Effectiveness of Narrative Photography in Increasing Nursing Students' Empathy: A Pretest-Posttest Study.

BACKGROUND: Narrative photography is a method that can enhance nursing students' empathy when caring for individuals with HIV. METHOD: This quasiexperimental pre-test-posttest study included 28 first-year nursing students from a public university in Barcelona, Spain. Empathy was assessed using the Spanish validated version of the Interpersonal Reactivity Index. RESULTS: Empathy scores were higher in the intervention group (p = .01). Women scored higher on empathy and also on the fantasy, empathic concern, and personal distress dimensions. A significant relationship was found between the perspective taking dimension and students choosing nursing as their first option at university. Having no experience in the health field was associated with higher scores on the empathic concern dimension (p = .027). CONCLUSION: Narrative photography is an effective learning method to promote nursing students' empathy when caring for individuals with HIV. [J Nurs Educ. 2022;61(12):701-705.].

Factores asociados a la colonización rectal por Enterobacteriaceae productoras de betalactamasas de espectro extendido en pacientes de consulta externa de un hospital al norte del Perú / Factors associated with rectal colonization by extended-spectrum beta-lactamase-producing Enterobacteriaceae in outpatients in a hospital in northern Peru

Introducción: Las Enterobacteriaceae productoras de betalactamasas de espectro extendido están presentes en las heces de los individuos de la comunidad. En Perú, la automedicación, el tipo de alimentación, condiciones sanitarias podrían asociarse a esta colonización. Objetivo: determinar la frecuencia de colonización rectal por EP-BLEE en pacientes de consulta externa del Hospital Regional Lambayeque, así como los factores asociados a la misma, durante los meses de julio 2018 a febrero 2019. Material y métodos: 331 pacientes participantes fueron entrevistados, de los cuales se obtuvieron tres muestras seriadas de heces recién emitidas. Las muestras fueron cultivadas en agar McConkey. Las EP-BLEE se confirmaron con la prueba de disco combinado (método americano). Resultados: el 85,8 % de los pacientes estuvieron colonizados por EP-BLEE, siendo Escherichia coli el aislamiento más frecuente (87,7 %). El análisis bivariado asoció el consumo de carne de cerdo (RP=1,15 IC 95%: 1,07 - 1,24), caprino (RP=1,18, IC 95%: 1,10 - 1,25) y el consumo de ensaladas frecuentemente (RP=1,15, IC 95 %: 1,05 - 1,28) con una mayor probabilidad de ser portador rectal de EP-BLEE. La automedicación presentó valores cercanos al límite de validez (p=0,051, RP 1,12, IC 95% 0,98 - 1,26). Conclusiones: Consumir carne de cerdo, caprino y ensaladas aumentan la probabilidad de ser portador de EP-BLEE, mientras que la automedicación podría estar asociada, por lo que es necesario seguir investigando, ya que se desconocen las razones de este hallazgo en pacientes de la comunidad.

Background:Extended-spectrumbeta-lactamase-producing Enterobacteriaceae(EP-BLEE) are present in the feces of individuals in the community. In Peru, self-medication, type of diet and sanitary conditions could be associated with this colonization. Objective:to determine the frequency of rectal colonization by EP-BLEE in outpatients of the "Hospital Regional Lambayeque", as well as the factors associated with it, during the months of July 2018 to February 2019. 331 participating patients Material and methods:were interviewed, and three serial samples of freshly emitted stool were obtained from them. The samples were cultured on McConkey agar. EP-BLEE were confirmed with the combined disc test (American method). 85.8% of patients were colonized by EP-BLEE, and Escherichia coliwas the most frequent isolate (87.7%). Bivariate Results:analysis associated the consumption of pork (RP=1.15, 95% CI: 1.07 - 1.24), goat (RP=1.18, 95% CI: 1.10 - 1.25) and frequent consumption of salads (RP=1.15, 95% CI: 1.05 - 1.28) with a higher probability of being a rectal carrier of EP-BLEE. Self-medication presented values close to the limit of validity (p=0.051, RP1.12, 95% CI 0.98 - 1.26). Consuming pork, goat meat and salads increase the probability Conclusions:of being a carrier of EP-BLEE, while self-medication could be associated, so further research is needed, since the reasons for this finding are unknown.

'Staying alive' with antiretroviral therapy: a grounded theory study of people living with HIV in Peru.

BACKGROUND: To achieve an optimal quality of life through chronic disease management, people living with HIV (PLHIV) must adhere to antiretroviral therapy (ART). ART has been available throughout Peru since 2004 without cost in all regions; yet only 60% (43 200) of PLHIV receive ART and 32% are virally suppressed. Despite the low adherence, little is known about the experience of PLHIV with ART adherence in the context of Latin America. METHODS: A constructivist grounded theory design was used to understand the ART adherence experiences of PLHIV in Northern Peru. Unstructured interviews were conducted with 18 participants resulting in theoretical saturation. All interviews were recorded, immediately transcribed and analysed concurrently with data collection using constant comparative analysis with Atlas.ti (V.8) software. Rigour was maintained through openness, reflexivity, audit trail, memo writing, debriefings, member checks and positionality. RESULTS: The core category 'staying alive' emerged through the interaction of four categories, including: (1) overcoming barriers; (2) working with the healthcare team; (3) tailoring self-care strategies; and (4) appreciating antiretrovirals. Adherence is not a spontaneous outcome, instead, the surprise of HIV diagnosis transitions to living with HIV as a chronic disease. The healthcare team helps PLHIV realise ART is their life source by enhancing, supporting and facilitating self-care and overcoming barriers. CONCLUSION: Adherence emerges from experiential learning as PLHIV recognised ART as their life source in balance with their desire to continue living a normal life. Social support and healthcare team interventions help PLHIV implement tailored self-care strategies to overcome personal, social, and structural barriers to adherence. Healthcare professionals need to recognise the challenges confronted by PLHIV as they learn how to continue living while trying to stay alive.

Attitudes and beliefs of nurses and physicians about managing sexual health in primary care: A multi-site cross-sectional comparative study.

Aim: To understand the attitudes and beliefs of nurses and physicians about managing the sexual health of patients during office visits in primary care centres. Design: A questionnaire-based, cross-sectional multi-centre study. Methods: The study was performed in 15 primary care centres in Barcelona (Spain), from December 2017-February 2018. Obtained data were analysed with descriptive and bivariate statistics. Results: Nearly half the participants believed they should manage sexual health in primary care, but a third of them disagreed this is a priority. Participants also believed patients are not comfortable speaking with them about sex. Statistically significant differences were observed between the professions as nurses more often reported receiving sexual health questions from patients and believed they had enough knowledge to appropriately respond. Most participants wanted additional education to speak with patients more comfortably and confidently about sex.

Nursing students' satisfaction with narrative photography as a method to develop empathy towards people with Hiv: A mixed-design study.

BACKGROUND: A major concern for people living with HIV during their lifetime is stigma and discrimination. It is therefore crucial to improve new generations of nurses' empathetic attitude towards these patients to eliminate fear and reduce discrimination using new educational interventions. OBJECTIVE: To analyze nursing students' satisfaction with narrative photography as a method to develop empathy towards people living with HIV. DESIGN: Concurrent mixed-method design. PARTICIPANTS: Seventeen first-year nursing students from a public university in Barcelona, Spain. METHODS: A 32-item questionnaire was administered at the end of the narrative photography training activity to determine nursing students' satisfaction with the methodology. Sociodemographic, attitudinal, skills, and satisfaction data were collected. Qualitative data were collected using a reflective open-ended question. RESULTS: Of the participants, 82.4% stated that narrative photography helped them to develop reflective thinking and perceive how people living with HIV may feel. Further, 88.2% said that the new method helped them to eliminate some of their prejudices about HIV/AIDS, consider different points of view, understand the importance of providing humanized care, and identify discriminatory behaviors when caring for people living with HIV. Finally, 70.6% stated that narrative photography taught them more than traditional lectures. CONCLUSIONS: Nursing students' satisfaction with narrative photography as a teaching strategy is very high; as a result, empathy is advanced in an academic and professional way during the nursing degree. However, more research is needed to demonstrate its efficacy in different scenarios.

Faculty Attitudes About Caring for People Living With HIV/AIDS: A Comparative Study.

BACKGROUND: People living with HIV/AIDS (PLHIV) experience stigma and discrimination. Negative attitudes of nursing faculty about caring for PLHIV can adversely affect student perceptions and their nursing care. The study purpose was to describe nursing faculty attitudes and beliefs about caring for PLHIV. METHOD: The HPASS (Healthcare Provider HIV/AIDS Stigma Scale), Spanish version, was delivered to nursing faculty in Colombia and Peru. RESULTS: The HPASS was completed by 98 nursing faculty. The overall mean score was 2.41 (SD = 0.69), with subscale scores: stereotypes, 2.55 (SD = 0.84); discrimination, 2.28 (SD = 0.74); and prejudices, 2.41 (SD = 0.63). Peruvian faculty had the highest scores, statistically correlated with the importance of religion, whereas Colombia had the lowest. CONCLUSION: Nursing faculty attitudes toward PLHIV were slightly positive in Colombia to slightly negative in Peru; however, both countries had negative stereotypes. Knowledge deficiencies about HIV persist and attitudes appear to be influenced by culture and religion. [J Nurs Educ. 2019;58(12):712-717.].

[Association between exclusive breastfeeding and atopic dermatitis in a third level of care hospital]. / Asociación entre lactancia materna exclusiva y dermatitis atópica en un hospital de tercer nivel de atención.

OBJETIVE.: To assess whether exclusive breastfeeding is associated with atopic dermatitis in children under seven years of age. MATERIALS AND METHODS.: Non-paired case and control type study conducted in a third level of care hospital (Lambayeque Regional Hospital) between June 2016 and May 2018 in which 260 cases and 260 controls recruited in outpatient consultation of the Dermatology and Pediatrics services were evaluated. The UK criteria were used for the diagnosis of atopic dermatitis, as well as a survey with possible risk factors. RESULTS.: In the bivariate analysis, differences were found between cases and controls in relation to exclusive breastfeeding (p=0.001), family history of atopy (p<0.001), parents' educational level (p<0.001), smoking in the presence of the child (p=0.006), and origin (p=0.002). Exclusive breastfeeding was present in 93 (35.8%) of cases compared to 132 (50.8%) of controls. The multivariate analysis using logistic regression found that exclusive breastfeeding would have a protective effect on the presence of atopic dermatitis (OR= 0.62; 95% CI= 0.41-0.94) adjusted by age, sex, background, parents' educational level, initiation of complementary feeding, family member with atopy, and smoking habit. CONCLUSIONS.: Exclusive breastfeeding would have a protective effect on the appearance of atopic dermatitis in children under the age of seven.

OBJETIVOS.: Evaluar si la lactancia materna exclusiva se asocia a la dermatitis atópica en niños menores de siete años. MATERIALES Y MÉTODOS.: Estudio tipo casos y controles no pareado, realizado en un hospital de tercer nivel de atención (Hospital Regional Lambayeque) entre junio de 2016 y mayo de 2018 en donde se evaluó 260 casos y 260 controles captados en consulta externa de los servicios de Dermatología y Pediatría. Se usaron los criterios del Reino Unido para el diagnóstico de dermatitis atópica y una encuesta con posibles factores de riesgo. RESULTADOS.: En el análisis bivariado se encontró diferencias entre los casos y controles en relación a lactancia materna exclusiva (p=0,001), antecedente familiar de atopia (p<0,001), nivel educativo de padres (p<0,001), hábito de fumar en presencia del niño (p=0,006) y procedencia (p=0,002). La lactancia materna exclusiva estuvo presente en 93 (35,8%) de los casos en comparación con 132 (50,8%) en los controles. En el análisis multivariado usando regresión logística se encontró que lactancia materna exclusiva tendría un efecto protector sobre la presencia de dermatitis atópica (OR= 0,62; IC95%= 0,41-0,94) ajustado por edad, sexo, procedencia, nivel educativo de los padres, inicio de alimentación complementaria, familiar con atopía y hábito de fumar. CONCLUSIONES.: La lactancia materna materna exclusiva tendría un efecto protector sobre la presencia de dermatitis atópica en niños menores de siete años.

Adherence to antiretroviral therapy and the associated factors among people living with HIV/AIDS in Northern Peru: a cross-sectional study.

BACKGROUND: There are approximately 72,000 people living with HIV/AIDS (PLHIV) in Peru. Non-adherence to antiretroviral therapy (ART) is the most important factor for therapeutic failure and the development of resistance. Peru has achieved moderate progress in meeting the 90-90-90 targets, but only 60% of PLHIV receiving ART are virally suppressed. The purpose of this study was to understand ART adherence in the Peruvian context, including developing sociodemographic and clinical profiles, evaluating the clinical management strategies, and analyzing the relationships between the variables and adherence of PLHIV managed at a regional HIV clinic in Lambayeque Province (Northern Peru). METHODS: This was a cross-sectional study with 180 PLHIV adults, non-randomly but consecutively selected with self-reported ART compliance (78.2% of the eligible population). The PLHIV profile (PLHIV-Pro) and the Simplified Medication Adherence Questionnaire (SMAQ) were used to collect sociodemographic information, clinical variables, and data specific to ART adherence. Descriptive analysis of sociodemographic and clinical characteristics was performed. Bivariate analysis was performed with the Mann-Whitney test, Chi square test, and Yates correction. RESULTS: The 180 PLHIV sample included 78.9% men, 49.4% heterosexual, 45% with a detectable HIV-1 viral load less than 40 copies/ml, 58.3% not consistently adherent, and only 26.1% receiving Tenofovir + Lamivudine + Efavirenz. Risk factors significant for non-adherence included concurrent tuberculosis, discomfort with the ART regime, and previous pauses in ART. Multivariate analysis of nested models indicated having children is a protector factor for adherence. CONCLUSIONS: Self-reported adherence appeared to be low and the use of first-line therapy is not being prescribed homogeneously. Factors associated with nonadherence are both medical and behavioral, such as having tuberculosis, pausing ART, or experiencing discomfort with ART. The Peruvian government needs to update national technical standards, monitor medication availability, and provide education to health care professionals in alignment with evidence-based guidelines and international recommendations. Instruments to measure adherence need to be developed and evaluated for use in Latin America.

Asociación entre lactancia materna exclusiva y dermatitis atópica en un hospital de tercer nivel de atención / Association between exclusive breastfeeding and atopic dermatitis in a third level of care hospital

RESUMEN Objetivos. Evaluar si la lactancia materna exclusiva se asocia a la dermatitis atópica en niños menores de siete años. Materiales y métodos. Estudio tipo casos y controles no pareado, realizado en un hospital de tercer nivel de atención (Hospital Regional Lambayeque) entre junio de 2016 y mayo de 2018 en donde se evaluó 260 casos y 260 controles captados en consulta externa de los servicios de Dermatología y Pediatría. Se usaron los criterios del Reino Unido para el diagnóstico de dermatitis atópica y una encuesta con posibles factores de riesgo. Resultados. En el análisis bivariado se encontró diferencias entre los casos y controles en relación a lactancia materna exclusiva (p=0,001), antecedente familiar de atopia (p<0,001), nivel educativo de padres (p<0,001), hábito de fumar en presencia del niño (p=0,006) y procedencia (p=0,002). La lactancia materna exclusiva estuvo presente en 93 (35,8%) de los casos en comparación con 132 (50,8%) en los controles. En el análisis multivariado usando regresión logística se encontró que lactancia materna exclusiva tendría un efecto protector sobre la presencia de dermatitis atópica (OR= 0,62; IC95%= 0,41-0,94) ajustado por edad, sexo, procedencia, nivel educativo de los padres, inicio de alimentación complementaria, familiar con atopía y hábito de fumar. Conclusiones. La lactancia materna materna exclusiva tendría un efecto protector sobre la presencia de dermatitis atópica en niños menores de siete años.

ABSTRACT Objetive. To assess whether exclusive breastfeeding is associated with atopic dermatitis in children under seven years of age. Materials and Methods. Non-paired case and control type study conducted in a third level of care hospital (Lambayeque Regional Hospital) between June 2016 and May 2018 in which 260 cases and 260 controls recruited in outpatient consultation of the Dermatology and Pediatrics services were evaluated. The UK criteria were used for the diagnosis of atopic dermatitis, as well as a survey with possible risk factors. Results. In the bivariate analysis, differences were found between cases and controls in relation to exclusive breastfeeding (p=0.001), family history of atopy (p<0.001), parents' educational level (p<0.001), smoking in the presence of the child (p=0.006), and origin (p=0.002). Exclusive breastfeeding was present in 93 (35.8%) of cases compared to 132 (50.8%) of controls. The multivariate analysis using logistic regression found that exclusive breastfeeding would have a protective effect on the presence of atopic dermatitis (OR= 0.62; 95% CI= 0.41-0.94) adjusted by age, sex, background, parents' educational level, initiation of complementary feeding, family member with atopy, and smoking habit. Conclusions. Exclusive breastfeeding would have a protective effect on the appearance of atopic dermatitis in children under the age of seven.

[Frequency and in vitro susceptibility antiparasitic of Blastocystis hominis from patients admitted to the Hospital Regional Lambayeque, Peru]. / Frecuencia y susceptibilidad antiparasitaria in vitro de Blastocystis hominis en pacientes admitidos en el HospitalRegional Lambayeque, Perú.

OBJECTIVE: To describe the frequency and antiparasitic in vitro susceptibility of Blastocystis hominis in patients admitted to theHospital Regional Lambayeque, Peru. MATERIAL AND METHODS: A cross-sectional study was conducted from January to August 2015 at 313 patients of all ages. B. hominis detection was performed on serial fecal samples by direct microscopic examination and microculture in modified Locke solution. The in vitro susceptibility testing against the drug metronidazole, nitazoxanide, trimethoprim-sulfamethoxazole and erythromycin was performed in 24 strains of B. hominis, which grew up (microculture method) in 10 double concentrations of each antimicrobial (from 256 ug/ml to 0.5 ug/mL) plus a control. RESULTS: 46.3% (145/313) of the sample had B. hominis, also the age between 12 to 17 years and 60 years was associated with higher frequency of parasites (OR: 2.93 and 2.62). The minimum inhibitory concentration (MIC) 90 of metronidazole and nitazoxanide was 3.19 ug/mL and 11.19 ug/ml, respectively, whereas the MIC 90 of trimethoprim-sulfamethoxazole and erythromycin were above 256 ug/mL. CONCLUSIONS: B. hominis occurs in high frequency in patients admitted to the Hospital Regional in Lambayeque, proving to be an important problem of public health in the region. Also B. hominis isolated from these patients were shown to be susceptible in vitro to low concentrations of metronidazole and nitazoxanide so they could be chosen for treatment of this parasite.