Prevalence and clustering of NANDA-I nursing diagnoses in the pre-hospital emergency care setting: A retrospective records review study.

AIM: To determine the prevalence and clustering of NANDA-International nursing diagnoses in patients assisted by pre-hospital emergency teams. DESIGN: Retrospective descriptive study of electronic record review. METHODS: Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two-step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020. RESULTS: Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six-cluster solution (n = 26.788) was found. Five clusters had a single high-prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co-occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051). CONCLUSION: Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre-hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre-hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre-hospital clinical setting. IMPACT: What problem did the study address? There are different models of pre-hospital emergency care services. The use of standardized nursing languages in the pre-hospital setting is not homogeneous. Studies on NANDA-I nursing diagnoses in the pre-hospital context are scarce, and those available are conducted on small samples. What were the main findings? This paper reports the study with the largest sample among the few published on NANDA-I nursing diagnoses in the pre-hospital care setting. Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance. Patients attended by pre-hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers. Where and on whom will the research have an impact? Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre-hospital setting, increasing the evidence of individualized and standardized care plans for pre-hospital care. REPORTING METHOD: STROBE checklist has been used as a reporting method. NO PATIENT OR PUBLIC CONTRIBUTION: Only patients' records were reviewed without further involvement.

Worldwide prevalence of inadequate work ability among hospital nursing personnel: A systematic review and meta-analysis.

PURPOSE: To estimate the worldwide pooled prevalence of inadequate work ability among hospital nursing personnel using the Work Ability Index (WAI). DESIGN: Systematic review and meta-analysis. METHODS: A systematic search was conducted on Medline/PubMed, Scopus, Web of Science, Scielo, PsychInfo, CINAHL, Nursing and Allied Health, LILACS, and Google Scholar from inception to July 2021 to identify observational studies on work ability among hospital nursing personnel using the WAI. Two researchers independently completed the study selection, quality assessments, and data extraction on the prevalence of inadequate work ability that was pooled using the random effects model. Finally, subgroup analyses were performed to explore sources of heterogeneity. FINDINGS: A total of 42 studies were included, consisting of 24,728 subjects worldwide from 14 countries. Of these, 35 studies were included in the meta-analytical analyses. The worldwide pooled prevalence of inadequate work ability among hospital nursing personnel was 24.7% (95% CI = 20.2%-29.4%). High levels of heterogeneity were detected in all studies. Prevalence was higher in studies where samples were composed of nurses and nursing assistive personnel (26.8%; 95% CI = 22.4%-31.5%) than in those of nurses alone (22.2%; 95% CI = 13.1%-32.9%) and in studies where the sample was over 40 (28.1%; 95% CI = 19.5%-37.5%) than in those with a sample under that age (22.4%; 95% CI = 15.8%-29.7%). CONCLUSIONS: Almost one in four members of hospital nursing staff in the world has inadequate work ability and therefore are at risk of several negative outcomes during their working life. These prevalence data correspond to the pre-pandemic period, so new studies should also be especially useful in quantifying the impact of the COVID-19 pandemic on work ability in the hospital nursing workforce. CLINICAL RELEVANCE: The above findings justify the launch of initiatives that include annual assessment for the early identification of inadequate work ability, offering the possibility of anticipated corrective measures. Nursing workforce older than 40 years and those belonging to the professional category of nursing assistive personnel should be priority target groups for screening and intervention to improve work ability.

NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care.

AIM: To determine the prevalence of NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care setting. DESIGN: Retrospective descriptive study of electronic record review. METHODS: Eight thousand three hundred three episodes recorded during the year 2019 were recovered from the electronic health records of a public emergency care agency. The prevalence of NANDA International nursing diagnosis, Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions was determined. A cross-tabulation analysis was performed to determine the linkages. Data were accessed in November 2020. RESULTS: NANDA International nursing diagnoses Anxiety (00146) and Fear (00148) represented more than 90% of the diagnoses recorded in the domain. Anxiety level (1211) and emotional support (5270) were the most recorded Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions, with almost 20% and 5% of total records, respectively. The linkage between nursing diagnosis Anxiety (00146), outcome Anxiety level (1211) and intervention Anxiety reduction (5820) was the most recorded with slightly more than 3% of the total. CONCLUSION: Eight different NANDA International nursing diagnoses in the coping/stress tolerance domain were recorded. Nursing Outcomes Classification outcomes were selected aimed mainly at psychological well-being and Nursing Interventions Classification interventions to support coping. In general, linkages were aimed to provide emotional support, physical well-being, information, education and safety. IMPACT: This study showed that pre-hospital emergency care nurses diagnose and treat human responses in the coping/stress tolerance domain. Expert consensus-based linkages may be complemented by the results of this study, increasing the levels of evidence of both individualized and standardized care plans for critical patients assisted by pre-hospital emergency care nurses.

Factors That Influence Nurse Staffing Levels in Acute Care Hospital Settings.

PURPOSE: To identify which patient and hospital characteristics are related to nurse staffing levels in acute care hospital settings. DESIGN: A cross-sectional design was used for this study. METHODS: The sample comprised 1,004 patients across 10 hospitals in the Andalucian Health Care System (southern Spain) in 2015. The sampling was carried out in a stratified, consecutive manner on the basis of (a) hospital size by geographical location, (b) type of hospital unit, and (c) patients' sex and age group. Random criteria were used to select patients based on their user identification in the electronic health record system. The variables were grouped into two categories, patient and hospital characteristics. Multilevel linear regression models (MLMs) with random intercepts were used. Two models were fitted: the first was the null model, which contained no explanatory variables except the intercepts (fixed and random), and the second (explanatory) model included selected independent variables. Independent variables were allowed to enter the explanatory model if their univariate association with the nurse staffing level in the MLM was significant at p < .05. RESULTS: Two hierarchical levels were established to control variance (patients and hospital). The model variables explained 63.4% of the variance at level 1 (patients) and 71.8% at level 2 (hospital). Statistically significant factors were the type of hospital unit (p = .002), shift (p < .001), and season (p < .001). None of the variables associated with patient characteristics obtained statistical significance in the model. CONCLUSIONS: Nurse staffing levels were associated with hospital characteristics rather than patient characteristics. CLINICAL RELEVANCE: This study provides evidence about factors that impact on nurse staffing levels in the settings studied. Further studies should determine the influence of patient characteristics in determining optimal nurse staffing levels.

Nurses' beliefs about nursing diagnosis: A study with cluster analysis.

AIMS: To identify clusters of nurses in relation to their beliefs about nursing diagnosis among two populations (Italian and Spanish); to investigate differences among clusters of nurses in each population considering the nurses' socio-demographic data, attitudes towards nursing diagnosis, intentions to make nursing diagnosis and actual behaviours in making nursing diagnosis. BACKGROUND: Nurses' beliefs concerning nursing diagnosis can influence its use in practice but this is still unclear. DESIGN: A cross-sectional design. METHODS: A convenience sample of nurses in Italy and Spain was enrolled. Data were collected between 2014-2015 using tools, that is, a socio-demographic questionnaire and behavioural, normative and control beliefs, attitudes, intentions and behaviours scales. RESULTS: The sample included 499 nurses (272 Italians & 227 Spanish). Of these, 66.5% of the Italian and 90.7% of the Spanish sample were female. The mean age was 36.5 and 45.2 years old in the Italian and Spanish sample respectively. Six clusters of nurses were identified in Spain and four in Italy. Three clusters were similar among the two populations. Similar significant associations between age, years of work, attitudes towards nursing diagnosis, intentions to make nursing diagnosis and behaviours in making nursing diagnosis and cluster membership in each population were identified. CONCLUSION: Belief profiles identified unique subsets of nurses that have distinct characteristics. Categorizing nurses by belief patterns may help administrators and educators to tailor interventions aimed at improving nursing diagnosis use in practice.

Blogged nursing: analysis of the phenomenon and contextualization in the Spanish setting.

Blogging within the health profession has grown in the recent past. This article aims to perform an analysis of the theoretical aspects of blogging, the use by professional nurses and students, benefits for patients, and, finally, an approach to the activities of Spanish nursing blogs. Blogs have great advantages as social communication tools. Immediacy in content update, closeness to information consumers, and compatibility with other Web 2.0 tools are points to be highlighted. Nurses use blogs for education and communication with other health professionals, students, and patients. For patients, therapeutic effects have been demonstrated in using blogging to share their health problems and express their experiential viewpoints. There are about 80 blogs written by Spanish nurses; most of them originated in the period between 2010 and 2012. These blogs are targeted to professionals (59%), patients (20%), or mixed (13%). There is a great heterogeneity in content: informative style (20%), opinion (28%), narrative (9%), experiential (2%), or humorous (2%). Nursing language is present in 15%, research and evidence-based practice in 13%, and protocols, guidelines, and procedures in 11% of them. We propose the need to plan institutional strategies for effective use of Web 2.0 resources as well as the need to unify criteria to provide quality content.

Work Ability Index: Psychometric Testing in Aeronautical Industry Workers.

Background: The Work Ability Index (WAI) is an instrument that measures work ability. The wide dispersion of the WAI internationally has led to its adaptation for use in different countries. This study aimed to evaluate the psychometric properties of the Spanish version of the WAI. Methods: A methodological design was used over an opportunistic sample of 233 workers in the aeronautical industry in Spain. Reliability was evaluated through internal consistency. Factorial validity, known groups, and convergent validity were tested. Results: The Cronbach's alpha and item-total correlation indicated an adequate internal consistency. The confirmatory factor analysis, performed to evaluate the factorial validity, found adequate fit indices for a two-factor solution with a high correlation between the factors. Factor 1, "Subjectively estimated work ability and resources", was composed of 3 subscales and factor 2, "Ill-health-related", of 2 subscales. Subscales 4 and 6 had loading in both factors. Workers under 45 years of age obtained higher significant scores than older ones. Convergent validity was also evidenced since WAI was highly correlated with self-assessment of health status. Conclusions: The Spanish version of the WAI has shown evidence of reliability and validity in this study, supporting its use in individual and collective health surveillance by occupational health professionals. The factorial solution that was found has previously been reported in another international context. However, further research is needed to resolve the discrepancies detected in the role of some subscales between other national and international studies.

The Spanish version of the Position on Nursing Diagnosis scale: cross-cultural adaptation and psychometric assessment.

AIM: To report the adaptation into Spanish and psychometric testing of the Position on Nursing Diagnosis scale. BACKGROUND: The Position on Nursing Diagnosis is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. DESIGN: Methodological design. METHOD: The scale was cross-culturally adapted through a process including translation, comparison with versions in other languages, back-translation, review, and pre-testing. An opportunistic sample of 621 Spanish registered nurses was recruited from August-December 2011. Reliability was evaluated through internal consistency and test-retest reliability. Construct validity, using both exploratory factor analysis and the known-group technique, and concurrent validity were assessed. FINDINGS: The Position on Nursing Diagnosis-Spanish Version was obtained from the cross-cultural adaptation process. High internal consistency and satisfactory test-retest reliability over a two week period (n = 240) were found. In the principal component analysis, all items loaded strongly on a single-factor which accounted for adequate variance, supporting the unidimensionality of the scale. A statistically significant difference was found comparing the scores of nurses who were members of the Spanish Association of Nomenclature, Taxonomy and Nursing Diagnosis and those who were not. Concurrent validity was supported by the significant correlation found between the scores and the degree of nursing diagnosis utilization and attendance to training sessions. CONCLUSION: The findings support the validity and reliability of the Position on Nursing Diagnosis-Spanish Version for its use among Spanish registered nurses as a measurement of their attitude towards the nursing diagnosis concept.

[A short form of the positions on nursing diagnosis scale: development and psychometric testing]. / Desarrollo y evaluación psicométrica de una forma abreviada de la escala de posicionamiento ante el diagnóstico enfermero.

The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.

Romanian nurses' beliefs on nursing diagnosis. A survey study based on the theory of planned behavior.

PURPOSE: To identify clusters of beliefs about nursing diagnosis (ND) among Romanian hospital nurses and to ascertain variations in attitudes, intention to use, behavior associated with the use of ND, and sociodemographic characteristics. METHODS: A cross-sectional online survey study was conducted on a convenience sample of 498 hospital nurses in Romania. The questionnaire comprises six scales measuring normative, behavioral, and control beliefs, intention to use, attitudes, and behavior toward ND. Results were reported through cluster analysis. FINDINGS: Three clusters were identified: highly positive, average, and highly negative beliefs about ND. Romanian nurses have more homogeneous beliefs regarding ND than nurses from other countries. Comparisons among clusters showed significant differences in intention [H(2) = 111.59, p < 0.001], attitudes [H(2) = 145.27, p < 0.001], and reported behavior [H(2) = 43.84, p < 0.001]. The stronger the attitude toward ND, the intention to use it, and the behavior of using ND, the more favorable the beliefs and vice versa. Significant disparities among clusters were discovered regarding education in ND, whereas differences were not observed regarding years of experience, age, and gender. CONCLUSION: Nurses exhibited different belief patterns about ND. Those with more positive beliefs demonstrated a more favorable attitude, a higher intention, and a more frequent behavior in using ND. Training in ND facilitates positive beliefs about it. IMPLICATIONS FOR NURSING PRACTICE: When designing interventions to promote ND in clinical practice, policymakers, administrators, and educators should consider addressing and potentially changing these beliefs. Modifying nurses' attitudes could positively impact patient care quality during their hospital stay and post-discharge.

Development and content validation of an NOC-based instrument for measuring knowledge and self-care behaviors in hypertensive disorders of pregnancy: CoNOCiTHE.

PURPOSE: The aim of this study is to design and validate the content of an instrument based on the Nursing Outcomes Classification (NOC) "Knowledge: disease process" and "Risk control: hypertension" to measure pregnant women's knowledge and self-care behaviors about hypertensive disorders. METHODS: The study was carried out in three phases: (a) content validity of the indicators, (b) construction, and (c) content validity of the instrument. FINDINGS: The instrument contains 72 items with an average content validity ratio and representativeness of 0.92. The items that did not reach the established values were eliminated or reformulated according to the observations made by the experts. CONCLUSIONS: This study provides the first instrument for perinatal maternal care designed from the NOC that has demonstrated adequate content validity and representativeness of the NOCs on which it is based. The next phase in the development of the instrument is to test its validity and reliability. IMPLICATIONS FOR NURSING PRACTICE: CoNOCiTHE is a tool that can be useful in assessing pregnant women's knowledge and self-care behaviors about hypertensive disorders, contributing to the documentation and quality of maternal perinatal nursing care.

Tackling perinatal loss, a participatory action research approach: research protocol.

AIM: The aim of this study was to promote changes to improve the care provided to parents who have experienced a perinatal loss through participatory action research. BACKGROUND: The birth of a child is a joyful event for most families, however, unfortunately some pregnancies end in loss. Perinatal loss creates a heavy emotional impact not only on parents but also on health professionals, where in most cases there is an evident lack of skills, strategies and resources to cope with these kinds of situations. DESIGN: Participatory action research is the methodology proposed to achieve the purpose of this study. METHODS: Participatory action research consists of five stages: outreach and awareness, induction, interaction, implementation and systematization. The working group will include professionals from the Mother and Child Unit for patients at a tertiary level public hospital in Spain. The duration of the study will be 3 years since the approval of the protocol in January 2011. The qualitative techniques used will include group dynamics such as the SWOT analysis the nominal group technique, focus groups and brainstorming, among others that will be recorded and transcribed, generating reports throughout the evolution of the group sessions and about the consensus reached. Content analysis will be conducted on the field diaries kept by the participants and researchers. This project has been funded by the Andalusian Regional Ministry of Health. DISCUSSION: Participatory action research is a methodological strategy that allows changes in clinical practice to conduct a comprehensive transformative action in the care process for perinatal loss.

Cross-Cultural Adaptation and Psychometric Evaluation of the Educational Content Validation Instrument in Health.

Healthcare professionals often use multimedia patient education media, but not all have the same content quality. This study aimed to cross-culturally adapt the Educational Content Validation Instrument in Health to the Spanish setting and assess its psychometric properties. A methodological validation study was carried out between January and September 2020. Data collection took place from May to June 2020. A translation, back translation, committee review, and pre-testing was carried out. Subsequently, reliability (internal consistency), and validity (factorial and convergent) were assessed by requiring 210 Healthcare Professionals to complete the instrument based on video material. In addition, a refinement of the instrument was conducted based on the modification indexes. The instrument showed adequate internal consistency, although some redundancy in the items (α = .93). Exploratory factor analysis suggested a unifactorial structure that explained an adequate variance (47.37%). Convergent validity was poor (r = .11; P = .05). After analysis, 6 items were deleted without impairing the validity results and eliminating redundancy. Therefore, a 12-item version of the instrument was created. It can help to assess more objectively the contents of the materials prescribed, facilitating the choice of those of higher quality and potentially improving their patients' health outcomes. Further studies are needed to confirm the previous results and reassess some of the shortcomings.

Development and Effectiveness of a Mobile Health Intervention in Improving Health Literacy and Self-management of Patients With Multimorbidity and Heart Failure: Protocol for a Randomized Controlled Trial.

BACKGROUND: Patients with multimorbidity and complex health needs are defined as a priority by the World Health Organization (WHO) and the European Union. There is a need to develop appropriate strategies with effective measures to meet the challenge of chronicity, reorienting national health systems. The increasing expansion of mobile health (mHealth) interventions in patient communication, the reduction of health inequalities, improved access to health care resources, adherence to treatment, and self-care of chronic diseases all point to an optimistic outlook. However, only few mobile apps demonstrate their effectiveness in these patients, which is diminished when they are not based on evidence, or when they are not designed by and for users with different levels of health literacy (HL). OBJECTIVE: This study aims to evaluate the efficacy of an mHealth intervention relative to routine clinical practice in improving HL and self-management in patients with multimorbidity with heart failure (HF) and complex health needs. METHODS: This is a randomized, multicenter, blinded clinical trial evaluating 2 groups, namely, a control group (standard clinical practice) and an intervention group (standard clinical practice and an ad hoc designed mHealth intervention previously developed), for 12 months. RESULTS: The contents of the mHealth intervention will address user-perceived needs based on the development of user stories regarding diet, physical exercise, cardiac rehabilitation, therapeutic adherence, warning signs and symptoms, and emotional management. These contents have been validated by expert consensus. The creation and development of the contents of the mHealth intervention (app) took 18 months and was completed during 2021. The mobile app is expected to be developed by the end of 2022, after which it will be applied to the experimental group as an adjunct to standard clinical care during 12 months. CONCLUSIONS: The trial will demonstrate whether the mobile app improves HL and self-management in patients with HF and complex health needs, improves therapeutic adherence, and reduces hospital admissions. This study can serve as a starting point for developing other mHealth tools in other pathologies and for their generalization to other contexts. TRIAL REGISTRATION: ClinicalTrials.gov NCT04725526; https://tinyurl.com/bd8va27w. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/35945.

Correction: Development and Effectiveness of a Mobile Health Intervention in Improving Health Literacy and Self-management of Patients With Multimorbidity and Heart Failure: Protocol for a Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/35945.].

[Case detection and follow-up of an outbreak of COVID-19 in repatriated workers: A case series study.] / Detección y segui-miento de casos de un brote de covid-19 en trabajadores repatriados: Un estudio de serie de casos.

OBJECTIVE: The mobility of workers to other countries in a globalized work world has posed an added risk in the current pandemy of COVID-19 and can carry with it an increased risk of spread and transmission of the disease. The collaboration of the Occupational Health Units of the companies and the Health Authorities has been fundamental in the investigation of COVID-19 outbreaks secondary to international travel of workers on mission. The objective of this study was to describe the process of detection and follow-up of cases in an outbreak of COVID-19 in repatriated workers after a six-month mission in a factory of aircraft components in Poland. METHODS: A case series study was conducted. Data on sociodemographic, epidemiological and clinical course variables of the cases were collected by telephone clinical interview. Descriptive statistics were used to summarize the data. RESULTS: The outbreak involved 20 workers who shared the workplace and made the repatriation trip together. The outbreak investigation was initiated after detecting that a worker presented symptoms compatible with COVID-19 during the 4 days prior to the return trip, which was later confirmed by PCR. During follow-up, 40% (n=8) of the workers were considered cases confirmed by PCR. Of these, only 62.5% (n=5) presented symptoms. Fifty percent (n=4) had fever, 25% (n=2) had cough, respiratory distress, general malaise, and diarrhea, and 12.5% (n=1) had anosmia, ageusia, and conjunctivitis. All of them underwent home isolation with outpatient telephone follow-up. At the end of the follow-up, all were asymptomatic and returned to work. The mean close contact was 1.85 per case within the group (SD=3.13), with a range of 0-11, occurring primarily during attendance at extra work social events that were limited to members of the workers' own group and/or during the return flight. The health authorities were informed through established channels so that they could proceed with the detection and tracking of close contacts with people outside the group of workers that occurred during the flight and after arrival to Spain. CONCLUSIONS: Early detection of potential cases of COVID-19 with transmission capacity by the Occupational Health and Safety Departments of the companies, in collaboration with the Health Authorities, is essential for more efficient case and contact management of imported cases of COVID-19.

OBJETIVO: La movilidad de los trabajadores a otros países en un mundo laboral globalizado, ha supuesto un riesgo añadido en el contexto actual de la pandemia de COVID-19 y puede llevar consigo un riesgo mayor de propagación y transmisión de la enfermedad. La colaboración de las Unidades de Salud Laboral de las empresas y las Autoridades Sanitarias ha sido fundamental en la investigación de brotes de COVID-19 secundarios a viajes internacionales de trabajadores en misión. El objetivo de este estudio fue describir el proceso de detección y seguimiento de casos en un brote de COVID-19 en trabajadores repatriados tras una misión de seis meses en una fábrica de elementos aeronáuticos en Polonia. METODOS: Se realizó un estudio de serie de casos. Se recogieron datos relativos a variables sociodemográficas, epidemiológicas y relativas al curso clínico de los casos mediante entrevista clínica telefónica. Se utilizó la estadística descriptiva para resumir los datos. RESULTADOS: El brote implicó a 20 trabajadores que compartían lugar de trabajo y realizaron el viaje de retorno juntos. La investigación del brote se inició tras detectar que un trabajador presentó sintomatología compatible con COVID-19 durante los 4 días previos al viaje de regreso, que posteriormente fue confirmado con PCR. Durante el seguimiento, el 40% (n=8) de los trabajadores fueron considerados casos confirmados con PCR. De ellos, únicamente el 62,5% (n=5) presentó sintomatología. El 50% (n=4) presentó fiebre, mientras que el 25% (n=2) presentó tos, dificultad respiratoria, malestar general y diarrea, y el 12,5% (n=1) presentó anosmia, ageusia y conjuntivitis. Todos realizaron aislamiento domiciliario con seguimiento ambulatorio telefónico y estaban asintomáticos al final del seguimiento causando alta laboral. Los casos presentaron una media de 1,85 (DE=3,13) contactos estrechos dentro del grupo con un rango de 0-11, principalmente ocurridos durante la asistencia a eventos sociales extralaborales que se limitaban a los miembros del propio grupo y/o durante el viaje de avión de regreso. Las autoridades sanitarias fueron informadas a través de los cauces establecidos para que procedieran a la detección y seguimiento de los contactos estrechos con personas externas al grupo de trabajadores sucedidos durante el vuelo y tras la llegada a España. CONCLUSIONES: La detección precoz de los casos de COVID-19 con capacidad de transmisión a través de los servicios de prevención de las empresas, en colaboración con las Autoridades Sanitarias, es fundamental para el manejo de casos y contactos más eficiente ante la eventual aparición de casos importados de COVID-19.

A New Instrument for Measuring Dietary Knowledge in Patients With Diabetes: Psychometric Testing of the CoNOCidiet-Diabetes.

PURPOSE: To determine the psychometric properties of the CoNOCidiet-Diabetes, a new instrument based on nursing outcome "Knowledge: prescribed diet." METHODS: Methodological design. The participant were 359 patients diagnosed with diabetes visiting 27 primary healthcare centers in Spain. Reliability (internal consistency and test-retest), validity (convergent criterion validity, concurrent content validity and known-groups validity), and sensitivity to change was tested. FINDINGS: CoNOCidiet-Diabetes has shown evidence of acceptable psychometric properties as instrument but some items should be revised. CONCLUSIONS: This research provides a new instrument developed to specifically measure dietary knowledge in individuals with diabetes. IMPLICATIONS: For nursing practice: The literalness of the CoNOCidiet-Diabetes with the nursing outcome "Knowledge: prescribed diet" facilitate its measurement using the patient's statements.

OBJETIVO: Determinar las propiedades psicométricas del CoNOCidiet-Diabetes, un nuevo instrumento basado en el resultado enfermero "Conocimiento: dieta prescrita". MÉTODOS: Diseño metodológico. Los participantes fueron 359 pacientes diagnosticados de diabetes que acudieron a 27 centros de atención primaria de salud en España. Se comprobó la fiabilidad (consistencia interna y test-retest), la validez (validez de criterio convergente, validez de contenido concurrente y validez de grupos conocidos) y la sensibilidad al cambio. RESULTADOS: El CoNOCidiet-Diabetes ha mostrado evidencias de tener unas propiedades psicométricas aceptables como instrumento, pero algunos ítems deben ser revisados. CONCLUSIONES: Esta investigación proporciona un nuevo instrumento desarrollado para medir específicamente el conocimiento sobre dieta en personas con diabetes. IMPLICACIONES PARA LA PRÉCTICA ENFERMERA: La literalidad del CoNOCidiet-Diabetes con el resultado enfermero "Conocimiento: dieta prescrita" facilita la medición de este último utilizando las declaraciones del paciente.

Nursing Diagnosis of Grieving in Cases of Perinatal Loss: A Preliminary Clinical Validation.

PURPOSE: To develop a preliminary clinical validation the NANDA-I nursing diagnosis "Grieving" in cases of perinatal loss. METHODS: Descriptive cross-sectional study using the Fehring model. FINDINGS: The overall clinical validity index for the diagnosis was 0.15. Only four defining characteristics and five manifestations identified in the literature were validated. CONCLUSIONS: The variability of manifestations identified in the study participants is considered to be detrimental to the overall clinical validity index. IMPLICATIONS FOR NURSING PRACTICE: The clinical validity of the diagnosis could not be substantiated by the preliminary results of this study and, therefore, additional research is necessary to determine the ability of the diagnosis to adapt to perinatal loss situations in real contexts. Some manifestations have been proposed to NANDA-I for inclusion as defining characteristics in the nursing diagnosis of grieving. OBJETIVO: Validar clínicamente de forma preliminar el diagnóstico enfermero NANDA-I duelo en caso de pérdida perinatal. MÉTODOS: Estudio descriptivo transversal usando el modelo de Fehring. RESULTADOS: El índice de validez clínica global del diagnóstico fue de 0.15. Se validaron únicamente cuatro características definitorias y cinco manifestaciones identificadas en la literatura. CONCLUSIONES: Se considera que la variabilidad de las manifestaciones presentadas por los participantes actuó en detrimento del índice de validación clínica global. IMPLICACIONES PARA LA PRÁCTICA ENFERMERA: La validez clínica del diagnóstico no pudo ser corroborada por los resultados preliminares de este estudio y, por tanto, se necesita investigación adicional para terminar la capacidad de este diagnóstico para adaptarse a las situaciones de pérdidas perinatales en contexto reales. Se han propuesto a NANDA-I algunas manifestaciones para que sean incluidas como Características Definitorias del diagnóstico enfermero Duelo.

[Turnicity as a determining factor in the occurrence of insomnia in the working population: a systematic review.] / La turnicidad como factor determinante en la aparición de insomnio en población laboral: revisión sistemática.

BACKGROUND: Insomnia is the most frequent sleep disorder in the adult population with a prevalence of around 30% being responsible for the deterioration in the quality of life. At work level, shift work is the main risk factor associated with the onset of insomnia. Despite its clinical relevance, it usually goes unnoticed by healthcare professionals due to lack of time, resources or information. The aim of this study was to analyze the influence of shift work in the occurrence of insomnia in the working population. METHODS: Systematic review following the PRISMA statement. A bibliographic search using the DeCS terms "Insomnia", "Occupational Health" and "Shift Work" was carried out in the Pubmed, Scopus, Web of Science and CINAHL databases, as well as in other sources such as the base of doctoral thesis data (TESEO). Articles published until November 2019 in English and Spanish were included. The methodological quality was evaluated through the CONSORT and STROBE guides. RESULTS: 13 studies that met the inclusion criteria were included. The methodological quality of the articles was high (STROBE: 18/22, CONSORT: 20/25). Based on the selected records, a prevalence of insomnia related to turnicity between 25% and 53% was identified. The duration and rotation of the shifts work influenced the onset of insomnia, with 12-hour shifts or fast and forward rotation systems being more beneficial. Other factors such as stress, anxiety, perceived health, healthy lifestyles and toxic habits, workplace accidents, fatigue or workload level were analyzed together with the turnicity. CONCLUSIONS: Insomnia influenced by turnicity is a public health problem worldwide that affects the quality of personal and work life. The characteristics and the context in which the work takes place in shifts, sometimes together with other factors, influence this affectation.

OBJETIVO: El insomnio es el trastorno del sueño más frecuente en la población adulta, con una prevalencia de alrededor del 30%, siendo responsable del deterioro en la calidad de vida. A nivel laboral, el trabajo a turnos es el principal factor de riesgo asociado en la aparición del insomnio. A pesar de su relevancia clínica, suele pasar inadvertido para los profesionales sanitarios debido a falta de tiempo, recursos o información. El objetivo de este estudio fue analizar la influencia del trabajo a turnos en la aparición de insomnio en la población laboral. METODOS: Se efectuó una revisión sistemática siguiendo la declaración PRISMA. Se realizó una búsqueda bibliográfica, utilizando los términos DeCS "Insomnia", "Occupational Health" y "Shift Work", en las bases de datos Pubmed, Scopus, Web of Science y CINAHL, así como en otras fuentes como la base de datos de tesis doctorales (TESEO). Se incluyeron artículos publicados hasta noviembre de 2019, tanto en ingles como en castellano. La calidad metodológica se evalúo por medio de las guías CONSORT y STROBE. RESULTADOS: Se incluyeron 13 estudios que cumplieron los criterios de inclusión. La calidad metodológica de los artículos fue alta (STROBE: 18/22, CONSORT: 20/25). En base a los registros seleccionados, se identificó una prevalencia para el insomnio relacionada con la turnicidad entre el 25% y el 53%. La duración y la rotación de los turnos influyeron en la aparición del insomnio, siendo mas beneficiosos los turnos de 12 horas o con sistemas de rotaciones rápidas y hacia adelante. Junto a la turnicidad se analizaron otros factores como el estrés, la ansiedad, la salud percibida, los estilos de vida saludable y hábitos tóxicos, la siniestralidad laboral, la fatiga o el nivel de carga laboral. CONCLUSIONES: El insomnio influenciado por la turnicidad es un problema de salud pública a nivel mundial que afecta a la calidad de vida personal y laboral. Las características y el contexto en el que se desarrolla el trabajo a turnos, a veces juntos a otros factores, influyen en dicha afectación.

Development and Validation of the Operational Definitions of the Defining Characteristics of the Nursing Diagnosis of Insomnia in the Occupational Health Setting.

PURPOSE: To develop and validate the operational definition (ODs) for each defining characteristic (DC) contained in the Nursing Diagnosis (ND) "insomnia" (00095) in the occupational health context. METHODS: Methodological study carried out in two stages, including a consensus of experts to develop the ODs (Stage 1) and an online Delphi panel, performed in two rounds, to validate them (Stage 2). FINDINGS: The 15 ODs proposed in Stage 1 were narrowed down to six validated ODs in the first round (diagnostic content validity index [DCVI] = 0.80-0.89). In the second round, five ODs were validated (DCVI = 0.80-0.94). Finally, the remaining four ODs were validated by the general consensus of experts. CONCLUSIONS: The ODs were validated, although there remains some doubt as to whether some of the DCs can be applied to the field of occupational health. IMPLICATIONS FOR NURSING PRACTICE: The ODs developed and validated could improve the diagnostic accuracy of the ND "insomnia" (00095) in the context of occupational health.