Community Activities in Primary Care: A Literature Review.

Community health promotion activities are a useful tool for a proactive approach to healthy lifestyles. However, the implementation of these types of activities at health centers is not standardized. The aim of this review was to analyse the characteristics of community activities undertaken in the primary care setting and substantiate available evidence on their health impact. We conducted a bibliographic review until November 15th, 2023 in the TRIPDATABASE, MEDLINE, EMBASE, and DIALNET databases. We included original papers on interventions, community activities, and actions and/or social prescriptions which had been implemented in a Primary Care setting, included a group approach in at least one session, and described some type of evaluation of the intervention applied. Studies targeted at professionals and those without involvement of the primary care team were excluded. The search identified 1912 potential studies. We included a total of 30 studies, comprising 11 randomized clinical trials, 14 quasi-experimental studies, 1 cohort study, and 4 qualitative studies. The issues most frequently addressed in community activities were healthy habits, physical activity, cardiovascular diseases and diabetes. Community activities can improve the physical and psychological environment of their participants, as well as their level of knowledge about the issues addressed. That said, however, implementation of these types of interventions is not uniform. The existence of a professional community-activity liaison officer at health centers, who would help integrate the health system with the community sector, could serve to standardize implementation and maximize the health impact of these types of interventions.

Confianza y actitud tras un diagnóstico negativo de alergia a fármacos betalactámicos y/o AINE / Trust and attitude after a negative diagnosis for allergy to betalactam drugs and/or NSAIDs

Objetivo: determinar el grado de confianza en el diagnóstico de exclusión de alergia en pacientes con sospecha de hipersensibilidad a antibióticos betalactámicos y/o AINE. Adicionalmente se pretendía describir la actitud del paciente hacia la toma futura del fármaco que motivó el estudio.Método: se realizó un estudio descriptivo transversal. Se seleccionaron 103 pacientes mayores de 18 años, de ambos sexos y con un resultado negativo en las pruebas diagnósticas de alergia a betalactámicos y/o AINE. Los participantes fueron evaluados mediante un cuestionario heteroadministrado en la práctica clínica habitual de alergología.Resultados: el grado de confianza hacia la etiqueta previa de alergia fue moderado para antibióticos betalactámicos (6,4/10) y para AINE (6,1/10), elevado hacia el diagnóstico negativo de alergia (betalactámicos: 7,5/10; AINE: 7,9/10), y moderado con relación a la futura toma del fármaco estudiado, tras un diagnóstico negativo de alergia (betalactámicos: 6,7/10; AINE: 6,3/10). El grado de confianza hacia el diagnóstico de exclusión de alergia a betalactámicos o AINE aumenta con relación al conferido previamente por el de sospecha, en ambos fármacos (p= 0,01).Conclusiones: el grado de confianza de los pacientes en el diagnóstico de exclusión de alergia a fármacos betalactámicos y/o AINE es elevado. Sin embargo, la confianza para la toma futura del fármaco que motivó el estudio, tras un diagnóstico negativo de alergia, se reduce a moderada. Los profesionales de la salud deben proporcionar una educación sanitaria efectiva que resuelva las inseguridades hacia la realización de la prueba y refuerce la confianza del paciente para la toma futura del fármaco.(AU)

Objective: to determine the level of trust in the diagnosis excluding allergy in patients with suspected hypersensitivity to betalactam antibiotics and/or NSAIDs. Additionally, it was intended to describe the attitude of patients towards taking in the future the drug which motivated the study.Method: a descriptive cross-sectional study was conducted; 103 >18-year old patients were selected, of both genders and with a negative result in diagnostic tests for betalactam drugs and/or NSAIDs. Participants were evaluated through a heteroadministered questionnaire at their usual Allergology clinical practice.Results: the level of trust towards the previous allergy label was moderate for betalactam antibiotics (6.4/10) and for NSAIDs (6.1/10), high towards the negative diagnosis for allergy (betalactam drugs: 7.5/10; NSAIDs: 7.9/10), and moderate regarding taking in the future the drug under study, after a negative diagnosis for allergy (betalactam drugs: 6.7/10; NSAIDs: 6.3/10). The degree of trust towards the diagnosis excluding allergy to betalactam drugs or NSAIDs increased regarding the previous degree for suspected allergy, in both drugs (p= 0.01).Conclusions: there is a high degree of trust in patients regarding their diagnosis excluding allergy to betalactam drugs and/or NSAIDs. However, trust regarding taking in the future the drug which motivated the study, after a negative diagnosis of allergy, was reduced to moderate. Health professionals must provide effective health education that solves uncertainties in terms of conducting the test and reinforces trust by patients for taking the drug in the future.(AU)

Translation, Cross-Cultural Adaptation, and Validation of the Galician Version of the Nurse Prescribing Self-Efficacy Scale.

Low self-efficacy has been identified as one of the factors that could hinder the prescribing competence of nurses. No valid and reliable existing instruments assess Galician nurses' confidence to prescribe. The aim of this study was to determine the reliability and validity of the Galician version of the Nurse Prescribing Self-Efficacy Scale (G-NP-SES, 19 items). The study was conducted in two phases: the translation and adaptation to the Galician version of the NP-SES, and the assessment of its psychometric properties. G-NP-SES was sent to nurses working in primary healthcare centers in Galicia (Spain) between March and June of 2022. Its content, construct and discriminant validity, and internal consistency reliability were examined. A total of 193 people participated in the study. As the original scale, G-NP-SES also had three dimensions (% of cumulative variance = 80.82%). It showed good internal consistency (Cronbach's alpha coefficient (α) = 0.90, with each factor ranging from 0.86 to 0.89), high content validity (scale's content validity index = 0.92, with item-content validity index ranged from 0.87 to 1), and good discriminant validity. G-NP-SES is an instrument with good psychometric properties which could be used to accurately assess Galician nurses' self-efficacy to prescribe and consequently to improve their job performance.

Attitudes and Intentions toward COVID-19 Vaccination among Spanish Adults: A Descriptive Cross-Sectional Study.

Vaccination against SARS-CoV-2 is postulated as the most effective measure to control the COVID-19 pandemic. However, the use of other protection measures is necessary to efficiently combat the spread of the virus. The aim of the present study was to determine the attitudes and intentions toward COVID-19 vaccination among non-regular social media users in Spain and to analyze how these factors could condition the acceptance of other personal protective measures once an individual has received the COVID-19 vaccine. A cross-sectional design was used in this work. In total, 719 subjects, ≥18 years old and of both sexes, were recruited from primary public healthcare centers to self-complete a questionnaire between March and April 2021. The majority of participants had a positive attitude toward vaccination and showed high levels of intention to be vaccinated. Likewise, except those participants who considered the vaccine to be the most effective measure to fight the COVID-19 pandemic, the rest of the participants highlighted the importance of continuing to limit social interactions and/or wearing masks even after being vaccinated. Since vaccination can create a perception of total immunity against SARS-CoV-2, it is necessary that healthcare staff organize effective awareness campaigns on the importance of maintaining personal protective measures until vaccination coverage is greater.

Knowledge, Attitudes, and Practices of Spanish Midwives and Midwifery Students toward Oral Healthcare during Pregnancy.

Pregnancy can affect the mother's oral health, increasing their susceptibility to oral diseases that have been associated with harmful effects on the newborn. Despite the severity of oral diseases during pregnancy, the demand for dental care during the gestational period is low, which may improve with the participation of midwives in promoting oral health activities. The objectives of this study were: (i) to determine the knowledge, attitudes, and practices of Spanish midwives and midwifery students regarding oral health in pregnant women; and (ii) to identify the barriers faced by these healthcare professionals in addressing oral health promotion during pregnancy. An observational cross-sectional descriptive study was conducted. A total of 128 midwives and/or midwifery students ≥ 18 years old and of both sexes were invited to self-complete a questionnaire between January and April 2020. A total of 85 people participated in the study. Participants had a regular level of knowledge about oral health during pregnancy (overall knowledge score: 6.53), and although they were interested in activities that promote oral healthcare, their oral healthcare practices during pregnancy were limited. As midwives play an important role in promoting health, their training in oral healthcare could help to improve pregnant women's oral health.

Successful Treatment of a Venous Leg Ulcer With Manuka Honey: A Case Study.

BACKGROUND: Refractory venous leg ulcers (VLUs) often require extended time to heal, and they carry a high risk of recurrence. This case study describes our experiences with a patient with a VLU refractory to multiple treatment strategies who was successfully treated with Manuka honey. CASE: Mr S. was a 76-year-old man with multiple comorbid conditions and hypersensitivity to silver-based compounds, who developed 3 VLUs of his right lower extremity. He experienced 90 days of unsuccessful treatments using an iodized cadexomer ointment, hydrodetersive fiber dressings, hydrocolloid meshes, compression therapy, and antibiotic treatment without progression toward wound healing. We then initiated treatment with Manuka honey and continued compression therapy. His primary VLU was completely epithelialized within 38 days, and an adjacent VLU also showed progression toward healing. Mr S. reported clinically relevant improvement in wound-related pain at 17 days. CONCLUSION: The use of Manuka honey proved effective in this patient with a VLU refractory to other treatment strategies.

Knowledge, Attitudes, and Intentions towards HIV Pre-Exposure Prophylaxis among Nursing Students in Spain.

Human immunodeficiency virus (HIV) infection is one of the main causes of morbidity and mortality worldwide. Among the preventive approaches proposed to control this disease is pre-exposure prophylaxis (PrEP), whose effectiveness depends on the medication adherence. The aim of the present study was to determine the knowledge and attitudes about PrEP among a sample of Spanish nursing students as well as their intentions of receiving it in case it was indicated. An observational cross-sectional descriptive study was carried out. A total of 570 nursing students from the University of Santiago de Compostela (Spain), ≥18 years old and of both sexes were invited to self-complete a questionnaire between February and March 2020. A total of 352 students decided to participate in the study. Participants had low knowledge [overall knowledge score 1(0-2)] and a neutral attitude towards PrEP. The intention of receiving PrEP improved significantly after the completion of the questionnaire and the administration of information about PrEP (p = 0.039; before: 23.58% and after: 93.77%). Nursing staff play an important role in the prevention of sexually transmitted diseases, so their training in preventive strategies, such as PrEP, could help to reduce the incidence of new cases of HIV infection.

Knowledge, Attitudes, and Intentions towards Human Papillomavirus Vaccination among Nursing Students in Spain.

Human papillomavirus (HPV), which is linked to specific types of cancer, can be prevented by vaccination. This study aimed to determine the knowledge and attitudes of nursing students about HPV and its vaccine as well as their intentions towards personal vaccination. A total of 536 Spanish nursing students were invited to complete the Spanish version of the questionnaire "Knowledge, attitudes and intentions towards HPV". Overall, 367 surveys were completed (68.4% response rate). Data analysis included the calculation of three scores: the knowledge score, categorized into low (<33%), moderate (33%-66%), and good knowledge (>66%); the attitude score, sorted into positive (<2.5), neutral (2.5-3.5), and negative attitude (>3.5); and the intention score, categorized into not favorable (<4), neutral (4-7), and favorable intention (>7). Knowledge about HPV and its vaccine was moderate (54.34 ± 0.9%), and the attitude towards vaccination was positive (2.34 ± 0.03). The intention towards personal vaccination increased significantly after completing the questionnaire (before: 4.14 ± 0.27, after: 6.02 ± 0.28; p < 0.001). The present study highlights the need of training future nurses about HPV and its vaccine, considering the important role it plays in the prevention of sexually transmitted diseases.

Nursing Students' Knowledge and Awareness of Antibiotic Use, Resistance and Stewardship: A Descriptive Cross-Sectional Study.

Antibiotic resistance is an emerging worldwide concern with serious repercussions in terms of morbi-mortality. Bearing in mind that the inadequate use of antibiotics, by healthcare staff as well as by the general population, is one of its main causes, a multidisciplinary approach is required to try to combat it. The aim of the present study was to determine nursing students' knowledge and awareness of antibiotic use, resistance and stewardship. A cross-sectional design was used. A total of 578 nursing students from the University of Santiago de Compostela (Spain), ≥18 years old of both sexes were invited to complete the Spanish version of the questionnaire "Knowledge and awareness of the use, resistance and administration of antibiotics" between February and April 2019. Students had a low level of knowledge about antibiotics, 4.1 (CI95% = 3.4-4.8), especially in relation to antibiotic resistance. As the students were aware of this deficiency, the majority affirmed (>90%) that the current curriculum of nursing degree should have more training on antibiotics and infection control. Nursing staff play an important role in the rational use of antibiotics and as teachers of patients, so their training could be key in fighting antibiotic resistance.