Conectar
Status epilepticus (SE) in adults is a serious neurological emergency that can lead to high morbidity and mortality rates. Although functional outcomes are often assessed using general scoring systems, limited data on health-related quality of life (HRQoL) in patients admitted to intensive care units (ICUs) are still limited. Furthermore, comprehensive evaluations of patient-reported physical, cognitive, mental health and psychological outcomes are lacking in this population. POSEIDON 2 aims to assess HRQoL and cognitive, physical and psychological impairments at 3 and 12 months after ICU discharge following SE and quantify caregiver burden.
POSEIDON 2 is a prospective, multicentre, longitudinal study conducted in 19 French ICUs. The study combines data from the SE ICTAL Registry with data from patients who survived admission to the ICU for SE, who will be recruited for the study. The study also includes patient-reported outcome (PRO) data collected 3 (M3) and 12 (M12) months after discharge from the ICU using validated instruments. The Zarit scale will be used to measure the burden on caregivers at M3 and M12. The primary endpoint is the prevalence of overall HRQOL impairment at M3 and M12, as defined by dichotomous scores on the physical and mental components of the 36-Item Short Form Health Survey compared with those of the general population. Secondary endpoints include domain-specific impairments, such as cognitive function, dependence, mental health and patient experiences. The sample size has been calculated based on an estimated prevalence of 75% for HRQoL impairment, with a planned sample size of 140 patients.
The POSEIDON 2 study protocol received ethical approval from the ethics committee ‘Comité de Protection des Personnes Ouest VI’ on 5 October 2023 (#2023-A01223-42). The study is conducted in accordance with the Declaration of Helsinki, Good Clinical Practice and the regulatory requirements of France. Written informed consent is obtained from participants, who are able to decline participation or withdraw from the study at any time. Findings will be disseminated through publication in peer-reviewed journals and presentations at scientific conferences.
This study investigated perinatal depressive symptoms among pregnant and postpartum Filipino women.
Cross-sectional survey.
The Philippines.
Participants were recruited online and face-to-face from maternal care facilities.
Perinatal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) score, with prevalence calculated based on ≥13 cut-off, indicating clinically significant symptoms of depression. Patterns of depressive symptoms were examined by demographics, perinatal time period and other obstetric information using adjusted regression coefficients (ab) and risk ratios (aRR).
A total of 856 women participated in the study, comprising 356 pregnant and 500 postpartum women. EPDS scores were, on average, similar between pregnant (14.4) and postpartum women (14.1). Using the locally validated cut-off of ≥13 revealed that 69.1% of pregnant and 62.0% of postpartum women reported clinically significant depressive symptoms. Consistent EPDS scores and prevalence were observed across pregnancy trimesters and within 12 months postpartum and beyond. Women who received adequate prenatal care were less likely to experience antenatal (ab=–1.59, 95% CI –3.13 to –0.05) and postpartum (ab=–1.30, 95% CI –2.48 to –0.12) depressive symptoms. Postpartum EPDS scores and depressive symptom prevalence (EPDS score ≥13) were higher among 18–24-year olds (ab=1.96, 95% CI 0.30 to 3.61; aRR=1.23, 95% CI 1.03 to 1.47) and single mothers (ab=3.46, 95% CI 0.22 to 6.71; aRR=1.42, 95% CI 1.07 to 1.90), compared with older and married mothers, respectively.
At least 60% Filipino mothers experienced clinically significant perinatal depressive symptoms, which exceeds the established global average of 25%. Younger and single postpartum women were at greater risk, while pregnant and postpartum women who attended adequate prenatal visits were less likely to report depressive symptoms. Our study underscores the need for further research to uncover the true burden of poor perinatal mental health and calls for targeted early interventions and integrative public health strategies to support at-risk mothers, particularly those from socially disadvantaged backgrounds.
Providing peer support can benefit youth peer support workers (peers)et by supporting self-determination, recovery and resilience to self-stigma. There is a need to clarify the role of the organisation in providing benefits for peers. We aimed to identify the organisational contexts and mechanisms that result in the creation of healthy workplaces for peers.
Rapid realist review guided by the Realist and Meta-Narrative Evidence Syntheses–Evolving Standards guidelines and Pawson’s iterative approach.
MEDLINE, CINAHL, PsycINFO, ERIC, SocINDEX, Google Scholar and Embase were searched from 1979 to 2025.
We included qualitative and quantitative peer-reviewed studies and grey literature that captured characteristics of organisational practices and employment considerations in youth peer support programmes.
Articles were screened independently by multiple reviewers. Inclusion criteria were adjusted to capture literature on organisational practices, and employment considerations for youth peer support programmes. Data were extracted and analysed retroductively to develop Context-Mechanism-Outcome Configurations (CMOCs).
Five employment-related risks to peer well-being were identified: (1) difficulty entering the job market, (2) lack of role clarity, (3) pressure to live up to ideals, (4) retraumatisation and (5) stigma. Six CMOCs were developed; all focused on the creation of equitable employment and supporting peer development and empowerment were developed.
Community-based mental health organisations can facilitate equitable peer employment through strategies that reduce professional stigma, enhance peer resilience and promote professional and personal development. Policy reform that addresses precarious work conditions is needed to support healthy work environments.
The COmmunity HEalth System InnovatiON (COHESION) project (2016–2019) was a 4-year collaboration between research teams from Mozambique, Nepal, Peru and Switzerland. It conducted formative health system research using tracer chronic conditions, non-communicable diseases (diabetes and hypertension) and one neglected tropical disease per country (schistosomiasis in Mozambique, leprosy in Nepal and neurocysticercosis in Peru).
Findings guided the co-creation of interventions to improve diagnosis and management through a participatory approach with communities, primary healthcare workers and regional health authorities.
As a continuation of this effort, the research team initiated the COHESION Implementation project (COHESION-I) with two objectives: (1) implement and evaluate the context-specific co-created interventions in Mozambique, Nepal and Peru (Component 1) and (2) adapt the COHESION approach to India, a country that did not benefit from a formative phase previously (Component 2). This protocol manuscript focuses on Component 1.
A mixed-methods, pre–post quasi-experimental design will be used, including quantitative, qualitative, economic and process evaluations. Each country will have three arms: (1) co-created and co-designed interventions; (2) only co-designed intervention and (3) the usual care arm. Data will be collected longitudinally over 18 months to assess the effect of the interventions. The main outcomes include patient satisfaction (Patient Satisfaction Questionnaire Short Form), health system responsiveness (WHO responsiveness domains) and quality of life (EuroQol 5 dimensions 5 levels). The qualitative evaluation will explore how satisfaction is perceived among service users with chronic conditions and healthcare workers. Other outcomes per type of evaluation will be considered such as perceived value of health services, cost estimation and acceptability of the intervention components, among others.
Approvals were obtained from Ethics Committees of Universidad Peruana Cayetano Heredia (Peru), Universidade Eduardo Mondale (Mozambique) and Nepal Health Research Council (Nepal). Results will be disseminated through peer-reviewed publications and scientific conferences.
The HOPSCOTCH study ‘Helping Optimise Primary Care Support During Transition From Children’s Hospice Care’ aims to develop a toolbox to enable engagement of primary care services in the care of young people with life-limiting conditions (LLC) with a specific focus on the point of transition from children’s hospice services.
Individual interviews will be held with young people with LLC, their families and healthcare professionals (HCPs). In alignment with Experience Based Co-Design (EBCD) methodology, extracts of film and audio from young people and family interviews will be combined to professionally produce a ‘catalyst film’ highlighting key points and experiences before, during and after the transition from children’s hospice care. Role-specific workshops will be held with young people with LLC, their families and HCPs working in primary care, children’s hospices and adult hospice services. The catalyst film will be used in feedback workshops to prompt prioritisation of key issues to take forward into toolbox development in a shared young people, family and HCP workshop. A documentary analysis of resources currently used to support transition and communication between care settings will support contextual understanding of the transition process. Young people, parents and professionals have shaped and continue to have influence over the study delivery as advisors alongside a multidisciplinary steering committee.
The study design has been guided by the UK Medical Research Council complex intervention framework. Intervention development draws on the principles of EBCD and is theoretically driven by the Behaviour Change Wheel.
The study is registered with the UK’s Clinical Study Registry (ISCTRN75964234).
Ethical approval was obtained from Wales 3 ethics board on 2 July 2025 (IRAS ID 334486). This study will include ongoing dissemination and knowledge transfer to key audiences (young people, parents, service providers, commissioners) via publications, national bodies, knowledge exchange events, web-based platforms, social media and clinical/academic forums.
Dementia is a chronic and progressive neurological condition characterised by cognitive and functional impairment. It is often associated with multimorbidity and imposes a significant economic burden on healthcare systems and families, especially in low-income and middle-income countries. In Peru, where dementia cases are increasing rapidly, timely detection and referral for diagnosis is crucial. This protocol is part of the IMPACT Salud project in Peru. Here, we focus on a specific component aimed at validating an mHealth tool for the detection of cognitive and functional impairment and assessing its cost-effectiveness. We will also assess changes in cognitive and functional impairment as well as health economic outcomes over 1 year.
This observational study will be conducted in four geographically diverse regions of Peru. Community health workers are expected to contact approximately 32 000 participants (≥60 years) to apply an mHealth-enabled tool that includes cognitive and functional instruments: Ascertain Dementia 8, Peruvian version of Rowland Universal Dementia Assessment Scale and Pfeffer Functional Activities Questionnaire. From this large sample, we aim to find 3600 participants and their study partners to enrol and interview at baseline regarding sociodemographic characteristics, lifestyles, comorbidities and health economic data including resource use, costs and health-related quality of life (HR-QoL). Psychologists, blind to previous results, will assess dementia stage of the participants using an abbreviated Clinical Dementia Rating (CDR) scale. At 6-month follow-up, participants will complete a brief health economics questionnaire on resource use, costs and HR-QoL. To validate the accuracy of the detection tool, a subsample of 600 participants who completed the baseline will undergo a gold-standard clinical neuropsychological assessment. This subsample will participate in a 12-month follow-up, including health economics, cognitive and functional impairment tests and the CDR scale. Results will be analysed and presented by cognitive status, site, sex and multimorbidity profile. Finally, data from all stages and external sources will inform a decision model to implement a cost-effectiveness analysis of the detection tool at the national level.
The study received ethics approval in Peru (Universidad Peruana Cayetano Heredia: CONSTANCIA-CIEI-378-33-23) and in the UK (Imperial College London: ICREC/SETREC reference number 6647445). Informed consent will be obtained from participants and their study partners, considering the participant’s capacity to consent. For illiterate participants, consent will be obtained through a witnessed procedure involving study partners, with a fingerprint obtained instead of a signature. The results will be disseminated through conferences, published articles, public presentations (particularly to those involved in dementia care) and presentations or meetings with local health authorities.
Nos enfocamos en conocer las representaciones de los curanderos náhuatl de los estados de Colima y Jalisco, en relación con el mundo, la salud, la enfermedad, los enfermos; y las prácticas que realizan para tratar de recuperar la salud. Se trata de un estudio descriptivo, fenomenológico, y la recolección de datos se realizó a través de entrevistas semiestructuradas. Para la organización y análisis de los datos, se siguieron las directrices del Modelo Dialéctico Estructural del Cuidado (MDEC), estructurando los datos en tres estructuras: unidad funcional, marco funcional y elemento funcional. Teniendo como resultado, el curandero describe dimensiones de contacto visual y corporal con el paciente, crea un canal no convencional, poniendo en juego pasiones, deseos y sentimientos, en conclusión, El curandero ofrece servicios más cercanos al individuo, proporcionando una «explicación» a los acontecimientos desde la perspectiva biológica, psicológica, ecológica y sobrenatural.
Objetivo: diseño de una intervención psicoeducativa de enfermería para el control del peso gestacional en mujeres embarazadas mexicanas basado en Modelo de Promoción de la Salud. Método: Uso de teorías en el diseño de intervenciones. Resultados: Los determinantes que se utilizaron para el diseño de la intervención, fue la autoeficacia, barreras percibidas e intenciones de implementación. Se diseñaron dos manuales, uno para el facilitador y otro para el participante. Conclusiones: El modelo de promoción de la salud es útil para guiar intervenciones psicoeducativas.
Objetivo. Comprender las vivencias de un grupo de profesionales de enfermería tuvo sobre la calidad de la atención en salud en la unidad de cuidados intensivos de adultos (UCI) durante la pandemia por la COVID-19, entre los años 2020 y 2021. Metodología. Estudio cualitativo desarrollado en la UCI de una institución prestadora de salud (IPS) de alta complejidad en la ciudad Medellín (Colombia). Se realizaron entrevistas en profundidad a 9 profesionales de enfermería. El análisis se realizó en paralelo con la recolección de la información a lo largo de toda la investigación usando herramientas analíticas de teoría fundamenta con el apoyo del software de investigación de datos cualitativos Atlas.ti. Resultados. Las vivencias de los profesionales de enfermería de este estudio se enmarcaron en las condiciones laborales difíciles, encuentro con la muerte, sobrecarga laboral, disminución de la calidad del cuidado, aumento de los eventos adversos, y tensiones entre emociones positivas y negativas. Conclusión. La pandemia fue un suceso emocional complejo, con tensiones entre valores y emociones, esto suscitado por condiciones laborales precarias, la creciente morbimortalidad, la sensación de que en ocasiones el esfuerzo no era reconocido, la angustia moral al sentir que no se podía actuar conforme a los propios principios y a la imperiosa decisión de tener que elegir qué pacientes salvar y cuidar, lo cual impactó negativamente en la calidad del cuidado.
ABSTRACT
Objective. To understand the experiences of a group of nursing professionals regarding the quality of health care in the intensive care unit (ICU) during the COVID-19 pandemic, between 2020 and 2021. Methodology. Qualitative study developed in the adult ICU of a high complexity health care institution (IPS) in the city of Medellin (Colombia). In-depth interviews were conducted with 9 nursing professionals. The analysis was carried out in parallel with the collection of information throughout the research using grounded theory analytical tools with the support of Atlas.ti qualitative data research software. Results. The experiences and meanings of the nursing professionals in this study were framed by difficult working conditions, encounter with death, work overload, decrease in the quality of care, increase in adverse events, and tensions between positive and negative emotions. Conclusion. The pandemic was a complex emotional event, with tensions between values and emotions, caused by precarious working conditions, increasing morbimortality, the feeling that sometimes the effort was not recognized, the moral anguish of feeling that one could not act according to one's own principles and the imperious decision of having to choose which patients to save and care for, which had a negative impact on the quality of care.
En este relato biográfico contamos la experiencia de una cirujana como voluntaria en varios proyectos de cirugía en países con bajos recursos. El objetivo es conocer cómo funcionan estos proyectos, la labor que llevan a cabo y la implicación física y psicológica que supone. Se realiza mediante un abordaje cualitativo de una entrevista semiestructurada para analizar diferentes aspectos. El informante aporta datos sobre la organización del proyecto y el trabajo que realizan, su visión sobre estos proyectos y sus vivencias. Cuenta con naturalidad y simpatía sus experiencias en Bolivia y Ghana, resalta su humildad a la hora de contar su participación y las críticas que realiza.
Este caso clínico presenta la situación de un paciente de 66 años insulino requirente, quien se negó a realizar amputación digital transmetatarsiana en el pie derecho como única opción de tratamiento para el pie diabético, el paciente fue atendido en clínica de heridas donde se elaboró el plan de cuidados utilizando el modelo de enfermería de Virginia Henderson, las taxonomías de la North American Nursing Diagnosis Association (Nanda), Nursing Outcomes Classification (Noc) y Nursing Interventions Classification (Nic). Se establecieron como diagnósticos enfermeros: deterioro de la integridad tisular, perfusión tisular periférica ineficaz y gestión ineficaz de la salud. El desbridamiento mecánico del tejido necrótico bajo la aplicación de procesos de asepsia, el compromiso del grupo multidiscipli-nario de la salud y la educación al paciente, permitieron el salvamento de 2 falanges del dedo y el retorno a la vida normal del paciente en un periodo de 7 meses.
Objetivo principal: Comparar la eficacia del uso del Expediente Clínico Electrónico (ECE) Vs Expediente Clínico Físico (ECF) en la mejora la calidad en atención de pacientes hospitalizados. Metodología: Se consideraron estudios relacionados con uso del ECE, utilizando los descriptores DeCS y MeSH, operadores booleanos AND, NOT y OR. Criterios inclusión: artículos de revisión con cinco años de publicación; criterios exclusión: pacientes ambulatorios o de consulta externa. Resultados principales: La evidencia establece ventajas del uso ECE como la facilidad de uso, accesibilidad, lectura, calidad en la documentación, control de información sobre los cuidados de los pacientes, cumplimiento normativo y toma de decisiones, lo cual reduce el riesgo de errores médicos; sin embargo, algunas desventajas es el empleo de hardware, software, redes; requiere soporte técnico las 24 horas al día. Conclusión principal: el empleo del ECE establece eficacia en la atención al paciente hospitalizado mediante la minimización de tiempos en registros y el aumento en la seguridad de la información.
Rev Enferm;39(5): 20-4, 2016 May. . [Artículo]
FreshRSS