Relationship Among Treatment Adherence, Family Functioning, and Self-Care Agency in Colombian Patients With Cardiovascular Disease.

BACKGROUND: Multiple factors affect treatment adherence in individuals with cardiovascular disease. However, information on the relationships among treatment adherence, family functioning, and self-care agency in these patients and their families is limited. PURPOSE: This study was developed to determine the relationships among treatment adherence, family functioning, self-care agency, and sociodemographic variables in patients with cardiovascular disease. Self-care agency, as defined by Orem, is the dynamic process patients use to engage in their own healthcare that involves discerning and addressing factors that allow their making decisions that improve self-care abilities. METHODS: This cross-sectional, observational-analytical study enrolled 151 adult patients with cardiovascular diseases who had undergone pharmacological and nonpharmacological treatments and 108 family members of these patients who had consented to participate. Measurements were performed using the "Questionnaire for measuring treatment adherence in patients with cardiovascular disease," the "Family Functioning Assessment Scale," and the "Self-care Agency Scale." RESULTS: Of the 151 patients, 119 (78.8%) were assessed as having a low risk of nonadherence, 60 (39.7%) as having low family functioning, and 131 (86.8%) as having high self-care agency. Treatment adherence and self-care agency showed a moderate and significant correlation ( r = .66, p < .001). Similarly, treatment adherence and family functioning showed a low but significant correlation ( r = .35, p < .001). Moreover, significant multivariate associations were found among the variables of interest. Patients with a low risk of nonadherence were found to be more likely to have a secondary or postsecondary education, not to have vision or hearing problems, and to have a contributory affiliation mode with the health system or private health insurance. In addition, participants with moderate or high levels of family functioning were less likely to be workers or to not have hearing or vision problems. Finally, significant differences were noted between patients with low self-care agency and those with high self-care agency in terms of kinship relationship with family members and affiliation mode with the health system. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results of this research help clarify the issue of treatment adherence in patients with cardiovascular disease. Although family functioning and self-care agency were found to be low to moderately correlated with treatment adherence, relevant information regarding these variables and sociodemographic variables is presented in this study. Nurses may use these results as a reference to design nursing care plans and interventions to address the conditions of their patients more appropriately.

Efectos de una intervención educativa sobre la capacidad de afrontamiento y adaptación en familiares de pacientes hospitalizados en la unidad de cuidado intensivo / Effects of an educational intervention on the ability to cope and adapt in relatives of patients hospitalized in the intensive care unit

Objetivos General Determinar el efecto de una intervención educativa sobre la capacidad de afrontamiento y adaptación en familiares de pacientes hospitalizados en una Unidad de Cuidado Intensivo. Específicos Describir la capacidad de afrontamiento y adaptación de familiares de pacientes hospitalizados en una UCI antes y después de la intervención educativa; Comparar la capacidad de afrontamiento antes y después de la intervención. Metodología Estudio de tipo Cuantitativo. Diseño Pre Experimental con un solo grupo y medición Pre test y Pos test. Población conformada por familiares de pacientes hospitalizados en la UCI de la Clínica Shaio durante el periodo de tiempo Diciembre a Marzo del 2014 Resultados La Escala de medición del Proceso de Afrontamiento y Adaptación de Roy clasifica a los cuidadores con un alto nivel de afrontamiento antes de la intervención educativa. Después de la intervención educativa todos los cuidadores mantuvieron y optimizaron el nivel alto de afrontamiento a los que obtuvieron puntajes inferiores a la intervención. Conclusiones Las familias tuvieron alta capacidad de afrontamiento antes de la intervención educativa, el nivel de capacidad de afrontamiento en algunos casos se mantuvo y en otros mejoró, se tradujo en el aumento del puntaje de CAP`S posterior a la intervención educativa. Recomendaciones Se recomienda continuar con el diseño de nuevas intervenciones educativas dirigidas a familias de pacientes en estado crítico que permitan evaluar su efectividad y que incluya a un equipo interdisciplinario ya que es un fenómeno multicausal. (AU)

Objectives. General objective. To determine the effect of an educational intervention on the ability of coping and adaptation in relatives of patients hospitalized in an Intensive Care Unit (ICU). Specific Objectives. To describe the ability of coping and adaptation of relatives of patients hospitalized in an ICU before and after the educational intervention. To compare the ability of coping before and after the intervention. Methodology. Quantitative study. PreExperimental design with a single group and pre-test and post-test measurement. Population composed of family members of patients hospitalized in the ICU from the "Shaio" Clinic during the period of time from December up to March, 2014. Results. The scale for measuring the Roy´s Coping and Adaptation Process classifies to caregivers with a high level of coping before the educational intervention. After the educational intervention all caregivers kept and optimized the high level of coping to those who got lower scores to the intervention. Conclusions. The families had a high capacity of coping before the educational 7 intervention, the ability level of coping in some cases was maintained and improved in other cases, and this resulted in an increase of the CAPS score after the educational intervention. Recommendations. It is recommend to continue with the design of new educational interventions aimed to families of critically ill patients to assess their effectiveness and to include an interdisciplinary team because this is a multi-causal phenomenon. (AU)

[Colonization by yeasts in newborns and healthcare personnel in a neonatal intensive care unit at a university hospital in Bogotá, Colombia]. / Colonización por levaduras en recién nacidos y personal de salud en la unidad de cuidados intensivos neonatales de un hospital universitario en Bogotá, Colombia.

Candida infections in the neonatal intensive care unit (NICU) are associated with high morbidity and mortality rates. The main objective of this work was to determine the risk factors for colonization by Candida species in the newborns in a hospital NICU in Bogota, Colombia, and to evaluate the colonization of intravascular devices and healthcare personnel. Fifty newborns at high risk (low birth-weight, gestational age under 35 weeks, previous exposure to antibiotics and eight days of stay in the NICU) were followed prospectively. Clinical specimens from conjunctiva, nasal orifices, oral cavity, inguinal skin, rectum, intravascular devices, and the resulting watery solution of the washing of hands of healthcare personnel were cultured. Samples were cultured on Sabouraud agar with chloramphenicol (50 ppm). Identification of yeasts was peformed using phenotypic and biochemical tests. A multivariate analysis of the risk factors for colonization in the newborns was performed. Growth of different Candida spp. was found in samples recovered from 38% of the newborns tested. However, no yeasts were obtained in cultures from intravascular devices. About 32% of the samples from healthcare personnel (paediatricians, undergraduate and postgraduate students, professional nurses and nurse assistants), showed presence of yeasts. In the multivariate regression analysis length of stay in the NICU was the only identified risk factor for colonization.

[Aspergillus spp. in risk areas of transplant patients in a university hospital]. / Presencia de Aspergillus spp. en áreas de riesgo en pacientes trasplantados en un hospital universitario.

As a consequence of the increase in the number of immunocompromised patients, cases of aspergillosis, due to the opportunist character of this fungus, have increased considerably. Aspergillus fumigatus, Aspergillus flavus, and Aspergillus niger have been found in air and water samples of the majority of investigated hospitals. The aim of the present study was to investigate the presence of aspergilli in transplant patients areas at the Hospital Universitario of Bogotá, Colombia. Samples of air were collected using the MAS-100 Air Sampler from each of the investigated areas. A sample of 100 ml of water was also recovered from these areas. All samples were taken for triplicate and were cultured in 2% Sabouraud Dextrose Agar. The average of aspergilli in air samples was 2.8 CFU/l corresponding to A. flavus, A. niger, Aspergillus versicolor and Aspergillus terreus. In water samples, the average was 17.1 CFU/l corresponding to A. flavus and Aspergillus clavatus. Because potentially pathogenic Aspergillus species were found in the hospital areas were transplant patients are usually kept, active surveillance and a high clinical suspicion should be considered in those patients. Since Aspergillus infections haven't been found so far, a higher fungal load and other host factors might be needed to facilitate the infection.