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Over 40 million people in low-income and middle-income countries (LMICs) experience serious health-related suffering (SHS) annually and require palliative care. Patient and caregiver experiences of SHS in LMICs are understudied despite their importance in guiding palliative care provision. Diabetes and cancer are the second-leading and third-leading causes of death in Mexico, causing a significant SHS burden on patients, families and health systems. This study examines SHS and palliative care from the point of view of patients with cancer and diabetes and their caregivers.
A qualitative descriptive study based on in-depth telephone interviews was conducted between August 2021 and February 2022. Data were analysed through inductive thematic analysis.
Overall, 20 patients with end-stage cancer, 13 patients with diabetes and 35 family caregivers were interviewed individually.
Participants were recruited from two family medicine clinics and a pain clinic in Mexico City.
Seven themes emerged: (1) suffering as a multifaceted phenomenon, (2) diversity in perceptions of suffering, (3) different coping strategies, (4) need and perceived importance of relief from suffering, (5) barriers to accessing services to relieve suffering, (6) demand for the health sector’s active and humane role in addressing suffering and (7) preferences and need for comprehensive care for relief from suffering. The primary coping strategies included family companionship, protective buffering and faith-based support. Participants lacked knowledge of palliative care. They expressed the importance of relief from suffering, viewing it as the health sector’s responsibility and requesting more humane, personalised care and access to medicines and pain clinics.
The multifaceted nature of SHS highlights the health system’s responsibility to provide high-quality palliative care. Policies to enhance access to palliative care should integrate it into primary care, redesigning services towards patient and caregiver biopsychosocial and spiritual needs and ensuring access to medicines and competent health personnel.
Many Canadians struggle to access the primary care they need while at the same time primary care providers report record levels of stress and overwork. There is an urgent need to understand factors contributing to the gap between a growing per-capita supply of primary care providers and declines in the availability of primary care services. The assumption of responsibility by primary care teams for services previously delivered on an in-patient basis, along with a rise in administrative responsibilities may be factors influencing reduced access to care.
In this mixed-methods study, our first objective is to determine how the volume of services requiring primary care coordination has changed over time in the Canadian provinces of Nova Scotia and New Brunswick. We will collect quantitative administrative data to investigate how services have shifted in ways that may impact administrative workload in primary care. Our second objective is to use qualitative interviews with family physicians, nurse practitioners and administrative team members providing primary care to understand how administrative workload has changed over time. We will then identify priority issues and practical response strategies using two deliberative dialogue events convened with primary care providers, clinical and system leaders, and policy-makers.
We will analyse changes in service use data between 2001/2002 and 2021/2022 using annual total counts, rates per capita, rates per primary care provider and per primary care service. We will conduct reflexive thematic analysis to develop themes and to compare and contrast participant responses reflecting differences across disciplines, payment and practice models, and practice settings. Areas of concern and potential solutions raised during interviews will inform deliberative dialogue events.
We received research ethics approval from Nova Scotia Health (#1028815). Knowledge translation will occur through dialogue events, academic papers and presentations at national and international conferences.
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 To determine the feasibility of a definitive trial of metformin to prevent type 2 diabetes in the postnatal period in women with gestational diabetes.
A multicentre, placebo-controlled, double-blind randomised feasibility trial with qualitative evaluation.
Three inner-city UK National Health Service hospitals in London.
Pregnant women with gestational diabetes treated with medication.
2 g of metformin (intervention) or placebo (control) from delivery until 1 year postnatally.
Rates of recruitment, randomisation, follow-up, attrition and adherence to the intervention.
Preliminary estimates of glycaemic effects, qualitative exploration, acceptability of the intervention and costs.
Out of 302 eligible women, 57.9% (175/302) were recruited. We randomised 82.3% (144/175) of those recruited, with 71 women in the metformin group and 73 women in the placebo group. Of the participants remaining in the study and providing any adherence information, 54.1% (59/109) took at least 75% of the target intervention dose; the overall mean adherence was 64% (SD 33.6). Study procedures were found to be acceptable to women and healthcare professionals. An increased perceived risk of developing type 2 diabetes, or a positive experience of taking metformin during pregnancy, encouraged participation and adherence to the intervention. Barriers to adherence included disruption to the medication schedule caused by the washout periods ahead of each study visit or having insufficient daily reminders.
It is feasible to run a full-scale definitive trial on the effectiveness of metformin to prevent type 2 diabetes in women with gestational diabetes, during the early postnatal period. Adherence and engagement with the study could be improved with more regular reminders and potentially the addition of ongoing educational or peer support to reinforce messages around type 2 diabetes prevention.
by Joseph B. Kahan, Patrick Burroughs, Logan Petit, Christopher A. Schneble, Peter Joo, Jay Moran, Maxwell Modrak, William Mclaughlin, Adam Nasreddine, Jonathan N. Grauer, Michael J. Medvecky
ObjectivesThe purpose of this study was to compare the rates of secondary knee surgery for patients undergoing meniscus repair with or without concurrent anterior cruciate ligament reconstruction (ACLr).
MethodsUtilizing a large national database, patients with meniscal repair with or without concurrent arthroscopic ACLr were identified. The two cohorts were then queried for secondary surgical procedures of the knee within the following 2 years. Frequency, age distribution, rates of secondary surgery, and type of secondary procedures performed were compared.
ResultsIn total, 1,585 patients were identified: meniscus repair with ACLr was performed for 1,006 (63.5%) and isolated meniscal repair was performed for 579 (36.5%). Minimum of two year follow up was present for 487 (30.7% of the overall study population).Secondary surgery rates were not significantly different between meniscus repair with concurrent ACLr and isolated meniscus repairs with an overall mean follow up of 13 years (1.5–24 years) (10.6% vs. 13.6%, p = 0.126). For the 2 year follow up cohort, secondary surgery rates were not significantly different (19.3% vs. 25.6%, p = 0.1098). There were no differences in survivorship patterns between the two procedures, both in the larger cohort (p = 0.2016), and the cohort with minimum 2-year follow-up (p = 0.0586).
ConclusionThe current study assessed secondary surgery rates in patients undergoing meniscus repair with or without concurrent ACLr in a large patient database. Based on this data, no significant difference in rates of secondary knee surgery was identified.
by Sadegh Moradi Vastegani, Seyed Esmaeil Khoshnam, Samireh Ghafouri, Nima Bakhtiari, Yaghoob Farbood, Alireza Sarkaki
IntroductionAnethole is the main compound of the essential oil of anise and several other plants, which has antioxidant, anti-inflammatory, and neuroprotective properties. Oxidative stress is considered as an important factor in the pathogenesis of PD. In the present study, we aimed to investigate the effects of anethole against rotenone-induced PD.
MethodsMale Wistar rats were randomly divided into six groups. Control group received DMSO + sunflower oil, model group received rotenone (2 mg/kg, s.c, daily for 35 days), positive control group received L-Dopa, and test groups received anethole (62.5, 125, and 250 mg/kg, i.g, daily for 35 days) 1 hour before each rotenone injection. Body weight changes, rotarod test, stride length test, and extracellular single unit recording were performed after treatment. After behavioral test, Brain water content and blood brain barrier (BBB) permeability were evaluated, and the levels of malondialdehyde (MDA), superoxide dismutases (SOD), alpha-synuclein and MAO-B were measured in the striatum.
ResultsChronic administration of rotenone induced body weight loss and caused significant dysfunction in locomotor activity, neuronl firing rate, and BBB. Rotenone also decreased SOD activity, increased MDA level, and elevated the expression of alpha-synuclein and MAO-B in the striatum. However, treatment with anethole attenuated body weight loss, motor function, neuronal activity, and BBB function. Furthermore, Anethole treatment attenuated oxidative stress and decreased the expression of alpha-synuclein and MAO-B compared to the rotenone group.
ConclusionOur results show that through its antioxidant properties, aethole can improve the cellular, molecular and behavioral characteristics of rotenone-induced Parkinson’s disease.
Persistent human papillomavirus (HPV) infection is a known cause of a subset of head and neck cancers (HNCs). In the last two decades, the proportion of HNCs attributable to HPV infection has increased worldwide, notably the oropharyngeal cancers. However, the trend of HPV-related HNC burden is not clearly understood yet in China. Thus, the absolute
BROADEN-China is a nationwide, multisite, cross-sectional study. A stratified, multistage, non-randomised cluster sampling method will be used to select 2601 patients with HNC from 14 hospitals across seven regions, based on population density in China. Patients with formalin-fixed paraffin-embedded tissue samples collected prior to treatment induction during three time periods will be included, and factors (eg, smoking status, alcohol consumption, betel nut chewing, Epstein-Barr virus, teeth loss, etc) associated with HNC will be assessed. HPV testing (HPV-DNA, HPV-mRNA and p16INK4a immunohistochemistry) and histological diagnosis of the tissue samples will be conducted at a central laboratory.
The study protocol and all required documents have been submitted for review and approval to the Independent Ethics Committees of all the participating sites. The informed consent was waived for all participants and all the recorded data will be treated as confidential.
We have included 14 hospitals as our participating sites, of which Henan Cancer Hospital is the leading site. The study has been approved by the independent ethics committees of the leading site on 3 December 2020. The other 13 participating site names of ethics committee and IRB that have approved this study.
Nurses increasingly use mindfulness as an effective mental health intervention to reduce psychological distress. The effectiveness of mindfulness-based interventions remains inconclusive, which may lead to implementation of interventions in an inefficient or ineffective manner. This study aimed to examine the effects of mindfulness-based interventions on reducing stress, anxiety, and depression among nurses.
Systematic review and meta-analysis.
Randomized controlled trials (RCTs) were searched using six databases published through May 20, 2023, which evaluated the effects of mindfulness-based interventions on reducing psychological distress among nurses. To assess the quality of methodology included in the RCTs, version 2 of the Cochrane risk-of-bias instrument for RCTs with five domains was used. Standardized mean difference (SMD) with 95% confidence interval (CI) were calculated using the random–effects model in the meta-analyses. Publication bias was assessed using Egger's regression test. Further, the robustness effect size of the pooled analysis was assessed using leave-one-out sensitivity analysis.
A total of 16 RCTs were included in the final analysis. Overall, the modalities appeared to alleviate stress (pooled SMD: −0.50 [95% CI: −0.82 to −0.18]; p < 0.001) and depression (pooled SMD: −0.42 [95% CI: −0.78 to −0.06]; p = 0.02) among nurses.
Mindfulness-based interventions appear to alleviate stress and depression in nurses. Future research evaluating mindfulness-based interventions among working nurses with more rigorous methodological and larger sample size.
Support for nurses' mental health must be included while implementing personal and professional development plans.
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.
There are many debates regarding the risk factors of surgical site infection (SSI) following posterior cervical surgery in previous studies. And, till now there is no such a study to examine cervical laminoplasty surgery. From January 2011 through October 2021, a total of 405 patients who were treated with unilateral open-door laminoplasty surgeries were enrolled in this study. We divided the patients into the SSI group and the non-SSI group and compared their patient-specific and procedure-specific factors. Univariate and multiple logistic regression analysis were performed to determine the risk factors. Of the 405 patients, 20 patients had SSI. The rate of SSI found to be 4.93%. There were significant differences between groups in the thicker subcutaneous fat thickness (FT) (p < 0.001), the higher ratio of subcutaneous FT to muscle thickness (MT) (p < 0.001), the higher preoperative Japanese Orthopaedic Association (JOA) Scores (p < 0.003), the decreased preoperative serum albumin (p < 0.001), the more postoperative drainage (p < 0.05) and the longer time of draining (p < 0.001). Logistic regression analysis of these differences showed that the higher ratio of subcutaneous FT/MT, the higher preoperative JOA scores, the decreased preoperative serum albumin and the longer time of draining were significantly related to SSI (p < 0.05). The higher ratio of subcutaneous FT/MT, the higher preoperative JOA scores, the decreased preoperative serum albumin and the longer time of draining are identified as the independent risk factors of SSI in cervical laminoplasty. Identification of these risk factors could be useful in reducing the SSI incidence and patients counselling.
Missed nursing care is defined as care that is delayed, partially completed, or not completed at all. The scenario created by the COVID-19 pandemic may have influenced multifactorial determinants related to the care environment, nursing processes, internal processes, and decision-making processes, increasing missed nursing care.
This scoping review aimed to establish the quantity and type of research undertaken on missed nursing care during the COVID-19 pandemic.
This review was conducted following the Joanna Briggs Institute methodology for scoping reviews. We searched CINAHL, MEDLINE, Scopus, two national and regional databases, two dissertations and theses databases, a gray literature database, two study registers, and a search engine from November 1, 2019, to March 23, 2023. We included quantitative, qualitative, and mixed studies carried out in all healthcare settings that examined missed nursing care during the COVID-19 pandemic. Language restrictions were not applied. Two independent reviewers conducted study selection and data extraction. Disagreements between the reviewers were resolved through discussion or with an additional reviewer.
We included 25 studies with different designs, the most common being acute care cross-sectional survey designs. Studies focused on determining the frequency and reasons for missed nursing care and its influence on nurses and organizational outcomes.
Missed nursing care studies during the COVID-19 pandemic were essentially nurses-based prevalence surveys. There is an urgent need to advance the design and development of longitudinal and intervention studies, as well as to broaden the focus of research beyond acute care. Further research is needed to determine the impact of missed nursing care on nursing-sensitive outcomes and from the patient's perspective.
Objetivo: Identificar la evidencia científica relacionada con los factores de riesgo y los estilos de vida en adolescentes asociados a la ocurrencia de cáncer pulmonar, cervicouterino, gastrointestinal, de piel y de mama en la adultez. Metodología: Revisión de alcance basada en la metodología del Joanna Briggs Institute (JBI), se exploraron cuatro bases de datos, a los artículos seleccionados se les realizó análisis, extracción y síntesis de datos. Resultados: Se incluyeron 33 artículos, los factores de riesgo identificados fueron antecedentes familiares, sexo, tabaco, alcohol, sobrepeso, bajo peso, exposición al sol, infección por virus del papiloma humano (VPH), desconocimiento sobre medidas de autocuidado, bajo consumo de frutas y verduras, consumo de carnes rojas y de grasas, bajo nivel socioeconómico, bajo nivel de escolaridad y sedentarismo; y, como estilos de vida: actividad física, uso del condón, seguimiento y detección de su situación de salud, vacuna contra el virus del papiloma humano (VPH), alimentación saludable y protección solar. Conclusión: Los factores de riesgos encontrados en la revisión de alcance son numerosos, según cada tipo de cáncer, existen factores modificables que desde la adolescencia se pueden poner en práctica como estilos de vida en sentido individual, familiar y escolar.
Objetivo principal: Los profesionales sanitarios fueron los trabajadores más afectados por Covid-19, especialmente durante las primeras oleadas. El objetivo del estudio es evaluar la percepción del riesgo de exposición al Covid-19, información recibida y participación laboral entre enfermeros, médicos y auxiliares de enfermería. Metodología: Se realizó un estudio transversal mediante una encuesta epidemiológica entre enfermeras, médicos y auxiliares de enfermería de un hospital universitario. Se realizó una validación de aspecto y contenido, un pretest cognitivo y un pilotaje de la encuesta epidemiológica con treinta sujetos. Se realizó un análisis descriptivo utilizando media y desviación estándar (DE) para las variables cuantitativas y las frecuencias absolutas (n) y relativas (%) para variables cualitativas. Se aplicó el test chi-cuadrado y el test ANOVA para evaluar la asociación de las respuestas con las variables: sexo, tipo de trabajador, área de trabajo y actividad en Unidades Covid-19. Resultados principales: Las enfermeras, médicos y auxiliares de enfermería trabajaban principalmente en áreas asistenciales y en unidades de alto riesgo de exposición. Los auxiliares de enfermería y las enfermeras tenían una mayor percepción de riesgo. Las enfermeras estaban menos implicadas en la organización, pero se sentían más apoyadas por sus compañeros. Los médicos se sentían más apoyados por sus superiores y mejor atendidos cuando tenían problemas de salud. Conclusión principal: Las enfermeras y auxiliares de enfermería presentaron mayor percepción de riesgo, las enfermeras se implicaron menos en la organización de la atención sanitaria, mientras que los médicos se sintieron más apoyados por sus superiores.
Introducción: durante la pandemia de COVID-19 se observa en la realización del trabajo diario un aumento del uso de las contenciones mecánicas debido a las condiciones excepcionales de trabajo: la limitación de acceso a las unidades, el tipo de aislamiento estricto, la falta de acompañamiento, etc. Objetivo: estimar la incidencia de contención mecánica en pacientes ingresados en unidad COVID-19, durante la pandemia y compararla con la de los pacientes de una unidad no COVID-19 y con pacientes previos a la pandemia. Método: estudio de cohortes retrospectivo, realizado en el Hospital Virgen de la Concha (Complejo Asistencial de Zamora) con pacientes mayores de 65 años ingresados en Medicina interna y divididos en tres subgrupos, uno en periodo de prepandemia (junio-diciembre 2019) y otro en periodo de pandemia (enero- mayo 2021) que se dividieron en pacientes ingresados por COVID-19 y pacientes ingresados por otras enfermedades (no COVID-19). Resultados: de los 312 casos evaluados, 104 eran de periodo de prepandemia y 208 en periodo de pandemia (104 pacientes COVID-19 y 104 pacientes con otras enfermedades). En prepandemia la incidencia de pacientes con contención mecánica fue del 7,7% (Intervalo de confianza del 95% [IC 95%]: 3,4 a 14,7%), mientras que durante la pandemia las incidencias fueron 21,2% (IC 95%: 13,7% a 30,2%) en pacientes COVID-19 Y 20,2% (IC 95%: 12,9% A 29,2%) en pacientes no COVID-19. Discusión: durante el periodo de pandemia fue mayor la incidencia de las contenciones que en el periodo de prepandemia, con independencia del acompañamiento, edad, sexo y del diagnóstico, o no, de COVID-19.
ABSTRACT
Introduction. During the COVID-19 pandemic we have observed an increase in the use of mechanical restraints due to exceptional working conditions: limited access to the units, the type of strict isolation, the lack of accompaniment, etc. Objective: to estimate the incidence of physical restraint in patients admitted to a COVID-19 unit during the pandemic and compare it with that of patients in a non-COVID-19 unit and with patients prior to the pandemic. Methodology: retrospective cohort study, carried out at the Virgen de la Concha Hospital (Zamora Assistance Complex) with Internal Medicine inpatients older than 65 years and divided into three subgroups, one in the pre-pandemic period (June-December 2019) and another in the pandemic period (January-May 2021) that we divided into patients admitted for COVID-19 and patients admitted for other diseases (not COVID-19). Results: of the 312 cases evaluated, 104 were from the pre-pandemic period and 208 from the pandemic period (104 COVID-19 patients and 104 patients with other diseases). In pre-pandemic, the incidence of patients with mechanical restraint was 7.7% (95% confidence interval [95% CI]: 3.4 to 14.7%), while during the pandemic the incidence was 21.2%. (95% CI: 13.7% to 30.2%) in COVID-19 patients and 20.2% (95% CI: 12.9% to 29.2%) in non-COVID-19 patients. Discussion: during the pandemic period the incidence of restraints was higher than in the pre-pandemic period, regardless of accompaniment, age, sex, and COVID-19 diagnosis.
Objetivo. Describir la prevalencia de pacientes con alteración de sueño en presencia de luz y ruidos nocturnos durante su internación en el 6º piso del Hospital Universitario Austral. Material y Métodos. Estudio transversal en una población de pacientes obstétricos y clínicos internados, elegidos mediante muestreo consecutivo. Para la recolección de datos se realizó una encuesta anónima por medio de una herramienta digital. Se incluyeron las variables sociodemográficas y ocho preguntas relacionadas a la satisfacción del descanso y la repercusión de la luz y el ruido de las últimas dos noches. Los datos fueron volcados en un Excel para su posterior análisis. Resultados. La prevalencia de pacientes con alteración del descanso en presencia de luz y de ruido fue del 9% (23). La población analizada fue de 246 pacientes, con una edad promedio de 34 años (DE ± 12); de las cuales 78% (191) fueron mujeres. En cuanto al tipo de paciente, 74% (180) fueron obstétricos y 17% (40) clínicos. Según la ubicación de las habitaciones, 34% (82) se encontraban ubicados cerca del office de enfermería y 66% (160) se encontraban lejos. La alteración del descanso de los pacientes no varía según el tipo de pacientes (obstétricos o clínicos) ni según su cercanía al office de enfermería. Discusión. La prevalencia de la alteración del sueño es muy baja. El instrumento midió la satisfacción con un instrumento corto, rápido, dinámico. Es la única herramienta encontrada en la literatura que responda a la satisfacción y percepción del sueño en relación con el ruido y la luz.
ABSTRACT
Objective. Describe the prevalence of inpatients with sleep alterations due to nocturnal lights and noises during their stay in the 6th floor of the Hospital Universitario Austral. Methodology. A cross-sectional study was conducted on a group of inpatients, either from the obstetric or the general care section, who were selected throughout consecutive sampling. Data recollection was done by an anonymous survey using a digital tool. The survey included socio demographic variables and eight questions about rest satisfaction and the impact of light and noise over rest within the last two nights. This information was transferred to an Excel for its further analysis. Results. The prevalence of patients with rest alteration in presence of light and noise was 9% (23). The study was carried out on a group of 246 patients, with an average age of 34 years old (± 12); 78% of which (191) were women. As regards the kind of patient, 74% (180) were obstetrical patients and 17% (40) were derived from the general care section. As to room location, 34% (82) were near the nurse working station and 66% (160) were far away from it. Sleep alteration in patients is not affected by the type of patient (obstetrical or general) or by their proximity to the nurse working station. Discussion. The prevalence of sleep alteration is very low. Satisfaction was measured with a short, quick and dynamic instrument. This is the only document found in literature which answers to rest satisfaction and perception in relation to light and noise.
El litio es el estabilizador del ánimo en uso más extendido. Posee un estrecho margen terapéutico, siendo tóxico en altas concentraciones. Esta guía va dirigida a profesionales y personas que estén utilizando Litio, pretende facilitar la toma correcta y el buen manejo de esta medicación [Fragmento de texto].
Objetivo. Analizar factores relacionados con la conducta suicida en pacientes con enfermedad mental para orientar la prevención y cuidados de salud mental especializados. Material y métodos. Estudio descriptivo transversal de una muestra de 44 pacientes hospitalizados por conducta suicida en psiquiatría. Durante 12 meses se registraron variables sociodemográficas y clínicas, se aplicaron la escala Columbia de cribado del riesgo suicida, la de Desesperanza de Beck, la de Impulsividad de Plutchik y el Inventario de Razones para Vivir. Se usó estadística descriptiva e inferencial para una significación estadística de p<0,05. Resultados. El 84% (n=37) presentó ideación suicida, el 63,3% (n=28) tentativa y el 2,3% (n=1) suicidio consumado. Realizaron más intentos previos las mujeres (60%/n=15) que los hombres (38%/n=7). La intoxicación medicamentosa fue el método más utilizado por ambos sexos seguido de autolesiones por mujeres (p<0,05) y precipitación por hombres (p<0,05). La depresión, trastorno más prevalente, se asoció a la edad y al medio rural (p<0,05). El trastorno de ansiedad fue el más predictivo para la intención/plan y tentativas suicidas (p<0,05). El 80% (n=16) de los intentos padecía enfermedad médica (p<0,05). Se evidenció la relación inversa entre las creencias de supervivencia/afrontamiento y la conducta suicida. Discusión. La conducta suicida supone más del 20% de los ingresos de una unidad psiquiátrica. No es posible determinar un perfil único de riesgo, se han evidenciado diferencias según el espectro suicida. Todos los factores relacionados deben ser valorados.
ABSTRACT
Objective. To analyze factors related to suicidal behavior in patients with mental illness to guide prevention and specialized mental health care. Methodology. A descriptive cross-sectional study carried out in a sample of 44 inpatients at a psychiatric unit who attempted suicide. Sociodemographic and clinical variables were registered during 12 months. The scales applied were the Columbia-Suicide Severity Rating Scale (C-SSRS), Beck Hopelessness Scale, Plutchik’s Impulsivity Scale and the Reasons for Living Inventory. A descriptive and inferential statistic has been applied for a statistical significance of p<0,05. Results. 84% (n=37) had suicidal thinking, 63,3% (n=28) attempted suicide and 2,3% (n=1) committed suicide. More women (60%; n=15) than men (38%; n=7) attempted suicide. Medication overdose was the main suicidal approach by both sexes followed by self-harm by women (p<0,05) and deliberate fall by men (p<0,05). Depression, the most prevalent disorder, was associated with age and rural environment (p<0,05). Anxiety had the highest predictive value of suicidal attempt (p<0,05). 80% (n=16) of those who attempted suicide suffered from a medical illness (p<0,05). There is evidence of inverse relationship between the survival and coping beliefs and the suicidal behaviour. Discussion. Suicidal behaviour surpasses 20% of the admissions at a psychiatric unit. It is not possible to determine a specific risk profile as differences according to the suicidal spectrum have been acknowledged. Every possible cause must be evaluated.
Objetivo principal: Analizar la efectividad del tratamiento de la pediculosis capitis con aceite de coco versus la permetrina o ivermectina para la reducción de la infestación en niños escolares. Metodología: Revisión sistemática con análisis interpretativo. Se consultaron bases de datos como PubMed, ScienceDirect, Epistemonikos, entre otros. Se incluyeron documentos publicados entre 2011 y 2021 derivados de la cadena de búsqueda: aceite de coco AND pediculosis capitis AND efectividad en español e inglés. Resultados principales: Después de aplicar criterios de exclusión y eliminación, se analizaron 10 documentos, que incluían ensayos comunitarios, estudios preclínicos de laboratorio y revisiones sistemáticas, los cuales proponen el aceite de coco como un tratamiento alternativo eficaz contra la pediculosis. Conclusión principal: Aunado a los reportes de alta efectividad de tratamiento, no se reportan efectos adversos y se sugiere el uso de gorra de baño así como un peinado vigoroso con una lendrera para aumentar la efectividad.
Objetivo principal: Valorar si la terapia con sanguijuelas, es beneficiosa en el alivio de la congestión venosa. Metodología: Lectura crítica con CARE. Resultados principales: Nivel de evidencia bajo, según GRADE. Conclusión principal: A pesar de la falta de evidencia, con-cluimos que la terapia con sanguijuelas, mejora la congestión venosa en heridas.
Objetivo principal: comprender la percepción de las enfermeras sobre la experiencia de asistencia ofrecida a la lactancia materna en el puerperio inmediato. Metodología: estudio de abordaje cualitativo, apoyado en etnografía, basado en etno-enfermería. La investigación se realizó en la maternidad de un hospital ubicado en el sur de Minas Gerais, con siete enfermeras que desarrollan prácticas de atención relacionadas con la mujer en el puerperio inmediato. Resultados principales: surgieron ocho categorías temáticas y sus respectivas sub-categorías: Lactancia materna y beneficios; ¡El parto normal ayuda! ¡El parto por cesárea se interpone! Práctica en asistencia a la lactancia materna; Atención prenatal y hospitalaria; Pautas; Lactancia materna en el puerperio inmediato; Dificultades enfrentadas durante la lactancia materna y percepción de la importancia del rol de la enfermería. Conclusión principal: las enfermeras, a pesar de tener práctica y conocimientos, se dan cuenta de que los cuidados de enfermería aún son deficientes, señalando muchas barreras que dificultan la práctica de la lactancia materna.
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