The role of nursing care continuity report in predicting length of hospital stay in older people: A retrospective cohort study.

BACKGROUND: The Nursing Care Continuity Report (NCCR) is a tool for evaluating the quality of nursing care during hospital admission. AIM: To explore the role of the NCCR in predicting longer length of stay (LOS) in older adults (≥65 years) admitted to a tertiary hospital and determine possible clinical differences at discharge between patients who had a short LOS (≤7 days) and a prolonged LOS (>7 days). RESEARCH DESIGN AND SETTING: A retrospective cohort study was conducted including all patients with a completed NCCR admitted to the hospital between 2015 and 2019. Sociodemographic data, risk of pressure injuries, level of dependence, presence and intensity of pain, and presence and type of pressure injury were the variables registered in the NCCR. RESULTS: A total of 41,354 patients were included in this study, with a mean age of 78 years, of whom 47% were female. At admission, 21% of patients were at potential risk of developing pressure ulcers. Age, admission to the internal or respiratory medicine unit, and having at least medium risk of developing pressure ulcers were the predictors of prolonged LOS using a random sample of 950 patients. At discharge, patients with prolonged LOS presented higher risk of pressure ulcers and a higher level of dependency and were more likely to present hospital-acquired pressure ulcers. CONCLUSIONS: Older adults from the internal or respiratory medicine unit who exhibited higher risk of pressure ulcers were related to a prolonged LOS, a higher level of dependency, and hospital-acquired ulcers at hospital discharge. RELEVANCE TO CLINICAL PRACTICE: Identifying clinical data that have a greater relationship with LOS could be a useful tool for nursing management and for the implementation of strategies to prevent adverse events during hospitalisation. NO PATIENT OR PUBLIC CONTRIBUTION: No direct patient contact was made during the data collection.

Nomophobia in university students during COVID-19 outbreak: a cross-sectional study.

Introduction: Currently, access to the Internet through smartphones has led to their functions going beyond purely communicative ones, allowing the management of massive, instantaneous, and easily accessible information. This research analyzed the differences in smartphone use and the prevalence of nomophobia, mainly according to gender and university degree of Health Sciences students at the University of Zaragoza during the COVID-19 confinement in Spain. Methods: A descriptive cross-sectional study was carried out on a sample of 318 first and second-grade students, who completed an online questionnaire sent to their institutional email, which included sociodemographic questions, other questions about smartphone use, and the Nomophobia Questionnaire (NMP-Q) scale. Results: Compared to men (n = 58), women (n = 260) were more likely to use their smartphones more intensively daily, as were occupational therapy students compared to the other degree programs studied. The prevalence of nomophobia was moderate, being around the risk of suffering from it. No significant differences in scores for nomophobia among students were found according to gender, university degree, or population nucleus for the nomophobia scores of the students. Discussion: The present study extends the existing literature on nomophobia by providing results of interest in terms of gender and the exceptional healthcare context of COVID-19. The results suggest that despite intense daily smartphone use young people did not reach severe nomophobia figures. This fact underlines the need for appropriate and healthy technology education. Understanding the characteristics of the populations that use the smartphone the most may help to analyze nomophobia rates and the massive use of the device.

Linking sedentary behavior and mental distress in higher education: a cross-sectional study.

Background: Sedentary behavior among university students could negatively affect their mental health. Objective: The aim of this study was to examine the relationship of mental health (anxiety and depression) and sedentary behavior between gender in Health Degrees at the University of Zaragoza. Design: Cross-sectional descriptive study. Participants: Sample of 257 University students who completed an online questionnaire. Methods: Sedentary behavior was assessed with the SBQ questionnaire. Anxiety and depression were assessed with the GADS questionnaire. The Mann-Whitney U test and multiple linear regression models were used. Results: In comparison to men, female students with symptoms of anxiety spend more time in total engaged in sedentary behaviors (10.56 ± 4.83) vs. (7.8 ± 3.28; p < 0.001) and mentally-passive sedentary activities [2.24 (1.57) vs. 1.15 (0.90; p < 0.005)]. Female students at risk of depression also spend more hours engaged in mentally-passive sedentary behaviors in comparison to men (8.28 ± 50.70 vs. 1.27 ± 1.02; p = 0.009). Conclusion: Female students at risk of anxiety and/or depression spend more time engaged in sedentary activities in comparison to male students. The risk of anxiety and depression is associated with the total number of hours a day spent engaged in sedentary behaviors and with mentally passive behaviors, but not mentally active behaviors.

Quality of Life after Radical Prostatectomy: A Longitudinal Study.

BACKGROUND: Men with prostate cancer who undergo radical prostatectomy experience a decrease in quality of life, often related to sexual disfunction and urinary incontinence. Knowing and measuring the impact of radical prostatectomy on the individual's social, emotional, and family quality of life could help to plan and develop an appropriate, patient-centred therapeutic approach. AIM: In this study, we aimed to evaluate changes in quality of life of patients with prostate cancer before and after radical prostatectomy. METHODS: A longitudinal, observational study of 114 participants was conducted using the method of test-retest. Quality of life before and after radical prostatectomy was measured through the following self-administered questionnaires: (1) The EORTC QLQ-C30 in its Spanish version was used to assess the generic quality of life the participants; (2) the EORTC QLQ-PR25 in its Spanish version was used to assess the specific, health-related quality of life of prostate cancer patients. RESULTS: A total of 114 men took part in this study. The results from the QLQ-C30 questionnaire indicated an improvement in the dimensions of emotional role and cognitive function, as well as in the symptoms of fatigue, pain, nausea and vomiting, insomnia, and loss of appetite, after surgery. Patients scored lower in the dimensions of role functioning, social function, and economic impact after radical prostatectomy. According to the results from the QLQ-PR25 questionnaire, 61.40% of the participants experienced sexual impotence and 26.31% suffered urinary incontinence after surgery. There were significant differences in some postsurgical outcomes between patients who had neurovascular bundles preserved and those who had not. CONCLUSIONS: In-depth knowledge of, and measurement of changes in, quality of life after radical prostatectomy should allow for comprehensive, multidisciplinary, patient-centred care planning. Psychosocial assessment, both before and after surgery, is crucial in patients with prostate cancer. This study was prospectively registered with the CEIC-A on 2012-06-27, with registration number C.P.-C.I. PI12/0088.

Ageism and nursing students, past or reality?: A systematic review.

OBJECTIVE: This systematic review aimed to summarise and update existing knowledge about ageism among nursing students through the following research question: what is the perception and attitudes of ageism among student nurses? DESIGN: A systematic review of longitudinal and cross-sectional studies of ageism in nursing students was carried out. DATA SOURCES: The literature search was conducted in the scientific databases Pubmed and Scopus in February 2021. REVIEW METHODS: After the screening process, 22 studies meeting the selection criteria were selected; 8 more were identified after manually searching the selected paper' reference lists. A total of 30 studies were included in the review. The JBI Critical Appraisal Checklists for Analytical Cross-Sectional studies and for Cohort Studies were used to appraise the articles' quality. RESULTS: There was large variability in the manifestation of ageism among student nurses, as well as in the instruments used for assessment. Most of the articles analysed attitudes towards old age, the majority of which were positive. Being a female student, being on the final year of study and having regular contact or cohabitation with an older adult were three of the main determinants in the expression of positive attitudes towards the elderly. CONCLUSIONS: Our findings suggest that student nurses generally have positive attitudes towards old age, although ageist beliefs and discriminatory behaviours were identified and should be studied in greater depth. Training programs for future care professionals have a responsibility to educate from a non-stereotypical perspective based on current societal needs.

Cognitive Effects of a Cognitive Stimulation Programme on Trained Domains in Older Adults with Subjective Memory Complaints: Randomised Controlled Trial.

Age-related subjective memory complaints (SMC) are a common concern among older adults. However, little is known about the effects of cognitive stimulation (CS) interventions on subjective memory complaints. The aim of this study was to analyse the effectiveness of a CS programme on global cognition and cognitive functions of older adults with SMC. A randomised clinical trial was conducted on older adults with SMC, including 308 participants ≥65 years of age assessed 6 and 12 months after the intervention. The assessment instrument was the Spanish version of the Mini-Mental State Examination (MEC-35), and all domains of the instrument were assessed. For statistical analysis, the data were analysed using robust ANOVA with means truncated at 20% utilising a two-way repeated measures model, with between (groups) and within (measurements) factors. In post hoc tests, a Wilcoxon signed-rank test of exact permutations between groups and Bonferroni correction were applied. In post hoc between-group tests, significant differences were found: (1) post-treatment in MEC-35, temporal orientation, short-term memory (STM), global language and praxis, and language and praxis (p ≤ 0.005); (2) at 6 months in MEC-35, global orientation, temporal orientation, and STM (p = 0.005); (3) at 12 months in MEC-35, global orientation, temporal orientation, STM, global language and praxis, and language (p = 0.005). This study shows benefits in global cognition and orientation, temporal orientation, STM, and language in older adults with SMC.

Acceptability of a Smartphone Application to Enhance Healthcare to Female Genital Mutilation Survivors in Liberia: A Qualitative Study.

In Liberia, female genital mutilation/cutting (FGM/C) is a legally allowed initiation ritual in the secret Sande society. Due to the secrecy, Liberian healthcare providers receive little education on FGM/C and its health consequences. As mobile learning approaches proved to efficiently increase providers' knowledge and skills, a mobile application ('app') was designed to support self-learning, decision-making, and the follow-up of FGM/C survivors' health. The 'app' was introduced in a capacity-building project in 2019 and evaluated through this qualitative study to assess healthcare provider's needs and acceptance. We conducted 22 semi-structured interviews and eight focus group discussions with 42 adult healthcare providers in three Liberian counties. A thematic approach grounded in descriptive phenomenology guided data analysis and led to three main themes: the 'app', mobile learning and health education, and personal impression. Healthcare providers judge the 'app' useful to broaden their knowledge and skills, which might lead to better FGM/C detection and management. The 'app' might further facilitate patient and community education about the negative health consequences of FMG/C, possibly contributing to a reduction of FGM/C prevalence.

Management of Female Genital Mutilation/Cutting-Related Obstetric Complications: A Training Evaluation.

Although female genital mutilation/cutting (FGM/C) is a prevalent practice in Liberia, healthcare workers lack the capacity to provide adequate care for FGM/C survivors. Therefore, Liberian nurses, physician assistants, midwives and trained traditional midwives were trained in sexual, obstetric and psychosocial care for FGM/C survivors in 2019. Through questionnaires, we assessed knowledge acquisition, trainee attitudes towards FGM/C care and acceptability to implement WHO-endorsed recommendations. The questionnaires were analyzed using descriptive statistics for quantitative data and an inductive approach for qualitative data. A total of 99 female and 34 male trainees participated. Most trainees perceived FGM/C as harmful to women's health, as a violation of women's rights and showed a willingness to change their clinical practice. While 82.8% (n = 74/90) perceived their role in advocating against FGM/C, 10.0% (n = 9/90) felt that they should train traditional circumcisers to practice FGM/C safely. The pre-training FGM/C knowledge test demonstrated higher scores among physician assistants (13.86 ± 3.02 points) than among nurses (12.11 ± 3.12 points) and midwives (11.75 ± 2.27 points). After the training, the mean test score increased by 1.69 points, from 12.18 (±2.91) points to 13.87 (±2.65) points. The trainings successfully increased theoretical knowledge of FGM/C-caused health effects and healthcare workers' demonstrated willingness to implement evidence-based guidelines when providing care to FMG/C survivors.

Estudio del síndrome confusional agudo en los registros de enfermería en pacientes geriátricos hospitalizados con interconsulta a psiquiatría / Study of delirium based on nursing records in hospitalized geriatric patients with psychiatric interconsultation

Objetivos: Analizar, a partir de los registros de enfermería, las variables asociadas con la aparición del síndrome confusional agudo (SCA) en pacientes geriátricos de un hospital general.Metodología:Estudio descriptivo transversal y retrospectivo realizado en el Hospital Royo Villanova, de Zaragoza, entre 2011-2014. Población de estudio: N = 881 diagnosticados de SCA (2,2% del total de ingresos); se obtuvo una muestra total de n = 79 pacientes de 60 años o más, con diagnóstico de SCA por psiquiatría de enlace.Resultados:La edad media de los pacientes fue de 82,8 años. La detección de SCA se realizó en los pacientes tras 1,1 a 3,5 días de media desde el ingreso. Las puntuaciones del Índice de Barthel fueron de 40,9 a 60,8. Los fallecimientos durante el episodio de SCA fueron entre el 10,3% y el 15%. El cuadro de SCA fue mayoritariamente de tipo hiperactivo y se inició por la noche y por la tarde. Los síntomas más frecuentes de SCA registrados por enfermería fueron alteraciones motoras (agitación, inquietud) y desorientación.Conclusión:Enfermería registra el SCA antes de la petición de colaboración al servicio de psiquiatría, la cual se da en escaso número. Estos registros son precisos y certeros y coinciden con los términos médicos. Serían necesarios nuevos estudios de investigación que permitan minimizar el infradiagnóstico y no solo detectar SCA del tipo hiperactivo, ya que todos conducen a aumentar la morbimortalidad de nuestros pacientes. (AU)

Objectives: To analyze, from the nursing records, the variables associated with the appearance of Acute Confusional Syndrome (here after SCA) in geriatric patients of a general hospital in the city of Zaragoza.Methodology:Descriptive cross-sectional and retrospective study conducted at the Royo Villanova hospital in Zaragoza between 2011-2014. Study population: N = 881 diagnosed with ACS (2.2% of total income). A total sample of n = 79 was obtained, patients ≥ 60 years, with a diagnosis of ACS by Link Psychiatry.Results:The average age of the patients was 82.8 years. The detection of ACS was performed in patients after 1.1 to 3.5 days on average from admission. Barthel Index scores were 40.9 to 60.8. The exitus during the episode of ACS were 10.3% / 15%. The SCA chart was mostly hyperactive and debuted at night and in the afternoon. The most frequent symptoms of ACS recorded by nursing were motor disorders (agitation, restlessness) and disorientation.Conclusions:Nursing usually register ACS before the request for collaboration to the psychiatry service, which occurs rarely. Besides these records are accurate and match with the medical terms. New research studies are required to minimize underdiagnosis and not only to detect hyperactivity ACS because all types lead to increased morbidity and mortality of our patients. (AU)

Gender Self-Perception and Psychological Distress in Healthcare Students during the COVID-19 Pandemic.

The aim of this study was to analyze university Health Sciences students' self-perception regarding gender stereotypes, and to explore whether there was any association between gender stereotypes and clinical/socio-demographic variables. METHODS: This cross-sectional study was conducted with a sample of 252 university students who completed a self-administrated online questionnaire (18.3% males, 81.7% females). We evaluated the self-perception of gender stereotypes as determined using the BSRI-12 questionnaire and explored the association of this measure with the impact of perceived stress measured using a modified scale (PSS-10-C) as well as anxiety and depression according to scores on the Goldberg scale (GADS). RESULTS: According to the students' self-perception of gender stereotypes, 24.9% self-perceived themselves as feminine, 20.1% as masculine, 24.9% as androgynous, and 30% as undifferentiated. The degree determines self-identification with gender stereotypes. Nursing and Occupational Therapy are studied mostly by women, 28.4% and 45%, respectively, while Physiotherapy is studied mainly by men (71.2%). Females indicated more anxiety (75.7%) and depression (81.7%) than males (52.9% and 67.3%, respectively). In contrast, males developed more stress (88.5%) than females (74.1%). CONCLUSIONS: University degree, anxiety, depression, and stress determined self-identification with gender stereotypes. The results of this study indicate that gender roles influence the possibility of developing mental disorders and should be taken into account in future studies.

Diferencia en la relación de apego entre niños nacidos prematuros y niños nacidos a término: revisión bibliográfica / Difference in the attachment relationship between children born prematurely and children born at term: bibliographic review

Objetivo: Analizar la relación de apego de los niños nacidos prematuros con sus madres y padres, y compararla con la relación establecida entre los nacidos a término. Metodología: Revisión bibliográfica de la literatura en lengua inglesa y española de los últimos 12 años. Se usaron las bases de datos PubMed, ScienceDirect, Scopus, WOS y ProQuest. Los términos MeSH utilizados fueron: object attachment, premature infants, prematurity, mother-child relations en combinación con los operadores booleanos AND y OR. Se seleccionaron los artículos que cumplieron con los criterios de calidad metodológica establecidos por los investigadores (una puntuación ≥11 en la declaración STROBE). Resultados: Fueron seleccionados para el estudio 22 artículos completos (5 estudios cualitativos y 17 cuantitativos). En total se analizó una muestra de 1.785 sujetos en estudios cuantitativos y 164 en estudios cualitativos. Conclusión: No se observa relación entre la edad gestacional y el tipo de apego (AU)

Objective: To analyze the attachment relationship of children born prematurely with their mothers and compare it with the relationship established between mothers born at term. Methodology: Bibliographic review of the literature in English and Spanish of the last 12 years. The databases were PubMed, ScienceDirect, Scopus, WOS and ProQuest. The MeSH terms used: object attachment, premature infants, prematurity, mother-child relations in combination with the Boolean operators AND and OR. Articles that met the methodological quality criteria established by the researchers (a score ≥11 points in the STROBE statement) were selected. Results: 22 full articles (5 qualitative and 17 quantitative studies) were chosen for the study. In total, a sample of 1785 subjects in quantitative studies and 164 in qualitative studies was analyzed. Conclusion: Relationship between gestational age and type of attachment is not observed. (AU)

Impact of Reducing Sitting Time in Women with Fibromyalgia and Obesity: A Randomized Controlled Trial.

BACKGROUND: Sitting time has negative effects on health, increasing the risk of obesity, osteoporosis, diabetes, and cancer. Thus, primary health care education interventions aimed to reduce sitting time and sedentary behavior could have beneficial effects on people's health and wellbeing. The purpose of this study was to assess the effectiveness of an intervention based on reducing sitting time to decrease cardiometabolic risk on a sample of women diagnosed with fibromyalgia and moderate obesity. METHODS: Randomized controlled trial to evaluate the effectiveness of an intervention to decrease cardiometabolic risk in 84 participants. Sedentary behavior was monitored using an accelerometer before and at 3-month follow-up. RESULTS: Compared with the control group, body mass index decreased, and the number of steps taken increased, in the intervention group 3 months after the intervention. No significant differences were found in the rest of the variables measured. CONCLUSION: The intervention group decreased sitting time after the intervention. Group activities and support from primary care may be useful to improve treatment adherence. RCT registration: NCT01729936.

Sense of Coherence and Quality of Life in Patients Treated with Antivitamin K Oral Anticoagulants: A Cross-Sectional Study.

The aim of this study was to analyze the correlation between the participants' self-reported quality of life and their sense of coherence in a sample (n = 85) of patients on treatment with oral antivitamin K anticoagulants. A cross-sectional design was used. The measurement instruments included a questionnaire on sociodemographic variables, the Spanish version of the Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF), an oral-anticoagulant-treatment-specific quality-of-life questionnaire, and the sense-of-coherence (SOC) scale. We analyzed the correlations between the participants' characteristics and the results from the quality-of-life and SOC scales. Age, level of education, employment status, living arrangement, and treatment length were the determinants of the quality of life in people treated with oral anticoagulants. We found a significant association between the four domains of the WHOQOL-BREF questionnaire and general treatment satisfaction (p < 0.01); no significant correlations were found between the SOC subscales and the oral-anticoagulant-treatment-specific quality of life in our sample. Women had a worse level of self-management than men. Nursing interventions should be tailored to the needs of the populations on treatment with oral anticoagulants in order to facilitate a higher level of self-management.

Los primeros 50 años de las matronas en la Universidad de Zaragoza (1878-1928) / The first 50 years of midwives at the University of Zaragoza (1878-1928)

El oficio y profesión de matrona y la administración de cuidados maternoinfantiles se remontan al principio de los tiempos, como demuestran testimonios de diversa índole: textos escritos, fuentes iconográficas y otros materiales. Larga ha sido su evolución hasta llegar a la publicación del Real Decreto 450/2005, de 22 de abril, con el que aparecen siete nuevas especialidades de Enfermería, entre las que se encuentra la de Enfermería Obstétrico-Ginecológica (Matrona). La enfermería se ha transformado, en los albores del siglo XXI, en una práctica con mayor presencia en el espacio público y en la institución universitaria debido, entre otros factores, a la implantación del Espacio Europeo de Educación Superior. Un abordaje de los fundamentos de cualquier disciplina o profesión, en el caso que nos ocupa de la Enfermería Obstétrico-Ginecológica (Matrona), pasa necesariamente por el conocimiento de su pasado, de su historia. Para aproximarnos a la realidad histórica de las matronas, se ha tomado como punto de partida de esta investigación el inicio de esta profesión dentro de la Universidad de Zaragoza en el año 1878. Para este trabajo ha sido imprescindible comprender, desde el análisis de género, la manera en que se inició su integración entre otras titulaciones universitarias y cómo se comportó en situaciones de conflicto frente a la supervivencia de sus funciones de asistencia maternoinfantil o en los planes higiénicos previstos por los gobiernos de las distintas épocas. El objetivo de este estudio es conceptualizar la profesión de matrona en los primeros años de titulación universitaria y conocer el perfil académico y sociodemográfico de las alumnas que optaron al título de matrona en los primeros 50 años en la Universidad de Zaragoza

The office and profession of midwifery care and management of maternal and child back to the beginning of time, as evidenced by the testimonies of various kinds: written texts, iconographic sources and other materials. Long has been, therefore, their evolution up to the publication of Royal Decree 450/2005 of 22 April, in which they appear seven new nursing specialties, among which is the midwives Nursing, Midwifery. Nursing has become the twenty-first century in an exercise with a greater presence in public space and the university, because, among other factors, the implementation of the European Higher Education Area. Anapproach to the fundamentals of any discipline or profession, at presentcase of midwives, necessarily requires the knowledge of his past, his history. To approach the historical reality of midwives has been taken as a starting point for this research, the beginning of this profession within the University of Zaragoza in 1878. For this work, has been essential to understand, from the analysis of gender, how it started way integration between other university degrees and how they behave in situations of conflict, compared to the survival of his duties as mother and child care or the hygiene plans provided by the governments of different periods.Theaim of this paper is to define the concept of the profession of mid-wife in the first years of the university qualification and identify the aca-demic and social/demographic profile of the students who studied for the qualification of midwife in tHe first 50 years at the University of Zaragoza

Análisis de los resultados obstétricos y neonatales de los partos inducidos en nulíparas en el Hospital Clínico de Zaragoza / Analysis of obstetric and neonatal results in induced birth in nulliparous women at the Hospital Clínico of Zaragoza

La longitud y la madurez cervicales son claves en la consecución de un parto vaginal tras inducción, pero no está claro el papel de otros factores. Conocerlos más ampliamente puede contribuir a un manejo más efectivo y eficiente de esta práctica obstétrica. Objetivo: Analizar los resultados obstétricos y neonatales de los partos inducidos en 2009 en el Hospital Clínico de Zaragoza en función de las variables edad y nacionalidad materna, sexo fetal, causa de la inducción y anestesia utilizada. Metodología: Estudio descriptivo transversal mediante revisión del libro de registros del paritorio e historias clínicas. Se incluyeron 283 nulíparas con embarazo a término y feto único, vivo y sano. Resultados: Las causas obstétricas y maternas fueron los principales motivos de inducción. La media de edad fue de 31 años. Se ingresó en la unidad de cuidados intensivos (UCI) neonatales al 10% de los recién nacidos. El parto fue eutócico en el 52,7% de los casos. Se practicó episiotomía en el 93% de los partos vaginales. La epidural se utilizó en el95% de los casos. Conclusiones: Se comprobó una fuerte asociación positiva entre la edad materna y el peso del recién nacido. Se hallaron diferencias estadísticamente significativas en cuanto a la necesidad de ingreso en UCI y el peso del recién nacido entre las inducciones por causa obstétrica y fetal, respecto al resto de motivos. No se encontraron diferencias en cuanto a tipo de parto, alumbramiento, episiotomía y puntuación Apgar entre los diferentes grupos de edad y nacionalidad materna o sexo fetal (AU)

Cervical length and ripening are keys in achieving vaginal delivery after induction, but it is still not clear about the role of other factors. Increasing public awareness can contribute to more effective and efficient management of this obstetric practice. Objective: To evaluate the obstetrical and neonatal outcomes of induced labor in 2009 at the Clinical Hospital of Zaragoza in terms of variables: maternal age and nationality, fetal sex, cause of induction and anesthesia used. Methodology: A cross-sectional descriptive study was conducted using revision of the delivery room log book and medical records. We included283 nulliparous women with term pregnancies, single fetus alive and healthy. Results: The maternal obstetric conditions were the main reasons for induction. The average age was 31 years. 10% of newborns were admitted in a neonatal intensive care unit (ICU). The success rate for noninstrumental vaginal delivery was 52.7%. Episiotomy was performed in93% of vaginal deliveries. Epidural analgesia was used in 95% of cases. Conclusions: We found a strong positive association between maternal age and newborn weight. We found statistically significant differences regarding the neonatal ICU admission and birth weight after induction of labor caused by obstetric and fetal conditions compared to other reasons. There were no differences in the type of labor, placental delivery, episiotomy, and Apgar scores between different age groups and maternal nationality or fetal sex (AU)

Episiotomía selectiva frente a episiotomía rutinaria. Valoración a los 3 años (2007-2008) / Selective episiotomy versus rutinary episiotomy. Assessment three years after (2007-2008)

Objetivo: Identificar, a los 3 años del parto, los resultados del uso de la episiotomía según un protocolo restrictivo o un protocolo sistemático. Personas y método: Estudio prospectivo experimental realizado en el Hospital Miguel Servet de Zaragoza en 2004-2005 en su primera fase, y a los 3 años posparto en su segunda fase. La muestra estaba formada por mujeres nulíparas, con un parto eutócico a término, realizado por matronas. En la segunda fase del estudio se valoraron los siguientes factores: gestaciones posteriores y tipo de parto, dolor perineal residual, dolor con la micción, la deposición o el coito, incontinencia de orina, tipo y frecuencia, incontinencia fecal, satisfacción con las relaciones sexuales, realización de ejercicios del suelo pélvico y lactancia. Resultados: Se entrevistó a 365 mujeres, 185 (50,68%) del grupo control y 180 (49,32%) del experimental. En el grupo control, a 156(84,32%) se les había practicado episiotomía y a 29 (15,68%) no. En el grupo experimental había 108 (60,0%) mujeres a quienes se les había realizado episiotomía y 72 (40,0%) a las que no (p <0,001). Tuvieron una gestación posterior 184 mujeres, y 181 no, sin que se observase significación estadística en ninguno de los grupos estudiados: control o experimental, o episiotomía sí-episiotomía no. No se encontraron diferencias, entre los grupos control-experimental o gruposepisiotomía sí-episiotomía no, para ninguna de las variables estudiadas. De 9 casos diagnosticados de prolapso genital, 8 pertenecían al grupo de las 184 mujeres con gestaciones posteriores (4,3%) y 1 al grupo de las 181 mujeres sin gestación posterior (0,6%) (p= 0,040). Conclusiones: La episiotomía rutinaria no protege de las disfunciones del suelo pélvico, las alteraciones de las relaciones sexuales ni la incontinencia urinaria a los 3 años del parto (AU)

Objective: To identify, three-year postpartum, the results of the usageof episiotomy according to either a restrictive protocol or a systematic protocol. Subjects and method: Experimental prospective study undertaken at Miguel Servet Hospital in Zaragoza in first stage in the years 2004-2005 and in second stage after 3 years postpartum. The patients are nulliparous women; childbirth is eutocic to term, assisted by midwife. In this second stage, posterior gestations and type of birth, residual perinealpain, urinary pain, defecation pain or coital pain, urinary incontinence(UI), type and frequency, fecal incontinence, sexual satisfaction, execution of pelvic floor exercises and breastfeeding are assessed. Results: 365 women were interviewed, 185 (50.68%) from the controlgroup and 180 (49.32%) from the experimental group. In the control group156 (84.32%) received episiotomy and 29 (15.68%) did not. In the experimental group, 108 (60.0%) women received episiotomy and 72(40.0%) did not (p <0.001).184 women showed posterior gestation and 181 did not, with no statistical significance in either of the studied groups: control or experimental,or with episiotomy-without episiotomy.No statistical differences were found, in the control groups-experimental or with episiotomy-without episiotomy, in either of the assessed variables. Of the 9 genital prolapse diagnosed cases, 8 happened in the 184 women with posterior gestation (4.3%), and 1 in the group of 181 womenwithout posterior gestation (0.6%) (p= 0.040). Conclusions: The routinary episiotomy does not protect from pelvicfloor disorders, sexual interaction or UI 3 years after childbirth (AU)