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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

The impact of a climate of perceived organizational support on nurses' well‐being and healthcare‐unit performance: A longitudinal questionnaire study

Abstract

Aim

To investigate the relationship between nurses' climate of perceived organizational support, and their well-being and healthcare-unit performance.

Design

A two-wave cohort questionnaire study among nurses within six hospitals in Sweden.

Methods

Hypotheses were tested using cross-lagged path models on the individual (organizational support, job satisfaction, burnout, intention to stay) and aggregate levels (care-unit organizational support, team effectiveness, patient safety climate and patient safety). Analyses were based on 1.817 nurses in 228 care-units (T1), 1.362 nurses in 213 care-units (T2) and longitudinal samples of 711 nurses and 140 care-units.

Results

Organizational support (T1) positively influenced job satisfaction (T2) and tended to decrease burnout (T2) but did not affect turnover intent. Reversed relationships were also found. No statistically significant prospective effects were found on the aggregate level.

Conclusion

The results indicated a prospective reciprocally reinforcing relationship between organizational support and job satisfaction. Burnout and intention to stay were predictors rather than outcomes of the organizational support climate.

Implications for the Profession and/or Patient Care

A climate where nurses perceive that their organization values their contributions and cares about their well-being is beneficial for their job satisfaction and health, which, according to previous research, may influence nurse retention.

Impact

The study addressed perceived organizational support as a potential predictor of nurses' well-being and healthcare-unit performance. A mutually reinforcing relation was indicated between organizational support and nurses' job satisfaction and health. Job dissatisfaction, burnout symptoms and turnover intentions were prospectively negatively related to the organizational support. Identifying and implementing a variety of practical measures to support perceptions of organizational support may be an effective way for healthcare management to start and sustain the development of a healthier work environment for healthcare professionals.

Reporting Method

STROBE statement for cohort studies.

Patient or Public Contribution

No patient or public contribution.

Developing and testing a reflection method for implementation of the informal care guideline in community nursing: Design‐based research

Abstract

Aim

To develop a reflection method for community nurses and certified nursing assistants to support the implementation of the Dutch Informal Care guideline in daily care.

Design

Design-based research.

Methods

A design group and four test groups of community nurses and nursing assistants were formed to develop a reflection method that aligns with the needs and preferences of its end-users. The design and test group meetings were video recorded. The video data were iteratively discussed and analysed thematically to adapt and refine the method and to identify its key features.

Results

A final reflection method was developed. Five main themes were identified from the analysis: the group, reflective triggers, knowledge about the guidelines, the coach and preconditions. The themes are linked to nine key features representing the building blocks of the reflection method. The key features are group size, participants with different (educational) backgrounds, pairs of participants, expressing thoughts, video feedback, reflection game, making the connection with the guideline, coaching as a process facilitator and meeting organizational and contextual conditions for implementation.

Conclusion

An evidence- and practice-based reflection method for community nurses and certified nursing assistants is developed to support the implementation. By involving community nurses and certified nursing assistants, the method closely matches their needs and preferences. Critical elements of the reflection method are a game element, video feedback and working in pairs in a group of participants from different (educational) backgrounds. Guidance is needed to make the transfer from theory to practice.

Impact

A reflection method for community nurses and certified nursing assistants was developed to enhance care work according to guideline recommendations, aiming to improve the care provided by informal caregivers.

Report Method

The COREQ guideline was used.

Patient or Public Contribution

This reflection method was developed in close collaboration with all stakeholders during the entire study.

Enhancing blood pressure management protocol implementation in patients with acute intracerebral haemorrhage through a nursing‐led approach: A retrospective cohort study

Abstract

Aim

To evaluate the impact of nurse care changes in implementing a blood pressure management protocol on achieving rapid, intensive and sustained blood pressure reduction in acute intracerebral haemorrhage patients.

Design

Retrospective cohort study of prospectively collected data over 6 years.

Methods

Intracerebral haemorrhage patients within 6 h and systolic blood pressure ≥ 150 mmHg followed a rapid (starting treatment at computed tomography suite with a target achievement goal of ≤60 min), intensive (target systolic blood pressure < 140 mmHg) and sustained (maintaining target stability for 24 h) blood pressure management plan. We differentiated six periods: P1, stroke nurse at computed tomography suite (baseline period); P2, antihypertensive titration by stroke nurse; P3, retraining by neurologists; P4, integration of a stroke advanced practice nurse; P5, after COVID-19 impact; and P6, retraining by stroke advanced practice nurse. Outcomes included first-hour target achievement (primary outcome), tomography-to-treatment and treatment-to-target times, first-hour maximum dose of antihypertensive treatment and 6-h and 24-h systolic blood pressure variability.

Results

Compared to P1, antihypertensive titration by stroke nurses (P2) reduced treatment-to-target time and increased the rate of first-hour target achievement, retraining of stroke nurses by neurologists (P3) maintained a higher rate of first-hour target achievement and the integration of a stroke advanced practice nurse (P4) reduced both 6-h and 24-h systolic blood pressure variability. However, 6-h systolic blood pressure variability increased from P4 to P5 following the impact of the COVID-19 pandemic. Finally, compared to P1, retraining of stroke nurses by stroke advanced practice nurse (P6) reduced tomography-to-treatment time and increased the first-hour maximum dose of antihypertensive treatment.

Conclusion

Changes in nursing care and continuous education can significantly enhance the time metrics and blood pressure outcomes in acute intracerebral haemorrhage patients.

Reporting Method

STROBE guidelines.

Patient and Public Contribution

No Patient or Public Contribution.

Analysis and clinical determinants of post-COVID-19 syndrome in the Lombardy region: evidence from a longitudinal cohort study

Por: Borgonovo · F. · Lovaglio · P. G. · Mariani · C. · Berta · P. · Cossu · M. V. · Rizzardini · G. · Vittadini · G. · Capetti · A. F.
Objective

To define macro symptoms of long COVID and to identify predictive factors, with the aim of preventing the development of the long COVID syndrome.

Design

A single-centre longitudinal prospective cohort study conducted from May 2020 to October 2022.

Setting

The study was conducted at Luigi Sacco University Hospital in Milan (Italy). In May 2020, we activated the ARCOVID (Ambulatorio Rivalutazione COVID) outpatient service for the follow-up of long COVID.

Participants

Hospitalised and non-hospitalised patients previously affected by COVID-19 were either referred by specialists or general practitioners or self-referred.

Intervention

During the first visit, a set of questions investigated the presence and the duration of 11 symptoms (palpitations, amnesia, headache, anxiety/panic, insomnia, loss of smell, loss of taste, dyspnoea, asthenia, myalgia and telogen effluvium). The follow-up has continued until the present time, by sending email questionnaires every 3 months to monitor symptoms and health-related quality of life.

Primary and secondary outcome measures

Measurement of synthetic scores (aggregation of symptoms based on occurrence and duration) that may reveal the presence of long COVID in different clinical macro symptoms. To this end, a mixed supervised and empirical strategy was adopted. Moreover, we aimed to identify predictive factors for post-COVID-19 macro symptoms.

Results

In the first and second waves of COVID-19, 575 and 793 patients (respectively) were enrolled. Three different post-COVID-19 macro symptoms (neurological, sensorial and physical) were identified. We found significant associations between post-COVID-19 symptoms and (1) the patients’ comorbidities, and (2) the medications used during the COVID-19 acute phase. ACE inhibitors (OR=2.039, 95% CI: 1.095 to 3.892), inhaled steroids (OR=4.08, 95% CI: 1.17 to 19.19) and COVID therapies were associated with increased incidence of the neurological macro symptoms. Age (OR=1.02, 95% CI: 1.01 to 1.04), COVID-19 severity (OR=0.42, 95% CI: 0.21 to 0.82), number of comorbidities (OR=1.22, 95% CI: 1.01 to 1.5), metabolic (OR=2.52, 95% CI: 1.25 to 5.27), pulmonary (OR=1.87, 95% CI: 1.10 to 3.32) and autoimmune diseases (OR=4.57, 95% CI: 1.57 to 19.41) increased the risk of the physical macro symptoms.

Conclusions

Being male was the unique protective factor in both waves. Other factors reflected different medical behaviours and the impact of comorbidities. Evidence of the effect of therapies adds valuable information that may drive future medical choices.

Patients' experiences of shared decision‐making in nursing care: A qualitative study

Abstract

Aim

To explore patients' experiences of shared decision-making, in nursing care during their stay in a healthcare institution.

Design

This study employed a qualitative descriptive design.

Methods

Twenty participants were interviewed from two rehabilitation centres, a nephrology ward of a hospital, and a rehabilitation ward of a long-term care facility. A constant comparative method was used for the inductive analysis.

Results

The main theme was ‘feeling seen and understood’, in the context of person-centred care, which served as the unifying thread across five themes. The five themes included the importance of a positive nurse–patient relationship as a foundation for shared decision-making. Next, patients experienced collaboration, and this was influenced by verbal and non-verbal communication. Another theme was that patients often felt overwhelmed during their stay, affecting shared decision-making. The fourth theme was that many decisions were not made through the shared decision-making process but were still perceived as satisfactory. The final theme highlighted patients' perspectives on their role in decision-making and influencing factors.

Conclusion

Patients describe how feeling seen and understood is a prerequisite for shared decision-making as a part of person-centred care. For nurses, this implies that they should focus on aspects such as building a good relationship and acknowledgement of patients' feelings and circumstances, next to empowering patients to feel knowledgeable and valued. This way patient's motivation to participate in shared decision-making will be enhanced.

Reporting Method

Following the EQUATOR guidelines, reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Patient or Public Contribution

Patients were involved in the study through interviews during the research process and member checks during analysis.

Implications for the profession and/or patient care

Before initiating shared decision-making processes, prioritise making the patient feel seen and understood. Be mindful that patients often feel overwhelmed during their stay. Use a person-centred approach to make patients feel knowledgeable—this empowers them for shared decision-making.

Impact

Research on patients' experiences of shared decision-making in nursing care is limited, yet crucial for understanding patients' needs in shared decision-making. This study highlights patients' perceptions that shared decision-making is best facilitated within the nurse–patient relationship by nurses who primarily focus on ensuring that patients feel acknowledged and understood.

Reallocating time between device-measured 24-hour activities and cardiovascular risk in Asian American immigrant women: An isotemporal substitution model

by Chorong Park, Britta Larsen, Simona C. Kwon, Yuhe Xia, Marianna LaNoue, Victoria V. Dickson, Harmony R. Reynolds, Tanya M. Spruill

The 24-hour day consists of physical activity (PA), sedentary behavior, and sleep, and changing the time spent on one activity affects the others. Little is known about the impact of such changes on cardiovascular risk, particularly in Asian American immigrant (AAI) women, who not only have a higher cardiovascular risk but also place greater cultural value on family and domestic responsibilities compared to other racial/ethnic groups. The purpose of this study was to evaluate the effects of reallocating 30 minutes of each 24-hour activity component for another on BMI, waist circumference, and blood pressure in AAI women. Seventy-five AAI women completed 7 days of hip and wrist actigraphy monitoring and were included in the analysis (age = 61.5±8.0 years, BMI = 25.5±3.6 kg/m2, waist circumference = 85.9±10.2 cm). Sleep was identified from wrist actigraphy data, and moderate-to-vigorous PA (MVPA), light PA, and sedentary behavior identified from hip actigraphy data. On average, the women spent 0.5 hours in MVPA, 6.2 hours in light PA, 10 hours in sedentary activities, and 5.3 hours sleeping within a 24-hour day. According to the isotemporal substitution models, replacing 30 minutes of sedentary behavior with MVPA reduced BMI by 1.4 kg/m2 and waist circumference by 4.0 cm. Replacing that same sedentary time with sleep reduced BMI by 0.5 kg/m2 and waist circumference by 1.4 cm. Replacing 30 minutes of light PA with MVPA decreased BMI by 1.6 kg/m2 and waist circumference by 4.3 cm. Replacing 30 minutes of light PA with sleep also reduced BMI by 0.8 kg/m2 and waist circumference by 1.7 cm. However, none of the behavioral substitutions affected blood pressure. Considering AAI women’s short sleep duration, replacing their sedentary time with sleep might be a feasible strategy to reduce their BMI and waist circumference.

Spatial confinement of <i>Trypanosoma brucei</i> in microfluidic traps provides a new tool to study free swimming parasites

by Mariana De Niz, Emmanuel Frachon, Samy Gobaa, Philippe Bastin

Trypanosoma brucei is the causative agent of African trypanosomiasis and is transmitted by the tsetse fly (Glossina spp.). All stages of this extracellular parasite possess a single flagellum that is attached to the cell body and confers a high degree of motility. While several stages are amenable to culture in vitro, longitudinal high-resolution imaging of free-swimming parasites has been challenging, mostly due to the rapid flagellar beating that constantly twists the cell body. Here, using microfabrication, we generated various microfluidic devices with traps of different geometrical properties. Investigation of trap topology allowed us to define the one most suitable for single T. brucei confinement within the field of view of an inverted microscope while allowing the parasite to remain motile. Chips populated with V-shaped traps allowed us to investigate various phenomena in cultured procyclic stage wild-type parasites, and to compare them with parasites whose motility was altered upon knockdown of a paraflagellar rod component. Among the properties that we investigated were trap invasion, parasite motility, and the visualization of organelles labelled with fluorescent dyes. We envisage that this tool we have named “Tryp-Chip” will be a useful tool for the scientific community, as it could allow high-throughput, high-temporal and high-spatial resolution imaging of free-swimming T. brucei parasites.

Cohort profile: COBLAnCE: a French prospective cohort to study prognostic and predictive factors in bladder cancer and to generate real-world data on treatment patterns, resource use and quality of life

Por: Lebret · T. · Bonastre · J. · Fraslin · A. · Neuzillet · Y. · Droupy · S. · Rebillard · X. · Vordos · D. · Guy · L. · Villers · A. · Schneider · M. · Coloby · P. · Lacoste · J. · Mejean · A. · Lacoste · J. · Descotes · J.-L. · Eschwege · P. · Loison · G. · Blanche · H. · Mariani · O. · Ghale
Purpose

Bladder cancer is a complex disease with a wide range of outcomes. Clinicopathological factors only partially explain the variability between patients in prognosis and treatment response. There is a need for large cohorts collecting extensive data and biological samples to: (1) investigate gene-environment interactions, pathological/molecular classification and biomarker discovery; and (2) describe treatment patterns, outcomes, resource use and quality of life in a real-world setting.

Participants

COBLAnCE (COhort to study BLAdder CancEr) is a French national prospective cohort of patients with bladder cancer recruited between 2012 and 2018 and followed for 6 years. Data on patient and tumour characteristics, treatments, outcomes and biological samples are collected at enrolment and during the follow-up.

Findings to date

We describe the cohort at enrolment according to baseline surgery and tumour type. In total, 1800 patients were included: 1114 patients with non-muscle-invasive bladder cancer (NMIBC) and 76 patients with muscle-invasive bladder cancer (MIBC) had transurethral resection of a bladder tumour without cystectomy, and 610 patients with NMIBC or MIBC underwent cystectomy. Most patients had a solitary lesion (56.3%) without basement membrane invasion (71.7% of Ta and/or Tis). Half of the patients with cystectomy were stage ≤T2 and 60% had non-continent diversion. Surgery included local (n=298) or super-extended lymph node dissections (n=11) and prostate removal (n=492). Among women, 16.5% underwent cystectomy and 81.4% anterior pelvectomy.

Future plans

COBLAnCE will be used for long-term studies of bladder cancer with focus on clinicopathological factors and molecular markers. It will lead to a much-needed improvement in the understanding of the disease. The cohort provides valuable real-world data, enabling researchers to study various research questions, assess routine medical practices and guide medical decision-making.

Roles and competencies of nurses and physicians in shared decision‐making in cardiac surgery: A scoping review

Abstract

Aim

Identification and synthesis of research data related to the roles and competencies of physicians and nurses that are prerequisites for careful shared decision-making with patients potentially undergoing cardiac surgery.

Design

A scoping review was conducted in accordance with the Joanna Briggs Institute's methodology for scoping reviews and the PRISMA Extension for Scoping Reviews.

Methods

PubMed, EMBASE and CINAHL were searched from inception dates up to March 2022, to identify primary studies published in a peer-reviewed journal. Study selection, assessment of the methodological quality and data extracting of the included studies were done by at least two independent researchers. To describe the findings of the studies, an emergent synthesis approach was used to visualize a descriptive representation of professional roles and competencies in shared decision-making, in an overview.

Results

The systematic search revealed 10,055 potential papers, 8873 articles were screened on title and abstract and 76 full texts were retrieved. Eight articles were included for final evaluation. For nurses and physicians, 26 different skills were identified in the literature to practice shared decision-making in cardiac surgery. The skills that emerged were divided into five professional roles: moderator; health educator; data collector; psychological supporter and translator.

Conclusions

This review specifies the professional roles and required competencies related to shared decision-making in cardiac surgery. Further research is needed to compare our findings with other clinical areas and from there to arrive at a professional division of roles between the different clinical disciplines involved.

Impact

The visualization of generic shared decision-making competencies and roles should establish the professional division of positions between various clinical physician and nurse disciplines in order to create a treatment plan based on evidence, values, preferences and the patient's personal situation.

Patient or Public Contribution

No patient or public contribution.

The role of perceived organizational support for nurses' ability to handle and resolve ethical value conflicts: A mixed methods study

Abstract

Aim

To explore if and how nurses' perceived organizational support affects their ability to handle and resolve ethical value conflicts.

Design

A mixed methods design with a longitudinal questionnaire survey and focus group interviews.

Methods

A questionnaire survey in six hospitals in two Swedish regions provided data from 711 nurses responding twice (November–January 2019/2020 and November–January 2020/2021). A cross-lagged path model tested the mutual prospective influence between the organizational climate of perceived organizational support, frequency of ethical value conflicts, and resulting moral distress. Four focus group interviews were conducted with 21 strategically selected nurses (April–October 2021). Qualitative data collection and analysis were inspired by Grounded Theory.

Results

A climate of perceived organizational support was empowering, contributing to role security. It prospectively decreased the frequency of ethical value conflicts but not the moral distress when conflicts did occur.

Conclusion

It is important to facilitate the development of perceived organizational support among nurses, but also to reduce the occurrence of ethical value conflicts that the nurses cannot resolve.

Implications for the Profession

By ensuring a shared care ideology, good inter-professional relations within the entire care organization, providing clear and supportive organizational structures, and utilizing competence adequately, healthcare managers can facilitate and support the development of perceived organizational support among nurses. Nurses who are empowered by perceived organizational support are stimulated by and take pride in their work and experience the work as meaningful and joyful.

Impact

The study addressed the question of whether healthcare organizations could support nurses to resolving ethical value conflicts, and thus reduce moral distress. Perceived organizational support is related to factors such as ideological caring alignment and supportive organizational preconditions. This study contributes specific knowledge about how healthcare organizations can empower nurses to effectively resolve ethical value conflicts and thereby reduce their moral distress.

Patient or Public Contribution

No patient or public contribution.

Fathers' experiences of living with a child with a progressive life‐limiting condition without curative treatment options: A qualitative systematic review

Abstract

Aim

To systematically review and synthesize findings across qualitative primary studies about fathers' experiences of living with a child with a progressive life-limiting condition without curative treatment options (C3 conditions).

Design

Systematic review and metasynthesis.

Methods

Sandelowski and Barosso's qualitative research methodology guided this review and metasynthesis. A modification of Ricoeur's interpretation theory, described by Lindseth and Norberg, guided the synthesis of qualitative data. The quality of the studies was evaluated using the Joanna Briggs Institute Checklist for Qualitative Research.

Data Sources

A systematic literature search was conducted on 6 May 2022 and updated on 19 July 2023 on MEDLINE, CINAHL Plus with Full Text, APA PsycInfo and Scopus. Inclusion criteria were English-written qualitative studies from the year 2000, from which we could extract data on fathers' experiences of living with a child from 0 to 18 years with a progressive life-limiting condition without curative treatment options.

Results

Seven reports from Western countries contributed to the review. Through structural analysis, we developed the following themes: ‘Being shattered in the perception of fatherhood’, ‘Establishing a new normal’ and ‘Striving to be acknowledged as a part of the caring team’.

Conclusion

Fathers had to establish a new normal, and they experienced anticipatory mourning, role conflicts and feeling sidelined in healthcare settings when living with a child with a C3 condition. An important issue for further research on paediatric palliative care (PPC) should be to include fathers in the research sample and report separately on fathers' or mothers' experiences instead of parents' experiences.

Impact

The findings will be of interest to healthcare personnel and multidisciplinary teams working within PPC, as they give insight into fathers' experiences and suggest interventions to increase healthcare personnel's involvement with fathers, such as telemedicine.

Reporting Method

Following EQUATOR guidelines, the study was reported according to the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) framework.

Patient or Public Contribution

No patient or Public Contribution.

Family engagement in paediatric acute care settings: A realist review

Abstract

Aim

To create a programme theory of family engagement in paediatric acute care to explicate the relationships between contexts and mechanisms of family engagement that align with family, direct care providers and healthcare organization outcomes.

Design

Realist review and synthesis.

Data Sources

PubMed, CINAHL, PsycINFO and Web of Science searches for the 2.5-year period (July 2019–December 2021) following our 2021 scoping review.

Review Methods

Following methods described by Pawson and Rycroft-Malone, we defined the scope of the review, searched for and appraised the evidence, extracted and synthesized study findings and developed a supporting narrative of our results.

Results

Of 316 initial citations, 101 were included in our synthesis of the final programme theory. Contexts included family and direct care provider individualism, and the organizational care philosophy and environment. Mechanisms were family presence, family enactment of a role in the child's care, direct care providers facilitating a family role in the child's care, unit/organizational promotion of a family role, relationship building and mutually beneficial partnerships. Outcomes were largely family-focussed, with a paucity of organizational outcomes studied. We identified four context–mechanism–outcome configurations.

Conclusion

This realist review uncovered underlying contexts and mechanisms between patients, direct care providers and organizations in the family engagement process and key components of a mutually beneficial partnership. Given that successful family engagement requires direct care provider and organizational support, future research should expand beyond family outcomes to include direct care providers, particularly nurses and healthcare organization outcomes.

Impact

The final programme theory of family engagement in paediatric acute care provides a roadmap for clinicians to develop complex interventions to engage families and evaluate their impact. The components of our final programme theory reflect family engagement concepts that have been evolving for decades.

Patient or Public Contribution

The team conducting this review included members from the practice setting (JT & KG). In the future, as we and others use this model in practice, we will seek input for refinement from clinicians, patients and caregivers.

Nurses' professional discretion in the purchaser‐provider split in home care in Norway

Abstract

Aim

To explore how nurses' professional discretion is operationalized in home care services that follow a purchaser–provider organization in Norway.

Design

A qualitative descriptive study.

Methods

Semi-structured interviews with open-ended questions were used, and data were collected from in-depth interviews with 15 registered nurses working in home care in four Norwegian local authority areas between April and November 2020. Braun and Clark's six-step analysis was used to analyse the empirical data.

Results

The analysis yielded two main themes, namely ‘The purchaser's instructions: facilitating and constraining care’ and ‘Professional discretion meets the purchaser–provider organisation of healthcare,’ with five associated codes.

Conclusion

Nurses are dependent on an organizational framework due to the complexity of health care services and the number of tasks involved. At the same time, they perform considerable compensatory work and need the ability to be flexible to enable this work and to perform actions related to the unforeseen needs of individual patients or those involving professional discretion.

Impact

The purchaser–provider model both facilitates and constrains nursing practice and professional responsibility in home nursing. Home nursing services need to be well organized because of their complexity and the wide variety of tasks they involve. In this context, the element of constraint is associated with the need for flexibility and professional discretion. Despite a strict framework, the nurses perform additional and compensatory tasks. Reforms inspired by ‘New Public Management,’ such as the purchaser–provider split, limit the workload for nurses; however, there is still a need to exercise discretion. The findings of this study may help home care managers and health policy-makers understand the interaction between management logic and health care logic, leading to a more appropriate organization of health care services where the nurses, as actors, gain more trust.

Implications

This study highlights home care nurses' opportunities to exercise discretion in an organizational framework that strives towards standardization. The nurses' ability to exercise discretion is important for individual and holistic patient care. At the same time, an organizational framework is needed because nurses cannot attend to all the needs the patients may have, as this will overload both home health services and the nurses.

Significado de no abandono en el adulto mayor de entornos comunitarios

Objetivo: comprender el significado del no abandono en el adulto mayor de la comunidad.  Metodología: estudio cualitativo descriptivo realizado en un municipio de Guanajuato, México de febrero-diciembre 2022. Se eligieron personas mayores de 60 años sin distinción de género; tipo de muestreo por conveniencia con saturación de información con 8 participantes; los datos fueron recolectados mediante entrevistas presenciales semi-estructuradas que fueron audio grabadas. Todos los participantes firmaron un consentimiento informado. Resultados: emergieron cuatro temas: 1. Necesidad de apoyo familiar, 2. Necesidad de sentirse integrado, 3. Necesidad de sentirse funcional y activo y 4. El abandono es soledad. Conclusión: el no abandono está construido a partir de la dinámica familiar y la funcionalidad, cada persona mayor le otorga un significado basado en la comunicación con sus familias, incluso a distancia, siendo reconfortante. Algunos viven solos y eso representa un espacio de satisfacción personal. La integración familiar es imperante, así mismo el mantenerse activos.

Caídas: adherencia a las medidas de prevención en un hospital de alta complejidad

Objetivo. Determinar la adherencia a las medidas de prevención de caídas en pacientes adultos internados en un hospital de alta complejidad desde el año 2019 al 2021. Metodología. Estudio cuantitativo, observacional, descriptivo y transversal. La población de estudio fueron las auditorías de prevención de riesgo de caídas en adultos en un hospital de alta complejidad de Buenos Aires, Argentina. La selección de la muestra fue de tipo probabilístico aleatorio, estratificado según el año de recolección del dato (2019-2021). Se tomó una muestra de 246 reportes. Resultados. El porcentaje de adherencia a las medidas de prevención de caídas son: 82% del 2019, 100% del 2020; y en el 2021 del 86%. Dentro del conjunto de medidas, las que presentaron mayor adherencia a lo largo de los últimos 3 años fueron: punto azul en puerta y timbre, arrojando entre un 99-100% de adherencia. Mientras que las medidas relacionadas a la educación y el material educativo presentaron un descenso en el 2021, pasando del 100% de adherencia en el 2020, a 90% y 82% respectivamente. Discusión. Se observó que, a lo largo de los últimos 3 años, la adherencia a las medidas de prevención fue alto, arrojando un 89% de adherencia. En un análisis posterior, observamos que las medidas punto azul pulsera, punto azul puerta, frenos, altura, barandas, educación, timbre y teléfono; fue en aumento. Mientras que, la medida de prevención en relación al material educativo brindado al paciente presentó una disminución en su nivel de adherencia.

 

ABSTRACT

Objective. To measure adherence to prevention measures in adult patients admitted to a highly complex hospital from 2019 to 2021. Methodology. Quantitative, observational, descriptive and cross-sectional study. The population observed was based on audit about the prevention risk of falls in adults hospitalized in a high complexity hospital from Buenos Aires, Argentina. The selection of the sample was of random probabilistic type, stratified according to the year of data collection (2019-2021). A sample of 246 audits was taken. Results. The percentage of adherence to fall prevention measures are: 82% in 2019, 100% in 2020; and in 2021 86%. Within the set of measures, those that presented greater adhesion over the last 3 years were: blue dot on the door and bell, yielding between 99-100% adherence. While the measure related to education and educational material presented a decrease in 2021, going from 100% adherence in 2020, to 90% and 82% respectively. Discussion. It was observed that, over the last 3 years, adherence to prevention measures was high, showing 89% adherence. During a later analysis, we observed that the measurements blue dot bracelet, blue dot door, brakes, height, railings, education, doorbell and telephone; increased. Meanwhile, the prevention measure in relation to the educational material provided to the patient, decrease in its level of adherence. 

 

 

Comorbilidad entre duelo complicado, sintomatología ansiosa y depresiva en dolientes de primer grado

Objetivo principal: valorar la presencia de duelo complicado (DC), la sintomatología ansiosa y depresiva, en dolientes de primer grado. Meto-dología: fueron evaluados 26 dolientes (84,60% mujeres), de 19 a 73 años (M=44,04; DT= 14,21), mediante: el Inventario de Duelo Complicado y la Escala Hospitalaria de Ansiedad y Depresión. Se realizaron análisis descriptivos, pruebas t, d de Cohen y correlaciones de Pearson. Resultados principales: un gran porcentaje (85,70%) mostraron DC, así como problemas clínicos de ansiedad (59,10%) y depresión (45,50%). El DC y la sintomatología emocional, fue mayor en hombres y cuando la pérdida era repentina. La presencia de DC se asoció con mayor ansiedad, depresión y malestar emocional general. Conclusión principal: es necesario conocer los factores de riesgo para desarrollar programas de intervención que incidan en ellos y favorezcan la salud física y mental de los dolientes.

Business Intelligence como herramienta de apoyo en la identificación de casos de suicidio en RS – Brasil

Introducción: Actualmente, el uso de tecnologías innovadoras ha ayudado a los profesionales a gestionar mejor el volumen de información de manera inteligente, para facilitar y optimizar el uso de acciones y prácticas preventivas. Entendido como un recurso capaz de expandir o acceder a datos, nuestro objetivo es analizar el tema del suicidio en Rio Grande do Sul, en el período de 2010 a 2019, desde el portal municipal de Business Intelligence. Método: Una investigación es de naturaleza cuantitativa, de tipo descriptivo, basada en los registros de muertes por suicidio en el estado de Rio Grande do Sul, escuchada por el portal público de inteligencia empresarial (BI). Los datos fueron analizados, basados en el número bruto de muertes por suicidio en la macro-región del Sur, registrada en el Portal BI / DGTI. Se realizó una descripción del número de muertes según el año, el sexo, el grupo de edad y la tasa de suicidios. Resultados: un total de 11,774 muertes por suicidio, registradas en los últimos 10 años, o el número más alto que ocurrió en los años 2017 y 2019, entre los hombres, con tasas más altas en los grupos de edad entre 20 y 69 años. Una tasa más alta registrada fue en 2019, con 12.41 muertes por cada 100,000 habitantes. Concluimos con este estudio sobre el uso de Bussiness Intelligence, que permite acciones más efectivas en la prevención del suicidio.

Satisfaction of Slovak Women with Psychosocial Aspects of Care during Childbirth

The objective of the study is to find out and assess satisfaction of Slovak women with psychosocial aspects of perinatal care.
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