[Content validation of the spanish version of the Long-term Quality of Life Instrument for long-term female breast cancer survivors.] / Validación de contenido de la versión en castellano del instrumento Long-term Quality of Life Instrument para mujeres supervivientes de cáncer de mama de larga duración.

OBJECTIVE: The quality of life of women affected by breast cancer diagnosed 5 or more years ago has been relatively unexplored in Spain; there are no instruments for its measurement validated. The objective of the study is to translate into Spanish, culturally adapt and examine the content validity of the Spanish version of the Long-Term Quality of Life Instrument (LTQL). METHODS: The initial translation was performed by two translators with Spanish as their mother tongue carried out the translation of the questionnaire, obtaining two initial versions in Spanish (T1 and T2). An analysis of the results and elaboration of a single preliminary version in Spanish (T-1-2) were performed. The retro-translation was performed by two translators with English as their mother tongue not familiar with the original version translated the joint version (T-1-2) back into the original language (RT1 and RT2) to identify inconsistencies. Finally, a final version of the questionnaire was obtained. For content validation a committee of experts (seven women affected by breast cancer) assessed the degree of clarity, accuracy and understanding of each of the items in the questionnaire translated into Spanish, and calculated the content validity index (CVI) of the questionnaire according to Lawshe and Tristán. RESULTS: The LTQL questionnaire was translated into Spanish with a low discrepancy between translators. An adequate CVI higher than 0.58 was obtained in clarity (0.95), precision (0.93), comprehension (0.91) and relevance (0.72). CONCLUSIONS: The LTQL is a useful questionnaire in the health field for the assessment of quality of life of women survivors of long-term breast cancer.

OBJETIVO: La calidad de vida de mujeres afectadas de cáncer de mama diagnosticadas hace 5 o más años ha sido relativamente poco explorada en España, no existen instrumentos para su medida validados. El objetivo del estudio fue traducir al castellano, adaptar culturalmente y examinar la validez de contenido del cuestionario Long-Term Quality of Life Instrument (LTQL). METODOS: La traducción inicial fue realizada por dos traductores con castellano como lengua materna que tradujeron independientemente el cuestionario (versiones T1 y T2). Se realizó un análisis de los resultados y se elaboró una única versión preliminar en castellano (T-1-2). La retrotraducción se realizó por dos traductores con inglés como lengua materna que tradujeron independientemente la versión conjunta (T-1-2) al idioma original (RT1 y RT2) para identificar inconsistencias. Finalmente, se obtuvo una versión final del cuestionario. Para la validación de contenido se constituyó un comité de expertas (siete mujeres afectadas de cáncer de mama) que valoró el grado de claridad, precisión, comprensión y relevancia de cada uno de los ítems del cuestionario traducido al castellano y se calculó el índice de validez de contenido (CVI) del cuestionario según Lawshe y Tristán. RESULTADOS: Se tradujo el cuestionario LTQL al castellano con una baja discrepancia entre los traductores. Se obtuvo un CVI adecuado mayor de 0,58 en claridad (0,95), precisión (0,93), comprensión (0,91) y relevancia (0,72). CONCLUSIONES: El LTQL en un cuestionario de utilidad en el campo de la salud para la evaluación de la calidad de vida de mujeres supervivientes de cáncer de mama de larga duración.

[Differences on postpartum family planning among nursing professionals.] / Diferencias en la planificación familiar posparto entre los profesionales de enfermería.

OBJECTIVE: In Spain, a total of 95,149 voluntary terminations of pregnancy (VTP) took place only in the year 2019, 90% of them requested by the woman, 53% of whom had at least one child. This situation highlights the relevance of postpartum family planning (PFP) and the work of the professionals in charge of its promotion. The aim of this study was to establish whether midwives and the rest of the nursing professionals regard PFP as an activity to perform within their professional role and how they implement it, as well as to identify their knowledge on it. METHODS: Study performed through an ad-hoc questionnaire between March 2017 and June 2019 in three groups of Nursing professionals dedicated to woman care (n=153) made up of: 1) Nurses specialized in Obstetrics and Gynecology Nursing (Midwifery) of the Delivery suite Department; 2) midwives in Primary Care; 3) Nurses in Postpartum Unit from 3 different hospitals and 37 associated health centers. Analysis by labor group and the comparison of the different professional activities were performed through Pearson chi-squared test or a likelihood ratio, depending on sample size in qualitative variables, and in quantitative variables, by Kruskal-Wallis' test. RESULTS: Not all professionals regard PFP as an activity within their professional role, and there is no consensus regarding its implementation (P<0.001). Concerning their level of knowledge, there are differences among professionals regarding the timeframe when the woman should receive the information on PFP (P=0.002), only 13% of them know that PFP should be started from day 21 of postpartum, and although 95% of them know about the incompatibility of breastfeeding with some contraceptive methods, this knowledge is higher among midwives than among general nurses (P=0.012). CONCLUSIONS: Although midwives are the most aware and knowledgeable professionals on PFP, the responsibility of informing women on postpartum contraception does not always fall on them, and this situation could have an effect on the woman's health and reduce the incidence of unwanted pregnancies.

OBJETIVO: En España, solo en 2019 se produjeron un total de 95.149 interrupciones voluntarias de embarazo (IVE), el 90% a petición de la mujer, de las cuales un 53% tenían al menos un hijo. Situación que resalta la importancia de la planificación familiar posparto (PFP) y la labor de los profesionales que se encargan de su promoción. El objetivo del presente estudio fue determinar si las matronas y el resto de los profesionales de Enfermería consideran la PFP como una actividad de su rol profesional y cómo la desarrollan, así como identificar sus conocimientos sobre ella. METODOS: Estudio realizado mediante un cuestionario ad hoc entre marzo de 2017 y junio de 2019 en tres grupos de profesionales de Enfermería dedicados al cuidado de la mujer (n=153) compuestos por: 1) enfermeras especialistas en Enfermería Obstétrico-Ginecológica (matronas) del Servicio de Paritorio; 2) matronas de Atención Primaria; 3) enfermeras de la Unidad de Puerperio, procedentes de 3 hospitales y sus 37 Centros de Salud asociados. Los análisis por grupo laboral y las comparaciones entre las distintas actividades profesionales se realizaron en las variables cualitativas mediante test chi-cuadrado de Pearson o razón de verosimilitudes, según tamaño de la muestra, y en las variables cuantitativas mediante test de Kruskal-Wallis. RESULTADOS: No todos los profesionales consideran la PFP una actividad de su rol profesional ni existe consenso en su desarrollo (P<0,001). En relación al nivel de conocimiento, existen diferencias entre los profesionales en cuanto al periodo en el que se debe informar a la mujer sobre PFP (P=0,002), solo un 12,7% conocen que la PFP se debe iniciar a partir del día 21 posparto, y aunque un 95,4% son conocedores de la incompatibilidad de la lactancia materna con algunos métodos anticonceptivos, este conocimiento es mayor entre las matronas que entre las enfermeras generalistas (P=0,012). CONCLUSIONES: Aunque las matronas son las profesionales más conscientes y conocedoras de la PFP, la responsabilidad de informar a la mujer sobre anticoncepción posparto no siempre recae sobre ellas, situación que podría repercutir sobre la salud de la mujer y la posibilidad de reducir la incidencia de embarazos no deseados.

Movement artifacts in pediatric cutaneous ultrasonography.

BACKGROUND: Cutaneous ultrasonography can be challenging in children. We aim to identify the most complicated cases and the best timing for assessment. METHODS: We retrospectively reviewed sonographic exams in pediatric patients from our cutaneous ultrasonography clinic over a two-year period. Movement artifacts were classified according to their consequences and their frequency was studied in relation to the age of the patient, location of the lesion, and underlying pathology. RESULTS: The overall frequency of exams affected by movement artifacts was 16.76% (91/543) and all belonged to children younger than 4 years of age. The frequency of impaired sonographies was particularly low in patients aged 0 to 4 months (12.77%; 6/47) and particularly high in children aged from 4 to 12 months (56.60%; 60/106). Regarding location, exams were more frequently disadvantaged when assessing the head and neck area (44.53%; 61/137). In relation to pathology, developmental anomalies showed a significantly higher frequency of exams damaged by movement artifacts (41.82%; 23/55). CONCLUSIONS: Cutaneous ultrasonography without sedation can be particularly difficult in children aged between 4 and 12 months, especially when lesions are located on the head and neck and a Doppler exam is required. When assessing congenital lesions, the first four months of life are ideal for a first examination.

Cognitive-emotional hyperarousal as a premorbid characteristic of individuals vulnerable to insomnia.

OBJECTIVE: To examine whether cognitive-emotional hyperarousal is a premorbid characteristic of middle-aged and young good sleepers vulnerable to stress-related insomnia. METHODS: Self-reported information was collected from two samples of 305 middle-aged and 196 young adults. From those adults, 149 middle-aged (50.34 +/- 4.47 years) and 85 young (20.19 +/- 1.31 years) good sleepers were selected for the present study. The Ford Insomnia Response to Stress Test (FIRST) was used to measure vulnerability to stress-related insomnia. Trait measures of personality, arousability, rumination, presleep arousal, and coping skills were entered as predictors in the linear regression models, at the same time controlling for gender, depression, and anxiety. RESULTS: The regression models showed that arousability (beta = 0.546), neuroticism (beta = 0.413), perceived stress (beta = 0.375), and rumination (beta = 0.214) were associated with FIRST scores in middle-aged adults. Among young adults, the regression models revealed that presleep cognitive arousal (beta = 0.448), arousability (beta = 0.426), neuroticism (beta = 0.320), presleep somatic arousal (beta = 0.290), emotion-oriented coping (beta = 0.220), and rumination (beta = 0.212) were associated with FIRST scores. Finally, individuals with high FIRST scores did not show lower scores in measures of cognitive-emotional hyperarousal compared with chronic insomniacs. CONCLUSIONS: These data suggest that cognitive-emotional hyperarousal may be a premorbid characteristic of subjects vulnerable to insomnia. It seems that maladaptive coping stress strategies and cognitive-emotional hyperarousal predispose to the development of insomnia and that interventions targeting these characteristics may be important in the prevention and treatment of chronic insomnia.

Nighttime sleep and daytime functioning correlates of the insomnia complaint in young adults.

The nighttime and daytime correlates of the insomnia complaint (IC) were assessed in an in-class survey on a sample of 1238 first year university students (18.85+/-1.45 years) at the Universidad Autónoma of Madrid, Spain. Evidence was found that the likelihood of complaining of insomnia was increased by perceiving difficulties with initiating and maintaining sleep, reporting low quality of nocturnal sleep, having a long sleep onset latency and having an evening circadian preference. The most strongly related daytime variables to IC being perceived difficulties in concentrating, feelings of irritability and fatigue, and symptoms of anxiety and depression. The data, in addition to confirm those of clinical studies on subjects complaining of insomnia, suggest that having an evening chronotype increases the vulnerability of adolescents and young adults to complain of insomnia.

Sleep and behavioral correlates of napping among young adults: a survey of first-year university students in Madrid, Spain.

OBJECTIVE: Between November 2002 and March 2003, the authors assessed the prevalence and correlates of napping among Spanish university students. PARTICIPANTS: The sample comprised 1,276 first-year university students; the mean age was 18.74 +/- 1.24 years, and 35.45% were men. METHODS: The study was cross-sectional, and the students completed self-report, anonymous questionnaires provided during an in-class survey. RESULTS: Almost half (44%) of the sample reported napping (90% did so after lunch for longer than 1 hour). Multiple logistic regression analysis showed that experiencing an irregular sleep-wakefulness pattern, having a morning school schedule, and being male were significant predictor variables of napping. Further significant outcome variables related to napping were having excessive daytime sleepiness, missing classes because of tiredness, better ability to concentrate later in the afternoon, and a perception of deeper nighttime sleep. CONCLUSIONS: Habitual napping is common among Spanish university students and associated with an irregular sleep-wakefulness pattern. Taking long postlunch naps seems to be used by students to cope with insufficient sleep and daytime sleepiness.

Insomnia and sleep quality among primary care physicians with low and high burnout levels.

OBJECTIVE: The aim of this study was to assess insomnia and sleep quality in primary care physicians with low and high burnout scores. METHODS: A representative sample of 240 physicians was drawn from 70 medical centers in Madrid, Spain. Based on quartile splits of the overall index of the Shirom-Melamed Burnout Questionnaire, 55 participants were allocated to a low-burnout group, and 58 were included in a high-burnout group. The questionnaire also included sociodemographic data, insomnia symptomatology, and the Pittsburgh Sleep Quality Index. RESULTS: Of the total sample, 18.8% met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for insomnia diagnoses. More individuals with high burnout scores (21.1%) than individuals with low burnout scores (6.9%) fulfilled these criteria. Results of multivariate logistic regression analyses showed that burnout was the only variable related to insomnia diagnoses (odds ratio=7.56; 95% confidence interval=2.38-14.02). Furthermore, the results of multivariate analysis of covariance, after adjustments for sociodemographic variables, indicated that subjects from the high-burnout group scored significantly higher than subjects from the low-burnout group on the global sleep quality index and its components, indicating significantly greater disturbed sleep for the former. CONCLUSION: The results of the present study provide support for a clear relationship between burnout and disturbed sleep, as shown by the high prevalence of insomnia and poor sleep quality among physicians with high levels of burnout.