Experiences for Geriatric Care from Nursing Students' Knowledge: A Qualitative Approach.

(1) Background: Studies have shown that clinical experience has an impact on how students perceive geriatric care. The vulnerability of older people particularly allows students to reflect on and evaluate their learning. In this context, communication between tutors and students is important to guiding a contextualized view of the complexity of clinical situations. The principal objective was to explore the feelings, perceptions, and experiences of nursing students in geriatric care units during their practices. (2) Methods: This is a qualitative study using content analysis where the data collected were analyzed deductively. An intentional sample of 81 nursing degree students enrolled in the subject of clinical practices. During these sessions, a dynamic discussion forum was incorporated. (3) Results: There were 6 forums with a total of 591 participants, with an average of 98.5 per forum. Four categories emerged: humanization, geriatric nurse, aging, and learning. (4) Conclusions: A change of management oriented to the person-centered model would improve the quality in the residences and as well as in the expectations of the students towards geriatric nursing. Changing perspectives could be a way to confront and become aware of the fallacies of care that have been evidenced. This study was not registered.

Análisis del uso de la contención mecánica en una unidad de geriatría de agudos: estudio observacional / Analysis of the use of mechanical restraint in an acute geriatric unit: observational study

Objetivos: Analizar el perfil del paciente geriátrico hospitalizado en una unidad de geriatría de agudos que requiere contención mecánica, así como medir la prevalencia del uso de la contención mecánica y determinar si el aumento de la comorbilidad, la fragilidad y el acompañamiento están relacionados con el uso de la contención mecánica. Asimismo, evaluar si presentar antecedentes de delirium, demencia o deterioro cognitivo se asocia a mayor uso de contención mecánica en este perfil de pacientes. Metodología: Estudio observacional, prospectivo, descriptivo y analítico, realizado en un hospital de segundo nivel durante diciembre de 2022 y enero de 2023. Se analizaron las características demográficas y clínicas de los pacientes geriátricos. Se obtuvo el dictamen favorable del comité ético de referencia y se realizó el análisis estadístico mediante RStudio. Resultados: Se incluyó una muestra de 107 pacientes de la unidad de geriatría de agudos, de los cuales el 10,28% fueron sometidos a contención mecánica, siendo los hombres el grupo más afectado (72,72%), y la contención abdominal la más usada (72,73%). No se encontró una asociación significativa entre el uso de contención mecánica y la comorbilidad, fragilidad, antecedentes neurológicos, delirium o deterioro cognitivo. Se observó una asociación estadísticamente significativa entre la contención mecánica y el tiempo que el paciente estuvo acompañado (p = 0,019). Conclusiones: se destaca la importancia de una atención personalizada para reducir la necesidad de contención mecánica y mejorar la calidad asistencial.(AU)

Objectives: To analyze the profile of hospitalized geriatric patients in an acute geriatric unit requiring mechanical restraint, measure the prevalence of mechanical restraint use, and determine if increased comorbidity, frailty, and patient accompaniment are associated with mechanical restraint use. Additionally, to evaluate if a history of delirium, dementia, or cognitive impairment is associated with increased use of mechanical restraint in this patient profile. Methodology: An observational, descriptive, prospective, descriptive, and analytical study was conducted in a secondary-level hospital during December 2022 and January 2023. Demographic and clinical characteristics of geriatric patients were analyzed. Ethical approval was obtained, and statistical analysis was performed using RStudio. Results: A sample of 107 patients from the acute geriatric unit was included, with 10.28% undergoing mechanical restraint. Men were the most affected group (72.72%), and abdominal restraint was the most used commonly (72.73%). No significant association was found between mechanical restraint use and comorbidity, frailty, neurological history, delirium, or cognitive impairment. A statistically significant association was observed between mechanical restraint use and patient accompaniment time (p = 0.019). Conclusions: The importance of personalized care is emphasized to reduce the need for mechanical restraint and improve the quality of healthcare provided.(AU)

A Hybrid Methodology for the Evaluation of Clinical Practice in Final-Year Nursing Students.

(1) Background: Clinical practice constitutes a scenario where the student approaches reality. The pedagogical relationship that is built between the nurse, the tutors and the student becomes important. And this requires intentional and reflective accompaniment. The principal objective was to design a hybrid-learner-centered training model requiring reflection and acquisition of specific skills. (2) Methodology: This was a prospective observational study using an intentional sample of 87 students. A hybrid model based on a dynamic virtual forum and Individual Improvement Plan (IIP) was constructed, evaluated using a self-completed questionnaire with a Likert scale. (3) Results: A model of accompaniment to the practices was built that allows for unifying a work plan. A transversal activity IIP was designed. A discussion forum was incorporated for each subject tutor. The analysis of the questionnaire showed that learning assessment, tutorials, virtual forums, self-assessment and satisfaction statistically differed. (4) Conclusions: The model allows students to be accompanied to acquire skills, knowledge, and attitudes and to develop critical thinking, as well as to improve the teaching quality of the practices of the Curriculum of the Nursing degree and to achieve their own competences through student-centered methodologies. This study was not registered.

Ictus isquémico y factores de riesgo vascular en el adulto joven y el adulto mayor. Estudio retrospectivo de base comunitaria (2011-2020) / Ischemic stroke and vascular risk factors in young and older adults. Community-based retrospective study (2011-2020)

Objetivo: Analizar la presencia de factores de riesgo vascular (FRV) entre pacientes adultos jóvenes y adultos mayores con ictus isquémico, con y sin seguimiento en atención primaria tras el alta hospitalaria. Diseño: Estudio observacional, retrospectivo y multicéntrico. Emplazamiento: Centros de salud de atención primaria y hospital Verge de la Cinta, Tortosa, España. Participantes: Pacientes con ictus isquémico de dos grupos de edad (≤55 y ≥65años) distribuidos en dos grupos (grupoA: sin seguimiento en atención primaria; grupoB: con seguimiento en atención primaria), entre 2011 y 2020. Mediciones principales: Datos sociodemográficos, clínicos y de FRV codificados según la Clasificación Internacional de Enfermedades (CIE-10). Estadística descriptiva e inferencial. Resultados: Se analizaron datos de 2.054 participantes. En el grupo de adulto joven, el 94,9% de los participantes del grupoA presentaban entre 1-2FRV, frente al 60% del grupoB. En el adulto mayor, el 84,4% del grupoA presentaban entre 1-2FRV, frente al 43,9% del grupoB. Los FRV más frecuentes entre pacientes adultos jóvenes y mayores con ictus isquémico fueron la hipertensión y la dislipemia en ambos grupos de seguimiento. No había registros sobre obesidad, ni tabaquismo ni consumo de alcohol en el grupoA. Se observó una asociación significativa entre realizar seguimiento en atención primaria tras el ictus y ser adulto joven y presentar entre 3 y 4FRV (p<0,001). Conclusiones: Los resultados refuerzan la necesidad de continuidad asistencial y seguimiento en las personas con ictus agudo en la atención primaria y la mejora de la calidad de los registros.(AU)

Objective: To analyze the presence of vascular risk factors (VRF) among young adult and older adult patients with ischemic stroke, with and without follow-up in primary care after hospital discharge. Design: Observational, retrospective, multicenter study. Setting: Primary care health centers and Hospital Verge de la Cinta, Tortosa, Spain. Participants: Patients with ischemic stroke of two age groups (≤55 and ≥65years) distributed in two groups (GroupA: without follow-up in primary care; and GroupB: with follow-up in primary care), between 2011-2020. Main measurements: Sociodemographic, clinical, and VRF data coded according to the International Classification of Diseases (ICD-10). Descriptive, and inferential statistics. Results: Data from 2054 participants were analyzed. In the young adult group, 94.9% of the participants in groupA had between 1-2VRFs, compared to 60% in groupB. In the older adult group, 84.4% of groupA had between 1-2VRFs, compared to 43,9% of groupB. The most frequent VRFs among younger and older adult patients with ischemic stroke were hypertension and dyslipidemia in both follow-up groups. There were no records of obesity, smoking, or alcohol consumption in groupA. There was a significant association between being followed up in primary care after stroke and being a young adult and presenting between 3-4 VRFs (P<0.001). Conclusions: The results reinforce the need for continuity of care and follow-up in people with acute stroke in primary care and the need to improve the quality of registries.(AU)

Early Diagnosis of Atrial Fibrillation and Stroke Incidence in Primary Care: Translating Measurements into Actions-A Retrospective Cohort Study.

(1) Background: AF-related strokes will triple by 2060, are associated with an increased risk of cognitive decline, and alone or in combination, will be one of the main health and economic burdens on the European population. The main goal of this paper is to describe the incidence of new AF associated with stroke, cognitive decline and mortality among people at high risk for AF. (2) Methods: Multicenter, observational, retrospective, community-based studies were conducted from 1 January 2015 to 31 December 2021. The setting was primary care centers. A total of 40,297 people aged ≥65 years without previous AF or stroke were stratified by AFrisk at 5 years. The main measurements were the overall incidence density/1000 person-years (CI95%) of AF and stroke, prevalence of cognitive decline, and Kaplan-Meier curve. (3) Results: In total, 46.4% women, 77.65 ± 8.46 years old on average showed anAF incidence of 9.9/103/year (CI95% 9.5-10.3), associated with a four-fold higher risk of stroke (CI95% 3.4-4.7), cognitive impairment(OR 1.34 (CI95% 1.1-1.5)), and all-cause mortality (OR 1.14 (CI95% 1.0-1.2)), but there was no significant difference in ischemic heart disease, chronic kidney disease, or peripheral arteriopathy. Unknown AF was diagnosed in 9.4% and of these patients, 21.1% were diagnosed with new stroke. (4) Conclusions: The patients at high AF risk (Q4th) already had an increased cardiovascular risk before they were diagnosed with AF.

Emotional exhaustion in nursing students. A multicenter study.

OBJECTIVE: To know emotional exhaustion in nursing students from four universities. METHOD: Cross-sectional, correlational study, carried out in Chile and Spain (2017-2018), with 1,368 students answering a self-applied instrument (sociodemographic/academic variables and the Emotional Exhaustion scale). Analysis with Stata 15, according to variables: Chi2 tests, Wilcoxon rank sum test (Mann Whitney U test), analysis of variance and multiple regression; confidence level 95% and significance 5% (p < 0.05). Approved by the Ethics Committee, Universidad de Girona. RESULTS: Academic variables and perceived stress with Quite Much/Much classification: Exams, Problem-Based Learning, Laboratory/Simulation. Statistically significant differences in emotional exhaustion, according to sex, dependent people, workers, commuting time >30 minutes. Greater emotional exhaustion when taking courses for the second time and in academic activities where they declare perceived stress as Quite Much/Much (p < 0.005). CONCLUSION: All students present mean level of emotional exhaustion (>26 and <37 points). The variables sex and having dependents are relevant aspects. Stress perceived by methodologies is significantly related to levels of emotional exhaustion.

[Ischemic stroke and vascular risk factors in young and older adults. Community-based retrospective study (2011-2020)]. / Ictus isquémico y factores de riesgo vascular en el adulto joven y el adulto mayor. Estudio retrospectivo de base comunitaria (2011-2020).

OBJECTIVE: To analyze the presence of vascular risk factors (VRF) among young adult and older adult patients with ischemic stroke, with and without follow-up in primary care after hospital discharge. DESIGN: Observational, retrospective, multicenter study. SETTING: Primary care health centers and Hospital Verge de la Cinta, Tortosa, Spain. PARTICIPANTS: Patients with ischemic stroke of two age groups (≤55 and ≥65years) distributed in two groups (GroupA: without follow-up in primary care; and GroupB: with follow-up in primary care), between 2011-2020. MAIN MEASUREMENTS: Sociodemographic, clinical, and VRF data coded according to the International Classification of Diseases (ICD-10). Descriptive, and inferential statistics. RESULTS: Data from 2054 participants were analyzed. In the young adult group, 94.9% of the participants in groupA had between 1-2VRFs, compared to 60% in groupB. In the older adult group, 84.4% of groupA had between 1-2VRFs, compared to 43,9% of groupB. The most frequent VRFs among younger and older adult patients with ischemic stroke were hypertension and dyslipidemia in both follow-up groups. There were no records of obesity, smoking, or alcohol consumption in groupA. There was a significant association between being followed up in primary care after stroke and being a young adult and presenting between 3-4 VRFs (P<0.001). CONCLUSIONS: The results reinforce the need for continuity of care and follow-up in people with acute stroke in primary care and the need to improve the quality of registries.

The Predictive Ability of C-Peptide in Distinguishing Type 1 Diabetes From Type 2 Diabetes: A Systematic Review and Meta-Analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to investigate the predictive ability of plasma connecting peptide (C-peptide) levels in discriminating type 1 diabetes (T1D) from type 2 diabetes (T2D) and to inform evidence-based guidelines in diabetes classification. METHODS: We conducted a holistic review and meta-analysis using PubMed, MEDLINE, EMBASE, and Scopus. The citations were screened from 1942 to 2021. The quality criteria and the preferred reporting items for systematic reviews and meta-analysis checklist were applied. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022355088). RESULTS: A total of 23,658 abstracts were screened and 46 full texts reviewed. Of the 46 articles screened, 12 articles were included for the meta-analysis. Included studies varied by race, age, time, and proportion of individuals. The main outcome measure in all studies was C-peptide levels. A significant association was reported between C-peptide levels and the classification and diagnosis of diabetes. Furthermore, lower concentrations and the cutoff of <0.20 nmol/L for fasting or random plasma C-peptide was indicative of T1D. In addition, this meta-analysis revealed the predictive ability of C-peptide levels in discriminating T1D from T2D. Results were consistent using both fixed- and random-effect models. The I2 value (98.8%) affirmed the variability in effect estimates was due to heterogeneity rather than sampling error among all selected studies. CONCLUSION: Plasma C-peptide levels are highly associated and predictive of the accurate classification and diagnosis of diabetes types. A plasma C-peptide cutoff of ≤0.20 mmol/L is indicative of T1D and of ≥0.30 mmol/L in the fasting or random state is indicative of T2D.

Emotional exhaustion in nursing students. A multicenter study / Fadiga emocional em estudantes de enfermagem. Estudo multicêntrico / Cansancio emocional en estudiantes de enfermería. Estudio multicéntrico

ABSTRACT Objective: To know emotional exhaustion in nursing students from four universities. Method: Cross-sectional, correlational study, carried out in Chile and Spain (2017-2018), with 1,368 students answering a self-applied instrument (sociodemographic/academic variables and the Emotional Exhaustion scale). Analysis with Stata 15, according to variables: Chi2 tests, Wilcoxon rank sum test (Mann Whitney U test), analysis of variance and multiple regression; confidence level 95% and significance 5% (p < 0.05). Approved by the Ethics Committee, Universidad de Girona. Results: Academic variables and perceived stress with Quite Much/Much classification: Exams, Problem-Based Learning, Laboratory/Simulation. Statistically significant differences in emotional exhaustion, according to sex, dependent people, workers, commuting time >30 minutes. Greater emotional exhaustion when taking courses for the second time and in academic activities where they declare perceived stress as Quite Much/Much (p < 0.005). Conclusion: All students present mean level of emotional exhaustion (>26 and <37 points). The variables sex and having dependents are relevant aspects. Stress perceived by methodologies is significantly related to levels of emotional exhaustion.

RESUMO Objetivo: Conhecer a fadiga emocional em estudantes de enfermagem de quatro universidades. Método: Estudo transversal, correlacional, realizado no Chile e na Espanha (2017-2018). Um total de 1.368 alunos respondeu a um instrumento autoaplicável (variáveis sociodemográficas/acadêmicas e Escala de Fadiga Emocional). Análise com Stata 15, de acordo com as variáveis: testes de Chi2, teste dos postos sinalizados de Wilcoxon (Mann Whitney), análise de variância e regressão múltipla; nível de confiança de 95% e significância de 5% (p < 0,05). Aprovado pelo Comitê de Ética da Universidade de Girona. Resultados: Variáveis acadêmicas e estresse percebido destaca Bastante/Muito: Exames, Aprendizagem Baseada em Problemas, Laboratório/Simulação. Diferenças estatisticamente significativas entre fadiga emocional, de acordo com o sexo, dependentes, trabalhadores, tempo de viagem > 30 minutos. Maior fadiga emocional ao cursar disciplinas pela segunda vez e em atividades acadêmicas em que declaram um estresse percebido como Bastante/Muito (p < 0,005). Conclusão: Todos os alunos apresentam fadiga emocional média (>26 e <37 pontos). As variáveis sexo, ter dependentes são aspectos relevantes. O estresse percebido pelas metodologias está significativamente relacionado com os níveis de fadiga emocional.

RESUMEN Objetivo: Conocer cansancio emocional en estudiantes de enfermería de cuatro Universidades. Método: Estudio de corte transversal, correlacional, realizado en Chile y España (2017-2018). Respondieron instrumento autoaplicado 1368 estudiantes (variables sociodemográficas/académicas y escala de Cansancio Emocional). Análisis con Stata 15, según variables: Pruebas de Chi2, sumas y rangos de Wilcoxon (Mann Whitney), análisis de varianza y regresión múltiple; nivel de confianza 95% y significancia 5% (p < 0,05). Aprobado por Comité de Ética, Universidad de Girona. Resultados: Variables académicas y estrés percibido destacan Bastante/Mucho para: Exámenes, Aprendizaje Basado en Problemas, Laboratorio/Simulación. Diferencias estadísticamente significativas entre cansancio emocional según sexo, personas a cargo, trabajadores, tiempo traslado > a 30 minutos. Mayor cansancio emocional al cursar asignaturas por segunda vez y en actividades académicas donde declaran un estrés percibido como Bastante/Mucho (p < 0,005). Conclusión: Todos los estudiantes presentan cansancio emocional medio (>26 y <37 puntos). Las variables sexo y tener personas a cargo son aspectos relevantes. Estrés percibido por metodologías se relaciona de manera importante con niveles de cansancio emocional.

Vascular Risk Factors in Ischemic Stroke Survivors: A Retrospective Study in Catalonia, Spain.

Background: The distribution of vascular risk factors (VRFs) and stroke management vary by geographic area. Our aim was to examine the percentage of the VRFs according to age and sex in ischemic stroke survivors in a geographical area on the Mediterranean coast of Southern Catalonia, Spain. Methods: This was a multicenter, observational, retrospective, community-based study of a cohort, the data of which we obtained from digital clinical records of the Catalan Institute of Health. The study included all patients with a confirmed diagnosis of ischemic stroke who were treated between 1 January 2011 and 31 December 2020. Patients met the following inclusion criteria: residing in the study area, age ≥ 18 years, and presenting ≥1 modifiable vascular risk factor. The exclusion criteria were as follows: death patients (non-survivors) and patients without modifiable VRFs. We collected the demographic, clinical, and VRF variables of the total of 2054 cases included, and we analyzed the data according to age groups, sex, and number of VRFs. Results: Most of the patients included were in the 55−80 age group (n = 1139; 55.45%). Of the patients, 56.48% (n = 1160) presented ≤ 2 modifiable VRFs, and the age group <55 years old (67.01%) presented more VRFs. Hypertension and (>80 years old (38.82%)) and dyslipidemia (<55 years (28.33%)) were the most prevalent VRFs. In the age group 55−80 (69.59% men), the prevalence of VRFs was higher ((3−4 VRF (42.76%) and >4 VRF (5.35%)). Conclusions: These results suggest the presence of many VRFs in people diagnosed with ischemic stroke­although with a lower percentage compared to other studies­and the need for specific individualized interventions for the control of modifiable RFs related to primary and secondary prevention of stroke.

Stressor Factors for Spanish Nursing Students in a Pandemic Context: An Observational Pilot Survey.

BACKGROUND: The context of the pandemic in Spain meant a high demand for care. The purpose of this pilot work was to determine the stress factors, conducted on final-year nursing students at a Spanish university, who volunteered to carry out healthcare tasks, in pandemic and post-pandemic contexts. METHODS: An observational prospective cohort pilot survey was conducted with an intentional sampling of the forty-seven students. We collected sociodemographic and stressor data using the validated KEZKAK questionnaire. The STROBE checklist was used to evaluate the study. RESULTS: The median scores obtained from nursing students incorporated as auxiliary health workers are lower than those who were not incorporated, and statistically significant differences were found: lack of skills and abilities (p = 0.016); relationship with tutors and colleagues (p = 0.004); impotence and uncertainty (p = 0.011); inability to manage the relationship with the patient (p = 0.009); emotional involvement (p = 0.032); distress caused by the relationship with patients and item overload (p = 0.039); and overload items (p = 0.011). The post-pandemic only maintained "lack of skill and abilities" (p = 0.048), from nursing students incorporated as auxiliary health workers. CONCLUSION: This pilot study showed that nursing students who joined as auxiliary health personnel presented less perceived stress than non-incorporated nursing students. Still, more prospectively designed clinical research is needed.

Analysis of Psychosomatic Disorders According to Age and Sex in a Rural Area: A Population-Based Study.

Psychosomatic disorders can develop unevenly depending on certain health determinants; therefore, the aim of this study was to analyze the prevalence of psychosomatic disorders and the differences by age and sex in a rural area. We conducted an observational descriptive retrospective population study to determine the prevalence of 201 diagnoses of psychosomatic nature grouped into 25 diagnostic categories by sex and age groups. A total of 33,680 participants with a diagnosis of psychosomatic disorder were identified (64.6% women, 35.4% men). We found statistically significant differences based on sex in 13 of the 25 diagnostic categories previously defined. When we analyzed these categories by age, we found that women showed a higher probability, between 1.23 and 10.85 times, of suffering from most of these health issues. We also observed that the older the age group, the most often they had a diagnosis. Notably, more women seem to suffer from psychosomatic disorders when compared to men in the same situation. In most of these disorders, being of the female sex was a risk factor, and the older the participants, the greater the probability of developing a disorder.

CD68 and CD83 immune populations in non-metastatic axillary lymph nodes are of prognostic value for the survival and relapse of breast cancer patients.

BACKGROUND: The foremost cause of death of breast cancer (BC) patients is metastasis, and the first site to which BC predominantly metastasizes is the axillary lymph node (ALN). Thus, ALN status is a key prognostic indicator at diagnosis. The immune system has an essential role in cancer progression and dissemination, so its evaluation in ALNs could have significant applications. In the present study we aimed to investigate the association of clinical-pathological and immune variables in the primary tumour and non-metastatic ALNs (ALNs-) of a cohort of luminal A and triple-negative BC (TNBC) patients with cancer-specific survival (CSS) and time to progression (TTP). METHODS: We analysed the differences in the variables between patients with different outcomes, created univariate and multivariate Cox regression models, validated them by bootstrapping and multiple imputation of missing data techniques, and used Kaplan-Meier survival curves for a 10-years follow-up. RESULTS: We found some clinical-pathological variables at diagnosis (tumour diameter, TNBC molecular profile and presence of ALN metastasis), and the levels of several immune markers in the two studied sites, to be associated with worse CSS and TTP. Nevertheless, only CD68 and CD83 in ALNs- were confirmed as independent prognostic factors for TTP. CONCLUSIONS: The study identified the importance of macrophage and dendritic cell markers as prognostic factors of relapse for BC. We highlight the importance of studying the immune response in ALNs-, which could be relevant to the prediction of BC patients' outcome.

Handover of Critical Patients in Urgent Care and Emergency Settings: A Systematic Review of Validated Assessment Tools.

The emergency handover of critical patients is used to describe the moment when responsibility for the care of a patient is transferred from one critical patient care healthcare team to another, requiring the accurate delivery of information. However, the literature provides few validated assessment tools for the transfer of critical patients in urgent care and emergency settings. To identify the available evaluation tools that assess the handover of critical patients in urgent and emergency care settings in addition to evaluations of their psychometric properties, a systematic review was carried out using PubMed, Scopus, Cinahl, Web of Science (WoS), and PsycINFO, in accordance with PRISMA guidelines. The quality of the studies was assessed using the COSMIN checklist. Finally, eight articles were identified, of which only three included validated tools for evaluating the handover of critical patients in emergency care. Content validity, construct validity, and internal consistency were the most studied psychometric properties. Three studies evaluated error and reliability, criterion validity, hypothesis testing, and sensitivity. None of them considered cross-cultural adaptation or the translation process. This systematic psychometric review shows the existing ambiguities in the handover of critically ill patients and the scarcity of validated evaluation tools. For all of these reasons, we consider it necessary to further investigate urgent care and emergency handover settings through the design and validation of an assessment tool.

Plan de Mejora Individual: instrumento evaluativo en las prácticas clínicas / Individual Improvement Plan: evaluative instrument in clinical practice

Objetivo: Analizar el Plan de Mejora Individual (PMI), para evaluar las prácticas clínicas en unidades de críticos del grado en enfermería, e identificar los elementos clave de aprendizaje. Método: Diseño cualitativo y descriptivo. Muestreo propositivo de 51 estudiantes matriculados en las prácticas clínicas de cuidados críticos. Se utilizó un análisis de contenido. Resultados: La estructura en seis apartados del PMI: reflexión, acción, evaluación, participación, personal, utilidad y transferencia permite la reflexión para identificar áreas de mejora. Se extrajeron seis categorías: Humanización, Comunicación, Aprendizaje, Saberes profesionales, Seguridad clínica y Complejidad. Estas conforman los elementos clave de aprendizaje. Conclusiones: El PMI se presenta como un instrumento estructurado, sumativo y evaluativo a partir del concepto de reflexión-en-la-acción, este ofrece la oportunidad de analizar y reflexionar sobre la práctica, evitando una experiencia de su prácticum que podrían devenir rutinaria y mecanizada. (AU)

Objective: To analyze the Individual Improvement Plan (IIP) as a document to evaluate the critical patient practices of the nursing degree and identify the key learning elements. Method: Qualitative and descriptive design. The sampling was purposeful 51 students enrolled in clinical practices of critical care units. It was used a content analysis. Results: The structure of the IIP: reflection, action, evaluation, participation, personnel, utility and transfer has allowed students to reflect and identify areas for improvement in critical services. It was extracted six categories: Humanization, Communication, Learning, Professional knowledge, Clinical safety and Complexity. These make up the key learning elements. Conclusions: The IIP is presented as a structured, summative and evaluative instrument based on reflection-in-action. The students have the opportunity to analyze and reflect on the practice, avoiding an experience of their practicum that could become routine and mechanized. (AU)

Influence of Pain and Discomfort in Stroke Patients on Coping Strategies and Changes in Behavior and Lifestyle.

The implementation of prevention strategies can reduce the risk of having a stroke. This prospective, longitudinal, multicenter observational study of 82 patients describes health habits, quality of life, coping strategies, and physical and neurological status at 3 months and 1 year after stroke. The EuroQoL-5D quality of life scale (EQ-5D) and the coping strategy measurement scale (COPE-28) were used to assess pain and discomfort, and behavioral and lifestyle changes. Significant differences were observed in the pain or discomfort levels of those patients with behavioral and lifestyle changes. Correlation was also found between pain or discomfort and the coping strategies associated with active emotional support at 1 year after stroke. The results of the pain or discomfort dimension were not, however, associated with better adherence to treatment. Pain and discomfort could have a predictive value in changes in lifestyles and behaviors but not for treatment adherence in patients who have had a stroke, which is significant at 1 year. In addition to important active coping strategies such as social support, these changes in behavior and lifestyle following a stroke are long-term and should therefore be assessed during the initial examination.

Psychological Well-Being in Nursing Students: A Multicentric, Cross-Sectional Study.

In addition to complying with strict academic standards, nursing students must acquire relevant knowledge and skills, and learn how to carry themselves in different and often stressful professional settings. These obligations could severely affect their mental health. The purpose of this study was to examine the mental health status of undergraduate nursing students and related factors. A total of 1368 nursing students from different universities in Spain and Chile were included in this study, which took place over the 2018-2019 academic year. We assessed their levels of stress related to specific learning methodologies and determined their mental health status using the General Health Questionnaire (GHQ-28). The results revealed that the more advanced the course was, the lower the total GHQ-28 score. The stress generated by different types of training activities had a significant effect on the total GHQ-28 score. These results suggest that nursing education could act as a protective factor against mental health disorders. Although a heavy academic workload could lead to higher levels of stress, overall, it seems that mental health is better in more advanced courses than in initial academic years.

Emergency handover of critical patients. A systematic review.

BACKGROUND: Emergency handover of critical patients is used to describe the moment of union between prehospital and hospital health team. However, the literature shows several definitions leading to great heterogeneity. PURPOSE: To study the emergency handover of critical patients between two critical-emergency care wards performed by emergency nurses worldwide and to identify the features of these processes. METHODS: We conducted an integrative review in eleven databases published from 2010 to 2019. Quality criteria and PRISMA checklist were applied. The protocol is registered with PROSPERO (CRD42020182335). RESULTS: A total of 22 studies included and the following factors were identified: variability vs standardization, identification, professionals' behavior, localization, environmental factors, patient participation, clinical records, education/training, responsability, and communication. CONCLUSIONS: The actual emergency handover occurs under conditions quite contrary to those recommended by experts so that it is neither safe nor effective, leading a serious problem for patient safety and quality care.

The influence of COVID-19 on the mental health of final-year nursing students: comparing the situation before and during the pandemic.

The COVID-19 pandemic has had an important impact on the academic world. It is known that university studies can influence the mental health of students, and especially those studying health sciences. In this study, we therefore sought to analyse whether the current pandemic has affected the mental well-being of final-year nursing students. This was a multi-centre study, with a descriptive, longitudinal, and prospective design. Mental well-being was evaluated using the General Health Questionnaire. A total of 305 participants were included in the study, of whom 52.1% had experienced the COVID-19 pandemic. Statistically significant differences were found between the two groups analysed in terms of age, access to university, average marks, mental well-being self-esteem, emotional exhaustion, and sense of coherence. In the case of mental well-being, a direct association was found with both the pandemic situation (OR = 2.32, P = 0.010) and emotional exhaustion scores (OR = 1.20, P < 0.001), while an inverse association was found with sense of coherence scores (OR = 0.45, P < 0.001). This study shows that the mental health of students is a significant factor and one that must be taken into consideration when training nursing staff at university. There is a need to promote healthy habits and provide appropriate coping strategies. It is also important to train and prepare students for pandemic situations as these can have an important impact on the mental health of both the members of the public who will be treated by these future nursing professionals and the students themselves.