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1.
Pain Manag Nurs ; 2020 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-32636062

RESUMO

BACKGROUND: Frailty is a frequent health condition in older adults of decreased functional reserve that leads to vulnerability to internal and external stressors. It has been associated with chronic pain, which is a common, costly and incapacitating condition in older adults. AIMS: To describe frailty status in a sample of community-dwelling older adults with chronic pain attending a primary health care centre. DESIGN: Cross-sectional investigation. PARTICIPANTS: Adults aged 65 years or older with chronic pain. METHODS: The Survey of Health, Ageing and Retirement in Europe Frailty Instrument (SHARE-FI) was used to assess frailty status and a visual analogue scale to assess pain intensity. Descriptive and analytical statistics were performed. RESULTS: Among 154 participants recruited, 20.1% were frail, 38.3% pre-frail and 41.6% robust. Women were more likely to be classified as frail or pre-frail (OR: 4.62, 95% CI: 2.23-9.59), as well as participants aged 75 years or older (OR: 3.41, 95% CI: 1.74-6.68) and participants reporting moderate and severe pain (OR: 4.20, 95% CI: 2.10-8.40). These results remained significant after adjustment. CONCLUSIONS: There is an association between frailty status and other variables such as older age, female gender and higher pain intensity.

2.
Rev Esp Salud Publica ; 932019 Aug 26.
Artigo em Espanhol | MEDLINE | ID: mdl-31447482

RESUMO

OBJECTIVE: People on methadone treatment have increased their life expectancy, aging prematurely with comorbidities. The objective of this study was to know the sociodemographic and clinical profile of these people in the Center for Addiction Care in the district of Latina (belonging to Madrid Salud), as well as the perception of the influence of the treatment on their aging. The Social Determinants of Health Model was used as a framework. METHODS: A mixed methodology was used in two phases: a quantitative one, to describe the sociodemographic and clinical characteristics of the study population; and another qualitative one, through semi-structured interviews to an intentional sample, to explore the history of life and the perception of future needs regarding the health of the participants. RESULTS: The results highlighted that the average age of the sample was 48.28 years, that they were mostly men (81.25%), of Spanish origin, with a low level of education and economics and with a medium stay in treatment with methadone of ± 13 years. An increase in mental pathologies was found the more years they had been in the program, as well as, at a lower age of onset in consumption, the presence of HIV and Hepatitis C virus increased. In their speeches it was found that the social determinants of Health have conditioned its vital history. CONCLUSIONS: Both consumption and methadone contribute to its stigmatization, not favoring its normalized inclusion in society and determining a high state of vulnerability. This increases as age does, not receive adequate resources to meet their future needs.


Assuntos
Envelhecimento , Metadona/uso terapêutico , Tratamento de Substituição de Opiáceos , Determinantes Sociais da Saúde , Estereotipagem , Adulto , Idade de Início , Comorbidade , Feminino , Infecções por HIV/complicações , Hepatite C/complicações , Humanos , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia
3.
Enferm. clín. (Ed. impr.) ; 29(4): 234-238, jul.-ago. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182917

RESUMO

Objetivo: Determinar los efectos en la satisfacción materna del uso de la pelota de parto como método de alivio del dolor, comparado con la administración subcutánea de petidina (50mg) y haloperidol (2,5mg), en el periodo de latencia de parto. Método: Ensayo clínico aleatorizado, unicéntrico, paralelo y controlado. Participantes: gestantes de bajo riesgo, ingresadas en la planta de embarazo patológico del HGU Gregorio Marañón, por gestación cronológicamente prolongada, rotura prematura de membranas o pródromos de parto. Intervención: una vez que la paciente manifestaba dolor con su proceso, se implementaban una serie de movimientos predeterminados con la pelota de partos, en el caso del grupo intervención, o se administraba petidina más haloperidol, vía subcutánea. Tras la intervención y en planta de puérperas la satisfacción era medida con la escala Mackey Satisfaction Childbirth, validada al castellano en 2016, en las primeras 48-72h posparto. Análisis: comparación de grupos: la t de Student para las variables continuas y la Chi-cuadrado para las categóricas. Resultados: La satisfacción materna fue significativamente mayor en el grupo experimental que en el grupo de comparación, en todas las esferas de la escala: obstetra (4,24/3,87), dilatación (4,02/3,35), expulsivo (4,27/3,67), recién nacido (4,72/4,43) y acompañamiento y comodidad (4,78/4,44). No hubo, sin embargo, diferencias estadísticamente significativas en la subescala matrona, aunque las puntuaciones fueron igualmente altas (4,65/4,45). Conclusión: El uso de pelotas de parto durante el periodo de latencia aumenta la satisfacción de la mujer en el proceso de parto, en mayor medida que la administración conjunta de petidina y haloperidol


Objective: To determine the effects on maternal satisfaction of the use of the birthing ball as a method of pain relief compared to the subcutaneous administration of pethidine (50mg) and haloperidol (2.5mg), during the latent phase of labour. Method: Randomised, unicentric, parallel and controlled clinical trial. Participants: Low-risk pregnant women hospitalised in a pathological pregnancy ward at the Gregorio Marañón University General Hospital (Madrid) due to prolonged pregnancy, premature rupture of membranes, or labour prodromes. Intervention: once the patient's labour had become painful, a series of pre-established movements were implemented with a birthing ball in the intervention group, or pethidine and haloperidol were administered at the same dose subcutaneously. After the intervention and on the post-natal ward, satisfaction was measured with the Mackey Satisfaction Childbirth scale, validated in Spanish in 2016, in the first 48-72hours after delivery. Analysis: group comparisons: Student's t for continuous variables and Chi-squared for categorical variables. Significance at p<0.05. Results: The maternal satisfaction was significantly higher in the experimental group than in the comparison group, in all the domains of the scale: obstetrician (4.24/3.87), dilatation (4.02/3.35), second stage (4.27/3.67), newborn (4.72/4.43), accompaniment and comfort (4.78/4.44). There were, however, no statistically significant differences in the midwife subscale, although the scores were equally high (4.65/4.45). Conclusion: Using birthing balls during the latent phase of labour increases women's satisfaction with their labour process more than administering pethidine and haloperidol during this period


Assuntos
Humanos , Feminino , Adulto , Trabalho de Parto/fisiologia , Dor do Parto/epidemiologia , Dor do Parto/psicologia , Manejo da Dor , Satisfação do Paciente , Centros de Assistência à Gravidez e ao Parto , Meperidina/administração & dosagem , Haloperidol/administração & dosagem , Análise de Dados
4.
Midwifery ; 77: 37-44, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31254962

RESUMO

AIM: To explore the experience of both the mothers and the fathers regarding the care received during delivery in cases of stillbirth. DESIGN: A hermeneutic phenomenological study based on semi-structured interviews with eleven mothers and fathers who experienced stillbirth. PARTICIPANTS: A purposive sample was recruited in Hospital XXX of XX and through a local pregnancy loss support organization. METHODS: Interviews were recorded and transcribed verbatim and analysed using inductive thematic analysis. FINDINGS: Four main categories identified: 1) denial of grief, 2) the life and death paradox, 3) guilt, and 4) go through and overcome the loss. The parents manifested a lack of recognition of their loss and their parenthood. Although the midwife was the highest valued professional, not all the experiences were positive and the parents would have appreciated being accompanied by trained people with good communication skills. They also referred to in-hospital logistic barriers that complicated the process, as well as the fact that these births occurred in the same place where healthy deliveries were attended. CONCLUSION: Findings highlight the importance of tailoring support systems according to mothers' and fathers' needs. Promoting social and institutional recognition of this kind of loss and training healthcare professionals in the accompaniment of this type of mourning is useful to plan comprehensive care to facilitate the initiation and subsequent evolution of healthy mourning.


Assuntos
Pai/psicologia , Mães/psicologia , Satisfação do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde/normas , Natimorto/psicologia , Adaptação Psicológica , Adulto , Luto , Pai/estatística & dados numéricos , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Mães/estatística & dados numéricos , Pesquisa Qualitativa , Qualidade da Assistência à Saúde/estatística & dados numéricos , Espanha/epidemiologia , Natimorto/epidemiologia
5.
Pain Manag Nurs ; 20(4): 309-315, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31103515

RESUMO

OBJECTIVE: Our aim was to examine the relationship between chronic pain and frailty in community-dwelling older adults. DESIGN: A systematic review method following the Joanna Briggs Institute Reviewers' Manual 2015. DATA SOURCES: MEDLINE, Cochrane Library Plus, Science Direct, Scielo, LILACS, and the Joanna Briggs Institute database of systematic reviews and implementation reports were searched using different combinations of the terms "frail," "frailty," and "pain." REVIEW/ANALYSIS METHODS: Original publications of nononcologic chronic pain and frailty status in community-dwelling older adults published in English or Spanish were included. Because of the heterogeneity of the studies, a narrative approach was used to summarize the results. RESULTS: A total of 23 studies were finally selected for the systematic review. Most of them (n = 14) were cross-sectional studies, and there were also longitudinal studies (n = 4), cohort studies (n = 3), and randomized controlled trials (n = 2). Most of the studies found an association between chronic pain and frailty in terms of prevalence; approximately 45% of frail patients had chronic pain, and prevalence can reach 70%. CONCLUSIONS: The studies analyzed suggest that chronic pain has a predictive effect for frailty in older adults compared with those reporting no pain. Higher pain intensity, chronic widespread pain, and higher pain interference were also related to frailty status. No specific interventions for managing chronic pain in frail or prefrail older adults were found.

6.
Enferm Clin ; 29(4): 234-238, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30902579

RESUMO

OBJECTIVE: To determine the effects on maternal satisfaction of the use of the birthing ball as a method of pain relief compared to the subcutaneous administration of pethidine (50mg) and haloperidol (2.5mg), during the latent phase of labour. METHOD: Randomised, unicentric, parallel and controlled clinical trial. PARTICIPANTS: Low-risk pregnant women hospitalised in a pathological pregnancy ward at the Gregorio Marañón University General Hospital (Madrid) due to prolonged pregnancy, premature rupture of membranes, or labour prodromes. INTERVENTION: once the patient's labour had become painful, a series of pre-established movements were implemented with a birthing ball in the intervention group, or pethidine and haloperidol were administered at the same dose subcutaneously. After the intervention and on the post-natal ward, satisfaction was measured with the Mackey Satisfaction Childbirth scale, validated in Spanish in 2016, in the first 48-72hours after delivery. ANALYSIS: group comparisons: Student's t for continuous variables and Chi-squared for categorical variables. Significance at p<0.05. RESULTS: The maternal satisfaction was significantly higher in the experimental group than in the comparison group, in all the domains of the scale: obstetrician (4.24/3.87), dilatation (4.02/3.35), second stage (4.27/3.67), newborn (4.72/4.43), accompaniment and comfort (4.78/4.44). There were, however, no statistically significant differences in the midwife subscale, although the scores were equally high (4.65/4.45). CONCLUSION: Using birthing balls during the latent phase of labour increases women's satisfaction with their labour process more than administering pethidine and haloperidol during this period.

7.
Eur J Cardiovasc Nurs ; 18(1): 48-56, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29923416

RESUMO

BACKGROUND: The technological advances of medicine, and specifically the techniques of organ transplants, have allowed crossing the border of life and death. This is especially relevant in the case of heart transplant, since its symbolism requires a redefinition not only of these traditional concepts, but also of the body or of one's own identity. AIMS: To explore the experiences of patients after receiving a heart from a donor. METHODS: A phenomenological qualitative approach, through Merleau Ponty and Levinas perspectives, was conducted to capture the subjective experiences of heart transplant patients. We conducted 22 in-depth interviews: 12 with heart transplant patients from two hospitals in Madrid (Spain), and 10 with relatives who lived with them. RESULTS: The line between life and death is erased for heart transplant patients. Three main themes arose from the analysis: towards death, the frontier between life and death, and towards life. The need to redefine the concepts of life and death is structured around issues such as the thought of facing one's own death and the concept of gift and resurrection. CONCLUSION: Organ transplant techniques open the door to a new definition of death, of the identity of the body and its parts and the limits of life. Considering the cultural, legal, psychological, social and symbolic elements involved in the heart transplant process, a qualitative approach provides new avenues of understanding the clinical process from the patients' perspective.


Assuntos
Adaptação Psicológica , Transplante de Coração/psicologia , Qualidade de Vida/psicologia , Transplantados/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Espanha
8.
Rev. esp. salud pública ; 93: 0-0, 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-189484

RESUMO

OBJETIVO: Las personas en tratamiento con metadona han aumentado su esperanza de vida, envejeciendo de una forma prematura con comorbilidades. El objetivo de este estudio fue conocer el perfil sociodemográfico y clínico de estas personas en el Centro de Atención a las Adicciones del distrito de Latina (perteneciente a Madrid Salud), así como la percepción de la influencia del tratamiento en su envejecimiento. Se tuvo como marco el Modelo de los Determinantes Sociales de Salud. MÉTODOS: Se utilizó una metodología mixta en dos fases: una cuantitativa, para describir las características sociodemográficas y clínicas de la población de estudio; y otra cualitativa, mediante entrevistas semiestructuradas a una muestra intencional, para explorar el historial de vida y la percepción de necesidades futuras respecto de la salud de los participantes. RESULTADOS: En los resultados destacó que la edad media de la muestra era de 48,28 años, que eran en su mayoría hombres (81,25%), de origen español, con un nivel de estudios y económico bajos y con una estancia media en tratamiento con metadona de +/-13 años. Se encontró un aumento de patologías mentales cuantos más años llevaban en el programa, así como que, a menor edad de inicio en el consumo, aumentaba la presencia de VIH y virus de la Hepatitis C. En sus discursos se halló que los determinantes sociales de la salud han condicionado su historia vital. CONCLUSIONES: Tanto el consumo como la metadona contribuyen a su estigmatización, no favoreciendo su inclusión normalizada en la sociedad y determinando un estado elevado de vulnerabilidad. Ésta aumenta a medida que lo hace su edad, no recibiendo los recursos adecuados para atender a sus futuras necesidades


OBJECTIVE: People on methadone treatment have increased their life expectancy, aging prematurely with comorbidities. The objective of this study was to know the sociodemographic and clinical profile of these people in the Center for Addiction Care in the district of Latina (belonging to Madrid Salud), as well as the perception of the influence of the treatment on their aging. The Social Determinants of Health Model was used as a framework. METHODS: A mixed methodology was used in two phases: a quantitative one, to describe the sociodemographic and clinical characteristics of the study population; and another qualitative one, through semi-structured interviews to an intentional sample, to explore the history of life and the perception of future needs regarding the health of the participants. RESULTS: The results highlighted that the average age of the sample was 48.28 years, that they were mostly men (81.25%), of Spanish origin, with a low level of education and economics and with a medium stay in treatment with methadone of +/- 13 years. An increase in mental pathologies was found the more years they had been in the program, as well as, at a lower age of onset in consumption, the presence of HIV and Hepatitis C virus increased. In their speeches it was found that the social determinants of Health have conditioned its vital history. CONCLUSIONS: Both consumption and methadone contribute to its stigmatization, not favoring its normalized inclusion in society and determining a high state of vulnerability. This increases as age does, not receive adequate resources to meet their future needs


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Envelhecimento , Metadona/uso terapêutico , Tratamento de Substituição de Opiáceos , Determinantes Sociais da Saúde , Estereotipagem , Idade de Início , Comorbidade , Infecções por HIV/complicações , Hepatite C/complicações , Expectativa de Vida
9.
Rev Lat Am Enfermagem ; 26: e3102, 2018 Nov 29.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-30517587

RESUMO

OBJECTIVE: to identify the predictive variables or the massive transfusion triggers in severely traumatized patients through the existing scales. METHOD: a review of the literature was carried out using the Scoping Review method across the electronic databases CINAHL, MEDLINE, LILACS, the Cochrane and IBECS libraries, and the Google Scholar search tool. RESULTS: in total, 578 articles were identified in the search and the 36 articles published in the last ten years were included, of which 29 were original articles and 7 review articles. From the analysis, scales for massive transfusion and their predictive triggers were examined. CONCLUSION: the absence of universal criteria regarding the massive transfusion triggers in traumatized patients has led to the development of different scales, and the studies on their validation are considered relevant for the studies about when to initiate this strategy.


Assuntos
Transfusão de Sangue , Hemorragia/terapia , Ferimentos e Lesões/terapia , Pressão Sanguínea , Serviços Médicos de Emergência , Humanos , Sístole , Índices de Gravidade do Trauma
10.
Midwifery ; 66: 127-133, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30170265

RESUMO

AIM: To explore the experiences of midwives regarding the attention given during labour in late foetal death. DESIGN: Qualitative research using a hermeneutic-interpretative phenomenological approach was carried out. Data were collected through focus groups, audio-recorded, transcribed verbatim, and analyzed using the van Manen approach. SETTING AND PARTICIPANTS: Three focus group with a purposive sample of 18 midwives from 10 public hospitals and 1 primary health centre in Madrid, Spain were conducted. FINDINGS: Two main themes were identified: Professionals for Life Not Death; and Organizing the Work Without Guidelines. Midwives felt there is a lack of social awareness related to the possibility of antepartum death that keeps the mourning hidden and affects the midwives´ practice during the late foetal death process. Midwives recognize difficulties in coping with a process that ends in death: organizations are not prepared for these events (not suitable rooms), there is lack of training to cope with them, and lack of continuity in the attention received by the parents when they are discharged. CONCLUSION: Midwives need to be trained in mourning and communication skills to guarantee good practice when attending late foetal death. Intervention guidelines and support mechanisms are required, not only for the parents, but also for the healthcare professionals.


Assuntos
Morte Fetal , Trabalho de Parto/psicologia , Enfermeiras Obstétricas/psicologia , Adulto , Atitude do Pessoal de Saúde , Feminino , Grupos Focais , Cuidados Paliativos na Terminalidade da Vida/métodos , Cuidados Paliativos na Terminalidade da Vida/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Complicações na Gravidez/psicologia , Pesquisa Qualitativa , Espanha
11.
Metas enferm ; 21(7): 24-32, sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-172703

RESUMO

Objetivo: analizar la evidencia disponible acerca del proceso de atención al parto en la muerte fetal tardía, que permita conocer la experiencia y las necesidades de madres y padres, y la experiencia y dificultades de los profesionales que atienden estos casos. Método: revisión narrativa de estudios cualitativos publicados desde 2005 hasta agosto de 2017 en las bases de datos Pubmed, Cinahl, Embase, Scielo, Cuiden y Lilacs en el campo de la muerte fetal tardía, atendiendo a su definición en el contexto español (a partir de 28 semanas de gestación) y en el internacional (a partir de la semana 24 de gestación). Se llevó a cabo un análisis temático de los artículos seleccionados, identificándose cuatro áreas temáticas en función a la experiencia de las madres y padres, por un lado, y dos áreas temáticas según la experiencia de los profesionales. Resultados: se seleccionaron siete artículos cualitativos (cuatro análisis de contenido, dos análisis fenomenológicos y una teoría fundamentada). Los temas identificados respecto a la experiencia de madres y padres estuvieron relacionados con un diagnóstico devastador, comienzo de la despedida, construcción de la maternidad y la paternidad, e impacto de la actuación de los profesionales. Los temas identificados en relación a la experiencia de los profesionales fueron impacto personal y profesional, y manejo del caso. Conclusiones: esta revisión pone de manifiesto tanto lo traumático de la experiencia de las madres y padres que sufren una pérdida fetal tardía como la afectación personal de los profesionales que les atienden, que presentan dificultades para afrontar adecuadamente el caso, y demandan formación específica para ayudar de forma eficiente en el proceso de duelo


Objective: to analyze the evidence available about the delivery care process in late fetal death, allowing to learn about the experience and needs of mothers and fathers, and the challenges for the professionals managing these cases. Method: a narrative review of qualitative studies published from 2005 to August, 2017 in the following databases: Pubmed, Cinahl, Embase, Scielo, Cuiden and Llilacs, on the area of late fetal death, according to its definition in the Spanish setting (from 28 gestation weeks onwards), and in the international setting (from week 24 of gestation). A themed analysis was conducted on the articles selected, and four theme areas were identified, based on the experience of mothers and fathers on one hand, and two theme areas according to the experience of professionals. Results: seven qualitative articles were selected: four content analyses, two phenomenological analyses, and one grounded theory. The themes identified regarding the experience of mothers and fathers were associated with a devastating diagnosis, the initial goodbye, building maternity and paternity, and the impact of the action by professionals. The themes identified associated with the experience of professionals were: personal and professional impact, and case management. Conclusions: this review shows the traumatic experience of mothers and fathers suffering a late fetal loss, as well as the personal impact on those professionals managing them, who will be faced with difficulties for addressing the case adequately, and demand specific training to help in the mourning process in an efficient way


Assuntos
Humanos , Feminino , Gravidez , Morte Fetal , Morte Perinatal , Parto Obstétrico/enfermagem , Pesar , Tocologia/psicologia , Pesquisa Qualitativa , Atitude do Pessoal de Saúde , Pais/psicologia
13.
Clin Nurs Res ; : 1054773818791096, 2018 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-30051736

RESUMO

The aim of this study was to explore the experience of Spanish people living with rheumatoid arthritis (RA) and the support these people received from health professionals, particularly nurses. Nineteen patients with >1 year diagnosis, disease activity moderate or severe (DAS28 > 3.2), and already treated with disease-modifying antirheumatic drugs (DMARDs) were interviewed. A thematic analysis was performed to interpret the discourses. The difficulties of symptom management; the need for home-adaptations, the difficulties of living with a deteriorating self-image; and the reluctant reliance on medication to control their disease were the main themes that emerged from the discourse analysis of this study. Nurses appeared to have a limited role in RA patients care, and focused primarily on giving information and training for biological therapies. RA patients in Spain would benefit from having contact with specialist nurses who could empower them to self-manage their disease, as happens in other countries.

14.
Enferm. clín. (Ed. impr.) ; 28(2): 81-88, mar.-abr. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-171685

RESUMO

Objetivo: Este trabajo tiene como objeto explorar las vivencias de las personas que transitan por el proceso de una colostomía. Método: Abordaje metodológico descriptivo de tipo cualitativo y con un encuadre fenomenológico, a través de entrevistas en profundidad. Seis mujeres y 12 hombres, entre 38 y 86 años de edad, fueron entrevistados antes y después de la cirugía, entre los 3 y los 6 meses posteriores a la intervención. Los discursos fueron grabados y transcritos verbatim y analizados siguiendo las 3 etapas de Taylor y Bogdan: de descubrimiento en progreso, de codificación de los datos y refinamiento de la comprensión del tema de estudio, y de relativización de los descubrimientos. Resultados: El cáncer de colon y la colostomía suponen cambios en la vivencia de la esfera privada, en la que se introduce este componente vital con connotaciones de «estigma». Se observa que la percepción del deterioro de la imagen corporal no está relacionada con el sexo sino más bien con la edad, con la situación laboral, con el tipo de trabajo que realiza el individuo y con el contexto social y cultural al que se pertenece. Conclusiones: La reconstrucción del mapa de relaciones del individuo, como estrategia de adaptación al proceso, se interrelaciona con factores sociales, culturales, de manejo del estoma y con la capacidad del individuo para la resolución efectiva de problemas (AU)


Objective: The purpose of this paper is to explore the experience of people who go through the process of a colostomy. Method: Methodological approach of qualitative type and with a phenomenological framework, through in-depth interviews. Six women and 12 men, between 38 and 86 years of age, were interviewed before and after surgery, between 3 and 6 months after the intervention. The discourses were recorded and transcribed verbatim and analyzed following the 3 stages of Taylor and Bogdan: finding in progress, data coding and refinement of the understanding of the subject of study, and relativisation of the findings. Results: Colon cancer and colostomy involve changes in a person's experience of privacy, and the connotations of "stigma" that can be attached to this vital element. It has been observed that the perception of deteriorated body image does not relate to an individual's gender, but rather to their age, work situation, type of work and social and cultural context. Conclusions: The reconstruction of an individual's relationship map, as a strategy for adapting to the process, is interrelated with social, cultural, and stoma management factors, and with their capacity for effective problem solving (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Colostomia/enfermagem , Neoplasias do Colo/enfermagem , Neoplasias do Colo/psicologia , Identificação Social , Imagem Corporal/psicologia , Pesquisa Qualitativa
16.
Enferm Clin ; 28(2): 81-88, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29453156

RESUMO

OBJECTIVE: The purpose of this paper is to explore the experience of people who go through the process of a colostomy. METHOD: Methodological approach of qualitative type and with a phenomenological framework, through in-depth interviews. Six women and 12 men, between 38 and 86 years of age, were interviewed before and after surgery, between 3 and 6 months after the intervention. The discourses were recorded and transcribed verbatim and analyzed following the 3 stages of Taylor and Bogdan: finding in progress, data coding and refinement of the understanding of the subject of study, and relativisation of the findings. RESULTS: Colon cancer and colostomy involve changes in a person's experience of privacy, and the connotations of "stigma" that can be attached to this vital element. It has been observed that the perception of deteriorated body image does not relate to an individual's gender, but rather to their age, work situation, type of work and social and cultural context. CONCLUSIONS: The reconstruction of an individual's relationship map, as a strategy for adapting to the process, is interrelated with social, cultural, and stoma management factors, and with their capacity for effective problem solving.


Assuntos
Colostomia/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Rev. latinoam. enferm. (Online) ; 26: e3102, 2018. graf
Artigo em Inglês | LILACS | ID: biblio-978597

RESUMO

Objective to identify the predictive variables or the massive transfusion triggers in severely traumatized patients through the existing scales. Method a review of the literature was carried out using the Scoping Review method across the electronic databases CINAHL, MEDLINE, LILACS, the Cochrane and IBECS libraries, and the Google Scholar search tool. Results in total, 578 articles were identified in the search and the 36 articles published in the last ten years were included, of which 29 were original articles and 7 review articles. From the analysis, scales for massive transfusion and their predictive triggers were examined. Conclusion the absence of universal criteria regarding the massive transfusion triggers in traumatized patients has led to the development of different scales, and the studies on their validation are considered relevant for the studies about when to initiate this strategy.


Objetivo identificar as variáveis preditivas ou os desencadeantes de transfusão maciça em pacientes com trauma grave através das escalas existentes. Método foi realizada uma revisão da literatura utilizando o método Scoping Review, nas bases de dados eletrônicas CINAHL, MEDLINE, LILACS, nas bibliotecas Cochrane e IBECS, e a ferramenta de busca do Google Scholar. Resultados foram identificados 578 artigos na pesquisa no total, dos quais foram incluídos os 36 artigos publicados nos últimos dez anos, sendo 29 artigos originais e 7 artigos de revisão. A partir da análise, foram examinadas as escalas de transfusão maciça e seus desencadeantes preditivos. Conclusão a falta de critérios universais com relação aos desencadeadores de transfusão em maciça em pacientes traumatizados levou à criação de diferentes escalas, sendo os estudos sobre sua validação considerados importantes para as estudos sobre quando iniciar essa estratégia.


Objetivo identificar las variables predictivas o los triggers de transfusión masiva en el paciente traumatizado grave a través de las escalas existentes. Método se realizó una revisión de la literatura mediante el método Scoping Review, en las bases de datos electrónicas CINAHL, MEDLINE, LILACS, las bibliotecas Cochrane e IBECS, y el buscador Google Scholar. Resultados un total de 578 artículos fueron identificados en la búsqueda, de los cuales, se incluyeron un total de 36 publicados en los últimos diez años, distribuidos en 29 originales y 7 de revisión. Del análisis, se examinaron las escalas de transfusión masiva y sus triggers predictivos. Conclusión la inexistencia de criterios universales respecto a los triggers de transfusión masiva en el paciente traumatizado ha traído consigo la creación de diferentes escalas, donde los estudios de validación de las mismas se detectan como relevantes para la investigación sobre cuando iniciar esta estrategia.


Assuntos
Humanos , Pressão Sanguínea/efeitos dos fármacos , Transfusão de Sangue/métodos , Serviços Médicos de Emergência , Hemorragia/terapia
18.
Rev. Rol enferm ; 40(2): 130-134, feb. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-160180

RESUMO

Introducción. La enfermedad crónica compleja requiere de un modelo asistencial basado en equipos multidisciplinares. El objetivo del estudio fue analizar el desarrollo del liderazgo enfermero en el manejo del paciente crónico complejo (PCC) e identificar cómo gestiona los recursos en la atención y seguimiento de estos pacientes. Método. Estudio cualitativo descriptivo, mediante observación participante, entrevistas en profundidad a 7 profesionales sanitarios y un grupo de discusión con 9 profesionales de enfermería de centros de Atención Primaria madrileños, seleccionados mediante muestreo intencional. Para el análisis del discurso se siguió el procedimiento propuesto por Conde: determinación de las posiciones discursivas, creación y análisis de las configuraciones simbólicas, análisis e interpretación de las configuraciones semánticas y elaboración del discurso. Resultados. Del discurso emergieron dos dimensiones de significado del liderazgo y la gestión enfermera en el manejo del PCC: a) el profesional de enfermería, líder de los cuidados: se reconoce la necesidad de liderazgo de los enfermeros y de mejorar las estructuras de coordinación, y b) el profesional de enfermería, gestor de recursos en la atención al PCC, en relación con los riesgos sociosanitarios y la coordinación de los recursos. Conclusiones. Los hallazgos resaltan la gestión de casos y la atención domiciliaria como los pilares centrales para el manejo eficaz del PCC, donde enfermería ocupa una posición privilegiada (AU)


Introduction. The complex chronic disease requires a model of care based found on multidisciplinary teams. The aim of this study was to analyse the development of nursing leadership in managing the complex chronic patient (CCP) and to identify how the resources for the attention and follow up of these patients are managed. Method. A qualitative descriptive approach was followed through participant observation, in-depth interviews to 7 health professionals (5 nurses, a doctor, and a social worker) and a discussion group with 9 Primary Health Care nurses from a intentional sample. Discourse analysis was undertaken following Conde approach: fixing discursive positions, creating and analysing symbolic configurations, analysing and interpreting semantic configurations and drawing up the discourse. Results. From discourse analysis two main dimensions emerged on the nursing leadership and management: a) nursing as the leader of care: the need of nursing leadership and of improvement in the coordination structures were recognized, and b) nursing as resources manager in the CCP care related to social and health risks and resources coordination. Conclusions. Our findings enhance the case management and the home delivery care as foundations to effective handle of CCP, where nursing has a privileged role (AU)


Assuntos
Humanos , Masculino , Feminino , Pesquisa em Enfermagem/métodos , Doença Crônica/enfermagem , Competência Profissional/normas , Papel do Profissional de Enfermagem , Cuidados de Enfermagem/organização & administração , Cuidados de Enfermagem , Liderança , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde , 25783/métodos , 25783/estatística & dados numéricos
19.
Rev Enferm ; 40(2): 50-6, 2017 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-30272421

RESUMO

Introduction: The complex chronic disease requires a model of care based found on multidisciplinary teams. The aim of this study was to analyse the development of nursing leadership in managing the complex chronic patient (CCP) and to identify how the resources for the attention and follow up of these patients are managed. Method: A qualitative descriptive approach was followed through participant observation, in-depth interview to 7 health professionals (5 nurses, a doctor, and a social worker) and a discussion group with 9 Primary Health Care nurses from a intentional sample. Discourse analysis was undertaken following Conde approach: fixing discurse positions, creating and analyzing symbolic configuratons, analyzing and interpreting semantic configurations and drawing up the discourse. Results: From discourse analysis two main dimensions emerged on the nursing leadership and management: a) nursing as the leader of care: the need of nursing leadership and of improvement in the coordination structures were recognized, and b) nursing as resources manager in the CCP care related to social and health risks and resources coordination. Conclusions: Our findings enhance the case management and the home delivery care as foundations to be effective handle of CCP, where nursing has a privileged role.


Assuntos
Doença Crônica/enfermagem , Continuidade da Assistência ao Paciente , Humanos , Liderança , Papel do Profissional de Enfermagem
20.
Nefrología (Madr.) ; 36(3): 292-298, mayo-jun. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-153214

RESUMO

Fundamento y objetivo: La hiponatremia es el trastorno electrolítico más frecuente. Algunos estudios afirman que aumenta la morbimortalidad. Existen nuevas líneas de investigación que buscan la relación entre hiponatremia y caídas. Objetivo: Determinar si la hiponatremia es un factor relacionado con las caídas en ancianos hospitalizados. Método: Diseño observacional analítico de casos y controles. Población de estudio: Se consideraron casos los pacientes mayores de 65 años que experimentaron una caída durante su ingreso en unidades de hospitalización del Hospital General Universitario Gregorio Marañón de Madrid. Los controles fueron pacientes que no wxperimentaron caída, pareados según las variables: unidad, edad, periodo de ingreso, género y Downton. El tamaño fue de 206 sujetos. Recogida de datos: Se estudiaron factores sociodemográficos, las variables incluidas en la ficha de registro de caídas y escala de Downton, y el sodio sérico. Se consideró hiponatremia Na+<135mmol/l. Análisis: Se realizó un análisis descriptivo para valorar la homogeneidad de la muestra, un análisis analítico utilizando el test chi cuadrado, calculando la OR y un análisis multivariante con regresión logística. Resultados: De 103 casos, 61 eran hombres (50,4%) y 42 mujeres (49,4%). En 29 se detectó hiponatremia; la relación con las caídas fue p: 0,002. La OR ajustada fue de 3,708 (1,6-8,3), IC 95%. Se identificaron como factores de riesgo para las caídas: hiponatremia y déficits sensoriales en extremidades. Conclusiones: Dado que la hiponatremia puede considerarse un factor de riesgo de caídas, sería importante valorar la inclusión de la determinación de sodio sérico dentro de las estrategias de prevención de caídas en ancianos (AU)


Background and aim: Hyponatraemia is the most common electrolyte disorder. Some studies have found that it increases morbidity and mortality. There are new lines of research that are investigating the link between hyponatraemia and patient falls. Aim: To determine if hyponatraemia is associated with falls in elderly hospitalised patients. Methods: Design observational, analytical, case-control study. Study population: Patients older than 65 years who had fallen during their hospitalisation at Gregorio Marañón Hospital (Madrid) were considered cases. Patients who did not fall were considered to be controls, paired according to the following variables: hospital ward, age, length of hospital stay, gender and Downton fall risk index. The sample size was 206 subjects. Data collection: Socio-demographic factors, variables included in the falls record sheet, Downton fall risk index and sodium levels were studied (hyponatraemia was considered Na+< 135mmol/l). Analysis: A descriptive analysis was performed to determine the sample homogeneity. The OR was calculated, and an analytical analysis using Chi-square test and a multivariate logistic regression analysis were also performed. Results: Of 103 cases recruited, 61 were men (50.4%) and 42 were women (49.4%). Hyponatraemia was detected in 29 cases with an association with falls of P: 0.002. The adjusted OR was 3.708 (1.6-8.3), 95% CI. Risk factors for falls were identified as hyponatraemia and limb sensory deficits. Conclusions: Given that hyponatraemia could be considered a risk factor for falls, the inclusion of the determination of sodium level would be important for fall prevention strategies in the elderly (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Hiponatremia/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Estudos de Casos e Controles , Fatores de Risco , Programas de Rastreamento
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