Revisión sobre aspectos genéricos acerca de la actividad física adaptada en la persona con lesión medular / Review of generic aspects about adapted physical activity in the person with spinal cord injury

Actualmente la lesión medular ocasiona discapacidad y dependencia, y provoca alteraciones de las funciones sensitivas, motoras y/o autonómicas por debajo del nivel de lesión. La mejora de la calidad de vida junto a la de los cuidados entre otros factores, han contribuido al incremento de la expectativa de vida, permitiendo que un mayor número de personas con lesión medular (PLM) lleguen más cualitativamente a edades más longevas. La PLM requiere seguir un programa de Actividad Física Adaptada (AFA) para mantener su estado de salud. El conocimiento de los beneficios de la AFA y sus modalidades permite potenciar esta actividad. Asimismo, la situación política-social de cada país puede influir en la concepción y la posibilidad de desarrollo de la AFA. En este artículo se realizó una búsqueda en las bases de SPORTDiscus, PubMed, Embase, Science Direct, PEDro y Cochrane Library, incluyendo revisión de los últimos diez años. Se obtuvieron 108 artículos y 24 de ellos cumplieron todos los criterios, que fueron: la temporalidad señalada, artículos con grado de evidencia de A, B o C y los artículos que destacasen la AFA en la PLM como tratamiento en fase crónica. Tras la revisión se puede concluir que 1) Hay que seguir promoviendo políticas favorecedoras de la inclusión de la AFA con el fin de hacerlas accesibles a toda la población con discapacidad y/o dependencia, y en particular a la PLM 2) La elección de la práctica deportiva de la PLM dependerá de factores externos o ambientales y especialmente de internos o personales 3) Los beneficios que más se señalan sobre la AFA son: el aumento de la calidad de vida relacionada con la salud y la mejora de la autoestima e imagen corporal de la PLM respecto a la sociedad

Nowadays the Spinal Cord Injury (SCI) implies disability and dependency. The SCI causes changes in sensorial functions, motor functions and/or autonomic functions below the level of injury. The improvement of quality of life as well as the care, among other factors, have contributed to increase life expectancy. This fact allows the person with spinal cord injury to have a lengthy quality life. The person with spinal cord injury requires to follow a long-term program of Adapted Physical Activity (APA) to maintain his / her health. The benefits of APA and its modalities can enhance this activity. Likewise, political-social situation of each country can influence the design and the possibility of development of the APA. This article has been based on the following databases: SPORTDiscus, PubMed, Embase, Science Direct, PEDro and Cochrane Library, including review of the last ten years. 108 articles were found and 24 of them met all the criteria and they were included in this review. The selection criteria were the publication date during the mentioned period, articles with level of evidence A, B or C, and articles which highlight the APA in the person with spinal cord injury during the chronic phase. This research concludes with the following 1) We must continue promoting policies which support the inclusion of the APA. We must make them accessible to all people with disabilities and / or dependency, and in particular the person with spinal cord injury 2) The sport choices of the person with spinal cord injury depends on external factors and especially internal factors 3). The increase of the quality of life related to health and the improvement of self-esteem stand out as benefits of APA

[Satisfaction of Users with Spinal Cord Injury in relation to the Service of Promotion of Personal Autonomy of the Balearic Islands, Spain]. / Satisfacción de las personas con lesión medular con el Servicio de Promoción de la Autonomía Personal en las Islas Baleares.

BACKGROUND: Public Service Promotion of Personal Autonomy aims to provide care to users with severe physical and/or physical-mental disabilities, including people with spinal cord injury. These users are in a chronic phase and thus they require educational-therapeutic measures of physiotherapy. This study is meant to determine the satisfaction of people with spinal cord injury who attend this service. METHODS: A descriptive, cross-sectional, quantitative study in the Public Service Promotion of Personal Autonomy after a sixteen-month therapeutic monitoring process was carried out, which began in March 2015. The final study sample was 25 people with spinal cord injury (17 men and 8 women). At the end of therapeutic intervention, users responded to the SERVQHOS questionnaire, which consists in nineteen questions that aim to measure the quality of the care services provided. A statistical analysis was conducted, calculating averages and standard deviations or frecuencies and percentages. RESULTS: The best valued external factor was the staff appearance with 4,5 on average and the worst scored external factor was the ease of access and / or signposting of the center with 2,6 on average. On the other hand, the best valued internal factor was the kindness of the staff with 4,8 on average and the worst scored factor was the speed in which the users receive what they requested with 4,2 on average. CONCLUSIONS: We concluded that the quality offered is determined by internal factors (kindness, trust, willingness to help) and weaknesses are related to structural factors of the center (external factors).

Satisfacción de las personas con lesión medular con el servicio de promoción de la autonomía personal en las Islas Baleares / Satisfaction of users with spinarl cord injury in relation to the service of promotion of personal autonomy of the Balearic Islands, Spain

Fundamentos: El Servicio de Promoción de la Autonomía Personal pretende ofrecer atención a sujetos con discapacidad física y/o físico-psíquica grave, entre ellos, a personas con lesión medular. Estas personas se encuentran en una fase crónica y por ello requieren medidas fisioterápicas educativo-terapéuticas. El objetivo de este estudio fue determinar la satisfacción de las personas con lesión medular que acuden a este servicio. Métodos: Se llevó a cabo un estudio descriptivo, transversal, cuantitativo después de un seguimiento terapéutico de dieciséis meses que se inició en marzo de 2015. La muestra final del estudio fue de 25 personas con lesión medular (17 hombres y 8 mujeres) que supusieron el 83% del total de las atendidas. Al finalizar la intervención terapéutica, estas personas respondieron al cuestionario SERVQHOS que consta de diecinueve preguntas y pretende medir la calidad asistencial de los servicios prestados. Se llevó a cabo un análisis estadístico a través Microsoft Office Excel 2013 y SPSS 23, calculando medias y desviaciones estándar o frecuencias y porcentajes. Resultados: El factor externo mejor valorado fue la apariencia del personal con un 4,5 de media y el peor valorado la accesibilidad y/o señalización con un 2,6 de media. El factor interno mejor valorado fue la amabilidad del personal con un 4,8 de media y el peor valorado la rapidez con la que se consigue lo que se solicita, con un 4,2 de media. Conclusiones: Tras el estudio se concluye que la calidad ofrecida está determinada por los factores internos (amabilidad, confianza y disposición de ayudar) y que las debilidades vienen relacionadas con factores externos estructurales del centro (AU)

Background: Public Service Promotion of Personal Autonomy aims to provide care to users with severe physical and/or physical-mental disabilities, including people with spinal cord injury. These users are in a chronic phase and thus they require educational-therapeutic measures of physiotherapy. This study is meant to determine the satisfaction of people with spinal cord injury who attend this service. Methods: A descriptive, cross-sectional, quantitative study in the Public Service Promotion of Personal Autonomy after a sixteen-month therapeutic monitoring process was carried out, which began in March 2015. The final study sample was 25 people with spinal cord injury (17 men and 8 women). At the end of therapeutic intervention, users responded to the SERVQHOS questionnaire, which consists in nineteen questions that aim to measure the quality of the care services provided. A statistical analysis through Microsoft Office Excel 2013 and SPSS 23 was conducted, calculating averages and standard deviations. Results: The best valued external factor was the staff appearance with 4,5 on average and the worst scored external factor was the ease of access and / or signposting of the center with 2,6 on average. On the other hand, the best valued internal factor was the kindness of the staff with 4,8 on average and the worst scored factor was the speed in which the users receive what they requested with 4,2 on average. Conclusions: We concluded that the quality offered is determined by internal factors (kindness, trust, willingness to help) and weaknesses are related to structural factors of the center (external factors) (AU)

Perception of evidence-based practice and the professional environment of primary health care nurses in the Spanish context: a cross-sectional study.

BACKGROUND: The study of the factors that encourage evidence-based clinical practice, such as structure, environment and professional skills, has contributed to an improvement in quality of care. Nevertheless, most of this research has been carried out in a hospital context, neglecting the area of primary health care. The main aim of this work was to assess the factors that influence an evidence-based clinical practice among nursing professionals in Primary Health Care. METHODS: A multicentre cross-sectional study was designed, taking the 619 Primary Care staff nurses at the Balearic Islands' Primary Health Care Service, as the study population. The methodology applied consisted on a self-administered survey using the instruments Evidence-Based Practice Questionnaire (EBPQ) and Nursing Work Index (NWI). RESULTS: Three hundred and seventy seven surveys were received (60.9% response rate). Self-assessment of skills and knowledge, obtained 66.6% of the maximum score. The Knowledge/Skills factor obtained the best scores among the staff with shorter professional experience. There was a significant difference in the Attitude factor (p = 0.008) in favour of nurses with management functions, as opposed to clinical nurses.Multivariate analysis showed a significant positive relationship between NWI and level of evidence-based practice (p < 0,0001). CONCLUSIONS: Institutions ought to undertake serious reflection on the lack of skills of senior nurses about Evidence-Based Clinical Practice, even when they have more professional experience. Leadership emerge as a key role in the transferral of knowledge into clinical practice.

Body adiposity index utilization in a Spanish Mediterranean population: comparison with the body mass index.

BACKGROUND: Body fat content and fat distribution or adiposity are indicators of health risk. Several techniques have been developed and used for assessing and/or determining body fat or adiposity. Recently, the Body Adiposity Index (BAI), which is based on the measurements of hip circumference and height, has been suggested as a new index of adiposity. The aim of the study was to compare BAI and BMI measurements in a Caucasian population from a European Mediterranean area and to assess the usefulness of the BAI in men and women separately. RESEARCH METHODOLOGY/PRINCIPAL FINDINGS: A descriptive cross-sectional study was conducted in a Caucasian population. All participants in the study (1,726 women and 1,474 men, mean age 39.2 years, SD 10.8) were from Mallorca (Spain). Anthropometric data, including percentage of body fat mass obtained by Bioelectrical Impedance Analysis, were determined. Body Mass Index (BMI) and BAI were calculated. BAI and BMI showed a good correlation (r = 0.64, p<0.001). A strong correlation was also found between BAI and the % fat determined using BIA (r = 0.74, p<0.001), which is even stronger than the one between BMI and % fat (r = 0.54, p<0.001). However, the ROC curve analysis showed a higher accuracy for BMI than for the BAI regarding the discriminatory capacity. CONCLUSION: The BAI could be a good tool to measure adiposity due, at least in part, to the advantages over other more complex mechanical or electrical systems. Probably, the most important advantage of BAI over BMI is that weight is not needed. However, in general it seems that the BAI does not overcome the limitations of BMI.

Self-perceived factors associated with smoking cessation among primary health care nurses: a qualitative study / Tabagismo em enfermeiras de cuidados primários à saúde: um estudo qualitativo / Tabaquismo en enfermeras de Atención Primaria: un estudio cualitativo

The aim of this work was to characterize the views of nurses about factors modulating smoking cessation. Results of this study will allow us to design helping interventions with the maximum specificity for nurses. A qualitative study through a semi-structured interview of 15 Primary Health Care nurses who were smokers was performed. In contrast with other studies in which nurses were not aware of any particular social pressure to give up smoking, 18 months after the application of the Anti-Smoking Spanish Law, this feeling was expressed. Therefore, the main reasons for giving up smoking include that smoking in public is every day worse seen, together with a sense of shame and guilt in front of their social and family environment, especially for being a professional group dedicated to health.

O objetivo deste estudo foi identificar os fatores percebidos por enfermeiras fumantes como facilitadores ao abandono do tabagismo, com o propósito de, posteriormente, elaborar intervenções de ajuda com maior especificidade para esse grupo. Foi realizado estudo qualitativo, por meio de entrevistas semiestruturadas, com 15 enfermeiras de cuidados primários à saúde, que eram fumantes. Ao contrário de outros estudos, os quais as enfermeiras não percebiam pressão social para deixar o hábito tabágico, 18 meses após a vigência da Lei de Prevenção ao Tabagismo, as enfermeiras entrevistadas expressaram sentir pressão social. Portanto, entre os principais motivos para abandonar o hábito tabágico é que, a cada dia, fumar em público é malvisto, e está aliado a sentimentos de vergonha e culpa no seu entorno social e familiar, principalmente por se tratar de um grupo profissional dedicado aos cuidados da saúde.

El objetivo de este trabajo fue identificar los factores percibidos por las enfermeras fumadoras como moduladores del cese tabáquico, con el fin de diseñar posteriormente intervenciones de ayuda con la máxima especificidad para este colectivo. Se realizó un estudio cualitativo mediante entrevista semiestructurada a 15 enfermeras fumadoras de Atención Primaria de Salud. Contrariamente a otros estudios en los que las enfermeras no percibían una especial presión social para dejar el hábito tabáquico, 18 meses después de vigencia de la Ley de Prevención del Tabaquismo sí que la expresan. Por ello, entre los principales motivos de cese figura el que cada día esté peor considerado fumar en público, unido a un sentimiento de vergüenza y de culpa ante su entorno social y familiar, especialmente por tratarse de un colectivo profesional dedicado a los cuidados de salud.

Self-perceived factors associated with smoking cessation among primary health care nurses: a qualitative study.

The aim of this work was to characterize the views of nurses about factors modulating smoking cessation. Results of this study will allow us to design helping interventions with the maximum specificity for nurses. A qualitative study through a semi-structured interview of 15 Primary Health Care nurses who were smokers was performed. In contrast with other studies in which nurses were not aware of any particular social pressure to give up smoking, 18 months after the application of the Anti-Smoking Spanish Law, this feeling was expressed. Therefore, the main reasons for giving up smoking include that smoking in public is every day worse seen, together with a sense of shame and guilt in front of their social and family environment, especially for being a professional group dedicated to health.

Tabaquismo en enfermeras de Atención Primaria: Factores que influyen en su inicio y mantenimiento / Smoking habits among Primary Health Care Nurses: Factors that influence taking up and maintaining it

Las enfermeras de Atención Primaria (AP) son profesionales adecuados en la lucha contra el tabaquismo. No obstante, algunas de ellas fuman y esto puede disminuir su credibilidad y su sentimiento de autoeficacia frente al problema. El objetivo de este estudio es evidenciar los factores que pueden influir en el inicio y el mantenimiento del hábito tabáquico.Para ello, se ha realizado un estudio cualitativo desde una perspectiva fenomenológica social, en 15 enfermeras fumadoras de AP, recogiendo los datos mediante entrevista semiestructurada en profundidad. Los principales temas que emergieron fueron la falta de concienciación y el papel socializador del tabaco. Se tiene poca conciencia del papel de la publicidad y no se considera al estrés como un determinante del hábito en el ámbito de AP. Puede resultar decisivo el control del peso corporal (AU)

Primary Health Care Nurses (PHC) are suitable professionals in the fight against the smoking habit. Nevertheless some of them smoke and this may diminish their credibility and their feeling of self-efficacy when faced with this problem. The aim of this study was to demonstrate the factors that may influence taking up and maintaining the smoking habit.Thus, we carried out a qualitative study from a social phenomenological perspective, in 15 PHC nurses who are smokers, collecting the data by means of a semi-structured in-depth interview. The main issues that emerged were lack of awareness and the socializing role of tobacco. There is little awareness of the role of publicity and stress is not considered to be a determining factor of the habit in the area of PHC. The control of body weight may be decisive (AU)

[Smoking among nursing and physical therapy students of the University of the Balearic Islands: opinions on regulation of smoking in public places]. / Hábito tabáquico entre los estudiantes de enfermería y fisioterapia de la Universitat de les Illes Balears: opinión ante la regulación del consumo en lugares públicos.

OBJECTIVE: To evaluate the prevalence, opinions and attitudes of nursing and physical therapy students at the University of the Balearic Islands toward smoking in public places and the influence of regulatory policies. METHOD: We performed a cross-sectional, descriptive, observational study using a self-administered questionnaire. The survey was designed to evaluate opinions on and the degree of agreement with smoking and regulatory policies on this issue. The assessment was performed using Likert scales. The survey was offered to all students attending class in the core subject with the greatest number of enrolled students on a normal academic day between February 15 and March 15, 2006. We calculated 95% confidence intervals for proportions. The Chi square test was used to compare qualitative variables and Student's t-test was used for quantitative variables. RESULTS: The sample consisted of 345 students, 82.2% of whom were women. The mean age was 21.9 years. The prevalence of regular smokers was 26.1% (26.9% among women and 22.6% among men). Almost all (93.8%) of the respondents agreed that smoking should be banned in closed spaces in educational institutions and 70.9% believed that the law should be complied with at the University of the Balearic Islands, with differences between 2003 and 2006. CONCLUSIONS: Smoking was less prevalent in our population than in the general regional and national populations, as well as in other Spanish nursing students of the same age and gender. The prevalence of occasional smokers has fallen since 2003. Most students had a favorable view of the new Smoking Prevention Act.

Intervención enfermera de deshabituación tabáquica en Atención Primaria / Nurses intervention to quit smoking developed in Primary Care

Objetivos: determinar la efectividad de una terapia grupalde deshabituación tabáquica, así como las variables asociadasa la misma. Caracterizar el perfil tabáquico de lospacientes que acudieron a dicha terapia.Método: estudio de intervención sin grupo control no aleatorizadode variables socio-demográficas y referentes alhábito tabáquico, de una población de 121 clientes, queasistieron a una terapia multicomponente grupal de deshabituacióntabáquica, llevada a cabo por enfermeras, entre2001 y 2005. En las variables cualitativas se usaron proporcionesy en las cuantitativas, la media con su DesviaciónEstándar (DE) y su intervalo de confianza al 95% (IC95%).Resultados: de los 121 clientes que terminaron el taller, alaño seguían abstinentes el 52,0%, a los dos años el 42,7%y a los tres años el 32,0%. Antes de acudir a esta consultanuestros clientes fumaron una media de 24,8 años. La mediade consumo es de 28,0 cigarrillos diarios en los hombresy 20,5 en las mujeres. La media de edad fue de 41,2 años.Conclusiones: nuestra población tiene un perfil similar alde la mayoría de poblaciones que acuden a consultas dedeshabituación realizadas a nivel nacional. La tasa de abstinenciaobtenida siguiendo la terapia multicomponente auno, dos o tres años es similar o superior a la que se obtienecon el mismo u otros métodos, por enfermeros u otros profesionales,tanto a nivel nacional como internacional y portanto, contribuye a validar a las enfermeras como profesionalescompetentes en el tratamiento del tabaquismo

Objectives: to determine the effectiveness of a group therapyintervention to quit smoking as well as the variablesassociated to such intervention. To characterise the smokingprofile of patients who attended the therapy group.Method: randomised interventional study with no controlgroup containing sociodemographic variables on the smokingprofile of a population of 121 patients who attended amulticomponent group therapy intervention to quit smokingundertaken by primary care nurses between 2001 and 2005.Ratios were used to measure quality variables and MeanStandard Deviation (SD) and their 95% Confidence Interval(CI 95%).Results: of the 121 individuals who completed the intervention,52% continued their abstinence at 1 year, 42,7% at2 years and 32,0% at 3 years. Before attending the intervention,these individuals had been smoking 24,8 years onaverage. Mean consumption was 28,0 cigarettes per dayfor men and 20,5 for woman. Mean age was 41,2 years.Conclusions: the profile of the study population is similarto that of most populations that attend group therapy nationwideto quit the habit. The abstinence rate achievedwith the multicomponent therapy at 1, 2 and 3 years is similaror above that obtained with the same or with othermethods, by nurses or other professionals, both nationallyand internationally. We can thus conclude that the methoddescribed validates the work undertaken by nurses as competentprofessionals to counsel individuals who wish to quit smoking (AU)

Demanda de cuidados en una sociedad multicultural / Care demand of a multicultural society

El propósito del artículo es dar una triple visión, antropológica, ética y profesional, sobre la incidenciadel fenómeno de la multiculturalidad en la demanda de cuidados. Se pretende respondera dos de las principales preguntas que actualmente hay formuladas con relación al sistemasanitario y al trabajo enfermero que en él se desarrolla: ¿cómo incide la multiculturalidad en lademanda de cuidados? y ¿cómo han de responder las enfermeras ante esta demanda?El artículo está estructurado en tres partes: en la primera se hace un resumen de los principalesconceptos que se abordarán en el texto; la segunda está dedicada a tratar, enfatizandomás en las perspectivas ética y antropológica, sobre cómo las sociedades multiculturales condicionanlas necesidades de cuidados; en el último apartado se hace una reflexión sobre cuáldebe ser la respuesta profesional de las enfermeras a las nuevas demandas de cuidados

The purpose of this paper is to provide a triple vision -from an anthropological, ethical andprofessional perspective- on the incidence of the multicultural phenomena for demand ofhealthcare. The aim is to provide an answer to two of the main questions currently beingasked regarding the healthcare system and the nursing work that takes place in this system.How does multiculturality impact on the healthcare demand? How do nurses need toapproach this demand?The paper is structured in three parts. The first part presents a summary of the main conceptsexamined in the text. The second part has to do with how multicultural societies affect theneed for care, with special emphasis on the ethical and anthropological perspectives. The lastpart presents a reflection on what the professional answer of nurses should be with regardto this new demand for care