Estado de salud de pacientes con trasplante hepático por enfermedad relacionada con el consumo de alcohol vs. otras etiologías: estudio de cohortes / Health status of patients with liver transplantation by alcohol-related disease vs another etiology: a cohort study

Objetivo: Estudiar el estado de salud de un grupo de pacientes con trasplante hepático (TH) por enfermedad relacionada con el consumo de alcohol vs. otras etiologías, antes y después del trasplante. Método: Estudio longitudinal de cohortes en pacientes trasplantados hepáticos desde noviembre de 2019 hasta julio de 2022. Se incluyeron pacientes atendidos para un primer TH tanto electivo como urgente en la Unidad de Trasplantes de un hospital. Se excluyeron aquellos pacientes que ya portaban un órgano trasplantado y aquellos que necesitaron un re-TH en el primer mes tras el primer trasplante. Se recogieron variables sociodemográficas y clínicas, Model for End-Stage Liver Disease (MELDNa), índice de fragilidad hepática (LFI), efectos emocionales-conductuales del trasplante, nivel de ansiedad y depresión. En el análisis estadístico se utilizaron las pruebas de X2 de Pearson, t de Student, U de Mann-Whitney y el signo de Wilcoxon. Resultados: La muestra fue n = 67 pacientes trasplantados hepáticos, con una edad promedio de 56,37 años, siendo 67,2% hombres y 39% por enfermedad hepática relacionada con el alcohol (EHRA). De todos los pacientes incluidos, 9% fueron trasplantes urgentes. El consumo de alcohol se asoció con una mayor edad, una alta tasa de fragilidad hepática y una situación laboral no activa. La etiología alcohólica se correlacionó con una mayor preocupación durante los primeros seis meses después del trasplante de hígado. Conclusión: Existen diferencias en el estado de salud de los pacientes trasplantados hepáticos por EHRA vs. otra etiología. Las enfermeras deben considerar la etiología de la enfermedad hepática para orientar los cuidados y las intervenciones durante todo el proceso de trasplante.(AU)

Aim: To study the health status of a group of patients with liver transplantation by alcohol-related disease vs another etiology before and after the transplantation. Method: Longitudinal cohort study of liver transplant patients from November 2019 to July 2022. Adult patients attended in the unit of transplantation of a hospital for a first liver transplant, both elective and urgent, were included. Patients who already had a transplanted organ and those who required liver re-transplantation in the first month after the first transplant were excluded. Sociodemographic and clinical variables, MELDNa, liver frailty index, emotional-behavioral effects of transplantation, level of anxiety and depression were collected. Pearson's chi-square, Student's t, Mann-Whitney U, and Wilcoxon sign tests were used for statistical analysis. Results: The sample was n = 67 liver transplant patients with a mean age of 56.37 years, 67.2% being men and 39% due to alcohol-related liver disease. 9% of all included patients were urgent transplants. Alcohol consumption was associated with older age, a high rate of liver frailty, and a non-active work situation. Alcoholic etiology correlated with increased concern during the first six months after liver transplantation. Conclusion: There are differences in the health status between liver transplant patients for alcohol-related liver disease vs other etiology. Nurses must consider the etiology of liver disease to guide care and interventions throughout the transplant process.(AU)

Health status of patients with liver transplantation by alcohol-related disease vs another etiology: A cohort study.

AIM: To study the health status of a group of patients with liver transplantation by alcohol-related disease vs another etiology before and after the transplantation. METHOD: Longitudinal cohort study of liver transplant patients from November 2019 to July 2022. Adult patients attended in the unit of transplantation of a hospital for a first liver transplant, both elective and urgent, were included. Patients who already had a transplanted organ and those who required liver re-transplantation in the first month after the first transplant were excluded. Sociodemographic and clinical variables, MELDNa, liver frailty index, emotional-behavioral effects of transplantation, level of anxiety and depression were collected. Pearson's chi-square, Student's t, Mann-Whitney U, and Wilcoxon sign tests were used for statistical analysis. RESULTS: The sample was n = 67 liver transplant patients with a mean age of 56.37 years, 67.2% being men and 39% due to alcohol-related liver disease. 9% of all included patients were urgent transplants. Alcohol consumption was associated with older age, a high rate of liver frailty, and a non-active work situation. Alcoholic etiology correlated with increased concern during the first six months after liver transplantation. CONCLUSION: There are differences in the health status between liver transplant patients for alcohol-related liver disease vs other etiology. Nurses must consider the etiology of liver disease to guide care and interventions throughout the transplant process.

Cross-cultural adaptation of the FRAIL scale for critically ill patients in Spain.

AIM: To translate and culturally adapt the FRAIL scale into Spanish and perform a preliminary test of diagnostic accuracy in patients admitted to intensive care units. DESIGN: Cross-sectional diagnostic study. METHODS: Five intensive care units (ICU) in Spain were participated. Stage 1: Three native Spanish-speaking bilingual translators familiar with the field of critical care translated the scale from English into Spanish. Stage 2: Three native English-speaking bilingual translators familiar with critical care medicine. Stage 3: Authors of the original scale compared the English original and back-translated versions of the scale. Stage 4: Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the comprehension and relevance of each of the items of the Spanish version in 30 patients of 3 different age ranges (<50, 50-65 and >65 years). RESULTS: The FRAIL scale was translated and adapted cross-culturally for patients admitted to intensive care units in Spain. The process consisted of four stages: translation, back translation, comparison and pilot test. There was good correspondence between the original scale and the Spanish version in 100% of the items. The participating patients assessed the relevance (content validity) and comprehensibility (face validity) of each of the items of the first Spanish version. The relevance of some of the items scored low when the scale was used in patients younger than 65 years. CONCLUSIONS: We have cross-culturally adapted the FRAIL scale, originally in English, to Spanish for its use in the critical care medical setting in Spanish-speaking countries. IMPLICATIONS FOR PROFESSIONALS: Physicians and nurses can apply the new scale to all patients admitted to the intensive care units. Nursing care can be adapted according to frailty, trying to reduce the side effects of admission to these units for the most fragile patients. REPORTING METHOD: The manuscript's authors have adhered to the EQUATOR guidelines, using the COSMIN reporting guideline for studies on the measurement properties of patient-reported outcome measures. PATIENT OR PUBLIC CONTRIBUTION: In a pilot clinical study, we applied the first version of the FRAIL-Spain scale to intensive care unit (ICU) patients. Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the relevance (content validity) and comprehensibility (face validity) of the five items of the first Spanish version. Relevance was assessed using a 4-point Likert scale ranging from 1 (no relevance) to 4 (high relevance), and comprehensibility was assessed as poor, acceptable or good. Each health professional applied the scale to three patients (total number of patients = 30) of three different age ranges (<50, 50-65 and >65 years) and recorded the time of application of the scale to each patient. Although the frailty scales were initially created by geriatricians to be applied to the elders, there is little experience with their application in critically ill patients of any age. Therefore, more information is needed to determine the relevance of using this scale in critical care patients. In this pilot study, we considered that nurses and critical care physicians should evaluate frailty using this adapted scale in adult patients admitted to the Intensive Care Units.

Análisis de las propiedades psicométricas de un cuestionario para medir la actitud hacia el humor en los profesionales sanitarios / Analysis of the psychometric properties of a questionnaire to measure the attitude towards humor in healthcare professionals

Objetivo principal: Analizar las propiedades psicométricas de un instrumento diseñado específicamente para evaluar la actitud ante el humor en profesionales sanitarios. Métodos: Estudio de validación, transversal. Se determinó la fiabilidad con el índice de discriminación, el coeficiente de correlación intraclase e ítem-total, el α de Cronbach y el índice de Pearson. La validez de constructo se analizó con el análisis factorial exploratorio. Resultados principales: La Escala Multidimensional del Humor en Profesionales Sanitarios (EMHUPS) consta de 35 ítems y 8 factores: humor con el paciente, en el trabajo, en los cuidados, en el entorno privado, formación en humor, en el entorno sanitario, demanda de formación en humor y humor y ocio. Presenta una varianza del 60,99% y una fiabilidad de 0,88. Conclusión principal: La escala EMHUPS presenta unas propiedades psicométricas aceptables en la medida del humor en profesionales sanitarios. (AU)

Objective: To evaluate the psychometric properties of an instrument designed specifically designed to determine attitude towards humor in health professionals. Methods: A cross-sectional and a validation study. The reliability study analysed the discrimination capacity of the items with discrimination index, the intraclass and item-total correlation coefficient, the Cronbach's α coefficient and the Pearson's correlation coefficient. In the validation study, the Exploratory Factor Analysis was carried out. Results: The Multidimensional Scale of Humor in Healthcare Professionals (EMHUPS) consists of 35 items divided into 8 factors: humor with the patient, humor at work, humor and care, humor in the private environment, training in humor, humor and the sanitary environment, demand for training in humor and humor and leisure. These factors explained a total variance of 60.99% with overall reliability of 0.88. Conclusions: EMHUPS presents acceptable psychometric properties in the measurement of humor in healthcare professionals. (AU)

Barriers and Facilitators to the Learning and Acquisition of Research Competencies among Nursing Students through Active Methodologies: A Qualitative Study Using Reflective Writing.

BACKGROUND: The development of educational research, critical thinking skills, and evidence-based practice requires proposals for educational innovation. The purpose of this study was to explore the perspectives of undergraduate nursing students on the barriers and facilitators after the implementation of a novel activity within the course of research methodology, composed of three active learning strategies: (a) project-based learning; (b) small-group learning; and (c) self-directed learning. METHODS: A qualitative exploratory study using reflective writing was conducted at the Nursing Department of the Red Cross School (Spain). Seventy-four nursing students participated in the study, enrolled in the research methodology course. Purposive sampling was used. Online reflective notes were collected from a script of open-ended questions. An inductive thematic analysis was performed. RESULTS: The new proposals facilitated learning of the subject matter and its contents. They were useful and enabled the students to put the contents into practice. In addition, they improved the students' organization, planning, and involvement. The barriers identified were a lack of time, ambiguity, inadequate tutoring or novelty of the work, and inequity in the distribution of tasks and workloads. CONCLUSIONS: Our findings shed light on the barriers and facilitators identified by nursing students when implementing an educational innovation proposal, using three active learning methodologies as learning tools for the subject of nursing research.

Resilience After COVID-19: A Descriptive, Cross-Sectional Study.

The main purpose of this study was to examine the relationship between resilience and health-related quality of life in patients following COVID-19 disease among those with and without lingering symptoms. The study design is descriptive and cross-sectional. Participants (n = 97) were adults who had earlier contracted COVID-19 disease and were in post-infection status between July and October 2020. Participants completed the following instruments: Connor-Davidson Resilience Scale, Short-Form 12-item Health Survey, and Hospital Anxiety and Depression Scale. Approximately 35% post-COVID-19 patients had a low level of resilience. The impact on the health status and resilience of those who had reported symptoms after 6 months was also significant. Age and depression had a significant impact on level of resilience. This relationship can affect patient recovery and negatively impact the ability to cope with COVID-19 disease. It is necessary to implement specialized training for clinicians on the effects of long-term COVID-19 to improve patient care. Long COVID symptoms might manifest months after an acute COVID-19 illness; clinicians who can confirm patient reports of these symptoms may help patients recover and become more resilient.

Preoperative respiratory therapy in patients undergoing surgery for lung cancer: A randomized controlled trial.

BACKGROUND: A preoperative respiratory therapy treatment was performed to analyze the effectiveness, with respect to postoperative air leak and pain, in patients undergoing surgery for lung cancer. OBJECTIVES: To analyze air leakage and postoperative pain. MATERIAL AND METHODS: Seventy one patients were studied, with a mean age of 62.58 years. Descriptive variables of gender, carcinogenic pathology, type of surgical incision and lung resection, use of glue and endostapler, and presence of adhesions were analyzed. Likewise, analysis of the quantitative variables of age, body mass index and forced expiratory volume in 1 s Two homogeneous groups resulted. Differentiated, experimental group (EG) that performed preoperative respiratory therapy and control group (CG). RESULTS: There were statistically significant differences in favor of the EG with respect to postoperative air leak on days 1-2 during the performance of physiotherapy techniques, the food and during the performance of the exercises autonomously. Furthermore, differences in air leakage were observed on days 2-4 during gait. The number of patients decreased to a greater extent in the EG. Regarding pain, there were statistically significant differences in the sample on days 1-4, with greater intensity of pain in the CG and after doing physiotherapy every day except the second. CONCLUSIONS: Preoperative respiratory therapy in patients undergoing surgery for lung cancer was effective in reducing the number of patients who presented postoperative air leak and reducing pain in the EG.

Design of an instrument to measure humor in health professionals.

AIM: The objective of this study was to develop an instrument for measuring humor in health professionals. METHODS: Observational, transversal and descriptive study of mixed methodology. The instrument was designed in several phases: literature review, item generation, determination of the scale format, review by the expert panel, pilot study, reevaluation by the expert panel, and test-retest. The pertinence, relevance and comprehension of the items were analyzed. Interobserver agreement was calculated with Kappa and the intraclass correlation coefficient considering values ≥0.61. Pared sample Student's t test and Pearson's correlation coefficient were used. A level of statistical significance was established at P < 0.05. RESULTS: The Three-Dimensional Scale of Humor in Health Professionals consists of 50 items measured with a 5-point Likert scale based on the degree of agreement. Experts' panel evaluated the global scale with 3.57 (0.79) points out of 5. An interobserver reliability of 0.69 (P < 0.001) was obtained in the pilot study. A Pearson correlation coefficient of 0.71 (P = 0.002) and an intraclass correlation coefficient of 0.69 (P = 0.001) resulted in the test-retest. No statistically significant differences were observed between test-retest scores. CONCLUSION: The Three-Dimensional Scale of Humor in Health Professionals is an innovative tool for measuring humor in the health context. This scale is created specifically for health professionals. It's necessary its validation in future studies.

Efficacy of the therapeutic use of video games on the depressive state of stroke patients: Protocol for systematic review and meta-analysis.

AIM: To assess the effects of virtual reality (VR) on the depressive state of patients with stroke admitted to neuro-rehabilitation units. Design: Systematic review and meta-analysis protocol. METHODS: Randomized Controlled Trials (RCTs) focusing on the effects of virtual reality on depressive state as a primary outcome will be included. Grey literature and the following databases will be consulted: PubMed, Cinahl, PsycInfo, Scopus, Embase, Cochrane Library and Web of Science. The recently revised Cochrane risk of bias tool will be used to assess the quality of included studies. Data will be extracted and meta-analyses will be performed within the specific condition of the emotional state of stroke patients admitted to neurorehabilitation units. Meta-regression and subgroup analyses will be used to identify effective modes and patterns of therapy delivery. The approach of assessment, development and evaluation of recommendations will be applied to reach a convincing conclusion. DISCUSSION: An accurate, transparent and standardized review process is expected to provide recommendations on the use of VR technology in the healthcare of stroke patients. IMPACT: Emotional difficulties are common after stroke and have an impact on rehabilitation outcome. VR seems to have an important role in the treatment and depression in neurological patients, as it is able to improve levels of well-being, coping strategies and social relationships. The systematic review may contribute to a more convincing and specific conclusion compared to existing studies of this type. TRIAL REGISTRATION: Systematic review registration: CRD42022303968.

Attitudes towards multi-organ donation among intensive care unit nurses in transplant hospitals.

AIM: To evaluate the attitudes towards deceased multi-organ donation and transplantation among nurses within the critical care units of the six public tertiary transplant hospitals in Madrid, Spain. BACKGROUND: Spain has a rate of 49 donations per million population, whereas Madrid has a lower donation rate of 34.2 per million population. Nurses generate social opinion, and their attitude can be one of the barriers against organ donation. METHOD: An observational descriptive study was conducted among critical care units' nurses. The measuring instrument was the Collaborative International Donor Project in Organ Donation and Transplantation. Data were collected from January to October 2019, and a statistical analysis was performed. RESULTS: A total of n = 313 questionnaires achieved a response rate of 51%. Of the intensive care unit nurses surveyed, 85% had a favourable opinion towards the donation of their organs being affected by psychosocial variables related to social variables with respect to family, religion and attitude towards the body. CONCLUSION: The intensive care unit nurses of the Madrid transplant hospitals maintain a favourable attitude towards organ donation and transplantation. It is necessary to implement specialized training and periodically evaluate training in this sector. To maintain and improve the attitude towards organ donation, family discussion among health personnel should be encouraged. Religion influences the attitude of nurses and donation rates. IMPLICATION FOR NURSING AND HEALTH POLICY: Intensive care nurses' attitude towards organ donation is influenced by social variables. This study shows that the attitude is positive but improvable. These findings contribute to promote awareness of the lack of organs and the benefits of organ donation.

Actitudes de los profesionales de enfermería ante la participación familiar en los cuidados de los pacientes pediátricos hospitalizados / Nursing attitude about the family involvement in hospitalized children care

INTRODUCCIÓN. La familia es una unidad que se caracteriza por las relaciones entre sus miembros. La interdependencia entre ellos presupone, en temas de salud, que los cuidados serán más eficientes si se dirigen al sistema familiar como unidad. En este sentido, el impacto de la enfermedad y, con ello, un ingreso hospitalario, impulsa al equipo de enfermería a incluir la familia en los cuidados de salud. Las enfermeras consideran que su relación con las familias, en ocasiones, no es fácil, lo que genera diferentes actitudes hacia ellas y a plantearse la posibilidad de permitir su participación en los cuidados. El objetivo de este estudio es analizar las actitudes de los profesionales ante la involucración de la familia en los cuidados de los pacientes. MATERIAL Y MÉTODO. Se realizó un estudio observacional transversal dirigido a los profesionales de enfermería del Departamento Materno-Infantil del Hospital General Universitario Gregorio Marañón (HGUGM). Se utilizó el cuestionario «Importancia de la familia en los cuidados de enfermería: Actitudes de las enfermeras». RESULTADOS. La mayoría de los profesionales, principalmente los pertenecientes a unidades de hospitalización de pacientes con patología crónica, consideran la familia parte de los cuidados de los pacientes, y encuentran que la buena relación con ellos les proporciona satisfacción en su trabajo, sin diferencia entre categorías. Más de la mitad de los profesionales de las Unidades de Cuidados Intensivos Pediátricos (UCIP) consideran que la presencia de la familia les genera estrés. CONCLUSIONES. La diferencia en la actitud de los profesionales está relacionada con el tiempo que estos pasan con las familias y la tecnificación de los cuidados (AU)

INTRODUCTION. Family it’s a unit which is characterized by the relationship between its members, the interdependence between them in health, presupposes that care will be more efficient if targeted the family system as a unit. In that fact the impact of illness and hospitalization drives the nursing staff to include the family in health care. Nurses think their relationship with families is not easy, which generates different attitudes towards them and present the possibility to allow its participation in care. The aim of this research was to analyze the attitudes of these professionals in the family involvement in patients care. MATERIAL AND METHODS. A descriptive cross-sectional study was applied to the nursing staff in Pediatric Department of a the university general hospital Gregorio Marañón (HGUGM), in Madrid, Spain. The data was collected using the «Families’ Importance in nursing care: Nurse´s attitudes scale». RESULTS. Most of the professionals, mostly units of patients with chronic disease, take into consideration the family like a resource in nursing care, finding that a good relationship with families give them job satisfaction, without differences between categories. More than half of the professionals from the units of pediatric intensive care (PICU) considered that the presence of the family generates stress. CONCLUSIONS. The difference in the attitude of professionals is related to the time they spent with families and technification of the care (AU)

[Nursing Attitude About the Family Involvement in Hospitalized Children Care]. / Actitudes de los profesionales de enfermería ante la participación familiar en los cuidados de los pacientes pediátricos hospitalizados.

Introduction: Family it's a unit which is characterized by the relationship between its members, the interdependence between them in health, presupposes that care will be more efficient if targeted the family system as a unit. In that fact the impact of illness and hospitalization drives the nursing staff to include the family in health care. Nurses think their relationship with families is not easy, which generates different attitudes towards them and present the possibility to allow its participation in care. The aim of this research was to analyze the attitudes of these professionals in the family involvement in patients care. Material and Methods: A descriptive cross-sectional study was applied to the nursing staff in Pediatric Department of the University General Hospital Gregorio Maranon (HGUGM), in Madrid, Spain. The data was collected using the "Families' Importance in nursing care: Nurse's attitude scale". Results: Most of the professionals, mostly units of patients with chronic disease, take into consideration the family like a resource in nursing care, finding that a good relationship with families give them job satisfaction, without differences between categories. More than half of the professionals from the units of pediatric intensive care (PICU) considered that the presence of the family generates stress. Conclusions: The difference in the attitude of professionals is related to the time they spent with families and technification of the care.