The voice of memory in hospital birth: A phenomenological study.

OBJECTIVE: To examine the perception of the hospital birth experience in women at 8 weeks and 8 months after the birth and to determine if there have been any changes in that perception. DESIGN: This was a prospective qualitative study with a phenomenological approach based on semi-structured, individual and in-depth interviews at 8 weeks and 8 months after childbirth as well as participant's observations. The data were transcribed and analysed thematically using ATLAS.ti 8 software. PARTICIPANTS: 43 women participated in the first interview, and 33 of those participated in the second interview. SETTING: Donostia University Hospital, Gipuzkoa, Spain, 2016-2017. FINDINGS: Two main topics emerged from the data analysis which summarize the women's perception of childbirth: (1) memory allows us to recall the experience of hospital birth in time and space; (2) some moments are specially remembered. In the second topic, three subtopics were distinguished: fondest memory: meeting the newborn for the first time; highlighted positive memories: support from partners and professionals; and the worst memories were marked by feelings of worry and fear. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: In the perception of the birth experience, positive and negative memories remain in intensity and continuity for at least up to 8 months. Their creation and evocation are highly influenced by the emotional experience and the initial visual impact of meeting the newborn for the first time, which constitutes a milestone in women's lives. The emotions experienced in childbirth and during the postpartum period shape the awareness, memory and new identity of being a mother.

Validação das atividades de enfermagem em centro de material esterilizado / Validation of nursing activities in a material and sterilization center / Validación de actividades de enfermería en un centro de material esterilizado

Objetivo: Validar as atividades de enfermagem do diagnóstico "Risco para contaminação de produtos para saúde (PPS)". Método: Trata-se de um estudo exploratório, descritivo, metodológico, de validação, utilizando-se o modelo adaptado de Fehring. Participaram 128 enfermeiros especialistas na área de centro cirúrgico e centro de material e esterilização, segundo critérios predefinidos. Utilizou-se instrumento composto de questões fechadas em que se atribuiu um valor conforme escala Likert para cada atividade. Neste estudo, consideraram-se validadas as atividades que apresentaram índice de validade de conteúdo de 0,95. Estudo aprovado pelo Comitê de Ética em Pesquisa. Resultados: Validaram-se 20 atividades de enfermagem para 12 fatores de risco e cinco intervenções. O fator de risco que não obteve representatividade em suas atividades foi "Esterilização de cargas sem o uso do pacote teste desafio". Conclusão: Conclui-se que a disposição das atividades de enfermagem relacionadas aos fatores de risco está adequada, uma vez que foram validadas com índice de validade de conteúdo de 0,95. O conhecimento produzido auxilia na implementação de atividades validadas, promo-vendo um cuidado de forma indireta de qualidade, baseando-se nos princípios da segurança do paciente

Objective: To validate the nursing activities of the diagnosis "Risk of contamination of health products". Method: This is an exploratory, descriptive, methodological, validation study, using the model adapted from Fehring. According to predefined criteria, 128 nurses specialized in the sur-gical center and material and sterilization center participated. An instrument composed of closed questions was used, in which a value according to the Likert scale was assigned to each activity. In this study, activities that presented a content validity index of 0.95 were considered validated. This study was approved by the Research Ethics Committee. Results: Twenty nursing activities were validated for 12 risk factors and 5 interventions. The risk factor that was not representative in its activities was "Sterilization of loads without the use of the process challenge device". Conclusion: The nursing activi-ties related to the risk factors have been found adequate, since they were validated with a content validity index of 0.95. The knowledge produced helps in the implementation of validated activities, promoting quality care indirectly, based on the principles of patient safety.

Objetivo: Validar las actividades de enfermería del diagnóstico "Riesgo por contaminación de productos sanitarios". Método: Se trata de un estudio exploratorio, descriptivo, metodológico, de validación, utilizando el modelo adaptado de Fehring. Participaron 128 enfermeras especialistas del centro quirúrgico y del centro de material y esterilización, según criterios predefinidos. Se utilizó un instrumento compuesto por preguntas cerradas, donde a cada actividad se le asignó un valor según la escala de Likert. En este estudio, se consideraron validadas las actividades que presentaron un índice de validez de contenido de 0,95. Estudio aprobado por el Comité de Ética en Investigación. Resultados: 20 actividades de enfermería fueron validadas para 12 factores de riesgo y cinco intervenciones. El factor de riesgo que no fue representativo en sus actividades fue "Esterilización de cargas sin utilizar el paquete de prueba de desafío". Conclusión: Se concluye que la provisión de actividades de enfermería relacionadas con los factores de riesgo es ade-cuada, una vez que fueron validadas con un índice de validez de contenido de 0,95. El conocimiento producido ayuda en la implementación de activida-des validadas, promoviendo indirectamente una atención de calidad, basada en los principios de seguridad del paciente.

Construction and validation of the CAPA questionnaire of Nutritional Knowledge among Adolescents diagnosed with Feeading and Eting disorders.

Feeding and eating disorders represent a serious problem especially in young population. Nutritional education is essential in its treatment and prevention.

Conceptual development and validation of the nursing diagnosis "Disturbed thought process".

PURPOSE: To validate the content of the nursing diagnosis proposal Disturbed thought process. METHODS: With an exploratory and descriptive design, the content validation for each component of the diagnosis proposal was pursued, based on a previous broad conceptual work, through consulting experts, applying Fehring's Diagnosis Content Validation Model. The modified Delphi technique was used by sending out three rounds of questionnaires electronically to seek consensus among the experts. FINDINGS: The nursing diagnosis version validated in this study includes the diagnosis label Disturbed thought process, the corresponding definition, 15 defining characteristics, and 13 related factors. The resulting diagnosis total Diagnosis Content Validation score was 0.99, implying its content validation. CONCLUSIONS: The validated diagnosis proposal describes a human response for which nursing professionals can autonomously assess and prescribe interventions leading to improvement of this health problem and/or alleviate its consequences, preserving the patient's autonomy and helping them to address their situation. It will be included in the next edition of the nursing diagnosis classification NANDA-I 2021-2023. IMPLICATIONS FOR NURSING PRACTICE: The results of this study will help nursing professionals reduce the potential impact among patients who suffer from an alteration in cognitive functioning in its executive function dimension, as the validated diagnosis proposal will make it possible to identify and report this problem precisely.

OBJETIVO: Llevar a cabo la validación de contenido de la propuesta de diagnóstico enfermero Trastorno del proceso de pensamiento. METODOLOGÍA: Con un diseño exploratorio y descriptivo, se procedió a la validación de contenido de cada uno de los componentes de la propuesta de diagnóstico, desarrollado en base a un amplio trabajo conceptual previo, a través de la consulta de expertos y la búsqueda de consenso, aplicando el Modelo de Validación de Contenido Diagnóstico de Fehring. Se empleó la técnica Delphi modificada mediante la que se enviaron tres rondas de cuestionarios de forma electrónica para buscar el consenso entre los panelistas. RESULTADOS: La versión del diagnóstico enfermero validada en este estudio incluye la etiqueta diagnóstica Trastorno del proceso de pensamiento, la correspondiente definición, 15 características definitorias y 13 factores relacionados. El índice total de validación de contenido del diagnóstico resultante fue de 0,99, implicando su validación de contenido. CONCLUSIONES: La propuesta de diagnóstico validada describe una respuesta humana sobre la que los profesionales de enfermería de manera autónoma, pueden valorar y prescribir intervenciones encaminadas a la mejoría de este problema de salud y/o paliar sus consecuencias, preservando la autonomía del paciente y facilitando su afrontamiento. Será incluido en la próxima edición de la clasificación de diagnósticos enfermeros NANDA-I 2021-2023. IMPLICACIONES PARA LA PRÁCTICA ENFERMERA: Los resultados de este estudio ayudarán a los profesionales de enfermería a disminuir el impacto potencial en los pacientes que sufren una alteración del funcionamiento cognitivo en su dimensión función ejecutiva, ya que la propuesta de diagnóstico validada les permitirá identificar y comunicar dicho problema con precisión.

Six-month breastfeeding maintenance after a self-efficacy promoting programme: an exploratory trial.

BACKGROUND: Breastfeeding care plays a fundamental role in establishing breastfeeding and longer duration after discharge. Practices though vary among professionals involved and are often inconsistent with good practices recommended, being a threat to women's breastfeeding self-efficacy. Breastfeeding self-efficacy is considered a predictor for successful breastfeeding and a significant variable amenable to intervention for promoting lactation AIM: To evaluate the efficacy, feasibility and acceptability of a new breastfeeding self-efficacy promoting programme (SIALAC) on 6-month breastfeeding maintenance. METHODS: In this exploratory multi-centre controlled trial, participants were allocated into control and intervention groups sequentially. Professionals in charge of the treatment groups were trained in between, with an especial focus on reducing practice variability. Control and intervention group women received usual care, and the intervention group received in addition SIALAC, a three-stage breastfeeding self-efficacy promoting programme. Primary outcome was breastfeeding maintenance up to 6 months analysed by Kaplan-Meier and Cox proportional hazard regression analysis. Student's t-test or chi-square tests were also used for continuous and categorical variables. Data on breastfeeding status and breastfeeding self-efficacy were collected at baseline, and 4, 8 and 24 weeks after birth. RESULTS: From May 2014 through November 2015, participants were enrolled. The sample consisted of 112 women. No relevant socio-demographic or obstetric difference was found between groups. The intervention achieved a significant difference between groups in breastfeeding survival (X2  = 4.94, p = 0.026). Six-month breastfeeding maintenance was significantly higher in the intervention group (67% vs. 55%; X2  = 5.384, p = 0.020). Breastfeeding dropout in the control group was 3.3 (CI 1.1, 10.1) times higher than that of the intervention group at 6 months. Breastfeeding self-efficacy scores were higher in the intervention group although without significant statistical difference. The programme showed good acceptability. CONCLUSION: Breastfeeding self-efficacy promoting programme SIALAC was beneficial in fostering 6-month breastfeeding survival. Full-scale trial should consider feasibility-related issues identified.

Integrative Review of Emotional Care Following Perinatal Loss.

Emotional care is an important part of the holistic labor and should be considered when providing care to people affected by perinatal losses. To synthesize the findings from recently published scientific evidence on the emotional care needed following perinatal loss, a search in PubMed, CINAHL, SCOPUS, and Web of Science was carried out in January 2020 yielding 22 studies which met the inclusion criteria and were analyzed following Whittemore and Knafl's (2005) methodology. One category on "offering emotional care" was identified: "Aspects influencing the psychosocial well-being of women after perinatal loss," comprising eight themes: risk of complicated grief, cultural values, perinatal losses in multiple pregnancies, experience of subsequent pregnancies, need of information, contact with the deceased baby, impact on relatives, and strategies for emotional care. In conclusion, the evidence highlights the need of specific emotional grief care.

Validação clínica de diagnósticos de enfermagem: revisão de literatura / Clinical validation of nursing diagnoses: literature review / Validación clínica de diagnósticos de enfermería: revisión de literatura

Introdução: Percebe-se a necessidade de identificar na literatura quais os métodos utilizados nas pesquisas de validação clínica de diagnósticos de enfermagem. Objetivo: Identificar quais os métodos estatísticos mais utilizados nos estudos de validação clínica de diagnósticos de enfermagem. Método: Optou-se por seguir as etapas descritas por Whittemore para revisão de literatura. A busca deu-se, através do Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. Resultados: Observa-se a predominância de estudos de acurácia diagnóstica com análise de classes latentes. Conclusões: Estudos de acurácia constituem um método capaz de classificar corretamente os indivíduos com ou sem um diagnóstico de enfermagem. A análise de classes latentes tem sido utilizada por vários pesquisadores da temática nos dias atuais

Introduction: It is noticed the need to identify in the literature the methods used in the clinical validation research of nursing diagnoses. Objective: Identify which statistical methods are most used in the clinical validation studies of nursing diagnoses. Method: It was decided to follow the steps described by Whittemore for literature review. The search was made in the Higher Education Personnel Improvement Coordination Journals Portal. Results: The prevalence of diagnostic accuracy studies with latent class analysis is observed. Conclusions: Accuracy studies are a method capable of correctly classifying individuals with or without a nursing diagnosis. The analysis of latent classes has been used by several researchers of the current theme

Introducción: Se percibe la necesidad de identificar en la literatura cuáles son los métodos utilizados en las investigaciones de validación clínica. Objetivo: Identificar qué métodos estadísticos más utilizados en los estudios de validación clínica de diagnósticos de enfermería. Método: Se optó por seguir las etapas descritas por Whittemore para revisión de literatura. La búsqueda se dio en el Portal de Revistas de Coordinación de Mejoramiento de Personal de Educación Superior. Resultados: Predominancia de estudios de exactitud diagnóstica con análisis de clases latentes. Conclusiones: Estudios de acuracia constituyen un método capaz de clasificar correctamente a los individuos con o sin un diagnóstico de enfermería. El análisis de clases latentes ha sido utilizado por varios investigadores de la temática en los días actuales

Design, implementation and evaluation of an education course to promote professional self-efficacy for breastfeeding care.

The objective of this study was to determine the effect of an education short course on professional' self-efficacy in the area of breastfeeding care. The intervention had a pre-post design. A total of 43 healthcare professionals attended the course. The Kirkpatrick model for the development, implementation and evaluation of education actions was used for a 4.5-h course. The aspects evaluated included professionals' satisfaction and learning regarding confidence to support lactating mothers, perceived transfer of knowledge to the workplace and organizational changes. Data were collected using self-administered questionnaires (participants, unit managers, and education planners), before and after the intervention. Participants' satisfaction with the education action was high in all of the aspects measured (greater than 3.9 in scores of 0-5). Professionals showed a significant increase in self-efficacy levels for supporting breastfeeding (Wilcoxon test p-value = < 0.05, before intervention: median = 55, [IQR] = 11; after intervention: median = 60, [IQR] = 14). Participants, managers and organizers of the course identified changes in the way that professionals cared for breastfeeding mothers. In conclusion, this educational intervention enhanced professional self-efficacy and performance in breastfeeding care.

[Changes in the physical activity of university students during the first three years of university]. / Modificación de la actividad física durante los tres primeros años de universidad.

INTRODUCTION: Introduction: physical inactivity is the fourth most important risk factor for mortality worldwide and university students present this risk factor at a high level. Objective: to determine the changes in the physical activity of university students in Navarra during the first three years of college. Methods: prospective observational study of a cohort of university students. They participated in the first year, and two years later in the third year. The cohorts were comprised of 454 students who answered a voluntary and anonymous self-completion questionnaire with sociodemographic and physical activity related variables. Data were analyzed with SPSS v21.0. Results: of the participants, 67.4% (n = 306) were women and 32.6% (n = 148) were men. In the first year, 61.6% of students performed more than 150 minutes of physical activity per week. This percentage increased by 2.7%. The frequency of physical activity at least three times a week increased 6.1%, reaching 30.5% of students. Conclusions: university does not play a significant role in the promotion of physical activity, finding minimal modifications. In the future, it would be convenient to consider the reasons that hinder physical activity and design programs according to current recommendations.

INTRODUCCIÓN: Introducción: la inactividad física constituye el cuarto factor de riesgo más importante de mortalidad en todo el mundo y los estudiantes universitarios presentan en un alto nivel este factor de riesgo. Objetivos: determinar la modificación de la actividad física de los estudiantes universitarios en Navarra durante los tres primeros años de universidad. Métodos: estudio observacional prospectivo de una cohorte de universitarios que participaron en el estudio en primer curso y dos años después, en tercer curso. Las cohortes fueron constituidas por 454 estudiantes que respondieron a un cuestionario de autocumplimentación voluntario y anónimo con variables sociodemográficas y relacionadas con la actividad física. Los datos se analizaron con el SPSS v21.0. Resultados: un 67,4% (n = 306) fueron mujeres y un 32,6% (n = 148) fueron hombres. El 61,6% de los estudiantes de primer curso realizaban más de 150 minutos a la semana de actividad física y se incrementó el porcentaje de estudiantes activos físicamente en un 2,7%. Entre quienes realizaban actividad física mínimo tres veces a la semana se observó un incremento del 6,1%, hasta alcanzar el 30,5% de estudiantes. Conclusiones: el periodo universitario no desempeña un papel significativo en la promoción de la actividad física, ya que se observan modificaciones mínimas en su práctica. A futuro, convendría plantearse los motivos que dificultan la actividad física y diseñar programas según las recomendaciones actuales.

A qualitative study of hospital birth perceptions: The helix of priority needs.

OBJECTIVE: To understand which needs are considered priorities in the hospital birth experience from the perspectives of postpartum women. DESIGN: This qualitative prospective study used a phenomenological approach. Data were collected through participant observations and semi-structured interviews recorded at eight weeks and eight months after childbirth. The data were analysed using a thematic approach. PARTICIPANTS: The study cohort consisted of 43 participants at eight weeks after childbirth and 33 participants eight months after childbirth. SETTING: Donostia University Hospital, San Sebastián, Spain, in 2016-2017. FINDINGS: Through the analysis, the following four main themes emerged, each in different categories: (a) Professional care: symbiosis between the woman and the professional: (a.1) professional treatment and its characteristics, (a.2) professional competence, and (a.3) professional information and listening: pillars in the support relationship. (b) Control and hospital safety: (b.1) hospital environment: external control. (c) Presence of the partner: (c.1) support, guidance, and participation. (d) Perception of observed feelings: (d.1) fear of complications or separation from the child, (d.2) fear of internal lack of control, and (d.3) fear of an instrumental delivery and/or caesarean section. CONCLUSIONS AND IMPLICATIONS FOR PRACTISE: The core of the hospital birth experience is constituted by the need to establish a supportive relationship based on mutual trust, exchange information that offers internal and external control and the security necessary to overcome feelings of fear, and obtain support and guidance from an involved partner.

Cultural Adaptation and Validation of the Inflammatory Bowel Disease Disability Index in a Spanish Population and Its Association with Sociodemographic and Clinical Factors.

Inflammatory bowel diseases generate disability. We aimed to adapt and validate the Inflammatory Bowel Disease Disability Index in a Spanish population and to analyze the sociodemographic and clinical factors associated with disability in patients with Crohn's disease and ulcerative colitis. Cultural adaptation and validation of psychometric properties in the index were done, along with an observational, cross-sectional, and analytical approach to determine associations with sociodemographic and clinical factors. Sociodemographic data, quality of life (using the Inflammatory Bowel Disease Questionnaire-32), and indicators of disease activity were collected, among others. A total of 170 subjects participated. The index showed high internal consistency, with a Cronbach's alpha of 0.869 and concurrent validity with the Inflammatory Bowel Disease Questionnaire-32 (r = 0.723, p < 0.001). The average score of the index was -3.91. Greater degrees of disability were found in women (mean = -6.77) than in men (mean = -1.25) (p = 0.018), in patients with Crohn's disease (mean = -5.94) rather than those with ulcerative colitis (mean = -0.94) (p = 0.028), and in patients in the moderately active disease phase (mean = -20.94) rather than those in the mildly active disease phase (mean = -2.65) and/or those in remission (mean = -1.40) (p < 0.001). The Disability Index is a valid tool for the Spanish population and is associated with sex, type of illness, and disease activity. It is a useful index in evaluating and monitoring disability in patients with inflammatory bowel disease.

Factors Influencing the Life Experiences of Individuals With Inflammatory Bowel Disease.

Inflammatory bowel disease has a negative impact on individuals perception of their health status and is associated with disabling processes that have physical, social, and work repercussions. The objectives of this study were to describe the life experiences of individuals with Crohn disease and ulcerative colitis and to develop a theoretical framework to describe the relationships of these diseases with personal and clinical factors. A qualitative study on the basis of grounded theory was conducted, involving individual and semistructured interviews on the life experiences of 14 adults of different ages with inflammatory bowel disease in relapse or inactive phase. The individuals in relapse phase and those with a short time since diagnosis had the most negative perceptions of their health, and experienced impaired ability for daily activities. The life experiences of individuals with inflammatory bowel disease were influenced by the time since diagnosis and the disease phase, with no gender difference in either factor. The predominant strategy of participants for coping with the disease was to pursue normality. According to these findings, nursing interventions should focus on the initial adaptation phase and on coping strategies during active phases of the disease.

The Nursing Diagnosis Disturbed Thought Processes: An Integrative Review.

PURPOSE: To analyze and synthetize the existing scientific literature in relation to the nursing diagnosis disturbed thought processes (DTPs) (00130). METHODS: An integrative review was developed, identifying relevant papers through a search of international and Spanish databases and the examination of key manuals. FINDINGS: Theoretical papers propose modifications for the nursing diagnosis DTPs. Most of the research papers offer data about its frequency in different clinical settings. CONCLUSIONS: There exists an interest in the nursing diagnosis DTPs. However, the available evidence is not very extensive and further work is necessary in order to refine this nursing diagnosis. IMPLICATIONS FOR NURSING PRACTICE: The re-inclusion of DTPs in the NANDA-I classification will specially contribute to increment its utility in mental healthcare.

Diseño y validez de un instrumento para evaluar la autoeficacia percibida por los profesionales de la salud acerca de su capacidad para procurar cuidados a las madres que amamantan / Design and validity of an instrument to evaluate health professionals' perceived self-efficacy to care for nursing mothers

La promoción y apoyo a la lactancia materna proporcionado por profesionales de la salud en diferentes entornos es una de las estrategias con evidencia de resultados exitosos. El propósito de este estudio es desarrollar una escala para conocer la autoeficacia percibida por los profesionales de salud acerca de su capacidad para procurar cuidados a las madres que amamantan. METODOLOGÍA. El diseño de la escala se hizo utilizando la versión española de la escala BreastfeedingSelf-EfficacyScale-Short Form para madres. Las pruebas de validación se realizaron creando un grupo de expertos y pilotando la herramienta con profesionales que cuidaban a madres lactantes de dos centros asistenciales. Las propiedades psicométricas de la escala se examinaron analizando su validez, fiabilidad, sensibilidad y factibilidad. RESULTADOS. La escala "Autoeficacia Profesional para los Cuidados en Lactancia" (APCLA)contiene 14 ítems conforme al dominio de interés, con opciones de respuesta de 1 a 5. Se elaboró en formato papel y electrónico. Tras la valoración del comité de expertos, se pilotó con 43 enfermeras y matronas. La escala muestra resultados prometedores con respecto a su validez, fiabilidad (Alpha de Cronbach 0,967), sensibilidad (p<0,05) y factibilidad. CONCLUSIÓN. Aunque será necesario continuar con el proceso de validación en otras poblaciones y con mayor número de participantes, el instrumento ha mostrado buenos resultados para la medición de la autoeficacia profesional. La valoración de la autoeficacia profesional para proporcionar cuidados a madres que amamantan ayudará a identificar áreas de formación para profesionales que permitan la reducción de la variabilidad de los cuidados.

The promotion and support of breastfeeding by health professionals in different settings is an interventional strategy with evidence of successful results. The purpose of this study is to develop a scale to understand the self-efficacy perceived by health professionals about their ability to care for breastfeeding mothers. METHODOLOGY. The design of the scale was made using the Spanish version of the 'Breastfeeding Self-Efficacy Scale-Short Form' scale for mothers. The validation tests were done by creating a group of experts and piloting the tool with professionals caring for nursing mothers from two centres. The psychometric properties of the scale were examined by analysing their validity, reliability, sensitivity and feasibility. RESULTS. The scale "Professional Self-Efficacy for Breastfeeding Care" (Autoeficacia Profesional para los Cuidados en Lactancia, APCLA) contains 14 items according to the domain of interest, with response options from 1 to 5. It was elaborated in paper and electronic format. After the assessment of the committee of experts, it was piloted with 43 nurses and midwives. The scale shows promising results with respect to its validity, reliability (Cronbach's Alpha 0.967) sensitivity (p <0.05) and feasibility. CONCLUSION. Although it will be necessary to continue the validation process in other populations and larger numbers of participants, the instrument has shown good results for the measurement of professionals' self-efficacy. Assessing professional perceived self-efficacy to care for breastfeeding mothers will help identify areas of training for professionals and reduce variability in care provision.

The Nursing Diagnosis Disturbed Thought Processes in Psychiatric Patients: Prevalence and Associated Characteristics.

PURPOSE: To analyze the frequency of the nursing diagnosis disturbed thought processes (DTP) (00130) in a sample of psychiatric and psychogeriatric patients in medium- and long-term units and to describe those factors associated with its presence. METHODS: A secondary analysis of the data obtained in a multicentric and cross-sectional study developed in Spain was undertaken. FINDINGS: The total sample was 624 patients, from which 39.4% (n = 246) had the nursing diagnosis DTP. A statistically significant relationship between the presence of DTP and different variables was found. CONCLUSIONS: The nursing diagnosis DTP is very frequent among psychiatric and psychogeriatric institutionalized patients. IMPLICATIONS FOR NURSING PRACTICE: Patients with DTP may require a more complex nursing attention as its presence is associated with specific care needs.

[Changes in body weight of the university students at university]. / MODIFICACIÓN DEL PESO CORPORAL DE LOS ESTUDIANTES UNIVERSITARIOS EN NAVARRA DURANTE LOS TRES PRIMEROS AÑOS DE UNIVERSIDAD.

INTRODUCTION: One of the strategies for the prevention of the obesity is the identification of critical periods of gain weight. Some studies confirm gain weight during the university period. OBJECTIVE: The purpose of the present study was to determine the changes in the body weight of the university students in Navarre. METHODS: Prospective cohort study. Public University of Navarre and the University of Navarre, in Pamplona. Study examined weight change among 452 students attending at university in Pamplona, during first and third course. Four hundred and fifty two students completed the questionnaire. Weight and height were measures and body mass index was calculated. RESULTS: The mean body weight increased 0,600 kg, 1,8 kg for males and no change in body weight was observed in female. 44,7 % of students gained weight (60,8 % of men and 36,8 % of women), and the gain weight was of 3,4 kg. DISCUSSION: University years are a critical factor for the gain weight, particularly males. Consideration of this, is necessary the development of effective weight gain prevention strategies during the university.

Introducción: una de las estrategias para la prevención de la obesidad es la identificación de periodos críticos de aumento de peso, y existen estudios que confirman un aumento de peso corporal durante el periodo universitario. Objetivo: determinar las modificaciones en el peso corporal de los estudiantes universitarios en España, durante los tres primeros años de universidad. Métodos: estudio longitudinal y prospectivo de una muestra de estudiantes universitarios en España. Participaron universitarios matriculados en primer curso, a quienes se siguió en tercer curso. De los 1.162 estudiantes iniciales, 499 volvieron a participar (pérdida de seguimiento del 57,05%) y la muestra fue constituida por 452 estudiantes (pérdida de seguimiento del 60,8 %). Los estudiantes respondieron a un cuestionario y se valoró el peso y la talla corporal. Resultados: el peso corporal experimentó un incremento medio de 0,600 kg. En los hombres 1,88 kg y sin apenas modificación en las mujeres. Entre el 44,7 % de los estudiantes que aumentaron de peso (60,8 % hombres y 36,8 % mujeres), la ganancia media de peso alcanzó los 3,4 kg. Discusión: durante el periodo universitario se produce un aumento del peso corporal que afecta principalmente a los hombres. Por este motivo, es necesario continuar con los programas de promoción de la salud en este entorno.

[Analysis of body image perception of university students in navarra]. / ANÁLISIS DE LA PERCEPCIÓN DE LA IMAGEN CORPORAL QUE TIENEN LOS ESTUDIANTES UNIVERSITARIOS DE NAVARRA.

INTRODUCTION: Current models of beauty represent an extreme thinness in the women and a muscular body in the men. The body image perception will condition the search of ideal beauty through different behaviors and can be transform in eating disorders. The university students, with the changes typical of youth and university transition, are a vulnerable group. OBJECTIVE: The purpose of this study was to evaluate the body image perception of university students in Navarra. METHODS: The study included 1162 subjects of which 64.2% were female. Students asked for a self-managed questionnaire and they were weighted and heighted to calculate the body mass index (BMI). Their body image perception were obtained asking the students to select a picture, according to their perception which corresponded to their current body image from nine different silhouettes for men and women. Their BMI were calculated and compared with their perceived BMI. RESULTS: 43.03% of students, overestimated their body image (10.65% in males and 59.69% in females) and 10.20% of students underestimated it. 46.75% of students had concordance between BMI and body image perception. DISCUSSION: There were more cases the alterations in the body image perception in women. In general, women saw themselves as being fatter than really were while men saw themselves as being thinner than they really were. The results shown that the women were more worried about their weight and body image than the men.

Introducción: Los modelos de belleza actuales representan una extremada delgadez en las mujeres y un cuerpo musculoso en los hombres. La propia percepción de imagen corporal va a condicionar la búsqueda del ideal de belleza, a través de diferentes conductas y comportamientos, que en último término pueden transformarse en trastornos de conducta alimentaria. Los jóvenes universitarios sometidos a los cambios propios de la juventud y de la transición universitaria, son un grupo de población especialmente vulnerable. Objetivo: El objetivo del estudio consistió en describir la percepción de la imagen corporal (PIC) de estudiantes universitarios en Navarra. Método: Se incluyeron 1.162 participantes de entre 17 y 35 años, que respondieron a un cuestionario de autocumplimentación anónimo y firmaron un consentimiento informado para someterse a mediciones antropométricas que permitieron calcular el índice de masa corporal. Para conocer la percepción de imagen corporal, los sujetos eligieron de entre 9 siluetas de hombres y mujeres, aquella con la que mejor se identificaban. Resultados: El 55,6% de los estudiantes tuvo una percepción de imagen corporal que no se correspondía con la realidad. Sobreestimando su índice de masa corporal el 9,7% de los hombres y el 58,1% de las mujeres. Discusión: Un alto porcentaje de universitarios tenían una percepción de imagen corporal que no se correspondía con la realidad, mostrando la preocupación de este grupo de población por su imagen corporal. Se identificaron más casos de alteración de la percepción de imagen corporal en mujeres, que en general sobreestimaban su índice de masa corporal. En los hombres, la tendencia era a subestimarlo. Coincidiendo con otras investigaciones, el sobrepeso/obesidad influye en la PIC. Los estudiantes más corpulentos, de ambos sexos, tendían a subestimar su índice de masa corporal.

Differences in the treatment and evolution of acute coronary syndromes according to gender: what are the causes?

AIMS AND OBJECTIVES: The objectives of this study were to analyse the differences in the treatment and the evolution of acute coronary syndromes according to the gender of the patient and to determine the likely causes of these differences. BACKGROUND: Epidemiological studies confirm the differences in the course and treatment of acute coronary syndromes according to factors such as gender and age. The factors associated with the observed gender-based differences are not known. DESIGN AND METHODS: This prospective study was conducted on 596 patients treated in the Hospital Emergency Service of the Hospital Complex of Navarra, Spain, from 1 January 2012 to April 2013 with acute coronary syndromes. A bivariate and logistic analysis has been made by adjusting the age and severity of process to know the differences by gender. RESULTS: A total of 71·8% (n = 428) were men, and the remaining 28·2% (168) were women. The mean age of the men was 66·4 ± 12·7 years, and the mean age of the women was 72·5 ± 13·9 years. We found that antiplatelet drugs (68·4 vs. 22·7%), blockers (70 vs. 25·4%), ACE inhibitors (56·2 vs. 15·6%), fibrinolysis (17·2 vs. 4·5%, p = 0·025) and primary angioplasty (AP) (38·7 vs. 16·3%, p = 0·008) were less frequently administered to women compared with men. We observed an additional delay in the demand for health care in women with acute coronary syndromes compared with men. CONCLUSIONS: There is an association between treatment differences and gender. The delay in the request of health care in women is observed to be the largest correlating factor, in addition to voluntary discharge in women affected by acute coronary syndromes. RELEVANCE TO CLINICAL PRACTICE: Delays in seeking medical care or voluntary discharge are likely factors related to worse outcomes in women. These factors should be explored, and the results should be made available to the public, particularly to women.

[Cross-sectional study of factors influencing adherence to the Mediterranean diet in pregnancy]. / Estudio transversal de los factores que influyen en la adhesión a la dieta mediterránea en el embarazo.

INTRODUCTION: Mediterranean diet is a lifestyle with contrasted beneficial effects on pregnancy, for both the mother and her offspring. However, factors influencing adherence to this diet are unknown. OBJECTIVE: To investigate the factors (educational level, occupation, place of birth, number of previous children and age) that influence adherence to the Mediterranean diet in pregnant women in the region of Pamplona. MATERIAL AND METHODS: Using the data from the Estudio Internacional de Sibilancias en Lactantes (EISL) in the region of Pamplona, associations between food and factors were analysed. A score of Mediterranean diet was established and the scores according to the factors were studied. RESULTS: Significant differences in the Mediterranean diet score by level of education (p=<0,001), occupation (p=0,015) and age (p=<0,001) were found. CONCLUSION: Women with better education, better occupation and older show a greater affinity to the Mediterranean diet during pregnancy.

Introducción: La dieta mediterránea es un estilo de vida con efectos beneficiosos contrastados en el embarazo, tanto para la madre como para su descendencia. Sin embargo, se desconocen los factores que influyen en la adhesión a esta dieta. Objetivo: Investigar los factores (nivel educativo, ocupación, lugar de nacimiento, número de hijos previo y edad) que influyen en la adhesión a la dieta mediterránea en mujeres embarazadas de la comarca de Pamplona. Material y métodos: Utilizando los datos del Estudio Internacional de Sibilancias en Lactantes (EISL) en la comarca de Pamplona, se analizaron las asociaciones entre los alimentos y los factores. Se estableció una puntuación de dieta mediterránea y se estudiaron las puntuaciones de acuerdo a los factores. Resultados: Se encontraron diferencias significativas en la puntuación de dieta mediterránea según el nivel de estudios (p=<0,001), la ocupación (p=0,015) y la edad (p=<0,001). Conclusión: Mujeres con mejor nivel educativo, mejor ocupación y mayor edad muestran una mayor afinidad a la dieta mediterránea durante el embarazo.

Cambios en el consumo de tabaco de los estudiantes de la Universidad Pública de Navarra, España, durante el periodo universitario / Changes in the Tobacco Consumption of Students in Navarre, Spain, during their College Life / Análise do consumo de tabaco dos estudantes em Navarra, Espanha, durante o período acadêmico

Objetivo: Analizar los cambios que se producen en el patrón de consumo de tabaco de estudiantes de la Universidad Pública de Navarra, en el tercer curso de titulación versus el primero. Metodología: Estudio de cohorte descriptivo-observacional. Se autoaplicó un cuestionario, con preguntas sobre el consumo de tabaco. La utilización de una clave elaborada por el propio estudiante permitió enlazar los cuestionarios en los dos momentos del estudio, para asegurar la confidencialidad de los datos. Para el análisis estadístico de los datos se utilizó el paquete estadístico SPSS v21.0. Resultados: La cohorte la constituyeron 245 estudiantes: el 64,1% eran mujeres (n = 157), y el 35,9%, hombres (n = 88). El porcentaje de fumadores a diario descendió de un 24,5% en primer curso a un 23,7% en tercero, así como el porcentaje de fumadores ocasionales (de 21,6% a 20,8%). Sin embargo, el consumo medio de cigarrillos diario entre los fumadores aumentó de 10,30% a 11,02%. En las mujeres se observó la misma tendencia de cambio que en la media general: 2,8% el descenso de las fumadoras a diario y 1% las fumadoras ocasionales. Entre tanto, en los hombres aumentó el porcentaje de fumadores a diario (1,2%) y el de fumadores ocasionales (1,10%), así como el número medio de cigarrillos consumidos al día que se aumenta en 2,6. Conclusiones: Un alto porcentaje de estudiantes mantiene la frecuencia de consumo de tabaco durante la vida universitaria, que resultan porcentajes similares entre los que modifican su hábito aumentando o disminuyendo la frecuencia de consumo.

Objective: To analyze the change in the tobacco consumption of the university students during their university studies. Methodology: A descriptive cohort study of university students followed from the first to third year. An anonymous questionnaire was administered to the students. The use of a key generated by the student questionnaires allowed linking the two stages of the study, ensuring the confidentiality of data. A statistical package SPSS v210 was used for the statistical analysis of data. Results: The cohort consisting of 245 students, with 64.1% of female (n=157) and 35.9% male (n=88). The percentage of daily smokers decreased from 24.5% in the first year to 23.7% in the third, and the percentage of occasional smokers (from 21.6% to 20.8%). However, the average daily consumption of cigarettes among smokers increased from 10.30% to 11.02%. In women, the same trend of change in the overall average being 2.8% declining daily smokers and 1.0% the casual smokers was observed. However in men the percentage of daily smokers increased (1.2%) and occasional smokers (1.10%) and the average number of cigarettes smoked per day increases by 2.6. Conclusions: A high percentage of students support the frequency of consumption of tobacco during the university life, turning out to be similar percentages between those who modify smoking increasing or decreasing the frequency of consumption.

Objetivo: O objetivo deste estudo foi analisar as mudanças que ocorrem no padrão de consumo de tabaco por estudantes universitários no terceiro ano de estudo em relação ao primeiro ano. Metodologia: Estudo de coorte descritivo de uma coorte de estudantes universitários seguiu para o primeiro e terceiro ano os alunos. Autocuplimentación questionário com perguntas sobre o consumo de tabaco foi aprovada. O uso de uma chave gerada pelos questionários dos alunos autorizados a ligar as duas etapas do estudo, garantindo a confidencialidade dos dados. Para a análise estatística do pacote estatístico SPSSS dados v21.0 foi usado. Resultado: A coorte constituída 245 alunos, com 64,1% de participantes do sexo feminino (n = 157) e 35,9% do sexo masculino (n = 88). O percentual de fumantes diários diminuiu de 24,5% no primeiro ano para 23,7% no terceiro, eo percentual de fumantes ocasionais (de 21,6% para 20,8%). No entanto, o consumo médio diário de cigarros entre os fumantes aumentou 10,30%- 11,02%. Nas mulheres, a mesma tendência de mudança na média geral sendo 2,8% de declínio fumantes diários e 1% dos fumantes ocasionais foi observada. No entanto, em homens, aumentou o percentual de fumantes diários (1,2%) e fumantes ocasionais (1,10%) e do número médio de cigarros fumados por dia aumenta em 2.6. Conclusões: Uma elevada percentagem de estudantes mantém a frequência de consumo de tabaco durante a vida da faculdade, resultando em taxas similares entre aqueles que mudam de hábito, aumentando ou diminuindo a frequência de consumo.