El estrés laboral en profesionales sanitarios en tiempos de pandemia / Work-related stress amongst health professionals in a pandemic

No disponible

[Validation of the Communication Skills Scale in nursing professionals]. / Validación de la Escala sobre Habilidades de Comunicación.

BACKGROUND: The Communication Skills Scale (CSS) is an instrument for evaluating communication skills in different health professionals; however, a differential analysis of their psychometric properties by professions and specific scales has not been performed. Therefore, the aim of the present study was to analyze the psychometric properties of the CSS and develop T-scores for the scale for nursing professionals. MATERIAL AND METHODS: We developed an instrumental study to analyze the psychometric properties of the CSS, evaluating its items, reliability, evidence of validity and its internal structure. For this purpose, a battery of questionnaires was administered, which included the CSS, the General Self-efficacy Scale and the Specific Self-efficacy Scale for communication in difficult situations. RESULTS: The questionnaires were applied to 692 nurses. Discrimination indices >0,30 were obtained in all items. The confirmatory factor analysis of the two models (with four oblique factors and adding a second-order factor) revealed that all items had adequate factor loadings and the fit indices of both models were good. The internal consistency was 0,88 for the total scale and between 0,70 and 0,77 for the dimensions. A positive relationship between communication skills and general and specific self-efficacy was obtained. CONCLUSION: The CSS displayed appropriate psychometric properties (item analysis, internal structure, reliability and evidence of validity), relating the communication skills of nurses with their general and specific self-efficacy in communication in difficult situations.

Validación de la Escala sobre Habilidades de Comunicación en profesionales de Enfermería / Validation of the Communication Skills Scale in nursing professionals

FUNDAMENTO: La Escala sobre Habilidades de Comunicación (EHC) es un instrumento para evaluar las habilidades de comunicación en diferentes profesionales sanitarios; sin embargo, no se ha realizado ni un análisis diferencial de sus propiedades psicométricas por profesiones, ni baremos específicos. Por ello, el objetivo del presente estudio fue analizar las propiedades psicométricas de la EHC y elaborar un baremo en profesionales de Enfermería. MATERIAL Y MÉTODOS: Estudio instrumental para analizar las propiedades psicométricas de la EHC, evaluándose los ítems, la fiabilidad, las evidencias de validez y su estructura interna. Para ello, se administró una batería de cuestionarios que incluía la EHC, la Escala de Autoeficacia General y la Escala de Autoeficacia Específica para la comunicación en situaciones difíciles. RESULTADOS: Los cuestionarios se aplicaron a 692 enfermeras. Se obtuvieron índices de discriminación >0,30 en todos los ítems. El análisis factorial confirmatorio de los dos modelos (de cuatro factores oblicuos y añadiendo un factor de segundo orden) reveló que todos los ítems tenían cargas factoriales adecuadas y que los índices de ajuste eran buenos. La consistencia interna fue de 0,88 para la escala total y entre 0,70 y 0,77 para las dimensiones. Se obtuvo una relación positiva entre las habilidades comunicativas y la autoeficacia general y específica. CONCLUSIONES: La EHC mostró unas adecuadas propiedades psicométricas en cuanto a análisis de ítems, estructura interna, fiabilidad y evidencias de validez, relacionando las habilidades de comunicación de las enfermeras con la autoeficacia general y específica para la comunicación en situaciones difíciles

BACKGROUND: The Communication Skills Scale (CSS) is an instrument for evaluating communication skills in different health professionals; however, a differential analysis of their psychometric properties by professions and specific scales has not been performed. Therefore, the aim of the present study was to analyze the psychometric properties of the CSS and develop T-scores for the scale for nursing professionals. MATERIAL AND METHODS: We developed an instrumental study to analyze the psychometric properties of the CSS, evaluating its items, reliability, evidence of validity and its internal structure. For this purpose, a battery of questionnaires was administered, which included the CSS, the General Self-efficacy Scale and the Specific Self-efficacy Scale for communication in difficult situations. RESULTS: The questionnaires were applied to 692 nurses. Discrimination indices >0,30 were obtained in all items. The confirmatory factor analysis of the two models (with four oblique factors and adding a second-order factor) revealed that all items had adequate factor loadings and the fit indices of both models were good. The internal consistency was 0,88 for the total scale and between 0,70 and 0,77 for the dimensions. A positive relationship between communication skills and general and specific self-efficacy was obtained. CONCLUSION: The CSS displayed appropriate psychometric properties (item analysis, internal structure, reliability and evidence of validity), relating the communication skills of nurses with their general and specific self-efficacy in communication in difficult situations

Disfunción neuromuscular adquirida en la unidad de cuidados intensivos / Acquired neuromuscular dysfunction in the intensive care unit

Introducción: La polineuropatía y la miopatía, agrupadas bajo el término «polineuromiopatía del paciente crítico» (PNMPC), son enfermedades neuromusculares que los pacientes de la unidad de cuidados intensivos (UCI) son susceptibles de presentar. Son enfermedades multifactoriales: la conexión prolongada al ventilador es uno de los factores más comunes. El objetivo de esta revisión ha sido identificar la eficacia de diferentes tratamientos rehabilitadores en pacientes con PNMPC y la relación entre esta y una serie de indicadores hospitalarios. Metodología: Se ha realizado una revisión sistemática de los estudios primarios seleccionados de las bases de datos Medline, Scielo, Web of Science, Cochrane, Cuiden y Science Direct, siguiendo las directrices de la declaración PRISMA, a través de la cual se estableció el protocolo de búsqueda. Resultados y conclusiones: De 161 artículos, solo 10 fueron seleccionados para formar parte de esta revisión, en la cual se estudiaron un total de 717 pacientes ingresados en la UCI. Se ha observado una relación estadísticamente significativa entre la PNMPC y el fallo en la desconexión del ventilador, la mortalidad, el aumento de estancia en UCI y del tiempo que los pacientes necesitan ventilación mecánica. Además, todo ello mejora en este tipo de pacientes con la aplicación de alguna terapia rehabilitadora. El uso de corticoides, por el contrario, no ha demostrado tener relación con la alteración neuromuscular

Introduction: Polyneuropathy and myopathy, grouped under the term «intensive care unit-acquired weakness» (ICUAW), are neuromuscular pathologies to which patients in the intensive care unit (ICU) are susceptible. They are multifactorial pathologies, prolonged connection to a ventilator is one of the most common. The objective of this review was to identify the efficacy of different rehabilitative treatments in patients with ICUAW, and the relationship between ICUAW and a series of indicators. Methods: A systematic review of the primary studies selected from the Medline, Scielo, Web of Science, Cochrane, Cuiden and Science Direct databases was carried out, following the guidelines of the PRISMA statement, by which the search protocol was established. Results and conclusions: Of 161 articles, only 10 were selected to be part of this review, in which a total of 717 patients admitted to the ICU were studied. A statistically significant relationship was observed between ICUAW and failure in ventilator disconnection, mortality, increase in ICU stay and the time that the patients required mechanical ventilation. Moreover, all this improved in this type of patients with the application of a rehabilitation therapy. The use of corticosteroids, was not shown to be related to neuromuscular alteration

Acquired neuromuscular dysfunction in the intensive care unit. / Disfunción neuromuscular adquirida en la unidad de cuidados intensivos.

INTRODUCTION: Polyneuropathy and myopathy, grouped under the term «intensive care unit-acquired weakness¼ (ICUAW), are neuromuscular pathologies to which patients in the intensive care unit (ICU) are susceptible. They are multifactorial pathologies, prolonged connection to a ventilator is one of the most common. The objective of this review was to identify the efficacy of different rehabilitative treatments in patients with ICUAW, and the relationship between ICUAW and a series of indicators. METHODS: A systematic review of the primary studies selected from the Medline, Scielo, Web of Science, Cochrane, Cuiden and Science Direct databases was carried out, following the guidelines of the PRISMA statement, by which the search protocol was established. RESULTS AND CONCLUSIONS: Of 161 articles, only 10 were selected to be part of this review, in which a total of 717 patients admitted to the ICU were studied. A statistically significant relationship was observed between ICUAW and failure in ventilator disconnection, mortality, increase in ICU stay and the time that the patients required mechanical ventilation. Moreover, all this improved in this type of patients with the application of a rehabilitation therapy. The use of corticosteroids, was not shown to be related to neuromuscular alteration.

Discovering mental models and frames in learning of nursing ethics through simulations.

The acquisition of ethical competence is necessary in nursing. The aims of the study were to analyse students' perceptions of the process of learning ethics through simulations and to describe the underlying frames that inform the decision making process of nursing students. A qualitative study based on the analysis of simulated experiences and debriefings of six simulated scenarios with ethical content in three different groups of fourth-year nursing students (n = 30), was performed. The simulated situations were designed to contain ethical dilemmas. The students' perspective regarding their learning and acquisition of ethical competence through simulations was positive. A total of 15 mental models were identified that underlie the ethical decision making of the students. The student's opinions reinforce the use of simulations as a tool for learning ethics. Thus, the putting into practice the knowledge regarding the frames that guide ethical actions is a suitable pedagogical strategy.

[Changes in quality of life in patients undergoing bariatric surgery following 24-months: comparison between gastric bypass and tubular vertical gastrectomy]. / Evolución de la calidad de vida a los 24 meses de seguimiento en pacientes sometidos a cirugía bariátrica: comparación entre el bypass gástrico y la gastrectomía vertical tubular.

BACKGROUND: Bariatric surgery has become the procedure of choice to deal with morbid and super-morbid obesity, with the greatest chance of success. The objectives of this study were: a) to analyse the evolution of the percentage of excess BMI lost (PEBMIL) and quality of life in the medium and long term after bariatric surgery; b) to evaluate the differences in PEBMIL and quality of life according to the surgical technique performed; and c) examine the relationship between PEBMIL and quality of life. METHODS: One hundred and ninety-one subjects participated in the present study, undergoing bariatric surgery with follow-up at 12 and 24 months after surgery. The SF-36 and OP-53 questionnaires were administered to assess the quality of life after surgery. RESULTS: There was a statistically significant reduction in the percentage of excess BMI lost at 12 and 24 months; and a significant improvement in quality of life at 12 months, which remained stable at 24 months for most variables. Taking into account the surgical technique, those undergoing gastric bypass surgery show a greater loss of PEBMIL at 12 and 24 months, and significant improvement at one year of evaluation in most of the dimensions that measure quality of life with respect to the tubular vertical gastrectomy technique. CONCLUSION: Bariatric surgery is effective in reducing the excess of BMI lost and significantly improving the quality of life of morbidly obese patients in the long term. Key words. Bariatric surgery. Quality of life. Morbid obesity.

Evolución de la calidad de vida a los 24 meses de seguimiento en pacientes sometidos a cirugía bariátrica: comparación entre el bypass gástrico y la gastrectomía vertical tubular / Changes in quality of life after 24 months in patients undergoing bariatric surgery: comparison between gastric bypass and tubular vertical gastrectomy

Fundamento: La cirugía bariátrica se ha convertido en el procedimiento de elección para afrontar, con las mayores posibilidades de éxito, los casos de obesidad mórbida y super-mórbida. Los objetivos de este estudio son: a) analizar la evolución del porcentaje del exceso de índice de masa corporal perdido (PEIMCP) y la calidad de vida a medio y largo plazo tras la cirugía bariátrica; b) evaluar las diferencias en PEIMCP y calidad de vida en función de la técnica quirúrgica realizada; y c) examinar la relación entre PEIMCP y la calidad de vida. Material y métodos: Han intervenido en el estudio 191 sujetos intervenidos de cirugía baríátrica con seguimiento a los 12 y 24 meses tras la cirugía. Se administraron los cuestionarios SF-36 y OP-53 para evaluar la calidad de vida tras la cirugía de manera autoinformada. Resultados: Se observa una reducción del porcentaje del exceso de índice de masa corporal (IMC) perdido estadísticamente significativa a los 12 y 24 meses y una mejora significativa en la calidad de vida a los 12 meses, que se mantuvo estable a los 24 meses para la mayoría de las variables. Los pacientes intervenidos mediante bypass gástrico muestran una mayor pérdida de PEIMCP a los 12 y 24 meses, y mejora significativa al año de evaluación en la mayoría de las dimensiones que miden calidad de vida con respecto a la técnica de gastrectomía vertical tubular. Conclusión: La cirugía bariátrica es eficaz para disminuir el porcentaje del exceso de IMC perdido y mejorar significativamente la calidad de vida de los pacientes con obesidad mórbida a largo plazo (AU)

Background: Bariatric surgery has become the procedure of choice to deal with morbid and super-morbid obesity, with the greatest chance of success. The objectives of this study were: a) to analyse the evolution of the percentage of excess BMI lost (PEBMIL) and quality of life in the medium and long term after bariatric surgery; b) to evaluate the differences in PEBMIL and quality of life according to the surgical technique performed; and c) examine the relationship between PEBMIL and quality of life. Methods: One hundred and ninety-one subjects participated in the present study, undergoing bariatric surgery with follow-up at 12 and 24 months after surgery. The SF-36 and OP-53 questionnaires were administered to assess the quality of life after surgery. Results: There was a statistically significant reduction in the percentage of excess BMI lost at 12 and 24 months; and a significant improvement in quality of life at 12 months, which remained stable at 24 months for most variables. Taking into account the surgical technique, those undergoing gastric bypass surgery show a greater loss of PEBMIL at 12 and 24 months, and significant improvement at one year of evaluation in most of the dimensions that measure quality of life with respect to the tubular vertical gastrectomy technique. Conclusion: Bariatric surgery is effective in reducing the excess of BMI lost and significantly improving the quality of life of morbidly obese patients in the long term (AU)

[Communication skills: a preventive factor in Burnout syndrome in health professionals]. / Las habilidades de comunicación como factor preventivo del síndrome de Burnout en los profesionales de la salud.

BACKGROUND: Health professionals are a group that suffers high levels of job stress and burnout. The aim of this study is to demonstrate empirically that the healthcare count on communication skills helps prevent Burnout Syndrome. METHOD: An observational, analytical, cross-sectional study was proposed, involving a sample of 927 health professionals (197 doctors, 450 nurses and 280 auxiliary nurses). Participants completed questionnaires measuring communication skills in health care (EHC-PS) and the Maslach Burnout Inventory Human Services Survey (MBI-HSS). RESULTS: A negative and statistically significant correlation between the different dimensions of communication skills and emotional exhaustion and depersonalization dimensions of burnout was obtained. On the other hand, a positive and statistically significant correlation between the dimensions of communication skills and the personal accomplishment dimension of burnout was observed. CONCLUSIONS: It was shown that the communication skills of health professionals provide protection from and cushion Burnout Syndrome.

Las habilidades de comunicación como factor preventivo del síndrome de Burnout en los profesionales de la salud / Communication skills: a preventive factor in Burnout syndrome in health professionals

Fundamento: Los profesionales de la salud son un colectivo que sufre altos niveles de estrés laboral. El objetivo de este estudio es analizar la relación entre habilidades de comunicación y síndrome de Burnout en profesionales sanitarios. La propuesta es demostrar empíricamente la hipótesis de que el hecho de que el profesional de la salud cuente con habilidades de comunicación contribuye a prevenir el síndrome de Burnout. Material y método: Se plantea un estudio observacional, analítico, transversal en una muestra de 927 profesionales sanitarios, 197 médicos (21,3%), 450 enfermeras (48,5%) y 280 auxiliares de enfermería (30,2%). Se han usado la Escala sobre Habilidades de Comunicación en Profesionales de la Salud (EHC-PS) y el Maslach Burnout Inventory Human Services Survey (MBI-HSS). Resultados: Se obtiene una correlación negativa y estadísticamente significativa entre las diferentes dimensiones de las habilidades de comunicación y las dimensiones agotamiento emocional y despersonalización del burnout. Por otro lado, se observa una correlación positiva y estadísticamente significativa entre las dimensiones de las habilidades de comunicación y la dimensión realización personal en el trabajo. Conclusiones: Se ha encontrado evidencia de que las habilidades de comunicación de los profesionales de la salud protegen y amortiguan el síndrome de Burnout (AU)

Background: Health professionals are a group that suffers high levels of job stress and burnout. The aim of this study is to demonstrate empirically that the healthcare count on communication skills helps prevent Burnout Syndrome. Method: An observational, analytical, cross-sectional study was proposed, involving a sample of 927 health professionals (197 doctors, 450 nurses and 280 auxiliary nurses). Participants completed questionnaires measuring communication skills in health care (EHC-PS) and the Maslach Burnout Inventory Human Services Survey (MBI-HSS). Results: A negative and statistically significant correlation between the different dimensions of communication skills and emotional exhaustion and depersonalization dimensions of burnout was obtained. On the other hand, a positive and statistically significant correlation between the dimensions of communication skills and the personal accomplishment dimension of burnout was observed. Conclusions: It was shown that the communication skills of health professionals provide protection from and cushion Burnout Syndrome (AU)

Habilidades sociales en los profesionales de urgencias y cuidados críticos de un hospital público comarcal / Social skills in emergency and critical care professionals of a regional public hospital

Objetivo Determinar las habilidades sociales del personal sanitario de la Unidad de Urgencias y Cuidados Críticos del Hospital Comarcal «Vega Baja», y analizar la existencia de la asociación entre una serie de variables sociodemográficas y profesionales y las habilidades sociales. Diseño Estudio descriptivo transversal. Método Se emplearon dos instrumentos de evaluación: un cuestionario de variables sociodemográficas y profesionales, y la escala de habilidades sociales (EHS) de Elena Gismero. Resultados Se obtiene una tasa de respuesta del 82,6%. Teniendo en cuenta los baremos realizados por la autora en la validación de la EHS, podemos observar que la muestra obtiene una puntuación media-alta en cada una de las dimensiones. Se encuentran diferencias significativas al considerar como variable independiente la variable sociodemográfica sexo con la puntuación total de la EHS (F=6,555; p=0,013) y con las dimensiones de la escala autoexpresión en situaciones sociales (F=4,468; p=0,039) y hacer peticiones (F=7,982; p=0,007). Conclusiones En cada una de las dimensiones de la EHS la muestra obtiene una puntuación media ligeramente superior a la de la muestra de baremación y que se situaría en torno al percentil 50–69, indicando la presencia de un nivel medio-alto de la habilidad social. Puntúan más alto los médicos que las enfermeras, aunque estas diferencias no son estadísticamente significativas (AU)

Objective To assess the social skills of health care professionals in the emergency and critical care units of the regional hospital Vega Baja and analyze the association between a series of sociodemographic and professionals variables and social skills. Aim A cross-sectional, descriptive study.Method Two evaluation tools were used. These included a sociodemographic and professional variables questionnaire, and the Elena Gismero's Social Skills Scale (SSS).Results A response rate of 82.6% was obtained. Considering the standards made by the author in SSS validation, it can be seen that the sample has obtained a medium-high score in each one of the aspects. Significant differences have been found when considering the sociodemographic variable gender as an independent variable with the complete score of SSS (F=6.555; p=0.013), and with the scale dimensions, self-expression in social situations (F=4.468; p=0.039) and making a demand (F=7.982; p=0.007). Conclusions In each one of the SSS dimensions, the sample has obtained a slightly higher score than the standard sample and it within the 50–69 percentile. This indicates the existence of a medium-high level of Social Skill. The doctors score higher than the nurses, although these differences are not statistically significant (AU)

[Social skills in emergency and critical care professionals of a regional public hospital]. / Habilidades sociales en los profesionales de urgencias y cuidados críticos de un hospital público comarcal.

OBJECTIVE: To assess the social skills of health care professionals in the emergency and critical care units of the regional hospital Vega Baja and analyze the association between a series of sociodemographic and professionals variables and social skills. AIM: A cross-sectional, descriptive study. METHOD: Two evaluation tools were used. These included a sociodemographic and professional variables questionnaire, and the Elena Gismero's Social Skills Scale (SSS). RESULTS: A response rate of 82.6% was obtained. Considering the standards made by the author in SSS validation, it can be seen that the sample has obtained a medium-high score in each one of the aspects. Significant differences have been found when considering the sociodemographic variable gender as an independent variable with the complete score of SSS (F=6.555; p=0.013), and with the scale dimensions, self-expression in social situations (F=4.468; p=0.039) and making a demand (F=7.982; p=0.007). CONCLUSIONS: In each one of the SSS dimensions, the sample has obtained a slightly higher score than the standard sample and it within the 50-69 percentile. This indicates the existence of a medium-high level of Social Skill. The doctors score higher than the nurses, although these differences are not statistically significant.

[Strategies of early reperfusion in acute myocardial infarction]. / Estratégias de reperfusão precoce no infarto agudo do miocárdio.

PURPOSE: To describe the use of myocardial reperfusion strategies (percutaneous transluminal coronary angioplasty-PTCA and intravenous trombolysis) whenever it is possible to use emergency cinecoronariography in acute myocardial infarction (AMI). METHODS: The records of patients admitted with initial diagnosis of AMI, until six hours after the beginning of symptoms, were reviewed retrospectively, between March/92 and December/93. RESULTS: One hundred forty-three patients were admitted with suspected AMI. Eighty-one (57%) presented definitive criteria for this diagnosis. Fifty-two patients (64%) were admitted in the first six hours from the beginning of symptoms. Thirty-eight (73%) were male and the mean age was 59 +/- 12 years. Cinecoronariography was indicated immediately in 36 of 52 (69%) patients, with purpose to use PTCA. That was done in 30 (58%). Two (4%) patients were submitted to emergency surgical myocardial revascularization. Intravenous thrombolysis was used in 11 (21%) patients. At admission, the conservative treatment was chosen for five out of nine left patients, based on clinical grounds. CONCLUSION: The availability of emergency cinecoronariography made an early reperfusion strategy possible in 83% of patients admitted with AMI in the first six hours after the beginning of symptoms.