Impact of the COVID-19-pandemic and perception of self-efficacy on the mental health of out-of-hospital emergency healthcare professionals by modality of care.

OBJECTIVE: To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services. DESIGN: Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February-30 April, 2021). METHODS: The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health. RESULTS: The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care. CONCLUSIONS: Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality. IMPLICATIONS: The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk. REPORTING METHOD: We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain). PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'.

Tesis doctorales españolas de ciencias de la salud en materia de género (1976-2022) / Spanish doctoral thesis in health sci-ences on gender subjects (1976-2022)

Objetivo principal: analizar cuantitativamente la producción de las tesis doctorales en materia sanitaria relacionadas con el género en España. Metodología: síntesis cuantitativa de indicadores de productividad de las tesis doctorales conseguidas en la base de datos española TESEO y defendidas en Universidades españolas entre 1976 y 2022. Los análisis empleados han sido descriptivos y el cálculo de predicción se basó en la metodología del modelo Holt-Winters. Resultados principales: el 18,75% de las tesis defendidas pertenecen a una Universidad de Madrid. El 75% de ellas son defendidas por graduados en Medicina. La temática de las tesis es en el 25% la violencia de género. El 87,5% son doctoras, pero solamente el 44% de las mujeres dirigen tesis. La predicción para los futuros 24 años indica que se generará alrededor de 1 tesis al año. Conclusión principal: la investigación española en tesis doctorales clínicas de género es escasa y masculinizada.(AU)

Main objective: to quantitatively analyze the production of gender-related doctoral theses in health in Spain. Methodology: quantitative synthesis of productivity indicators of the doctoral theses obtained in the Spanish TESEO database and defended in Spanish Universities between 1976 and 2022. The analyzes used have been descriptive and the prediction calculation was based on the methodology of the Holt- Winters. Main results: 18.75% of the theses defended belong to a University of Madrid. 75% of them are defended by graduates in Medicine. The theme of the theses is gender violence in 25%. 87.5% are doctors, but only 44% of women direct theses. The prediction for the future 24 years indicates that around 1 thesis will be generated per year. Main conclusion: Spanish research in gender clinical doctoral theses is scarce and masculinized.(AU)

Exploring Disparities in Self-Reported Mental Health Symptoms Across Professional Categories in Spain's Emergency Medical Services: A Nationwide Cross-Sectional Study.

OBJECTIVE: This study aimed to analyze stress, anxiety, depression, and self-efficacy levels among Spanish out-of-hospital emergency medical professionals from February 1, 2021, to April 30, 2021. METHODS: A nationwide survey was completed by 1666 Emergency Medical Services (EMS) workers. The Depression, Anxiety, and Stress Scale (DASS-21) and the General Self-Efficacy Scale (GSE) were used. Data analysis used chi-squared, análisis of variance (ANOVA), and logistic regressions. RESULTS: The sample comprised 833 (50%) men, with an average age of 44.3 ± 9.9 y (range: 19-67 y). Occupational distribution included 453 (27.2%) physicians, 474 (28.4%) nurses, and 739 (44.4%) emergency medical technicians (EMTs). EMTs exhibited higher odds of severe or extremely severe depression compared with physicians (odds ratio [OR]: 1.569; 95% confidenceinterval [95% CI]: 1.213-2.030) and nurses (OR: 1.561; 95% CI: 1.211-2.012). EMTs also displayed higher probabilities of severe or extremely severe anxiety compared with nurses (OR: 1.944; 95% CI: 1.529-2.701). Furthermore, EMTs demonstrated elevated probabilities of severe or extremely severe stress compared with physicians (OR: 1.387; 95% CI: 1.088-1.770). However, no significant differences were found in self-efficacy, with a median value of 73 [20]. CONCLUSIONS: Out-of-hospital EMS workers experienced mental health challenges, showing varying levels of depression, stress, and anxiety across different occupational groups. EMTs were particularly affected.

Análisis de los programas para la presencia de familiares en la parada cardiorrespiratoria extrahospitalaria en paciente adulto / Analysis of the programs for the presence of family members in the extrahospital cardiorrespiratory stop in adult patient

Objetivo: Explorar los programas orientados a la participación de familiares en situaciones de PCR en adultos en el medio extrahospitalario. Método: Revisión narrativa de la literatura científica, en bases de datos primarias (Scielo, PubMed, Cuiden y Cochrane Plus y CINAHL), con empleo de lenguaje estructurado DeCS y MeSH, de 2005 a 2020, en español e inglés. Se obtienen 23 estudios. Resultados: Los estudios muestran que el duelo de los familiares de una parada cardiorrespiratoria en el medio extrahospitalario es menos traumática si se les permite estar presentes. Permanecer junto a la víctima debe asegurarse salvo que el profesional considere que es perjudicial. Las ventajas de la presencia de familiares son tanto para el familiar como para el equipo asistencial. A pesar de existir una necesidad social y ética de acuerdo con el principio de autonomía del paciente para la implementación de estos programas apenas existen y esto suele ser debido a las resistencias generadas por los propios profesionales o los gestores. Conclusiones: Las principales sociedades científicas internacionales recomiendan en caso de PCR en el adulto en el medio extrahospitalario, la implantación de programas para la presencia de familiares, lo que hace que se convierta en una necesidad. La literatura científica demuestra más ventajas que inconvenientes, fundamentalmente en cuanto a un mejor duelo en familiares y mayor satisfacción y menor posibilidad de demandas jurídicas en los sanitarios, promoción de la humanización de los cuidados que se traduciría en un gasto asistencial menor en prevalencia de duelo patológico. (AU)

Presencia de factores de riesgo de maltrato en ancianos asistidos en extrahospitalaria en Segovia / Presence of risk factors abuse in assisted elderly people in out-of-hospital in Segovia

OBJETIVO: Determinar la frecuencia de factores de riesgo de maltrato en personas ancianas asistidas por la unidad móvil de emergencias extrahospitalarias de Segovia. METODOLOGÍA: Se trata de un estudio descriptivo, con el fin de describir los factores de riesgo presentes en las personas ancianas de la investigación. La muestra está formada por 365 participantes mayores de 65 años. RESULTADOS: La muestra es homogénea por género (188 hombres y 177 mujeres); el grupo mayoritario es el de 71 a 90 años (67,9%). La edad media es de 80 años (σ = 8,91); el estado de salud mayoritario es de grado medio (41,6%); los grados de dependencia leve y moderado suponen en total un 56,7%; la presencia de deterioro cognitivo es del 50,4%; la frecuencia de incontinencia urinaria es de un 72,1%; el aislamiento social lo padecen el 24,4%; la situación actual es en el 51,2%, el 24,4% tienen depresión, abusan del alcohol el 13,2%, pocos viven en instituciones (15,6%) y la relación con el cuidador es buena en el 86% de los casos. CONCLUSIONES:La población seleccionada es bastante envejecida, lo que en sí ya supone más riesgo de padecer maltrato. Las personas con riesgo de maltrato por estado de salud general, deterioro cognitivo y dependencia suponen casi la mitad de la muestra. La incontinencia urinaria es el factor más común. Los trastornos depresivos no son frecuentes, al igual que el consumo de alcohol, pero su ponderación es muy elevada. Cabe destacar que la demora en solicitar ayuda es alta, muchos son hiperfrecuentadores, y algunos están malnutridos y se caen de forma repetida

OBJECTIVE: to determine the frequency of risk factors of abuse in elderly people assisted by the emergency mobile unit of extra-hospital emergencies in Segovia. METHODOLOGY: it ́s a descriptive study with the purpose of describing the risk factors present in the elderly people of the research. The sample consists of 365 participants over 65 years. RESULTS: the sample is homogeneous by gender (188 men and 177 women), the majority group is 71 to 90 years (67.9%). The average age is of 80 years (σ = 8.91), the majority health status is of medium degree (41.6%), the degree of media dependence and the moderate one suppose a total of 56.7%, the presentation of a cognitive is 50.4%. The frequency of urinary incontinence is 72.1%, social isolation appears in 24.4, the current situation is 51.2%, 24.4%, alcohol abuse, 13.2%, few they live in institutions (15.6%). The relationship with the caregiver is good in 86% of cases. CONCLUSIONS: the population has been quite old, what is already in it ́s more risk of suffering abuse. People at risk of abuse by general health status, cognitive knowledge and dependence, account for almost half of the sample. Urinary incontinence is the most common factor. Depressive disorders are not frequent, as is the consumption of alcohol, but its weight is very high. Highlight that the delay in requesting help is high, being many hyperusers, and some are malnourished and fall repeatedly

Reflexiones sobre la lactancia materna desde el feminismo / Reflections on breastfeeding from the perspective of feminism

No disponible

Concepción sociocultural del climaterio en Occidente / Concepção sociocultural do climatério no Ocidente / Sociocultural conception of climacteric in the West

Introducción: Incluir la perspectiva socio-cultural en el cuidado de las mujeres es clave para alcanzar una buena salud integral. El modelo biomédico ha obviado estos factores en el estudio del climaterio, de modo que se ha creado una nueva patología femenina, el Síndrome Climatérico. Objetivo principal: Reflexionar desde la perspectiva feminista, sobre la dimensión sociocultural Occidental del climaterio. Metodología: Se presenta un artículo original de reflexión teórica basado en la Teoría Feminista del Paradigma holístico de salud que entiende el género como una variable. Conclusiones: Otras culturas nos muestran una mujer climatérica que no padece los signos y síntomas que encontramos en las mujeres Occidentales, lo cual nos hace pensar en la importancia de la sociedad de referencia como factor que influye en la vivencia del climaterio. La menopausia marca un punto de inflexión en la mujer que pasa de la madurez a la senectud por medio de un rito de paso facilitador, pero éste en Occidente está diluido y la mujer vive esta etapa de modo negativo (AU)

Introdução: Integrar a perspectiva socio-cultural no cuidado das mulheres é fundamen-tal para alcançar uma boa saúde. O modelo biomédico tem ignorado esses fatores no estu-do do climatério, de modo que criou uma nova patologia feminina, síndrome climatérica. Principal objetivo: Para refletir a partir de uma perspectiva feminista na dimensão socio-cultural ocidental do climatério. Metodologia: um artigo original de refle-xão teórica baseada na teoria feminista de paradigma de saúde holística que entende gênero como uma variável é apresentado. Conclusões: Outras culturas mostram uma mulher na menopausa que não tem os sinais e sintomas encontrados nas mulheres ocidentais, que nos faz pensar sobre a importância da sociedade de referência como um fator que influencia o climatério. A menopausa marca um ponto de viragem em mulheres que passam de maturidade para a senescência através de um rito de passagem facilitador, mas este no Ocidente é diluído e mulheres vivem nesta fase de uma forma negativa (AU)

Introduction: Including the sociocultural perspective in the care of women is key to at-taining good health. The biomedical model has obviated these factors in the study of climacteric, so that a new female pathology, Climatérico Syndrome, has been created. Main objective: To reflect from the feminist perspective, on the western sociocultural dimension of the climacteric. Methodology: We present an original article of theoretical reflection based on the Feminist Theory of the Holistic Health Paradigm that understands gender as a variable. Conclusions: Other cultures show us a climacteric woman who does not suffer from the signs and symptoms that we find in Western women, which makes us think of the importance of the society of reference as a factor that influences the experience of the climacteric. Menopause marks a turning point in the woman who passes from maturity to senescence through a facilitating rite of passage, but this in the West is diluted and the woman lives this stage in a negative way (AU)

Efectos del hábito tabáquico en el ciclo reproductivo de la mujer y en el neonato / Effects of smoking on the female reproductive cycle and on newborns

OBJETIVO: analizar la evidencia científica disponible en materia de tabaquismo durante el ciclo reproductivo de la mujer y sus efectos neonatales. MÉTODO: revisión narrativa de la bibliografía existente en bases de datos electrónicas (Biblioteca Cochrane Plus, Medline, Cuiden, CINAHL y Pubmed) y en revistas científicas en formato papel (Rol de Enfermería, Metas de Enfermería y Matronas profesión), desde enero de 2000 hasta diciembre de 2015, resultando 23 artículos. RESULTADOS: fumar tiene efectos negativos sobre la gestación como el aumento de abortos, la rotura prematura de membranas y la anemia materna, pero además afecta a la placenta que suele ser más madura de lo normal. La nicotina pasa al recién nacido con la leche materna y reduce la fertilidad femenina y la calidad embrionaria. Los hijos de madre fumadora pesan de media 200 g menos al nacer y tienen más riesgo de padecer muerte súbita. Se conoce la de privación de nicotina en el neonato como síndrome de abstinencia neonatal de nicotina. CONCLUSIONES: a pesar de conocerse los efectos de la nicotina en el embarazo para la madre y para el feto, apenas existen programas de deshabituación tabáquica que tengan en cuenta a la mujer gestante y su pareja como grupo especialmente vulnerable. Es esencial la instauración de dichos programas que deberían ser incluidos en la Cartera de Servicios del Sistema Nacional de Salud. Además, es importante crear una encuesta validada específica de valoración al neonato con síndrome de abstinencia de nicotina, para mejorar el diagnóstico precoz

OBJECTIVE: to analyze the scientific evidence available on smoking during the female reproductive cycle and its effects on newborns. METHOD: a narrative review of the bibliography currently available in electronic databases (Cochrane Plus Library, Medline, Cuiden, CINAHL and Pubmed) and in scientific journals in paper format (Rol de Enfermería, Metas de Enfermería, Nure Investigación and Matronas profesión) from January, 2000 to December, 2015; 23 articles were obtained. Outcomes: smoking has negative effects on pregnancy, such as an increase in miscarriages, premature rupture of membranes, and maternal anaemia; but it will also affect the placenta, which will usually be more mature than normal. Nicotine is transferred to the newborn through mother milk, and it reduces female fertility and embryo quality. Children of a smoking mother will weigh a mean 200g less at birth, and present a higher risk of sudden death. Nicotine deprivation in newborns is known as Neonatal Nicotine Withdrawal Syndrome. CONCLUSIONS: even though the effects of nicotine on pregnancy for the mother and the foetus are well known, there are very few programs for smoking cessation that will take into account pregnant women and their partners as a particularly vulnerable group. It is essential to implement these programs, which should be included in the portfolio of services offered by the National Health System. Besides, it is important to create a specific validated survey for assessing newborns with Nicotine Withdrawal Syndrome, in order to improve an early diagnosis