Defining a competency framework for health and social professionals to promote healthy aging throughout the lifespan: an international Delphi study.

The promotion of healthy aging has become a priority in most parts of the world and should be promoted at all ages. However, the baseline training of health and social professionals is currently not adequately tailored to these challenges. This paper reports the results of a Delphi study conducted to reach expert agreement about health and social professionals' competencies to promote healthy aging throughout the lifespan within the SIENHA project. Materials and methods: This study was developed following the CREDES standards. The initial version of the competence framework was based on the results of a scoping review and following the CanMEDS model. The expert panel consisted of a purposive sample of twenty-two experts in healthy aging with diverse academic and clinical backgrounds, fields and years of expertise from seven European countries. Agreement was reached after three rounds. The final framework consisted of a set of 18 key competencies and 80 enabling competencies distributed across six domains. The SIENHA competence framework for healthy aging may help students and educators enrich their learning and the academic content of their subjects and/or programs and incentivize innovation.

Professional competences to promote healthy ageing across the lifespan: a scoping review.

As societies age, the development of resources and strategies that foster healthy ageing from the beginning of life become increasingly important. Social and healthcare professionals are key agents in this process; therefore, their training needs to be in agreement with societal needs. We performed a scoping review on professional competences for social and health workers to adequately promote healthy ageing throughout life, using the framework described by Arksey and O'Malley and the Joanna Briggs Institute Guidelines. A stakeholder consultation was held in each of the participating countries, in which 79 experts took part. Results show that current literature has been excessively focused on the older age and that more attention on how to work with younger population groups is needed. Likewise, not all disciplines have equally reflected on their role before this challenge and interprofessional approaches, despite showing promise, have not been sufficiently described. Based on our results, health and social professionals working to promote healthy ageing across the lifespan will need sound competences regarding person-centred communication, professional communication, technology applications, physiological and pathophysiological aspects of ageing, social and environmental aspects, cultural diversity, programs and policies, ethics, general and basic skills, context and self-management-related skills, health promotion and disease prevention skills, educational and research skills, leadership skills, technological skills and clinical reasoning. Further research should contribute to establishing which competences are more relevant to each discipline and at what level they should be taught, as well as how they can be best implemented to effectively transform health and social care systems.

Comparing Preferred and Actual Clinical Learning Environments and Perceptions of First-Year Nursing Students in Long-Term Care: A Cross-Sectional Study.

The clinical learning environment, which includes the culture of clinical units, the mentoring process, and the different health organizations, influences the learning process of nursing students. However, scarce literature has been published on the impact of the clinical learning environment on first-year nursing students in long-term care. We aimed to assess first-year nursing students 'preferred' and 'actual' clinical learning environments when conducting their first placements in nursing homes within an innovative placement model that comprised the active participation of academic mentors. The validated Spanish version of the Clinical Learning Environment Inventory (CLEI) instrument was used in our study, and 99 first-year nursing students participated. The highest mean scores for the CLEI-Actual were found for the Satisfaction (22.7) and Involvement scales (19.09). The lowest mean scores were found for the Personalization (17) and Individualization (17.27) scales. The multiple correlation (R) between the Satisfaction and the other CLEI scales was 0.61 (p > 0.001), which means that in this study the association between student satisfaction and their perception of the clinical learning environment was strong. First-year students conducting their first clinical placements in nursing homes can have a positive learning experience considering a well-designed and organized pedagogical strategy, including constant support and feedback from academic and clinical mentors.

Autopercepción en competencias docentes en tutores/as de formación sanitaria especializada: estudio transversal / Self-perception in teaching competences in specialized health training mentors: a cross-sectional study

Introducción: La figura del tutor/a en la formación de residentes es relevante y tiene un importante impacto en la formación del profesional. Es objetivo de este estudio conocer las competencias docentes percibidas por los/las tutores/as de formación sanitaria especializada. Material y métodos: Estudio con diseño cuantitativo, descriptivo, transversal y exploratorio, realizado en la Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Costa Ponent. Se emplearon las escalas de competencia de las/los tutores/as (Mentors Competence Instrument) y de competencia cultural de los/las tutores/las (Mentors Cultural Competence Instrument) y 12 preguntas sobre antecedentes. La fiabilidad de las escalas se estimó mediante el coeficiente Alfa de Cronbach, considerándose como puntuación mínima aceptable 0.70. Resultados: Participó el 100% de la población diana (34 personas). El 50% (n=17) no había participado en formaciones de tutorización previamente. El 44,1% (n=15) hacía menos de una semana que había tutorizado estudiantes. El 35.3% (n=12) planificaba 30 minutos/día para la acción tutorial. El 76.5% (n=26) no tenía experiencia en tutorizar estudiantes con diversidad lingüística y cultural. La mayoría (91.2%; n=31) de las/los tutoras/es se perciben como competentes en: la “reflexión durante la tutorización”, las “características de la tutora o el tutor” y la “motivación del tutor/a”. Conclusión: Las/los participantes perciben poseer un elevado nivel competencial en la tutorización del estudiantado. Sin embargo, autoevalúan como medio-bajo su nivel en competencia cultural como tutor/a. Se requiere una formación en tutorización acreditada y continuada en la competencia docente y que potencie la competencia cultural de la tutorización. (AU)

Introduction: The role of the mentor in the training of speciality nursing students is relevant and has a relevant impact on the training of the professional. The objective of this study is to know the teaching competencies perceived by the mentors of specialized health training. Material and methods: A quantitative, descriptive, cross-sectional, and exploratory design study, carried out in the Multiprofessional Teaching Unit for Family and Community Care Costa Ponent. The Mentors Competence Instrument and the Mentors Cultural Competence Instrument were used to assess the participants’ self-perceived level of competency. Additionally, different sociodemographic characteristics of the population were also gathered through a 12-item questionnaire. The reliability of the scales was estimated using Cronbach’s alpha coefficient, considering 0.70 as a minimum acceptable score. Results: 100% of the target population (34) participated in the study: 50% of the sample (n = 17) had not previously participated in mentoring training; 44.1% (n = 15) had mentored students for less than a week; 35.3% (n = 12) planned 30 minutes / day for the mentoring action; 76.5% (n = 26) had no experience in mentoring students with linguistic and cultural diversity. The majority (91.2%; n = 31) perceived themselves as competent in: “reflection during the mentoring process”, the “characteristics of the mentor” and the “motivation of the mentor”. Conclusions: The participants perceive that they have a high level of competence in the students mentoring. However, they self-assess their level of cultural competence as a mentor as medium-low. Accredited and continuous training in mentoring is required in teaching competence and enhancing the mentors’ cultural competence. (AU)

Analysis of gender perspective in the use of NANDA-I nursing diagnoses: A systematic review.

AIM: To identify, describe and analyse the gender perspective in the use of the diagnoses contained in the NANDA-I taxonomy in observational studies published in the scientific literature. DESIGN AND METHODS: A systematic review has been conducted spanning from 2002 to 2020. The most frequent NANDA-I nursing diagnoses in care plans reported in observational studies, and the defining characteristics and related factors identified for men and women have been described. The Preferred Reporting Items for Systematic Reviews (PRISMA-P) have guided our research. The main findings have been summarized using a descriptive narrative synthesis approach. RESULTS: Forty-one articles were included in our study. With regard to gender analysis, the percentage of men and women that make up the sample were not specified in all articles, and half of the studies did not identify gender either in the diagnosis label or in their defining characteristics or related factors. Based on the reviewed articles, gender perspectives are not systematically incorporated in the use of the NANDA-I diagnosis. Therefore, gender biases in its use in the scientific literature may exist. This situation poses barriers to determine the health responses that are different and unequal between women and men.

The association between social capital indicators and psychological distress in Catalan adolescents.

According to the WHO, globally, one in seven adolescents experiences a mental disorder, being in a detrimental situation toward educational achievement, social cohesion, future health and life chances. Calls to identify risk and resilience factors to develop effective preventive actions have been made. Following a systemic approach, we conducted a cross-sectional study on the relationship between social capital and psychological distress in a sample of Catalan adolescents in Barcelona, taking into account a range of other relevant aspects at different levels influencing mental health, including gender, age, migrant status, family background, lifestyle factors, body mass index, and self-rated health. Data were collected through validated questionnaires in December 2016 from 646 of 14- to 18-year-old adolescents from three public and private high schools in Barcelona (Spain). Data analysis included descriptive analysis, a correlational study and logistic regression to obtain the odds ratio for social capital indicators to be associated with psychological distress. Our results suggest that reporting higher levels of family support and higher levels of teacher-student trust reduce the likelihood of suffering psychological distress. Higher levels of neighborhood informal control were associated with mental health, but a possible detrimental effect cannot be ruled out. Being a girl, reporting low self-rated health or higher media use was also associated with higher likelihood of psychological distress. Current results may encourage interventions that focus on social capital as a means to reduce psychological distress and foster well-being in youth.

Factors Influencing Nurse Assistants' Job Satisfaction in Nursing Homes in Canada and Spain: A Comparison of Two Cross-Sectional Observational Studies.

OBJECTIVES: To access associations between job satisfaction and supervisory support as moderated by stress. METHODS: For this cross-sectional study, data collected from 591 nursing assistants in 42 nursing homes in Canada and Spain were analyzed with mixed-effects regression. RESULTS: In both countries, stress related to residents' behaviors was negatively associated with job satisfaction, and, in Canada, it moderated the positive association between supervisory support and job satisfaction. Stress related to family conflict issues moderated the positive association of supervisory support and job satisfaction differently in each location: in Canada, greater stress was associated with a weaker association between supervisory support and job satisfaction; in Spain, this was also observed but only when supervisory support was sufficiently weak. DISCUSSION: Stress was associated with lower job satisfaction and moderated the association of supervisory support and job satisfaction, reinforcing the importance of supervisors supporting nursing assistants, especially during the COVID-19 pandemic.

The influence of supervisory support, work effectiveness, work empowerment and stress secondary to residents' responsive behaviours on job satisfaction of nursing staff: A multisite cross-sectional study.

AIM: To examine the association between stress secondary to residents' responsive behaviours and job satisfaction of nurses and nursing assistants working in nursing homes. To test whether supervisory support, work effectiveness and work empowerment confound this relationship. BACKGROUND: Understanding how the stress secondary to residents' responsive behaviours influences job satisfaction for staff and determining the factors influencing this relationship are important for retention of staff in nursing homes. The term 'responsive behaviours' refers to the subset of behavioural and psychological symptoms of dementia. METHODS: Survey responses from 191 nursing assistants and 81 nurses in five nursing homes in Ontario were analysed. RESULTS: Staff's stress attributed to residents' responsive behaviours was negatively associated with job satisfaction. This direct effect was weakened by more than a third through the confounding net effects of supervisory support, work effectiveness and work empowerment. CONCLUSION: The work environment created by leaders in nursing homes can lessen the influence of stress secondary to residents' responsive behaviours on staffs' job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Supervisors need training and education to support and mentor their staff effectively, and to guide their use of evidence-based practices that integrate the patient-centred care approach in order to effectively respond and minimize responsive behaviours.

Interventions across the Retirement Transition for Improving Well-Being: A Scoping Review.

(1) Background: The work-to-retirement transition involves a process of psychologically and behaviorally distancing oneself from the workforce that is often accompanied by other social changes, which can influence health and well-being. However, research on interventions targeting the work-to-retirement transition to improve health status is limited. Our objective was to summarize and describe interventions aiming to improve well-being across the retirement transition; (2) Methods: We conducted a scoping review following the methodological framework described by Arksey and O'Malley; the Joanna Briggs Institute guidelines as well as the PRISMA-ScR statements; we systematically searched articles and gray literature to identify interventions and policies that aimed to improve well-being across the retirement transition. (3) Results: 15 publications were included, which comprised both experimental designs (n = 10) and systematic reviews (n = 5). (4) Conclusions: More research on how to promote overall well-being during the work-to-retirement transition is needed. The results of this scoping review show that most reported interventions address one single lifestyle behavior, and that relevant social determinants of health have been barely considered in their design. Future investigations need to consider vulnerable groups and country-specific structural conditions. Adopting a patient and public involvement approach will contribute to developing interventions that address the significant needs of those in the transition to retirement.

Interventions across the retirement transition for improving well-being: a scoping review protocol.

INTRODUCTION: The work-to-retirement transition involves a process of psychologically and behaviourally distancing oneself from the workforce that is often accompanied by other social changes. The person is confronted with new social roles, expectations, challenges and opportunities that can influence lifestyle and well-being. In the scientific literature, we find recent reports of interventions aimed at improving health and well-being in people at retirement age. However, there is still a gap of knowledge on how different interventions during retirement might improve health status. We intend to conduct a scoping review with the aim of describing interventions for improving well-being across the retirement transition. METHODS AND ANALYSIS: The methodological framework described by Arksey and O'Malley; the Joanna Briggs Institute guidelines as well as the Preferred Reporting Items for scoping reviews and Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols statements will be followed. Eligibility criteria comprise of: (a) all type of original studies, review articles or reports published on journals as well as grey literature; (b) describing interventions to improve the well-being in adults across their retirement transition; (c) including participants before, during and after retirement; (d) all publications must describe variables associated with participants' physical and/or psychological and/or social well-being and/or perceived quality of life related to these; (e) no language restriction and (f) published from January 2000 to March 2019. The main findings will be summarised using a narrative descriptive synthesis approach and grouped following the population, concept and context principles. A stakeholder meeting will be held to provide feedback on the findings and to develop next steps in research and practice. ETHICS AND DISSEMINATION: Approval from a research ethics committee is not required, as no personal information will be collected. We plan to disseminate our research findings at different levels: scientific community, clinical and social arenas, as well as to healthcare leaders and policymakers and general population. The project has been registered at Open Science Framework with the name TRANSITS: work to retirement transition project.

Relación entre precisión diagnóstica y actitud frente a los diagnósticos de enfermería en estudiantes de grado / Relationship between diagnostic accuracy and attitudes towards diagnoses in undergraduate nursing students

PROPÓSITO: Evaluar la precisión diagnóstica de los estudiantes de tercer curso del Grado en Enfermería y analizar su posible relación con la actitud hacia el diagnóstico de enfermería. MÉTODOS: Mediante la resolución de un caso escenario se evaluó la precisión diagnóstica de los diagnósticos NANDA-I con la escala de precisión de Lunney, y la actitud hacia el diagnóstico con la versión española de la Escala de Posicionamiento ante el Diagnóstico Enfermero. RESULTADOS: El promedio de las actitudes hacia el diagnóstico de enfermería fue de 103,5 (DE 18,47) y el promedio de la precisión diagnóstica fue de 3,94 (DE 0,66). No hubo correlación significativa entre ambos (r = 0,162 y p = 0,113). Conclusión e implicaciones: No existe correlación entre la precisión diagnóstica y la actitud frente al diagnóstico de enfermería. El análisis de casos resueltos con un instrumento de medida de la precisión diagnóstica permite evaluar la competencia de los estudiantes en formulación diagnóstica y reorientar su formación para mejorar las habilidades de razonamiento clínico y el uso adecuado de los diagnósticos de enfermería

PURPOSE: To evaluate the diagnostic accuracy of third-year Nursing students and to analyse its possible relationship with attitudes towards nursing diagnosis. METHODS: The Scale for Degrees of Accuracy-Number Criteria by Lunney, and the Spanish version of the Positions on Nursing Diagnosis scale were used in order to measure the diagnostic precision of a case scenario. Findings: The mean score for the attitudes towards nursing diagnosis was 103.5 (SD 18.47), and the mean score for diagnostic accuracy was 3.94 (SD 0.66). There was no significant correlation between them (r = 0.162 and P = .113). Conclusion and implications: Diagnostic reasoning was not influenced by the attitude towards nursing diagnosis. The measuring of the diagnostic accuracy in case resolution improves clinical reasoning skills and diagnostic accuracy

Exploring the sensory screening experiences of nurses working in long-term care homes with residents who have dementia: a qualitative study.

BACKGROUND: The prevalence of vision and hearing loss is higher amongst older individuals with dementia, as well as higher in long-term care settings than in the wider community. However, the incidence of sensory impairment is underreported and often goes untreated. In this study, we aimed to understand nurses' current experiences of screening and caring for long-term care residents who have dementia and sensory impairment. METHODS: As part of a larger study on the sensory screening of long-term care residents with dementia, an environmental scan was conducted with front-line healthcare providers. We report here on the findings from the content analysis of individual, semi-structured interviews with nurses working in two long-term care homes in Southern Ontario, Canada. Twenty regulated nurses, including designated resident assessment coordinators, working full- or part-time with individuals who have dementia, participated across the two sites. All interviews were transcribed, and their contents reviewed and coded for themes by means of inductive thematic analysis. RESULTS: Following a systematic and recursive approach, three analysts identified several themes relating to: 1) the sensory screening process, 2) communication strategies, and 3) quality of life, sensory loss, and dementia. Participants reported on the strengths and limitations of screening procedures, what improvements should be made, which informal strategies are effective, and the continued professional development that is needed. CONCLUSIONS: Nurses demonstrated insight into the facilitators and barriers to effective screening and care of residents with dementia and sensory impairments, and expressed the need for further education, more suitable screening tools, and formalised accountability within the screening process for vision and hearing loss in these long-term care residents.

Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a scoping review of the literature and international policies.

Background: frailty impacts older adults' ability to recover from an acute illness, injuries and other stresses. Currently, a systematic synthesis of available interventions to prevent or reduce frailty does not exist. Therefore, we conducted a scoping review of interventions and international policies designed to prevent or reduce the level of frailty in community-dwelling older adults. Methods and analysis: we conducted a scoping review using the framework of Arksey and O'Malley. We systematically searched articles and grey literature to identify interventions and policies that aimed to prevent or reduce the level of frailty. Results: fourteen studies were included: 12 randomised controlled trials and 2 cohort studies (mean number of participants 260 (range 51-610)), with most research conducted in USA and Japan. The study quality was moderate to good. The interventions included physical activity; physical activity combined with nutrition; physical activity plus nutrition plus memory training; home modifications; prehabilitation (physical therapy plus exercise plus home modifications) and comprehensive geriatric assessment (CGA). Our review showed that the interventions that significantly reduced the number of frailty markers present or the prevalence of frailty included the physical activity interventions (all types and combinations), and prehabilitation. The CGA studies had mixed findings. Conclusion: nine of the 14 studies reported that the intervention reduced the level of frailty. The results need to be interpreted with caution, as only 14 studies using 6 different definitions of frailty were retained. Future research could combine interventions targeting more frailty markers including cognitive or psychosocial well-being.

Metabolic syndrome and dietary patterns: a systematic review and meta-analysis of observational studies.

PURPOSE: Lifestyle is linked to the risk of developing metabolic syndrome (MetS); however, its relationship with dietary patterns remains unclear. This systematic review and meta-analysis aims to analyse the association of a posteriori dietary patterns with the metabolic syndrome. METHODS: The PubMed, CINAHL and Scopus databases were searched for epidemiological studies of dietary patterns and MetS. The association between dietary patterns and MetS was estimated using a random-effects meta-analysis with 95 % confidence intervals (CIs). RESULTS: A total of 28 cross-sectional studies and three cohort studies were included in the meta-analysis. In a comparison of the highest to the lowest category of prudent/healthy dietary patterns, the pooled odds ratio (OR) for MetS was 0.83 (95 % CI 0.76, 0.90; P for heterogeneity =0.0; and I 2 = 72.1 %) in cross-sectional studies, and the pooled relative risk (RR) for MetS in cohort studies was 0.91 (95 % CI 0.68, 1.21; P for heterogeneity =0.005; I 2 = 81.1 %). The pooled OR for MetS in a comparison of the highest to the lowest category of Western dietary patterns was 1.28 (95 % CI 1.17, 1.40; P for heterogeneity =0.0; and I 2 = 72.0 %) in cross-sectional studies, and the RR was 0.96 (95 % CI 0.53, 1.73; P for heterogeneity =0.102; I 2 = 62.6 %) in cohort studies. CONCLUSIONS: The results from cross-sectional studies showed that a prudent/healthy pattern is associated with a lower prevalence of MetS, whereas a Western/unhealthy is associated with an increased risk for MetS. Additional prospective studies are needed to confirm the association between dietary patterns and MetS.

Las influencias interpersonales en mujeres con incontinencia urinaria / The interpersonal influences in women with urinary incontinence

OBJETIVO: Describir las influencias interpersonales que presentan las mujeres con incontinencia urinaria (IU). METODOLOGÍA: La perspectiva teórico-metodológica utilizada ha sido la cualitativa fenomenológica, con la participación de 34 mujeres de la provincia de Barcelona. Los datos se recogieron mediante entrevistas en profundidad y la técnica del grupo focal. La selección de la muestra fue intencional o de conveniencia, y el análisis categorial temático se realizó a partir de las transcripciones de los discursos de las participantes. RESULTADOS: Las influencias interpersonales más significativas para las participantes fueron las mujeres de su familia, las amigas y los profesionales de la salud. Dicha influencia ha sido mayoritariamente negativa y las involucró poco o nada en conductas promotoras de la salud en la resolución de su IU. CONCLUSIONES: La mayoría de las influencias interpersonales descritas en el estudio son fruto de las creencias derivadas de los estereotipos de género, que se transmiten en el proceso de socialización y que condicionan la percepción de la IU como una enfermedad tratable

OBJECTIVE: Describe the interpersonal influences that present women with urinary incontinence (UI). METHODS: The theoretical-methodological approach used was qualitative phenomenological, involving 34 women in the province of Barcelona (Spain). Data were collected through in-depth interviews and focus group technique. The sample selection was intentional or convenience categorical, and thematic analysis was conducted from the transcripts of the speeches of the participants. RESULTS: The most significant interpersonal influences for participants are the women of his family, friends and health professionals. This influence is mostly negative and involves little or no health-promoting behaviors was solving its UI. CONCLUSIONS: Most of interpersonal influences described are the result of beliefs derived from gender stereotypes that are transmitted in the socialization process and shape perceptions of the UI as a treatable disease

Diagnósticos de enfermería y migración. Estudio fenomenológico desde la visión de los inmigrantes / Nursing diagnoses and migration: phenomenological study from the immigrant´s point of view

Objetivo. El objetivo de esta investigación pretende identificar los diagnósticos de enfermería NANDA predominantes en la población inmigrante, vinculados al proceso migratorio, y está enmarcada en el modelo Outcome Present State Test (OPT) de razonamiento clínico de Pesut y Herman. Metodología. Considerando los objetivos, esta investigación sigue el paradigma cualitativo y las propuestas de la investigación fenomenológica. El estudio se ha realizado con entrevistas individuales semiestructuradas a 30 persones inmigradas, realizando la categorización según los dominios de la taxonomía NANDA para la identificación de los diagnósticos de enfermería. El análisis se ha realizado con el apoyo informático del programa Atlas-ti 6.0. Resultados. Se han identificado 23 diagnósticos en 9 de los 13 dominios de la taxonomía NANDA, analizando sus relaciones siguiendo la propuesta del modelo OPT, creando una red de razonamiento clínico. El diagnóstico principal para esta muestra es Disposición para mejorar el afrontamiento. Conclusiones. La definición y las características definitorias que recoge la taxonomía NANDA para Disposición para mejorar el afrontamiento no hacen alusión explícita al fenómeno migratorio. Consideramos que se debe adecuar el lenguaje enfermero para que describa las respuestas específicas derivadas de la experiencia migratoria y se promueva una atención sanitaria de calidad (AU)

Objective. The objective of this research is to identify nursing diagnosis NANDA which is predominant within the immigrant community, linked to the migratory process and part of the framework of the Outcome Present State Test (OPT) of Pesut and Herman’s critical awareness. Methodology. Keeping in mind the objectives of this research, this approaches the quality-based paradigm and follows the proposals of phenomenology research. The study was carried out using an individual semi-structured interview of 30 immigrants. A categorization of the data has been applied in accordance with the domains of NANDA for the identification of nursing diagnosis and its analysis has been carried with computer support with Atlas-ti 6.0. Results. Twenty three diagnoses were identified in nine out of thirteen taxonomy NANDA domains. Analysis of their interrelationships according to the OPT model were carried out and a clinical reasoning net was created. The main diagnoses achieved in our study was: Readiness for Enhanced Coping. Conclusions. NANDA taxonomy doesn’t include the migratory process in the characteristics and related factors of this nursing diagnosis. We consider that nursing taxonomy should be reassessed in order to describe more in depth the specific responses derived from the migratory experience so it can lead to a high quality health care (AU)

Dietary patterns and CVD: a systematic review and meta-analysis of observational studies.

Epidemiological studies show that diet is linked to the risk of developing CVD. The objective of this meta-analysis was to estimate the association between empirically derived dietary patterns and CVD. PubMed was searched for observational studies of data-driven dietary patterns that reported outcomes of cardiovascular events. The association between dietary patterns and CVD was estimated using a random-effects meta-analysis with 95 % CI. Totally, twenty-two observational studies met the inclusion criteria. The pooled relative risk (RR) for CVD, CHD and stroke in a comparison of the highest to the lowest category of prudent/healthy dietary patterns in cohort studies was 0·69 (95% CI 0·60, 0·78; I 2=0%), 0·83 (95% CI 0·75, 0·92; I 2=44·6%) and 0·86 (95% CI 0·74, 1·01; I 2=59·5%), respectively. The pooled RR of CHD in a case-control comparison of the highest to the lowest category of prudent/healthy dietary patterns was 0·71 (95% CI 0·63, 0·80; I 2=0%). The pooled RR for CVD, CHD and stroke in a comparison of the highest to the lowest category of western dietary patterns in cohort studies was 1·14 (95% CI 0·92, 1·42; I 2=56·9%), 1·03 (95% CI 0·90, 1·17; I 2=59·4%) and 1·05 (95% CI 0·91, 1·22; I 2=27·6%), respectively; in case-control studies, there was evidence of increased CHD risk. Our results support the evidence of the prudent/healthy pattern as a protective factor for CVD.

[NURSING DIAGNOSES AND MIGRATION: PHENOMENOLOGICAL STUDY FROM THE IMMIGRANT'S POINT OF VIEW]. / Diagnósticos de enfermería y migración. ESTUDIO FENOMENOLÓGICO DESDE LA VISIÓN DE LOS INMIGRANTES.

OBJECTIVE: The objective of this research is to identify nursing diagnosis NANDA which is predominant within the immigrant community, linked to the migratory process and part of the framework of the Outcome Present State Test (OPT) of Pesut and Herman's critical awareness. METHODOLOGY: Keeping in mind the objectives of this research, this approaches the quality-based paradigm and follows the proposals of phenomenology research. The study was carried out using an individual semi-structured interview of 30 immigrants. A categorization of the data has been applied in accordance with the domains of NANDA for the identification of nursing diagnosis and its analysis has been carried with computer support with Atlas-ti 6.0. RESULTS: Twenty three diagnoses were identified in nine out of thirteen taxonomy NANDA domains. Analysis of their interrelationships according to the OPT model were carried out and a clinical reasoning net was created. The main diagnoses achieved in our study was: Readiness for Enhanced Coping. CONCLUSIONS: NANDA taxonomy doesn't include the migratory process in the characteristics and related factors of this nursing diagnosis. We consider that nursing taxonomy should be reassessed in order to describe more in depth the specific responses derived from the migratory experience so it can lead to a high quality health care.