Pain and Satisfaction Perceptions of Ultrasound-Guided Versus Conventional Peripheral Intravenous Catheterization: A Randomized Controlled Trial.

BACKGROUND: While many emergency department (ED) patients need peripheral vascular catheterization, diagnosis and treatment are often delayed by difficult intravenous access (DIVA). AIMS: This study of ED patients with DIVA was designed to evaluate ultrasound (US)-guided peripheral intravenous (IV) catheterization, compare it with conventional catheterization, and analyse patient pain and satisfaction regarding catheterization. DESIGN: Randomized controlled clinical trial. METHODS: Adult patients treated in the ED who scored >3 on the Adult-Difficult Venous Catheterization scale were randomly assigned to either US-guided or conventional peripheral IV catheterization. Data were collected from April to December 2016. Study variables were catheter insertion success, number of catheterization attempts, time required to perform the procedure, catheter length and calibre, puncture site, complications, and catheter functioning. Pain and patient satisfaction were also analysed for each group and the full sample. RESULTS: 120 and 138 patients were recruited for the US-guided and conventional peripheral IV catheterization groups, respectively. For the US-guided compared to the conventional procedure, insertion success was greater (91.75% versus 89.9%; p=0.04), the mean (SD) number of attempts was lower (1.29 (0.59) versus 1.81 (1.28); p<0.001), mean (SD) satisfaction was greater (7.59 (2.04) versus 6.69 (2.28); p=0.03), and the mean (SD) required time in minutes was greater (7.89 (7.13) versus 5.1 (3.69); p=0.045). Mean (SD) pain was moderate in both groups (4.6 (2.75) versus 4.33 (2.91) (p=0.32). Logistic regression for the full sample indicated that more attempts and greater pain were both associated with reduced satisfaction, while use of higher-calibre catheters was associated with greater satisfaction. CONCLUSION: US-guided compared to conventional peripheral IV catheterization in patients with DIVA was more successful, required fewer attempts, enabled use of longer and higher-calibre catheters, and led to greater patient satisfaction. Patients who underwent US-guided intravenous catheterization reported moderate pain, similar to that reported for the conventional procedure. CLINICAL IMPLICATIONS: US-guided peripheral intravenous catheterization improves ED patient care, as it requires fewer catheterization attempts. It is especially recommended for patients with DIVA.

Positive mental health and sense of coherence among emergency medical service professionals.

Background: Positive mental health (PMH) is a construct used to define and evaluate health from a positive perspective. Healthcare professionals in the emergency ambulance service are more likely to experience mental health disorders than the overall population. The demographic and occupational variables and Sense of Coherence (SOC) can act as predictors of PMH and can serve as protective elements against stress and demanding situations in the work environment. Objective: This study aimed to evaluate PMH and its relationship with demographic and occupational variables and determine if SOC is a predictive variable for PMH in health professionals working in the emergency ambulance service. Methods: A descriptive, cross-sectional, and correlational study was conducted with a sample of 406 healthcare professionals from the emergency ambulance service in eight health regions of Catalonia, Spain. The following variables were analyzed: Age, biological sex, household members, dependents family members, professional category, type of contract, job satisfaction and sense of collaboration with other institutions. The following assessment instruments were used: Positive Mental Health Questionnaire and Sense of Coherence scale. Results: High scores were obtained in Positive Mental Health (PMH). Study participants who reported feeling completely satisfied in their work also showed a significant relationship with all PMH factors: greater satisfaction with their personal life, in their helpful prosocial attitude toward others, in their capability to deal effectively with stress and navigate conflict scenarios, in their ability to solve problems and self-realization, greater empathy and ability to understand the feelings of others, greater ability to establish interpersonal relationships. Comprehensibility, as a dimension of SOC, was identified as a predictor for some factors of PMH: a greater personal satisfaction, self-control, autonomy, interpersonal skills and total PMHQ. More than 43% of positive mental health in health professionals is explained by higher Meaningfulness and Comprehensibility values of the SOC, the absence of dependent family members and having a non-graduate background. Conclusion: Healthcare workers in the emergency ambulance service had high PMH. Meaningfulness (ME) and Comprehensibility (C), dimensions of SOC, were identified as model predictors of greater PMH, showing higher scores in most of PMH factors. To enhance SOC as a mental health promotion measure, resilience programs should be implemented to help professionals develop skills to face and overcome adverse situations. Educating in stress management thought networks are key elements to strengthen SOC. Managers in emergency medical services play a key role in transforming healthcare work environments to promote positive outcomes in the mental health of their healthcare workers.

Assessment of Standardized Care Plans for People with Chronic Diseases in Primary Care Settings.

BACKGROUND: Aging populations are driving a shift in emphasis toward enhancing chronic disease care, reflected in Catalonia's regional plan which prioritizes standardized nursing care plans in primary care settings. To achieve this, the ARES-AP program was established with a focus on harmonizing standards and supporting routine nursing clinical decision-making. This study evaluates nurses' perceptions of ARES-AP's standardized care plans for chronic diseases. METHODS: A mixed-methods approach based on an ad hoc questionnaire (n = 141) and a focus group (n = 14) was used. Quantitative data were statistically analysed, setting significance at p < 0.05. Qualitative data were explored via content analysis. RESULTS: ARES-AP training was assessed positively. The resources for motivational interviewing and care plans for the most prevalent chronic diseases were rated very positively. This study identified key factors influencing program implementation, including facilitators such as structured information and nursing autonomy, barriers such as resistance to change, motivators such as managerial support, and suggested improvements such as technological improvements and time management strategies. CONCLUSIONS: This study identifies areas for improvement in implementing standardized nursing care plans, including additional time, motivation, enhanced IT infrastructure, and collaboration among primary care professionals. It enhances understanding of these plans in primary care, especially in managing chronic diseases in aging populations. Further research should assess the program's long-term impact on chronic patients. This study was not registered.

Assessing the Student Nurses' Knowledge of Oral Health Care.

Oral health is crucial for the overall well-being and quality of life, and nurses play a significant role in promoting it. This study assessed the oral health knowledge of fourth-grade nursing degree students. Seventy-two students completed a questionnaire covering sociodemographic variables, oral health-related factors, knowledge about oral health, and perceptions of its importance and learning experiences. The results showed that 83.3% of students attended regular dental check-ups for preventive purposes, and 55.6% had visited a dentist during the last year. Most of the students reported experiencing cavities (66.7%) and undergoing orthodontic treatment (54.2%). The average knowledge score in oral health was 6.4 out of 10, and students recognized the importance of oral health in the nursing role. However, their knowledge acquired during their nursing degree scored relatively low, being 2.5 out of 5. Notably, students who valued problem-based learning achieved higher knowledge scores (p < 0.05). Overall, fourth-grade nursing students demonstrated a moderate level of oral health knowledge. Improving oral health education within nursing curricula, particularly through problem-based learning, is essential to enhance their preparedness in addressing oral health issues effectively. This study was not registered.

Service Learning Experience on Health Habits in High School Students Conducted by Nursing Students: A Qualitative Design.

Service learning is a teaching methodology that combines learning and service to the community in the same well-articulated project, where the participants are trained to improve and work on the real needs of the environment. This paper aimed to explore learning about healthy habits and standards of nursing professional practice through a service learning activity between nursing students and high school students. Data of participants (N = 127 high school students and N = 12 nursing students) were collected by the high school students' healthy habits mind map and with the help of the nursing students' reflective journals. A generic qualitative design using content analysis was performed. After the activity, high school students identified which habits they should improve, such as diet, physical activity, resting time, and emotional health. By performing the activity, nursing students increased their knowledge about health habits, as well as their communication skills, confidence in public speaking, and awareness about community nurses' tasks. Service learning activity on health habits conducted by nursing students in a high school has a positive effect on the knowledge of healthy habits for both participants, nursing and high school students. Participating in an activity of service learning improves communication skills among first-year nursing students and narrows the gap between university theory and nursing practice.

Factors Favoring and Hindering Volunteering by Older Adults and Their Relationship with Subjective Well-Being: A Mixed-Method Approach.

A mixed methodology was used through the triangulation of quantitative and qualitative data to determine older adults' perspectives regarding volunteering and identify what factors can contribute to promoting it, with special emphasis on the role that their own well-being plays in this behavior. The results reveal that satisfaction with life as a whole contributes positively to volunteer behavior and satisfaction with the groups one belongs to contributes negatively. The volunteers were less satisfied than non-volunteers with interpersonal relationships and with the groups they belong to. Knowing the opinion of the older adults with regard to volunteering and understanding how this prosocial behavior relates to their own well-being is very useful for developing strategic plans that allow future volunteers to be captured.