During the years she worked as a nurse, Esther I. Bernhofer, an associate professor at the Frances Payne Bolton School of Nursing and the School of Medicine at Case Western Reserve University, was struck by the fact that patients and their families They were told “try to rest” in almost any situation: after an operation, when they were in pain, after receiving bad news… “It always seemed strange to me and I wondered what I would do to rest if I were in one of those cases,” he recalls. . Some time later, she experienced it firsthand after undergoing a small outpatient intervention and she asked herself once again what exactly that general recommendation that, of course, was made to her consisted: rest.
He then decided to go to the scientific literature to see how rest was defined. What he found was little concrete research, that there was no consistent definition and that the term was often used synonymously with others such as sleep or relaxation. Out of her review of the literature came a conceptual analysis that she published in 2016 in the
Journal of Advanced Nursing
.
Rest is a concept that we all think we know until we scratch a little deeper. According to the
Dictionary of the Spanish Language
, rest is “to cease work, to repair one's strength with stillness.” The
Pan-Hispanic Dictionary of Medical Terms
, for its part, defines rest as “stillness of the body, generally to recover from fatigue or to promote the healing of an illness.” However, there are also those who know that their way of rest is to go for a walk or, rather than stay still, to stop thinking about something. At a time when many people go to the doctor's office precisely because they feel exhausted, knowing how to clearly define what is meant by rest seems especially important. “If you're going to prescribe rest, you have to be able to define it,” Bernhofer points out.
“It is true that we recommend it, but we do not specify exactly what it is,” reflects Pablo Baz, coordinator of the Neurology Working Group of the Spanish Society of Primary Care Physicians (Semergen), who admits that it is something very personal. “The definition could be to lower the basal level of activity that one has,” he points out, although he adds that they should try to be clearer – something that if they do not do it is due to lack of time – since for each person, situation and pathology that rest It will take one form or another. “Rest is not the same for an athlete as it is for a sedentary person, it is not the same if what you are recovering from is a respiratory infection or gastroenteritis.”
As an example of this need to be a little less lazy when prescribing rest, Aurora Gómez, psychologist at Corio Psicología, mentions a situation that is often found with patients who, due to depression, have sick leave from work. “As they are often told that they have to rest, they often stay still at home. Furthermore, with depression, that is the main symptom: not having energy, not wanting to go out or socialize,” she explains. However, for someone with depression, rest would be behavioral activation, says Gómez, which involves “getting a lot of positive stimuli, things that you like and that fit with your values. Walking, playing sports, eating food you like, being with the people you love...
The psychologist also reflects on all those concepts that “they are family, they are cousins”, but they are not the same: “rest is not the same as sleep, rest is not the same as vacations, rest is not the same as leisure. There may be breaks that include that, but they don't have to.”
Rest is also mental
In a small study conducted in Sweden in 2015, 63 people were asked about their sleep experiences. What does rest mean to you? How do you rest? Tell me about a specific rest experience. With the answers, the author, Margareta Asp, professor of Health, Care and Social Welfare at the University of Mälardalen, drew a series of conclusions: rest occurs within a cycle in which the other element is non-rest, rest It means forgetting responsibilities temporarily, rest is feeling that you are accepted without judging you, rest is peace and calm, rest is perceiving pleasant sensations.
The largest survey on the subject was carried out by Hubbub, a group of researchers in different areas during a residency at The Wellcome Foundation, in collaboration with a BBC programme. More than 18,000 people from 134 countries took a long half hour to answer
The Rest Test
questions . Among the preliminary results, concepts with which they associated rest (some obvious, such as
pleasant, positive
or
necessary
; others alarming, more frequent among women, such as
difficult
or
guilty
) and a ranking of activities that relate to rest. At number 1 on that list, above sleeping (which is number 2) is reading. Also in the top 10 are observing or being in a natural environment, spending time alone, listening to music or doing nothing in particular, among others.
A pattern that is repeated when asking a person what rest means to them is to refer more to mental rest than to physical rest. The title of a qualitative study carried out in 2009 by Carmen De La Cuesta-Benjumea, from the Department of Health Psychology at the University of Alicante, on how 19 caregivers of family members with dementia perceived rest is quite clear in this regard:
“Being calm ”: the experience of rest for caregivers of patients with advanced dementia
. It's not so much that they relieve you for a few hours, but also that you can stop thinking or worrying, even if it's just for a few minutes.
Esther I. Bernhofer, the author of the review on the concept of rest, reflects on how complicated it is to achieve this mental rest. “If they tell you not to think about something, you will do it. The best way to achieve this is to immerse yourself in fiction. It is interesting and you wonder what is going to happen, but they are not your problems and it is not your responsibility to solve them,” she points out, helping to understand why reading was placed at number 1 in The
Rest Test
survey .
Let it be beneficial, let it be deliberate
Although the definitions of rest vary greatly, all those interviewed are clear that it is necessary, both when recovering from an illness and as a preventive measure. He who is healthy and does not rest will end up getting sick. They also agree that it is difficult. “A mother with three children, for example, if she is alone, how does she rest? There are situations where the person will not be able to apply it. And it would be convenient, the process will probably get worse or longer and have more complications,” reflects Pablo Baz, from Semergen.
Beyond the burdens of each person, the culture of productivity itself makes it difficult to take those breaks that work as preventive medicine. “I have clients who, due to their schedule and how they feel, could take a nap and feel better, but they don't accept the idea because what will people say?” explains psychologist Aurora Gómez. “In addition, sometimes it even seems that rest has to conform to aesthetic patterns, to everything about self-care that you see on social networks. As if your thick housecoat didn't matter, just a cute kimono. It is something that must be dismantled in consultation to be able to discover the best way to rest for each person,” she points out.
This discovery process is important so as not to equate rest with lying on the couch and scrolling non-stop on social networks. “If it's just for a while and then you go out for a walk or watch a movie or go down to talk to the neighbor... I think that many of us are understanding inactivity and a sedentary lifestyle as resting. When we are exhausted, when our mental load is excessive, we simply remain motionless. That cannot be resting, because it is not healthy. And because you haven't chosen it, it's just that it's the only thing you're capable of doing,” says Gómez, who insists that choice is a key part of rest. The contrast is also important: if the work is physical, rest will imply stillness; In a sedentary teleworking, going for a walk is a good option.
In her conceptual analysis, Esther I. Bernhofer ended up giving a proposed definition: rest is “a human need, a beneficial state that is deliberate, temporary and restorative” that implies “the cessation, minimization or change” from a series of situations. These antecedents are “physical, mental or spiritual work, fatigue, trauma, illness or stress.” Including them in the definition, she explains in the article, helps rest not to be understood as laziness or laziness, but more as a necessary response that will try to recover the body or mind from the effects of that situation that precedes it.
That it is beneficial is also key. The moment it becomes a problem (spending hours on the couch when, to recover from surgery, you have been recommended to move every so often, for example), it is no longer rest, indicates the researcher, who is working on the development of a broader theory about the concept.
What is the result when you finally get to rest? “I think you feel renewed, that you can start again. Which doesn't mean you won't have to rest again in a few hours,” says Bernhofer. Psychologist Aurora Gómez offers her own interpretation of waking up having rested. “I understand what it means to wake up not tired, without pain and with cognitive alertness. And with the desire to do things.”