caso-controle, com abordagem quantitativa, realizado em unidade de terapia intensiva geral adulto do interior de São Paulo, Brasil, com 205 pacientes que desenvolveram lesão renal aguda e o mesmo número de controles, durante os anos de 201 4 e 2015. Coleta de dados realizada mediante levantamento dos registros de prontuário. Relações foram estatisticamente signifi cativas se p<0,05.Resultados: A prevalência de lesão renal aguda foi de 7,5% e os principais fatores associados foram: hipertensão arterial (p=0,004; OR=1,9615; IC=1,0491-3,6645); hipovolemia (p=0,006; OR=5,6071; IC=1,6382-19,1854); insufi ciência cardíaca (p=0,003; OR=5,3123; IC=1,7521-16,1051); noradrenalina (p<0,0001; OR=9,4913; IC=4,4824-20,0981); dopamina (p=0,0009; OR=3,5212; IC=1,6701-7,4242); dobutamina (p=0,0131; OR=5,2612; IC=1,4172-19,5323); e antibióticos simultâneos (p<0,0001; OR=3,7881; IC=2,0253-7,0884). A coexistência de mais de três fatores de risco foi estatisticamente signifi cante para lesão renal aguda (p<0,0001; OR=5,0074; IC=2,5601-9,7936).Conclusão: A lesão renal aguda é um evento multifatorial que se associou à doença de base, às complicações decorrentes da gravidade dos participantes e à utilização de medicamentos nefrotóxicos. Ter três ou mais fatores de risco aumentou as chances para o desenvolvimento da doença. AbstractObjective: Identify the prevalence and associated factors of acute renal injury in intensive clinical patients and compare them with a control group; analyze if the coexistence of factors serves as a predictor for the risk of developing acute renal injury.Method: Case-control study with a quantitative approach, developed at a general adult intensive care unity in the interior of São Paulo, Brazil, involving 205 patients who developed acute renal injury and the same number of controls, during 2014 and 2015. Data were collected through a survey of patient fi le records. Relationships were statistically signifi cant if p<0.05.Results: The prevalence of acute renal injury was 7.5% and the main associated factors were: arterial hypertension (p=0.004;Fatores de risco para lesão renal aguda em pacientes clínicos intensivos 7.0884). The coexistence of more than three risk factors was statistically significant for acute renal injury (p<0.0001; OR=5.0074; CI=2....

Background Psoriasis is a multifactorial inflammatory disease prevalent in dermatology. We aimed to understand the perceptions of patients living with psoriasis in relation to their quality of life and to identify aspects to improve it. Methods This is qualitative research carried out in a dermatology outpatient clinic of the São Paulo State University (UNESP) medical school, Botucatu, Brazil, with 81 psoriasis patients. The interviews were transcribed and analysed using the Discourse of the Collective Subject method (DCS). Results Quality of life was linked to well-being, happiness, leisure, good food and financial stability. However, disease symptoms, social and clothing restrictions, impairment of professional activities and the absence of a cure, negatively influenced their perceptions. Suggestions for improvements included an increase of public awareness, stress reduction, disease acceptance and multidisciplinary care. Conclusion The meanings of quality of life revealed by the participants are subjective, multidimensional, linked to moments experienced by them and to the health-disease process. Public health policies promoting reduction in social stigma and stress as well as multidisciplinary approaches towards care can contribute to improvements of QoL in psoriasis.