Effectiveness of a Fibromyalgia Online Nursing Consultation in the Quality of Life: A Randomized Controlled Trial.

BACKGROUND: Aim: To evaluate the effectiveness of an online nursing consultation through the Internet platform Red Sinapsis (RS) in improving the perceived quality of life of patients with fibromyalgia (FM). METHOD: Eighty patients with FM were randomized to an intervention group (n = 40) or control group (n= 40). The intervention group (IG) was monitored by a nursing specialist through the online platform RS while the control group (CG) received standard follow-up at the clinic. The Fibromyalgia Impact Questionnaire (FIQ) and 36-item Short-Form Health Survey (SF-36) were used at baseline, 6-month, and 12-month follow-up. RESULTS: The IG showed a 65% improvement in the perception of their general state of health at 12 months into the study, compared with an improvement of 5.6% in the CG (p < .001). The IG also achieved better results for emotional status, with a maintained improvement throughout the study of more than 2 points in the anxiety variable (from 7.64 to 5.36), that remained constant in the CG. The depression variable also showed constant improvement over the 12 months of the study in the IG, rising from an average of 7.72 (standard deviation [SD] = 2.05) to 5.33 (SD = 1.65), while in the CG a slight deterioration was observed. In both cases, the difference in mood evolution was significant (p < .001). CONCLUSIONS: Online nursing follow-up for people with fibromyalgia improves patients' perceived quality of life related to their welfare and emotional state. Fibromyalgia (FM) is among the diseases causing the highest rate of occupational disability in Spain. Fibromyalgia (FM) is a complex condition that causes pain, fatigue, non-refreshed sleep, mood disturbance and cognitive impairment.

Prevalence and Correlates of Frailty in Community-Dwelling Older Adults with Chronic Pain: A Cross-Sectional Study.

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.

Chronic Pain and Frailty in Community-Dwelling Older Adults: A Systematic Review.

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.

Paediatric Emergency Nurses' Perception of Medication Errors: A Qualitative Study.

Patient safety is fundamental to healthcare. Adverse events, particularly medication errors, cause harm to patients, especially the paediatric population in the emergency department. AIM: To explore paediatric emergency nurses' perceptions of medication administration errors. METHOD: A qualitative, ethnomethodological, descriptive study. The participants were nurses working in the paediatric emergency department. Data were collected through in-depth individual interviews with paediatric emergency nurses. The study excluded nurses employed for less than six months. Ten individual interviews were carried out. All interviews were face-to-face and audio-recorded with the participant's consent. Interviews took between 52 min and 1 h 25 min. A questions guide was followed during the interviews. The analysis of the data was carried out according to the scheme proposed by Taylor and Bogdan. RESULTS: The participants' discourse revealed three main categories: Safety culture, transmitted by supervisors and safety groups. Teamwork, with good communication and a positive relationship. Error management, the lack of formal support and negative feelings despite an understanding of the multifactorial nature of errors. The study identifies several challenges in the healthcare system. Emphasis was placed on the perception of errors in terms of patient harm, while near misses or dose delays or omissions are not treated as errors. CONCLUSIONS: Although institutions have implemented safety culture strategies, nurses have not fully embraced them. There is a need to promote a positive safety culture and a safe working environment that encourages communication within the team. The hospital should provide training in safe management and patient safety and develop effective protocols. This study was not registered.

Nurses' perceptions and demands regarding COVID-19 care delivery in critical care units and hospital emergency services.

BACKGROUND: The COVID-19 pandemic is a public health challenge that puts health systems in a highly vulnerable situation. Nurses in critical care units (CCUs) and hospital emergency services (HESs) have provided care to patients with COVID-19 under pressure and uncertainty. OBJECTIVE: To identify needs related to safety, organisation, decision-making, communication and psycho-socio-emotional needs perceived by critical care and emergency nurses in the region of Madrid, Spain, during the acute phase of the epidemic crisis. METHODS: This is a cross-sectional study (the first phase of a mixed methods study) with critical care and emergency nurses from 26 public hospitals in Madrid using an online questionnaire. RESULTS: The response rate was 557, with 37.5% reporting working with the fear of becoming infected and its consequences, 28.2% reported elevated workloads, high patient-nurse ratios and shifts that did not allow them to disconnect or rest, while taking on more responsibilities when managing patients with COVID-19 (23.9%). They also reported deficiencies in communication with middle management (21.2%), inability to provide psycho-social care to patients and families and being emotionally exhausted (53.5%), with difficulty in venting emotions (44.9%). CONCLUSIONS: Critical care and emegency nurses may be categorised as a vulnerable population. It is thus necessary to delve deeper into further aspects of their experiences of the pandemic.

Living With Rheumatoid Arthritis in Spain: A Qualitative Study of Patient Experience and the Role of Health Professionals.

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.

The life and death construct in heart transplant patients.

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.

Atender las necesidades sociosanitarias de las personas con capacidades diferentes / Adressing social-health needs of people with different abilities

No disponible

La experiencia de medicalizar un hotel en Madrid durante la primera ola de la pandemia COVID-19 / The experience of medicalizing a hotel in Madrid during the first wave of the covid-19 pandemic

La pandemia por COVID-19 ha mostrado la capacidad de adaptación del sistema sanitario español, poniendo en marcha medidas excepcionales e innovadoras como la creación de hoteles medicalizados. El objetivo a alcanzar consistía en liberar camas de hospital y garantizar el aislamiento de personas que o bien no disponían en sus domicilios de infraestructura para poder realizarlo tras el alta hospitalaria, o bien porque compartían hogar con personas vulnerables o frágiles, evitando de esta forma el contagio de los convivientes. El objetivo del presente trabajo es presentar la experiencia de haber medicalizado un hotel en la ciudad de Madrid vinculado al Hospital Universitario Gregorio Marañón (HGUGM) durante la primera ola pandémica de la COVID-19, desde el 19 de marzo hasta el 31 de mayo de 2020. Se aborda la puesta en marcha, contemplando los recursos materiales y humanos que se necesitaron, la organización, el desarrollo de la actividad y la humanización; así como los resultados de la experiencia. Fueron atendidos un total de 465 pacientes, con una estancia media de 10 días. La progresión de la ocupación se correspondió con la curva de contagios (pico máximo primera semana de abril: 146 pacientes). El personal de Enfermería realizó una media de 10 PCR por día, con un total de 817 pruebas. La participación en el estudio de seroprevalencia (Servicio de Microbiología del HGUGM) fue superior al 89% del personal de Enfermería, con un resultado de tres PCR positivas. En el contexto de la pandemia COVID-19, las enfermeras de la Comunidad de Madrid han demostrado estar capacitadas para habilitar espacios y lugares de atención a los pacientes en márgenes de tiempo de 48 h. Se formaron equipos multidisciplinares que funcionaron de forma eficiente, resolutiva y sin ningún conflicto

The COVID-19 pandemic has shown the adaptation ability of the Spanish Health System, through the implementation of exceptional and innovative measures such as the creation of medicalized hotels. The objective to be reached was the release of hospital beds, and ensuring isolation for people who had no infrastructure at home to be isolated after hospital discharge, or shared their home with vulnerable or fragile persons, thus preventing contagion among those living together. The objective of the present article is to present the experience of medicalizing a hotel in the city of Madrid, linked to the Hospital Universitario Gregorio Marañón (HGUGM), during the first wave of the COVID-19 pandemic, from March, 19th to May, 31st, 2020. Its implementation is addressed, considering the material and human resources required, its organization, the development of the activity and humanization, as well as the outcomes of the experience. In total, 465 patients were managed, with a mean 10-day stay. The occupation progression corresponded with the contagion curve (maximum peak during the first week of April: 146 patients). The Nursing staff performed a mean 10 PCR tests per day, with 817 tests in total. There was a >89% participation in the Seroprevalence Study (Microbiology Unit of the HGUGM) by the Nursing staff, with three positive PCR tests as outcome. In the context of the COVID-19 pandemic, the Community of Madrid nurses have demonstrated being qualified to provide spaces and places for patient care within a 48-hour margin. Multidisciplinary teams were formed, which worked in an efficient and operative way and without any conflicts