Chirveches Pérez E, Roca Closa J, Puigoriol Juvanteny E
… +3 more, Úbeda-Bonet I, Subirana Casacuberta M, Moreno Casbas MT
Rev Enferm
· 2017 Apr · PMID 30278119
OBJECTIVES: To analyze the correlation between the state of health, knowledge, and social support of surgical patients' caregivers at home, with the intensity of nursing care and its consequences. METHODS: A longitudinal...OBJECTIVES: To analyze the correlation between the state of health, knowledge, and social support of surgical patients' caregivers at home, with the intensity of nursing care and its consequences. METHODS: A longitudinal observational study with follow-up at admission, discharge and 10 days following discharge at home, held in the surgical hospitalization unit at the Vic University Hospital, (Barcelona). A non-randomized and consecutive sample of 317 informal caregivers of surgical patients with abdominal surgery was included in the study. The characteristics of caregivers were studied using the Nursing Outcomes Classification indicators. The intensity of nursing care, consequences and impact on patient quality of life was evaluated through the validated ICUB97-R questionnaire. RESULTS: Most of the caregivers were women, with an average age of 52,9 ± 13,7years, with no previous experience as caregivers. The greatest intensity of care and impact was observed on caregivers who attended dependent and/or cancer diagnosed patients at home, dedicating the largest time to provide care (p < 0,005). Predictor variables for the occurrence of consequences during convalescence at home were emotional health satisfaction, routine activity disruption, fear, sleep pattern and being a dependent patient. CONCLUSIONS: Emotional health satisfaction, routine activity disruption, fear, sleep pattern and being a dependent patient before surgery are strong predictive variables for the occurrence of consequences on caregivers during convalescence at home. There is a significant negative correlation between punctuations in the ICUB97-R questionnaire and the Nursing Outcomes Classification indicators.
In the last decade we have witnessed a significant legislative transformation with regard to the death and dignity process, and respect the decision of the people in this framework. In that way, different legislation at...In the last decade we have witnessed a significant legislative transformation with regard to the death and dignity process, and respect the decision of the people in this framework. In that way, different legislation at regional level in our country have been articulated to ensure the right of patients to produce documents of advanced directives or living will. This fact has highlighted the need not only to legal regulation, but a deep change in the pattern of relationship between health professional and patient. Advance planning of healthcare (PAAS) represents an important step in respect for patient autonomy and the desire to involve the person in the decision making process, in matters relating to his own death. This process is developed in order to find solutions to ensure the autonomy and freedom of those who, from a given moment, have lost the ability to make decisions. In this model of care, the role of nursing is not only necessary but essential.
Burguete Ramos MD, Sáez Álvarez EJ, Giménez Ledo A
… +1 more, Martínez Riera JR
Rev Enferm
· 2017 Apr · PMID 30277709
INTRODUCTION: Aiming at detecting possible causes for the lack of male nursing professionals, Bartfay et al. developed a questionnaire named Attitudes Towards Men in Nursing Scale (ATMINS), which they tested a university...INTRODUCTION: Aiming at detecting possible causes for the lack of male nursing professionals, Bartfay et al. developed a questionnaire named Attitudes Towards Men in Nursing Scale (ATMINS), which they tested a university in Ontario, Canada. OBJECTIVE: Achieve a cross-cultural adaptation and validation of the Attitudes Towards Men in Nursing Scale (ATMINS), in order to evaluate if results achieved using a Spanish sample are comparable with the Canadian study's results. PARTICIPANTSM, MATERIALS, AND METHOD: Participants were recruited in universities of Alicante and Donostia (Basque Country). To assure voluntary participation in the study, all candidates were informed about the objective of the study and giving enough time to read the questionnaire. The questionnaire used was the Attitudes Toward Men in Nursing Scale (ATMINS), translated to Spanish. The Spanish version of the ARMINS scale was handed over to a total of 142 students from the Nursing Universities of Alicante and Donostia. Time needed to fill the questionnaires didn't exceed 5 minutes in any case, and no difficulty was observed during implementation. After testing the scale, an internal consistency analysis was performed using Cronbach's Alpha with correction by eliminating items. Validation of construct was done via Exploratory Factorial analysis with Varimax rotation. RESULTS: The results show a reliability which does not reach a moderate degree. Eliminating item 6 in all subsamples, as well as the total sample suppressing any of the other 5 items, increases internal consistency. The exploratory factorial analysis supports a bi-factorial structure of the questionnaire with very high saturation on each factor and a negative charge inside factor 2 for item 6. The negative charge of item 6 keeps the saturation (0.717) after its inversion. By performing an internal consistency analysis taking only into account items of factor 1, the scale's consistency improves with results close to 0.70. CONCLUSION: The revised scale is a tool which enables easy and fast application. It is valid for the Spanish sample and provides an acceptable internal consistency. The results obtained in both universities in Spain and in Canada are comparable.
SUMMARY: Given the type of pathology and age of patients in the inpatient unit of Neurology, Hospital de Cabueñes (Gijon), acute confusional syndrome (ACS) is very common in this service. OBJECTIVE: To determine the infl...SUMMARY: Given the type of pathology and age of patients in the inpatient unit of Neurology, Hospital de Cabueñes (Gijon), acute confusional syndrome (ACS) is very common in this service. OBJECTIVE: To determine the influence of the family, within the limits of the hospital, in patients with neurological disease suffering from SCA. METHODOLOGY: A prospective, observational, descriptive study of 53 patients with neurological disease that suffered from SCA was performed. The study variables were: disorientation, agitation, medication, effectiveness, and body grip on each shift with and without family. All those patients suffering from any dementia or psychiatric problem before entering were discarded. RESULTS: The mean age of the patients was 83 years old. The most common pathology was ICTUS. The patients with family were 47.4% versus 52.6% without family in three shifts. 70.3% of the patients became disoriented with family; for patients without family the percentage increased up to 83.8%. As far as nervousness is concerned, 11.4% of the patients with family experienced this behaviour in the three shifts; no-family patients suffering from nervousness were 29.4%. Medication was administered to 33% of the patients with family, and to 44% of no-family patients. The effectiveness was 66.5% for patients with family and 48% for no-family patients. The use of body grip in the three shifts was 7.6% for patients with family and 64.5% for no-family patients. CONCLUSIONS: Family has a beneficial effect on neurological patients with ACS, specially by reducing the use of mechanical restraint, helping to preserve the dignity of elderly patients in an adverse environment such as a hospital.
García Hernández MN, García Moreno V, Mahtani Chugani V
… +1 more, García Andrés MC
Rev Enferm
· 2017 Apr · PMID 30277706
OBJECTIVE: To design an instrument to measure impairment of skin integrity in the diaper area of infants and severity of injury for the prevention and management of irritative diaper dermatitis. METHODOLOGY: Design in 3...OBJECTIVE: To design an instrument to measure impairment of skin integrity in the diaper area of infants and severity of injury for the prevention and management of irritative diaper dermatitis. METHODOLOGY: Design in 3 phases: 1) comprehensive review and critical appraisal of literature to design the preliminary content of the instrument; 2) critical evaluation of initial proposal by an expert group (nursing and pediatric medicine) with opinion survey and ad hoc questions; 3) content analysis using data tabulation for the modification and final design of the instrument. SETTING: Primary Care Management of Tenerife. RESULTS: In the 1st phase a proposed instrument is designed: two groups of risk factors (10 modulators risk and 9 high risk); and a severity scale with 5 aspects to assess including 4-5 items each (depth, location, extension, type of injury, signs of infection). The 2nd phase involved 19 professionals. A Tabulation of the data grouped into add or omit factors was used. The 3rd phase ends with a modified version of the instrument: 10 modulating factors, 5 of hig risk and 4 items for each aspect to assess severity. DISCUSSION-CONCLUSIONS: The scarce bibliography found and absence of similar tools explain the design. The next phase will be the validation of RDIC-lac instrument. CLINICAL RELEVANCE: Susceptibility to prevent skin lesions in the diaper area in the pediatric age.
INTRODUCTION: Tele-Health or eHealth are defined as diversified health services provided remotely by a team of professionals using ICT (Information and Communication Technology) to improve the health of a user or populat...INTRODUCTION: Tele-Health or eHealth are defined as diversified health services provided remotely by a team of professionals using ICT (Information and Communication Technology) to improve the health of a user or population. DEVELOPMENT: The development of ICT during the 2000 and 2010 decades allowed for a wider applicability of these services. Techniques like teleradiology and telepathology appeared. Tele-nursing began to be practiced through teleconsultations. Tele-nursing emerged from consulting telephone nurses in the United Kingdom and Canada. In 2005, the WHO established the Global eHealth Observatory to review the benefits of ICT. Currently in Spain, 061 Cat Salut Respon, managed by nurses, gives coverage to Catalonia through its website, telephone, email or chat. In Andalusia, Salud Responde is a service and information center providing citizens with remote healthcare. CONCLUSIONS: Health systems offer services through multichannel schemes and specific applications (apps) improving accessibility anytime, anywhere, provided with internet connection. The involvement of nurses in eHealth programs, such as telenurses, is increasingly spreading in Spain, mirroring the trend at an international level.
Urinary incontinence is one of the most influential factors which negatively affect patients' quality of life suffering from spinal cord injury. It affects their self-esteem, interpersonal and work relations, their indep...Urinary incontinence is one of the most influential factors which negatively affect patients' quality of life suffering from spinal cord injury. It affects their self-esteem, interpersonal and work relations, their independence, together with their leisure and free time activities. Urine collectors are among the products that contribute to improve the autonomy and quality of life of patients with urinary incontinence. A simple functioning device which can be determinant in achieving that urinary incontinence has an almost nil impact in the life of a patient with spinal cord injury. Choosing the right product is the key to success and the reason why we introduce Conveen® Optima, analyzing the manifold factors directly or indirectly related to the use of this collector.
Casado Verdejo I, Iglesias Guerra JA, Muñoz Bermejo L
… +3 more, Bárcena Calvo C, López Pertegal B, Postigo Mota S
Rev Enferm
· 2017 Mar · PMID 30277695
Nowadays, social and health representatives are putting the focus on emerging need: promote intergenerational programs and practices to generate spaces of encounter and collaboration between people of different ages. Acc...Nowadays, social and health representatives are putting the focus on emerging need: promote intergenerational programs and practices to generate spaces of encounter and collaboration between people of different ages. According to it, the purpose of intergenerational practices should be to achieve as aim for a society for all ages, regardless of age, an expression proposed by United Nations, not only to integrate all ages but to respond to their needs and provide them a higher quality of life.
OBJECTIVES: To analyze the social emergency caused by vulnerability situations or exclusion risk discovered through the health service SAMU in the city of Valencia. METHOD: To do it mixed methodology has been used. For t...OBJECTIVES: To analyze the social emergency caused by vulnerability situations or exclusion risk discovered through the health service SAMU in the city of Valencia. METHOD: To do it mixed methodology has been used. For the quantitative part 195 questionnaires were collected in the eight SAMU mobile units, all of them were completed during services, descriptive and inferential statistics were used. For qualitative part semi-structured interviews were performed to SAMU and SAUS professionals. Categories and qualitative matrix was analyzed with ATLAS.tiv7. RESULTS: From a total of 195 emergencies, 35 (17.9%) were attended on Tuesday. December was the month in which most emergencies were presented 48 (24.6%). 54.7% took place between 9 and 16 hours, of which 93 (47.7%) out of the SAUS working hours. From emergencies, 84 (50.5%) did not require transfer to hospital, compared to 83 (49.5%) than were required. SAMU units asked for social intervention in 27 (14%) cases, 24 (89%) required transfer to hospital. There was a significant (0.000), existing relationship between emergencies requiring hospital transfer by the SAMU and requiring social intervention. In interviews is demonstrated detection by the SAMU and intervention by the SAUS of social emergency. Of the qualitative results, we obtained that the SAMU across his sanitary emergencies detects social needs subject to valuation and intervention for SAUS. CONCLUSIONS: This study shows that SAMU of Valencia is a social emergency detector subject to social intervention in their daily work. The results support the proposal of a service that runs 24 hours seven days a week.
Galimany Masclans J, Sancho Agredano R, Morin Fraile V
… +1 more, Jodar Solà G
Rev Enferm
· 2017 Mar · PMID 30277675
Nursing university education has to respond to the challenges of the 21st century. Health conditions are highly complex with associated social problems. The universities should train nurses with a transforming vision, by...Nursing university education has to respond to the challenges of the 21st century. Health conditions are highly complex with associated social problems. The universities should train nurses with a transforming vision, by defining study plans, preventive approach and promoting health, in a context of community health. The information and communication technologies along with the nurse leadership are also essential elements of value for graduated nurses. An innovative response to social needs and transformation of society requires commitment in defining the study plans of degree and also in the master's degree and in the continuing education programs. Investigate is how to acquire the necessary skills to generate knowledge to help ensure the professional development of nurses and contribute to the persons health.
Ordóñez Rufat P, Polit Martínez V, Escofet Gómez R
… +1 more, Martínez Estalella G
Rev Enferm
· 2017 Mar · PMID 30277372
INTRODUCTION: The channeling of central venous catheters (CVC) is a technique used in intensive care units (ICUs) but it doesn't come without the risk of infection in the placement and subsequent handling. OBJECTIVE: Eva...INTRODUCTION: The channeling of central venous catheters (CVC) is a technique used in intensive care units (ICUs) but it doesn't come without the risk of infection in the placement and subsequent handling. OBJECTIVE: Evaluate the effectiveness of a prevention of infection following the introduction of new multifactorial strategies in the prevention program Central line-associated bloodstream infection (CLABSI) at ICU. METHODOLOGY: Comparative descriptive study in two periods, including all patients admitted in multipurpose ICUs of a tertiary hospital 2014. We analyzed 2014 data compared with 2013, to test the impact of new measures CRB prevention program. Variables: number of catheters, number of infections/1000 catheter days and path. Actions carried out were: prospective surveillance of the incidence rate, sequential program multifactorial prevention implementation of different measures, checklist for insertion of new catheters, introduction of weekly monitoring compliance, reporting episodes team are, continuing education for sanitary personal and implementation of the semipermeable transparent dressings with chlorhexidine gel. RESULTS: The overall incidence density rate decreased from 3.1 episodes/1000 catheter days in 2013 to 2.3 episodes/1000 catheter days in 2014, improving in different units. The utilization ratio of the different accesses was: 35% humeral; 33% jugular; 25% subclavian; 10% femoral, and 13% hemodialysis catheter. CONCLUSIONS: The new measures applied to reduce the bacteremia have allowed a decrease in the rate of infection, what brings closer to the objective of the Bacteremia Zero program.
García Hernández MN, Aguirre-Jaime A, Grupo de trabajo SUP
Rev Enferm
· 2017 Mar · PMID 30277368
OBJECTIVE: Measure the validity, reliability and consistency of two alternative diagnostic systems, Nurse Pediatric Emergency Assessment for Primary Care system (VEUPAP) and web_e-PAT®, using expert pediatricians judgmen...OBJECTIVE: Measure the validity, reliability and consistency of two alternative diagnostic systems, Nurse Pediatric Emergency Assessment for Primary Care system (VEUPAP) and web_e-PAT®, using expert pediatricians judgment as a gold standard. MATERIAL AND METHODS: Random sample of 300 children aged 0-14 years treated at the Pediatric Urgency Service Dr. Jaime Chaves in Santa Cruz de Tenerife between March 2009 and March 2010. Demographics data, time, presentation of complications and referrals to high, triage results according VEUPAP and web_e-PAT®, medical discharge and interview results to escort the child report, were registered. Sensitivity, specificity, frequency of false positive and negative predictive values of results, their concordance with the gold standard, and reliability of both methods, were estimated. RESULTS: VEUPAP offers better values that web_e-PAT® with sensitivity 94% (95% Cl: 91-97%) vs. 36% (95% Cl: 31-41%), specificity 93(90-96)% vs. 87(83-91)%, positive predictive value of 89 (86-92)% vs. 63(58-68)%, and negative 96(94-98)% vs. 69(64-74)%, yield a4 vs. 3 times more, according to expert pediatrician 84(80-88)5 vs. 12(9-15)% reliability and 64(59-69)% vs. 59(54-63)% according to the weighted kappa Cohen (p < 0.001). Three levels lower and upper of triage discrepancies do not occur with any of the systems, the discrepancy in lower and upper triage at 2 levels do not occur with VEUPAP and is 14% and 4% respectively with web_e-PAT® (p = 0.032-0.045). Most of the discrepancies occur with triage level 1 being for VEUPAP 2-8% and 10-36% for web_e-PAT® (p < 0.001). The time consumption for both systems reached significance only for priority level 3: 4 (2-7) vs. 4 minutes (2-14), respectively (p = 0.044). CONCLUSIONS: VEUPAP is a homogeneous and systematic objective tool. The characteristics of accuracy, validity, accuracy, reliability, usefulness and ease of use make it suitable to assessment and classification pediatric patients in primary care emergency.
BACKGROUND: The nursing diagnosis Body image disturbance is present in al the burned people. The approach of this diagnosis is a nursing responsibility, so nurses must carry out the assessment of the functional pattern S...BACKGROUND: The nursing diagnosis Body image disturbance is present in al the burned people. The approach of this diagnosis is a nursing responsibility, so nurses must carry out the assessment of the functional pattern Self-perception-Self-concept knowing in depth the concepts of "self-concept" and "self-esteem". AIMS: To identify the most effective nursing interventions to address the Body image disturbance. METHOD: A literature review has been made consulting the following databases PubMed, CINAHL, Cuiden, COCHRANE and PsychInfo. The main selected articles have been: randomized clinical trials, descriptive studies and literature reviews. RESULTS: The proposed nursing care plan is based on a focused assessment of the functional pattern Self-perception-Self-concept using the Satisfaction With Appearance Scale and applying the nursing inverventions: Cognitive restructuring and Body image enhancement. CONCLUSIONS: Both assessment and interventions have shown to be based on evidence and being an effective way to take care of the Body image disturbance in the burned person.
OBJECTIVES: To establish the differences in social support, resilience, coping, and three burnout dimensions (emotional exhaustion, depersonalization, and reduced personal accomplishment) among special units nursing and...OBJECTIVES: To establish the differences in social support, resilience, coping, and three burnout dimensions (emotional exhaustion, depersonalization, and reduced personal accomplishment) among special units nursing and nursing staff of others hospital services; as well as to determine psychological variables that predict burnout in these professionals. METHOD: Correlational and cross-sectorial study. A sample of 133 nursing professionals from University Hospital of Fuenlabrada (Madrid) took part in the study, of whom 61 worked in special units and 72 in wards. Instruments: Maslach Burnout Inventory-Human Services Survey (MBI-HSS), Social Support Subscale, 10-Item CD-RISC (resilience), Brief-Cope (coping), and sociodemographic variables. RESULTS: No differences were found in any assessed psychological variables as regards hospital service worked in. Social support, resilience and coping strategies determined three burnout dimensions: social support (β = -0.21, support coping (β = -0.22) and disengagement coping (β = 0.22) predicted emotional exhaustion; resilience (V = -0.22) and disengagement coping (β = 0.30) predicted depersonalization; and engagement coping (β = -0.55) predicted reduce personal accomplishment. CONCLUSIONS: Differences in burnout, social support, resilience and coping strategies are not determined by hospital service. Social support, resilience, engagement coping, and support coping (adaptives) constitute three tools to face burnout in nursing. These tools could be developed by specific programs from universities and health institutions to improve nursing clinical practice.