The Management and Prevention of Delirium in Elderly Patients Hospitalised in Intensive Care Units: A Systematic Review.

BACKGROUND: Delirium or an acute confusional state (ACS) is characterised as being a frequent and complex hospital complication in older adult patients, which can affect their level of independence and increase patient morbidity and mortality. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium, leading to longer hospital and ICU stays, increased mortality and long-term impairment. OBJECTIVES: This review aims to assess existing evidence of interventions that can be considered effective for the management and prevention of delirium in ICUs, reducing short-term morbidity and mortality, ICU and hospital admission times and the occurrence of other long-term complications. METHODOLOGY: For this systematic review, we searched Medline, PubMed, Cochrane Library, CINHAL, LILACS, SciELO and Dialnet from January 2018 to August 2024, in English, Spanish and French. MeSH descriptors were adjusted to search the different databases. We also checked Prospero for ongoing systematic reviews. MAIN RESULTS: The electronic search yielded a total of 2656 studies, of which 14 trials met the eligibility criteria, with a total of 14,711 participants. We included eight randomised clinical trial (RCTs), four cohort analyses, one systematic review and one observational trial, including participants over 65 years admitted to the ICU. Ten of these studies were based on pharmacological interventions, three of them examined non-pharmacological interventions and the remaining study examined mixed (pharmacological and non-pharmacological) interventions. Six placebo RCTs were included, plus four reported comparisons between different drugs. Regarding non-pharmacological interventions, nursing programmes focused on optimising modifiable risk factors or the use of therapies such as bright light are emerging. Regarding mixed interventions, we found the combination of invasive techniques and with sedoanalgesia. CONCLUSIONS: Due to its satisfactory level of sedation, dexmedetomidine is presented as a viable option because, although olanzapine offers safer results, postoperative administration angiotensin inhibitor systems significantly reduced the incidence of delirium. As for propofol, no significant differences were found. Among the non-pharmacological and mixed therapies, bright light therapy was able to reduce the incidence of delirium, and the combination of epidural/general anaesthesia was effective in all subtypes of delirium. Concerning the remaining interventions, the scientific evidence is still insufficient to provide a definitive recommendation.

Transcultural adaptation and theoretical models validation of the Spanish version of the Self-Care of Diabetes Inventory.

Background: For patients with diabetes mellitus, self-care is crucial because it prevents complications and helps preserve quality of life. Clinicians and researchers require effective tools for assessing self-care behaviors across various dimensions to identify individual needs and maximize resource allocation. The aim of this study was to evaluate the validity and reliability of the Spanish version of the Self-Care of Diabetes Inventory (SCODI). Methods: Two hundred eighteen participants with DMT1 and DMT2 who were recruited through convenience sampling from a university hospital participated in our cross-sectional study. After translation and cultural adaptation, the enrolled patients answered the questions. We performed an exploratory factor analysis (EFA) on each of the SCODI scales and Confirmatory factor analysis (CFA) was performed using our models which appropriate fit indices. Results: The original structure of the four-dimensions tool was confirmed. The overall consistency across the four scales was assessed by Cronbach's alpha: self-care maintenance (0.766), self-care monitoring (0.790), self-care management (0.771), and self-care confidence (0.936). The model fit yielded a chi-square index of 1.028 with 773 degrees of freedom. Confirmatory factor analysis showed a good fit, thereby affirming the reliability of the model. Conclusion: The internal consistency and reliability of the SCODI Spanish version are deemed adequate. This tool is appropriate when it is desired to evaluate the self-care practices of Spanish persons suffering from diabetes due to its good psychometric qualities.

Social Networks as a Tool for Evidence-Based Health Education: Umbrella Review.

BACKGROUND: The number of people who access social networking sites continues to increase at an exponential rate. The use of technology is an essential skill for nursing professionals and its development represents a challenge in improving health education, promotion and care. The objective of this systematic review is to analyse the use of social networking sites by healthcare professionals as an intervention tool for evidence-based public health education. METHODS: The protocol of this umbrella review was registered in the International Prospective Register of Systematic Reviews (CRD42023407249). Searches were carried out in MEDLINE (PubMed), Web of Science, CINAHL, PsycINFO (EBSCOhost), and Cochrane Library of Systematic Reviews, in February 2023. A narrative synthesis of the results was conducted. RESULTS: 1896 articles were found, of which 15 reviews fulfilled the inclusion criteria. Social networks broadened the profession; they were YouTube, X (formerly Twitter), Facebook, and Instagram. The target population was mainly young professionals, and they came across different topic areas that addressed health education. CONCLUSIONS: It is important to have information backed by scientific evidence to make health decisions. Health professionals active on social networking sites have a unique opportunity to educate the public about health by sharing scientific evidence in an accessible and clear way, which helps to combat misinformation.

Epidemiology, use, and practice of the intraosseous route in an out-of-hospital emergency department: a retrospective cross-sectional study.

Introduction: The Spanish Emergency Medical Services, according to the model we know today, were formed during the 80s and 90s of the 20th century. The Health Emergency Service (EMS), 061 La Rioja, began to assist the population of La Rioja in November 1999. An essential part of the mission of the SES is the provision of care and the transfer of critical patients using advanced life support unit (ALSU) techniques. In daily practice, out-of-hospital emergency services are faced with situations in which they must deal with the care of serious or critically ill patients, in which the possibility of being able to channel peripheral vascular access as part of ALSU quickly may be difficult or impossible. In these cases, cannulation of intraosseous (IO) vascular access may be the key to early and adequate care. Aim: This study aimed to determine the incidence and epidemiology use of IO vascular access in SES 061 La Rioja during the year 2022. Matherial and methods: We performed observational retrospective cross-sectional studies conducted in 2022. It included a population of 4.364 possible patients as a total of interventions in the community of La Rioja in that year. Results: A total of 0.66% of patients showed a clinical situation that required the establishment of IO vascular access to enable out-of-hospital stabilization; this objective was achieved in 41.3%. A total of 26.1% of patients who presented with cardiorespiratory arrest (CA) were stabilized, while 100% presented with shock and severe trauma. Discussion: IO vascular access provides a suitable route for out-of-hospital stabilization of critically ill patients when peripheral vascular access is difficult or impossible.

Health equity in urban and rural settings: implementation of the place standard tool in Spain.

The physical, social, and economic characteristics of neighborhoods and municipalities determine the health of their residents, shaping their behaviors and choices regarding health and well-being. Addressing local environmental inequalities requires an intersectoral, participatory, and equity-focused approach. Community participation plays a vital role by providing deeper insights into local contexts, integrating community knowledge and values into processes, and promoting healthier, fairer, and more equitable actions. In recent years, various tools have been developed to assess places and transform them into health-promoting settings. One such tool, the Place Standard Tool (PST), facilitates discussions on Social Determinants of Health grouped into 14 themes, serving as a starting point for local health interventions. In this study, that took place between August 2019 and February 2020, we described the resident's perceptions of two municipalities in the Valencian Community, Spain, using the validated Spanish version of the PST. A mixed-method convergent-parallel design was used to gain a holistic insight into residents' experiences concerning their physical, economic, and social environment. A total of 356 individuals from both municipalities participated in the study through discussion groups, structured interviews, and online survey. Descriptive analysis of the individual questionnaire answers was conducted, and differences between municipalities were explored. Qualitative thematic analysis was conducted on structured interviews and discussion groups. Quantitative and qualitative data were integrated to facilitate their comparison and identify areas of convergence or divergence in the findings. Overall, rural areas received more favorable evaluations compared to urban ones. Public Transport as well as Work and Local Economy were consistently rated the lowest across all groups and contexts, while Identity and Belonging received the highest ratings. In the urban area, additional negative ratings were observed for Traffic and Parking, Housing and Community, and Care and Maintenance. Conversely, Identity and Belonging, Natural Spaces, Streets and Spaces, Social Interaction, and Services emerged as the highest-rated themes overall. In the rural context, positive evaluations were given to Walking or Cycling, Traffic and Parking, Housing and Community, and Influence and Sense of Control. Significant differences (p < 0.01) between urban and rural settings were observed in dimensions related to mobility, spaces, housing, social interaction, and identity and belonging. Our study illustrated the capacity of the PST to identifying aspects within local settings that influence health, revealing both positive and challenging factors. Successful implementation requires appropriate territorial delineation, support from local authorities, and effective management of expectations. Furthermore, the tool facilitated community participation in decision-making about local environments, promoting equity by connecting institutional processes with citizen needs.

Psychometric properties and cultural adaptation of the Polish Version of the Gay Affirmative Practice Scale.

Introduction: The lesbian, gay, bisexual, and transgender (LGBT) people often face unique medical disparities, including obstacles to accessing adequate and respectful care. The purpose of this study was to test the psychometric properties(internal consistency, reliability, and factor structure) of the Polish-language version of the Gay Affirmative Practice Scale (GAP-PL). Material: The study was conducted over a 6-month period in 2023, from February to June, involving 329 medical students and professionals who evaluated the GAP-PL. Methods: Before testing the psychometric properties of the original Gay Affirmative Practice Scale (GAP), it was translated and adapted from the original English language version into the Polish language. Authors then tested the psychometric properties of the tool on a sample of 329 participants. The internal coherence of the questionnaire was tested with the analysis of verifying factors (Confirmatory Factor Analysis). Cronbach alpha and the discriminatory power index were used as internal consistency measures. Results: There were more female than male participants (55.32%). More than 53% of the participants were heterosexual, and the average age of the respondents was ~30 years. The internal consistency of the Polish-language version and its domains was strong with the overall Cronbach's alpha ranges for each subscale domains ranging between 0.936 and 0.949. The McDonald's omega coefficient was 0.963. Conclusion: The GAP-PL has excellent properties of factorial validity and can be used in research and clinical practice in Polish-speaking populations.

Mental Health Nursing Student's Perception of Clinical Simulation about Patients at Risk of Suicide: A Qualitative Study.

Suicide is a serious public health problem, with a global mortality rate of 1.4% of all deaths worldwide and the leading cause of unnatural death in Spain. Clinical simulation has proven to be a beneficial tool in training nursing students. Such experiences allow them to develop cognitive and affective skills that are fundamental for the detection of warning signs and the use of interventions in cases of people who want to take their own lives. Working in a mental health environment can be difficult for nursing students; therefore, the purpose of this study was to explore the perceptions of nursing students on the approach, management, and intervention of suicidal crisis through clinical mental health simulation. METHODS: qualitative descriptive phenomenological study through focus groups and reflective narratives in a sample of 45 students. A thematic analysis was performed using ATLAS-ti. RESULTS: After the analysis, three themes were obtained: (a) management and handling of emotions, (b) identification of suicide motives, and (c) intervention in suicidal crisis. DISCUSSION: Clinical simulation in mental health allows students to exercise clinical judgment reasoning, detect warning signs for a better treatment approach, and provide tools for effective intervention and management of patient care. The results of this study indicate that nursing students face challenges in approaching mental health clinical simulation due to a lack of prior exposure.

Early removal of the etonogestrel contraceptive implant in Spanish women: a prospective cohort study.

Purpose: To know the discontinuation rate and characterize predictors and reasons of contraceptive implant removal within 12 months of insertion in our community setting. Methods: This prospective cohort study included women receiving the etonogestrel contraceptive implant at sexual and reproductive health centers between September 2019 and September 2020. The variables collected were implanted insertion timing, reproductive and demographic characteristics, medical conditions, sexual activity and counseling. Our primary outcome was implant discontinuation. Kaplan-Meier survival curves were used to show the cumulative discontinuation rate of implants contraceptive within the first year of insertion. We also identified factors that increased the risk of implant removal using the log-rank test and the Cox regression model. Reasons for discontinuation were documented. Results: 199 women were followed up. Implant discontinuation was documented in 17.1% of implant users prior to 12 months. Factors that increase the risk of implant removal are living with a partner, being aged 25-34 years and not receiving comprehensive and structured counseling from the midwife. The main reason for removal was unsatisfactory bleeding (97.1%), but this was combined with other reasons such as cessation of sexual intercourse (58.8%), worsening mood (58.8%), weight gain (55.9%) or decreased libido (50.0%). Conclusion: The rate of discontinuous implant uses in the first year is relevant in relation to cost-effectiveness, there is room for improvement that should not be overlooked. Comprehensive and structured midwife-led counseling can reduce early implant abandonment removal. The development in different countries of the role of midwives in the management of contraceptives can contribute to the economic benefit of health services and the satisfaction of women.

Evaluation of the impact of "speak out" and "human libraries" educational methodologies on nursing students' attitudes toward immigration.

Introduction: Measuring and understanding attitudes toward migrants is crucial in Health Sciences professionals. Nursing students, as future professionals in the healthcare system, must be comprehensively trained and prepared from the undergraduate level to effectively face the challenges of caring for health and disease processes in an increasingly globalized world. Our study aims to determine the level of attitudinal change in nursing students for immigrants, based on a training intervention with sessions of coexistence with immigrants in Spain. Methods: Quasi-experimental controlled and non-randomized study, carried out in 2019 in Nursing School La Fe, Valencia (Spain), with 201 participants (74 intervention group, 127 control group). Instrument: Attitudes toward Immigration Instrument (IAHI) questionnaire. Educational techniques of the training intervention: Speak outs and Human Libraries. Descriptive statistical analysis and comparison of results between groups was performed. Results: The participants in the intervention group showed significant changes in attitude modification, both in the total score of the questionnaire and in 4 of the 5 dimensions (pre-post intervention medition). When comparing the differences between the intervention group and the control group, we observed significant differences in 3 of the 5 dimensions: equality principles and policies, positive favorability, and negative favorability. Conclussion: Sessions involving coexistence, discussion, and reflection with immigrants, as educational intervention methods for nursing students (Speak outs and Human Libraries), are useful and effective tools to promote positive attitudinal changes toward immigrants within the healthcar context in nursing students.

Language and Cultural Barriers and Facilitators of Sexual and Reproductive Health Care for Migrant Women in High-Income European Countries: An Integrative Review.

INTRODUCTION: Dealing with intercultural communicative barriers in European countries' national health services is an increasing and necessary challenge to guarantee migrant women's right to health care. This integrative review describes the communication barriers and facilitators that migrant women encounter to access and use sexual and reproductive health (SRH) services in Europe. METHODS: A literature search was performed to identify original studies in PubMed, CINAHL, PsycINFO, Web of Science, and Scopus, using keywords associated with migrant women and SRH services. This was supplemented by scanning the reference lists from relevant studies and similar reviews. Studies exploring the perspective of migrant women about communication barriers and facilitators to the access and use of SRH services were included, whereas those that solely explored health professional's experiences were excluded. Findings were organized into 4 themes: (1) verbal-linguistic barriers, (2) nonverbal language barriers, (3) cultural barriers, and (4) communication facilitators. RESULTS: Nineteen studies met the inclusion criteria. Results showed that when women had problems understanding or being understood by health professionals, they experienced feelings of anxiety, fear, insecurity, and discrimination that discouraged them from using SRH services. The most requested facilitators by women were health education, access to professional interpreters and translation of written information, and increasing the practitioners' cultural competence. DISCUSSION: Communication barriers undermine migrant women's right to benefit from preventive SRH programs and to make informed decisions concerning their health. It is necessary to establish tailored plans in each health care center to improve intercultural communication that integrate facilitators proposed by women. Future research should provide solid evidence on the effectiveness of each facilitator implemented.

Spanish version of the Heart Failure Somatic Perception Scale (HFSPS v.3) - psychometric properties.

Background: The Heart Failure Somatic Perception Scale (HFSPS) is an instrument that examine the existence and gravity of physical signs and symptoms in patients with heart failure, as well as early and subtle symptoms of HF that have clinical value, we aimed to translate and adapt the HFSPS from English to Spanish and evaluate the psychometric properties. Method: HFSPS translation and back translation were carried out according to the method established by of Beaton et al. A confirmatory factor analysis (CFA) was performed to test the factor structures. To assess criterion-related validity, HFSPS factor scores were correlated with Kansas City Cardiomyopathy Questionnaire (KCCQ) scores using the Spearman correlation method. The reliability of the internal consistency of the HFSPS was determined by calculating the Cronbach's alpha coefficient and the factor score determination coefficient. Results: Data from 173 patients with a mean age of 80.7 years (SD 9.1), women (51.1%), were analyzed. The majority (74.7%) were NYHA class II/III. The confirmatory factor analysis of four factors after eliminating one item showed fit indices close to the recommended indices: χ2 = 169.237, p < 0.001, CFI = 0.920, TLI = 0.901, RMSEA = 0.057 and SRMR = 0.061. Regarding the validity related to the criterion, all the scores of the HFSPS dimensions were correlated with all the scores of the KCCQ dimensions and were statistically significant. The reliability of the HFSPS factors of the coefficient of determination obtained scores of 0.73 for the dyspnea factor and early and subtle and lower for edema and chest discomfort with fewer items. Cronbach's alpha was acceptable for three of the scales >0.71 and poor 0.52 for chest discomfort with two items. The internal consistency index based on the model was 0.850. Conclusion: The Spanish version of the HFSPS is a valid and reliable instrument that that would be feasible to use in clinical and research setting to evaluate in the perception of symptoms in patients with heart failure.

Exploring the Link between Interoceptive Body Awareness and Suicidal Orientation in University Students: A Cross-Sectional Study.

INTRODUCTION: The transition to college life can impact the mental health of students. There are mental health care strategies that promote connection with the body's internal signals, which can help to improve mental well-being, manage emotions, and reduce the risk of suicide in university students. AIM: This study aimed to examine the association between interoceptive body awareness variables and suicidal orientation in a sample of 169 undergraduate students in Colombia. METHODS: An observational, cross-sectional study was conducted in 2023 with Colombian students as the participants. RESULTS: The findings revealed a significant and moderately negative correlation between the Multidimensional Assessment of Interoceptive Awareness (MAIA) total score and the Inventory of Suicide Orientation (ISO-30) total score (r = -0.54, p < 0.001). Confidence and self-regulation were identified as the most influential factors in the relationship between MAIA and ISO-30. Significant correlations were observed (p < 0.001), indicating moderate correlation values ranging from -0.43 to -0.57. DISCUSSION: Our findings support the existence of a negative correlation between interoceptive body awareness and suicidal orientation. Further research is needed to better understand this relationship and to develop specific interventions based on body awareness to prevent suicide orientation. CONCLUSION: There are practical implications associated with recognizing the importance of body awareness in relation to decreasing suicidal orientation, and multidisciplinary teams addressing mental health can incorporate this knowledge.

Effects of COVID-19 Lockdown on Heart Failure Patients: A Quasi-Experimental Study.

INTRODUCTION: The COVID-19 lockdown has been associated with reduced levels of physical activity, quality of life, and sleep quality, but limited evidence exists for its impact on heart failure patients. This study examined the influence of the COVID-19 lockdown on these aspects in heart failure patients, with specific comparisons by age and sex. METHODS: A quasi-experimental cross-sectional study of patients with heart failure was conducted. The assessment involved two time points: during the COVID-19 lockdown (March to June 2020) and post-lockdown (July to October 2020). A total of 107 HF patients participated, with assessments of overall PA (using the International Physical Activity Questionnaire), QoL (employing the Cantril Ladder of Life), and sleep quality (utilizing the Minimal Insomnia Symptom Scale) conducted during and after the COVID-19 lockdown. RESULTS: HF patients reported lower levels of total PA (p = 0.001) and walking PA (p < 0.0001) during lockdown than after lockdown, whilst no differences were observed in QoL nor sleep quality. In addition, both younger and older patients reported lower walking PA and total PA during lockdown than after lockdown, while older patients reported lower QoL during lockdown than after lockdown. Moreover, both men and women reported lower walking PA and total PA during lockdown than after lockdown, whilst women reported lower QoL. CONCLUSIONS: HF patients need improved PA programs during lockdowns, as these programs can elevate PA levels and enhance QoL, especially when faced with the risk of decompensation during health crises.

Application of the Delphi Method for Content Validity Analysis of a Questionnaire to Determine the Risk Factors of the Chemsex.

Chemsex is understood as "the intentional use of stimulant drugs to have sex for an extended time among gay, bisexual, and other men who have sex with men". It is a public health problem because of the increased incidence of cases and because of the consequences on the physical and mental health of those who practice it. AIM: This study aimed to analyze, with the help of the Delphi method, the content validity of a new instrument to assess the risk of behaviors associated with the chemsex phenomenon. METHOD: First, a bank of items identified from the literature was elaborated. Secondly, 50 experts with knowledge of the chemsex phenomenon at the national level were contacted. A Delphi group was formed with them to carry out two rounds of item evaluation. The linguistic evaluation (comprehension and appropriateness) was assessed using a Likert scale from 1 to 5 for each item. Items that did not reach a mean score of 4 were eliminated. Content assessment was calculated using each item's content validity index (CVI) and Aiken's V (VdA). A minimum CVI and VdA value of 0.6 was established to include the items in the questionnaire. RESULTS: A total of 114 items were identified in the literature. In the first round of Delphi evaluation, 36 experts evaluated the items. A total of 58 items were eliminated for obtaining a CVI or VdA of less than 0.6, leaving 56 items. In a second Delphi round, 30 experts re-evaluated the 56 selected items, where 4 items were eliminated for being similar, and 10 items were also eliminated for not being relevant to the topic even though they had values higher than 0.6, leaving the scale finally composed of 52 items. CONCLUSION: A questionnaire has been designed to assess the risk of behaviors associated with the chemsex phenomenon. The items that make up the questionnaire have shown adequate content and linguistic validity. The Delphi method proved to be a helpful technique for the proposed objective.

Media Exposure of Suicidal Behaviour: An Umbrella Review.

AIM: To analyse recommended interventions for the safe and responsible dissemination of suicidal behaviour in the media for preventive purposes. BACKGROUND: Suicide is a serious public health problem that leads to more than 700,000 deaths per year, which translates into one death every forty seconds. The media play a significant role in shaping public perceptions and reflecting societal issues. Because of its active role in the construction of reality, the way in which the media report and expose suicidal behaviour has the capacity to influence the population in either a preventive or harmful way. DESIGN: An umbrella review was carried out and a report was written according to the Preferred Reporting Items for Overviews of Reviews. METHODS: We systematically searched for reviews published from inception to February 2023 in MEDLINE (PubMed), CINAHL and PsycInfo (via EBSCOhost), Web of Science, Embase, Cochrane Library of Systematic Reviews, Scopus, and Google Scholar. A narrative synthesis of the results was conducted. RESULTS: Six systematic reviews with a moderate to high quality level were selected. Among the recommended interventions were the inclusion of positive messages of hope, resilience, or of overcoming the event, narratives with information on available resources or the promotion of support-seeking attitudes as an effective prevention mechanism, as well as the avoidance of repetitive reporting of the same suicide. The appropriate and responsible dissemination of information on suicidal behaviour in the media with complete and up-to-date information on available centres, organisations, institutions, and resources has proven to be effective, especially in vulnerable populations. CONCLUSION: Educating and training the media in an appropriate approach to disseminating suicidal behaviour helps to reduce the number of suicidal behaviours. Knowing what information is advisable to include in the news item as well as what information to avoid is a strong point. Guidelines to promote responsible media reporting are a key component of suicide prevention strategies. This study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 23 April 2022 with the registration number CRD42022320393.

Perception of patient safety culture among nursing students: A cross-sectional study.

AIM: To analyse the perception of patient safety culture among nursing students and to compare patient safety outcomes between the different year nursing groups. DESIGN: A cross-sectional descriptive study was conducted with nursing students (n = 266) between first and fourth years from one university in Spain. METHODS: The project was conducted during the 2020/21 academic year. The data were collected using a translated and adapted version of the "Hospital Survey on Patient Safety" developed by the Agency of Healthcare Quality (AHQR). RESULTS: Significant differences were found between the year of study of the nursing degree and whether or not specific training in patient safety culture had been received. The nursing students who had received specific training gave scores lower than anyone else in all questionnaire items, but only the indicators of "good practice" (p = 0.00) and "frequency of reported events" (p = 0.0012) showed significant differences. In some cases, fourth-year students had lower significant mean scores in their "perception of patient safety within unit/sector," "indicators of good practice" and "total score." PUBLIC CONTRIBUTION: Adverse events related to clinical practice continue to be a global problem. Improvements in patient safety require an increase in the patient safety culture of professionals and the promotion of development facilitators. Clinical practice and specific theoretical training foster greater awareness and demand related to patient safety, which is of interest when it comes to the development of new programmes that combine both methodologies and improve their effectiveness. Patient safety will continue to be a focus for all healthcare systems. The patient safety culture of future healthcare professionals should be developed at the university level in order to avoid unnecessary adverse events.

Nomophobia in university students during COVID-19 outbreak: a cross-sectional study.

Introduction: Currently, access to the Internet through smartphones has led to their functions going beyond purely communicative ones, allowing the management of massive, instantaneous, and easily accessible information. This research analyzed the differences in smartphone use and the prevalence of nomophobia, mainly according to gender and university degree of Health Sciences students at the University of Zaragoza during the COVID-19 confinement in Spain. Methods: A descriptive cross-sectional study was carried out on a sample of 318 first and second-grade students, who completed an online questionnaire sent to their institutional email, which included sociodemographic questions, other questions about smartphone use, and the Nomophobia Questionnaire (NMP-Q) scale. Results: Compared to men (n = 58), women (n = 260) were more likely to use their smartphones more intensively daily, as were occupational therapy students compared to the other degree programs studied. The prevalence of nomophobia was moderate, being around the risk of suffering from it. No significant differences in scores for nomophobia among students were found according to gender, university degree, or population nucleus for the nomophobia scores of the students. Discussion: The present study extends the existing literature on nomophobia by providing results of interest in terms of gender and the exceptional healthcare context of COVID-19. The results suggest that despite intense daily smartphone use young people did not reach severe nomophobia figures. This fact underlines the need for appropriate and healthy technology education. Understanding the characteristics of the populations that use the smartphone the most may help to analyze nomophobia rates and the massive use of the device.

NANDA nursing diagnoses associated with the occurrence of psychomotor agitation in patients with severe mental disorder: a cross-sectional study.

BACKGROUND: Psychomotor agitation is increased psychomotor activity, restlessness and irritability. People with psychomotor agitation respond by overreacting to intrinsic and extrinsic stimuli, experiencing stress and/or cognitive impairment. the aim was to analyse the association of nursing diagnoses with the disinhibition dimension, the aggressiveness dimension and the lability dimension of the Corrigan Agitated Behaviour Scale. METHODS: This study was conducted in Spain using a multicentre cross-sectional convenience sample of 140 patients who had been admitted to psychiatric hospital units and had presented an episode of psychomotor agitation between 2018 and 2021. RESULTS: The Corrigan Agitated Behaviour Scale was used to assess psychomotor agitation. Associated nursing diagnoses, violence directed at professionals and the environment are shown to be predictive values for the severity of the agitation episode. Moderate-severe psychomotor agitation episodes are shown as predictors of violence directed mainly at professionals and the environment. CONCLUSIONS: There is an urgent need for mental health nurses to have knowledge of the extended clinic in order to care for users and improve their health conditions in dealing with people, with their social, subjective and biological dimension.

Mental health knowledge and classroom experiences of school teachers in Aragon, Spain.

Background: Research shows that many mental disorders begin in childhood but are sometimes not diagnosed until later years. School-age children spend much of their time in schools and have daily interactions with school teachers. Aim: Examine school teachers' experiences of mental disorders in school going children and adolescents and their associated mental health training needs. Method and sample: A descriptive cross-sectional study was carried out with teachers in Infant-Primary and Secondary Education-Baccalaureate schools. Results: A convenience sample of 685 teachers responded to the online survey. Participants worked in both urban and rural areas and in Infant-Primary and Secondary Education-Baccalaureate schools. Over half of participants reported classroom experiences of learner mental disorders such as ADHD, anxiety, conduct disorders or autism. Most participants acknowledged a training need, both in recognition of symptoms of mental disorders and in care resources and processes. However, 80% of respondents reported having not received any training in this regard. Participant preferences for training included face-to-face or hybrid - combined online learning. Participants also considered the management of their own mental health to be deficient, therefore any training should incorporate personal mental health awareness and self-help strategies. Conclusion: In Aragón (Spain), teachers of children and adolescents with mental disorders, recognize a need for training in the identification of symptoms and other aspects of mental healthcare, such as availability and access to services. Protocols for early identification and referral would promote mentally healthy school environments and reduce stigma which could be a barrier to timely intervention. In addition, any training should include mental health self-care for teachers.

Interventions of choice for the prevention and treatment of suicidal behaviours: An umbrella review.

AIM: This umbrella review aims to determine which interventions can be considered as effective in the prevention and treatment of suicidal behaviour. DESIGN: Umbrella review. METHODS: A systematic search was conducted of works indexed in the PubMed, CINAHL, Cochrane Database of Systematic Reviews, Scopus, ISI Web of Knowledge and Joanna Institute Briggs databases. The search covered works published from 2011 to 2020. RESULTS: The scientific literature shows that, in addition to being the most prevalent interventions in use, dialectical and cognitive behavioural therapies are the most effective in the treatment and management of suicide attempts and suicidal ideation. It is shown that the prevention and treatment of suicidal behaviour requires multidisciplinary and comprehensive management. Among the interventions that stand out the most are the promotion of providing coping tools, work based on thought and behaviour, and behavioural, psychoanalytic and psychodynamic therapies for the management of emotions.