Efectividad de las intervenciones enfermeras en el control de la diabetes mellitus tipo 2 / Effectiveness of nursing interventions in the control of type 2 diabetes mellitus

FUNDAMENTO: Analizar si las intervenciones de enfermería clasificadas mediante la taxonomía NIC y aplicadas a pacientes con diabetes mellitus tipo 2 (DM2) que cuenten con el diagnóstico de enfermería NANDA Disposición para mejorar la gestión de su propia salud se relacionan con la consecución de un mejor control de la enfermedad. MÉTODO: Estudio trasversal con 721 pacientes de Atención Primaria cuyos datos se obtuvieron de la historia clínica electrónica. Se analizó la relación del estado controlado o no de los parámetros hemoglobina glicosilada (HbA1c), colesterol-LDL (Col-LDL) e índice de masa corporal (IMC), con las intervenciones NIC realizadas, especialmente las correspondientes a recomendaciones para el manejo de la DM2. RESULTADOS: Se realizaron 137 tipos de intervenciones de enfermería NIC en 2.401 ocasiones, de las cuales 1.714 (71,4%) fueron intervenciones recomendadas para la DM2, un 41,2% ellas pertenecientes al dominio Conductual, siendo Vigilancia la intervención más frecuente (25,4%). La consecución de objetivos fue superior al 50% para HbA1c y Col-LDL y del 13,6% para el IMC. Las intervenciones NIC fueron más frecuentes en los pacientes con parámetros controlados, especialmente nueve de ellas; dos presentaron una relación negativa con el control del IMC. CONCLUSIONES: A mayor aplicación de las NIC recogidas en las recomendaciones de las guías de práctica clínica para la DM2 se ha observado mayor consecución de objetivos de control y mejores resultados en salud

BACKGROUND: To analyze whether nursing interventions classified according to NIC taxonomy and applied to patients with type 2 diabetes mellitus (T2DM), showing the NANDA diagnoses "Willingness to improve your own health management", are related to better achievement of T2DM control. METHODS: Cross-sectional study conducted on 721 patients in Primary Care whose data were obtained from their electronic clinical record. The control of parameters such as hemoglobin-glycosylated (HbA1c), LDL-cholesterol and body mass index (BMI) was related to NIC interventions performed, particularly to those recommended for management of T2DM. RESULTS: One hundred and thirty-seven NIC interventions were performed on 2,401 occasions, 1,714 of which (71.4%) were interventions recommended for management of T2DM. Of these, 41.2% belonged to Behavioral domain, while Surveillance was the most frequent intervention (25.4%). Control of both HbA1c and LDL-cholesterol was achieved in more than 50% of cases, but BMI only was achieved in 13.6%. NIC interventions were more frequently performed on patients with controlled parameters, especially on nine of them; two interventions were negatively related to control of BMI. CONCLUSION: We have observed that with a higher incidence in the application of the NIC included in the recommendations of the clinical practice guidelines for T2DM, better health results are obtained

[Effectiveness of nursing interventions in the control of type 2 diabetes mellitus].

BACKGROUND: To analyze whether nursing interventions classified according to NIC taxonomy and applied to patients with type 2 diabetes mellitus (T2DM), showing the NANDA diagnoses "Willingness to improve your own health management", are related to better achievement of T2DM control. METHODS: Cross-sectional study conducted on 721 patients in Primary Care whose data were obtained from their electronic clinical record. The control of parameters such as hemoglobin-glycosylated (HbA1c), LDL-cholesterol and body mass index (BMI) was related to NIC interventions performed, particularly to those recommended for management of T2DM. RESULTS: One hundred and thirty-seven NIC interventions were performed on 2,401 occasions, 1,714 of which (71.4%) were interventions recommended for management of T2DM. Of these, 41.2% belonged to Behavioral domain, while Surveillance was the most frequent intervention (25.4%). Control of both HbA1c and LDL-cholesterol was achieved in more than 50% of cases, but BMI only was achieved in 13.6%. NIC interventions were more frequently performed on patients with controlled parameters, especially on nine of them; two interventions were negatively related to control of BMI. CONCLUSION: We have observed that with a higher incidence in the application of the NIC included in the recommendations of the clinical practice guidelines for T2DM, better health results are obtained.

Influence of the Mediterranean diet during pregnancy in the development of wheezing and eczema in infants in Pamplona, Spain.

BACKGROUND: This study examined the relationship between different food groups and the adherence to a Mediterranean diet during pregnancy and the risk of wheezing and eczema in children aged 12-15 months. METHODS: The study involves 1087 Spanish infants from the International Study of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). The study of the association of the different food consumption and Mediterranean diet with wheezing, recurrent wheezing and eczema was performed using different models of unconditional logistic regression to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: No association was found between a good adherence to the Mediterranean diet during pregnancy and the development of wheezing (p=0.372), recurrent wheezing (p=0.118) and eczema (p=0.315). The consumption once or twice a week of white fish (OR: 1.95[1.01-3.75]), cooked potatoes (OR: 1.75[1.22-2.51]) and industrial pastry (OR: 1.59[1.13-2.24]), and the consumption more than three times a week of industrial pastry (OR: 1.47 [1.01-2.13]) during pregnancy increases the risk of "wheezing" at 12 months. Instead, high fruit consumption during the pregnancy has a protective effect against "wheezing" in 12-month-old infants (OR: 0.44 [0.20-0.99]). No statistically significant differences were observed between food intake during pregnancy and "recurrent wheezing". No statistically significant differences were observed between the consumption of any food during pregnancy and the presence of eczema at 12 months. CONCLUSIONS: The present study showed that the consumption of Mediterranean diet during pregnancy did not have a protective effect for wheezing, recurrent wheezing or eczema.

Análisis de la intensidad de colaboración profesional entre enfermeras en un área de críticos / Analysis of the intensity of professional collaboration among nurses in a critical care area

Objetivo/s: Analizar la intensidad de colaboración profesional (ICP) entre enfermeras de un área de críticos (AC) polivalente y su relación con el lugar de trabajo «unidad de cuidados intensivos (UCI) y área de hospitalización especializada (AHE)», nivel de educación, edad y años de actividad profesional en AC. Método: Estudio descriptivo transversal. La población atiende a 57 enfermeras de un AC. Registro de variables sociodemográficas: edad, nivel de educación, especialidad, años de ejercicio profesional y tipo de jornada, años de actividad profesional en AC y participación científica. Instrumento: cuestionario «Intensité de la Collaboration Interprofessionalle». Análisis estadísticos: SPSS 20.0. Resultados: Participaron un total de 47 enfermeras (UCI/AHE). Edad media: 35,91 (9,59) años. El 74,46% son diplomadas en enfermería, con formación de posgrado en UCI. Mediana y rango intercuartílico de años de actividad profesional 14 y 14,50. Y de años trabajando en AC 8,50 y 16. El 51,10% trabajan a jornada reducida. Un 61,70% han participado en trabajos científicos. Puntuación media de ICP: 61,68 (6,84). El 57,40% aportan valores de ICP alta. La relación entre el lugar de trabajo (UCI/AHE) y el nivel de educación con la ICP no es estadísticamente significativa (p > 0,05). Sí se encuentran diferencias estadísticamente significativas al comparar la ICP con la edad y los años de actividad profesional en AC (p < 0,05). Conclusiones: El presente estudio muestra que existe una buena ICP en el AC. Las enfermeras de menor edad obtienen una mejor puntuación en la ICP, así como las que llevan trabajando menos tiempo en AC. Las enfermeras con título de grado o máster poseen un nivel de ICP más alto que el resto. También las enfermeras que desarrollan simultáneamente su actividad profesional en UCI y AHE

Objective/s: To analyse the intensity of professional collaboration (IPC) between the nurses in a multidisciplinary critical area (CA) and the relationship with the workplace 'intensive care unit (ICU) and special hospitalisation area (SHA)', educational level, age, and years of professional activity in CA. Method: A cross-sectional descriptive study was conducted with 57 nurses from CA, recording socio-demographic data: age, educational level, speciality titles, years of professional activity and workday type, years of professional activity in the CA, and involvement in scientific works. Tool: Intensity of Inter-professional Collaboration Questionnaire. Statistical analysis: SPSS 20.0. Results: The study included a total of 47 nurses (ICU/SHA), with a mean age of 35.91 (9.59) years. Almost three-quarters (74.46%) were nursing graduates with a posgraduate in ICU. Median and interquartile range of professional experience was 14 and 14.50 years, respectively, and years working in CA was 8.50 and 16 years, respectively. Just over half of them (51.10%) worked part-time, and 61.70% participated in scientific works. The mean IPC score was 61.68 (6.84), with 57.40% providing values of high IPC. The relationship between the workplace (ICU/SHA) and educational level with IPC was not statistically significant (p > .05). There are statistical significant differences between IPC with age and years of professional activity in CA (p < .05). Conclusions: The present study demonstrates the existence of good IPC in the CA. Younger nurses obtain a better IPC score, as well as nurses who have been working for less time in CA. Nurses with a Degree or Masters have a higher level of IPC than the rest, as well as nurses who perform professional activity combining ICU and SHA

[Quality of life in patients with inflammatory bowel diseases]. / Calidad de vida relacionada con la salud en pacientes con enfermedad inflamatoria intestinal.

BACKGROUND: To determine the health-related quality of life in patients with Crohn disease and ulcerative colitis, as well as to evaluate differences according to sex, type of disease and other sociodemographic variables. METHOD: Cross sectional study of 100 outpatients in the Digestive Service of the Navarre Hospital Complex.A questionnaire with sociodemographic and clinical variables was used, as well as a version of the Inflammatory Bowel Disease Questionnaire-32 adapted to Spanish, in order to measure quality of life. RESULTS: The average score of the questionnaire on quality of life was 166 points (D.T.=40.06) out of a maximum of 232. Statistically significant differences were found according to type of disease (p=0.005)and sex (p=0.001). CONCLUSIONS: People with Crohn disease or females perceive a worse quality of life related to health in comparison to patients with ulcerative colitis or men.

Calidad de vida relacionada con la salud en pacientes con enfermedad inflamatoria intestinal / Quality of life in patients with inflammatory bowel diseases

Fundamento: Determinar la calidad de vida relacionada con la salud en pacientes con enfermedad de Crohn y colitis ulcerosa, así como evaluar las diferencias en función del sexo, tipo de enfermedad y otras variables sociodemográficas. Método: Estudio observacional, descriptivo y transversal en 100 pacientes atendidos en el servicio de Digestivo del Complejo Hospitalario de Navarra. Se empleó un cuestionario con variables sociodemográficas y clínicas, además del Inflammatory Bowel Disease Questionnaire-32, en su versión adaptada al castellano, para medir la calidad de vida. Resultados: La media de la puntuación total del cuestionario de calidad vida es de 166 puntos (D.T.=40,06) sobre un máximo de 232. Se han hallado diferencias estadísticamente significativas en función del tipo de enfermedad (p=0,005) y el sexo (p=0,001). Conclusiones: Las personas con enfermedad de Crohn o sexo femenino perciben peor calidad de vida relacionada con la salud respecto a pacientes con colitis ulcerosa u hombres (AU)

Background: To determine the health-related quality of life in patients with Crohn disease and ulcerative colitis, as well as to evaluate differences according to sex, type of disease and other sociodemographic variables. Method. Cross sectional study of 100 outpatients in the Digestive Service of the Navarre Hospital Complex. A questionnaire with sociodemographic and clinical variables was used, as well as a version of the Inflammatory Bowel Disease Questionnaire-32 adapted to Spanish, in order to measure quality of life. Results: The average score of the questionnaire on quality of life was 166 points (D.T.=40.06) out of a maximum of 232. Statistically significant differences were found according to type of disease (p=0.005) and sex (p=0.001). Conclusions: People with Crohn disease or females perceive a worse quality of life related to health in comparison to patients with ulcerative colitis or men (AU)

[Analysis of the intensity of professional collaboration among nurses in a critical care area]. / Análisis de la intensidad de colaboración profesional entre enfermeras en un área de críticos.

OBJECTIVE/S: To analyse the intensity of professional collaboration (IPC) between the nurses in a multidisciplinary critical area (CA) and the relationship with the workplace "intensive care unit (ICU) and special hospitalisation area (SHA)", educational level, age, and years of professional activity in CA. METHOD: A cross-sectional descriptive study was conducted with 57 nurses from CA, recording socio-demographic data: age, educational level, speciality titles, years of professional activity and workday type, years of professional activity in the CA, and involvement in scientific works. Tool: Intensity of Inter-professional Collaboration Questionnaire. STATISTICAL ANALYSIS: SPSS 20.0. RESULTS: The study included a total of 47 nurses (ICU/SHA), with a mean age of 35.91 (9.59) years. Almost three-quarters (74.46%) were nursing graduates with a posgraduate in ICU. Median and interquartile range of professional experience was 14 and 14.50 years, respectively, and years working in CA was 8.50 and 16 years, respectively. Just over half of them (51.10%) worked part-time, and 61.70% participated in scientific works. The mean IPC score was 61.68 (6.84), with 57.40% providing values of high IPC. The relationship between the workplace (ICU/SHA) and educational level with IPC was not statistically significant (p>.05). There are statistical significant differences between IPC with age and years of professional activity in CA (p<.05). CONCLUSIONS: The present study demonstrates the existence of good IPC in the CA. Younger nurses obtain a better IPC score, as well as nurses who have been working for less time in CA. Nurses with a Degree or Masters have a higher level of IPC than the rest, as well as nurses who perform professional activity combining ICU and SHA.

[Gender differences in the treatment and outcome of patients with acute coronary syndrome in Navarre]. / Diferencias según sexo en el tratamiento y la evolución de los pacientes afectados de síndrome coronario agudo en Navarra.

BACKGROUND: Gender-based approaches have revealed the differing prevalence, incidence, progression and mortality of acute coronary disease by sex. This study aims to determine the difference by sex in the treatment and outcomes of patients with acute coronary syndrome (ACS) in Navarre. METHODS: Thirty-five variables were analysed from 130 users with acute coronary disease who attended the Navarre Hospital (CHN) emergency department consecutively from January to April 2012. The dependent variable was sex and independent variables were time, treatments and final outcome of the process. RESULTS: Males accounted for 74.6% of the sample, with a mean age of 67, which was less than the mean age of 72 for the female patients (p = 0.043). The median for cardiovascular risk factors was three in men and two in women (p = 0.026). The patient delay in seeking health care was 161 minutes in men compared to 266 minutes in women (p = 0.006). Treatment via revascularization by primary angioplasty or fibrinolysis was performed in 71.6% of men and 41.2% of women (p = 0.002). A 5.9% death rate was registered for women, with no deaths among the men (p = 0.017). CONCLUSIONS: In Navarre, acute coronary syndrome remains more prevalent among men yet more severe in women. Treatment differs according to gender. Greater delay in seeking health care is observed among women, as is self-discharge from hospital, which may contribute to their less favourable outcomes.

Diferencias según sexo en el tratamiento y la evolución de los pacientes afectados de síndrome coronario agudo / Gender differences in the treatment and outcome of patients with acute coronary syndrome

Fundamento: La perspectiva de género en salud nos alerta de la diferente prevalencia, incidencia, evolución y letalidad de las patologías coronarias agudas según sexo. Este estudio pretende conocer la diferencia en el tratamiento y la evolución de los pacientes afectos de Síndrome Coronario Agudo (SCA) según sexos en Navarra. Métodos: Se analizaron 35 variables de 130 usuarios que acudieron consecutivamente al servicio de Urgencias (SU) del Complejo Hospitalario de Navarra (CHN) con patología coronaria aguda desde enero hasta abril de 2012. La variable dependiente fue el sexo y las independientes los tiempos, tratamientos y evolución final del proceso. Resultados: Un 74,6% de la muestra fueron varones con una edad media de 67 años, inferior a los 72 años de la muestra femenina (p=0,043). Se obtuvo una mediana de 3 factores de riesgo cardiovascular (FRC) en los hombres y de dos en las mujeres (p=0,026). El tiempo de demora generado por los pacientes fue de 161 minutos en varones vs 266 minutos en féminas (p=0,006). El tratamiento llevado a cabo mediante revascularización por angioplastia primaria (AP) o fibrinolisis se realizó en un 71,6% de los hombres y un 41,2% de las mujeres (p=0,002). Se registró un 5,9% de muertes en mujeres, sin hallarse casos de fallecimiento en varones (p=0,017). Conclusiones: En Navarra, los procesos coronarios siguen siendo una patología de predominio masculino pero de mayor gravedad en mujeres. El tratamiento se realizó de forma distinta según sexo. Se observó un mayor retraso en la solicitud de atención sanitaria en las mujeres así como la presencia de alta voluntaria en ellas, lo que puede influir en la peor evolución de las mismas (AU)

Background: Gender-based approaches have revealed the differing prevalence, incidence, progression and mortality of acute coronary disease by sex. This study aims to determine the difference by sex in the treatment and outcomes of patients with acute coronary syndrome (ACS) in Navarre. Methods: Thirty-five variables were analysed from 130 users with acute coronary disease who attended the Navarre Hospital (CHN) emergency department consecutively from January to April 2012. The dependent variable was sex and independent variables were time, treatments and final outcome of the process. Results: Males accounted for 74.6% of the sample, with a mean age of 67, which was less than the mean age of 72 for the female patients (p = 0.043). The median for cardiovascular risk factors was three in men and two in women (p = 0.026). The patient delay in seeking health care was 161 minutes in men compared to 266 minutes in women (p = 0.006). Treatment via revascularization by primary angioplasty or fibrinolysis was performed in 71.6% of men and 41.2% of women (p = 0.002). A 5.9% death rate was registered for women, with no deaths among the men (p = 0.017). Conclusions: In Navarre, acute coronary syndrome remains more prevalent among men yet more severe in women. Treatment differs according to gender. Greater delay in seeking health care is observed among women, as is self-discharge from hospital, which may contribute to their less favourable outcomes (AU)

Alcohol consumption and attitudes towards banning alcohol sales on campus among European university students.

OBJECTIVES: The European Commission's new health strategy for improving health at the European Union (EU) level includes tackling alcohol consumption. This study aimed to assess the prevalence of alcohol consumption and problem drinking, as well as students' attitudes towards banning the sale of alcohol on campus. STUDY DESIGN: In total, 5826 students from universities in seven European countries (Denmark, Germany, Spain, Lithuania, Poland, Bulgaria and Turkey) took part in this cross-sectional study. METHODS: A self-administered questionnaire assessed sociodemographic information, frequency of alcohol consumption, problem drinking and attitudes towards banning the sale of alcohol on campus. RESULTS: The highest prevalence of drinking alcohol more than once per week was reported in Bulgarian (males 46%, females 64%) and Spanish students (males 59%, females 64%). Among those students who drank alcohol (n=3170), problem drinking (CAGE score >1) was found in 24% of males and 13% of females. Male gender, depressive moods and a low importance of good grades at university were risk factors for drinking alcohol more than once per week as well as for problem drinking. There were substantial country differences in the proportion of students who would support a ban of alcohol sales on campus (23% in Denmark, 88% in Poland). Support for a ban was higher among female students and among students who drank alcohol once or less per week. CONCLUSIONS: Problem drinking is a concern among students in many European countries, especially among males. Students' support for banning the sale of alcohol on campus varies between countries and should be considered in developing EU policy.

Role of the home environment in rhinoconjunctivitis and eczema in schoolchildren in Pamplona, Spain.

BACKGROUND AND OBJECTIVE: Indoor air quality has become an important factor for sensitization and development of allergic diseases because of increased time spent in homes. We aimed to analyze the possible home-condition risk factors for allergic rhinoconjunctivitis, atopic eczema, and severe disease in schoolchildren aged 5 through 8 years. MATERIAL AND METHODS: The parents of 3360 school children in Pamplona, Spain in the 5-8-year-old age bracket answered questions about rhinitis and eczema symptoms from the protocol of the International Study of Asthma and Allergies in Childhood (ISAAC). The instrument contained additional questions about current home conditions related to mold and dust exposure and about conditions in the first year of life. Associations between the allergic diseases and early and current exposure were studied with chi(2) tests and bivariate and multivariate logistic regression. RESULTS: Exposure to certain home conditions related to molds and dust in the first year of life increased the risk of allergic disease, but having good isolating windows in the first year of life protected against allergic rhinoconjunctivitis and severe atopic eczema. Some current home conditions were also related to an increased risk of current allergic disease; severe atopic eczema was more common among children with single glazing over the bedroom window. CONCLUSION: Current and first-year-of-life home conditions related to dust and mold exposure should be controlled because they influence the prevalence of allergic rhinoconjunctivitis and atopic eczema diseases. Moreover, having a double-glazed window currently and in the first year of life seems to protect against these diseases.

Revisión de conocimientos para cuidar a pacientes con sepsis severa / Application for membership to the scociety

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Revisión de conocimientos para cuidar a pacientes con sepsis severa / Review of knowledge to care for patients with severe sepsis

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Revisión de conocimientos sobre cuidados a pacientes con problemas endocrinometabólicos / Review of knowledge on the care of patients with endocrine-metabolic problems

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Revisión de conocimientos para atender a pacientes con problemas respiratorios / Knowledge review to take care of patients with respiratory problems

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Revisión de conocimientos para cuidara pacientes con problemas respiratorios / Review of knowledge on care patients with respiratory problems

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