Wellbeing Training Based on Contemplative Practices in a Sample of Intensive Care and Homecare Professionals: A Pilot and Feasibility Non-Randomized Clinical Trial.

BACKGROUND: Intensive care unit (ICU) and homecare unit professionals are susceptible to higher levels of stress and burnout than other healthcare professionals, which has an impact on their well-being, and in turn on their patients. In terms of data, there is not much research about the effects of psychological interventions on ICU and homecare professionals. The aim of this study was to investigate the effectiveness of Wellbeing Training based on Contemplative Practices (WTCP) for the increase of psychological functioning in a sample of ICU and homecare professionals. METHODS: A pilot and feasibility non-randomized clinical trial was conducted. Participants in the WTCP group (n = 19) attended an at-work 8-session/2 h group WTCP program aimed at directly training four basic skills: (a) sustained positive emotions, (b) recovery from negative emotions, (c) pro-social behavior and generosity, and (d) mind wandering, mindfulness, and "affective stickiness". Nineteen professionals were allocated in the control group. RESULTS: Results indicated that WTCP had a positive impact on self-compassion, personal accomplishment (burnout), and frequency of negative emotions. Moreover, a thematic analysis of participant interviews (n = 14) was conducted. CONCLUSIONS: These preliminary results are promising, though future research is needed to evaluate the effectiveness of WTCP using randomized controlled trial methodologies.

Intra-Abdominal Pressure as a Marker of Enteral Nutrition Intolerance in Critically Ill Patients. The PIANE Study.

To determine whether elevated intra-abdominal pressure (IAP) is associated with a higher rate of enteral nutrition-related gastrointestinal (GI) complications; to assess the value of IAP as a predictor of enteral nutrition (EN) intolerance. Intensive Care Unit (ICU) patients on mechanical ventilation requiring at least 5 days of EN were recruited for a prospective, observational, non-interventional, multicenter study. EN was performed and GI complications were managed with an established protocol. IAP was determined via a urinary catheter. Patients who developed any GI complications were considered as presenting EN intolerance. Variables related to EN, IAP and GI complications were monitored daily. Statistical analysis compared patients without GI complications (group A) vs. GI complications (group B). 247 patients were recruited from 28 participating ICUs (group A: 119, group B: 128). No differences between groups were recorded. Patients in group B (p < 0.001) spent more days on EN (8.1 ± 8.4 vs. 18.1 ± 13.7), on mechanical ventilation (8.0 ± 7.7 vs. 19.3 ± 14.9) and in the ICU (12.3 ± 11.4 vs. 24.8 ± 17.5). IAP prior to the GI complication was (14.3 ± 3.1 vs. 15.8 ± 4.8) (p < 0.003). The best IAP value identified for EN intolerance was 14 mmHg but it had low sensitivity and specificity. Although a higher IAP was associated with EN intolerance, IAP alone did not emerge as a good predictor of EN intolerance in critically ill patients.

[OPINION OF HEALTH PROFESSIONALS ON ADHERENCE AND MANAGEMENT OF LONG-TERM TREATMENTS IN ADOLESCENTS]. / Opinión de los profesionales sanitarios sobre a adherencia y manejo de tratamientos de larga duración en adolescents.

OBJECTIVE: To assess opinion of health professionals about adherence and management of long-term treatments in adolescents in a tertiary hospital. METHOD: A cross-sectional study was carried out in the Vall d'Hebron University Hospital in Barcelona, Spain. Participants were health professionals who care adolescents with solid organ transplant, hematologic disease, diabetes, cystic fibrosis or HIV+. Data collection was performed by self-administered questionnaire, developed specifically for this study. RESULTS: A total of 105 professionals (70%) participated in the study, 80% were nurses, 56% of them indicated that treatment compliance was good. 43% indicated that adherence was not addressed well and 79% of professionals did not have planned time to conduct health education related to treatment. 19.5% of nurses and 72.2% of physicians reported having adherence assessment tools. 39% of participants made suggestions for improvement. CONCLUSIONS: Almost half of the professional indicate that the adherence is not adequately addressed. It is important to evaluate adherence to treatment to identify causes of low compliance and establish and evaluate appropriate interventions.