The role of nursing care continuity report in predicting length of hospital stay in older people: A retrospective cohort study.

BACKGROUND: The Nursing Care Continuity Report (NCCR) is a tool for evaluating the quality of nursing care during hospital admission. AIM: To explore the role of the NCCR in predicting longer length of stay (LOS) in older adults (≥65 years) admitted to a tertiary hospital and determine possible clinical differences at discharge between patients who had a short LOS (≤7 days) and a prolonged LOS (>7 days). RESEARCH DESIGN AND SETTING: A retrospective cohort study was conducted including all patients with a completed NCCR admitted to the hospital between 2015 and 2019. Sociodemographic data, risk of pressure injuries, level of dependence, presence and intensity of pain, and presence and type of pressure injury were the variables registered in the NCCR. RESULTS: A total of 41,354 patients were included in this study, with a mean age of 78 years, of whom 47% were female. At admission, 21% of patients were at potential risk of developing pressure ulcers. Age, admission to the internal or respiratory medicine unit, and having at least medium risk of developing pressure ulcers were the predictors of prolonged LOS using a random sample of 950 patients. At discharge, patients with prolonged LOS presented higher risk of pressure ulcers and a higher level of dependency and were more likely to present hospital-acquired pressure ulcers. CONCLUSIONS: Older adults from the internal or respiratory medicine unit who exhibited higher risk of pressure ulcers were related to a prolonged LOS, a higher level of dependency, and hospital-acquired ulcers at hospital discharge. RELEVANCE TO CLINICAL PRACTICE: Identifying clinical data that have a greater relationship with LOS could be a useful tool for nursing management and for the implementation of strategies to prevent adverse events during hospitalisation. NO PATIENT OR PUBLIC CONTRIBUTION: No direct patient contact was made during the data collection.

Impact of hospitalization on nutritional status in persons aged 65 years and over (NUTRIFRAG Study): Protocol for a prospective observational study.

BACKGROUND: Malnutrition is a recurring problem that has become more relevant in recent years. The aim of this study is to assess the risk of malnutrition and nutritional status on admission and its evolution until discharge in patients aged 65 and over admitted to medical and surgical hospitalization units in hospitals of the Spanish National Health System. METHODS: Prospective observational study to be carried out in the medical-surgical hospitalization units of 9 public hospitals between 01/09/2022 and 31/12/2024. Using consecutive sampling, a total of 4077 patients will be included (453 in each hospital). Variables included are related to the care process, functionality, cognition and comorbidity, risk profile, nutritional status and dysphagia; as well as frailty, dietary quality and contextual variables. The incidence of risk of malnutrition, undernutrition and dysphagia during the care process and at discharge will be calculated. The association with risk factors will be studied with logistic regression models and multivariate Cox regression models. In addition, an analysis of participants' satisfaction with food services will be carried out. The study was approved by the Ethics and Research Committee on 30/09/2020, approved for funding on 02/12/2021 and with registration number RBR-5jnbyhk in the Brazilian clinical trials database (ReBEC) for observational studies. DISCUSSION: Some studies address nutritional status or dysphagia in older people in various care settings. However, there is a lack of large sample studies including both processes of the impact of hospitalization. The results of the project will provide information on the incidence and prevalence of both pathologies in the study subjects, their associated factors and their relationship with the average length of stay, mortality and early readmission. In addition, early detection of a problem such as malnutrition related to the disease and/or dysphagia during a hospital stay will favor the action of professionals to resolve both pathologies and improve the health status of patients.

Reliability and Validity of Computerized Adventitious Respiratory Sounds in People with Bronchiectasis.

Background: Computerized adventitious respiratory sounds (ARS), such as crackles and wheezes, have been poorly explored in bronchiectasis, especially their measurement properties. This study aimed to test the reliability and validity of ARS in bronchiectasis. Methods: Respiratory sounds were recorded twice at 4 chest locations on 2 assessment sessions (7 days apart) in people with bronchiectasis and daily sputum expectoration. The total number of crackles, number of wheezes and wheeze occupation rate (%) were the parameters extracted. Results: 28 participants (9 men; 62 ± 12 y) were included. Total number of crackles and wheezes showed moderate within-day (ICC 0.87, 95% CI 0.74−0.94; ICC 0.86, 95% CI 0.71−0.93) and between-day reliability (ICC 0.70, 95% CI 0.43−0.86; ICC 0.78, 95% CI 0.56−0.90) considering all chest locations and both respiratory phases; wheeze occupation rate showed moderate within-day reliability (ICC 0.86, 95% CI 0.71−0.93), but poor between-day reliability (ICC 0.71, 95% CI 0.33−0.87). Bland−Altman plots revealed no systematic bias, but wide limits of agreement, particularly in the between-days analysis. All ARS parameters correlated moderately with the amount of daily sputum expectoration (r > 0.4; p < 0.05). No other significant correlations were observed. Conclusion: ARS presented moderate reliability and were correlated with the daily sputum expectoration in bronchiectasis. The use of sequential measurements may be an option to achieve greater accuracy when ARS are used to monitor or assess the effects of physiotherapy interventions in this population.

Actividad física y salud mental ¿dúo inseparable? / Physical activity and mental health, an inseparable duet?

La interrelación entre la mente y el cuerpo ha sido objeto de discusióny estudio entre filósofos y psicólogos desde tiempos históricos.Se conoce la capacidad potencial del ejercicio físico sobre la salud mental,sin embargo, su eficacia no está suficientemente demostrada.Objetivo: el objetivo de este trabajo ha sido analizar el conocimientoexistente sobre el efecto de la actividad física en la salud mental y laposible explicación de dicha relación.Metodología: se realizó una revisión de artículos publicados en revistascon revisión por pares, empleando bases de datos (Pubmed,Dialnet) y recursos electrónicos (Google, Scielo). Para las búsquedasse utilizaron las siguientes palabras clave, en español y en inglés:“ejercicio físico”, “actividad física”, “salud mental”, “ansiedad” y “depresión”.No se limitó la búsqueda temporalmente. La selección deartículos tuvo en cuenta que fueran trabajos originales disponiblesa texto completo gratuito en español e inglés. Se recogió informaciónsobre los efectos del ejercicio en la salud mental, así como delas hipótesis propuestas para explicar dicha relación.Resultados y conclusiones: la práctica regular de ejercicio físicopresenta beneficios físicos y psicológicos que resultan positivos parala salud mental y la calidad de vida del ser humano, lo que parecetener su explicación orgánica en los cambios que la actividad físicaproduce en el cerebro. El ejercicio físico tiene relación con la disminuciónde la ansiedad, con la protección frente a la depresión y conel alivio de sus síntomas, con la preservación de la función cognitivay con la mejora en autoestima, motivación, autocontrol y la autoeficacia (AU)

The interrelationship between mind and body has been subject ofdiscussion and study among philosophers and psychologists throughouthistory. The potential capacity of physical exercise on mentalhealth is known; however, this correlation has not been demonstratedsufficiently.Objective: the objective of this work was to analyse the availableknowledge on the effect of physical activity on mental health and thepossible explanation to this relationship.Methodology: a review of articles published in scientific journals wascarried out using the pair review method, databases (Pubmed, Dialnet)and human resources (Google, Scielo). The following tag wordsin Spanish and English were used in the search: “physical exercise”,“physical activity”, “mental health”, “anxiety” and “depression”. Thesearch was not temporarily limited in time. The selection of articlestook into account that the Works had to be originals available bothas free full text in English and Spanish. Data was gathered on theeffects of exercise on mental health as well as on the hypothesisproposed to exclude such relationship.Results and conclusions: the practice of regular physical exercisepresents physical as well as psychological benefits that are positivefor mental health and human quality of life. This appears to beorganically explained by the changes that exercise produces in thebrain. Physical exercise is related to less anxiety, with protectionagainst depression and with the relief of its symptoms, with preservationof cognitive function and improvement of self-esteem,motivation, self-control and self-efficiency (AU)