Envejecer en una residencia de ancianos en España: una revisión integradora / Ageing in a nursing home in Spain: an integrative review

Objetivos: España presenta uno de los índices más elevados de envejecimiento mundial. La mayor longevidad de las personas está asociada a una mayor probabilidad de precisar algún tipo de cuidado continuo y específico para realizar los autocuidados básicos de la vida en el día a día y, con ello, el ingreso en una residencia de ancianos. El objetivo general es conocer las características de los centros residenciales de mayores de España. Metodología: Se realizó una revisión integradora entre mayo y junio de 2022 en las diferentes bases de datos: CINAHL, PubMed, WOS, Science Direct y Dialnet. Se analizaron también las páginas web del Instituto de Mayores y Servicios Sociales y de la Organización Iberoamericana de Seguridad Social. Resultados: Los centros residenciales son equipamientos sociales que proporcionan alojamiento y atención especializada, de manera temporal o permanente, a las personas mayores que por su situación económica, familiar y social, así como por sus limitaciones de autonomía personal, no pueden ser cuidadas en su domicilio. En España hay un total de 5.529 centros residenciales, con 389.677 plazas en total. Conclusiones: Las residencias de ancianos disponen de una red de servicios comprendida por los cuidados de enfermería y médicos habituales, los cuidados paliativos, la ayuda a la familia y los servicios comunitarios y de alojamiento, que aseguran la continuidad de cuidados (AU)

Objectives: Spain has one of the highest rates of ageing in the world.The greater longevity of people is associated with a greater probability of needing some type of continuous and specific care to carry out the basic self-care of life on a daily basis, and with this, admission to a nursing home. The general objective is to find out the characteristics of residential care homes for the elderly in Spain. Methodology: An integrative review was carried out between May and June 2022 in the different databases: CINAHL, PubMed, WOS, Science Direct and Dialnet. The websites of the Instituto de Mayores y Servicios Sociales and the Organización Iberoamericana de Seguridad Social were also analysed. Results: Residential centers are social facilities that provide accommodation and specialized care, on a temporary or permanent basis, to those elderly people who, due to their economic, family and social situation, as well as their limited personal autonomy, cannot be cared for at home. In Spain, there are a total of 5,529 residential centres with 389,677 places in total. Conclusions: Nursing homes for the elderly have a network of services, comprising standard nursing and medical care, palliative care, family support and community and accommodation services, which ensure continuity of care (AU)

Attitudes Toward Organ Donation: Differences Between Medical and Nursing Andalusian Students.

INTRODUCTION: A favorable attitude toward organ donation and transplantation (ODT) is fundamental among health professionals at the time of transplant promotion. In this sense, the training and awareness of professionals are fundamental. OBJECTIVE: To analyze the differences in the attitude toward ODT and the factors that condition it among Andalusian medical and nursing students. METHODS AND DESIGN: The study is a sociologic, multicenter, observational study. The population includes medical and nursing students in Andalusian universities. Database of the Collaborative International Donor Project is used and data are stratified by geographic area and academic course. The instrument of measurement was a validated questionnaire (PCID-DTO-RIOS) that was handed out to every student in a compulsory session. Completion of the questionnaire was anonymous and self-administered. The sample included Andalusian medical and nursing students (99% confidence and precision of ±1%) stratified by geographic area and year of study. RESULTS: There was a completion rate of 91%; 79% (n = 2879) of Andalusian students were in favor of donation and 21% were not in favor. The attitude toward ODT is more favorable in medical compared with nursing students (80% vs 77%; P = .021). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): knowing a transplant patient, having received information about the subject, attitude toward family donation, and having discussed transplantation with family and friends. CONCLUSION: Andalusian medical students favored organ donation more than Andalusian nursing students, and the favorable attitude is associated with having an awareness of the subject.

Impact of in-hospital birth weight loss on short and medium term breastfeeding outcomes.

BACKGROUND: The definition for lower limit of safe birthweight loss among exclusively breastfed neonates is arbitrary. Despite this, in cases of great in-hospital weight loss, breastfeeding adequacy is immediately questioned. The aim of this study was to examine the relationship between weight loss at discharge from hospital, when babies are ready to go home, and eventual cessation of exclusive breastfeeding since birth. METHODS: This is a secondary analysis of a cohort study. Study participants were 788 full term, breastfed and stable babies, born in 2007-2012 consecutively enrolled to primary care pediatric clinics in Majorca, Spain. Data were collected by chart review. The main predictor was birthweight loss at discharge. Extreme weight loss was defined as the 90th and 95th centiles of birthweight loss for babies who were delivered by vaginal delivery and by cesarean section. Main outcomes were cessation of exclusive breastfeeding by 7, 15, 30 and 100 days of life. Multivariate regression analysis was performed to study the relationship of selected variables with exclusive breastfeeding cessation since birth. RESULTS: We observed a median weight loss of 6%. In bivariate analysis, quartiles of birthweight loss at discharge were predictive of exclusive breastfeeding cessation at 15, 30 and 100 days postpartum. In multivariate analysis: in-hospital weight loss above the median did predict exclusive breastfeeding cessation by 15, 30 and 100 days of life, Adjusted Odds Ratios (AORs) (95% Confidence Intervals [CIs]): 1.57 (1.12, 2.19), 1.73 (1.26, 2.38) and 1.69 (1.25, 2.29), respectively. In contrast, we did not find that newborn extreme weight losses were associated with exclusive breastfeeding cessation. CONCLUSIONS: We report that extreme birthweight loss does not trigger immediate formula supplementation. We do not identify any cut-off values to be used as predictors for the initiation of supplementary feeding, this research question remains unanswered.

Estenosis glóticas posteriores de origen cicatricial. Nuestra experiencia / Cicatricial posterior glottic stenosis. Our experience

Introducción y objetivos: Presentar los resultados obtenidos en el tratamiento de estenosis glóticas posteriores cicatriciales. Métodos: Estudio retrospectivo de 34 pacientes diagnosticados y tratados de estenosis glóticas posteriores cicatriciales por nuestro servicio. Resultados: El 85,36% de nuestros pacientes fueron decanulados. Los pacientes con estenosis de localización únicamente glótica fueron decanulados en un 80%, mientras que paradójicamente en los que tenían asociada además otro tipo de estenosis laringotraqueal, el porcentaje de decanulación fue del 92,9%. El 70% de los pacientes requirieron más de un procedimiento quirúrgico, aunque la mayoría de ellos se hicieron por protocolo y con la finalidad de resolver pequeños problemas. El número de reintervenciones está condicionado por la localización de la estenosis, siendo mayor cuando la estenosis glótica posterior se asocia a otro tipo de estenosis laringotraqueal (p = 0,001). Conclusiones: Los resultados quirúrgicos obtenidos en el tratamiento de las estenosis glóticas posteriores cicatriciales son buenos, pero a diferencia de otro tipo de estenosis glóticas posteriores (como por ejemplo las parálisis de abductores de origen neurogénico) requieren más intervenciones para la decanulación definitiva. Los procedimientos endoscópicos juegan un papel destacado y suponen nuestra principal herramienta de trabajo (AU)

Introduction and objectives: Presentation of the results obtained in the treatment of cicatricial posterior glottic stenosis. Methods: A retrospective study of 34 patients diagnosed and treated for cicatricial posterior glottic stenosis in our ENT Department. Results: In our series, 85.36% of our patients were decannulated. Of these, 80% of the patients with glottic stenosis were decannulated, while 92.9% of the patients with other associated laryngotracheal stenosis were paradoxically decannulated. Of all the patients, 70% required more than 1 surgical procedure, although most of these interventions were to resolve minor issues following our protocol. The number of subsequent interventions was determined by the location of the stenosis, with there being more interventions when the posterior glottic stenosis was associated with another type of laryngotracheal stenosis (p=.001). Conclusions: The surgical results for treating cicatricial posterior glottic stenosis are quite positive. However, unlike other types of posterior glottic stenosis (such as neurogenic abductor paralysis), it requires a greater number of interventions to achieve definitive decannulation. Endoscopic procedures play an important role and represent our main tool (AU)

The Effects of Mild Gestational Hyperglycemia on Exclusive Breastfeeding Cessation.

Gestational diabetes increases the risk of a range of adverse perinatal outcomes, including breastfeeding failure, but the best cut-off point for gestational diabetes is unknown. The purpose of this study was to evaluate the association between mild gestational glucose tolerance impairment and the early cessation of exclusive breastfeeding (EBF). This is an observational study of 768 women with full term pregnancies that were screened for gestational diabetes at 24-28 weeks gestation. Subjects were divided into two groups: those with a normal 1-h glucose challenge test and those with an elevated 1-h glucose challenge test but still did not qualify for gestational diabetes. We constructed multivariable logistic regression models using data from 616 women with normal gestational glucose tolerance and 152 women with an isolated positive 1-h glucose challenge test. The risk of early exclusive breastfeeding cessation was found to increase in women with mildly impaired glucose tolerance during pregnancy (adjusted OR, 1.65; 95% CI: 1.11, 2.45). Risks of early EBF cessation were also independently associated with the amount of neonatal weight loss and admission to the neonatal ward. Instead, parity was associated with a decreased risk for shorter EBF duration. Insulin resistance-even in the absence of gestational diabetes mellitus-may be an impeding factor for EBF.

Cicatricial posterior glottic stenosis. Our experience. / Estenosis glóticas posteriores de origen cicatricial. Nuestra experiencia.

INTRODUCTION AND OBJECTIVES: Presentation of the results obtained in the treatment of cicatricial posterior glottic stenosis. METHODS: A retrospective study of 34 patients diagnosed and treated for cicatricial posterior glottic stenosis in our ENT Department. RESULTS: In our series, 85.36% of our patients were decannulated. Of these, 80% of the patients with glottic stenosis were decannulated, while 92.9% of the patients with other associated laryngotracheal stenosis were paradoxically decannulated. Of all the patients, 70% required more than 1 surgical procedure, although most of these interventions were to resolve minor issues following our protocol. The number of subsequent interventions was determined by the location of the stenosis, with there being more interventions when the posterior glottic stenosis was associated with another type of laryngotracheal stenosis (p=.001). CONCLUSIONS: The surgical results for treating cicatricial posterior glottic stenosis are quite positive. However, unlike other types of posterior glottic stenosis (such as neurogenic abductor paralysis), it requires a greater number of interventions to achieve definitive decannulation. Endoscopic procedures play an important role and represent our main tool.

¿Quién es el receptor de intervenciones sociosanitarias y cuáles son sus necesidades? / Who is the user of socio-health interventions and what are their needs?

Las intervenciones sociosanitarias incluyen las actuaciones y cuidados destinados a atender las necesidades de las personas que a causa de su edad, enfermedad o discapacidad, han sufrido merma en su autonomía personal. Orientadas hacia el logro de una mejora en la calidad de vida de las personas en esa situación, tratan de atender a las personas de una forma integral. Intervenir en esas situaciones supone ofrecer las ayudas técnicas, los cambios ambientales, de costumbres y sociales así como el cuidado personal necesarios para mejorar su calidad de vida y potenciar sus capacidades y bienestar. Los avances científicos y cambios demográficos y sociales han condicionado una modificación en el perfil de los receptores de intervenciones sociosanitarias, destacando la longevidad, la cronicidad de los procesos y el envejecimiento del cuidador informal. El objetivo de este trabajo es caracterizar a la persona que recibe las intervenciones sociosanitarias y reflexionar sobre cuáles son sus necesidades. Para ello se ha llevado a cabo una revisión de estudios biomédicos mediante búsquedas bibliográficas en ScienceDirect así como documentación institucional nacional relativas a personas en situación de dependencia y sus cuidadores familiares. Las personas que precisan ayuda sociosanitaria constituyen una población heterogénea en cuanto a sus necesidades. Tanto la persona con discapacidad como su cuidador informal precisan ser consideradas objeto de interés y atención

Socio-health interventions include performance and care intended to attend to the needs of people who have suffered a decrease in their personal autonomy because of their age, illness or disability. Oriented towards achieving an improvement in the quality of life of people in that situation, they try to meet the requirements of people in an integrated way. To intervene in those situations involves providing technical aids and environmental, custom and social changes as well as personal care needed to improve their quality of life and enhance their skills and well-being. Scientific advances and demographic and social changes have determined a change in the profile of socio-health interventions’ receivers, highlighting longevity, chronicity of processes and aging of the informal caregiver. The aim of this work is to characterize the person receiving the social-health interventions and to reflect on what their needs are. To do this we have conducted a biomedical studies’ review through literature searches at ScienceDirect as well as a review of national institutional documentation related to people in dependent situations and their family caregivers. People who need socio-health help establish a heterogeneous population in respect of their needs. Both the person with disabilities and their informal caregiver need to be considered as an object of interest and attention

[Who is the user of socio-health interventions and what are their needs?]. / ¿Quién es el receptor de intervenciones sociosanitarias y cuáles son sus necesidades?

Socio-health interventions include performance and care intended to attend to the needs of people who have suffered a decrease in their personal autonomy because of their age, illness or disability. Oriented towards achieving an improvement in the quality of life of people in that situation, they try to meet the requirements of people in an integrated way. To intervene in those situations involves providing technical aids and environmental, custom and social changes as well as personal care needed to improve their quality of life and enhance their skills and well-being. Scientific advances and demographic and social changes have determined a change in the profile of socio-health interventions' receivers, highlighting longevity, chronicity of processes and aging of the informal caregiver. The aim of this work is to characterize the person receiving the social-health interventions and to reflect on what their needs are. To do this we have conducted a biomedical studies' review through literature searches at ScienceDirect as well as a review of national institutional documentation related to people in dependent situations and their family caregivers. People who need socio-health help establish a heterogeneous population in respect of their needs. Both the person with disabilities and their informal caregiver need to be considered as an object of interest and attention.

Inteligencia emocional y relaciones interpersonales en los estudiantes de enfermería / Emotional intelligence and interpersonal relationship among nursing students

Los estudiantes de enfermería necesitan ser capaces de establecer relaciones interpersonales adecuadas porque son importantes en su aprendizaje y forman parte de las competencias necesarias para ejercer la enfermería con éxito. La inteligencia emocional (IE) se ha presentado como una característica que facilita las relaciones interpersonales, debido a que permite ser consciente de las emociones, comprenderlas, manejarlas en uno mismo y en otros, y utilizarlas para razonar mejor. Entendida como un rasgo de personalidad o como una capacidad cognitiva, se presume componente crucial del ejercicio de la enfermería y del aprendizaje, pues podría facilitar el desempeño en todas aquellas facetas de la actividad donde haya situaciones cargadas de información emocional. Para actuar y ajustar su conducta, además de contar con las capacidades oportunas, el estudiante debe querer hacerlo. En este trabajo se analizan las relaciones comentadas y los hallazgos más significativos obtenidos en la investigación respecto a estas, ofreciendo evidencias y sugiriendo estrategias para su desarrollo

Nursing students need to be able to establish adequate interpersonal relationships because they are important in their learning and are part of the competencies required to practice Nursing successfully. Emotional intelligence (EI henceforth) has been presented as a feature that facilitates interpersonal relationships, due to the fact that it lets be aware of emotions, understand them, manage them in oneself and in others, and use them to reason better. Understood as a personality trait or as a cognitive ability, it is presumed to be a crucial component of the practice of Nursing and of learning, it could facilitate the performance in at all levels of the activity where there are situations fraught with emotional information. To act and adjust their behavior, in addition to taking in account the convenient skills, the student should want to do it. This paper analyzes the relationships discussed and the most significant findings in the research with respect thereto, providing evidence and suggesting strategies for its development

Validity of the Spanish version of the Emotional Labour Scale.

In this article we address concerns raised by Brumit and Glenn (2013) regarding the validity of the Spanish version of the Emotional Labour Scale (ELS). We respond to requests in relation to the translated version of the scale and the eigenvalue series. We also give an explanation of the differences in results between the original version and the Spanish version of the scale.

The Spanish version of the Emotional Labour Scale (ELS): a validation study.

AIM: To validate the Spanish version of the Emotional Labour Scale (ELS), an instrument widely used to understand how professionals working with people face emotional labor in their daily job. METHOD: An observational, cross-sectional and multicenter survey was used. Nursing students and their clinical tutors (n=211) completed the self-reported ELS when the clinical practice period was over. First order and second order Confirmatory Factor Analyses (CFA) were estimated in order to test the factor structure of the scale. CONCLUSIONS: The results of the CFA confirm a factor structure of the scale with six first order factors (duration, frequency, intensity, variety, surface acting and deep acting) and two larger second order factors named Demands (duration, frequency, intensity and variety) and Acting (surface acting and deep acting) establishing the validity of the Spanish version of the ELS.

El ultrasonido en algunas afecciones del tiroides / Use of ultrasonography in some thyroid diseases

El ultrasonido es la primera modalidad de diagnóstico por imagen empleada en la investigación de las enfermedades del tiroides, y entre sus ventajas se distingue por ser un método no invasivo y barato, así como para servir de guía para la biopsia. Ciertas características ultrasonográficas son significativamente más frecuentes en los nódulos malignos que en los benignos. Con el objetivo de crear un estándar entre las lesiones ultrasonográficas y su correlación con malignidad, se ha desarrollado, por el Colegio Americano de Radiología, el sistema de datos y reporte de imágenes tiroideas(AU)

Ultrasonography is the first diagnostic modality through imaging that is used in the study of thyroid diseases, and some of the advantages include being a cheap, non-invasive method and a guide for biopsy. Certain ultrasonographic features are significantly more frequent in malignant than in benign nodules. With the objective of creating a standard of the ultrasonographic lesions and the correlation with malignancy, the American College of Radiology has developed the system of thyroid image data and reporting(AU)

El ultrasonido en algunas afecciones del tiroides / Use of ultrasonography in some thyroid diseases

El ultrasonido es la primera modalidad de diagnóstico por imagen empleada en la investigación de las enfermedades del tiroides, y entre sus ventajas se distingue por ser un método no invasivo y barato, así como para servir de guía para la biopsia. Ciertas características ultrasonográficas son significativamente más frecuentes en los nódulos malignos que en los benignos. Con el objetivo de crear un estándar entre las lesiones ultrasonográficas y su correlación con malignidad, se ha desarrollado, por el Colegio Americano de Radiología, el sistema de datos y reporte de imágenes tiroideas(AU)

Ultrasonography is the first diagnostic modality through imaging that is used in the study of thyroid diseases, and some of the advantages include being a cheap, non-invasive method and a guide for biopsy. Certain ultrasonographic features are significantly more frequent in malignant than in benign nodules. With the objective of creating a standard of the ultrasonographic lesions and the correlation with malignancy, the American College of Radiology has developed the system of thyroid image data and reporting(AU)

Carcinoma ductal in situ, ¿factor de riesgo de mastectomía? / Ductal carcinoma in situ: a risk factor for mastectomy?

Objetivo. Conocer las características histológicas e inmuno-histoquímicas de los carcinomas ductales in situ (CDIS) que pudieran influir en el estado de los márgenes en la primera cirugía, y el tratamiento quirúrgico finalmente realizado en los CDIS. Material y métodos. Estudio retrospectivo de los 485 diagnosticados en los años 2003, 2004 y 2005, en el Servicio de Ginecología del Hospital Universitario 12 de Octubre de Madrid, 54 de los cuales (11,1%) fueron carcinomas ductales in situ (CDIS) y 280 (57,7%) ductales infiltrantes. Resultados. Solamente un 10% de CDIS fueron palpables. Los CDIS supusieron la cuarta parte de los carcinomas diagnosticados mediante biopsia con arpón. Los bordes estuvieron afectos en la primera cirugía de intención conservadora en el 50% de CDIS y solo en el 34% de carcinomas ductales infiltrantes (CDI), por lo que las segundas y terceras cirugías (por bordes persistentemente afectos) fueron más frecuentes en CDIS que en CDI. En CDIS, los grados histológicos altos se relacionaron con más bordes afectados, más resultados positivos en reescisiones y más mastectomías. La tasa de mastectomía en CDIS (43%) fue mayor que en CDI diagnosticados mediante arpón (27%), y similar a la de CDI considerados globalmente (41%). Conclusiones. El cribado mamográfico ha permitido un aumento de detección de CDIS, pero en ocasiones es difícil conseguir márgenes libres en ellos. Esto lleva a la aparente paradoja de tener que realizar mastectomía en CDIS, cuando en CDI podemos permitir cirugía conservadora sin empeorar el pronóstico (AU)

Objective. To determine the histological or immunohistochemical characteristics of ductal carcinomas in situ (DCIS) that could influence margin status at first surgery and at final surgery. Material and methods. We retrospectively studied the 485 breast carcinomas diagnosed in 2003, 2004 and 2005 at the Doce de Octubre Hospital (Madrid), of which 54 (11.1%) were DCIS and 280 (57.7%) were invasive ductal carcinomas (IDC). Results. Only 10% of DCIS were palpable. DCIS represented 25% of all carcinomas diagnosed by mammographic wire-guided biopsy. We found positive margins on first breast-conserving surgery in 50% of DCIS and in 34% of IDC. Consequently, a second or even a third intervention (for persistently involved margins) was more frequent in DCIS than in IDC. In DCIS higher histological grades were associated with more frequent margin involvement and a higher rate of re-excision with positive margins and mastectomy. The mastectomy rate in DCIS (43%) was higher than that in IDC diagnosed by mammographic wire-guided biopsy (27%), and was similar to that in IDC overall (41%). Conclusions. Mammographic screening programs have improved the detection of DCIS, but clear margins are sometimes difficult to achieve in this entity, leading to the paradox that women with palpable IDC are able to undergo breast-conserving surgery without compromising prognosis, whereas a mammographically detected DCIS requires mastectomy (AU)

Úlceras por presión iatrogénicas de localización nasal / Iatrogenic pressure ulcers of nasal location

Introducción: Uno de los riesgos del uso de sondas endonasales (SE) es la apariciónde úlceras por presión (UPP). Objetivo: Averiguar la incidencia de pacientescon UPP nasales, estudiar factores de riesgo de aparición y encontrarvariables predictivas. Metodología: Estudio de doce meses, observacional prospectivo,realizado en pacientes ingresados en la unidad de cuidados intensivosportadores de SE. Conclusiones: Los tiempos de estancia y de permanenciacon la SE, además de la anemia, se asocian estadísticamente con la apariciónde UPP. Tras el estudio multivariante, el tiempo que el paciente permanececon SE es la variable que influye en que aparezcan las UPP nasales (AU)

Introduction: One of the risks of using endonasal tubes (ET) is the developmentof pressure ulcers (PU). Aim: to find out the incidence of patients with nasal PU,study the risks factors for its development and find the predictable variables.Methods: a twelve-month observational and prospective study was carried out incritically ill patients carrying a ET admitted to our intensive care unit. Conclusion:time of stay and time spent carrying the ET, along with the anaemia, is statisticallyassociated with the development of nasal PU. The multivariate studyshowed that the time spent carrying the ET is the most influential variable in thedevelopmente of nasal PU (AU)

Non-epithelial lesions of the larynx: review of the 10-year experience in a tertiary Spanish hospital.

CONCLUSION: In this report we review the diagnosis, therapy, and outcome of laryngeal non-epithelial tumors and comment on the literature on these rare lesions. OBJECTIVES: Non-epithelial tumors of the larynx are rather rare and most cases have been reported as isolated or short series of cases from different centers all over the world. The aim of the present study was to review the 10-year experience with non-epithelial lesions in a 400-bed tertiary hospital covering a population of almost 250 000 people in Madrid, Spain. PATIENTS AND METHODS: We reviewed 2631 laryngeal samples corresponding to this time period. RESULTS: In all, 737 corresponded to carcinomas (726 squamous cell carcinomas). We had two cases of chondrosarcoma, one case of liposarcoma, one case of synovial sarcoma, and one neural benign tumor, suggestive of neurinoma. In this period we also had an inflammatory pseudotumor affecting the vocal cord, a case of primary laryngeal extramedullary plasmocytoma, and one case of high grade diffuse malignant lymphoma with exclusive involvement of the larynx. In our series most patients were women (five vs three patients) and ages ranged between 12 and 92 years.