Humanizing Birth in a Third-Level Hospital: Revealing the Benefits of Natural Cesarean Sections.

BACKGROUND AND AIMS: Efforts to humanize childbirth focus on promoting skin-to-skin contact, labor accompaniment, and breastfeeding. Despite these advancements, cesarean sections often lack a consideration of immediate mother-child contact, early breastfeeding initiation, and follow-up. This underscores the need for a 'natural' approach to cesarean sections, aiming to 'humanize' the procedure and emulate some aspects of vaginal birth. MATERIALS AND METHODS: An observational longitudinal cohort study was conducted, involving pregnant women scheduled for a cesarean section. Two comparison groups were established: one undergoing conventional cesarean sections and the other receiving a humanization intervention. While in "conventional cesarean sections," newborns are separated from mothers at birth, preventing actions such as early breastfeeding or skin-to-skin contact, and maternal companionship is lacking in the operating room, the intervention of cesarean section humanization was based on avoiding the separation of the mother and newborn, promoting skin-to-skin contact, early breastfeeding, and maternal accompaniment during surgery. Descriptive data on maternal and neonatal variables, including breastfeeding initiation, maintenance, and baby weight trends, were collected. Additionally, a validated survey assessed the pain, satisfaction, and anxiety among the 73 participating women. RESULTS: Women undergoing natural cesarean sections reported higher satisfaction, lower anxiety, and reduced postoperative pain, requiring less analgesia. Although their exclusive breastfeeding rates at 10 days postpartum showed no significant difference, statistically significant differences favored natural cesarean sections at 3 months (67.5% vs. 25%) and 6 months (50% vs. 4.5%). Neonates in the natural cesarean group exhibited greater weight gain at 10 days postpartum compared to those delivered conventionally (+49.90 g vs. -39.52 g). No significant differences in blood counts were observed between the groups. CONCLUSIONS: This study underscores the manifold advantages offered by the natural cesarean procedure compared to the conventional cesarean approach. Notably, a NC demonstrates superior outcomes in terms of heightened maternal satisfaction with the obstetric process, the enhanced sustainability of exclusive breastfeeding, and augmented neonatal weight gain.

Psychological distress in relatives of critically ill patients: Risk and protective factors.

The admission to an intensive care unit can result in a significant burden of emotional distress in the family. This study analyzes the psychological distress of 89 relatives of intensive care unit patients and the potential risk/protective factors for such distress. Families show high levels of anxiety, depression, and stress. Regarding risk factors, having steady partner, being a woman, and being a mother are associated with increased risk of anxiety, depression, and stress. Contrarily, being younger and having higher educational level are associated with reduced anxiety and stress. Influencing these trends could change positively the suffering course experienced by relatives and intensive care unit patients indirectly.

Efectividad de los productos empleados en la prevención de la radiodermatitis en pacientes con cáncer de mama. Revisión sistemática / Effectiveness of the products used in the prevention of radiodermatitis in patients with breast cancer. A systematic review

INTRODUCCIÓN: La radioterapia es uno de los tratamientos más utilizados en los pacientes paliativos, siendo la radiodermatitis el efecto secundario más frecuente de la radioterapia, afectando a un 85-95 % de los pacientes con cáncer sometidos a este tratamiento. OBJETIVO: el propósito de esta revisión es identificar aquellos productos con mayor eficacia en la prevención de la radiodermatitis en los pacientes con cáncer de mama. METODOLOGÍA: Revisión sistemática de ensayos clínicos aleatorizados sobre la prevención de la radiodermatitis en pacientes con cáncer de mama en tratamiento radioterápico no concomitante, recopilados en las bases de datos PubMed, Lilacs, CINHAL, Trip Databases y Proquest Health & Medical Complete, publicados en los últimos seis años (2021 a 2018) en lengua inglesa y española. RESULTADOS: Los productos que fueron efectivos en la prevención de la radiodermatis son: la glutamina enteral, la curcumina oral, los apósitos de fi lm transparente, la sulfadiazina de plata, la película o la crema de barrera con polimeros, el furoato de mometasona, la crema con hidrocortisona al 1 %, la crema con melatonina y la crema con factor de crecimiento epidérmico (EGF). Se desaconseja el uso del ácido hialurónico y del aloe vera. No mejoró la radiodermatitis con el empleo de cremas hidratantes, caléndula, boswellia, alantoína y el aceite de emú. CONCLUSIONES: En la prevención de la dermatitis por radioterapia, es efectivo el empleo de productos cuya finalidad sea la protección de la piel, como los apósitos tipo fi lm y las cremas o películas con barrera de polímeros. Además de productos potenciadores del sistema inmunitario (glutamina enteral) y productos con propiedades antioxidantes (curcumila oral, la crema de melatonina o el factor de crecimiento epidérmico), otros productos, como los corticoides y los antibióticos tópicos, son efectivos pero su uso a largo plazo conlleva efectos secundarios

INTRODUCTION: Radiotherapy is one of the most widely used treatments in palliative patients, with radiodermatitis being the most frequent side effect of radiation therapy, affecting 85-95 % of cancer patients undergoing this treatment. OBJECTIVE: The purpose of this review was to identify the products with greater efficacy in the prevention of radiodermatitis in patients with breast cancer. METHODOLOGY: A systematic review of randomized clinical trials on the prevention of radiodermatitis in patients with breast cancer receiving non-concomitant radiotherapym was performed. The studies were collected from the PubMed, Lilacs, CINHAL, Trip, and Proquest Health & Medical Complete databases, and included those published in the last 6 years (2021 to 2018) either in English or Spanish. RESULTS: Products effective in preventing radiodermatis included: enteral glutamine, oral curcumin, clear film dressings, silver sulfadiazine, polymer barrier film or cream, mometasone furoate, cream with 1 % hydrocortisone, melatonin cream, and epidermal growth factor (EGF) cream. The use of hyaluronic acid and aloe vera is not recommended. Radiodermatitis did not improve with the use of moisturizers, calendula, boswellia, allantoin, or emu oil. CONCLUSIONS: In the prevention of dermatitis by radiotherapy, the use of products whose purpose is to protect the skin, such as film-type dressings and creams, or films with polymer barriers, is effective. In addition to immune system enhancing products (enteral glutamine), and to products with antioxidant properties (oral curcumilla, melatonin cream or epidermal growth factor), other products such as corticosteroids and topical antibiotics are effective, but their long-term use is associated with side effects

Afectación de la calidad de vida y del nivel de somnolencia en enfermeras / Impact on the quality of life and in the level of sleepiness in nurses

INTRODUCCIÓN: La turnicidad es un factor de riesgo para la salud, ya que interfiere en la calidad de vida, tanto desde el punto de vista personal como laboral. Las enfermeras representan un grupo de riesgo, puesto que gran parte de este colectivo trabaja a turnos. OBJETIVO: Describir la calidad de vida y nivel de somnolencia en enfermeras. MÉTODO: Estudio observacional, descriptivo y transversal, realizado en el Hospital General Universitario de Castellón a las enfermeras asistenciales. Se calculó una muestra de 157 enfermeras. Los instrumentos aplicados fueron el Cuestionario de Calidad de Vida Profesional y el Cuestionario de Somnolencia Diurna de Epworth, ambos autoadministrados y de respuesta voluntaria. Se realizaron análisis univariados y bivariados. Las diferencias se exploraron con el estadístico T de Student y Anova; las correlaciones, con el estadístico de Pearson. Se aceptó un nivel de significación p≤0,05. RESULTADOS: La calidad de vida global percibida fue valorada con un 6,13 sobre 10. La mayoría de profesionales eran interinos, y estos mostraban ser los más afectados. Enfermeras con relación contractual fija mostraron una mayor calidad de vida. Las enfermeras con mayor experiencia fueron más autónomas y libres. El nivel de somnolencia diurna también resultó negativamente afectado. CONCLUSIONES. La calidad de vida de las enfermeras resultó influenciada de forma significativa por el sexo, la edad, la situación laboral, el servicio, el turno y los años trabajados, además del nivel de somnolencia diurna que resultó negativamente afectado

BACKGROUND: Turnicity is a risk factor for health as it interferes with quality of life both personally and at work. Nurses represent a risk group, since much of them works on shifts. AIM: To describe the quality of life and the drowsiness' level of the nurses. METHODS: Observational, descriptive, prospective and cross-sectional study has been carried out. This study has been done at the General University Hospital of Castellón. An adjusted sample of 157 nurses has been calculated. The selected measuring instruments have been the Professional Quality of Life Questionnaire and the Epworth Drowsiness Questionnaire. Both went self-administered and voluntarily answered. Descriptive and bivariate analyzes were carried out. In addition, the Pearson correlation coefficient was also applied. A level of statistical significance p≤0.05 was accepted. RESULTS: It was obtained that the overall quality of life that the nurses perceived is scored with 6.13 out of 10. Most of the nurses were interim, and they showed that they were the most affected. Nurses with a fixed contractual relationship showed a higher quality of life. Nurses with more experience were more autonomous and freer. The level of daytime sleepiness is affected by different factors. CONCLUSIONS: With the results obtained, it is concluded that the quality of life of nurses is significantly influenced by sex, age, work situation, service, shift and years worked, in addition to the level of daytime sleepiness present

Psychometric Evaluation of a Rubric to Assess Basic Performance During Simulation in Nursing.

AIM: This study was conducted to evaluate the psychometric properties of a rubric to assess nursing student performance in medium- and low-fidelity simulation. METHOD: A psychometric study was carried out. Content validity was explored by a group of experts. Internal consistency was determined by means of Cronbach's coefficient alpha. Interrater agreement and the level of concordance were established by the kappa coefficient and intraclass correlation index. RESULTS: The relevance of the dimensions and the definition of each category scored higher than 3.25 on a Likert-type scale (maximum value of 4); content validity ratio values were close to +1. The kappa index was above 0.61 (p < .001) in all dimensions, thereby indicating a good level of interrater agreement; the intraclass correlation index showed values above .82 (p < .001). CONCLUSION: The rubric appears to be psychometrically sound, thus supporting its reliability.