Research on missed nursing care during the COVID-19 pandemic: A scoping review.

BACKGROUND: Missed nursing care is defined as care that is delayed, partially completed, or not completed at all. The scenario created by the COVID-19 pandemic may have influenced multifactorial determinants related to the care environment, nursing processes, internal processes, and decision-making processes, increasing missed nursing care. AIM: This scoping review aimed to establish the quantity and type of research undertaken on missed nursing care during the COVID-19 pandemic. METHODS: This review was conducted following the Joanna Briggs Institute methodology for scoping reviews. We searched CINAHL, MEDLINE, Scopus, two national and regional databases, two dissertations and theses databases, a gray literature database, two study registers, and a search engine from November 1, 2019, to March 23, 2023. We included quantitative, qualitative, and mixed studies carried out in all healthcare settings that examined missed nursing care during the COVID-19 pandemic. Language restrictions were not applied. Two independent reviewers conducted study selection and data extraction. Disagreements between the reviewers were resolved through discussion or with an additional reviewer. RESULTS: We included 25 studies with different designs, the most common being acute care cross-sectional survey designs. Studies focused on determining the frequency and reasons for missed nursing care and its influence on nurses and organizational outcomes. LINKING EVIDENCE TO ACTION: Missed nursing care studies during the COVID-19 pandemic were essentially nurses-based prevalence surveys. There is an urgent need to advance the design and development of longitudinal and intervention studies, as well as to broaden the focus of research beyond acute care. Further research is needed to determine the impact of missed nursing care on nursing-sensitive outcomes and from the patient's perspective.

Patient-Reported Outcome Measures of Quality of Life in People Affected by Diabetic Foot: A Psychometric Systematic Review.

OBJECTIVES: This psychometric systematic review aimed to identify the most suitable patient-reported outcome measures (PROMs) of quality of life (QoL) in people affected by diabetic foot. METHODS: We performed a literature search in MEDLINE (PubMed), CINAHL (EBSCOhost), and PsycINFO (EBSCOhost) databases from inception to February 1, 2022. We also searched gray literature databases. Eligible studies were full-text reports developing a QoL condition-specific PROM or assessing one or more of its measurement properties in people affected by diabetic foot. We assessed the methodological quality of included studies independently using the "Consensus-Based Standards for the Selection of Health Measurement Instruments Risk of Bias" checklist. The measurement properties were evaluated using specific criteria. We graded the quality of the evidence using a "Grading of Recommendations Assessment, Development and Evaluation" approach modified by Consensus-Based Standards for the Selection of Health Measurement Instruments. RESULTS: Forty-three reports (46 studies) providing information on the measurement properties of 10 different PROMs were included. We did not identify any instruments that could be recommended for use. We identified 2 PROMs that were not recommended for use and 8 that were potentially recommended but would require further investigation. Of these 8 PROMs, 4 had better evidence for content validity. CONCLUSIONS: Available PROMs to measure QoL in people affected by diabetic foot have limited evidence for their measurement properties. There is no fully suitable PROM. Pending further evidence, 4 PROMs could potentially be recommended for use.

The Tilburg Frailty Indicator: A psychometric systematic review.

BACKGROUND: The Tilburg Frailty Indicator (TFI) is one of the most prominent multidimensional frailty assessment instruments. This review aimed to critically appraise and summarise its measurement properties. METHODS: Reports were eligible if they included results of studies aimed at developing the TFI or evaluating its measurement properties. We performed a literature search in MEDLINE, CINAHL, and PsycINFO databases from their inception until December 8, 2021. We also searched grey literature databases. We assessed the methodological quality of the included studies using the "COSMIN Risk of Bias". The measurement properties were evaluated using specific criteria. We graded the quality of the evidence using a GRADE approach. RESULTS: Sixty-three studies were included. We found moderate sufficient evidence for TFI content validity, although it is still insufficient for the comprehensiveness of its items. TFI construct validity was based on sufficient evidence from two studies of its structural validity as well as multiple hypothesis-testing for construct validity studies with inconsistent results. We did not find any studies that assessed cross-cultural validity. Only one of TFI's three dimensions showed sufficient evidence for the internal consistency of its scores, and results in test-retest reliability were inconsistent. The TFI showed high sufficient concurrent validity with the comprehensive geriatric assessment. We identified several studies assessing its predictive validity for adverse frailty-related outcomes, although most of the evidence from these studies was insufficient. We did not find any studies that assessed the responsiveness of TFI scores. CONCLUSIONS: The TFI had evidence gaps in several relevant measurement properties. Further research is needed to strengthen its usefulness as a clinical decision-making tool.

La atención sanitaria a pacientes con multimorbilidad. La percepción de los profesionales / Health care for patients with multimorbidity. The perception of professionals

OBJETIVO: Explorar las percepciones de los profesionales sanitarios sobre las características de la atención sanitaria a pacientes con multimorbilidad. DISEÑO: Estudio cualitativo de trayectoria fenomenológica realizado entre enero y septiembre de 2015 mediante 3 entrevistas grupales (grupos de discusión) y 15 individuales. Emplazamiento: Servicio Aragonés de Salud. PARTICIPANTES: Profesionales médicos y de enfermería del Servicio Aragonés de Salud pertenecientes a distintos servicios: Medicina Interna, Atención Primaria, Urgencias y Gestión. También se incluyó un farmacéutico. MÉTODOS: Se realizó un muestreo intencional no probabilístico que permitiese configurar las unidades muestrales buscando criterios de representatividad del discurso, permitiendo conocer e interpretar el fenómeno estudiado en profundidad, en sus diferentes visiones. Se entrevistó a profesionales sanitarios con perfiles diferentes que conociesen en profundidad la atención a pacientes con multimorbilidad. Las entrevistas fueron grabadas, transcritas literalmente e interpretadas, mediante el análisis social del discurso. RESULTADOS: Se identifica una cultura profesional orientada a la atención de enfermedades individuales, falta de coordinación entre especialidades, pacientes sometidos a numerosas prescripciones, Guías de Práctica Clínica y formación especialmente centradas en enfermedades individuales. CONCLUSIONES: Tanto la cultura profesional como la organización del sistema sanitario se encuentran orientadas a la atención de enfermedades individuales, lo que redunda en dificultades para ofrecer una atención más integral a los pacientes con multimorbilidad

OBJECTIVE: To explore the perceptions of health professionals about the characteristics of health care for patients with multimorbidity. DESIGN: Qualitative study of phenomenological trajectory made between January and September 2015 through 3 group interviews and 15 individual interviews. LOCATION: Aragonese Health Service. PARTICIPANTS: Medical and nursing professionals of the Aragon Health Service belonging to various services: Internal Medicine, Primary Care, Emergency and Management. A pharmacist was also included. METHODS: A non-probabilistic intentional sampling was carried out that allowed for the selection of professionals in terms of discourse representation criteria, allowing to know and interpret the phenomenon studied in depth, in its different visions. We interviewed health professionals with different profiles who knew in depth the characteristics of care provided to patients with multimorbidity. The interviews were recorded, transcribed literally and interpreted, through the social analysis of the discourse. RESULTS: Professional culture oriented to individual pathologies, lack of coordination among professionals, high prevalence of multi-prescriptions, Clinical Practice Guidelines oriented to individual pathologies and specialist training focused on individual diseases. CONCLUSIONS: Both the professional culture and the organization of the healthcare system have been oriented towards the attention to individual pathologies, which results in the difficulty to offer a more integrated care to patients with multimorbidity

[Health care for patients with multimorbidity. The perception of professionals]. / La atención sanitaria a pacientes con multimorbilidad. La percepción de los profesionales.

OBJECTIVE: To explore the perceptions of health professionals about the characteristics of health care for patients with multimorbidity. DESIGN: Qualitative study of phenomenological trajectory made between January and September 2015 through 3 group interviews and 15 individual interviews. LOCATION: Aragonese Health Service. PARTICIPANTS: Medical and nursing professionals of the Aragon Health Service belonging to various services: Internal Medicine, Primary Care, Emergency and Management. A pharmacist was also included. METHODS: A non-probabilistic intentional sampling was carried out that allowed for the selection of professionals in terms of discourse representation criteria, allowing to know and interpret the phenomenon studied in depth, in its different visions. We interviewed health professionals with different profiles who knew in depth the characteristics of care provided to patients with multimorbidity. The interviews were recorded, transcribed literally and interpreted, through the social analysis of the discourse. RESULTS: Professional culture oriented to individual pathologies, lack of coordination among professionals, high prevalence of multi-prescriptions, Clinical Practice Guidelines oriented to individual pathologies and specialist training focused on individual diseases. CONCLUSIONS: Both the professional culture and the organization of the healthcare system have been oriented towards the attention to individual pathologies, which results in the difficulty to offer a more integrated care to patients with multimorbidity.

Adaptación y validación de un cuestionario para evaluar las prácticas de autocuidado en población infantil sana residente en España / Adapting and validating a questionnaire to measure the self-care practices in healthy child population residing in Spain

OBJETIVO: Adaptar y validar el Child and Adolescent Self-Care Performance Questionnaire (CASPQ) al contexto de la población infantil sana de 8 a 12 años residente en España y evaluar sus propiedades métricas. DISEÑO: Estudio de validación fundamentado en la Teoría Clásica de los Tests. Emplazamiento: Cuatro centros educativos participantes en el programa «Salut I Escola» de un centro de atención primaria de Barcelona (España). PARTICIPANTES: Un total de 498 alumnos y alumnas de educación primaria participaron en el estudio durante los primeros seis meses de 2016. Mediciones principales: Se realizó la adaptación cultural del cuestionario. Se evaluó el proceso de respuesta, la estructura factorial y se analizaron las relaciones de las puntuaciones del CASPQ con las del cuestionario KIDSCREEN-27. Asimismo, se evaluaron la consistencia interna y la reproducibilidad de las puntuaciones. RESULTADOS: Se obtuvieron 489 cuestionarios. El análisis factorial confirmatorio de su estructura teórica mostró un ajuste suficiente. Se observó una asociación positiva entre las puntuaciones del cuestionario y las del KIDSCREEN-27. La consistencia interna global fue satisfactoria; no obstante, la de cada factor fue marginal o moderada. La reproducibilidad de las puntuaciones fue óptima. CONCLUSIONES: El CASPQ adaptado a la población infantil sana de 8 a 12 años muestra unas propiedades métricas adecuadas y similares a las del cuestionario original. Por ello, es un instrumento útil para evaluar las prácticas de autocuidado y planificar intervenciones dirigidas a su promoción

OBJECTIVE: To adapt and validate the Child and Adolescent Self-Care Performance Questionnaire (CASPQ) to the context of healthy children aged 8 to 12years residing in Spain and evaluate their metric properties. DESIGN: Validation study based on Classical Test Theory. LOCATION: Four schools participating in the Salut I Escola programme of a Primary Care Centre of Barcelona (Spain). PARTICIPANTS: Four hundred and ninety-eight elementary school students participated in the study during the first six months of 2016. MAIN MEASUREMENTS: Cultural adaptation of the questionnaire was carried out. Response process and factorial structure were evaluated and the relationships of the adapted questionnaire scores with those of the KIDSCREEN-27 questionnaire were analysed. Likewise, internal consistency and reproducibility of the scores were evaluated. RESULTS: Four hundred and eighty-nine questionnaires were obtained. The confirmatory factor analysis of its theoretical structure showed a sufficient adjustment. A positive association was observed between the questionnaire scores and those of KIDSCREEN-27. The overall internal consistency was satisfactory; nevertheless, that of each factor was marginal or moderate. The reproducibility of the scores was optimal

[Adapting and validating a questionnaire to measure the self-care practices in healthy child population residing in Spain]. / Adaptación y validación de un cuestionario para evaluar las prácticas de autocuidado en población infantil sana residente en España.

OBJECTIVE: To adapt and validate the Child and Adolescent Self-Care Performance Questionnaire (CASPQ) to the context of healthy children aged 8 to 12years residing in Spain and evaluate their metric properties. DESIGN: Validation study based on Classical Test Theory. LOCATION: Four schools participating in the Salut i Escola programme of a Primary Care Centre of Barcelona (Spain). PARTICIPANTS: Four hundred and ninety-eight elementary school students participated in the study during the first six months of 2016. MAIN MEASUREMENTS: Cultural adaptation of the questionnaire was carried out. Response process and factorial structure were evaluated and the relationships of the adapted questionnaire scores with those of the KIDSCREEN-27 questionnaire were analysed. Likewise, internal consistency and reproducibility of the scores were evaluated. RESULTS: Four hundred and eighty-nine questionnaires were obtained. The confirmatory factor analysis of its theoretical structure showed a sufficient adjustment. A positive association was observed between the questionnaire scores and those of KIDSCREEN-27. The overall internal consistency was satisfactory; nevertheless, that of each factor was marginal or moderate. The reproducibility of the scores was optimal. CONCLUSIONS: The CASPQ adapted to the healthy child population of 8 to 12years old shows appropriate metric properties and similar to those of the original questionnaire. Therefore, it is a useful tool to assess self-care practices and plan interventions aimed at its promotion.

Multidimensional instruments with an integral approach to identify frailty in community-dwelling people: protocol for a systematic psychometric review.

INTRODUCTION: An increasing number of investigations highlight the complex nature of frailty; therefore, the use of multidimensional assessment instruments could be useful in clinical decision-making. Frail people are found mainly in the community setting which is why this is the ideal environment for early screening and intervention. For this purpose, it is necessary to have valid, time-effective and easy-to-use frailty assessment instruments. The aim of this review is to critically appraise, compare and summarise the quality of the measurement properties of all multidimensional instruments with an integral approach to identify frailty in community-dwelling people. METHODS AND ANALYSIS: Medline, Psychological Information Database (PsycINFO) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) will be searched from their inception dates. We will also conduct searches in databases of grey literature. No limits will be applied for language. A highly sensitive validated search filter will be used for finding studies on measurement properties. An additional search including the names of the instruments found in the initial search will also be undertaken. Studies aiming at the development of a measurement instrument, the evaluation of one or more measurement properties or the evaluation of its interpretability will be included. The instrument should have an integral approach (physical, psychological and social) and it should measure all three domains. The context of use should be a community setting. Two reviewers independently will screen the references and assess the risk of bias by consensus-based standards for the selection of health measurement instruments checklist. To assess the overall evidence for the measurement properties of the identified instruments, the results of the different studies, adjusted for their methodological quality, will be combined. ETHICS AND DISSEMINATION: Ethical approval and patient consent are not required as this is a psychometric review based on published studies. The results of this review will be disseminated at conferences and published in an international peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42019120212.

Instruments to assess self-care among healthy children: A systematic review of measurement properties.

AIM: To identify, critically appraise and summarize the measurement properties of instruments to assess self-care in healthy children. BACKGROUND: Assessing self-care is a proper consideration for nursing practice and nursing research. No systematic review summarizes instruments of measurement validated in healthy children. DESIGN: Psychometric review in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) panel. DATA SOURCES: MEDLINE, CINAHL, PsycINFO, Web of Science and Open Grey were searched from their inception to December 2016. REVIEW METHODS: Validation studies with a healthy child population were included. Search was not restricted by language. Two reviewers independently assessed the methodological quality of included studies using the COSMIN checklist. RESULTS: Eleven studies were included in the review assessing the measurement properties of ten instruments. There was a maximum of two studies per instrument. None of the studies evaluated the properties of test-retest reliability, measurement error, criterion validity and responsiveness. Internal consistency and structural validity were rated as "excellent" or "good" in four studies. Four studies were rated as "excellent" in content validity. Cross-cultural validity was rated as "poor" in the two studies (three instruments) which cultural adaptation was carried out. CONCLUSION: The evidence available does not allow firm conclusions about the instruments identified in terms of reliability and validity. Future research should focus on generate evidence about a wider range of measurement properties of these instruments using a rigorous methodology, as well as instrument testing on different countries and child population.

Safety of the reuse of needles for subcutaneous insulin injection: A systematic review and meta-analysis.

OBJECTIVE: Many people with diabetes often reuse disposable needles for subcutaneous insulin injection. We aimed to identify, critically appraise and summarize the available evidence about the safety of this practice. DESIGN: Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. DATA SOURCES: MEDLINE (via PubMed), CINALH (via EBSCO), SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials and Open Grey were searched from their inception to December 2015, with no language restrictions. REVIEW METHODS: Epidemiologic and experimental studies assessing adverse effects of reusing needles in people of any age or sex, with or without diabetes, were included. Two reviewers independently assessed the methodological quality of included studies using a multi-design tool. RESULTS: In total, 25 studies were included. All studies had a high risk of bias and data from only nine studies could be pooled. Five studies showed no association between infection at site of injection and reuse of needles (risk difference=-0.00; 95% confidence interval=-0.12-0.11; P=0.99); heterogeneity between these studies was substantial (I(2)=66%; P=0.02). Five cross-sectional studies showed an association between lipohypertrophy and needle reuse (risk difference=0.16, 95% confidence interval=0.05-0.28, P=0.006); there was strong evidence of heterogeneity between these studies (I(2)=87%; P<0.001). Pooled data of two studies with no evidence of heterogeneity between them showed more perceived pain among reusers (risk difference=0.24; 95% confidence interval=0.06-0.43; P=0.006). Reusing a pen needle or disposable syringe-needle was not associated with worse glycaemic control. CONCLUSIONS: There is currently no clear scientific evidence to suggest for or against the reuse of needles for subcutaneous insulin injection. This practice is very common among people with diabetes; consequently, further research is necessary to establish its safety.

Elastofibroma dorsi: serie de 4 casos diagnosticados en atención primaria / Elastofibroma dorsi: A series of 4 cases diagnosed in Primary Care

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