Stressors inherent to clinical practices and their relationship with emotional intelligence in nursing students: A cross sectional study.

BACKGROUND: There is a wide body of knowledge about Emotional Intelligence and its benefits in health care, generating better productivity, clinical performance and communication with work teams, patients and families. Its relationship with stress and with performance of clinical practices has also been studied, although the results are not conclusive or up-to-date. OBJECTIVES: To study and correlate the perception of Emotional Intelligence and the stressors inherent to Nursing students' clinical practices. DESIGN: A multicenter and observational study was carried out through cross-sectional surveys with Nursing students during the 2021/2022 academic year. PARTICIPANTS: 377 students were included in the study, recruited through non-probabilistic sampling in four Spanish universities. METHODS: Sociodemographic and academic variables were collected, as well as the following main variables: perceived Emotional Intelligence and stressors in clinical practices. RESULTS: The study sample consisted of 377 students (89.1 % women; mean age of 23.15 ± 5.50). The perception of Emotional Intelligence obtained adequate ranges. The stressors that generate most concern are being attacked by the patients, lack of competence, and impotence and uncertainty. There are statistically significant differences in Emotional Intelligence by gender and university, as well as in stressors between each other. The Emotional Intelligence dimensions are weakly correlated with the stressors, although with statistical significance. CONCLUSIONS: This study shows that Emotional Intelligence slightly influences the stressors inherent to clinical practices, so that EI can help cope with the difficulties of clinical work. Specifically, emotional clarity has an inverse relationship with some stressors. However, the attention and repair dimensions do not present such a clear relationship in our study or in previous ones. This shows the need to include Emotional Intelligence training in Nursing training curricula.

Impact of coronavirus infection on anxiety and quality of life in individuals with a kidney transplant / Impacto de la infección por coronavirus en la ansiedad y en la calidad de vida de las personas con un trasplante renal

ABSTRACT Background: The consequences of SARSCoV- 2 infection on the mental health of kidney transplant recipients have not yet been investigated. Objectives: This study compares anxiety and quality of life in individuals with a kidney transplant who did or did not test positive for coronavirus. Design: Retrospective study of two prospective cohorts. Participants: Kidney transplant recipients under follow-up in a Spanish tertiary teaching hospital who tested positive for coronavirus (cases); and consecutive kidney recipients who had not suffered the infection (not-cases). Methods: Mortality and case fatality data were compared between the two cohorts for the two pandemic waves. For the second wave (July 1 to December 5, 2020), the data compared between cases (n=22) and not-cases (n=36) were state and trait anxiety (STAI), kidney transplant-related quality of life (KTQ), and mortality as the main outcome variables. Results: 601 transplanted persons of mean age 61.7 years (SD 12.8), 61.9% men. 12.1% (n=73) tested SARS-CoV-2-positive over the first two pandemic waves with a mortality of 2.9% and case fatality of 24.7%. Over the second wave, the mean quality of life score was 4.1 (SD 0.9) and the overall anxiety score was 49 (SD 24.3) for the two cohorts, which did not vary in terms of the impacts of these measures on the descriptive variables examined. Conclusions: Quality of life is invariably affected, and levels of anxiety are high regardless of whether or not they have had a SARS-CoV-2 infection. Over the period examined, mortality was low while coronavirus case fatality was high.

RESUMEN Introducción: Las personas con un trasplante renal forman una población vulnerable para la infección por SARS-CoV-2, lo que las puede llevar a sufrir consecuencias psicológicas que aún no han sido estudiadas. Objetivos: Comparar la incidencia de ansiedad y el nivel de calidad de vida, en personas con un trasplante renal, que se han contagiado de SARS-CoV-2 frente a los que no se han contagiado; así como describir la incidencia de contagios y la mortalidad en la población a estudio. Material y Métodos: Estudio retrospectivo de cohortes prospectivas. Durante la segunda ola de la pandemia (del 1 de julio al 5 de diciembre de 2020) se compararon los datos de la cohorte de casos (n=22) y la cohorte de no casos (n=36) en cuanto a ansiedad estado y ansiedad rasgo (medidas con el STAI), la calidad de vida (medida mediante el KTQ) y la mortalidad, como variables de interés principales. Resultados: La población a estudio fue de 601 personas trasplantadas, con una edad media de 61.7 años (DE: 12.8), 61.9% (372) fueron hombres. Se infectaron de SARS-CoV-2 el 12.1% (73) y fallecieron 6.2% (37), siendo el 52.9% (18) por SARSCoV- 2. Esto supone una tasa de mortalidad del 2.9% y una tasa de letalidad del 24.7%. Durante la segunda ola se infectaron un 6.2% (37). La calidad de vida media fue de 4.1 (DE: 0.9). En los infectados la media fue 4.2 (DE: 0.8), y en los no infectados 4 (DE: 1). Mientras que la media de ansiedad fue de 49 (DE:24.3); siendo 54.6 (DE: 25.7) en los infectados y 45.4 (DE: 23.1) en no infectados. No se encontraron diferencias estadísticamente significativas. Conclusiones: Las personas con un trasplante renal tienen afectada su calidad de vida y presentan altos niveles de ansiedad, independientemente de si han pasado o no la infección por SARS-CoV-2.La tasa de mortalidad durante el periodo analizado fue baja, mientras que la letalidad fue alta y ambas disminuyeron de la primera a la segunda ola de la infección.

How effective is orthotic treatment in patients with recurrent diabetic foot ulcers?

BACKGROUND: We assessed the efficacy of customized foot orthotic therapy by comparing reulceration rates, minor amputation rates, and work and daily living activities before and after therapy. Peak plantar pressures and peak plantar impulses were compared with the patients not wearing and wearing their prescribed footwear. METHODS: One hundred seventeen patients with diabetes were prescribed therapeutic insoles and footwear based on the results of a detailed biomechanical study and were followed for 2 years. All of the patients had a history of foot ulcers, but none had undergone previous orthotic therapy. RESULTS: Before treatment, the reulceration rate was 79% and the amputation rate was 54%. Two years after the start of orthotic therapy, the reulceration rate was 15% and the amputation rate was 6%. Orthotic therapy reduced peak plantar pressures in patients with reulcerations and in those without (P < .05), although a significant decrease in peak plantar impulses was achieved only in patients not experiencing reulceration. Sick leave was reduced from 100% to 26%. CONCLUSIONS: Personalized orthotic therapy targeted at reducing plantar pressures by off-loading protects high-risk patients against reulceration. Treatment reduced the reulceration rate and peak plantar pressures, leading to patients' return to work or other activities.

[Outpatient use of topical antimicrobials in Spain associated with other drugs (2005-2007)]. / Consumo español de antibióticos tópicos asociados a otros principios activos (2005-2007).

INTRODUCTION: The consumption of antibiotics for systemic use has been well studied. However, data of topical use in our country are an anecdotal reference in the literature. OBJECTIVE: To evaluate the outpatient use of topical antimicrobials in Spain associated with other drugs during the period December 2005 and November 2007. METHODS: A descriptive quantitative study was conducted between December 1, 2005 to November 30, 2007. The sample amounted to a total of 112 drugs, representing 131 dosage forms. The data on consumption of drugs were sold by the company Intercontinental Marketing Services (IMS), while demographic data were obtained from the municipal census of 2006 and 2007. The study variables were grouped into three categories: those relating to consumption, those on medications and other variables such as geographic location and time period. RESULTS: During the study period the outpatient consumption of topical antimicrobials in Spain was 41.755.951 vials (130.637.368 euros) whose composition included associations between antimicrobials or antimicrobials with other drugs. The average monthly consumption amounted to 1.739.831 vials and 5.443.223 euros. The dermal route of administration was the most dispensed and according to the Anatomical, Therapeutic, Chemical classification system (ATC) and the D07CC subgroup was the most used. The association between tobramycin and dexamethasone ophthalmic suspension as 30% was the drug most used in Spain. CONCLUSIONS: The consumption of topical antimicrobials in Spain during the period 2006-2007 increased by 2.36% in the number of vials and 7.28% in economic cost. These antimicrobials were more used in summer. The average cost of a topical antimicrobial was half (3.13 euros) compared to the average cost of a drug (7.89 euros).