Psychosocial changes during COVID-19 lockdown on nursing home residents, their relatives and clinical staff: a prospective observational study.

BACKGROUND: Previous works have observed an increase of depression and other psychological disorders on nursing home residents as a consequence of coronavirus disease 2019 (COVID-19) lockdown; however, there are few studies that have performed a comprehensive evaluation of all people involved in nursing homes environment. The objective of the work was to analyse the impact of lockdown on psychosocial factors of nursing home residents, relatives and clinical staff and how these variables have influenced residents' survival. METHODS: A prospective study was designed. Evaluations were performed at three different times: a) at the beginning of Spanish confinement, in March 2020; b) just before the second wave of the pandemic, with relaxation of security measures but in lockdown, and c) in January-February 2021, at the end of the second wave, when visits were already allowed. The study was conducted on three different nursing homes. Three hundred and one residents, 119 clinical staff and 51 relatives took part in the study. Anxiety and depression were evaluated in all participants. A scale on the meaning of suffering was also performed. In addition, burnout status was also determined in the clinical staff. RESULTS: All participants showed lower depression during lockdown, while at the beginning and at the end of the confinement, these values were significantly increased. In residents, these changes were dependent of cognitive status (p = 0.012). Anxiety was significantly higher in residents. The evolution of anxiety was similar than with depression, with lower values during confinement, although clinical staff showed higher anxiety levels at the beginning. The feeling of suffering was significantly lower in the clinical staff than in resident and relative groups. Residents' survival was dependent of cognitive status (p = 0.018) and voluntary confinement (p < 0.001). CONCLUSIONS: During the first COVID-19 lockdown, psychological wellbeing of residents cared in nursing homes, their relatives and staff did not seem to be seriously affected. Previous mental health in relatives and staff together with a resilient approach to the adversity might partly be protecting factors. The lack of consequences on residents' anxiety, depression and perception of social support may reflect the special attention and care they received. Finally, as in the current study only data of the first two COVID-19 waves were analysed, its findings might be partly generalized to all the pandemic.

Impact of Dog-Assisted Therapy for Institutionalized Patients With Dementia: A Controlled Clinical Trial.

CONTEXT: Animal-assisted interventions have been used in recent years to complement other therapies of various types for dementia patients. OBJECTIVE: The study intended to evaluate the benefits of dog-assisted interventions for the emotional, behavioral, cognitive, and functional areas of the lives of dementia patients. DESIGN: The research team designed an experimental study that used dog-assisted therapy (DAT) as the intervention. SETTING: The study was conducted at the Enoc Center, a nursing home, in Azucaica, Toledo, Spain. PARTICIPANTS: Participants were 21 residents who had been living at the center for more than one year, were over 65 years old, and had symptoms associated with dementia or affective disorders. INTERVENTION: Participants were randomly divided into three groups: the control, intervention, and healthy groups. The intervention and healthy groups attended the DAT in addition to the center's regular therapies. The control group didn't attend the DAT but did attend the center's regular therapies. The program occurred over six months, with weekly sessions of 45 minutes in both cases. OUTCOME MEASURES: Participants were evaluated at baseline and postintervention using specific scales appropriate to an area: (1) cognitive-Mini-Mental Status Examination (MMSE), (2) functional-Modified Barthel Index, (3) affective-Yesavage Geriatric Depression Scale: Short Form and (4) behavioral-Neuropsychiatric Inventory Scale (NPI). RESULTS: The study revealed significant differences between the control group and the intervention group and between the control group and the healthy group in the cognitive, affective, and behavioral areas but not in the functional area. CONCLUSIONS: The program was beneficial for elderly institutionalized patients with dementia in the emotional, behavioral, and cognitive areas.

Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth.

Background: Perinatal asphyxia is a significant contributing factor for neonatal morbidity and mortality. The aim of this study was to investigate the clinical factors associated with umbilical artery pH variability and fetal acidosis at birth. Methods: This is a single center cross-sectional study in a public regional hospital in southeastern Spain from January to December 2019. The reference population was 1.655 newborns, final sample of 312 experimental units with validated values of umbilical cord blood pH. Results: Factors such as gestational age at term ( X ¯ at - term : 7.26 ± 0.08- X ¯ no -at-term: 7.31 ± 0.05, p: 0.00), primiparity ( X ¯ primiparity : 7.24 ± 0.078- X ¯ multiparity : 7.27 ± 0.08, p: 0.01), induced labor ( X ¯ induced : 7.24 ± 0.07- X ¯ spontaneous : 7.26 ± 0.081, p: 0.02), vaginal delivery ( X ¯ vaginal :7.25 ± 0.08- X ¯ cesarean :7.27 ± 0.07, p: 0.01), and prolonged dilation duration ( X ¯ AboveAverage : 7.22 ± 0.07- X ¯ BelowAverage : 7.27 ± 0.08, p: 0.00), expulsion duration ( X ¯ AboveAverage : 7.23 ± 0.07- X ¯ BelowAverage : 7.26 ± 0.08, p: 0.01), and total labor duration ( X ¯ AboveAverage : 7.23 ± 0.07- X ¯ BelowAverage : 7.27 ± 0.08, p: 0.00) are associated with a decrease in umbilical artery pH at birth. However, only three factors are associated with acidosis pH (<7.20) of the umbilical artery at birth: the induction of labor [OR: 1.74 (95% CI: 0.98-3.10); p: 0.04], vaginal delivery [OR: 2.09 (95% CI: 0.95-4.61); p: 0.04], and total duration of labor [OR: 2.06 (95% CI: 1.18-3.57); p: 0.01]. Conclusions: Although several factors may affect the variability of umbilical artery pH at birth by decreasing their mean values (gestational age, primiparity, induced labor, vaginal delivery and prolonged: dilation duration, expulsion duration and total labor duration), only induction of labor, vaginal delivery and total duration of labor are associated with an acidosis (<7.20) of same.

Tecnologias utilizadas para apoio ao processo de enfermagem: revisão de escopo / Tecnologías utilizadas para apoyar el proceso de enfermería: revisión de alcance / Technologies used to support the nursing process: scoping review

Resumo Objetivo: Identificar e mapear as tecnologias utilizadas para apoio ao processo de enfermagem. Métodos: Trata-se de uma scoping review, realizada em Novembro e Dezembro de 2019, em 15 bases de dados nacionais e internacionais. Os dados para análise foram extraídos a partir de indicadores para uma planilha do Microsoft Excell 2010®. Resultados: A amostra do estudo foi composta por 14 estudos, publicados principalmente no ano de 2017 e oriundos do Brasil. As tecnologias desenvolvidas são principalmente software, voltados para o ensino e como público alvo profissionais que já atuam na assistência à saúde. Conclusão: A pesquisa aponta que a inserção de tecnologias para apoio ao processo de enfermagem é crescente e está voltado principalmente para o ensino, com a finalidade de fortalecer a formação dos enfermeiros.

Resumen Objetivo: Identificar y mapear las tecnologías utilizadas para apoyar el proceso de enfermería. Métodos: Se trata de una scoping review, realizada en noviembre y diciembre de 2019, en 15 bases de datos nacionales e internacionales. Los datos para el análisis fueron extraídos a partir de indicadores a una planilla de Microsoft Excel 2010®. Resultados: La muestra estuvo compuesta por 14 estudios, publicados principalmente en 2017 y oriundos de Brasil. La principal tecnología desarrollada es software, utilizados para la enseñanza, cuyo público destinatario son profesionales que ya actúan en la atención a la salud. Conclusión: El estudio indica que la incorporación de tecnologías para apoyar el proceso de enfermería está creciendo y se orienta principalmente a la enseñanza, con la finalidad de fortalecer la formación de los enfermeros.

Abstract Objective: To identify and map the technologies used to support the nursing process. Methods: This is a scoping review carried out in November and December 2019, in 15 national and international databases. Data for analysis were extracted from indicators for a spreadsheet of Microsoft Excell 2010®. Results: The study sample consisted of 14 studies, published mainly in 2017 and from Brazil. The technologies developed are mainly software, aimed at teaching and as target audience professionals who already work in health care. Conclusion: The research points out that the insertion of technologies to support the nursing process is growing and is mainly focused on teaching, with the purpose of strengthening nursing training.

Transcultural adaptation and new proposal for the nursing outcome, Physical condition (2004).

OBJECTIVES: cross-culturally adapt to the Spanish context and make a new proposal for the nursing outcome, Physical Condition (2004), of the Nursing Outcomes Classification (NOC) for its precise use in clinical practice. METHOD: a cross-cultural adaptation study and a proposal for the nursing outcome, Physical Condition, was conducted and supported by the opinion of 26 experts. The data was obtained through an electronic form, and a quantitative analysis was conducted, using the SPSS software. RESULTS: the version adapted to the Spanish context was obtained and the proposal of the outcome, Physical Condition, received agreement from 26 experts, with a mean score greater than 7.6 for adequacy of the outcome definition and its indicators, and 8.5 for the relevance of the indicators. CONCLUSIONS: the version adapted to the Spanish context and a new proposal for Physical Condition were obtained. The results obtained indicate a high level of adequacy and relevance, an instrument of great utility in the clinic, and research was obtained to evaluate the interventions directed to the improvement of the physical condition.

Transcultural adaptation and new proposal for the nursing outcome, Physical condition (2004) / Adaptação transcultural e nova proposta do resultado de enfermagem Condição física (2004) / Adaptación transcultural y nueva propuesta del resultado de enfermería Condición física (2004)

ABSTRACT Objectives: cross-culturally adapt to the Spanish context and make a new proposal for the nursing outcome, Physical Condition (2004), of the Nursing Outcomes Classification (NOC) for its precise use in clinical practice. Method: a cross-cultural adaptation study and a proposal for the nursing outcome, Physical Condition, was conducted and supported by the opinion of 26 experts. The data was obtained through an electronic form, and a quantitative analysis was conducted, using the SPSS software. Results: the version adapted to the Spanish context was obtained and the proposal of the outcome, Physical Condition, received agreement from 26 experts, with a mean score greater than 7.6 for adequacy of the outcome definition and its indicators, and 8.5 for the relevance of the indicators. Conclusions: the version adapted to the Spanish context and a new proposal for Physical Condition were obtained. The results obtained indicate a high level of adequacy and relevance, an instrument of great utility in the clinic, and research was obtained to evaluate the interventions directed to the improvement of the physical condition.

RESUMO Objetivos: adaptar transculturalmente ao contexto espanhol e idealizar uma nova proposta do resultado de enfermagem Condição física (2004) da Nursing Outcomes Classification (NOC) para uso acurado na prática clínica. Método: foi realizado um estudo de adaptação transcultural e elaboração de proposta do resultado de enfermagem Condição física, comprovada pela opinião de 26 especialistas. Os dados foram coletados por meio de formulário eletrônico e análise quantitativa foi realizada utilizando o software SPSS. Resultados: obteve-se a versão adaptada ao contexto espanhol e proposta do resultado de enfermagem Condição física a partir do consenso de 26 especialistas, com uma pontuação média superior a 7.6 para a adequação da definição do resultado e de seus indicadores e 8.5 para a relevância dos indicadores. Conclusões: obteve-se a versão adaptada ao contexto espanhol e uma nova proposta do resultado Condição física. Os resultados obtidos indicam um alto nível de adequação e relevância. Um instrumento de grande utilidade na clínica e pesquisa foi obtido para avaliar as intervenções direcionadas à melhoria da condição física.

RESUMEN Objetivos: adaptar transculturalmente al contexto español y realizar una nueva propuesta del resultado de enfermería Condición física (2004) de la Nursing Outcomes Classification (NOC) para su uso preciso en la práctica clínica. Método: se llevó a cabo un estudio de adaptación transcultural y una propuesta del resultado de enfermería Condición física, avalada por la opinión de 26 expertos. Los datos se obtuvieron mediante un formulario electrónico y se llevó a cabo un análisis cuantitativo utilizando el software SPSS. Resultados: se obtuvo la versión adaptada al contexto español y la propuesta del resultado Condición física consensuada por 26 expertos, con una puntuación media superior a 7.6 en la adecuación de la definición del resultado y de sus indicadores y 8.5 en la relevancia de los indicadores. Conclusiones: se obtuvo la versión adaptada al contexto español y una nueva propuesta del resultado Condición física. Los resultados obtenidos indican un alto nivel de adecuación y relevancia, se obtuvo un instrumento de gran utilidad en la clínica e investigación para evaluar las intervenciones dirigidas a la mejora de la condición física.

Avaliação da ferramenta web nanda: diagnóstico de enfermagem com estudantes de enfermagem / Evaluación de la herramienta web nanda. es de diagnósticos de enfermería con estudiantes de enfermería / Assessment of the web tool nanda. es for nursing diagnoses by nursing students

Objetivos: avaliar a percepção de ajuda que os alunos de 2°ano de Enfermagem da Universidade Católica de Murcia tem através da "ferramenta Nanda.es", para a realização de planos de cuidado. Método: estudo descritivo, transversal com a participação de 109 estudantes de enfermagem do segundo ano, os dados foram analisados com o software SPSS, versão 19. Resultados: 73,4% dos alunos acreditam que a ferramenta apoiava bastante ou muito, para 87,5% e 90,3% respondeu que a ferramenta web lhes apoiava para uma melhor compreensão da metodologia de enfermagem, 33% que a dificuldade para realizar um plano de cuidados é nada ou pouco difícil: 88,9% recomendaria aos profissionais enfermeiros, e 91,7% recomendaria aos estudantes de enfermagem. Conclusões: esta ferramenta web é um bom aliado para implementar diagnósticos de enfermagem e planos de cuidado, com boa precisão e otimização de tempo.

Aims: evaluate the perception of help from students of the 2nd year of Nursing at Catholic University of Murcia concerning “Nanda.es Tool” for carrying out care plans. Methods: Descriptive, transverse study involving 109 nursing students in the second year, the data were analyzed with SPSS software, version 19.Results: 73.4 % of students believe the tool helps a lot or very much, 87.5% and 90.3 % responded that the web tool supports them for better methodological understanding of nursing; 33% believe that the difficulty in making a care plan is not difficult or a little difficult; 88.9% would recommend it to nurses, and 91.7 % would recommend it to nursing students. Conclusions: This web tool is a good ally for nursing diagnoses and care plans, with good accuracy and time improvement.

Objetivos: evaluar la percepción de ayuda que los alumnos de 2º Grado Enfermería de la Universidad Católica de Murcia tienen a través de la “Herramienta Nanda.es” para la realización de planes de cuidados. Método: estudio descriptivo, transversal con la participación de 109 estudiantes de enfermería 2º Grado. Los datos fueron analizados con el software SPSS, versión 19. Resultados: el 73,4% de los alumnos creen que la herramienta web les apoya para una mejor comprensión metodológica de enfermería; el 33% opinan que la dificultad para realizar un plan de cuidados es nada o poco difícil; el 88.9% se lo recomendaría las enfermeras; y 91.7% se le recomendaría a los estudiantes de enfermería. Conclusiones: esta herramienta web es un buen aliado para implementar diagnósticos de enfermería y planes de cuidados, con una buena precisión y mejora del tiempo.

Validação de conteúdo da intervenção de enfermagem Controle Ambiental: segurança do trabalhador / Content validation of the nursing intervention called Environmental Control: worker safety

Objetivo: Validar o conteúdo da intervenção de enfermagem Controle Ambiental: segurança do trabalhador na Espanha. Métodos: Estudo exploratório e descritivo, utilizando o método Fehring associado ao método Delphi. Amostra de 11 especialistas em enfermagem do trabalho. Para a clareza da definição e das atividades, foi utilizada Escala variando entre confusa (1) e clara (7) ou vagamente (1) e exatamente (7). Para ação de enfermagem e a necessidade da atividade para sua intervenção, atribuímos Escala Likert (1- totalmente em desacordo / 5- totalmente de acordo). Resultados: A ação de enfermagem foi considerada crítica com pontuação média de 0,86% (DV=0,23), 73% dos expertos consideraram que o título da intervenção identifica exatamente o conteúdo da definição. Conclusão: A intervenção foi considerada válida para a saúde laboral, com a necessidade da aplicabilidade prática utilizando um sistema de classificação próprio da enfermagem na saúde laboral, com a implementação do Processo de Enfermagem. .

Objective: Validating the content of the nursing intervention called Environmental Control: worker safety in Spain. Methods: An exploratory and descriptive study using the Fehring method associated with the Delphi method and a sample of 11 experts in occupational nursing. For the clarity of definition and the activities was used a scale ranging from confusing (1) and clear (7) or vaguely (1) and exactly (7). A Likert scale (1 - totally disagree /5 - totally agree) was used for the nursing action and the need of the activity for its intervention. Results: The nursing action was considered as critical with the mean score of 0.86% (SD=0.23) and 73 % of the experts considered that the title of the intervention exactly identifies the contents of the definition. Conclusion: The intervention was considered valid for occupational health with the need for practical applicability using a system of classification specific for occupational health nursing, with the Nursing Process implementation. .

Cómo cuantificar los aspectos cualitativos en escalas de clasificación de resultados NOC para etiquetas psico-socioculturales / Como quantificar os aspectos qualitativos nas escalas de classificação de resultados NOC para etiquetas psicossocioculturais / How to quantify the qualitative aspects of nursing outcomes classification scales with psychosociocultural indicators

El hecho de trabajar necesariamente con escalas Likert en la medición de resultados NOC tiene la ventaja de la unificación, pero acarrea también la dificultad de cómo reducirlo a un número del 1 al 5, especialmente cuando una investigación es cualitativa y que por tanto trabaja con palabras y expresiones, con observaciones y percepciones. ¿Qué quiere exactamente decir un 2 o un 3 en el NOC Creencias sobre la salud? En el artículo se muestran las diferentes propuestas para la operacionalización de conceptos y su transformación en números, pero se advierte que en ellas siempre se termina con un análisis cuantitativo. Se hace una propuesta de utilización de observaciones cualitativas emic/etic para las etiquetas psicosociales y culturales siguiendo los postulados de la etnografía. La investigación en lenguajes enfermeros, básica y aplicada, debe tener cimientos metodológicos correctos y atender los mismos criterios de idoneidad metodológica que cualquier otra investigación.

O fato de trabalhar necessariamente com Escalas tipo Likert para medir resultados NOC tem a vantagem de unificar, mas existe a dificuldade de como convertê-lo a um número de 1 ao 5, especialmente, quando uma pesquisa é qualitativa e por tanto trabalha com palavras e expressões, com observações e percepções. Que quer dizer exatamente 2 ou 3 nos NOC Crenças sobre a saúde? Neste artigo apresentamos diferentes propostas para operacionalização de conceitos e sua transformação em números, advertindo que a mesma sempre termina com uma análise quantitativa. Propomos utilizar as observações qualitativas emic/etic para etiquetas psicossociais e culturais, seguindo postulados da etnografia. Os estudos em linguagem enfermeiro, básica e aplicada, devem ter cimentos metodológicos corretos e atender aos mesmos critérios de idoneidade metodológica que qualquer outro estudo.

Working necessarily with Likert scales to measure Nursing Outcomes Classification (NOC) outcomes has the advantage of unification, but also presents difficulty in reducing the rating from 1 to 5, especially when the research is qualitative and thus includes the use of words and expressions, as well as observations and perceptions. What exactly does a score of 2 or 3 mean with regard to the NOC Health beliefs? In this paper, we make a number of different proposals for operationalizing concepts and transforming them to numbers; however, it should be noted that such proposals always end in a quantitative analysis. Thus, we propose the use of emic/etic qualitative observations for psychosocial and cultural indicators, following ethnographic principles. Basic and applied research on nursing languages must have correct methodological foundations and seek to satisfy the same criteria of methodological suitability as any other research.

[How to quantify the qualitative aspects of nursing outcomes classification scales with psychosociocultural indicators]. / Cómo cuantificar los aspectos cualitativos en escalas de clasificación de resultados NOC para etiquetas psico-socioculturales.

Working necessarily with Likert scales to measure Nursing Outcomes Classification (NOC) outcomes has the advantage of unification, but also presents difficulty in reducing the rating from 1 to 5, especially when the research is qualitative and thus includes the use of words and expressions, as well as observations and perceptions. What exactly does a score of 2 or 3 mean with regard to the NOC Health beliefs? In this paper, we make a number of different proposals for operationalizing concepts and transforming them to numbers; however, it should be noted that such proposals always end in a quantitative analysis. Thus, we propose the use of emic/etic qualitative observations for psychosocial and cultural indicators, following ethnographic principles. Basic and applied research on nursing languages must have correct methodological foundations and seek to satisfy the same criteria of methodological suitability as any other research.