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To synthesise qualitative literature on (1) the perceptions of patients with cancer of participating in an exercise intervention while undergoing chemotherapy and (2) to inform and guide professionals in oncology and haematology practice.
A qualitative meta-synthesis based on Noblit and Hare’s seven-step meta-ethnography.
Six electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, EMBASE, PubMed, SCI-Expanded—SSCI and Scopus (final search June 2022) were used to identify qualitative literature containing individual or focus group interviews. The transparency of reporting for each study was assessed using the Consolidated criteria for Reporting Qualitative research checklist.
The search identified 5002 articles, 107 of which were selected for full-text review. Seventeen articles from five countries with patients undergoing chemotherapy during exercise interventions were included. Eleven articles were included in the meta-synthesis, which comprised 193 patients with various cancer diagnoses, disease stages, sexes and ages. Four main themes were identified: chemotherapy overpowers the body; exercise in battle with side effects; a break from gloomy thoughts; and a question of survivorship.
The meta-synthesis emphasised that patients with cancer undergoing chemotherapy and simultaneously participating in exercise interventions may experience momentary relief from overwhelming side effects, even though full bodily recovery may be perceived as a distant prospect. The synthesis offers a sparse empirical basis for gaining insight into what patients experience existentially following exercise interventions. It is up to patients to independently apply the transfer value of exercise to their own existential circumstances.
Introducción: El asma, enfermedad crónica infantil más frecuente, está aumentando probablemente en relación a la exposición a factores ambientales. Estos están asociados a la aparición de asma y como desencadenante de síntomas. La literatura al respecto es controvertida. El objetivo de este trabajo es comprobar la posible influencia de la exposición a animales y/o humo de tabaco en el domicilio sobre el grado de control de la enfermedad y el número de exacerbaciones en población pediátrica asmática. Metodología: Estudio observacional realizado en población pediátrica que acudía a consulta de Neumología Pediátrica del hospital de referencia diagnosticados de asma y que tuviera pautado tratamiento inhalado. Como variable dependiente se consideró el número de exacerbaciones y como variables independientes se incluyeron sociodemográficas, variables asociadas a factores ambientales, así como a la técnica de inhalación. Resultados: Participaron 204 familias (66,7% niños). El 70,6% no tenían animales y el 78% no eran fumadores. La media de las exacerbaciones durante el periodo a estudio fue de 1,62. Un 84,8% de los/las pacientes presentan un buen control de la enfermedad. Discusión: Se encuentra relación entre el tener o no animales en casa y/o estar expuestos al tabaco y el grado de control de la enfermedad y número de exacerbaciones, confirmando lo descrito por varios autores. Es importante realizar una intervención individual donde se evalúen los factores que afectan a niños asmáticos y tratar los que sean modificables: manejo guiado de síntomas y tratamiento de exacerbaciones, consejo antitabaco, fomento actividad física… para mejorar su calidad de vida.
ABSTRACT
Introduction: Asthma, the most common chronic disease in childhood, is probably increasing in relation to exposure to environmental factors. These are associated with the onset of asthma and as a trigger for symptoms. The evidence on this is controversial. The objective of this study is to verify the possible influence of exposure to animals and/or tobacco smoke at home on the degree of control of the disease and the number of exacerbations in the paediatric asthmatic population. Methodology: Observational study carried out in a paediatric population that were attended at the paediatric pulmonology consultation of the reference hospital diagnosed with asthma and who had scheduled inhaled treatment. The number of exacerbations was considered as a dependent variable, and sociodemographic variables, variables associated with environmental factors, as well as the inhalation technique were included as independent variables. Results: 204 families participated (66,7% boys). 70,6% did no have animals and 78% were not smokers. The mean number of exacerbations during the study period was 1,62. 84,4% of the patients have good control of the disease. Discussion: A relationship was found between having or not having animals at home and/or being exposed to tobacco smoke and the degree of control of the disease and the number of exacerbations, confirming what has been described by several authors. It is important to carry out an individual intervention where the factors that affect asthmatic children are evaluated and treat those that are modifiable: guided management of symptoms and treatment of exacerbations, anti-smoking advice, physical activity promotion … to improve their quality of life.
Objetivo principal: Evaluar si el uso de catéter venoso central (CVC) impregnado en antimicrobiano es útil para la reducción de la bacteriemia relacionada con el catéter en pacientes ingresados en la Unidad de Cuidados Intensivos (UCI), e identificar el antimicrobiano más efectivo. Metodología: Se realizó una revisión sistemática en Bases Datos (CINAHL, PUBMED, CUIDEN, EMBASE, LILACS y SCIELO). Incluidos artículos de 2009 a 2017, inglés y español, que fuesen ensayos clínicos aleatorizados e incluyeran pacientes de UCI con CVC impregnado comparado con CVC convencional. Se evaluó la calidad metodológica de los artículos mediante la herramienta CASPE. Resultados principales: De los 8 estudios, 4 mostraron significancia en cuanto al uso de CVC impregnados para la reducción de infecciones relacionadas con el catéter. Dentro de los antimicrobianos usados, la minociclina-rifampicina muestra la mayor efectividad. Conclusión principal: El uso de CVC impregnado, puede ser efectivo en la reducción de infecciones en UCI. Dentro de las limitaciones de este tipo de catéter, a mayor número de luces y tiempo de mantenimiento de CVC, menor efectividad antimicrobiana.
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