Symptomatology and knowledge regarding pelvic floor dysfunctions and influence of gender stereotypes in female athletes.

Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions.

Determinants of Communication Failure in Intubated Critically Ill Patients: A Qualitative Phenomenological Study from the Perspective of Critical Care Nurses.

AIM: To explore what factors determine communication with awake intubated critically ill patients from the point of view of critical care nursing professionals. BACKGROUND: Impaired communication frequently affects mechanically ventilated patients with artificial airways in the intensive care unit. Consequences of communication breaches comprise emotional and ethical aspects as well as clinical safety, affecting both patients and their conversation partners. Identification of determining factors in communication with awake intubated patients is needed to design effective action strategies. DESIGN: A qualitative phenomenological approach was used. METHODS: Semi-structured interviews were used as the data collection method. A total of 11 participants from three intensive care units of three Majorcan public hospitals, selected by purposive sampling, were interviewed. FINDINGS: Three major themes regarding the communication determinants of the awake intubated critically ill patients were identified from the interviewees' statements: factors related to the patient (physical and cognitive functionality to communicate, their relational and communicative style and their personal circumstances), to the context (family presence, ICU characteristics, workload, availability/adequacy of communication aids, features of the messages and communication situations) and, finally, those related to the professionals themselves (professional experience and person-centredness). CONCLUSIONS: The present study reveals determinants that influence communication with the awake intubated patient, as there are attitudes and professional beliefs. RELEVANCE TO CLINICAL PRACTICE: The discovery of relations between different kinds of determinants (of patient, context or professionals) provides a multi-factor perspective on the communicative problem which should be considered in the design of new approaches to improve communicative effectiveness. This study is reported according to the COREQ checklist.

The emotional impact of COVID-19 on Spanish nurses and potential strategies to reduce it.

Background: Although the emotional and psychological impact of nurses' work had been identified before the COVID-19 pandemic, the pandemic aggravated risk indicators for their mental health. Aim: The objective of this study was to analyse the levels of anxiety, depression, post-traumatic stress and burnout of nurses in the Balearic Islands (Spain) during the pandemic to identify possible sociodemographic and related occupational factors. Design: A cross-sectional study of 892 nurses was conducted during four weeks from February to March 2021. Methods: Sociodemographic data related to the pandemic were collected and anxiety, depression, burnout and post-traumatic stress were measured with validated scales. A multivariate and predictive analysis was carried out with risk estimates. Findings: About 75.6% of the nurses had experience in COVID-19 units, and 49.1% had worked for more than 10 months in a COVID-19 unit. Nurses in COVID-19 units (hospital ward or ICU) were more likely to report emotional fatigue (OR 1.9, p < 0.001) and anxiety (OR 1.5, p = 0.021). In general, moderate post-traumatic stress was evident in general nurses (p = 0.027), and severe post-traumatic stress was evident in ICU nurses (p = 0.027). A 1.24-month reduction in COVID-19 patient care predicted reduced levels of emotional fatigue (5.45 points), depersonalisation (1.87 points) and post-traumatic stress (4.65 points) in nurses. Conclusion: Given the occurrence of new waves of COVID-19, the need to establish preventive strategies that focus on the personal and occupational characteristics related to these indicators and to implement urgent psychological support strategies is demonstrated. Impact: Given these findings, it is imperative solutions are urgently applied in order to prevent compounding risk to the health system.

Self-Perceptions and Behavior of Older People Living Alone.

It is currently acknowledged that older people prefer to live in their own home, even if they are lonely or disabled in some way. The factors that condition aging among older people members of the population living alone include the following: the existence or absence of a social network, gender, the home or place where they live, their capacity to function, and welfare and health resources. The main goal of this study was to explore the perceptions of older peoples over 75 years old about adaptation strategies and the social, gender, physical autonomy, and socio-health resource factors that determine their permanence at home. The authors used a qualitative methodology, within a critical social framework, based on the theories of Pierre Bourdieu. When the interviewees' discourse was analyzed, four main categories were evident: (a) "A desire to stay at home", (b) "Changes and every-day aspects of domestic life", (c) "Reliance on social and family assistance", and (d) "The use of social services and resources". In synthesis, the participants questioned the benefits of the type of home life offered by members of the family. They believed that, in some cases, this option did not overcome the problem of loneliness or the need to hire assistance. The findings of the study revealed that one needs to dispel the notion of geriatric care as a form of charity, and to distinguish between the activities of caring, providing support, and offering companionship to someone. It is important to identify products designed for older people who might live for a long time.

Emergency and Mental Health Nurses' Perceptions and Attitudes towards Alcoholics.

Knowing professionals' attitudes is the basis for the development of skills for dealing with drug dependence. These attitudes may affect patients' clinical safety and the cost-benefit ratio of the interventions. The goal of this study was to assess emergency and mental health nurses' attitudes and perceptions towards alcoholics. A multicenter prospective descriptive study was conducted in six hospitals with 167 emergency and mental health nurses. Nurses classified alcoholics as sick individuals, although there was a tendency to feel uncomfortable working with them. Results indicated that these professionals had a rejecting attitude towards moderate alcohol consumption. It found that there was a significant association between the attitude of the nurse and gender, with the degree of rejection towards the alcoholic being higher in men than in women, and with less punitive attitudes in professionals with 0 to 11 years of professional experience.

Canalización de vías venosas periféricas difíciles y utilidad de técnicas ecográficas en un Servicio de Urgencias / Catheterization in cases with difficult peripheral venous access, and the utility of ultrasound techniques in an Emergency Unit

Objetivo: averiguar los factores asociados con «vía venosa difícil» (VVD) en pacientes adultos atendidos en el servicio de urgencias, así como describir el uso que las enfermeras hacen de las técnicas de punción asistidas por ultrasonido (técnica eco-facilitada -EF- y técnica eco-guiada -EG-) y el grado de éxito de cada una frente a la técnica de canalización tradicional. Método: estudio descriptivo transversal realizado en pacientes adultos con «vía venosa difícil» atendidos en el servicio de urgencias del Hospital de Manacor (Mallorca). La enfermera que realizaba la canalización cumplimentaba un registro anónimo con variables relacionadas con su intervención, con la salud del paciente y con el éxito en cada una de las técnicas. Las pruebas de contraste de hipótesis utilizadas para determinar la asociación fueron la U de Mann-Whitney para variables cuantitativas y Chi cuadrado para categóricas. Resultados: se analizaron 51 casos. Las variables vinculadas a VVD fueron: no encontrar venas a la palpación (72,6%), no encontrar venas visibles (66,7%), historia previa de dificultad (66,7%) y más de dos intentos fallidos de canalización (49%). el factor agudo más común fue la hipotensión (29,4%), los factores crónicos más habituales fueron la obesidad (45,1%), tratamiento con quimioterapia (29,4%) y diabetes (23,5%). En 40 pacientes se utilizó la técnica «ciega» y en 39 casos se usaron técnicas asistidas por ecografía, que resultaron más eficaces que el abordaje habitual (p<0.05). Conclusiones: hay indicios de la existencia de factores asociados a la dificultad en la función periférica, las técnicas ecográficas permiten solucionar eficazmente estos casos provocando menor número de punciones (AU)

Objective: to find out the factors associated with «difficult venous access» (DVA) in adult patients managed at the Emergency Unit, as well as to describe the use by nurses of ultrasound-assisted puncture techniques (ultrasound-assisted (UA) technique and ultrasound-guided (UG) technique), and the degree of success of each one vs. the traditional catheterisation technique. Method: a descriptive transversal study conducted in adult patients with «difficult venous access» seen at the Emergency Unit of the Hospital de Manacor (Majorca). The nurse conducting the catheterization completed an anonymous record with variables associated with their intervention, the health of the patient, and success in each one of the techniques. the contrast hypothesis tests used to determine association were Mann-Whitney’s U for quantitative variables and Square Chi for categorical variables. Results: dirty-one (51) cases were studied. The DVA-associated variables were: not finding veins at palpation (72.6%), not finding visible veins (66.7%), previous history of difficulty (66.7%) and >2 failed catheterization attempts (49%). The most common acute factor was hypotension (29.4%), the most usual chronic factors were obesity (45.1%), chemotherapy treatment (29.4%) and diabetes (23.5%). The «blind» technique was used in 40 patients, and ultrasound-assisted techniques were used in 39 cases, which were more effective than the usual approach (p<0.05). Conclusions: there are signs of the presence of factors associated with difficulty in peripheral puncture; ultrasound techniques offer an effective solution for these cases, leading to a lower number of punctures (AU)

La atención sanitaria relacionada con el consumo de drogas en un contexto de crisis económica / Health care on drug use in economic crisis context

El objetivo de este artículo es describir cómo la crisis económica influye sobre diversos aspectos relacionados con el consumo de drogas. La actual crisis ha producido un cambio en la tendencia del consumo. Igualmente se constata un incremento en la incidencia de trastornos mentales. Se ha demostrado que las actitudes, percepciones y conocimientos de las enfermeras influyen en la calidad de la atención a estos drogodependientes. Estas actitudes pueden verse modificadas o influenciadas por factores personales, ambientales. La mayoría de autores consideran que la formación y los conocimientos adquiridos pre o postgrado o por experiencia son un aspecto importante para modificar las actitudes del personal sanitario. Los recortes también repercuten en la formación e investigación de los profesionales sanitarios, influyendo a su vez en la calidad asistencial prestada

The aim of this article is to describe how the economic crisis influences on various aspects related to drugs use. The current crisis there has been a change in the trend of consumption. Similarly there is an increase of incidence of mental disorders. It has been shown that attitudes, perceptions and knowledge of nurses have an impact on the quality of the care of these drug-dependent. These attitudes may be changed or influenced by factors, personal and environment. It should be noted that most authors believe that the undergraduate and postgraduate training and knowledge or practical experience are an important aspect to modify the attitudes of health personnel. The cuts will also have an impact on the training and research of health care professionals, influencing in turn the quality of care provided

Percepción, conocimientos y actitudes de las enfermeras de urgencias y salud mental frente al alcoholismo y otras drogodependencias / Perception, knowledge and attitudes of Emergency and Mental Health nurses regarding alcoholism and other drug dependencies

OBJETIVO: describir las percepciones, conocimientos y actitudes delos profesionales de Enfermería que tratan pacientes consumidores de alcohol en las unidades de Urgencias y Salud Mental de hospitales de las Islas Baleares. MATERIAL Y MÉTODO: estudio descriptivo transversal multicéntrico sobre las enfermeras de los servicios de Urgencias y Salud Mental de cinco hospitales de las Islas Baleares. Para la recogida de los datos se utilizó la escala validada al castellano de Seaman e Mannello, que mide los conocimientos y las actitudes de los profesionales de Enfermería con relación al alcoholismo y al consumo del alcohol. RESULTADOS: se recogieron 159 cuestionarios de un universo de257. El 99,1% había tenido contacto con personas con drogodependencias durante su experiencia profesional. Cerca del 75% había tenido dificultades a la hora de atenderlos (20,6% por falta de protocolos y 17,1% por la falta de recursos). Los aspectos que dificultaban la atención eran: falta de conocimientos, actitud del propio profesional y percepción social, falta de habilidades en la comunicación, experiencias previas, organización y tipo de servicio donde trabajaba y opiniones personales. Cuando tenían dificultades, consultaban a otros profesionales para resolver sus dudas; solamente un 7,1% acudía a bases de datos científicas como fuente confiable de información. CONCLUSIONES: la enfermera percibe al paciente alcohólico como una persona enferma que necesita terapia. El déficit de conocimientos es el factor que más negativamente influye en la atención que se presta al drogodependiente, las actitudes aparecen en menor medida. El aspecto organizativo y lugar de trabajo también intervienen

OBJECTIVE: to describe the perceptions, knowledge and attitudes of nursing professionals who treat alcoholic patients in the Emergency and Mental Health units of hospitals in the Balearic Islands. MATERIALS AND METHOD: a descriptive transversal multicenter study with nurses in the Emergency and Mental Health units of five hospitals in the Balearic Islands. For data collection, the Seaman-Mannello Scale was used, validated into Spanish, which measures the knowledge and attitudes of Nursing professionals regarding alcoholism and alcohol intake. RESULTS: 150 questionnaires were collected, out of a universe of257. Out of these, 99.1% had become in contact with drug dependent persons during their professional experience. Almost 75% of them had had difficulties when managing them (20.6% due to lack of protocols, and 17.1% due to lack of resources). The factors which made patient care difficult were: lack of knowledge, attitude by the professional and social perception, lack of communication skills, previous experiences, organization and type of unit where they worked, and personal opinions. When they had difficulties, they consulted other professionals to clarify their doubts; only 7.1% used scientific databases as a reliable source of information. CONCLUSIONS: nurses perceive alcoholic patients as sick persons who need therapy. Lack of knowledge is the factor with the highest negative impact on patient care offered to drug dependent patients, while attitudes appear to a lesser extent. Organization aspects and place of work are also involved