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Cronicidad: Significado construido por los cuidadores y las personas cuidadas

Introducción: Las enfermedades crónicas no transmisibles van en aumento, ocasionando discapacidad y dependencia en quien la padece, así como la necesidad de un cuidador. La cronicidad es un concepto que se ha analizado desde la mirada de la persona que la padece, dejando un vacío en la comprensión del significado para el cuidador.

Objetivo: comprender el significado de la cronicidad para las personas con Enfermedades crónicas no transmisibles y sus cuidadores informales.

Materiales y métodos: investigación cualitativa fenomenológica-hermenéutica según la propuesta de Van Manen, muestreo casual orientado por criterio, participaron 10 personas enfermas y 9 cuidadores. Los criterios de rigor de credibilidad y confirmabilidad, confiabilidad y la transferibilidad, garantizaron la calidad del estudio.

Resultados: emergieron los siguientes temas: Brindar y recibir cuidado como un acto de amor; unión de la familia; enfrentarse a la dureza; Recibir, brindar y buscar apoyo; Estar pendiente; Cambio de vida; Proceso de aprendizaje; una compañía para toda la vida; Imponer restricciones, limitaciones y pérdidas.

Conclusiones: el significado de la cronicidad para los cuidadores y las personas enfermas es complejo, dinámico y multidimensional; por lo tanto, es necesario realizar intervenciones que ayuden a mitigar el impacto que esta produce en la vida de este binomio.

Adherence to PRISMA 2020 reporting guidelines and scope of systematic reviews published in nursing: A cross‐sectional analysis

Abstract

Introduction

Systematic reviews are considered the highest level of evidence that can help guide evidence-informed decisions in nursing practice, education, and even health policy. Systematic review publications have increased from a sporadic few in 1980s to more than 10,000 systematic reviews published every year and around 30,000 registered in prospective registries.

Methods

A cross-sectional design and a variety of data sources were triangulated to identify the journals from which systematic reviews would be evaluated for adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting guidelines and scope. Specifically, this study used the PRISMA 2020 reporting guidelines to assess the reporting of the introduction, methods, information sources and search strategy, study selection process, quality/bias assessments, and results and discussion aspects of the included systematic reviews.

Results

Upon review of the 215 systematic reviews published in 10 top-tier journals in the field of nursing in 2019 and 2020, this study identified several opportunities to improve the reporting of systematic reviews in the context of the 2020 PRISMA statement. Areas of priority for reporting include the following key areas: (1) information sources, (2) search strategies, (3) study selection process, (4) bias reporting, (5) explicit discussion of the implications to policy, and lastly, the need for (6) prospective protocol registration.

Discussion

The use of the PRISMA 2020 guidelines by authors, peer reviewers, and editors can help to ensure the transparent and detailed reporting of systematic reviews published in the nursing literature.

Clinical Relevance

Systematic reviews are considered strong research evidence that can guide evidence-based practice and even clinical decision-making. This paper addresses some common methodological and process issues among systematic reviews that can guide clinicians and practitioners to be more critical in appraising research evidence that can shape nursing practice.

Predictors of mental health in healthcare workers during the COVID‐19 pandemic: The role of experiential avoidance, emotion regulation and resilience

Abstract

Aims

This study explores the mediational role of resilience, experiential avoidance and emotion regulation in the levels of anxiety, depression and posttraumatic stress disorder (PTSD) of healthcare workers during the COVID-19 pandemic. Additionally, we explored the association of such levels with personal and professional variables.

Design

Cross-sectional study.

Methods

Healthcare professionals working in Spain (N = 786) were recruited following a snowball approach in November and December 2021. Resilience, emotion regulation, experiential avoidance, depression, anxiety, PTSD and work-related variables were measured. Mean differences and correlations were computed, and a path analysis with latent variables (PALV) model was tested.

Results

In total, 18.8% of the sample scored above the cut-off score for depression, 24.6% for anxiety and 36.4% for PTSD. Higher resilience and lower experiential avoidance and expression suppression were correlated with better mental health. The PALV model explained 42%–53% of mental health outcomes. Experiential avoidance showed the greatest explanatory power and mediated the impact that stressors had on mental health. Some work-related variables correlated with greater psychological impact. These factors encompassed being a nurse, feeling that their job remained stressful and had not yet returned to its pre-pandemic state and having interacted with individuals facing economic difficulties due to the pandemic, and those who had lost their lives to COVID-19.

Conclusion

Healthcare workers showed high levels of psychological impact during the COVID-19 pandemic. Such impact was predicted from some work-stress variables and the reliance on maladaptive strategies such as experiential avoidance and expressive suppression.

Impact

Training healthcare professionals to use coping strategies incompatible with experiential avoidance may improve their mental health. Additionally, better working conditions are fundamental for reducing the impact of critical situations on healthcare workers' mental health.

Patient or Public Contribution

No patient or public contribution.

Implementation of rapid genomic sequencing in safety-net neonatal intensive care units: protocol for the VIrtual GenOme CenteR (VIGOR) proof-of-concept study

Por: D'Gama · A. M. · Hills · S. · Douglas · J. · Young · V. · Genetti · C. A. · Wojcik · M. H. · Feldman · H. A. · Yu · T. W. · G Parker · M. · Agrawal · P. B. · VIGOR Network · Agrawal · Allcroft · Bhandari · Cantu · DGama · Douglas · Feldman · Genetti · Hills · Honrubia · Kritzer · Parke
Introduction

Rapid genomic sequencing (rGS) in critically ill infants with suspected genetic disorders has high diagnostic and clinical utility. However, rGS has primarily been available at large referral centres with the resources and expertise to offer state-of-the-art genomic care. Critically ill infants from racial and ethnic minority and/or low-income populations disproportionately receive care in safety-net and/or community settings lacking access to state-of-the-art genomic care, contributing to unacceptable health equity gaps. VIrtual GenOme CenteR is a ‘proof-of-concept’ implementation science study of an innovative delivery model for genomic care in safety-net neonatal intensive care units (NICUs).

Methods and analysis

We developed a virtual genome centre at a referral centre to remotely support safety-net NICU sites predominantly serving racial and ethnic minority and/or low-income populations and have limited to no access to rGS. Neonatal providers at each site receive basic education about genomic medicine from the study team and identify eligible infants. The study team enrols eligible infants (goal n of 250) and their parents and follows families for 12 months. Enrolled infants receive rGS, the study team creates clinical interpretive reports to guide neonatal providers on interpreting results, and neonatal providers return results to families. Data is collected via (1) medical record abstraction, (2) surveys, interviews and focus groups with neonatal providers and (3) surveys and interviews with families. We aim to examine comprehensive implementation outcomes based on the Proctor Implementation Framework using a mixed methods approach.

Ethics and dissemination

This study is approved by the institutional review board of Boston Children’s Hospital (IRB-P00040496) and participating sites. Participating families are required to provide electronic written informed consent and neonatal provider consent is implied through the completion of surveys. The results will be disseminated via peer-reviewed publications and data will be made accessible per National Institutes of Health (NIH) policies.

Trial registration number

NCT05205356/clinicaltrials.gov.

Effectiveness of CO-OP group intervention for children with developmental coordination disorder: single-case experimental design study protocol

Por: Madieu · E. · Therriault · P.-Y. · Cantin · N. · Baghdadli · A.
Introduction

With the Cognitive Orientation to daily Occupational Performance (CO-OP) approach, children with developmental coordination disorder learn to use a problem-solving strategy to deal with their motor difficulties and perform daily activities of their choice. Therapists use guided discovery to enable children to find their own solutions. Although CO-OP is recommended in a group setting, studies are needed to support its effectiveness.

Methods and analysis

A single-case study design with multiple baselines across participants and four systematic replications will be used. In each of the five groups, four children (aged 8–12 years) will be randomly included at the baseline. The baseline includes 5–8 measurements, and the CO-OP intervention stage is comprised of 10 sessions. The follow-up stage includes five measurements. Prior to baseline, each child in each of the five groups will choose five activities of which three will be carried out during the intervention sessions. Children’s performance in each of these activities will be scored using the Performance Quality Rating Scale (PQRS) as the main measure. Three secondary measures will be collected: perceived activity performance using the Canadian Occupational Performance Measure, quality of life using the Kidscreen-27 and spontaneous motor rhythm using a computerised typing task. Graphed data will be analysed visually at the individual level with the Visual Aid Implying an Objective Rule (VAIOR) protocol which provides a colour code based on the level and trend of two consecutive phases, facilitating an objective visual analysis. Statistics will be performed for PQRS scores at the individual level and at the group level.

Ethics and dissemination

The protocol has been approved by the Comité de protection des personnes Sud-Est I (CPP 2021070) and the Comité d’éthique de la recherche avec les êtres humains de l’Université du Québec à Trois-Rivières (CER-22-294-07.03). Results will be published in a peer-reviewed scientific journal.

Trial registration number

NCT05231486.

Factors influencing the acceptability of alcohol drinking for a patient with colorectal cancer

by Camille Auriol, Nicole Cantisano, Patrick Raynal

Introduction

Colorectal cancer is the second deadliest cancer worldwide. One of the risk factors for the development of this type of cancer is alcohol consumption. Patients with colorectal cancer may be stigmatized regarding their cancer and regarding drinking behaviors they may exhibit. This study aimed to analyze community persons’ and health professionals’ acceptability judgments regarding alcohol drinkers having colorectal cancer.

Method

This study relies on an experimental method enabling the identification of variables involved in one’s judgment, based on the exhaustive combination of factors yielding several scenarios rated by participants. Scenarios implemented factors possibly influencing participants’ perception of a woman character having colorectal cancer. Factors included her drinking habits, post-diagnosis drinking behavior and type of diagnosis/prognosis. The participants were community persons (N’ = 132) or health professionals (N" = 126). Data were analyzed using a within-subject factorial ANOVA.

Results

In both samples, the "Post-diagnosis behavior" factor had large effect sizes, with drinking cessation being more acceptable than other drinking behaviors. Another factor, "Drinking habits", had significant influences on participants judgments, as higher drinking was considered less acceptable. A third factor, "Diagnosis" (polyps, early- or late-stage cancer), was taken into account by participants when it interacted with "Drinking habits" and "Post-diagnosis behavior". Indeed, participants considered most acceptable to continue drinking in the case of late-stage cancer, especially in the health professional sample where the acceptability of continuing drinking was almost doubled when the character had advanced- rather than early-cancer.

Conclusion

The lesser the drinking behavior, the better the acceptability. However, advanced cancer stage attenuated the poor acceptability of drinking in both samples, as participants’ attitudes were more permissive when the patient had advanced cancer.

A comparative analysis of depressive-like behavior: Exploring sex-related differences and insights

by Ana Carolina Cavalcante Rodrigues, Caroline Vitória de Lima Moreira, Camila Carlos Prado, Luan Silvestro Bianchini Silva, Rafael Fernandes Costa, Adesina Paul Arikawe, Gustavo Rodrigues Pedrino, Elson Alves Costa, Osmar Nascimento Silva, Hamilton Barbosa Napolitano, Iranse Oliveira-Silva, James Oluwagbamigbe Fajemiroye

Profiling the variability related to the estrous cycle is essential for assessing depressive-like behavior and screening drugs. This study compares circulating plasma corticosterone levels [CORT] and behavioral alterations in mice exposed to sucrose preference, forced swimming, and tail suspension tests (SPT, FST, and TST, respectively). While SPT exposure did not significantly alter [CORT], FST and TST showed notable changes. Mice in the TST exhibited increased movement and decreased immobility time compared to FST, suggesting a lower likelihood of depressive-like behavior in male mice. Notably, during the proestrus phase, female mice displayed the highest tendency for depressive-like behavior and elevated [CORT], but similar response to antidepressants (imipramine and fluoxetine). The inherent stress of the FST and TST tasks appears to influence [CORT] as well as depressant and antidepressant effects. These comparisons provide valuable insights for further behavioral phenotyping, model sensitivity assessment, and deepen our neurobiological understanding of depression in the context of drug screening.

Intravenous immunoglobulin treatment in childhood encephalitis (IgNiTE): a randomised controlled trial

Por: Hill · M. · Iro · M. · Sadarangani · M. · Absoud · M. · Cantrell · L. · Chong · K. · Clark · C. · Easton · A. · Gray · V. · Kneen · R. · Lim · M. · Liu · X. · Pike · M. · Solomon · T. · Vincent · A. · Willis · L. · Yu · L.-M. · Pollard · A. J. · The IgNiTE study team · Pollard · Lim · Solomon
Objective

To investigate whether intravenous immunoglobulin (IVIG) improves neurological outcomes in children with encephalitis when administered early in the illness.

Design

Phase 3b multicentre, double-blind, randomised placebo-controlled trial.

Setting

Twenty-one hospitals in the UK.

Participants

Children aged 6 months to 16 years with a diagnosis of acute or subacute encephalitis, with a planned sample size of 308.

Intervention

Two doses (1 g/kg/dose) of either IVIG or matching placebo given 24–36 hours apart, in addition to standard treatment.

Main outcome measure

The primary outcome was a ‘good recovery’ at 12 months after randomisation, defined as a score of≤2 on the Paediatric Glasgow Outcome Score Extended.

Secondary outcome measures

The secondary outcomes were clinical, neurological, neuroimaging and neuropsychological results, identification of the proportion of children with immune-mediated encephalitis, and IVIG safety data.

Results

18 participants were recruited from 12 hospitals and randomised to receive either IVIG (n=10) or placebo (n=8) between 23 December 2015 and 26 September 2017. The study was terminated early following withdrawal of funding due to slower than anticipated recruitment, and therefore did not reach the predetermined sample size required to achieve the primary study objective; thus, the results are descriptive. At 12 months after randomisation, 9 of the 18 participants (IVIG n=5/10 (50%), placebo n=4/8 (50%)) made a good recovery and 5 participants (IVIG n=3/10 (30%), placebo n=2/8 (25%)) made a poor recovery. Three participants (IVIG n=1/10 (10%), placebo n=2/8 (25%)) had a new diagnosis of epilepsy during the study period. Two participants were found to have specific autoantibodies associated with autoimmune encephalitis. No serious adverse events were reported in participants receiving IVIG.

Conclusions

The IgNiTE (ImmunoglobuliN in the Treatment of Encephalitis) study findings support existing evidence of poor neurological outcomes in children with encephalitis. However, the study was halted prematurely and was therefore underpowered to evaluate the effect of early IVIG treatment compared with placebo in childhood encephalitis.

Trial registration number

Clinical Trials.gov NCT02308982; ICRCTN registry ISRCTN15791925.

Remote and technology‐mediated working during the COVID‐19 pandemic: A qualitative exploration of the experiences of nurses working in general practice (the GenCo Study)

Abstract

Aim

To explore how nurses working in general practice experienced remote and technology-mediated working during the COVID-19 pandemic.

Design

Exploratory qualitative study with nursing team members working in general practices in England and national nurse leaders.

Methods

Data were collected between April and August 2022. Forty participants took part in either semi-structured interviews or focus groups. Data were analysed using Framework Analysis informed by the PERCS (Planning and Evaluating Remote Consultation Services) Framework. University of York ethics approval [HSRGC/2021/458/I] and Health Research Authority approval were obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. The study was funded by The General Nursing Council for England and Wales Trust.

Results

Participants continued to deliver a significant proportion of patient care in-person. However, remote and technology-mediated care could meet patients' needs and broaden access in some circumstances. When remote and technology-mediated working were used this was often part of a blended model which was expected to continue. This could support some workforce issues, but also increase workload. Participants did not always have access to remote technology and were not involved in decision-making about what was used and how this was implemented. They rarely used video consultations, which were not seen to add value in comparison to telephone consultations. Some participants expressed concern that care had become more transactional than therapeutic and there were potential safety risks.

Conclusion

The study explored how nurses working in general practice during the COVID-19 pandemic engaged with remote and technology-mediated working. It identifies specific issues of access to technology, workload, hybrid working, disruption to therapeutic relationships, safety risks and lack of involvement in decision-making. Changes were implemented quickly with little strategic input from nurses. There is now an opportunity to reflect and build on what has been learned in relation to remote and technology-mediated working to ensure the future development of safe and effective nursing care in general practice.

Impact

The paper contributes to understanding of remote and technology-mediated working by nurses working in general practice during the COVID-19 pandemic and indicates to employers and policy makers how this can be supported moving forward.

Reporting method

Standards for Reporting Qualitative Research (O'Brien et al., 2014).

Patient or public contribution

This was a workforce study so there was no patient or public contribution.

Implications for the profession and patient care

The paper highlights specific issues which have implications for the development of remote, technology-mediated and blended working for nurses in general practice, care quality and patient safety. These require full attention to ensure the future development of safe and effective nursing care in general practice moving forward.

The well‐being of nurses working in general practice during the COVID‐19 pandemic: A qualitative study (The GenCo Study)

Abstract

Aim

Exploration of experiences of nurses working in general practice during the COVID-19 pandemic to evaluate the impact on nurses' professional well-being.

Design

An exploratory qualitative study comprised of case studies of three general practice sites in England and a nationwide interview study of nurses working in general practice and nurse leaders. The study was funded by The General Nursing Council for England and Wales Trust. University of York ethics approval (HSRGC/2021/458/I) and Health Research Authority approval was obtained (IRAS: 30353, Protocol number: R23982, Ref 21/HRA/5132, CPMS: 51834).

Methods

Forty participants took part. Case site data consisted of interviews/focus groups and national data consisted of semi-structured interviews. Data collection took place between April and August 2022. Analysis was underpinned by West et al.'s The courage of compassion. Supporting nurses and midwives to deliver high-quality care, The King's fund, 2020 ABC framework of nurses' core work well-being needs.

Findings

The majority of participants experienced challenges to their professional well-being contributed to by lack of recognition, feeling undervalued and lack of involvement in higher-level decision-making. Some participants displayed burnout and stress. Structural and cultural issues contributed to this and many experiences pre-dated, but were exacerbated by, the COVID-19 pandemic.

Conclusions

By mapping findings to the ABC framework, we highlight the impact of the COVID-19 pandemic on the well-being of nurses working in general practice and contributing workplace factors. The issues identified have implications for retention and for the future of nursing in general practice. The study highlights how this professional group can be supported in the future.

Impact

The study contributes to our understanding of the experiences of nurses working in general practice during the COVID-19 pandemic and beyond. Findings have implications for this skilled and experienced workforce, for retention of nurses in general practice, the sustainability of the profession more broadly and care quality and patient safety.

Reporting Method

Standards for Reporting Qualitative Research (O'Brien et al. in Journal of the Association of American Medical Colleges, 89(9), 1245–1251, 2014).

Patient or Public Contribution

As this was a workforce study there was no patient or public contribution.

Grado de ansiedad del cuidador primario del niño hospitalizado

Objetivos. Conocer el grado de ansiedad del cuidador primario del niño hospitalizado e identificar la ansiedad de estos en función de la cronicidad de la patología. Asimismo, describir la relación entre el nivel de ansiedad y las características sociodemográficas. Metodología. Estudio transversal. La población de estudio estuvo conformada por cuidadores primarios de niños ingresados en un hospital de tercer nivel en la comunidad autónoma de Andalucía que accedieron voluntariamente a participar en el estudio (n=61). Por tanto, las variables fueron recogidas a través del cuestionario STAI y de un cuestionario sociodemográfico. Resultados. El grado general de ansiedad del cuidador primario fue de 52,98±18,60 puntos, con puntuaciones de ansiedad rasgo de 23,15±9,62 y ansiedad estado de 29,84±10,99. Los cuidadores de niños con patología crónica presentaron mayores niveles de ansiedad tanto generalizada como ansiedad estado que los que estaban hospitalizados por patología aguda (p≤0,05). Las mujeres expresaron niveles de ansiedad rasgo más elevados (p=0,02). Asimismo, este fue más elevado entre los que no desempeñaban actividad remunerada (p=0,04). Además, los cuidadores que no tenían más personas a cargo presentaron un grado de ansiedad superior general (p=0,02) y rasgo en comparación con los que sí (p=0,01). Discusión. Los cuidadores primarios de niños hospitalizados presentan un elevado nivel de ansiedad. Particularmente, este nivel es más elevado entre aquellos que cuidan a niños con patología crónica, aquellos que no tienen personas a cargo y que no desempeñan una actividad remunerada.

ABSTRACT

Objectives. To evaluate the general degree of anxiety of the primary caregiver of the hospitalized child and to identify the anxiety of caregiver depending on the chronicity of the pathology. Likewise, describe the relationship between the anxiety level and the socio-demographic characteristics. Methodology. Cross-sectional study. The population study was composed by primary caregivers of children admitted to a third level hospital in the autonomous community of Andalusia who voluntarily agreed to participate in the study (n=61). Therefore, the variables were collected through the STAI questionnaire and a sociodemographic questionnaire. Results. The primary caregiver's overall anxiety score was 52.98±18.60 points, as a trait 23.15±9.62 and as a state 29.84±10.99. Caregivers of children with chronic pathology presented higher levels of generalized anxiety and as a state than those who were hospitalized with acute pathology (p≤0.05). Women presented higher level of anxiety as trait. Likewise, the degree of anxiety as a trait was higher among those who did not perform paid activity (p=0.04). Also caregivers who had no other dependents presented a higher degree of generalized anxiety (p=0.02) and as a trait compared to those who did have other dependents (p=0.01). Discussion. Primary caregivers of hospitalized children present a high level of anxiety. It is particularly higher among those who care for children with a chronic pathology, those who do not have any dependents and who do not carry out a remunerated activity.

La historia de vida de la enfermera Águeda Medina Soto como elemento clave de la relevancia de la cultura de los cuidados en la enfermería de Jaén.

En esta propuesta presentamos un análisis crítico feminista de la importancia que han jugado las enfermeras, siendo la historia de vida de la enfermera Águeda Medina Soto un ejemplo de su relevancia en Jaén.

En este sentido, la metodología que nos facilita el estudio de nuestro pasado reciente es la historia de vida, siendo esta parte de un análisis intergeneracional crítico-reflexivo, estableciendo causa-efecto entre las experiencias personales, la sociedad y la Enfermería. Además, enlazándolo con la perspectiva de género, nos presta otro un necesario análisis para reflexionar sobre cómo se conformaba la sociedad, el acceso y limitaciones que se presentaban a las mujeres de la época para la incorporación en la rama de enfermería, además de la diferencia estructural y de reconocimiento de los roles sexo-genéricas entre las mujeres y hombres que ejercían dichos oficios (enfermeras y practicantes respectivamente).

Los resultados obtenidos muestran la utilidad que ofrece la historia de vida, para visibilizar las diferencias tanto estructurales, académicas y prácticas diferenciadas sexo-genéricas asociadas a las enfermeras y los practicantes. A su vez, visibilizar la relevancia social de las enfermeras dentro del ámbito sanitario en la cultura de los cuidados, a través del caso de la enfermera Águeda.

Monitorización con Índice biespectral para reducción de complicaciones asociadas a sobresedación en adultos: revisión sistemática

Objetivo: Demostrar mediante la monitorización con el índice biespectral la reducción de complicaciones asociadas a sobresedación en paciente con ventilación mecánica. Metodología: Enfermería basada en evidencia. Traducción a lenguaje científico DeCS y MeSH. Fuentes documentales: Epistemonikos, PUBMED, ELSEVIER, DOAJ y Google académico. Operador booleano AND, OR y NOT. Lectura critica mediante FLC 3.0. Jerarquización con Scottish Intercollegiate Guidelines Network (SIGN). Resultados: Ocho de 10 artículos demuestran reducción de eventos adversos, 5 de 10 artículos indican reducción de dosis empleadas y administradas de sedantes, también una fuerte evidencia de la precisión para valorar el nivel de sedación y reducción de la incidencia de la sedación. Se necesitan más estudios. Conclusión: La monitorización con índice Biespectral tiene un índice de especificidad más objetivo que escalas de sedación comúnmente usadas y demostró que reduce complicaciones asociadas a la sobresedación. Se requieren más estudios.

Diez claves para conocer mejor el Litio

El litio es el estabilizador del ánimo en uso más extendido. Posee un estrecho margen terapéutico, siendo tóxico en altas concentraciones. Esta guía va dirigida a profesionales y personas que estén utilizando Litio, pretende facilitar la toma correcta y el buen manejo de esta medicación [Fragmento de texto].

Enfermedad renal crónica como causa de disfunción familiar: análisis fenomenológico desde una perspectiva holística

Objetivo principal: Evaluar la disfunción familiar desde una perspectiva holística en enfermos renales en terapia sustitutiva en un hospital de Monterrey, México. Metodología: Diseño mixto, analítico, transversal. Población conformada por 634 enfermos renales en terapias de sustitución de un hospital de segundo nivel en Monterrey. Se usó estadística descriptiva e inferencial para datos cuantitativos. Para la parte cualitativa se usó metodología fenomenológica conforme a la teoría fundamentada y análisis de dominios. Resultados principales: Alta prevalencia de disfuncionalidad familiar (70%). Según los enfermos renales en etapas avanzadas, el abandono por parte del cónyuge, la infidelidad marital, la exclusión familiar y los problemas económicos, son los principales factores que fracturan los lazos y la estruc-tura familiar. Conclusión principal: La enfermedad renal puede ser factor de disfuncionalidad familiar, hecho que compromete las relacio-nes entre los miembros familiares y afecta el apego a los tratamientos sustitutivos, al ser estos dependientes de un cuidador primario.

Proceso de enfermería en la asistencia a pacientes en terapia de hemodiálisis

Objetivo: identificar los diagnósticos de enfermería y las intervenciones más frecuentes en la asistencia a los pacientes en hemodiálisis. Método: se realizó un estudio descriptivo, transversal, retrospectivo con un enfoque cuantitativo, realizado con 175 prontuarios de pacientes en hemodiálisis, asistidos en el servicio por un período de seis meses. Para la recolección de los datos, se utilizó la plataforma Google Forms®, generando una hoja de trabajo en Microsoft Excel®, un software que permite organizar, describir y analizar los mismos. Resultados principales: se identificaron tres diagnósticos de enfermería como más frecuentes: Riesgo de sangrado (67,2%); Riesgo de caída (56,5%) y Exceso de volumen de líquido (54,8%), en más de la mitad de los pacientes de acuerdo con los registros en los prontuarios. Las intervenciones de enfermería están dirigidas por el protocolo del procedimiento de hemodiálisis y no por los diagnósticos de enfermería. Conclusión: los diagnósticos más frecuentes se centran en las condiciones clínicas de la población estudiada, y no subvencionan las intervenciones de enfermería, que se definen con base en técnica de hemodiálisis.

Actuación de enfermería ante el síndrome de resección transuretral en una histeroscopia quirúrgica

La histeroscopia es un procedimiento con finalidad terapéutica y de diagnóstico, permitiendo una visión directa de la cavidad uterina. Es relativamente sencillo pero no exento de complicaciones. La solución más comúnmente utilizada para la distensión es glicina 1.5% debi-do a su baja viscosidad, bajo costo, transparencia y compatibilidad con electrocirugía. Una de las complicaciones más temidas durante la cirugía histeroscópica es hemodilución por absorción de medios de distensión. Presentamos el caso de una mujer de 64 años, con ab-sorción excesiva de glicina durante una histeroscopia. Destacamos la importancia de una vigilancia continua y una comunicación efectiva entre el equipo quirúrgico: ginecólogo, anestesiólogo y equipo de enfermería. Sin duda, esto nos permite identificar los factores de riesgo que pueden prevenir la absorción intraoperatoria de estos fluidos, así como establecer un diagnóstico temprano y aplicar un tratamiento oportuno y eficaz para minimizar complicaciones.

Actuación de enfermería ante el síndrome de resección transuretral en una histeroscopia quirúrgica

La histeroscopia es un procedimiento con finalidad terapéutica y de diagnóstico, permitiendo una visión directa de la cavidad uterina. Es relativamente sencillo pero no exento de complicaciones. La solución más comúnmente utilizada para la distensión es glicina 1.5% debi-do a su baja viscosidad, bajo costo, transparencia y compatibilidad con electrocirugía. Una de las complicaciones más temidas durante la cirugía histeroscópica es hemodilución por absorción de medios de distensión. Presentamos el caso de una mujer de 64 años, con ab-sorción excesiva de glicina durante una histeroscopia. Destacamos la importancia de una vigilancia continua y una comunicación efectiva entre el equipo quirúrgico: ginecólogo, anestesiólogo y equipo de enfermería. Sin duda, esto nos permite identificar los factores de riesgo que pueden prevenir la absorción intraoperatoria de estos fluidos, así como establecer un diagnóstico temprano y aplicar un tratamiento oportuno y eficaz para minimizar complicaciones.

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