Ten steps to transform ideas into product innovations: An interdisciplinary collaboration between nursing and engineering.

AIMS: To describe the development process of a device from the conception of the idea to the first contact with the commercial environment, and to demonstrate its practical application through an interdisciplinary collaboration between nursing and engineering for the design of a protective device for peripheral venous catheters. BACKGROUND: Nurses are key agents for identifying unresolved needs or problems related to nursing care. To address these needs, creative ideation processes are often triggered among nurses to seek technological answers to these challenges. RESULTS: The ten steps to develop a device are presented: (1) detecting an unsatisfied clinical need; (2) searching for preexisting marketed products; (3) searching for patents; (4) maintaining confidentiality throughout the process; (5) obtaining institutional support; (6) forming a multidisciplinary team; (7) developing the idea; (8) applying for a patent; (9) building the prototype; (10) marketing the device. This methodology was applied to design a protective device for peripheral venous catheters in hospitalized patients. CONCLUSIONS: Nurses can play a key role in the promotion of healthcare innovation in their field to improve procedures, thanks to their direct contact with patients, and by providing their insight on devices that can enhance patient care. The successful interdisciplinary collaboration between nurses and engineers can provide a response to relevant clinical problems such as the manipulation or removal of peripheral venous catheters. IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: A hospital policy is required to encourage the participation of nurses in innovative actions. Furthermore, it is important to support nurse leaders who can play a pivotal role in incorporating creativity into work environments and empowering other nurses to innovatively address clinical issues. NO PATIENT OR PUBLIC CONTRIBUTION: This article describes the process for developing a health device.

Prenatal and Birth Care of Roma Women.

BACKGROUND: The reproductive health of Roma women has been poorly studied. It is important to determine the follow-up care received by Roma women from pregnancy to the first postpartum visit, together with neonatal outcomes, to improve prenatal care and maternal-child outcomes. OBJECTIVE: The aim of this study was to examine differences in prenatal care and maternal-infant outcomes between Roma and non-Roma women. METHODS: A retrospective longitudinal study was conducted in 122 pregnant women (28 Roma and 94 non-Roma women) recruited from seven primary care centers in three districts of Asturias (Spain). Sociodemographic variables, prenatal control, birth characteristics, feeding, and neonatal outcomes (gestational age, weight, and APGAR [appearance, pulse, grimace, activity, and respiration]) were collected from the electronic medical records. Prenatal care was assessed using three indices: the Kessner index, the Modified Adequacy of Prenatal Care Utilization Spanish Index, and an ad hoc index that considered adherence to the recommendations for pregnant women in Spain. RESULTS: Compared with non-Roma women, advanced maternal age (≥35 years) and primigravida were less common among Roma women. Roma women visited the dentist less often, smoked more, and underwent group B streptococcus screening less frequently. No differences were found in the number of prenatal visits between Roma and non-Roma women. Consequently, there were no differences between the Kessner index and the Modified Adequacy of Prenatal Care Utilization Spanish Index. Using the ad hoc index, the non-Roma women more frequently had adequate prenatal visits. There were no differences in birth characteristics, type of feeding, and neonatal outcomes. DISCUSSION: Overall, prenatal care was slightly worse in Roma women; however, this did not imply worse neonatal health outcomes. Both study groups had similar birth characteristics and immediate puerperium, including feeding.

Differential characteristics of cases of patients diagnosed with pneumonia and delayed discharge for non-clinical reasons in Northern Spain.

BACKGROUND: Delayed discharge for non-clinical reasons is related to a failure to plan for discharge and a lack of availability of intermediate care resources as an alternative to acute hospitalisation. The literature concerning the relationship with pneumonia is scarce. At present, the coronavirus pandemic is a new cause of complicated pneumonias that can further affect the functionality of the most fragile patients. OBJECTIVE: The aim of this study was to understand what characteristics are typical of patients affected by pneumonia, compared with other cases of delayed discharge. METHODS: A cross-sectional study was conducted. All cases of delayed discharge were studied at the hospitalisation units of a general university hospital in Northern Spain from 2007 to 2015. In order to compare the differential characteristics of the groups of patients with pneumonia with the total Student's T-test and Pearson's chi-square test (χ²) were used. RESULTS: 170 patients were identified with a diagnosis of pneumonia and delayed discharge for non-clinical reasons during the study period. These cases accumulated a total of 4790 days of total stay, of which 1294 days corresponded to the prolonged stay. The mean age of the patients was 80.23 years. The mean DRG weight was 2.28 [SD 0.579], and 14.12% of patients with pneumonia and delayed discharge died. So, patients with pneumonia were older (P = .001), less complex (P = .001) and suffered greater deaths compared with the remaining patients (P = .001). CONCLUSIONS: The sum of these factors has to do with comorbidities and complications associated with ageing and the characteristics of conditions such as aspiration pneumonia.

Contribution of students to nursing practice settings during clinical training: Design and validation of a questionnaire.

BACKGROUND: A validated questionnaire to measure the contributions of nursing students to clinical settings could potentially assist in the improved management of students in healthcare institutions. AIM: To develop and test the psychometric properties of the questionnaire 'Nursing Student Contributions to Clinical Settings' (CEEEC, Spanish acronym for 'Contribuciones de los Estudiantes de Enfermería a los Entornos Clínicos'). DESIGN: Instrument design and psychometric testing. PARTICIPANTS/SETTINGS: A multicentre study involving 1,098 nursing professionals from three universities and five hospitals of Spain, between January 2019 and March 2020. METHODS: The study was carried out in two phases. Phase 1 involved the questionnaire design by experts (n = 28), which required a review of the available literature, cognitive interviews and Delphi rounds, and a preliminary validity study, which included a pilot test with responses from a sample of nurses (n = 143). Phase 2 involved a formal validation with a wider sample of nurses (n = 927), including factor analysis and a study of convergent validity with the Practice Environment Scale-Nursing Work Index and Health Sciences-Evidence Based Practice. RESULTS: Experts selected 42 items on student contributions. After cognitive interviews, three items were eliminated and seven failed to reach the minimum content validity index (78%). Based on the remaining 32 items, the discrimination index of each item was calculated, and those with <0.3, eight items were sequentially eliminated. The resulting questionnaire contained 24 items grouped into a single factor, which explained 41% of the variance. The internal consistency was excellent (Cronbach's alpha: 0.94), and the convergent validity was confirmed. CONCLUSIONS: A 24-item questionnaire was designed and validated to measure the contributions of nursing students to clinical practice settings. IMPACT: Most hospitals are also teaching centres where nursing students undergo clinical practice. The application of this test will provide insight into the nursing professionals' perception of the students' role.

A mixed-methods study to evaluate the acceptability of information leaflets for breast cancer screening.

AIMS AND OBJECTIVES: To obtain feedback regarding the comprehension and acceptability of an information leaflet on breast cancer screening among women. BACKGROUND: Women usually receive a leaflet inviting them to participate in breast cancer screening programmes for early detection of breast cancer. These leaflets include relevant information about mammograms to aid with decision-making. It is important to know how the target population perceives these leaflets, as this may influence the attitude towards breast cancer screening. DESIGN: A mixed-methods study (concurrent triangulation design). METHODS: Participants were 41 women aged between 40-60 years in the north of Spain. The leaflet included information about breast cancer, mammograms, benefits/risks of screening, and the breast cancer mortality and survival rates in relation to screening. Three written methods were used to assess the leaflet: a readability assessment (Flesch Index) and two comprehension assessments (Cloze and multiple-choice questions). In addition, 26 semi-structured interviews were conducted to explore the women's opinions regarding comprehension, acceptability and the contribution of the leaflet as a decision aid. The COREQ checklist was used to guarantee the quality and rigour of the qualitative study. RESULTS: Overall, women found the leaflet fairly easy to read and most understood the content. Some women found the information on mortality alarming, difficult to understand and a cause for rejection. The leaflet was viewed as a decision aid, although further information was requested on mammograms, the need for complementary tests and the risks and symptoms of breast cancer. CONCLUSION: The leaflet was accepted by women and, overall, easy to understand. The participation of the target population enabled the content and format of the leaflet to be adjusted to their needs. RELEVANCE FOR CLINICAL PRACTICE: Nurses can contribute towards improving the breast cancer screening leaflets, considering women's perceptions surrounding screening.

Evolution of Nursing Workload Indicators Since the Implementation of the Electronic Health Record at a Tertiary Hospital in Spain.

Nurses can be overwhelmed by the growing need for documentation derived from the implantation of electronic health records. The objective was to describe the evolution of nursing workload since the implementation of the EHR. We performed a longitudinal study of global workload indicators over a 5-year period at a referral hospital in Spain since introduction of the EHR (2014). Clinical activity records of each nurse were monitored using audit logs of their accesses to EHRs. During the study period, the number of EHR sessions, the number of EHR sessions in which a nursing order was changed, and the time needed to complete each session significantly increased. The number of mouse clicks and keystrokes and the time required to complete each nursing order decreased. Documentation of the following nursing tasks increased: administration of medication, peripheral vascular catheters, urinary catheters, pressure ulcers, nursing assessment forms, and pre-surgical verification. In conclusion, since the implementation of the EHR, an increase in the workload of nursing professionals-estimated through indirect indicators-has been observed due to greater documentation.

Knowledge of the Human Papillomavirus by Social Stratification Factors.

BACKGROUND: Social determinants of health explain most health inequities. Intermediate determinants dictate differences in the exposure and vulnerability of people based on social stratification. Vulnerable women (lower education level, older age, uninsured, etc.) have lower adherence to recommended Pap smear screening guidelines. However, a gap remains concerning the effect of social determinants on human papillomavirus (HPV) infection. OBJECTIVES: The aim of this study was to analyze the association between the level of knowledge about HPV infection and HPV vaccines with education level and residential setting among a sample of Spanish women. METHODS: A cross-sectional study at six primary care centers (Cantabria, Spain) was performed. All women >21 years consecutively attended by midwives for routine follow-up were invited to participate during the study period (2015-2016) until a convenience sample was recruited. Participants completed an anonymous questionnaire addressing sociodemographic variables (age, education level, and residential setting) and the level of knowledge regarding HPV infection, including general knowledge about infection and knowledge about the HPV vaccine. Associations between education level (primary, secondary, and university) and residential setting (urban, semiurban, and rural) with the level of knowledge of HPV infection and HPV vaccine were calculated using adjusted logistic regressions. Dose-response associations were estimated based on p-trend. RESULTS: Compared to university women, a lower education level was associated with limited or no knowledge of either HPV infection or the HPV vaccine. Women living in rural areas poorly identified "promiscuity" as a risk factor of HPV infection and "the use of condoms" as a protective factor. Moreover, living in rural areas was associated with limited or no knowledge of HPV infection and HPV vaccine. There were significant dose-response trends; those who were more educated and living in more urban areas had more knowledge about either HPV infection or the vaccine. DISCUSSION: In our sample, the level of knowledge of HPV infection and HPV vaccine was high. However, vulnerable women, defined by a lower education level and living in rural areas, presented a greater lack of knowledge regarding HPV infection and the HPV vaccine.

What do we know about the health of Spanish Roma people and what has been done to improve it? A scoping review.

Objectives: This study aims to review the published literature on the health of the Roma population in Spain, particularly that which describes health interventions and outcomes. Design: A scoping review of published articles/reports on Roma population health was carried out in Spain for publications between 2002 and 2014. Articles in Spanish or English were identified from Pubmed, Scopus, Science Direct, Web of Science, Scielo, IBECS, MEDES, Dialnet, Index Foundation, a database of theses and Google Scholar. After an initial assessment of the article title and summary, genetic studies, editorials, reviews and grey literature with incomplete data were excluded. Two independent researchers followed a protocol to analyze the selected papers in terms of general information, methodology, themes, and results or conclusions. Results: Forty studies were selected for inclusion, primarily located through PubMed and Google Scholar. Most of the papers were scientific articles, published after 2007 in Spanish scientific journals (70.0%) followed by institutional reports (20.0%). The main language was Spanish (84.2%). The studies were carried out mainly by public institutions (35.0%) or universities (22.5%). Most (67.5%) followed a descriptive design and nearly half (47.5%) were concerned only with the Roma population. The main thematic areas were: child health (25%), infectious diseases (25%), health and social education context (20%), perceived health and lifestyle (15%), sexual and reproductive health (7,5%) and health services use (7,5%). We found seven intervention studies related to health, educational environment, or social services. Conclusions: There are few publications related to the health of the Roma community in Spain and even fewer related to health interventions and outcomes. Those that are available have focused on areas such as child health or infectious disease outbreaks. It is important to promote health interventions in Roma communities and longitudinal studies that include a comprehensive vision and account for the social determinants of health.

How work setting and job experience affect professional nurses' values.

BACKGROUND:: The development of professional values in nursing is directly related to quality and ethical clinical practise and may also increase practitioner and patients' satisfaction. Some factors, such as work setting or work experience, can influence the importance granted to the professional values of nursing. OBJECTIVES:: To compare in primary care nurses and hospital care nurses the importance granted to professional values and to contrast this perception as a function of professional experience. RESEARCH DESIGN, PARTICIPANTS AND RESEARCH CONTEXT:: Descriptive cross-sectional study. Participants were 380 nursing professionals from the public health system (primary care and hospital care). Three dimensions were analysed: ethics, professional expertise and professional mastery. Data were collected from January to June 2015. ETHICAL CONSIDERATIONS:: We obtained permission from the Ethics Committee and participants' informed consent. FINDINGS:: Hospital care professionals attached more importance to all the values analysed, regardless of their work experience. Ethical values, such as confidentiality and respect for the person, were considered to be very important in both systems. Values related to professional expertise obtained lower scores, especially in primary care. In general, professionals with more than 20 years' experience granted less importance to the values. CONCLUSION:: The professional setting influenced the importance assigned to professional nursing values, and clear differences were observed between primary and hospital care. The domain of ethics was considered the most important. It is necessary to reflect on the significance attributed to professional values, especially in more expert nursing staff.

[Sexual risk behaviours and PAP testing in university women vaccinated against human papillomavirus]. / Conductas sexuales de riesgo y actividades preventivas frente al cáncer de cuello uterino en mujeres universitarias vacunadas frente al VPH.

AIM: To estimate the association between the human papillomavirus (HPV) vaccine and sexual risk behaviour, as well as the participation in the Cervical Cancer Screening Program (CCSP). DESIGN: Cross-sectional study. LOCATION: School of Medicine and Health Sciences, School of Law, and School of Economics and Business (University of Oviedo). PARTICIPANTS: Female university students. MAIN MEASUREMENTS: Information was collected about contraceptive methods, sexual behaviours, HPV knowledge, and participation in the CCSP. Furthermore, proportions and odds ratio (OR) were estimated with their corresponding 95% confidence intervals (95%CI). RESULTS: Approximately two-thirds (67.7%) of the sample was vaccinated against HPV, and 216 women (65.3%) were sexually active. Barrier contraceptive methods were used by 67.6% during their current intimate relationships, being less frequent in non-vaccinated women (54.9% vs. 75.4% in vaccinated female students) (P=.002). The risk of having at least one sexual risk behaviour was higher in non-vaccinated women: OR2.29 (95%CI: 1.29-4.07). In addition, the probability of having a PAP test within the CCSP was higher in non-vaccinated women: OR2.18 (95%CI: 1.07-4.47). CONCLUSIONS: The prevalence of sexual risk behaviours in non-vaccinated women is elevated, and it is related to the lack of use of barrier contraceptive methods. The vaccination against HPV could affect sexual behaviours and the participation in the CCSP. Therefore, the information received by young people about contraceptive methods, sexually transmitted diseases, and cancer prevention should be reinforced.

[Sexist attitudes and recognition of abuse in young couples]. / Actitudes sexistas y reconocimiento del maltrato en parejas jóvenes.

AIM: To explore the association between gender-role attitudes and the recognition of abuse among adolescents and young adults during dating relationships. DESIGN: Cross-correlation study. LOCATION: 57 schools of secondary education, vocational education and university in five provinces of Spain (Huelva, Seville, A Coruña, Pontevedra and Asturias). PARTICIPANTS: 4,337 students aged between 15 and 26 years (40.6% males and 59.4% female) who had a dating relationship that lasted more than a month. MAIN MEASUREMENTS: The Gender Role Attitudes Scale was used, which consists of 20 indicators of egalitarian or sexism attitudes at the family, social and occupational level. The students also reported whether they suffered from recognized abuse (RA), unperceived abuse (UPA), or not abused (NA). RESULTS: In the whole sample, 68.6% declared themselves NA, 26.4% were under a situation of UPA, and 5.0% were RA. The RA group was more frequent among the females (6.3%), ≥18 years (6.4%) and university students (6.9%). UPA was more common in males (30.2%). The most sexist attitudes were found in the occupational dimension and especially in men and adolescents (15-17 years). Less sexist attitudes were associated with a lower probability of experiencing UPA (odds ratio=.71; P-trend<.001). CONCLUSIONS: Sexism seems to hinder the recognition of abuse. Achieving gender equity in adolescence and youth is imperative. Public health efforts should focus on men, as they constitute the group with more sexist attitudes and with higher prevalence of UPA.

[Prevalence of non-vaccinable high risk genotypes of human papillomavirus in the Early Detection of Cervical Cancer Program in Cantabria]. / Prevalencia de genotipos del virus del papiloma humano de alto riesgo no vacunables dentro del programa de Detección Precoz de Cáncer de Cérvix en Cantabria.

OBJECTIVE: To estimate the prevalence of infection with non-vaccinable high risk genotypes of human papillomavirus (HPV). DESIGN: Cross-sectional study. LOCATION: Seven randomly selected health centres in Cantabria (Northern Spain). PARTICIPANTS: All women with an evaluable vaginal smear (n=3,359) between 2010 and 2011. MAIN MEASURES: The variables collected were cytological diagnosis, PCR results, and family planning method. The vaginal smear results were classified with the Bethesda system. The classification by Muñoz et al. was used for typing as oncogenic risk HPV. Proportions and odds ratio (OR) were estimated with corresponding confidence intervals at 95% (95% CI). RESULTS: The prevalence of HPV infection was 2.71% (95% CI: 2.15 to 3.27). The prevalence of high oncogenic risk HPV genotypes was 2.26%; (95% CI: 1.75 to 2.78). The most frequent genotype was 16 (28.89%). More than half of the women were positive for one of the non-vaccinable high risk genotypes: 51 (18.89%) and 58 (13.33%) and 68 (12.22%) or 31 (11.11%). At least two non-vaccinable high-risk genotypes co-existed in 23.33% of women. Younger women (≤30 years) had twice the risk of any HPV infection: OR 2.01 (95% CI: 1.02 to 3.96); and were twice as likely to use condoms compared to hormonal contraceptives, OR 2.09 (95% CI: 1.64 to 2.67). CONCLUSIONS: According to the high percentage of non-vaccinable high oncogenic risk HPV types, there should be a re-think of the prevention strategy in the population, who may have a false sense of protection.

Face-to-face Information and Emotional Support from Trained Nurses Reduce Pain During Screening Mammography: Results from a Randomized Controlled Trial.

Pain and discomfort during breast examination can affect a woman's adherence to breast cancer-screening programs. The aim of this study was to determine whether a nursing intervention protocol that provides verbal information and support to women could reduce pain during mammography. A randomized controlled trial of 436 Spanish women aged 50-69 who attended a breast-screening program was performed. The experimental group received a customized nursing intervention that provided face-to-face information and emotional support during the examination. Pain and anxiety were measured using a visual analogue scale and the State-Trait Anxiety Inventory, respectively. Data regarding several potential confounders were also collected. The adjusted means of pain level in the study group were obtained from multiple linear regressions, and the adjusted odds ratios (OR) and 95% confidence intervals (CI) were obtained via logistic regression. After the intervention, the level of pain was significantly lower (p = .03) in the experimental group (0.98 ± 2.28) compared with the group treated with normal care (1.48 ± 2.29). Consequently, the probability of feeling pain during mammography was lower among women in the experimental group (OR = 0.44; 95% CI: 0.24-0.81). The intervention was more effective among women with the highest anxiety levels (OR = 0.33; 95% CI: 0.11-0.98), who did not expect pain (OR = 0.28; 95% CI: 0.08-0.97), and who did not fear the outcome of the mammography (OR = 0.18; 95% CI: 0.04-0.85). Providing verbal information, as well as supporting the women during the test, is a simple and achievable intervention for nurses and can help to reduce pain during screening mammography.

Association Between Preterm Birth and Parent-Reported Health-Related Quality of Life During the Preschool Years: A Retrospective Matched Cohort Study.

INTRODUCTION: This hospital-based retrospective matched cohort study explored the association between preterm birth (PB) and health-related quality of life (HRQoL) in preschool children. METHOD: PB children were matched by sex and day of birth (1:2) with full-term birth (FTB) children (PB = 89, FTP = 178). The children's parent-reported HRQoL was assessed using the TNO-AZL Preschool Children Quality of Life Questionnaire. The association between PB and HRQoL was examined using conditional logistic regressions. RESULTS: PB children were mostly moderate-to-mild preterm (64%) and exhibited a lower probability of presenting an HRQoL below the median in the sleeping (OR = 0.46; 95% CI = 0.23-0.91) and behavior (OR = 0.46; 95% CI = 0.23-0.85) subscales. Conversely, this probability in communication HRQoL was higher in the PB group (OR = 1.91; 95% CI = 1.01-3.64). DISCUSSION: PB was associated to better sleeping and behavior HRQoL, but poorer communication HRQoL. These findings could imply a potential normalization of developmental outcomes in moderate-to-mild PB.

[Gender violence in nursing students during their dating relationships]. / Violencia de género en estudiantes de enfermería durante sus relaciones de noviazgo.

AIM: To determine the prevalence of gender violence (GV) suffered by student nurses and to identify its relationship with some sociodemographic and personal variables (social support and self-esteem) and their perception about their role as primary care providers. DESIGN: Cross-sectional study. LOCATION: Faculty of Medicine and Health Sciences (University of Oviedo). PARTICIPANTS: Nursing students. MAIN MEASUREMENTS: The CUVINO questionnaire was used. It measures 42 behavioral indicators and 8 GV factors and allows to identify technical and perceived violence during courtship and other related situations. The level of social self-esteem, support and variables related with the nursing role were also measured. RESULTS: Using the standard of "zero tolerance", 85.8% suffered technical violence, mainly by "detachment" and "coercion" (73.3%), while almost 1 in 5 also suffered "physical" violence (18.3%). A lower percentage (9.0%) reported having been really ill-treated, perception related to the global proportion of students who felt trapped (31.7%, P <.001), felt fear (13.8%, P <.001) and a further delay in breaking the relationship (13.2 months vs. 3.6; P <.05). Suffering technical violence was associated with less social support (P <.05) and less social self-esteem (P <.01). Academic training in GV improves recognition. CONCLUSIONS: The prevalence of GV situations between student nurses is very high and recognition is poor. Academic training could improve the perception of the problem, thus it would be desirable to strengthen its inclusion in the university curriculum, together with specific skills training.

[Reacciones de las mujeres ante el folleto del Programa de Detección Precoz del Cáncer de Mama.] / Women's reactions upon reading a leaflet on Breast Cancer Screening Program.

OBJECTIVE: Breast cancer screening (BCS) leaflets are important for outreach and dissemination of BCS programs. Knowing how women perceive these leaflets is relevant to better understand their attitude towards BCS. The objective of this paper was to explore women's reactions regarding BCS leaflet. METHODS: A simple descriptive qualitative design was performed involving women aged between forty and sixty years of age in Asturias (Spain). Twenty-six semi-structured interviews were conducted with women of different socioeconomic profiles in 2018. Thematic analysis was carried out. RESULTS: Reading the leaflet elicited positive emotions such as peace of mind, well-being or gratitude, in addition to fear or anxiety. The women expressed various beliefs about breast cancer (highly prevalent and high survival rates), about BCS (a program aimed at prevention, a normative activity among their peers) and about the relevant role of health services and the media. Ambivalent attitudes towards BCS were detected, related to emotions. CONCLUSIONS: The emotional response after reading the brochure is ambivalent, although most of the women express positive emotions. Women compare the information with previous beliefs, especially regarding breast cancer (BC) and BCS. It is important to understand how certain emotions (especially negative ones) are closely related to the attitude towards BCS.

OBJETIVO: El folleto del Programa de Detección Precoz del Cáncer de Mama (PDPCM) es una importante herramienta de difusión de ese programa. Conocer la percepción de las mujeres sobre ese material informativo es relevante para entender mejor su actitud hacia el PDPCM. El objetivo del estudio fue explorar las reacciones de las mujeres respecto al folleto del PDPCM. METODOS: Se realizó un estudio cualitativo descriptivo en mujeres de entre cuarenta y sesenta años en Asturias (España). Se realizaron veintiséis entrevistas semiestructuradas a mujeres de diferentes perfiles socioeconómicos en 2018. Se realizó un análisis de contenido para identificar inductivamente las categorías emergentes. RESULTADOS: La lectura del folleto despertó emociones positivas como tranquilidad, bienestar o gratitud, pero también miedo o inquietud. Las mujeres expresaron diversas creencias sobre el CM (enfermedad muy prevalente y de elevada supervivencia), sobre el PDPCM (programa dirigido a la prevención y que suponía una actividad normalizada en su entorno) y sobre el relevante papel de los servicios de salud y los medios de comunicación. Se detectaron actitudes ambivalentes hacia el PDPCM y estas actitudes estaban relacionadas con las emociones. CONCLUSIONES: La respuesta emocional al leer el folleto es ambivalente, aunque la mayoría de las mujeres expresan emociones positivas. Las mujeres comparan la información con sus creencias previas, especialmente respecto al CM y al PDPCM. Es importante entender cómo ciertas emociones (especialmente las negativas) están estrechamente relacionadas con la actitud hacia este programa.

[Feeding and growth patterns in preterm children at 3-4 years of age]. / Patrones de alimentación y crecimiento de los niños prematuros a los 3-4 años de vida.

Introduction: Aim: to describe the feeding and growth patterns of preterm-born children at preschool age, considering feeding problems based on behaviours and skills, diet quality and parental feeding practices. Methods: a cross-sectional study was performed on preterm children born in Asturias (Spain) in 2016 (n = 94). When preterm-born children reached 3-4 years of age their families were asked to complete the Behavioral Pediatrics Feeding Assessment Scale and a food frequency questionnaire to identify possible feeding problems and assess diet quality (KIDMED index), respectively. Self-reported anthropometric data were also collected to assess weight growth. Electronic health records were reviewed to gather gestational and neonatal clinical data. Results: feeding problems were found in 7.4 % of children and 20.2 % of parents. According to the KIDMED index, 25.5 % of children had a high-quality diet. Feeding problems were higher in children born before 32 weeks of gestation, and decreased in frequency as the gestational age increased (p = 0.030). No differences were found in parental feeding practices (p = 0.455) or diet quality according to gestational age (p = 0.399), but body weight at 3-4 years was lower in preterm-born children (p = 0.015). Conclusions: feeding patterns of preterm-born children were suitable at the age of 3-4 years, but diet quality was moderate to poor in the majority of children. Follow-up of very preterm children beyond 3-4 years of age becomes necessary as they displayed more feeding problems and lower body weight.

Introducción: Objetivo: describir el patrón de alimentación y crecimiento de los niños prematuros en edad preescolar, incluyendo los problemas de alimentación basados en sus conductas y habilidades, la calidad de la dieta y el afrontamiento de sus padres. Métodos: estudio transversal de niños prematuros nacidos en Asturias en 2016 (n = 94). A los 3-4 años se contactó con las familias y se utilizó el cuestionario Behavioral Pediatrics Feeding Assessment Scale para identificar problemas en la alimentación, y el índice KIDMED para resumir la calidad de la dieta. También se recopilaron datos antropométricos autoinformados para evaluar el crecimiento ponderal. Se revisaron las historias clínicas electrónicas para recopilar información gestacional y neonatal. Resultados: el 7,4 % de los niños y el 20,2 % de los padres presentaron problemas relacionados con la alimentación infantil. El 25,5 % tenían un patrón dietético de alta calidad. En los prematuros < 32 semanas se identificaron más conductas alimentarias alteradas, disminuyendo su frecuencia al incrementarse su edad gestacional (p = 0,030). No se observaron diferencias en las conductas de los padres (p = 0,455), ni en la calidad de la dieta según la edad gestacional (p = 0,399), pero sí en el peso, que fue menor en los muy prematuros (p = 0,015). Conclusiones: el patrón de alimentación de los prematuros a los 3-4 años y las estrategias de sus padres fueron adecuados, y la calidad de la dieta moderada. Es importante un adecuado seguimiento de los prematuros con menor edad gestacional, ya que presentaron más dificultades en la alimentación y menor peso.

Patient deaths during the period of prolonged stay in cases of delayed discharge for nonclinical reasons at a university hospital: a cross sectional study.

Background: Delayed discharge for non-clinical reasons also affects patients in need of palliative care. Moreover, the number of people dying in hospitals has been increasing in recent years. Our aim was to describe characteristics of patients who died during prolonged stay, in comparison with the rest of patients with delayed discharge, in terms of length of hospital stay, patient characteristics and the context of care. Methods: A descriptive cross-sectional study at a high complexity public hospital in Northern Spain (2007-2015) was conducted. To compare the differential characteristics of the groups of patients died during delayed discharge with the rest, Student's T test and Pearson's chi-square test (χ 2) were used. Results: A total of 198 patients died (6.57% of the total), with a mean total stay of 27.45 days and a prolonged stay of 10.69 days. Mean age 77.27 years. These were highly complex cases, 77.79% resided in the urban area, were admitted urgently (95.45%), to internal medicine or oncology wards, and the most common diagnosis was pneumonia. In people with terminal illness, clinicians can better identify when therapeutic possibilities are exhausted and acute hospitalization is not an adequate resource for their needs. Living in an urban area with the availability of palliative care hospital beds is related to the decision to die in hospital.

Cost of stay and characteristics of patients with stroke and delayed discharge for non-clinical reasons.

Delayed discharge for non-clinical reasons (bed-blocking) is characteristic of pathologies associated with ageing, loss of functional capacity and dependence such as stroke. The aims of this study were to describe the costs and characteristics of cases of patients with stroke and delayed discharge for non-clinical reasons (bed-blocking) compared with cases of bed-blocking (BB) for other reasons and to assess the relationship between the length of total stay (LOS) with patient characteristics and the context of care. A descriptive cross-sectional study was conducted at a high complexity public hospital in Northern Spain (2007-2015). 443 stroke patients presented with BB. Delayed discharge increased LOS by approximately one week. The median age was 79.7 years, significantly higher than in cases of BB for other reasons. Patients with stroke and BB are usually older patients, however, when younger patients are affected, their length of stay is longer in relation to the sudden onset of the problem and the lack of adequate functional recovery resources or residential facilities for intermediate care.

Gender roles and intimate partner violence among female university students in Spain: A cross-sectional study.

BACKGROUND: Traditional gender roles (GRs) have a considerable influence on relationships among couples. These can lead to negative health effects in women; however, their impact on intimate partner violence (IPV) has been less explored, especially among younger women. OBJECTIVE: To explore the association between traditional GRs and several indicators of IPV on a sample of Spanish female university students involved in heterosexual dating relationships. METHODS: A cross-sectional study involving female university students (n = 1,005) pursuing ten degrees (four Health Science degrees and six Social Sciences degrees). Data were collected using two validated scales: 1) the Questionnaire on the Gender Determinants of Contraception (COGANT), used to examine four traditional GRs (submissive, blind, and passive attitudes of female students, and male dominance), and 2) the Dating Violence Questionnaire-R (DVQ-R) scale, used to measure five types of IPV-behaviors (coercion, detachment, humiliation, sexual violence, and physical violence), perceived fear, entrapment, and abuse. Logistic and linear regressions were conducted to study the association between GR and a series of IPV indicators in dating relationships. RESULTS: Traditional GRs were highly prevalent (57.0% submissive, 52.0% blind attitude, 75.7% passive, and 31.7% identified their boyfriend as being dominant). Up to 66.3% experienced some type of violent behavior. All GRs were significantly associated with IPV indicators. A submissive attitude in female students was the GR that was most strongly associated to total IPV-behavior (adjusted odd ratio [OR] = 3.18; 95% confidence interval [CI]: 2.29-4.42), followed by male dominance (OR = 2.79: 95% CI:1.71: 4.54). Both GRs were also highly associated with perceived fear, entrapment, and abuse. CONCLUSIONS: A high presence of traditional GRs was found in the relationships held by female university students, which was significantly associated with IPV indicators. Universities must adopt policies for gender equality and raise awareness on dating violence.