Self-care nursing assessment: cross-cultural adaptation and validation of the Spanish version of the Self-care of chronic illness inventory.

BACKGROUND: Self-care is the primary means of caring for a chronic condition. Therefore, it is necessary to assess it by using a good validity and reliability instrument. The Self-Care of Chronic Illness Inventory (SC-CII) is a generic instrument developed to measure self-care processes behaviors using three separate scales in patients with chronic illness. The original cross-cultural assessment concluded the need for future studies sampling patients from different sites to increase the generalizability of the psychometric evaluation results. It was unclear whether this tool had sound psychometrics properties in the context of Spanish culture. The purpose of this study was to cross-culturally adapt the SC-CII, test its psychometric properties and validate its use among Spanish people with chronic diseases. METHODS: A cross-cultural translation of the SC-CII was performed from English to Spanish. The psychometric evaluation was conducted in a sample of 350 patients with chronic conditions through a multicenter cross-sectional study based on the STROBE guideline. Data were collected from face-to-face interviews during 2022. Internal validity was assessed with Confirmatory Factor Analysis, internal consistency reliability with Cronbach alpha for unidimensional scales and McDonald's Omega reliability coefficient for multidimensional scales. RESULTS: Most (63.4%) participants were older adults aged 65 years or older with a mean age of 65.45 ± 14.97. The average number of chronic conditions reported was 2.81%; the most common conditions were hypertension (52.3%), musculoskeletal disorders (46.3%) and diabetes (38.9%). Patients reported adequate self-care behaviors in all three scales of the SC-CII. The Self-Care Maintenance and Management scales were multidimensional, and the Self-Care Monitoring scale was unidimensional. In Confirmatory Factor Analysis, the Self-Care Maintenance and Monitoring scales had satisfactory fit indices. The Self-care Management scale had acceptable fit indices. The Omega reliability coefficient for multidimensional scales was 0.75 (Self-Care Maintenance) and 0.72 (Self-Care Management). The Cronbach alpha coefficient of the Self-Care Monitoring scale was 0.85. Item-total correlations were all significant except one. Test-retest reliability showed an intraclass correlation coefficient of 0.92. CONCLUSIONS: The SC-CII has appropriate psychometrics characteristics and is a culturally suitable and reliable instrument for assessing to the self-care behaviors of patients with chronic disease in Spain. The scale provides a simple and rapid solution to assess the self-care process.

Chemotherapy-Related Cognitive Impairment in Patients with Breast Cancer Based on Functional Assessment and NIRS Analysis.

Background: Chemotherapy-related cognitive impairment (CRCI), or "chemobrain," isdefined as a phenomenon of cognitive deficits in cancer patients after chemotherapy and is characterized by deficits in areas of cognition, including memory, attention, speed of processing, and executive function, which seriously affect quality of life. The purpose of this study is to investigate the impact of CRCI in breast cancer (BC) patients in chemotherapy treatment (CT+) or not (CT−) and to analyze their relationship with detectable objective changes in cerebral activity during the execution of a phonological and semantic verbal fluency task (PVF and SVF). Methods: An observational, cross-sectional study was carried out at Badajoz University Hospital (Spain). A total of 180 women with BC were included. We used Cognitive Scale (FACT-Cog) for neuropsychological subjective assessment, obtaining scores of perceived cognitive impairment (PCI), and near-infrared spectroscopy system (NIRS) for neuropsychological objective assessment during a verbal fluency task (PVF and SVF), determining alterations in the prefrontal cortex (PFC) assessed as changes in regional saturation index (rSO2). Results: A total of 41.7% percent of the patients in the sample had PCI. CT+ was significantly associated with a worse impact in PCI (X¯ = 50.60 ± 15.64 vs. X¯ = 55.01 ± 12.10; p = 0.005). Average rSO2 decreased significantly in CT+ (X¯ = 63.30 ± 8.02 vs. X¯ = 67.98 ± 7.80; p < 0.001), and BC patients showed a significant decrease in PVF and SVF on average (X¯ = 41.99 ± 9.52 vs. X¯ = 47.03 ± 9.31, and X¯ = 33.43 ± 11.0 vs. X¯ = 36.14 ± 10.68, respectively; p < 0.001). Conclusions: Our findings suggest that cognitive impairments in the domain of executive functioning exist among patients with BC who received CT. The results corroborate the hypothesis that CT is an important factor in cognitive impairment in patients with BC, which has been demonstrated by both subjective (PCI) and objective (PVF, SVF, and rSO2) neuropsychological measures. The combination of doxorubicin, cyclophosphamide, and docetaxel induce cognitive impairment.

Factors Related to Anxiety, Depressive Symptoms and Quality of Life in Breast Cancer.

Breast cancer (BC) is a major public health problem internationally. Although illness survival rates have improved, patients usually suffer multiple symptoms, both physical and psychological, which can affect their quality of life (QoL). The main aim of this study was to evaluate depressive symptoms, anxiety and the QoL of people with BC. An observational, cross-sectional study was carried out at Badajoz University Hospital (Spain). A total of 200 women with BC were included. EORTC QLQ-C30 and QLQ-BR23 questionnaires were used to assess QoL. Patients were screened for depressive symptoms using the Beck Depression Inventory (BDI) and for state anxiety and trait anxiety using the State Anxiety Inventory (STAI). Thirty-eight percent of the patients in the sample had moderate to severe anxiety, which was related to the time of diagnosis, advanced stage of illness and surgical treatment. We found that 28% of patients had depressive symptoms, related mainly with time of diagnosis, adjuvant therapy and number of cycles of chemotherapy (CT). Patients with the longest time since diagnosis, in stage III, and in treatment with CT, especially those with the greatest number of cycles, had the worst scores in QoL. We found a positive association between depressive symptoms and anxiety with QoL in patients with BC.

Night Shift and Decreased Brain Activity of ICU Nurses: A Near-Infrared Spectroscopy Study.

BACKGROUND: Shift working is associated with a profound desynchronization of circadian rhythm and in particular, night-shift work disrupts normal circadian physiology. Sleep deprivation affects the functioning of certain brain areas and thus impairs cognitive performance. The purpose of this study was to investigate the effects of the night shift on cognitive performance and cerebral oxygenation/haemodynamics. METHODS: A prospective, observational, comparative, randomized and cross-over study was carried out. A total of 74 intensive care unit nurses in Spain were included in the study. The following variables were measured: sociodemographic, burnout, anxiety, baseline cerebral oxygenation levels on night and day shift using a near-infrared spectroscopy system and cognitive task performance during a verbal fluency task to evaluate the alterations in the prefrontal cortex, assessed as changes in regional saturation index. RESULTS: The average regional saturation index decreased significantly in the night shift (r = 0.560, p < 0.001). The ICU nurses showed a significant decrease in the verbal fluency test on average (8.53 ± 8.49, p < 0.001) and, in general, there was also a significant increase in anxiety score (3.17 ± 7.56, p = 0.001). CONCLUSIONS: Sleep deprivation during the night shift was considered to be related to decreased dorsolateral PFC reactivity. After the night shift, the nurses showed a decrease in prefrontal cortex activity and in cognitive performance.

Depressive Symptoms and Quality of Life Associated With the Use of Monoclonal Antibodies in Breast Cancer Treatment.

OBJECTIVES: To assess the relationship between (a) chemotherapy and monoclonal antibody (mAb) treatments and (b) depressive symptoms and quality of life (QOL) in patients with breast cancer. SAMPLE & SETTING: 182 women with breast cancer in Spain who were undergoing chemotherapy with or without mAbs. METHODS & VARIABLES: An observational, cross-sectional study was carried out. The European Organisation for Research and Treatment of Cancer (EORTC) QOL Questionnaire-Core 30 and the EORTC QOL Questionnaire-Breast Cancer were used to assess QOL. Patients were screened for depressive symptoms using the Beck Depression Inventory-II. RESULTS: No relationship was found between the use of mAbs with chemotherapy and QOL, except for incidence of diarrhea. However, depressive symptoms had a negative and highly significant influence on the majority of the QOL parameters. IMPLICATIONS FOR NURSING: The presence of depressive symptoms negatively affects QOL. Used concurrently, mAbs and chemotherapy do not negatively influence QOL, but some adverse effects, such as diarrhea, are common.

Understanding Resilience Factors Among Caregivers of People with Alzheimer's Disease in Spain.

INTRODUCTION: Alzheimer's disease (AD) caregivers resilience involves the interaction between different risk and protective factors. Context of care, objective stressors, perceived stressors caregiver assessment, mediators factors and consequences of care were associated with resilience. We have developed a more integrated and operational conceptual model of resilience and care than previous models in our sociocultural environment. PURPOSE: To assess the resilience of caregivers of people with AD and the related factors grouped according to an established operational conceptual model of Alzheimer´s caregivers stress. PATIENTS AND METHODS: A total of 120 primary informal caregivers of AD persons in Badajoz (Spain) were included in a cross-sectional design. The following variables have been measured on AD persons and caregivers: socio-demographic data, dependency level, cognitive decline, neuropsychiatric and behavioral symptoms, anxiety, depression, severity of somatic symptoms, level of burden, self-esteem, coping, social support, health-related quality of life (HRQOL) and resilience. RESULTS: Most of the caregivers reported symptoms of anxiety (63.3%) and depression (62.5%). We found out higher levels of resilience in caregivers with lower dependence caring (p=0.004). Higher resilience levels of caregivers were related to minor depressive (p=0.006) and anxiety symptoms (p=0.000), and higher HRQOL (p=0.000). Coping dimension mostly used was problem-based strategies such as active coping, positive reinterpretation and acceptance (p= 0.000). CONCLUSION: Those caregivers reporting higher levels of resilience exhibited moderate to intense indicators of burden, fewer symptoms of depression and anxiety and fewer somatic symptoms. They also used adequate problem-focused coping strategies, showed higher levels of HRQOL and demonstrated an appropriate perception of social support. Despite the fact that the characteristics relating to the care context and to social support exert an undeniable influence on caregiver resilience, it would appear that the caregiver's own intra-psychic resources reveal stronger correlations. RELEVANCE FOR CLINICAL PRACTICE: The early and accurate identification of caregivers with lower levels of resilience could enable the implementation of vital psychological and educative support interventions to help caregivers to improve their well-being.

The importance of early identification of infusion-related reactions to monoclonal antibodies.

Monoclonal antibodies constitute important and useful tools in clinical practice and biotechnology for diagnosing and treating infectious, inflammatory, immunological and neoplastic diseases. This article reviews evidence on the different acute adverse effects of monoclonal antibodies, specifically infusion-related reactions (IRRs), and on the measures that should be taken before and during crises. A literature search using key terms relating to IRRs produced by monoclonal antibodies was undertaken to generate a comprehensive narrative review of the information available. Immunomodulatory monoclonal antibodies may produce IRRs and hypersensitivity-related reactions. Strategies to avoid or minimize the appearance of IRRs depend on the monoclonal antibody and type of patient and reaction (pre-medication, slowing infusion rates, infusion interruption or desensitization, etc.). Considering the great number of available monoclonal antibodies in current practice and those which will soon be authorized, it is mandatory to have clear guidelines that can give support to practitioners and nurses to help them respond quickly and safely to the different IRRs related to the use of these therapeutic drugs.

Trasplante hepático urgente por fallo hepático agudo por enfermedad de Wilson / Urgent liver transplantation for acute liver failure due Wilson's disease

No disponible

Interés para la enfermería de los nuevos anticuerpos monoclonales. Una revolución terapéutica / Monoclonal antibodies: a new revolutionary therapy

Los anticuerpos monoclonales (mAb) son una poderosa herramienta para el diagnóstico y tratamiento de muchas enfermedades. En los últimos años la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) ha autorizado la comercialización de nuevos mAb y otros se incorporarán en un futuro próximo. Los profesionales de enfermería, como responsables de la administración, deben conocer las características más importantes de este tipo de herramientas terapéuticas. Se pretende relacionar los diferentes tipos de mAb aprobados en España, sus indicaciones terapéuticas y reacciones adversas, así como destacar otros aspectos importantes sobre el desarrollo de estos nuevos fármacos en el mercado. Los mAb son eficaces para el tratamiento de enfermedades oncológicas, reumatológicas, dermatológicas o neurológicas, entre otras. Además, se están desarrollando numerosos ensayos clínicos con otros nuevos mAb que incrementarán el número de fármacos disponibles, así como nuevas indicaciones para los ya existentes. Aunque la introducción de estos nuevos productos en el mercado está contribuyendo a disminuir la mortalidad y mejorar la calidad de vida de los pacientes, en la práctica clínica existe un gran debate sobre la necesidad de aprobar tantos nuevos fármacos con altos costes para el sistema sanitario y con un beneficio dudoso con respecto al resto de los de su grupo ya comercializados (AU)

Monoclonal antibodies (mAb) are a powerful tool for numerous illnesses' diagnosis and therapy. Over the last few years, the Spanish Agency for Medical Drugs and Health Products (AEMPS) has approved the merchandising of new mAb. Many more approvals are expected to come in the near future. Nursing professionals, responsible for drug administration, should know the most important characteristics of this type of therapeutic tools. Our aim is to link the different types of mAb licensed in Spain, their therapeutic indications, adverse effects, and point out important aspects of the development of these new drugs in the pharmacological market. MAb are very effective for the treatment of oncologic, dermatologic and neurologic diseases among others. Ongoing medical trials with new mAb will increase the current available arsenal, including new indications on the already approved drugs. Although the introduction of this new class of drugs in the pharmaceutical market is reducing mortality and improving the quality of patients' lives, an important debate is going on in real clinical practice over the need to endorse so many new drugs, which pose a huge economic burden on the National Health System and doubtful advantages in comparison to the rest of readily commercialized mAb (AU)

Impact factor evolution of nursing research journals: 2009 to 2014.

BACKGROUND: The use of bibliometric indicators (impact factor [IF], impact index, h-index, etc.) is now believed to be a fundamental measure of the quality of scientific research output. In this context, the presence of scientific nursing journals in international databases and the factors influencing their impact ratings is being widely analyzed. PURPOSE: The aim of this study was to analyze the presence of scientific nursing journals in international databases and track the changes in their IF. METHODS: A secondary analysis was carried out on data for the years 2009 to 2014 held in the JCR database (subject category: nursing). Additionally, the presence of scientific nursing journals in Medline, CINAHL, Scopus, and SJR was analyzed. DISCUSSION: During the period studied, the number of journals indexed in the JCR under the nursing subject category increased from 70 in 2009 (mean IF: 0.99, standard deviation: 0.53) to 115 in 2014 (mean IF: 1.04, standard deviation: 0.42), of which only 70 were listed for the full six years. Although mean IF showed an upward trend throughout this time, no statistically significant differences were found in the variations to this figure. CONCLUSION: Although IF and other bibliometric indicators have their limitations, it is nonetheless true that bibliometry is now the most widely used tool for evaluating scientific output in all disciplines, including nursing, highlighting the importance of being familiar with how they are calculated and their significance when deciding the journal or journals in which to publish the results of our research. That said, it is also necessary to consider other possible alternative ways of assessing the quality and impact of scientific contributions.