Abstract

Abstract
Depression is a psychiatric disorder and major contributor to the burden of disease worldwide. The strength of evidence of the benefits of exercise as a therapeutic intervention for patients with depression has expanded in the last 30 years. In fact, the available evidence indicates exercise can not only help manage depressive symptoms, but also effect significant improvements in other health outcomes. Clinical guidelines including such recommendations have been issued by different agencies, namely the UK National Institute for Health and Clinical Excellence (NICE), the American Psychiatric Association (APA), and the Royal Australian and New Zealand College of Psychiatrists (RANZCP). With increasing recognition of the benefits of exercise and shortcomings of healthcare systems, other countries, such as Sweden and Canada, have included exercise in their national guidelines for treating depression. Unfortunately, progress in incorporating exercise guidelines into clinical practice has been slow, and Portugal and Brazil reflect this reality. In this update, we reemphasize the importance of bridging this gap and integrating exercise into clinical practice guidelines as an essential component of depression treatment.

Abstract
Background: Suffering in nurses is associated with the delivery of care to patients in suffering and factors related to the working conditions. It is a multidimensional experience that occurs in situations of loss, damage, or threat to human integrity. Objective: To compare the mean scores in the dimensions of suffering (Emotional Pain, Relational Loss, and Avoidance) based on the sociodemographic and professional variables of nurses. Methodology: A descriptive and cross-sectional study with a quantitative approach was conducted with a sample of 100 nurses. A self-administered questionnaire was applied, as well as the Caregiver Grief Scale for assessing suffering. Results: Women with children, with a partner, without specialization in nursing, and with more years of service had higher mean scores of suffering. In men, the highest mean scores were found in nurses without children, without a partner, with specialization in nursing, and with more years of service. Conclusion: Nurses showed higher mean scores of suffering in the dimension of Emotional Pain, followed by Relational Loss, and Avoidance, and suffering was higher among women.

Abstract

Abstract
There is a great deal of information about caregivers’ suffering. However, there is a lack of scales in Portugal that evaluate this dimension of human behavior. The purpose of this study was to validate and adapt the Caregiver Grief Scale (CGS), developed by Franziska Meichsner, Denise Schinköthe, and Gabriele Wilz (2016) for the German population, to assess the degree of suffering of caregivers. To analyze the instrument’s psychometric properties, we used confirmatory factorial analysis with a sample of 150 caregivers (formal and informal). The results did not confirm the proposal of a 4-factor model (emotional pain, relational loss, complete loss, and loss acceptance), as proposed by the German study. Subsequently, we used the exploratory factorial analysis that suggested a unifactorial model, which confirmatory factorial analysis showed was more adequate for the study sample, with values of: ?² / df = 2.023; CFI = .970; GIF = .923; RMSEA = .083; AIC = 110.724. The internal consistency analysis indicated a Cronbach alpha of .936, and the Composite Reliability was .934. In conclusion, the German Caregiver Grief Scale multifactorial structure was not replicated in the Portuguese sample. For the Portuguese population, the caregivers suffering scale presented a unifactorial construct. In Portugal, it is recommended that future studies be carried out with a differentiated sample of caregivers.

Abstract