Sociodemographic and Clinical Characteristics Associated with Suicidal Behaviour and Relationship with a Nurse-Led Suicide Prevention Programme.

Suicidal behaviour is a major public health problem that needs to be tackled by all health agents including mental health nurses. AIMS: The purpose of this study was to analyse the relationship between demographic and clinical characteristics and different kinds of suicidal behaviour with a nurse-led suicide prevention programme. METHODS: The design was a cross-sectional study, performed in the region of Osona (Catalonia) in the five-year period 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt or completed suicide. RESULTS: The sample included 753 patients (of whom 53 completed suicide) who experienced 931 suicidal behaviour episodes. Men represented only 38.4% of the sample but 81.1% of completed suicides. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. Two thirds (66.4%) of the individuals (0.8% (n = 4) of whom completed suicide) were participants in a nurse-led suicidal behaviour case management programme. CONCLUSION: The main risk factors were being a woman for suicidal behaviour and being a man and being older for completed suicide. Mental disorders, widowhood and retirement were also associated with completed suicide. The completed suicide rate was lower among participants in the nurse-led programme.

Pacientes quirúrgicos e intervenciones enfermeras estandarizadas. Estudio descriptivo sobre resultados / Descriptive study of the results of nursing interventions applied to surgical patients

Objetivos: conocer la evolución de los resultados de salud de los pacientes quirúrgicos durante su estancia hospitalaria, evaluando criterios de resultado NOC al ingreso y alta. Método: estudio prospectivo observacional realizado en las plantas de hospitalización quirúrgica del Hospital General de Vic, con pacientes que precisaron una intervención quirúrgica de cualquier especialidad, a partir de 18 añ;os, con niveles de riesgo anestésico I, II o III. Las variables principales de resultado fueron indicadores asociados a cada NOC de un plan de cuidados estandarizado, basado en el concepto «paciente tipo». Resultados: participaron 460 pacientes, de ellos 69(15%) fueron intervenidos de operaciones del sistema musculoesquelético y 391(85%) de operaciones del aparato digestivo, urinario y órganos genitales masculinos y femeninos, de operaciones de la piel, tegumentos y/o sistema endocrino. Las puntuaciones NOC al alta de todos los pacientes se mantuvieron o mejoraron, nunca empeoraron y en todos los pacientes el número de caídas y de infecciones recurrentes fue una constante. Prácticamente ningún enfermo se cayó, ni se infectó. Conclusiones: la mayoría de los pacientes quirúrgicos en el momento de recibir el alta hospitalaria mejoran o mantienen sus condiciones de ingreso y los que empeoran nunca lo hacen sustancialmente(AU)

Objectives: Knowing the evolution of health outcomes of surgical patients during their hospital stay, evaluating NOC outcome criteria at admission and discharge. Material and methods: Prospective observational study conducted in the surgical hospital wards of the Hospital General de Vic, with patients who required surgical intervention of any specialty, of 18 or more years old and anesthetic risk levels I, II or III. The main outcome variables were indicators associates with each NOC of a standard of care based on the "patient type" concept. Results: Four hundred and six patients participated. Of these, 69 (15%) were operated of the musculoskeletal system and 391 (85%) were operated on the digestive or urinary systems, male/female genitalia, skin, integuments, and endocrine system. NOC scores high of all patients were maintained or improved, never worse and in all patients the number of falls and recurrent infections was constant, virtually no patient fell or became infected. Conclusions: The majority of surgical patients at the time of hospital discharge improves or maintain their conditions of admission and patients who never worse substantially(AU)

[Descriptive study of the results of nursing interventions applied to surgical patients]. / Pacientes quirúrgicos e intervenciones enfermeras estandarizadas. Estudio descriptivo sobre resultados.

OBJECTIVES: Knowing the evolution of health outcomes of surgical patients during their hospital stay, evaluating NOC outcome criteria at admission and discharge. MATERIAL AND METHODS: Prospective observational study conducted in the surgical hospital wards of the Hospital General de Vic, with patients who required surgical intervention of any specialty, of 18 or more years old and anesthetic risk levels I, II or III. The main outcome variables were indicators associates with each NOC of a standard of care based on the "patient type" concept. RESULTS: Four hundred and six patients participated. Of these, 69 (15%) were operated of the musculoskeletal system and 391 (85%) were operated on the digestive or urinary systems, male/ female genitalia, skin, integuments, and endocrine system. NOC scores high of all patients were maintained or improved, never worse and in all patients the number of falls and recurrent infections was constant, virtually no patient fell or became infected. CONCLUSIONS: The majority of surgical patients at the time of hospital discharge improves or maintain their conditions of admission and patients who never worse substantially.

Trauma infantil y esquizofrenia / Childhood trauma and schizophrenia

Introducción: La prevalencia de antecedentes de trauma en la psicobiografía de los pacientes psicóticos es alta, hasta el punto de que algunos autores defienden que hay un subgrupo de esquizofrenia, la esquizofrenia traumática inducida, que se caracterizaría por la preponderancia de los síntomas psicóticos positivos. Observación clínica: Presentamos el caso de una paciente joven que sufrió abusos sexuales repetidos en su infancia y que desarrolló, a los 19 años, una esquizofrenia. El inicio de la enfermedad fue con alucinaciones auditivas sobre el abusador, sintomatología depresiva e ideación delirante de autorreferencia y de control del pensamiento que obligó a un ingreso hospitalario. Durante los 7 años de curso de la enfermedad, siempre presentó alucinaciones auditivas, cenestésicas y visuales, en ocasiones relacionadas con los abusos y en otras, no. Destaca también la ausencia de síntomas negativos. Discusión: La alta prevalencia de trauma infantil en pacientes psicóticos hace pensar en que el abuso grave podría ser uno de los factores ambientales que influyen en el desarrollo de la esquizofrenia. Una delas consecuencias de este hecho es la necesidad de indagar de forma sistemática en las posibles experiencias traumáticas en la biografía de cualquier paciente que se nos presente con sintomatología psicótica (AU)

Introduction: The prevalence of a history of trauma in the psychobiography of psychotic patients is high, and some authors argue for the existence of a subtype of schizophrenia, trauma-induced schizophrenia, characterized by a preponderance ofpositive psychotic symptoms.Case report: We report the case of a Young female patient who suffered repeated sexual abuse in childhood and developed schizophrenia at the age of nineteen. The presenting symptoms of the disease consisted of auditory hallucinations that spoke of her abuser, depressive symptoms and delusional ideationand thought control, leading to hospitalization. During the 7-year course of the disease, the patient has always experienced auditory, visual and kinesthetic hallucinations, sometimes -but not always- related to abuse. A striking feature is the absence of negative symptoms. Discussion: The high prevalence of childhood trauma in psychotic patients suggests that serious abuse could be one of the environmental factors influencing the development of schizophrenia. One consequence of this finding is the need to routinely investigate any traumatic experiences in the life of any patient with psychotic symptoms (AU)