Impact of COVID-19 Restrictions in Childbirth and Puerperium: A Cross-Sectional Study.

Introduction (1): The COVID-19 pandemic led to changes in healthcare during pregnancy, childbirth and puerperium. The objective of this study was to know the impact of visit restrictions, PCR performance and use of masks on delivery and puerperium care. Methods (2): A descriptive cross-sectional study was carried out. A survey was used to assess the impact of COVID-19-related measures on women who had given birth in hospitals in the Region of Murcia, Spain, between March 2020 and February 2022. Results (3): The final sample size was 434 women. The average scores were 4.27 for dimension 1 (Visit restrictions), 4.15 for dimension 2 (PCR testing) and 3.98 for dimension 3 (Mask use). More specifically, we found that the restriction of visits was considered a positive measure for the establishment of the mother-newborn bond (mean score 4.37) and that the use of masks at the time of delivery should have been made more flexible (mean score 4.7). Conclusions (4): The policy of restricting hospital visits during the pandemic caused by COVID-19 has been considered beneficial by mothers, who expressed that they did not feel lonely during their hospital stay.

Telephone-Based Structured Communication Simulation Program for the Follow-Up of COVID-19 Cases and Contacts in Primary Care.

(1) The COVID-19 pandemic has had many consequences on health systems worldwide. In the Spanish health system, telephone-based consultations were coupled to in-person consultations. This type of consultation was mainly a challenge for the primary care teams, who had to assume the greatest load of care provision. The objective of the present study was to discover the satisfaction and perception of health professionals related to a training program on efficient communication based on high-fidelity simulation. (2) Methods: A cross-sectional descriptive study based on a convergent and parallel mixed method. The satisfaction and perception of 275 health professionals associated with COVID-19 training based on the structured communication model CERCAR© was analyzed. (3) Results: The assessment of the satisfaction with the training and methodology was high. With respect to the transfer of information, the participants gave a high score to the categories of consolidation of learning, applicability to their work, and benefits for the institution. The qualitative results supported these findings. (4) Conclusions: The training program and its virtual modality were well received, and had a high degree of transference. The application of active, online learning methodologies is a relevant format for continuous education.

[Rate of episiotomy in the University Clinical Hospital of Arrixaca and factors that influence in its practice.] / Tasa de episiotomía en el Hospital Clínico Universitario de La Arrixaca y factores que influyen en su práctica.

OBJECTIVE: The conduction of episiotomy is a questioned practice given the strong scientific evidence on its adverse effects. The study objectives were to know the episiotomy rate and its adaptation to the recommendations of the Ministry of Health, Consumption and Social Welfare and assess the associated factors. METHODS: It has been made a Observational, descriptive and transversal quantitative study, it was carried out in the university clinical hospital arrixaca. Data were collected from deliveries attended between January 1, 2016 and October 30, 2017, obtaining a sample of 10,630 women, registered in the SELENE computer program which is the clinical database of said hospital. To perform the data analysis, were used the SPSS statistical program and an Excel database. At the first level, it was carried out a descriptive analysis of the obstetric variables and, at a second level, the data were compared with the Ministry of Health indicators by means of a comparison of two proportions and the chi-square test. In order to estimate the Effect Size, the Cramer V was used for qualitative variables and the relative risk was calculated for each pair of qualitative variablesas a relative measure of the effect, to determine the strength of association between the variables. RESULTS: The episiotomy rate was 36.5%. When the birth started spontaneously, the percentage was 35.5%, when it was induced 47.2% and stimulated rate was 42.3%. The rate in eutocic deliveries was 20.6% and in instrumented was 95.25%. In primiparas, the episiotomy was 49.64% and in multiparas the conduction was 15.55%. Was observed a tendency of second-degree tears (43.40%), followed by first-degree (35.61%) and third-degree (19.81%) with episiotomy. CONCLUSIONS: The episiotomy rate in our study exceeds current recommendations. The variables associated with the performance of the episiotomy are induced or stimulated delivery, instrumentation and primiparity. There is a significant relationship between the practice of episiotomy and the greater degree of tear.

OBJETIVO: La realización de episiotomías es una práctica cuestionada dada la fuerte evidencia científica existente sobre sus efectos adversos. Los objetivos de este estudio fueron conocer la tasa de episiotomías y su adecuación a las recomendaciones del Ministerio de Sanidad, Consumo y Bienestar Social y valorar los factores asociados. METODOS: Se realizó un estudio cuantitativo observacional, descriptivo y transversal, que fue llevado a cabo en el Hospital Clinico Universitario Arrixaca. Se recogieron datos De los partos atendidos entre el 1 de enero de 2016 y el 30 de octubre de 2017, obteniendo una muestra de 10.630 mujeres, a través del programa informático SELENE, que es la base de datos clínicos de dicho hospital. Para realizar el análisis de datos se utilizó el programa estadístico SPSS y una base de datos Excel. En un primer nivel, se efectuó un análisis descriptivo de las variables obstétricas y, en un segundo nivel, se contrastaron los datos con los indicadores del Ministerio de Sanidad, Consumo y Bienestar Social mediante una comparación de dos proporciones y el test de la ji al cuadrado. Para poder estimar el Tamaño del Efecto se utilizó la V de Cramer para variables cualitativas, y se calculó el riesgo relativo para cada par de variables cualitativas como medida relativa del efecto, para determinar así la fuerza de asociación entre las variables. RESULTADOS: La tasa de episiotomías fue del 36,5%. Cuando el parto comenzó espontáneamente el porcentaje fue del 35,5%; cuando fue inducido, la tasa fue del 47,2% y cuando fue estimulado, el porcentaje fue del 42,3%. La tasa en partos eutócicos fue del 20,6% y en instrumentados fue del 95,25%. En primíparas, la realización de episiotomía fue del 49,64% y en multíparas la realización fue del 15,55%. Se observó una tendencia a desgarros de segundo grado (43,40%), seguidos de primer grado (35,61%) y de tercer grado (19,81%) con episiotomía. CONCLUSIONES: La tasa de episiotomía de nuestro estudio supera las actuales recomendaciones. Las variables asociadas a la realización de la episiotomía son el parto inducido o estimulado, la instrumentación y la primiparidad. Se evidencia una relación significativa entre la práctica de episiotomia y el mayor grado de desgarro.

Tasa de episiotomía en el Hospital Clínico Universitario de La Arrixaca y factores que influyen en su práctica / Rate of episiotomy in the University Clinical Hospital of Arrixaca and factors that influence in its practice

OBJETIVO: La realización de episiotomías es una práctica cuestionada dada la fuerte evidencia científica existente sobre sus efectos adversos. Los objetivos de este estudio fueron conocer la tasa de episiotomías y su adecuación a las recomendaciones del Ministerio de Sanidad, Consumo y Bienestar Social y valorar los factores asociados. MÉTODOS: Se realizó un estudio cuantitativo observacional, descriptivo y transversal, que fue llevado a cabo en el Hospital Clinico Universitario Arrixaca. Se recogieron datos De los partos atendidos entre el 1 de enero de 2016 y el 30 de octubre de 2017, obteniendo una muestra de 10.630 mujeres, a través del programa informático SELENE, que es la base de datos clínicos de dicho hospital. Para realizar el análisis de datos se utilizó el programa estadístico SPSS y una base de datos Excel. En un primer nivel, se efectuó un análisis descriptivo de las variables obstétricas y, en un segundo nivel, se contrastaron los datos con los indicadores del Ministerio de Sanidad, Consumo y Bienestar Social mediante una comparación de dos proporciones y el test de la ji al cuadrado. Para poder estimar el Tamaño del Efecto se utilizó la V de Cramer para variables cualitativas, y se calculó el riesgo relativo para cada par de variables cualitativas como medida relativa del efecto, para determinar así la fuerza de asociación entre las variables. RESULTADOS: La tasa de episiotomías fue del 36,5%. Cuando el parto comenzó espontáneamente el porcentaje fue del 35,5%; cuando fue inducido, la tasa fue del 47,2% y cuando fue estimulado, el porcentaje fue del 42,3%. La tasa en partos eutócicos fue del 20,6% y en instrumentados fue del 95,25%. En primíparas, la realización de episiotomía fue del 49,64% y en multíparas la realización fue del 15,55%. Se observó una tendencia a desgarros de segundo grado (43,40%), seguidos de primer grado (35,61%) y de tercer grado (19,81%) con episiotomía. CONCLUSIONES: La tasa de episiotomía de nuestro estudio supera las actuales recomendaciones. Las variables asociadas a la realización de la episiotomía son el parto inducido o estimulado, la instrumentación y la primiparidad. Se evidencia una relación significativa entre la práctica de episiotomia y el mayor grado de desgarro

OBJECTIVE: The conduction of episiotomy is a questioned practice given the strong scientific evidence on its adverse effects. The study objectives were to know the episiotomy rate and its adaptation to the recommendations of the Ministry of Health, Consumption and Social Welfare and assess the associated factors. METHODS: It has been made a Observational, descriptive and transversal quantitative study, it was carried out in the university clinical hospital arrixaca. Data were collected from deliveries attended between January 1, 2016 and October 30, 2017, obtaining a sample of 10,630 women, registered in the SELENE computer program which is the clinical database of said hospital. To perform the data analysis, were used the SPSS statistical program and an Excel database. At the first level, it was carried out a descriptive analysis of the obstetric variables and, at a second level, the data were compared with the Ministry of Health indicators by means of a comparison of two proportions and the chi-square test. In order to estimate the Effect Size, the Cramer V was used for qualitative variables and the relative risk was calculated for each pair of qualitative variablesas a relative measure of the effect, to determine the strength of association between the variables. RESULTS: The episiotomy rate was 36.5%. When the birth started spontaneously, the percentage was 35.5%, when it was induced 47.2% and stimulated rate was 42.3%. The rate in eutocic deliveries was 20.6% and in instrumented was 95.25%. In primiparas, the episiotomy was 49.64% and in multiparas the conduction was 15.55%. Was observed a tendency of second-degree tears (43.40%), followed by first-degree (35.61%) and third-degree (19.81%) with episiotomy. CONCLUSIONS: The episiotomy rate in our study exceeds current recommendations. The variables associated with the performance of the episiotomy are induced or stimulated delivery, instrumentation and primiparity. There is a significant relationship between the practice of episiotomy and the greater degree of tear

Connections between academic burnout, resilience, and psychological well-being in nursing students: A longitudinal study.

AIMS: The aim of this study was to explore the longitudinal associations between academic burnout and resilience and psychological well-being, and the stability of these variables in a sample of university nursing students. BACKGROUND: Nursing students frequently suffer academic burnout, which is brought on by different situations experienced during the training process and that can concern his psychological well-being. Resilience is a personal resource that allows adverse situations to be handled in a successful way. DESIGN: Longitudinal design. METHODS: Data were collected at two moments separated by 18 months (2014-2016), with 218 students at T1 and 113 at T2. At each time a questionnaire was given to them, with questions about socioeconomic demographics and three validated scales to measure academic burnout, resilience, and psychological well-being. RESULTS: The three dimensions that make up academic burnout remained steady over time, while resilience increased and psychological well-being improved. Hierarchical regression analyses revealed the longitudinal effect of emotional exhaustion at T1 and at T2 they showed the longitudinal effect of resilience on psychological well-being at T2. The inverse hierarchical regression analyses did not reveal significant relationships for any of the variables measured at T2 in connection with psychological well-being measured at T1. CONCLUSIONS: Emotional exhaustion was the most relevant dimension of academic burnout when predicting psychological well-being in the analysed sample. Moreover, resilience has an important positive effect on psychological well-being in the analysed sample. The practical implications of the results are discussed from the perspective of academic training and some recommendations are given for future research in this field.

El contexto del nacimiento en los años cuarenta en una zona rural del sur de España / Birth context in the forties in a rural area of southern Spain / Contexto do nascimento em quarenta anos em uma área rural do sul da Espanha

En este estudio nos planteamos como objetivos conocer el contexto del nacimiento en un pueblo rural de España en un período de posguerra, 1945-1950; determinar cómo influyeron los roles de género en la vivencia de estos acontecimientos; identificar qué valores y creencias influyeron en el proceso del nacimiento de sus hijos y descubrir qué actitudes promovieron cambios. Desde el enfoque cualitativo hemos escogido el método etnográfico. La información se obtuvo a través de historias de vida y entrevistas semiestructuradas durante 2009. El estudio se llevó a cabo en un pueblo rural del sureste de España (Abarán-Murcia). Se realizaron 11 historias de vida a mujeres que fueron madres entre 1945 y 1950 y 5 entrevistas semiestructuradas para la triangulación y ampliación de la información. Tras la trascripción y fragmentación de las entrevistas y mediante análisis temático del contenido surgieron tres categorías: trabajo/economía doméstica, matrimonio/familia y nacimiento. Los roles de género se han impuesto en la vida de los hombres y las mujeres. El modelo social relaciona a la mujer con las actividades dentro del hogar, sin embargo, la mujer trabajaba duro fuera de casa en labores agrícolas. Las creencias transmitidas provocaban que las mujeres no conocieran su propio cuerpo incluso en el momento del parto, la matrona es el personal de referencia para este acontecimiento

In this study we set objectives to define the birth context of a rural town in Spain in the post-war period 1945-1950; to define what influence gender roles had on experience of these events; to identify what values and beliefs had influence on the childbirth process and to investigate which attitudes promoted change. Taking a qualitative approach, we chose an ethnographic method. The information was obtained through life story reports and semi-structured interviews during 2009. The study was carried out in a rural town in southern Spain: Abarán, in the Region of Murcia. Eleven life stories were collected from women who became mothers between 1945 and 1950 and five semi-structured interviews were also carried out to enable triangulation and information expansion.After transcription of the interviews, the information was fragmented and, after thematic analysis of the content, three categories were defined: household work/ economy, marriage/family and childbirth. Despite the way that gender roles defined the lives of men and women. Even though the social model of the time links women to activities at home, these women also worked hard at agricultural labour outside the home. The prevailing beliefs meant that many of the women were ignorant of their own bodies, even up until the moment of giving birth. Midwives were the reference professionals for this event

Este estudo tem como objectivos conhecer o contexto do nascimento numa vila rural de Espanha no período de pós-guerra, 1945- 1950; determinar como o papel de género influiu na vivência desses eventos; identificar quais valores e crenças influíram no processo do nascimento dos filhos e descobrir quais actitudes promoveram as mudanças. A partir da abordagem qualitativa foi escolhido o método etnográfico. As informações foram obtidas através das histórias de vida e entrevistas semi-estruturadas ao longo de 2009. O estudo desenvolveu-se numa vila rural no sudeste da Espanha (Abarán, Murcia). Foram realizadas onze histórias de vida a mulheres que foram mães entre 1945 e 1950, e cinco entrevistas semi-estruturadas para a triangulação e ampliação da informação. Após a transcrição e fragmentação das entrevistas e da análise temática do conteúdo, surgiram três categorias: trabalho/economia doméstica, casamento/ família e nascimento. O papel do género tem-se imposto na vida dos homens e das mulheres. O modelo social relaciona à mulher com as actividades dentro de casa, no entanto, a mulher trabalhava duramente fora de casa na agricultura. As crenças transmitidas fizeram com que as mulheres não conhecessem o seu próprio corpo, mesmo no momento do parto, sendo a parteira a pessoa de referência para este acontecimento

Factores de estrés laboral en el personal de enfermería hospitalario del equipo volante según el modelo de demanda-control-apoyo / Factors of work-related stress in hospital nursing bureau according to the demand-control-support model

Objetivos: Analizar la presencia de estrés laboral en el equipo volante de enfermería de un Hospital General Universitario tomando como referencia el modelo demandas-control-apoyo de Karasek. Método: Estudio observacional de corte transversal. La muestra estuvo constituida por 38 profesionales de enfermería del equipo volante de un Hospital General Universitario. Instrumentos de evaluación: para conocer la percepción de los profesionales de enfermería sobre el contenido de su trabajo y determinar los estresores laborales, se empleó el cuestionario Job Content Questionnaire (JCQ) traducido y validado para enfermería hospitalaria. Resultados: La tasa de participación fue del 90,47% (N=38). Se registró una media para la dimensión de apoyo social de 2,59±0,47, para la dimensión de demandas psicológicas en el trabajo de 3,26±0,47, y para la dimensión de control sobre el trabajo se obtuvo una media de 2,87±0,40. El análisis de datos puso de manifiesto un nivel moderado de estresores, destacando un déficit de apoyo social por parte de los superiores, que resultó ser más acusado en el grupo de profesionales adscritos a la dirección de enfermería (2,89 vs 2,49; p<0,05). Ninguna de las tres dimensiones se mostró asociada a las variables socio-laborales de sexo, edad, turno, adscripción y tipo de vinculación al hospital. Conclusiones: Existe una percepción moderada de estresores laborales, resaltando el escaso apoyo social por parte de los superiores, siendo este aspecto una área de mejora sobre la que intervenir

Objectives: To analyse the presence of work-related stress in the nursing bureau of a University General Hospital taking as reference Karasek's demand-control-support model. Methods: Cross-sectional observational study. The sample included 38 nursing professionals from the nursing bureau of a University General Hospital. Assessment tools: the Job Content Questionnaire (JQC), translated and validated for hospital nursing, was used to know the perception of nursing professionals concernins their work, and to determine the presence of any work-related stressors. Results: The participation rate was 90.47% (N=38). The average for the social support dimension was 2.59±0.47, for the psychological demands of 3.26±0.47, and for control over their own work of 2.87±0.40. Data analysis pointed to a moderate level of stress, reflecting a deficit in the social support provided by superiors, particulary in the group of professionals assigned to nursery management (2.89 vs 2.49; p<0.05). None of the three dimensions showed a link of any kind with socio-occupational variables of gender, age, shift, assignment or type of connection to the hospital. Conclusion: Improvement is needed in this area on the part of human resources management in order to lessen the effect of work-related stress, psychological demands and lack of control over these

Impact of support networks for breastfeeding: A multicentre study.

BACKGROUND: The rates of breastfeeding worldwide are slowly improving since 1996. Europe is still trailing behind the global breastfeeding incidence and prevalence rates. Thus, breastfeeding promotion, protection, prolongation and support have become an important challenge as breastfeeding sharply decreases in the first six months of life. OBJECTIVES: The aim of this project is to determine, assess and identify the real impact of breastfeeding support networks in Murcia (Spain). METHODS: After searching unsuccessfully for a validated questionnaire, a specific one was developed and validated for measuring the impact of formal and informal support networks through five dimensions: satisfaction, consultation, experience, problems and support. The questionnaire was provided to 500 mothers with experience in breastfeeding, who brought their children to baby paediatricians between 2 June and 27 November 2014. Upon completion of the survey and fieldwork, a detailed statistical analysis was conducted. RESULTS: The degree of satisfaction perceived by the users of the services of support breastfeeding networks is remarkable. In addition, mothers who clarified their doubts and discussed their problems with health professionals and/or breastfeeding support networks were more likely to breastfeed for a longer duration compared to those who did not (p=0.005). Furthermore, mothers who sought support in breastfeeding are more likely to breastfeed for more than 6 months (p<0.0005). CONCLUSION: Based on this information, we conclude that breastfeeding support networks have a positive influence in the duration of a women's decision to breastfeed.

Comparative study analysing women's childbirth satisfaction and obstetric outcomes across two different models of maternity care.

OBJECTIVES: To describe the differences in obstetrical results and women's childbirth satisfaction across 2 different models of maternity care (biomedical model and humanised birth). SETTING: 2 university hospitals in south-eastern Spain from April to October 2013. DESIGN: A correlational descriptive study. PARTICIPANTS: A convenience sample of 406 women participated in the study, 204 of the biomedical model and 202 of the humanised model. RESULTS: The differences in obstetrical results were (biomedical model/humanised model): onset of labour (spontaneous 66/137, augmentation 70/1, p=0.0005), pain relief (epidural 172/132, no pain relief 9/40, p=0.0005), mode of delivery (normal vaginal 140/165, instrumental 48/23, p=0.004), length of labour (0-4 hours 69/93, >4 hours 133/108, p=0.011), condition of perineum (intact perineum or tear 94/178, episiotomy 100/24, p=0.0005). The total questionnaire score (100) gave a mean (M) of 78.33 and SD of 8.46 in the biomedical model of care and an M of 82.01 and SD of 7.97 in the humanised model of care (p=0.0005). In the analysis of the results per items, statistical differences were found in 8 of the 9 subscales. The highest scores were reached in the humanised model of maternity care. CONCLUSIONS: The humanised model of maternity care offers better obstetrical outcomes and women's satisfaction scores during the labour, birth and immediate postnatal period than does the biomedical model.

An exploratory study of the relationship between resilience, academic burnout and psychological health in nursing students.

OBJECTIVES: The purpose of this study was to examine the relationship between resilience, academic burnout and psychological health in a sample of nursing students. METHOD/DESIGN: A descriptive and cross-sectional design was applied, with questionnaires as tools. PARTICIPANTS: The convenience sample consisted of 113 nursing students in their final academic year, who voluntarily participated in the study. RESULTS: The results indicated a statistically significant relationship between resilience and both emotional exhaustion (r = -.55; p < .01) and psychological health (r = -.62; p < .01), as well as between all three dimensions of burnout and psychological health. Hierarchical multiple regression analysis indicated that high scores for resilience and low scores for emotional exhaustion predict better perceived psychological health [F(2.96) = 17.75; p < .001]. CONCLUSIONS: Resilience was associated with lower levels of psychological discomfort and academic burnout. These findings highlight the importance of developing resilience and integrating it as an element in the nursing educational programme.

Episiotomy and its relationship to various clinical variables that influence its performance.

OBJECTIVE: to understand the episiotomy rate and its relationship with various clinical variables. METHOD: a descriptive, cross-sectional, analytic study of 12,093 births in a tertiary hospital. VARIABLES: Parity, gestational age, start of labor, use of epidural analgesia, oxytocin usage, position during fetal explusion, weight of neonate, and completion of birth. The analysis was performed with SPSS 19.0. RESULTS: the global percentage of episiotomies was 50%. The clinical variables that presented a significant association were primiparity (RR=2.98), gestational age >41 weeks (RR=1.2), augmented or induced labor (RR=1.33), epidural analgesia use (RR=1,95), oxytocin use (RR=1.58), lithotomy position during fetal expulsion (RR=6.4), and instrumentation (RR=1.84). Furthermore, maternal age ≥35 years (RR=0.85) and neonatal weight <2500 g (RR=0.8) were associated with a lower incidence of episiotomy. CONCLUSIONS: episiotomy is dependent on obstetric interventions performed during labor. If we wish to reduce the episiotomy rate, it will be necessary to bear in mind these risk factors when establishing policies for reducing this procedure.

Episiotomy and its relationship to various clinical variables that influence its performance / Episiotomia e sua relação com diferentes variáveis cínicas que influenciam sua realização / La episiotomía y su relación con distintas variables clínicas que influyen en su realización

Objective: to understand the episiotomy rate and its relationship with various clinical variables. Method: a descriptive, cross-sectional, analytic study of 12,093 births in a tertiary hospital. Variables: Parity, gestational age, start of labor, use of epidural analgesia, oxytocin usage, position during fetal explusion, weight of neonate, and completion of birth. The analysis was performed with SPSS 19.0. Results: the global percentage of episiotomies was 50%. The clinical variables that presented a significant association were primiparity (RR=2.98), gestational age >41 weeks (RR=1.2), augmented or induced labor (RR=1.33), epidural analgesia use (RR=1,95), oxytocin use (RR=1.58), lithotomy position during fetal expulsion (RR=6.4), and instrumentation (RR=1.84). Furthermore, maternal age ≥35 years (RR=0.85) and neonatal weight <2500 g (RR=0.8) were associated with a lower incidence of episiotomy. Conclusions: episiotomy is dependent on obstetric interventions performed during labor. If we wish to reduce the episiotomy rate, it will be necessary to bear in mind these risk factors when establishing policies for reducing this procedure.

Objetivo: conhecer a taxa de episiotomia e sua relação com diferentes variáveis clínica. Método: e Estudo descritivo, transversal e analítico de 12.093 partos em um hospital terciário. Variáveis: paridade, idade gestacional, início do parto, uso de analgesia epidural, uso de oxitocina, posição durante expulsão do feto, peso do neonato e finalização do parto. A análise foi feita com o SPSS 19.0. Resultados: a porcentagem global de episiotomias foi de 50%. As variáveis clínicas que apresentaram uma associação significativa foram: primiparidade (RR=2,98), idade gestacional > 41 semanas (RR=1,2), início do parto estimulado ou induzido (RR=1,33), uso de analgesia epidural (RR=1,95), uso de ocitocina (RR=1,58), posição de litotomia durante a expulsão fetal (RR=6,4) e instrumentação (RR=1,84). Por outro lado, idade materna ≥ 35 anos (RR=0.85) e peso do neonato < 2500 g (RR=0,8) estão associados a uma menor incidência de episiotomia. Conclusões: a episiotomia depende de intervenções obstétricas feitas durante o parto. Se desejarmos reduzir a taxa de episiotomia, será necessário manter em mente esses fatores de risco para estabelecer políticas para reduzir esse procedimento.

Objetivo: conocer la tasa de episiotomía y su relación con distintas variables clínicas. Método: estudio descriptivo, transversal y analítico, de 12.093 partos en un hospital de tercer nivel. Las variables fueron: paridad, edad gestacional, inicio del parto, uso de analgesia epidural, uso de oxitocina, posición durante la expulsión fetal, peso del recién nacido y finalización del parto. El análisis se realizó con el programa estadístico SPSS 19.0. Resultados: el porcentaje global de episiotomías fue de 50%. Las variables clínicas que presentaron una asociación significativa fueron: primiparidad (RR=2,98), edad gestacional > 41 semanas (RR=1,2), inicio del parto estimulado o inducido (RR= 1,33), uso de analgesia epidural (RR=1,95), uso de oxitocina (RR=1,58), posición de litotomía durante la expulsión fetal (RR=6,4) e instrumentación (RR=1,84). Por otra parte, la edad materna fue ≥35 años (RR=0,85) y el peso del recién nacido < 2500g. (RR=0,8), se asociaron con una menor incidencia de episiotomía. Conclusiones: la episiotomía estuvo condicionada por las intervenciones obstétricas que se realizaron durante el desarrollo del parto. Si deseamos reducir la tasa de episiotomía será necesario tener en cuenta los factores de riesgo para establecer políticas de reducción de este procedimiento.

El concepto del Baby Café como red internacional de apoyo a la lactancia materna / O conceito do Baby Café como rede internacional de apoio à amamentação materna / The Baby Café concept as an international network of support to breastfeeding

El objetivo general de este trabajo consiste, en reflexionar sobre el fenómeno del Baby Café como recurso novedoso y conveniente dentro del mundo de la promoción, protección y apoyo a la lactancia materna a nivel internacional. El Baby Café es una iniciativa de apoyo a la lactancia materna, que coordina una red internacional de centros en los que se combina el apoyo formal proveniente de los profesionales sanitarios especializados en lactancia y el apoyo informal propio de los grupos o redes de apoyo a la lactancia. Con el fin último de promover proteger y apoyar a la lactancia materna, adentrándonos en la iniciativa del Baby Café y animando a que se realicen más estudios que avalen el verdadero impacto que éste tipo de iniciativas tienen sobre la sociedad; hemos desarrollado, mediante el estado de la cuestión y un diario de campo, un estudio cualitativo, que nos ha permitido explorar el fenómeno del Baby Café en el distrito 10 de Singapur, durante el mes de marzo de 2015 (AU)

O objetivo geral deste trabalho consiste em refletir sobre o fenômeno do bebe café como novo e conveniente recurso dentro do mundo da promoção, proteção e apoio a amamentação materna a nível internacional. O bebe café é uma iniciativa de apoio a amamentação materna que coordena uma rede internacional de centros nos quais se combina o apoio formal proveniente dos profissionais sanitários especializados em amamentação, e no apoio informal próprio dos grupos o redes de apoio a amamentação. Com o fim de promover, proteger e apoiar a amamentação materna aprofundando a iniciativa do bebe café e incentivando a que se realizem mais estudos que avaliem o verdadeiro impacto que este tipo de iniciativa tem sobre a sociedade; temos desenvolvido, mediante o estado da questão e um diário de campo, um estudo qualitativo, que nos permitiu explorar o fenômeno do bebe café no distrito de Singapura durante o mês de Março 2015 (AU)

The general objective of this work is to reflect on the phenomenon of The Baby Café as a novel and convenient concept in a world of promotion, protection and support of breastfeeding worldwide. The Baby Café is an initiative to support breastfeeding that coordinates an international network of centers that combines formal support from health professionals who specialize in lactation with informal support groups or networks of breastfeeding. With the ultimate goal of the promotion, protection and support of breastfeeding, the introduction of The Baby Café initiative encourages more studies of such nature to be conducted, eventually demonstrating the true impact of such initiatives on society; we have developed, through the theoretical framework and a field diary, a qualitative study, which has allowed us to explore the phenomenon of the Baby Cafe in the 10th district of Singapore, during the month of March 2015 (AU)

La satisfacción de la vida laboral de los enfermeros de las unidades móviles de emergencias de la Región de Murcia / Working life satisfaction in the nursing staff of the emergency mobile units of the Región of Murcia

El análisis de la satisfacción laboral es un indicador de la calidad del servicio prestado, convirtiéndose de forma indirecta, en un instrumento para mejorar la calidad de la atención sanitaria. Objetivo: Analizar la satisfacción laboral de los profesionales de enfermería de las Unidades Móviles de Emergencias de la Región de Murcia. Metodología: Estudio cuantitativo de corte transversal, con una muestra de conveniencia de 77 profesionales de enfermería de las Unidades Móviles de Emergencias, realizado en febrero/abril de 2013. Se utilizó la escala NTP 394: Satisfacción Laboral: escala general de satisfacción. Se procedió al análisis descriptivo y estadístico de asociación de variables con el programa estadístico SPSS (v.15). Resultados: La participación fue del 90,58%. Los resultados del estudio reflejan una satisfacción general media (M=72.12; DT=13,97), los 'compañeros de trabajo' y el 'horario de trabajo' son los aspectos mejor evaluados. Conclusiones: Este estudio mostró un elevado nivel de satisfacción laboral de los profesionales de enfermería de las Unidades Móviles de Emergencias de la Región de Murcia. No obstante, la detección de facetas laborales que producen insatisfacción constituye una herramienta importante para el establecimiento de acciones de mejora por parte de los gestores de las organizaciones de salud (AU)

The analysis of the job satisfaction is an indicator of the quality of the service provided, becoming in an indirect way, an instrument for improving the quality of health care. Objective: analyze the job satisfaction of nursing professionals of the Mobile Units of Emergencies in the Region of Murcia. Methodology: Quantitative cross-sectional study with a convenience sample of 77 nurses from the Emergency Mobile Units. The study was conducted from February to April 2013. Overall level of satisfaction: the NTP 394 scale: Job Satisfaction was used to measure satisfaction. We proceeded to the descriptive and statistical analysis of association of variables with the statistical program SPSS (V.15). Results: The response rate was 90.58%. The study results reflect an average overall satisfaction (M=72.12; SD=13.97); the 'colleagues' and 'working shift' are the best evaluated aspects. Conclusions: This study showed a high level of job satisfaction of nurses in the Emergency Mobile Units of the Region of Murcia. However, the detection of occupational aspects that produce dissatisfaction is an important tool concerning the establishment of improvement actions from managers of health organizations (AU)

Satisfacción laboral de los profesionales sanitarios de un Hospital Universitario: análisis general y categorías laborales / Job satisfaction of health professionals in a University Hospital: General analysis and job categories

La satisfacción laboral en los servicios de salud está implicada en la calidad asistencial, de ahí la importancia de su medición en los trabajadores de las instituciones sanitarias. El objetivo fue explorar y analizar el fenómeno de la satisfacción laboral en una muestra constituida por 546 profesionales sanitarios pertenecientes a un Hospital Universitario público. Se administró un cuestionario general que contenía un conjunto de preguntas de contenido sociodemográfico y se utilizó la Escala General de Satisfacción (Overall Job Satisfacción) adaptada y validada al castellano. Los resultados del estudio reflejan una satisfacción general media (M = 71.37; DT = 14.03), los “compañeros de trabajo” y el “superior inmediato” son los aspectos mejor evaluados. Los principales hallazgos reflejan diferencias importantes en los distintos niveles de satisfacción atendiendo a la categoría profesional, siendo los grupos de gestión y los médicos residentes lo más satisfechos, mientras que los facultativos especialistas de área, profesionales de enfermería y auxiliares de enfermería manifiestan niveles de satisfacción más reducidos

Job satisfaction in health services is measured by the quality of care provided, hence the importance of surveying the workers of health institutions. The objective was to explore and analyze the phenomenon of the satisfaction of working in a sample made up of 546 health professionals belonging to a public University Hospital. Both a socio-demographic questionnaire and General Scale of Satisfaction (Overall Job Satisfacción) that were both validated in Spanish were given to the participants. The results of general satisfaction showed a mean of 71.37 (SD = 14.03). The subscales with better results were: colleagues and immediate superior. There were important differences in satisfaction scores between the different professional categories. The higher levels of general satisfaction were found in hospital management groups and resident doctors, while the lower levels of general satisfaction were found in medical area specialists, nurses and auxiliary nurses

Desarrollo y validación de un instrumento diseñado para medir el impacto de las redes de apoyo a la lactancia materna / Development and validation of an instrument designed to measure the impact of networks of support for breastfeeding

Antecedentes: partimos de la hipótesis de que no existen suficientes cuestionarios validados que midan el impacto de las redes de apoyo a la lactancia materna para población hispano hablante. Objetivo: Por ese motivo, nos planteamos como objetivo general de este trabajo, elaborar y validar (a nivel de contenido y constructo) un instrumento de medida cuantitativa. Método: Se evaluó la validez de contenido sometiendo el cuestionario a un juicio de expertos en lactancia materna de la Región de Murcia. La prueba piloto se llevó a cabo entre los meses de marzo y abril de 2014. Las encuestas fueron realizadas directamente por las usuarias que acudían al grupo de apoyo a la lactancia «Lactando». Para la validez de constructo se realizó un análisis factorial con el que se determinaron las distintas dimensiones que el cuestionario podría medir. Se realizó una estadística descriptiva de cada uno de los ítems. A través del análisis de componentes principales, se obtuvo la varianza total explicada, determinando así, los factores con los elementos que los definían. Resultados: A través del análisis factorial, el cuestionario obtuvo una alta consistencia interna para sus cinco componentes (satisfacción, consultas, experiencia, problemas y apoyo), consiguiendo valores de 0,942 a 0,632. Y un porcentaje de varianza total explicada elevado (11,157%-5,093%). Conclusión: Este estudio ha servido para crear un instrumento pertinente y válido a nivel de contenido y de constructo, capaz de medir el impacto de las redes de apoyo a la lactancia a través de 5 dimensiones (AU)

Background: the hypothesis of this study is that there are not enough validated questionnaires that measure the impact of networks to support breastfeeding for the Spanish speaking population. Objective: For this reason, we ask as a general objective of this study, to develop and validate (in terms of content and construct) a quantitative instrument of measure. Method: We evaluated the content validity, subjecting the survey to a breastfeeding expert's opinion in the Region of Murcia. The pilot test was conducted between the months of March and April 2014. Surveys were carried out directly by users who attended the breast-feeding support group «Lactando». For construction validity, a factor analysis was conducted, which determined the different dimensions that the survey could measure. A description of each of the items on the statistics was conducted. Through principal component analysis, the total variance explained was obtained, determining the factors that define the elements. Results: Through factor analysis, the questionnaire has a high internal consistency for its five components (satisfaction, consultations, experience, problems and support), obtaining values from 0.942 to 0.632. And a high percentage of total variance explained (11,157%-5,093%). Conclusion: This study has served to create a relevant and valid in terms of content and construction, instrument, capable of measuring the impact of networks of support for breastfeeding through 5 dimensions (AU)

[Development and validation of an instrument designed to measure the impact of networks of support for breastfeeding]. / Desarrollo y validación de un instrumento diseñado para medir el impacto de las redes de apoyo a la lactancia materna.

BACKGROUND: the hypothesis of this study is that there are not enough validated questionnaires that measure the impact of networks to support breastfeeding for the Spanish speaking population. OBJECTIVE: For this reason, we ask as a general objective of this study, to develop and validate (in terms of content and construct) a quantitative instrument of measure. METHOD: We evaluated the content validity, subjecting the survey to a breastfeeding expert's opinion in the Region of Murcia. The pilot test was conducted between the months of March and April 2014. Surveys were carried out directly by users who attended the breast-feeding support group "Lactando". For construction validity, a factor analysis was conducted, which determined the different dimensions that the survey could measure. A description of each of the items on the statistics was conducted. Through principal component analysis, the total variance explained was obtained, determining the factors that define the elements. RESULTS: Through factor analysis, the questionnaire has a high internal consistency for its five components (satisfaction, consultations, experience, problems and support), obtaining values from 0.942 to 0.632. And a high percentage of total variance explained (11,157% - 5,093%). CONCLUSION: This study has served to create a relevant and valid in terms of content and construction, instrument, capable of measuring the impact of networks of support for breastfeeding through 5 dimensions.

Antecedentes: partimos de la hipótesis de que no existen suficientes cuestionarios validados que midan el impacto de las redes de apoyo a la lactancia materna para población hispano hablante. Objetivo: Por ese motivo, nos planteamos como objetivo general de este trabajo, elaborar y validar (a nivel de contenido y constructo) un instrumento de medida cuantitativa. Método: Se evaluó la validez de contenido sometiendo el cuestionario a un juicio de expertos en lactancia materna de la Región de Murcia. La prueba piloto se llevó a cabo entre los meses de marzo y abril de 2014. Las encuestas fueron realizadas directamente por las usuarias que acudían al grupo de apoyo a la lactancia "Lactando". Para la validez de constructo se realizó un análisis factorial con el que se determinaron las distintas dimensiones que el cuestionario podría medir. Se realizó una estadística descriptiva de cada uno de los ítems. A través del análisis de componentes principales, se obtuvo la varianza total explicada, determinando así, los factores con los elementos que los definían. Resultados: A través del análisis factorial, el cuestionario obtuvo una alta consistencia interna para sus cinco componentes (satisfacción, consultas, experiencia, problemas y apoyo), consiguiendo valores de 0,942 a 0,632. Y un porcentaje de varianza total explicada elevado (11,157% - 5,093%). Conclusión: Este estudio ha servido para crear un instrumento pertinente y válido a nivel de contenido y de constructo, capaz de medir el impacto de las redes de apoyo a la lactancia a través de 5 dimensiones.

Adecuación entre la práctica clínica obstétrica en el Hospital Clínico Universitario Virgen de la Arrixaca (Murcia) y las recomendaciones de la Estrategia de Atención al Parto Normal / Adaptation between the obstetric clinical practise at the University Hospital Virgen de la Arrixaca (Murcia) and the recommendations of the Strategy Normal Birth Care

OBJETIVO: Comprobar el grado de adecuación de la práctica clínica obstétrica a las recomendaciones de la Estrategia de Atención al Parto Normal. Personas, material y método: Estudio descriptivo, transversal, de la actividad obstétrica de 12.093 mujeres durante el proceso de parto (en los años 2011 y 2012) en el Hospital Clínico Universitario Virgen de la Arrixaca (Murcia). Las variables estudiadas fueron: paridad, edad gestacional, inicio del parto, utilización de analgesia epidural, uso de oxitocina, posición durante la etapa de expulsión fetal, peso del recién nacido y finalización del parto. RESULTADOS: Se observa una adecuación de la práctica clínica a las recomendaciones de la Estrategia de Atención al Parto Normal en la tendencia a disminuir las siguientes practicas: el rasurado perineal (13%), el uso de enemas (7%) y el número de cesáreas urgentes (11,38%). Asimismo, se constata una tendencia a aumentar el acompañamiento al parto (88,7%), la monitorización continua (99%), la ingesta de líquidos intraparto (34,8%), el número de partos vaginales tras cesárea previa (93,1%) y el porcentaje de epidural (77%). El resto de variables estudiadas (realización de amniotomia y partos instrumentados) se mantienen sin cambios. CONCLUSIONES: Las recomendaciones de la Estrategia no se siguen en su totalidad. Se han identificado puntos de mejora. Es necesario desarrollar políticas que permitan reducir los procedimientos desaconsejados por el Ministerio de Sanidad, así como reforzar la formación del equipo interdisciplinar

OBJECTIVE: The aim is to check the adaption of the obstetric clinical practise and the recommendations of the Strategy Normal Birth Care. Persons, material and methods: This has been a descriptive, transversal and analytical study of the obstetrical activity of 12,093 childbirths which took place between 2011 and 2012 in the Clinical University Hospital Virgen de la Arrixaca (Murcia). The studied variables were: parity, gestational age, onset of labor, use of epidural analgesia, use of oxytocin, stage position during fetal expulsion, new-born weight and type of delivery (eutocic, implemented or cesarean). RESULTS: The clinical appropriateness of the recommendations of the Strategy Normal Birth Care presents a tendency to decrease in the following practises: perineal saving (13%), the use of enemas (7%) and the number of emergency caesareans (11.38%). Likewise, some practices have also had a tendency to increase: accompaniment of childbirth (88.7%), continuous monitoring (99%), intrapartum fluid intake (34.8%), the number of vaginal births after cesarean (93.1%) and the number of women with epidural (77%). There has not been any variation in the remaining studied variables (amniotomy and performing instrumental births). CONCLUSIONS: The recommendations of the Strategy are not followed entirely. Some points of improvement have been identified. It will be necessary to develop some reduction policies of procedure advised against by the Ministry, and to reinforce the interdisciplinary team training

Resiliencia, Síndrome de Estar Quemado en el Trabajo y Malestar Psicológico en estudiantes de enfermería / Resilience, Burnout and psychological distress in nursing students

Esta investigación pretende analizar la relación entre la variable psicológica de resiliencia y las dimensiones que componen el síndrome de quemarse por el trabajo, así como el potencial efecto protector de la capacidad de la resiliencia ante dicho proceso de desgaste y la aparición de síntomas de malestar psicológico en los estudiantes. La muestra estaba constituida por 218 alumnos de enfermería de segundo de grado de la Universidad de Murcia. Se les aplicaron tres instrumentos: la Escala de Resiliencia (CD-RISC-10), el Inventario de Burnout de Maslach (MBI-GS) y el Cuestionario de Salud General (GHQ-12). Los resultados apoyan la relación negativa entre la capacidad psicológica de la resiliencia y el síndrome de burnout y la presencia de sintomatología psicológica. Finalmente, se sugieren algunas recomendaciones para la investigación futura con estudios analíticamente más complejos que profundicen en la relación entre las variables estudiadas y su aplicabilidad en el contexto formativo de los estudiantes

The aim of this research is to analyze the relationship between the psychological variable of resilience and burnout dimensions, as well as the possible effects of resilience as a protective factor against burnout and its consequences on students’ health. The sample was composed of 218 nursing students of second degree of Murcia University. Three assessment instruments were used: The Resilience Scale (CD-RISC-10), the Maslach Burnout Inventory (MBI-GS), and a spanish version of the General Health Questionnaire (GHQ-12). The results support the negative relationship between psychological resilience and burnout syndrome and the presence of psychological symptoms. Finally, recommendations for future research by analytically more complex studies to deepen the relationship between the studied variables and their applicability in the educational context of the students are suggested

Gestión de enfermería: proceso de creación de un complejo hospitalario. Área ii del servicio murciano de salud (Cartagena) / Nursery management: creation of a hospital complex. area ii of the murcia health care service (Cartagena)

INTRODUCCIÓN. Se analiza, mediante un estudio descriptivo, el traslado y cierre del Hospital Básico de Defensa, junto al cambio y reestructuración del Hospital Universitario Santa María del Rosell, al nuevo Hospital Universitario Santa Lucía, coincidiendo con la creación de la Gerencia Única del Área de Salud II. El objetivo es estudiar el proceso de apertura de un complejo hospitalario coincidiendo con la remodelación del Área Sanitaria. METODOLOGÍA. Se examina toda la labor de planificación, formación y traslado que afectó a más de 600 camas y a 275.000 habitantes, profundizando en las actuaciones desarrolladas en infraestructuras, logística y formación. Todo el proceso se hace desde el punto de vista de enfermería, como colectivo profesional implicado en el conocimiento de las funciones tanto de hospitales como de personal. El periodo de estudio comprende desde octubre de 2010, inicio de la actividad en el nuevo hospital, a noviembre de 2011, culminación efectiva del traslado. RESULTADO. El resultado fue el traslado a las nuevas instalaciones y la reestructuración de las anteriores en un tiempo breve para la magnitud del proceso (once meses). Todos los pacientes se trasladaron sin ningún incidente. CONCLUSIÓN. Durante todo el proceso se dio continuidad asistencial y se ocasionó el menor impacto tanto económico como en los pacientes y profesionales. Desde el punto de vista de futuro e implicaciones prácticas, se han sentado las bases para una prestación moderna y de calidad, y obtenido de los medios que se han puesto por la sociedad a nuestra disposición el mejor resultado en calidad asistencial (AU)

INTRODUCTION. This paper analyzes, by a descriptive study, the closing of the Basic Hospital of the Defence the restructuration of the Santa María del Rosell University Hospital, and the moving of both to a new hospital: the Santa Lucía University Hospital. This process was carried out in coordination with a coincident objective: the creation of an only management staff for the area. The aim is the analysis of the opening of a hospital complex that coincided with the restructuration of the health area. METHODOLOGY. This paper analyzes the actions in relation to the scheduling, training and moving, that concerned above 600 hospital beds and 275.000 inhabitants. Analyzes the intervention in infrastructures, logistics and training. The whole process is seen from de nursery point of view, as a professional stratus that knows the roles of the hospital and personnel. The period of the study comprises since October 2010, beginning of the activity in the new hospital, to November 2011, moment of the effective culmination of the move. RESULT. The result of the works carried out was the transfer of people and roles in a very short time (eleven months). All the patients were moved without any event. CONCLUSION. During the whole process healthcare continuity was obtained, whit the less economic impact, as in patients and professionals. From the point of view of future and practical implications, the basis for a modern and qualified provision of services have been established; and best results from means provided have been obtained in relation to health care quality (AU)