Ethical issues in research with second victims: A scoping review.

BACKGROUND: Second victim is the name given to the healthcare personnel-most often a nursing professional-involved with the error that led to the adverse event to a patient and who, as a result, have experienced negative psychological effects. Research with second victims has increased over the years, however concerns exist with regards to the ethical risks imposed upon these individuals. AIM: To explore the extent to which research with second victims of adverse events in healthcare settings adhere to ethical requirements. METHODS: A scoping review was conducted following Arksey and O'Malley's methodological framework and using the following databases: PUBMED, Web of Science, and SCOPUS. Original research of any study design focused on second victims and published in English, Spanish, or Portuguese in 2014-2023 were included. A critical narrative approach was used to discuss the findings. ETHICAL CONSIDERATIONS: The review followed ethical guidelines emphasizing accurate authorship attribution and truthful data reporting. RESULTS: Fifteen studies using qualitative (n = 2), quantitative (n = 10), and mixed-method (n = 3) designs were included. Over half were not assessed by a research ethics committee, with questionable reasons given by the authors. One-third did not refer to having used an informed consent. In two studies, participants were recruited by their workplace superiors, which could potentially right to autonomy and voluntary participation. CONCLUSION: Over half of the included studies with second victims did not comply with fundamental ethical aspects, with risk to inflict respect for individual autonomy, confidentiality, and of not causing any harm to participants. IMPLICATIONS FOR NURSING RESEARCH: Healthcare personnel involved in adverse events are most often nursing professionals; therefore, any breach of ethics in research with this population is likely to directly affect their rights as research participants. We provide recommendations to promote better research practices with second victims towards safeguarding their rights as research participants.

Coping trajectories of intensive care nurses as second victims: A grounded theory.

A qualitative study that provides evidence of the institutional support required by intensive care unit (ICU) nurses as second victims of adverse events (AEs). BACKGROUND: The phenomenon of second victims of AE in healthcare professionals can seriously impact professional confidence and contribute to the ongoing occurrence of AEs in hospitals. OBJECTIVES: The objective of this study was to describe the coping trajectories of second victims among nurses working in ICUs in public hospitals in Chile. METHODS: Conducting qualitative research through the grounded theory method, this study focused on high-complexity hospitals in Chile, using theoretical sampling. The participants consisted of 11 nurses working in ICUs. Techniques used included in-depth interviews conducted between March and May 2023, as well as a focus group interview. Analysis, following the grounded theory approach proposed by Strauss and Corbin, involved constant comparison of data. Open, axial, and selective coding were applied until theoretical data saturation was achieved. The study adhered to reliability and authenticity criteria, incorporating a reflexive process throughout the research. Ethical approval was obtained from the ethics committee, and the study adhered to the consolidated criteria for reporting qualitative research. RESULTS: From the interviews, 29 codes were identified, forming six categories: perception of support when facing an AE, perception of helplessness when facing an AE, initiators of AE, responses when facing an AE, professional responsibility, and perception of AE. The perception of support when facing an AE emerged as the main category, determining whether the outcome was stagnation or overcoming of the phenomenon after the AE. CONCLUSIONS: For the coping process of ICU nurses following an AE, the most crucial factor is the support from colleagues and supervisors.

[Frequency of diabetic retinopathy and associated factors in Puerto Montt, Chile]. / Estudio de prevalencia de retinopatía diabética en pacientes diabéticos tipo 2 de la comuna de Puerto Montt y sus factores asociados.

BACKGROUND: Diabetic retinopathy (DR) is an important cause of decreased visual acuity, whose prevalence has increased between 1990 and 2020. In Chile the prevalence of diabetic retinopathy was estimated at 24.8%. AIM: To assess the prevalence of DR in a southern Chilean city. MATERIAL AND METHODS: From a database of diabetic patients attending primary health care centers at Puerto Montt, Chile, 196 patients with DR and 392 patients without DR, matched by age and presence of chronic complications, were chosen for this case-control study. RESULTS: The prevalence of DR in the database of diabetic patients was 33.3%. glycated hemoglobin, the frequency insulin use, systolic blood pressure, HDL cholesterol, microalbuminuria, and proteinuria were significantly worse in cases. A multivariate analysis showed that retinopathy is much more likely to occur when the variables insulin use, neuropathy, and microalbuminuria concur. CONCLUSIONS: DR was associated with worse metabolic parameters and the presence of neuropathy in this case control study.

Prevalence of the second victim phenomenon among intensive care unit nurses and the support provided by their organizations.

BACKGROUND: Health professionals can be 'second victims' of adverse patient events. Second victimhood involves a series of physical and psychological signs and symptoms of varying severity and is most prevalent among nurses and women and in intensive care units (ICUs). Previous research has described personal and organizational coping strategies. AIM: The objective of this research is to determine the prevalence of second victimhood, focusing on psychological distress, among Chilean adult intensive care nurses and its relationship with the support provided by their organizations. STUDY DESIGN: A descriptive, correlational and cross-sectional study was conducted in seven intensive care units of Chilean hospitals. RESULTS: Of a sample of 326 nurses, 90.18% reported having been involved in an adverse event and 67% reported psychological distress resulting from the adverse event. Embarrassment was the most prevalent psychological symptom (69%). Only 2.8% reported that their organization had an action plan for professionals in the event of a serious adverse event. Participants who had spent longer working in an ICU reported more support from their organization around adverse events. CONCLUSION: Two-thirds of Chilean adult intensive care unit nurses report psychological stress following an adverse event. These results should be assessed internationally because second victims have major implications for the well-being of health professionals and, therefore, for retention and the quality of care. RELEVANCE TO CLINICAL PRACTICE: Critical care leaders must actively promote a safe environment for learning from adverse events, and hospitals must establish a culture of quality that includes support programmes for second victims.

Estudio de prevalencia de retinopatía diabética en pacientes diabéticos tipo 2 de la comuna de Puerto Montt y sus factores asociados / Frequency of diabetic retinopathy and associated factors in Puerto Montt, Chile

BACKGROUND: Diabetic retinopathy (DR) is an important cause of decreased visual acuity, whose prevalence has increased between 1990 and 2020. In Chile the prevalence of diabetic retinopathy was estimated at 24.8%. AIM: To assess the prevalence of DR in a southern Chilean city. MATERIAL AND METHODS: From a database of diabetic patients attending primary health care centers at Puerto Montt, Chile, 196 patients with DR and 392 patients without DR, matched by age and presence of chronic complications, were chosen for this case-control study. RESULTS: The prevalence of DR in the database of diabetic patients was 33.3%. glycated hemoglobin, the frequency insulin use, systolic blood pressure, HDL cholesterol, microalbuminuria, and proteinuria were significantly worse in cases. A multivariate analysis showed that retinopathy is much more likely to occur when the variables insulin use, neuropathy, and microalbuminuria concur. CONCLUSIONS: DR was associated with worse metabolic parameters and the presence of neuropathy in this case control study.

Nurse-led telehealth intervention effectiveness on reducing hypertension: a systematic review.

BACKGROUND: Hypertension is a public health concern for many countries. The World Health Organization has established a global objective to reduce the prevalence of non-communicable diseases, including hypertension, which is associated with cardiovascular disease. Remote nursing interventions can potentially lessen the burden on the healthcare system and promote a healthier population. This systematic review aims to synthesize available evidence on the effectiveness of nursing-led telehealth interventions in reducing blood pressure in hypertensive patients. METHODS: A systematic review was conducted. The search was performed from May to June 2021, in the databases: PubMed, Scopus, Cochrane Library, Web of Science, CINAHL, and ProQuest within 2010-2021 in English, Spanish and Portuguese. Randomized controlled trials and Quasi-experimental studies were considered. This systematic review followed the criteria of the Cochrane Handbook for Systematic Reviews of Interventions, with the support of the PRISMA guidelines and registered in PROSPERO. For critical analysis, the tools of the Joanna Briggs Institute were used. RESULTS: Of the 942 articles found, six controlled clinical trials and one quasi-experimental study were selected. Different nurse-led interventions (telehealth devices, remote video consultation, calls and email alerts) have demonstrated a significant decrease in blood pressure (especially systolic blood pressure) in the intervention groups. Nurse-led interventions also effect hypertension awareness, self-efficacy, and self-control. Positive effects on lowering cholesterol, consumption of fruits and vegetables, physical activity and adherence to medication were also described. CONCLUSION: Nurse-led interventions delivered remotely have a positive effect in lowering the blood pressure of patients with hypertension. Further research is required to support strategies that will deliver the best continuous, quality, and cost-effective nursing care.

Perfil académico, percepción de competencias en estudiantes de enfermería y desempeño en el examen de grado basado en simulación de alta fidelidad

Objetivo: Analizar la relación entre perfil académico y la percepción de competencias en estudiantes de enfermería, con su desempeño en el examen de grado basado en simulación de alta fidelidad para la obtención del título de enfermera/o. Material y Método: Estudio cuantitativo, transversal y correlacional que siguió la guía STROBE. Midió variables del perfil académico (número de semestres cursados, asignaturas reprobadas, calificación de internado y al 8vo semestre) y la percepción de competencias en una muestra probabilística de 101 estudiantes de enfermería previo al examen de grado basado en simulación clínica de alta fidelidad. Luego se relacionaron con la calificación obtenida en el examen de grado. Resultados: El 36,6% de los estudiantes tardó 14 o más semestres en completar la carrera, y 52,4% tuvo más de 5 asignaturas reprobadas. En el 8vo semestre, el 58,4% obtuvo calificación suficiente. Durante el internado, el 55,4% tuvo calificación muy buena, el 94% percibió sus competencias como buenas o excelente antes del examen de grado y en el examen de grado, el 67,1% obtuvo calificación muy buena y 6,9% sobresaliente. Se encontraron relaciones significativas entre percepción de competencias del estudiante y calificación del examen de grado (p= 0,012), y entre calificación del internado y examen de grado (p= 0,029). No hubo relaciones significativas entre semestres cursados, asignaturas reprobadas y promedio al 8vo semestre con calificación del examen de grado. Conclusiones: Antes del examen de grado, los estudiantes de enfermería perciben su competencia como excelente o buena. Esto se relaciona con calificación en este examen y del internado. La calificación del examen de grado no se relaciona con los semestres cursados, nota al 8vo semestre, ni asignaturas reprobadas.

Objective: To analyze the relationship between academic profile, perception of competence in nursing students, with their performance in the final exam, based on high-fidelity simulation. Material and Method: A quantitative, cross-sectional, and correlational study following the STROBE guidelines. The study measured academic profile variables (number of semesters completed, failed subjects, internship grade and 8th semester grade) and the perception of competence in a probabilistic sample of 101 nursing students, prior to the final exam, based on high-fidelity clinical simulation. They were then related to the final exam grades. Results: 36.6% of students took 14 or more semesters to graduate, and 52.4% had failed more than 5 subjects. In the 8th semester, 58.4% obtained a sufficient grade. During the internship, 55.4% received a very good grade. 94% of students perceived their competence as good or excellent before the final exam, and in the final exam, 67.1% had a very good grade, and 6.9% had an excellent grade. Significant relationships were found between students' perceptions of competence and final exam grades (p= 0.012), and between internship grades and final exam grades (p= 0.029). There were no significant relationships between semesters completed, failed subjects, and 8th semester grade with the final exam grade. Conclusion: Before the final exam, nursing students perceive their competence as excellent or good. This perception is related to their performance in the exam and during the internship. The final exam grade is not related to the number of semesters completed, the 8th semester grade or the failed subjects.

Objetivo: Analisar a relação entre o perfil académico, a percepção de competências dos estudantes de enfermagem e seu desempenho no exame de graduação, com base na simulação de alta fidelidade. Material e Método: Estudo quantitativo, transversal e correlacional que seguiu o guia STROBE. O estudo mediu variáveis de perfil académico (número de semestres cursados, disciplinas reprovadas, nota do estágio e nota do 8° semestre) e a percepção de competência em uma amostra probabilística de 101 estudantes de enfermagem, antes do exame de graduação, com base em simulação clínica de alta fidelidade. Em seguida, essas variáveis foram relacionadas com a nota do exame de graduação. Resultados: 36,6% dos estudantes levaram 14 semestres ou mais para concluir o programa de estudos, e 52,4% tiveram mais de 5 disciplinas reprovadas. No 8° semestre, 58,4% obtiveram uma nota suficiente. Durante o estágio, 55,4% receberam uma nota muito boa. 94% dos estudantes perceberam suas competências como boas ou excelentes antes do exame de graduação. No exame de graduação, 67,1% obtiveram uma nota muito boa e 6,9% uma nota excelente. Foram encontradas relações significativas entre a percepção de competência do estudante e a nota do exame de graduação (p= 0,012), e entre a nota do estágio e o exame de graduação (p= 0,029). Não houve relações significativas entre semestres cursados, disciplinas reprovadas e a nota do 8° semestre com a nota do exame de graduação. Conclusão: Antes do exame de graduação, os estudantes de enfermagem percebem suas competências como excelentes ou boas. Isso está relacionado com a nota neste exame e no estágio. A nota do exame de graduação não está relacionada com os semestres cursados, a nota no 8° semestre ou as disciplinas reprovadas.

Evaluación del estrés en tiempo de pandemia de COVID - 19: una mirada de profesionales de salud. Paraguay. 2020

La pandemia del COVID-19 nos ha sorprendido con una cruda realidad, la difusión a través de los noticieros de la aparición de un virus muy letal de la familia de los coronavirus, ante una carencia casi total de equipos de protección individual en que se debatían los hospitales públicos y privados. El presente estudio tuvo un diseño observacional, descriptivo y transversal. Formaron parte de la investigación 101 profesionales de salud. Se realizó un muestreo no probabilístico de conveniencia. El contacto con los participantes fue a través de medios telemáticos, se les administró un cuestionario elaborado utilizando la aplicación Google Forms. Para evaluar el estrés de los participantes, fue aplicado el cuestionario de problemas psicosomáticos y para el nivel de ansiedad la escala de trastorno de ansiedad. Los hallazgos más relevantes en cuanto a las características sociodemográficas fueron: 70,5 % de sexo femenino, 34,1 % del grupo etario de 21 a 30 años, y 65,9 % de nivel académico universitario. El 47,7 % (48) de los profesionales presentó estrés leve y 36,4 % se encontró en fase de alarma. En cuanto a la ansiedad, el 45,5 % (46) presentó ansiedad moderada y el 36,4% (37), ansiedad de nivel leve. Se concluye que la mayoría de estos profesionales de salud presentó un nivel de estrés leve en tiempo de la pandemia de COVID-19.

The COVID-19 pandemic has surprised us with a crude reality, the diffusion through the news of the appearance of a very lethal virus of the coronavirus family, in the face of an almost total lack of personal protective equipment in which public and private hospitals were struggling. The present study had an observational, descriptive and cross-sectional design. A total of 101 health professionals took part in the study. Non-probabilistic convenience sampling was used. Participants were contacted by telematic means and a questionnaire was administered using Google Forms. To evaluate the stress of the participants, the psychosomatic problems questionnaire was applied and for the level of anxiety, the Anxiety Disorder Scale was used. The most relevant findings for the sociodemographic characteristics were: 70.5 % was female, 34.1 % of the age group 21 to 30 years, with a university academic level 65.9 %. Of the professionals, 47.7% (48) presented mild stress and 36.4% was in the alarm phase. Regarding anxiety, 45.5 % (46) presented moderate anxiety and 36.4 % (37), mild anxiety. It was concluded that the majority of these health professionals presented a mild level of stress during the COVID-19 pandemic.

Best Nursing Intervention Practices to Prevent Non-Communicable Disease: A Systematic Review.

Objectives: To explore nursing health education interventions for non-communicable disease patients. Methods: The design was a systematic review of research work published between 2008 and 2018. The data sources included the Web of Science, PubMed, Scopus, COCHRANE, and LILACS. The studies that met the inclusion were assessed, and the analysis for methodological quality through the recommended tools CASPe, and JADAD. Results: Fifteen original studies from eight counties were included in the review; Findings revealed 13 studies with randomized samples and six used power analysis. Nurses' interventions included house calls, home care, and individual and group health education. Conclusion: Nursing interventions showed 76.4% the effectiveness of results in patient outcomes to promote and improve healthier lifestyles and quality of life of non-communicable disease patients. This review discloses the significant impact of nursing health education interventions. Nursing leadership and political decision-makers should consider providing programs to enhance health education knowledge and abilities. All of this can favor the sustainability of the global economy by changing the life style of thousands of people worldwide. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42020208809.

Coping strategies in health care providers as second victims: A systematic review.

AIM: To analyze personal and organizational strategies described in the literature for dealing with the second victim phenomenon among healthcare providers. BACKGROUND: The second victim phenomenon involves many associated signs and symptoms, which can be physical, psychological, emotional, or behavioral. Personal and organizational strategies have been developed to deal with this phenomenon. MATERIALS AND METHODS: A systematic review was carried out in PubMed, Cochrane Library, Web of Science, Scopus, PsycINFO, Science Direct, and Cumulative Index to Nursing and Allied Health Literature databases, searching for evidence published between 2010 and 2019 in Spanish, English, German, and Portuguese. RESULTS: Seven hundred and eighty-three articles were identified. After eliminating duplicates, applying inclusion and exclusion criteria and critical analysis tools of the Joanna Briggs Institute, 16 research articles were included: 10 quantitative studies (design: descriptive, correlational, systematic, or integrative review) and six qualitative studies (descriptive, systematic review). There are several different personal and organizational strategies for dealing with the second victim phenomenon. Among these, peer support and learning from adverse events are highly valued. In personal strategies stands out the internal analysis of the adverse event that the professional performs to deal with the generated negative feelings. In organizational strategies, the most valued are second victim support programs with rapid response teams and made up of peers. CONCLUSIONS: The main organizational coping strategies for tackling this phenomenon are online programs in countries such as the United States, Spain, and other European countries. Formal evaluation of these programs and research is required in Latin America. IMPLICATIONS FOR NURSING AND HEALTH POLICIES: Adequately coping with the second victim phenomenon allows health professionals and organizations to learn from adverse events. Furthermore, by supporting health professionals who suffer from the second victim phenomenon, the organization takes care of its most valuable resource, its human capital. This contributes toward building a culture of healthcare quality in organizations, which will reduce adverse events in the future.

¿Es la revisión sistemática el mejor estudio para tomar decisiones en salud? / Are systematic reviews the best study for decision making in health?

OBJETIVO: Definir el mejor diseño de investigación para la práctica de enfermería. METODOLOGÍA: se realiza una revisión narrativa con los términos MeSH: Alfabetización Informacional, Estudios Epidemiológicos, Medicina Basada en la Evidencia, Enfermería basada en evidencia en las bases de datos PUBMED, ProQuest, Ebsco, Ovid. SÍNTESIS DEL CONTENIDO: Se realiza una síntesis de los diseños de investigación disponibles y su utilidad al momento de responder una pregunta de investigación. CONCLUSIONES: La mejor evidencia disponible son las revisiones sistemáticas y el enfoque de investigación mixto. Su uso para práctica basada en evidencia asegura que podamos sustentar nuestros cuidados de manera eficiente y segura.

OBJECTIVE: Define the best research design for nursing practice. METHODOLOGY: a narrative review is carried out with the MeSHterms: Information Literacy, Epidemiological Studies, Evidence-Based Medicine, Evidence-Based Nursing in the PUBMED, ProQuest, Ebsco, Ovid databases. SYNTHESIS OF THE CONTENT: A synthesis of the available research designs and their usefulness when answering a research question is made. CONCLUSIONS: The best available evidence is the systematic reviews and the mixed research approach. Its use for evidence-based practice ensures that we can sustain our care efficiently and safely.