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Introducción. El objetivo de la siguiente revisión fue determinar los factores de riesgo asociados a las conductas suicidas (intento de suicidio, ideación suicida y suicidio consumado) en adolescentes. Metodología. La presente revisión de la evidencia se llevó a cabo utilizando varios estudios que se hayan publicado en los últimos 10 años en cualquier país a nivel mundial; la búsqueda de la información se realizó con el uso del término de texto libre “conducta suicida” en las bases de datos PubMed, Epistemonikos, Scielo y Dialnet, identificando un total de 424 artículos y de ellos, 12 estudios se incluyeron en esta investigación. Resultados. Se determinó que los principales factores de riesgo que están asociados con la conducta suicida a partir del análisis de la evidencia científica disponible son: ser mujer, antecedentes de suicidios en la familia, violencia familiar, ausencia de padres y grupo familiar, conflictos con los padres, trauma infantil, rechazo, acoso escolar, conflictos con los compañeros, dificultades académicas, influencia de los amigos o conocidos cibernéticos, bullying, problemas para regular las emociones, depresión, desesperación, tristeza, soledad, enfermedad física y mental, eventos estresantes, impotencia, abuso de sustancias psicoactivas y violencia física o psicológica. Discusión. La conducta suicida en los adolescentes continúa siendo una problemática multicausal frecuente de salud pública, los factores de riesgo para desarrollar el comportamiento suicida incluyen aspectos personales, familiares, académicos y sociales, con base a estos hallazgos se pueden construir planes de cuidado enfermero individualizados, ajustados a las necesidades de cada persona.
ABSTRACT
Introduction. The objective of the following review was to determine the risk factors associated with suicidal behaviors (suicide attempt, suicidal ideation, and completed suicide) in adolescents. Methodology. The present evidence review was carried out using several studies that have been published in the last 10 years in any country worldwide; the search for information was carried out using the free text term "suicidal behavior" in the databases PubMed, Epistemonikos, Scielo and Dialnet, identifying a total of 424 articles and of these, 12 studies were included in this research. Results. It was determined that the main risk factors associated with suicidal behavior from the analysis of the available scientific evidence are: being female, history of suicide in the family, family violence, absence of parents and family group, conflicts with parents, childhood trauma, rejection, school bullying, conflicts with peers, academic difficulties, influence of cyber friends or acquaintances, bullying, problems regulating emotions, depression, despair, sadness, loneliness, physical and mental illness, stressful events, helplessness, abuse of psychoactive substances, and physical or psychological violence. Discussion. Suicidal behavior in adolescents continues to be a frequent multicausal public health problem. The risk factors for developing suicidal behavior include personal, family, academic and social aspects; based on these findings, individualized nursing care plans can be constructed, adjusted to the needs of each person.
To explore how long-term and late effects of paediatric brain tumours influence the everyday lives of survivors at various ages and their parents.
A qualitative interview study using reflexive thematic analysis.
We conducted individual interviews and focus groups with 14 paediatric brain tumour survivors aged 9–52 years and 16 parents, which were audiorecorded and transcribed. We inductively analyzed the data using Braun and Clarke's reflexive thematic analysis. Inductively derived themes were then mapped onto the components of the International Classification of Functioning, Disability and Health framework to examine the survivors' everyday functioning.
All survivors experienced ongoing long-term and late effects but with considerable variations in how these restricted the survivors' functioning and thus their ability to participate in everyday life activities (e.g. social, educational and work activities). All survivors expressed an explicit focus on and use of different strategies to manage their perceived functional limitations and participation restrictions. Many survivors expressed discrepancies between their own goals, expectations and actual abilities post-cancer; making them very aware of their limitations. In addition, many survivors and parents experienced ongoing concerns about the survivors’ future, including the risk of late effects, relapse or other complications.
A wide range of long-term and late effects continue to affect the survivors and their parents' functioning and everyday lives. Their ongoing needs emphasize the importance of comprehensive, life-long follow-up care, as recommended.
The complex challenges across the biopsychosocial realms faced by the survivors supports the call for multidisciplinary survivorship care. Nurses are well positioned to lead such care, as they are trained to provide holistic care and thereby support survivors' functioning and activity participation in everyday life.
We used the COREQ guidelines when reporting the study.
Two user representatives (one young adult PBT survivor and one mother of a PBT survivor) ensured the relevance and quality of the semi-structured interview guides prior to the interviews with the survivors and parents. The guides were sent to the user representatives by mail, and they provided their written feedback by mail to the first author.
This study was conducted to evaluate the ability of risk assessment to predict healthcare resource utilisation (HCRU), costs, treatments, health-related quality of life (HRQoL) and survival in patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH).
Retrospective observational study.
Pulmonary hypertension referral centre in the UK.
Adults diagnosed with CTEPH between 1 January 2012 and 30 June 2019 were included. Cohorts were retrospectively defined for operated patients (received pulmonary endarterectomy (PEA)) and not operated; further subgroups were defined based on risk score (low, intermediate or high risk for 1-year mortality) at diagnosis.
Demographics, clinical characteristics, comorbidities, treatment patterns, HRQoL, HCRU, costs and survival outcomes were analysed.
Overall, 683 patients were analysed (268 (39%) operated; 415 (61%) not operated). Most patients in the operated and not-operated cohorts were intermediate risk (63%; 53%) or high risk (23%; 31%) at diagnosis. Intermediate-risk and high-risk patients had higher HCRU and costs than low-risk patients. Outpatient and accident and emergency visits were lower postdiagnosis for both cohorts and all risk groups versus prediagnosis. HRQoL scores noticeably improved in the operated cohort post-PEA, and less so in the not-operated cohort at 6–18 months postdiagnosis. Survival at 5 years was 83% (operated) and 49% (not operated) and was lower for intermediate-risk and high-risk patients compared with low-risk patients.
Findings from this study support that risk assessment at diagnosis is prognostic for mortality in patients with CTEPH. Low-risk patients have better survival and HRQoL and lower HCRU and costs compared with intermediate-risk and high-risk patients.
To explore and model factors affecting antibiotic prescribing decision-making early in the pandemic.
Semistructured qualitative interview study.
National Health Service (NHS) trusts/health boards in England and Wales.
Clinicians from NHS trusts/health boards in England and Wales.
Individual semistructured interviews were conducted with clinicians in six NHS trusts/health boards in England and Wales as part of the Procalcitonin Evaluation of Antibiotic use in COVID-19 Hospitalised patients study, a wider study that included statistical analysis of procalcitonin (PCT) use in hospitals during the first wave of the pandemic. Thematic analysis was used to identify key factors influencing antibiotic prescribing decisions for patients with COVID-19 pneumonia during the first wave of the pandemic (March to May 2020), including how much influence PCT test results had on these decisions.
During the first wave of the pandemic, recommendations to prescribe antibiotics for patients with COVID-19 pneumonia were based on concerns about secondary bacterial infections. However, as clinicians gained more experience with COVID-19, they reported increasing confidence in their ability to distinguish between symptoms and signs caused by SARS-CoV-2 viral infection alone, and secondary bacterial infections. Antibiotic prescribing decisions were influenced by factors such as clinician experience, confidence, senior support, situational factors and organisational influences. A decision-making model was developed.
This study provides insight into the decision-making process around antibiotic prescribing for patients with COVID-19 pneumonia during the first wave of the pandemic. The importance of clinician experience and of senior review of decisions as factors in optimising antibiotic stewardship is highlighted. In addition, situational and organisational factors were identified that could be optimised. The model presented in the study can be used as a tool to aid understanding of the complexity of the decision-making process around antibiotic prescribing and planning antimicrobial stewardship support in the context of a pandemic.
by Susan Nakireka, David Mukunya, Crescent Tumuhaise, Ronald Olum, Edith Namulema, Agnes Napyo, Quraish Serwanja, Prossie Merab Ingabire, Asad Muyinda, Felix Bongomin, Milton Musaba, Vivian Mutaki, Ritah Nantale, Phillip Akunguru, Rozen Ainembabazi, Derrick Nomujuni, William Olwit, Aisha Nakawunde, Specioza Nyiramugisha, Pamela Mwa Aol, Joseph Rujumba, Ian Munabi, Sarah Kiguli
BackgroundIn Uganda, approximately 170,000 confirmed COVID-19 cases and 3,630 deaths have been reported as of January 2023. At the start of the second COVID-19 wave, the Ugandan health system was overwhelmed with a sudden increase in the number of COVID-19 patients who needed care, and the Ministry of Health resorted to home-based isolation and care for patients with mild to moderate disease. Before its rollout, the COVID-19 home-based care strategy had neither been piloted nor tested in Uganda.
ObjectiveTo explore the experiences of COVID-19 patients managed at home in Uganda.
MethodsThis was a qualitative study that was conducted to explore the lived experiences of COVID-19 patients managed at home. The study was carried out among patients who presented to three hospitals that were designated for treating COVID-19 patients in Uganda. COVID-19 patients diagnosed at these hospitals and managed at home were followed up and contacted for in-depth telephone interviews. The data were analysed using thematic content analysis with the aid of NVIVO 12.0.0 (QRS International, Cambridge, MA).
ResultsParticipants experienced feelings of fear and anxiety: fear of death, fear of losing jobs, fear of infecting loved ones and fear of adverse events such as loss of libido. Participants also reported feelings of loneliness, hopelessness and depression on top of the debilitating and sometimes worsening symptoms. In addition to conventional medicines, participants took various kinds of home remedies and herbal concoctions to alleviate their symptoms. Furthermore, COVID-19 care resulted in a high economic burden, which persisted after the COVID-19 illness. Stigma was a major theme reported by participants. Participants recommended that COVID-19 care should include counselling before testing and during and after the illness to combat the fear and stigma associated with the diagnosis. Another recommendation was that health workers should carry out home visits to patients undergoing home-based care and that COVID-19 treatment should be free of charge.
ConclusionCOVID-19 home-based care was associated with fear, anxiety, loneliness, depression, economic loss and stigma. Policymakers should consider various home-based follow-up strategies and strengthen counselling of COVID-19 patients at all stages of care.
Relative to outdoor air pollution, there is little evidence examining the composition and concentrations of indoor air pollution and its associated health impacts. The INGENIOUS project aims to provide the comprehensive understanding of indoor air pollution in UK homes.
‘Real Home Assessment’ is a cross-sectional, multimethod study within INGENIOUS. This study monitors indoor air pollutants over 2 weeks using low-cost sensors placed in three rooms in 300 Born in Bradford (BiB) households. Building audits are completed by researchers, and participants are asked to complete a home survey and a health and behaviour questionnaire, in addition to recording household activities and health symptoms on at least 1 weekday and 1 weekend day. A subsample of 150 households will receive more intensive measurements of volatile organic compound and particulate matter for 3 days. Qualitative interviews conducted with 30 participants will identify key barriers and enablers of effective ventilation practices. Outdoor air pollution is measured in 14 locations across Bradford to explore relationships between indoor and outdoor air quality. Data will be analysed to explore total concentrations of indoor air pollutants, how these vary with building characteristics, and whether they are related to health symptoms. Interviews will be analysed through content and thematic analysis.
Ethical approval has been obtained from the NHS Health Research Authority Yorkshire and the Humber (Bradford Leeds) Research Ethics Committee (22/YH/0288). We will disseminate findings using our websites, social media, publications and conferences. Data will be open access through the BiB, the Open Science Framework and the UK Data Service.
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.Objetivo: Generar una teoría de situación específica para explicar el control de miedo, ansiedad y estrés postraumático en personal de enfermería que atendió a pacientes Covid. Desarrollo: La teoría de las transiciones, fue base para la teoría de situación específica con los cuatro pasos de Dulock y Holzemer: (1) identificar y aislar principales conceptos, (2) especificar relaciones entre conceptos, (3) ordenar jerárquicamente los conceptos según nivel de abstracción, y (4) ilustrar relaciones actuales entre variables. Conclusión principal: La teoría de situación específica para explicar el control de miedo, ansiedad y estrés postraumático basada en la Teoría de las Transiciones es útil para explicar las condiciones de transición personales que facilitan e inhiben el paso hacia un nuevo rol de cuidado y explicar indicadores que intervienen en el proceso y resultado en el personal de enfermería.
To investigate the self-reported levels of social support from friends and family and from nurses as mediators of the relationship between self-rated physical and psychological condition in hospitalised patients.
Cross-sectional study of adult inpatients at a large tertiary-care hospital in the northeast United States.
Multiple mediation analysis of survey data.
In surveys received from 324 inpatients, one fourth of the variation in patients' self-rated psychological condition was explained by self-rated physical condition. Social support from family and friends mediated a significant proportion (11.0%) of the relationship between self-rated physical and psychological condition, however social support from nurses did not.
Social support from family and friends can positively influence the psychological health of inpatients, but nurses are not an adequate replacement for the social support provided by family and friends.
Although nurses cannot replace the social support provided by family and friends, the assessment of social isolation and care planning of interventions to support patients is a fundamental nursing role. Technology to connect patients with friends and family should be used to mitigate isolation for hospitalised patients unable to receive in-person visits from loved ones.
The influence of social support from family and friends and nurses was addressed. The study found social support from family and friends, but not nurses, to influence the relationship between physical and psychological ratings. This finding has implications for the role of nurses in the hospital setting.
Strengthening the Reporting of Observational Studies in Epidemiology guidelines were followed.
FreshRSS 