Perceptions of Patients and Their Families Regarding Limitation of Therapeutic Effort in the Intensive Care Unit.

OBJECTIVE: Our objective was to determine and describe the opinion and attitudes of patients and their families regarding the limitation of therapeutic effort and advanced directives in critical patients and whether end-of-life planning occurs. Religious affiliation, education level, and pre-admission quality of life were also evaluated to determine whether they may influence decisions regarding appropriate therapeutic effort. METHODS: A prospective, observational and descriptive study, approved by the center's ethical committee, was carried out with 257 participants (94 patients and 163 family members) in the intensive care unit (ICU). A questionnaire regarding the opinions of patients and relatives about situations of therapeutic appropriateness in case of poor prognosis or poor quality of life was used. The questionnaire had three sections. In the first section, sociodemographic features were investigated. In the second section, information was collected on the quality of life and functional situation before ICU admission (taking as a reference the situation one month before admission) assessed by the Karnofsky scale, Barthel index, and the PAEEC scale (Project for the Epidemiological Analysis of Critical Care Patients). The third section aimed to determine whether the family knew the patient's opinion regarding his/her end of life. RESULTS: Of those interviewed, 62.2% would agree to limit treatment in case of poor prognosis or poor quality of future life. In contrast, 37.7% considered that they should fight for life, even if it is irretrievable. Only 1.6% had advanced directives registered, 43.9% of the participants admitted deterioration in their quality of life before ICU admission, 18.2% with moderate-severe deterioration. Our study shows that the higher the educational level, the lower the desire to fight for life when it is irretrievable and the greater the agreement to limit treatment. Besides, those participants not affiliated with a religion were significantly less likely to fight for life, including when irretrievable, than Catholics and were more likely to agree to limit treatment. CONCLUSIONS: More than half of the participants would agree to limit treatment in the case of a poor prognosis. Our results indicate that patients do not prepare for the dying process well in advance. Religion and educational level were determining factors for the choice of procedures at the end of life, both for patients and their families.

The Impact on Nursing Students of Creating Audiovisual Material through Digital Storytelling as a Teaching Method.

The creation of videos in teaching has a high educational potential and is a challenge that can motivate students. There is little evidence on the use of this method when applied to the creation of digital stories. Thus, the aim of this study was to measure student satisfaction with the creation of audiovisual material through digital storytelling, measure its usefulness, and evaluate its impact on their motivation to study the subject. As a secondary objective, we intended to determine the influence of this learning experience on raising awareness of society toward mental illnesses by measuring the impact by the number of views on social networks. A cross-sectional descriptive study design was used. The participants were 90 third-year nursing students enrolled in the subject "Psychiatric Nursing". The students created eight themed videos (depression, suicide, anxiety, anorexia, mobile phone addiction, obsessive-compulsive disorder, drug addiction, schizophrenia). The students were then asked to complete an ad hoc questionnaire on the matter. A total of 90% of the nursing students thought that creating the videos improved the acquisition of nursing knowledge, 91.2% replied that they would like to use the method in other subjects on the degree in nursing syllabus, and 67.8% thought that their clinical skills improved after using narrated digital stories to create videos. Students acknowledged that this training activity helped them feel better prepared and helped them better understand the subject. They believe that this teaching technique is more stimulating and more enjoyable than the conventional system, giving them more motivation to study the subject. Students acknowledge that the experience gained from this initiative has helped them feel better prepared and helped them better understand the subject, and they think that it will be a useful resource in the future as it has improved the process of the creation of audiovisual material through digital storytelling.

Incidencia De Delirio Según El Regimen De Visitas En Una Unidad De Cuidados Intensivos / Incidence Of Delirium According To The Visiting Regime In An Intensive Care Unit

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Adaptation and validation of the Spanish version of the ORTO-15 questionnaire for the diagnosis of orthorexia nervosa.

The aim of this study was the validation and analysis of the psychometric properties of a Spanish translation of the ORTO-15 questionnaire; an instrument designed to assess orthorexia nervosa behavior. Four hundred and fifty-four Spanish university students (65% women) aged between 18 and 51 years (M = 21.48 ± 0.31) completed the Spanish version of ORTO-15 and the Eating Disorders Inventory-2 (EDI-2). The Principal Component Analysis suggested a three-factor structure for the abbreviated 11-item version of the instrument. The internal consistency of the measurement was adequate (Cronbach's alpha = 0.80). The proposed test demonstrated a good predictive capacity at a threshold value of <25 (efficiency 84%, sensitivity 75% and specificity 84%). Our results support the psychometric properties of the proposed Spanish shortened-version of the ORTO-15 as being a reliable tool for assessing orthorexia nervosa. Its use is expected to greatly contribute to a better understanding of the impact of this disorder in Spain.

[Infant pain response according to vaccine administration]. / Respuesta al dolor de lactantes según el orden de administración de las vacunas.

OBJECTIVE: To determine if acute pain response in infants after administration of pentavalent diphtheria (polio, tetanus, acellular pertussis and B Type Hemophilus influenzae: Pentavac) and meningitis C vaccine (NeisVacC) vary according to the administration order. METHOD: A multicenter, randomized control trial, double-blind was performed in three pediatric nursing consultations of three healthcare centers between December 2010, and December 2011. Two months healthy children in subjected to a routine immunization. Routine immunizations are given in a different order to children; first NeisVac C and then Pentavac are given to the Group A and first Pentavac and then NeisVac C are given to the Group B. Was measured infant pain during the injection of the vaccine using a validates method, the Modified Behavioral Pain Scale (MBPS). Parents measured pain with the VAS scale and evaluated the presence of tears before the beginning of vaccination. RESULTS: Within the 184 infants, 92 received the A order, and 92 the B order. There were no differences between groups in terms of sociodemographic characteristics. The average (AV) pain scores per infant after receiving injections were significantly lower when Pentavac was administered in a second place in A Group. MBPS 5.6 (SD 1.5) versus NeisVac C 7.6 (SD 1.3) (p = 0.0001), EVA 3.6 Parents (SD) versus 5.4 (DE 1.9) (p = 0.0001). In B Group, the average for Pentavac" BPS pain was 7.6 (SD 1.5) versus 7.9 (DE 1.2) to NeisVac C Parents EVA 5.5 (SD 1.8) versus 6.3 (SD 1.6) (p = 0.004). CONCLUSIONS: Pain was reduced when Pentavac vaccine was administered before NeisVac C in infants subjected to a routine vaccination. It is recommended that the order of injections of the vaccine will be first Pentavac followed by NeisVac C.

Respuesta al dolor de lactantes según el orden de administración de las vacunas / Infant pain response acording to vaccunes administration

Objetivo. Determinar si la respuesta de dolor agudo en lactantes después de la administración de la vacuna pentavalente de la difteria, la poliomielitis, el tétanos, la tosferina acelular y la Haemophilus influenzae tipo b (Pentavac®) y la vacuna contra la meningitis C (NeisVac C®) se ve afectada por el orden de administración. Método. Ensayo clínico, multicéntrico, aleatorizado y doble ciego realizado en tres consultas de enfermería pediátrica de tres Centros de Atención Primaria, entre los meses de diciembre de 2010 y diciembre de 2011. Se incluyen niños sanos de dos meses de edad sometidos a la inmunización rutinaria. Se administran las vacunas rutinarias con un orden distinto en los niños. Grupo A (primero se inyecta NeisVac C® y después Pentavac®), y Grupo B (primero se inyecta Pentavac® y después NeisVac C®). Se midió el dolor del lactante durante la inyección de la vacuna, utilizando un método validado, la Escala de Comportamiento ante el Dolor Modificada o Modified Behavioral Pain Scale (MBPS). Los padres midieron el dolor con la escala EVA y se valoró la presencia de llanto antes del inicio de la vacunación. Resultados. Participaron un total de 184 lactantes: 92 recibieron el orden A y 92 el orden B. No hubo diferencias entre los grupos en cuanto a características sociodemográficas. La media y desviación estándar (DE) de las puntuaciones de dolor por lactante después de recibir las inyecciones fueron significativamente más bajas cuando Pentavac® se administró en el Grupo A en segundo lugar -MBPS 5.6 (DE 1.5)- frente a NeisVac C(R) -MBPS 7.6 (DE 1.3)- (p = 0.0001); EVA Padres 3.6 (DE 2) frente a 5.4 (DE 1.9) (p = 0.0001). En el Grupo B, la media de dolor MBPS para Pentavac® fue de 7.6 (DE 1.5) frente a 7.9 (DE 1.2) para NeisVac C®; EVA Padres 5.5 (DE 1.8) frente a 6.3 (DE 1.6) (p = 0.004). Conclusiones. El dolor se redujo cuando la vacuna Pentavac® se administró antes que NeisVac C® en los lactantes sometidos a la vacunación rutinaria. Se recomienda que el orden de las inyecciones de la vacuna sea primero Pentavac®, seguido por NeisVac C® (AU)

Objective. To determine if acute pain response in infants after administration of pentavalent diphtheria (polio, tetanus, acellular pertussis and B Type Hemophilus influenzae: Pentavac®) and meningitis C vaccine (NeisVacC®) vary according to the administration order. Method. A multicenter, randomized control trial, double-blind was performed in three pediatric nursing consultations of three healthcare centers between December 2010, and December 2011. Two months healthy children in subjected to a routine immunization. Routine immunizations are given in a different order to children; first NeisVac C® and then Pentavac® are given to the Group A and first Pentavac® and then NeisVac C® are given to the Group B. Was measured infant pain during the injection of the vaccine using a validates method, the Modified Behavioral Pain Scale (MBPS). Parents measured pain with the VAS scale and evaluated the presence of tears before the beginning of vaccination. Results. Within the 184 infants, 92 received the A order, and 92 the B order. There were no differences between groups in terms of sociodemographic characteristics. The average (AV) pain scores per infant after receiving injections were significantly lower when Pentavac® was administered in a second place in A Group. MBPS 5.6 (SD 1.5) versus NeisVac C® 7.6 (SD 1.3) (p = 0.0001), EVA 3.6 Parents (SD 2) versus 5.4 (DE 1.9) (p = 0.0001). In B Group, the average for Pentavac® MBPS pain was 7.6 (SD 1.5) versus 7.9 (DE 1.2) to NeisVac C ®. Parents EVA 5.5 (SD 1.8) versus 6.3 (SD 1.6) (p = 0.004). Conclusions. Pain was reduced when Pentavac® vaccine was administered before NeisVac C® in infants subjected to a routine vaccination. It is recommended that the order of injections of the vaccine will be first Pentavac® followed by NeisVac C® (AU)

Conocimientos sobre resucitación cardiopulmonar del profesional enfermero en unidades sin monitorización de pacientes / Knowledge of cardiopulmonary resuscitation by the nursing professional in patient monitoring units

Objetivos: determinar el grado de conocimiento sobre resucitación cardiopulmonar(RCP) en los profesionales enfermeros de unidades sin monitorización de pacientes del Hospital General de Ciudad Real, así como la relación entre el grado de conocimiento y la edad y el tiempo de experiencia profesional.Material y métodos: estudio descriptivo transversal realizado en unidades médicas y quirúrgicas en el Hospital General de Ciudad Real sobre una población de 94 enfermeras. Se utilizó un cuestionario de elaboración propia que recorría las recomendaciones internacionales sobre RCP y que podía oscilar entre 0 y 10 (máximo nivel de conocimientos). Se calcularon índices de estadística descriptiva e inferencia estadística (test de X2) para contrastar la hipótesis de asociación entre edad y tiempo de experiencia profesional con el nivel de conocimientos. Resultados: se obtuvo una tasa de respuesta del 85,1%. Un 85% eran mujeres.La media de respuestas correctas fue de 3,4. No se encontraron diferencias significativas en cuanto a conocimiento entre los distintos servicios estudiados (p = 0,79), ni con la edad (p = 0,32), ni con el tiempo de experiencia profesional (p = 0,32).Conclusiones: los profesionales enfermeros no conocen adecuadamente las últimas recomendaciones sobre RCP, que tienen su origen en el informe del Consejo Europeo de Resucitación del año 2005. Los centros sanitarios han de proporcionar una atención eficaz a las víctimas de las paradas cardiacas, asegurando que sus plantillas reciben entrenamiento regular y actualizado, mediante la implantación de programas de RCP hospitalarios orientado a conseguir una aplicación correcta de las recomendaciones internacionales en esta materia (AU)

Objectives: to determine the degree of knowledge on cardiopulmonary resuscitation of nursing professionals in patient monitoring units at the Ciudad Real General Hospital, as well as the relationship between the degree of knowledge and the age and time of professional experience. Material and methods: cross-sectional descriptive study carried out inmedical and surgical units at the Ciudad Real General Hospital on a population comprised of 94 nurses. A self-elaborated questionnaire was used containing the international recommendations on CPR and which varied inscore between 0 and 10 (maximum level of knowledge). Descriptive statistics indexes and statistical inference were calculated a (test de X2) to compare the association hypothesis between age and time of professional experience and the level of knowledge.Results: a response rate of 85,1% was obtained. 85% were women. The mean for correct answers was 3,4. No significant differences were found with regard to knowledge among the different hospital department studied(p = 0,79), neither regarding age (p = 0,32), or the time of professional experience (p = 0,32).Conclusions: nursing professionals do not have a sufficient knowledge ofthe latest CPR recommendations derived from the 2005 European Resuscitation Council. Health centres should provide more effective medical care to of cardiac arrest victims by ensuring that their staff received regular and up-to-date training via the implantation of hospital CPR programmes aimedat achieving the correct administration of the international recommendations on the subject (AU)

Know-how y know why / Know-how and know why

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¿Están justificados los recortes de plantillas de enfermería en las unidades de cuidados intensivos? / Is cutting the nursing staff in the intensive care units justified?

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