A Qualitative Exploration of the Perceptions of Women Living with Pelvic Floor Disorders and Factors Related to Quality of Life.

Background: Pelvic floor dysfunction encompasses conditions like urinary and fecal incontinence, pelvic organ prolapse, and pelvic pain, significantly affecting women's quality of life. Despite its prevalence, few studies have adopted a qualitative approach to understanding women's perceptions and emotions regarding these issues. This study aims to delve into how women with pelvic floor disorders perceive their condition and its impact on their daily lives. Methods: We analyzed qualitative data from interviews with 160 women suffering from pelvic floor dysfunctions. Using inductive qualitative content analysis, we systematically examined the data to identify variations, differences, and similarities. Results: The analysis revealed four primary themes in the women's narratives: "Physical Impacts", "Emotional and Psychological Impacts", "Social and Relational Impacts", and "Sexual Health Impacts", along with 12 subthemes. The findings predominantly highlight how pelvic floor dysfunctions detrimentally affect women's quality of life and emotional well-being, instilling fear and insecurity in daily activities, compounded by sleep disturbances and sexual dysfunction. Conclusions: Women living with pelvic floor dysfunction face multifaceted challenges that adversely affect various aspects of their lives, diminishing their overall quality of life. This includes notable impacts on sleep, physical, and sexual activities. However, not all affected women report these issues, often due to fear of stigma, choosing instead to conceal their struggles in an effort to maintain an appearance of normalcy.

Professional approach to the care of women who have suffered a perinatal loss.

To understand the experience, training, and needs of midwives in their approach to perinatal grief. A descriptive cross-sectional study was carried out using an online questionnaire with 26 questions related to institutional management and individual clinical practices in the care of a perinatal loss was developed by a team of midwives from the Hospital "La Mancha-Centro" of Alcazar de San Juan (Ciudad Real). Strobe checklist was followed. A total of 267 midwives participated. A total of 92.1% (246) of the centers had specific protocols for action, but each professional applied their own criteria. The presence of a perinatal psychology team was nonexistent according to 88% (235) of those surveyed. Regarding their training and professional experience, 16.5% (44) of the midwives had never received training. Only 4.1% (11) of the midwives felt very prepared to care for women with a perinatal loss. Among the factors associated with greater application of recommended practices in the face of perinatal death by midwives were being a woman, having prior training on care during perinatal death, and a greater perception of preparation (p < 0.05). The perception of lack of preparation on the part of midwives in the accompaniment of these families was high.

Osteocalcin associates with bone mineral density and VDR gene polymorphisms in type 1 and type 2 diabetes.

Objectives: Bone metabolism is impaired in diabetes mellitus (DM). Our objective is to evaluate the association of bone turnover markers (BTM) and vitamin D receptor (VDR) gene polymorphisms with bone mineral density (BMD) in DM type 1 (T1D) and DM type 2 (T2D). Methods: A total of 165 patients (53 T1D and 112 T2D) were enrolled. BMD was measured by dual-energy X-ray absorptiometry (DEXA). Plasma osteocalcin (OC), beta-CrossLaps (ß-CTX) and N-amino terminal propeptide of type I collagen (P1NP) and VDR gene polymorphisms were evaluated. Results: Participants were 53 T1D (41 years [31-48]) and 112 T2D (60 years [51-66]). BMD were not statistically different between the groups. OC (p<0.001) and P1NP levels (p<0.001) were higher in patients with T1D. The areas under the curve for the prediction of bone pathology were 0.732 (p=0.038) for OC in T1D and 0.697 (p=0.007) in T2D. A significant association was found between lower lumbar BMD and the A allele of BsmI (p=0.03), the A allele of ApaI (p=0.04) and the allele C of the Taql (p=0.046). Also, a significant correlation was found with higher OC levels and the G allele of BsmI (p=0.044), C allele of ApaI (p=0.011), T allele of Taql (p=0.006) and with C allele of FokI (p=0.004). Conclusions: The high negative predictive value of the cut-off point for OC suggests that could be useful in excluding the risk suffering bone loss, allowing offering a personalized clinical approach to prevent this pathology.

Influence of Pelvic Floor Disorders on Sleep Quality in Women.

Pelvic floor disorders, the impact of their symptoms, and their association with sleep quality and sleep disorders is a little studied area. The aim of this study was to determine if an association exists between pelvic floor disorders in women and sleep disorders. An observational study was conducted among women in Spain during 2021 and 2022. A self-developed questionnaire was used to collect sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems. A validated questionnaire, the Pittsburgh Sleep Quality Index (PSQI), was used to assess the quality of sleep. The presence and impact of pelvic floor problems was assessed with the Pelvic Floor Distress Inventory (PFDI-20). Odds ratios (OR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals were calculated using logistic regression. A total of 1396 women participated in the study. The total PSQI indicated that 75.36% (1052) of women have altered general sleep quality. Women with pelvic floor disorders have a higher probability of developing sleep alterations (aOR: 1.32; 95% CI: 1.22-1.42; for every 20 points). A high BMI (aOR: 1.04; 95% CI: 1.01-1.07; for each point) and the presence of musculoskeletal disorders (aOR: 3.14; 95% CI: 1.20-8.27) are also associated with sleep quality in women. Women with pelvic floor disorders are more likely to develop sleep disorders, probably due to all the discomfort they entail.

Variability of clinical practice in the care of the second stage of labor among midwives in Spain.

BACKGROUND: There are recommendations based on scientific evidence on care in the second stage of labor, but it is not known to what degree the professionals comply with these recommendations. OBJECTIVE: The aim of this study is to examine the variability in clinical practices among midwives during the second stage of labor, including positions, mobility, practices, and the maximum time allowed before initiating active pushing, and to assess their adherence to clinical practice guidelines. METHODS: A cross-sectional observational study. A self-designed questionnaire was developed and distributed online through scientific societies. The main variables studied were professional and work environment characteristics, maternal positions and mobility, practices during this stage, maximum time to start active pushing and duration of the second stage of labor. Descriptive statistics were calculated using SPSS 24.0. RESULTS: Regarding the woman's position during childbirth, 80.3% (245) of midwives frequently or always allow the woman to choose her birthing position. Furthermore, 44.6% (136) of professionals prefer using side-lying positions for the mother. Regarding drinking fluids during childbirth, 51.1% (156) of midwives allowed the woman to drink the amount of liquids she wanted, whereas 11.1% (34) said that they would allow them to do so however, this was against the protocol of their hospital. When inquiring about the Kristeller maneuver, it was reported to be excessively performed in 35.1% (107) of cases for fetal bradycardia, 33.1% (101) for maternal exhaustion, and 38.4% (117) to avoid instrumental birth. Finally, a great variability was observed in the time criteria used for the initiation of active pushing and the maximum duration of the second stage of labor. CONCLUSIONS: Certain practices, such as the Kristeller maneuver, are overused among midwives, with great variability in the use of certain procedures, the waiting times to initiate pushing and completion of the second stage of labor. Further training and awareness campaigns are needed for professionals to apply evidence-based care.

Evaluation of Knowledge and Competencies in Sexual and Reproductive Health Care Using an Escape Room with Scenario Simulations.

To determine the usefulness of combining two methodologies (OSCE and escape room) in a scenario simulation to evaluate a subject, and determine the evaluation of the students of this experience. An observational cross-sectional study was carried out with students enrolled in a sexual and reproductive health-care course as a part of their nursing degree. The students had to solve four clinical cases based on the contents of the teaching practices of the subject by solving clues that led them to carry out procedures and techniques and provide care in scenario simulators. Students evaluated the experience using the GAMEX (Gameful Experience in Gamification) scale. Mean differences were estimated with their respective 95% confidence intervals. A total of 124 students participated. Of these, 63.7% (79) solved the clinical cases with their knowledge and skills. Most (80.6%, 100) students stated that they completely remembered and applied the knowledge of the topic during the game. Almost all (98.4%, 122) would recommend this experience. The dimensions with the best rating on the GAMEX scale were "fun", with an average score of 4.7 points (0.49), followed by "critical thinking", with 4.2 (0.59). Women presented statistically better scores than men (mean difference: 1.58; 95% CI: 0.55, 2.61). The OSCE combined with an escape room using scenario simulations may be a useful tool to evaluate the subject. In addition, the students were satisfied, had fun, and recommended the experience. This study was not registered.

Factors related to a disturbance in the mother-child bond and attachment.

INTRODUCTION: Establishing an adequate bond and attachment between a mother and child is essential for preventing pathologies and developing this relationship in the future. PURPOSE: To identify the factors related to a disturbance of the mother-child bond or attachment. METHODS: A cross-sectional descriptive study was carried out with women with a biological child between 6 weeks and 18 months of age. The Mother-Child Bond-Attachment Questionnaire (VAMF, for its name in Spanish) was administered to measure the bond and postnatal attachment together with a questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn. RESULTS: 1114 women participated. The multivariate analysis showed that skin-to-skin contact (aOR = 0.58; 95% CI: 0.37, 0.90) and breastfeeding (aOR = 0.55; 95% IC: 0.35, 0.86) reduce the probability of presenting a bond disturbance. Anxiety during pregnancy, childbirth, and the puerperium (aOR = 3.95; 95% CI: 2.57, 6.05) and postpartum complications (aOR = 1.60; 95% CI: 1.03, 2.48) increase the chance of having a bond disturbance. Skin-to-skin contact (aOR = 0.61; 95% CI: 0.38, 1.00), breastfeeding (aOR = 0.47; 95% CI: 0.27, 0.80,) and an older age of the infant (months) (aOR = 0.77: 95% CI: 0.72, 0.82) reduces the probability of presenting an attachment disturbance. CONCLUSIONS: Skin-to-skin contact and breastfeeding are associated with a lower probability of impaired bonding and attachment. Anxiety states during pregnancy, childbirth, and the puerperium, and complications after childbirth increase the probability of developing a bond disorder. The older the age of the infant, the lower the frequency of having an impaired attachment. IMPLICATIONS TO PRACTICE: Identifying the factors associated with the establishment of the mother-child bond and attachment is essential for the development of prevention strategies and early identification of cases that may present alterations and avoid their consequences on the health of the mother and child.

Influence of pelvic floor disorders on sexuality in women.

OBJECTIVE: To determine the association between different pelvic floor disorders and the presence of sexual dysfunction in women. METHOD: An observational study of non-pregnant women was carried out in Spain in 2021 and 2022. To assess the presence of pelvic floor problems, the Pelvic Floor Distress Inventory (PFDI-20) was used, consisting of the subscales Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6; prolapse symptoms), Colorectal-Anal Distress Inventory (CRADI-8; colorectal symptoms), and Urinary Distress Inventory-6 (UDI-6; urinary symptoms). The validated tool, Female Sexual Function (FSF), was used to evaluate female sexual function. RESULTS: In total, 1008 women participated. Of these, 288 (28.6%) had some type of sexual dysfunction. Regarding symptoms, 52 (5.2%) stated that they do not reach orgasm and 172 (17.1%) said they had never or occasionally felt sexual desire in the last month. Women with sexual dysfunctions had higher mean scores on the POPDI-6, CRADI-8, and UDI-6 subscales than those who did not have sexual dysfunction (P ≤ 0.005). Risk factors identified included being postmenopausal, with an adjusted odds ratio (aOR) of 2.98 (95% confidence interval [CI] 2.12-4.18), and a greater impact of the symptoms of pelvic floor problems as assessed by the PFDI-20 scale, in such a way that for each point increase the probability of sexual dysfunction increases with an aOR of 1.008 (95% CI 1.005-1.011). CONCLUSION: Women with pelvic floor disorders and postmenopausal women present sexual dysfunction more frequently.

Influence of pelvic floor disorders on quality of life in women.

Objective: To determine whether the different pelvic floor disorders are associated with changes in perceived quality of life (QoL), globally and in its sub-dimensions. Methods: An observational study was conducted with women in Spain between 2021 and 2022. Information was collected using a self-developed questionnaire on sociodemographic data, employment, history and health status, lifestyle and habits, obstetric history, and health problems. The SF-12 questionnaire was used to assess quality of life. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor problems, and includes the POPDI-6 subscales for prolapse, CRADI- 8 for colorectal symptoms, and UDI-6 for urinary symptoms. Crude (MD) and adjusted mean differences (aMD) were estimated with their respective 95% confidence intervals (CI). Results: Thousand four hundred and forty six women participated in the study with a mean age of 44.27 (SD = 14.68). A statistical association was observed between all the pelvic floor disorders and QoL, overall and in all its dimensions (p <0.001), in the bivariable analysis. The lowest scores were observed in the emotional component. After adjusting for confounding factors, the pelvic floor disorders in general (aMD -0.21, 95% CI: -0.23 to -0.20), the impact of uterine prolapse symptoms (aMD -0.20, 95% CI: -0.27 to -0.12), the colorectal-anal symptoms (aMD -0.15, 95% CI: -0.22 to -0.09), and urinary symptoms (aMD -0.07, 95% CI: -0.13 to -0.03) was negatively associated on the score on the SF-12 questionnaire (p <0.05). Conclusions: Women who have a pelvic floor dysfunction, symptoms of pelvic organ prolapse, colorectal-anal symptoms, or urinary symptoms, have a worse perceived quality of life in all dimensions. Prolapse symptoms have the biggest impact, and the emotional component of QoL is the most affected sub-domains.

[Documento de consenso de la Sociedad Española de Obstetricia y Ginecologia (SEGO) y el Comité Español Interdisciplinario para la Prevención Vascular (CEIPV). Ventana de oportunidad: prevención del riesgo vascular en la mujer. Resultados adversos del embarazo y riesgo de enfermedad vascular.] / Consensus document of the Spanish Society of Obstetrics and Gynecology (SEGO) and the Spanish Interdisciplinary Committee for Vascular Prevention (CEIPV). Opportunity window: vascular risk prevention in women. Adverse pregnancy outcomes and risk of vascular disease.

This document summarises the evidence regarding the association between adverse pregnancy outcomes (APOs), such as hypertensive disorders, preterm birth, gestational diabetes, fetal growth defects (small for gestational age and/or fetal growth restriction), placental abruption, fetal loss, and the risk that a pregnant individual in developing vascular risk factors (VR) that may lead to future vascular disease (VD): coronary heart disease, stroke, peripheral vascular disease, and heart failure. Furthermore, this document emphasises the importance of recognising APOs when assessing VR in women. A history of APOs serves as a sufficient indicator for primary prevention of VD. In fact, adopting a healthy diet and increasing physical activity among women with APOs, starting during pregnancy and/or postpartum, and maintaining it throughout life are significant interventions that can reduce VR. On the other hand, breastfeeding can also reduce the future VR of women, including a lower risk of mortality. Future studies evaluating the use of aspirin, statins, and metformin, among others, in women with a history of APOs could strengthen recommendations regarding pharmacotherapy for primary prevention of VD in these patients. Various healthcare system options exist to improve the transition of care for women with APOs between different healthcare professionals and implement long-term VR reduction strategies. One potential process could involve incorporating the fourth-trimester concept into clinical recommendations and healthcare policies.

Este documento resume la evidencia que existe entre los resultados adversos del embarazo (RAE), tales como son los trastornos hipertensivos, el parto pretérmino, la diabetes gestacional, los defectos en el crecimiento fetal (feto pequeño para la edad gestacional y/o restricción del crecimiento), el desprendimiento de placenta y la pérdida fetal, y el riesgo que tiene una persona gestante de desarrollar factores de riesgo vascular (RV) que pueden terminar provocando enfermedad vascular (EV) futura: cardiopatía coronaria, accidente cerebrovascular, enfermedad vascular periférica e insuficiencia cardíaca. Asimismo, este documento destaca la importancia de saber reconocer los RAE cuando se evalúa el RV en mujeres. Un antecedente de RAE es un indicador suficiente para hacer una prevención primaria de EV. De hecho, adoptar una dieta saludable y aumentar la actividad física entre las mujeres con RAE, de inicio en el embarazo y/o postparto y manteniéndolo a lo largo de la vida, son intervenciones importantes que permiten disminuir el RV. Por otro lado, la lactancia materna también puede disminuir el RV posterior de la mujer, incluyendo menos riesgo de mortalidad. Estudios futuros que evalúen el uso del ácido acetilsalicílico, las estatinas y la metformina, entre otros, en las mujeres con antecedentes de RAE podrían reforzar las recomendaciones sobre el uso de la farmacoterapia en la prevención primaria de la EV entre estas pacientes. Existen diferentes opciones dentro de los sistemas de salud para mejorar la transición de la atención de las mujeres con RAE entre los diferentes profesionales e implementar estrategias para reducir su RV a largo plazo. Una posible estrategia podría ser la incorporación del concepto del cuarto trimestre en las recomendaciones clínicas y las políticas de atención de la salud.

Pelvic floor dysfunction: prevalence and associated factors.

BACKGROUND: Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions. OBJECTIVE: Determine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women. MATERIAL AND METHODS: This observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated. RESULTS: One thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia. CONCLUSIONS: The prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.

Impact and Influence of Urinary Incontinence on Physical Activity Levels.

Background: The benefits of physical activity are numerous on both physical and mental levels. Urinary incontinence (UI) can influence physical activity level; among US women, nearly two out of three view this problem as a barrier to physical activity, meaning that they do not exercise, exercise less, or even have to change their activity routines to accommodate this pelvic floor dysfunction. Objective: To determine whether UI influences the pattern of physical activity and whether a greater impact of urinary symptoms could influence the level of physical activity. Design setting and participants: An observational study was carried out with women in 2021 and 2022 in Spain. Outcome measurements and statistical analysis: The main dependent variable was level physical activity, as measured by the International Physical Activity Questionnaire (IPAQ). The Urogenital Distress Inventory (UDI-6) scale was used to determine the presence of UI and its impact. Sociodemographic, health status, lifestyle and obstetric data were obtained. Bivariate and multivariate analyses were performed using binary logistic regression, obtaining adjusted odds ratio (aOR) with its 95% confidence interval (95% CI). Results and limitations: A total of 1446 women participated, of whom 55.8% (807) had UI and 25.7% (371) reported low physical activity. Mixed incontinence (aOR: 1.53; 95% CI: 1.09-2.15) overall and a greater intensity of urinary symptoms (UDI-6 score; aOR: 1.014; 95% CI: 1.01-1.02) in the group of women with incontinence were statistically associated with a higher frequency of low physical activity. Other variables related to low physical activity were age, body mass index, pelvic pain, and income level (p < 0.001). Conclusions: Mixed-type UI is associated with low-level physical activity or inactivity in the whole group of women, while among women with UI, the greater impact of the symptoms increases the probability of low physical activity or inactivity. Patient summary: In this report, it is analyzed how urinary incontinence affects physical activity. It was found that women who suffer from mixed-type urinary incontinence have a low level of physical activity or inactivity, while those who experience a greater impact of urinary incontinence symptoms have an increased likelihood of having low physical activity or inactivity.

Validation of a short version of the high-fidelity simulation satisfaction scale in nursing students.

BACKGROUND: Clinical simulation provides a practical and effective learning method during the undergraduate education of health professions. Currently there is only one validated scale in Spanish to assess nursing students' satisfaction with the use of high-fidelity simulation, therefore, our objective is to validate a brief version of this scale in undergraduate nursing students with or without clinical experience. METHOD: A cross-sectional descriptive study was performed. Between 2018 and 2020, the students from all academic courses of the Fundación Jiménez Díaz nursing school completed the satisfaction scale at the end of their simulation experiences. To validate this scale, composed of 33 items and eight dimensions, exploratory factor analysis (EFA) of the principal components was performed, the internal consistency was studied using Cronbach's alpha, and the corrected item-test correlation of each of the items of the total scale was reviewed. RESULTS: 425 students completed the scale, after the exploratory factor analysis, a scale consisting of 25 items distributed into six subscales, each containing between two and six items, explained a variance of 66.5%. The KMO test (Kaiser-Meyer-Olkin) obtained a value of 0.938, Bartlett's sphericity test was < 0.01 and Goodness of Fit Index (GFI) was 0.991. CONCLUSION: The modified ESSAF scale, reduced from 33 to 25 items and divided into six subscales, is as valid and reliable as the original scale for use in nursing students of different levels, with, or without clinical experience.

Association between sexual function in women and sleep quality.

Objective: To determine the relationship between sexual dysfunction and sleep disorders. Methods: Observational study was conducted in 2021 and 2022 including 975 Spanish women over 18 years of age. The Women's Sexual Function Questionnaire (FSM-12) was used as a source of information, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. A bivariate and multivariate analysis was performed using binary logistic regression, adjusting for confounding variables. Crude (OR) and adjusted (aOR) odds ratios were estimated with their respective 95% confidence intervals (CI). Results: Around 29.2% (285) of the women presented some type of sexual dysfunction, and 73.4% (716) showed sleep disturbance with scores ≥5 on the PSQI scale. The mean score on the PSQI was 8.23 points (SD = 3.93). All the dimensions of the sexual function scale were statistically related to sleep disturbance (p ≤ 0.05), except for sexual activity and the reasons for sexual activity not having penetration. In the multivariable analysis, women with sexual dysfunction presented an aOR of sleep disturbance of 1.88 (95% CI: 1.29-2.76) compared to women without dysfunction. Conclusion: Global sexual dysfunction and almost all the dimensions that make up sexual function are related to changes in sleep quality.

Magnitude of general anxiety disorder among nursing students and its associated factors.

Background: University training in nursing together with other student variables can increase the risk of anxiety in students. It is important to assess the student's level of anxiety, which can have repercussions on their training and mental health. There are several validated tools such as the generalized anxiety disorder scale (GAD-7). Objective: To know which factors are associated with the appearance of anxiety and which protect against it in university nursing students. Method: A cross-sectional descriptive study was carried out in which 170 university nursing students from University of Jaén participated. A bivariate and multivariate analysis was performed, calculating odds ratio and adjusted odds ratio (aOR) with 95% confidence intervals (CIs) to determine which factors were associated with a higher score on the GAD-7 questionnaire, and therefore with the presence of anxiety. Results: In total, 66.5% (113) of the students have suffered an anxiety crisis on some occasion and 48.8% (83) of the students did not carry out activities of any kind to control anxiety and stress. Practicing religious and spiritual beliefs increased the probability of having anxiety compared to those who did not have religious beliefs (aOR = 3.92; 95% CI = 1.09, 14.08), as well as having previously suffered an anxiety crisis (aOR = 5.13; 95% CI = 2.39, 11.04). Protective factors against anxiety appear to be second-year students (aOR = 0.33; 95% CI = 0.16, 0.72) and being deeply satisfied with the teaching staff (aOR = 0.03; 95% CI = 0.01, 0.79). Discussion/Implications for practice: Knowing the factors that are associated with the appearance of anxiety is necessary to facilitate early detection and care in nursing university students.

Nursing students' attitudes towards sexuality before training in sexual and reproductive health.

AIM: To know the attitudes towards sexuality of nursing students and those sociodemographic and cultural factors that can influence it. DESIGN: An observational study was carried out on Nursing degree students. One hundred and eighteen nursing degree students who were going to take the sexual and reproductive health nursing course. METHODS: A self-administered online questionnaire. This questionnaire had several parts specifically designed to collect sociodemographic variables. In order to determine the attitudes towards sexuality, the questionnaire based on the ATSS (Attitudes Towards Sexuality Scale). The Double Standard Scale (DSS) was also used. This scale evaluates double standards within the area of sexuality. The Rape Supportive Attitude Scale (RSAS), was included to determine beliefs about rape, rapists and their victims. RESULTS: The ATSS shows a statistically significant association with religious beliefs (p = 0.005), with mean scores of 113.84 (SD = 9.81) for non-believers (no religion), 108.36 (SD = 15.68) for non-practicing believers and 102.32 (SD = 17.87) for believers (those who practice their faith). The mean score in the DSS shows a statistically significant association with alcohol consumption (p = 0.001). The mean score on the RSAS is statistically significantly associated with the place of residence (p = 0.050), the means were 44.32 (SD = 9.26) for those who lived in the city, 34.94 (SD = 19.21) if the place of residence was between 10,000 and 5000 inhabitants and 32.54 (SD = 15.01) if the family home was in a town with less than 5000 inhabitants. CONCLUSION: Religious beliefs reduce liberalism and positive attitudes towards sexuality, whereas sporadic alcohol consumption increases them. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

The Influence of Hyperparathyroidism Patient Profile on Quality of Life After Parathyroidectomy.

BACKGROUND: Improvements in quality of life (QoL) after parathyroidectomy in patients with primary hyperparathyroidism (PHPT) is discussed. It has not been analyzed whether these improvements can be influenced by a specific socio-personal or clinical patient profile. OBJECTIVES: to analyze QoL differences after parathyroidectomy and to determine a socio-personal and clinical profile that influences improvement after parathyroidectomy. METHODS: A longitudinal prospective cohort study in patients with PHPT. SF-36 and PHPQOL questionnaires were completed by the patients. A comparative preoperatory analysis was carried out, at three and twelve months after surgery. Student's t test was used for the correlations. The size of the effect was assessed using G*Power software. A multivariate analysis was performed to evaluate the socio-personal and clinical variables affecting the improvement in QoL after surgery. RESULTS: Forty-eight patients were analyzed. Three months after surgery an improvement was found in physical function, general health, vitality, social function, emotional role, mental health and in the patient's declared health assessment. One year after the intervention a general improvement was observed, with a greater effect on mental health and declared health evolution. Patients with bone pain presented with a higher probability of improvement after surgery. Patients with prior psychological disease had a lower associated probability of an improvement and high levels of PTH related to a greater probability of improvement after surgery. CONCLUSIONS: There is an improvement in the QoL of PHPT patients after parathyroidectomy. Patients with bone pain and high PTH levels prior to the parathyroidectomy present with a greater probability of having a greater improvement in QoL after surgery.

Prediction of an effective cervical ripenning in the induction of labour using vaginal dinoprostone.

To develop a predictive model for successful cervical ripening in women that undergo induction of labour by means of a vaginal prostaglandin slow-release delivery system (Propess®).  Prospective observational study on 204 women that required induction of labour between February 2019 and May 2020 at "La Mancha Centro" hospital in Alcázar de San Juan, Spain. The main variable studied was effective cervical ripening (Bishop score > 6). Using multivariate analysis and binary logistic regression, we created three initial predictive models (model A: Bishop Score + Ultrasound cervical length + clinical variables (estimated fetal weight, premature rupture of membranes and body mass index)); model B: Ultrasound cervical lenght + clinical variables; and model C: Bishop score + clinical variables) to predict effective cervical ripening. All three predictive models obtained (A, B and C) presented good predictive capabilities, with an area under the ROC curve ≥ 0.76. Predictive model C, composed of the variables: gestational age (OR 1.55, 95% CI 1.18-2.03, p = 0.002), premature rupture of membranes (OR 3.21 95% CI 1.34-7.70, p = 0.09) body mass index (OR 0.93, 95% CI 0.87-0.98, p = 0.012), estimated fetal weight (OR 0.99, 95% CI 0.99-1.00, p = 0.068) and Bishop score (OR 1.49 95% CI 1.18-1.81, p = 0.001), is presented as the model of choice with an area under the ROC curve of 0.76 (95% CI 0.70-0.83, p < 0.001). A predictive model composed of the variables: gestational age, premature rupture of membranes, body mass index, estimated fetal weight and Bishop score upon admission presents good capabilities in predicting successful cervical ripening following administration of prostaglandins. This tool could be useful in making clinical decisions with regard to induction of labour.