Introducción. La quimioterapia produce el efecto secundario más temido por los pacientes con cáncer, la alopecia, que podría evitarse con gorros de crioterapia del cuero cabelludo. Objetivo principal. Evaluar la crioterapia del cuero cabelludo como método preventivo para la alopecia inducida por quimioterapia. Metodología. Se ha realizado una revisión bibliográfica narrativa, seleccionándose 22 artículos, introduciendo ecuaciones de búsqueda en varias bases de datos. Desarrollo. Su eficacia es difícil de determinar y la efectividad es muy variable, aprobándose en pacientes con cánceres sólidos. Sin embargo, existen ciertos efectos secundarios, requiriéndose de cuidados de enfermería independientemente de la técnica utilizada. Conclusiones. Estudios han demostrado que el uso de este método es eficaz y efectivo, y que su uso no aumenta el riesgo de metástasis en el cuero cabelludo, contraindicándose en pacientes con tumores hematoló-gicos.
In recent years, hydrosurgery is a technology that has been applied more and more in debridement procedures. However, the selectivity of hydrosurgery to cutaneous necrotic tissues has not been proved. This study was designed to investigate the possible tissue selectivity of hydrosurgery in the debridement in burn wounds. Deep partial‐thickness burns were produced on the back of porcine, and 48 hours later, both burn wounds and normal skin were debrided using the hydrosurgery system. Then tissue samples were taken, and histological staining was performed and observed under microscope. Burn wound resection rates and the normal skin damaged rates were measured. Our result indicated that the burn wounds were significantly more sensitive than the normal skin when the water pressure produced by the hydrosurgery system was set between 3000 and 5000 psi (pounds per square inch), that is, the necrotic tissue portions were debrided more easily than the normal skin tissue. Based on these data, we suggest that 3000 to 5000 psi of water pressure in the hydrosurgery system has a skin tissue selectivity in burn wounds.
Objetivo principal: relatar a experiência das práticas de educação em saúde, por um grupo de profissionais, integrantes da Atenção Primária em Saúde, em zonas de prostituição de Rio Grande/RS. Metodologia: Trata-se de um relato de experiência, realizado em 2016, por um grupo de profissionais (Enfermeira, Assistente Social, Educador Social e motorista), vinculados a secretaria de saúde de um município do extremo sul do Brasil. Em uma unidade móvel de saúde, o grupo percorreu as zonas de prostituição (postos de gasolina, ruas e boates). De abril a agosto de 2016, os profissionais de saúde desenvolveram ações de conscientização sobre a importância dos riscos inerentes a profissão, sobre o cuidado de si, através da oferta de testes rápidos, distribuição de preservativos masculinos e femininos e lubrificantes íntimos. Resultados: Vinte zonas de prostituição foram encontradas pela equipe, concentrados em ruas, boates e postos de combustíveis espalhados pela cidade. Cerca de 200 profis-sionais do sexo, foram atendidas pelo grupo, sendo ofertados mensalmente 40 exames de testes rápidos e 40 carteiras sociais. Quanto a pre-venção as ISTs, foram distribuídos 1500 preservativos masculinos, 200 preservativos femininos e 500 lubrificantes íntimos. Conclusão: A equipe, de forma itinerante, atuou de forma exitosa na busca, não somente de orientá-las quanto aos riscos inerentes a profissão, mas também de conhecer um pouco da sua história, do resgate a cidadania e da autoestima, a uma população que tem seus direitos frequentemente violados. Percebe-se nessa vivência a importância da educação em saúde como um instrumento de promoção e prevenção, na busca pela valorização dessas pessoas.
by Danny Chan, Carmen Martin-Ruiz, Gabriele Saretzki, Dermot Neely, Weiliang Qiu, Vijay KunadianBackground
Non-ST elevation acute coronary syndrome (NSTEACS) occurs more frequently in older patients with an increased occurrence of recurrent cardiac events following the index presentation. Telomeres are structures consisting of repeated DNA sequences as associated shelterin proteins at the ends of chromosomes. We aim to determine whether telomere length (TL) and telomerase activity (TA) predicted poor outcomes in older patients presenting with NSTEACS undergoing invasive care.Method
Older patients undergoing invasive management for NSTEACS were recruited to the ICON-1 biomarker study (NCT01933581). Peripheral blood mononuclear cells (PBMC) were recovered on 153 patients. DNA was isolated and mean TL was measured by quantitative PCR expressed as relative T (telomere repeat copy number) to S (single copy gene number) ratio (T/S ratio), and a telomere repeat amplification assay was used to assess TA during index presentation with NSTEACS. Primary clinical outcomes consisted of death, myocardial infarction (MI), unplanned revascularisation, stroke and significant bleeding recorded at 1 year. TL and TA were divided into tertile groups for analysis. Cox proportional hazards regression was performed. Ordinal regression was performed to evaluate the relationship between TL and TA and traditional cardiovascular risk factors at baseline.Results
298 patients were recruited in the ICON-1 study of which 153 had PBMC recovered. The mean age was 81.0 ± 4.0 years (64% male). Mean telomere length T/S ratio was 0.47 ± 0.25 and mean TA was 1.52 ± 0.61 units. The primary composite outcome occurred in 44 (28.8%) patients. There was no association between short TL or low TA and incidence of the primary composite outcome (Hazard Ratio [HR] 1.50, 95% Confidence Interval [CI] 0.68–3.34, p = 0.32 and HR 1.33, 95% CI 0.52–3.36, p = 0.51 respectively).Conclusion
TL and TA are not found to be associated with the incidence of adverse outcomes in older patients presenting with NSTEACS undergoing invasive care.Clinical trial registration
URL: https://www.clinicaltrials.gov Unique identifier: NCT01933581
To evaluate the efficacy of the reduction of visual and auditory stimuli on pain during venipuncture in premature newborns of 32–36 weeks of gestation.
Open, randomized, non‐blind parallel clinical trial.
Study to take place at the neonatal intensive care unit of a University Hospital in 2019–2021. Fifty‐six recently born babies between 32‐36 weeks of gestation will participate. The dependent variable is the level of pain determined using the premature infant pain profile instrument. The intervention will be assigned randomly using the random.org software. Data analysis will be carried out using the IBM SPSS v.25 software assuming a level of significance of 5%.
The evidence for the efficacy of reducing sensory stimulation and its effect on pain in minor procedures has not been studied in depth. There are no studies that evaluate the reduction of visual and auditory stimuli in a combined way.
It is easy to incorporate the reduction of visual and auditory stimuli into nursing practice. The results of this study could have a direct impact on clinical practice.
Trial registered at clinicaltrials.gov: NCT04041635
To examine whether there were significant differences in sleep during weekdays/weekends and whether the intra‐individual variability in sleep was related to glycaemic control in patients with type 2 diabetes.
Correlational, longitudinal design.
Data were collected between February 2017–January 2018. In all, 56 adults with type 2 diabetes were included (60.7 years, 55.4% female). Sleep was measured using the Consensus Sleep Diary over 8 days. Intra‐individual variability of sleep was calculated as the standard deviation of sleep variables. Standard deviations of sleep duration, sleep efficiency, sleep quality, and mid‐sleep time were obtained. Glycaemic control was measured by haemoglobin A1C. Paired t test and multiple regression analysis were used.
Overall, there were no differences in sleep parameters between weekdays and weekends. Participants slept 20 min more over the weekends than during weekdays. The mid‐sleep time during weekends was about 35 min later than during weekdays. Intra‐individual variability of sleep duration and mid‐sleep ranged from 27.6–167.4 min and 13–137 min, respectively. Controlling for covariates (e.g., distress, symptoms, and self‐care), larger variability in sleep duration, and mid‐sleep were significantly related to higher A1C levels.
Diabetes educators are recommended to include the assessment of intra‐individual variability in sleep. Maintaining a regular sleep habit (e.g., sleep duration and sleep timing) should be highlighted during patient education.
Intra‐individual variability in sleep is an alternative dimension for sleep assessment. This study examined whether intra‐individual variability in sleep was related to glycaemic control in an older sample of type 2 diabetes patients using a sleep diary across 8 days. This sample had a similar sleep pattern during weekdays and weekends. Larger intra‐individual variabilities in sleep duration and mid‐sleep time were independently related to worse glycaemic control. Diabetes patients are recommended to maintain a regular sleep routine.
The aim was to examine the reciprocal relationships of emotional labour strategies with emotional exhaustion and professional identity.
This study adopted a four‐wave cross‐lagged panel design.
Survey data were collected in 2018 from a sample of 171 newly hired nurses from 58 hospitals in 11 provinces of China. Nurses’ emotional labour (i.e., deep acting and surface acting), emotional exhaustion and professional identity were repeatedly measured. Cross‐lagged panel analyses were conducted to examine the reciprocal relationships we hypothesized.
We found that emotional exhaustion was positively related to surface acting (but not vice versa); deep acting was negatively related to emotional exhaustion (but not vice versa); professional identity was positively related to deep acting (but not vice versa).
Our findings suggest that deep acting and professional identity may decrease the level of emotional exhaustion, whereas emotionally exhausted nurses are more likely to employ surface acting strategies.
This research finding will have an impact on the nursing management. Healthcare managers may consider workshops or training and development programs that promote nurses’ professional identify to promote nurses’ use of deep acting and consequently reduce their level of emotional exhaustion, which has been associated with a variety of negative consequences, such as low quality of patient service, high medical accidents, and turnover rate.
To clarify the specific impact paths among physical activity, activity of daily living, depression and quality of life among dementia patients.
A descriptive, cross‐sectional design.
Dementia patients and their caregivers from five tertiary general hospitals and one dementia patients’ club were recruited. A total of 216 valid questionnaires were collected from November 2018 ‐ March 2019. Path analysis was performed by Mplus 7.0 to test the casual relationship among physical activity, activity of daily living, depression and quality of life.
Most patients with dementia presented a low level of physical activity and suffered from impaired quality of life. The modified model presented a good model fit and revealed that physical activity had indirect positive effects on quality of life mediated by activity of daily living and depression.
The results showed that physical activity was a promising non‐pharmacological method to improve the performance of activity of daily living and reduce depressive symptoms and then enhance the quality of life among dementia patients.
The findings were beneficial to elevate the awareness of physical activity among patients and professionals. This study was helpful to understand how physical activity exerted effects on life quality of dementia patients. This study provided a new perspective for researchers to elucidate the causal relationship of variables among dementia patients.
To investigate workplace violence and nurse outcomes by comparing gender differences.
A secondary analysis of cross‐sectional survey data.
Workplace violence was measured by four items from the International Hospital Outcome Study. Nurse outcomes were measured by tools including burnout, job satisfaction and intention to stay. We used propensity score matching to generate a sociodemographic balanced dataset of 108 male and 288 female nurses. A hypothetical relationship model was derived from the affective events theory. Comparative statistics and multi‐group structural equation modelling were conducted to analyze gender differences. Data were collected in China from December 2013 – August 2014.
Male nurses reported more workplace violence from staff and less intention to stay than females. Besides finding the mediation of burnout sharing with female nurses consistent with the affective events theory, workplace violence was directly linked to less intention to stay in male nurses.
Male nurses experience more workplace violence by staff than female nurses. Besides responding emotionally to workplace violence like female nurses, male nurses also respond behaviourally.
What problem did the study address? Gender differences in workplace violence and its relationship to nurse outcomes. What were the main findings? Male nurses experienced more workplace violence than female nurses, linked directly to less intention to stay. Workplace violence linked to less job satisfaction and intention to stay in nurses was mediated by burnout. Where and on whom will the research have impact? Gender‐based prevention of and coping with workplace violence should be included in nursing training.
To examine the prevalence of work stress and prediabetes in computer technology company employees; to analyse the relationships among stress, work stress, and prediabetes; and to explore the potential mediating effects sleep on the relationship between work stress and prediabetes.
A descriptive, cross‐sectional design was used. A convenience sample included employees from a large computer technology company in central Texas.
Data collection during March–October 2015 included: retrospective electronic medical record review and online surveys. Electronic medical record review data included: height, weight, waist circumference, blood pressure, high‐density lipids, triglycerides, and fasting glucose. Online surveys collected demographic, global stress, diet, exercise, coping, sleep and work stress data from participants. Spearman rho calculations analyzed associations between demographic, socio‐cultural factors, health behaviours, work stress, and prediabetes variables. Logistic regression analyses identified probability variables. A structural equation model examined mediating variables.
Prediabetes prevalence was lower and prevalence of work stress was higher in the participant sample than in the USA population. Findings suggested that low job imbalance increases the probability for prediabetes. Job imbalance was inversely related to prediabetes. Three variables increased the probability prediabetes: alcohol, job imbalance, and sleep. Sleep potentially modified the relationship between job imbalance and prediabetes.
Participants were college‐educated males working in white‐collar, technical jobs. Participants had high rates of work stress. Job imbalance was inversely related to prediabetes, which challenges previous empirical data. Future research should continue to explore the relationship between work stress and prediabetes in this population.
This study explored the relationship between work stress and prediabetes in a white‐collar worker population in technical industry. Findings suggested that workers in industry have a unique type of stress. Nurses who learn to recognize the non‐traditional risk factors for prediabetes can improve screening for prediabetes by including work stress and poor sleep questions.
Graduate and professional students are reported to have higher than average rates of depression compared to age‐ and gender‐matched populations. Further, more than half of student health visits are due to anxiety, yet little is known about the relationships among depression, anxiety, and healthy lifestyle behaviors in this population as well as what factors predict depression and anxiety.
The purposes of this study were as follows: (a) to examine the prevalence of depression, anxiety, stress, physical health, healthy beliefs, and lifestyle behaviors in incoming first‐year health sciences professional students; (b) to describe the relationships among these variables; and (c) to determine predictors of depression and anxiety.
A descriptive correlational study design was used with baseline data collected from first‐year graduate health sciences students from seven health professions colleges who were participating in a wellness onboarding intervention program, including Dentistry, Medicine, Nursing, Optometry, Pharmacy, Social Work, and Veterinary Medicine.
Seventeen percent of incoming students reported moderate‐to‐severe depressive symptoms with 6% reporting suicidal ideation. In addition, 14% of the participating students reported moderate‐to‐severe anxiety. Factors that predicted depression and anxiety included having less than 7 hr of sleep per night, worse general health, lower healthy lifestyle beliefs, lower healthy lifestyle behaviors, higher stress, and a perceived lack of control.
These findings highlight the need to routinely screen incoming health sciences students for depression and anxiety upon entrance into their academic programs so that evidence‐based interventions can be delivered and students who report severe depression or suicidal ideation can be immediately triaged for further evaluation and treatment. Providing cultures of well‐being and emphasizing self‐care throughout academic programs also are essential for students to engage in healthy lifestyles.
The main aim of this study was to investigate the indirect effects of emotional dissonance and workload on presenteeism and emotional exhaustion through sleep quality and relaxation.
Numerous investigations have found that job demands are related to employees' health and behaviours, but additional studies are needed among nurse samples. Specifically, little is known about the relationships between nurses' emotional dissonance and workload on one hand, and presenteeism and emotional exhaustion on the other hand. Moreover, research is needed to further explore the psychological mechanisms underlying these relationships.
We used a cross‐sectional design. Our study was carried out between October 2015–February 2016. Precisely, we asked nurses from various French healthcare centres to fill out a questionnaire survey. We ensured to meticulously follow the STROBE guidelines for cross‐sectional research in designing and reporting this study.
An empirical study with a sample of 378 nurses was conducted.
In line with our hypotheses, our findings revealed that emotional dissonance and workload were negatively linked to sleep quality and relaxation, which were, in turn, related to lower levels of presenteeism and emotional exhaustion. Workload and emotional dissonance were also directly and positively related to emotional exhaustion, while emotional dissonance was associated with higher levels of presenteeism. Finally, the indirect effects of emotional dissonance and workload on emotional exhaustion through sleep quality as well as the indirect effects of emotional dissonance on emotional exhaustion through relaxation were significant and positive.
Overall, our results provide insight into the effects of emotional dissonance and workload on presenteeism and emotional exhaustion through recovery processes.
The present findings have some practical implications for reducing nurses' emotional exhaustion and presenteeism. Specifically, managers and organisations should try to design and craft jobs to decrease the presence of negative work characteristics (i.e., workload and emotional dissonance). Our results also suggest that recovery processes may be important factors to focus on.
To examine the dissimilarity between Chinese myocardial infarction (MI) patients’ and spouses’ illness perceptions (IPs), and to explore the relationship between patients’ IP, differences in couples’ IP and patients’ lifestyle after discharge.
An individual's IP is affected and moderated by several factors, including the social context. One of the most influential members of the social network of patients is the spouse.
From April 2016–April 2017, 111 MI patients and their spouses were recruited. Before discharge from hospital, revised Illness Perception Questionnaire was administered to MI patients and their spouses separately. Two months after discharge, patients’ lifestyle was assessed using Health Promoting Lifestyle Profile II. The manuscript was organised according to STROBE guidelines.
Spouses were more likely to believe that the illness would last for a long time, and patients perceived MI as being more controllable than their spouses did. The patient–spouse dissimilarity in the perception of consequences was negatively correlated with both nutrition and stress control behaviours. Patients in couples with more dissimilar perception of environmental factors as a cause were more likely to choose a healthy diet, while patients in couples with more dissimilar perceived treatment control were more able to control stress.
There are both similarities and dissimilarities between MI patients’ and spouses’ IP, and these dissimilarities contributed the majority of the explained variance in patients’ lifestyle after discharge.
We should consider both couples when examining how a patient copes with a chronic illness.
To compare nurse and patient satisfaction with intentional rounding in a rural Australian hospital setting, and examine which aspects of care predict satisfaction.
Intentional rounding is a systematic process used by healthcare professionals to anticipate and address fundamental needs of hospitalised patients. Despite a wealth of literature about nurse and patient satisfaction with intentional rounding, no studies have compared nurse and patient satisfaction, and little is known about intentional rounding in a rural setting.
A cross‐sectional study was undertaken with nursing staff and patients at a rural hospital and reported in accordance with STROBE guidelines.
Nurses (n = 63) and patients (n = 66) were invited to complete the Patient Satisfaction Survey between April and June 2018. Nurse and patient responses were compared and predictors of nurse and patient satisfaction with intentional rounding care were determined using Generalised‐Estimating‐Equation models.
Both nurses and patients positively rated satisfaction with all aspects of nursing care provided and received through intentional rounding. Nurses’ satisfaction with care provided to patients through intentional rounding was predicted by interest in patients’ feelings about their care. Patient satisfaction with the care they received while hospitalised was predicted by the ability to see a nurse when they needed to, the provision of pain relief when needed, feeling comfortable and safe, and the perception that nurses were interested in their feelings about their care.
Intentional rounding is a means for nurses to regularly attend to patients’ emotional and physical needs which is central to patients feeling safe and cared for while hospitalised.
Intentional rounding practices ensure that patients feel genuinely cared for by nursing staff whilst hospitalised, and can improve nurse and patient interactions, satisfaction and outcomes.
Este é um estudo quantitativo, de abordagem epidemiológica, realizado com dados secundários, que teve como objetivo avaliar as práticas de autocuidado e o grau de risco para o pé diabético em idosos com DM acompanhados em um Ambulatório de Pé Diabético de um município do interior de Minas Gerais. Utilizou-se a ficha de atendimento de idosos com DM, considerando o período de agosto de 2015 a agosto de 2016. Considerou-se 46 pessoas em atendimento no período, das quais, 54,3% eram homens; 52,2% morando com companheiro (a); com médias de: idade 68,2 anos (dp=6,3) e tempo de diagnóstico de DM de 16,76 anos (dp=8,04). Em uso de biguanidas (69,6%), com doenças do aparelho circulatório (89,1%), com destaque para hipertensão arterial. A falta de exame dos pés alcançou 47,8% e dos sintomas neuropáticos os mais importantes foram: queimação, dormência e formigamento (84,6%), assim como as deformidades comuns eram: calosidades (37%), ressecamento (34,8%) e unhas grossas (32,6%). O estudo mostra a necessidade de se melhorar o monitoramento dos idosos com DM, bem como, a ampliação de ações de educação em saúde que possam ser significativas direcionadas ao melhor autocuidado dos pés, com vista a evitar complicações e manter a qualidade de vida.