Breast cancer survivors suffering from lymphedema: What really do affect to corporeality/body image? A qualitative study.

Breast cancer-related lymphedema is currently one of the most serious complications that most affect the quality of life of women undergoing breast cancer. The aim of this study was to explore in-depth the experience of women who suffer from lymphoedema after breast cancer and how does this condition affect corporeality, with no judgements. For this purpose, a qualitative methodology was followed. In-depth interviews, interviewer's field notes and participants' letters were used for data collection. The participants were twenty Spanish women with lymphoedema after overcome a breast cancer in the past. Healthcare specialists with experience in the topic were also included. Results showed 2 main categories: "From cancer to lymphedema, another disease another disease" and "Potential for transition and transformation towards a new way of life". As a conclusion, the difficulty in accessing adequate treatment, the need for greater awareness of lymphedema and the importance of the emotional and psychological dimension of this chronic disease. Highlighting the attitudes that these women develop for self-care and the concept of new corporeality. After breast cancer, women with lymphedema experience a drastic change that affects all areas of their lives. The adaptation process, and the search for resources and aid, play a fundamental role in overcoming this process.

Using a station within an objective structured clinical examination to assess interprofessional competence performance among undergraduate nursing students.

AIM/OBJECTIVE: To describe and analyse the use of a station within an OSCE to assess interprofessional competence performance in undergraduate nursing students. The specific objectives were: - To measure the students' level of competence performance in relation to the interprofessional competences Roles and Responsibilities, Communication and Teamwork. - To determine inter-observer concordance in the assessment of the interprofessional competences. BACKGROUND: Teamwork competencies are key to improving patient safety and avoiding medical errors. Today, healthcare professionals work in interdisciplinary teams. To foster a culture of safety, some of the measures that can be taken at the individual, team and organisational levels include fostering clear communication among team members, knowledge of respective roles and functions, and deepening team functioning through respect and trust in judgement and capabilities. The World Health Organization recommends starting to develop these competencies in university studies, through interprofessional education. There are numerous programmes in universities all over the world, but more research is needed on the assessment of interprofessional education activities, preferably through objective methods. Competency performance can be assessed by an external evaluator, in a simulated environment, with the Objective Structured Clinical Examination, which is widely used in nursing. DESIGN: Cross-sectional study. METHODS: 63 second-year nursing undergraduate students completed an interprofessional competencies station within an 8-station OSCE. Communication, Roles and Responsibility and Teamwork competences were assessed. The Interprofessional Collaborator Assessment Rubric (ICAR) was used as a model to assess the performance of students. Inter-observer concordance analysis was performed using the kappa coefficient and the concordance rate. RESULTS: 92.1% of students reached a good level in communication competence, 88.9% in roles and responsibility competence, and 55.6% in teamwork competence. The global concordance rate was 83.8%, and the kappa coefficient was 0.67. CONCLUSIONS: Most students have demonstrated interprofessional competence performance at a good level. However, the inter-observer concordance obtained for some of the items was not as expected. The assessment of interprofessional competencies, as it deals mainly with relational and communicative aspects, requires greater preparation both in terms of the specification of assessment items and in agreement between examiners.

Nevus anemicus: a distinctive cutaneous finding in neurofibromatosis type 1.

Nevus anemicus (NA) is a cutaneous anomaly characterized by pale, well-defined patches with limited vascularization after rubbing. They are largely known to be associated with neurofibromatosis 1 (NF1) and have received little attention in the literature until recently. We sought to characterize the prevalence and clinical features of patients with NA and NF1. We conducted an observational prospective study of 99 children with NF1 at the Hospital Niño Jesús, Madrid, Spain, from January 1, 2012, through July 31, 2013, and reviewed three other series of patients with NF1 and NA recently reported. The prevalence of NA in children with NF1 ranged from 8.8% to 51%, being much more prevalent at younger ages. Prospective studies yielded a higher prevalence than retrospective studies. NA was located most commonly on the trunk, particularly on the anterior chest wall, and was often multiple. Patients with segmental NF1 or isolated café au lait spots rarely had NA, and NA was absent in other genodermatoses. The collection of data was not homogeneous in all studies. NA has a high prevalence in individuals with NF1 patients but seems to be absent in connection with other genodermatoses, therefore its presence can assist in the diagnosis of suspected cases of NF1. The subtle clinical appearance of NA makes its detection difficult, and physicians involved in the care of children with NF1 must be aware of its possible presence and significance.

[NURSING ACTION BEFORE THE TERMINAL PATIENT PHYSICAL CARE]. / Actuación de enfermería ante e culdado físico en el paciente terminal.

Palliative care is a group of actions performed by nurses in order to increase the comfort and well-being of patients with terminal illnesses. The World Health Organization (WHO) defines this term as: An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual [1]. Cicely Mary Strode Saunders is considered as the precursor of the palliative care, who explained the need to change the Palliative Care Units in order to improve the quality of life of patients with terminal illnesses. Palliative care is necessary for patients with a terminal illness. In such cases, the life expectancy is less than six months. Human being is considered a biopsychosocial model. For this reason, the nurse must take into account all the requirements arising from these three dimensions of the human being. In this essay, we deal with palliative care in patients with terminal illnesses, considering the role of the nurse as an important reference when teaching palliative care to the main carer.

[Problem-based learning, a comparison in the acquisition of transversal competencies]. / Portafolio y aprendizaje basado en problemas (ABP).

In the European Higher Education Area (EEES in Spanish reference), a change in the pedagogical model has occurred: from teaching centered on the figure of the professor to learning centered on students, from an integral perspective. This learning must bring together the full set of competencies included in the program requirements necessary to obtain a degree. The specific competencies characterize a profession and distinguish one from others. The transversal competencies surpass the limits of one particular discipline to be potentially developed in all; these are subdivided in three types: instrumental, interpersonal and systemic. The authors describe and compare the acquisition of transversal competencies connected to students' portfolios and Problem-based Learning as pedagogical methods from the perspective of second year nursing students at the European University in Madrid during the 2007-8 academic year To do so, the authors carried out a transversal descriptive study; data was collected by a purpose-made questionnaire the authors developed which they based on the transversal competencies of the Tuning Nursing Project. Variables included age, sex, pedagogical method, perception on acquisition of those 24 competencies by means of a Likert Scale. U de Mann-Whitney descriptive and analytical statistics. The authors conclude that the portfolio and Problem-based Learning are useful pedagogical methods for acquiring transversal competencies; these results coincide with those of other studies. Comparing both methods, the authors share the opinion that the Problem-based Learning method could stimulate the search for information better than the portfolio method.