Factors Associated with Quality of Life in Relatives of Adults with Serious Mental Illness: A Systematic Review.

Caring for a family member with a serious mental illness often has an impact on the quality of life (QoL) of caregivers. This could have negative repercussions on their caring skills and thus affect the care provided to that individual. The aim of this paper is to identify current evidence on QoL factors affecting relatives of individuals suffering from serious mental illness. A systematic review related to the research question was conducted in six databases by two independent reviewers. The QoL factors of relatives include sociodemographic, contextual, psychological, physical, and patient factors. The findings are consistent with the results of previous research. Mental health professionals may support a family with a member diagnosed with a serious mental illness by enhancing their education about QoL factors, which would trigger and promote protective factors so that family members could assess and act on them on an ongoing basis.

Family and Social Variables Associated with Family Health.

The current study examined the interrelationships among potentially relevant family and social factors associated with family health. A cross-sectional study was conducted by collecting demographic information from 432 families, including family typology, family life cycle (FLC), and social status as well as social support and stressful life events (SLEs), with self-perception of family health being measured as a dependent variable. Descriptive analysis of the sample and univariate and multivariate linear regression analyses were performed. Multivariate analyses showed that the FLC stage of families as launching centers, lower educational level of household heads, and impact of SLEs were negatively associated with family health, whereas adequate perceived social support and the number of close friends and relatives were positively associated with family health. Therefore, these factors must be considered by family nurses to promote family health and prevent family dysfunction.

Effect of support groups on caregiver's quality of life.

The objective of this study was to evaluate the effect that participating in support groups for caregivers has on the quality of life and psychotropic drug use of family caregivers of adults with limitations in activities of daily living. A controlled quasi-experimental longitudinal design was used with 134 caregivers (64 in the experimental group and 70 in the control group). The outcomes were health-related quality of life (EuroQol 5D3L test) and psychotropic drug use (no/yes). The analyses were performed using SPSS and R statistical software. An interaction was observed between the condition and the level of limitations in activities of daily living of the care receiver, having an effect on the caregiver's psychotropic drug use (p = 0.003), with this use being lower among caregivers who attend support groups when their relatives present fewer limitations in activities of daily living. Moreover, the quality of life was higher in the post-test in the experimental group (B = 8.66, p = 0.015). In conclusion, support groups could improve the caregiver's quality of life and decrease psychotropic drug use when the care receiver has low limitations in activities of daily living.

El objetivo de este estudio es evaluar el efecto que tiene la participación en grupos de apoyo para cuidadores en la calidad de vida y el consumo de fármacos psicotrópicos de cuidadores familiares de adultos con limitaciones en las actividades de la vida diaria. Se usó un diseño longitudinal cuasiexperimental controlado con 134 cuidadores (64 en el grupo experimental y 70 en el grupo de referencia). Los criterios de evaluación fueron la calidad de vida relacionada con la salud (test EuroQol 5D3L) y el consumo de fármacos psicotrópicos (sí / no). Los análisis se realizaron usando los programas estadísticos SPSS y R. Se observó una interacción entre la enfermedad y el nivel de limitaciones en las actividades de la vida diaria del receptor del cuidado y el efecto que tuvo en el consumo de fármacos psicotrópicos del cuidador (p=0.003). Este consumo fue menor entre los cuidadores que asisten a grupos de apoyo cuando sus familiares presentan menos limitaciones en las actividades de la vida diaria. Además, la calidad de vida fue mayor en el grupo experimental después del test (B=8.66, p=0.015). En resumen, los grupos de apoyo podrían mejorar la calidad de vida del cuidador y disminuir el consumo de fármacos psicotrópicos cuando el receptor del cuidado tiene pocas limitaciones en las actividades de la vida diaria.

Spirituality in a Doctor's Practice: What Are the Issues?

INTRODUCTION: It is becoming increasingly important to address the spiritual dimension in the integral care of the people in order to adequately assist them in the processes of their illness and healing. Considering the spiritual dimension has an ethical basis because it attends to the values and spiritual needs of the person in clinical decision-making, as well as helping them cope with their illness. Doctors, although sensitive to this fact, approach spiritual care in clinical practice with little rigour due to certain facts, factors, and boundaries that are assessed in this review. OBJECTIVE: To find out how doctors approach the spiritual dimension, describing its characteristics, the factors that influence it, and the limitations they encounter. METHODOLOGY: We conducted a review of the scientific literature to date in the PubMed, Scopus, and CINAHL databases of randomised and non-randomised controlled trials, observational studies, and qualitative studies written in Spanish, English, and Portuguese on the spiritual approach adopted by doctors in clinical practice. This review consisted of several phases: (i) the exclusion of duplicate records; (ii) the reading of titles and abstracts; (iii) the assessment of full articles and their methodological quality using the guidelines of the international Equator Network. RESULTS: A total of 1414 publications were identified in the search, 373 of which were excluded for being off-topic or repeated in databases. Of the remaining 1041, 962 were excluded because they did not meet the inclusion criteria. After initial screening, 79 articles were selected, from which 17 were collected after reading the full text. A total of 8 studies were eligible for inclusion. There were three qualitative studies and five cross-sectional observational studies with sufficient methodological quality. The results showed the perspectives and principal characteristics identified by doctors in their approach to the spiritual dimension, with lack of training, a lack of time, and fear in addressing this dimension in the clinic the main findings. CONCLUSIONS: Although more and more scientific research is demonstrating the benefits of spiritual care in clinical practice and physicians are aware of it, efforts are needed to achieve true holistic care in which specific training in spiritual care plays a key role.

Non-pharmacological interventions to reduce anxiety in pregnancy, labour and postpartum: A systematic review.

BACKGROUND: The anxiety mothers experience during pregnancy is well known and may have negative consequences for the emotional, psychological, and social development of newborns. Anxiety must therefore be reduced using different strategies. OBJECTIVE: To determine published non-pharmacological interventions to reduce anxiety during pregnancy, childbirth and postpartum. METHODS: A systematic peer-review of experimental and quasi-experimental studies was conducted using the PubMed, Scopus, Web of Science (WOS), and CINAHL databases. The quality of the studies was assessed using the Spanish version of the PEDro scale. Two researchers participated independently in the data selection and extraction process. FINDINGS: 587 articles were identified, of which 21 met the eligibility criteria. In eleven studies the intervention was performed during pregnancy, in three of them during labour, in four of them during the postpartum period, and in three of them during pregnancy and postpartum. During pregnancy, the most effective interventions were behavioural activation, cognitive behavioural therapy, yoga, music therapy, and relaxation; during childbirth: aromatherapy; during pregnancy and postpartum: antenatal training, massage by partners, and self-guided book reading with professional telephone assistance. CONCLUSION AND IMPLICATIONS: The most effective interventions to reduce anxiety were performed either during pregnancy or during the postpartum period, not during labour. Most of the interventions were performed on the women, with few of them being performed on both partners. Non-pharmacological interventions may be applied by nurses and midwives to reduce anxiety during pregnancy, labour and postpartum.

[Work climate, work stress and alcohol consumption in workers in the industry. A systematic review.] / Clima laboral, estrés laboral y consumo de alcohol en trabajadores de la industria. Una revisión sistemática.

BACKGROUND: The negative work climate influences the maladjustment of the staff and there are labor, physiological and psychological consequences in the workers. Work stress can appear as a result of the relationship between the individual, the work environment and the individual perception of threatening factors derived from work, which endangers physical, psychological and social well-being and increases the probability of alcohol consumption. Alcohol consumption is a frequent behavior in the working population, as a negative coping with stress. The objective of this work was to know the state of the art of the relationship between the work environment, work stress and alcohol consumption in workers. METHODS: Systematic review of primary studies in English, Portuguese and Spanish from 2009 to 2019, the study population was workers of both sexes. Search in multiple databases: PubMed, Scielo, Scopus, EBSCO Host, Redalyc; the Google Scholar search engine was used to obtain full-text documents. Three reviewers participated in the data selection and extraction process independently, agreeing on the results. RESULTS: 533 studies were found, of which 17 met the eligibility criteria. An association was identified between the work environment (work environment) and/or work stress with the consumption of alcohol in the working population, a meta-analysis was also analyzed which concludes that the workers who presented greater work stress were low-risk drinkers of 20 g/day (2 UBEs) for men and 10 g/day (1 UBE) for women; and risk drinkers with 40 g/d (4 UBEs/day) in men and >20-25 g/d (2-2.5 UBEs/day) in women. CONCLUSIONS: The work environment and work stress predict alcohol consumption and the type of alcohol consumption in workers.

OBJETIVO: El clima laboral negativo influye en la inadaptación del personal y aparecen consecuencias laborales, fisiológicas y psicológicas en los trabajadores. El estrés laboral puede aparecer como resultado de la relación entre el individuo, el clima laboral y la percepción individual de factores amenazantes derivados del trabajo, que pone en peligro el bienestar físico, psicológico y social y aumenta la probabilidad del consumo de alcohol. El consumo de alcohol es una conducta frecuente en la población trabajadora, como afrontamiento negativo al estrés. El objetivo de este trabajo fue conocer el estado del arte de la relación entre el clima laboral, el estrés laboral y el consumo de alcohol en los trabajadores. METODOS: Revisión sistemática de estudios primarios en inglés, portugués y español del año 2009 al 2019, la población de estudio fueron trabajadores de ambos sexos. Búsqueda en múltiples bases de datos: PubMed, Scielo, Scopus, EBSCO Host, Redalyc; se recurrió al buscador Google Académico para la obtención de documentos en texto completo. Tres revisores participaron en el proceso de selección y extracción de datos de forma independiente, consensuando resultados. RESULTADOS: Se encontraron 533 estudios de los cuales 17 cumplían los criterios de elegibilidad. Se identificó asociación entre el clima laboral (ambiente de trabajo) y/o el estrés laboral con el consumo de alcohol en población trabajadora, también se analizó un metaanálisis el cual concluye que los trabajadores que presentaban mayor estrés laboral eran bebedores de bajo riesgo de 20 g/día (2 UBEs) para hombres y 10 g/día (1 UBE) para mujeres; y bebedores de riesgo con 40 g/d (4 UBEs/día) en hombres y >20-25 g/d (2-2,5 UBEs/día) en mujeres. CONCLUSIONES: El clima laboral y el estrés laboral predicen el consumo de alcohol y el tipo de consumo de alcohol en los trabajadores.

Illness Process and Recovery From the Perspective of the Alcoholic Patient.

The aim of this work was to gain understanding, using the self-transcendence theory, of the perspective of the alcoholic patient. This was a qualitative study using the grounded theory method. Eight semistructured interviews were conducted with alcohol-dependent individuals. Eleven categories emerged that allowed for understanding the process of becoming alcohol dependent to later seeking help and maintaining abstinence through the intervention program developed by Alcoholics Anonymous.

Revisión sistemática: influencia de los Grupos de Ayuda Mutua sobre cuidadores familiares / Systematic review: influence of Self-Help Groups on family caregivers

INTRODUCCIÓN: Desde la incorporación de la mujer al mundo laboral, junto con el envejecimiento progresivo de la población y el aumento de las enfermedades crónicas, se produce una alteración en el rol del cuidador, debido a la carga física, laboral y familiar que soporta, generándose conflictos emocionales y con el resto de miembros de la familia. La ayuda mutua puede ser una alternativa eficaz para promover el bienestar de los cuidadores, así como el de sus familias y dependientes. OBJETIVO: Conocer las características de los grupos de ayuda mutua (GAM) para cuidadores familiares y su influencia sobre los cuidadores, la persona dependiente y la salud familiar. METODOLOGÍA: Revisión sistemática. La estrategia de búsqueda incluyó las bases de datos Pubmed, Scopus, Psycinfo, Eric, Cochrane plus y CSIC. Se buscaron artículos escritos en español, catalán, inglés, portugués o francés, publicados en los últimos 10 años. RESULTADOS: Se seleccionaron 12 artículos relacionados con el tema de estudio. Todos los estudios muestran que la participación en estos grupos puede mejorar el bienestar físico-psicológico, el estado de salud de los cuidadores y, al mismo tiempo, reforzar su sentimiento de apoyo social, aunque faltan estudios en nuestro medio, con un tamaño muestral superior y de mayor calidad. CONCLUSIONES: Los cuidadores se benefician de participar en grupos de ayuda mutua. Por lo tanto, deben convertirse en un componente de rutina del cuidador familiar

INTRODUCTION: Since the incorporation of women into the world of work, together with the progressive ageing of the population and the increase of chronic diseases, there is an alteration in the role of the caregiver, due to the physical, work and family burden it bears, emotional conflicts and with other family members. Mutual aid can be an effective alternative to promoting the well-being of caregivers, as well as their families and dependents. OBJECTIVE: To know the characteristics of self-help groups for family caregivers and their influence on caregivers, the dependent and family health. METHODOLOGY: Systematic review. The search strategy included the Pubmed, Scopus, Psycinfo, Eric, Cochrane plus and CSIC databases; selecting scientific articles in either Spanish, Catalan, English, Portuguese or French, for the last 10 years. RESULTS: 12 articles related to the study topic were selected. All studies show that participation in these groups can improve the physical-psychological well-being, the health of caregivers and, at the same time, reinforce their sense of social support, although there is a lack of studies in our environment, with a size higher quality sample. CONCLUSIONS: Caregivers benefit from participating in self-help groups. Therefore, they should become a routine component of the family caregiver

A Web-Based, Computer-Tailored Intervention to Reduce Alcohol Consumption and Binge Drinking Among Spanish Adolescents: Cluster Randomized Controlled Trial.

BACKGROUND: Alcohol consumption, including binge drinking (BD) and heavy episodic drinking (HED), is one of the leading risk factors among Spanish adolescents leading to significant social, health, and economic consequences. Reduction of BD and HED in adolescents can be achieved using Web-based, computer-tailored (CT) interventions, providing highly personalized feedback that is adapted to a person's individual characteristics and needs. Randomized controlled trials assessing the effects of tailored BD reduction programs among Spanish adolescents are scarce. OBJECTIVE: The aim of this study was to test the effectiveness of the Web-based, CT intervention Alerta Alcohol, aimed at the prevention of BD in Spanish adolescents. As a secondary outcome, effects on HED, weekly consumption, and any consumption were also assessed. The adherence and process evaluation were assessed. METHODS: A cluster randomized controlled trial conducted among 15 Spanish schools was developed. Each school was randomized into either an experimental condition (EC) (N=742) or a control condition (CC) (N=505). Finally, 351 participants for the EC and 261 for the CC were included in the analysis (N=612). Baseline assessment took place in January and February 2017. Demographic variables and alcohol use were assessed at baseline. Follow-up assessment of alcohol use took place 4 months later in May and June 2017. Participants were compared according to their randomization group (EC versus CC). After the baseline assessment, participants in the EC started the intervention, which consisted of short stories about BD, in which CT feedback was based on the I-Change Model for behavior change. Participants in the CC group only received the baseline questionnaire. Effects of the intervention were assessed using a three-level mixed logistic regression analysis for BD, HED, and any consumption, and a three-level mixed linear regression analysis for weekly consumption. RESULTS: In total, 1247 adolescents participated in the baseline assessment and 612 participated in the follow-up assessment; the attrition rate was 50.92%. The intervention was effective in reducing HED among adolescents; the odds of HED in the CC was nine times that in the experimental condition (P=.04). No effects were found for BD, weekly consumption, and any consumption. Process evaluations revealed that the adolescents were satisfied with the program (68.8%), would use the program again (52.9%), and would recommend it to someone else (62.8%). Females and non-binge drinkers showed better responses in the process evaluation. CONCLUSIONS: Our intervention was effective regarding HED but not regarding BD, weekly consumption, and any consumption. It may be that limiting alcohol consumption to prevent HED was easier in the Spanish context than it was to carry out further steps, such as reducing other patterns of alcohol consumption. Hence, additional actions are needed to accomplish these latter goals, including community approaches and policy actions aimed at denormalizing alcohol consumption among Spanish adolescents. TRIAL REGISTRATION: ClinicalTrials.gov NCT03288896; https://clinicaltrials.gov/ct2/show/NCT03288896. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-018-5346-4.

Tutorías y satisfacción: Percepciones de los estudiantes y profesores de enfermería de la Universidad de Sevilla / Mentoring and satisfaction: Perceptions of students and professors nursing of the University of Seville / Tutoriais e satisfação: Percepções dos alunos e professores de enfermagem da Universidade de Sevilha

El grado de satisfacción de las tutorías viene dado por la percepción de beneficio y de que estas ayudan a cubrir las necesidades del alumnado. OBJETIVO: El objetivo de este estudio fue conocer la satisfacción de los estudiantes y profesores con las tutorías llevadas a cabo en los distintos centros docentes de Enfermería de la Universidad de Sevilla. MÉTODO: El diseño fue no experimental, correlacional, transversal. La muestra estuvo compuesta por 1.015 estudiantes y 181 profesores. La recogida de datos se llevó a cabo mediante cuestionarios, voluntarios y anónimos. RESULTADOS: El 60% (102) de los profesores afirmó estar bastante o muy satisfecho con las tutorías (Media=3,47 y desviación típica=0,90), frente al 55,3% (476) de los estudiantes (Media=3,44 y desviación típica=0,95). CONCLUSIONES: La estructura y características del centro docente (propio o adscrito a la Universidad de Sevilla) influyen en la satisfacción con las tutorías, tanto de profesores como de estudiantes. Además, en los profesores influye la dedicación docente (completa o parcial) y en los estudiantes la edad y curso. Es importante conocer la satisfacción que tienen los estudiantes y los profesores con las tutorías, ya que esta influye en la calidad del sistema educativo

Students are satisfied with the mentoring, when obtain a benefit and perceive that these help them meet their needs. OBJECTIVE: The aim of this study was to know the satisfaction of students and professors with mentoring carried out in different educational centers of Nursing at the University of Seville. METHOD: The design was non-experimental, correlational, cross. The sample was composed by 1,015 students and 181 professors. The data collection was carried out through questionnaires, voluntary and anonymous. RESULTS: 60% (102) of the professors said they were fairly or very satisfied with mentoring (average=3.47 and standard deviation=0.90), compared with 55.3% (476) of the students (average=3.44 and standard deviation=0.95). CONCLUSIONS: The structure and characteristics of the educational center (own or attached to the University of Seville) influence satisfaction with mentoring, both teachers and students. In addition, the professors influences the teaching activity (complete or partial) and to the students the age and course. It is important to know the satisfaction with students and professors with mentoring, as this influences the quality of the education system

O grau de satisfação dos tutoriais é dado pela percepção do benefício e que estes ajudam a atender às necessidades dos alunos. OBJETIVO: O objetivo deste estudo foi conhecer a satisfação dos alunos e professores com os tutoriais realizados nos diferentes centros de ensino de Enfermagem da Universidade de Sevilha. MÉTODO: O desenho não foi experimental, correlacional, transversal. A amostra consistiu de 1.015 alunos e 181 professores. A coleta de dados foi realizada através de questionários, voluntários e anônimos. RESULTADOS: 60% (102) dos professores declararam que estavam bastante ou muito satisfeitos com os tutoriais (média=3,47 e desvio padrão=0,90), em comparação com 55,3% (476) 44 e desvio padrão=0,95). CONCLUSÕES: A estrutura e as características do centro de ensino (próprio ou vinculado à Universidade de Sevilha) influenciam a satisfação com os tutoriais, professores e estudantes. Além disso, os professores são influenciados pela dedicação pedagógica (completa ou parcial) e nos alunos a idade eo curso. É importante conhecer a satisfação que os alunos e os professores têm com os tutoriais, uma vez que isso influencia a qualidade do sistema educacional

La docencia en enfermería comunitaria. ¿Teoría solamente? / Teaching in community nursing. Only theory?

Desde la Atención Primaria de Salud, la enfermera comunitaria atiende a personas, familias, grupos y comunidades, en todas sus circunstancias, poniendo los cuidados lo más cerca posible de los lugares donde las personas viven y trabajan, orientados a la promoción de la salud, la prevención, la atención y control de problemas de salud. La docencia en enfermería comunitaria debe fomentar el desarrollo de competencias para unos cuidados de calidad y basados en la evidencia científica. Pero, ¿cuál es la metodología docente más adecuada? En este trabajo debatimos la importancia de imbricar la teoría y la práctica en la docencia, aplicando metodologías innovadoras, poniendo de ejemplo las metodologías empleadas en las asignaturas de Enfermería del Adulto en el Ámbito Comunitario y Enfermería Familiar y Comunitaria del Grado de Enfermería de la Universidad de Sevilla. A través de las taxonomías enfermeras, el aprendizaje basado en problemas, el role-playing o la simulación, se abarcan los cuidados centrados en la persona; mediante la realización de una valoración enfermera, desde un modelo de atención familiar, y aplicando las taxonomías a la unidad familiar, se abarcan los cuidados centrados en la familia; y usando las prácticas de campo en colaboración con asociaciones y grupos de autoayuda y realizando mapeos de activos para la salud, se abarcan los cuidados centrados en la comunidad. Para concluir, a pesar de que se ha avanzado en la formación enfermera orientada al trabajo con personas, consideramos necesario seguir profundizando en la docencia orientada a las unidades familiares y grupos comunitarios

From the Primary Health Care, the community nurse attends to people, families, groups and communities, in all their circumstances, putting care as close as possible to the places where people live and work, oriented to the promotion of health, the prevention, attention and control of health problems. Teaching in community nursing should encourage the development of competencies for a quality and evidence based care. But, what is the most appropriate teaching methodology? In this work we discuss the importance of imbricating the theory and practice in teaching, applying innovative methodologies, setting the example of the methodologies used in the subjects of Nursing of Adult in the Community and Family and Community Nursing of the Degree of Nursing of the University of Sevilla. Through the nursing taxonomy, problem-based learning, role-playing or simulation, care centered on the person is covered; by carrying out a nursing assessment, from a model of family care, and applying the taxonomy to the family unit, care centered on the family is included; and using field practices in collaboration with associations and self-help groups and mapping assets for health, community-centered care is covered. To conclude, despite the fact that progress has been made in nurse education oriented to work with people, we consider it is necessary to continue deepening in teaching oriented to family units and community groups

Características presentes en escolares de secundaria que no fuman o no tienen intención de hacerlo / Characteristics present in secondary school students who do not smoke and who have no intention to smoke

Objetivo: Conocer las variables presentes en escolares de primero y segundo de secundaria que no consumen tabaco o no tienen intención de fumar desde un modelo de salud positiva. Métodos: Estudio transversal con 482 estudiantes en Andalucía y Cataluña usando un cuestionario validado (proyecto ESFA y PASE). Se realizaron análisis de regresión logística binaria. Resultados: Quienes no tenían intención de fumar presentaron una actitud desfavorable al tabaco y una alta autoeficacia (p <0,001). En los/las no consumidores/as las variables más asociadas fueron la actitud, el modelo social (p <0,001) y la autoeficacia (p = 0,005). Conclusiones: Los resultados reflejan factores motivacionales presentes en escolares que no fuman ni pretenden hacerlo. La actitud y la autoeficacia se asocian fuertemente con la intención y con el comportamiento. Esta información puede ser útil para desarrollar estrategias positivas de promoción de la salud desde un modelo salutogénico

Objective: To know the variables present in primary and secondary school students who do not smoke or intend to smoke from a positive health model. Methods: Cross-sectional study with 482 students from Andalusia and Catalonia using a validated questionnaire (ESFA and PASE project). Binary logistic regression analysis was performed. Results: Those who did not intend to smoke viewed smoking unfavourably and had high self-efficacy (p <0.001). In non-consumers, the most associated variables were attitude, social model (p <0.001), and self-efficacy (p =0.005). Conclusions: The results show motivational factors present in students who do not smoke and do not intend to do so. Attitude and self-efficacy are strongly associated with intention and behaviour. This information might be useful for developing positive health promotion strategies from a salutogenesis approach

Efecto de la estrategia de promoción de salud escolar Forma Joven / Effect of the school health promotion strategy "Forma Joven"

Objetivo: Evaluar el efecto de la Estrategia Forma Joven (EFJ) sobre las actitudes y los comportamientos del alumnado de 4° curso de Educación Secundaria Obligatoria de la provincia de Sevilla (España). Métodos: Se utilizó un diseño observacional longitudinal con dos grupos, uno que recibió la EFJ (grupo EFJ) y otro que no lo hizo (grupo no EFJ). En la evaluación inicial se contó con 402 participantes seleccionados aleatoriamente, y en el seguimiento, a los 6 meses, con 322 (161 por grupo). Se utilizaron instrumentos validados para la recogida de datos y se calcularon tablas de 2×2, odds ratio (OR) y ANOVA generales para diseños factoriales mixtos 2×2 (p<0,05). Resultados: Se encontraron efectos favorables de la EFJ. En el área de sexualidad, el porcentaje de participantes que iniciaron relaciones sexuales completas en la evaluación final fue menor en el grupo EFJ (14,9% vs. 23,4%; OR=0,57). También se observaron efectos contrarios: el inicio del consumo de tabaco fue estadísticamente superior en el grupo EFJ (19,5% vs. 9,1%; OR=2,43), si bien estas diferencias no llegaron a ser estadísticamente significativas. Conclusiones: La similitud del currículum de promoción de la salud escolar de los centros con la EFJ y sin la EFJ ha podido influir en la falta de resultados concluyentes. Las asesorías individuales o grupales en los centros, rasgo diferenciador de la EFJ, podrían haber retrasado las relaciones sexuales de sus participantes. Basándose en los estudios sobre intervenciones de promoción de la salud escolar, se recomiendan buenas prácticas que podrían ayudar a mejorar la efectividad de la EFJ

Objective: To evaluate the impact of the Youth Form Strategy (EFJ, Estrategia Forma Joven) on the attitudes and behaviours of students in the fourth year of compulsory secondary school in Seville, Spain. Methods: A longitudinal observational design was used with two groups; one received the EFJ (EFJ group) and other did not (non-EFJ group). In the initial evaluation, 402 participants were randomly selected and, in the follow-up at 6 months, 322 participants were evaluated (161 per group). Validated data collection tools were used, and 2×2 tables, odds ratio (OR) and general ANOVA for 2×2 mixed factorial design (p<0.05) were calculated. Results: Favourable effects of the EFJ were found: in the area of sexuality, the percentage of participants who had sexual intercourse in the final assessment was lower in the EFJ group (14.9% vs 23.4%; OR=0.57), as were counter-effects: start of tobacco use was higher in the EFJ group (19.5% vs 9.1%; OR=2.43). However, these differences were not statistically significant. Conclusions: The similarities in the school health promotion programme in centres with and without EFJ may have influenced the lack of conclusive results. Individual and/or group counselling at schools, a distinguishing feature of the EFJ, could have delayed sexual intercourse in the EFJ group. Based on the studies on school health promotion activities, good practices that could help to improve the effectiveness of the EFJ are recommended

[Characteristics present in secondary school students who do not smoke and who have no intention to smoke]. / Características presentes en escolares de secundaria que no fuman o no tienen intención de hacerlo.

OBJECTIVE: To know the variables present in primary and secondary school students who do not smoke or intend to smoke from a positive health model. METHODS: Cross-sectional study with 482 students from Andalusia and Catalonia using a validated questionnaire (ESFA and PASE project). Binary logistic regression analysis was performed. RESULTS: Those who did not intend to smoke viewed smoking unfavourably and had high self-efficacy (p <0.001). In non-consumers, the most associated variables were attitude, social model (p <0.001), and self-efficacy (p =0.005). CONCLUSIONS: The results show motivational factors present in students who do not smoke and do not intend to do so. Attitude and self-efficacy are strongly associated with intention and behaviour. This information might be useful for developing positive health promotion strategies from a salutogenesis approach.

[Effect of the school health promotion strategy "Forma Joven"]. / Efecto de la estrategia de promoción de salud escolar Forma Joven.

OBJECTIVE: To evaluate the impact of the Youth Form Strategy (EFJ, Estrategia Forma Joven) on the attitudes and behaviours of students in the fourth year of compulsory secondary school in Seville, Spain. METHODS: A longitudinal observational design was used with two groups; one received the EFJ (EFJ group) and other did not (non-EFJ group). In the initial evaluation, 402 participants were randomly selected and, in the follow-up at 6 months, 322 participants were evaluated (161 per group). Validated data collection tools were used, and 2×2 tables, odds ratio (OR) and general ANOVA for 2×2 mixed factorial design (p<0.05) were calculated. RESULTS: Favourable effects of the EFJ were found: in the area of sexuality, the percentage of participants who had sexual intercourse in the final assessment was lower in the EFJ group (14.9% vs 23.4%; OR=0.57), as were counter-effects: start of tobacco use was higher in the EFJ group (19.5% vs 9.1%; OR=2.43). However, these differences were not statistically significant. CONCLUSIONS: The similarities in the school health promotion programme in centres with and without EFJ may have influenced the lack of conclusive results. Individual and/or group counselling at schools, a distinguishing feature of the EFJ, could have delayed sexual intercourse in the EFJ group. Based on the studies on school health promotion activities, good practices that could help to improve the effectiveness of the EFJ are recommended.

Razones para decidir morir en el hospital o en el domicilio. Visión de los/las profesionales / Reasons for deciding to die in hospital or at home. The vision of professionals

Objetivo: Conocer las razones que llevan a decidir que los pacientes terminales mueran en el hospital o en su domicilio, desde la perspectiva de los/las profesionales. Método: Estudio cualitativo fenomenológico. Muestreo intencionado. Se realizaron cuatro grupos focales multidisciplinarios: dos en hospitales y dos en centros de Atención Primaria de Salud (APS) de Sevilla. Participaron 29 profesionales con al menos 2 años de experiencia con pacientes terminales, siguiendo el criterio de saturación teórica. Resultados: Las respuestas obtenidas del guion inicial se agruparon en tres categorías centrales: paciente y familia, profesionales y proceso asistencial. No suele consultarse al paciente sobre sus preferencias respecto al lugar donde quiere morir, y si además la familia las desconoce, no se puede realizar una planificación anticipada de cuidados. La familia elige el hospital por inseguridad respecto a la posibilidad de seguimiento y recursos en APS. Los/las profesionales poseen formación para abordar la muerte, pero no se sienten preparados, focalizando la atención en aspectos clínicos o administrativos. El proceso asistencial favorece a los pacientes oncológicos, pues es más sencillo identificar su terminalidad. No hay equidad en los recursos y es mejorable la comunicación interniveles. No se facilita la integración de la familia en el proceso que interfiere en su toma de decisiones. Conclusiones: Se debe fomentar la planificación anticipada de cuidados y usar el documento de voluntades anticipadas, la comunicación y la coordinación interniveles, dotar de recursos, especialmente a APS, y formar y preparar a los/las profesionales para abordar la muerte. Hay que implicar a la familia en el proceso, aportándole el apoyo necesario

Objective: To discover the reasons for deciding to die in hospital or at home, from the perspective of professionals involved. Method: Qualitative phenomenological study. Intentional sample. Four multidisciplinary focus groups were held, two in hospitals and two in primary care centres in Seville (Spain). Twenty-nine professionals with at least two years experience in the care of people with a terminal disease participated, following the theoretical saturation of information criterion. Results: Responses from the first script were gathered in three core categories: patient and the family, professionals and care process. Patients are generally not asked about their preferences as to where they wish to die, and if their family is not aware of their preference, it is not possible to carry out advanced planning of care. Families tend to choose the hospital because of the possibility of monitoring and resources in primary care. Professionals are trained in how to approach death, but they do not feel sufficiently prepared and focus on the clinical and administrative issues. The care process favours oncology patients because it is easier to identify their illness as terminal. Resources are not equal and interlevel communication needs to be improved. The family's involvement in the process is not facilitated, which impedes their decision-making. Conclusions: Advance care planning and use of the advance directive should be promoted, as well as, interlevel communication and coordination, supply resources, especially in primary care, and professionals should receive training on how to approach death.. The patient's family should be involved in the care process and provided the necessary support

[Reasons for deciding to die in hospital or at home. The vision of professionals]. / Razones para decidir morir en el hospital o en el domicilio. Visión de los/las profesionales.

OBJECTIVE: To discover the reasons for deciding to die in hospital or at home, from the perspective of professionals involved. METHOD: Qualitative phenomenological study. Intentional sample. Four multidisciplinary focus groups were held, two in hospitals and two in primary care centres in Seville (Spain). Twenty-nine professionals with at least two years experience in the care of people with a terminal disease participated, following the theoretical saturation of information criterion. RESULTS: Responses from the first script were gathered in three core categories: patient and the family, professionals and care process. Patients are generally not asked about their preferences as to where they wish to die, and if their family is not aware of their preference, it is not possible to carry out advanced planning of care. Families tend to choose the hospital because of the possibility of monitoring and resources in primary care. Professionals are trained in how to approach death, but they do not feel sufficiently prepared and focus on the clinical and administrative issues. The care process favours oncology patients because it is easier to identify their illness as terminal. Resources are not equal and interlevel communication needs to be improved. The family's involvement in the process is not facilitated, which impedes their decision-making. CONCLUSIONS: Advance care planning and use of the advance directive should be promoted, as well as, interlevel communication and coordination, supply resources, especially in primary care, and professionals should receive training on how to approach death.. The patient's family should be involved in the care process and provided the necessary support.

Discapacidad intelectual en niños y adolescentes: influencia en la familia y la salud familiar. Revisión sistemática / Intellectual disability in children and teenagers: Influence on family and family health. Systematic review

Objetivo: Analizar la influencia en la unidad familiar de la existencia de un hijo en edad infantil o adolescente, con discapacidad intelectual. Método: Revisión sistemática de la literatura, siguiendo las recomendaciones de la declaración PRISMA, en PubMed, Scopus, CINAHL, PsycINFO y Psicodoc. Se localizaron artículos originales, publicados en los últimos 5 años, en español, inglés, portugués, italiano o francés, con resumen y texto completo y calidad metodológica satisfactoria o buena. Dos investigadores independientes consensuaron decisiones. Resultados: Generalmente el cuidado se presta en la familia, asumiendo las madres la mayor responsabilidad, presentando menor bienestar que los padres. El apoyo del cónyuge mejora su calidad de vida. El subsistema fraternal puede afectarse en la calidez de la relación, el estatus/poder y los problemas comportamentales. La salud familiar puede afectarse en todas sus dimensiones: clima y funcionamiento familiar por las mayores demandas y modificaciones en la organización y distribución de roles; resistencia y afrontamiento familiares por el aumento de gastos y disminución de recursos; la integridad familiar puede reforzarse al fortalecerse los lazos familiares. El apoyo emocional favorece la calidad de vida familiar. Conclusiones: Estas familias pueden necesitar atención diferenciada por su mayor demanda de cuidados, disminución de recursos o problemas de salud familiar. Las enfermeras, desde un enfoque de atención centrado en la familia, pueden identificarlas y ayudarlas a normalizar su situación, fomentando la salud familiar y el bienestar de sus miembros (AU)

Objective: To examine the influence of a child or adolescent with intellectual disabilities on the family unit. Method: A systematic review of the literature, following the recommendations of the PRISMA statement, was carried out on the PubMed, Scopus, CINAHL, PsycINFO and Psicodoc databases. Original articles were found, published in the last 5 years, in Spanish, English, Portuguese, Italian or French, with summary and full text and satisfactory or good methodological quality. Two independent researchers agreed on their decisions. Results: In general, care is provided in the family, mothers assume the greater responsibility, and their wellbeing is lower than that of fathers. Having the support of the husband improves their quality of life. The fraternal subsystem can be affected, with regard to the warmth and the status/power of the relationship, and behavioural problems. Family health may be affected in all its dimensions: family functioning and atmosphere due to increased demands and changes in the organisation and distribution of roles; family resilience and family coping, due to rising costs and dwindling resources; family integrity could be strengthened by strengthened family ties. Quality of family life is enhanced by emotional support. Conclusions: These families may need individualised attention due to the increased demand for care, diminishing resources or other family health problems. Nurses using a family-centred care approach can identify these families and help them to normalise their situation by promoting their family health and the well-being of its members (AU)

Intellectual disability in children and teenagers: Influence on family and family health. Systematic review. / Discapacidad intelectual en niños y adolescentes: influencia en la familia y la salud familiar. Revisión sistemática.

OBJECTIVE: To examine the influence of a child or adolescent with intellectual disabilities on the family unit. METHOD: A systematic review of the literature, following the recommendations of the PRISMA statement, was carried out on the PubMed, Scopus, CINAHL, PsycINFO and Psicodoc databases. Original articles were found, published in the last 5 years, in Spanish, English, Portuguese, Italian or French, with summary and full text and satisfactory or good methodological quality. Two independent researchers agreed on their decisions. RESULTS: In general, care is provided in the family, mothers assume the greater responsibility, and their wellbeing is lower than that of fathers. Having the support of the husband improves their quality of life. The fraternal subsystem can be affected, with regard to the warmth and the status/power of the relationship, and behavioural problems. Family health may be affected in all its dimensions: family functioning and atmosphere due to increased demands and changes in the organisation and distribution of roles; family resilience and family coping, due to rising costs and dwindling resources; family integrity could be strengthened by strengthened family ties. Quality of family life is enhanced by emotional support. CONCLUSIONS: These families may need individualised attention due to the increased demand for care, diminishing resources or other family health problems. Nurses using a family-centred care approach can identify these families and help them to normalise their situation by promoting their family health and the well-being of its members.

[Relationship between family variables and conjugal adjustment]. / Relación entre variables familiares y el ajuste conyugal.

OBJECTIVE: To determine whether family variables, such as type of relationship, years of marriage, existence of offspring, number of members of family, stage of family life cycle, transition between stages, perceived social support, and/or stressful life events are related to conjugal adjustment. DESIGN: A cross-sectional and correlational study using questionnaires. LOCATION: Primary care and hospital units of selected centres in the province of Seville, Spain. PARTICIPANTS: Consecutive stratified sampling by quotas of 369 heterosexual couples over 18years of age, who maintained a relationship, with or without children, living in Seville. MAIN MEASUREMENTS: A self-report questionnaire for the sociodemographic variables, and the abbreviated version of the Dyadic Adjustment Scale, Questionnaire MOS Perceived Social Support, and Social Readjustment Rating Scale, were used. Descriptive and inferential statistics were performed with correlation analysis and multivariate regression. RESULTS: Statistically significant associations were found between conjugal adjustment and marriage years (r=-10: P<.05), stage of family life cycle (F=2.65; P<.05), the transition between stages (RPB=.11; P<.05) and perceived social support (r=.44; P<.001). The regression model showed the predictive power of perceived social support and the family life cycle stage (mature-aged stage) on conjugal adjustment (R2=.21; F=9.9; df=356; P<.001). CONCLUSIONS: Couples may be assessed from Primary Care and be provide with resources and support. In addition, it can identify variables that may help improve the conjugal relationship.