Suitability of therapeutic effort in paediatric intensive care units: Opinion and attitude of professionals. / Adecuación del esfuerzo terapéutico en unidades de cuidados intensivos pediátricos: opinión y actitud de los profesionales.

OBJECTIVE: To determine the opinion and describe the attitude of different health professionals on suitability of therapeutic effort. METHOD: Multi-centre, cross-sectional observational study carried out with nurses and doctors who work in the paediatric intensive care units of four hospitals in the Madrid region. A self-administered questionnaire, previously piloted to assess its viability, was used and a sealed box was set up at the nursing station to hand it in. The analysis was performed using SPSS 21.0 software. RESULTS: The 98.9% of the respondents were in favour of suitability of therapeutic effort. Doctors consider that the decision is made with the agreement of the multidisciplinary staff and the child's parents (48.8%). Of the nurses, 51.1% believe that the decision is made by agreement with the doctors and parents. Of the nurses, 65.5% state that they are never asked about decision-making for their patients. Of the doctors, 75% are always or almost always asked. Fifty-seven percent of the nurses and 83% of the doctors feel capable of making decisions about suitability of therapeutic effort. Of the professionals, 77.2% believe that suitability is used less often than required. CONCLUSIONS: There are differences between doctors and nurses both in the perception of the decision-making model and in the way to proceed. Professionals seem not to follow any protocols or circuits in the decision-making process.

Randomised crossover trial showed that using breast milk or sucrose provided the same analgesic effect in preterm infants of at least 28 weeks.

AIM: Repeated, ongoing exposure to pain influences the growth, cognitive and motor functions, behaviour, personality and neurodevelopment of preterm infants. We compared the analgesic effects of expressed breast milk (EBM) and 24% oral sucrose on preterm neonates during venipuncture. METHODS: This multicentre randomised, noninferiority, crossover trial focused on five neonatal university units in Madrid, Spain, from October 2013 to October 2014. It comprised 66 preterm infants born at less than 37 weeks and randomly split into two groups. They received either EBM or sucrose two minutes before venepuncture, together with nonnutritive sucking and swaddling, then the opposite procedure at a later point. Pain was measured with the premature infant pain profile (PIPP) and crying was also measured. RESULTS: There were no statistically significant differences between the groups. The PIPP scores were seven (4-9) with breast milk and six (4-8.25) with sucrose (p = 0.28). The 11 infants born at under 28 weeks of age showed higher median scores of nine (9-14) for breast milk and four (4-7) for sucrose (p = 0.009). CONCLUSION: EBM and 24% sucrose had the same analgesic effect during venipuncture in most of the preterm neonates, but sucrose worked better in extremely preterm infants.

[Questionnaire to evaluate the importance of the family in nursing care. Validation of the Spanish version (FINC-NA)]. / Cuestionario para evaluar la importancia de la familia en los cuidados de enfermería. Validación de la versión española (FINC-NA).

BACKGROUND: The nursing profession is focused on patient care, without forgetting that patients are part of a social group, the family. The aim of this study was the adaptation of the "Families' Importance in Nursing Care-Nurses' Attitudes" (FINC-NA) scale to the Spanish language and its validation. METHODS: A descriptive cross-sectional study was carried out, using the bidirectional translation method for linguistic-cultural adaptation. It was applied to the nursing staff in the Paediatric Department of a University Hospital in Madrid. To evaluate the psychometric properties of the Spanish version, reliability, internal consistence and construct validity were calculated. RESULTS: The sample consisted of 274 professionals. Cronbach´s Alpha coefficient for the total scale was 0.864, oscillating between 0.888 and 0.769 in the subscales. The principal components factor analysis identified 4 factors, which explained 54.22% of total variance. CONCLUSIONS: The new instrument makes it possible to determine the importance nurses give to participation by family members and their attitude to involving the latter in patient care, and the possibility of involving them in planning. It has been adapted to the Spanish population with good psychometrics results and enough evidence for its use in this context.

Evaluación y dimensiones que definen el clima y la satisfacción laboral en el personal de enfermería / Evaluation and dimensions that define the labor environment and job satisfaction in nursing staff

Objetivos. Describir las dimensiones con mayor impacto en la valoración de la satisfacción laboral y en la valoración del clima laboral en el personal de enfermería en un hospital de alta complejidad. Métodos. Estudio transversal analítico y observacional realizado a personal de enfermería en situación laboral estable. Métodos. El instrumento utilizado es un cuestionario adaptado de la encuesta de satisfacción Osakidetza. Variables resultado: valoración global del clima y satisfacción laboral. Variables independientes: características de las personas y de las organizaciones. Métodos. Se ha realizado un análisis multivariante global y por categoría profesional. Resultados. Se recibieron 1.676 cuestionarios. Edad media: 40,8 años (9,7); antigüedad: mediana 12 años (RI: 4–20). Resultados. La valoración media global del clima laboral fue de 5,9 (2) y de la satisfacción 6,7 (2). Resultados. Las variables que explican el clima laboral son: condiciones físicas, formación, satisfacción, promoción, organización interna, relación con compañeros, relación con compañeros de otros turnos, conocimiento de objetivos de la dirección y adecuación de las decisiones de la dirección y la satisfacción laboral son: aprovechamiento de la capacidad, reconocimiento, organización interna, satisfacción, información recibida, conocimiento de los objetivos de la dirección y receptividad de la dirección. Conclusiones. La valoración global tanto del clima como de la satisfacción es buena/alta tanto de modo global como por categorías, aunque las dimensiones que determinan esta valoración son diferentes dependiendo de cada categoría. Se observa que las dimensiones que definen el clima laboral están más relacionadas con el entorno laboral y las que definen la satisfacción más relacionadas con los profesionales(AU)

Objectives. To describe the dimensions with the greatest impact on the job satisfaction and work environment in the nursing staff in a tertiary hospital. Methods. Cross-sectional analytical and observational study, carried out in nurses with a full-time job. Methods. The instrument used was a questionnaire adapted from the satisfaction survey of the Basque Country (Spain) Outcome variables: global evaluation of work environment and job satisfaction. Independent variables: characteristics of individuals and organizations. Methods. An overall and by professional categories analysis has been made by a multivariate regression. Results. 1676 questionnaires were received. Average age: 40.8 years (9.7) Seniority: Median: 12 years (IR: 4–20). Results. The average overall evaluation of work environment was 5.9 (2) and of the job satisfaction 6.7 (2). Results. The variables that explain the work environment are: physical conditions, training, satisfaction, promotion, organization, relationships with colleagues, knowledge of the directive objectives, adequacy of management decisions. Job satisfaction is defined by: use of the professional capacity, recognition, organization, satisfaction, information, knowledge of the directive objectives and receptiveness of nursing directive. Conclusions. The overall evaluation of work environment and job satisfaction is good/high overall and by categories, although the dimensions that determine the evaluation are different depending on each category. It is noted that the dimensions that define the work environment are more related to work environment and those which define job satisfaction are more related to individual factors(AU)

[Evaluation and dimensions that define the labor environment and job satisfaction in nursing staff]. / Evaluación y dimensiones que definen el clima y la satisfacción laboral en el personal de enfermería.

OBJECTIVES: To describe the dimensions with the greatest impact on the job satisfaction and work environment in the nursing staff in a tertiary hospital. METHODS: Cross-sectional analytical and observational study, carried out in nurses with a full-time job. The instrument used was a questionnaire adapted from the satisfaction survey of the Basque Country (Spain) Outcome variables: global evaluation of work environment and job satisfaction. INDEPENDENT VARIABLES: characteristics of individuals and organizations. An overall and by professional categories analysis has been made by a multivariate regression. RESULTS: 1676 questionnaires were received. Average age: 40.8 years (9.7) Seniority: Median: 12 years (IR: 4-20). The average overall evaluation of work environment was 5.9 (2) and of the job satisfaction 6.7 (2). The variables that explain the work environment are: physical conditions, training, satisfaction, promotion, organization, relationships with colleagues, knowledge of the directive objectives, adequacy of management decisions. Job satisfaction is defined by: use of the professional capacity, recognition, organization, satisfaction, information, knowledge of the directive objectives and receptiveness of nursing directive. CONCLUSIONS: The overall evaluation of work environment and job satisfaction is good/high overall and by categories, although the dimensions that determine the evaluation are different depending on each category. It is noted that the dimensions that define the work environment are more related to work environment and those which define job satisfaction are more related to individual factors.