Evaluation of the impact of "speak out" and "human libraries" educational methodologies on nursing students' attitudes toward immigration.

Introduction: Measuring and understanding attitudes toward migrants is crucial in Health Sciences professionals. Nursing students, as future professionals in the healthcare system, must be comprehensively trained and prepared from the undergraduate level to effectively face the challenges of caring for health and disease processes in an increasingly globalized world. Our study aims to determine the level of attitudinal change in nursing students for immigrants, based on a training intervention with sessions of coexistence with immigrants in Spain. Methods: Quasi-experimental controlled and non-randomized study, carried out in 2019 in Nursing School La Fe, Valencia (Spain), with 201 participants (74 intervention group, 127 control group). Instrument: Attitudes toward Immigration Instrument (IAHI) questionnaire. Educational techniques of the training intervention: Speak outs and Human Libraries. Descriptive statistical analysis and comparison of results between groups was performed. Results: The participants in the intervention group showed significant changes in attitude modification, both in the total score of the questionnaire and in 4 of the 5 dimensions (pre-post intervention medition). When comparing the differences between the intervention group and the control group, we observed significant differences in 3 of the 5 dimensions: equality principles and policies, positive favorability, and negative favorability. Conclussion: Sessions involving coexistence, discussion, and reflection with immigrants, as educational intervention methods for nursing students (Speak outs and Human Libraries), are useful and effective tools to promote positive attitudinal changes toward immigrants within the healthcar context in nursing students.

A Systematic Review of the Effectiveness of Non-Pharmacological Therapies Used by Nurses in Children Undergoing Surgery.

OBJECTIVE: The aim of this study was to identify non-pharmacological pain relief therapies in children undergoing surgery. DESIGN AND DATA SOURCES: Using keywords extracted from Medical Subject Headings and "Descriptores en Ciencias de la Salud" we searched for articles in the Web of Science, Scopus, Cuiden, PubMed, and CINHAL databases from the last five years, and performed a reverse search. We assessed the documentary quality of the articles using various standardized instruments. RESULTS: The final review included eleven studies. In terms of cognitive-behavioral techniques, there is evidence that both music and video therapy are effective in reducing postoperative pain in children in seven studies, and therapeutic play in five studies. Other methods used less frequently but found to be effective included laughter therapy in one study and deep breathing in another. Regarding physical methods of pain relief, massage was found to be an effective non-pharmacological therapy for reducing pediatric postoperative pain in two studies and ineffective in another. CONCLUSIONS: In this study, we highlight the importance of non-pharmacological therapies in pediatric postoperative pain management. Cognitive-behavioral techniques, especially music therapy, video therapy, and therapeutic play, reduce pediatric postoperative pain. They are therefore effective therapies that nurses can use in this area. Further research into the effectiveness of storytelling is necessary, as the evidence is not entirely conclusive. More evidence is also needed on physical methods of pain relief, particularly massage.

Resultados y experiencia en salud en gestión de casos de enfermería en pacientes con patologías crónicas: una revisión de revisiones / Results and experience in Health in Nursing Case Management in Patients with Chronic Pathologies: a review of reviews

Objetivo: Sintetizar la evidencia reciente sobre la atención por gestión de casos de enfermería dirigida a pacientes adultos con patologías crónicas, en relación a resultados en salud, calidad de vida y satisfacción para el paciente. Material y métodos: Revisión de revisiones realizada en el año 2022, incluyendo estudios publicados entre 2011 y 2021, ambos incluidos, a través de las bases de datos Pubmed, Web of Science (WoS), Cochrane y el Índice bibliográfico español de ciencias de la Salud (IBECS). Resultados: Se incluyeron un total de 9 revisiones. Todas ellas analizaron la gestión de casos enfermera en relación a la efectividad en general. De ello, cinco estudios, además, se centraron también en calidad de vida del paciente, cuatro estudios en satisfacción del paciente, uno de ellos se centró en resultados en salud y otro hizo alusión a aspectos emocionales. La mayor parte de los artículos se centran en analizar la gestión de casos en varias enfermedades crónicas. El resto de artículos analizaron otras situaciones concretas: presión arterial y colesterol, insuficiencia cardiaca, depresión en enfermedades crónicas y atención domiciliaria. Discusión y conclusiones: Los estudios demuestran que existe una mejoría en los resultados de salud tras la gestión de casos, disminuyendo los ingresos hospitalarios y la atención en los servicios de urgencias. También se observa un aumento en la satisfacción del paciente. Con respecto a la calidad de vida, aunque existente escaso respaldo, los estudios reflejan resultados positivos en dicha variable. Los diferentes autores subrayan la necesidad de realizar más estudios con mayor calidad metodológica. (AU)

Objective: Synthesize recent evidence on nursing case management care aimed at adult patients with chronic pathologies, in relation to health outcomes, quality of life and patient satisfaction. Material and methods: Review of reviews carried out in the year 2022, including studies published between 2011 and 2021, both included, through the Pubmed, Web of Science (WoS), Cochrane databases and the Spanish Bibliographic Index of Health Sciences (IBECS). Results: A total of 9 reviews were included. All of them analyzed nursing case management in relation to overall effectiveness. Of this, five studies also focused on patient quality of life, four studies on patient satisfaction, one of them focused on health outcomes and another alluded to emotional aspects. Most of the articles focus on analyzing case management in various chronic diseases. The rest of the articles analyzed other specific situations: blood pressure and cholesterol, heart failure, depression in chronic diseases and home care. Discussion and Conclusions: Studies show that there is an improvement in health outcomes after case management, decreasing hospital admissions and care in emergency services. The existence of very little published bibliography on the repercussion on the quality of life of patients with chronic pathologies has been evidenced. Regarding patient satisfaction, it can be concluded that said satisfaction has increased compared to patients who have received care without SG. The best valued aspect was accessibility to health care. The different authors underline the need to carry out more studies with higher methodological quality. (AU)

Physiotherapists' ethical behavior in professional practice: a qualitative study.

Background: In health professions, ethics is considered a fundamental competence. The increase in clinical autonomy in the field of physiotherapy is associated with an increase in ethical situations in their clinical practice. Objective: To explore the ethics of the clinical relationship between physiotherapists and patients, the ethics training received by physiotherapists, and if in the clinical context, physiotherapists identify the necessary attitudes and apply the ethical recommendations of the profession for the ethical situations they experience. Methods: A qualitative exploratory and descriptive study was performed with physiotherapists. Data were collected through semi-structured interviews. The data were analyzed using content analysis, as proposed by Krippendorf. The study protocol was approved by the University of Valencia Ethics Committee of Human Research. Results: This study included 15 physiotherapists (66.66% women, average age = 42.2 years), which was sufficient to reach data saturation. We identified four categories: (i) Ethics of the clinical relationship (ethical values, principles, and norms; type of clinical relationship), (ii) Ethics training received (during the physiotherapy studies; current training of students; low importance of ethics in the curriculum), (iii) Necessary attitudes for professional ethical practice (main attitudes were identified: personal attitudes and professional attitudes); (iv) Experiences from professional practice (general; public sector vs. private sector). Conclusion: The ethics of the clinical relationship between physiotherapists and patients is determined by the attitudes of the practitioner, which are the result of his or her values and previous experiences; and are very centered on ethics of indication (founded mainly on the principles of Beneficence and Non-Maleficence). It is necessary to improve the ethical training received by physiotherapists, which is poorly focused on professional attitudes.

The Parental Stress Scale: Psychometric Properties in Pediatric Hospital Emergency Setting.

Parental psychological distress has been identified as a predisposing factor in attendance at and the inappropriate use of hospital pediatric emergency departments (PEDs). The aim of the study was to validate the Parental Stress Scale (PSS), a 12-item Spanish scale, in parents seeking care at PEDs. The study involved 270 participants with a mean age of 37.9 (SD = 6.76) years, of which 77.4% were women. The properties of the PSS were analyzed. The scale showed adequate internal consistency for the different factors (0.80 for the "Stressors" factor and 0.78 for the "Baby's Rewards" factor) and optimal model fit (chi-square = 107.686; df = 53; CFI = 0.99; TLI = 0.98; RMSEA = 0.028; 90% CI = 0.00-0.05). The 12-item Spanish version of the PSS is a valid and reliable instrument for assessing the stress levels of parents seeking care in PEDs.

Leisure Programmes in Hospitalised People: A Systematic Review.

Nurses carry out holistic assessments of patients during hospital admission. This assessment includes the need for leisure and recreation. Different intervention programmes have been developed to meet this need. The aim of this study was to investigate hospital leisure intervention programmes described in the literature in order to determine their effects on patient health and highlight the strengths and weaknesses of the programmes as reported by health professionals. A systematic review of articles in English or Spanish published between 2016 and 2022 was carried out. A search was performed in the following databases: CINAHL COMPLETE, PubMed, Cochrane Library and Dialnet and the Virtual Health Library and Web of Science resources. A total of 327 articles were obtained, of which 18 were included in the review. The methodological quality of the articles was assessed using the PRISMA, CASPe and STROBE scales. A total of six hospital-based leisure programmes were identified, including a total of 14 leisure interventions. The activities developed in most of the interventions effectively reduced the levels of anxiety, stress, fear and pain in patients. They also improved factors such as mood, humour, communication, wellbeing, satisfaction and hospital adaptation. Among the main barriers to implementing hospital leisure activities is the need for more training, time and adequate spaces for them develop. Health professionals consider it beneficial for the patient to develop leisure interventions in the hospital.

La necesaria formación en competencia cultural / The necessary training in cultural competence

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Health Inequities in LGBT People and Nursing Interventions to Reduce Them: A Systematic Review.

BACKGROUND: Lesbian, gay, bisexual, and transgender (LGBT) people present poorer mental and physical health results compared to the heterosexual and cisgender population. There are barriers in the healthcare system that increase these health inequities. OBJECTIVE: To synthesise the available evidence on how nurses can intervene in reducing health inequities in LGBT people, identifying their specific health needs and describing their experiences and perceptions of the barriers they face in the healthcare system. METHODS: Systematic review. Between March and April 2021, a bibliographic search was carried out in the Cuiden, LILACS, PubMed, Dialnet, SciELO, Trip Database, and Web of Science databases and metasearch engines. INCLUSION CRITERIA: Articles published in the last 5 years that address the specific health needs of LGBT people, their experiences and perceptions, or interventions in this group in which nurses may engage. RESULTS: A total of 16 articles were selected. Health disparities were detected in the LGBT community, which exhibited higher rates of mental health problems, substance abuse, risky sexual behaviours, self-harm, and suicide. These inequalities were related to minority stress, and each of them differently impacted individual populations within the broader LGBT community depending on their sexual orientations and gender identities. The impact of these factors was, in turn, modified by the intersections of race/ethnicity, geographic region, and socioeconomic factors. LGBT people described discriminatory experiences by health professionals, as well as their distrust and fear in this setting. Nurses can carry out interventions such as inclusive education about sex and sexual and gender diversity and bullying and suicide prevention programmes, and can provide gender-affirming and family-centred care. CONCLUSIONS: LGBT people experience health inequities and discrimination in the healthcare system. Nurses can implement diverse interventions to reduce these problems and, moreover, these health professionals are obliged to acquire cultural competence regarding LGBT health.

Physiotherapy Students' Experiences about Ethical Situations Encountered in Clinical Practices.

(1) Background: It is important to explore the ethical situations that physiotherapy students encountered in their clinical practices. (2) Methods: Qualitative, explorative, descriptive study. The participants included third-year physiotherapy students. They had to write five narratives about ethical situations encountered in their clinical practices. Krippendorff's method for qualitative content analysis was used to cluster units within the data to identify emergent themes. The study protocol was approved by the authors' University Ethic Committee of Human Research (H1515588244257). (3) Result: 280 narratives were reported by 64 students (23.34 ± 4.20 years, 59% women). Eight categories were identified from the qualitative analysis of the data: (a) professional responsibility, (b) professional competence, (c), beneficence, (d) equality and justice, (e) autonomy, (f) confidentiality, (g) respect for privacy, and (h) sincerity. All participants were informed and provided written informed consent. (4) Conclusions: Ethical principles were frequently violated in physiotherapy. Experiences of physiotherapy students must be examined to tailor educational interventions prior to their initiation into practice. Ethics education is needed in workplaces and should be increased in basic education. Facilitating the ethical awareness of future physiotherapists is a challenge for university teachers who provide ethical competence training.

Impact of Nurses' Intervention in the Prevention of Falls in Hospitalized Patients.

BACKGROUND: Clinical safety is a crucial component of healthcare quality, focused on identifying and avoiding the risks to which patients are exposed. Among the adverse events that occur in a hospital environment, falls have a large impact (1.9-10% of annual income in acute care hospitals); they can cause pain, damage, costs, and mistrust in the health system. Our objective was to assess the effect of an educational intervention aimed at hospital nurses (systematic assessment of the risk of falls) in reducing the incidence of falls. METHODS: this was a quasi-experimental study based on a sample of 581 patients in a third level hospital (Comunitat Valenciana, Spain). An educational program was given to the intervention group (n = 303), and a control group was included for comparison (n = 278). In the intervention group, the nurses participated in a training activity on the systematized assessment of the risk of falls. Analysis was undertaken using the Bayesian logistic regression model. RESULTS: a total of 581 patients were studied (50.6% male, 49.4% female), with an average age of 68.3 (DT = 9) years. The overall incidence of falls was 1.2% (0.3% in the intervention group and 2.2% in the control group). Most of the falls occurred in people ≥65 years old (85.7%). The intervention group had a lower probability of falling than the control group (OR: 0.127; IC95%: 0.013-0.821). Neither the length of hospital stay, nor the age of the participants, had any relevant effect. CONCLUSIONS: the systematic assessment of the risk of a patient falling during hospital processes is an effective intervention to reduce the incidence of falls.

Exposición y percepción de las enfermeras ante la violencia laboral en urgencias hospitalarias. Revisión sistemática / Nurses' exposure and perceptions of workplace violence in the emergency service. A systematic review

INTRODUCCIÓN: El departamento de urgencias hospitalarias, debido a sus características, es uno de los lugares donde mayor violencia laboral presentan sus profesionales. Por ello, el objetivo del estudio fue evaluar la exposición de las enfermeras ante la violencia laboral en urgencias hospitalarias. METODOLOGÍA: Revisión sistemática realizada entre los años 2013-2018, a través de bases de datos y meta buscadores como LILACS, IBECS, Dialnet Plus, CUIDEN, Cuidatge, ENFISPO y PubMed. Se encontraron 145 artículos. Tras el proceso de selección se obtuvo una muestra final de 20 artículos. RESULTADOS: La incidencia de violencia fue diferente entre los diversos países estudiados, siendo la violencia verbal la más frecuente; las enfermeras más expuestas fueron las de menor antigüedad profesional y las más jóvenes. La demora asistencial fue la causa principal que la desencadenó. CONCLUSIONES: Las enfermeras son de los profesionales que más sufren violencia laboral, considerándola endémica en su lugar de trabajo. La formación de los profesionales y la implicación de los directivos es fundamental para disminuirla o erradicarla

INTRODUCTION: The hospital emergency department, due to its characteristics, is one of the places where more work-place violence occurs in their professionals. Therefore, the objective of the study was to assess the exposure of nurses to workplace violence in hospital emergencies. METHODOLOGY: Systematic review conducted between 2013-2018, through databases and search engines such as LILACS, IBECS, Dialnet Plus, CUIDEN, Cuidatge, ENFISPO and PubMed. 145 articles were found. After the selection process a final sample of 20 articles is obtained. RESULTS: The incidence of violence was different among the various countries studied, with verbal violence being the most frequent; the most exposed nurses were the youngest professionals and the youngest. The delay in care was the main cause that triggered it. CONCLUSIONS: Nurses are one of the professionals who suffer more workplace violence, considering it endemic. The training of professionals and the involvement of managers is essential to reduce or eradicate it

Results of Nurse Case Management in Primary Heath Care: Bibliographic Review.

BACKGROUND: The new characteristics of today's population, together with the presence of chronic diseases in the elderly, require a new approach to care, promoting coordination between different levels of care. In this sense, we find the figure of the nurse case manager (NCM) in primary health care mainly responsible for ensuring continuity of care in complex patients with chronic diseases. OBJECTIVE: to describe the role of the NCM in care management, determining its effectiveness in addressing chronic disease (health outcomes and quality of life) and its efficiency in the health system. METHODS: Bibliographic review of scientific evidence on case management applied to nursing. Between March and April 2020 a bibliographic search was carried out in the Dialnet, Scielo, Scopus and Pubmed databases. INCLUSION CRITERIA: articles written in the last 5 years, which analyze how this nursing rol influences the care and health of patients. RESULTS: A total of 16 articles were selected. The NCM reduced the use of the emergency department, hospital admissions, readmissions, and the duration of these in the patients studied. CONCLUSION: The NCM is effective and efficient for both patients and health institutions, and a common practice model is needed that includes standardized protocols and evidence-based practices.

Development of a short questionnaire based on the Practice Environment Scale-Nursing Work Index in primary health care.

BACKGROUND: Professional nursing environments determine the quality of care and patient outcomes. Assessing the quality of environments is essential to improve and obtain better health outcomes. Simplifying and shortening the way to evaluate environments reliably is also important to help nurses better understand the strengths and weaknesses of their environments. In that sense, identifying essential elements of nursing environments would allow the construction of short assessment tools to improve such environments. OBJECTIVE: To construct a short tool to assess primary health care (PHC) nursing environments based on the Practice Environment Scale-Nursing Work Index (PES-NWI) questionnaire. METHODS: Observational, cross-sectional, analytical study (data collection February-April 2015). Tool: PES-NWI (31 items). Population: PHC nurses (three health districts in Valencia, Spain) with more than 3 months in the organization. The nurses were asked to select the 10 elements of the questionnaire (items) that they considered key to facilitate and improve professional care, establishing as a final selection criterion that they obtain a global election >40%. Variables: sociodemographic and 31 questionnaire items. Analysis: descriptive statistics, reliability, multidimensional scaling (ALSCAL), factor analysis, multiple linear regression. Finally, we have analyzed the concordance between both measurements (TOP10 score on the full scale score) using the Bland-Altman method. RESULTS: Study sample = 269 (Response rate = 80.29%). A total of 10 elements were identified based on selection frequency of the questionnaire PES-NWI. A factorial analysis explained 62.1% of variance, internal structure of three dimensions: (1) Participation in leadership and management, (2) Nursing foundations for quality of care, (3) Adequacy of resources, with Accumulate Variance explained: Component (1): 24%; Component (2): 43.1%; Component (3): 62.1%. Reliability (Cronbach's Alpha) was 0.816 for short questionnaire, and >0.8 for all measurements. Stress = 0.184 and RSQ = 0.793. Bland-Altman method: the scaling tends to be 1.92 points higher (equivalent to a maximum deviation of 1.54%) than the full-scale PES-NWI score (max score on PES-NWI = 124 points). CONCLUSIONS: It is possible to identify essential elements of environments to construct a short tool that simplifies the study of PHC environments. Conducting rapid studies of environments will provide managers with information about specific elements that require prioritization to enhance quality of care and safety.

Evaluación de la video-simulación como metodología docente para la entrevista motivacional en estudiantes de enfermería / Evaluation of the video-simulation as a teaching methodology for the motivational interview in nursing students / Avaliação de um vídeo-simulação como metodologia de ensino para a entrevista motivacional em estudantes de enfermagem

INTRODUCCIÓN: La Video-Simulación como herramienta pedagógica ha sido escasamente utilizada. Pretendemos evaluar la utilidad y la satisfacción con la metodología utilizada en el aprendizaje de entrevista motivacionales mediante VS. METODOLOGÍA: Estudio observacional descriptivo transversal (2015) con estudiantes de enfermería de 4. º curso de la Escuela de Enfermería La Fe (Valencia, España). Se diseñó un cuestionario Likert de 12 ítems. Se midieron las puntuaciones obtenidas, la fiabilidad, y se realizó un análisis factorial. RESULTADOS: La edad media fue 23,6 ± 4,5 años. Alfa de Cronbach de 0,91. El análisis factorial identificó dos dimensiones que explican el 32,4% y el 32,1% de la varianza (64,5% varianza total). El 70,6% de los estudiantes están bastante o totalmente de acuerdo con que la videosimulación les permite mejorar sustancialmente el aprendizaje CONCLUSIONES: Los estudiantes mostraron un alto nivel de satisfacción con este método de aprendizaje, que consideran útil para mejorar las habilidades en entrevista motivacional

INTRODUCTION: The Video-Simulation how a new pedagogical method has been scarcely used. We pretend to evaluate the utility and satisfaction with methodology used in the learning of the motivational interview technique through video-simulation. METHOD: A descriptive cross-sectional study (2015) in students of 4 th nursing course of Nursing School La Fe (Valencia, España). The scores obtained were measured, and the reliability of the questionnaire (Cronbach Alfa), through a factorial analysis. RESULTS: Average age=23.6 ± 4.5 years. Cronbach Alpha = 0.91. The factorial analysis identified two dimensions explaining 32.4% and 32.1% of the variance (64.5% total variance).70.6% of the students are quite or totally in agreement with the fact that the video-simulation allows them to improve substantially the learning. CONCLUSIONS: Students showed a high level of satisfaction with the learning methodology implemented. It is an effective learning method, that they consider useful to improve the skills in motivational interviewing

INTRODUÇÃO: A Vídeo-Simulação como método e ferramenta pedagógica tem sido pouco utilizada. Pretendemos avaliar a utilitário, satisfação e metodología utilizada na aprendizagem da entrevista motivacional a través da video-simulação. METODOLOGIA: Estudo descritivo de corte transversal (2015) em escolares do 4. º curso enfermagem do Escola Enfermagem La Fe (Valencia, España). Realizou-se um questionário de Likert de 12 itens. Os resultados obtidos foram mensurados assim como a confiabilidade do questionário (Cronbach Alfa), através de uma análise fatorial. RESULTADOS: A idade média foi de 23,6 ± 4,5 anos. Alfa de Cronbach de 0,91. A análise fatorial identificou duas dimensões que explicam 32,4% e 32,1% da variância (64,5% da variância total).70,6% dos alunos estão totalmente ou totalmente de acordo com o fato de que a videoimulação permite que eles melhorem substancialmente sua aprendizagem. CONCLUSÕES: Os estudantes mostraram um alto nível de satisfação com o método de aprendizagem implementado, que eles consideram útil para melhorar as habilidades em entrevistas motivacionais

[Population impact of nurses in care interventions chronicity in Spain. Systematic review]. / Impacto de las intervenciones enfermeras en la atención a la cronicidad en España. Revisión sistemática.

BACKGROUND: Epidemiological projections for the coming decades suggest that most chronic diseases will increase its prevalence. Different models of care have been developed to meet the challenge of chronicity; all implemented initiatives point to primary health care and especially the community nurse as the guarantors of chronic patient care, family and community. However, health policies do not endorse facts. The objective of this review was to evaluate the impact of different nursing interventions in the care strategy to chronicity in Spain. METHODS: Systematic review of the literature on the nurse contribution to address the chronicity in adult patients in Spain. The search was carried out in Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME and CUIDEN, databases. Inclusion criteria: written articles in Castilian and English published between 2007 and 2016 involving patients with chronic disease in all their life stages. The quality of the studies was assessed following Prisma criteria and the CEBM levels of evidence and recommendation. RESULTS: The Nursing interventions with the highest impact on the strategy of chronicity care in Spain were cases management and advanced nursing practice (50%), the home-care program offered from Primary Care (41,7%) and Telemonitoring intervention (8,3%). CONCLUSIONS: Nurses interventions have shown favorable results in effectiveness and satisfaction more studies that demonstrate the efficiency of the nurse contribution to the chronicity are needed.

OBJETIVO: Las proyecciones epidemiológicas para las próximas décadas sugieren que la mayor parte de las patologías crónicas incrementarán su prevalencia. Se han desarrollado diferentes modelos de atención para afrontar el reto que supone la cronicidad; todas las iniciativas implementadas señalan a la atención primaria de salud y especialmente a la enfermera comunitaria como los garantes de la atención al paciente crónico, su familia y la comunidad, si bien las políticas sanitarias no lo refrendan. El objetivo de esta revisión fue evaluar el impacto de las distintas intervenciones enfermeras incluidas en la estrategia de atención a la cronicidad en España. METODOS: Revisión sistemática de la literatura sobre la aportación enfermera en la atención a la cronicidad en pacientes adultos en España. La búsqueda se realizó en las bases de datos Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME y CUIDEN. Criterios de inclusión: artículos escritos en castellano e inglés publicados entre 2007-2016, que incluyesen pacientes con enfermedad crónica en todas las etapas del ciclo vital. Se evaluó la calidad de los estudios siguiendo los criterios Prisma y los niveles de evidencia y recomendación CEBM. RESULTADOS: Las intervenciones enfermeras de mayor impacto en la estrategia de atención a la cronicidad en España fueron la gestión de casos y la práctica avanzada (50%), los programas de atención domiciliaria desde atención primaria (41,7%) y la telemonitorización (8,3%). CONCLUSIONES: Las intervenciones enfermeras demuestran resultados favorables en efectividad y satisfacción. Se necesitan más estudios que evidencien la eficiencia de la aportación enfermera en la cronicidad.

Impacto de las intervenciones enfermeras en la atención a la cronicidad en España. Revisión sistemática / Population impact of nurses in care interventions chronicity in Spain. Systematic review

Fundamentos: Las proyecciones epidemiológicas para las próximas décadas sugieren que la mayor parte de las patologías crónicas incrementarán su prevalencia. Se han desarrollado diferentes modelos de atención para afrontar el reto que supone la cronicidad; todas las iniciativas implementadas señalan a la atención primaria de salud y especialmente a la enfermera comunitaria como los garantes de la atención al paciente crónico, su familia y la comunidad, si bien las políticas sanitarias no lo refrendan. El objetivo de esta revisión fue evaluar el impacto de las distintas intervenciones enfermeras incluidas en la estrategia de atención a la cronicidad en España. Métodos: Revisión sistemática de la literatura sobre la aportación enfermera en la atención a la cronicidad en pacientes adultos en España. La búsqueda se realizó en las bases de datos Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME y CUIDEN. Criterios de inclusión: artículos escritos en castellano e inglés publicados entre 2007-2016, que incluyesen pacientes con enfermedad crónica en todas las etapas del ciclo vital. Se evaluó la calidad de los estudios siguiendo los criterios Prisma y los niveles de evidencia y recomendación CEBM. Resultados: Las intervenciones enfermeras de mayor impacto en la estrategia de atención a la cronicidad en España fueron la gestión de casos y la práctica avanzada (50%), los programas de atención domiciliaria desde atención primaria (41,7%) y la telemonitorización (8,3%). Conclusiones: Las intervenciones enfermeras demuestran resultados favorables en efectividad y satisfacción. Se necesitan más estudios que evidencien la eficiencia de la aportación enfermera en la cronicidad

Background: Epidemiological projections for the coming decades suggest that most chronic diseases will increase its prevalence. Different models of care have been developed to meet the challenge of chronicity; all implemented initiatives point to primary health care and especially the community nurse as the guarantors of chronic patient care, family and community. However, health policies do not endorse facts. The objective of this review was to evaluate the impact of different nursing interventions in the care strategy to chronicity in Spain. Methods: Systematic review of the literature on the nurse contribution to address the chronicity in adult patients in Spain. The search was carried out in Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME and CUIDEN, databases. Inclusion criteria: written articles in Castilian and English published between 2007 and 2016 involving patients with chronic disease in all their life stages. The quality of the studies was assessed following Prisma criteria and the CEBM levels of evidence and recommendation. Results: The Nursing interventions with the highest impact on the strategy of chronicity care in Spain were cases management and advanced nursing practice (50%), the home-care program offered from Primary Care (41,7%) and Telemonitoring intervention (8,3%). Conclusions: Nurses interventions have shown favorable results in effectiveness and satisfaction more studies that demonstrate the efficiency of the nurse contribution to the chronicity are needed

La formación de especialistas en Enfermería Familiar y Comunitaria según las responsables de las unidades docentes / The training of specialists in Family and Community Health Nursing according to the supervisors of the teaching units

OBJETIVO: Analizar la situación actual de la formación de especialistas en Enfermería Familiar y Comunitaria desde la perspectiva de las enfermeras responsables de las unidades docentes. MÉTODOS: Análisis exploratorio mediante técnica de grupo nominal de las aportaciones realizadas por representantes de 19 unidades docentes multiprofesionales de atención familiar y comunitaria de 11 comunidades autónomas. Se categorizan y ponderan dichas aportaciones. RESULTADOS: Las categorías emergentes sobre las dificultades y fortalezas encontradas han estado en relación con las tutoras, al entorno donde se realiza la formación, con la propia estructura de la unidad docente, con la organización de la docencia y el programa oficial de la especialidad, con los apoyos externos y con la formación teórica. CONCLUSIONES: La formación en Enfermería Familiar y Comunitaria es una oportunidad de mejora de la atención primaria de salud para capacitar en competencias novedosas y necesarias aunque complejas de adquirir. Se hace necesario dar apoyo para que la formación sea efectiva y se debe dar a conocer la especialidad y su formación. Las tutoras son una pieza clave en este proceso

OBJETIVO: Analizar la situación actual de la formación de especialistas en Enfermería Familiar y Comunitaria desde la perspectiva de las enfermeras responsables de las unidades docentes. MÉTODOS: Análisis exploratorio mediante técnica de grupo nominal de las aportaciones realizadas por representantes de 19 unidades docentes multiprofesionales de atención familiar y comunitaria de 11 comunidades autónomas. Se categorizan y ponderan dichas aportaciones. RESULTADOS: Las categorías emergentes sobre las dificultades y fortalezas encontradas han estado en relación con las tutoras, al entorno donde se realiza la formación, con la propia estructura de la unidad docente, con la organización de la docencia y el programa oficial de la especialidad, con los apoyos externos y con la formación teórica. CONCLUSIONES: La formación en Enfermería Familiar y Comunitaria es una oportunidad de mejora de la atención primaria de salud para capacitar en competencias novedosas y necesarias aunque complejas de adquirir. Se hace necesario dar apoyo para que la formación sea efectiva y se debe dar a conocer la especialidad y su formación. Las tutoras son una pieza clave en este proceso (AU) - es OBJECTIVE: To analyze the current situation of the training of specialists in family and community nursing from the perspective of nurses responsible for teaching units. METHODS: Exploratory analysis using nominal group technique of the contributions made by representatives of 19 multidisciplinary teaching units in family and community care from 11 Spanish autonomous communities. They categorized and weighted those contributions. RESULTS: The emerging categories on the strengths and difficulties encountered related to the tutors, the environment where the training took place, the structure of the teaching unit, the organization of the teaching and the official programme of the speciality, the external supports and the theoretical training. CONCLUSIONS: Training in Family and Community Nursing is an opportunity to improve primary health care to train in news and necessary but complex skills. Support is required for training to be effective and the specialty and training should be made known. Tutors are a key part of this process

The training of specialists in Family and Community Health Nursing according to the supervisors of the teaching units. / La formación de especialistas en Enfermería Familiar y Comunitaria según las responsables de las unidades docentes.

OBJECTIVE: To analyze the current situation of the training of specialists in family and community nursing from the perspective of nurses responsible for teaching units. METHODS: Exploratory analysis using nominal group technique of the contributions made by representatives of 19 multidisciplinary teaching units in family and community care from 11 Spanish autonomous communities. They categorized and weighted those contributions. RESULTS: The emerging categories on the strengths and difficulties encountered related to the tutors, the environment where the training took place, the structure of the teaching unit, the organization of the teaching and the official programme of the speciality, the external supports and the theoretical training. CONCLUSIONS: Training in Family and Community Nursing is an opportunity to improve primary health care to train in news and necessary but complex skills. Support is required for training to be effective and the specialty and training should be made known. Tutors are a key part of this process.