Riesgo de depresión materna perinatal tras una pérdida gestacional: prevalencia y factores asociados. Un estudio exploratorio / Risk of perinatal maternal depression after pregnancy loss: prevalence and associated factors. An exploratory study

Objetivo: Evaluar la prevalencia del riesgo de depresión materna en el periodo perinatal, y los factores asociados a la misma, en las mujeres atendidas en Parc Taulí Hospital Universitari de Sabadell (Barcelona) que han tenido una pérdida gestacional de más de 13 semanas de gestación. Material y método: Se diseñó un estudio observacional de tipo analítico. Las variables estudiadas fueron: el riesgo de depresión materna perinatal, el tiempo transcurrido entre el diagnóstico y la expulsión, las pérdidas gestacionales previas, la viabilidad fetal, ver y sostener al bebé, la obtención de huellas y fotografías de recuerdo, y percibir contradicciones profesionales. El riesgo de depresión posparto fue evaluado mediante la Escala de Edimburgo. Se realizó un análisis de regresión múltiple por pasos para evaluar el efecto de las variables de estudio sobre la depresión posparto al alta. Resultados: Participaron 29 mujeres entre julio de 2018 y diciembre de 2020. El 37,9 % (n= 11/29) de las participantes al alta y el 26,7 % (n= 4/15) al mes presentaban puntuaciones superiores a 13 en la Escala de Edimburgo. La ecuación de la regresión fue estadísticamente significativa (F(4,23)= 7,31, p <0,001), llegando a explicar el 48,3 % (R2 ajustada) de la varianza de la depresión posparto al alta. El tiempo transcurrido entre el diagnóstico y la expulsión superior a 24 horas (B= 4,91; IC del 95 %= 0,83-8,99), así como las pérdidas gestacionales previas (B= 5,99; IC del 95 %= 1,92-10,06) se asociaron con una mayor puntuación en la Escala de Edimburgo, mientras que ver al hijo/a (B= –5,84; IC del 95 % = –11,55 a –0,12) se asoció con una disminución de la puntuación. (AU)

Objective: To evaluate the prevalence of the risk of maternal depression in the perinatal period and the factors associated with it, in women treated at Hospital Parc Taulí Hospital Universitari of Sabadell (Barcelona), who have had a gestational loss of more than 13 weeks of gestation. Material and method: An analytical observational study was designed. The variables studied were: the risk of perinatal maternal depression, the time elapsed between diagnosis and expulsion, previous pregnancy losses, fetal viability, seeing and holding the baby, obtaining footprints and souvenir photographs, and perceiving professional contradictions. The risk of postpartum depression was assessed using the Edinburgh Scale. A stepwise multiple regression analysis was performed to evaluate the effect of the study variables on postpartum depression at discharge. Results: 29 women participated between July 2018 and December 2020. 37.9% (n= 11/29) of the participants at discharge and 26.7% (n= 4/15) at one month had scores higher than 13 on the Edinburgh Scale. The regression equation was statistically significant (F(4,23)= 7.31, p <0.001) explaining 48.3% (R2 Adjusted) of the variance of postpartum depression at discharge. The time elapsed between diagnosis and expulsion greater than 24 hours (B = 4.91; 95% CI = 0.83 – 8.99), as well as previous pregnancy losses (B = 5.99; 95% CI = 1.92 – 10.06) were associated with a higher score on the Edinburgh Scale, while seeing the child (B = -5.84; 95% CI = -11.55 – -0.12 ) was associated with a decrease in score. (AU)

"Care left undone" and quality of care during the COVID-19 pandemic: Influential factors and modulating strategies.

OBJECTIVE: To analyze the quality of care provided during the COVID-19 pandemic, identifying what care has been prioritized and factors that have influenced such care. BACKGROUND: Given the need to adapt care due to the pandemic, nurses may have been subjected to factors that have negatively affected them, however it has also been possible to find actions that have enabled nurses to maintain the quality of care provided. METHOD: Exploratory study with a sample of 225 nurses. Data collection was performed using a self-assessment of the care provided, the 'Care Left Undone' Scale, and ad hoc questionnaire for demographic variables. RESULTS: The mean rate of missed care was 5.76. Significant differences were identified according to age, professional experience, field of specialty and personal and professional strategies. CONCLUSION: Both personal and professional feelings, characteristics, and strategies have an effect in the perception of quality of care provided and missed care during the pandemic.

«Cuidados perdidos» y calidad de los cuidados durante la pandemia por COVID-19: factores y estrategias influyentes / “Missed care” and quality of care during the COVID-19 pandemic: Influential factors and modulating strategies

Objetivo:Analizar la calidad de los cuidados brindados durante la pandemia por COVID-19, identificando los cuidados que se han priorizado y los factores que han influido. Ante la situación de adaptación de los cuidados exigidos por la pandemia, las enfermeras han podido estar sometidas a factores que las hayan afectado de manera negativa, pero también se han podido encontrar estrategias que han permitido mantener la calidad de los cuidados.Método:Estudio descriptivo con muestra de conveniencia de 225 enfermeras que atendieron a pacientes con COVID-19. Para la recogida de datos se emplea un cuestionario ad hoc de variables personales y laborales, una autovaloración de los cuidados y la escala Care Left Undone.Resultados:La tasa media de cuidados perdidos ha sido de 5,76 (DS 3,1). Se identifican diferencias significativas en función de la edad, experiencia profesional y del cambio de estructura y de especialidad. Las estrategias que se asocian de manera significativa con mayor valoración de la calidad de los cuidados estuvieron relacionadas con la cohesión del equipo, evitar la despersonalización, búsqueda activa de información, estrategias de control de estrés y de pensamiento positivo. Se han identificados sentimientos, características y estrategias personales y profesionales, que influyen tanto en la percepción de la calidad como en la pérdida de cuidados durante la atención a la pandemia.

Objective:To analyze the quality of care provided during the COVID-19 pandemic, identifying what care has been prioritized and factors that have influenced such care.Background:Given the need to adapt care due to the pandemic, nurses may have been subjected to factors that have negatively affected them, however it has also been possible to find actions that have enabled nurses to maintain the quality of care provided.Method:Exploratory study with a sample of 225 nurses. Data collection was performed using a self-assessment of the care provided, the ‘Care Left Undone’ Scale, and ad hoc questionnaire for demographic variables.ResultsThe mean rate of missed care was 5.76. Significant differences were identified according to age, professional experience, field of specialty and personal and professional strategies.Conclusion:Both personal and professional feelings, characteristics, and strategies have an effect in the perception of quality of care provided and missed care during the pandemic.

["Missed care" and quality of care during the COVID-19 pandemic: Influential factors and modulating strategies]. / «Cuidados perdidos¼ y calidad de los cuidados durante la pandemia por COVID-19: factores y estrategias influyentes.

Objective: To analyze the quality of care provided during the COVID-19 pandemic, identifying what care has been prioritized and factors that have influenced such care. Background: Given the need to adapt care due to the pandemic, nurses may have been subjected to factors that have negatively affected them, however it has also been possible to find actions that have enabled nurses to maintain the quality of care provided. Method: Exploratory study with a sample of 225 nurses. Data collection was performed using a self-assessment of the care provided, the 'Care Left Undone' Scale, and ad hoc questionnaire for demographic variables. Results: The mean rate of missed care was 5.76. Significant differences were identified according to age, professional experience, field of specialty and personal and professional strategies. Conclusion: Both personal and professional feelings, characteristics, and strategies have an effect in the perception of quality of care provided and missed care during the pandemic.

Ansiedad y depresión en las madres de recién nacidos prematuros. Estrategias de intervención y revisión de la bibliografía / Anxiety and depression in mothers of preterm infants. Intervention strategies and literature review

INTRODUCCIÓN: El parto prematuro es una situación muy estresante para las mujeres que lo sufren, ya que supone enfrentarse a una realidad no esperada, en la que se pierden sus expectativas sobre la vivencia del embarazo y el parto normal. Además, deberán afrontar no sólo la separación inicial de su hijo, sino también la pérdida de su rol maternal, ya que los cuidados se asumirán en la unidad neonatal (UNN). Por todo ello, durante el puerperio estas mujeres serán especialmente vulnerables a los problemas de salud mental, y tendrán más riesgo de sufrir niveles altos de ansiedad, depresión e incluso síntomas de estrés postraumático. OBJETIVOS: Conocer y valorar las estrategias de intervención que han demostrado ser eficaces para prevenir, mejorar y/o tratar los riesgos para la salud mental de las madres que pasan por el proceso de tener un hijo prematuro. METODOLOGÍA: Se ha realizado una búsqueda de la bibliografía publicada en los últimos 5 años en las bases de datos CINHAL, PubMed, Web of Science y PsycINFO. RESULTADOS: Las estrategias que han demostrado ser eficaces para mejorar la salud mental son las que incluyen a las madres como cuidadoras, ya sea a través de la promoción de la lactancia materna, el método canguro o los masajes en la UNN, y también las intervenciones que aumentan los conocimientos, tanto en referencia al ambiente de la UNN como a los cuidados y progresos de sus hijos. CONCLUSIONES: La matrona, como profesional de referencia del cuidado del puerperio, ha de conocer el riesgo para la salud mental de estas puérperas, con el fin de detectarlo precozmente y promover actividades preventivas que faciliten su rol maternal, y así contribuir a mejorar la experiencia de tener un hijo prematuro

INTRODUCTION: Preterm birth represents a stressful situation for women who suffer it. They have to face an unexpected reality. A new reality far from their initial expectations about pregnancy and birth, as well as the separation from their baby after giving birth. Premature babies need special cares assumed by the neonatal intensive care unit so mothers have to delegate her maternal role to health professionals. Therefore, all women who have to face a preterm birth are especially vulnerable during the postpartum period to develop mental health problems and to present more anxiety, depression and even post-traumatic stress. OBJECTIVE: Identify and evaluate intervention strategies that proved to be effective in order to prevent, improve and/or treat the risks in mental health of all mothers who have to face a preterm baby. METHODOLOGY: Bibliographic research in the scientific literature published during the last five years in the databases CINHAL, PubMed, Web of Science and PsycINFO. RESULTS: The strategies which demonstrated to be more effective to improve the mental health are interventions that included mothers as the responsible of giving care to the baby. There are different strategies such the promotion in breastfeeding, the kangaroo method or the introduction in massage techniques in the neonatal unit. The activities that help them to increases the knowledge about the function of the neonatal intensive care unit and giving them all the information about the care and progress of their baby are effective options as well. CONCLUSIONS: The midwife is the responsible to take care of mothers during the postpartum. This professional has to know the risk of this women to develop mental health problems during this process. In that case, they have to detect it early and work to promote preventive activities that help mothers to develop her maternal role in this way they will contribute to improve the experience of having a premature baby

El triaje obstétrico: nuevo reto para las matronas. Experiencia del Hospital Parc Taulí en la implementación de un sistema de triaje obstétrico / The obstetric triage: a new challenge for midwives. Experience at the Hospital Parc Taulí in the implementation of an obstetric triage system

El triaje es una práctica ampliamente implantada en los servicios de urgencias generales de nuestro país, que ha demostrado su eficacia en la identificación de situaciones de riesgo al asegurar la priorización de la visita médica en función de la urgencia. En las urgencias obstétricas el triaje es una actividad relativamente nueva. Basándonos en la revisión bibliográfica y competencial realizada, se defiende que el profesional más adecuado para realizar esta actividades la matrona, ya que la valoración de la gestante y la atención de enfermería que de ella se deriva requieren la actuación de una enfermeraespecializada. Mediante el ejemplo de la instauración del triaje obstétrico en el Hospital de Sabadell se describe cómo se intenta mejorar la respuesta a las necesidades de las usuarias que acuden a urgencias (AU)

Triage practice is widely implemented in general emergency departments of our country, which has proved effective in identifying risk situations,ensuring prioritization of medical visits according to urgency. In midwifery is the midwife who performs the triage, as it is the nursespecialist in obstetrics and gynecology. The resulting nursing care of the grounds of urgency as well as conducting advanced triage requires actionby a nurse practitioner.The introduction of obstetric triage in CSPT, while improving responsivenessto the needs of users, establishes uniform criteria and consistent scientific adequate attention to the needs of the user has about their demand for care (AU)