Evolution of Quality of Life and Treatment Adherence after One Year of Intermittent Bladder Catheterisation in Functional Urology Unit Patients.

OBJECTIVE: To determine patient difficulties and concerns when performing IBC (Intermittent Bladder Catheterisation), as well as the evolution of adherence, quality of life, and emotional state of patients one year after starting IBC. METHOD: A prospective, observational, multicentre study conducted in 20 Spanish hospitals with a one-year follow-up. Data sources were patient records and the King's Health Questionnaire on quality of life, the Mini-Mental State Examination (MMSE), and the Hospital Anxiety and Depression Scale (HADS). Perceived adherence was measured using the ICAS (Intermittent Catheterization Adherence Scale) and perceived difficulties with IBC were assessed using the ICDQ (Intermittent Catheterization Difficulty Questionnaire). For data analysis, descriptive and bivariate statistics were performed for paired data at three points in time (T1: one month, T2: three months, T3: one year). RESULTS: A total of 134 subjects initially participated in the study (T0), becoming 104 subjects at T1, 91 at T2, and 88 at T3, with a mean age of 39 years (standard deviation = 22.16 years). Actual IBC adherence ranged from 84.8% at T1 to 84.1% at T3. After one year of follow-up, a statistically significant improvement in quality of life (p ≤ 0.05) was observed in all dimensions with the exception of personal relationships. However, there were no changes in the levels of anxiety (p = 0.190) or depression (p = 0.682) at T3 compared to T0. CONCLUSIONS: Patients requiring IBC exhibit good treatment adherence, with a significant proportion of them performing self-catheterisation. After one year of IBC, a significant improvement in quality of life was noted, albeit with a significant impact on their daily lives and their personal and social relationships. Patient support programmes could be implemented to improve their ability to cope with difficulties and thus enhance both their quality of life and the maintenance of their adherence.

Assessment, diagnosis and treatment of peristomal skin lesions by remote imaging: An expert validation study.

BACKGROUND: Prevention and treatment of peristomal skin problems should be a priority for nurses caring for ostomates, even when the assessment of lesions must be done remotely. OBJECTIVE: To measure the level of agreement on assessment, diagnosis and care indications for peristomal skin lesions using remote imaging among nurses in Spain. DESIGN: Prospective observational multicentre study to assess the diagnostic validity and inter- and intraobserver agreement between nurses in peristomal skin lesions. Data were collected between March and October 2019. SETTINGS AND PARTICIPANTS: The research sample consisted of a group of 39 nurses with expertise in the care of ostomates. METHODS: A panel of experts established a list of 24 common signs/findings, 15 diagnostic options and 35 treatment approaches for peristomal skin lesions. Three expert stoma therapy nurses compiled the clinical cases, which they described thoroughly and documented with photographs. The 39 participating nurses evaluated the cases in two rounds to measure inter and intraobserver agreement. RESULTS: A high or very high level of agreement (κ > 0.61) was observed for the following signs: encrustation, nodules, mucocutaneous separation and varicose veins; for the following diagnoses: mucocutaneous dehiscence, allergic contact dermatitis, encrustation and varicose veins (caput medusae); for the following treatments: recommending a diet rich in vitamin C/blueberries, applying acetic acid dressings, applying cold and topical tacrolimus treatment. CONCLUSIONS: The most easily identifiable lesions were those most prevalent and with visible signs. There was a lower level of agreement in identifying lesions for which photographs required additional information (laboratory data, description of signs and symptoms, type of diet and level of self-care). It is important to train nurses caring for ostomates to correctly describe ostomy-related lesions, which is important for nursing records, continuity of care and telehealth care.

Beneficios de la sonda hidrofílica Onli(R) en la técnica del cateterismo intermitente en pacientes con retención urinaria / Benefits of the Onli(R) hydrophilic probe in the intermittent catheterization technique for patients with urinary retention

Objetivo: conocer el grado de aceptación de la sonda vesical intermitente Onli(R) a través de la valoración de pacientes y profesionales enfermeros de consultas y unidades de urodinamia, en cuanto a su facilidad de empleo y la importancia que le atribuyen a sus características técnicas. Método: estudio observacional prospectivo multicéntrico sobre el uso y beneficios que aporta la sonda hidrofílica Onli(R) con tecnología vaporfílica en pacientes con disfunción vesical, cuyo tratamiento de elección es el sondaje vesical intermitente y la valoración por parte de los profesionales de Enfermería que atienden a dichos pacientes. Se utilizó un cuestionario de elaboración propia que contenía 27 ítems (20 para pacientes y 7 para profesionales) tipo Likert. Resultados: el estudio se realizó sobre la valoración de 137 pacientes y 29 profesionales de Enfermería de consulta de urodinamia procedentes de 23 hospitales españoles. El 84-92% de profesionales y pacientes consideran fácil o muy fácil el empleo de la sonda Onli(R) (inserción, progreso y retirada) y el 89-97% la disponibilidad, diseño y manejo del fiador en la sonda masculina y el diseño de la sonda femenina, que permiten la técnica "no tocar". El 97,1% de los profesionales, en función a su experiencia, consideró que es probable o muy probable que recomiende este tipo sonda. Conclusiones: la valoración de la sonda Onli(R) por parte de profesionales y pacientes ha presentado una muy buena aceptación, tanto por su diseño, características específicas y únicas de este tipo de sonda, como en la facilidad de uso y permitir la técnica "no tocar"

Objective: to understand the level of acceptance for the Onli(R) intermittent vesical probe through the assessment of patients and professionals in urodynamic practices and units, in terms of its ease of use and the importance assigned to its technical characteristics. Method: a multicenter prospective observational study on the use and benefits offered by the Onli(R) hydrophilic probe with steam technology in patients with vesical dysfunction, when the treatment of choice is intermittent vesical probing and the assessment by the Nursing professionals managing said patients. A self-prepared Likert-type questionnaire was used, including 27 items (20 for patients and 7 for professionals). Results: the study was conducted on the assessment by 137 patients and 29 Nursing professionals from urodynamic units in 23 Spanish hospitals. Of these professionals and patients, 84-92% considered easy or very easy to use the Onli(R) probe (insertion, progression and removal), and 89-97% the availability, design and management of the guide-wire in the male probe and the design of the female probe, which allow the "non-touch" technique. Based on their experience, 97.1% of professionals considered that they would be likely or very likely to recommend this type of probe. Conclusions: the assessment of the Onli(R) probe by professionals and patients has shown a very good acceptance, both for its design and the specific and unique characteristics of this type of probe, and for its ease of use and allowing the "non-touch" technique

Aproximaciones teóricas a la satisfacción de las necesidades de los niños de adopción internacional desde la perspectiva enfermera / Theoretical approach to the satisfaction of international adoption children needs from the nurse's point of view

Los niños de adopción internacional presentan problemas de salud consecuencia de la exposición a factores de riesgo e institucionalización, que no ofrece las condiciones necesarias para satisfacer sus necesidades. El objetivo del trabajo es sustentar teóricamente la satisfacción de las necesidades de los niños adoptados desde la perspectiva enfermera, tomando como referencia teorías de diferentes disciplinas. Desde el metaparadigma enfermero, la persona es el niño adoptado y su familia, la salud se analiza desde la Teoría de las Necesidades Infantiles de Ochaita y Espinosa, el entorno desde la Teoría Ecológica del Desarrollo Humano de Bronfenbrenner y el cuidado desde la Teoría de la Necesidades de Henderson

The Internationally Adoption children have health problems due to the exposure to risk factors and institutionalization, which does not provide the necessary conditions to satisfy their needs. This work aims to theoretically sustain the satisfaction of adopted children's needs from the nurse's perspective, reffering to theories of different disciplines. From the nursing metaparadigm, the adopted child and his family are the persons, health is analyzed from the Ochaita and Espinosa's Theory of Needs Children's point of view, the environment from the Ecological Theory of Human Development from Bronfenbrenner, and the care is analyzed Theory of Needs Henderson

Adecuación del uso de absorbentes de incontinencia urinaria en pacientes adultos ingresados en un hospital / Appropriateness of the use of incontinence absorbent products in hospitalized adults

INTRODUCCIÓN: La utilización inapropiada de absorbentes de incontinencia en adultos puede afectar negativamente a la autoestima, calidad de vida, e independencia del paciente, así como aumentar la carga de trabajo y provocar eventos adversos. Existen pocos estudios que valoren la adecuación del uso del pañal utilizando escalas validadas para ello, ni la justificación de las enfermeras para su uso en personas mayores hospitalizadas. OBJETIVO: Determinar la frecuencia de uso de pañal en pacientes ingresados en un centro hospitalario así como identificar los criterios que determinaron su uso y el grado de adecuación. MÉTODO: Estudio observacional, transversal sobre pacientes adultos que utilizaban pañal estando ingresados en unidades de hospitalización. Para la recogida de datos se realizó un corte de un día en abril de 2013, recogiendo datos de los registros de valoración de enfermería y de los propios pacientes y familia. Se utilizaron como criterios de adecuación los ítems del Índice de Barthel referentes a movilidad y eliminación. RESULTADOS: De los 228 pacientes ingresados 83 (34,4%) llevaban pañal y de ellos 25 (30,1%) no tenían criterios para su uso. El 28,8% (21) no utilizaba pañal previamente al ingreso siendo en la mitad de ellos inadecuado su uso. Los factores asociados al uso inadecuado de pañal fueron mayor edad, sexo femenino, más comobilidad y días de ingreso. CONCLUSIÓN: Los resultados de este estudio ponen de manifiesto la excesiva frecuencia con la que se utilizan los absorbentes de incontinencia de forma inadecuada sin que su uso se base en criterios validados

BACKGROUNDS: Improper use of incontinence absorbent products in adults can negatively affect self-esteem, quality of life and independence of the patient, as well as increase the workload and cause adverse events. There are few studies evaluating the appropriateness of diapers using validated scales for it, or the justification of nurses for its use in elderly who are hospitalized. · To determine the frequency of diaper use in patients admitted to a hospital and to identify the criteria that determined their use and adequacy. · Observational, cross-sectional study of adult patients using diapers while admitted in Inpatient Units. For data collection cut day was held in April 2013, collecting data from nursing assessment records, patients themselves and their family. Barthel Index items were used as criteria of adequacy concerning mobility and disposal. Results: 228 patients admitted. 83 (34.4%) of them had diapers and 25 (30.1%) of them had no criteria for using them. 28.8% (21) had not previously used diapers, the use of diapers in half of them was inappropriate. Factors associated with inappropriate use of diapers were older age, being female, more comorbidity and days of hospitalization. · The results of this study show the often excessive use of incontinence absorbent products without proper appplication, not based on validated criteria

[Appropriateness of the use of incontinence absorbent products in hospitalized adults]. / Adecuación del uso de absorbentes de incontinencia urinaria en pacientes adultos ingresados en un hospital.

BACKGROUNDS: Improper use of incontinence absorbent products in adults can negatively affect self-esteem, quality of life and independence of the patient, as well as increase the workload and cause adverse events. There are few studies evaluating the appropriateness of diapers using validated scales for it, or the justification of nurses for its use in elderly who are hospitalized. OBJECTIVE: To determine the frequency of diaper use in patients admitted to a hospital and to identify the criteria that determined their use and adequacy. METHOD: Observational, cross-sectional study of adult patients using diapers while admitted in Inpatient Units. For data collection cut day was held in April 2013, collecting data from nursing assessment records, patients themselves and their family. Barthel Index items were used as criteria of adequacy concerning mobility and disposal. RESULTS: 228 patients admitted. 83 (34.4%) of them had diapers and 25 (30.1%) of them had no criteria for using them. 28.8% (21) had not previously used diapers, the use of diapers in half of them was inappropriate. Factors associated with inappropriate use of diapers were older age, being female, more comorbidity and days of hospitalization. CONCLUSION: The results of this study show the often excessive use of incontinence absorbent products without proper application, not based on validated criteria.

Plan de mejora continua en prevención-tratamiento de úlceras por presión según el ciclo de Deming / Continuous improvement plan in prevention-treatment by pressure ulcers Deming cycle

Las úlceras por presión (UPP) constituyen un importante problema de salud, consumo de recursos e incluso de responsabilidad legal; de aquí surge la necesidad de crear un plan integral de mejora continua para abordar este problema. Las actuaciones dirigidas a la prevención, disminución de la variabilidad, y mejora en la coordinación entre todos los niveles asistenciales, son líneas estratégicas a seguir para reducir las cifras de prevalencia, con actuaciones concretas para su logro como la creación de un protocolo; la formación y concienciación de los profesionales; la actualización de material; asesoramiento a los familiares; mejora en la organización interna de los distintos servicios y un largo etcétera (AU)

(UPP) pressure ulcers, constitute a major health problem, consumption of resources and even legal liability; hence the need to create a comprehensive continuous improvement Plan to address this problem. Action aimed at prevention, reduction of variability, and improvement in coordination between all levels of care, are strategies to reduce the figures of prevalence, with specific actions for its achievement as the creation of a Protocol, the training and awareness of professionals; the updating of material, advice to relatives; improvement in the internal organizations of the various services; etc (AU)

Modelos explicativos y posicionamiento paradigmático de profesionales de la salud y pacientes ante un mismo proceso de enfermedad / Explanatory models and paradigmatic position of nurses and patients when faced with the same disease process

Los profesionales de Enfermería en el desarrollo de su trabajo tienen un contacto permanente con los pacientes, sin que el profesional sea consciente de los diferentes marcos referenciales que sobre el concepto de salud/enfermedad tienen los pacientes y ellos mismos. Objetivo del estudio: desvelar mediante el método etnográfico los modelos explicativos que enfermeras y pacientes manejan ante un mismo proceso de enfermedad (hipertensión y diabetes) e identificar la posición paradigmática en la relación enfermera-paciente. Material y método: el estudio se llevó a cabo desde una aproximación cualitativa. Escenario social: dos centros de salud de Ciudad Real en2010. Participantes: personas con diabetes y/o hipertensión arterial. Método de recogida de datos: observación durante el encuentro clínico entre la enfermera y el paciente y posteriormente entrevista semiestructurada a ambos. Análisis e interpretación: análisis de contenido de las entrevistas y de las metáforas utilizadas. Resultados: se realizaron un total de ocho entrevistas a pacientes y dos a enfermeras. Discusión: el desconocimiento demostrado por los enfermos parece estar relacionado con su nivel de instrucción y la clara influencia del paradigma racional tecnológico, habiendo evolucionado las enfermeras hacia el paradigma hermenéutico. Conclusiones: entender el modelo explicativo del otro es una oportunidad de acercamiento y de iniciar un proceso de cambio en el que el pacientes e corresponsabilice de sus autocuidados (AU)

Nursing professionals in the development of their work have regular contact with patients, without the professional being aware of the different frames of reference that patients have regarding the concept of health/illness and about themselves. Study objectives: to reveal by means of the ethnographic method the explanatory models that nurses and patients manage when faced with the same disease process (hypertension and diabetes) and to identify the paradigmatic position in the nurse-patient relationship. Material and method: qualitative study with ethnographic method that was conducted in two primary care centers of Ciudad Real in 2010. Participants were people with diabetes and/or arterial hypertension and the centre’s nurses. The used techniques were participant observation during the clinical meeting between the nurse and the patient, and subsequently, the semi-structured interview in both. Analysis and interpretation: contents analysis of the interviews and metaphors used. Results: there were a total of eight interviews to patients and to two nurses. Discussion: the lack of knowledge shown by patients appears to be related to their level of education and the influence of rational technological paradigm in which they are implemented, with nurses having evolved toward a hermeneutic paradigm. Conclusions: understanding the explanatory model of the other is an opportunity to approach and initiate a process of change in which the patient shares the responsibility of their self-care (AU)