Spiritual needs during COVID 19 pandemic in the perceptions of Spanish emergency critical care health professionals.

OBJECTIVES: To investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic. METHODS: A qualitative investigation was carried out using in-depth interviews. SETTING: Emergency and emergency and ICU health professionals from different regions of Spain. FINDINGS: The sample consisted of 47 nursing and one nursing assistant. The qualitative analysis yielded four main themes that reflect the following categories: "the experience with spirituality in clinical practice"; "resources and barriers to provide spiritual care"; "the COVID pandemic and spiritual care" and "training in spiritual care". In addition, two subdeliveries were also obtained: "ethical dilemma" and "rituals of death". CONCLUSIONS: The majority of emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients' spiritual needs. During the COVID-19 pandemic in Spain, professionals felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of health professionals is that more training and resources are needed on this topic. IMPLICATIONS FOR CLINICAL PRACTICE: Health professionals in emergency intensive care must provide nursing care that meets the spiritual needs of their patients to improve care in crisis situations such as the one suffered by the COVID-19 pandemic. For this, emergency services professionals must work and participate in the development of measures to overcome certain barriers present in emergency services, such as lack of time, lack of training and misconceptions that make it difficult to approach emergency services these needs.

Tipos de lactancia materna y factores que influyen en su abandono hasta los 6 meses. Estudio LACTEM / Types of breastfeeding and reasons that influence to stop it before 6 months. LACTEM Study

Objetivo: Conocer la evolución de la lactancia materna (LM) y la lactancia materna exclusiva (LME) desde el nacimiento hasta los 6 meses de edad. Identificar las principales dificultades, las causas de abandono y las expectativas de las usuarias sobre la lactancia. Material y métodos: Estudio observacional, de seguimiento longitudinal de una cohorte de madres/hijos desde las 35 semanas de embarazo, el puerperio temprano y tardío, y hasta los 6 meses de vida en el Área Metropolitana Norte de Barcelona. Se realizó un seguimiento final de 541 sujetos. Los datos fueron recogidos por las matronas a través de un cuestionario específico. Se recogen los tipos de lactancia definidos por la Organización Mundial de la Salud, las dificultades, las causas de abandono y la intención de duración de ésta. Resultados: Al alta, la LM y la LME fueron del 94,8 y el 75,3%, respectivamente, y a los 6 meses del 63,3 y 16,8%. Los accesorios (chupetes, tetinas, pezoneras) son los principales elementos que dificultan la lactancia (20,2%). Las principales causas de abandono fueron la sensación subjetiva de hambre en el niño (35%) y de hipogalactia (22,8%). El 95% de las madres manifestaron la voluntad de iniciar la lactancia y una duración de ésta mayor a 1 año. Conclusiones: Por primera vez disponemos de información relativa a la LME a los 6 meses en nuestro territorio, que pone de manifiesto la necesidad de nuevas estrategias de promoción de la lactancia que permitan aumentar la LME, dirigidas a las causas evitables de destete, así como programas de información, asesoramiento, apoyo y seguimiento, antes y después del parto, para evitar destetes precoces por causas evitables y no deseados por las madres

Objective: To understand the current evolution of de breastfeeding (BF) and exclusive breastfeeding (EBF) from birth to 6 months of age. To identify the main difficulties and causes for abandonment. Methodology: Longitudinal, observational study of a cohort of mothers/children from the Barcelona's Northern Metropolitan Area, from the 35th gestation weeks, puerperium until at 6 months of age. Final follow-up of 541 subjects. The data was collected by midwifes through a specific questionnaire. The types of lactation defined by the WHO, difficulties, causes of abandonment and the intention of its duration are listed. Results: At discharge BF and EBF were 94.8 and 75.3%, respectively, and at 6 month 63.3 and 16.8%. Accessories (pacifiers, teats, liners) are the biggest obstacle (20.2%). The main causes for abandonment were the child's subjective sensation of hungry (35%) and the subjective sensation of hypogalactia (22.8%). 95% of the mothers expressed their willingness to start breastfeeding and its duration was greater than one year. Conclusions: For the first time we have relative information on EBF at 6 months in our territory. New strategies for the promotion of breastfeeding are needed to allow increasing EBF which should be directed at avoidable causes of weaning. Breastfeeding information, good advice and follow-up and support programs, before and after delivery, to prevent early weaning unwanted by mothers and for avoidable causes