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Chronic wounds, characterized by prolonged healing processes, pose a significant medical challenge with multifaceted aetiologies, including local and systemic factors. Here, it explores the complex pathogenesis of chronic wounds, emphasizing the disruption in the normal phases of wound healing, particularly the inflammatory phase, leading to an imbalance in extracellular matrix (ECM) dynamics and persistent inflammation. Senescent cell populations further contribute to impaired wound healing in chronic lesions. Traditional medical management focuses on addressing underlying causes, but many chronic wounds resist to conventional treatments, necessitating innovative approaches. Recent attention has turned to autologous orthobiologics, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF) and mesenchymal stem cells (MSCs), as potential regenerative interventions. These biologically derived materials, including bone marrow aspirate/concentrate (BMA/BMAC) and adipose tissue-derived stem cells (ADSCs), exhibit promising cytokine content and regenerative potential. MSCs, in particular, have emerged as key players in wound healing, influencing inflammation and promoting tissue regeneration. This paper reviews relevant scientific literature regarding basic science and brings real-world evidence regarding the use of orthobiologics in the treatment of chronic wounds, irrespective of aetiology. The discussion highlights the regenerative properties of PRP, PRF, BMA, BMAC and SVF, showcasing their potential to enhance wound healing. Despite advancements, further research is essential to elucidate the specific roles of each orthobiologic and determine optimal applications for different wound types. The conclusion underscores the evolving landscape in chronic wound management, with a call for more comprehensive studies to refine treatment strategies and maximize the benefits of regenerative medicine.
Actualmente el fenómeno de la relación de la perdida significativa de un ser querido y el consumo excesivo de alcohol ha minimizado las implicaciones sobre mecanismos de afrontamientos para generar conductas saludables. Este artículo se basa en entrevistas semiestructuradas a profundidad en hombres de entre 30 y 70 años, miembros con más de 10 años de Alcohólicos Anónimos del Estado de Tamaulipas, México, con el objetivo de reflexionar y analizar sobre los significados de la relación de la pérdida significativa de un ser querido y el consumo de alcohol. En la búsqueda del significado, se explica que lo que en realidad es un factor que lleva al alcoholismo no es una sola pérdida significativa y no solo de personas queridas o cercanas, sino más bien un cumulo de pérdidas inmateriales que suceden sobre todo en los primeros años de vida. Por otro lado se reflejaron recursos limitados para afrontar las pérdidas que iban experimentando, es decir, vivieron los duelos de forma compleja, lo que los llevó a seguir dependientes del alcohol, sin embargo se observan aprendizajes y características de ser resilientes ante emociones negativas y conductas dependientes.
To analyse the differences between nurses with and without substance use disorders (SUDs) admitted to a specialised mental health programme.
Retrospective, observational study.
Specialised mental health treatment programme for nurses in Catalonia, Spain.
1091 nurses admitted to the programme from 2000 to 2021.
None.
Sociodemographic, occupational and clinical variables were analysed. Diagnoses followed Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision criteria.
Most nurses admitted to the programme were women (88%, n=960) and came voluntarily (92.1%, n=1005). The mean age at admission was 45 (SD=10.4) years. The most common diagnoses were adjustment disorders (36.6%, n=399), unipolar mood disorders (25.8%, n=282), anxiety disorders (16.4%, n=179) and SUDs (13.8%, n=151). Only 19.2% (n=209) of the sample were hospitalised during their first treatment episode. After multivariate analysis, suffering from a SUD was significantly associated with being a man (OR=4.12; 95% CI 2.49 to 6.82), coming after a directed referral (OR=4.55; 95% CI 2.5 to 7.69), being on sick leave at admission (OR=2.21; 95% CI 1.42 to 3.45) and needing hospitalisation at the beginning of their treatment (OR=12.5; 95% CI 8.3 to 20).
Nurses with SUDs have greater resistance to voluntarily asking for help from specialised mental health treatment programmes and have greater clinical severity compared with those without addictions. SUDs are also more frequent among men. More actions are needed to help prevent and promote earlier help-seeking behaviours among nurses with this type of mental disorder.
The qualities of primary healthcare (PHC) make it a very relevant environment for research; however, there is still work to be done to enhance the research capabilities of family physicians in healthcare units. Considering there is no ongoing review that specifically addresses this objective, the proposed goal of this scoping review is to determine the depth of the literature on the current strategies that support research capacity building among family physicians in the context of PHC.
The scoping review will include studies from PubMed, Scopus, Web of Science, Cochrane Library and grey literature, published from 2008 to 2023, that address strategies to promote research capacity building among family physicians in the context of PHC. Only studies published in English, Portuguese or Spanish will be considered. All study designs, including quantitative, qualitative and mixed-methods studies, will be eligible for inclusion. The literature search will be performed from January to March of 2024 and data charting will employ a descriptive-analytical method, systematically summarising study objectives, methodologies, findings and implications. This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols and the review will employ the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.
This review does not need ethical approval. Peer-reviewed publications, policy summaries, presentations at conferences and involvement with pertinent stakeholders are all part of our outreach approach.
Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann–Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.
To investigate the health-related quality of life (HRQoL), symptoms, psychological and cognitive state and pulmonary and physical function of nonhospitalised COVID-19 patients at long-term, and to identify factors to predict a poor HRQoL in this follow-up.
Studies have focused on persistent symptoms of hospitalised COVID-19 patients in the medium term. Thus, long-term studies of nonhospitalised patients are urgently required.
A longitudinal cohort study.
In 102 nonhospitalised COVID-19 patients, we collected symptoms at 3 months (baseline) and at 6–7 months (follow-up) from diagnosis (dyspnoea, fatigue/muscle weakness and chest/joint pain), HRQoL, psychological state, cognitive function, pulmonary and physical function. This study adhered to the STROBE statement.
HRQoL was impaired in almost 60% of the sample and remained impaired 6–7 months. At 3 months, more than 60% had impaired physical function (fatigue/muscle weakness and reduced leg and inspiratory muscle strength). About 40%–56% of the sample showed an altered psychological state (post-traumatic stress disorder (PTSD), anxiety/depression), cognitive function impairment and dyspnoea. At 6–7-months, only a slight improvement in dyspnoea and physical and cognitive function was observed, with a very high proportion of the sample (29%–55%) remained impaired. Impaired HRQoL at 6–7 months was predicted with 82.4% accuracy (86.7% sensitivity and 83.3% specificity) by the presence at 3 months of muscle fatigue/muscle weakness (OR = 5.7 (1.8–18.1)), PTSD (OR = 6.0 (1.7–20.7)) and impaired HRQoL (OR = 11.7 (3.7–36.8)).
A high proportion of nonhospitalised patients with COVID-19 experience an impaired HRQoL, cognitive and psychological function at long-term. HRQoL, PTSD and dyspnoea at 3 months can identify the majority of patients with COVID-19 who will have impaired quality of life at long-term.
Treatments aimed at improving psychological state and reducing the fatigue/muscle weakness of post-COVID-19 patients could be necessary to prevent the patients’ HRQoL from being impaired at 6–7 months after their reported recovery.
The aim of this study was to systematically consolidate evidence on perspectives and thoughts of women living with HIV regarding the peer support they have encountered during pregnancy and after childbirth.
Mixed studies systematic review.
PubMed, EMBASE, Cochrane, PsycINFO, CINAHL, Scopus and ProQuest were sourced from 1981 to January 2022.
A convergent qualitative synthesis approach was used to analyse the data. Quality appraisal was performed using the Mixed Methods Appraisal Tool.
A total of 12 studies were included, involving 1596 pregnant women and 1856 new mothers living with HIV. An overarching theme, ‘From One Mother to Another: The Supportive Journey of Pregnant Women and New Mothers Living with HIV’, and two themes were identified: (1) Emotional support buddies and extended networks and (2) Link bridge to healthcare support and self-empowerment.
Peer support played an indispensable role in the lives of women living with HIV and served as a complementary support system to professional and family support.
What problem did the study address? Pregnant women and new mothers living with HIV face preconceived stigma and discrimination.
What were the main findings? Peer support was perceived to be beneficial in enhancing emotional support among women living with HIV and was well-accepted by them.
Where and on whom will the research have an impact? Healthcare providers and community social workers could develop or enhance peer support educational programmes tailored to pregnant women and new mothers living with HIV. Policymakers and administrators can leverage public awareness, advocacy and political will to formulate and implement policies and campaigns aimed at fostering awareness and receptivity towards peer support interventions.
Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA).
No patient or public contribution.
This study aimed to describe the process of construction, validation, and usability of the chatbot ESTOMABOT to assist in the self-care of patients with intestinal ostomies. Methodological research was conducted in three phases: construction, validation, and usability. The first stage corresponded to the elaboration of a script through a literature review, and the second stage corresponded to face and content validation through a panel of enterostomal therapy nurses. In the third phase, the usability of ESTOMABOT was assessed with the participation of surgical clinic nurses, patients with intestinal elimination ostomies, and information technology professionals, using the System Usability Scale. The ESTOMABOT content reached excellent criteria of adequacy, with percentages of agreement equal to or greater than 90%, which were considered adequate, relevant, and representative. The evaluation of the content validity of the script using the scale content validity index/average proportion method reached a result above 0.90, and the Fleiss κ was excellent (P During the Coronavirus (COVID-19) pandemic, healthcare providers have overcome difficult experiences such as workplace violence. Nurses are particularly vulnerable to workplace violence. The objective of this study was to characterize violence and aggression against nurses during the COVID-19 pandemic in Latin America.
An electronic cross-sectional survey was conducted in 19 Latin American countries to characterize the frequency and type of violent actions against front-line healthcare providers.
Of the original 3544 respondents, 16% were nurses (n = 567). The mean age was 39.7 ± 9.0 years and 79.6% (n = 2821) were women. In total, 69.8% (n = 2474) worked in public hospitals and 81.1% (n = 2874) reported working regularly with COVID-19 patients. Overall, about 68.6% (n = 2431) of nurses experienced at least one episode of workplace aggression during the pandemic. Nurses experienced weekly aggressions more frequently than other healthcare providers (45.5% versus 38.1%, p < .007). Nurses showed a trend of lower reporting rates against the acts of aggression suffered (p = .076). In addition, nurses were more likely to experience negative cognitive symptoms after aggressive acts (33.4% versus 27.8%, p = .028). However, nurses reported considering changing their work tasks less frequently compared to other healthcare providers after an assault event (p = .005).
Workplace violence has been a frequent problem for all healthcare providers during COVID-19 pandemic in Latin America. Nurses were a particularly vulnerable subgroup, with higher rates of aggressions and cognitive symptoms and lower rate of complaints than other healthcare providers who suffered from workplace violence. It is imperative to develop strategies to protect this vulnerable group from aggressions during their tasks.
Sr. Director: El Reglamento Sanitario Internacional (2005) exponía que las amenazas para la salud pública internacional en el siglo XXI se centraban en 7 campos: enfermedades epidemiógenas, enfermedades transmitidas por los alimentos, brotes accidentales, brotes intencionados, accidentes por sustancias químicas tóxicas, accidentes radio nucleares y desastres ambientales [Fragmento de texto].
Introducción: Los estudiantes de enfermería dentro de sus procesos de aprendizaje se encuentran enfrentados a un sin número de estrategias de evaluación sumativa, de ahí la importancia del uso de la rúbrica como una de las estrategias en las cuales los estudiantes son actores activos en el proceso de evaluación en el marco del aprendizaje autónomo. Objetivo: Identificar la percepción de los estudiantes de enfermería ante la rúbrica como estrategia de evaluación. Metodología: Estudio cualitativo y exploratorio realizado en treinta y cuatro enfermeros en formación de una universidad pública. La recolección de la información se realizó mediante la aplicación de un formato on line con pregunta abierta. Se llevó a cabo durante el mes de noviembre, del 2020 y se analizaron con el software IRAMUTEQ. Resultados: se identificaron tres categorías: La rúbrica como guía para el diseño, la rúbrica como método de evaluación sumativa, la rúbrica tiene desventajas. Conclusión: los estudiantes consideran que las rúbricas son importantes en su formación debido a que les permite adoptar un rol más activo en sus aprendizajes y les orienta en el desarrollo de las actividades indicadas. Sin embargo, también identificaron que las rúbricas deben ser claras, sencillas y precisas para que sean entendidas cumpliendo así su función sustancial.
Objetivo principal: Exponer las vivencias de una persona al adaptarse al vivir con nuevas limitaciones. Metodología: Se escoge una metodología cualitativa llevándose a cabo mediante una entrevista en profundidad y su posterior transcripción a un relato biográfico. Resultados: Los resultados del estudio, muestran cómo Luna tuvo que enfrentarse a un cambio de vida, que no le resultó fácil. No supo cómo actuar con las limitaciones que se fue encontrando día a día, sin apoyos por parte del personal sanitario, y las dificultades que tuvo al solicitar un grado de minusvalía. Conclusión: Esta investigación pone en manifiesto que como personal sanitario deberíamos valorar el contexto de nuestros pacientes e intentar apoyarles en sus dudas, darles tiempo a manifestarlas para intentar ayudarles, es decir, mantener un buen feedback con ellos para obtener una buena relación terapéutica.
Objetivo: caracterizar las producciones científicas sobre atención integral de salud, promovidas a través de políticas públicas para perso-nas que conviven con el Virus de Inmunodeficiencia Humana. Metodología: Revisión integrativa de literatura, a través de la búsqueda en las bases de datos PUBMED, LILACS y la biblioteca virtual SCIELO, utilizando los descriptores “Políticas Públicas de salud”, “Síndrome de inmunodeficiencia adquirida”, “Atención integral de salud” y el operador booleano “Y”, resultando en una muestra, después de leídos, de 12 artículos. Los resultados de este estudio nos permitieron identificar y clasificar el estado de las políticas públicas para la atención de esta población, en tres categorías: A: políticas y / o directrices insuficientes; B: Necesidad de mejoras e inversiones en políticas existentes; C: éxito de los programas, siendo imprescindible una articulación internacional de gobiernos y organismos no gubernamentales para la elaboración de políticas más ajustadas a las realidades y objetivando la atención integral de salud de esta población.
Rev Enferm;41(2): 141-146, feb. 2018. ilus. [Artículo]
FreshRSS 