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PROBLEM: There is little documented evidence of job satisfaction in midwives who work in birthing rooms. BACKGROUND: Job satisfaction in midwives who work in birthing rooms may have changed in recent decades due to the medicalization of maternal health. AIM: To analyse job satisfaction levels among midwives working in birthing rooms. METHODS: We searched Web of Science, SCOPUS, MEDLINE, CUIDEN and CINAHL for observational and mixed method studies. The literature search was carried out from September to October 2022. FINDINGS: A total of 13 studies were included in the systematic review. A meta-analysis of the variable "midwives' job satisfaction" was performed on 12 of the studies. Midwives rated their job satisfaction positively: DME, CI (95%) = 1.24 [0.78, 1.69]. Subgroup 1: DME, CI (95%) = 2.41 [2.05, 2.76]); Subgroup 2: DME, CI (95%) = 0.76 [0.65, 0.86]; subgroup 3: DME, CI (95%) = 1.11 [0.95, 1.27]; subgroup 4: DME, CI (95%) = 0.10 [-0.11, 0.31]. DISCUSSION: Although midwives show high levels of satisfaction, the heterogeneity of instruments, lack of specificity and limited number of studies found restrict the outcomes. CONCLUSION: There are no specific measurement instruments for assessing job satisfaction among midwives working in labour wards, so it is possible that these data do not correspond to reality as they do not take into account specific professional aspects within this field of practice.
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BACKGROUND: The audience response systems are being implemented to support active learning in nursing degree programs. The benefits of audience response systems have been studied in lecture-based classes and seminars, but their advantages or inconveniences when included in the debriefing phase of a high-fidelity clinical simulation have not been explored. The study aim was to discover student´s experience about using of interactive questions during debriefing, and the self-perceived effects on attention, participation and motivation. METHODS: A Mixed-methods study was used exploratory sequential design in a university. The participants were 4th-year students enrolled in the Nursing Degree in a university in Southern Spain. (1) Qualitative phase: a phenomenological approach was utilized, and focus groups were used for data-collection. (2) Quantitative phase: cross-sectional descriptive study using a questionnaire designed "ad hoc", on the experiences on the use of interactive questions in the debriefing phase and the Debriefing Experience Scale. RESULTS: (1) Qualitative phase: the students highlighted the facilitating role of the interactive questions during the reflection part of the debriefing, and mentioned that the interactive questions helped with stimulating attention, participation, and motivation during the analytical part of the debriefing; (2) Quantitative phase: it was observed that the best evaluated dimension was "Motivation", with a mean of 4.7 (SD = 0.480), followed by the dimension "Participation", with a mean of 4.66 (SD = 0.461), and lastly, the dimension "Attention", with a mean of 4.64 (SD = 0.418). CONCLUSIONS: The use of interactive questions contributed the attention, participation, and motivation of the students during the debriefing, contributing towards a highly satisfactory experience of high-fidelity clinical simulation.
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BACKGROUND: Out-of-hospital cardiac arrest is considered a global problem. In the last few years, there has been a growing interest in telephone-cardiopulmonary resuscitation guided by a telecommunicator. Indeed, several studies have demonstrated that it increases the chances of survival rate. This study focuses on the key points the operator should follow when performing telephone-cardiopulmonary resuscitation. The main objective of this paper is to design an algorithm to improve the telephone-cardiopulmonary resuscitation response protocol. METHODS: The available evidence and the areas of uncertainty that have not been previously mentioned in the literature are discussed. All the information has been analyzed by two discussion groups. Later, a consensus was reached among all members. Finally, a response algorithm was designed and implemented in clinical simulation. RESULTS: All the witnesses were able to recognize the OHCA, call for emergency assistance, follow all the operator's instructions, move the victim, and place their hands in the correct position to perform CPR. DISCUSSION: The results of the pilot study provide us a basis for further experimental studies using randomization and experimental and control groups. CONCLUSIONS: No standardized recommendations exist for the operator to perform telephone-guided CPR. For this reason, a response algorithm was designed.
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PURPOSE: In modern societies, motorcycle accidents have become a great problem for health systems worldwide. In Spain, the size and the power of the engine of 2-wheel vehicles determine the type of driving license and the age at which these vehicles can be used (mopeds and motorcycles, which at the same time can have a small or large engine capacity). The objective of the present study was to analyze and characterize low- and high-power motorcycle accidents in Spain, between 2014 and 2020, both included and compared these categories with each other. METHODS: Retrospective, descriptive, and observational study of motorcycle and moped accidents in Spain between 2014 and 2020, both included. RESULTS: The mortality of motorcycle accident riders in Spain is associated with males aged between 30 and 40 years old, with a high-power motorcycle, and an A or A1 driver's license, who is 6.7 times more likely to die in crossings and highways than a moped, while wearing a helmet, and if not, this increases to 4.89 times. During the COVID-19 pandemic, an increase in death at 24 h after a high-power motorcycle accident was observed, as compared with a large reduction in the total medical assistance provided in 2019-2020. CONCLUSIONS: High-power motorcycles had higher scores in mortality and morbity rates than low-power ones, with a significant increase in mortality during the pandemic, even though number of accidents and medical assistance provided were drastically reduced.
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Childhood obesity has reached epidemic levels in developed countries and is becoming a major cause for concern in the developing world. The causes of childhood obesity are complex and multifactorial, involving the interaction between individual genetics and environmental and developmental factors. Among the environmental factors, there is a growing interest in understanding the possible relationship between the so-called environmental obesogens and the development of obesity in children. Exposure to these obesogens such as phthalates, bisphenol A, or parabens, has been identified as a promoter of obesity through different mechanisms such as the alteration of adipocyte development from mesenchymal progenitors, the interference with hormone receptors, and induced inflammation. However, less attention has been paid to the inheritance of epigenetic modifications due to maternal exposure to these compounds during pregnancy. Thus, the aim of this review is to summarize the current knowledge of epigenetic modifications due to maternal exposure to those obesogens during pregnancy as well as their potential implication on long-term obesity development in the offspring and transgenerational inheritance of epiphenotypes.
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Disruptores Endócrinos , Obesidade Infantil , Efeitos Tardios da Exposição Pré-Natal , Criança , Gravidez , Feminino , Humanos , Obesidade Infantil/induzido quimicamente , Obesidade Infantil/epidemiologia , Obesidade Infantil/genética , Efeitos Tardios da Exposição Pré-Natal/genética , Disruptores Endócrinos/toxicidade , Adipócitos , Epigênese Genética , Exposição AmbientalRESUMO
(1) Background: Bullying is a worldwide public health problem, with short- and long-term physical, mental, and socio-economic implications for all involved, including consequences as serious as suicide. (2) Objective: The aim of this study is to compile data on nursing interventions for preventing and addressing bullying at the international level. (3) Methods: A systematic review was conducted in accordance with the guidelines laid out in the PRISMA statement. The search included papers written in Spanish, English, and Portuguese over the previous five years from the following databases: Web of Science, CUIDEN, CINHAL, BDENF, Cochrane, Lilacs, and PubMed. The following descriptors were used: "Acoso escolar AND Enfermería", "Bullying AND Nursing" and "Intimidação AND Enferma-gem". Due to the heterogeneity in the methodology of the studies, a narrative synthesis of the results is provided. (4) The synthesis of results shows nurses' involvement in tackling and preventing bullying. Interventions are categorised into awareness raising; coping mechanisms; and approach/care, nursing skills in the face of bullying, and the role of the family in the face of bullying. (5) Conclusions: It is clear that at the international level, nursing is involved in planning and developing autonomous and interdisciplinary interventions to address and prevent bullying. The evidence paves the way for school nurses and family and community nurses to take steps to tackle this phenomenon.
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Bullying , Suicídio , Humanos , Bullying/prevenção & controle , Adaptação Psicológica , Saúde PúblicaRESUMO
Introduction (1): The COVID-19 pandemic led to changes in healthcare during pregnancy, childbirth and puerperium. The objective of this study was to know the impact of visit restrictions, PCR performance and use of masks on delivery and puerperium care. Methods (2): A descriptive cross-sectional study was carried out. A survey was used to assess the impact of COVID-19-related measures on women who had given birth in hospitals in the Region of Murcia, Spain, between March 2020 and February 2022. Results (3): The final sample size was 434 women. The average scores were 4.27 for dimension 1 (Visit restrictions), 4.15 for dimension 2 (PCR testing) and 3.98 for dimension 3 (Mask use). More specifically, we found that the restriction of visits was considered a positive measure for the establishment of the mother-newborn bond (mean score 4.37) and that the use of masks at the time of delivery should have been made more flexible (mean score 4.7). Conclusions (4): The policy of restricting hospital visits during the pandemic caused by COVID-19 has been considered beneficial by mothers, who expressed that they did not feel lonely during their hospital stay.
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OBJECTIVE: To develop and validate a tool to assess the non-technical skills of medical and surgical hospital units undergraduate nursing students. BACKGROUND: In the area of healthcare, non-technical skills complement technical ones, and contribute to patient safety. High-fidelity simulation is an ideal resource for working on these skills. Thus, evaluation instruments are needed to understand the efficiency of this methodology. Although many evaluation instruments already exist, none measure non-technical skills of undergraduate nursing students in medical and surgical hospital units. DESIGN: An instrumental study design was employed. METHODS: Two-phases were used to develop and validate the scale: 1) Scale development. A group of experts defined the dimensions and components. Afterwards, the content was validated by experts, and a pilot study was conducted with undergraduate Nursing students. 2) Analysis of the psychometric properties of the scale. A total of 393 students were evaluated in high-fidelity simulation scenarios by three evaluators, through the use of the Non-Technical Skills in Medical and Surgical Hospital Units (NTS-Nursing) Scale. RESULTS: The content validity indexes were adequate for the total of the items and the total of the scale. The statistical descriptors of the items, the internal structure, and the reliability (internal consistency and inter-evaluator reliability) were analyzed, as well as the external evidence of validity, with adequate values obtained. CONCLUSION: The NTS-Nursing scale is a valid and reliable instrument. Its structure of 10 items makes its use fast and easy.
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Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Bacharelado em Enfermagem/métodos , Psicometria , Reprodutibilidade dos Testes , Projetos Piloto , Competência Clínica , Unidades Hospitalares , Inquéritos e QuestionáriosRESUMO
Disruptive behavior in the healthcare context has an impact on patient care, healthcare personnel, and the health organization, and it also influences the therapeutic relationship, communication process, and adverse events. However, there is a lack of instruments that could be used for its analysis in the hospital care environment in the Spanish context. The objective of the study was to culturally adapt and perform a content validation of the tool "Nurse−Physician Relationship Survey: Impact of Disruptive Behavior on Patient Care", to the Spanish content (Spain). An instrumental study was conducted, which included an analysis of conceptual and semantic equivalence. A panel of experts analyzed the translations, by analyzing the Content Validity Index (CVI) of the group of items in the scale through the Relevance Index (RI) and the Pertinence Index (PI). Only a single item obtained an RI value of 0.72, although with PI value of 0.81, with consensus reached for not deleting this item. The CVI of all the items was >0.80 for the mean value of the RI, as well as the PI. The instrument was adapted to the Spanish context and is adequate for evaluating the disruptive behaviors on nurse−physician relationships and its impact on patient care. However, the importance of continuing the analysis of the rest of the psychometric properties in future studies is underlined.
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AIM: The aim of this study was to identify and compare birthing complications in women originating from countries where they are at risk (may become victims) of FGM with those of Spanish women, all having given birth from 2012 to 2015 at the "Virgen de la Arrixaca" University Clinical Hospital in Murcia, Spain. METHODS: A transversal, observational, quantitative study was carried out, retrospectively, comparing 245 sub-Saharan women originating from countries where FGM is practiced with 490 Spanish women, in terms of obstetric complications. Data collection was performed via electronic clinical records. RESULTS: The sub-Saharan women presented higher rates of intrapartum and emergency caesareans, intense postpartum haemorrhages, concurrent episiotomies and tears (2nd and 3rd degree), failed inductions, and non-progressive labours, and a more severe risk of foetal distress when compared with Spanish women. CONCLUSIONS: The fact that the sub-Saharan women originating from countries where FGM is practiced presented a greater number of birthing complications than the Spanish women proves the need for Spanish healthcare professionals to receive training towards cultural competency acquisition, in order to provide a multidisciplinary approach, with standardized action protocols focused fundamentally on prevention.
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Circuncisão Feminina , África Subsaariana/epidemiologia , Estudos Transversais , Episiotomia , Feminino , Humanos , Gravidez , Estudos RetrospectivosRESUMO
(1) Background: The informed consent form must contain all the relevant information about the procedure to be performed to guarantee the patient's freedom to choose. (2) Objective: To analyze the formal quality of, and compliance with informed consent forms in critical care and surgical areas in a county hospital in Spain. (3) Methods: The formal quality of informed consent forms in critical care and surgical areas from the hospital were analyzed, following the established formal quality criteria for informed consent forms. The compliance with specific criteria for each of the operated patients during the period of study was also evaluated. (4) Results: The formal quality of 224 informed consent forms was analyzed from 8 disciplines observing a median of non-compliances of 4 with a minimum of 1 and a maximum of 5, with the most breaches being in verifying the delivery of a copy to the patient and showing contraindications. The compliance of 376 documents from 188 operated patients were assessed, highlighting that the non-complied items were: the personalized risks and complete identification of the patient and the physician. A significant association was found between disciplines analyzed and the identification of the physician and personalized risks, with anesthesia and critical care showing the best compliance. (4) Conclusions: The informed consent forms in critical care and surgical areas were shown to have a deficient formal quality and an inadequate compliance. These deficiencies should be corrected to improve the information received by the patients and to guarantee their freedom to choose. As nurses have a responsibility to ensure that patients are adequately informed about both nursing interventions and care, as well as the surgical treatments they receive, consideration should be given to the possibility of nursing professionals taking the lead in obtaining informed consent.
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OBJECTIVES: get to know, analyze and describe the current situation of the Delivery and Birth Plans in our context, comparing the delivery and birth process between women who presented a Delivery and Birth Plan and those who did not. METHOD: quantitative and cross-sectional, observational, descriptive and comparative cohort study, carried out over two years. All women who gave birth during the study period were selected, including 9303 women in the study. RESULTS: 132 Delivery and Birth Plans were presented during the first year of study and 108 during the second. Among the variables analyzed, a significant difference was found in "skin to skin contact", "choice of dilation and delivery posture", "use of enema", "intake of foods or fluids", "eutocic deliveries", "late clamping of the umbilical cord" and "perineal shaving". CONCLUSIONS: the Delivery and Birth Plans positively influence the delivery process and its outcome. Health policies are needed to increase the number of Delivery and Birth Plans in our hospitals.
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Parto Obstétrico , Planejamento de Assistência ao Paciente , Estudos de Coortes , Estudos Transversais , Parto Obstétrico/normas , Feminino , Humanismo , Humanos , Planejamento de Assistência ao Paciente/normas , Planejamento de Assistência ao Paciente/estatística & dados numéricos , Gravidez , Cuidado Pré-NatalRESUMO
get to know, analyze and describe the current situation of the Delivery and Birth Plans in our context, comparing the delivery and birth process between women who presented a Delivery and Birth Plan and those who did not. quantitative and cross-sectional, observational, descriptive and comparative cohort study, carried out over two years. All women who gave birth during the study period were selected, including 9303 women in the study. 132 Delivery and Birth Plans were presented during the first year of study and 108 during the second. Among the variables analyzed, a significant difference was found in "skin to skin contact", "choice of dilation and delivery posture", "use of enema", "intake of foods or fluids", "eutocic deliveries", "late clamping of the umbilical cord" and "perineal shaving". the Delivery and Birth Plans positively influence the delivery process and its outcome. Health policies are needed to increase the number of Delivery and Birth Plans in our hospitals.
conhecer, analisar e descrever a situação atual dos Planos de Parto e Nascimento no contexto estudado, comparando o processo de parto e sua finalização entre as mulheres que apresentaram e as que não apresentaram um Plano de Parto e Nascimento. estudo de coorte quantitativo, transversal, observacional descritivo comparativo, realizado durante um biênio. Foram selecionadas todas as mulheres que deram à luz no período estudado, incluindo 9303 mulheres. o número de Planos de Parto e Nascimento apresentados no primeiro ano foi de 132, contra 108 no segundo. Entre as variáveis analisadas, foi encontrada uma diferença significativa para "contato pele a pele", "eleição de posição de dilatação e parto", "uso de enema", "ingestão de alimentos ou líquidos", "partos normais", "clampeamento tardio do cordão" e "depilação do períneo". os Planos de Parto y Nascimento influenciam positivamente o processo de parto e sua finalização. São necessárias políticas sanitárias para aumentar o número de Planos de Parto e Nascimento apresentados nos hospitais estudados.
conocer, analizar y describir la situación actual de los Planes de Parto y Nacimiento en nuestro entorno, comparando el proceso de parto y la finalización del mismo entre las mujeres que han presentado un Plan de Parto y Nacimiento y las que no lo han hecho. estudio de corte cuantitativo, transversal, observacional descriptivo comparativo, en un bienio. Se ha seleccionada a la totalidad de mujeres que dieron a luz en el periodo de estudio, incluyéndose en el estudio un total de 9303 mujeres. el número de Planes de Parto y Nacimiento presentados en el primer año de estudio fue de 132, y en el segundo de 108. De las variables analizadas se encontró una diferencia significativa en "contacto piel con piel", "elección de postura en dilatación y parto", "uso de enema", "ingestión de alimentos o líquidos", "partos eutócicos", "pinzamiento tardío del cordón" y "rasurado del periné". los Planes de Parto y Nacimiento influyen positivamente en el proceso de parto y en la finalización del mismo. Son necesarias políticas sanitarias para aumentar el número de Planes de Parto y Nacimiento que se presentan en nuestros hospitales.