Cultural adaptation and validation of the nursing students' perceptions of instructor caring into spanish.

OBJECTIVE: This paper aims to provide a Spanish version of the nursing students'' perceptions of instructor caring with content validity and reliability. METHODS: A forward and backward translation procedure was conducted, and a panel of 15 experts assessed face validity. Content validity was established by calculating content validity indexes for each item and for the scale. The internal consistency was assessed in a sample of 120 students. RESULTS: Content validity indexes resulted in higher than 0.78 for all items except Does not reveal any of his or her personal sides and serves as a trusted resource for personal problem solving; content validity index for the scale was 0.9 and Cronbach α was 0.942. DISCUSSION: Results regarding reliability were similar to that of other studies in which the nursing students' perceptions of instructor caring has been used as a measuring tool. Item 12 deletion implies a considerable improvement in internal consistency. CONCLUSION: The Spanish nursing students' perceptions of instructor caring is a valid and reliable tool to be used in the Spanish context. Its use will enhance the understanding of clinical mentors' impact on nursing students.

[Change of care model in natural childbirth: Implementation in La Ribera delivery room]. / Cambio de modelo asistencial en la atención al parto normal: aplicación en el paritorio de La Ribera.

OBJECTIVE: To assess knowledge, wish for inclusion and implementation of normal childbirth care protocols at La Ribera University Hospital, the reason why they are not applied, and to assess the attendance at antepartum training activities. MATERIAL AND METHOD: Cross-sectional descriptive study. They were carried out 186 surveys by convenience sampling to pregnant women attending fetal well-being control at hospital between 2014 and 2015. They were collected data about knowledge, wish for inclusion, compliance of protocols and reasons for non-compliance, and attendance at antepartum training activities. Percentages and confidence intervals were calculated. Chi-square test was used to compare categorical variables. RESULTS: They were collected percentages of knowledge (77%, CI95%: 75,5-78,5) and wish for inclusion (84,6%, CI95%: 82,5-86,7). Protocol compliance ranged from 6% (nitrous oxide administration) to 91% (skin-to-skin contact). The main reasons for non-compliance were due to circumstances of childbirth process (56,3%, CI95%: 51,1-61,5). Attendance at maternal education classes was 62%, mainly primiparous women (p=0,0001) with medium or high education level (p=0,001). CONCLUSIONS: Pregnant women have a high knowledge and wish for inclusion of normal childbirth care protocols. Attendance at antepartum training activities could by improved and the main reason for non-attendance is lack of information. Compliance is good enough in most protocols; when they are not applied is due to childbirth circumstances. Remaining tasks include the introduction of additional protocols and to involve pregnant women in decision-making.

The use and usefulness of information for patients undergoing anaesthesia.

Informed consent is a process rather than just simply the signing of a form. It should provide the patient with the information and understanding needed to authorize a procedure. The aim of the present study was to try to understand the patient's attitude to, and understanding of, the pre-anaesthesia informed consent (IC) document. A prospective descriptive study was made of 159 adults who attended a pre-operative consultation prior to programmed surgery at a teaching hospital. The patients were given a questionnaire on different aspects of the pre-anaesthesia IC document they had signed (ease of understanding and other aspects of the information received and expected) and five questions on how well they remembered the information given in the IC form they had read previously. A series of epidemiological variables, anaesthesia and surgery-associated risks (ASA) and whether the patients had undergone anaesthesia previously, were evaluated. The mean age of the study population was 55 (SD:19.63), with 36% over the age of 65, while 77% had not received secondary education. 21% of the patients who signed did not read the document and 14% found it difficult to understand. 89% found the information sufficient and 46% said they preferred to receive such information in written form. 64% had no or very little recall of the information they had been given, the proportion of those making this claim being in direct relation with age over 50 years and low level of studies. The findings suggest that improvements are needed in the pre-anaesthesia informed consent document so that, rather than serving as a mere legal prerequisite, it fulfils its purpose of providing the patient with the information necessary and in a clearly understood way so that he/she can authorize the proposed surgery.

Assessment of evidence and quality of clinical practice guidelines on deterioration of skin integrity: ulcers and chronic wounds / Evaluación de las evidencias y calidad de las guías de práctica clínica sobre deterioro de la integridad cutánea: úlceras y heridas crónicas.

Background. The epidemiological, social, and economic situation that surrounds the deterioration of skin integrity is a big problem for the health system. Its prevention and treatment create uncertainty and professional variability and it remains a priority to have good clinical practice guidelines (CPG). The objective was to determine the quality of the CPG on prevention and treatment of pressure ulcers (PU), venous ulcers of the leg (VUL) and diabetic foot ulcers (DFU). Methodology. Systematic review of the quality of Spanish and international CPG on PU, VUL and DFU. Bibliographic search in specialized sources. Selection of CPG, not older than 5 years (2010-2015). Use of the AGREE Instrument II and revision by 4 experts. Descriptive statistics. Results. Twenty-three CPG (10 PU, 6 VUL and 7 DFU), of which 4 were Spanish and 19 international. Eight CPG on PU, 3 VUL and 5 DFU were considered "Highly Recommended". Domain nº 2 (participation) and Domain nº 5 (applicability) were the worst valued. The quality of the evidence was "very good" in 19 GPC. The best CPG were the British NICE (PU), the Australian AWMA (VUL) and the Canadian RNAO (DFU). Conclusions. We observed a good methodological quality in the CPG on PU and DFU, but there needs to be improvement in the VUL. In general, it would be necessary to increase the participation of users, and describe possible barriers for the implementation of the CPG in clinical practice.

The cost of infection in hip arthroplasty: a matched case-control study. / El coste de la infección en artroplastia de cadera: estudio de casos y controles emparejado.

OBJECTIVE: Surgical site infection (SSI) represents 30% of all causes of health care-associated infection (HAI) and is one of the most dreaded complications in surgical patients. We estimated the excess direct costs of SSI using a matched nested case-control study in acute-term care at Ramon y Cajal University Hospital in Spain. MATERIAL AND METHOD: Cases were patients who developed a first episode of SSI according to the criteria established by the CDC's National Healthcare Safety Network. Controls were matched to cases in 1:1 ratio taking into account the American Society of Anesthesiologists score, age, sex, surgery date, and principal diagnosis. RESULTS: This study found that infection in hip replacement increased direct costs by 134%. Likewise, the excess cost due to the infections caused by methicillin resistant Staphylococcus aureus was 69% higher than the excess cost attributable to infections caused by other microorganisms. CONCLUSIONS: SSI after hip replacement continues to be a costly complication from the hospital perspective. Costs due to SSI can be used to prioritise preventive interventions to monitor and control HAI.

[Nursing care for myelomeningocele in infancy]. / Mielomeningocele en la infancia (I). Cuidados enfermeros.

After studying the factors which most often lead to the hospitalization, recuperation and treatment facilitating release from hospitalization of newborns affected by myelomeningocele, we present this treatment plan. One commences with an evaluation, after which various problems are detected. Once identified, establish priorities setting objectives to meet and their corresponding dates; continue by drawing up an action plan which lists those activities that help achieve one's objectives. The purpose of this plan is to provide individualized quality treatments as well as to create a relaxed, confidential atmosphere in which parents express their fears while becoming secure in their practice of those treatments their child needs in their home.

Intraocular pressure in 528 university students: effect of refractive error.

BACKGROUND: Very few studies measuring the intraocular pressure (IOP) in students are available. Recognizing the higher prevalence of myopia among students, IOP was analyzed in 528 university students according to age, gender, and refractive error. METHODS: The IOP was measured in 1,056 eyes with the Keeler Pulsair noncontact tonometer. The refractive error was determined with an autorefractometer (Shin-Nippon brand, model QR-007). RESULTS: The analysis of variance (ANOVA) showed no significant influence of age and gender on students' IOP (mean IOP, 15.77 +/- 2.67 mmHg). Refractive error did not significantly influence the mean of IOP (ANOVA) in the different categories: (a) severe myopia, (b) medium myopia, (c) emmetropia and mild ametropia, and (d) hypermetropia. The chi 2 test revealed significant differences, as a result of age, between the eyes with IOP < 21 mmHg or > or = 21 mmHg (6.3%). Nevertheless, there was no significant IOP difference as a result of gender or refractive error among eyes with normal IOPs and eyes with IOP above 20 mmHg. CONCLUSIONS: Among university students, intraocular pressure is not influenced by age, gender, or refractive status. Likewise, except for age, there is no significant correlation between any of the other variables and the normal range of IOP. After the age of 25 years, there is a slight increase in the number of eyes with an IOP above 20 mmHg.

[An epidemiological study of congenital dyschromatopsias in schoolchildren]. / Estudio epidemiológico de las discromatopsias congénitas en escolares.

BACKGROUND: Taking into consideration that present-day communication is based on colours and shapes, the prevalence of anomalies in the chromatic sight in the red-green axis has been studied in the school boys of the city of Albacete. METHODS: The test of Ishihara has been used in an aleatory representative sample; and dyschromatopsic pupils, so classified in this test, have been further explored with the anomaloscopy Pickford-Nicolson, in order to know their anomaly kind and degree. RESULTS: The prevalence obtained is similar to those reported by other studies carried out in the European white race. CONCLUSIONS: Taking into account the transcendence of this phenomenon, we consider that this exploration must be included in the systematic examinations at school labour and general level.

[Development of a health education program prior to a hepatitis B vaccination campaign among hospital personnel]. / Desarrollo de un programa de educación sanitaria previo a una campaña de vacunación contra la hepatitis B en personal hospitalario.

The hepatitis B (HB) is the most frequent occupational infection in health care workers, and HB vaccination the best way to prevent it. Although sanitary staff participation in vaccination programs in rather small, it is enlarged after the previous information. In order to increase staff participation in a second vaccination program, we have developed an information campaign in our hospital. In an inquiry to a sample of not vaccination personnel (87/304; 28.6 per 100), we got the following answers: 92.9 per 100 declared HB as dangerous, 95.4 per 100 believed there was a greater risk for the hospital staff, 87.4 per 100 asked for more information (spoken preferably), and 85.1 per 100 accepted vaccination. However, at the beginning of the campaign, the attachment was reduced to 57.9 per 100. In spite of this decrease, we believe that the acceptance rate of unwilling personnel is the result of the information provided.