Relationship between hair cortisol concentrations and cognitive functioning in adolescents with ADHD.

Background: Our study aimed to explore whether the hair cortisol concentration (HCC), a measure of long-term cortisol output, is associated with poorer cognitive functioning in adolescents with attention deficit and hyperactivity disorder (ADHD). We further aimed to test the potential moderating effects of sex and childhood maltreatment.Methods: In this cross-sectional study, fifty-three adolescents with ADHD were studied. The ADHD Rating Scale (ADHD-RS) and Childhood Trauma Questionnaire (CTQ) were administered. Seven cognitive tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were administered, and two cognitive factors (attention and memory and executive functioning) were identified by confirmatory factor analysis. A 3-cm hair sample from the posterior vertex region of the head was obtained. HCCs were determined by a high-sensitivity enzyme immunoassay kit. Multiple linear regression analyses were used to explore the association between HCCs and either cognitive performance or ADHD severity while adjusting for sex, childhood maltreatment and the ADHD-RS total score.Results: Sex moderated the relationship between HCCs and attention/memory confirmatory factor analysis (CFA) scores, with better performance in boys with higher HCCs. HCCs were not associated with executive functioning or ADHD symptoms. Childhood maltreatment was associated with inattention symptoms in adolescents with ADHD.Conclusions: Our study suggests that HCCs are positively associated with attention and memory performance in adolescents with ADHD, with a moderating effect of sex (the relationship is strongest in boys).

We studied the relationship between cortisol and cognition in adolescents with ADHD.Hair cortisol concentrations (HCCs) were determined.We explored the moderating effects of sex and childhood trauma.Sex moderated the relationship between HCCs and attention and memory.Childhood trauma did not moderate the relationship between HCCs and cognition.

Affectivity, sexuality, and autism spectrum disorder: qualitative analysis of the experiences of autistic young adults and their families.

BACKGROUND: Autistic people have communication, sensorial, and social difficulties, which on many occasions, make their adaptation on the sexual and affective levels difficult. For this reason, it is important to know the opinion of individuals with autism spectrum disorders (ASD) and their families, to offer this perspective to professionals to facilitate adapted health education programs in mental health units. METHODS: This qualitative descriptive design presents the experiences of autistic individuals and their families in relation to the affective-sexual experiences from individual, family, and social perspectives. Two focus group sessions were held with eight family members and seven individual semi-structured interviews with autistic young adults. The transcripts were qualitatively analysed using content analysis. RESULTS: Four themes (Family and social dynamic; Social behaviour of the autistic individual; Affective-sexual relationships; Addressing affective and sex education) and 13 related categories emerged from these results. Communication and social interaction problems act as barriers for young adults when developing affective-sexual relationships, leading to the emergence of negative feelings and experiences that reinforce avoidance behaviours, further intensifying their difficulties in interacting with others. Families, especially mothers, exhibit a poor perception of their ability to provide affective-sexual guidance, leading to anxiety and frustration. There are also reports of poor sex education and lack of support systems. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The experiences of young people and their families are sometimes conflicting when it comes to affectivity and sexuality, but the parental role emerges as relevant in the sex education process. Families play a pivotal role in sex education, which is why professionals should provide them with support and information through health education programmes, foster empathetic communication and promote sexual and emotional development that is adapted to the characteristics and interests of autistic people.

Affectivity and Sexuality in Adolescents with Autism Spectrum Disorder from the Perspective of Education and Healthcare Professionals: A Qualitative Study.

People with autism spectrum disorder (ASD) present several different characteristics that predispose them to greater difficulties with intimate emotional and sexual relationships. This qualitative study uncovers the perspective of education and healthcare professionals on the affective and sexual needs of young people with ASD by analysing their narratives in semi-structured focus group sessions. Professionals highlight the inadequate training they receive in this aspect of health. They consider it should be commonplace for professionals working with autistic people as it would aid their collaborative efforts when treating children and adolescents with ASD. They show that, by working together with the families to establish joint objectives, these professionals can appropriately address sex and affective education, preventing risky behaviours among young people with ASD, and improving the interactions these individuals have with others. Sex and affective education is described as an indispensable tool at this stage of development and should be specially adapted for those with ASD.

COVID-19 Pandemic Has Changed the Psychiatric Profile of Adolescents Attempting Suicide: A Cross-Sectional Comparison.

The COVID-19 pandemic is having a major impact on the mental health of adolescents, leading to suicidal behaviors. However, it remains to be clarified whether the COVID-19 pandemic has changed the psychiatric profile of adolescent suicide attempters. METHODS: a retrospective observational analytical study was conducted to assess age, gender and clinical characteristics of adolescents attempting suicide during the year before and the year after the global lockdown. RESULTS: ninety adolescents (12-17 y.o.) were recruited consecutively from February 2019 to March 2021 at the emergency ward for having attempted suicide. Fifty-two (57.8%) attended before the lockdown (pre-pandemic group) and thirty-eight (42.2%) the year after (pandemic group). There were significant differences in diagnostic categories between the periods (p = 0.003). Adjustment and conduct disorders were more frequent in the pre-pandemic group, while anxiety and depressive disorders were more prevalent during the pandemic. Although the severity of suicide attempts did not show significant differences between the two study periods (0.7), the generalized linear model showed that the suicide attempt severity was significantly associated with current diagnosis (p = 0.01). CONCLUSIONS: the psychiatric profile of adolescents attempting suicide was different before and during the COVID-19 pandemic. During the pandemic, the proportion of adolescents with a prior psychiatric history was lower, and most of them were diagnosed with depressive and anxiety disorders. These diagnoses were also associated with a greater severity in the intentionality of suicide attempt, regardless of the study period.

Service Learning in the Nursing Bachelor Thesis: A Mixed-Methods Study.

The Final Degree Project (FDP) is a module that, although intended for the completion of a bachelor thesis (BT), consists of theoretical and clinical teaching. Therefore, introducing service learning (SL) can support student adjustments to the real-world professional role. This study plans to evaluate a teaching innovation project that combines BT and SL through Kirkpatrick's four-level model (reaction, learning, behaviour and results). It takes the form of a convergent parallel mixed-methods design study. The participants were 15 final-year students obtaining a Bachelor of Nursing degree, 4 BT supervising mentors and 4 nurses. At the request of a hospital institution, in their BT, students completed a review of evidence-based nursing protocols. For data collection, the researchers used: an SL questionnaire, student narratives, mentor field diaries and nurse interviews. According to student opinion, the results showed high satisfaction rates (4.44 out of 5), the most developed skills were Independent Work and Information Management, but they signal the need to reinforce the research methodology skills. Finally, positive feedback from all participants is that using SL promotes both the opinion that the BT is useful and also promotes a collaboration between academic and clinical settings.

The effect of writing a bachelor thesis on attitudes towards nursing research and development: A cross-sectional comparative study between students and professionals.

BACKGROUND: Research is essential to practice nursing and must be duly enhanced during university training. Therefore, writing a bachelor thesis may help to develop research skills and thus transfer this skill set to practical application. OBJECTIVES: 1) To ascertain whether writing a bachelor thesis has a bearing on attitudes towards nursing research and development; 2) to establish a comparison between groups (students and nurses), and 3) to analyse other factors (work experience, advanced training, research experience) that may influence the relationship between nurses and nursing research and development. DESIGN: A cross-sectional comparative study. SETTING AND PARTICIPANTS: The participants totalled 204: 38 nursing students and 166 nurses. METHODS: Data were gathered using the instrument Nurses' Attitudes towards Research and Development within Nursing devised by Björkström and Hamrin (2001) version II validated in Spanish. This instrument consists of 33 statements grouped into 7 factors, whose responses offer 5 alternatives on a Likert scale. RESULTS: Most participants were female (86.3 %), with a mean age of 36 (SD = 11.65). The participants who have written a bachelor thesis obtained a higher score (Mdn = 4.14; range = 2.06) than those who have not (Mdn = 3.98; range = 2.13), with a significant difference (U = 3959.5; p = 0.012) and a moderate effect size (Hedges's g = 0.40). The students are those who obtained the highest scores. Amongst the nurses, educational training is the element that is most positively correlated with attitudes towards nursing research and development (r = 0.340). CONCLUSION: The results suggest that writing a bachelor thesis engenders greater interest and a favourable attitude towards nursing research and development and displays that the most interested group is the students, followed by nurses holding a degree in nursing, and lastly those with a Diploma of Higher Education in nursing. Nurses' educational training is the most influential aspect, standing above researcher or professional experience.

Nursing student learning of biosciences through movies and concept maps: A mixed study.

BACKGROUND: acquisition of bioscience knowledge is challenging for nursing students. This calls for teaching methodologies that allow them to acquire this knowledge and add value in the nursing context. OBJECTIVE: to evaluate a teaching experience using a movie clip and the collaborative use of C-Maps in first-year bioscience learning in nursing students. DESIGN: embedded mixed methods study. PARTICIPANTS: 143 students. METHODS: data were collected in two phases: first, collecting quantitative data through a questionnaire on utility, satisfaction and perceived competency development, and collecting qualitative data on learning, teaching materials and developed competencies through an open-question instrument. The second phase consisted of a focus group to explore in greater depth learning experience. RESULTS: six themes emerged from the qualitative analysis: using C-Maps as a learning process; developing group competencies; knowledge integration and transfer; teacher-student relationship; art as a didactic support; and difficulties encountered and proposals for improvement. Regarding utility, the students highlighted learning and relating concepts. Elements of satisfaction were working in small groups and having the teacher as a guide. Finally, the competencies most developed were teamwork and learning ability. CONCLUSION: the combination of a movie clip and a C-Map is an innovative strategy motivating and valuable for learning biosciences.

Translation, Adaptation, and Psychometric Validation of the Spanish Version of the Attitudes towards Research and Development within Nursing Questionnaire.

The promotion of research competence is essential for the development of the nursing profession and discipline. The aim of this study was to translate into Spanish, adapt, and validate an instrument measuring nurses' attitudes towards nursing research and development. A quantitative, cross-sectional, analytical design was used for the cross-cultural adaptation and cultural validation of the instrument. A total of 367 participants were selected using intentional sampling. A process of translation, back-translation, expert consultation, and pilot testing was followed. Subsequently, reliability and statistical validity were assessed, a new factor structure was proposed, and means were compared to assess the power to discriminate between factors by groups of participants. The results showed internal consistency tests with a Cronbach's alpha of 0.913. Confirmatory factor analysis of the comparative fit index (CFI = 0.549) and Tucker-Lewis index (TLI = 0.491) indicate that the factors did not match the original clustering model. The new factor structure consisted of seven factors. Between-group comparisons revealed statistically significant differences. In conclusion, the instrument exhibits high levels of statistical reliability and validity compared to the original instrument. The new factorial proposal is consistent, but further research is needed to verify its replicability in other contexts.

An mHealth intervention for the treatment of patients with an eating disorder: A multicenter randomized controlled trial.

OBJECTIVE: The current multicentre randomized controlled trial assessed the clinical efficacy of a combined mHealth intervention for eating disorders (EDs) based on cognitive behavioral therapy (CBT). METHOD: A total of 106 ED patients from eight different public and private mental health services in Spain were randomly assigned to two parallel groups. Patients of the experimental group (N = 53) received standard face-to-face CBT plus a mobile intervention through an application called "TCApp," which provides self-monitoring and an online chat with the therapist. The control group (N = 53) received standard face-to-face CBT only. Patients completed self-report questionnaires on ED symptomatology, anxiety, depression, and quality of life, before and after treatment. RESULTS: Significant reductions in primary and secondary outcomes were observed for participants of both groups, with no differences between groups. Results also suggested that the frequency with which patients attended their referral mental health institution after the intervention was lower for patients in the experimental group than for those in the control group. DISCUSSION: The current study showed that CBT can help to reduce symptoms relating to ED, regardless of whether its delivery includes online components in addition to traditional face-to-face treatment. Besides, the additional component offered by the TCApp does not appear to be promising from a purely therapeutic perspective but perhaps as a cost-effective tool, reducing thus the costs and time burden associated with weekly visits to health professionals.

Efficacy of a Short Psychoeducational Group Intervention for the Prevention of Cardiovascular Risk in Patients With Severe Mental Disorder: A Randomized Trial.

Psychoeducational interventions to improve healthy habits regarding cardiovascular risk (CVR) in people with a severe mental disorder showed scarce results in the literature. In this article, we showed the results of a randomized clinical trial including 80 adult outpatients (mainly psychosis spectrum) with moderate to very high CVR. A short-term psychoeducational group intervention to improve healthy habits regarding CVR was added to their as-usual individual psychoeducational schedule. With an intention-to-treat analysis, we expected improvements in the different parameters. Baseline and 1-year follow-up included CVR factors and indexes (REGICOR, SCORE, and DORICA). Basal characteristics did not show statistically significant differences between the groups. No significant improvements in any of the variables studied were observed in the intervention enriched group compared with the control individual group. Compliance with the sessions was scarce. The satisfaction with the intervention and the acquisition of knowledge were adequate. Moreover, the benefits of both interventions were weak.

Measure of clinical improvement in children and adolescents with psychiatric disorders: an evaluation of multiple perspectives with HoNOSCA. / Valoración de la mejoría clínica en niños y adolescentes con trastornos psiquiátricos: una evaluación de múltiples perspectivas con HoNOSCA.

INTRODUCTION: Routine outcome assessment is helpful to inform decision-making, resource allocation, and health policy design. Routine outcome assessment in the hospital setting for children and adolescents with psychiatric disorders remains limited. The clinical instrument HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents), which has recently become available in Spanish and Catalan, allows outcome assessment in this population from the perspective of patients, their parents or legal guardians, and clinicians. HoNOSCA measures 13 areas of health and psychosocial functioning. OBJECTIVES: The aim of this study was to assess mental health outcomes in psychiatric day hospital pediatric patients from three perspectives (patient, par-ent/legal guardian, clinician), using the Spanish and Catalan versions of HoNOSCA. METHODS: We recruited patients up to 18 years old with any psychiatric disorder at the day unit of the Salut Mental Parc Taulí Hospital Universitari (Sabadell, Catalonia, Spain). We obtained admission and discharge HoNOSCA scores for the patients, their parents or legal guardians, and their clinicians. RESULTS: We recruited 99 patients over the study period (January 2015 to December 2017), 11 of which were lost to follow-up. Among the remaining 88, we found significant improvement in HoNOSCA scores from admission to discharge. Agreement between the HoNOSCA scores for the three different groups of evaluators (patients, parents/legal guardians, and clinicians) was weak at admission but better at discharge. In general, evaluations from patients and their parents or legal guardians had lower HoNOSCA scores (indicating a better mental health status) at admis-sion compared to those from clinicians. At discharge, however, the scores were more homogenous across the three groups of stakeholders. CONCLUSIONS: Use of HoNOSCA allows for routine evaluation of mental health outcomes in the psychiatric day hospital setting from the perspective of pa-tients, their parents or legal guardians, and clinicians.

INTRODUCCIÓN: La evaluación rutinaria de variables de resultado ayuda en la toma de decisiones, la asignación de recursos y el diseño de políticas en salud. La evaluación rutinaria de variables de resultado en el entorno hospitalario para niños y adolescentes con trastornos psiquiátricos sigue siendo limitada. La Health of the Nation Outcome Scales for Children and Adolescents, HoNOSCA, que recientemente se ha traducido al español y al catalán, permite la evaluación de resultados en esta población desde la perspectiva de pacientes, padres o tutores legales y clínicos. Este instrumento mide 13 áreas de salud y funcionamiento psicosocial. OBJETIVOS: Evaluar variables de resultado en salud mental entre pacientes jóvenes de hospital de día de psiquiatría desde estas tres perspectivas usando Health of the Nation Outcome Scales for Children and Adolescents. MÉTODOS: Reclutamos pacientes pediátricos (18 años o menos) con cualquier trastorno psiquiátrico en el hospital de día de la unidad de psiquiatría y psicología juvenil del Hospital Salut Mental Parc Taulí (Sabadell, Cataluña, España). Obtuvimos puntuaciones de Health of the Nation Outcome Scales for Children and Adolescents desde la perspectiva de pacientes, sus padres o tutores legales y clínicos, al ingreso y al alta. RESULTADOS: Reclutamos 99 pacientes entre enero de 2015 y diciembre de 2017; once se perdieron durante el seguimiento. Entre los 88 restantes, encontramos una mejora significativa en las puntuaciones de Health of the Nation Outcome Scales for Children and Adolescents desde el ingreso hasta el alta. El acuerdo en las puntuaciones de esta escala entre los diferentes evaluadores fue débil al inicio, pero mejor al alta. En general, los pacientes y los padres o tutores legales reportaron puntuaciones más bajas de Health of the Nation Outcome Scales for Children and Adolescents (mejor estado de salud) al ingreso en comparación con los profesionales de la salud. Al alta, las puntuaciones fueron homogéneas desde las tres perspectivas. CONCLUSIONES: La Health of the Nation Outcome Scales for Children and Adolescents permite la evaluación rutinaria de variables de resultado en salud mental en el entorno de hospital de día de psiquiatría desde la perspectiva de los pacientes, sus padres o tutores legales y los profesionales de la salud.

Valoración de la mejoría clínica en niños y adolescentes con trastornos psiquiátricos: una evaluación de múltiples perspectivas con HoNOSCA / Measure of clinical improvement in children and adolescents with psychiatric disorders: an evaluation of multiple perspectives with HoNOSCA

INTRODUCCIÓN La evaluación rutinaria de variables de resultado ayuda en la toma de decisiones, la asignación de recursos y el diseño de políticas en salud. La evaluación rutinaria de variables de resultado en el entorno hospitalario para niños y adolescentes con trastornos psiquiátricos sigue siendo limitada. La Health of the Nation Outcome Scales for Children and Adolescents, HoNOSCA, que recientemente se ha traducido al español y al catalán, permite la evaluación de resultados en esta población desde la perspectiva de pacientes, padres o tutores legales y clínicos. Este instrumento mide 13 áreas de salud y funcionamiento psicosocial. OBJETIVOS Evaluar variables de resultado en salud mental entre pacientes jóvenes de hospital de día de psiquiatría desde estas tres perspectivas usando Health of the Nation Outcome Scales for Children and Adolescents. MÉTODOS Reclutamos pacientes pediátricos (18 años o menos) con cualquier trastorno psiquiátrico en el hospital de día de la unidad de psiquiatría y psicología juvenil del Hospital Salut Mental Parc Taulí (Sabadell, Cataluña, España). Obtuvimos puntuaciones de Health of the Nation Outcome Scales for Children and Adolescents desde la perspectiva de pacientes, sus padres o tutores legales y clínicos, al ingreso y al alta. RESULTADOS Reclutamos 99 pacientes entre enero de 2015 y diciembre de 2017; once se perdieron durante el seguimiento. Entre los 88 restantes, encontramos una mejora significativa en las puntuaciones de Health of the Nation Outcome Scales for Children and Adolescents desde el ingreso hasta el alta. El acuerdo en las puntuaciones de esta escala entre los diferentes evaluadores fue débil al inicio, pero mejor al alta. En general, los pacientes y los padres o tutores legales reportaron puntuaciones más bajas de Health of the Nation Outcome Scales for Children and Adolescents (mejor estado de salud) al ingreso en comparación con los profesionales de la salud. Al alta, las puntuaciones fueron homogéneas desde las tres perspectivas. CONCLUSIONES La Health of the Nation Outcome Scales for Children and Adolescents permite la evaluación rutinaria de variables de resultado en salud mental en el entorno de hospital de día de psiquiatría desde la perspectiva de los pacientes, sus padres o tutores legales y los profesionales de la salud.

INTRODUCTION Routine outcome assessment is helpful to inform decision-making, resource allocation, and health policy design. Routine outcome assessment in the hospital setting for children and adolescents with psychiatric disorders remains limited. The clinical instrument HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents), which has recently become available in Spanish and Catalan, allows outcome assessment in this population from the perspective of patients, their parents or legal guardians, and clinicians. HoNOSCA measures 13 areas of health and psychosocial functioning. OBJECTIVES The aim of this study was to assess mental health outcomes in psychiatric day hospital pediatric patients from three perspectives (patient, par-ent/legal guardian, clinician), using the Spanish and Catalan versions of HoNOSCA. METHODS We recruited patients up to 18 years old with any psychiatric disorder at the day unit of the Salut Mental Parc Taulí Hospital Universitari (Sabadell, Catalonia, Spain). We obtained admission and discharge HoNOSCA scores for the patients, their parents or legal guardians, and their clinicians. RESULTS We recruited 99 patients over the study period (January 2015 to December 2017), 11 of which were lost to follow-up. Among the remaining 88, we found significant improvement in HoNOSCA scores from admission to discharge. Agreement between the HoNOSCA scores for the three different groups of evaluators (patients, parents/legal guardians, and clinicians) was weak at admission but better at discharge. In general, evaluations from patients and their parents or legal guardians had lower HoNOSCA scores (indicating a better mental health status) at admis-sion compared to those from clinicians. At discharge, however, the scores were more homogenous across the three groups of stakeholders. CONCLUSIONS Use of HoNOSCA allows for routine evaluation of mental health outcomes in the psychiatric day hospital setting from the perspective of pa-tients, their parents or legal guardians, and clinicians.

Validation of the Spanish and Catalan versions of the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA).

Outcome measurement in outpatient and day-care mental health facilities for children and adolescents in Spain remains limited, in part due to a lack of validated scales. To address this issue, we translated HoNOSCA (glossary, score sheet, self-rated questionnaire, and parent/legal guardian questionnaire) into Spanish and Catalan using a reverse translation approach. We ascertained the validity and psychometric quality of the HoNOSCA in Spanish by assessing correlation with the Children's Global Assessment Scale (C-GAS). We recruited 64 participants 7-17 years of age in five day-care Psychiatry hospitals in Catalonia (Spain). Two evaluators administered both instruments twice, two weeks apart. Patients and parents/legal guardians completed the corresponding HoNOSCA versions. We calculated Cronbach's alpha for assessing internal consistency, intra-class correlation coefficients (ICC) for inter-rater and test-retest reliability, and Pearson's correlation coefficients for validity. We found that all HoNOSCA versions in Spanish presented satisfactory internal consistency, inter-rater and test-retest reliability. Concurrent validity for HoNOSCA-Glossary was also acceptable, with Pearson's coefficients of -0.543 and -0.519 for evaluators in the first administration, and of -0.675 and -0.685 in the second administration. HoNOSCA was also successfully translated into Catalan; acceptability was determined using cognitive interviews.

Crisis in the health sector: Impact on nurses' working conditions. / Crisis en el sector sanitario: impacto percibido en las condiciones de trabajo de las enfermeras.

In a context of economic crisis and policies to reduce the public deficit, the budgets of the Catalan Health Institute (CHI) were cut by 15.33% between 2010 and 2014. OBJECTIVE: To assess the perceived impact on nurses' work conditions of measures to contain health spending. METHOD: The study design was descriptive and transversal. A sample of 1,760 nurses from the province of Barcelona answered a questionnaire on the perceived impact of health spending containment measures implemented in their workplace during the early years of the crisis. RESULTS: Among the main aspects of the perceived impact of these measures, 86.6% of the nurses identified a pay cut and an increase in the following relevant parameters of their working conditions: number of hours worked (66.7%), final ratio of treated patients (35.2%), task complexity and workload (75.3%), rotation through various departments (31.5%), work shifts (21.4%) or work areas (23.4%), job insecurity (58.4%) and loss of employment by dismissal (6.6%) or non-renewal of contract (9%). CONCLUSIONS: The perceived impact of the crisis showed a triple negative component: Pay cut, work overload and job insecurity. As a combined effect of this multiple trend, the nurses acknowledged a deterioration in their working conditions and quality of working life.

Assistance continuity from primary care in an inter-level nursing plan for a case of pediatric liver transplant. / Continuidad asistencial desde atención primaria en un plan de cuidados interniveles para un caso de trasplante hepático pediátrico.

Spain is one of the countries where most solid organ transplants are performed each year, in the year 2014 a 2.7% of them were given in childhood. Given the complexity and severity of this disease it is necessary to establish a care plan that covers both pre-transplant and post-transplant, with close cooperation between different levels of care, to approach the several problems that can appear and assure continuum of care. In the following example, a Gambian teen with risk of social exclusion fostered a collaboration between the primary care nurse and transplant nurse that was the key to continuum care. Multiple strategies were used in the care plan to ensure better adherence and compliance of the treatment. However, the knowledge of the culture of origin must be deepened to establish more individualized care plans and thus improve results. The care plan included problems according to the NANDA, NOC, NIC taxonomy.

[Cardiovascular risk factors in users with severe mental disorder]. / Factores de riesgo cardiovascular en usuarios con trastorno mental severo.

OBJECTIVE: To identify the prevalence of the cardiovascular risk (RCV) in users with a Severe Mental Disorder (SMD) attended in mental health service in ParcTaulí (Sabadell - Barcelona). METHOD: This is an observational, descriptive and transversal study of the factors of cardiovascular risk in 789 users with SMD. The instrument used was the scale of assessment of the Registre Gironí del Cor, which estimates the risk of cardiovascular disease. RESULTS: 26.6% of the sample has RCV (22.5% moderate, 3.8% high and 0.3% very high). The analysis of the modifiable risk factors shows that 16.5% of the patients are hypertensive, 55.2% are smokers, 19.77% have hyperglycaemia (8.2% of whom are diagnosed of diabetes mellitus), 40.2% have obesity, 36.2% overweight and 47.27% hypercholesterolemia. CONCLUSIONS: The study confirms that the prevalence of the RVC in SMD users is greater than the RCV in general population and it's associated to the presence of modifiable risk factors. Health education carried out by nurses is the best to prevent the RCV in SMD users.

[Choking phobia: care plan in children and adolescents]. / Fobia a tragar: plan de cuidados en la infancia y adolescencia.

Eating disorders are a common problem in childhood. Swallowing phobia is characterised by fear of choking on having consumed food, liquids or tablets. Although they are considered a minor disorder and have low prevalence, there has been an increase in its incidence in children and adolescents in the past few years. The analysis of four cases treated in our day hospital for this specific phobia provides an assessment and the care necessary for its treatment and solution, in collaboration with other professionals and the family. The importance of the role that nurses have in the treatment of this psychological disorder is emphasised, as well admission to Day Units, the correct application of the treatment plan, the establishment of robust and reliable links with the family and the patient, and the motivation for therapeutic change by the whole family. It is essential to include the disorder in the differential diagnosis of eating disorders in children, as well as knowledge of this by community workers, in order to establish adequate early treatment to improve therapeutic outcomes.

[Nursing intervention in the family treatment plan for anorexia nervosa]. / Intervención enfermera en el plan terapéutico familiar de la anorexia nerviosa.

One of the main nursing interventions in the treatment of eating disorders is family psycho-education, an essential aspect of mental health treatment. This article describes and analyses the difficulties families expressed in the performance of a treatment plan for patients hospitalised for anorexia nervosa (AN) in the adolescent Day Hospital of Mental Health, of the Corporació Sanitària Parc Taulí, during 2009. Data was also collected data on professional interventions, performed by the nurse assigned to this unit, in order to group and categorise them, and as an aid to nursing intervention. A total of 10 families of the 10 patients admitted with a diagnosis of AN were included in the study period. In all cases, the patients were young women who had received treatment before in an Outpatient Unit, with partial or no response to the treatment. The difficulties expressed by the families were grouped into five categories from content analysis: problems in preparing a balanced diet, problems as they are unable to handle the behaviour and emotions of the patient, problems because as there are no previous family eating habits, problems because there is no family control or supervision, and problems with the established guidelines. Specific individualised interventions are proposed for developing and promoting a nursing care plan, and assessing the results.

[Profile of adolescents with social withdrawal admitted to a partial hospitalization unit of Mental Health]. / Perfil de los adolescentes con retraimiento social ingresados en una Unidad de Hospitalización Parcial de Salud Mental.

OBJECTIVE: To analyse the general characteristics of teenagers admitted to the Day Care Unit who fulfilled the criteria of social withdrawal, in order to implement a specific action plan within the existing resources for adolescents. METHOD: In this retrospective descriptive observational study, data were collected from withdrawal adolescent teenagers admitted to the unit over the year 2008. The data analysed were personal variables, diagnostic assessment on discharge, IQ assessment and Scale for Assessment of Communication and Interaction Skills and truancy. RESULTS: Of the 76 adolescents admitted to the unit, a total of 33 teenagers with social isolation were included in this study (43%). They had an average age of 15 years, an equal distribution between sexes and with a stay in the Unit 33 days longer than the general population studied. The average intellectual quotient of the social isolation group did not exceed the lower zone of the Weschler Scale (<80), and they scored below 50 points in the Scale for Assessment of Communication and Interaction Skills. CONCLUSIONS: The present research has enabled us to quantify the withdrawal phenomenon and some of its characteristics in a sample of adolescents admitted to the unit, in order to develop an interdisciplinary treatment program that allows us to address social withdrawal using a more holistic and effective approach.