Cuidados de enfermería desde la experiencia de personas que padecen trastornos alimentarios: un estudio cualitativo / Nursing care experiences of people with eating disordes: a qualitative study from patients' perspective

Resumen Los Trastornos de la Conducta Alimentaria suponen uno de los problemas más prevalentes en la sociedad, siendo los cuidados prestados por las enfermeras fundamentales para su recuperación. Es por ello necesario comprender la experiencia que tienen los pacientes de los cuidados que reciben, para poder adaptarse a sus necesidades. Este estudio cualitativo propone aproximarse a la vivencia de cuidados de pacientes que padecen trastornos alimentarios desde un enfoque fenomenológico hermenéutico. Diecinueve pacientes de Alcalá de Henares (Madrid) colaboraron en la investigación a través de entrevistas y relatos, que fueron grabados, transcritos y analizados temáticamente. Los resultados se agruparon en cuatro categorías: 1. Una ayuda inesperada, 2. Buscar raíces: encontrar el origen, 3. Derribar barreras y construir contrafuertes, 4. Entender el significado del Trastorno Conducta Alimentaria. Para los pacientes, las enfermeras son una figura tanto inesperada como relevante, mostrando la importancia de los aspectos psicológicos y emocionales, sociales y personales como reguladores de su relación con la comida, la imagen y la vivencia de la corporeidad. A través del estudio, se profundiza en la relación de cuidados entre enfermera y paciente, obteniendo una perspectiva de cuidados desconocida, que posibilita ampliar el conocimiento e individualizar los cuidados prestados.

Abstract Eating Disorders are one of the most prevalent problems in our society being nursing care essential for recovery. It is therefore necessary to understand patients' experience in order to adapt their actions to patients' needs. This qualitative study offers an approach to nursing care experience of people with eating disorders from an hermeneutical phenomenological approach. Nineteen patients from Alcalá de Henares (Madrid) collaborated in the research through in-depth interviews and stories, which were thematically recorded, transcribed and analyzed. The results were grouped in four categories: 1. Unexpected help, 2. In search for roots: discovering the origin, 3. To break down barriers and build buttresses, 4. To understand the meaning of the eating disorder. Patients emphasize that nurses are as unexpected as relevant in their lives, showing the importance of psychological, emotional, social and personal aspects, as regulators of their food relationship, their body image and their corporeality experience. This investigation allows getting a deeper view of care relationship between nurses and patients, previously unknown, which makes it possible to widen the knowledge and to individualize the care provided.

A 120-second stretch improves postural control and plantar pressure: quasi-experimental study

ABSTRACT BACKGROUND: There are no studies on long-term bilateral calf stretching in relation to balance and plantar pressure. OBJECTIVES: To demonstrate that there is better control of posture and pressures after continuous stretching of the posterior calf muscles. DESIGN AND SETTING: Pre and post-intervention study conducted in a private clinic. METHODS: We measured static footprints and stabilometry before and after continuous passive plantar flexor stretching of duration 120 seconds, among 24 healthy subjects. RESULTS: We found differences in Y displacement with eyes closed (P = 0.010), but not among other variables with eyes closed: X displacement (P = 0.263); surface (P = 0.940); laterolateral speed displacement (P = 0.279); and anteroposterior speed displacement (P = 0.914). There were also no differences in eyes-open variables: X displacement (P = 0.341); Y displacement (P = 0.491); surface (P = 0.167); laterolateral speed displacement (P = 0.852); and anteroposterior speed displacement (P = 0.079). The plantar pressures in the heel (maximum pressure, P = 0.048; mean pressure, P = 0.001) and in the midfoot (maximum pressure, P = 0.004; mean pressure, P = 0.004) were reduced, but not in the forefoot (maximum pressure, P = 0.391; mean pressure, P = 0.225). The surface became larger in the forefoot (P = 0.000) and midfoot (P = 0.021). CONCLUSIONS: Continuous static stretching of plantar flexors for 120 seconds improved stance balance and reduced plantar pressures (maximum and mean) in the rearfoot and midfoot. It also increased the surface in the midfoot and forefoot. TRIAL REGISTRATION: at clinicaltrials.gov, under the number NTC03743168.

Non-alcoholic beverage and fast-food consumption, among first- and fourth-year nursing students in Madrid

Sugar-sweetened beverages and fast-food consumption have been associated with non-communicable diseases. Objective. Was to analyze consumption of non-alcoholic beverage and fast-food consumption among first- and fourth-year nursing students. Materials and methods. A questionnaire-based survey was conducted among first-and fourth-year nursing students in Madrid, Spain. Anthropometric data (weight and height) and demographic data were collected, as were data on consumption of specific foods and beverages. Results. The survey was completed by 436 students. Mean (SD) age was 22.0 (6.8) years, 84.1 % of were women.26.2 % of the students were underweight; 6.3 % were overweight. Consumption of sugar-sweetened beverages and diet drinks was moderate. Slightly more than three-quarters of the students (75.5 %) purchased fast food in the previous month. Burger bars were the most frequently visited fast-food outlet (77.2 %). A direct relationship was observed between BMI and fast-food consumption (rho = 0.099; p = 0.042) and between BMI and consumption of diet cola or carbonated drinks (rho = 0.120; p = 0.013). Conclusion. We provide new epidemiological data from a specific university population that could be useful to promote more studies that help design appropriate strategies to increase a healthy lifestyle(AU)

Las bebidas azucaradas y el consumo de comida rápida se han asociado con enfermedades no transmisibles. Objetivo. Analizar el consumo de bebidas no alcohólicas y el consumo de comida rápida entre estudiantes universitarios de primer y cuarto curso de enfermería. Materiales y métodos. Cuestionario validado entre estudiantes de enfermería de primer y cuarto año en Madrid, España. Se recopilaron datos antropométricos (peso y altura) y demográficos, así como datos sobre consumo de alimentos y bebidas específicos. Resultados. La encuesta fue completada por 436 estudiantes. La edad media (DE) fue de 22,0 (6,8) años, el 84,1 % eran mujeres; el 26,2 % de los estudiantes tenían bajo peso y el 6,3% mostraban sobrepeso. El consumo de bebidas azucaradas y bebidas dietéticas fue moderado. Más de tres cuartas partes de estudiantes (75,5%) compraron comida rápida en el mes anterior. Las hamburgueserías fueron el restaurante de comida rápida más visitado (77,2%). Se observó una relación directa entre el IMC y el consumo de comida rápida (rho = 0,099; p = 0,042) y entre el IMC y el consumo de refrescos dietéticos o bebidas gaseosas (rho = 0,120; p = 0,013). Conclusión. Aportamos nuevos datos epidemiológicos de una población universitaria concreta, que podrían ser de utilidad para promover más estudios que ayuden a diseñar estrategias adecuadas para incrementar un estilo de vida saludable(AU)

Allergic rhinitis improvement after septorhinoplasty in a sample of allergic rhinitis patients with septal deviation: a quasi-experimental study

ABSTRACT BACKGROUND: Allergic rhinitis (AR) is a chronic inflammatory disease that affects almost 30% of the adult population. OBJECTIVE: To describe and compare the evolution of symptoms in patients diagnosed with AR and septal deviation prior to and following septoplasty (STP). DESIGN AND SETTING: Quasi-experimental study developed in A Coruña University Hospital. METHODS: Patients aged 18-65 years who had been diagnosed with AR and septal deviation were recruited. Obstruction airflow was evaluated before and after surgery, by means of anterior rhinomanometry (RNM). Severity symptoms and quality of life were assessed using a visual analogue scale (VAS) and the ESPRINT questionnaire, respectively. RESULTS: A total of 50 subjects underwent STP and 42 were included in this study. Their mean age at the time of surgery was 34.16 ± 9.74 years (range 18-64). Significant reductions in mean VAS and ESPRINT were observed after surgery (P < 0.01). These outcomes were considered to represent an overall improvement in quality of life. The RNM results also improved significantly, from mean values of 478.07 ± 165.4 cm3/s before STP to 826.4 ± 175.5 cm3/s afterwards (P < 0.01). CONCLUSIONS: The negative correlations of VAS and ESPRINT with RNM, from before and to after STP, demonstrate the efficacy of scales and questionnaires as objective methods for determining obstruction in the absence of rhinomanometry. Patients with allergic rhinitis and septal deviation showed improvements in obstruction severity and medication use after STP.

Self-reported depression and anxiety among COPD patients. A case-control study

Abstract BACKGROUND: Anxiety and depression are the most prevalent mental disorders worldwide. However, the exact mechanisms linking chronic obstructive pulmonary disease (COPD) with depression and anxiety have not been identified. OBJECTIVES: To compare self-reported depression and anxiety among patients diagnosed with COPD in relation to healthy controls. DESIGN AND SETTING: Case control study at a public hospital institution in Spain. METHODS: We designed a case-control study. Patients were recruited using a consecutive sampling method from a single institution. Two groups were created: COPD and healthy controls. Data on medical history and demographic background were collected from the medical records. Self-reported depression levels were assessed using Beck's depression inventory (BDI). Self-reported anxiety was measured using the State-trait anxiety inventory (STAI). RESULTS: Fifty-two patients with COPD and fifty healthy patients were included in this study. BDI scores were higher for COPD patients (10.23 ± 6.26) than in the control group (5.2 ± 6.56). STAI-state scores were higher for COPD patients (41.85 ± 12.55) than for controls (34.88 ± 9.25). STAI-trait scores were higher for COPD patients (41.42 ± 10.01) than for controls (34.62 ± 9.19). CONCLUSIONS: This study showed that there were higher levels of depression and anxiety among COPD patients than among healthy controls.

Influence of foot pain on frailty symptoms in an elderly population: a case-control study

ABSTRACT BACKGROUND: Frailty is a condition that can increase the risk of falls. In addition, foot disorders can negatively influence elderly people, thus affecting their condition of frailty. OBJECTIVE: To determine whether foot pain can influence a greater degree of frailty. DESIGN AND SETTING: Cross-sectional descriptive study conducted at the University of Valencia, Valencia, Spain. METHODS: A sample older than 60 years (n = 52), including 26 healthy subjects and 26 foot pain patients, was recruited. Frailty disability was measured using the 5-Frailty scale and the Edmonton Frailty scale (EFS). RESULTS: There were statistically significant differences in the total EFS score and in most of its subscales, according to the Mann-Whitney U test (P < 0.05). In addition, foot pain patients presented worse scores (higher 5-Frailty scores) than did healthy patients, regarding matched-paired subjects (lower EFS scores). With regard to the rest of the measurements, there were no statistically significant differences (P > 0.05). The highest scores (P < 0.001) were for fatigue on the 5-Frailty scale and the EFS, and for the subscale of independence function in EFS. CONCLUSIONS: These elderly patients presented impairment relating to ambulation and total 5-Frailty score, which seemed to be linked to the presence of frailty syndrome and foot disorders.

Intra and intersession repeatability and reliability of dynamic parameters in pressure platform assessments on subjects with simulated leg length discrepancy. A cross-sectional research

ABSTRACT BACKGROUND: Leg length discrepancy (LLD) may play a key role in exercise biomechanics. Although the Podoprint platform has been used in dynamic pressure studies, there are no data regarding the reliability and repeatability of dynamic measurements under simulated LLD conditions. OBJECTIVES: To determine the intra and intersession repeatability and reliability of dynamic parameters of the Podoprint pressure platform under simulated LLD conditions. DESIGN AND SETTING: Observational cross-sectional study at a public university. METHODS: Thirty-seven healthy volunteers participated in this study. LLD was simulated using ethyl vinyl acetate plantar lifts with heights of 5 mm, 10 mm, 15 mm and 20 mm located under the right shoe of each volunteer. The procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Stance time, mean pressure and peak pressure measurements were registered in three trials for each foot and each LLD level. Data were collected during two separate testing sessions, in order to establish intrasession and intersession reliability. RESULTS: The intraclass correlation coefficients (ICCs) for intrasession reliability ranged from 0.775 to 0.983 in the first session and from 0.860 to 0.985 in the second session. The ICCs for intersession reliability ranged from 0.909 to 0.990. Bland-Altman plots showed absence of systematic measurement errors. CONCLUSIONS: The results from this study indicate that the Podoprint platform is a reliable system for assessing dynamic parameters under simulated LLD conditions. Future studies should evaluate plantar pressures under LLD conditions, in association with exercise, biomechanics and musculoskeletal disorders.

Association between sex differences on foot health related to the quality of life in a sample of sedentary people

SUMMARY Sedentary (sitting) time may produce many anatomical and physiological consequences which are supposedly associated with a decreased quality of life (QoL) related to foot health. Accordingly, this study aimed to analyze the QoL impact on the overall health and the foot health among male and female sedentary people. A total of 312 participants with an age mean of 39.81 ± 15.40 years completed all phases of the study. In addition, self-reported data were registered. The participants' sedentary lifestyle was determined using the European Prospective Investigation into Cancer and Nutrition (EPIC) physical activity questionnaire. Furthermore, the scores obtained from the Portuguese version of the Foot Health Status Questionnaire were registered. Sedentary people in the equivalent metabolic energy had 301.09 ± 72.22 (min/week). In the first section, values were higher for foot pain and foot function and lower for general foot health and footwear. In the second section, values were higher for general health and vigor and lower for physical activity and social capacity. The differences between the sex groups of the study were statistically significant for footwear (P = 0.008), physical activity (P= 0.002), social capacity (P = 0.001) and vigor (P = 0.001) showing a worst QoL related to foot health in favor of male subjects in comparison with females. The rest of the domains did not show any statistically significant difference (P ≥ .01). The sedentary population evidenced a negative impact on the QoL related to foot health. This problem may be associated with this lifestyle, especially for males.

RESUMO O tempo sedentário (sentado) pode produzir muitas consequências anatômicas e fisiológicas que supostamente estão associadas a uma redução de qualidade de vida (QoL) relacionada à saúde do pé. Por conseguinte, o objetivo deste estudo foi analisar o impacto da QV sobre a saúde geral e a saúde do pé entre pessoas sedentárias masculinas e femininas. Uma amostra de 312 participantes com idade média de 39,81 ± 15,40 anos completou todas as fases do processo de estudo. Além disso, os dados autorrelatados foram registrados. O comportamento sedentário dos informantes foi determinado usando o questionário de prospecção prospectiva de câncer e nutrição (Epic). Além disso, os resultados obtidos com a versão em português do Questionário de Status de Saúde do Pé (PFHSQ) foram registrados. As pessoas sedentárias no equivalente de energia metabólica apresentaram 301,09 ± 72,22 (min/semana). Na primeira seção, os valores foram maiores para a dor no pé e função do pé e diminuíram a saúde e o calçado do pé geral. Na segunda seção, os valores foram maiores para saúde geral e vigor e menores para atividade física e capacidade social. As diferenças entre os grupos sexuais do estudo foram estatisticamente significativas para o calçado (P = 0,008), atividade física (P = 0,002), capacidade social (P = 0,001) e vigor (P = 0,001), mostrando uma pior QV relacionada à saúde do pé a favor dos sujeitos do sexo masculino em relação aos participantes sedentários femininos. O restante dos domínios não apresentou diferença estatisticamente significante (P ≥ 0,01). A população sedentária evidenciou um impacto negativo na QoL relacionada à saúde dos pés. Esse problema pode estar associado a este comportamento, especialmente no sexo masculino.

Evaluation of podiatric disorders in a sample of children with intellectual disabilities: an analytical cross-sectional study

ABSTRACT BACKGROUND: Intellectual disabilities (IDs) usually derive from neurodevelopmental disabilities. They limit intellectual functioning and cause adaptive behaviors and orthopedic problems. These disabilities have harmful effects on health, everyday practical skills and social functioning, and they diminish quality of life. The goal of our research was to perform podiatric evaluations on schoolchildren with and without ID and ascertain their records of foot disorders. DESIGN AND SETTING: Analytical cross-sectional study conducted at a podiatric clinic in the city of Piedras Blancas, province of Asturias, Spain. METHODS: An analytical cross-sectional study on 82 schoolchildren affected by ID, compared with 117 healthy schoolchildren, was conducted at a podiatric clinic. Demographic data, clinical characteristics and measurements relating to podiatric examinations were recorded among the participants who completed all phases of the tool that was used in the study process. RESULTS: Almost 90% of the schoolchildren with and without ID presented foot disorders relating to smaller toes, nail disorders, flat feet or lower-limb alterations. CONCLUSIONS: The participants showed elevated prevalence of foot disorders. Podiatric evaluations are a significant means for preventing the appearance of medical conditions and/or foot problems, and they also improve general health.

Comparison of health-related quality of life between patients with different metatarsalgia types and matched healthy controls: a cross-sectional analysis

ABSTRACT BACKGROUND: Metatarsalgia can be considered to be a common complaint in clinical practice. The aim of this study was to compare quality of life (QoL) between participants with different metatarsalgia types and matched-paired healthy controls. DESIGN AND SETTING: A cross-sectional analysis on a sample of 124 participants of median age ± interquartile range of 55 ± 22 years was carried out in the University Clinic of Podiatric Medicine and Surgery, Ferrol, Spain. They presented primary (n = 31), secondary (n = 31) or iatrogenic (n = 31) metatarsalgia, or were matched-paired healthy controls (n = 31). METHODS: Self-reported domain scores were obtained using the Foot Health Status Questionnaire (FHSQ) and were compared between the participants with metatarsalgia and between these and the healthy controls. RESULTS: Statistically significant differences were shown in all FHSQ domains (P ≤ 0.001). Post-hoc analyses showed statistically significant differences (P < 0.05) between the metatarsalgia types in relation to the matched healthy control group, such that the participants with metatarsalgia presented impaired foot-specific and general health-related QoL (lower FHSQ scores). CONCLUSION: This study demonstrated that presence of metatarsalgia had a negative impact on foot health-related QoL. Foot-specific health and general health were poorer among patients with metatarsalgia, especially among those with secondary and iatrogenic metatarsalgia, in comparison with matched healthy controls.

Effect of generalized ligamentous hyperlaxity related of quality of life in the foot: a case controlled study

SUMMARY Generalized ligamentous hyperlaxity (GLH) has been shown to predispose an individual to a number of orthopaedic conditions. Little is known about how GLH affects people' foot health-related quality of life. This study analyses a sample of people with GLH and people without GLH with normalised reference values of the scores collected with regard to using the Foot Health Status Questionnaire (FSHQ). A total of 100 respondents with mean age of 22.69 ± 3.78 years old, who attended a health centre were classified as GLH (n = 50) or non-GLH (n = 50). The GLH was determined of the patients with and without GLH using assessment with Beighton tool and the scores on the FHSQ were compared. The control group recorded higher scores in the First Section for foot pain, foot function and general foot health, and lower scores in footwear. In the Second Section, they obtained higher scores in social capacity and lower scores in physical activity, vigour and general health. Differences between the two groups were evaluated through a t-test for independent samples, showing statistical significance (P<0.001). This study has detected measurable differences of association between GLH (Beighton score ≥4) with impaired quality of life related to foot health.

RESUMO A hiperlaxia ligamentosa generalizada (HLG) demonstrou predispor um indivíduo a várias condições ortopédicas. Pouco se sabe sobre como a HLG afeta a qualidade de vida relacionada à saúde do pé das pessoas. Este estudo analisa uma amostra de pessoas com HLG e pessoas sem HLG com valores de referência normalizados das pontuações coletadas no que diz respeito ao Foot Health Status Questionnaire (FSHQ). Um total de 100 informantes com média de idade de 22,69 ± 3,78 anos que eram atendidos em um centro de saúde foi classificado como HLG (n = 50) ou não HLG (n = 50). A HLG foi determinada com os pacientes com e sem HLG usando a ferramenta Beighton e os escores na FHSQ foram comparados. O grupo de controle registrou pontuações mais altas na primeira seção para a dor no pé, função do pé e saúde geral do pé, e menores pontuações no calçado. Na segunda seção obtiveram maiores escores em capacidade social e menores escores em atividade física, vigor e saúde geral. As diferenças entre os dois grupos foram avaliadas por meio de um teste t para amostras independentes, mostrando significância estatística (P<0,001). Este estudo detectou diferenças mensuráveis de associação entre HLG (pontuação de Beighton≥4) com deterioração da qualidade de vida relacionada à saúde dos pés.

The influence of heel height related on quality of life on the foot in a sample of women

SUMMARY Many women have worn high-heel shoes (HHS) at some point in their lives and many wear them on a daily basis, with higher prevalence between 39% and 78% observed in institutional and clinical settings. The purpose of this study was to describe and compare the scores obtained with regard to foot health and health in general in a sample of women that use HHS as opposed to a sample of women without HHS with normalized reference values. A sample of 120 participants with a mean age of 41.94 ± 13.912 came to a health center where self-reported data were registered. The subjects with and without HHS were determined and the scores obtained were compared in the Foot Health Status Questionnaire (FHSQ). This questionnaire is made of 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The women in the HHS group showed a worse quality of life related to health in general and to foot health specifically. Differences between the two groups were evaluated by means of a t-test for independent samples, showing statistical significance (P<0.01). Women with HHS present a negative impact on the quality of life related to foot health.

RESUMO Muitas mulheres usaram sapatos de salto alto (SSA) em algum momento de suas vidas e muitas usam diariamente, com maior prevalência entre 39% e 78%, observadas em contextos institucionais e clínicos. O objetivo deste estudo foi descrever e comparar os escores obtidos em relação à saúde dos pés e à saúde em geral em uma amostra de mulheres que utilizam SSA em oposição a uma amostra de mulheres sem SSA com valores de referência normalizados. Uma amostra de 120 participantes com idade média de 41,94 ± 13,912 chegou a um centro de saúde onde os dados autorrelatados foram registrados, os informantes com e sem SSA foram determinados e os escores obtidos foram comparados no Foot Health Status Questionnaire (FHSQ). Esse documento tem 13 questões que avaliam quatro domínios de saúde dos pés, nomeadamente dor, função, saúde geral e calçado. As mulheres do grupo SSA apresentaram pior qualidade de vida relacionada à saúde em geral e à saúde dos pés, especificamente. As diferenças entre os dois grupos foram avaliadas por meio de um teste t para amostras independentes, mostrando significância estatística (P <0,01). As mulheres com SSA apresentam um impacto negativo na qualidade de vida relacionada à saúde dos pés.

Foot health and quality of life among university students: cross-sectional study

ABSTRACT BACKGROUND: Foot problems are believed to reduce quality of life and are increasingly present. Even among young adults of university age, untreated foot problems can lead to postural and mobility problems. Accordingly, our aim here was to determine the relationship between foot health and quality of life and general health among male and female university students. DESIGN AND SETTING: Observational cross-sectional quantitative study conducted at the Podiatric Medicine and Surgery Clinic of the University of Coruña, Ferrol, Spain. METHODS: A sample of 112 participants of median age 22 years came to a health center, where self-reported data were registered, including professional activity, and scores obtained through the Foot Health Status Questionnaire (FHSQ) were compared. RESULTS: In Section One of the FHSQ, the university students recorded lower scores of 66.66 in the footwear domain and 60 in the general foot health domain and higher scores of 84.37 in the foot pain domain and 93.75 in the foot function domain. In Section Two, they obtained lower scores of 60 in the overall health domain and 62.50 in the vigor domain and higher scores of 100 in the physical activity and 87.50 in the social capacity domain. Differences between males and females were evaluated using the Wilcoxon rank-sum test, which showing statistical significance (P < 0.05) regarding the dimensions of footwear and general foot health. CONCLUSIONS: These university students' quality of life relating to foot health was poor. This appears to be associated with the university period, regardless of gender.

Conscientious objection in spanish podiatrists students: a questionnaire survey / Objeción de conciencia en estudiantes españoles de podología: estudio mediante cuestionario / Objeção de consciência em estudantes de podologia na Espanha: um questionário de sondagem

Objective: To explore attitudes towards conscientious objections among podiatrists students in Spain. Methods: Podiatrists students at University of A Coruña, King Rey Juan Carlos University, University of Sevilla and Complutense University of Madrid were emailed a link to complete an anonymous online questionnaire, hosted by an online survey company. A total of 432 podiatrists students responded. Results: Nearly half of the students in this survey stated that they believed in the right of podiatrist to conscientiously object to any procedure. Demand for the right to conscientiously object is greater in Roman Catholic podiatrists students when compared with other groups of religious podiatrists students. Discussion: Examining patients and podiatric treatments continues to be controversy issues among podiatrists students and this may contribute to the looming crisis in podiatry services over next years. This project sheds some light on how future podiatrist view some of their ethical rights and obligations. Using empirical evidence, it reveals that conscientious objection is an issue in the Spain podiatrists student body today. These data could help anticipate problems that may arise when these podiatrists students qualify and practice podiatry in the community. Conclusion: Clearer guidance is needed for podiatrists students about the issue of conscientious objection at podiatry school.

Objetivo: Explorar actitudes hacia la objeción de conciencia entre estudiantes de podología en España. Métodos: Se realizó un cuestionario anónimo online vía email a estudiantes de podología de la Universidad del Rey Juan Carlos de la Coruña, la Universidad de Sevilla y la Universidad Complutense de Madrid, organizado por una empresa de encuestas online. Respondieron un total de 432 estudiantes de podología. Resultados: Casi la mitad de los estudiantes afirmaron en la encuesta que creían en el derecho del podólogo a la objeción de conciencia en cualquier procedimiento. La exigencia del derecho a objeción de conciencia fue mayor en estudiantes de podología católicos que en otros grupos de otras religiones. Discusión: Examinar a pacientes y los tratamientos de podología continúan siendo temas controversiales entre los estudiantes de podología y esto puede que contribuya a la inminente crisis en servicios de pedicura en los próximos años. Este proyecto derrama algo de luz sobre como futuros podólogos ven algunos de sus derechos y obligaciones éticas. Usando evidencia científica, revela que la objeción de conciencia es un tema para los estudiantes de podología en España hoy día. Estos datos pueden ayudar a anticipar problemas que puedan surgir cuando estos estudiantes de podología califiquen y practiquen podología en la comunidad. Conclusión: Se necesitan pautas más claras para estudiantes de podología sobre el tema de objeción de conciencia en la Escuela de Podología.

Objetivo: Explorar atitudes com relação à objeção de consciência entre os estudantes de podologia na Espanha. Método: Aos estudantes de podologia da Universidade Universidade Rei Juan Carlos, de Corunha, da Universidade de Sevilla e da Universidade Complutense de Madri foram enviados por email um link para completar um questionário online anônimo, hospedado por uma empresa de pesquisa on-line. Um total de 432 alunos de podologia responderam. Resultados: Quase metade dos alunos nesta pesquisa afirmaram que acreditavam no direito de podólogo se opor conscientemente a qualquer procedimento. A demanda para o direito de se opor conscientemente é maior em estudantes católicos romanos, quando comparado com outros grupos religiosos de estudantes. Discussão: O exame de pacientes e tratamentos podiátricos continuam a ser problema de controvérsia entre os alunos de podologia e isso pode contribuir para a crise iminente nos serviços de podologia para os próximos anos. Este projeto lança alguma luz sobre a forma de o futuro podólogo conhecer alguns dos seus direitos e obrigações éticas. Usando a evidência empírica, revela que a objeção de consciência é um problema no corpo discente de podologia da Espanha, hoje. Estes dados poderiam ajudar a antecipar problemas que podem surgir quando esses estudantes de podología se qualificarem e praticarem a podologia na comunidade. Conclusão: Orientação mais esclarecida é necessária para alunos de podologia sobre a questão da objeção de consciência no curso de graduação.

Impact of shoe size in a sample of elderly individuals / Impacto do tamanho do calçado em uma amostra de idosos

Summary Introduction: The use of an improper shoe size is common in older people and is believed to have a detrimental effect on the quality of life related to foot health. The objective is to describe and compare, in a sample of participants, the impact of shoes that fit properly or improperly, as well as analyze the scores related to foot health and health overall. Method: A sample of 64 participants, with a mean age of 75.3±7.9 years, attended an outpatient center where self-report data was recorded, the measurements of the size of the feet and footwear were determined and the scores compared between the group that wears the correct size of shoes and another group of individuals who do not wear the correct size of shoes, using the Spanish version of the Foot Health Status Questionnaire. Results: The group wearing an improper shoe size showed poorer quality of life regarding overall health and specifically foot health. Differences between groups were evaluated using a t-test for independent samples resulting statistically significant (p<0.05) for the dimension of pain, function, footwear, overall foot health, and social function. Conclusion: Inadequate shoe size has a significant negative impact on quality of life related to foot health. The degree of negative impact seems to be associated with age, sex, and body mass index (BMI).

Resumo Introdução: o uso de sapatos com tamanhos inadequados é comum em pessoas idosas e acredita-se resultar em efeito negativo sobre a qualidade de vida relacionada à saúde do pé. O objetivo é descrever e comparar o impacto de uma amostra de participantes usando calçados de tamanho adequado e indivíduos com calçados de tamanho inadequado, e as pontuações relacionadas com a saúde do pé e geral. Método: de uma amostra de 64 participantes, com idade média de 75,3±7,9, de um centro ambulatorial, dados de autorrelato foram registrados e medidas do tamanho dos pés e dos calçados foram determinadas. Os escores foram comparados pelo Foot Health Status Questionnaire, na versão em espanhol, entre os grupos que usavam sapatos de tamanhos corretos e incorretos. Resultados: o grupo que utilizava sapatos inadequados mostrou pior qualidade de vida relacionada à saúde geral e no pé. Diferenças entre os grupos foram avaliadas utilizando o teste t para amostras independentes, sendo estatisticamente significativas (p<0,05) para dimensão da dor, função, calçados, saúde geral, do pé e função social. Conclusão: o uso de calçado inadequado tem um impacto negativo significativo sobre a qualidade de vida relacionada à saúde do pé. O grau de impacto negativo parece estar associado com idade, sexo e índice de massa corpórea (IMC).

Bioethical positioning of Spanish health professionals: a semi-quantitative study / Posición bioética de profesionales de la salud de España: un estudio semi-cuantitativo / Posicionamento bioético dos profissionais de saúde espanhóis: um estudo semi-quantitativo

The present study was undertaken to examine the positions of Spanish health professionals on a variety of bioethical issues and to determine the relationships between these positions and the professionals’ religious beliefs and political views. The study sample consisted of 50 individuals randomly selected from a database of Spanish health professionals who had received solid training in bioethics. A structured questionnaire was designed that contained six closed questions on positions on biomedical advances and science and biotechnology (eugenics, use of nonimplanted embryos for experimental purposes, human cloning, and the idea that science should have limits) and the respondents’ sociopolitical and religious views, and assessment scales were developed for the responses. The distribution of the responses was subjected to statistical analysis using analysis of variance (ANOVA). For the items with responses scored on a Likert scale, from ‘strongly agree’ to ‘strongly disagree’, the positions taken were moderately adverse, and the vast majority of respondents believed that there should be limits to science. Religious convictions had greater influence on the responses than political orientation. There was evidence that liberal beliefs corresponded with what the authors consider to be more progressive ideas about the bioethics issues addressed in the study. The important questions of bioethics require an interdisciplinary approach and a combination of state and private-sector action to strengthen the links between religion and science, keep general knowledge up to date, and properly train biotechnology professionals.

Se realizó el presente estudio para examinar las posiciones de profesionales de la salud española sobre una variedad de temas bioéticos y para determinar las relaciones entre estas posiciones y las creencias religiosas y puntos de vista políticos de los profesionales. La muestra del estudio consistió de 50 individuos seleccionados al azar de una base de datos de profesionales de la salud en España que habían recibido formación sólida en bioética. Se diseñó un cuestionario estructurado que contenía seis preguntas cerradas sobre posiciones acerca de avances biomédicos, de ciencia y biotecnología (eugenesia, uso de embriones no implantados para propósitos experimentales, clonación humana y la idea de que la ciencia debería tener límites), y los puntos de vista sociopolíticos y religiosos de los respondientes, y se desarrollaron escalas de evaluación para las respuestas. Se sometió la distribución de las respuestas a análisis estadístico usando análisis de varianza (ANOVA). Para los elementos con respuestas valuadas con una escala Likert, desde "fuertemente de acuerdo" a "fuertemente en desacuerdo", las posiciones tomadas fueron moderadamente adversas y la inmensa mayoría de los respondientes creían que debería haber límites para la ciencia. Las convicciones religiosas tuvieron mayor influencia en las respuestas que la orientación política. Hubo evidencia de que las creencias liberales se correspondieron con las que el autor consideraba ideas más progresistas sobre temas de bioética abordados en el estudio. Las preguntas importantes de bioética requieren una aproximación interdisciplinaria y una combinación de acción estatal y del sector privado para fortalecer los vínculos entre religión y ciencia, mantener el conocimiento general actualizado y formar apropiadamente a los profesionales de la biotecnología.

O presente estudo foi realizado para examinar a posição de profissionais de saúde da Espanha sobre uma variedade de temas bioéticos e determinar a correlação entre estas posições e crenças religiosas dos profissionais e pontos de vista políticos. A amostra estudada consistiu de 50 indivíduos selecionados aleatoriamente da base de dados de profissionais de saúde da Espanha que receberam sólido treinamento em bioética. Um questionário estruturado foi definido para conter seis questões fechadas sobre posições a cerca de avanços biomédicos, ciência e biotecnologia (eugenia, utilização de embriões não implantados para projetos experimentais, clonagem humana e a ideia de que a ciência deveria ter limites) e os pontos de vista sociopolítico e religioso dos respondentes, e escalas de avaliação foram desenvolvidas para as respostas. A distribuição das respostas foi objeto de análises estatísticas utilizando a análise de variância (ANOVA). Para os itens com respostas computadas pela escala de Likert, desde de ‘concorda fortemente’ a ‘discorda fortemente’, as posições tomadas foram moderadamente adversas, e a vasta maioria dos respondentes acreditaram que deveria haver limites para a ciência. Convicções religiosas tiveram maior influência nas respostas do que aquelas de orientação política. Houve evidência de que crenças liberais corresponderam com o que os autores consideram ser ideias mais progressistas sobre temas bioéticos direcionados pelo estudo. As importantes questões de bioética requerem uma abordagem interdisciplinar e uma ação combinada dos setores público (estatal) e privado para revigorar os elos entre religião e ciência, manter um conhecimento geral atualizado, e treinar adequadamente profissionais em biotecnologia.

Nurse attitudes in relation to health care ethics and legal regulations for nursing / Actitudes de las enfermeras en relación con la ética de la salud y las regulaciones legales de enfermería / Atitudes das enfermeiras com relação à ética em saúde e às regulamentações legais de enfermagem

The nursing environment is full of situations under ethical and legal constraints. Therefore this study focused on the knowledge, position and attitudes of nurses in relation to healthcare ethics and nursing legal regulations. We conducted a pretest and posttest study using a specific questionnaire administered to a convenience sample of nurses who worked in a healthcare system in Principado de Asturias, a northern state of Spain and were enrolled in a continuing nursing education program about ethical and legal aspects in the nursing profession. The main findings suggest that nurses are very concerned about situations that create ethical and legal conflicts but do not feel sufficiently trained. In general, they demonstrated sufficient knowledge to address the most frequent ethical and moral situations of nursing work, and the training received during a postgraduate course in ethics and legislation provided them with greater knowledge and tools to solve the dilemmas. In conclusion, although the nurses have university-level education about professional deontology, bioethics and nursing legislation, they require periodic continuing education.

El ámbito de la enfermería está llena de situaciones clínicas que comportan limitaciones éticas y legales. Por ello, este estudio se centró en demostrar el conocimiento, posicionamiento y actitudes de las enfermeras en relación con la las regulaciones ético legales inherentes a la práctica de enfermería. Se realizó un estudio pretest y posttest, mediante un cuestionario específico administrado a una muestra de conveniencia de las enfermeras que trabajaban en un sistema de salud en el Principado de Asturias de España, y que se habían inscrito en un curso de educación continua sobre los aspectos éticos y legales en la de enfermería profesional. Las principales conclusiones indican que las enfermeras están muy preocupadas por las situaciones que generan conflictos éticos y legales, pero no se sienten suficientemente capacitadas para resolverlas. En general, demostraron conocimientos suficientes para hacer frente a las situaciones ético-morales más frecuentes del trabajo enfermero, y la formación recibida durante un curso de posgrado en la ética y la legislación les proporcionó un mayor conocimiento y herramientas para resolver otros dilemas éticos. En conclusión, aunque las enfermeras tienen conocimientos aprendidos en la universidad sobre deontología profesional, bioética y legislación en enfermería, se requiere de una educación continua en el ámbito ético-legal en enfermería.

O âmbito da enfermagem está cheio de situações clínicas que comportam limitações éticas e legais. Por isso, este estudo se centrou em demonstrar o conhecimento, posicionamento e atitudes das enfermeiras com relação às regulamentações ético-legais inerentes à prática de enfermagem. Realizou-se um estudo pré-teste e pós-teste, mediante um questionário específico administrado a uma amostra de conveniência das enfermeiras que trabalhavam num sistema de saúde no Principado de Astúrias, Espanha, e que se inscreveram num curso de educação continuada sobre os aspectos éticos e legais da enfermagem profissional. As principais conclusões indicam que as enfermeiras estão muito preocupadas com situações que geram conflitos éticos e legais, porém não se sentem suficientemente capacitadas para resolvê-las. Em geral, demonstraram conhecimentos suficientes para fazer frente às situações ético-morais mais frequentes do trabalho de enfermagem, e a formação recebida durante um curso de pós-graduação em ética e legislação lhes proporcionou um maior conhecimento e ferramentas para resolver outros dilemas éticos. Em conclusão, ainda que as enfermeiras tenham conhecimentos aprendidos na universidade sobre deontologia profissional, bioética e legislação em enfermagem, se requer uma educação continuada no âmbito ético-legal em enfermagem.

El análisis de datos cualitativos mejora las investigaciones médicas / Qualitative data analysis improves medical research

Los métodos cualitativos pueden ayudar a comprender y mejorar las intervenciones médicas (clínica, educación, investigación y gestión) y las respuestas de los pacientes. Una de las fases clave en la investigación cualitativa es el análisis de los datos cualitativos. El análisis se fundamenta en la identificación de aquellos elementos relevantes de los participantes, sobre la base de su experiencia, situación social, entorno y expectativas. Objetivo: Describir las estrategias de análisis para los datos cualitativos, aplicados en investigación médica. Diseño: Revisión de la bibliografía de referencia sobre metodología cualitativa para el desarrollo de estrategias prácticas de análisis de datos cualitativos. Resultados: Se describen aproximaciones de análisis cualitativo que pueden aplicarse de manera deductiva e inductiva, junto al empleo de la codificación para guiar el análisis y la interpretación. Conclusión: Las investigaciones cualitativas pueden mejorar la descripción de fenómenos complejos en la investigación médica y en la práctica clínica. El análisis de datos cualitativos es un instrumento que ayuda a los médicos en su práctica clínica y en sus investigaciones...

History of bioethics in professional nursing education: a spanish view / Historia de la bioética en la educación profesional de enfermería: una visión española / História da bioética na educação do profissional de enfermagem: uma visão espanhola

Nursing education and the nursing profession must go hand by hand to emphasize efforts to improve knowledge in ethical decision-making and professional deontology. The nursing profession in Spain has struggled for legislation of the profession as well as a professional code of ethics. Based on the ethical specifications for nursing practice, it is evident that education in nursing ethics is of the most importance and should be emphasized as an integral component of higher-level nursing education. Nursing schools should seek to establish programs that effectively integrate the humanities with the biotechnological aspects of the profession and define strategies for monitoring nursing professionals who graduate from those schools.

La enseñanza y la profesión de enfermería deben ir de la mano para enfatizar la mejora del conocimiento en deontología y la toma de decisiones éticas y profesionales. La profesión de enfermería en España ha luchado por tener su propia legislación profesional, así como un código ético. Para la práctica de enfermería, es evidente que la educación en ética debe tener una gran importancia y debe ser un componente integral de la educación en enfermería universitaria. Las escuelas de enfermería deben tratar de establecer programas que integren de forma efectiva las humanidades con los aspectos biotecnológicos propios de la profesión, y definir estrategias de seguimiento y formación continua para los profesionales egresados.

O ensino e a profissão de enfermeiro devem se dar as mãos para enfatizar a melhoria do conhecimento em deontologia e a tomada de decisões éticas e profissionais. A categoria de enfermeiro na Espanha lutou para ter sua própria legislação profissional, assim como um código ético. Para a prática de enfermagem é evidente que a educação em ética deve ter uma grande importância e deve ser um componente integral da educação em enfermagem universitária. As escolas de enfermagem devem tratar de estabelecer programas que integrem de forma efetiva as humanidades com os aspectos biotecnológicos próprios da profissão, e definir estratégias de seguimento e formação contínua para os profissionais egressos dos cursos de enfermagem.