Symptomatology and knowledge regarding pelvic floor dysfunctions and influence of gender stereotypes in female athletes.

Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions.

Determinants of Communication Failure in Intubated Critically Ill Patients: A Qualitative Phenomenological Study from the Perspective of Critical Care Nurses.

AIM: To explore what factors determine communication with awake intubated critically ill patients from the point of view of critical care nursing professionals. BACKGROUND: Impaired communication frequently affects mechanically ventilated patients with artificial airways in the intensive care unit. Consequences of communication breaches comprise emotional and ethical aspects as well as clinical safety, affecting both patients and their conversation partners. Identification of determining factors in communication with awake intubated patients is needed to design effective action strategies. DESIGN: A qualitative phenomenological approach was used. METHODS: Semi-structured interviews were used as the data collection method. A total of 11 participants from three intensive care units of three Majorcan public hospitals, selected by purposive sampling, were interviewed. FINDINGS: Three major themes regarding the communication determinants of the awake intubated critically ill patients were identified from the interviewees' statements: factors related to the patient (physical and cognitive functionality to communicate, their relational and communicative style and their personal circumstances), to the context (family presence, ICU characteristics, workload, availability/adequacy of communication aids, features of the messages and communication situations) and, finally, those related to the professionals themselves (professional experience and person-centredness). CONCLUSIONS: The present study reveals determinants that influence communication with the awake intubated patient, as there are attitudes and professional beliefs. RELEVANCE TO CLINICAL PRACTICE: The discovery of relations between different kinds of determinants (of patient, context or professionals) provides a multi-factor perspective on the communicative problem which should be considered in the design of new approaches to improve communicative effectiveness. This study is reported according to the COREQ checklist.

The emotional impact of COVID-19 on Spanish nurses and potential strategies to reduce it.

Background: Although the emotional and psychological impact of nurses' work had been identified before the COVID-19 pandemic, the pandemic aggravated risk indicators for their mental health. Aim: The objective of this study was to analyse the levels of anxiety, depression, post-traumatic stress and burnout of nurses in the Balearic Islands (Spain) during the pandemic to identify possible sociodemographic and related occupational factors. Design: A cross-sectional study of 892 nurses was conducted during four weeks from February to March 2021. Methods: Sociodemographic data related to the pandemic were collected and anxiety, depression, burnout and post-traumatic stress were measured with validated scales. A multivariate and predictive analysis was carried out with risk estimates. Findings: About 75.6% of the nurses had experience in COVID-19 units, and 49.1% had worked for more than 10 months in a COVID-19 unit. Nurses in COVID-19 units (hospital ward or ICU) were more likely to report emotional fatigue (OR 1.9, p < 0.001) and anxiety (OR 1.5, p = 0.021). In general, moderate post-traumatic stress was evident in general nurses (p = 0.027), and severe post-traumatic stress was evident in ICU nurses (p = 0.027). A 1.24-month reduction in COVID-19 patient care predicted reduced levels of emotional fatigue (5.45 points), depersonalisation (1.87 points) and post-traumatic stress (4.65 points) in nurses. Conclusion: Given the occurrence of new waves of COVID-19, the need to establish preventive strategies that focus on the personal and occupational characteristics related to these indicators and to implement urgent psychological support strategies is demonstrated. Impact: Given these findings, it is imperative solutions are urgently applied in order to prevent compounding risk to the health system.

Self-Perceptions and Behavior of Older People Living Alone.

It is currently acknowledged that older people prefer to live in their own home, even if they are lonely or disabled in some way. The factors that condition aging among older people members of the population living alone include the following: the existence or absence of a social network, gender, the home or place where they live, their capacity to function, and welfare and health resources. The main goal of this study was to explore the perceptions of older peoples over 75 years old about adaptation strategies and the social, gender, physical autonomy, and socio-health resource factors that determine their permanence at home. The authors used a qualitative methodology, within a critical social framework, based on the theories of Pierre Bourdieu. When the interviewees' discourse was analyzed, four main categories were evident: (a) "A desire to stay at home", (b) "Changes and every-day aspects of domestic life", (c) "Reliance on social and family assistance", and (d) "The use of social services and resources". In synthesis, the participants questioned the benefits of the type of home life offered by members of the family. They believed that, in some cases, this option did not overcome the problem of loneliness or the need to hire assistance. The findings of the study revealed that one needs to dispel the notion of geriatric care as a form of charity, and to distinguish between the activities of caring, providing support, and offering companionship to someone. It is important to identify products designed for older people who might live for a long time.

Emergency and Mental Health Nurses' Perceptions and Attitudes towards Alcoholics.

Knowing professionals' attitudes is the basis for the development of skills for dealing with drug dependence. These attitudes may affect patients' clinical safety and the cost-benefit ratio of the interventions. The goal of this study was to assess emergency and mental health nurses' attitudes and perceptions towards alcoholics. A multicenter prospective descriptive study was conducted in six hospitals with 167 emergency and mental health nurses. Nurses classified alcoholics as sick individuals, although there was a tendency to feel uncomfortable working with them. Results indicated that these professionals had a rejecting attitude towards moderate alcohol consumption. It found that there was a significant association between the attitude of the nurse and gender, with the degree of rejection towards the alcoholic being higher in men than in women, and with less punitive attitudes in professionals with 0 to 11 years of professional experience.