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☐ ☆ ✇ Journal of Clinical Nursing

Nurses' intention and attitude to participate in advance care planning: An extended theory of planned behaviour using structural equation modelling–A cross‐sectional study

Por: Apiradee   · Chung‐Yin Lin · Virapun Wirojratana · Peng‐Chan Lin · Bih‐Ching Shu — Mayo 21st 2024 at 08:04

Abstract

Aims

This study aimed to investigate the factors influencing nurses' intentions to participate in advance care planning (ACP) by examining the mediating roles of attitude, subjective norm, and perceived behavioural control in the relationship between knowledge and intention, using an extended theory of planned behaviour and structural equation modelling.

Methods

A descriptive cross-sectional survey was conducted between January and April 2023, involving 515 registered nurses, selected through two-stage sampling. Data were collected using a self-administered online survey distributed via the internal communication system of hospital. Structural equation Modelling was employed to analyse the relationships among knowledge, attitude, subjective norm, perceived behavioural control and intention to participate in ACP.

Results

The results supported two hypotheses regarding the relationships between knowledge, attitude, subjective norm, perceived behavioural control, and intention (p < 0.05). While the direct effect of knowledge on intention was not significant (β = 0.087, p = 0.292), the total indirect effect through attitude, subjective norm and perceived behavioural control was significant (β = 0.449, p < 0.001), accounting for approximately 83.77% of the total effect on intention. This underscores the critical role of these mediators in influencing nurses' intention to participate in ACP.

Conclusions

This study highlights the significant indirect influence of knowledge on nurses' intentions to participate in ACP through attitude, subjective norms and perceived behavioural control. These findings suggest that targeted educational is needed to enhance ACP participation among nurses.

Implications for the Profession and/or Patient Care

Understanding the role of attitude, subjective norm and perceived behavioural control can enhance nursing practice. Creating supportive environments and promoting interdisciplinary collaboration are crucial. Professional development through training, mentorship and role modelling can empower nurses in ACP. Comprehensive programs that increase knowledge and foster positive attitudes are essential for advancing ACP practice among nurses.

Impact

Educational programs aimed at nurses should include components designed to strengthen knowledge and the identified mediators, equipping nurses with the necessary ACP skills. Organizational support through appropriate policy frameworks can facilitate these educational endeavours and ensure a sustainable impact on practice.

Reporting Method

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.

☐ ☆ ✇ Journal of Clinical Nursing

Prevalence and risk factors of depression and anxiety symptoms in intensive care unit patients with cardiovascular disease: A cross‐sectional study

Por: Saikun Wang · Ruiting Zhu · Hongwei Cai · Jing Mao · Wei Zhou · Changyue Zhang · Mengjiao Lv · Hongli Meng · Lirong Guo — Mayo 6th 2024 at 09:48

Abstract

Aims

To investigate the prevalence of anxiety and depression symptoms in intensive care unit (ICU) patients with cardiovascular disease (CVD) and to explore which elements are risk factors for the development of anxiety and depression symptoms.

Design

A cross-sectional study.

Methods

A total of 1028 ICU patients with CVD were enrolled in this cross-sectional study. Logistic regression was used to assess risk factors and associations between anxiety and depression symptoms, and mediation analysis was used to explore the effect of risk factors on the association between anxiety and depression symptoms. Reporting of the study followed the STROBE checklist.

Results

The results showed that among ICU patients with CVD, 38.1% had anxiety symptoms, 28.7% had depression symptoms and 19.3% had both anxiety and depression symptoms, and there was a significant association between anxiety and depression symptoms. We also identified female gender, hypertension, hyperlipidemia and cardiac function class IV as independent risk factors for anxiety and depression symptoms. Importantly, these factors also mediated the association between anxiety and depression symptoms, emphasising their role in the psychological well-being of this patient group.

Conclusion

ICU patients with CVD were prone to anxiety and depression symptoms. Female gender, hypertension, hyperlipidemia and cardiac function class IV were identified as independent risk factors that also served as mediators in the relationship between anxiety and depression symptoms. Especially, cardiac function class IV emerged as a critical factor in this association.

Relevance to Clinical Practice

It is imperative for critical care professionals to recognize the elevated risk of depression and anxiety among ICU patients with severe CVD, especially those with cardiac function class IV, hypertension, hyperlipidemia and females. Proactive and supportive measures are essential for this vulnerable group during their ICU stay to safeguard their mental health and prevent negative outcomes.

Patient or Public Contribution

No Patient or Public Contribution.

☐ ☆ ✇ PLOS ONE Medicine&Health

Identification of triciribine as a novel myeloid cell differentiation inducer

Por: Souma Suzuki · Susumu Suzuki · Yuri Sato-Nagaoka · Chisaki Ito · Shinichiro Takahashi — Mayo 14th 2024 at 16:00

by Souma Suzuki, Susumu Suzuki, Yuri Sato-Nagaoka, Chisaki Ito, Shinichiro Takahashi

Differentiation therapy using all-trans retinoic acid (ATRA) for acute promyelocytic leukemia (APL) is well established. However, because the narrow application and tolerance development of ATRA need to be improved, we searched for another efficient myeloid differentiation inducer. Kinase activation is involved in leukemia biology and differentiation block. To identify novel myeloid differentiation inducers, we used a Kinase Inhibitor Screening Library. Using a nitroblue tetrazolium dye reduction assay and real-time quantitative PCR using NB4 APL cells, we revealed that, PD169316, SB203580, SB202190 (p38 MAPK inhibitor), and triciribine (TCN) (Akt inhibitor) potently increased the expression of CD11b. We focused on TCN because it was reported to be well tolerated by patients with advanced hematological malignancies. Nuclear/cytoplasmic (N/C) ratio was significantly decreased, and myelomonocytic markers (CD11b and CD11c) were potently induced by TCN in both NB4 and acute myeloid leukemia (AML) M2 derived HL-60 cells. Western blot analysis using NB4 cells demonstrated that TCN promoted ERK1/2 phosphorylation, whereas p38 MAPK phosphorylation was not affected, suggesting that activation of the ERK pathway is involved in TCN-induced differentiation. We further examined that whether ATRA may affect phosphorylation of ERK and p38, and found that there was no obvious effect, suggesting that ATRA induced differentiation is different from TCN effect. To reveal the molecular mechanisms involved in TCN-induced differentiation, we performed microarray analysis. Pathway analysis using DAVID software indicated that “hematopoietic cell lineage” and “cytokine-cytokine receptor interaction” pathways were enriched with high significance. Real-time PCR analysis demonstrated that components of these pathways including IL1β, CD3D, IL5RA, ITGA6, CD44, ITGA2B, CD37, CD9, CSF2RA, and IL3RA, were upregulated by TCN-induced differentiation. Collectively, we identified TCN as a novel myeloid cell differentiation inducer, and trials of TCN for APL and non-APL leukemia are worthy of exploration in the future.
☐ ☆ ✇ BMJ Open

Cohort profile: the Environmental Reproductive and Glucose Outcomes (ERGO) Study (Boston, Massachusetts, USA) -- a prospective pregnancy cohort study of the impacts of environmental exposures on parental cardiometabolic health

Por: Preston · E. V. · Quinn · M. R. · Williams · P. L. · McElrath · T. F. · Cantonwine · D. E. · Seely · E. W. · Wylie · B. J. · Hacker · M. R. · O'Brien · K. · Brown · F. M. · Powe · C. E. · Bellavia · A. · Wang · Z. · Tomsho · K. S. · Hauser · R. · James-Todd · T. · the Environmental Rep — Mayo 8th 2024 at 17:36
Purpose

Pregnancy and the postpartum period are increasingly recognised as sensitive windows for cardiometabolic disease risk. Growing evidence suggests environmental exposures, including endocrine-disrupting chemicals (EDCs), are associated with an increased risk of pregnancy complications that are associated with long-term cardiometabolic risk. However, the impact of perinatal EDC exposure on subsequent cardiometabolic risk post-pregnancy is less understood. The Environmental Reproductive and Glucose Outcomes (ERGO) Study was established to investigate the associations of environmental exposures during the perinatal period with post-pregnancy parental cardiometabolic health.

Participants

Pregnant individuals aged ≥18 years without pre-existing diabetes were recruited at

Findings to date

We enrolled 653 unique pregnancies and retained 633 through delivery. Participants had a mean age of 33 years, 10% (n=61) developed gestational diabetes and 8% (n=50) developed pre-eclampsia. Participant pregnancy and postpartum urinary phthalate metabolite concentrations and postpartum glycaemic biomarkers were quantified. To date, studies within ERGO found higher exposure to phthalates and phthalate mixtures, and separately, higher exposure to radioactive ambient particulate matter, were associated with adverse gestational glycaemic outcomes. Additionally, certain personal care products used in pregnancy, notably hair oils, were associated with higher urinary phthalate metabolite concentrations, earlier gestational age at delivery and lower birth weight.

Future plans

Future work will leverage the longitudinal data collected on pregnancy and cardiometabolic outcomes, environmental exposures, questionnaires, banked biospecimens and paediatric data within the ERGO Study.

☐ ☆ ✇ BMJ Open

Autologous concentrated bone marrow injection for precollapse osteonecrosis of the femoral head concurrent with contralateral total hip arthroplasty: protocol for a clinical trial

Por: Homma · Y. · Yamasaki · T. · Tashiro · K. · Okada · Y. · Shirogane · Y. · Watari · T. · Hayashi · K. · Baba · T. · Nagata · K. · Yanagisawa · N. · Ohtsu · H. · Fujiwara · N. · Ando · J. · Yamaji · K. · Tamura · N. · Ishijima · M. — Mayo 8th 2024 at 17:36
Introduction

The femoral head contralateral to the collapsed femoral head requiring total hip arthroplasty (THA) often manifests in the precollapse stage of osteonecrosis of the femoral head (ONFH). It is not yet demonstrated how autologous concentrated bone marrow injection may prevent collapse of the femoral head concurrent with contralateral THA. The primary objective is to evaluate the efficacy of autologous concentrated bone marrow injection for the contralateral, non-collapsed, femoral head in patients with bilateral ONFH, with the ipsilateral collapsed femoral head undergoing THA.

Methods and analysis

This is a multicentre, prospective, non-randomised, historical-data controlled study. We will recruit patients with ONFH who are scheduled for THA and possess a non-collapsed contralateral femoral head. Autologous bone marrow will be collected using a point-of-care device. After concentration, the bone marrow will be injected into the non-collapsed femoral head following the completion of THA in the contralateral hip. The primary outcome is the percentage of femoral head collapse evaluated by an independent data monitoring committee using plain X-rays in two directions 2 years after autologous concentrated bone marrow injection. Postinjection safety, adverse events, pain and hip function will also be assessed. The patients will be evaluated preoperatively, and at 6 months, 1 year and 2 years postoperatively.

Ethics and dissemination

This protocol has been approved by the Certified Committee for Regenerative Medicine of Tokyo Medical and Dental University and Japan’s Ministry of Healthy, Labour and Welfare and will be performed as a class III regenerative medicine protocol, in accordance with Japan’s Act on the Safety of Regenerative Medicine. The results of this study will be submitted to a peer-review journal for publication. The results of this study are expected to provide evidence to support the inclusion of autologous concentrated bone marrow injections in the non-collapsed femoral head in Japan’s national insurance coverage.

Trial registration number

jRCTc032200229.

☐ ☆ ✇ International Wound Journal

Combining antibiotic‐loaded bone cement‐based free vastus lateralis muscle‐sparing flap with split‐thickness skin grafts: A reliable strategy for reconstructing diabetic foot ulcers at non‐weight‐bearing areas

Abstract

Diabetic foot ulcers (DFUs) present significant challenges due to their associated amputation rates, mortality, treatment complexity and excessive costs. Our earlier work introduced a wound surgical integrated treatment (WSIT) for DFUs, yielding promising outcomes. This study focuses on a specific WSIT protocol employing antibiotic-loaded bone cement (ALBC) in the first Stage, and free vastus lateralis muscle-sparing (VLMS) flaps and split-thickness skin grafts (STSGs) in the second stage to repair non-weight-bearing DFUs. From July 2021 to July 2023, seven DFU patients (aged 47–71 years) underwent this treatment. Demographic data, hospital stay and repair surgery times were collected. Histological and immunohistochemical analyses assessed angiogenesis, collagen deposition and inflammation. SF-36 questionnaire measured pre- and postoperative quality of life. Preoperative ultrasound Doppler showed that the peak blood flow velocity of the recipient area artery was significantly >30 cm/s (38.6 ± 6.8 cm/s) in all patients. Muscle flap sizes varied from 8 × 3.5 × 1 to 18 × 6 × 2 cm. The operation time of the repair surgery was 156.9 ± 15.08 minutes, and the hospital stay was 18.9 ± 3.3 days. Histological analysis proved that covering DFUs with ALBC induced membrane formation and increased collagen, neovascularization and M2 macrophages fraction while reducing M1 macrophages one. All grafts survived without amputation during a 7- to 24-month follow-up, during which SF-36 scores significantly improved. A combination of ALBC with free VLMS flaps and STSGs proved to be safe and effective for reconstructing non-weight-bearing DFUs. It rapidly controlled infection, enhanced life quality and foot function, and reduced hospitalization time. We advocate integrating this strategy into DFU treatment plans.

☐ ☆ ✇ PLOS ONE Medicine&Health

Knowledge, attitudes, and practices about HIV and other sexually transmitted infections among High School students in Southern Italy: A cross-sectional survey

by Francesco Di Gennaro, Francesco Vladimiro Segala, Giacomo Guido, Mariacristina Poliseno, Laura De Santis, Alessandra Belati, Carmen Rita Santoro, Irene Francesca Bottalico, Carmen Pellegrino, Roberta Novara, Luisa Frallonardo, Mariangela Cormio, Michele Camporeale, Sergio Cotugno, Vincenzo Giliberti, Stefano Di Gregorio, Valentina Totaro, Nicola Catucci, Anna De Giosa, Roberta Giusto, Ilaria Viviana Lanera, Gioacchino Angarano, Sergio Lo Caputo, Annalisa Saracino

High School students, recognized as a high-risk group for sexually transmitted infections (STIs), were the focal point of an educational campaign in Southern Italy to share information and good practices about STIs and HIV/AIDS. A baseline survey comprising 76 items was conducted via the REDCap platform to assess students’ initial knowledge, attitudes, and practices (KAP) related to STIs and HIV/AIDS. Sociodemographic variables were also investigated. The association between variables and KAP score was assessed by Kruskal-Wallis’ or Spearman’s test, as appropriate. An ordinal regression model was built to estimate the effect size, reported as odds ratio (OR) with a 95% confidence interval (CI), for achieving higher KAP scores among students features. On a scale of 0 to 29, 1702 participants achieved a median KAP score of 14 points. Higher scores were predominantly reported by students from classical High Schools (OR 3.19, 95% C.I. 1.60–6.33, p
☐ ☆ ✇ PLOS ONE Medicine&Health

Self-administration medication errors at home and its predictors among illiterate and low-literate community-dwelling older adults with polypharmacy: A negative binomial hierarchical regression

by Nafiseh Ghassab-Abdollahi, Haidar Nadrian, Elnaz Shaseb, Narges Kheirollahi, Mina Hashemiparast

Background

Older adults with polypharmacy are more prone to medication errors. People with low educational attainment have more difficulties in taking their medications.

Objectives

This study aimed to identify the extent of medication self-administration errors (MSEs) and the contributing factors among illiterate and low-literate community-dwelling older adults with polypharmacy.

Method

The present cross-sectional study was conducted among people aged 60 and above. The data were collected using the sociodemographic, clinical, and Belief about Medicines Questionnaires (BMQ). To determine the extent of MSE, a medication error checklist was used. The negative binomial hierarchical regression model in the five blocks was performed.

Results

The final sample size was 276 people. The frequency of MSEs in the last 6 months was 69.2%. Sixteen percent of participants had made four or more mistakes. The most common MSEs were forgetting, improper taking of medications with food, improper timing, incorrect dosage (lower dose), and forgetting the doctor’s instructions. Near 18% of participants reported adverse events following their mistakes. The significant predictors of MSEs were being completely illiterate (p = 0.021), the higher number of doctor visits per year (p = 0.014), irregularly seeing doctors (p Conclusion

Despite the high prevalence of MSEs among older patients, practical strategies to deal with them at their homes have not been established among health systems. MSE as a multifactorial event can be caused by a collection of internal and external factors. Further studies to identify the role of patients, clinicians, procedures, and systems in developing MSEs as interconnected components are needed.

☐ ☆ ✇ BMJ Open

Skin closUre in carPal tunnEl Release (SUPER): protocol for a blinded randomised controlled trial comparing absorbable and non-absorbable sutures in carpal tunnel release

Por: Savolainen · A. · Nietosvaara · Y. · Sirola · J. · Hytönen · M. · Reito · A. · Heikkinen · N. · Räisänen · M. P. — Abril 16th 2024 at 18:01
Introduction

Carpal tunnel syndrome is a common disorder affecting a substantial portion of the general population. Surgical intervention is often deemed necessary, with the median nerve release being one of the most frequent operations. Optimising all the aspects of this procedure can enhance patient satisfaction with the treatment.

Methods and analysis

We aim to determine the differences in the aesthetic outcome of the scar as well as the pain experienced during the healing process between the use of absorbable and non-absorbable sutures. The primary outcome measure will be the patients’ subjective satisfaction with the aesthetic appearance of the scar 1 year after the operation. Secondary outcomes will include a similar evaluation of the aesthetics performed by a blinded outcome assessor, as well as pain experienced by the patients during the 2 weeks postoperatively. The severity and improvement of the patients’ symptoms will also be measured by a Finnish version of the Boston Carpal Tunnel Questionnaire. Costs will be evaluated for both groups. Safety of the wound closure will be followed and reported.

Ethics and dissemination

This protocol was approved by the Research Ethics Committee of the Northern Savo Hospital District (2319/2021). The trial will be conducted in accordance with the principles of Good Clinical Practice and the Declaration of Helsinki. The results will be disseminated through publication in peer-reviewed journals.

Trial registration number

NCT05503719.

☐ ☆ ✇ BMJ Open

Real-world data evaluating Guys rapid diagnostic clinic as an alternate pathway for patients with FIT levels below 10

Por: Monroy-Iglesias · M. J. · Martin · S. · Cargaleiro · C. · Jones · G. · Steward · L. · Murtagh · C. · Bruno · F. · Millwaters · J. · Schizas · A. · Watson · H. · Haire · A. · Haire · K. · Moss · C. L. · Russell · B. · Srirajaskanthan · R. · Van Hemelrijck · M. · Dolly · S. — Abril 16th 2024 at 08:27
Objective

To analyse the effectiveness of rapid diagnostic clinics (RDCs) as an alternative pathway for patients with concerning symptoms and a faecal immunochemical test (FIT) result

Design

A retrospective and prospective cohort study.

Setting

GSTT RDC, one of England’s largest single-centre RDCs. Sociodemographic and clinical characteristics of FIT

Participants

Patients with an FIT result

Results

A total of 1299 patients with an FIT

Conclusion

This study demonstrates the effectiveness of RDCs as an alternate pathway for FIT

☐ ☆ ✇ BMJ Open

Community perceptions, beliefs and factors determining family planning uptake among men and women in Ekiti State, Nigeria: finding from a descriptive exploratory study

Por: Ibikunle · O. O. · Ipinnimo · T. M. · Bakare · C. A. · Ibirongbe · D. O. · Akinwumi · A. F. · Ibikunle · A. I. · Ajidagba · E. B. · Olowoselu · O. O. · Abioye · O. O. · Alabi · A. K. · Seluwa · G. A. · Alabi · O. O. · Filani · O. · Adelekan · B. — Abril 11th 2024 at 17:57
Objectives

To examine family planning through the community’s perception, belief system and cultural impact; in addition to identifying the determining factors for family planning uptake.

Design

A descriptive exploratory study.

Setting

Three communities were selected from three local government areas, each in the three senatorial districts in Ekiti State.

Participants

The study was conducted among young unmarried women in the reproductive age group who were sexually active as well as married men and women in the reproductive age group who are currently living with their partners and were sexually active.

Main outcome measures

Eight focus group discussions were conducted in the community in 2019 with 28 male and 50 female participants. The audio recordings were transcribed, triangulated with notes and analysed using QSR NVivo V.8 software. Community perception, beliefs and perceptions of the utility of family planning, as well as cultural, religious and other factors determining family planning uptake were analysed.

Results

The majority of the participants had the perception that family planning helps married couple only. There were diverse beliefs about family planning and mixed reactions with respect to the impact of culture and religion on family planning uptake. Furthermore, a number of factors were identified in determining family planning uptake—intrapersonal, interpersonal and health system factors.

Conclusion

The study concluded that there are varied reactions to family planning uptake due to varied perception, cultural and religious beliefs and determining factors. It was recommended that more targeted male partner engagement in campaign would boost family planning uptake.

☐ ☆ ✇ PLOS ONE Medicine&Health

Development of a prognostic risk score to predict early mortality in incident elderly Japanese hemodialysis patients

by Hirokazu Okada, Atsushi Ono, Koji Tomori, Tsutomu Inoue, Norio Hanafusa, Ken Sakai, Ichiei Narita, Toshiki Moriyama, Yoshitaka Isaka, Kei Fukami, Seiji Itano, Eiichiro Kanda, Naoki Kashihara

Background

Information of short-term prognosis after hemodialysis (HD) introduction is important for elderly patients with chronic kidney disease (CKD) and their families choosing a modality of renal replacement therapy. Therefore, we developed a risk score to predict early mortality in incident elderly Japanese hemodialysis patients.

Materials and methods

We analyzed data of incident elderly HD patients from a nationwide cohort study of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) to develop a prognostic risk score. Candidate risk factors for early death within 1 year was evaluated using multivariate logistic regression analysis. The risk score was developed by summing up points derived from parameter estimate values of independent risk factors. The association between risk score and early death was tested using Cox proportional hazards models. This risk score was validated twice by using an internal validation cohort derived from the JRDR and an external validation cohort collected for this study.

Results

Using the development cohort (n = 2,000), nine risk factors were retained in the risk score: older age (>85), yes = 2, no = 0; sex, male = 2, female = 0; lower body mass index (2.0 mg/dL), yes = 2, no = 0. In the internal and external validation cohorts (n = 739, 140, respectively), the medium- and high-risk groups (total score, 6 to 10 and 11 or more, respectively) showed significantly higher risk of early death than the low-risk group (total score, 0 to 5) (p Conclusion

We developed a prognostic risk score predicting early death within 1 year in incident elderly Japanese HD patients, which may help detect elderly patients with a high-risk of early death after HD introduction.

☐ ☆ ✇ BMJ Open

Side effects of COVID-19 vaccines in paediatric patients: a review systematic and meta-analysis protocol

Por: Freitas · C. L. · Sarmento · A. C. A. · Serquiz · N. · Nobre · M. L. · Costa · A. P. F. · Medeiros · K. S. · Goncalves · A. K. — Abril 10th 2024 at 03:18
Introduction

The paediatric population represents a quarter of the world’s population, and like adult patients, they have also suffered immeasurably from the SARS-CoV-2 pandemic. Immunisation is an effective strategy for reducing the number of COVID-19 cases. With the advancements in vaccination for younger age groups, parents or guardians have raised doubts and questions about adverse effects and the number of doses required. Therefore, systematic reviews focusing on this population are needed to consolidate evidence that can help in decision-making and clinical practice. This protocol aims to assess the safety of COVID-19 vaccines in paediatric patients and evaluate the correlation between the number of vaccine doses and side effects.

Methods and analysis

We will search the PubMed, ClinicalTrials.gov, Web of Science, Embase, CINAHL, Latin American and Caribbean Health Sciences Literature, Scopus and Cochrane databases for randomised and quasi-randomised clinical trials that list the adverse effects of the COVID-19 vaccine and assess its correlation with the number of doses, without any language restrictions. Two reviewers will select the studies according to the inclusion and exclusion criteria, extract data and asses for risk of bias using the Cochrane risk-of-bias tool. The Review Software Manager (RevMan V.5.4.1) will be used to synthesise the data. We will use the Working Group’s Grading of Recommendations Assessment, Development and Evaluations to grade the strength of the evidence of the results.

Ethics and dissemination

Formal ethical approval is not required as no primary data are collected. This systematic review will be disseminated through a peer-reviewed publication.

PROSPERO registration number

CRD42023390077.

☐ ☆ ✇ Cultura de los cuidados

La alimentación de los enfermos en los hospitales de la edad moderna, el caso de Vitoria (Álava, España)

Por: Manuel Ferreiro Ardións — Abril 10th 2024 at 00:00

El conocimiento sobre alimentación en los hospitales de la edad moderna en España está sustentado en documentación de muy pocos centros, mayoritariamente de grandes urbes, siendo necesarias nuevas aportaciones para ampliar la evidencia existente. A tal objeto se ha analizado la documentación del hospital Santiago de Vitoria, un hospital y una ciudad más representativos de la mediana peninsular. Se ha hallado un inequívoco enfoque económico de la documentación sobre alimentos y la consignación de su adquisición solo recoge gastos extraordinarios, mayoritariamente alimentos destinados a la botica (80% de los asientos). La dieta basal solo nos es conocida por su descripción teórica, anotándose su gasto por número de raciones o su fracción. Se evidencia una supervisión triple en su preparación y administración, así como una cuidada prescripción médica de los alimentos en las dietas individualizadas. En conclusión, los gastos no evidencian el consumo efectivo ni tampoco representan la dieta real, pues la inmensa mayoría de los alimentos consignados estuvieron destinados a la botica y no a la alimentación de los enfermos. Debe preguntarse si los estudios precedentes, que utilizan también datos de gastos, no han hecho una mala interpretación de estos extrapolando erróneamente una dieta magnífica cuando, en el caso vitoriano, tuvo una composición de clases populares.

☐ ☆ ✇ Cultura de los cuidados

Espiritualidad, vocación y sentido. Recursos generales de resistencia para profesionales de enfermería según la figura de San Juan de Dios

Este artículo tiene como objetivo elaborar una reflexión hacia aquellos elementos que actuaron como recursos espirituales en el proceso de formación de San Juan de Dios como enfermero y elaborar una serie de aportaciones actuales para reforzar el sentido de coherencia de las enfermeras post pandemia. Se utilizó la metodología historiográfica aplicada a historia de la enfermería para la reconstrucción de la memoria profesional, tomando como referencia y ejemplo la figura de San Juan de Dios y se recogieron los elementos siguiendo la herramienta de valoración espiritual FICA. Los textos muestran a Juan de Dios con un sentido de coherencia interna que se hizo posible a través de los recursos psico-espirituales de la época. Éstos facilitaron encontrar y desarrollar la vocación propia y la motivación para desarrollarla y alcanzar la autorrealización. La propuesta es contemplar en la profesionalización enfermera un cuidado por paraklesis, que implica presencia personal, actitud dialogal y palabra sapiencial, luminosa y alentadora siguiendo el modelo de San Juan de Dios, y su relación con el modelo de valoración espiritual FICA.

☐ ☆ ✇ Cultura de los cuidados

Necesidades humanas básicas en gestantes con alto riesgo obstétrico analizado bajo la Teoría de Wanda Horta

Objetivo: identificar las necesidades humanas básicas de las embarazadas de alto riesgo hospitalizadas con base en la Teoría de Wanda Horta. Método: investigación asistencial realizada con dieciséis gestantes de alto riesgo hospitalizadas en una maternidad de referencia en Ceará entre septiembre y noviembre de 2019. Se recolectó información a través de diario de campo y ficha de caracterización de las gestantes y registros de necesidades humanas básicas. Los resultados se analizaron mediante estadística descriptiva simple y un enfoque integral a la luz del marco de Wanda Horta. Resultados: las gestantes presentaron necesidades psicobiológicas, psicosociales y psicoespirituales, siendo prevalentes: ausencia de actividades de ocio, inseguridad emocional, escaso conocimiento, sueño y descanso perjudicados, y actividades físicas restringidas por indicación de descanso. Consideraciones finales: se cree que el razonamiento crítico y el juicio clínico de los enfermeros se centraron en la individualidad de las gestantes, identificando necesidades en los tres niveles propuestos por la teoría, apuntando caminos para cualificar el cuidado de enfermería a las gestantes de alto riesgo.

☐ ☆ ✇ Cultura de los cuidados

Salud Mental en enfermeras al cuidado de pacientes en área COVID: estudio de caso

La enfermería es la labor que abarca la atención autónoma a personas de todas las edades, familias, grupos y comunidades, la principal característica y esencia es el cuidado, implica establecer una relación de comprensión y acompañamiento de manera integral, convirtiéndolos en los principales cuidadores formales en la asistencia, lo que pone de manifiesto la necesidad de mirar su salud mental y bienestar del personal de enfermería. El objetivo fue describir el impacto en la salud mental de un profesional de la enfermería en la atención a pacientes del área COVID en tiempos de pandemia, en el periodo 2022-2023. Se realizó un estudio cualitativo, primero mediante el análisis documental y posteriormente mediante el método fenomenológico, descriptivo con base en el estudio de caso, considerando la temporalidad en tres momentos, antes, durante y después de la pandemia por COVID. Los hallazgos dan constancia, de cambios e impactos a nivel biológico, psicológico, social y espiritual que derivan en afectaciones en salud mental que se experimentaron, y, por otro lado, de la escasez acciones para dotar a los profesionales de la salud de un acompañamiento, capacitación y sensibilización en salud mental para la mejora de su labor y bienestar personal.

☐ ☆ ✇ BMJ Open

Comparing nurses attending a specialised mental health programme with and without substance use disorder: a retrospective, observational study in Spain

Por: Braquehais · M. D. · Mozo · X. · Llavayol · E. · Gausachs · E. · Santiago · R. · Nieva · G. · Valero · S. · Grau-Lopez · L. · Ramos-Quiroga · J. A. · Bruguera · E. — Abril 6th 2024 at 03:44
Objectives

To analyse the differences between nurses with and without substance use disorders (SUDs) admitted to a specialised mental health programme.

Design

Retrospective, observational study.

Setting

Specialised mental health treatment programme for nurses in Catalonia, Spain.

Participants

1091 nurses admitted to the programme from 2000 to 2021.

Interventions

None.

Primary and secondary outcomes

Sociodemographic, occupational and clinical variables were analysed. Diagnoses followed Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision criteria.

Results

Most nurses admitted to the programme were women (88%, n=960) and came voluntarily (92.1%, n=1005). The mean age at admission was 45 (SD=10.4) years. The most common diagnoses were adjustment disorders (36.6%, n=399), unipolar mood disorders (25.8%, n=282), anxiety disorders (16.4%, n=179) and SUDs (13.8%, n=151). Only 19.2% (n=209) of the sample were hospitalised during their first treatment episode. After multivariate analysis, suffering from a SUD was significantly associated with being a man (OR=4.12; 95% CI 2.49 to 6.82), coming after a directed referral (OR=4.55; 95% CI 2.5 to 7.69), being on sick leave at admission (OR=2.21; 95% CI 1.42 to 3.45) and needing hospitalisation at the beginning of their treatment (OR=12.5; 95% CI 8.3 to 20).

Conclusions

Nurses with SUDs have greater resistance to voluntarily asking for help from specialised mental health treatment programmes and have greater clinical severity compared with those without addictions. SUDs are also more frequent among men. More actions are needed to help prevent and promote earlier help-seeking behaviours among nurses with this type of mental disorder.

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