Be Bold: Use Nursing Knowledge to Guide the Practice / Sé audaz: utiliza el conocimiento de enfermería para guiar la práctica / Seja ousado: use o conhecimento de enfermagem para guiar a prática

The imagination, bravery, and audacity that many nurses have shown throughout the history of our profession lead to the recognition of nursing as a discipline, profession, and science. For maintaining it, the Sigma Theta Tau International Honor Society of Nursing ­Sigma­ (1) and other associated organizations promote the science-guided exercise of the practice through the creation and transfer of knowledge, emphasizing the three elements that nurture, legitimize, consolidate, and guarantee disciplinary autonomy: theory, research, and practice. Sigma, in its presidential call 2022-2023, invited nurses to be bold and contribute to the development of nursing knowledge.

La imaginación, valentía y audacia que muchas enfermeras han mostrado a lo largo de la historia de nuestra profesión llevaron a que hoy en día se reconozca a la enfermería como disciplina, profesión y ciencia. Para mantener este reconocimiento, la Sociedad Internacional de Honor de la Enfermería ­Sigma­ y organizaciones asociadas promueven el ejercicio de la práctica guiado por la ciencia a través de la creación y la traslación de conocimientos, haciendo énfasis en los tres elementos que nutren, legitiman, consolidan y garantizan la autonomía disciplinar: la teoría, la investigación y la práctica. Sigma, en su llamado presidencial 2022-2023, invita a las enfermeras de la práctica a que sean audaces y contribuyan al desarrollo del conocimiento de enfermería.

A imaginação, a coragem e a audácia que muitos profissionais de enfermagem demonstraram ao longo da história da nossa profissão fizeram com que a enfermagem fosse hoje reconhecida como disciplina, profissão e ciência. Para manter este reconhecimento, a International Nursing Honor Society (Sigma) e as organizações associadas promovem o exercício da prática guiada pela ciência através da criação e transferência de conhecimento, enfatizando os três elementos que nutrem, legitimam, consolidam e garantem a autonomia disciplinar: teoria, pesquisa e prática. A Sigma, na sua chamada presidencial 2022-2023, convida os profissionais de enfermagem praticantes a serem ousados ​​e a contribuírem para o desenvolvimento do conhecimento de enfermagem.

Necesidades de información para la toma de decisiones de los padres frente a la hospitalización de sus hijos en unidades de cuidado intensivo pediátrico / Information needs for decision-making of parents regarding the hospitalization of their children in pediatric intensive care units

Introducción: La hospitalización de un niño en una unidad de cuidado intensivo es un evento complejo que causa en sus padres y familiares trastornos psicosociales y psicosomáticos. Las restricciones en el acceso a la información, que empeoran estos cuadros y limitan su participación en el cuidado, crean necesidades en los padres que la enfermera debe satisfacer para ayudarlos a sobrellevar el estrés padecido. Infortunadamente, con frecuencia la perspectiva que padres y enfermeras tienen de estas necesidades difiere y genera conflictos. Identificar estas necesidades es entonces una prioridad para el cuidado de enfermería. Objetivos: Determinar las necesidades de información de los padres para la toma de decisiones frente a la hospitalización de sus hijos en la Unidad de Cuidado Intensivo Pediátrica del Hospital Federico Lleras Acosta de Ibagué, Colombia. Métodos: Se realizó un estudio de cohorte descriptivo, cualitativo, micro etnográfico. El contenido de la información, recolectada a través de entrevistas semiestructuradas (n=12) y notas de campo, fue analizado y constantemente comparado, hasta determinar categorías y subcategorías temáticas, de las cuales emergió una idea central. Resultados: Cinco categorías principales fueron establecidas: (i) la hospitalización de un niño afecta a la familia; (ii) cambios en el estado de ánimo; (iii) necesidades de comunicación; (iv) tomar decisiones; y (v) factores que influyen en la toma de decisiones. A partir de estas categorías emergió una idea central, Conocer para decidir. Conclusiones: Conocer y satisfacer las necesidades de información de los padres de niños hospitalizados le permitiría a la enfermera incluirlos en los planes de cuidado, ayudando así a todos a sobrellevar las consecuencias del estrés causado por la hospitalización. Al comparar nuestros resultados con los reportados en otras culturas, encontramos que las necesidades de los padres de niños hospitalizados en unidades de cuidado intensivo son similares, pero que su grado de acceso y participación en el cuidado y en la toma de decisiones difiere de acuerdo a la cultura.

Introduction: Hospitalization of a child in the intensive care unit is a complex process that is a cause of numerous psychosocial and psychosomatic issues to parents and families. Restrictions on access to information, which worsen these problems and limit parental participation in care, create needs in parents that the nurse should meet to help cope with the suffered stress. Unfortunately, a conflict is very often created between the perspective of parents and nurses of these needs. Identifying these needs is therefore a priority for nursing care. Purpose: To determine the informational needs of parents for making critical decisions over their hospitalized children in the Hospital Federico Lleras Acosta Pediatric Intensive Care Unit, in Ibagué, Colombia. Methods: A qualitative, descriptive, microethnographic study was conducted. The content of the data, collected through semi-structured interviews (n=12) and field notes, was analyzed and compared constantly, until determining thematic categories and subcategories, out of which emerged the core variable. Results: Five main categories were established: (i) child´s hospitalization affects the whole family; (ii) changes in mood; (iii) communication needs; (iv) decision making; and (v) factors influencing the decision making process. From these categories emerged the core variable: Knowing for Deciding. Conclusions: To meet and satisfy the need for information of parents of hospitalized children would allow the nurse to include them in care plans, thereby helping everyone to cope with the consequences of the stress of hospitalization. After comparing our results with those reported in other cultures, we found that the needs of parents of hospitalized children in Pediatric Intensive Care Units are similar, but their level of access and participation in care and decision-making differs significantly.

Fisiopatología de la retinopatía y nefropatía diabéticas / Pathophysiology of diabetic retinopathy and nephropathy

Despite the availability of multiple therapeutic approaches, diabetes mellitus with chronic hyperglycemia remains as the main cause of new cases of blindness and chronic renal failure in the western hemisphere. We herein review the molecular mechanisms by which chronic hyperglycemia causes retinopathy and nephropathy in type I and type 2 diabetic patients. Diabetic retinopathy develops silently along years or decades, producing symptoms only in its very ¡ate stages. Its slow development starts with the activation of aldose reducíase, shortly followed by the destruction of the retinal pericyte cells, and ends in sudden blindness when vitreous hemorrhage ensues. Nephropathy, on the other hand, centers its pathophysiology in the mesangial cell, that starts as a modified smooth-muscle cell, and turns itself into a myo-fibroblast, produces such amounts of cytoplasm and extracellular protein that strangulates the glomerular capillaries and causes renal failure. After a detailed review of the molecular mechanisms of the aforementioned complications, we conclude that, apart from directing our attention to the emerging medications that are being developed to block these molecular pathways, we should never abandon the struggle for improving the glycemic control of our diabetic patients.

Prevalencia de síncope en una muestra de mujeres mexicanas residentes de la ciudad de México / Prevalence of syncope in a sample of Mexican women residents in Mexico City

OBJECTIVE: To identify the frequency of syncope in a sample of women regular residents of Mexico City. METHODS: Two hundred and twenty one women between 18 and 88 years old with voluntary participation were included in the study. Trained interviewers through a structured questionnaire obtained syncope information. Prevalence of syncope was obtained, and it's relation with: age, time since the last syncope and frequency of syncope in their live span was registered. RESULTS: Thirty eight percent informed they had suffered syncope, of them 50% had only one syncopal episode during their lives. The others had two or more episodes. Most women had their last syncope between 19 and 50 years of age. CONCLUSIONS: The frequency of syncope was a little higher than previous studies. This is a first approximation, which must be corroborated with larger studies with well population variability representation.