Prevalence of Cardiovascular Risk Factors in Spain: A Systematic Review.

Cardiovascular diseases are the leading cause of death in Spain, according to data from the National Institute of Statistics, with the lack of control of cardiovascular risk factors (CVRF) being the main contributing factor. The CVRFs of greatest clinical interest are high blood pressure (HBP), smoking, diabetes mellitus (DM2), overweight, obesity, hypercholesterolaemia, and sedentary lifestyle. The main objective of this review was to compare the prevalence of the different CVRFs according to population-based studies carried out in Spain. For this, a systematic review based on publications assessing CVRFs in the adult population and estimating their national prevalence was conducted. Pubmed and Dialnet databases were consulted, and the selected articles were analysed using the Critical Appraisal Skills Programme Español (CASPe) tool for cohort studies and the Berra et al. tool for cross-sectional studies. A total of 33 studies were obtained from the autonomous regions of Andalusia, the Canary Islands, Castilla-Leon, Castilla-La Mancha, Catalonia, Extremadura, the Balearic Islands, Madrid, Murcia, and Navarra. In all the population-based studies, there was a greater representation of women in the sample. The most prevalent CVRFs differed across the studies according to the autonomous region targeted, with dyslipidaemia, sedentary lifestyle, high blood pressure, hypercholesterolaemia, overweight, and obesity standing out. Numerous differences exist between the studies included in this review, such as the age range, the CVRFs analysed and their prevalence, and remarkable aspects such as the over-representation of the female sex in all cases. It can be concluded that, based on the presented results, the prevalence of CVRFs in Spain varies according to the autonomous region, the sex of the individual, and the studied age range.

Comparison between self-concept, self-perception, physical exercise and lifestyle variations from 1st to 4th grade students of nursing in Tenerife, Spain.

The aim of this study was to describe and compare the self-concept, self-perception, physical exercise, and lifestyle of students from 1st to 4th year of the Nursing university studies. Descriptive observational cross-sectional study with analytical components. The study sample consisted of 1st and 4th year undergraduate Nursing students. Five questionnaires were used: a sociodemographic survey, the RSES, the GHQ-12, the PAQ-A and the HBSC. The sample consisted of 197 subjects. 44.2% had a low self-concept and a perception of self-value that improved as they progressed academically, while confidence decreased. The PAQ-A showed that 65.5% performed moderate physical activity and 15.7% were sedentary, 58.9% reported a fair lifestyle and 20.8% of the subjects reported an inadequate diet. In the GHQ-12, the perception of self-value subscale showed an improvement with respect to the academic year. The SOC-13 data showed fair coping with traumatic situations, which worsened in the 4th year, being 88.9% in males and 84.6% in females. The study identified low self-concept, an adequate self-perception, moderate physical activity with a tendency towards sedentary lifestyles, and a fair lifestyle. It is significant that adolescents do not perceive the poor figures they obtain in self-concept, physical exercise, diet, sleep, and violence as reflected in their health. It is known that the changes adopted in adolescence will be perpetuated in adulthood. Therefore, influencing this population group, and even more so, if they are potential future health professionals, is deemed necessary.

Research, Reading, and Publication Habits of Nurses and Nursing Students Applied to Impact Journals: International Multicentre Study.

Publishing in JCR and SJR journals has become crucial for curricular development. Results from nursing investigations "compete" for publication in journals which are not specific to the field of care, affecting the academic development of these investigators. This phenomenon may lead to an ongoing adverse effect on nursing researchers and academics engaged in research in nursing care. The aim of this study was to evaluate habits regarding scientific literature consulting, the transfer of published material, and the citation of nursing investigations. A cross-sectional descriptive study by means of questionnaires was carried out, focusing on both Spanish and Portuguese nurses. The findings of the study reveal the following reasons for reading the scientific literature: that the language was understood; for learning and applying what was learnt; that the journal was of open access; for elaborating protocols and work procedures; and that the journal was indexed in scientific databases and in nursing databases. The reasons for reading, using, and publishing in journals were related to knowledge of the language and the associated usefulness of learning and applying knowledge. Creating a specific index of research publications in nursing will have a positive effect on the scientific production of caring methodologies.

International Comparison of Self-Concept, Self-Perception and Lifestyle in Adolescents: A Systematic Review.

Objectives: Adolescence is considered a vital time to address healthy attitudes and values towards an effective transition to adulthood. The aim of this review was to analyse self-concept, self-perception, physical exercise, and lifestyle in the late adolescent population. Methods: Systematic review of studies assessing the results by the Rosenberg Self-Esteem Scale, the General Health Questionnaire, the Activity Questionnaire for Adolescents, and the Health Behaviour in School-aged Children questionnaires in late adolescents. The PRISMA recommendations were followed. The CASPe quality-check system was applied, excluding articles with a score <8. Results: 1589 studies were found, and 69 articles were selected. Adolescents with high self-concept and self-perception tend to be emotionally stable, sociable, and responsible. No significant differences were found regarding self-concept and self-perception between different countries, but there were differences between men and women. Physical activity and healthy diet improve self-concept and perception of body image. Conclusion: Self-concept and self-perception are associated with responsibility, stability, and mental strength. Most healthy behaviours during adolescence are followed during adulthood. Socio-cultural level of Health Science students is a differential factor for overweight and obesity.

Questionnaires Assessing Adolescents' Self-Concept, Self-Perception, Physical Activity and Lifestyle: A Systematic Review.

INTRODUCTION: Adolescence is considered a fundamental time to promote change. During this time, young people consolidate their social and individual identity. By influencing positive changes, chronic diseases can be avoided, delayed or modified in the future. The use of valid and reliable questionnaires is an optimal resource for gathering information and thus useful for this study. OBJECTIVES: The objectives of the study were to: (1). identify the questionnaires that assess self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; (2). analyse the psychometric measures of the questionnaires used to assess the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; and (3). determine which questionnaires are the most reliable and valid for assessing the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents. METHOD: A bibliographic search was carried out in the following databases: Virtual Health Library, Cochrane, Medline, Cuiden, Scielo, Dialnet, PubMed and Ministry of Health, Consumption and Social Welfare following the PICO method. The recommendations of the PRISMA statement were followed. RESULTS: A total of 71 scientific articles were collected. Within the self-perception/self-concept questionnaires, the Rosenberg Self-Esteem Scale stands out for being an optimal and widely used resource in adolescents. Regarding the questionnaires that evaluate self-perception, the General Health Questionnaire is the most used; it is used in numerous national health surveys in different countries. The Physical Activity Questionnaire for Adolescents ranks first with respect to the rest of the tools. It is a widely used resource internationally and provides enough information on the physical activity carried out by the subject in a given week. Although there are several questionnaires that measure lifestyle, the Health Behavior in School-aged Children instrument was selected. This instrument is at the European level and involves the collaboration of 48 countries and allows us to compare the lifestyle habits of adolescents from different countries. DISCUSSION: The questionnaire that stands out in the assessment of self-esteem/self-concept is the Rosenberg Self-Esteem Scale. The General Health Questionnaire has been selected as the best tool for assessing self-perception. To measure physical exercise, the Physical Activity Questionnaire for Adolescents is identified as the ideal instrument because it is widely used and can be completed quickly. Regarding lifestyle, the Health Behavior in School aged Children is shown to be an effective instrument in assessing lifestyle.

Prevention and Treatment of Phlebitis Secondary to the Insertion of a Peripheral Venous Catheter: A Scoping Review from a Nursing Perspective.

The objective of this work was to identify available evidence on nursing interventions for the prevention and treatment of phlebitis secondary to the insertion of a peripheral venous catheter. For this, a scoping systematic review was carried out following the guidelines in the PRISMA declaration of documents published between January 2015 and December 2020. The search took place between December 2020 and January 2021. Scielo, Pubmed, Medline, Scopus, WOS, CINHAL, LILACS, and Dialnet databases were consulted, and CASPe, AGREE, and HICPAC tools were used for the critical reading. A total of 52 studies were included to analyze nursing interventions for treatment and prevention. Nursing interventions to prevent phlebitis and ensure a proper catheter use included those related to the maintenance of intravenous therapy, asepsis, and choosing the dressing. With regard to the nursing interventions to treat phlebitis, these were focused on vigilance and caring and also on the use of medical treatment protocols. For the prevention of phlebitis, the highest rated evidence regarding asepsis include the topical use of >0.5% chlorhexidine preparation with 70% alcohol or 2% aqueous chlorhexidine, a proper hygienic hand washing, and the use clean gloves to handle connections and devices. Actions that promote the efficacy and safety of intravenous therapy include maintenance of venous access, infusion volume control, verification of signs of phlebitis during saline solution and medication administration, and constant monitoring. It is recommended to remove any catheter that is not essential. Once discharged from hospital, it will be necessary to warn the patient about signs of phlebitis after PVC removal.

Assessment of Cardiovascular Risk Factors in Young Adults through the Nursing Diagnosis: A Cross-Sectional Study among International University Students.

Four out of five deaths from cardiovascular disease are due to heart attacks and strokes in low- and middle-income countries. Early identification of risk factors in exposed individuals will help to develop interventions that may eliminate and/or reduce these risks and prevent the development of cardiovascular diseases. So, it is necessary to investigate the risk of impaired cardiovascular function in university students due to the increase in some risk factors and cardiovascular events in young adults, and to describe its epidemiology among international university students. For this, an observational cross-sectional study through interviews is designed. The clinical validity was addressed following the Fehring model. In addition, anthropometric data and results of laboratory tests were collected. The nursing diagnosis "Risk of impaired cardiovascular function" showed clinical validity, high sensitivity and specificity, as well as predictive values. Fehring ratio values were above 0.79 and Kappa Index above 0.72. The study showed a high frequency of this nursing diagnosis among university students, especially in students of Brazilian nationality. The main risks of impaired cardiovascular function found in 86.8% of students were: family history of cardiovascular disease, sedentary lifestyle, pharmacological agent, dyslipidemia, and insufficient knowledge. The most prevalent risk factors of the nursing diagnosis in the studied population were related to insufficient knowledge of modifiable health habits, such as sedentary lifestyle. The information provided is expected to serve as the basis for the planning and implementation of health actions aimed at reducing modifiable risk factors for cardiovascular disease.

Non-Pharmacological Interventions towards Preventing the Triad Osteoporosis-Falls Risk-Hip Fracture, in Population Older than 65. Scoping Review.

Osteoporosis leads to increased risk of falls, and thus an increase in fractures, highlighting here hip fractures, that result in high mortality, functional disability, and high medical expenditure. The aim is to summarise the available evidence on effective non-pharmacological interventions to prevent the triad osteoporosis/falls risk/hip fracture. A scoping review was conducted consulting the Scientific Electronic Library Online (Scielo), National Institute for Health and Care Excellence (NICE), Cumulative Index to Nursing & Allied Health Literature (CINAHL) y PubMed.databases. Inclusion criteria were articles published between 2013 and 2019, in Spanish or English. In addition, publications on a population over 65 years of age covering non-pharmacological interventions aimed at hip fracture prevention for both institutionalised patients in long-stay health centres or hospitals, and patients cared for at home, both dependent and non-dependent, were included. Sixty-six articles were selected and 13 non-pharmacological interventions were identified according to the Nursing Interventions Classification taxonomy, aimed at preventing osteoporosis, falls, and hip fracture. The figures regarding the affected population according to the studies are alarming, reflecting the importance of preventing the triad osteoporosis, falls risk, and hip fracture among the population over 65 years of age. The most effective interventions were focused on increasing Bone Mineral Density through diet, exercise, and falls prevention. As a conclusion, primary prevention should be applied to the entire adult population, with special emphasis on people with osteoporosis.

Relationship between the self-concept and physical activity towards the prevention of chronic illnesses.

The objective of this work is to verify the relationship between the self-perception of health and the self-concept of physical appearance in adolescents, in order to check their influence on the physical activity they perform with the aim of preventing chronic illnesses. To this end, an observational, cross-sectional descriptive study with analytical components was carried out. Opportunistic activity, in which young people, between the ages of 16 and 22, were recruited from 5 secondary schools of the municipality of San Cristóbal de La Laguna, on the island of Tenerife (Spain). Data were collected through the General Health Questionnaire, the Rosemberg Self-esteem Scale, and the physical exercise habits test physical activity questionnaire for adolescents-A, revealing the first 2 that most percentage of responses were grouped on the positive side. The physical exercise habits test physical activity questionnaire for adolescents-A described that the most commonly performed physical activity was walking (75%).

Methodology Proposal for the Management of Nursing Competencies towards a Strategic Training. A Theoretical Analysis.

Professional and academic legislation relating to nursing skills reflects conceptual and professional developments. In this sense, conceptual and methodological analyses are required to describe the concept of nursing competencies, the individual or group self-perception of competencies, to identify training needs, and to specify the nursing professional profile within the health organization. A sequential mixed methodology was proposed combining qualitative and quantitative approaches. The qualitative methodology involves the Focus Group and the Delphi technique. The quantitative methodology involves surveying and analyzing self-perception (descriptive and analytical in relation to personal and professional variables and levels of excellence). The methodology was piloted among primary care nurses. Competencies were analyzed and distributed across the training program. The combination of qualitative and quantitative methods showed that obtaining a deep insight into the nurses' competencies would be a good process. This proposal is applicable as an approach to global nursing competencies or to a particular specialty.

Influence of Workload on Primary Care Nurses' Health and Burnout, Patients' Safety, and Quality of Care: Integrative Review.

The increase in the demand for care has not led to a proportional growth in the number of primary care nurses. This imbalance is related to the decrease in the quality of care and patient safety, and also to the impact on the health of the professional group. The objective of this study is to identify relationships between overload, illness of the nurse, professional exhaustion, quality and safety in the services; and differentiate study methods and instruments for measuring the phenomena. For this, a comprehensive and structured review of the literature following the scoping review model is performed. The studies on which this review is based allow us to recognize that the scope of this phenomenon is global. The review includes 45 studies that show that there is a high pressure of care for Primary Care nursing, who suffer many alterations of their health due to burnout syndrome and that this situation contributes to the impairment of the quality of care and patient safety. However, for future lines, new evidence is needed to determine the degree of relationship between the high pressure suffered by Primary Care nursing and the attainment of health goals for professionals and patients.

VIH+/SIDA de la mortalidad a la cronicidad: a propósito de un caso clínico / HIV+/AIDS. From mortality to chronicity: a purpose of a clinical case

El presente artículo describe un caso clínico de un paciente atendido en la consulta de atención primaria por presentar afrontamiento defensivo frente a su enfermedad, causado por una infección de VIH+ en estadio de SIDA. Se realiza seguimiento del usuario en la consulta de enfermera de familia, se desarrolla el plan de cuidados siguiendo el modelo AREA (Análisis del Resultado del Estado Actual) para la priorización de diagnósticos, teniendo en cuenta las preferencias del propio usuario. Se siguen las directrices CARE para la elaboración del caso

The present article describes a clinical case of a patient taken care of in the primary care consultation who pre-sent defensive facing against his disease, caused by an infection of VIH+ in stage of SIDA. The user is followed up in the Family Nursing consultation, the care plan is developed following the AREA model for the prioritization of diagnoses, taking into account the preferences of the user. The CARE guidelines are followed for the preparation of the case

[Why do not pregnant women want to get vaccinated against the flu? A scoping review]. / ¿Por qué las embarazadas no se vacunan de la gripe? Una scoping review.

BACKGROUND: Pregnant women and newborns are at increased risk of complications from seasonal flu. Vaccination is effective and safe but there is low adherence in pregnant women. Objective: to identify the reasons that lead pregnant women not to be vaccinated against seasonal influenza. METHODS: Scoping Review in which we used as search terms. DeCS "Pregnant Women", "Vaccines against Influenza". MeSH "Pregnant Women", "Influenza Vaccines", united by AND. Databases: Medline, VHL, Scielo, CUIDEN. The PRISMA model and the Joanna Briggs Institute tool were used to sort the search and synthesize the results. Motives were identified in each study and ordered according to frequency of appearance. RESULTS: 16 studies were found that identify 15 reasons for not being vaccinated. The most frequent were: Concern about side effects and / or vaccine safety and lack of information / recommendation from health professionals. CONCLUSIONS: The decision of not to be vaccinated seems to be multifactorial. In some cases, health professionals can play a fundamental role in adherence. These results could be useful for future research.

OBJETIVO: Las mujeres embarazadas, los neonatos y los recién nacidos tienen mayor riesgo de complicaciones por la gripe estacional. La vacunación es efectiva y segura, pero hay baja adherencia en embarazadas. El objetivo de este trabajo fue identificar los motivos que llevan a las embarazadas a no vacunarse contra la gripe estacional. METODOS: Scoping Review, en la que su utilizaron como términos de búsqueda: DeCS "Mujeres Embarazadas", "Vacunas contra la Influenza". MeSH "Pregnant Women", "Influenza Vaccines". Las bases de datos en las que se realizaron las búsquedas fueron: Medline, BVS, Scielo, CUIDEN. Se utilizó el modelo PRISMA y herramienta del Instituto Joanna Briggs para ordenar la búsqueda y sintetizar los resultados. Se identificaron los motivos de no vacunación en cada estudio y se ordenaron según su frecuencia de aparición. RESULTADOS: 16 estudios que identifican 15 motivos para no vacunarse. Los más frecuentes: Preocupación por los efectos secundarios y/o seguridad de la vacuna y falta de información/recomendación por parte del personal sanitario. CONCLUSIONES: La decisión para no vacunarse parece ser multifactorial. En algunos motivos hallados el papel del profesional puede jugar un papel fundamental en la adherencia. Estos resultados podrían ser útiles para futuras investigaciones y pueden servir de ejemplo para discusiones internas entre los profesionales sanitarios con el objetivo de promover la vacunación antigripal en embarazadas.

Impact of the Case Management Model through Community Liaison Nurses.

The objective of the present study is to assess the model's impact on patients and their families in terms of outcomes and the efficiency results for the health system in Tenerife, Canary Islands, selecting a period of eight years from the time interval 2002-2018. The employed indicators were collected on a monthly basis. They referred to home care and its impact on clinical outcomes and on the use of resources. The comparison between the indicators' tendencies with and without the liaison nurse model was done with the F-test by Snedecor. All these tests are bilateral, with a level of significance of p < 0.05. In those areas with community liaison nurse (CLN), improvements have been found in indicators that describe: (1) the management of the clinical status of patients, (2) the efficiency of the use of resources, and (3) the quality and compliance with the process that also includes home visits and social risk detection and management. It can be said that in the basic areas of primary health care where the work of the CLN develops there are improvements in the management of the patients' clinical condition as well as in the quality and efficiency of care.

Abordaje de la obesidad con framingham bajo y findrisk alto / Approach to obesity with low framingham and high findrisk

Se exponen dos casos de mujeres con obesidad mórbida que quieren bajar de peso, atendidas en consulta de Enfermería de Familia, desde un abordaje biopsicosocial en el con-texto de la entrevista motivacional. Ambos casos presentan un riesgo cardiovascular bajo (Framingham) y un riesgo de padecer diabetes mellitus tipo 2 elevado (Findrisk), por lo que la incorporación de hábitos de vida saludables y la disminución del peso se convierten en objetivos fundamentales para evitar su aparición. Tras la valoración por patrones funcionales de salud de Marjory Gordo identificación y priorización de los diagnósticos de enfermería siguiendo el modelo AREA, se elaboraron los planes de cuidados utilizando el lenguaje estandarizado de enfermería NANDA-NOC-NIC. Aunque el abordaje de la obesidad fue similar (entrevista motivacional, aumento de la actividad física, manejo del sueño y emociones, alimentación saludable y disminución de la ingesta energética) se individualizó para cada caso. Se obtiene una evolución diferente en casa ocasión, probablemente debido al diferente grado de motivación y a los diferentes recursos de afronta-miento identificados en cada una de las pacientes

We present two cases of women with morbid obesity who want to lose weight, assisted in the Family Nurse consultation, from a biopsychosocial approach in the context of the motivational interview. Both cases have a low cardiovascular risk (Framingham) and high risk of developing diabetes mellitus type 2 (Findrisk), so the incorporation of healthy lifestyle habits and weight reduction become fundamental objectives to prevent their appearance. After an assessment using Marjory Gordon’s functional health patterns, nursing diagnoses were identified and prioritized based on the AREA model. By last, care plans were elaborated using the standardized nursing language NANDA-NOC-NIC. Although the approach to obesity was similar (motivational interview, increase in physical activity, management of sleep and emotions, healthy eating and decrease in energy intake) was individualized for each case; a different evolution was obtained, probably due to the different degree of motivation and the different coping resources identified in each patient

Benefits of Advanced Practice Nursing for Its Expansion in the Spanish Context.

The objective of this study is to describe the impact of the Advanced Practice Nurse role on the clinical practice and patient benefit, as well as to provide reasons for its implementation and expansion in Spain. Through the scoping review method, this study has been carried out according to five thematic blocks: life quality, cost-effectiveness, health results, satisfaction, and accessibility. The critical appraisal was performed with the Critical Appraisal Skills Programme (CASP) tool and the level of evidence and strength of recommendation have been analysed following the Oxford Centre for Evidence-Based Medicine (OCEBM) system. The results show that it is possible to formally implement advanced practice nursing in the Spanish context. The analysis of the Spanish regulatory framework reveals that the generalisation of the Case Manager Nurse is the starting point for the development of advanced practice nursing in Spain. This implementation would have a positive impact on patients in terms of health results, satisfaction, and life quality, given that the advanced practice nurse performs a more effective follow-up of chronic patients with a better control of risk factors, symptoms and health outcomes, and an earlier detection of complications. Considering these results, regional governments should promote the role of the Advanced Practice Nurse to contribute to its expansion.

Cardiovascular risk assessment tools: A scoping review.

OBJECTIVES: The objective of this review was to describe cardiovascular risk (CVR) assessment methods and to identify evidence-based practice recommendations when dealing with population at risk of developing cardiovascular diseases. REVIEW METHODS AND DATA SOURCES: A literature review following the Arksey and O'Malley scoping review methodology was conducted. By using appropriate key terms, literature searches were conducted in PubMed, SciELO, Cochrane Library, Dialnet, ENFISPO, Medigraphic, ScienceDirect, Cuiden, and Lilacs databases. A complementary search on websites related to the area of interest was conducted. Articles published in English or Spanish in peer-review journals between 2010 and 2017. Critical appraisal for methodological quality was conducted. Data was extracted using ad-hoc tables and qualitatively synthesized. RESULTS: After eliminating duplicates, 55325 records remained, and 1432 records were selected for screening. Out of these, 88 full-text articles were selected for eligibility criteria, and finally, 67 studies were selected for this review, and 25 studies were selected for evidence synthesis. In total, 23 CVR assessment tools have been identified, pioneered by the Framingham study. Qualitative findings were grouped into four thematic areas: assessment tools and scores, CVR indicators, comparative models, and evidence-based recommendations. CONCLUSIONS: It is necessary to adapt the instruments to the epidemiological reality of the population. The most appropriate way to estimate CVR is to choose the assessment tool that best suits individual conditions, accompanied by a comprehensive assessment of the patient. More research is required to determine a single, adequate, and reliable tool.

¿Por qué las embarazadas no se vacunan de la gripe? / Why do not pregnant women want to get vaccinated against the flu? A scoping review

OBJETIVO: Las mujeres embarazadas, los neonatos y los recién nacidos tienen mayor riesgo de complicaciones por la gripe estacional. La vacunación es efectiva y segura, pero hay baja adherencia en embarazadas. El objetivo de este trabajo fue identificar los motivos que llevan a las embarazadas a no vacunarse contra la gripe estacional. MÉTODOS: Scoping Review, en la que su utilizaron como términos de búsqueda: DeCS "Mujeres Embarazadas", "Vacunas contra la Influenza". MeSH "Pregnant Women", "Influenza Vaccines". Las bases de datos en las que se realizaron las búsquedas fueron: Medline, BVS, Scielo, CUIDEN. Se utilizó el modelo PRISMA y herramienta del Instituto Joanna Briggs para ordenar la búsqueda y sintetizar los resultados. Se identificaron los motivos de no vacunación en cada estudio y se ordenaron según su frecuencia de aparición. RESULTADOS: 16 estudios que identifican 15 motivos para no vacunarse. Los más frecuentes: Preocupación por los efectos secundarios y/o seguridad de la vacuna y falta de información/recomendación por parte del personal sanitario. CONCLUSIONES: La decisión para no vacunarse parece ser multifactorial. En algunos motivos hallados el papel del profesional puede jugar un papel fundamental en la adherencia. Estos resultados podrían ser útiles para futuras investigaciones y pueden servir de ejemplo para discusiones internas entre los profesionales sanitarios con el objetivo de promover la vacunación antigripal en embarazadas

BACKGROUND: Pregnant women and newborns are at increased risk of complications from seasonal flu. Vaccination is effective and safe but there is low adherence in pregnant women. Objective: to identify the reasons that lead pregnant women not to be vaccinated against seasonal influenza. METHODS: Scoping Review in which we used as search terms. DeCS "Pregnant Women", "Vaccines against Influenza". MeSH "Pregnant Women", "Influenza Vaccines", united by AND. Databases: Medline, VHL, Scielo, CUIDEN. The PRISMA model and the Joanna Briggs Institute tool were used to sort the search and synthesize the results. Motives were identified in each study and ordered according to frequency of appearance. RESULTS: 16 studies were found that identify 15 reasons for not being vaccinated. The most frequent were: Concern about side effects and / or vaccine safety and lack of information / recommendation from health professionals. CONCLUSIONS: The decision of not to be vaccinated seems to be multifactorial. In some cases, health professionals can play a fundamental role in adherence. These results could be useful for future research

Gestión de la demanda por enfermeras en Atención Primaria / Management of nursing demand in primary care

Introducción: Existe un problema de sobrecarga asistencial en el ámbito de la Atención Primaria (AP), al tiempo que las enfermeras han aumentado progresivamente sus competencias para el abordaje de problemas habituales en AP, de modo que es ya una realidad la enfermera que gestiona la demanda. Por ello, el objetivo de esta revisión es identificar la mejor evidencia disponible sobre la gestión enfermera de la demanda de pacientes no programados en AP y su eficacia, y aportar recomendaciones para la mejora de los servicios de AP. Métodos: Scoping review. Forma de síntesis de la evidencia disponible en un área determinada. Su objetivo es realizar un mapa del conocimiento respondiendo a la pregunta: ¿Qué alcance tiene el conocimiento en este campo?. Resultados: Las enfermeras en el ámbito de la AP pueden abordar y resolver la mayoría de los problemas de carácter leve, de manera autónoma y eficiente, utilizando guías o protocolos de intervenciones junto a una adecuada formación. Conclusiones: Los resultados representan una oportunidad para el sistema sanitario por la necesidad de abordar la cuestión de la presión asistencial, y sitúan a la enfermera como una puerta de entrada eficaz y eficiente ante los problemas agudos de pacientes en AP

Introduction: There is a problem of health care overload in Primary Care (PA), due to the increase in demand by the population and a reduced workforce of health workers. Simultaneously, nursing professionals have increased their competencies to deal with common PA problems, and the nurse who manages the demand is already a reality. Therefore, the objective of this review is to identify the best available evidence on the nurse management of the demand for non-programmed patients and its effectiveness, and, together, to elaborate recommendations for the improvement of PA services. Method: Scoping review. Form of synthesis of the available evidence in a certain area. Its objective is to map knowledge by answering the question: What is the scope of knowledge in this field?. Results: The main result of this study is that nurses in the field of PA can address and solve most problems of a mild nature, autonomously and efficiently using interventions guidelines or protocols together with training. Conclusions: The results represent an opportunity for the health system because of the need to address the question of the pressure on PA. The recommendation to investigate this issue is of great importance since nursing is shown as an effective and efficient gateway to the acute problems of PA patients

Enfermería familiar y comunitaria: ¿Qué enseñar? ¿Qué sabemos y hacemos? ¿Qué sabemos y no hacemos?: Un análisis desde la perspectiva del desarrollo de competencias / Community and family health nursing: what to teach? What do we know and do? What do we know and not do? an analysis from the perspective of competency development

Las competencias en la especialidad de enfermería familiar y comunitaria las establece la ley, tanto en términos de formación como del ejercicio de la especialidad. Son de adquisición progresiva y plantean tres cuestiones: qué debemos enseñar cada año, qué no podemos enseñar porque no lo sabemos y qué no podemos enseñar porque no lo hacemos. Se describe una línea de investigación con metodología mixta que responde a dos objetivos: facilitar el aprendizaje de residentes y una guía a los tutores; y, de otra parte, conocer la autopercepción de conocimientos y necesidades de formación de las enfermeras de Atención Primaria en sus perfiles y lugares de trabajo. Se diferencian estilos de práctica enfermera entre práctica técnica, controladora y metodóloga. Esta propuesta se basa en cruzar el proceso de resolución de problemas con la actitud resolutiva de la enfermera y su requerimiento de información para documentar el proceso. El número de especialistas es importante y va a aumentar a corto plazo. Son un recurso humano con un alto nivel de competencia avalado por la ley y disponible para desplegar un arsenal de competencias que mejorarán sin duda la calidad del sistema sanitario, público y privado. Sin embargo, en la actualidad, no se les utiliza como prestadores de servicios avanzados. La ley abre la posibilidad de seguir avanzando en la acreditación de competencias y para ello se dispone de dos caminos aún inexplorados por las enfermeras. Uno dentro de la especialidad, las áreas de capacitación, y otro fuera, los diplomas de acreditación y acreditación avanzada. El enfoque de competencias abre oportunidades para todo el sistema: pacientes, usuarios y cuidadoras; enfermeras y otros profesionales de la salud. El reto es llevar a la práctica las ventajas que ofrece la especialidad con la visión de enfermería de práctica avanzada, en la gestión clínica, la mesogestión y la política sanitaria. Tal vez, la participación de las enfermeras en la política sanitaria marcará el camino para ello

In terms of training and practice, the competencies required for community and family health nursing are established by law. They are acquired progressively and raise three educative issues: what should we teach each year; what we cannot teach because we do not know; and what we cannot teach because we do not do. The following article describes a line of research based on a mixed methodology that responds to two objectives: to facilitate residents' learning process and to provide a guide for tutors; while at the same time to learn about the self-perception of knowledge and training needs of primary healthcare nurses, consistent with their profiles and workplaces. Nursing practice styles can be classified as technical, controlling and methodological. This proposal aims at crossing nurses' problem-solving process and problem-solving attitude, together with their need for information in order to document the nursing process. The number of nursing specialists is significant and will increase in the short term. These specialists are a human resource with a high level of competency guaranteed by law, and are readily available to deploy an arsenal of skills that will undoubtedly improve the quality of the public and private healthcare system. Unfortunately, they are currently not being harnessed as advanced service providers. The current law opens up the possibility for further progress in the accreditation of competencies, opening two paths that still remain unexplored. One relies within the specialty, in the area of training; and the other one can be found outside, among the accreditation diplomas and advanced accreditation. The competency-approach opens up opportunities for the entire healthcare system: patients, users and caretakers, together with nurses and other health professionals. The challenge is to put into practice the advantages offered by nursing specialties, consistent with the vision of advanced practice nursing in clinical management, meso-management and health policy. Perhaps the involvement of nurses in health policy will pave the way for the desired outcome