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The menopause transition is a critical period of life for women associated with a variety of symptoms that may impact health status and quality of life. Menopause education can improve menopause knowledge and self-efficacy, leading to the adaptation of self-management strategies that may reduce menopause symptom burden and enhance quality of life. The purpose of this review is to systematically evaluate the research on the effect of menopause education interventions among midlife women (age 35–55 years) on menopause knowledge, self-efficacy, symptoms and quality of life.
This protocol is guided by the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. We will comprehensively search for articles published from all publication years through December 2024 in PubMed, Embase, CINAHL, PsycINFO, ProQuest Dissertation and Theses, and Scopus. The search strategy will include the following key terms and Medical Subject Headings terms: ‘menopause’, ‘menopausal’, ‘menopause transition’, ‘climacteric’, ‘health promotion’, ‘health education’ and ‘patient education’. Eligible studies will be experimental or quasi-experimental and include midlife women (age 35–55 years) who have received a menopause education intervention. Studies must report on the impact of menopause education interventions on menopause knowledge, self-efficacy, symptoms or quality of life. Only peer-reviewed articles and dissertations in English and Spanish will be included. Behavioural interventions (diet, physical activity, yoga) and medical interventions will be excluded. Two reviewers will independently perform data extraction and assess study quality/risk of bias with the Cochrane Risk of Bias tool for randomised experimental studies (RoB2) and the Risk of Bias in Non-Randomized Studies of Interventions tool (ROBINS-I). A narrative approach will be used to synthesise findings.
Ethical approval is not required for this systematic review of published literature. Findings will be disseminated via peer-reviewed journal publications, presentations at professional scientific meetings and social media.
CRD42024599106.
The HOLA study is a 12-month randomised, hybrid implementation-effectiveness, phase IV, double-arm, open-label, multicentric study including virologically suppressed people living with HIV (PWH). HOLA, which started in September 2023, evaluates acceptability, appropriateness, feasibility and satisfaction of out-of-hospital administration of cabotegravir and rilpivirine long-acting (CAB+RPV LA).
A total of 110 PWH who are already under treatment with CAB+RPV LA or switch their antiretroviral therapy to CAB+RPV LA will be recruited from two main hospitals in Barcelona (Germans Trias I Pujol and Vall d’Hebrón) and Costa del Sol Hospital, in Marbella. The patients will be randomised 1:1 into a hospital group (administration of CAB+RPV LA in the hospital) and the outpatient group (out-of-hospital administration), including community or primary care centres. The main objectives of the study are to compare the acceptability at month 12 of the administration of CAB+RPV LA in and out-of-hospital centres from the perspective of patients, and assess and compare the safety and tolerability of CAB+RPV LA. The study takes place at nine clinical units in Catalonia and Andalusia (three tertiary hospitals (recruiting centres), one community centre, one sexually transmitted infection clinic and four primary care centres).
The current publication refers to V.3.0 of the protocol, with issue date 14 April 2024, as approved by the Comité de Ética de la Investigación con medicamentos del Hospital Universitari Germans Trias i Pujol (approval number AC-23-042-HGT-CEIM). The clinical trial will be conducted according to the principles of the Declaration of Helsinki, Fortaleza, Brazil, October 2013. This study will be conducted according to Spanish regulations regarding clinical trials (Royal Decree 1090/2015) and biomedical investigations (Organic Law 14/2007 of biomedical investigation and the Royal Decree 1716/2011), and the Clinical Trial Regulation (Regulation EU No 536/2014). Confidentiality requirements will follow the required Data Protection legislation. Enrolment completion in the study is expected by the end of May 2024, with an end of study expected in May 2025. Results emerging from this study will be reported in HIV national and international meetings as well as published in international journals with a high impact factor. If the outcome is deemed positive, we will also develop and propose policy guidelines for the integration of the administration of CAB+RPV LA in alternative outpatient facilities into the standard of care in the HIV care pathway.
NCT06185452/EUCT number: 2023-503963-41-00.
To analyse the impact of the COVID-19 pandemic on the sustainability of a breastfeeding (BF) clinical practice guideline (CPG) for women without COVID-19, throughout the 5 waves of the pandemic.
A mixed-methods design was utilised.
For the quantitative approach, an interrupted time series design was utilised, as well as the analysis of CPG sustainability reports as a qualitative approach. The study setting was in a health area in the Spanish health system from April 2019, until October 2021. The sample was composed of 2239 mother–infant dyads.
The exclusive-BF rate at hospital discharge obtained values between 90% and 94.8%, without statistically significant changes. A significant increase in the risk of not starting BF in the first feeding was observed (adjusted odds ratio = 9.36; 95% CI: 1.04–84.13), between the pre-pandemic period and the first wave. Skin-to-skin contact (SSC) decreased in the first wave to 82.20%, and the oscillations observed throughout the pandemic were not statistically significant. In general, the qualitative indicators were maintained. A decrease was observed in the spaces used for postpartum care due to the re-assigning to the intensive care unit. Also, the acquisition of materials and equipment decreased.
The measures implemented for the sustainability of the BF CPG during the 5 waves of the pandemic were positive. The programmes of implementation of BF guidelines were shown to resist the COVID-19 pandemic.
Our findings contribute to the understanding and evolution of the main indicators of the sustainability of a BF CPG on COVID-19 context, providing details on the magnitude of the effect and the process of change.
The Preferred Reporting Items for observational studies (STROBE) checklist was followed.
No Patient or Public Contribution.
Método: Investigación de enfoque cualitativo, cuya población fueron mujeres del Resguardo indígena Nasa de Juan Tama. Se conformó muestra por criterio de 8 participantes, con quienes se realizaron grupos focales. El análisis de datos fue mediante herramientas analíticas de la teoría fundamentada.
Resultados: Surgieron 180 códigos descriptivos agrupados en 5 categorías analíticas: prácticas de preparación, rituales, promoción, prevención y de cuidado de LM.
Conclusiones: Las prácticas ancestrales han sufrido un debilitamiento en los territorios indígenas. En resistencia, se preservan prácticas a través de mayoras, parteras y abuelas. La coexistencia de prácticas son una oportunidad de aprendizaje mutuo de comunidades indígenas y agentes de salud, promoviendo enfoques de salud que respeten y valoren las tradiciones culturales.
Palabras clave: Lactancia materna; mujeres; pueblos indígenas; creencias; cultura indígena
To assess the prevalence of malnutrition in hospitalised adult patients, and to evaluate the accuracy of the most commonly used nutritional screening tools for identifying individuals at risk of malnutrition.
A prospective cross-sectional study was conducted on a total of 248 hospitalised patients in internal medicine wards (mean age: 75.2 years; 39.5% females). Nutritional screening was performed within 48 h of admission using the following tools: Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening Tool (NRS-2002), Malnutrition Screening Tool (MST), Short Nutritional Assessment Questionnaire (SNAQ), and Mini Nutritional Assessment Short Form (MNA-SF). The criteria of the European Society for Clinical Nutrition and Metabolism (ESPEN) were used as the gold standard for defining malnutrition. Patients were also evaluated using the Subjective Global Assessment (SGA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Accuracy was determined by examining sensitivity, specificity, and positive and negative predictive values, and diagnostic agreement was determined by calculation of Cohen's kappa (κ). The study is reported as per the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
The ESPEN criteria classified 20.2% of the hospitalised patients as malnourished. Overall, the MUST had the highest sensitivity (80.0%), specificity (74.7%) and positive predictive value (44.4%). For the subgroup of patients aged >65 years, the MNA-SF had high sensitivity (94.4%) but low specificity (39.0%). Based on Cohen's κ, the SGA and GLIM criteria showed low agreement with the ESPEN criteria.
The MUST was the most accurate nutritional screening tool, through the MST is more easily applied in many clinical settings. A comprehensive assessment of malnutrition that considers muscle mass is crucial for the reliable diagnosis of malnutrition.
The present findings underscore the importance of accurate assessment of the malnutrition status of hospitalised patients and the need for a reliable screening tool.
No patient or public contribution.
Objetivo principal: Determinar qué autocuidados son recomendables, en los procesos de duelo, para las enfermeras. Metodología: Lectura crítica del artículo seleccionado, evaluado con la parrilla de preguntas CASPe, con los criterios propuestos por Arnau y Sala para revisiones narrativas y con The Literature Review Checklist de Leite et al. Resultados principales: Según el sistema GRADE, hablamos, en general, de Moderada Calidad de la Evidencia. Conclusión principal: Tras la lectura crítica y junto a la literatura revisada, vemos a cualquiera de las intervenciones de autocuidado propuestas por McAdam como recomendable. Aun así se hacen precisos más estudios que aporten mayor grado de evidencia en intervenciones concretas.
Objetivo: Determinar la influencia de la sarcopenia en la funcionalidad de Adultos Mayores Mexicanos. Método: diseño correlacional-predictivo. Muestra: 316 adultos mayores que asistieron al centro de actividades artísticas y deportivas. Instrumentos: cédula de datos sociodemográficos-clínicos, SARC-F, índice de Barthel y escala de Lawton. Resultados: La sarcopenia tiene impacto negativo sobre las actividades instrumentales de la vida diaria e influye en mayor porcentaje en las básicas convirtiéndola en variable predictora explicando un 34% las actividades de la vidia diaria y un 22% las instrumentales. Conclusiones: La sarcopenia es una variable predictora para las actividades básicas e instrumentales de la vida diaria. Los resultados presentados plantean bases para futuras intervenciones multidisciplinarias para disminuir el riesgo de sarcopenia y complicaciones en quienes la padecen. Es necesario adoptar estrategias de valoración de individuos con sarcopenia o en riesgo de desarrollarla, a través de consultas en el primer nivel de atención, para prevenirla.
Objetivo: Demostrar que el uso de solución salina 0.9% es tan eficaz como la heparina sódica para mantener la permeabilidad y prevenir obstrucciones del catéter central de inserción periférica en pacientes oncológicos tratados con quimioterapia. Metodología: Estudio analítico de cohortes retrospectivo, en pacientes oncológicos portadores de un catéter central de inserción periférica para administración de quimioterapia ambulatoria en un hospital de Tarragona. Resultados: De los 103 pacientes estudiados, 4 presentaron obstrucción del catéter. La incidencia de obstrucción fue superior en catéteres heparinizados que en catéteres salinizados. Conclusión: La heparina sódica y la solución salina demuestran la misma eficacia para el mantenimiento de la permeabilidad del catéter y la prevención de obstrucciones. Además, es suficiente la salinización del catéter cada 3 semanas, suponiendo una disminución en el número de visitas al centro sanitario y, por consiguiente, una mejora en la calidad de vida de los pacientes.
Objetivo principal: Comparar el número de trombosis venosas (TV) asociadas al lugar donde queda alojada su punta, en la inserción periférica del catéter venoso central de inserción periférica (PICC). Metodología: Estudio observacional retrospectivo en pacientes onco-lógicos. Resultados principales: De los 379 catéteres insertados, el 4,22% presentaron TV sintomática. De éstos, el 1,58% tenían la punta alojada en vena cava superior (VCS), y el 2,63% en subclavia. Existieron diferencias en cuanto al sexo y al diagnóstico. Conclusión principal: La correcta posición de la punta del PICC en el borde del tercio inferior de la VCS y la unión cavo-auricular es crucial para evitar la TV. Es importante conocer las complicaciones asociadas y su incidencia, para prevenirlas, reconocerlas y tratarlas adecuadamente. La inserción ecoguiada supone una técnica menos agresiva con reducción del número de trombosis y de costes sanitarios. La TV afecta la calidad de vida del paciente y su entorno conllevando, además, un aumento en el gasto sanitario.
Este caso clínico presenta la situación de un paciente de 66 años insulino requirente, quien se negó a realizar amputación digital transmetatarsiana en el pie derecho como única opción de tratamiento para el pie diabético, el paciente fue atendido en clínica de heridas donde se elaboró el plan de cuidados utilizando el modelo de enfermería de Virginia Henderson, las taxonomías de la North American Nursing Diagnosis Association (Nanda), Nursing Outcomes Classification (Noc) y Nursing Interventions Classification (Nic). Se establecieron como diagnósticos enfermeros: deterioro de la integridad tisular, perfusión tisular periférica ineficaz y gestión ineficaz de la salud. El desbridamiento mecánico del tejido necrótico bajo la aplicación de procesos de asepsia, el compromiso del grupo multidiscipli-nario de la salud y la educación al paciente, permitieron el salvamento de 2 falanges del dedo y el retorno a la vida normal del paciente en un periodo de 7 meses.
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