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Chen CC, Tsai CF, Chen SC. Consensus and agreements on the sonographic definitions of pediatric tenosynovitis: comment on the article by Collado et al. Arthritis Care Res (Hoboken) 2023; 75:2544-2545. [PMID: 37382037 DOI: 10.1002/acr.25185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Chun-Chieh Chen
- Chung Shan Medical University School of Medicine and Chung Shan Medical University Hospital Health Management Center, Taichung, Taiwan
| | - Chin-Feng Tsai
- Chung Shan Medical University School of Medicine and Chung Shan Medical University Hospital Health Management Center, Taichung, Taiwan
| | - Shiuan-Chih Chen
- Chung Shan Medical University School of Medicine and Chung Shan Medical University Hospital Health Management Center, Taichung, Taiwan
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102
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Zhang L, Wan R, Iyendo TO, Apuke OD, Tunca EA. A randomized control trial establishing the effectiveness of using interactive television-based art, music, and poetry therapies for treating the post-traumatic stress disorder of children exposed to traumatic events. Psychiatry Res 2023; 330:115582. [PMID: 37979317 DOI: 10.1016/j.psychres.2023.115582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/20/2023]
Abstract
This study aimed to compare the effectiveness of interactive television-based music, art, and poetry therapies in reducing symptoms of posttraumatic stress disorder among school children who have experienced abduction. A randomized control trial was adopted using school children from three selected secondary schools in Northern Nigeria that have experienced the issue of kidnapping. The treatment is characterized by (1) group setting, (2) TV instruction (3) school collaboration, and (4) use of artistic mediation. The study sample comprised 470 students randomly divided into a control group of 235 and an experiment group of 235. The treatment group was further divided into art (N = 78), music (N = 78) and poetry (N = 79), respectively. Results suggest that interactive television art, music and poetry therapies are an effective intervention strategy for reducing the PTSD of school children who have experienced kidnapping in Nigeria. However, art therapy is more effective in reducing PTSD. This study has offered empirical evidence that could guide the planning and implementation of therapies aimed at assisting school children to recover from traumatic experiences.
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Affiliation(s)
- Lei Zhang
- College of Literature Law and art, East China University of Technology, Nanchang City, Jiangxi Province, China.
| | - Ran Wan
- Architecture and Design College, Nanchang University, No.999, Xuefu Road, Honggu district, Nanchang City, Jiangxi Province, China, 330031.
| | - Timothy Onosahwo Iyendo
- Department of Architecture, Faculty of Environmental Sciences, Nile University of Nigeria, Plot 681, Institute Area, Federal Capital Territory, Abuja, Nigeria.
| | - Oberiri Destiny Apuke
- Faculty of Communication and Media Studies, Department of Mass Communication, Taraba State University, PMB 1167 Jalingo, Nigeria.
| | - Elif Asude Tunca
- The European University of Lefke, Faculty of Communication Sciences, Department of New Media and Journalism, Lefke, Northern Cyprus, TR-10 Mersin, Turkey.
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103
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Chahine J, Kosmopoulos M, Raveendran G, Yannopoulos D, Bartos JA. Impact of age on survival for patients receiving ECPR for refractory out-of-hospital VT/VF cardiac arrest. Resuscitation 2023; 193:109998. [PMID: 37832628 DOI: 10.1016/j.resuscitation.2023.109998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Extracorporeal cardiopulmonary resuscitation (ECPR) has been shown to improve neurologically favorable survival for patients with refractory ventricular tachycardia (VT)/ventricular fibrillation (VF) out-of-hospital cardiac arrest. Prior studies of the impact of age on outcomes in ECPR have demonstrated mixed results and we aim to investigate this relationship. METHODS Patients treated with ECPR at the University of Minnesota Medical Center for refractory out-of-hospital VT/VF arrest from December 2015 to February 2023 were included. The primary endpoints included neurologically favorable survival to discharge. A receiver operating characteristic curve was used to determine an optimal predictive age limit with the highest accuracy for neurologically favorable survival. RESULTS 391 consecutive patients were included: 22% (n = 86) were female and the mean age was 56.9 ± 11.8 years. Age was independently associated with neurologically favorable survival to discharge, with a 30% decrease in survival with every 10-year increase in age (OR 0.7 (0.57-0.87), p = 0.001. Among those with neurologically favorable survival to discharge, older patients had longer length of hospital stay compared to younger age groups (p = 0.002) while patients who failed to achieve neurologically favorable survival to discharge had similar length of stay independent of age (p = 0.51). CONCLUSIONS Age is associated with neurologically favorable survival to discharge for patients receiving ECPR for refractory out-of-the-hospital VT/VF cardiac arrest. However, with a survival rate of 23% in the oldest age group, caution should be used when choosing age criteria for patient selection.
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Affiliation(s)
- Johnny Chahine
- Division of Cardiology, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States
| | - Marinos Kosmopoulos
- Division of Cardiology, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States
| | - Ganesh Raveendran
- Division of Cardiology, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States; Center for Resuscitation Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States
| | - Demetris Yannopoulos
- Division of Cardiology, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States; Center for Resuscitation Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States
| | - Jason A Bartos
- Division of Cardiology, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States; Center for Resuscitation Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States. https://twitter.com/@jason_bartos
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104
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Bedi PK, DeHaan K, Ofosu D, Olmstead D, MacLean JE, Castro-Codesal M. Predictors of NIV-related adverse events in children using long-term noninvasive ventilation. Pediatr Pulmonol 2023; 58:3549-3559. [PMID: 37701936 DOI: 10.1002/ppul.26689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/10/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND AND OBJECTIVES An increasing number of children with diverse medical conditions are using long-term noninvasive ventilation (NIV). This study examined the impact of demographic, clinical, and technology-related factors on long-term NIV adverse events in a large cohort of children using long-term NIV. METHODS This was a multicenter retrospective review of all children who initiated long-term NIV in the province of Alberta, Canada, from January 2005 to September 2014, and followed until December 2015. Inclusion criteria were children who had used NIV for 3 months or more and had at least one follow-up visit with the NIV programs. RESULTS We identified 507 children who initiated NIV at a median age of 7.5 (interquartile range: 8.6) years and 93% of them reported at least one NIV-related adverse event during the initial follow-up visit. Skin injury (20%) and unintentional air leaks (19%) were reported more frequently at the initial visit. Gastrointestinal symptoms, midface hypoplasia, increased drooling, aspiration and pneumothorax were rarely reported (<5%). Younger age and underlying conditions such as Down syndrome, achondroplasia, and Duchenne muscular dystrophy were early predictors of unintentional air leak. Younger age also predicted child sleep disruption in the short term and ongoing parental sleep disruption. Obesity was a risk factor for persistent nasal symptoms. Mask type was not a significant predictor for NIV-related short- or long-term complications. CONCLUSIONS This study demonstrates that NIV-related complications are frequent. Appropriate mask-fitting and headgear adaptation, and a proactive approach to early detection may help to reduce adverse events.
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Affiliation(s)
- Prabhjot K Bedi
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Women & Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
| | - Kristie DeHaan
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Daniel Ofosu
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Joanna E MacLean
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Women & Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
| | - Maria Castro-Codesal
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Women & Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
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105
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Holch P, Turner G, Keetharuth AD, Gibbons E, Cocks K, Absolom KL. The impact of COVID-19 on PRO development, collection and implementation: views of UK and Ireland professionals. J Patient Rep Outcomes 2023; 7:121. [PMID: 38010558 PMCID: PMC10682296 DOI: 10.1186/s41687-023-00663-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND PROs are valuable tools in clinical care to capture patients' perspectives of their health, symptoms and quality of life. However the COVID-19 pandemic has had profound impacts on all aspects of life, in particular healthcare and research. This study explores the views of UK and Irish health professionals, third sector and pharmaceutical industry representatives and academic researchers on the impact of COVID-19 on PRO collection, use and development in clinical practice. METHODS A volunteer sample took part in a 10 question cross sectional qualitative survey, on the impact of COVID-19, administered online via Qualtrics. Demographic data was descriptively analysed, and the qualitative free text response data was subject to thematic analysis and summarised within the Strengths, Weaknesses, Opportunities and Threats (SWOT) framework. RESULTS Forty nine participants took part located in a range of UK settings and professions. Participants highlighted staff strengths during the pandemic including colleagues' flexibility and ability to work collaboratively and the adoption of novel communication tools. Weaknesses were a lack of staff capacity to continue or start PRO projects and insufficient digital infrastructure to continue studies online. Opportunities included the added interest in PROs as useful outcomes, the value of electronic PROs for staff and patients particularly in relation to integration into systems and the electronic patient records. However, these opportunities came with an understanding that digital exclusion may be an issue for patient groups. Threats identified included that the majority of PRO research was stopped or delayed and funding streams were cut. CONCLUSIONS Although most PRO research was on hold during the pandemic, the consensus from participants was that PROs as meaningful outcomes were valued more than ever. From the opportunities afforded by the pandemic the development of electronic PROs and their integration into electronic patient record systems and clinical practice could be a lasting legacy from the COVID-19 pandemic.
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Affiliation(s)
- Patricia Holch
- Department of Psychology, School of Humanities and Social Sciences, Leeds Beckett University, Portland Building, Room PD402, City Campus, Leeds, LS1 9HE, UK.
| | - Grace Turner
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Anju D Keetharuth
- School of Health and Related Research, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - E Gibbons
- Evidera Ltd, 201 Talgarth Rd, The Ark, London, W6 8BJ, UK
| | - Kim Cocks
- Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, SK10 5JB, UK
| | - Kate L Absolom
- Leeds Institute of Medical Research, University of Leeds, St James's Hospital, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
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106
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Samper Amargós M, González-Viana A, Vergara Duarte M, Rua MIP. [The role of the nurse in the field of public health]. GACETA SANITARIA 2023; 37:102337. [PMID: 38007960 DOI: 10.1016/j.gaceta.2023.102337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 09/28/2023] [Accepted: 10/01/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE Identify the role of public health nurses and differentiate it from that of community care nurses in the context of Catalonia, through the experiences and perspectives of professionals in the field of public health. METHOD Descriptive phenomenological qualitative study. Fourteen interviews were conducted with key informants, from the field of public health and community care, selected by i purposive sampling. Content analysis using thematic methodology, creation of categories from the triangulation of results. RESULTS The professional competencies and functions performed by nursing in the field of public health are analysed. Most of the specific functions were the ones related to "care" and the "global vision" of health. The indeterminacy of functions and roles, related to gender inequality, leads to a low recognition of the profession and a lack of appropriateness of the professional category, reflected in a low presence of nurses in management positions in public health. Although some competencies are shared with the family and community nurse, there are also differences. CONCLUSIONS This study sheds light on the role of public health nursing, often overlooked. It is urgent to define public health nurses role and functions, in order to avoid inequalities and increase their recognition.
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Affiliation(s)
| | - Angelina González-Viana
- Agència de Salut Pública de Catalunya, Barcelona, España; Departamento de Enfermería de Salud Pública, Salud Mental y Maternoinfantil, Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), España
| | - Montserrat Vergara Duarte
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), España; Agència de Salut Pública de Barcelona, Barcelona, España
| | - M Isabel Pasarín Rua
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau, Barcelona, España
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107
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Zemdegs J, Iroz A, Vecchio M, Roze S, Lotan Y. Water intake and recurrent urinary tract infections prevention: economic impact analysis in seven countries. BMC Health Serv Res 2023; 23:1197. [PMID: 37924070 PMCID: PMC10623695 DOI: 10.1186/s12913-023-10234-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/28/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND To estimate the economic impact of preventing urinary tract infections (UTI) by increasing water intake among women with recurrent UTI and low fluid intake across seven countries: France, United Kingdom, Spain, United States of America, Mexico, China and Australia. METHODS A Markov model was developed to compare costs and outcomes of UTIs associated with low fluid intake in women versus a strategy of primary prevention by increasing water intake. Model inputs were based on randomized controlled trial data which found that increasing water intake by 1.5 L/day decreased the risk of developing cystitis by 48% in women with low fluid intake and recurrent UTI. A time horizon of 10 years was used; outcomes were from the payer perspective and included both direct and indirect costs, reported in 2019 United States dollars ($). Discounting rates varied by country. Scenarios of increasing levels of compliance to the increased water intake strategy were evaluated. RESULTS The total cost of one UTI episode, including diagnostics, treatment and complications, ranged from $2164 (Mexico) to $7671 (Australia). Assuming 80% compliance with the increased water intake strategy over a 10-year time horizon, the number of UTIs prevented ranged from 435,845 (Australia) to 24150,272 (China), resulting in total savings of 286 million (Australia) to $4.4 billion (China). Across all countries, increased water intake resulted in lower cost and fewer UTIs compared with low water intake. CONCLUSION Preventing recurrent UTIs by increasing water intake would reduce both the clinical and economic burden associated with UTI. Public, healthcare professionals and patients should be made aware about the preventive positive impact of appropriate water intake on UTIs.
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Affiliation(s)
- Juliane Zemdegs
- Danone Global Research and Inovation Center, Gif-Sur-Yvette, France
| | - Alison Iroz
- Danone Global Research and Inovation Center, Gif-Sur-Yvette, France
| | | | | | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
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108
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Valls-Matarín J, Peradejordi-Torres RM, Del Cotillo-Fuente M. Dependency-related skin lesions in the prone critical patient. Incidence study. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:424-431. [PMID: 37898167 DOI: 10.1016/j.enfcle.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/19/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE To determine the incidence of dependence-related skin lesions (DRSL) in patients in prone position (PP) and to identify the predisposing factors. METHOD Follow-up study in two polyvalent intensive care units. Patients undergoing invasive mechanical ventilation and PP with no skin lesions on admission were included. We recorded the 3 types of DRSL: (pressure ulcers [PU], moisture-associated skin damage [MASD] and friction injuries [FI]), demographic variables, diagnosis, length of stay, PP episodes, postural changes, APACHE II (Acute Physiology and Chronic Health Disease Classification System), prealbumin level on admission, body mass index (BMI), diabetes, hypertension, smoking, peripheral vascular disease (PVD), vasoactive drugs, Braden scale and mortality. Bivariate analysis: chi-square test, t-test or Mann-Whitney U test. Multivariate analysis: logistic regression. RESULTS Forty nine patients were included and 170PP were performed.Forty-one DRSL appeared in 22 patients with a cumulative incidence of 44.9% (95%CI: 31.6-58.7). PU accounted for 63.4% (73.1% facial; 76.9% stage II), 12.2% were MASD (60% inguinal; 60% stage II) and 24.4% were FI (50% thoracic; 70% stage III). The median age of the lesion group (LG) was 66.5 [61.8-71.3] vs. 64 [43-71] years old in the non-lesion group (NLG), p=0.04. Eighty percent of the LG had PVD vs. 20% of the NLG, p=0.03. The median total hours on PP of the LG was 96.9 [56.1-149.4] vs. 38.2 [18.8-57] of the NIG, p<0.001. Multivariate analysis selected total PP hours (OR=1.03; 95%CI:1.01-1.05) and PVD (OR=8.9; 95%CI:1.3-58.9) as predisposing factors for developing DRSL. CONCLUSIONS There is a high incidence of skin lesions related to prone decubitus dependence, mostly pressure lesions, although of low severity.The accumulated hours in probe position and peripheral vascular disease favor their development.
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Affiliation(s)
- Josefa Valls-Matarín
- Unidad de Cuidados Intensivos, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain.
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Gonzalez-Baz MD, Pacheco Del Cerro E, Ferrer-Ferrándiz E, Araque-Criado I, Merchán-Arjona R, de la Rubia Gonzalez T, Moro Tejedor MN. Psychometric validation of the Kolcaba General Comfort Questionnaire in critically ill patients. Aust Crit Care 2023; 36:1025-1034. [PMID: 36906429 DOI: 10.1016/j.aucc.2022.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/14/2022] [Accepted: 12/23/2022] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND There is a lack of validated tools to measure comfort in critically ill patients. OBJECTIVE The objective of this study was to evaluate the psychometric properties of the General Comfort Questionnaire (GCQ) in patients admitted to intensive care units (ICUs). METHODOLOGY A total of 580 patients were recruited, randomising the sample into two homogeneous subgroups of 290 patients for exploratory factor analysis and confirmatory factor analysis, respectively. The GCQ was used to assess patient comfort. Reliability, structural validity, and criterion validity were analysed. RESULTS The final version included 28 of the 48 items from the original version of the GCQ. This tool was named the Comfort Questionnaire (CQ)-ICU, maintaining all types and contexts of the Kolcaba theory. The resulting factorial structure included seven factors: psychological context, need for information, physical context, sociocultural context, emotional support, spirituality, and environmental context. A Kaiser-Meyer-Olkin value of 0.785 was obtained, with Bartlett's sphericity test (0.000) being significant, and the total variance explained was 49.750%. The Cronbach's alpha was 0.807, with subscale values ranging from 0.788 to 0.418. Regarding convergent validity, high positive correlations were obtained between the factors and the GCQ score, the CQ-ICU score, and the criterion item GCQ31: "I am content". In terms of divergent validity, correlations were low with the APACHE II scale and with the NRS-O except for physical context (-0.267). CONCLUSION The Spanish version of the CQ-ICU is a valid and reliable tool to assess comfort in an ICU population 24 h after admission. Although the resulting multidimensional structure does not replicate the Kolcaba Comfort Model, all types and contexts of the Kolcaba theory are included. Therefore, this tool enables an individualised and holistic evaluation of comfort needs.
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Affiliation(s)
- Ma Dolores Gonzalez-Baz
- Department of Evidence Based Practice, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Department of Nursing, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Spain.
| | - Enrique Pacheco Del Cerro
- Department of Nursing, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Spain; Nursing Management, San Carlos Clinical Hospital, Madrid, Spain.
| | - Esperanza Ferrer-Ferrándiz
- Escuela Universitaria de Enfermería La Fe, Valencia, Spain; Grupo Investigación Arte y Ciencia del Cuidado (GREIAC) of Instituto de Investigación Sanitaria La Fe, Spain.
| | - Irene Araque-Criado
- Department of Evidence Based Practice, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Raúl Merchán-Arjona
- Escuela de Enfermería de Cruz Roja Española, Universidad Autónoma de, Madrid, Spain.
| | | | - Ma Nieves Moro Tejedor
- Nursing Research Support Unit, Hospital General Universitario Gregorio Marañon, Madrid, Spain; Red Cross University College of Nursing, Spanish Red Cross, Autonomous University of Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Spain.
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Cantero-García M, Llorente M, Gómez-Martínez S, González-Moreno J. Attitudes toward death and burnout syndrome in geriatrics and gerontology healthcare personnel. Rev Esp Geriatr Gerontol 2023; 58:101422. [PMID: 37897943 DOI: 10.1016/j.regg.2023.101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Geriatric and gerontology healthcare workers are associated with a series of psychosocial risks such as death, bereavement and illness, and this implies a significant emotional and work overload, which can lead to negative attitudes toward death. OBJECTIVE The aims of this study were to assess attitudes toward death, the level of burnout and the relationship between geriatrics and gerontology professionals. METHOD A correlational, cross-sectional study was conducted, in which the 42 participants in the sample completed an online questionnaire including the Revised Profile of Attitudes to Death (PAM-R) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). RESULTS The results obtained show that the predominant attitude toward death in the sample is that of neutral acceptance, and with regard to burnout syndrome, moderate average levels are found in the dimensions of emotional exhaustion and personal accomplishment, but a low level of depersonalisation. CONCLUSION Healthcare workers with attitudes of greater fear of death or acceptance of escape tend to experience higher levels of emotional exhaustion and depersonalisation, as do those with an attitude of death avoidance, who also have lower personal fulfillment.
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Affiliation(s)
- María Cantero-García
- Universidad a Distancia de Madrid (UDIMA), Madrid, Spain; Universidad Internacional de Valencia, Área de salud, Spain.
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111
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Mata Ferro M, Falcó Pegueroles A, Fernández Lorenzo R, Saz Roy MÁ, Rodríguez Forner O, Estrada Jurado CM, Bonet Julià N, Geli Benito C, Hernández Hernández R, Bosch Alcaraz A. The effect of a live music therapy intervention on critically ill paediatric patients in the intensive care unit: A quasi-experimental pretest-posttest study. Aust Crit Care 2023; 36:967-973. [PMID: 36868934 DOI: 10.1016/j.aucc.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/29/2022] [Accepted: 01/07/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Music therapy as a nonpharmacological means of managing patient pain, anxiety, and discomfort is a recognised technique, although it is not widely used in the paediatric intensive care unit (PICU). AIM The aim of this study was to assess the clinical effect of a live music therapy intervention on vital signs and levels of discomfort and pain for paediatric patients in the PICU. METHODS This was a quasi-experimental pretest-posttest study. The music therapy intervention was carried out by two music therapists who were specifically trained, each possessing a master's degree in the field of hospital music therapy. Ten minutes before the start of the music therapy session, the investigators recorded the vital signs of the patients and assessed their levels of discomfort and pain. The procedure was repeated at the start of the intervention; at 2, 5, and 10 min during the intervention; and at 10 min following the conclusion of the intervention. RESULTS Two hundred fifty-nine patients were included; 55.2% were male, with a median age of 1 year (0-21). A total of 96 (37.1%) patients suffered a chronic illness. The main reason for PICU admission was respiratory illness, at 50.2% (n = 130). Significantly lower values were observed for heart rate (p = 0.002), breathing rate (p < 0.001), and degree of discomfort (p < 0.001) during the music therapy session. CONCLUSIONS Live music therapy results in reduced heart rates, breathing rates, and paediatric patient discomfort levels. Although music therapy is not widely used in the PICU, our results suggest that using interventions such as that used in this study could help reduce patient discomfort.
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Affiliation(s)
- María Mata Ferro
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| | - Anna Falcó Pegueroles
- Department of Fundamental Care and Medical-Surgical Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
| | | | - M Ángeles Saz Roy
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
| | | | | | | | | | | | - Alejandro Bosch Alcaraz
- Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain; Department of Public Health, Mental Health and Maternal and Child Health Nursing, School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain.
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Kitamura JC, Nicolosi JT, Paggiaro AO, Fernandes de Carvalho V. Educational interventions on preventing pressure injuries targeted at nurses: systematic review and meta-analysis. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S40-S50. [PMID: 37949494 DOI: 10.12968/bjon.2023.32.sup20.s40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND Although preventable, pressure injuries are commonly observed in the hospital setting and are estimated to be the third most costly condition, after cancer and cardiovascular disease. AIM Nurses play a crucial role in the prevention and management of pressure injuries, however, published evidence on the effectiveness of educational interventions, directed specifically at nurses in the hospital environment, is scarce. METHOD The authors retrieved published studies on the subject from selected databases (Pubmed/Medline, Embase, Web of Science and the Cochrane Library) in a number of languages (Portuguese, English, French and Spanish). The search yielded randomised controlled trials, as well as quasi-experimental and comparative studies. FINDINGS In total, 11 studies were selected. The outcomes analysed, following some type of educational intervention, included the attitudes and knowledge of the nursing professionals, as well as the incidence of pressure injuries. CONCLUSION The present study demonstrated that different educational strategies can help prevent pressure injuries in the hospital environment.
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Affiliation(s)
| | | | - André Oliveira Paggiaro
- Professor, Nursing Postgraduate Programme, Guarulhos University, and Plastic Surgeon, Plastic Surgery Division, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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Kokkonen Nassef S, Blennow Bohlin M, Jirwe M. Experiences of parents whose school-aged children were treated with therapeutic hypothermia as newborns: A focus group study. Nurs Open 2023; 10:7411-7421. [PMID: 37752681 PMCID: PMC10563413 DOI: 10.1002/nop2.1994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/26/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
AIM To describe parents' past and present experiences of their newborn infant's therapeutic hypothermia (TH) treatment after perinatal asphyxia 10-13 years after the event. BACKGROUND Newborn infants are treated with TH following perinatal asphyxia to improve neurodevelopmental outcomes. DESIGN A qualitative descriptive design using focus groups (FGs). METHODS Twenty one parents to 15 newborn infants treated with TH between 2007 and 2009 participated in five FGs. The FGs were transcribed verbatim and analysed using framework approach. The SRQR checklist was followed for study reporting. RESULTS Two main categories were identified: hardships and reliefs during TH treatment and struggles of everyday life. Both categories include three subcategories, the first: (1) concern and gratitude for the unrecognized treatment, (2) insufficiency of information and proposed participation and (3) NICU nurses instilled security and hope. The second with subcategories: (1) unprocessed experiences of the TH treatment, (2) later challenges at school and (3) existential and psychological challenges in everyday life. CONCLUSION TH of their newborns affected the parents psychologically not only during the treatment, but lasted months and years later. Information and communication with health care professionals and school management were inefficient and inadequate. The parents' concerns could be prevented by an improved identification and understanding of the problems and the needs of the infants and their families before discharge. RELEVANCE FOR CLINICAL PRACTICE Through more personalized and efficient preparation and communication by the nursing staff before discharge, many of the parents' worries and problems could be reduced. Check-up of parents' needs of psychosocial support before and after discharge and offering counselling should become routine. Also, nurses at Well-Baby Clinics and in school health care should receive knowledge about TH treatment and the challenges the children and the parents experience. PATIENT OR PUBLIC CONTRIBUTION Participation of parents was limited to the data provided through interviews.
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Affiliation(s)
- Sari Kokkonen Nassef
- Department of Clinical Science, Intervention and Technology, Division of PaediatricsKarolinska InstitutetStockholmSweden
| | - Mats Blennow Bohlin
- Department of Clinical Science, Intervention and Technology, Division of PaediatricsKarolinska InstitutetStockholmSweden
- Department of NeonatologyKarolinska University HospitalStockholmSweden
| | - Maria Jirwe
- Department of Health SciencesThe Swedish Red Cross UniversityStockholmSweden
- Department of Neurobiology, Care Sciences and Society, Division of NursingKarolinska InstitutetStockholmSweden
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Pérez Lucendo A, Piñeiro Otero P, Matía Almudévar P, Alcántara Carmona S, López López E, Ramasco Rueda F. Individualised analgesia, sedation, delirium and comfort management strategies in the ICU: a narrative review. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2023; 70:509-535. [PMID: 37742996 DOI: 10.1016/j.redare.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/20/2023] [Indexed: 09/26/2023]
Abstract
This group is a product of the collaboration agreement signed by SOMIAMA (Sociedad de Medicina Intensiva de Madrid) and SAR MADRID (Sociedad de Anestesiología, Reanimación y Terapéutica del Dolor de Madrid) under which the organisations agreed to create joint working groups to improve critical patient care. Pain, discomfort, agitation, and delirium cause suffering, delay discharge, and can lead to serious complications in patients admitted to medical and surgical critical care units and post-anaesthesia care units. The main objectives in this type of unit include: Ensuring the comfort of patients suffering or recovering from a critical illness.Avoiding complications associated with the measures, particularly pharmacological, taken to ensure that comfort.
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Affiliation(s)
- A Pérez Lucendo
- Servicio de Medicina Intensiva, Hospital Universitario de La Princesa, Madrid, Spain.
| | - P Piñeiro Otero
- Servicio de Anestesiología y Reanimación, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - P Matía Almudévar
- Servicio de Medicina Intensiva, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - S Alcántara Carmona
- Servicio de Medicina Intensiva, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - E López López
- Servicio de Anestesiología y Reanimación, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Ramasco Rueda
- Servicio de Anestesiología y Reanimación, Hospital Universitario de La Princesa, Madrid, Spain
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Mateos-Dávila A, Betbesé Roig AJ, Santos Rodríguez JA, Guix-Comellas EM. Comparison of diluted vs concentrated regional citrate anticoagulation in continuous renal replacement therapy: A quasi-experimental study. Nurs Crit Care 2023. [PMID: 37897131 DOI: 10.1111/nicc.12991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The incidence of coagulation of continuous renal replacement therapy circuits remains high. To the best of our knowledge, no scholar has published a protocol to avoid management errors when different types of citrates coexist in the same Intensive Care Unit. AIM To assess the safety and efficacy of the unification of two protocols with different concentrations of citrate solution. STUDY DESING A prospective, quasi-experimental study was carried out in the intensive care unit of a tertiary referral hospital (in Barcelona, Spain), over 3 years. Consecutive adult patients requiring continuous renal replacement therapy with citrate were included. The sample was divided into two groups, a control group (concentrated citrate) and an intervention group (diluted citrate). The decision to initiate anticoagulation with diluted (18 mmol/L) or concentrated (136 mmol/L) citrate was made based on the machine available and the decision of the doctor responsible for the patient. It was not possible to randomize the sample. Both protocols were matched with a starting citrate dose of 3.5 mmol/L, and a dialysis solution was used. Post-filter replacement was not used, and the citrate solution was the only fluid administered pre-filter. RESULTS The analysis included 59 circuits in the concentrated citrate group and 40 circuits in the diluted citrate group. An increased need for electrolyte replacement was observed in the diluted group (p < .001). The concentrated citrate group had a longer filter life (p < .05), and there was a slight trend toward alkalosis. CONCLUSION The diluted citrate group had a higher incidence of electrolyte replacement. The concentrated citrate group had longer circuit lifespan and a trend toward metabolic alkalosis, although this was not statistically significant. If these conclusions are considered, the protocol can be unified. RELEVANCE TO CLINICAL PRACTICE The present work aims to provide information on the differences in the use of regional anticoagulation with diluted or concentrated citrate. The objective is to pay special attention to aspects that can lead to complications. The unified protocol proposed in this paper could be extrapolated to any machine on the market that uses either of these two types of citrate concentration.
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Affiliation(s)
- Almudena Mateos-Dávila
- Department of Fundamental and Medico-Surgical Nursing, Nursing School, Faculty of Medicine and Health Sciences, Campus Clínic, Universitat de Barcelona, Barcelona, Spain
- Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Eva Maria Guix-Comellas
- Department of Fundamental and Medico-Surgical Nursing, Nursing School, Faculty of Medicine and Health Sciences, Campus Clínic, Universitat de Barcelona, Barcelona, Spain
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Sandell M, Ericsson A, Al-Saadi J, Södervall B, Södergren E, Grass S, Sanchez J, Holmin S. A novel noble metal stent coating reduces in vitro platelet activation and acute in vivo thrombosis formation: a blinded study. Sci Rep 2023; 13:17225. [PMID: 37821529 PMCID: PMC10567768 DOI: 10.1038/s41598-023-44364-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/06/2023] [Indexed: 10/13/2023] Open
Abstract
Inherent to any stenting procedure is the prescription of dual antiplatelet therapy (DAPT) to reduce the platelet response. Clinical guidelines recommend 6-12 months of DAPT, depending on stent type, clinical picture and patient factors. Our hypothesis is that a nanostructured noble metal coating has the potential to reduce protein deposition and platelet activation. These effects would reduce subsequent thrombo-inflammatory reactions, potentially mitigating the need for an extensive DAPT in the acute phase. Here, a noble metal nanostructure coating on stents is investigated. Twelve pigs underwent endovascular implantation of coated and non-coated stents for paired comparisons in a blinded study design. The non-coated control stent was placed at the contralateral corresponding artery. Volumetric analysis of angiographic data, performed by a treatment blinded assessor, demonstrated a significant thrombus reduction for one of the coatings compared to control. This effect was already seen one hour after implantation. This finding was supported by in vitro data showing a significant reduction of coagulation activation in the coated group. This novel coating shows promise as an implant material addition and could potentially decrease the need for DAPT in the early phases of stent implementation.
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Affiliation(s)
- Mikael Sandell
- Division of Micro and Nanosystems, KTH Royal Institute of Technology, Malvinas väg 10, 114 28, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
- MedTechLabs, Stockholm, Sweden
| | - Anna Ericsson
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
| | - Jonathan Al-Saadi
- Department of Clinical Neuroscience, Karolinska Institute, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Billy Södervall
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
| | - Erika Södergren
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
| | - Stefan Grass
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
| | - Javier Sanchez
- Bactiguard AB, Alfred Nobels allé 150, 146 48, Tullinge, Sweden
- Department of Clinical Sciences, Danderyd Hospital, 182 88, Stockholm, Sweden
| | - Staffan Holmin
- Department of Clinical Neuroscience, Karolinska Institute, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
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Salas-Bergües V, Lizarazu-Armendáriz E, Eraso-Pérez de Urabayen M, Mateo-Manrique P, Mendívil-Pérez M, Goñi-Viguria R. Levels of burnout and exposure to ethical conflict and assessment of the practice environment in nursing professionals of intensive care. ENFERMERIA INTENSIVA 2023; 34:195-204. [PMID: 37455225 DOI: 10.1016/j.enfie.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/11/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Nursing professionals working in Intensive Care Units (ICU) are at high risk of developing negative emotional responses as well as emotional and spiritual problems related to ethical issues. The design of effective strategies that improve these aspects is determined by knowing the levels of burnout and ethical conflict of these professionals, as well as the influence that the practice environment might have on them. OBJECTIVES To analyze the relationship between levels of burnout, the exposure to ethical conflicts and the perception of the practice environment among themselves and with sociodemographic variables of the different intensive care nursing professionals. METHODS Descriptive, correlational, cross-sectional, observational study in an ICU of a tertiary level university hospital. The level of burnout was evaluated with the Maslach Burnout Inventory Human Services Survey scale; the level of ethical conflict with the Ethical Conflict Questionnaire for Nurses and the perception of the environment with the Practice Environment Scale of the Nursing Work Index. Descriptive and inferential statistics were performed. The association between categorical variables was analyzed using Fisher's exact chi-square test (χ2) RESULTS: 31 nurses and 8 nursing assistants were evaluated, which meant a participation rate of 82,93%. 31,10% of the nursing professionals presented signs of burnout, 14,89% considered that they work in an unfavorable environment and 87,23% presented a medium-high index of exposure to ethical conflict. The educational level (χ2=11.084, p=0.011) and the professional category (χ2=5.007, p=0.025) influenced the level of burnout: nursing assistants presented higher levels of this. When comparing the level of burnout with the environment and the index of ethical conflict, there were no statistically significant differences. CONCLUSIONS The absence of association found in the study between Burnout and ethical conflict with the perception of the practice environment suggests that personal factors may influence its development.
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Affiliation(s)
- V Salas-Bergües
- Enfermería, Área de Investigación, Clínica Universidad de Navarra, Pamplona, Spain
| | - E Lizarazu-Armendáriz
- Enfermería, Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, Spain
| | | | - P Mateo-Manrique
- Enfermería, Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, Spain.
| | - M Mendívil-Pérez
- Enfermería, Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, Spain
| | - R Goñi-Viguria
- Enfermería, Práctica Avanzada del Área de Críticos, Clínica Universidad de Navarra, Spain
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Azharuddin S, Vital-Daley K, Mustovic V, Marshall T, Calvin B, DuMont T, Swanson G, Barker B. Mental Health in Women. Crit Care Nurs Q 2023; 46:336-353. [PMID: 37684730 DOI: 10.1097/cnq.0000000000000471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Mental health illness has been increasing worldwide. The prevalence of mental illness and is higher among females than among males. It is estimated that one in 5 women experience a common mental health disorder. This article highlights gender disparities in the risk, prevalence, and presentation of different mental health disorders. Nearly all survivors of critical illness experience 1 or more domains of the post-intensive care syndrome. We review different mental health disorders including anxiety disorders, mood disorders, psychotic disorders, and post-intensive care syndrome, and medications used to manage these disorders. Delirium in the intensive care unit can be misdiagnosed as a primary psychiatric disorder and is important to distinguish from each other. We also highlight the inadequacy of surveillance and recognition of mental health disorders in the intensive care unit, leading to missed opportunities to properly manage these important psychiatric conditions.
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Affiliation(s)
- Syed Azharuddin
- Psychiatry and Behavioral Health Institute (Drs Vital-Daley, Mustovic, and Swanson), Division of Pulmonary and Critical Care Medicine (Drs Azharuddin, Marshall, DuMont, and Barker), and Division of Nursing, Allegheny General Hospital (Mr Calvin), Allegheny Health Network, Pittsburgh, Pennsylvania
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119
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Herrera CN, Guirardello EDB. Patient Safety Climate, Quality of Care, and Intention of Nursing Professionals to Remain in Their Job During the COVID-19 Pandemic. J Patient Saf 2023; 19:403-407. [PMID: 37186670 DOI: 10.1097/pts.0000000000001133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE This study aimed to examine the relationship between patient safety climate, quality of care, and intention of nursing professionals to remain in their job. METHODS A cross-sectional study was carried out in a teaching hospital in Brazil wherein nursing professionals were surveyed. The Brazilian version of the Patient Safety Climate in Healthcare Organizations tool was applied to measure the patient safety climate. Spearman correlation coefficient and multiple linear regression models were applied for the analysis. RESULTS A high percentage of problematic response was observed for most dimensions, except for fear of shame. Quality of care resulted in a strong correlation with organizational resources for safety and with overall emphasis on patient safety, and the nurse-perceived staffing adequacy was strongly correlated with organizational resources for safety. The multiple linear regression model showed higher scores in quality of care in dimensions related to organizational, work unit, and interpersonal aspects as well as in the adequacy of the number of professionals. A higher score in intention to stay in one's job was also found in the dimensions of fear of blame and punishment, provision of safe care, and adequacy of the number of professionals. CONCLUSIONS The organizational and work unit aspects can lead to a better perception of the quality of care. Improving interpersonal relationships and increasing the number of professionals on staff were found to increase nurses' intention to remain in their jobs. Assessing a hospital's patient safety climate will enable improvement in the provision of safe and harm-free health care assistance.
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120
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Li J, Ibarra-Estrada M, Guérin C. Prone Positioning for Patients With COVID-19-Induced Acute Hypoxemic Respiratory Failure: Flipping the Script. Respir Care 2023; 68:1449-1464. [PMID: 37722733 PMCID: PMC10506644 DOI: 10.4187/respcare.11227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
During the COVID-19 pandemic, prone positioning (PP) emerged as a widely used supportive therapy for patients with acute hypoxemic respiratory failure caused by COVID-19 infection. In particular, awake PP (APP)-the placement of non-intubated patients in the prone position-has gained popularity and hence is detailed first herein. This review discusses recent publications on the use of PP for non-intubated and intubated subjects with COVID-19, highlighting the physiological responses, clinical outcomes, influential factors affecting treatment success, and strategies to improve adherence with APP. The use of prolonged PP and the use of PP for patients undergoing extracorporeal membrane oxygenation are also presented.
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Affiliation(s)
- Jie Li
- Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University, Chicago, Illinois.
| | - Miguel Ibarra-Estrada
- Unidad de Terapia Intensiva, Hospital Civil Fray Antonio Alcalde Guadalajara, Universidad de Guadalajara, Jalisco, México; Grupo Internacional de Ventilación Mecánica WeVent; and Latin American Intensive Care Network (LIVEN)
| | - Claude Guérin
- Médecine Intensive Réanimation, Hôpital Édouard Herriot, Lyon, France; Université de Lyon, Lyon, France; and Institut Mondor de Recherches Biomédicales, INSERM 955 CNRS 7000, Créteil, France
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121
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Paúles-Cuesta IM, Montoro-Huguet M, Fueyo-Díaz R. [Burnout syndrome in health professionals at a university hospital in Spain]. Semergen 2023; 49:102023. [PMID: 37348253 DOI: 10.1016/j.semerg.2023.102023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/23/2023] [Accepted: 05/17/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To evaluate the risk of Burnout in the health professionals of the Huesca University Hospital, 50 years after its inauguration, to investigate the variables related to the work motivation of the hospital health personnel and to assess the predisposing and protective factors of the risk of Burnout. MATERIAL AND METHODS An observational, analytical, prospective and unicentric study was conducted from September 2017 to April 2019, evaluating all the health professionals who worked at the Hospital San Jorge de Huesca (n=209). RESULTS The mean age was 42.86 years. 72.2% were women. 12.4% had moderate risk of burnout. There was 12.4% of high emotional exhaustion, 36.8% of high depersonalization and 44.5% of low personal accomplishment. Burnout was statistically significant associated with the professional category (P=.010), work experience (P=.026), hours of work per week (P=.036), choice of the same profession (P=.001) and recommendation to the offspring (P<.001). CONCLUSIONS One tenth of the sample had a moderate risk of burnout. Almost half of the health workers confirmed a high degree of satisfaction with the work environment and the majority expressed an adequate use of well-being strategies and a high degree of autonomy, recognition and satisfaction at work.
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Affiliation(s)
- I M Paúles-Cuesta
- Medicina Familiar y Comunitaria, Centro de Salud Amando Loriga, Caspe, Zaragoza, España.
| | - M Montoro-Huguet
- Unidad de Gastroenterología y Hepatología, Hospital San Jorge, Huesca, España
| | - R Fueyo-Díaz
- Departamento de Psicología y Sociología, Facultad de Ciencias Humanas y de la Educación, Universidad de Zaragoza, Zaragoza, España
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Esteban-Sepúlveda S, Giró-Formatger D, Hernández-García AF, Serratosa-Cruzado S, Moreno-Leyva M, Terradas-Robledo R, Lacueva-Pérez L. Info-NAS: A Computer Program for the Calculation of Intensive Care Unit Nurse Workload. Comput Inform Nurs 2023; 41:825-832. [PMID: 36912356 DOI: 10.1097/cin.0000000000001012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
The purpose of this study was to design an algorithm that allows automatic calculation of nursing workload in intensive care units, based on the Nursing Activities Score scale, through a computer program. Three methodological steps were used: (1) Delphi method (group of experts); (2) identification of the correspondence: Nursing Activities Score items-variables in the EHR, namely, standardized terminology, laboratory values, and prescriptions; and (3) weighting of variables independently by a group of experts. Finally, the algorithm of the computer program was tested. The results showed an algorithm that calculates the nursing workload in an ICU. The calculation is objective and automatic through the EHRs. This study shows the feasibility of the algorithm as a rapid and objective strategy to quantify adequate nurse staffing in intensive care units. Moreover, it provides nurses with a practical resource for the correct completion of records and is thus an incentive to maintain or improve their quality.
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Affiliation(s)
- Silvia Esteban-Sepúlveda
- Author Affiliations: Methodology, Quality and Nursing Research Department, Consorci Parc de Salut MAR de Barcelona (Drs Esteban-Sepúlveda and Terradas-Robledo, Ms Giró-Formatger, Ms Hernández-García, Mr Serratosa-Cruzado, and Ms Lacueva-Pérez); and Departament d'Infermeria Fonamental i Medicoquirúrgica, Escola d'Infermeria, Universitat de Barcelona (Dr Esteban-Sepúlveda)
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Danielis M, Mattiussi E, Piani T, Iacobucci A, Tullio A, Molfino A, Vetrugno L, Deana C. Diarrhoea and constipation during artificial nutrition in intensive care unit: A prospective observational study. Clin Nutr ESPEN 2023; 57:375-380. [PMID: 37739681 DOI: 10.1016/j.clnesp.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 09/24/2023]
Abstract
PURPOSE To describe the occurrence of gastrointestinal (GI) complications, specifically diarrhoea and constipation, in artificially (enterally or parenterally) fed critically ill patients within their first seven-day stay in Intensive Care Unit (ICU). METHODS Observational prospective study conducted from September 1st to October 30th, 2019 and from August 1st to October 30th, 2021, in an ICU of a 1000-bed third-level hospital. General characteristics, nutritional variables, and medications administered were recorded and analysed. This study was registered on ClinicalTrials.gov (Identifier: NCT05473546). RESULTS In total, 100 critically ill patients were included. Diarrhoea was present in 44 patients (44.0%), while constipation occurred in 22 (22.0%) patients. Patients with diarrhoea were generally those admitted for respiratory failure, whereas patients without diarrhoea were mostly affected by neurological disorders (22.7% vs 25%, respectively; p = 0.002). Likewise, patients with constipation were primarily those admitted for trauma (36.4%). Trauma patients were almost 24 times more likely to be constipated than patients with respiratory failure (OR 23.99, CI 1.38-418.0) and patients receiving diuretics were over 16 times more likely to have diarrhoea than patients not receiving diuretics (OR 16.25, IC 1.89-139.86). CONCLUSION GI complications of enteral nutrition represent still a very common issue in ICU. The main predictor of constipation was an admission for trauma whereas the main predictor of diarrhoea was the use of diuretics. Clinicians should consider and integrate these findings into more personalized nutritional and management protocols to avoid gastrointestinal complications.
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Affiliation(s)
- Matteo Danielis
- Department of Anesthesia and Intensive Care, Health Integrated Agency Friuli Centrale, Academic Hospital of Udine, Piazzale Santa Maria della Misericordia 15, Udine, Italy; Laboratory of Studies and Evidence Based Nursing, Department of Medicine, University of Padua, Italy
| | - Elisa Mattiussi
- School of Nursing, Department of Medical Sciences, University of Udine, Viale Ungheria 20, 33100, Udine, Italy
| | - Tommaso Piani
- Department of Anesthesia and Intensive Care, Health Integrated Agency Friuli Centrale, Academic Hospital of Udine, Piazzale Santa Maria della Misericordia 15, Udine, Italy
| | - Anna Iacobucci
- Department of Anesthesia and Intensive Care, Health Integrated Agency Friuli Centrale, Academic Hospital of Udine, Piazzale Santa Maria della Misericordia 15, Udine, Italy
| | - Annarita Tullio
- Hygiene and Clinical Epidemiology Unit, Health Integrated Agency Friuli Centrale, Piazzale Santa Maria della Misericordia 15, Udine, Italy
| | - Alessio Molfino
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Luigi Vetrugno
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; Department of Anesthesiology, Critical Care Medicine and Emergency, SS. Annunziata Hospital, 66100 Chieti, Italy
| | - Cristian Deana
- Department of Anesthesia and Intensive Care, Health Integrated Agency Friuli Centrale, Academic Hospital of Udine, Piazzale Santa Maria della Misericordia 15, Udine, Italy.
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Yüceler Kaçmaz H, Kaplan Ö, Kaplan A, Şahin MG, Cetinkaya A, Avci A. Incontinence-Associated Dermatitis: Prevalence in Intensive Care Units and Knowledge, Attitudes, and Practices of Nurses. J Nurs Care Qual 2023; 38:354-360. [PMID: 36947830 DOI: 10.1097/ncq.0000000000000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Incontinence-associated dermatitis (IAD) is a major concern among hospitals, especially in intensive care units (ICUs). PURPOSE To describe ICU nurses' knowledge, attitudes, and practices of IAD and to examine the relationships with IAD prevalence in the ICU setting. METHODS A descriptive correlational design was used including the Knowledge, Attitudes and Practices of Incontinence-Associated Dermatitis Questionnaire and 1-month IAD prevalence data. RESULTS The prevalence of IAD in ICUs was 6.89%. A positive correlation was found between IAD prevalence and nurses' IAD knowledge and attitudes. Nurses working in the ICU for more than 7 years, caring for patients at high risk for or having IAD, and thinking IAD-related nursing practices were sufficient had significantly higher IAD knowledge, attitudes, and practices. CONCLUSIONS Findings indicate that ICU nurses learned about IAD through clinical experience and have inadequate training on IAD. A standardized evidence-based care protocol for IAD should be developed.
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Affiliation(s)
- Hatice Yüceler Kaçmaz
- Department of Nursing, Health Science Faculty, Erciyes University, Kayseri, Turkey (Drs Yüceler Kaçmaz and Özlem Kaplan); First and Emergency Aid Program, İncesu Ayşe and Saffet Arslan Health Services Vocational School, University of Kayseri, Kayseri, Turkey (Dr Ali Kaplan); Department of Women's Health Nursing, Erciyes University, Kayseri, Turkey (Ms Şahin); Ministry of Health, Kayseri City Hospital, Kayseri, Turkey (Ms Şahin); and Departments of Internal Medicine (Mr Cetinkaya) and Dermatology (Mr Avci), Health Science University Kayseri City Hospital, Kayseri, Turkey
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Pérez-Juan E, Maqueda-Palau M, Feliu-Roig C, Gómez-Arroyo JM, Sáez-Romero D, Ortiz-Monjo A. Incidence of pressure ulcers due to prone position in patients admitted to the ICU for Covid-19. ENFERMERIA INTENSIVA 2023; 34:176-185. [PMID: 37248133 PMCID: PMC10201329 DOI: 10.1016/j.enfie.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/20/2022] [Indexed: 05/31/2023]
Abstract
The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces. OBJECTIVES To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals. METHODS Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0. RESULTS A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48 h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (P = .002), location (P = .000) and median duration of hours per PD episode (P = .001). CONCLUSIONS The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.
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Affiliation(s)
- E Pérez-Juan
- Unidad de Cuidados Intensivos, Hospital Comarcal de Manacor, Manacor, Spain; Institut d'investigació sanitària Illes Balears (idISBa), Cures cronicitat i evidències en salut (cuREs), Palma, Spain.
| | - M Maqueda-Palau
- Institut d'investigació sanitària Illes Balears (idISBa), Cures cronicitat i evidències en salut (cuREs), Palma, Spain; Unidad de Cuidados Intensivos, Hospital Universitari Son Espases, Palma, Spain
| | | | | | - D Sáez-Romero
- Unidad de Cuidados Intensivos, Hospital Son Llàtzer, Palma, Spain
| | - A Ortiz-Monjo
- Unidad de Cuidados Intensivos, Hospital Son Llàtzer, Palma, Spain
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126
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García-Díez R, Vázquez-Calatayud M. In response to «Oral care with chlorhexidine: One size does not fit all». ENFERMERIA INTENSIVA 2023; 34:228-229. [PMID: 37743168 DOI: 10.1016/j.enfie.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 09/26/2023]
Affiliation(s)
- R García-Díez
- Seguridad de Pacientes, Osi Bilbao Basurto, Consejo Asesor Proyectos Zero, Representante de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC)
| | - M Vázquez-Calatayud
- Área de Desarrollo Profesional e Investigación en Enfermería, Clínica Universidad de Navarra, Universidad de Navarra, Grupo de investigación ICCP-UNAV, Innovación para un Cuidado Centrado en la Persona, IdisNA, Instituto de Investigación Sanitaria de Navarra, Consejo Asesor Proyectos Zero, Representante de la Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC).
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Santana-Padilla YG, Santana-Cabrera L. Dysphagia, the great unknown for critical care nurses. ENFERMERIA INTENSIVA 2023; 34:173-175. [PMID: 38040484 DOI: 10.1016/j.enfie.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Affiliation(s)
- Y G Santana-Padilla
- Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Canary Islands. Spain.
| | - L Santana-Cabrera
- Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Canary Islands. Spain
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Llaurado-Serra M, Afonso E, Mellinghoff J, Conoscenti E, Deschepper M. Oral care with chlorhexidine: One size does not fit all. ENFERMERIA INTENSIVA 2023; 34:227-228. [PMID: 38040485 DOI: 10.1016/j.enfie.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 12/03/2023]
Affiliation(s)
- M Llaurado-Serra
- Nursing Department, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - E Afonso
- Anglia Ruskin University, United Kingdom; Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - J Mellinghoff
- University of Brighton, United Kingdom; Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - E Conoscenti
- Infection Control Nurse IRCCS-ISMETT UPMC Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Sicily, Palermo, Italy; Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - M Deschepper
- Data Science Institute, Ghent University Hospital, Ghent, Belgium
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Laguna A, Pusil S, Acero-Pousa I, Zegarra-Valdivia JA, Paltrinieri AL, Bazán À, Piras P, Palomares i Perera C, Garcia-Algar O, Orlandi S. How can cry acoustics associate newborns' distress levels with neurophysiological and behavioral signals? Front Neurosci 2023; 17:1266873. [PMID: 37799341 PMCID: PMC10547902 DOI: 10.3389/fnins.2023.1266873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/07/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction Even though infant crying is a common phenomenon in humans' early life, it is still a challenge for researchers to properly understand it as a reflection of complex neurophysiological functions. Our study aims to determine the association between neonatal cry acoustics with neurophysiological signals and behavioral features according to different cry distress levels of newborns. Methods Multimodal data from 25 healthy term newborns were collected simultaneously recording infant cry vocalizations, electroencephalography (EEG), near-infrared spectroscopy (NIRS) and videos of facial expressions and body movements. Statistical analysis was conducted on this dataset to identify correlations among variables during three different infant conditions (i.e., resting, cry, and distress). A Deep Learning (DL) algorithm was used to objectively and automatically evaluate the level of cry distress in infants. Results We found correlations between most of the features extracted from the signals depending on the infant's arousal state, among them: fundamental frequency (F0), brain activity (delta, theta, and alpha frequency bands), cerebral and body oxygenation, heart rate, facial tension, and body rigidity. Additionally, these associations reinforce that what is occurring at an acoustic level can be characterized by behavioral and neurophysiological patterns. Finally, the DL audio model developed was able to classify the different levels of distress achieving 93% accuracy. Conclusion Our findings strengthen the potential of crying as a biomarker evidencing the physical, emotional and health status of the infant becoming a crucial tool for caregivers and clinicians.
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Affiliation(s)
| | | | | | - Jonathan Adrián Zegarra-Valdivia
- Facultad de Medicina, Universidad Señor de Sipán, Chiclayo, Peru
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Achucarro Basque Center for Neuroscience, Leioa, Spain
| | - Anna Lucia Paltrinieri
- Neonatology Department, Barcelona Center for Maternal-Fetal and Neonatal Medicine (BCNatal), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Clàudia Palomares i Perera
- Neonatology Department, Barcelona Center for Maternal-Fetal and Neonatal Medicine (BCNatal), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Oscar Garcia-Algar
- Neonatology Department, Barcelona Center for Maternal-Fetal and Neonatal Medicine (BCNatal), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- Department de Cirurgia I Especialitats Mèdico-Quirúrgiques, Universitat de Barcelona, Barcelona, Spain
| | - Silvia Orlandi
- Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi” (DEI), University of Bologna, Bologna, Italy
- Health Sciences and Technologies Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy
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130
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López J, Sánchez C, Fernández SN, González R, Solana MJ, Urbano J, López-Herce J. Development and validation of a clinical score for early diagnosis of constipation in critically ill children. Sci Rep 2023; 13:14822. [PMID: 37684310 PMCID: PMC10491593 DOI: 10.1038/s41598-023-41674-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
Constipation affects almost 50% of critically ill pediatric patients and is related to their morbidity and mortality. However, little attention is paid to it and it is diagnosed late and when there are already complications. The objective of this study is to develop and validate a score to identify critically ill children with high risk of constipation 48 h after admission. A single center two phase-study was carried out; the first one (retrospective observational study) to develop the score and the second one to validate it in another prospective observational study. Children between 15 days of life and 18 years old admitted to the PICU for more than 3 days were included. Demographic and clinical data during the first 48 h after PICU admission were collected. Univariate and multivariate analysis and ROC curves were used to develop and validate the score. Data from 145 patients (62.8% boys) with a mean age of 34.9 ± 7.3 months were used to develop the score. Independent factors identified to develop the score were: weight > 7 kg, admission to PICU after surgery, need of vasoconstrictors, doses of fentanyl ≥ 2 mcg/kg/h, and initiation of enteral nutrition later than 48 h after admission. Two cut-off values were identified to set low constipation risk (< 5.7 points) and high constipation risk (> 6.2 points). This score was validated in 124 patients showing a sensibility of 63.2%, specificity of 95.5% and a positive/negative predictive values (P/NPV) of 100% and 82.1% respectively to identify constipated patients. This is the first score to identify high constipation risk in critically ill children. This score is easy to apply, and internal validation has shown a PPV of 100%.
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Affiliation(s)
- J López
- Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network (RICORS) RD21/0012/0011 of Instituto de Salud Carlos III, Complutense University of Madrid, Spain. C/ Dr Castelo 47, 28009, Madrid, Spain.
| | - C Sánchez
- Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network (RICORS) RD21/0012/0011 of Instituto de Salud Carlos III, Complutense University of Madrid, Spain. C/ Dr Castelo 47, 28009, Madrid, Spain
- Pediatric Gastroenterology Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network (RICORS) RD21/0012/0011 of Instituto de Salud Carlos III, Complutense University of Madrid, Madrid, Spain
| | - S N Fernández
- Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network (RICORS) RD21/0012/0011 of Instituto de Salud Carlos III, Complutense University of Madrid, Spain. C/ Dr Castelo 47, 28009, Madrid, Spain
| | - R González
- Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network (RICORS) RD21/0012/0011 of Instituto de Salud Carlos III, Complutense University of Madrid, Spain. C/ Dr Castelo 47, 28009, Madrid, Spain
| | - M J Solana
- Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network (RICORS) RD21/0012/0011 of Instituto de Salud Carlos III, Complutense University of Madrid, Spain. C/ Dr Castelo 47, 28009, Madrid, Spain
| | - J Urbano
- Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network (RICORS) RD21/0012/0011 of Instituto de Salud Carlos III, Complutense University of Madrid, Spain. C/ Dr Castelo 47, 28009, Madrid, Spain
| | - J López-Herce
- Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network (RICORS) RD21/0012/0011 of Instituto de Salud Carlos III, Complutense University of Madrid, Spain. C/ Dr Castelo 47, 28009, Madrid, Spain.
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Hao Y, Zhu W, Wu H, Guo Y, Mu W, Li D, Ren X, Fan L. Experience of cardiopulmonary resuscitation by healthcare professionals in emergency departments: A descriptive phenomenological study. Int Emerg Nurs 2023; 70:101336. [PMID: 37657134 DOI: 10.1016/j.ienj.2023.101336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 07/11/2023] [Accepted: 07/16/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Emergency department healthcare professionals have the most contact with patients in cardiac arrest, and their physical and mental state has a significant impact on the quality of cardiopulmonary resuscitation and patient outcomes. However, there is limited research discussing the experience of resuscitation by emergency department healthcare professionals. AIM To explore the experiences of emergency department healthcare professionals in performing cardiopulmonary resuscitation. METHODS A descriptive phenomenological study. The study used purposive sampling and selected 9 nurses and 6 physicians from the emergency departments of four general hospitals of different levels in western China between May 2022 and October 2022. Semi-structured interview guides and face-to-face interviews were used to collect information. Colaizzi analysis was used to analyze the data. RESULTS The study identified 3 themes and 11 sub-themes. These themes and sub-themes include 1) emotional experience (A sense of achievement, A sense of powerlessness and trauma, Stress, Empathy, Psychological resilience strengthens), 2) cognitive growth (Understanding CPR rationally, Increasing concern for personal and family health, Mastering self-relaxation methods), and 3) the desire for continued development (Seeking professional development, Hoping for professional psychological assistance, Strengthening team support). CONCLUSIONS The experience of performing cardiopulmonary resuscitation by healthcare professionals in emergency departments is dynamic, with changes in mood and cognitive growth. Managers in hospitals should pay attention to their experiences and need at different stages of career development and actively carry out targeted cognitive guidance, skills training, and psychological support to help them achieve professional development and physical and mental health. At the same time, to promote the development of CPR for all, it is recommended that the authorities actively improve the public infrastructure for first aid and related policy protection.
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Affiliation(s)
- Yaru Hao
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Wei Zhu
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Hui Wu
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Yue Guo
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Wenjing Mu
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Dan Li
- Cardiac Care Unit, The First Hospital of Lanzhou University, Lanzhou, China.
| | - Xuanlin Ren
- General Surgery II, The First Hospital of Lanzhou University, Lanzhou, China.
| | - Luo Fan
- School of Nursing, Lanzhou University, Lanzhou, China; Nursing Administration Department, The First Hospital of Lanzhou University, Lanzhou, China.
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Villarreal-Ondarza I, Rodríguez-Salinas CA, Gómez-Gutierrez R, Guerrero-Izaguirre I, Rizo-Topete LM. Use of hepatic support with MARS in a patient with SARS-CoV-2 Pneumonia, in treatment with ECMO and CRRT therapies: Case Report. THE JOURNAL OF EXTRA-CORPOREAL TECHNOLOGY 2023; 55:130-133. [PMID: 37682211 PMCID: PMC10487337 DOI: 10.1051/ject/2023025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 07/05/2023] [Indexed: 09/09/2023]
Abstract
Extracorporeal Membrane Oxygenation (ECMO) therapy had an important role in the treatment of severe COVID-19 pneumonia, where invasive mechanical ventilation was not enough to provide correct oxygenation to various organ systems. However, there are other extracorporeal technologies, such as the Molecular Absorbent Recirculation System (MARS) and Continuous Renal Replacement Therapy (CRRT), that provide temporal support for any critical patient. The following case describes a 60-year-old man with severe Acute Respiratory Distress Syndrome (ARDS), who needed ECMO therapy. During the critical days of hospitalization, CRRT was used, but a sudden hyperbilirubinemia ensued. Consequently, MARS therapy was initiated; followed by an improvement of bilirubin levels. Additional studies are needed to establish the possible benefits of the combination of MARS therapy and ECMO; however, we detected that concomitantly, there was a decrease in other laboratory parameters such as acute phase reactants. Even though, no change in clinical course was observed, as shown in some studies.
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Affiliation(s)
- Irma Villarreal-Ondarza
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Internal Medicine Resident, Department of Health Sciences, Christus Muguerza Health System, UDEM 64060 Monterrey Nuevo Leon Mexico
| | | | - Rene Gómez-Gutierrez
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Pediatrics, Director of the ECMO Unit, Christus Muguerza Health System, UDEM 64060 Monterrey Nuevo Leon Mexico
| | - Israel Guerrero-Izaguirre
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Critical Medicine, Internal Medicine, Internal Medicine Professor, Department of Health Sciences, Christus Muguerza Health System, UDEM 64060 Monterrey Nuevo Leon Mexico
| | - Lilia María Rizo-Topete
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Nephrology of the Critically Ill Patient, Internal Medicine, Internal Medicine Professor, Department of Health Sciences, Christus Muguerza Health System, UDEM 64060 Monterrey Nuevo Leon Mexico
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Associate Professor of Nephrology Service, Hospital Universitario “José Eleuterio González”, UANL 64460 Monterrey Nuevo Leon Mexico
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Kiwanuka F, Nanyonga RC, Sak-Dankosky N, Kvist T. Influence of perceived benefits, barriers and activities of family engagement in care on family nursing practice: A cross-sectional correlational study. J Adv Nurs 2023; 79:3487-3497. [PMID: 37066738 DOI: 10.1111/jan.15677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/08/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023]
Abstract
AIMS To describe nurses' perceptions of family nursing practice and to explore the influence of their perceptions of the benefits, barriers and activities of family engagement in care on family nursing practice. DESIGN A cross-sectional correlational study. METHODS In total, 460 nurses from two tertiary hospitals in the central region of Uganda participated. Quantitative and qualitative data were collected between August 2020 and January 2021 using the Family Nursing Practice Scale. Analyses included descriptive statistics, t-test, Pearson correlation, analysis of variance and ordinal logistics regression. Quantitative content analysis was carried out on the textual data. RESULTS Nurses who perceived that family engagement in care improves patient and family outcomes were more likely to rate family nursing practice highly. Perceived barriers to family engagement in care particularly time constraints, work overload and family-related conflicts have a negative and significant influence on family nursing practice. Nurse characteristics such as education, usual shift pattern and personal experience of having a family member in hospital are significantly associated with family nursing practice; nurses who work morning shifts were likely to report higher family nursing practice. CONCLUSION The study reveals that several parameters (perceived barriers, perceived benefits and nurse characteristics) influence nursing practice with families. Thus, bearing in mind the diversity of healthcare contexts, the findings show that multiple interacting factors are important for advancing family nursing interventions and practice. IMPACT Probabilistic factor-specific predictions of nursing practice with families are provided in this study - this addresses a gap in the evidence regarding the elements that should be optimized when designing well-informed policies and interventions to advance family nursing practice. A comparison of results in the literature with the present study's findings suggests a need to broaden the scope and context perspective in future research and broaden the understanding of how nurses´ perceptions influence family engagement in care. REPORTING METHOD The study adheres to the STROBE reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION Family members/caregivers were involved in the design of the study particularly in assessment of validation of the tools used in the study.
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Affiliation(s)
- Frank Kiwanuka
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | | | | | - Tarja Kvist
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Li J, Cai S, Mei J, Liu X, Wang X, Pan W, Zhang Y. The beliefs and attitudes of intensive care unit nurses and patient families regarding an open visitation policy in China. Nurs Crit Care 2023; 28:800-807. [PMID: 36585813 DOI: 10.1111/nicc.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/15/2022] [Accepted: 11/28/2022] [Indexed: 01/01/2023]
Abstract
AIMS To investigate the beliefs and attitudes of intensive care unit (ICU) nurses and patients' family members towards an open visitation policy in the ICU in China and to explore the reasons that promote or hinder open visitation to improve visitation policy. BACKGROUND Open visitation policies are widely recommended in many countries. However, there are gaps between evidence and practice. Most ICUs in China still use a restrictive policy for family visits, which raises controversy. There are limited visiting times, and family visitors are not allowed to enter the ICU. STUDY DESIGN A multicentre survey was conducted in seven hospitals in China. The Beliefs and Attitudes towards Visitation in the Intensive Care Unit Questionnaire (BAVIQ) was administered to ICU nurses and patient families from 11 the ICUs of seven hospitals. A total of 275 questionnaires were completed and returned by ICU nurses and 139 by patients' family members. RESULTS Among nurses, the belief scale score was 2.87 ± 0.33 (range 2-4), and the attitude scale score was 5.53 ± 1.12 (range 2.33-7). The belief scale was divided into three subscales: nurses, patients, and patients' families. The subscale score for patients' families was the highest, and the nurses' subscale score was the lowest. Most (84.0%) of the nurses were satisfied with the current ICU visitation policy. The belief and attitude scores were 3.13 ± 0.39 (range 1.96-4) and 6.18 ± 1.20 (range 1.67-7), respectively, for family members. The scores of the three subscales, that is, patients, patients' families and nurses, were 3.13 ± 0.40, 3.26 ± 0.43, and 3.04 ± 0.49, respectively. CONCLUSION Nurses' beliefs and attitudes towards implementing an open visitation policy in China are at a less positive level than those of patient family members. RELEVANCE TO CLINICAL PRACTICE The beliefs and attitudes of nurses towards open visitation policy in China need to be improved. The question of how to mobilize nurses' enthusiasm for an open visitation policy poses a challenge for ICU management.
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Affiliation(s)
- Jingjing Li
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| | - Shining Cai
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jinghua Mei
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Xiao Liu
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Xiaorong Wang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Wenyan Pan
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yuxia Zhang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- School of Nursing, Fudan University, Shanghai, People's Republic of China
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Delgado-Hito P, Alcalà-Jimenez I, Martinez-Momblan MA, de la Cueva-Ariza L, Adamuz-Tomás J, Cuzco C, Benito-Aracil L, Romero-García M. Satisfaction of intensive care unit patients linked to clinical and organisational factors: A cross-sectional multicentre study. Aust Crit Care 2023; 36:716-722. [PMID: 36456425 DOI: 10.1016/j.aucc.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/17/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The satisfaction of critical care patients with the nursing care they receive is a key indicator of the quality of hospital care. OBJECTIVES The objectives of this study were to analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and sociodemographic, clinical, and organisational variables. DESIGN This was a prospective, descriptive correlational study. SETTING AND METHODS The population consisted of all patients discharged from the intensive care units (ICUs) of 19 hospitals in Spain between December 2018 and December 2019. The level of satisfaction was measured using the validated Nursing Intensive Care Satisfaction Scale, and sociodemographic, clinical, and organisational data were collected. RESULTS Participants' mean age (n = 677) was 59.7 (standard deviation: 16.1), and 62.8% of them were men (n = 426). Satisfaction with the nursing care received was 5.66 (SD: 0.68) out of a possible 6. The score for overall satisfaction presented statistically significant relationships with the hours of mechanical ventilation (p = 0.034), with the participant's perception of own health status (p = 0.01), with the participant's perceived degree of own recovery (p = 0.01), with the hospital's complexity level (p = 0.002), with the type of hospital (p = 0.005), and with the type of ICU (p = 0.004). Finally, the logistic regression model shows that the Nursing Intensive Care Satisfaction Scale score was not linked to age or sex but did have a statistically significant relationship with the perceived degree of recovery (p < 0.001) and the type of ICU (p=<0.001). The variables that predicted satisfaction were age, degree of recovery, and the type of ICU. CONCLUSION Several studies show that patient satisfaction is related to the patient's perceived health status and perceived degree of recovery, a finding that is confirmed in our study. Our study moves beyond these outcomes to show that the hours of mechanical ventilation and the characteristics of the hospital also have a significant relationship with patients' satisfaction.
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Affiliation(s)
- Pilar Delgado-Hito
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain
| | | | - Maria Antonia Martinez-Momblan
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain
| | - Laura de la Cueva-Ariza
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain
| | - Jordi Adamuz-Tomás
- Nursing Knowledge Management and Information Systems Department, Bellvitge University Hospital (IDIBELL), L'Hospitalet de Llobregat, Catalunya, Spain; School of Nursing, Medicine and Health Science Faculty, University of Barcelona, Barcelona, Spain
| | - Cecilia Cuzco
- Department of Fundamental and Medical-Surgical Nursing, School of Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Llúcia Benito-Aracil
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain.
| | - Marta Romero-García
- School of Nursing, University of Barcelona (Barcelona), Spain; Fundamental Care and Medical-Surgical Nursing Department, Spain; IDIBELL, Institute of Biomedical Research, Spain; International Research Project for the Humanization of Health Care, Proyecto HU-CI, Spain
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136
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Guo FX, Wu CY. Study on the prevention and nursing intervention of infection after flap transfer for hand trauma. Medicine (Baltimore) 2023; 102:e34756. [PMID: 37653820 PMCID: PMC10470726 DOI: 10.1097/md.0000000000034756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 09/02/2023] Open
Abstract
To analyze the factors associated with infection after flap transfer for hand trauma and use them to develop nursing strategies and observe the effects of their application. Eighty-two patients admitted to our hospital for flap transfer for hand trauma from January 2020 to May 2020 were selected for the retrospective analysis. Logistic regression analysis was performed to analyze the factors associated with postoperative infections to develop care strategies. Another 88 patients admitted for flap transfer for hand trauma from September 2020 to June 2021 were retrospectively analyzed and divided into the observation (n = 44) and control groups (n = 44) according nursing strategies that they received. The operative time, intraoperative bleeding, incision healing time, first postoperative time to get out of bed on their own and hospital stay were compared between the 2 groups. The patients postoperative adverse effects and flap survival rates were also counted. visual analogue score, total active motion, manual muscle test, Barthel index, self-rating anxiety scale, self-rating depression scale scores were used to assess patients pain, hand function recovery and psychology before and after treatment. Logistic regression analysis manifested that postoperative bed rest time, affected limb immobilization, and pain were independent factors affecting postoperative infection after flap transfer (P < .05). After using targeted care strategies, the observation group had dramatically shorter operative time, intraoperative bleeding, incision healing time, time to first postoperative bed release on their own, and hospital stay, less postoperative pain and adverse effects, and higher flap survival rate than the control group (P < .05). Total active motion, manual muscle test, and Barthel index were higher in the observation group than in the control group after treatment, while self-rating anxiety scale and self-rating depression scale scores were lower than in the control group (P < .05). Finally, total satisfaction was higher in the observation group than in the control group (P < .05). Postoperative bedtime, fixation of the affected limb, and pain are independent factors affecting postoperative infection after flap transfer for hand trauma. Implementing infection prevention care strategies based on these factors can effectively improve the safety of flap transfer, reduce the possibility of infection, and shorten the recovery period of patients, which has high clinical application value.
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Affiliation(s)
- Fang-Xiang Guo
- Department of Operating Room, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan, China
| | - Cai-Yun Wu
- Department of Operating Room, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan, China
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Borgonovo F, Quici M, Gidaro A, Giustivi D, Cattaneo D, Gervasoni C, Calloni M, Martini E, La Cava L, Antinori S, Cogliati C, Gori A, Foschi A. Physicochemical Characteristics of Antimicrobials and Practical Recommendations for Intravenous Administration: A Systematic Review. Antibiotics (Basel) 2023; 12:1338. [PMID: 37627758 PMCID: PMC10451375 DOI: 10.3390/antibiotics12081338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Most antimicrobial drugs need an intravenous (IV) administration to achieve maximum efficacy against target pathogens. IV administration is related to complications, such as tissue infiltration and thrombo-phlebitis. This systematic review aims to provide practical recommendations about diluent, pH, osmolarity, dosage, infusion rate, vesicant properties, and phlebitis rate of the most commonly used antimicrobial drugs evaluated in randomized controlled studies (RCT) till 31 March 2023. The authors searched for available IV antimicrobial drugs in RCT in PUBMED EMBASE®, EBSCO® CINAHL®, and the Cochrane Controlled Clinical trials. Drugs' chemical features were searched online, in drug data sheets, and in scientific papers, establishing that the drugs with a pH of <5 or >9, osmolarity >600 mOsm/L, high incidence of phlebitis reported in the literature, and vesicant drugs need the adoption of utmost caution during administration. We evaluated 931 papers; 232 studies were included. A total of 82 antimicrobials were identified. Regarding antibiotics, 37 reach the "caution" criterion, as well as seven antivirals, 10 antifungals, and three antiprotozoals. In this subgroup of antimicrobials, the correct vascular access device (VAD) selection is essential to avoid complications due to the administration through a peripheral vein. Knowing the physicochemical characteristics of antimicrobials is crucial to improve the patient's safety significantly, thus avoiding administration errors and local side effects.
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Affiliation(s)
- Fabio Borgonovo
- Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Massimiliano Quici
- Internal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | - Antonio Gidaro
- Internal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | - Davide Giustivi
- Emergency Department and Vascular Access Team ASST Lodi, 26900 Lodi, Italy
| | - Dario Cattaneo
- Unit of Clinical Pharmacology, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Cristina Gervasoni
- Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Maria Calloni
- Internal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | - Elena Martini
- Internal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | - Leyla La Cava
- Internal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | - Spinello Antinori
- Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Chiara Cogliati
- Internal Medicine Unit, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | - Andrea Gori
- Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
| | - Antonella Foschi
- Department of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, University of Milan, 20157 Milan, Italy
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138
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Sener T, Haenen W, Smits P, Hans GH. Large-scale real-life implementation of technology-enabled care to maximize hospitals' medical surge preparedness during future infectious disease outbreaks and winter seasons: a viewpoint. Front Public Health 2023; 11:1149247. [PMID: 37621607 PMCID: PMC10446840 DOI: 10.3389/fpubh.2023.1149247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Hospitals can be overburdened with large numbers of patients with severe infectious conditions during infectious disease outbreaks. Such outbreaks or epidemics put tremendous pressure on the admission capacity of care facilities in the concerned region, negatively affecting the elective program within these facilities. Such situations have been observed during the recent waves of the coronavirus disease pandemic. Owing to the imminent threat of a "tripledemic" by new variants of the coronavirus disease (such as the new Omicron XBB.1.16 strain), influenza, and respiratory syncytial virus during future winter seasons, healthcare agencies should take decisive steps to safeguard hospitals' surge capacity while continuing to provide optimal and safe care to a potentially large number of patients in their trusted home environment. Preparedness of health systems for infectious diseases will require dynamic interaction between a continuous assessment of region-wide available hospital capacity and programs for intensive home treatment of patients who can spread the disease. In this viewpoint, we describe an innovative, dynamic coupling system between hospital surge capacity and cascading activation of a nationwide system for remote patient monitoring. This approach was developed using the multi-criteria decision analysis methodology, considering previously published real-life experiences on remote patient monitoring.
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Affiliation(s)
- Talia Sener
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Winne Haenen
- Federal Public Service for Health, Food Chain Safety and Environment, Brussels, Belgium
| | - Patrick Smits
- Cell Crisis Preparedness, Agentschap Zorg en Gezondheid, Brussels, Belgium
| | - Guy H. Hans
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Chief Medical Officer, Antwerp University Hospital (UZA), Edegem, Belgium
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139
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Cardile D, Corallo F, Ielo A, Cappadona I, Pagano M, Bramanti P, D’Aleo G, Ciurleo R, De Cola MC. Coping and Quality of Life Differences between Emergency and Rehabilitation Healthcare Workers. Healthcare (Basel) 2023; 11:2235. [PMID: 37628433 PMCID: PMC10454017 DOI: 10.3390/healthcare11162235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Audit and Feedback (A&F) is a systematic process involving the collection of data, which are subsequently compared with the established reference standards and then subsequently disseminated to healthcare providers through feedback meetings. This allows continuous improvement to be ensured in the quality of care processes. Often, the parameters taken into account concern only the patient and the treatment processes, neglecting other variables. Quality of life in the workplace and coping skills are determining variables for the clinical performance of all healthcare professionals. For this reason, in this study, these variables were investigated and differences were highlighted in two different role categories and context: cardiovascular emergency and neurological rehabilitation. A psychological screening was carried out by sending the computerized Coping Orientation to Problems Experienced-Nuova Versione Italiana (COPE-NVI) and Professional Quality of Life Scale-5 (ProQoL) questionnaires to all healthcare workers involved. Ninety-five healthcare providers (mean ± SD age: 47 ± 10.4 years; 37.9% male) answered the questionnaire and were assigned into two groups (G1 and G2) based on the ward in which they worked. These were further divided into two subgroups (R1 and R2) based on their role. The obtained results show that avoidance strategies are used more by health professionals working in rehabilitation (G2) wards than in intensive-care units (G1). Moreover, in G1 nurses, physical therapists and speech therapists (R2) obtained higher scores in terms of turning to religion (TR) and compassion satisfaction (CS), while physicians and psychologists (R1) obtained higher scores on the burnout scale (BO). The TR score for R2 was found to be higher, even in G2. The response trend of the two groups in the different departments was analyzed and commented on.
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Affiliation(s)
- Davide Cardile
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Francesco Corallo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Augusto Ielo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Irene Cappadona
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Maria Pagano
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Placido Bramanti
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
- Faculty of Psychology, Università degli Studi eCampus, Via Isimbardi 10, 22060 Novedrate, Italy
| | - Giangaetano D’Aleo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Rosella Ciurleo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
| | - Maria Cristina De Cola
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy; (D.C.); (A.I.); (I.C.); (M.P.); (P.B.); (G.D.); (R.C.); (M.C.D.C.)
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140
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de Souza MFC, Zanei SSV, Whitaker IY. Predictive validity of the EVARUCI scale to evaluate risk for pressure injury in critical care patients. J Wound Care 2023; 32:clxi-clxv. [PMID: 37561701 DOI: 10.12968/jowc.2023.32.sup8.clxi] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
OBJECTIVE To compare the predictive capacity of the current risk assessment scale for pressure ulcers in intensive care (EVARUCI), translated into Brazilian Portuguese, using the Braden scale. METHOD This cross-sectional study collected prospective data from adult patients in three intensive care units. The receiver operating characteristic (ROC) and precision-recall curve (PR curve) were used to analyse the predictive capacity for pressure injury (PI) using both predictive values and odds ratios (ORs). RESULTS The incidence of PIs in the study sample of 324 patients was 14.2%. The area under the ROC curve was 0.807 for EVARUCI and 0.798 for the Braden scale. At a cutoff point of 10 on the EVARUCI scale, sensitivity was 69.6%; specificity 78.4%; positive predictive value 34.8%; and OR 8.3. At a cutoff point of 11 on the Braden scale, sensitivity was 76.1%; specificity 75.9%; positive predictive value 34.3%; and OR 10. The area under the PR curve was 0.396 for the EVARUCI scale and 0.348 for the Braden scale, reflecting a smaller area for both. The F1 score value was 0.476 with 37.5% precision and 65.2% recall for the EVARUCI scale, and 0.473 with 34.3% precision and 76.1% recall for the Braden scale. CONCLUSION The EVARUCI scale predictive capacity was similar to that of the Braden scale. However, the precision of both scales was low for the accurate prediction of patients at risk of developing PIs.
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Affiliation(s)
| | - Suely Sueko Viski Zanei
- Adjunct Professor, Paulista Nursing School, Federal University of São Paulo (UNIFESP), Brazil
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141
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Park YG, Kim BS, Kang KT, Ha YC. Effects of Abdominal Massage for Preventing Acute Postoperative Constipation in Hip Fractures: A Prospective Interventional Study. Clin Orthop Surg 2023; 15:546-551. [PMID: 37529190 PMCID: PMC10375809 DOI: 10.4055/cios22091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 08/03/2023] Open
Abstract
Background This prospective randomized controlled study aimed to determine the effects of abdominal massage on constipation management in elderly patients with hip fractures. Methods From August 2017 to December 2018, patients aged above 65 years with hip fractures (n = 88) were randomly assigned to a massage group that received a bowel massage (n = 48) or a control group that did not receive a bowel massage (n = 40). Patients in the bowel massage group received a bowel massage from a trained caregiver after breakfast at approximately 9:00 AM for an hour. On admission, 5 days after surgery, and on the day of discharge, the patient's normal and actual defecation pattern, stool consistency, and any problems with defecation were assessed through a structured interview. The questionnaire comprising the Bristol Stool Scale, patient assessment of constipation, time to defecation, medication for defecations, failure to defecate, cause of admission, admission period, and date of surgery were recorded. Statistical analyses were performed 5 days after surgery and on the day of discharge. Results The mean age of the study cohort was 81.4 years (range, 65-99 years). The number of constipation remedies was significantly lower in the massage group than in the control group on postoperative day (POD) 5 and at discharge (9 vs. 15, p = 0.049 and 6 vs. 11, p = 0.039, respectively). The number of defecation failures was significantly lower in the massage group than in the control group (10 vs. 17, p = 0.028) on POD 5. However, the number of defecation failures at discharge was not significantly different between the two groups (p = 0.131). The development of postoperative ileus (p = 0.271) and length of hospital stay (p = 0.576) were not different between the groups. Conclusions The number of constipation remedies was significantly lower in the massage group than in the control group on POD 5 and discharge, and the number of defecation failures was significantly lower in the massage group than in the control group on POD 5. Therefore, abdominal massage may be considered as an independent nursing initiative for constipation management.
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Affiliation(s)
- Yong-Gum Park
- Department of Surgery, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea
| | - Boo Seop Kim
- Department of Orthopedic Surgery, Chung-Ang University H.C.S. Hyundae General Hospital, Namyangju, Korea
| | - Kyu-Tae Kang
- Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea
| | - Yong-Chan Ha
- Department of Orthopedic Surgery, Seoul Bumin Hospital, Seoul, Korea
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142
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Stark AJ, Chohan S. The association of intensive care capacity transfers with survival in COVID-19 patients from a Scottish district general hospital: A retrospective cohort study. J Intensive Care Soc 2023; 24:277-282. [PMID: 37744069 PMCID: PMC9548487 DOI: 10.1177/17511437221111638] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: During the second wave of COVID-19 cases within Scotland, local evidence suggested that a large number of interhospital transfers occurred due to both physical capacity and staff shortages. Although there are inherent risks with transferring critically ill patients between hospitals, there are signals in the literature that mortality is not affected in COVID-19 patients when transferred between intensive care units. With a lack of evidence in the Scottish population, and as the greatest source of capacity transfers in our critical care network at that time, we sought to determine whether these transfers impacted on survival to hospital discharge.Methods: We conducted a retrospective cohort study of all patients admitted to our unit between the 1st October 2020 and the 31st March 2021 with a primary diagnosis of COVID-19 pneumonia. Patients were grouped according to whether they underwent an interhospital capacity transfer or not, either for unit shortage of beds or unit shortage of staff. The primary outcome measure was survival to ultimate hospital discharge, and secondary outcomes included total ventilator days and total intensive care unit length of stay. Baseline characteristic data were also collected for all patients. Survival data were entered into a backward stepwise logistic regression analysis that included transfer status, and coefficients transformed into odds ratios and 95% confidence intervals.Results: A total of 108 patients were included. Of these, 30 were transferred to another intensive care unit due to capacity issues at the base hospital. From the baseline characteristic data, age was significantly higher in those transferred out, while other characteristics were similar. Unadjusted mortality rates were 30.8% for those not transferred, and 40% for those transferred out. However, when entered into a logistic regression analysis to attempt to control for confounders in the baseline characteristics, being transferred had an odds ratio of 1.14 (95% confidence interval 0.43-3.1) for survival to hospital discharge. Total ventilator days and total ICU length of stay were both higher in the transferred patients.Conclusion: This unique study of COVID-19 patients transferred from a Scottish district general hospital did not show an association between transfer status and survival to hospital discharge. However, the study was likely underpowered to detect small differences. As the situation continues to evolve, a prospective regional multi-centre study may help to provide more robust findings.
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Affiliation(s)
- Adam J Stark
- Department of Anaesthesia and Intensive Care Medicine, University Hospital Monklands, Airdrie, UK
| | - Sanjiv Chohan
- Department of Anaesthesia and Intensive Care Medicine, University Hospital Monklands, Airdrie, UK
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Bringel JMDA, Abreu I, Muniz MCMC, de Almeida PC, Silva MRG. Excessive Noise in Neonatal Units and the Occupational Stress Experienced by Healthcare Professionals: An Assessment of Burnout and Measurement of Cortisol Levels. Healthcare (Basel) 2023; 11:2002. [PMID: 37510443 PMCID: PMC10379383 DOI: 10.3390/healthcare11142002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Excessive noise in the work environment has been associated with extra-auditory symptoms, which can have harmful long-term effects on individuals. The purpose of this study was to identify noise levels in neonatal intensive care units and investigate their impact on the occurrence of stress among healthcare professionals, using cortisol levels as a biomarker for Burnout Syndrome. This descriptive, observational, and cross-sectional study was conducted in four public teaching hospitals in Fortaleza, Ceará, Brazil. Sound pressure levels in the environment were measured, and questionnaires were administered to collect sociodemographic data and assess perceptions of the work environment and Burnout symptoms. Saliva samples were collected at the beginning and end of work shifts for cortisol quantification. The average sound pressure ranged from 59.9 to 66.4 dB(A), exceeding the recommended levels set by Brazilian and international legislation. Among the 256 participants, the average age was 39.4 years, with 95% being female. The majority (70.9%) were nurses, and 22.7% were physicians. There was no significant association found between noise and Burnout Syndrome, nor with changes in cortisol levels. However, a significant association was observed between the perception of excessive noise and the sensation of a stressful work shift (p = 0.012). All evaluated professionals displayed symptoms of Burnout. The high sound pressure levels indicated that the assessed environments did not meet the recommended standards for acoustic comfort, and this was associated with the participants' perception of stressful work shifts. While Burnout symptoms were evident in our participants, it was not possible to confirm a correlation with high noise levels.
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Affiliation(s)
| | - Isabel Abreu
- Faculty of Science and Technology, University Fernando Pessoa, 4249-004 Porto, Portugal
- FP-I3ID, University Fernando Pessoa, 4249-004 Porto, Portugal
| | | | - Paulo César de Almeida
- Postgraduate Program in Clinical Health Care Nursing, Universidade Estadual do Ceará, Fortaleza 60714-903, Brazil
| | - Maria-Raquel G Silva
- FP-I3ID, University Fernando Pessoa, 4249-004 Porto, Portugal
- Faculty of Health Sciences, University Fernando Pessoa, 4200-150 Porto, Portugal
- CIAS-Research Centre for Anthropology and Health-Human Biology, Health and Society, University of Coimbra, 3000-456 Coimbra, Portugal
- CHRC-Comprehensive Health Research Centre, Nova Medical School, Nova University of Lisbon, 1150-090 Lisbon, Portugal
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Stanton E, Gillenwater J, Pham TN, Sheckter CC. Temperature Derangement on Admission is Associated With Mortality in Burn Patients-A Nationwide Analysis and Opportunity for Improvement. J Burn Care Res 2023; 44:845-851. [PMID: 36335477 PMCID: PMC10321386 DOI: 10.1093/jbcr/irac168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Although single-institution studies have described the relationship between hypothermia, burn severity, and complications, there are no national estimates on how temperature on admission impacts hospital mortality. This study aims to evaluate the relationship between admission temperature and complications on a national scale to expose opportunities for improved outcomes. The US National Trauma Data Bank (NTDB) was analyzed between 2007 and 2018. Mortality was modeled using multivariable logistic regression including burn severity variables (% total burn surface area (TBSA), inhalation injury, emergency department (ED) temperature), demographics, and facility variables. Temperature was parsed into three categories: hypothermia (<36.0°C), euthermia (36.0-37.9°C), and hyperthermia (≥38.0°C). A total of 116,796 burn encounters were included of which 77.9% were euthermic, 20.6% were hypothermic and 1.45% were hyperthermic on admission. For every 1.0C drop in body temperature from 36.0°C, mortality increased by 5%. Both hypothermia and hyperthermia were independently associated with increased odds of mortality when controlling for age, gender, inhalation injury, number of comorbidities, and %TBSA burned (p < .001). All temperatures below 36.0°C were significantly associated with increased odds of mortality. Patients with ED temperatures between 32.5 and 33.5°C had the highest odds of mortality (22.0, 95% CI 15.6-31.0, p < .001). ED hypothermia and hyperthermia are independently associated with mortality even when controlling for known covariates associated with inpatient death. These findings underscore the importance of early warming interventions both at the prehospital stage and upon ED arrival. ED temperature could become a quality metric in benchmarking burn centers to improve mortality.
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Affiliation(s)
- Eloise Stanton
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, USA
| | - Justin Gillenwater
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, USA
| | - Tam N Pham
- Department of Surgery, University of Washington, Seattle, USA
| | - Clifford C Sheckter
- Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, USA
- Northern California Regional Burn Center, Santa Clara Valley Medical Center, Palo Alto,USA
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145
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Uzhytchak M, Smolková B, Frtús A, Stupakov A, Lunova M, Scollo F, Hof M, Jurkiewicz P, Sullivan GJ, Dejneka A, Lunov O. Sensitivity of endogenous autofluorescence in HeLa cells to the application of external magnetic fields. Sci Rep 2023; 13:10818. [PMID: 37402779 DOI: 10.1038/s41598-023-38015-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 06/30/2023] [Indexed: 07/06/2023] Open
Abstract
Dramatically increased levels of electromagnetic radiation in the environment have raised concerns over the potential health hazards of electromagnetic fields. Various biological effects of magnetic fields have been proposed. Despite decades of intensive research, the molecular mechanisms procuring cellular responses remain largely unknown. The current literature is conflicting with regards to evidence that magnetic fields affect functionality directly at the cellular level. Therefore, a search for potential direct cellular effects of magnetic fields represents a cornerstone that may propose an explanation for potential health hazards associated with magnetic fields. It has been proposed that autofluorescence of HeLa cells is magnetic field sensitive, relying on single-cell imaging kinetic measurements. Here, we investigate the magnetic field sensitivity of an endogenous autofluorescence in HeLa cells. Under the experimental conditions used, magnetic field sensitivity of an endogenous autofluorescence was not observed in HeLa cells. We present a number of arguments indicating why this is the case in the analysis of magnetic field effects based on the imaging of cellular autofluorescence decay. Our work indicates that new methods are required to elucidate the effects of magnetic fields at the cellular level.
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Affiliation(s)
- Mariia Uzhytchak
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, Prague, 18221, Czech Republic
| | - Barbora Smolková
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, Prague, 18221, Czech Republic
| | - Adam Frtús
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, Prague, 18221, Czech Republic
| | - Alexandr Stupakov
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, Prague, 18221, Czech Republic
| | - Mariia Lunova
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, Prague, 18221, Czech Republic
- Institute for Clinical and Experimental Medicine (IKEM), Prague, 14021, Czech Republic
| | - Federica Scollo
- J. Heyrovský Institute of Physical Chemistry of the Czech Academy of Sciences, Prague, 18223, Czech Republic
| | - Martin Hof
- J. Heyrovský Institute of Physical Chemistry of the Czech Academy of Sciences, Prague, 18223, Czech Republic
| | - Piotr Jurkiewicz
- J. Heyrovský Institute of Physical Chemistry of the Czech Academy of Sciences, Prague, 18223, Czech Republic
| | - Gareth John Sullivan
- Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Pediatric Research, Oslo University Hospital, Oslo, Norway
- Department of Immunology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alexandr Dejneka
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, Prague, 18221, Czech Republic
| | - Oleg Lunov
- Department of Optical and Biophysical Systems, Institute of Physics of the Czech Academy of Sciences, Prague, 18221, Czech Republic.
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146
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Peradejordi-Torres RM, Valls-Matarín J. Perception of the safety culture in a critical area. ENFERMERIA INTENSIVA 2023; 34:148-155. [PMID: 37246107 DOI: 10.1016/j.enfie.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 11/04/2022] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Critical care Area (CCA) is one of the most complex in the hospital system, requiring a high number of interventions and handling of amounts of information. Therefore, these areas are likely to experience more incidents that compromise patient safety (PS). AIM To determine the perception of the healthcare team in a critical care area about the patient safety culture. METHOD Cross-sectional descriptive study, September 2021, in a polyvalent CCA with 45 beds, 118 health workers (physicians, nurses, auxiliary nursing care technicians). Sociodemographic variables, knowledge of the person in charge in PS and their general training in PS and incident notification system were collected. The validated Hospital Survey on Patient Safety Culture questionnaire, measuring 12 dimensions was used. Positive responses with an average score ≥75%, were defined as an area of strength while ≥50% negative responses were defined as an area of weakness. Descriptive statistics and bivariate analysis: X2 and t-Student tests, and ANOVA. Significance p ≤ 0.05. RESULTS 94 questionnaires were collected (79.7% sample). The PS score was 7.1 (1.2) range 1-10. The rotational staff scored the PS with 6.9 (1.2) compared to 7.8 (0.9) for non-rotational staff (p = 0.04). A 54.3% (n = 51) was familiar with the incident reporting procedure, 53% (n = 27) of which had not reported any in the last year. No dimension was defined as strength. There were three dimensions that behaved like a weakness: security perception: 57.7% (95% CI: 52.7-62.6), staffing: 81.7% (95% CI: 77.4-85.2) and management support: 69 .9% (95% CI: 64.3-74.9). CONCLUSIONS The assessment of PS in the CCA is moderately high, although the rotational staff has a lower appreciation. Half of the staff do not know the procedure for reporting an incident. The notification rate is low. The weaknesses detected are perception of security, staffing and management support. The analysis of the patient safety culture can be useful to implement improvement measures.
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Affiliation(s)
- R M Peradejordi-Torres
- Unidad de Cuidados Intensivos del Hospital Universitari Mútua Terrassa, Barcelona, Spain.
| | - J Valls-Matarín
- Unidad de Cuidados Intensivos del Hospital Universitari Mútua Terrassa, Barcelona, Spain
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147
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Hughes AM, Riska K, Farmer MJS, Krishnakumar D, Shea CM, Hess DR, Lindenauer PK, Stefan MS. Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation. J Interprof Care 2023; 37:576-587. [PMID: 36264072 PMCID: PMC10983066 DOI: 10.1080/13561820.2022.2118681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 12/24/2022]
Abstract
Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared cognitive tasks in interprofessional teams using NIV for patients with COPD exacerbation. We used a cognitive task analysis approach (CTA) to engage nurses, rapid response team members, respiratory therapists, and physicians involved in the use of NIV to treat patients with COPD exacerbation. Clinicians participated in a semi-structured interview (n = 21) that elicited cognitions needed to treat COPD exacerbation. Three shared cognitive tasks were identified: Complete a thorough assessment, Formulate a care plan, and Continuously monitor patient status. Findings attest to the importance of having access to up-to-date information and expertise necessary to make accurate clinical inferences for patient assessment. Shared understanding of the formulated care plan among all members of the care team was important to its execution. Continuous monitoring was crucial; however, this cognitive task relied on patient assessment skills and ongoing collaboration within the clinical care team. Application of NIV for patients with COPD exacerbation may require enhancing collaboration through nontechnical skills and interprofessional training.
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Affiliation(s)
- Ashley M Hughes
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago
- Center for Innovations in Chronic, Complex Healthcare, Edward Hines JR VA Medical Center, Hines
| | - Karen Riska
- Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School - Baystate, Springfield
| | - Mary Jo S Farmer
- Department of Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield
- Division of Pulmonary and Critical Care, Department of Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield
| | | | - Christopher M Shea
- Department of Health Policy and Management, Gilling's School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
| | - Dean R Hess
- College of Professional Studies, Respiratory Care Leadership, Northeastern University, Boston MS, United States
- Department of Respiratory Care, Massachusetts General Hospital, Boston, MS, United States
| | - Peter K Lindenauer
- Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School - Baystate, Springfield
- Department of Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MS, United States
| | - Mihaela S Stefan
- Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School - Baystate, Springfield
- Department of Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield
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148
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Amoako-Mensah E, Achempim-Ansong G, Gbordzoe NI, Adofo CE, Sarfo JO. Perceptions of nurses regarding quality of adult cardiopulmonary resuscitation in Ghana: a qualitative study. BMC Nurs 2023; 22:220. [PMID: 37370085 DOI: 10.1186/s12912-023-01388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVES Cardiopulmonary resuscitation (CPR) is a necessary life-saving emergency intervention for patients with cardiac arrest and other medical conditions. The study's primary objective was to qualitatively explore nurses' perceptions of the quality of adult cardiopulmonary resuscitation in Ghana. METHODS An exploratory descriptive qualitative study was conducted among 13 purposively sampled nurses in Ghana. We collected thirteen face-to-face and telephone interviews using a semi-structured interview guide. Data were transcribed verbatim and analysed using the thematic analysis approach recommended by Braun and Clarke. RESULTS Data analysis revealed that nurses were filled with positive emotions when patients regained consciousness following resuscitation. When the otherwise happens, they tend to become tortured psychologically and filled with negative emotions. Besides, environmental factors such as the time of initiating CPR following a cardiac arrest, the availability and appropriateness of equipment and medications, workplace ergonomics, and institutional regulations affected the quality of resuscitation practices of nurses. Participants perceived that attitudes of condemnation, prejudice, apathy and skills deficiency also impacted the quality of resuscitation practices. Significant aspects of self-reported behavioural competence that affected resuscitation were knowledge and skills of CPR, confidence in initiating CPR, and the need for effort maximisation. CONCLUSION This study revealed several non-medical factors that influenced the resuscitation practices of nurses from their perspective. Nurses need to maximise their effort toward seeking further education in speciality areas such as emergency nursing and critical care nursing to guide their CPR practices and other newly emerging evidence-based protocols.
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149
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Beltrán-Morillas AM, Sánchez-Hernández MD, Herrera MC, Villanueva-Moya L, Expósito F. Self-Efficacy and Well-Being in Professionals Working in Intimate Partner Violence: Recovery Experiences and Burnout as Associated Variables. Psychol Rep 2023:332941231183331. [PMID: 37336760 DOI: 10.1177/00332941231183331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
The negative consequences of intimate partner violence against women (IPVAW) are observed not only in the victims but also in the professionals who work in this field. Self-efficacy has been observed as a significant variable in the perception of work efficiency and general well-being, and in coping with work-related stress and burnout syndrome. Thus, we performed a correlational study (N = 200) to examine the mediating role of recovery experiences and emotional exhaustion in the relationship between self-efficacy and psychological well-being in these professionals. The mediating analyses revealed that self-efficacy was related to higher levels of well-being through its effects on the increase in recovery experiences and the decrease in burnout levels. These findings emphasize the need to develop intervention programs aimed at improving self-efficacy these professionals. This is necessary to improve their employment situations, increase their health, and optimize both institutional resources and the quality of the services offered.
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Affiliation(s)
| | | | - M Carmen Herrera
- Department of Social Psychology, University of Granada, Granada, Spain
| | - Laura Villanueva-Moya
- Department of Social Psychology, Mind, Brain and Behavioral Research Center (CIMCYC), Granada, Spain
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150
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González Aguña A, Fernández Batalla M, Herrero Jaén S, Sierra Ortega A, Martínez Muñoz ML, Santamaría García JM. Active and Healthy Confinement: Care Recommendations on Activity, Sleep and Relationships. Healthcare (Basel) 2023; 11:1773. [PMID: 37372890 DOI: 10.3390/healthcare11121773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Persons that lived through periods of confinement suffered an impact on their physical and mental health. The adaptation of the lifestyle in relation to activity, sleep and social relationships is key to facing these periods of confinement. The aim is to validate a series of care recommendations aimed at being able to maintain an active and healthy confinement, which serves to prepare the population for future health crises. This study is part of a general strategy based on a care recommendation guide for COVID-19. The validation was carried out by a group of experts using the Delphi technique through a questionnaire that uses the Content Validity Index (CVI) and considers high validation those with a score >0.80. A total of 75 care recommendations are proposed: 30 on activity-exercise (CVI = 0.82), 14 on sleep-rest (CVI = 0.83) and 31 on roles-relationships (CVI = 0.83). Additionally, 49 recommendations achieve high validation. The care recommendations integrate a person-centred model, which addresses individual characteristics (age, health status, professional role). An active and healthy confinement requires respecting social distance measures, maintaining a balance between physical activity and sleep, and using technologies to promote social contact, which promote well-being and avoid depression and anxiety.
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Affiliation(s)
- Alexandra González Aguña
- Intensive Care Unit, Henares University Hospital, Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), 28822 Madrid, Spain
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Madrid, Spain
| | - Marta Fernández Batalla
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Madrid, Spain
- Torres de la Alameda Health Centre, Community of Madrid Health Service (SERMAS), 28813 Madrid, Spain
| | - Sara Herrero Jaén
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Madrid, Spain
- Mejorada del Campo Health Centre, Community of Madrid Health Service (SERMAS), 28880 Madrid, Spain
| | - Andrea Sierra Ortega
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Madrid, Spain
- Meco Health Centre, Community of Madrid Health Service (SERMAS), 28880 Madrid, Spain
| | | | - José María Santamaría García
- Research Group MISKC, Department of Computer Science, University of Alcala, Polytechnic Building, University Campus, Barcelona Road Km. 33.6, 28805 Madrid, Spain
- Meco Health Centre, Community of Madrid Health Service (SERMAS), 28880 Madrid, Spain
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