Formación universitaria en actividad física: explorando competencias y evaluación desde las guías docentes / University training in physical activity: exploring competences and assessment

Este estudio persigue analizar, explorar y comparar guías docentes de dos titulaciones universitarias españolas de Grado referidas a la formación en actividad física desde el modelo basado en competencias. Se realizó un análisis documental delas competencias y un análisis de los sistemas de evaluación, desde un prisma formativo,de54 guías docentes de asignaturas de tipología común en ambas titulaciones, consiguiéndose, tras ello, variables medibles. Se aplicóun análisis MANOVA Biplot que permitió representar gráficamente las variables que caracterizaron a las asignaturas. Los resultados mostraron diferencias sustanciales entre las titulaciones y entre perfiles de asignaturas en el Grado en Ciencias de la Actividad Física y el Deporte, que no acontecieron en el Grado en Magisterio de Educación Primaria mención Educación Física. El estudio muestra un modelo de análisis útil para la evaluación de la calidad de las guías docentes que podría ser extrapolado y ajustado a otras titulaciones. (AU)

This study seeks to analize, explore and compare teaching guides of two Spanish degrees related to training in physical activity from the competency- bassed model. A documentary analysis of the competencies and an analysis of the assessment systems, according to formative point of view, in 54 subject teaching guides in common typology of both degrees, obtaining at the end mesurables variables. A MANOVA Biplot analysis is applied to graphically represent the variables that characterize each subject profile. Its application shows substantial differences between degrees and, also, between the three subject profiles in the Degree in Physical Activity and Sports Sciences, which do not happend in the Degree in Teacher Initial Training (Physical Education at Primary School). Eventually, the study shows a useful analysis model for evaluating the quality of teaching guides that could be extrapolated and met to other degrees. (AU)

Cultural adaptation and validation of the nursing students' perceptions of instructor caring into spanish.

OBJECTIVE: This paper aims to provide a Spanish version of the nursing students'' perceptions of instructor caring with content validity and reliability. METHODS: A forward and backward translation procedure was conducted, and a panel of 15 experts assessed face validity. Content validity was established by calculating content validity indexes for each item and for the scale. The internal consistency was assessed in a sample of 120 students. RESULTS: Content validity indexes resulted in higher than 0.78 for all items except Does not reveal any of his or her personal sides and serves as a trusted resource for personal problem solving; content validity index for the scale was 0.9 and Cronbach α was 0.942. DISCUSSION: Results regarding reliability were similar to that of other studies in which the nursing students' perceptions of instructor caring has been used as a measuring tool. Item 12 deletion implies a considerable improvement in internal consistency. CONCLUSION: The Spanish nursing students' perceptions of instructor caring is a valid and reliable tool to be used in the Spanish context. Its use will enhance the understanding of clinical mentors' impact on nursing students.

La resiliencia familiar como activo en salud / Family resilience as a health asset

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Expectativas de parto de las gestantes de La Ribera: una aproximación cualitativa / Childbirth expectations of La Ribera pregnant women: a qualitative approach

Objetivo: El cambio de modelo asistencial en la atención al parto normal, el interés por parte de las autoridades sanitarias en que se exploren las expectativas de parto de las gestantes, y su especificidad cultural y social, hacen que el estudio de tales expectativas sea pertinente en este momento. El objetivo del presente estudio es conocer cuáles son las expectativas de parto de una muestra de gestantes españolas y estudiar las diferencias entre las expectativas de las gestantes primíparas y multíparas. Metodología: Estudio cualitativo basado en una pregunta de respuesta libre sobre expectativas de parto. Se recogieron datos a gestantes de tercer trimestre del área de salud de La Ribera (Alzira, Valencia) durante 2014-2015. Se analizaron los datos mediante análisis del contenido. Resultados: Muestra de 213 gestantes cuyas principales expectativas de parto fueron tener un parto rápido, con buen resultado obstétrico, sin dolor y con apoyo de los profesionales. Las expectativas relacionadas con los protocolos de atención al parto normal supusieron un 5.2% del total de las respuestas. No se encontraron diferencias estadísticamente significativas entre gestantes primíparas y multíparas. Conclusiones: El conocimiento de las expectativas resulta importante, ya que las gestantes miden su satisfacción con el parto en base al cumplimiento de tales expectativas. Ayudarlas a desarrollar expectativas realistas aumentará su satisfacción. Las matronas tienen un importante papel a través de la formación que imparten (educación maternal) y del apoyo en el momento del parto (fundamental para que las gestantes se sientan protagonistas del mismo) (AU)

Objective: Change of healthcare model in normal childbirth, health authorities interest in exploring childbirth expectations of pregnant women, and their cultural and social specificity make relevant the study of these expectations at this moment. The aim is to know what are the childbirth expectations from a sample of Spanish pregnant women and to study the differences between primiparous and multiparous pregnant women expectations. Methodology: Qualitative study based on an open-ended question about childbirth expectations. Data were collected during 2014-2015 to third trimester pregnant women in La Ribera health area (Alzira, Valencia). Data were analyzed using content analysis. Results: Sample of 213 pregnant women whose main expectations were to have a fast delivery, with good obstetric outcome, painlessly and with professional support. Expectations regarding normal childbirth protocols accounted for 5.2% of total responses. No statistically significant differences between primiparous and multiparous pregnant women were found. Conclusions: Knowledge about childbirth expectations is highly relevant because pregnant women measure their satisfaction with childbirth through the fulfillment of these expectations. Helping them to develop realistic expectations will increase their satisfaction. Midwives play an important role through the training they give (maternal education) and through the support during delivery (this is essential for the pregnant women in order to feel themselves protagonist of their delivery) (AU)

[Change of care model in natural childbirth: Implementation in La Ribera delivery room]. / Cambio de modelo asistencial en la atención al parto normal: aplicación en el paritorio de La Ribera.

OBJECTIVE: To assess knowledge, wish for inclusion and implementation of normal childbirth care protocols at La Ribera University Hospital, the reason why they are not applied, and to assess the attendance at antepartum training activities. MATERIAL AND METHOD: Cross-sectional descriptive study. They were carried out 186 surveys by convenience sampling to pregnant women attending fetal well-being control at hospital between 2014 and 2015. They were collected data about knowledge, wish for inclusion, compliance of protocols and reasons for non-compliance, and attendance at antepartum training activities. Percentages and confidence intervals were calculated. Chi-square test was used to compare categorical variables. RESULTS: They were collected percentages of knowledge (77%, CI95%: 75,5-78,5) and wish for inclusion (84,6%, CI95%: 82,5-86,7). Protocol compliance ranged from 6% (nitrous oxide administration) to 91% (skin-to-skin contact). The main reasons for non-compliance were due to circumstances of childbirth process (56,3%, CI95%: 51,1-61,5). Attendance at maternal education classes was 62%, mainly primiparous women (p=0,0001) with medium or high education level (p=0,001). CONCLUSIONS: Pregnant women have a high knowledge and wish for inclusion of normal childbirth care protocols. Attendance at antepartum training activities could by improved and the main reason for non-attendance is lack of information. Compliance is good enough in most protocols; when they are not applied is due to childbirth circumstances. Remaining tasks include the introduction of additional protocols and to involve pregnant women in decision-making.

Assessment of evidence and quality of clinical practice guidelines on deterioration of skin integrity: ulcers and chronic wounds / Evaluación de las evidencias y calidad de las guías de práctica clínica sobre deterioro de la integridad cutánea: úlceras y heridas crónicas.

Background. The epidemiological, social, and economic situation that surrounds the deterioration of skin integrity is a big problem for the health system. Its prevention and treatment create uncertainty and professional variability and it remains a priority to have good clinical practice guidelines (CPG). The objective was to determine the quality of the CPG on prevention and treatment of pressure ulcers (PU), venous ulcers of the leg (VUL) and diabetic foot ulcers (DFU). Methodology. Systematic review of the quality of Spanish and international CPG on PU, VUL and DFU. Bibliographic search in specialized sources. Selection of CPG, not older than 5 years (2010-2015). Use of the AGREE Instrument II and revision by 4 experts. Descriptive statistics. Results. Twenty-three CPG (10 PU, 6 VUL and 7 DFU), of which 4 were Spanish and 19 international. Eight CPG on PU, 3 VUL and 5 DFU were considered "Highly Recommended". Domain nº 2 (participation) and Domain nº 5 (applicability) were the worst valued. The quality of the evidence was "very good" in 19 GPC. The best CPG were the British NICE (PU), the Australian AWMA (VUL) and the Canadian RNAO (DFU). Conclusions. We observed a good methodological quality in the CPG on PU and DFU, but there needs to be improvement in the VUL. In general, it would be necessary to increase the participation of users, and describe possible barriers for the implementation of the CPG in clinical practice.

Evaluación de las evidencias y calidad de las guías de práctica clínica sobre deterioro de la integridad cutánea: úlceras y heridas crónicas / Assessment of evidence and quality of clinical practice guidelines on deterioration of skin integrity: ulcers and chronic wounds

Fundamento: La situación epidemiológica, sociosanitaria y económica que rodea al deterioro de la integridad cutánea supone un gran problema para el sistema sanitario. Su prevención y tratamiento crea incertidumbre y variabilidad profesional siendo prioritario contar con buenas Guías de Práctica Clínica (GPC). El objetivo fue conocer la calidad de las GPC sobre prevención y tratamiento de úlceras por presión (UPP), úlceras venosas de la pierna (UVP) y úlceras de pie diabético (UPD). Metodología: Revisión sistemática de la calidad de GPC españolas e internacionales sobre UPP, UVP y UPD. Búsqueda bibliográfica en fuentes especializadas. Selección de GPC con antigüedad no superior a 5 años (2010-2015). Uso del Instrumento AGREE II y revisión por 4 expertos. Estadística descriptiva. Resultados: Veintitrés GPC (10 UPP, 6 UVP y 7 UPD); de ellas, 4 eran españolas y 19 internacionales. Fueron consideradas «muy recomendables» 8 GPC sobre UPP, 3 de UVP y 5 de UPD. El Dominio nº 2 (participación) y el Dominio nº 5 (aplicabilidad) fueron los peor valorados. La calidad de la evidencia fue «muy buena» en 19 GPC. La mejor GPC fue la inglesa de la NICE (UPP), la australiana de la AWMA (UVP) y la canadiense de la RNAO (UPD). Conclusiones: Se observa una buena calidad metodológica en las GPC sobre UPP y UPD, pero habría que mejorar en las UVP. En general, habría que aumentar la participación de los usuarios, y describir las posibles barreras para la implementación de las GPC en la práctica clínica (AU)

Background: The epidemiological, social, and economic situation that surrounds the deterioration of skin integrity is a big problem for the health system. Its prevention and treatment create uncertainty and professional variability and it remains a priority to have good clinical practice guidelines (CPG). The objective was to determine the quality of the CPG on prevention and treatment of pressure ulcers (PU), venous ulcers of the leg (VUL) and diabetic foot ulcers (DFU). Methodology: Systematic review of the quality of Spanish and international CPG on PU, VUL and DFU. Bibliographic search in specialized sources. Selection of CPG, not older than 5 years (2010-2015). Use of the AGREE Instrument II and revision by 4 experts. Descriptive statistics. Results: Twenty-three CPG (10 PU, 6 VUL and 7 DFU), of which 4 were Spanish and 19 international. Eight CPG on PU, 3 VUL and 5 DFU were considered «Highly Recommended». Domain nº 2 (participation) and Domain nº 5 (applicability) were the worst valued. The quality of the evidence was «very good» in 19 GPC. The best CPG were the British NICE (PU), the Australian AWMA (VUL) and the Canadian RNAO (DFU). Conclusions: We observed a good methodological quality in the CPG on PU and DFU, but there needs to be improvement in the VUL. In general, it would be necessary to increase the participation of users, and describe possible barriers for the implementation of the CPG in clinical practice (AU)

El coste de la infección en artroplastia de cadera: estudio de casos y controles emparejado / The cost of infection in hip arthroplasty: a matched case-control study

Objetivo. La infección de localización quirúrgica (ILQ) representa el 30% de todas las causas de infecciones relacionadas con la atención sanitaria (IRAS), siendo una de las complicaciones más temidas en pacientes quirúrgicos. Se estimó el exceso de costes directos de la ILQ mediante un estudio de casos y controles emparejado y anidado en una cohorte, en un hospital de agudos en España (Hospital Universitario Ramón y Cajal). Material y método. Los casos fueron pacientes que desarrollaron un primer episodio de ILQ según los criterios establecidos por el National Healthcare Safety Network de los CDC. Los controles fueron emparejados a los casos en una razón de 1:1, teniendo en cuenta la clasificación de la American Society of Anesthesiologists, la edad, el sexo, la fecha de la cirugía y el diagnóstico principal. Resultados. Este estudio encontró que la infección en reemplazo de cadera incrementó los costes directos en un 134%. Asimismo, el exceso de costes debido a la infección causada por Staphylococcus aureus resistente a la meticilina fue 69% mayor que el exceso de costes debido a las infecciones causadas por otros microorganismos. onclusiones. La ILQ después de reemplazo de cadera sigue siendo una complicación costosa desde la perspectiva del hospital. Los costes debidos a la ILQ pueden ser utilizados para priorizar intervenciones preventivas de vigilancia y control de las infecciones relacionadas con la atención sanitaria (AU)

Objective. Surgical site infection (SSI) represents 30% of all causes of health care-associated infection (HAI) and is one of the most dreaded complications in surgical patients. We estimated the excess direct costs of SSI using a matched nested case-control study in acute-term care at Ramon y Cajal University Hospital in Spain. Material and method. Cases were patients who developed a first episode of SSI according to the criteria established by the CDC's National Healthcare Safety Network. Controls were matched to cases in 1:1 ratio taking into account the American Society of Anesthesiologists score, age, sex, surgery date, and principal diagnosis. Results. This study found that infection in hip replacement increased direct costs by 134%. Likewise, the excess cost due to the infections caused by methicillin resistant Staphylococcus aureus was 69% higher than the excess cost attributable to infections caused by other microorganisms. Conclusions. SSI after hip replacement continues to be a costly complication from the hospital perspective. Costs due to SSI can be used to prioritise preventive interventions to monitor and control HAI (AU)

The cost of infection in hip arthroplasty: a matched case-control study. / El coste de la infección en artroplastia de cadera: estudio de casos y controles emparejado.

OBJECTIVE: Surgical site infection (SSI) represents 30% of all causes of health care-associated infection (HAI) and is one of the most dreaded complications in surgical patients. We estimated the excess direct costs of SSI using a matched nested case-control study in acute-term care at Ramon y Cajal University Hospital in Spain. MATERIAL AND METHOD: Cases were patients who developed a first episode of SSI according to the criteria established by the CDC's National Healthcare Safety Network. Controls were matched to cases in 1:1 ratio taking into account the American Society of Anesthesiologists score, age, sex, surgery date, and principal diagnosis. RESULTS: This study found that infection in hip replacement increased direct costs by 134%. Likewise, the excess cost due to the infections caused by methicillin resistant Staphylococcus aureus was 69% higher than the excess cost attributable to infections caused by other microorganisms. CONCLUSIONS: SSI after hip replacement continues to be a costly complication from the hospital perspective. Costs due to SSI can be used to prioritise preventive interventions to monitor and control HAI.

The use and usefulness of information for patients undergoing anaesthesia.

Informed consent is a process rather than just simply the signing of a form. It should provide the patient with the information and understanding needed to authorize a procedure. The aim of the present study was to try to understand the patient's attitude to, and understanding of, the pre-anaesthesia informed consent (IC) document. A prospective descriptive study was made of 159 adults who attended a pre-operative consultation prior to programmed surgery at a teaching hospital. The patients were given a questionnaire on different aspects of the pre-anaesthesia IC document they had signed (ease of understanding and other aspects of the information received and expected) and five questions on how well they remembered the information given in the IC form they had read previously. A series of epidemiological variables, anaesthesia and surgery-associated risks (ASA) and whether the patients had undergone anaesthesia previously, were evaluated. The mean age of the study population was 55 (SD:19.63), with 36% over the age of 65, while 77% had not received secondary education. 21% of the patients who signed did not read the document and 14% found it difficult to understand. 89% found the information sufficient and 46% said they preferred to receive such information in written form. 64% had no or very little recall of the information they had been given, the proportion of those making this claim being in direct relation with age over 50 years and low level of studies. The findings suggest that improvements are needed in the pre-anaesthesia informed consent document so that, rather than serving as a mere legal prerequisite, it fulfils its purpose of providing the patient with the information necessary and in a clearly understood way so that he/she can authorize the proposed surgery.

[Nursing care for myelomeningocele in infancy]. / Mielomeningocele en la infancia (I). Cuidados enfermeros.

After studying the factors which most often lead to the hospitalization, recuperation and treatment facilitating release from hospitalization of newborns affected by myelomeningocele, we present this treatment plan. One commences with an evaluation, after which various problems are detected. Once identified, establish priorities setting objectives to meet and their corresponding dates; continue by drawing up an action plan which lists those activities that help achieve one's objectives. The purpose of this plan is to provide individualized quality treatments as well as to create a relaxed, confidential atmosphere in which parents express their fears while becoming secure in their practice of those treatments their child needs in their home.

Intraocular pressure in 528 university students: effect of refractive error.

BACKGROUND: Very few studies measuring the intraocular pressure (IOP) in students are available. Recognizing the higher prevalence of myopia among students, IOP was analyzed in 528 university students according to age, gender, and refractive error. METHODS: The IOP was measured in 1,056 eyes with the Keeler Pulsair noncontact tonometer. The refractive error was determined with an autorefractometer (Shin-Nippon brand, model QR-007). RESULTS: The analysis of variance (ANOVA) showed no significant influence of age and gender on students' IOP (mean IOP, 15.77 +/- 2.67 mmHg). Refractive error did not significantly influence the mean of IOP (ANOVA) in the different categories: (a) severe myopia, (b) medium myopia, (c) emmetropia and mild ametropia, and (d) hypermetropia. The chi 2 test revealed significant differences, as a result of age, between the eyes with IOP < 21 mmHg or > or = 21 mmHg (6.3%). Nevertheless, there was no significant IOP difference as a result of gender or refractive error among eyes with normal IOPs and eyes with IOP above 20 mmHg. CONCLUSIONS: Among university students, intraocular pressure is not influenced by age, gender, or refractive status. Likewise, except for age, there is no significant correlation between any of the other variables and the normal range of IOP. After the age of 25 years, there is a slight increase in the number of eyes with an IOP above 20 mmHg.

[An epidemiological study of congenital dyschromatopsias in schoolchildren]. / Estudio epidemiológico de las discromatopsias congénitas en escolares.

BACKGROUND: Taking into consideration that present-day communication is based on colours and shapes, the prevalence of anomalies in the chromatic sight in the red-green axis has been studied in the school boys of the city of Albacete. METHODS: The test of Ishihara has been used in an aleatory representative sample; and dyschromatopsic pupils, so classified in this test, have been further explored with the anomaloscopy Pickford-Nicolson, in order to know their anomaly kind and degree. RESULTS: The prevalence obtained is similar to those reported by other studies carried out in the European white race. CONCLUSIONS: Taking into account the transcendence of this phenomenon, we consider that this exploration must be included in the systematic examinations at school labour and general level.

[Development of a health education program prior to a hepatitis B vaccination campaign among hospital personnel]. / Desarrollo de un programa de educación sanitaria previo a una campaña de vacunación contra la hepatitis B en personal hospitalario.

The hepatitis B (HB) is the most frequent occupational infection in health care workers, and HB vaccination the best way to prevent it. Although sanitary staff participation in vaccination programs in rather small, it is enlarged after the previous information. In order to increase staff participation in a second vaccination program, we have developed an information campaign in our hospital. In an inquiry to a sample of not vaccination personnel (87/304; 28.6 per 100), we got the following answers: 92.9 per 100 declared HB as dangerous, 95.4 per 100 believed there was a greater risk for the hospital staff, 87.4 per 100 asked for more information (spoken preferably), and 85.1 per 100 accepted vaccination. However, at the beginning of the campaign, the attachment was reduced to 57.9 per 100. In spite of this decrease, we believe that the acceptance rate of unwilling personnel is the result of the information provided.