Locked-in syndrome: A qualitative study of a life story.

INTRODUCTION: Locked-in syndrome (LIS) is characterized by tetraplegia, anarthria, paralysis of cranial nerves, and facial musculature, with the preservation of consciousness and cognitive abilities, as well as vertical eye movements and eyelid movements, hearing, and breathing. Three types of LIS are distinguished: classic, incomplete, and total. The aim of the present study was to describe the life history of a person with LIS, as well as the wife's experience and perspective of this life history. METHODS: A qualitative life history study was conducted with two participants: a 54-year-old man diagnosed with LIS and his 50-year-old wife. Data were collected through interviews and autobiographical documents submitted by the participants and analyzed following Braun and Clarke's method of inductive thematic analysis. RESULTS: Five main themes were identified: (1) how to understand and overcome the new situation; (2) the process of care and rehabilitation; (3) communication; (4) writing as a way of helping oneself and others; and (5) personal autonomy and social participation. CONCLUSION: The participants valued the support of their friends and family in the acceptance stage of the new situation, giving special importance to the communication skills and medical attention received after diagnosis.

The role of duty, gender and intergenerational care in grandmothers' parenting of grandchildren: a phenomenological qualitative study.

OBJECTIVES: The aim of this study was to describe grandmothers' experiences of taking care of their grandchildren in terms of their care-giving tasks, motivations and emotions. METHODS: A qualitative phenomenological study was conducted. Purposive sampling was used, based on the relevance of the research question. Seventeen participants were included, women ≥ 65 years old, grandmothers who care for their grandchildren at least 10 h per week and who attended the Nursing units of the Primary Care Health Centers (Madrid Public Health Service). Seventeen in-depth interviews were conducted. The interviews were audio-recorded, transcribed verbatim and thematic analysis was carried out from the perspective of hermeneutic phenomenology. For the analysis, the Excel program was used to organize and share the coding process. Also, we followed COREQ guidelines. RESULTS: Four main themes were identified: (a) Care out of obligation, where participants feel an obligation to help their children by caring for grandchildren, regardless of their number, and prefer to do so voluntarily; (b) Care out of responsibility, where grandmothers see their role as a responsibility that includes saving costs by caring for grandchildren and facilitating their children's work life balance; (c) Care as a social duty, reflecting a moral commitment inherited from their mothers to help future generations; and (d) Construction of care from a gender perspective, where grandmothers, as women, primarily assume the care and upbringing of grandchildren. DISCUSSION: Our results contribute to increase knowledge about childcare provided by grandmothers to their grandchildren. Grandmothers become fundamental pillars of families by helping their children balance family and work. Behind this care there is a strong sense of obligation, duty and generational responsibility. Grandmothers' help presents differences in the distribution of tasks and care by sex. Identifying factors that motivate grandmothers to care for their grandchildren helps nurses to perform higher quality comprehensive care.

The impact of developmental and epileptic encephalopathies on families: a qualitative study.

Developmental and epileptic encephalopathies (DEEs) cause disability and dependence affecting both children and the family. The aim of the study was to describe the perspective of parents of children with DEEs regarding the impact of the disease on the family. We carried out a qualitative study based on the interpretivist paradigm. Twenty-one participants were selected using purposive sampling. Parents of children with DEEs of SCN1A, KCNQ2, CDKL5, PCDH19, and GNAO1 variants were included. In-depth interviews and researcher notes were used for data collection. A thematic analysis was performed on the data. Three themes were identified in the results: (a) Assuming conflicts and changes within the couple, causing them to distance themselves, reducing their time and intimacy and leading them to reconsider having more children; (b) impact of the disorder on siblings and grandparents, where siblings perceived DEE as a burden in their lives, felt neglected, and needed to grow and mature alone; conversely, the grandparents suffered for their grandchildren and the parents, in addition to perceiving that their health worsened, and (c) reconciling the care of the child with family life and work; this led the parents to share tasks, abandon or reduce working hours and ask for help.Conclusions: Caring for a child with DEE can result in neglect of social, psychological, emotional, recreational, educational, or occupational needs and obligations that ultimately impact all family members. What is Known: • Children with DEE may develop seizures and experience developmental and cognitive problems. • Caring for a child with DEE has a social and psychological impact on the entire family.

Experience of Diagnosis and Initiation of Renal Replacement Therapy in Women with Chronic Kidney Disease.

Chronic kidney disease (CKD) has considerable effects on the quality of life of female patients. Receiving the diagnosis and beginning renal replacement therapy (RRT) has a great personal impact on patients. The purpose of this study was to describe the experience of female patients with CKD at an ambulatory dialysis unit regarding diagnosis, life changes, and initiation of RRT. A qualitative exploratory study was conducted based on a social contructivism framework. Participants were recruited using purposeful sampling. In total, 18 women who received treatment for CKD with RRT were included. The women were attending the Ambulatory Dialysis Unit at a hospital belonging to the public health system of Madrid (Spain). Unstructured and semi-structured in-depth interviews, researchers' field notes, and women's personal letters were used. A systematic text condensation analysis was performed. The criteria used to control trustworthiness were credibility, transferability, dependability, and confirmability. Two themes emerged from the data: (a) A turning point in their lives, and (b) The emotional journey of beginning RRT. The diagnosis of CKD and the beginning of treatment implies changing routines and adapting to a new life with CKD. The first dialysis and puncture of the arteriovenous fistula is a major experience. Support from other CKD patients with more experience is perceived as a necessity and a tool to share their experiences and resolve doubts among peers. The diagnosis and initiation of RRT leads to numerous changes in the lives of women with CKD, which may influence the acceptance of treatment.

Trends in the nonmedical misuse of benzodiazepines and Z-hypnotics among school-aged adolescents (2016-2021): gender differences and related factors.

BACKGROUND: The misuse of psychotropic medication has increased during the past decade, especially among adolescents. The aim of our study was to describe the prevalence and patterns of the nonmedical use of benzodiazepines (BDZ) and Z-hypnotics among school-aged adolescents through the lens of sex. In addition, we sought to analyze the temporal evolution of the nonmedical use of these drugs during the period 2016-2021. METHODS: The temporal evolution of the nonmedical use of these drugs was analyzed based on survey data collected in 2016, 2018 and 2021, which includes the first years of the COVID-19 pandemic. To assess the possible effect of the COVID-19 pandemic, the year at survey was conducted was introduced as a categorical variable. We used data from the Spanish State Survey on Drug Use in Secondary Education, which covers drug use among students aged 14-18 years. Using multivariate logistic regression models, we estimated the independent effect of different variables (sociodemographic data, use of other psychoactive substances, risk perception and availability) on the nonmedical use of BDZ and Z-hypnotics. RESULTS: In total, survey data from 95,700 adolescents were included in our analysis. The nonmedical use of BDZ and Z-hypnotics increased among adolescents during the study period. The adjusted odds ratio (AOR) from 2016 to 2018 was 1.11 (95% CI 0.94-1.31) and from 2018 to 2021 the AOR was 1.26 (95% CI 1.08-1.46), using 2016 and 2018, respectively, as reference years. The nonmedical use of BDZ and Z-hypnotics was more likely in adolescent girls than boys (AOR = 2.11). The nonmedical use of prescription opioids (AOR = 3.44), novel psychoactive substances and other illicit psychoactive drugs (AOR = 4.10) were risk factors for the nonmedical use of BDZ and Z-hypnotics in both sexes. Use of cannabis (AOR = 1.38) was a predictor of nonmedical use in female adolescents only. CONCLUSIONS: This study shows that the trend of the nonmedical use of BDZ and Z-hypnotics among school-aged adolescents in Spain increased between 2016 and 2021. Among adolescents aged 14 to 18, the probability of nonmedical use of these psychoactive substances was twice as high for female adolescents as for male adolescents.

Living and Coping with Olfactory and Taste Disorders: A Qualitative Study of People with Long-COVID-19.

Taste and smell disorders are common symptoms of SARS-CoV-2 acute infection. In post-COVID-19 condition, symptoms can persist leading to disruption in patients' lives, to changes in their coping skills, and to the need to develop strategies for everyday life. This study aimed to describe the perspective of a group of patients with Long-COVID-19, a condition where loss of taste and/or smell was the most predominant symptom. A qualitative descriptive study was conducted. Participants who had suffered SARS-CoV-2 infection and had Long-COVID-19 loss of taste and/or smell were recruited. Purposive sampling was applied, and participants were recruited until data redundancy was reached. In-depth interviews were used for data collection and thematic analysis was applied. Twelve COVID-19 survivors (75% women) were recruited. The mean age of the participants was 55 years, and the mean duration of post-COVID-19 symptoms was 25 months. Three themes were identified: (a) Living with taste and smell disorders, describing the disorders they experience on a daily basis, how their life has changed and the accompanying emotions, (b) Changes and challenges resulting from the loss of taste and smell, changes in habits, self-care and risk in certain jobs or daily activities, (c) Coping with taste and smell disorders, describing the daily strategies used and the health care received. In conclusion, Long-COVID-19 taste and/or smell disorders limit daily life and involve changes in habits, meal preparation, and the ability to detect potentially dangerous situations.

Gender Differences in the Co-Use of Tranquilizers, Sedatives, Sleeping Pills and Alcohol among Spanish Adolescents: A Nationwide Population-Based Study.

Adolescence is a critical developmental stage for the initiation of substance use worldwide, which is one of the main risk-taking behaviors that may impact adolescents' physical and mental well-being. The aims of this study were to (1) assess the prevalence of the co-use of tranquilizers, sedatives, and sleeping pills with alcohol (TSSp&AC) by gender in the Spanish adolescent population in 2018 and (2) identify the variables associated with TSSp&AC. An observational cross-sectional study following STROBE guidelines was conducted. We analyzed data from 38,010 adolescents aged 14 to 18 years old (18,579 males and 19,431 females) who participated in ESTUDES (Survey on Drug Use in Secondary Education in Spain) 2018. Female adolescents reported a higher prevalence of TSSp&AC than males (p < 0.001). The factors associated with female co-use were being 16-18 years of age (OR 1.65); the consumption of tobacco (OR 1.73), cocaine (OR 1.84), other illicit psychoactive drugs (OR 1.89); and novel illicit psychoactive drugs (OR 1.74); no perceived health risk from the consumption of TSSps (OR 2.45); and the perceived availability of TSSps (OR 2.23) and alcohol (OR 2.09). There are several factors associated with TSSp&AC in Spanish female adolescents with potential implications for healthcare providers.

Supervised Telerehabilitation and Home-Based Respiratory Muscle Training for Post-COVID-19 Condition Symptoms: A Nested Qualitative Study Exploring the Perspectives of Participants in a Randomized Controlled Trial.

OBJECTIVE: The purpose of this study was to describe the experiences of individuals with post-coronavirus 19 (COVID-19) condition symptoms who underwent a supervised telerehabilitation and home-based respiratory muscle training (TSHB-RMT) program. METHODS: A qualitative descriptive study was conducted. Participants were recruited using purposeful sampling. The inclusion criteria consisted of: patients aged over 18 years who presented persistent COVID-19 symptoms of fatigue and dyspnea for at least 3 months after the COVID-19 diagnosis. In total, 28 patients were included. In-depth interviews and researcher field notes were used to collect the data. A thematic analysis was performed. RESULTS: Three themes reflect the patients' perspective on the TSHB-RMT before the program (reasons for participating), during the treatment program, and upon completion of the study. Among the reasons for participation, participants highlighted the absence of improvement and treatment, and feeling abandoned and forgotten by the health system. The treatment required discipline on behalf of the patients. Mondays and Tuesdays were the most difficult days for performing the therapy, and the physical therapist was perceived as a tool for adherence, change, and a source of validated information. The patients perceived positive effects quite soon; however, it was necessary to extend the follow-up after completing the program because they abandoned the program due to the lack of guidance for exercise supervision. CONCLUSION: This study described relevant aspects that physical therapist professionals should consider when providing TSHB-RMT treatment. IMPACT: TSHB-RMT requires discipline, perseverance, effort, and a commitment to the group. The physical therapist is perceived as the tool that facilitates adherence and participation. The effects are rapidly perceived, leading to improved self-confidence and autonomy; however, it is necessary to increase the follow-up time.

Coping with the hospital environment during the COVID-19 pandemic: A qualitative study of the survivors' perspective during their stay at the ICU and inpatient ward.

The COVID-19 pandemic has significantly affected the clinical practice of healthcare professionals. This study aimed to explore the perspectives of COVID-19 survivors regarding the healthcare they received during their stay in the Intensive Care Unit (ICU) and the inpatient COVID-19 ward. A qualitative case-study approach was implemented. Participants were recruited using non-probabilistic purposeful sampling strategy. Inclusion criteria included patients aged ≥18 years who received follow-up from the Pulmonology service at a Hospital in de North of Spain, were diagnosed with COVID-19 and bilateral pneumonia, and were admitted to the ICU before being transferred to a COVID-19 inpatient ward. Data was collected through in-depth interviews and researchers' field notes, and thematic analysis was performed. Techniques such as credibility, transferability, dependability, and confirmability were employed to ensure the trustworthiness of the data. A total of 25 individuals (six women) were included in the study. Three main themes emerged from the analysis: common challenges faced in both units, coping with the hospital stay, and developing strategies. Findings highlighted the need to improve information dissemination, individualize care, and enhance direct patient interaction. Moreover, the study shed light on the psychological impact of hospitalization and ICU experience, including feelings of loneliness, confinement, and the lack of memories from the ICU stay, as well as the influence of care and healthcare language. Finally, strategies such as keeping the mind occupied and maintaining self-discipline were identified as crucial during hospitalization. These findings provide valuable insights for healthcare professionals in delivering care to individuals with COVID-19 in the ICU and hospital ward settings.

The Meaning of Physical Education Practice in Students with Attention-Deficit Hyperactivity Disorder (ADHD).

Purpose: This study seeks to describe the perspective of students with attention-deficit hyperactivity disorder (ADHD) and physical education (PE) teachers concerning physical activity practice in high school. Methods: A qualitative descriptive study based on an interpretative framework was conducted with secondary school students with ADHD, and their teachers of physical education. In-depth interviews and researchers' field notes were used to collect the data. Purposive sampling and inductive thematic analysis were applied. Results: Results show that ADHD is not experienced as limiting the practice of PA and PE by students, except in motor activities that require concentration such as tactical games. On the contrary, PA and PE helps them feel better. Teachers have not had to make extensive methodological modifications in their teaching styles with students with ADHD in relation to other situations or incidents. Conclusions: Students with ADHD do not seem to show significant difficulties in PE lessons or in the practice of extracurricular PA. PE teachers do not need to make significant adaptations with these students.

La experiencia de realizar una investigación cualitativa con mujeres con enfermedad renal crónica / The experience of conducting qualitative research with women with chronic kidney disease

La investigación es la plataforma para que la enfermería pueda contribuir a la calidad y gestión en el cuidado de los pacientes. La enfermería se hará visible a los ojos de los propios profesionales como de la sociedad a medida que aplique más intervenciones basadas en la investigación, de esta manera habrá una mayor necesidad de crear conocimiento potenciando la enfermería como disciplina humanista y revelando el carácter autónomo y social que la profesión posee.El propósito del siguiente artículo es narrar desde la mirada de una enfermera la experiencia de realizar una investigación cualitativa con mujeres con enfermedad renal crónica en una unidad de diálisis de un hospital público de la Comunidad de Madrid. (AU)

Research is the platform for nursing to contribute to the quality and management of patient care. Nursing will become visible in the eyes of the professionals themselves as well as of society as it applies more research-based interventions, in this way there will be a greater need to create knowledge, promoting nursing as a humanistic discipline and revealing the autonomous and social character that the profession possesses.The purpose of the following article is to narrate from the perspective of a nurse the experience of conducting qualitative research with women with chronic kidney disease in a dialysis unit of a public hospital in the Community of Madrid. (AU)

Experiência de famílias de doadores falecidos durante o processo de doação de órgãos: um estudo qualitativo / Experiencia de familias de donantes fallecidos durante el proceso de donación de órganos: un estudio cualitativo / Deceased donor's family experience during the organ donation process: a qualitative study

Resumo Objetivo A família é o principal componente da doação de órgãos. Este estudo descreve a experiência da família do doador com os cuidados de enfermagem durante o processo de doação. Métodos Foi realizado um estudo fenomenológico. Os participantes eram familiares que aceitaram a doação de órgãos de um parente em hospitais, e foram recrutados por meio de amostragem intencional. Foram realizadas entrevistas em profundidade e anotações em campo, além de uma análise temática. Resultados Três temas foram identificados: Aspectos positivos do cuidado de enfermagem na unidade de terapia intensiva (UTI); Aspectos positivos do cuidado do enfermeiro coordenador de transplantes (ECT); e Aspectos improváveis do cuidado de enfermagem durante o processo de doação de órgãos. A flexibilidade dos horários na unidade de terapia intensiva para favorecer o acompanhamento dos familiares e fornecer informações adequadas e adaptadas sobre a doação são cuidados diferenciados para as famílias. Elas destacaram áreas para melhorias relacionadas à intimidade e privacidade durante o processo de doação. Conclusão As famílias dos doadores prezam e valorizam os cuidados de enfermagem no processo de doação de órgãos.

Resumen Objetivo La familia es el principal componente de la donación de órganos. Este estudio describe la experiencia de la familia del donante con los cuidados de enfermería durante el proceso de donación. Métodos Se realizó un estudio fenomenológico. Los participantes fueron familiares que aceptaron la donación de órganos de un pariente en hospitales, reclutados por medio de muestreo intencional. Se realizaron entrevistas en profundidad y anotaciones en campo, además de un análisis temático. Resultados Se identificaron tres temas: Aspectos positivos del cuidado de enfermería en la unidad de cuidados intensivos (UCI); Aspectos positivos del cuidado del enfermero coordinador de trasplantes (ECT); y Aspectos improbables del cuidado de enfermería durante el proceso de donación de órganos. La flexibilidad en los horarios en la unidad de cuidados intensivos para favorecer el acompañamiento de los familiares y suministrar informaciones adecuadas y adaptadas respecto a la donación constituyen cuidados diferenciados con las familias. Destacaron áreas para mejoras relacionadas con la intimidad y la privacidad durante el proceso de donación. Conclusión Las familias de los donantes precian y valoran los cuidados de enfermería en el proceso de donación de órganos.

Abstract Objective The family is the main component for organ donation. This study describes the experience of the donor's family with the nursing care during the donation process. Methods A phenomenological study was applied. Participants were family members who accepted the donation of organs from a relative in hospitals, using purposeful sampling. In-depth interviews and field notes were conducted. A thematic analysis was performed. Results Three themes were identified: Positive aspect of intensive care unit nurses' care; Positive aspects of nurses transplant coordinators' care; and Improvable aspects of nursing care during the organ donation process. The flexibility of hours in the intensive care unit to favor the accompaniment of family members, and to provide adequate and adapted information about the donation are outstanding care for families. They highlight areas for improvement related to intimacy and privacy during the donation process. Conclusion Donor's families appreciate and value nursing care within the organ donation process.

Estudio descriptivo del conocimiento de enfermeras y médicos de las abreviaturas en los informes de alta hospitalaria / A descriptive study of the knowledge of nurses and doctors of clinical abbreviations in hospital discharge reports

Introducción: Los informes de alta de hospitalización presentan gran cantidad de abreviaturas y su significado puede ser desconocido por médicos y enfermeras, pudiendo comprometer la seguridad del paciente. Objetivo: Evaluar el conocimiento de médicos y enfermeras de las abreviaturas clínicas presentes en el informe de alta. Métodos: Estudio observacional-transversal mediante un cuestionario elaborado ad hoc dirigido a médicos y enfermeras del Hospital Universitario de Fuenlabrada. Para la validación del cuestionario se realizó la evaluación del contenido y de la validez lógica. La cumplimentación fue anónima y voluntaria y se difundió online a través de los correos corporativos de los profesionales. El cuestionario incluía variables sociodemográficas y 14 abreviaturas presentes en los informes de alta. Los datos se obtuvieron de la historia clínica electrónica. Resultados: De 756 profesionales, el cuestionario fue respondido por 68 médicos y 86 enfermeras (n = 154). La edad media de los profesionales fue de 40,58 años (DE ±7,54), y la media de años de experiencia profesional fue de 17,10 años (DE ±7,37). Los profesionales presentan un porcentaje medio de aciertos del 35,84% de todas las abreviaturas evaluadas. El personal médico presentó un 55,94% de contestaciones correctas, y el personal de enfermería un 23,17%. Las abreviaturas en las que se produjeron más errores fueron: SNG, NPIM, EEA y RCP, con un porcentaje de aciertos del 5,19, 6,49, 6,49 y 7,79%, respectivamente. Conclusiones: La identificación de las abreviaturas en los informes de alta por parte de los médicos es superior a la del personal de enfermería. A nivel global, el conocimiento de las abreviaturas en ambos profesionales es bajo

Introduction: Medical Records have a large number of abbreviations and doctors and nurses may not be aware of their meaning, which could compromise patient safety. Objective: To evaluate the knowledge of doctors and nurses of the clinical abbreviations in medical discharge reports. Methods: Observational-cross sectional study through a questionnaire developed ad hoc for doctors and nurses from Hospital Universitario de Fuenlabrada. The content and logical validity of the questionnaire was assessed. The questionnaire was completed anonymously and voluntarily. The questionnaire was also distributed online to the professionals' corporate emails. The questionnaire included sociodemographic variables and 14 abbreviations present in medical discharge reports. The data were obtained from the Electronic Clinical Record. Results: Out of a total of 756 professionals, the questionnaire was answered by 68 doctors and 86 nurses (n = 154).The mean age of the professionals was 40.58 years (SD ±7.54), and the mean number of years of professional experience was 17.10s (SD ±7.37). The professionals gave an average percentage of correct answers of 35.84%. Doctors gave 55.94% of the correct answers, and nurses 23.17%. The abbreviations for which the most errors occurred were SNG, NPIM, EEA, RCP, with a success rate of 5.19%, 6.49%, 6.49% and 7.79%, respectively. Conclusions: The identification of the abbreviations in medical discharge reports by doctors is superior to that of nursing staff. Overall the knowledge of abbreviations in both professionals is low

Efectos de la inmersión vertical en el agua sobre el sistema nervioso: revisión sistemática / Effects of vertical water immersion on the nervous system: a systematic review

Introducción. La inmersión vertical induce una variedad de respuestas fisiológicas en diferentes sistemas corporales, dependiendo de las propiedades de la mecánica de fluidos, las cuales son la base que sustenta los programas de terapia acuática en diferentes patologías. Objetivo. Realizar una revisión sistemática para analizar y describir los efectos que la inmersión vertical produce en el sistema nervioso en sujetos sanos. Sujetos y métodos. Se llevó a cabo una búsqueda sistemática de la bibliografía existente en las bases de datos BRAIN, PubMed, PEDro y Web of Science. Se evaluó metodológicamente la calidad mediante la guía CASPe y el nivel de evidencia se categorizó mediante la escala Oxford. Se incluyó un total de 12 artículos, con un rango de puntuación de 7-10 según CASPe, niveles de evidencia 1b-2b y grado de recomendación B. Resultados. Todos los estudios mostraron resultados positivos a las diferentes formas de exposición de la inmersión vertical en el agua y a la suma de estímulos empleados, sin referir efectos adversos en ningún caso. Conclusiones. La inmersión vertical en el agua genera efectos positivos sobre los flujos circulatorios cerebrales, la activación cortical, las funciones ejecutivas y la producción de neurotrofinas en sujetos sanos

Introduction. Vertical immersion induces a variety of physiological responses in different body systems, depending on the properties of fluid mechanics, which are the basis that underpins aquatic therapy programs in different pathologies. Aim. To perform a systematic review to analyze and describe the effects that vertical immersion produces on the nervous system in healthy subjects. Subjects and methods. A systematic search of the existing literature was conducted in the databases BRAIN, PubMed, PEDro and Web of Science. Quality was methodologically assessed using the CASPe guideline and the level of evidence was categorized using the Oxford scale. A total of 12 articles were included, with a score range of 7-10 according to CASPe, levels of evidence 1b-2b and grade of recommendation B. Results. All studies showed positive results to the different forms of exposure of vertical immersion in water and the summation of the stimuli used; no adverse effects were reported in any case. Conclusions. The vertical immersion in the water generates positive effects on cerebral blood flows, cortical activation, executive functions and the production of neurotrophins in healthy subjects

Hospitalización por bronquiolitis: Factores influyentes en la vivencia de los progenitores / Hospitalization due to bronchiolitis: factors influencing parents' experience

OBJETIVO: Describir la experiencia de los progenitores de niños hospitalizados por bronquiolitis. MÉTODO: Estudio cualitativo fenomenológico. Se incluyeron progenitores con hijos ingresados por bronquiolitis, entre el 7 de diciembre de 2015 y el 8 enero de 2016, en el servicio de Pediatría de un hospital del Servicio Madrileño de Salud. Se recogieron los datos mediante grupos focales y notas de los investigadores. Se realizó el análisis temático de los datos. Se incluyeron 10 progenitores con edades comprendidas entre los 30 y 39 años. Se exploraron 5 temas: percepción de la monitorización, necesidad de saber, percepción de fragilidad del niño, estrategias de afrontamiento, y reorganización del entorno familiar. RESULTADOS: La monitorización de la saturación de oxígeno produce dependencia e incertidumbre en los progenitores. Además, existe una necesidad de conocer, que favorece la búsqueda de información en Internet. Los progenitores perciben la fragilidad del niño hospitalizado a través de su aspecto y estado físico. Además, desarrollan diferentes estrategias de afrontamiento para buscar y confirmar la información, aproximarse a los profesionales y estar presentes junto a los hijos/as. Por último, se produce una reorganización de la familia para mantener la presencia constante de los progenitores durante la hospitalización. CONCLUSIONES: Los resultados obtenidos pueden orientar a los profesionales de pediatría a manejar la información administrada a los progenitores y potenciar el empoderamiento de los progenitores

AIM: To describe the experience of the parents of children hospitalized due to bronchiolitis. METHOD: Phenomenological qualitative study. Purposeful sampling was undertaken of parents with children diagnosed with bronchiolitis, from December 7, 2015 to January 8, 2016, and admitted to the paediatric department of a public hospital of the Madrid Health Service. Data collection strategies included focus groups and researchers' field notes. Afterwards, the data were analyzed using thematic analysis. We included 10 parents, aged between 30 and 39 years. Five themes were explored: perception of monitoring, need to know, perception of child fragility, coping strategies, and reorganization of the family environment. RESULTS: Oxygen saturation monitoring through devices produced dependence and uncertainty in the parents. In addition, there was a need to know and understand the technical language, which encouraged searching for information on the Internet. The parents perceived the fragility of the hospitalized child through their appearance and physical state. In addition, they developed different coping strategies to seek and confirm information, to approach professionals and be present with their children. Finally, the family was reorganised to maintain the constant presence of the parents during hospitalization. CONCLUSIONS: The results obtained can help paediatric professionals manage the information given to parents and thus empower them

La experiencia de ser portador de un catéter venoso central para hemodiálisis: estudio cualitativo / The experience of having a central venous catheter for hemodialysis: qualitative study

Introducción: La enfermedad renal crónica (ERC), produce una pérdida gradual e irreversible de la función de los riñones. Sus modalidades de tratamiento son invasivas y la existencia de un acceso vascular adecuado para hemodiálisis es fundamental para garantizar la supervivencia de los pacientes. Las diferencias de género existen con respecto a la epidemiología, la evolución y el pronóstico de las enfermedades crónicas del riñón, y pueden existir diferencias en las respuestas y perspectivas de las mujeres ante la ERC. Objetivos: Describir la experiencia de los pacientes con enfermedad renal crónica en hemodiálisis; su experiencia como portadores de un catéter venoso central (CVC), y si existen diferencias de género en las experiencias y vivencias de los portadores/as. Material y Método: Estudio cualitativo fenomenológico. Se aplicó un muestreo por propósito, se recogieron datos a través de entrevistas en profundidad, y se aplicó un análisis temático. Resultados: La enfermedad renal crónica supone un gran impacto en sus vidas. Todos los pacientes narran su preferencia sobre el CVC, son conscientes de su implicación en su tratamiento y en su expectativa vital, y se preocupan de su viabilidad y seguridad. Conclusiones: Existen diferencias de género, sobre todo en el impacto de la enfermedad y el tratamiento en el trabajo y en su nivel de autonomía y actividad

Introduction: Chronic Kidney Disease (CKD) is a disease that involves the gradual and irreversible loss of kidney function. The existence of adequate vascular access for hemodialysis is fundamental to guarantee a survival of the patients. Gender differences exist with respect to the epidemiology, evolution and prognosis of chronic kidney diseases. There are differences in the responses and perspectives of women on CKD. Objectives: To describe the experience of patients with CKD on hemodialysis; their experience as holders of a central venous catheter (CVC), and if there are gender differences in the responses and experiences of the holders. Material and Method: Qualitative phenomenological study was applied. Purposeful sampling was used and in-depth interviews was applied by researchers. Also, thematic analysis was used to qualitative data analysis. Results: CKD has a great impact on the patients’ lives. All patients report their preference about the use of CVC, are aware of the involvement in the treatment and their life expectancy, and are concerned about the viability and safety. Conclusions: There are gender differences, especially in the impact of the disease and treatment at work and in their level of autonomy and activity

La anosmia neurosensorial: relación entre subtipo, tiempo de reconocimiento y edad / Sensorineural anosmia: relationship between subtype, recognition time, and age

En la actualidad, el olfato es considerado uno de los sistemas sensoriales más complejos y desconocidos que existen. La reciente investigación ha descubierto una posible relación entre la pérdida de olfato y enfermedades neurodegenerativas, centrándose en su papel como indicador precoz. El objetivo del presente estudio se centra en analizar la variable tiempo de reconocimiento (TRC) del test de Valoración de Estímulos Olfativos Cotidianos Abreviado (V.E.O.C.A.) y su relación con la edad y el tipo de anosmia de los participantes. Se utilizó una muestra de 64 sujetos con anosmia, derivados del Hospital Universitario Fundación de Alcorcón (HUFA). Los resultados mostraron diferencias significativas en el TRC respecto a las variables analizadas. Estos hallazgos sugieren una posible influencia de ciertos aspectos cognitivos, en consonancia con estudios previos. Se concluye la existencia de mayores puntuaciones de TRC en el caso de la anosmia traumática y en los jóvenes con respecto al resto de grupos

Currently, smell is considered one of the most complex and unknown sensory system that exist. A recent research concluded that there is a possible relationship between the loss of smell and neurodegenerative diseases, focusing on its importance like an early indicator. The present study focuses on the relationship between the variable Recognition Time (RCT) of the Valoración de Estímulos Olfativos Cotidianos Abreviado (V.E.O.C.A.) test, age, and type of anosmia. A sample of 64 subjects with anosmia derived from the Alcorcón Foundation University Hospital was used for the study. The results indicated TRC significant differences in the variables analyzed. These findings suggested a possible influence of cognitive aspects, according with previous studies. Higher scores were found on TRC in the cases of the traumatic anosmia and young people compared to the rest of groups

Evaluación psicológica del síndrome de burnout en profesores de educación primaria en la Comunidad de Madrid: comparación entre centros públicos y concertado / Psychological Assessment of Burnout Syndrome in Teachers of Primary Education in the Community of Madrid: Comparison between Public and Concerted Centers

Resumen El objetivo del estudio fue explorar el estado psíquico de profesores de educación primaria de varios centros públicos y concertados de la Comunidad de Madrid. Se evaluó la sintomatología ansiosa y depresiva y el síndrome de burnout, mediante la Escala HADS y el Cuestionario de Burnout del Profesorado. Los resultados indicaron que, aunque los docentes de colegios concertados reportan más sintomatología ansiosa, los profesores de colegios públicos presentan mayor presencia del síndrome de burnout en las escalas de cuestiones organizacionales, supervisión y reconocimiento. Se evidencia que los profesores de educación primaria son profesionales de alto riesgo, a pesar de que los estudios se han centrado mayoritariamente en educación secundaria.

Abstract The study objective was to explore the psychic state of Primary Education teachers of several public and concerted centers of the community of Madrid. We evaluated anxiety and depression symptoms and burnout syndrome using the HADS scale and the Burnout Questionnaire of teachers. The results indicated that, although concerted schools teachers report more symptoms anxious, teachers of public schools have a greater presence of the Burnout syndrome in the scales of organizational issues, supervision and recognition. It is evident that the primary education teachers are high-risk professionals, despite the fact that the studies have focused mainly in Secondary Education.

Dificultades para ofrecer cuidados al final de la vida en las unidades de cuidados intensivos. La perspectiva de enfermería / End of life care difficulties in intensive care units. The nurses’ perspective

Objetivo: Describir las dificultades percibidas por el personal de enfermería para prestar cuidados al final de la vida al paciente grave dentro de la unidad de cuidados intensivos (UCI). Método: Estudio cualitativo fenomenológico descriptivo. Se aplicó un muestreo por propósito y de bola de nieve. Las enfermeras debían tener una experiencia mínima de 1 año en UCI. Se incluyeron 22 participantes. Los datos se recopilaron mediante entrevistas en profundidad (no estructuradas y semiestructuradas) y notas de campo del investigador. El análisis se realizó mediante la propuesta de Giorgi. Resultados: Se identificaron tres temas: dificultades académico-culturales, relacionadas con la orientación curativa de la UCI y la falta de formación en cuidados al final de la vida; dificultades estructurales-arquitectónicas, relacionadas con la falta de espacio e intimidad para el paciente y la familia en los últimos momentos; y dificultades psicoemocionales, relacionadas con el distanciamiento emocional como estrategia aplicada por el personal de enfermería. Conclusiones: El personal de enfermería necesita formación sobre los cuidados al final de la vida mediante el uso de guías o protocolos y el desarrollo de estrategias de afrontamiento, junto a un cambio en la organización de la UCI orientado al cuidado terminal de los pacientes graves y a la atención de la familia (AU)

Objective: To describe the difficulties perceived by nursing staff in the delivery of end-of-life care to critically ill patients within intensive care units (ICU). Method: A descriptive phenomenological qualitative study was performed. A purposeful and snowball sampling of nursing staff with at least 1 year's previous experience working in an ICU was conducted. Twenty-two participants were enrolled. Data collection strategies included in-depth unstructured and semi-structured interviews and researcher's field notes. Data were analysed using the Giorgi proposal. Results: Three themes were identified: academic-cultural barriers, related to the care orientation of the ICU and lack of training in end of life care; architectural-structural barriers, related to the lack of space and privacy for the patient and family in the last moments of life; and psycho-emotional barriers, related to the use of emotional detachment as a strategy applied by nursing staff. Conclusions: Nursing staff need proper training on end-of-life care through the use of guidelines or protocols and the development of coping strategies, in addition to a change in the organisation of the ICU dedicated to the terminal care of critically ill patients and family support (AU)

Prevalencia de polifarmacia en la población mayor de 65 años en España: análisis de las Encuestas Nacionales de Salud 2006 y 2011/12 / Prevalence of polypharmacy among the population older than 65 years in Spain: Analysis of the 2006 and 2011/12 National Health Surveys

Introducción. La polifarmacia en las personas mayores es el resultado de la interconexión de múltiples factores y un fenómeno muy común a pesar de los riesgos asociados. No son muchos los estudios de base poblacional realizados en España con el objetivo de medir su magnitud en este grupo de población. Material y métodos. Estudio descriptivo, transversal realizado con datos individualizados de individuos de 65 años o más, de ambos sexos, no institucionalizados, procedentes de las Encuestas Nacionales de Salud de España (ENSE) 2006 (N=7.835) y 2011/12 (N=5.896). Se estimó la prevalencia de polifarmacia (consumo de al menos 4 fármacos en las 2 semanas previas a la encuesta) para las 2 encuestas utilizadas, así como por sexo y grupos de edad, y las prevalencias de uso de los diferentes grupos de fármacos entre los mayores polimedicados. Resultados. La polifarmacia ocurrió en aproximadamente uno de cada 3 mayores en la ENSE 2006 (32,54%), fue significativamente superior en la ENSE 2011/12 (36,37%) (p<0,05) y mayor en ambos casos en mujeres que en hombres y entre los individuos de mayor edad (≥85años) respecto a los más jóvenes. En las 2 encuestas analizadas, los grupos de fármacos más usados fueron los analgésicos (ENSE 2006: 71,93%; ENSE 2011/12: 76,27%; p<0,05) y antihipertensivos (ENSE 2006: 70,26%; ENSE 2011/12: 78,10%; p<0,05). Conclusiones. La magnitud de la polifarmacia en mayores es considerable y una práctica creciente en el tiempo. Se hace necesario conocer esta práctica en mayor profundidad, identificando a aquellos mayores con un riesgo elevado de consumir múltiples fármacos de forma simultánea (AU)

Introduction. Polypharmacy in older people is the result of several inter-connected factors, and is very common despite the associated risks. Not many population-based studies have been conducted in Spain to ascertain the magnitude of polypharmacy in this population. Material and methods. A descriptive, cross-sectional study was conducted with individualised data for non-institutionalised older people (65 or older) of both sexes from the Spanish National Health Surveys (SNHS) 2006 (N=7,835) and 2011/12 (N=5,896). The prevalence of polypharmacy (use of 4 or more drugs within the 2 weeks preceding the survey) was ascertained for the 2 surveys used, as well as by sex and age groups. The prevalence of use of the different drug groups was also estimated in the elderly who used polypharmacy. Results. Polypharmacy occurred in about a third of the older people in the 2006 SNHS (32.54%), and was significantly higher in the 2011/12 SNHS (36.37%) (P<.05). In both surveys, the prevalence of polypharmacy was higher in women than men and among the older individuals (≥85 years) compared to the less old. The type of drugs most commonly used were analgesics (2006 SNHS: 71.93%, 2011/12 SNHS: 76.27%; P<.05), and antihypertensive drugs 2006 SNHS: 70.26%, 2011/12 SNHS: 78.10%; P<.05). Conclusions. The magnitude of polypharmacy is considerable in older people and increasing over time. Further research on this issue is needed to identify those individuals who are at higher risk of using multiple drugs concomitantly (AU)