[Diagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian male population]. / Validez y utilidad diagnóstica de la escala Eating Attitudes Test-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población masculina de Medellín, Colombia.

OBJECTIVE: To establish the diagnostic validity and usefulness of Eating Attitudes Test-26 (EAT-26) for the risk assessment of eating disorders in a male population. DESCRIPTION: Observational validation study questionnaire. SETTING: Performed in Medellin city at a community care level of mixed (public and private) psychiatric clinics. SUBJECTS: The study included 21 male subjects aged ≥14 with DSM-IV-TR diagnostic criteria for anorexia nervosa, bulimia nervosa, and Eating Disorder Not Otherwise Specified (EDNOS), and 93 controls without ED. MAIN OUTCOME MEASUREMENTS: A convenience sample was used for the cases and a simple, randomised one for controls. A reference standard (structured psychiatrist interview confirming the fulfilment of ED case inclusion criteria) was compared with the EAT-26 questionnaire. Reliability, cultural, semantics, and factorial validation were performed, and the best cut-off score was established with the ROC curve. RESULTS: Four domains remain in the instrument: dieting-bulimia and food pre-occupation, dieting, oral control-dieting, and oral control-bulimia. The Cronbach's alpha was 0.89, and a score of ≥20 is the best cut-off (sensitivity=100% and specificity=97.8%). The positive predictive value was 91.3% and the negative predictive value was 100.0%. CONCLUSIONS: EAT-26 questionnaire is an ideal multidimensional instrument for Eating Disorder screening in risk populations, with excellent reliability, sensitivity and specificity values. EAT-26 could be a useful tool to be considered when strategies for early detection of Eating Disorders are implemented in the male population.

Physical Activity in Latin American Immigrant Adults Living in Seville, Spain.

BACKGROUND: Self-rated health status of the Latin American immigrant population in Spain varies by gender, education and doing physical exercise. Physical activity patterns have not been described. OBJECTIVE: The aims are to describe self-reported physical activity in adult Latin American immigrants living in Seville (Spain) and explore relationships of physical activity with sociodemographic and health-related variables. METHOD: A representative sample of 190 immigrants between the ages of 25 and 44 years who live in Seville responded to the Centers for Disease Control's Behavioral Risk Factor Surveillance System (Spanish-language version) from May 2010 through May 2011. RESULTS: Physical activity (PA) was practiced by 66.8% during leisure time, 49.2% had a normal weight, and 20.5% were on a diet. The practice of PA was higher in women who had a normal weight, a good state of health and a higher education. Older age was associated with exercising during free time. DISCUSSION: Population-specific strategies are needed to improve the practice of PA among Latin American immigrants in Spain. Research focused on other emerging immigrant groups is needed.

[Diagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian female population]. / Validez y utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población femenina de Medellín, Colombia.

OBJECTIVE: To establish diagnostic validity and usefulness of EAT-26 for the risk assessment of Eating Disorder (ED) in a female population. DESCRIPTION: Observational validation study questionnaire. SETTING: Performed in a Medellin city community care level of mixed (public and private) psychiatric consultation. SUBJECTS: Twenty five subjects aged 15 to 25 with DSM-IV-TR diagnostic criteria for anorexia and bulimia nervosa and 111 controls without ED. MAIN OUTCOMES MEASURES: The case sample was for convenience and in controls an aleatory simple one. Gold standard (structured psychiatrist interview confirming the fulfillment of ED case inclusion criteria) was compared with EAT-26 questionnaire; reliability was assessed, cultural, semantics and factorial validation was made and the best cut-off score was established with the ROC curve. RESULTS: Four domains remain in the instrument: bulimia, dieting, food preoccupation and oral control. The Cronbach's alpha was 92.1% and a score of 11 and over is the best cut-off (sensitivity 100%, and specificity 85.6%). CONCLUSIONS: This modified and abbreviated EAT-26 questionnaire is an ideal multidimensional instrument for ED screening in risk population, with excellent reliability and sensitivity values and satisfactory specificity. EAT-26 is a useful measure to be considered when strategies for ED early detection are implemented in young women.

[Risk factors and cardiovascular events in adult Latin American immigrants in the Macarena District, Seville, Spain: a pilot study]. / Factores de riesgo y eventos cardiovasculares en inmigrantes latinoamericanos adultos en el Distrito Macarena, Sevilla, España: estudio piloto.

In order to estimate the prevalence of self-reported risk factors and cardiovascular events in an adult immigrant Latin American population of District 2 (Macarena) in Seville, we conducted a pilot study using cross-sectional descriptive research. We used an anonymous questionnaire with self-reported risk factors and cardiovascular events. 34 people participated (18% of the sample); mean age: 31.8 years, mean residence: 6.5 years, women: 52.9%. Prevalence of risk factors: diabetes 8.8%, high cholesterol 14.7% and high blood pressure 23.5%. Prevalence of coronary events was 8.8%; angina pectoris, myocardial infarction and stroke, 2.9% each. The conclusion is that self-reported prevalence of cardiovascular events was higher than in the literature, this issue deserving the attention of health agencies. This knowledge should be considered by nurses to develop culturally appropriate care plans of the context of immigrants.

Do health literacy levels of nursing students change throughout the study programme? A cross-sectional study.

OBJECTIVES: The aim of this research was to analyse if the level of health literacy (HL) of nursing students changes throughout the study programme. DESIGN: A cross-sectional study with anonymous self-reporting was conducted. PARTICIPANTS/SETTING: 329 public university nursing students in Seville, Spain; 243 of the first year and 86 of the fourth. INTERVENTIONS: The short Spanish version of the Health Literacy Survey Questionnaire-European Union was used to evaluate HL. PRIMARY AND SECONDARY OUTCOME MEASURES: The proportions of the limited level of HL were compared between academic years and the crude and corrected OR were calculated with the Mantel-Haenszel test to evaluate the effect of confusion of the sex variable on the HL level and academic year relationship. A logistic regression model with step-by-step analysis was run, including the independent variables sex, age, marital status, academic year and HL level (limited/sufficient) as the dependent variable. RESULTS: 62.1% of the participants of the first year versus 47.7% of the fourth year had a limited literacy level for a crude OR of 1.5 (95% CI 1.10 to 2.21; p=0.014) and a corrected by sex OR of 1.8 (95% CI 1.10 to 2.96; p=0.026). Only the strata in women had a statistically significant relationship. The logistic regression model ratified that the HL was a function exclusive to the academic year. CONCLUSION: The HL level of nursing students increases from the first to the fourth academic year, even when controlling for sex. Although the HL level in the fourth academic year was greater than that of the first, both groups had inadequate HL levels. It is hence recommended to implement intervention strategies, which reinforce in the curriculum the knowledge and experiences related with health communication and education to ensure that future professionals improve their HL. Achieving adequate HL is crucial to be able to provide care to patients, their families and the community.

Countries' cultures and professional nursing values: Cross-cultural evidence from Spanish and Colombian nursing students.

This study aimed to identify countries' cultural values associated with the importance given to certain professional nursing values by nursing students from Spain and Colombia. Weis and Schank's Nurses Professional Values Scale-Revised (NPVS-R) in its Spanish version and the Hofstede cultural classification were used for this purpose. The sample was composed of 880 nursing students. Nursing students from both countries showed a greater importance for professional nursing values compared to evidence from other countries. Significant differences were also found in the total score, dimensions, and items, always being higher for Colombian students. Based on regression results, the impact that the academic year had on the importance given to NPVS-R is non-linear (U-inverted). Both groups of students gave the highest importance to the same group of items. Those showing the largest difference in the rankings were associated with country culture differences based on the scores identified by Hofstede. Colombian and Spanish societies present similarities in Power Distance and Uncertainty Avoidance, as well as differences in the other cultural dimensions.

Changes in anti-fat attitudes among undergraduate nursing students.

BACKGROUND: The number of people with obesity has been increasing significantly in recent decades. Nursing students play a role in the care of obese patients, but the presence of a stigma regarding this patient group reduces the quality of care due to a climate of mistrust and lack of expectations. OBJECTIVES: To analyse if the anti-fat attitudes of nursing students at the Faculty of Nursing, Physiotherapy and Podiatry at Universidad de Sevilla (Spain) change during their degree training. DESIGN: A cross-sectional study was carried out. SETTINGS: Undergraduate nursing institution in Spain. PARTICIPANTS: 578 nursing students enrolled at the Faculty in all academic years, from the first through the fourth. METHODS: Following ethical approval, each participant took part in an individual self-report via the Anti-Fat Attitudes (AFA) Questionnaire, in its validated Spanish version. RESULTS: The mean standardised AFA total was 2.29.; by domains: 1.29 in Dislike, 2.87 in Fear of fat, and 3.73 in Willpower. Analysis of variance tests showed significant differences in the AFA total score and domains by sex and academic year. Multiple linear regression analysis demonstrated that the highest prejudices were shown by enrolled participants in their first year, particularly when the AFA total score was considered. CONCLUSIONS: Nursing students at the Faculty do not have many prejudices towards obese people. Anti-obesity attitudes among nursing students decrease as the students progress in their degree, implying that the specific training received (degree curriculum) also enables students to develop their non-technical skills.

Validez de contenido de una intervención educativa para mejorar conocimientos, actitudes y prácticas relacionados con la malaria en una comunidad indígena / Content validity of an educational intervention to improve knowledge, attitudes and practices related to malaria in an indigenous community / Validade de conteúdo de uma intervenção educativa para melhorar conhecimentos, atitudes e práticas relacionadas à malária em uma comunidade indígena

Introducción: Las intervenciones educativas en salud dirigidas a las poblaciones indígenas deben ser revisadas por expertos con el fin de evaluar si su adaptación cultural es apropiada y precisa. Objetivo: Determinar la validez de los contenidos contemplados en una intervención educativa para el mejoramiento de conocimientos, actitudes y prácticas relacionados con la malaria en la población Emberá Katío del departamento de Córdoba - Colombia, mediante el juicio de expertos. Materiales y métodos: Estudio de validación por medio de juicio de expertos de una intervención educativa que incluyó cuatro módulos, administrados en sesiones presenciales, en las que se utilizaron estrategias educativas como clases, discusiones guiadas y talleres. Participaron trece expertos en trabajo con comunidades indígenas, quienes evaluaron los criterios de claridad, pertinencia, relevancia y coherencia del contenido de cada módulo. Se estimó el índice de validez de contenido (IVC) de Lawshe modificado por Tristán y se asumió el valor ≥ 0.58 para considerar la aprobación de los criterios de los módulos. Resultados: Todos los módulos obtuvieron IVC globales que fluctuaron entre 0.83 y 0.90. La claridad del Módulo 1, 'Conociendo la malaria', tuvo un valor de 0.69 y el resto de los valores de los cuatro criterios osciló entre 0.77 y 1. Discusión: Los criterios evaluados superaron el punto de corte establecido por la literatura para aprobar la intervención, y las observaciones y recomendaciones de los expertos fueron consideradas para ajustes en la misma. Conclusión: Se determina que la intervención educativa evaluada por juicio de expertos, tiene alta validez de contenido en sus módulos según los criterios contrastados.

Introduction: Health education programs for the indigenous population must be reviewed by experts in order to assess whether their cultural adaptation is appropriate and accurate. Objective: To determine the validity of the content contemplated in an educational intervention to improve knowledge, attitudes and practices related to malaria in the Emberá Katío population in the department of Córdoba, Colombia. Materials and methods: Validation study by experts' judgment of an educational intervention that included four modules, administered in face-to-face sessions, in which educational strategies such as classes, guided discussions and workshops were used. Thirteen experts in work with indigenous communities participated, who evaluated the criteria of clarity, pertinence, relevance and coherence of the content of each module. The content validity index (CVI) of Lawshe modified by Tristán was estimated and the value ≥ 0.58 was assumed to consider the approval of the module criteria. Results: All the modules obtained global CVIs fluctuated between 0.83 and 0.90. The clarity of Module 1, 'Knowing malaria', had a value of 0.69 and the rest of the values of the four criteria ranged between 0.77 and 1. Discussion: The evaluated criteria exceeded the cut-off point established by the literature to approve the intervention, and the observations and recommendations of the experts were considered for adjustments in it. Conclusion: It is determined that the educational intervention evaluated by expert judgment has high content validity in its modules according to the contrasted criteria.

Introdução: As intervenções de educação em saúde voltadas para populações indígenas devem ser revisadas por especialistas a fim de avaliar se sua adaptação cultural é apropriada e precisa. Objetivo: Determinar a validade do conteúdo de uma intervenção educacional para a melhoria do conhecimento, das atitudes e das práticas relacionadas à malária na população Emberá Katío, no departamento de Córdoba - Colômbia, por meio do julgamento de especialistas. Materiais e métodos Estudo de validação por meio de julgamento de especialistas de uma intervenção educacional que incluiu quatro módulos, administrados em sessões presenciais, nos quais foram utilizadas estratégias educativas como aulas, orientadas e oficinas. Participaram treze especialistas em trabalhos com comunidades indígenas, que avaliaram os critérios de clareza, pertinência, relevância e coerência do conteúdo de cada módulo. Estimou-se o índice de validade de conteúdo (IVC) de Lawshe modificado por Tristán e assumiu-se o valor ≥ 0,58 para considerar a aprovação dos critérios do módulo. Resultados: Todos os módulos obtiveram IVC global que oscilou entre 0,83 e 0,90. A clareza do Módulo 1, 'Conhecendo a malária', tinha um valor de 0,69 e os demais valores dos quatro critérios variaram entre 0,77 e 1. Discussão: Os critérios avaliados excederam o ponto de corte estabelecido pela literatura para aprovar a intervenção, e as observações e recomendações dos peritos foram consideradas para ajustes no mesmo. Conclusão: Foi determinado que a intervenção educacional avaliada por julgamento de especialistas tem alta validade de conteúdo em seus módulos, de acordo com os critérios contrastados.

Persistent Delirium in Elderly patients Three Months After Hospital Discharge from a University Clinic. / La persistencia de delirium a los 3 meses del egreso de los pacientes ancianos hospitalizados en una clínica universitaria.

OBJECTIVE: The purpose of the study was to determine the prevalence and characteristics of patients with persistent delirium (PD) at three months after hospital discharge. METHODOLOGY: Longitudinal descriptive study to assess the prevalence and characteristics of in-patients aged 65 years and older in the Clinica Universitaria Bolivariana who met DSM-5 criteria for delirium at admission, at discharge, and at a 3-month follow up assessment. Socio-demographic features were determined, and CGI-S and DRS-R98 scales used. RESULTS: A total of 30 patients were evaluated between April and October 2013, but 6 did not fulfil the inclusion criteria. The study included 24 patients, with 9 (37.5%) dying during hospitalisation. Of the 15 surviving patients, five (20.8% of the total sample) had their delirium resolved at discharge, and ten (41.6% of the sample) continued with symptoms. These established the PD group, of whom five of them (20.8%) had full PD, and the other five (20.8%) sub-syndromal PD (SSPD). At the final assessment, only two patients (8.3%) continued with full PD, and another two (8.3%) with SSPD. Among the PD group, 30% had a full delirium at admission (prevalence), and 70% developed full delirium during hospitalization (incidence). CONCLUSIONS: A significant number of patients did not recover from delirium at leaving hospital, and remained symptomatic three months after discharge. The study findings suggest a course of gradual improvement of delirium, with a persistence of symptoms over time in 40% of the patients, which would have implications for the clinical practice.

The Journal Investigación y Educación en Enfermería is Indexed in PubMed Central

As Editor, it is a joy to share with you the great news that the journal Investigación y Educación en Enfermería was accepted for indexation in PubMed Central (PMC), which is the world's largest repository of knowledge on health sciences. PubMed Central has close to seven million articles in full text and in Open Access that can be recovered through the PubMed search engine. Currently, PMC archives over 3018 journals accepted after demanding scientific and technical evaluations. Being included in this repository is a recognition distinction of the quality of our publication with the global academic community, with 22 nursing journals sharing this honor globally and only two of these are Latin American.

Lifestyles of nursing students from a Colombian public university.

OBJECTIVE: To assess the lifestyles of nursing students from a Colombian public university. METHODS: A cross-sectional study was conducted in 2014. 380 students answered by self-reporting the adapted version in Spanish of FANTASTIC Lifestyles Assessment Questionnaire of Wilson and Ciliska. RESULTS: Lifestyles were poor in 9.2%, fair in 31.3%, good in 53.7%, and excellent in only 5.8% of the participants. Statistically-significant differences of the total mean score were not found when comparing with gender, age group, and course year, but were detected in two domains by gender: a) physical activity (higher score in men) and b) cigarette smoking (higher score in women). CONCLUSION: An important proportion of our nursing students has inadequate lifestyles, which means deferred risks for the development of chronic diseases. Universities should promote the training of the future professionals in nursing with knowledge and skills aimed at healthy lifestyles.

[Trends in mortality from homicide in Medellín (Colombia): 1975-2003]. / Evolución de la mortalidad por homicidio en Medellín (Colombia): 1975-2003.

OBJECTIVE: To describe and evaluate homicide mortality trends in the city of Medellin, Colombia, between 1975 and 2003. METHOD: Deaths from homicide between January, 1975 and December, 2003 were studied. With the aid of the SSS1 program, an analysis of temporary series was run using iterative procedures for ARIMA model construction. RESULTS: The mean monthly homicide mortality rate was 13.2 x 10(5) (minimum 1.94 February 1977 and maximum 38.78 December 1992). A peak was observed in the central period of the series. Several models were studied and an ARIMA (0,1,1)(0,0,1)12 model was selected. CONCLUSIONS: Marked annual seasonal variation was found in mortality from homicide in the city of Medellín. The highest rates were found in the month of December.

[Sociodemographic characteristics and mental disorders in children and adolescents psychiatric outpatient clinic children of Medellin]. / Características sociodemográficas y trastornos mentales en niños y adolescentes de consulta externa psiquiátrica infantil de una clínica de Medellín.

INTRODUCTION: Mental disorders in the world affecting 15% to 30% in children and adolescents, altering its function and emotional, cognitive and social. Affect interpersonal relationships, school performance and increased substance use and the risk of suicide. OBJECTIVE: describe the social-demographic characteristics and mental disorders of children and adolescents of psychiatric consultation. METHOD: Retrospective descriptive study that analyzed all the histories of children and adolescents of both sexes from 5 to 16 years who attended for the first time outpatient psychiatry university clinic of Medellin, from July 2010 to July 2012. RESULTS: We studied 197 patients, the average age was 11±3.5 years, male sex was the most common 69%, 46.2% belonged to nuclear family. The most prevalent psychiatric disorders were 44.2% ADHD, depressive disorders 9.1% and 8.1% TOC. 61% had psychiatric comorbidity, the most frequent was oppositional defiant disorder with ADHD 35.6%. CONCLUSIONS: The frequency of mental disorders and comorbidities found in this study were similar to those reported by other researchers.

High-performance athletes’ attitude towards doping: Validation of the Spanish version of the Performance Enhancement Attitude Scale for Colombia / Actitud frente al dopaje de deportistas de alto rendimiento: Validación de la versión española de la Performance Enhancement Attitude Scale para Colombia

BACKGROUND: Doping is the use of substances to achieve a better performance in sports. This practice is considered to be growing worldwide. Despite regulations by the World Anti-Doping Agency, 14-39% of high-performance athletes have consumed prohibited substances at least once in their sports career. The attitudes towards this type of consumption are used as predictors of the intent of usage of prohibited substances to improve physical performance. OBJECTIVE: This study aimed to validate the Spanish Version of the Performance Enhancement Attitude Scale of high-performance athletes in the Colombian context. METHODOLOGY: A cross-sectional study was performed with a convenience sampling of 112 athletes aged 15 and older, registered in a State Sports Institute in Medellín, Colombia in 2016. The participants self-completed Petróczi and Aidman instrument, Performance Enhancement Attitude Scale, adapted into Spanish by Morente-Sánchez, et al. in 2014. The reliability of the scale was assessed using Cronbach's Internal Consistency Coefficient and an exploratory and confirmatory factor analysis (CFA) was conducted to evaluate the scale's structure. RESULTS: The scale had a reliability of 0.87 and the factor analysis confirmed the unidimensionality. Of all the athletes participating in the research, the Performance Enhancement Attitude Scale average was 35.8 of 102 points, indicating a low tendency of attitudes towards doping. CONCLUSION: The psychometric properties of the 17 items of the Performance Enhancement Attitude Scale are adequate and could be used when assessing attitudes towards doping of high-performance athletes in similar contexts. This information could be used for the purposes of developing educational strategies for doping prevention in our athletes

INTRODUCCIÓN: El dopaje es el uso de sustancias para lograr un mejor desempeño en los deportes. Esta práctica parece estar creciendo en todo el mundo. A pesar de las regulaciones de la World Anti-Doping Agency, 14-39% de los deportistas de alto rendimiento han consumido sustancias prohibidas al menos una vez durante su carrera deportiva. las actitudes hacia este tipo de consumo se emplean como predictores de la intención de uso de sustancias prohibidas para mejorar el rendimiento físico. OBJETIVO: El objetivo del estudio fue validar en deportistas de alto rendimiento en el contexto colombiano la versión española de la escala de Actitudes frente al mejoramiento del rendimiento. DISEÑO: Se realizó un estudio de corte transversal en 2016 con una muestra por conveniencia de 112 deportistas de 15 y más años inscritos en un instituto deportivo estatal en Medellín (Colombia). METODOLOGÍA: Los participantes autodiligenciaron el instrumento de Petróczi y Aidman Performance Enhancement Attitude Scale (PEAS), adaptado al español por Morente-Sánchez et al. Se evaluó la confiabilidad de la escala con el coeficiente de consistencia internal de Cronbach y se hicieron análisis factorial exploratorio y confirmatorio para evaluar la estructura de la escala. RESULTADOS: Los resultados indicaron que la escala tenía una confiabilidad de 0,87 y el análisis factorial confirmó la unidimensionalidad. En los deportistas participantes en la investigación el promedio de la PEAS fue de 35,8 de 102 puntos posibles, indicando baja tendencia de actitudes hacia el dopaje. CONCLUSIÓN: Las propiedades psicométricas de los 17 ítems de la PEAS son adecuadas, y podría ser utilizada en la evaluación de actitudes hacia el dopaje en deportistas de alto rendimiento en contextos similares. Esta información podría ser utilizada para el desarrollo de estrategias educativas para la prevención del dopaje en nuestros deportistas

Use of health services by adult Latin American immigrants residing in Seville.

OBJECTIVE: This work sought to describe the use of health services by adult Latin American immigrants from Seville. METHODOLOGY: This was a descriptive cohort study with the participation of 190 adult Latin American immigrants from 25 to 44 years of age, residing in the city of Seville (Spain) in 2011. A self-report survey was applied. RESULTS: Within the past year, 67% of the individuals have visited a physician and 23% have attended nursing consultation. A total of 14% of the immigrants who called on a healthcare center reported that their experience was worse than that of others. La annual prevalence by accidents was: 10% domestic, 4% traffic-related and 9% occupational; nearly half these accidents justified emergency care or hospitalization due to their severity. The logistic regression model revealed that health services were used mostly by: women, those in poor self-perceived health status, those with secondary level of education, the elderly, and those who were single. CONCLUSION: The population studied presents adequate use of health services, although it would be recommendable to implement prevention activities by nurses in the immigrant's work and family environment to reduce the accident incidence described by this group.

Estresores en las prácticas clínicas de los estudiantes de enfermería de una universidad pública en Colombia / Stressors in Clinical Practices of Nursing Students of a Public University in Colombia / Estressores nas práticas clínicas dos estudantes de enfermagem de uma universidade pública em Antioquia, Colômbia

Objetivos: identificar los estresores en las prácticas clínicas de los alumnos de la Facultad de Enfermería de una universidad pública de Antioquia (Colombia) y explorar la relación entre el grado de estrés y las variables sexo y semestre académico. Métodos: estudio cuantitativo de tipo transversal realizado durante el primer semestre académico de 2016. La población de estudio fueron todos los estudiantes de quinto a octavo semestres en práctica clínica. No se hizo muestreo. Los participantes contestaron por autorreporte la escala KEZKAK de Zupiría et al. que evalúa 41 estresores en las prácticas clínicas de los estudiantes de enfermería. Los puntajes mayores de 1,5 indican que hay estrés. Resultados: participaron 156 de los 224 estudiantes matriculados (69,6% del total). El promedio de la escala fue de 2,0, que equivale a un estrés moderado. En el 88% de los ítems mostraron algún grado de estrés (3 ítems con nivel alto > 2,5: hacer mal mi trabajo y perjudicar al paciente, hacer daño físico al paciente, y confundirme de medicación). Se presentaron diferencias estadísticamente significativas en el puntaje promedio total en las variables sexo (mayor en el femenino) y semestre académico (mayor en el quinto). Se encontró que los dominios del KESKAK con mayores puntajes fueron: falta de competencia (2,2), sobrecarga de trabajo (2,2), contacto con el sufrimiento (2,0) y que el paciente busque una relación íntima (2,0). Conclusión: los estudiantes de enfermería tienen un estrés moderado ocasionado por situaciones de la práctica clínica; predominan los factores relacionados con la falta de competencia y la sobrecarga de trabajo.

Objective: To identify the stressors in clinical practices in students from the Faculty of Nursing at a public university in Antioquia (Colombia) and to explore the relationship between stress level and the variables sex and academic semester. Methods: A cross-sectional, quantitative study was conducted during the first 2016 academic semester. The study population was all students from 5th to 8th semester in clinical practice, no sampling was done. The participants answered by self-report the KEZKAK scale by Zupiria et al. to evaluate 41 stressors in the clinical practices of nursing students. Scores above 1,5 indicated the presence of stress. Results: 156 of the 224 enrolled students participated in the study (69.6% of the total). The mean for the scale was 2,0, which is equivalent to moderate stress level; 88% of the items showed some degree of stress (3 items with high level >2,5: poor work performance and harming the patient, causing physical harm to the patient, and confusing the types of medications). Statistically significant differences were found in the total average score by gender (highest in females) and academic semester (highest during the fifth). It was found that the KESKAK domains with the highest scores were: lack of skills (2,2), work overload (2,2), contact with suffering (2,0), and the patient seeking a close relationship (2,0). Conclusion: nursing students have a moderate level of stress caused by situations of the clinical practice, factors related to lack of skills and work overload were predominated.

Objetivo: identificar os estressores nas práticas clínicas nos alunos da Faculdade de Enfermagem de uma Universidade pública do Antioquia (Colômbia) e explorar a relação entre os níveis de estresse e sexo e semestre acadêmico. Métodos: estudo quantitativo de tipo transversal realizado durante o primeiro semestre acadêmico de 2016. A população do estudo consistiu de todos os alunos da 5a a 8a semestre na prática clínica, nenhuma amostragem foi feita. Os participantes responderam por autorreporte a escala KEZKAK de Zupiría et al. para avaliar 41 estressores nas práticas clínicas dos estudantes de enfermagem. As pontuações maiores de 1,5 indicavam que havia estresse. Resultados: 156 dos 224 alunos inscritos participaram (69,6% do total). A média da escala foi de 2,0 o que equivale a nível de estresse moderado. Em 88% dos itens mostraram algum grau de estresse (3 itens com nível alto >2,5: Fazer mal meu trabalho e prejudicar ao paciente, fazer dano físico ao paciente, e Confundir-me de medicação). Se apresentaram diferencias estatisticamente significativas na pontuação média total nas variáveis sexo (maior no feminino) e semestre acadêmico (maior no quinto). Se encontrou que os domínios de KESKAK com maiores pontuações foram: falta de competência (2,2), sobrecarga de trabalho (2,2), contato com o sofrimento (2,0) e que o paciente busque uma relação íntima (2,0). Conclusão: os estudantes de enfermagem têm um nível de estresse moderado ocasionado por situações da prática clínica, foram fatores predominantes os relacionados com a falta de competência e sobrecarga de trabalho.

Perfil clínico y epidemiológico de pacientes con enfermedad pulmonar obstructiva crónica hospitalizados en un centro de alta complejidad de la ciudad de medellín, colombia, durante el año 2015

Introducción. La enfermedad pulmonar obstructiva crónica (EPOC) es una condición que cursa con limitación del flujo aéreo espiratorio e inflamación crónica de las vías aéreas, y que representa un problema de salud pública a nivel mundial. Objetivo. Determinar el perfil clínico y epidemiológico de pacientes con EPOC en una institución hospitalaria de la ciudad de Medellín, Colombia. Metodología. Se realizó un estudio transversal, con una muestra de 50 pacientes, con diagnóstico clínico o espirométrico de enfermedad pulmonar obstructiva crónica, atendidos de forma intrahospitalaria en una institución privada en Medellín durante el año 2015. A las variables cuantitativas se les calculó el promedio, desviación estándar y valores mínimo y máximo. A las cualitativas, medidas de nivel nominal y ordinal y se les estimaron proporciones. Resultados. La edad promedio fue de 73,5±9,3 años, el 52% fueron mujeres. El promedio de tiempo de diagnóstico fue de 7,8±1,3 años. Las características clínicas más frecuentes fueron las siguientes: el 36% tenía como clasificación estadio D para la enfermedad, el 34% tenía VEF1 <30%, el 88% tenían antecedente de tabaquismo y el 52% utilizaba oxígeno en casa. Conclusiones. La mayoría de nuestra población fue clasificada como GOLD categoría D, con una limitación grave del flujo aéreo espiratorio (VEF1 < 30%) y requerimiento de uso de oxígeno domiciliario. Lo anterior indica un inadecuado control de la enfermedad, debido, probablemente, al contexto intrahospitalario de los pacientes incluidos en el estudio.

Introduction. Chronic Obstructive Pulmonary Disease (COPD) is a condition that limits the air flow and produce chronic inflammation of the airways, which represents a public health problem worldwide. Objective. To determine the clinical and epidemiological profile of patients with COPD in a hospital of the city of Medellin, Colombia. Methodology. A cross-sectional study was carried out, with a sample of 50 subjects, who had a clinical or spirometric diagnosis of Chronic Obstructive Pulmonary Disease, receiving Inpatient care in a private institution in Medellin in 2015. It was calculated on quantitative variables, the average, standard deviation and minimum and maximum values. It was estimated on qualitative variables, measures of nominal and ordinal level and proportions. Results. The average age was 73.5 ) 9,3 years, 52% were women. The average of Diagnostic time was 7.8 ) 1,3 years. The most common clinical characteristics were the following: 36% had a stage D classification for the disease, 34% had FEV1 <30%, 88% had a smoking history and 52% used oxygen at home. Conclusions. The majority of our population was classified as GOLD category D, with a severe limitation to breath (FEV1 <30%) and had to use oxygen at home. The foregoing indicates that there is an inadequate control of the disease, due to the inpatient environment of the subjects involved in the study.

Introdução. A doença pulmonar obstrutiva crônica (DPOC) é uma condição caracterizada por fluxo respiratório limitado e inflamação crônica das vias aéreas, e representa um problema de saúde pública em todo o mundo. Objetivo. Determinar o perfil clínico e epidemiológico dos pacientes com DPOC em uma instituição hospitalar da cidade de Medellín, Colômbia. Metodologia. Foi realizado um estudo transversal, com uma amostra de 50 pacientes, com diagnóstico clínico e espirométrico da doença pulmonar obstrutiva crônica, que receberam atenção hospitalar em uma instituição privada em Medellín durante o ano de 2015. Para as variáveis quantitativos foram calculados a média, desvio padrão e valores mínimo e máximo. Para medidas qualitativas de nível nominal e ordinal se estimaram proporções. Resultados. A idade média foi de 73,5 ± 9,3 anos, 52% eram mulheres. A média do tempo de diagnóstico foi de 7,8 ± 1,3 anos. As características clínicas mais frequentes foram: 36% tinham classificação no estádio D para a doença, 34% tinham VEF1 <30%, 88% tinham história de tabagismo e 52% usavam oxigênio em casa. Conclusões. A maioria da nossa população foi classificada como GOLD categoria D, com uma limitação severa do fluxo de ar (VEF1 <30%) e exigência de uso de oxigênio domiciliar. O que precede indica um controle inadequado da doença, devido, provavelmente, ao contexto hospitalar dos pacientes incluídos no estudo.

La persistencia de delirium a los 3 meses del egreso de los pacientes ancianos hospitalizados en una clínica universitaria / Persistent Delirium in Elderly patients Three Months After Hospital Discharge from a University Clinic

RESUMEN Objetivos: El delirium es muy prevalente entre los pacientes ancianos con enfermedad general. Si no se revierte en el momento del alta hospitalaria, se lo considera «delirium persistente¼ (DP). El propósito del estudio es describir la prevalencia y las características de los pacientes con DP 3 meses después del egreso hospitalario de la Clínica Universitaria Bolivariana (CUB). Métodos: Se realizó un estudio descriptivo longitudinal para evaluar la prevalencia y las características de los pacientes de 65 o más arios del servicio de hospitalización de la CUB que cumplieran criterios de delirium del DSM-5 al ingreso, el egreso y 3 meses después. Se determinaron las variables sociodemográficas y se aplicaron las escalas CGI-S y DRS-R98. Resultados: Se evaluó a 30 pacientes con diagnóstico de delirium con interconsulta por psiquiatría de enlace entre abril y octubre de 2013, y se excluyó a 6 por no cumplir los criterios de inclusión. Se incluyó en el estudio a 24 pacientes, de los que 9 fallecieron durante la hospitalización (37,5%). De los 15 sobrevivientes, 5 (el 20,8% de la muestra) presentaron remisión del delirium al egreso y 10 (41,6%) continuaron con síntomas y conformaron el grupo de DP. Del grupo de DP, 5 (20,8%) presentaron DP completo y los otros 5 (20,8%), DP subsindrómico (DPSS). A los 3 meses del egreso, solo 2 pacientes (8,3%) continuaron con DP completo y otros 2 (8,3%), con DPSS. En el grupo de pacientes con DP, la prevalencia fue del 30% (diagnóstico de delirium al ingreso) y una incidencia del 70% (aparición del delirium durante la hospitalización). Conclusiones: Un grupo importante de pacientes con delirium continúan sintomáticos 3 meses después del alta. El 40% de los pacientes con síntomas persistentes en el seguimiento a 3 meses indica una trayectoria de mejoría gradual del delirium, lo cual tiene implicaciones en la práctica clínica.

ABSTRACT Objective: The purpose of the study was to determine the prevalence and characteristics of patients with persistent delirium (PD) at three months after hospital discharge. Methodology: Longitudinal descriptive study to assess the prevalence and characteristics of in-patients aged 65 years and older in the Clinica Universitaria Bolivariana who met DSM-5 criteria for delirium at admission, at discharge, and at a 3-month follow up assessment. Socio-demographic features were determined, and CGI-S and DRS-R98 scales used. Results: A total of 30 patients were evaluated between April and October 2013, but 6 did not fulfil the inclusion criteria. The study included 24 patients, with 9 (37.5%) dying during hospitalisation. Of the 15 surviving patients, five (20.8% of the total sample) had their delirium resolved at discharge, and ten (41.6% of the sample) continued with symptoms. These established the PD group, of whom five of them (20.8%) had full PD, and the other five (20.8%) sub-syndromal PD (SSPD). At the final assessment, only two patients (8.3%) continued with full PD, and another two (8.3%) with SSPD. Among the PD group, 30% had a full delirium at admission (prevalence), and 70% developed full delirium during hospitalization (incidence). Conclusions: A significant number of patients did not recover from delirium at leaving hospital, and remained symptomatic three months after discharge. The study findings suggest a course of gradual improvement of delirium, with a persistence of symptoms over time in 40% of the patients, which would have implications for the clinical practice.