Effectiveness of MOVI-KIDS programme on health-related quality of life in children: Cluster-randomized controlled trial.

OBJECTIVE: To test the effectiveness of an 8-month school-based multicomponent intervention (MOVI-KIDS) in improving health-related quality of life (HRQoL) in schoolchildren. STUDY DESIGN: A randomized cluster trial was conducted including 1168 children aged 4-6 years who attended 21 schools in two Spanish provinces (Cuenca and Ciudad Real). MOVI-KIDS study is a multicomponent physical activity intervention, which consisted of (i) 3 × 60-min sessions/week, (ii) educational materials for parents and teachers, and (iii) school playground modifications. The parent's proxy report of the KINDL-R Spanish version (6 subdimensions and a total score), and the KINDL-R self-reported by children (total score) was used to measure HRQoL. Mixed linear regression models were conducted to test differences in each HRQoL dimension between intervention and control groups, controlling for baseline values, cardiorespiratory fitness, and socioeconomic status, by gender. RESULTS: The boys in the intervention group presented better scores on total HRQoL than the control group in both the parent (ß = 1.46; 95% CI: 0.23-2.70) and self-reported (ß = 2.13; 95% CI: 0.53-3.74) versions, as well as on the emotional well-being dimension (ß = 2.43; 95% CI: 0.48-4.36). There was no significant effect of the intervention on physical well-being, self-esteem, family, and friends. In girls, no statistically significant differences were found between those who participated in MOVI-KIDS and those who did not. CONCLUSION: Our data support gender differences in the effect of MOVI-KIDS, such that while in boys the intervention was successful in increasing total scores of HRQoL, as well as emotional well-being scores, the intervention was not effective in improving girls' HRQoL.

Relationship between both cardiorespiratory and muscular fitness and health-related quality of life in children and adolescents: a systematic review and meta-analysis of observational studies.

BACKGROUND: No review to date has evaluated the association between physical fitness and health-related quality of life (HRQoL) in healthy children and adolescents. The aims of this systematic review and meta-analysis were to examine the relationship between both cardiorespiratory fitness (CRF) and muscular fitness (MF) and HRQoL in healthy subjects under 18 years of age and to describe the dimensions of HRQoL in which these relationships are more robust. METHODS: The Medline, Embase, Cochrane Library, SCIELO, SPORTDiscus and PEDro databases were systematically searched to collect observational studies that examined the relationship between CRF and HRQoL and between MF and HRQoL in participants under 18 years of age without any diagnosed medical condition. Pooled effect sizes (ES) were estimated for the associations between both CRF and MF and the various HRQoL dimensions. RESULTS: The pooled ES (95% CI) estimates for the relationship between CRF and HRQoL were as follows: 0.19 (0.10 to 0.27) for physical well-being, 0.19 (0.07 to 0.32) for psychological well-being, 0.20 (- 0.14 to 0.55) for perceived health status, 0.10 (0.00 to 0.20) for self-perception/self-esteem, 0.07 (- 0.05 to 0.19) for quality of family relationship, 0.14 (0.04 to 0.25) for quality of peer relationship, 0.17 (0.04 to 0.29) for everyday functioning at school and 0.20 (0.12 to 0.28) for total HRQoL score. The pooled ES (95% CI) estimates for the relationship between MF and HRQoL were: 0.25 (0.12 to 0.37) for physical well-being, 0.11 (0.04 to 0.17) for psychological well-being, 0.08 (0.01 to 0.15) for quality of family relationship, 0.14 (0.03 to 0.25) for quality of peer relationship, and 0.09 (0.03 to 0.14) for total HRQoL score. CONCLUSIONS: Our data suggest that both CRF and MF are positively associated with HRQoL, mainly in physical, psychological and peer relationships. Moreover, CRF is positively associated with school dimensions and MF is positively associated with family relationships. Trail registration Protocol PROSPERO registration number: CRD42015025823.

Associations between health-related quality of life and physical fitness in 4-7-year-old Spanish children: the MOVIKIDS study.

PURPOSE: Health-related quality of life (HRQOL) in childhood is defined as an individual's subjective perception of the impact of health status on physical, psychological and social functioning. Nowadays, measuring of HRQOL has become an important outcome indicator in evaluating health-care. However, in younger children, the role of cardiorespiratory and other physical fitness components on HRQOL is unclear. The aims of this study were to analyse the association between components of physical fitness and HRQOL, as well as to determine which component of physical fitness was the best predictor of higher HRQOL. METHODS: This was a cross-sectional study of 1413 schoolchildren (4 to 7 years old) from Spain. HRQOL was evaluated with the KINDL-R questionnaire for parents. Cardiorespiratory fitness, muscle strength and speed-agility were assessed using the ALPHA-Fitness battery. ANCOVA models were used to assess differences in HRQOL across physical fitness categories, controlling for age and BMI, by gender. Multiple linear regression was used to determine the independent association between the different physical fitness components and HRQOL. RESULTS: Children with high physical fitness levels had better scores in physical well-being, school and total HRQOL score than those who had low physical fitness levels. The best predictor of HRQOL (total score) was muscular strength in boys and speed-agility among girls. CONCLUSIONS: Children with high physical fitness levels have higher HRQOL, although the association between components of physical fitness and HRQOL varies according to gender. Improving physical fitness could be a good strategy for improving HRQOL in children.

Obesity as a Mediator between Cardiorespiratory Fitness and Blood Pressure in Preschoolers.

OBJECTIVES: To analyze the relationships between body mass index (BMI), cardiorespiratory fitness (CRF), and blood pressure (BP), and to examine whether obesity acts as a mediator between fitness and BP in children. STUDY DESIGN: A cross-sectional analysis using a population-based sample of 1604 school children aged 4-7 years attending 21 schools from the provinces of Ciudad Real and Cuenca, Spain, was undertaken. Data on anthropometric variables, BP measurements, and CRF were collected. The relationships between body composition (BMI, percent body fat, and waist circumference), CRF, and mean arterial pressure was estimated using Pearson correlation coefficients. ANCOVA tested the differences in BP measurements by categories of BMI and CRF, controlling for different sets of confounders. The PROCESS macro developed by Preacher and Hayes was used for mediation analysis. RESULTS: BP values were significantly higher in school children with excess weight and poorer CRF. In addition, BMI acts as a full mediator in the association between CRF and mean arterial pressure in boys at 62.28% (z = -5.433; P ≤ .001) and a partial mediator in girls at 35.24% (z = -5.246; P ≤ .001). CONCLUSIONS: BMI mediates the relationship between CRF and mean arterial pressure. These findings highlight the importance of maintaining a healthy weight for the prevention of high BP levels in childhood. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01971840.

A Qualitative Exploration of the Perceptions of Women Living with Pelvic Floor Disorders and Factors Related to Quality of Life.

Background: Pelvic floor dysfunction encompasses conditions like urinary and fecal incontinence, pelvic organ prolapse, and pelvic pain, significantly affecting women's quality of life. Despite its prevalence, few studies have adopted a qualitative approach to understanding women's perceptions and emotions regarding these issues. This study aims to delve into how women with pelvic floor disorders perceive their condition and its impact on their daily lives. Methods: We analyzed qualitative data from interviews with 160 women suffering from pelvic floor dysfunctions. Using inductive qualitative content analysis, we systematically examined the data to identify variations, differences, and similarities. Results: The analysis revealed four primary themes in the women's narratives: "Physical Impacts", "Emotional and Psychological Impacts", "Social and Relational Impacts", and "Sexual Health Impacts", along with 12 subthemes. The findings predominantly highlight how pelvic floor dysfunctions detrimentally affect women's quality of life and emotional well-being, instilling fear and insecurity in daily activities, compounded by sleep disturbances and sexual dysfunction. Conclusions: Women living with pelvic floor dysfunction face multifaceted challenges that adversely affect various aspects of their lives, diminishing their overall quality of life. This includes notable impacts on sleep, physical, and sexual activities. However, not all affected women report these issues, often due to fear of stigma, choosing instead to conceal their struggles in an effort to maintain an appearance of normalcy.

Are Physical Activity Interventions Effective in Improving Health-Related Quality of Life in Children and Adolescents? A Systematic Review and Meta-Analysis.

CONTEXT: Physical activity (PA) interventions improve well-being and positive mental health in children and adolescents, but the results of previous systematic reviews included participants with chronic medical conditions and did not accurately assess the multidimensional nature of health-related quality of life (HRQoL). OBJECTIVE: The aims of this meta-analysis were to (1) evaluate the effects of PA interventions on several domains of HRQoL in healthy <18-year-olds and (2) examine the effectiveness of interventions on HRQoL according to whether they were successful in increasing PA, the type of intervention delivered, and the duration of the intervention. DATA SOURCES: PubMed (Medline), EMBASE, the Cochrane Library, SCIELO, SPORTDiscus, and PEDro databases were systematically searched from inception to September 30, 2022. STUDY SELECTION: Experimental studies that examined the effectiveness of PA interventions on HRQoL participants aged <18 years. STUDY DESIGN: Systematic review with meta-analysis and meta-regression. LEVEL OF EVIDENCE: Level 1. METHODS: Random-effects models were used to calculate pooled effect size (ES) for total HRQoL score and its dimensions. Subgroup analyses were conducted to examine the effect of PA program characteristics. RESULTS: A total of 17 studies were included. Pooled ES (95% CI) estimations were as follows: 0.179 (0.045, 0.002) for total HRQoL score, 0.192 (0.077, 0.306) for physical well-being, 0.158 (0.080, 0.237) for psychological well-being, 0.118 (0.044, 0.192) for autonomy and parent relation, 0.135 (0.043, 0.227) for social support and peers, and 0.129 (-0.013, 0.270) for school environment. Subgroup analyses suggested there were no differences in the effectiveness of the interventions by category of PA increase or by type and duration of intervention. CONCLUSION: Exercise interventions are an effective strategy for improving overall HRQoL and its most significant domains in children and adolescents.

Nurses' Perceptions Regarding Their Professional Commitment and Development during the COVID-19 Pandemic.

INTRODUCTION: During the pandemic, nurses have undergone a high level of professional burnout, suffering emotional exhaustion, depersonalization, and lack of personal realization. OBJECTIVE: The object of this study is to understand in depth, through a phenomenological study of Giorgi, the perceptions on commitment and professional development of frontline nurses during the first and second waves of the COVID-19 pandemic. METHOD: Qualitative study designed and analyzed using Giorgi's phenomenological focus. For data collection, semi-structured interviews were utilized in a theoretical sample of frontline nurses who worked in public hospitals of Extremadura and Madrid, Spain, until saturation of data. The interviews were conducted between the months of May and December 2020 following an outline of topics. The analysis was based on the phenomenological focus of Giorgi and was supported by the software Atlas-Ti 8.0. RESULTS: A total of 14 nurses participated in this study. Two main themes emerged to explain the perceptions of the nurses: (1) the professional commitment of the nurses during the pandemic and (2) the effects of the pandemic on professional development; seven subcategories were also identified. CONCLUSION: The social and professional development of nurses is important. If nurses feel that they are quality professionals, this will enable them to protect their psychosocial health and increase professional commitment toward their patients in difficult situations such as pandemics. The results of this study may serve as a guide for better understanding the problems and needs of nurses as healthcare providers. This may help administrators in the generation of solutions for the establishment of a safe and reliable work environment, which will in turn promote a healthcare system that can efficiently respond to future catastrophes.

Effectiveness of an Educational Intervention With High-Fidelity Clinical Simulation to Improve Attitudes Toward Teamwork Among Health Professionals.

BACKGROUND: Failures in teamwork are a common reason for adverse medical events. The goals of this study are to evaluate attitudes toward teamwork among an interprofessional group of health professionals and to analyze the effectiveness of an educational intervention with high-fidelity clinical simulation to improve these attitudes. METHOD: An educational intervention was developed that used a 6-hour session that included three simulated clinical cases. The Attitudes Toward Health Care Teams Scale was used for assessment. Mean difference before and after the intervention was calculated with the Wilcoxon test. RESULTS: Positive attitude toward teamwork after completion of the training activities was measured. The health care professionals who showed the most positive attitude toward teamwork were physicians (93.92, SD = 6.58) and resident physicians (95.01, SD = 6.33). The greatest increase was observed among orderlies (p < .001) and nursing assistants (p < .001). CONCLUSION: The use of clinical simulation for interprofessional training of health care professionals showed a positive effect on attitudes toward teamwork. [J Contin Educ Nurs. 2021;52(10):457-467.].

Association between physical activity, sedentary behavior, and fitness with health related quality of life in healthy children and adolescents: A protocol for a systematic review and meta-analysis.

BACKGROUND: Health related quality of life (HRQoL) is a subjective, multidimensional and changing over time construct. When HRQoL is decreased, a child is less likely to be able to develop normally and mature into a healthy adult. Physical inactivity is a priority public health problem. Evidence suggests how even moderate levels of physical activity or high fitness levels are associated with benefits for the health in children and adolescents. The aims of this systematic review are to examine the evidence about the relationship between physical activity, sedentary behavior, and fitness with HRQoL, and estimate the effects of interventions that have tested the effectiveness of the increase of the physical activity, the improvement of the physical fitness or the avoidance of sedentary behaviors in HRQoL in healthy subjects aged under 18 years old. METHODS: This systematic review and meta-analysis protocol was conducted following the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. To identify relevant studies, the following electronic databases will be searched: MEDLINE, EMBASE, Cochrane Database, Web of Science, and PEDro. Reference lists of relevant studies will be examined for links to potential related articles. The methodological quality of the observational included studies will be scored using a quality assessment checklist. For the intervention studies, the risk of bias will be estimated using The Cochrane Collaboration tool for assessing risk of bias. Reviewers will determine whether a meta-analysis is possible when data have been extracted. If it is, subgroup analyses will be carried out by age and socioeconomic status, and by the different dimensions of the HRQoL. If is not possible, a descriptive analysis will be conducted. CONCLUSION: To our knowledge, this systematic review and meta-analysis will be the first that synthesizes the existing results about the relationship between physical activity, sedentary behavior, physical fitness, and HRQoL, and the effect of physical activity interventions on HRQoL, in healthy subjects under 18 years old. This study will clarify this relationship and will provide evidence for decision-making. Limitations may include the quality of the selected studies and their characteristics. Only studies published in English and Spanish will be included. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015025823.

Niveles de ansiedad de los equipos interprofesionales durante el entrenamiento con simulación clínica / Anxiety levels in interprofessional teams during training with clinical simulation

Objetivo: analizar el efecto de la simulación clínica en el nivel de ansiedad pre/post-actividad formativa en varios grupos profesionales y en estudiantes de Enfermería, y evaluar la autoconfianza percibida antes/después de la simulación en cada grupo.Métodos: estudio cuasi-experimental en profesionales sanitarios (enfermeras, técnicos en cuidados auxiliares de Enfermería o TCAE y médicos) y estudiantes de Enfermería (4º curso) sometidos por primera vez a una intervención de simulación clínica en el Hospital General Universitario de Ciudad Real. Se evaluó el nivel de ansiedad estado antes/después de la simulación mediante el cuestionario STAI de Spielberg, y se valoró la autoconfianza percibida antes/después de la simulación. Se realizó análisis descriptivo. Se usó la t de Student para la comparación de medias. Se estableció significación estadística si p< 0,05.Resultados: participaron 53 sujetos, 43 (81,2%) profesionales y 10 (18,8%) estudiantes de Enfermería. Edad media (DE) fue 39 (11,8) años; 84,9% (n= 45) mujeres. El nivel de ansiedad medio (DE) al inicio de la simulación fue mayor en los estudiantes de Enfermería 24,6 (5,4) y menor en los médicos 14,4 (5,8). Tras la intervención se redujo la media (DE) del nivel de ansiedad-estado en todos los grupos, siendo significativo (p< 0,001) en TCAE -13,1 (6,9) y enfermeras -12,5 (8,4). Hubo un aumento del nivel de autoconfianza de todos los participantes al finalizar la actividad.Conclusiones: los profesionales que participaron por primera vez en una actividad de simulación clínica presentaron alto grado de ansiedad, aunque en médicos fue inferior. Hubo un descenso de la ansiedad y aumento de la confianza al final de la simulación clínica.(AU)

Objective: to analyze the effect of clinical simulation in the level of anxiety pre- and post- training activity in different professional groups and Nursing students, and to assess the self-confidence perceived before/after the simulation in each group.Methods: a quasi-experimental study in healthcare professionals (nurses, assistant nursing technicians or TCAE, and doctors), and Nursing students (4th year), who underwent for the first time a clinical simulation intervention at the Hospital General Universitario de Ciudad Real. The level of anxiety was evaluated before/after the simulation, through Spielberger’s STAI questionnaire, and the level of self-confidence perceived was also evaluated before / after the simulation. Descriptive analysis was conducted, and Student’s t test was used for mean comparison. Statistical significance was established at p< 0.05.Results: the study included 53 subjects: 43 (81.2%) were professionals and 10 (18.8%) were Nursing students; their mean age (SD) was 39 (11.8) years; and 84.9% (n= 45) were female. The mean anxiety level (SD) at the start of the simulation was higher in Nursing students, with 24.6 (5.4), and lower in doctors, with 14.4 (5.8). After the intervention, the mean (SD) level of anxiety-status was reduced in all groups; it was significant (p< 0.001) in the TCAE group, with -13.1 (6.9) and nurses, with -12.5 (8.4). There was an increase in the level of self-confidence in all participants by the end of the activity.Conclusions: the professionals who participated for the first time in a clinical simulation activity presented a high level of anxiety, though this was lower among doctors. There was a reduction in anxiety and increase in confidence by the end of the clinical simulation.(AU)