Prácticas de autocuidado en el adulto mayor con Diabetes Mellitus Tipo II / Self-care prectices in the elderly with Diabetes Mellitus II

Objetivo: Describir la vivencia del cuidado y el autocuidado en el adulto mayor diagnosticado de diabetes mellitus II. Material y método: Estudio cualitativo fenomenológico de enfoque explicativo-interpretativo. Se persigue entender las vivencias ante los autocuidados en personas diabéticas mayores de 65 años. Se lleva a término en el CAP Les Planes de Sant Joan Despí, Barcelona (España). Se realizó un muestreo opinático, no probabilístico intencionado y razonado. La muestra final se compuso de 13 participantes. Para la recogida de datos se utilizó la entrevista semiestructurada e individual. Las entrevistas se llevaron a cabo entre junio del 2019 y diciembre del 2020. Se realizó un análisis temático siendo concomitante a la recogida de estos. Resultados: El diagnóstico de diabetes supone para la persona el conocimiento sobre la pérdida de su salud, de la vivencia de este momento dependerá la forma en que afrontará la enfermedad. La mayoría de los pacientes de este estudio afirman no haber recibido ningún tipo de información sobre los cuidados a realizar respecto a la dieta, el ejercicio físico o el cuidado de los pies, aunque sí que recuerdan el tratamiento farmacológico. Conclusiones: El cuidado de enfermería en las personas con Diabetes Mellitus tipo II debe incluir la consideración de los aspectos físicos, tecnológicos, económicos y educativos de la persona cuidada, adaptando la planificación de los cuidados a cada una de ellas, según dichos factores. (AU)

Objective: To describe the experience of care and self-care in the elderly diagnosed with diabetes mellitus II Material and method: Qualitative phenomenological study with an explanatory-interpretive approach. The aim is to understand the experiences of self-care in diabetic people over 65 years of age. It takes place at the CAP Les Planes de Sant Joan Despí, Barcelona (Spain). An opinionated, non-probabilistic intentional and reasoned sampling was carried out. The final sample consisted of 13 participants. For data collection, the semi-structured and individual interview was used. The interviews were carried out between June 2019 and December 2020. A thematic analysis was carried out, concomitant with the collection of these. Results: Diagnosis of diabetes supposes for the person the knowledge about the loss of his health, the experience of this moment will depend on the way in which he will face the disease. Most of the patients in this study claim not to have received any type of information about the care to be taken regarding diet, physical exercise or foot care, although they do remember the pharmacological treatment Conclusions: Nursing care in people with type II Diabetes Mellitus should include the consideration of the physical, technological, economic and educational aspects of the person cared for, adapting the care planning to each one of them, according to these factors. (AU)

The nursing critical thinking in clinical practice questionnaire for nursing students: A psychometric evaluation study.

AIM: To adapt and validate the N-CT-4 Practice for use with Spanish nursing students. BACKGROUND: Promoting critical thinking is one of the primary objectives of nursing education programs all over the world. Using reliable and valid instruments to measure critical thinking is essential. The Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice) is used internationally to assess critical thinking in nursing practice. However, little is known about the possible applications of this instrument in the context of nursing education. METHODS: Two-phase study: Phase I, adaptation of the N-CT-4 Practice for use with nursing students and verification of its content validity; phase 2, cross-sectional study to validate its psychometric properties in a sample of 331 nursing students from three university nursing schools. A subsample of 34 students completed the questionnaire on two occasions, with a time interval of two weeks. The construct validity and reliability of the instrument were tested using confirmatory factor analysis, convergent validity, internal consistency reliability and test-retest reliability. The STROBE guidelines and the COSMIN checklist were followed. RESULTS: All items obtained optimal content validity values. The model fit indices obtained from the confirmatory factor analysis supported the hypothesis of the four-dimensional structure on which the original questionnaire was based. Cronbach's alpha of 0.96 indicated high reliability. The correlations between the total score and the scores for the dimensions were statistically significant, positive and high, with values above r = 0.78 (p < 0.05). Lin's concordance correlation coefficient was 0.6 (p < 0.001). CONCLUSIONS: The adapted version of the N-CT-4 Practice is suitable for measuring critical thinking skills in the educational context of the degree course in nursing in Spain. Its psychometric validation yielded satisfactory results.

Sexuality in people living with a serious mental illness: A meta-synthesis of qualitative evidence.

WHAT IS KNOWN ON THE SUBJECT: A serious mental illness influences sexual life and people affected have worries about their sexual health. People living with a serious mental illness can and want to participate in interventions related to sexual health. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: People who suffer a serious mental illness are interested in maintaining an active sex life. People who suffer a serious mental illness experience rejection when they open up and they lose intimate relationships or possibilities of meeting other people because of ignorance and prejudices surrounding mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE: Mental health services must respond to this need, that is including sexual needs assessment among routine standard practices or training nurses on sexual education to allow them to advise patients and their families and friends. Health systems should promote awareness programmes and reduce the stigma surrounding mental health and sexuality. ABSTRACT: INTRODUCTION: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality. AIM: To explain how people with a serious mental illness perceive and experience their sexuality. METHOD: A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. RESULTS: Four categories were identified: "Pathologized sexuality," which explains how the disorder and treatment affect sexuality; "Not my sexuality anymore," which describes feelings emerging from the perceived limitations and the role of self-acceptance; "Learning to manage intimate relationships," which explains the desire to establish intimate personal relationships and define their meaning; and "Reconstructing my sexuality," which elucidates the influence of the environment on sexuality. DISCUSSION: Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma. IMPLICATIONS FOR PRACTICE: Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.

'Staying alive' with antiretroviral therapy: a grounded theory study of people living with HIV in Peru.

BACKGROUND: To achieve an optimal quality of life through chronic disease management, people living with HIV (PLHIV) must adhere to antiretroviral therapy (ART). ART has been available throughout Peru since 2004 without cost in all regions; yet only 60% (43 200) of PLHIV receive ART and 32% are virally suppressed. Despite the low adherence, little is known about the experience of PLHIV with ART adherence in the context of Latin America. METHODS: A constructivist grounded theory design was used to understand the ART adherence experiences of PLHIV in Northern Peru. Unstructured interviews were conducted with 18 participants resulting in theoretical saturation. All interviews were recorded, immediately transcribed and analysed concurrently with data collection using constant comparative analysis with Atlas.ti (V.8) software. Rigour was maintained through openness, reflexivity, audit trail, memo writing, debriefings, member checks and positionality. RESULTS: The core category 'staying alive' emerged through the interaction of four categories, including: (1) overcoming barriers; (2) working with the healthcare team; (3) tailoring self-care strategies; and (4) appreciating antiretrovirals. Adherence is not a spontaneous outcome, instead, the surprise of HIV diagnosis transitions to living with HIV as a chronic disease. The healthcare team helps PLHIV realise ART is their life source by enhancing, supporting and facilitating self-care and overcoming barriers. CONCLUSION: Adherence emerges from experiential learning as PLHIV recognised ART as their life source in balance with their desire to continue living a normal life. Social support and healthcare team interventions help PLHIV implement tailored self-care strategies to overcome personal, social, and structural barriers to adherence. Healthcare professionals need to recognise the challenges confronted by PLHIV as they learn how to continue living while trying to stay alive.

From physical to emotional pain in chronic kidney disease: Nurses' perceptions.

BACKGROUND: Changes in body image are a recurring theme in the literature on chronic kidney disease (CKD). There is insufficient evidence identifying nurses' perceptions of this topic. OBJECTIVE: To explore nurses' perceptions of changes in the bodies of persons with CKD. DESIGN: Phenomenological study. METHODS: Data were collected by semi-structured interviews with nephrology nurses selected through pragmatic sampling until data saturation. The interviews were transcribed and analyzed using the seven phases of Colazzi. FINDINGS: Information saturation was achieved with six nurses. Coexisting elements were found between the physical and emotional impact of CKD, and therefore the data were organised into a central theme: "From physical to emotional pain in the individual's body". This central theme was defined by seven subthemes that describe the coexistence of these two physical and emotional spheres, giving rise to the appearance of important meanings in the changes occurring in the bodies of individuals diagnosed with CKD. These meanings included stigma, dysfunctionality, emotional pain, the feeling of slavery, lack of information, taboo and hope. CONCLUSIONS: In the nurses' perspective, the changes occurring in the bodies of people with CKD can transcend the physical sphere and acquire more complex meanings. Nurses have a unique insight into these complex meanings, which include all the domains of the person, and which have important implications for daily practice. IMPLICATIONS FOR PRACTIC: Nurses should have specialised training in providing effective responses to patients' emotional needs. It is also important to incorporate professional profiles that support nursing interventions.

Student satisfaction with content and language integrated learning in nursing education: A cross-sectional study.

Content and language integrated learning is an evidenced approach focused on teaching content in which the language is learnt implicitly, facilitating internationalization. The purpose of this study was to determine nursing student satisfaction with a clinical skills course taught in English in a non-English speaking country. It includes the exploration of variables, barriers, benefits, and competence acquisition as perceived by the students. A cross-sectional study was conducted using a self-reported questionnaire administered to students who had completed the Clinical Skills course during the 2016/17 and 2017/18 academic years (n = 159). The students did not perceive the lessons in English as a barrier to acquisition of knowledge and clinical skills (mean 1.08; SD 1.64), and they were satisfied with the lessons received (mean 4.04; SD 1.65). Most students considered that receiving lessons in English adds value to their training process (mean 4.04; SD 2.35), and most agreed that it would benefit them in future (mean 4.48; SD 1.75). From the outcomes of our investigation we conclude that the content and language integrated learning approach should be maintained in future courses owing to the evidenced benefits, which may advance professional internationalization and the nursing competence development of students, leading to high student satisfaction.