ABSTRACT
Many healthcare professionals are unaware of the necessary skills and barriers hindering interpersonal health communication. This study aimed to evaluate the healthcare professional's perception regarding health communication training's necessity, barriers, facilitators and critical skills in health communication. Data from a cross-sectional online survey in the framework of the H-Com project were utilized. The study included 691 healthcare professionals (physicians, nurses, students and allied health professionals) from seven European countries. Only 57% of participants had participated in health communication training, while 88.1% of them indicated a willingness to be trained in health communication. Nurses were more likely (OR = 1.84; 95% CI 1.16, 2.91) to have received such training, compared to physicians. Most examined communication skills, barriers and facilitators of effective communication, and perceived outcomes of successful communication were considered crucial for most participants, although physicians overall seemed to be less concerned. Most agreed perceived outcomes were improved professional-patient relations, patient and professional satisfaction, physical and psychological health amelioration and patients' trust. Nurses evaluated the importance of these communication skills and communication barriers, facilitators and outcomes higher than physicians. Physicians may underestimate the importance of communication skills more than nurses. Health communication should become an integral part of training for all health professionals.
ABSTRACT
PURPOSE: To assess the association between vulnerable populations and nursing care needs, using NANDA-I diagnostics, in the population of the Canary Islands, Spain. METHODS: Nursing social epidemiology study. Cross Mapping of Medical Records to NANDA-I to Identify Nursing Diagnoses in a Population usinga medical, epidemiological follow-up study of a cohort of 7,190 people. The level of vulnerability of the participants was assigned, among those who were also assigned nursing diagnoses, using the "ICE index" to calculate the expected associations. FINDINGS: The most prevalent nursing diagnosis in our sample was Sedentary lifestyle (60.5%), followed by Ineffective health self-management (33.8%) and Risk-prone health behaviour (28.7%). Significant differences were found by sex, age group and social class, with the nursing diagnoses included in the study being more prevalent among the most socio-economically disadvantaged social class. CONCLUSIONS: The cross-mapping method is useful to generate diagnostic information in terms of care needs, using the NANDA-I classification. The expected associations between high social vulnerability and care needs have been verified in a comprehensive and representative sample of the Canarian population (Spain). IMPLICATIONS FOR NURSING PRACTICE: From an epidemiological perspective, identifying nursing diagnoses at the population level allows us to find the most prevalent needs in the different community groups and to focus appropriate nursing interventions for their implementation and impact assessment.
OBJETIVO: Evaluar la asociación entre las poblaciones vulnerables y las necesidades de cuidados de enfermería, utilizando la clasificación diagnóstica NANDA-I, en la población de las Islas Canarias, España. MÉTODOS: Estudio de epidemiología social enfermera. Mapeo cruzado de registros médicos con la clasificación NANDA-I para identificar los diagnósticos de enfermería en una población mediante un estudio de seguimiento médico y epidemiológico de una cohorte de 7.190 personas. Se asignó el nivel de vulnerabilidad de los participantes, entre los que también se asignaron diagnósticos de enfermería, utilizando el "índice REI" para calcular las asociaciones esperadas. RESULTADOS: El diagnóstico de enfermería más prevalente en nuestra muestra fue Estilo de vida sedentario (60,5%), seguido de Autogestión ineficaz de la salud (33,8%) y Tendencia a adoptar conductas de riesgo para la salud (28,7%). Se encontraron diferencias significativas por sexo, grupo de edad y clase social, siendo los diagnósticos de enfermería incluidos en el estudio más prevalentes entre la clase social más desfavorecida socioeconómicamente. CONCLUSIONES: El método de mapeo cruzado es útil para generar información diagnóstica en términos de necesidades de cuidados, utilizando la clasificación NANDA-I. Se han verificado las asociaciones esperadas entre alta vulnerabilidad social y necesidades de cuidados en una muestra amplia y representativa de la población canaria (España). IMPLICACIONES PARA LA PRÁCTICA ENFERMERA: Desde una perspectiva epidemiológica, la identificación de los diagnósticos de enfermería a nivel poblacional permite encontrar las necesidades más prevalentes en los diferentes grupos de la comunidad y focalizar las intervenciones enfermeras adecuadas para su implementación y evaluación de impacto.
Subject(s)
Nursing Diagnosis , Standardized Nursing Terminology , Humans , Vulnerable Populations , Follow-Up Studies , Medical RecordsABSTRACT
We investigate child height inequality and inequality of predicted height in the Sub-Saharan Africa (SSA) region by socioeconomic, demographic and geographical factors. We characterize their changes in age-cohorts (from 0-1 up to 4-5 years old) and determine the contribution of each factor to these changes. We extract data from the Demographic and Health Surveys (DHS) for 33 SSA countries covering the period from 2009 to 2016. Our measure of health is the standardized height of children below the age of five, adjusted by the age and gender distribution in each country. We show that height inequality is lower for older children than for their younger peers. However, the share of inequality caused by our set of factors rises along the age distribution in more than 80% of countries. We find that family background (reflected by maternal education and the household wealth), followed by home infrastructures related to water, toilet and cooking facilities, and the region of residence contribute to explaining the differences observed in child health inequality along the age distribution in SSA.
Subject(s)
Child Health , Health Status Disparities , Child , Humans , Adolescent , Socioeconomic Factors , Educational Status , Body Height , Health SurveysABSTRACT
Objetivo: Diseñar y validar un procedimiento enfermero de cribado de la neuropatía periférica diabética en atención primaria. Método: El estudio se llevó a cabo en tres fases. 1) Construcción de un banco de ítems para conformar el procedimiento con una puntuación de salida que describiera la situación clínica del paciente. 2) Prueba y reducción del procedimiento tentativo inicial sobre una muestra de 50 pacientes usuarios de consultas enfermeras comunitarias, eliminando los componentes con baja fiabilidad inter-intra enfermeras. 3) Validación de la versión del procedimiento obtenida en el paso anterior sobre una muestra de 106 pacientes. Cálculo de validez y fiabilidad eliminando componentes con baja validez de criterio respecto a los resultados de la electromiografía diagnóstica utilizada como patrón de referencia. Se estimaron puntos de corte para el empleo del procedimiento como herramienta de cribado, valores predictivos, rendimiento, consistencia interna y fiabilidad inter-intra enfermera. Resultados: El procedimiento tentativo inicial constó de 12 componentes que fueron reducidos a 10. En el proceso de validación de esta segunda versión el procedimiento se simplificó nuevamente, quedando conformado por 6 componentes, con un punto de corte de 2,5 en su escala de salida, punto en el que alcanza valores adecuados de sensibilidad y predictivos negativos para emplearlo como instrumento de cribado. Para este punto de corte la fiabilidad inter-intra enfermeras, la validez de criterio y la validez predictiva alcanzaron valores aceptables. Conclusiones: NeuDiaCan como procedimiento de cribado enfermero de la neuropatía periférica diabética en atención primaria resulta válido, fiable y de fácil empleo
Objective: To design and validate a nursing screening procedure for diabetic peripheral neuropathy in primary care. Methods: The study was carried out in three phases. 1) Construction of an item bank to form the procedure with an exit score describing the patient's clinical situation. 2) Test and reduction of the initial tentative procedure on a sample of 50 patients using community nurse consultations, eliminating the components with low inter-intra nurse reliability. 3) Validation of the version of the procedure obtained in the previous step on a sample of 106 patients. Calculation of validity and reliability by eliminating components with low criterion validity with respect to the results of the diagnostic electromyography used as a reference standard. Cut-off points were estimated for the use of the procedure as a screening tool, predictive values, performance, internal consistency and inter-nurse reliability. Results: The initial tentative procedure consisted of 12 components that were reduced to 10. In the process of validation of this second version the procedure was simplified again, eventually comprising 6 components, with a cut-off point of 2.5 in its output scale, the point at which it reaches adequate values of sensitivity and negative predictors to be used as a screening instrument. For this cut-off point the inter-intra nurse reliability, criterion validity and predictive validity reached acceptable values. Conclusions: NeuDiaCan as a nursing screening procedure for diabetic peripheral neuropathy in primary care is valid, reliable and easy to use
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Peripheral Nervous System Diseases/diagnosis , Peripheral Nervous System Diseases/nursing , Diabetic Neuropathies/diagnosis , Diabetic Neuropathies/nursing , Observer Variation , Reproducibility of Results , ElectromyographyABSTRACT
OBJECTIVE: To design and validate a nursing screening procedure for diabetic peripheral neuropathy in primary care. METHODS: The study was carried out in three phases. 1)Construction of an item bank to form the procedure with an exit score describing the patient's clinical situation. 2)Test and reduction of the initial tentative procedure on a sample of 50 patients using community nurse consultations, eliminating the components with low inter-intra nurse reliability. 3)Validation of the version of the procedure obtained in the previous step on a sample of 106 patients. Calculation of validity and reliability by eliminating components with low criterion validity with respect to the results of the diagnostic electromyography used as a reference standard. Cut-off points were estimated for the use of the procedure as a screening tool, predictive values, performance, internal consistency and inter-nurse reliability. RESULTS: The initial tentative procedure consisted of 12 components that were reduced to 10. In the process of validation of this second version the procedure was simplified again, eventually comprising 6 components, with a cut-off point of 2.5 in its output scale, the point at which it reaches adequate values of sensitivity and negative predictors to be used as a screening instrument. For this cut-off point the inter-intra nurse reliability, criterion validity and predictive validity reached acceptable values. CONCLUSIONS: NeuDiaCan as a nursing screening procedure for diabetic peripheral neuropathy in primary care is valid, reliable and easy to use.
Subject(s)
Diabetes Mellitus , Diabetic Neuropathies , Diabetic Neuropathies/diagnosis , Humans , Mass Screening , Primary Health Care , Reproducibility of ResultsABSTRACT
Objetivo: Diseñar y validar un cuestionario para valorar el riesgo de embarazo adolescente no planificado (EANP). Método: Diseño de un cuestionario para valorar el riesgo de EANP a partir de todos los factores relacionados descritos en la literatura. Se validó posteriormente sobre una muestra de adolescentes de La Palma clasificadas como EANP y no EANP con estimación de fiabilidad por test-retest. Resultados: El cuestionario partía de 36 ítems. Con la finalidad de validar la apariencia y el contenido de este cuestionario inicial, se constituyó un grupo de expertos y otro de adolescentes con EANP. La muestra de validación la conformaron 148 adolescentes, con una media de edad ± desviación estándar de 21 ± 2 años, entre las que figuraba un 36% de EANP. Se eliminaron 27 ítems por no tener relación con el EANP. Su coeficiente alfa de Cronbach alcanzó un valor de 0,78 con la eliminación de un ítem redundante, por lo que el cuestionario final quedó conformado por 8 ítems. La validez de constructo mediante análisis factorial confirmatorio ratificó la estructura de 5 dimensiones, con un 76% de variabilidad de respuestas explicada. Se establecieron reglas cualitativas de afectación de ítems, dimensiones y de salida global del cuestionario. La validez de criterio mostró una sensibilidad de 0,87 (intervalo de confianza [IC] del 95%: 0,81-0,93) y un valor predictivo de resultado negativo de 0,86 (IC del 95%: 0,80-0,92). La fiabilidad presentó un índice kappa de 0,77 (IC del 95%: 0,70-0,84). Todos estos parámetros alcanzaron un valor de p <0,001. Conclusión: Las propiedades métricas del cuestionario obtenido (Instrumento de valoración del Riesgo de Embarazo No Esperado [IRENE]), junto con su facilidad y rapidez de administración, lo convierten en un medio adecuado de cribado para detectar a una adolescente en situación de riesgo de embarazo no planificado y valorar sobre qué aspectos podemos incidir para intentar reducirlo
Objective: Design and validate a questionnaire to assess the risk of unplanned adolescent pregnancy (UAP). Method: The design of a questionnaire to assess the risk of UAP from all the related factors described in the literature. It is subsequently validated on a sample of adolescents from La Palma classified as UAP and not UAP with reliability estimation by test-retest. Results: The questionnaire starts from 36 items. An expert group and another group of teenagers with UAP carry out their validity of appearance and content. The validation sample is made up of 148 adolescents aged 21 ± 2 years with 36% of UAP. 27 items are eliminated because they are not related to the UAP. The Cronbach alpha reaches 0.78 with an elimination of a redundant item, the final questionnaire was formed by 8 items. The construct validity by confirmatory factor analysis confirms the 5-dimensional structure with 76% variability of responses explained. Qualitative rules of affectation of items, dimensions and global exit of the questionnaire are established. The criterion validity shows 0.87 (95% CI: 0.81-0.93) of sensitivity and 0.86 (95% CI: 0.80-0.92) of predictive value of negative result. Reliability presents a kappa index of 0.77 (95% CI: 0.70-0.84). All these parameters achieve p <0.001. Conclusion: The metric properties of the questionnaire obtained (Unexpected Pregnancy Risk Assessment Instrument [IRENE]), together with its ease and speed of administration, make it an adequate means of screening to detect a teenager at risk of unplanned pregnancy and assess what aspects we can influence to try to reduce it
Subject(s)
Humans , Female , Pregnancy , Adolescent , Pregnancy in Adolescence/prevention & control , Pregnancy in Adolescence/statistics & numerical data , Risk Assessment/methods , Pregnancy, Unwanted , Health Status Indicators , Surveys and Questionnaires , Confidence Intervals , Spain , Data AnalysisABSTRACT
La muerte, y todo lo relacionado con ella, ha sido un tema que ha inquietado a hombres y mujeres a lo largo de la historia. El abordaje de los diversos conceptos en torno a la muerte y lo que sucederá posteriormente a ella puede hacerse a través de diversas disciplinas siendo una de ellas la antropología. El presente trabajo pretende ser una aproximación a las diversas ideas que tienen respecto a la muerte, el morir y lo que imaginan que sucede posteriormente a ella, un grupo de veinte ancianos residentes en una residencia de válidos del barrio de Ofra. Para ello, estableciendo unos criterios de inclusión, hemos utilizado como método la entrevista semiestructurada organizada en torno a unas preguntas centrales. A través de los resultados obtenidos pretendemos exponer descriptivamente la variedad de conceptos e ideas en este grupo concreto de población (AU)
