Estrés y ansiedad en estudiantes de enfermería durante la primera ola de la pandemia de COVID-19.

OBJECTIVE: To compare anxiety and acute stress levels among nursing students who joined the labour market during the first wave of the COVID-19 pandemic   and those who did not. METHODS: A cross-sectional, multicentre descriptive study across three Spanish public universities. A total of 216 nursing students participated in our study. Data collection was carried through an online questionnaire, that included variables on conditions for entering the labour market, the Zung Anxiety Self-Assessment Scale and the Stanford Acute Stress Reaction Questionnaire. We performed univariate and multivariate analyses.  Results: Overall, 42.6% (n=92) of the students entered the labour market during the first wave of the COVID-19 pandemic. The global anxiety score was x?=36.31 (SD=5.71) and the stress score was x?=82.39 (SD=30.84). Lower anxiety levels were observed among those who joined the labour market (x?=35.67; SD=5.78) as compared to those who did not (x?=36.73; SD=5.67). Overall 92.4% of the students were acutely stressed. Acute stress was higher among those who did not work (x?=84.35; SD=32.38) and significantly in women.  Conclusions: Nursing students were able to cope with stress in situations such as the COVID-19 pandemic. A healthy worker effect could not be ruled out. Stress and anxiety among nursing students should be considered by clinical practice preceptors and at the time students first enter the labour market.

OBJETIVO: Comparar los niveles de ansiedad y estrés agudo entre los/las estudiantes de enfermería que se incorporaron al trabajo durante la primera ola de la pandemia de COVID-19 y aquellos que no lo hicieron. Métodos: Estudio descriptivo transversal multicéntrico realizado en tres universidades públicas españolas. Un total de 216 estudiantes de enfermería participaron en nuestro estudio. La recopilación de datos se realizó mediante un formulario en línea. Se recopilaron variables relacionadas con las condiciones para ingresar al mercado laboral y se incluyó la Escala de Autoevaluación de Ansiedad de Zung y el Cuestionario de Reacción Aguda al Estrés de Stanford. Se llevaron a cabo análisis univariados y multivariados. RESULTADOS: El 42,6% de los estudiantes ingresaron al mercado laboral. La puntuación global de ansiedad fue x?=36,31 (DE=5,71) y la puntuación de estrés fue x?=82,39 (DE=30,84). Los niveles más bajos de ansiedad se encontraron en aquellos que se incorporaron al mercado laboral (x?=35,67; DE=5,78), en comparación con aquellos que no lo hicieron (x?=36,73; DE=5,67). El 92,4% del total de alumnos presentaron estrés agudo. El estrés agudo fue mayor en aquellos que no trabajaron (x?=84,35; DE=32,38), y significativamente en mujeres.  Conclusiones: Los estudiantes de enfermería mostraron ser capaces de hacer frente al estrés en situaciones como la pandemia de COVID-19. No se puede descartar un efecto del trabajador sano. El estrés y ansiedad de los estudiantes de enfermería deben tenerse en cuenta por los tutores de prácticas clínicas y cuando se incorporan al mercado laboral por primera vez.

Psychometric properties of the Spanish version of the Health of Nation Outcome Scales for schizophrenia patients.

Accessible Summary What is known on the subject? Functioning is one of the most affected areas in schizophrenia. Social, occupational and personal domains are affected, and these deficits are responsible for a major part of the disability associated with the disorder. There are several instruments to measure functioning, but the HoNOS provides a wide assessment of impairment in 12 areas of functioning. What does the paper add to existing knowledge? The Spanish version of the HoNOS shows good properties in terms of reliability and validity for use in schizophrenia patients. Although some authors divide the scale according to proposed underlying dimensions, in schizophrenia this division may not be appropriate. What are the implications for practice? A reliable and easy-to-use measure of impairment in different areas of functioning is useful for optimizing the treatment and rehabilitation of patients with schizophrenia. ABSTRACT: INTRODUCTION: The HoNOS scale was designed for the assessment of psychosocial impairment in various domains. While it is widely used in psychiatric settings, it has not been validated in Spanish for use in patients with schizophrenia. AIM: To examine the psychometric properties of the Spanish version of the HoNOS scale in a sample of schizophrenia patients. METHOD: A total of 194 individuals aged 18 to 65 with schizophrenia spectrum diagnoses were evaluated using the HoNOS. Illness severity and level of functioning were also assessed. RESULTS: The HoNOS showed moderate internal consistency, good inter-observer reliability and good test-retest reliability. Factor analysis revealed an internal structure consisting of four factors, with item distribution differing from the theoretical dimensions proposed for the original scale. DISCUSSION: The Spanish version of the HoNOS scale is a reliable and valid instrument for assessing psychosocial impairment in individuals diagnosed with schizophrenia spectrum disorders. However, further research is needed to determine its internal structure more accurately. IMPLICATIONS FOR PRACTICE: The HoNOS scale provides researchers and clinicians with a valid measure of impairment in twelve different domains, which can facilitate and guide the treatment of schizophrenia patients.

Stress and anxiety in nursing students during the first wave of the COVID-19 pandemic / Estrés y ansiedad en estudiantes de enfermería durante la primera ola de la pandemia de COVID-19

Objetivo: Comparar los niveles de ansiedad y estrés agudo entre los/las estudiantes de enfermería que se incorporaron al trabajo durante la primera ola de la pandemia de COVID-19 y aquellos que no lo hicieron. Métodos: Estudio descriptivo transversal multicéntrico realizado en tres universidades públicas españolas. Un total de 216 estudiantes de enfermería participaron en nuestro estudio. La recopilación de datos se realizó mediante un formulario en línea. Se recopilaron variables relacionadas con las condiciones para ingresar al mercado laboral y se incluyó la Escala de Autoevaluación de Ansiedad de Zung y el Cuestionario de Reacción Aguda al Estrés de Stanford. Se llevaron a cabo análisis univariados y multivariados. Resultados: El 42,6% de los estudiantes ingresaron al mercado laboral. La puntuación global de ansiedad fue x?=36,31 (DE=5,71) y la puntuación de estrés fue x?=82,39 (DE=30,84). Los niveles más bajos de ansiedad se encontraron en aquellos que se incorporaron al mercado laboral (x?=35,67; DE=5,78), en comparación con aquellos que no lo hicieron (x?=36,73; DE=5,67). El 92,4% del total de alumnos presentaron estrés agudo. El estrés agudo fue mayor en aquellos que no trabajaron (x?=84,35; DE=32,38), y significativamente en mujeres. Conclusiones: Los estudiantes de enfermería mostraron ser capaces de hacer frente al estrés en situaciones como la pandemia de COVID-19. No se puede descartar un efecto del trabajador sano. El estrés y ansiedad de los estudiantes de enfermería deben tenerse en cuenta por los tutores de prácticas clínicas y cuando se incorporan al mercado laboral por primera vez (AU)

Objective: To compare anxiety and acute stress levels among nursing students who joined the labour market during the first wave of the COVID-19 pandemic and those who did not.Methods: A cross-sectional, multicentre descriptive study across three Spanish public universities. A total of 216 nursing students participated in our study. Data collection was carried through an online questionnaire, that included variables on conditions for entering the labour market, the Zung Anxiety Self-Assessment Scale and the Stanford Acute Stress Reaction Questionnaire. We performed univariate and multivariate analyses. Results: Overall, 42.6% (n=92) of the students entered the labour market during the first wave of the COVID-19 pandemic. The global anxiety score was x̄=36.31 (SD=5.71) and the stress score was x̄=82.39 (SD=30.84). Lower anxiety levels were observed among those who joined the labour market (x̄=35.67; SD=5.78) as compared to those who did not (x̄=36.73; SD=5.67). Overall 92.4% of the students were acutely stressed. Acute stress was higher among those who did not work (x̄=84.35; SD=32.38) and significantly in women. Conclusions: Nursing students were able to cope with stress in situations such as the COVID-19 pandemic. A healthy worker effect could not be ruled out. Stress and anxiety among nursing students should be considered by clinical practice preceptors and at the time students first enter the labour market (AU)

Impact of hospitalization on nutritional status in persons aged 65 years and over (NUTRIFRAG Study): Protocol for a prospective observational study.

BACKGROUND: Malnutrition is a recurring problem that has become more relevant in recent years. The aim of this study is to assess the risk of malnutrition and nutritional status on admission and its evolution until discharge in patients aged 65 and over admitted to medical and surgical hospitalization units in hospitals of the Spanish National Health System. METHODS: Prospective observational study to be carried out in the medical-surgical hospitalization units of 9 public hospitals between 01/09/2022 and 31/12/2024. Using consecutive sampling, a total of 4077 patients will be included (453 in each hospital). Variables included are related to the care process, functionality, cognition and comorbidity, risk profile, nutritional status and dysphagia; as well as frailty, dietary quality and contextual variables. The incidence of risk of malnutrition, undernutrition and dysphagia during the care process and at discharge will be calculated. The association with risk factors will be studied with logistic regression models and multivariate Cox regression models. In addition, an analysis of participants' satisfaction with food services will be carried out. The study was approved by the Ethics and Research Committee on 30/09/2020, approved for funding on 02/12/2021 and with registration number RBR-5jnbyhk in the Brazilian clinical trials database (ReBEC) for observational studies. DISCUSSION: Some studies address nutritional status or dysphagia in older people in various care settings. However, there is a lack of large sample studies including both processes of the impact of hospitalization. The results of the project will provide information on the incidence and prevalence of both pathologies in the study subjects, their associated factors and their relationship with the average length of stay, mortality and early readmission. In addition, early detection of a problem such as malnutrition related to the disease and/or dysphagia during a hospital stay will favor the action of professionals to resolve both pathologies and improve the health status of patients.

Healing techniques for split-thickness skin grafts donor sites. Umbrella review.

OBJECTIVES: To summarize the existing evidence and provide recommendations for the most effective management of partial-thickness graft donor sites in adults, with the goals of enhancing re-epithelialization, reducing pain, and preventing infection. METHODOLOGY: Umbrella review. A systematic search was conducted encompassing databases such as Pubmed, CUIDEN, Cochrane Library, CINHAL Plus, SCOPUS, and LILACS. The search targeted systematic reviews published since 2011 that focused on examining the effectiveness of different approaches for the treatment of partial-thickness graft donor sites. Reviews with a low critical appraisal score according to AMSTAR 2 were excluded. The included reviews were evaluated using the SIGN scale to assess the level of evidence and grade the recommendations. RESULTS: Five systematic reviews with meta-analysis were incorporated in the analysis. Platelet-rich plasma and human amniotic membrane demonstrated statistically significant improvements in re-epithelialization and pain reduction when compared to the control group. Moreover, platelet-rich plasma also exhibited a decrease in wound infection rates. Recombinant human growth hormone was found to expedite the re-epithelialization process. CONCLUSIONS: Based on the findings, the use of platelet-rich plasma is recommended to enhance re-epithelialization, alleviate pain, and reduce infection in partial-thickness graft donor sites among adults. Application of human amniotic membrane is recommended to accelerate re-epithelialization and alleviate pain, while recombinant human growth hormone is suggested to expedite the overall healing time of these wounds.

From students to nurses under pressure: Nursing students' entry into employment during the first COVID-19 wave.

AIMS AND OBJECTIVE: To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID-19 pandemic (May-June 2020). BACKGROUND: As other healthcare professionals, nursing students who worked during the first COVID-19 wave suffered from dysfunctional mental health symptoms. DESIGN: Sequential, mixed-method, multicentre study. METHODS: The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi-structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting. RESULTS: The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned. CONCLUSION: The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members. RELEVANCE TO CLINICAL PRACTICE: In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience.

Interventions of choice for the prevention and treatment of suicidal behaviours: An umbrella review.

AIM: This umbrella review aims to determine which interventions can be considered as effective in the prevention and treatment of suicidal behaviour. DESIGN: Umbrella review. METHODS: A systematic search was conducted of works indexed in the PubMed, CINAHL, Cochrane Database of Systematic Reviews, Scopus, ISI Web of Knowledge and Joanna Institute Briggs databases. The search covered works published from 2011 to 2020. RESULTS: The scientific literature shows that, in addition to being the most prevalent interventions in use, dialectical and cognitive behavioural therapies are the most effective in the treatment and management of suicide attempts and suicidal ideation. It is shown that the prevention and treatment of suicidal behaviour requires multidisciplinary and comprehensive management. Among the interventions that stand out the most are the promotion of providing coping tools, work based on thought and behaviour, and behavioural, psychoanalytic and psychodynamic therapies for the management of emotions.

Limpieza de úlceras de etiología venosa. Una revisión sistemática / Cleansing venous leg ulcers. A systematic review

Objetivo: Evaluar los efectos de la limpieza, así como las soluciones y técnicas utilizadas, para el tratamiento de las úlceras de etiología venosa. Metodología: Se realizó una revisión sistemática siguiendo las últimas recomendaciones de la declaración PRISMA. La búsqueda se realizó en 3 bases de datos (PubMed, CINAHL, Cochrane), limitándose por idioma (inglés/español) y por año (de enero de 2011 a diciembre de 2021). Siguiendo el diagrama PRISMA, se realizó la depuración y evaluación de calidad de los estudios por pares, utilizando las normas de la Red EQUATOR, y seleccionando únicamente ensayos clínicos aleatorizados y revisiones sistemáticas de calidad media o alta. Resultados: Se identificaron un total de 790 artículos, de los cuales se eliminaron 58 por estar duplicados, 700 tras la revisión por título y resumen, y 25 en el cribado por texto completo. De los 7 artículos restantes, se incluyeron 5 al presentar alta calidad metodológica (cumplieron > 70% de los ítems), 3 con diseño de estudio clínico aleatorizado y 2 revisiones sistemáticas. Conclusiones: Actualmente, no se dispone de evidencias científicas sólidas que den valor a la limpieza dentro del tratamiento integral de las heridas. Se necesitan más estudios que permitan orientar a los profesionales en la toma de decisiones para realizar una práctica segura y una optimización de los recursos existentes, considerando a la persona, sus necesidades y su satisfacción en el proceso del cuidado de las lesiones (AU)

Objectives: To evaluate the effects of cleansing venous ulcers on the healing, as well as wound cleansing solutions available and wound cleansing techniques used. Methodology: A systematic review has been made following the PRISMA statement recommendations. This research used 3 databases (PubMed, CINAHL, Cochrane), filtering by language (English/Spanish) and by date (from January 2011 to December 2021). Diagram PRISMA was the base for filtering and evaluating the peer review quality, using the EQUATOR Network and selecting only the randomised clinical trial (RCT) and high or medium quality systematic reviews (SR). Results: A total of 790 articles were identified, of which 58 were eliminated as duplicates, 700 after reviewing by title and abstract, and 25 after screening by full text. Of the 7 remaining articles, 5 of them were included as they were of high methodological quality (more than 70% of the items were accomplished), 3 with an RCT design and 2 SR. Conclusions: Currently, there is no solid scientific evidence that gives credence that cleansing injuries, adds value, within the comprehensive treatment of wounds. More studies are needed, to give professionals decision-making guidelines for providing safe practices and optimising existing resources, considering the state of the patient, their needs and their comfort during the process of injury care (AU)

Atención a pacientes con úlceras y heridas en un servicio de hospitalización a domicilio: estudio retrospectivo / Care for patients with ulcers and wounds in a home hospitalization service: a retrospective study

Introducción: Las Unidades de Hospitalización a Domicilio (HAD) atienden en sus domicilios a pacientes que precisan tratamientos de intensidad hospitalaria, que incluyen medicaciones endovenosas y cuidados de alta complejidad no asumibles por otro nivel asistencial.Objetivos:Cuantificar y describir los pacientes con úlceras y heridas en la HAD del Hospital Dos de Maig (HDM) de Barcelona durante de diez años.Método:Estudio retrospectivo y análisis de los pacientes con heridas llevados por la Unidad de Hospitalización a Domicilio del Hospital Dos de Mayo de Barcelona durante el periodo 2011-202. Variables recogidas: número de pacientes; estancias media y totales; etiología (presión, vasculares, pie diabético, complicaciones de heridas quirúrgicas, lesiones traumáticas con o sin celulitis); pacientes con tratamiento endovenoso y destino al alta.Resultados:1111 pacientes (12% del total ingresaron por úlceras o heridas o complicaciones de las mismas, con una estancia media de 14 días de ingreso (rango 1-79), sumando un total de 16.254 estancias. Etiologías: 447 complicaciones de heridas quirúrgicas, 252 úlceras vasculares y 187 úlceras por presión, 95 heridas traumáticas, hematomas o picaduras con celulitis, 56 amputaciones con complicación o dehiscencia, 54 heridas en pie diabético sin intervención quirúrgica y 20 post operatorios sin complicación en la herida. El 92% de pacientes requirieron tratamiento endovenoso. El 2% de los pacientes precisó ingreso imprevisto por complicaciones.Conclusiones:Las úlceras y heridas complejas con criterio de ingreso hospitalario son un motivo frecuente de atención en una HAD, con buenos resultados al alta. (AU)

Introduction: Hospital at Home Units (HAH) attend Patients than are hospitalized in their homes to receive intravenous treatments or complex wounds healing than cannot be done for another assistant level than hospital.Objectives:Demonstrate that wounds and ulcers have been treated in Hospital at Home services of Hospital Dos de Mayo(HDM) in Barcelona and record what type of injuries have been treated last 10 years.Method:Retrospective study and analysis of all the injuries taken by Home Hospitalization Unit of HDM in Barcelona during the period 2011-2020; variables collected: number of patients, average and total stays and types of wounds according to the following classification: pressure ulcers, vascular ulcers, diabetic foot, surgical wound complications, post-surgical intervention injuries without complications and traumatic injuries with or without cellulite; patients with intravenous treatment and destination at dischargeResults:The 12% of patients in HAH 1111(9327) were entered with a diagnosis related injuries or complications thereof, 14 average stay (1-79). They add up to a total of 16.254 stays. Classifications of wounds: 56 amputations with complication or dehiscence, 95 traumatic wounds and/or bruises with cellulitis, 447 complications of surgical injuries from trauma or general surgery, 54 diabetic foot wounds without surgical intervention, 20 post operative wounds without complications in the wound, 252 vascular ulcers and 187 pressure ulcers. The 8% don’t take intravenous treatment and only 2% required unexpected admission due to complications.Conclusions:Ulcers and complex wounds with criteria for hospital admission are a frequent reason for care in an HAD, with good results at discharge. (AU)

Prevalence of falls in noninstitutionalized people aged 65-80 and associations with sex and functional tests: A multicenter observational study.

Falls have a considerable impact on the functional prognosis of older adults. The main focus of this multicenter, retrospective, observational study was to examine the prevalence of falls in Spanish people aged 65-80 years still living at home. The secondary aims included examining the overall sociodemographic and clinical variables associated with a history of falls and then stratifying these findings by sex. We also aimed to determine the differences between sexes with regard to the history and consequences of falls and to evaluate associations between fall history and functional performance tests. The 747 older adults had all participated in the otago exercise program, which is a progressive home program of strength, balance, and endurance exercises. They were recruited by nurses in 21 primary care centers in 10 Spanish provinces between September 2017 to December 2018. The participants' mean age was 72.2 (SD: 4.3) years, and 67% were women. We recorded sociodemographic and clinical variables, functional performance test results, and any falls and/or injuries in the last 12 months. We found that 32% had fallen, 36% of those had fallen more than once, and 48% had sustained injuries when they fell. The bivariate analysis showed that women had more than twice the odds of falling than men and that living alone and being obese or overweight increased the odds of a fall, although living alone was not associated with falls in the multivariable analysis. Our results could guide the development of risk-specific fall prevention programs to prevent disabilities in older people.

Use of a gamified website to increase pain neurophysiology knowledge and improve satisfaction and motivation among students studying for a degree in physiotherapy: a quasi-experimental study.

BACKGROUND: The scientific evidence highlights the difficulties that healthcare professionals experience when managing patients with chronic pain. One of the causes of this difficulty could be related to the acquired training and the lack of knowledge about the neurophysiology of pain. In the present study, we assessed the effectiveness of a gamified web platform in acquiring knowledge about pain neurophysiology and determining the satisfaction and motivation of students of the Degree in Physiotherapy at the University of Lleida. METHODS: A quasi-experimental study was carried out with a sample of 60 students who had access to a gamified web platform that included notes, videos, and clinical cases prepared by the teaching staff and was based on a previous study that included patients and healthcare professionals. RESULTS: The results show that after the intervention, there was a statistically significant increase in knowledge about the neurophysiology of pain, and the effect size was in the desired area of ​​effect. Likewise, many students considered that their motivation had increased as a result of the methodology used in the present study. CONCLUSIONS: The results support the use of this methodology to promote knowledge about the neurophysiology of pain while improving students' motivation.

Job expectations and intolerance to uncertainty of nursing students: Results from a multicentre, mixed-methods study in Spain.

AIM: To identify the job expectations and intolerance to uncertainty in final-year nursing students from three Spanish universities and evaluate the differences between them. DESIGN: Multicentre, mixed-methods study. METHODOLOGY: We included nursing students from three universities in Spain (Lleida, A Coruña and Murcia). Questionnaires were used to collect data on sociodemographic variables, job expectations and intolerance to uncertainty. In addition, in-depth personal interviews were conducted to complement quantitative data. Descriptive statistics were calculated and comparison tests (ANOVA, chi-square) were performed to analyse the differences between universities and a content analysis was carried out for qualitative data. RESULTS: The sample included 305 final-year nursing students enrolled in the 2017-2018 and 2018-2019 courses, of which 21 participants were interviewed for the qualitative phase. Findings were reported based on four main themes: Expected employment conditions, perceptions of working conditions, job uncertainty and increased chances of getting a job by continuing education after finishing the nursing degree. Results showed that 92.13% of the students were concerned about their future employment. Analysis of the in-depth interviews highlighted the uncertainty of finding a job as a nurse and the anticipated precarious employment conditions (i.e. lack of stability stemming from daily or weekly temporary contracts) in case they managed to find work. Moreover, it was shown that these perceptions affect their health, leading to situations of anxiety, stress and negativity during their time as nursing students. Overall, 65.57% considered migrating outside their town/region to increase their job opportunities and 97.0% wanted to continue their education after finishing their degree, motivated by their vocation, professional aspirations and to increase their possibilities of finding work. CONCLUSION: Nursing students find themselves in a situation of great uncertainty before finishing their studies, anticipating a future with great stress and even frustration as a result of unemployment and job insecurity. They even consider the possibility of migrating when they finish their degree to increase their job opportunities. Therefore, it is necessary to improve the recruitment process of nurses in Spain through increased security and stability and thus contribute to reducing the stress and frustration of future nurses.

Misbeliefs about non-specific low back pain and attitudes towards treatment by primary care providers in Spain: a qualitative study.

AIM: To identify misbeliefs about the origin and meaning of non-specific chronic low back pain and to examine attitudes towards treatment by primary health care providers. DESIGN: Generic qualitative study. METHODS: Ten semi-structured interviews were conducted between October and November 2016 with physicians and nurses from primary health care centres in Lleida. The interviews were transcribed and analysed using inductive thematic analysis via Atlas.ti-8 software. RESULTS: Five themes were identified: i. beliefs about the origin and meaning of chronic low back pain, ii. psychosocial aspects of pain modulators, iii. Therapeutic exercise as a treatment for chronic low back pain, iv. biomedical attitudes of primary health care providers, and v. difficulties in the clinical approach to chronic low back pain. CONCLUSION: Primary health care providers have a unifactorial view of chronic low back pain and base their approach on the biomedical model. Professionals attribute chronic low back pain to structural alterations in the lumbar spine while psychosocial factors are only recognized as pain modulators. For professionals, therapeutic exercise represents a possible solution to chronic low back pain; however, they still do not prescribe it and continue to educate on postural hygiene and recommend limiting physical and/or occupational activities, as opposed to clinical practice guidelines. These findings suggest that to improve the adherence of primary health care providers to the biopsychosocial model, it may be necessary first to modify their misbeliefs about non-specific chronic low back pain by increasing their knowledge on pain neurophysiology. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02962817 . Date of registration: 11/11/2016.

Factors Influencing Nurse Assistants' Job Satisfaction in Nursing Homes in Canada and Spain: A Comparison of Two Cross-Sectional Observational Studies.

OBJECTIVES: To access associations between job satisfaction and supervisory support as moderated by stress. METHODS: For this cross-sectional study, data collected from 591 nursing assistants in 42 nursing homes in Canada and Spain were analyzed with mixed-effects regression. RESULTS: In both countries, stress related to residents' behaviors was negatively associated with job satisfaction, and, in Canada, it moderated the positive association between supervisory support and job satisfaction. Stress related to family conflict issues moderated the positive association of supervisory support and job satisfaction differently in each location: in Canada, greater stress was associated with a weaker association between supervisory support and job satisfaction; in Spain, this was also observed but only when supervisory support was sufficiently weak. DISCUSSION: Stress was associated with lower job satisfaction and moderated the association of supervisory support and job satisfaction, reinforcing the importance of supervisors supporting nursing assistants, especially during the COVID-19 pandemic.

Cognitive behavioral therapy for insomnia (CBT-i) in patients with fibromyalgia: a systematic review and meta-analysis.

PURPOSE: We aimed to evaluate the effectiveness of CBT-i in patients with fibromyalgia in comparison with other non-pharmacological treatments. METHODS: Randomized controlled trials assessing the effects of CBT-i in adults with fibromyalgia, published in English or Spanish, were eligible. Electronic searches were performed using PubMed, Scopus, The Cochrane Library, WebOfKnowledge and Psicodoc databases in March 2021. The main outcome measures were sleep efficiency and sleep quality. Secondary outcomes included pain, depression, and anxiety. RESULTS: Of 226 studies reviewed, five were included in the meta-analysis. CBT-i compared with non-pharmacological treatments showed no significant improvements in sleep efficiency (p = 0.05; standardized mean difference (SMD) [95% CI] 0.31 [-0.00 to 0.61]). CBT-i showed significant improvements in sleep quality (p = 0.009; SMD [95% CI] - 0.53 [-0.93 to -0.13]), pain (p = 0.002; SMD [95% CI] - 0.41 [-0.67 to -0.16]), anxiety (p = 0.001; SMD [95% CI] - 0.46 [-0.74 to 0.18]) and depression (p = 0.02; SMD [95% CI] - 0.33 [-0.61 to -0.05]), compared to non-pharmacological treatments. Effect sizes ranged from small to moderate. CONCLUSIONS: CBT-i was associated with a significant improvement in sleep quality, pain, anxiety, and depression, although these results are retrieved from very few studies with only very low to low quality evidence. Trial registration: The review protocol was registered with PROSPERO (Record ID = CRD42016030161).IMPLICATIONS FOR REHABILITATIONCBT-i has been proven to improve sleep quality, pain, anxiety and depression, although with small effect sizes.Implementing hybrid CBT for pain and sleep or combining CBT and mindfulness may improve symptoms in people diagnosed with FM.This meta-analysis results highlight the need to enhance sleep management skills among people suffering from this health condition.

Cross-cultural validation and psychometric testing of the supportive supervisory scale in Spanish.

BACKGROUND: Supervisory effectiveness in long-term care facilities has been identified a key factor in staff satisfaction and quality of care. Determining its utility in Spanish speaking countries will assist with understanding different cultural and health service contexts. OBJECTIVES: To develop and psychometrically test the Supervisory Support Scale in Spanish. The Spanish version of the Supportive Supervisory Scale could be useful for cross-cultural comparisons of supervisory support, which is a key factor to improving work relationships in long-term care facilities. METHODS: Validation was carried out with 405 participants in 37 long-term care facilities. One-way analysis of variance was the test of significance performed to examine the differences among the facilities and Pearson product-moment correlations were used to assess construct validation of the scale. The mean and standard deviation were calculated for each supervisory score in each facility. Structural equation modelling was used to confirm the dimensions of the scale. RESULTS: The item-to-item correlations were positive, ranging from 0.44 to 0.78, indicating good reliability of the scale. The coefficient alpha for the total scale was 0.96. The 15-item had mean item scores which ranged from 2.89 to 3.96 (SD = 1.01-1.26). Standardised factor loadings ranged within a narrow range: 0.75-0.86 for the 'respecting uniqueness' latent variable and 0.76-0.88 for the 'being reliable' latent variable. Construct validity was demonstrated as measure was positively associated with job satisfaction (r = 0.412, p < 0.0001) and was negatively correlated with HCAs' stress and burden. CONCLUSION: The two-factor solution identified in the original scale that highlighted two key attributes of the supervisor; being reliable and respecting uniqueness, was also demonstrated in the Spanish Supervisory Support Scale as there was a moderate fit of the model. IMPLICATIONS FOR PRACTICE: The Spanish version of the Supportive Supervisory Scale could be useful for cross-cultural comparisons of supervisory support in nursing facilities which is a key factor to improving staff relationships and care in nursing facilities.

Abordaje integral de la persona con una lesión neoplásica cutánea. Plan estandarizado de cuidados de enfermería basado en la evidencia / Comprehensive approach to the person with a neoplastic skin lesion. Evidence-based standardized nursing care plan

Introducción: Las lesiones neoplásicas cutáneas generan un elevado impacto en salud por la complejidad de su abordaje sintomatológico y las complicaciones asociadas, entre las que destaca el impacto emocional que provocan tanto en el paciente como en la familia. Es muy importante detectar las necesidades del paciente y, en ausencia de un horizonte curativo, brindar bienestar y confortabilidad, mejorando así la calidad de vida. Desarrollo del plan de cuidados: Se desarrolla un plan de cuidados estandarizado basado en la mejor evidencia científica disponible para atender las necesidades de una mujer de 65 años que presenta una herida neoplásica de 6 meses de evolución en la zona pectoral. Se proponen diagnósticos enfermeros basados en la taxonomía NANDA I, criterios de resultados (NOC) y las intervenciones enfermeras (NIC), así como las actividades correspondientes basadas en la evidencia científica. Se formulan los problemas de colaboración y complicaciones potenciales. Discusión y conclusiones: La valoración holística del paciente con enfermedad neoplásica y el abordaje integral mediante un equipo multidisciplinar son factores clave para brindar al paciente y a su familia, en ausencia de objetivos curativos, la mejor calidad de vida posible (AU)

Introduction: Neoplastic skin lesions cause a huge impact on health related with the complexity of symptomatic management and the associated complications, standing out the emotional impact caused on the patient and his family. It is very important to detect the patient's needs and, in the absence of a healing horizon, provide well-being and comfort, thus improving the quality of life. It is very important to detect the patient's needs and, in the absence of a healing horizon, provide well-being and comfort, thus improving the quality of life. Development of the care plan: A standardized care plan is developed based on scientific evidence to attend the needs of a 65-year-old woman who has a 6-month evolution neoplastic wound in the chest area. Nursing diagnoses based on the NANDAI taxonomy, outcome criteria (NOC) and nursing interventions (NIC) are proposed, as well as the corresponding activities based on scientific evidence. Collaboration problems and potential complications are also formulated. Discussion and conclusions: The holistic assessment of the patient with neoplastic disease and the comprehensive approach through a multidisciplinary team are key factors to provide the patient and his or her family, in the absence of curative objectives, with the best possible quality of life (AU)

Burnout and job satisfaction among nurses in three Spanish regions.

AIMS: To determine the levels of job satisfaction and burnout syndrome and related factors among nurses in three Spanish regions. BACKGROUND: The nursing profession involves high work stress due to emotional involvement, workload and available resources. METHODS: Descriptive multicentric cross-sectional study. Sociodemographic and migration data were collected and participants completed the Job Satisfaction Questionnaire S20/23 and Maslach Burnout Inventory. The data were analysed using descriptive statistical methods using the program SPSS. RESULTS: The sample included 228 nurses (187 women and 41 men), with a mean age of 37.11 ± 10.87. Reported job satisfaction was medium to high. Overall, values were low in emotional fatigue and medium in depersonalization and personal fulfilment. In terms of migration, 21.59% of the participants had already moved to other Spanish regions or another country, while 18.58% had the intention of doing so. CONCLUSION: Nurses with a temporary contract showed a high burnout rate, and high levels of emotional fatigue, depersonalization and lack of personal fulfilment. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies are needed to improve working and contractual conditions such as enhancing teamwork, management and leadership skills in nurses; achieving internal promotion; and having higher participation in decision-making and a better balance of power between health institution managers and health professionals.