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1.
J Clin Nurs ; 33(6): 2226-2236, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38476057

RESUMEN

AIMS: To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. DESIGN: A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. METHODS: Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper. RESULTS: A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened. CONCLUSIONS: COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. IMPACT: Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , Estudios Longitudinales , Estudios Prospectivos , Masculino , Enfermedad Crónica , Femenino , Persona de Mediana Edad , Anciano , Pandemias , SARS-CoV-2 , España/epidemiología , Adulto , Atención Primaria de Salud
2.
Int J Mol Sci ; 24(8)2023 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-37108335

RESUMEN

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the progressive loss of motor neurons in the spinal cord, brain stem, and cerebral cortex. Biomarkers for ALS are essential for disease detection and to provide information on potential therapeutic targets. Aminopeptidases catalyze the cleavage of amino acids from the amino terminus of protein or substrates such as neuropeptides. Since certain aminopeptidases are known to increase the risk of neurodegeneration, such mechanisms may reveal new targets to determine their association with ALS risk and their interest as a diagnostic biomarker. The authors performed a systematic review and meta-analyses of genome-wide association studies (GWASs) to identify reported aminopeptidases genetic loci associated with the risk of ALS. PubMed, Scopus, CINAHL, ISI Web of Science, ProQuest, LILACS, and Cochrane databases were searched to retrieve eligible studies in English or Spanish, published up to 27 January 2023. A total of 16 studies were included in this systematic review, where a series of aminopeptidases could be related to ALS and could be promising biomarkers (DPP1, DPP2, DPP4, LeuAP, pGluAP, and PSA/NPEPPS). The literature reported the association of single-nucleotide polymorphisms (SNPs: rs10260404 and rs17174381) with the risk of ALS. The genetic variation rs10260404 in the DPP6 gene was identified to be highly associated with ALS susceptibility, but meta-analyses of genotypes in five studies in a matched cohort of different ancestry (1873 cases and 1861 control subjects) showed no ALS risk association. Meta-analyses of eight studies for minor allele frequency (MAF) also found no ALS association for the "C" allele. The systematic review identified aminopeptidases as possible biomarkers. However, the meta-analyses for rs1060404 of DPP6 do not show a risk associated with ALS.


Asunto(s)
Esclerosis Amiotrófica Lateral , Enfermedades Neurodegenerativas , Humanos , Esclerosis Amiotrófica Lateral/diagnóstico , Esclerosis Amiotrófica Lateral/genética , Aminopeptidasas , Estudio de Asociación del Genoma Completo , Pronóstico , Biomarcadores
3.
J Adv Nurs ; 78(5): 1228-1244, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34935178

RESUMEN

AIM: To analyse the effects of active video games on physical function in independent community-dwelling older adults. DESIGN: Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES: The CINAHL, LILACS, Medline, Proquest and Scopus databases were consulted, with no restriction by year of publication. REVIEW METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The meta-analysis was performed using RevMan software. RESULTS: The analysis included 22 randomized controlled trials with a total of 1208 participants (all ≥55 years old). In our meta-analyses, the effects produced by playing the active video games (mean differences) were statistically significant for the variables Gait speed and Timed up-and-go. The differences between the control and experimental groups were not significant in the following tests: 6-minute walk, 30-second chair stand, balance (measured with the Berg Balance Scale), cadence, grip strength, knee extension strength, 8-Foot Up-and-Go or velocity. CONCLUSIONS: Physical exercise from participation in active video games has beneficial effects on two clinical parameters (Gait speed and Timed up-and-go) in independent community-dwelling older adults. However, the effects on other parameters do not differ from those obtained with conventional exercise training. Therefore, the clinical significance of these benefits is limited. IMPACT: Older adults usually perform little physical activity. In consequence, researchers have increasingly considered alternatives to traditional forms of exercise. One such is that provided by active video games, which can be a source of stimulation, encouraging adherence and motivation in exercise programmes. Our review shows that active video games can improve gait speed and mobility, but in other respects obtain no differences from conventional exercises. Further tailored randomized clinical trials should be undertaken with diverse populations of older adults to evaluate different physical function variables to determine the most appropriate training approach and its optimal design and duration.


Asunto(s)
Vida Independiente , Juegos de Video , Anciano , Ejercicio Físico/fisiología , Terapia por Ejercicio , Humanos , Persona de Mediana Edad , Equilibrio Postural/fisiología
4.
J Clin Nurs ; 31(23-24): 3350-3367, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35075716

RESUMEN

BACKGROUND: Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non-invasive and non-pharmacological. AIMS: To determine whether a game-based intervention (via gamification or virtual reality) during the induction of anaesthesia reduces preoperative pain and anxiety in paediatric patients. METHODS: A systematic review with meta-analysis of randomised controlled trials was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and using RevMan software. The review was based on a search of the EMBASE, CINAHL, Medline, SciELO and Scopus databases, conducted in July 2021. No restriction was placed on the year of publication. RESULTS: 26 studies were found, with a total study population of 2525 children. Regarding pain reduction, no significant differences were reported. For anxiety during anaesthesia induction, however, a mean difference of -10.62 (95% CI -13.85, -7.39) on the Modified Yale Preoperative Anxiety Scale, in favour of game-based intervention, was recorded. CONCLUSIONS: Game-based interventions alleviate preoperative anxiety during the induction of anaesthesia in children. This innovative and pleasurable approach can be helpful in the care of paediatric surgical patients. RELEVANCE TO CLINICAL PRACTICE: In children, preoperative management is a challenging task for healthcare professionals, and game-based strategies could enhance results, improving patients' emotional health and boosting post-surgery recovery. Distractive games-based procedures should be considered for incorporation in the pre-surgery clinical workflow in order to optimise healthcare.


Asunto(s)
Anestesia General , Ansiedad , Humanos , Niño , Ansiedad/prevención & control , Ansiedad/psicología , Anestesia General/psicología , Trastornos de Ansiedad , Emociones , Dolor
5.
Medicina (Kaunas) ; 58(6)2022 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-35743989

RESUMEN

Background and Objectives: Acute respiratory distress syndrome is a life-threatening lung condition that prevents enough oxygen from getting to the lungs and blood. The causes can be varied, although since the COVID-19 pandemic began there have been many cases related to this virus. The management and evolution of ARDS in emergency situations in the last 5 years was analyzed. Materials and Methods: A systematic review was carried out in the PubMed and Scopus databases. Using the descriptors Medical Subject Headings (MeSH), the search equation was: "Emergency health service AND acute respiratory distress syndrome". The search was conducted in December 2021. Quantitative primary studies on the care of patients with ARDS in an emergency setting published in the last 5 years were included. Results: In the initial management, adherence to standard treatment with continuous positive airway pressure (CPAP) is recommended. The use of extracorporeal membrane reduces the intensity of mechanical ventilation or as rescue therapy in acute respiratory distress syndrome (ARDS). The prone position in both intubated and non-intubated patients with severe ARDS is associated with a better survival of these patients, therefore, it is very useful in these moments of pandemic crisis. Lack of resources forces triage decisions about which patients are most likely to survive to start mechanical ventilation and this reflects the realities of intensive care and emergency care in a resource-limited setting. Conclusions: adequate prehospital management of ARDS and in emergency situations can improve the prognosis of patients. The therapeutic options in atypical ARDS due to COVID-19 do not seem to vary substantially from conventional ARDS.


Asunto(s)
COVID-19 , Síndrome de Dificultad Respiratoria , Cuidados Críticos , Humanos , Pandemias , Respiración Artificial , Síndrome de Dificultad Respiratoria/terapia
6.
J Adv Nurs ; 77(8): 3274-3285, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33755246

RESUMEN

AIMS: The aim of this review and meta-analysis is to analyse the effectiveness of nursing interventions for the management of preoperative anxiety in adults. BACKGROUND: The perioperative process is a stressful situation for many people who are going to be operated and it can generate feelings of anxiety. Also, preoperative anxiety can appear in the perioperative period. Nursing management of preoperative anxiety through individualized interventions can be effective for reducing anxiety. DESIGN: A systematic review with meta-analysis was performed. DATA SOURCES: CINAHL, CUIDEN, Pubmed, ProQuest and Scopus databases were consulted without restriction per year of publication. The search was conducted in February 2020. REVIEW METHODS: Experimental studies on nursing management in preoperative anxiety with adults sample (>18 years) published in English and/or Spanish were included. All types of surgery were included in the review. A random effects meta-analysis was performed to estimate the effect size for preoperative anxiety measured with STAI. RESULTS: After the selection process n = 9 quantitative studies with nursing interventions for preoperative anxiety were included. A preoperative educational and informative interview was used in six studies, one study used empathic interview, one used motivational interview and one used hand massage. The meta-analysis, including four studies using nursing interviews, had a sample of n = 419 in the intervention group and n = 445 in the control group. The mean difference in preoperative state anxiety measured with the STAI was in favour of the nursing intervention. CONCLUSION: Nursing interventions for patients who are going to be operated seems to have a positive impact in their preoperative anxiety. However, due to the low number of studies and the heterogeneity of the sample, more research is needed about the topic.


Asunto(s)
Ansiedad , Entrevista Motivacional , Adulto , Ansiedad/prevención & control , Trastornos de Ansiedad , Humanos , Cuidados Preoperatorios
7.
J Clin Nurs ; 30(1-2): 207-216, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33090612

RESUMEN

AIMS AND OBJECTIVES: To analyse the prevalence, levels and phases of burnout syndrome in midwives and obstetrics and gynaecology nurses, and to evaluate the relationship between burnout and sociodemographic, occupational and psychological factors. BACKGROUND: Burnout syndrome is a major problem in occupational health, characterised by feelings of exhaustion, depersonalisation and a low sense of personal achievement that appears after long-term occupational stress. Recent research has found that burnout harms the physical and mental well-being of workers, and jeopardises the quality of care provided. The association between burnout and a risk profile in maternity wards has not previously been investigated but it deserves special attention since it is a highly stressful area to work in. DESIGN: A cross-sectional survey design was selected. METHODS: A total of 150 nurses and midwives at 18 hospitals participated in this study. The data were collected using the Maslach Burnout Inventory, NEO Personality Inventory and the Educational-Clinical Questionnaire: Anxiety and Depression. This study adhered to the STROBE guideline. RESULTS: 17% of participants presented high levels of emotional exhaustion, 16.6% high depersonalisation and 55.1% a sense of low personal accomplishment. The sociodemographic and occupational variables related to burnout were gender, marital status and work shift. The three dimensions of the syndrome, emotional exhaustion, depersonalisation and personal accomplishment were predicted by depression, neuroticism, agreeableness and openness. CONCLUSIONS: One third of the sample presented high levels of burnout, which was most strongly experienced as feelings of low personal accomplishment. Furthermore, personality factors play an important role in the development of burnout syndrome. RELEVANCE TO CLINICAL PRACTICE: Managers and policy makers should promote strategies to reduce burnout. To prevent the syndrome, personality factors should be taken into account, for the early identification of a profile of professionals most at risk of developing burnout.


Asunto(s)
Agotamiento Profesional , Ginecología , Estrés Laboral , Agotamiento Profesional/epidemiología , Estudios Transversales , Femenino , Humanos , Personalidad , Embarazo , Encuestas y Cuestionarios
8.
J Adv Nurs ; 76(5): 1124-1140, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32026484

RESUMEN

AIM: To analyse the effect of mindfulness training on levels of burnout among nurses. BACKGROUND: Burnout syndrome is a common occupational hazard for nursing staff. Mindfulness training has been proposed as a valid intervention for burnout. DESIGN: Systematic review and meta-analysis. DATA SOURCES: The CINAHL, LILACS, Medline, ProQuest, PsycINFO, Scielo and Scopus databases were consulted, using the search equation 'Nurs * AND burnout AND mindfulness'. There was no restriction on the year of publication. REVIEW METHODS: Papers were selected for analysis in accordance with the PRISMA guidelines. The meta-analysis was carried out using Review Manager 5.3 software. RESULTS: The sample was of 17 articles including 632 nurses. Mindfulness training reduces levels of burnout, producing lower scores for emotional exhaustion and depersonalization and higher for personal accomplishment. The differences in the means were 1.32 (95% CI: -9.41-6.78), 1.91 (95% CI: -4.50-0.68) and 2.12 (95% CI: -9.91-14.14), respectively, between the intervention and control groups. CONCLUSION: Mindfulness training reduces the emotional burden and hence levels of burnout, among nurses. However, further randomized clinical trials are required.


Asunto(s)
Terapia Conductista/métodos , Agotamiento Profesional/psicología , Agotamiento Profesional/terapia , Agotamiento Psicológico/terapia , Atención Plena/métodos , Personal de Enfermería/psicología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad
9.
Nurs Health Sci ; 22(4): 1022-1029, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33405371

RESUMEN

The success of a coronary artery bypass graft surgery has been shown to be related to health-related quality of life, and being able to predict this is extremely useful. We investigate the associations between health-related quality of life and sociodemographic and clinical characteristics, and examine the impact of prior percutaneous coronary interventions on health-related quality of life in Palestinian patients undergoing a coronary artery bypass graft for the first time. A cross-sectional study was conducted on a convenience sample of 119 Palestinian patients. The Short Form-36 Health Survey was applied 1 year after the coronary artery bypass graft surgery. An analysis of variance shows that as age increases, health-related quality of life decreases. In contrast, the higher the level of education, job security, and salary, the higher the health-related quality of life. Patients who had undergone prior percutaneous endovascular interventions had a worse health-related quality of life than those who had not. In conclusion, a history of prior percutaneous endovascular interventions in addition to sociodemographic factors should be considered by nursing staff so that they can deliver high-quality patient care.


Asunto(s)
Puente de Arteria Coronaria/efectos adversos , Intervención Coronaria Percutánea/estadística & datos numéricos , Calidad de Vida/psicología , Adulto , Anciano , Árabes/estadística & datos numéricos , Puente de Arteria Coronaria/métodos , Puente de Arteria Coronaria/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría/instrumentación , Psicometría/métodos , Factores de Riesgo , Estadísticas no Paramétricas , Resultado del Tratamiento
10.
Medicina (Kaunas) ; 56(12)2020 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-33256039

RESUMEN

Palliative care (PC) prevents and alleviates patients´ suffering to improve their quality of life in their last days. In recent years, there has been an increase in visits to the emergency services (ES) by patients who may need this type of care. The aims were to describe the training and capacitation of nurses from ES in PC. Accordingly, a systematic review was performed. Medline, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were used. The search equation was "Palliative care and nursing care and emergency room". A total of 12 studies were selected. The studies agree on the need for training professionals in PC to provide a higher quality care, better identification of patient needs and to avoid unnecessary invasive processes. Similarly, the implementation of a collaborative model between ES and PC, the existence of a PC specialized team in the ES or proper palliative care at home correspond to a decrease in emergency visits, a lower number of hospitalizations or days admitted, and a decrease in hospital deaths. The development of PC in the different areas of patient care is necessary. Better palliative care leads to a lower frequency of ES by terminal patients, which has a positive impact on their quality of life. Access to PC from the emergency unit should be one of the priority health objectives due to increment in the aged population susceptible to this type of care.


Asunto(s)
Servicios Médicos de Urgencia , Cuidados Paliativos , Anciano , Servicio de Urgencia en Hospital , Hospitalización , Humanos , Calidad de Vida
11.
Int Emerg Nurs ; 73: 101422, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38401479

RESUMEN

BACKGROUND: Peripheral intravenous cannulation is a common procedure in the emergency department. Nevertheless, failure rates during the first attempt are as high as 40% in adults and 65% in children. Evidence suggests that physician performed ultrasound-guided peripheral intravenous cannulation (USG-PIVC) is an effective alternative to the traditional method; however, there is insufficient data on the efficacy of the technique performed by nurses. OBJECTIVE: To examine the efficacy of the USG-PIVC technique performed by emergency department nurses. METHODS: A literature review with meta-analysis was performed. The databases used were PubMed, Scopus and CINAHL. The search was conducted in March 2023. Two meta-analysis one of clinical trials about the effectiveness and one about the succession rate were performed. RESULTS: 20 studies were selected and analysed. The studies showed that USGPIVC performed by emergency nurses increased the probability of both the overall success and a successful first attempt compared to the standard technique. In addition, patients showed high satisfaction and lower complication rates. However, the procedure had no significant effect on the time or number of attempts required. A lower probability of success was obtained as regards peripheral intravenous cannulation when the standard technique was used, OR = 0.42 (95 %CI 0.25-0.70p < 0,05). CONCLUSIONS: Ultrasound-guided peripheral intravenous cannulation performed by emergency nurses is a safe and effective technique.


Asunto(s)
Cateterismo Periférico , Enfermería de Urgencia , Ultrasonografía Intervencional , Humanos , Cateterismo Periférico/métodos , Servicio de Urgencia en Hospital , Ultrasonografía Intervencional/métodos
12.
J Cardiovasc Dev Dis ; 11(1)2024 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-38248891

RESUMEN

BACKGROUND: This study considers care management for older chronic patients during and after the COVID-19 pandemic. AIMS: To identify groups of variables at previous time points as a basis for deriving efficient classification models during and after a pandemic situation and to quantify the effect of each variable within the model to predict levels of worsening risk in diastolic and systolic arterial hypertension (AHT). MATERIAL AND METHODS: In this prospective longitudinal study, data were collected at three time points: before, during, and after the COVID-19 pandemic period. RESULTS: The study included 148 patients with an average age of 81.6 years. During the study period, mean systolic blood pressure among this population rose by 5 mmHg to 128.8 mmHg; the number of patients with systolic blood pressure > 140 mmHg rose by 45.3%; among those with diastolic blood pressure > 90, the number rose by 41.2%; mean triglycerides levels rose to 152.6 mg/dL; cholesterol levels rose to 147 mg/dL; and LDL cholesterol rose to 112.2 mg/dL. Meanwhile, mean levels of HDL cholesterol decreased to 46.5 mg/dL. Binary-response logistic regression models were constructed to identify the most relevant variables for predicting AHT risk during and after the pandemic. The heart rate (OR = 1.79; 95% CI: 1.22-2.72) and body mass index (OR = 1.75; 95% CI: 1.08-2.94) variables were significant at the population level (p < 0.05) for diastolic and systolic AHT in the pandemic period risk models. The body mass index variable was also significant for diastolic AHT in the post-pandemic period risk model (OR = 1.97; 95% CI: 1.32-2.94), whilst the triglycerides variable was significant in the systolic AHT post-pandemic period risk model (OR = 1.49; 95% CI: 1.01-1.86). CONCLUSIONS: Bad control of arterial hypertension in older patients with chronic disease is associated with elevated levels of LDL cholesterol, total cholesterol, systolic blood pressure, heart rate and triglycerides, and lower levels of HDL cholesterol.

14.
J Clin Med ; 12(14)2023 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-37510963

RESUMEN

BACKGROUND: B cells are central to the pathogenesis of systemic lupus erythematosus (SLE). We aimed to analyze the efficacy and safety of new B cell-targeted drug therapies for SLE. METHODS: A systematic review of randomized controlled trials (RCTs) and reference lists of relevant articles published from inception to 2022 were selected from PubMed, Scopus and Web of Science databases. Random effects meta-analyses were performed to estimate an overall effect size for the risk of adverse events (AEs) and serious adverse events (SAEs) with belimumab and tabalumab treatment. Heterogeneity was assessed using the I2 statistic and meta-regression. Funnel asymmetry was evaluated using Egger's test. RESULTS: This study included 13 RCTs, of which three showed high risk of bias. Egger's test showed no asymmetry. The risk of SAEs and AEs was lower in the treatment group with belimumab treatment. The risk of AEs for tabalumab treatment was lower in the treatment group and lower for SAEs. CONCLUSION: Belimumab and tabalumab therapies are effective and safe in the treatment of SLE, although tabalumab does not show sufficient statistical power. Advances in understanding the underlying mechanisms of SLE will be directed towards correlating clinical manifestations with specific pathogenic pathways and the development of precision medicine.

15.
Front Public Health ; 11: 1142576, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37213651

RESUMEN

Introduction: Burnout may be suffered not only by experienced nurses, but also by those in training. The university environment can be highly stressful for student nurses, who are exposed to various stress-producing situations. Aim: The aim of this study is to identify and analyse the main risk factors for burnout among nursing students. Methods: A systematic review with meta-analysis was performed. The search equation used was "Burnout AND Nursing students". Quantitative primary studies on burnout in nursing students, and related risk factors published in English or Spanish and with no restriction by year of publication were included. Results: A sample of n = 33 studies were included. Three variables are identified can influence burnout in nursing students: academic, interpersonal, environmental and/or social factors. The meta-analyses, with the higher sample of n = 418 nursing students, show that some personality factors, empathy, and resilience are correlated with emotional exhaustion, depersonalization and personal accomplishment. Conclusion: The personality factors that can influence the development of burnout in nursing students, such as resilience and empathy, among others, must be taken into account when preventing the appearance and treating burnout. Professors should teach nursing students to prevent and recognize the most frequent symptoms of burnout syndrome.


Asunto(s)
Agotamiento Profesional , Estudiantes de Enfermería , Humanos , Agotamiento Profesional/psicología , Agotamiento Psicológico , Emociones , Empatía
16.
Int Emerg Nurs ; 60: 101109, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34952482

RESUMEN

BACKGROUND: In emergency services is important to accurately assess and classify symptoms, which may be improved with the help of technology. One mechanism that could help and improve predictions from health records or patient flow is machine learning (ML). AIM: To analyse the effectiveness of ML systems in triage for making predictions at the emergency department in comparison with other triage scales/scores. METHODS: Following the PRISMA recommendations, a systematic review was conducted using CINAHL, Cochrane, Cuiden, Medline and Scopus databases with the search equation "Machine learning AND triage AND emergency". RESULTS: Eleven studies were identified. The studies show that the use of ML methods consistently predict important outcomes like mortality, critical care outcomes and admission, and the need for hospitalization in comparison with scales like Emergency Severity Index or others. Among the ML models considered, XGBoost and Deep Neural Networks obtained the highest levels of prediction accuracy, while Logistic Regression performed obtained the worst values. CONCLUSIONS: Machine learning methods can be a good instrument for helping triage process with the prediction of important emergency variables like mortality or the need for critical care or hospitalization.


Asunto(s)
Servicios Médicos de Urgencia , Triaje , Servicio de Urgencia en Hospital , Hospitalización , Humanos , Aprendizaje Automático
17.
Medicine (Baltimore) ; 101(30): e30004, 2022 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-35905273

RESUMEN

Game-based learning is increasing in nursing education. Also, the assessment of the utility of the escape room game is growing. To explore nursing students' opinion about the escape room as an evaluation game, a qualitative observational study with nursing students was carried out. An ad hoc questionnaire with open questions was sent after the game learning experience. The escape room included knowledge and techniques from different specialties. The escape room learning game was a positive experience for the students. The main highlighted characteristics were fun, dynamic, and motivating way to study and learn. Other interesting variables were: "Working as a team and under pressure" (It's a group activity in which everyone must work together. It is a good challenge to learn how to work in urgent situations) and "Different way to assess students´ learning" (In this type of game, I can show more things and not only theoretical knowledge). Game-based learning is increasing in nursing education, as well as the assessment of the utility of the escape room game. Using an escape room for assessing nursing students' knowledge is a positive experience. This learning experience can be also used with nurses in different specialties to promote teamwork and working under pressure.


Asunto(s)
Educación en Enfermería , Servicios Médicos de Urgencia , Estudiantes de Enfermería , Competencia Clínica , Humanos , Aprendizaje
18.
Artículo en Inglés | MEDLINE | ID: mdl-35954541

RESUMEN

Burnout in the primary care service takes place when there is a high level of interaction between nurses and patients. Explanatory models based on psychological and personality related variables provide an approximation to level changes in the three dimensions of the burnout syndrome. A categorical-response ordinal logistic regression model, based on a quantitative, crosscutting, multicentre, descriptive study with 242 primary care nurses in the Andalusian Health Service in Granada (Spain) is performed for each dimension. The three models included all the variables related to personality. The risk factor friendliness was significant at population level for the three dimensions, whilst openness was never significant. Neuroticism was significant in the models related to emotional exhaustion and depersonalization, whilst responsibility was significant for the models referred to depersonalization and personal accomplishment dimensions. Finally, extraversion was also significant in the emotional exhaustion and personal accomplishment dimensions. The analysis performed provides useful information, making more readily the diagnosis and evolution of the burnout syndrome in this collective.


Asunto(s)
Agotamiento Profesional , Enfermeras y Enfermeros , Enfermería de Atención Primaria , Logro , Agotamiento Profesional/epidemiología , Emociones , Humanos , Personalidad
19.
Artículo en Inglés | MEDLINE | ID: mdl-35270693

RESUMEN

Coronary artery disease is the leading cause of death worldwide and patient continuity of care is essential. Health professionals can help in the transition stage by providing resources to achieve pharmacological treatment adherence, as well as social and emotional support. The objective was to analyse the effects of nursing interventions based on continuity of care in patients with coronary artery disease after hospital discharge. A systematic review of randomised controlled trials and quasi-experimental studies was carried out. Cochrane, CINAHL, Health & medical collection, Medline, and Scopus databases were consulted in January 2022. PRISMA guidelines were followed with no time limits. In total, 16 articles were included with a total of 2950 patients. Nurse-led continuity of care programs improved the monitoring and control of the disease. Positive effects were found in the quality of life of patients, and in mental health, self-efficacy, and self-care capacity dimensions. Clinical parameters such as blood pressure and lipid levels decreased. The continuity of care provided by nurses had a positive influence on the quality of life of patients with coronary artery disease. Nurse-led care focused on the needs and resources, including continuity of care, plays a key role.


Asunto(s)
Enfermedad de la Arteria Coronaria , Enfermedad de la Arteria Coronaria/terapia , Humanos , Calidad de Vida , Autoeficacia
20.
Healthcare (Basel) ; 10(5)2022 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-35628091

RESUMEN

Burnout can affect nurses' sleep quality. The aim of this study was to analyze the relationship between burnout syndrome and sleep problems in nurses. A systematic review with meta-analysis was performed. PubMed, CINAHL and Scopus databases were used. Some of the inclusion criteria were quantitative studies, in which the levels of burnout and sleep disorders were investigated in a sample of nurses using validated scales. A total of 12 studies were included. Sociodemographic variables did not influence the relation between burnout and sleep problems, except for being female. The environment and workplace violence, together with psychological traits and shifts, affect the probability of developing burnout and insomnia. The meta-analysis sample was n = 1127 nurses. The effect size of the correlation between burnout and sleep disorders was r = 0.39 (95% CI 0.29−0.48) with p < 0.001, indicating that the higher the level of burnout in nurses, the greater the presence of sleep disorders. The positive correlation between burnout and sleep disorders is a problem that must be addressed to improve the health of nurses. Developing turnicity strategies, using warmer lights in hospital units during night shifts and eliminating the fixed night shift could improve nurses' working conditions.

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