Best Nursing Intervention Practices to Prevent Non-Communicable Disease: A Systematic Review.

Objectives: To explore nursing health education interventions for non-communicable disease patients. Methods: The design was a systematic review of research work published between 2008 and 2018. The data sources included the Web of Science, PubMed, Scopus, COCHRANE, and LILACS. The studies that met the inclusion were assessed, and the analysis for methodological quality through the recommended tools CASPe, and JADAD. Results: Fifteen original studies from eight counties were included in the review; Findings revealed 13 studies with randomized samples and six used power analysis. Nurses' interventions included house calls, home care, and individual and group health education. Conclusion: Nursing interventions showed 76.4% the effectiveness of results in patient outcomes to promote and improve healthier lifestyles and quality of life of non-communicable disease patients. This review discloses the significant impact of nursing health education interventions. Nursing leadership and political decision-makers should consider providing programs to enhance health education knowledge and abilities. All of this can favor the sustainability of the global economy by changing the life style of thousands of people worldwide. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42020208809.

The Implementation of Nursing Specialties in Spain, 2005-2018: A Documental Study.

Nursing specialization is considered a significant professional requirement to meet the challenges and needs of the health systems under evolving epidemiological patterns and scientific, technological, and social advances. In Spain, experiences in the training of specialist nurses have followed the same pattern and have been consolidated through legislation. This study aimed to analyze the implementation of the Spanish Nursing Specialty process according to the Royal Decree 450/2005. It used the documentary and systematic analysis method: a systematic review of official regulation documents published in the State Official Bulletin of Spain, Spanish legislative and historical nursing inventories, and other nursing-specific literature. This study shows an extensive account of nursing specialties' development process through a rather long period in Spain. It evidences the complexity involved to ensure legislative legality. The study also points to the need for homogeneity within the programs across the national territory and legal definition for specialty practice. This study could be an illustration to stimulate other nurse leaders in the world working in regulation and nursing specialty development to empower nurses' development and enhance the nurse specialists' contribution to archive the needs of the health system and healthcare of the population. HIGHLIGHTS:.

Foot biomechanics in patients with diabetes mellitus: doubts regarding the relationship between neuropathy, foot motion, and deformities.

BACKGROUND: We sought to identify the biomechanical characteristics of the feet of patients with diabetes mellitus and the interrelationship with diabetic neuropathy by determining the range of joint mobility and the presence and locations of calluses and foot deformities. METHODS: This observational comparative study involved 281 patients with diabetes mellitus who underwent neurologic and vascular examinations. Joint mobility studies were performed, and deformities and hyperkeratosis locations were assessed. RESULTS: No substantial differences were found between patients with and without neuropathy in joint mobility range. Neuropathy was seen as a risk factor only in the passive range of motion of the first metatarsophalangeal joint (mean ± SD: 57.2° ± 19.5° versus 50.3° ± 22.5°, P = .008). Mean ± SD ankle joint mobility values were similar in both groups (83.0° ± 5.2° versus 82.8° ± 9.3°, P = .826). Patients without neuropathy had a higher rate of foot deformities such as hallux abductus valgus and hammer toes. There was also a higher presence of calluses in patients without neuropathy (82.8% versus 72.6%; P = .039). CONCLUSIONS: Diabetic neuropathy was not related to limited joint mobility and the presence of calluses. Patients with neuropathy did not show a higher risk of any of the deformities examined. These findings suggest that the etiology of biomechanical alterations in diabetic people is complex and may involve several anatomically and pathologically predisposing factors.

Validating the probe-to-bone test and other tests for diagnosing chronic osteomyelitis in the diabetic foot.

OBJECTIVE: To compare the diagnostic characteristics of tests used for a prompt diagnosis of chronic osteomyelitis in the diabetic foot, using bone histology as the criterion standard. The tests assessed were probe-to-bone (PTB), clinical signs of infection, radiography signs of osteomyelitis, and ulcer specimen culture. RESEARCH DESIGN AND METHODS: A prospective study was performed on patients with foot ulcers referred to our diabetic foot clinic. Ulcer infection was diagnosed by recording clinical signs of infection and taking specimens for culture. The presumptive diagnosis of osteomyelitis was based on these results and the findings of a plain X-ray and PTB test. All patients with a clinical suspicion of bone infection were subjected to surgical treatment of the affected bone. During surgery, bone specimens were obtained for a histological diagnosis of osteomyelitis. RESULTS: Over 2.5 years, 210 foot lesions were consecutively examined and 132 of these wounds with clinical suspicion of infection selected as the study sample. Of these, 105 (79.5%) lesions were diagnosed as osteomyelitis. Among the tests compared, the best results were yielded by the PTB test including an efficiency of 94%, sensitivity of 98%, specificity of 78%, positive predictive value of 95%, and negative predictive value of 91% (P < 0.001, κ 0.803); the positive likelihood ratio was 4.41, and the negative likelihood ratio was 0.02 (95% CI). CONCLUSIONS: In our outpatient population with a high prevalence of osteomyelitis, the PTB test was of greatest diagnostic value, especially for neuropathic ulcers, and proved to be efficient for detecting osteomyelitis in the diabetic foot.