Impact of the COVID-19 pandemic on the self-care and health condition of the older adults. CUIDAMOS+75. A mixed methods study protocol.

Aims: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. Design: Multicentric, mixed method concurrent study. Methods: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). Discussion: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. Trial Registration: Identifier: NCT05249868 [ClinicalTrials.gov].

Patient Safety Culture from a Nursing Perspective in a Chilean Hospital.

Patient safety culture is relevant both in the delivery of care and in the training of nursing staff, its purpose being to prevent and reduce risks associated with health care. This research aims to evaluate patient safety culture from the perspective of the nursing teams in a highly complex public hospital in the city of Valparaíso, Chile. A cross-sectional study with a quantitative approach applying descriptive, bivariate, and inferential statistical analysis was conducted on 259 nurses and nursing assistants from 13 adult medical-surgical units of the Carlos Van Buren hospital. The participants were obtained through a non-probabilistic convenience sample, answering the hospital survey on Patient Safety Culture version 2.0 (HSOPS 2.0), adapted to the Chilean population. The best-evaluated dimension was communication and receptivity; the worst was the support administrators provide for patient safety. This study identified the weaknesses and strengths of the hospital, the most worrying weakness being the shortage of human capital, material, and financial resources necessary to improve patient safety. This study was not registered.

Can Virtual Reality Help Improve Motor and Cognitive Function in Active Aging in Older Adults? A Scoping Review.

BACKGROUND: Active aging is considered one of the most effective methods for a healthy aging process. There are numerous clinical practice guidelines that address this model and propose multiple strategies for its achievement through the improvement of motor and cognitive function. Virtual reality is emerging as a potential tool, with various modalities focused on promoting good health maintenance in older adults. The objectives of this review were to map the potential benefits of virtual reality for active aging and delve into adaptability and adherence in older individuals. METHODS: A scoping review was conducted on studies published between 2013 and 2023 in English, Spanish, or Catalan, examining virtual reality interventions in older adults. The search was performed using the Medline, CINAHL, Scopus, and Web of Science databases. The methodological quality was assessed using CASPe and FLC 3.0 critical appraisal guidelines. The graphical data were reported narratively, grouping results based on the study characteristics and the impact of virtual reality. RESULTS: The review process resulted in the inclusion of 22 articles out of the initial 459 following the application of the selection criteria. Most articles were randomized controlled trials (45.4%; n = 10), systematic reviews (40.9%; n = 9), observational studies (9%; n = 2), and pilot studies (4.5%; n = 1). The information was organized based on the virtual reality modality (immersive, non-immersive, and 360) and application area (motor, cognitive, and mental health). CONCLUSIONS: Virtual reality (both immersive and non-immersive) is a valuable tool for promoting physical exercise in older adults, helping to prevent recurrent accidental falls. It also yields positive results for cognitive stimulation in healthy older individuals, improving memory, depression, and mental health in those with cognitive impairment. Virtual reality is generally well-received by older adults, achieving high adherence rates.

Socioeconomic Inequalities as a Cause of Health Inequities in Spain: A Scoping Review.

The objectives of this review were to identify the population groups most frequently studied, to determine the methods and techniques most commonly used to show health inequities, and to identify the most frequent socioeconomic and health indicators used in the studies on health inequities due to socioeconomic inequalities that have been carried out on the Spanish healthcare system. A scoping review was carried out of the studies conducted in the Spanish State and published in literature since 2004, after the publication of the Law of Cohesion and Quality of the National Health System. The PRISMA extension for scoping reviews was followed. The methodological quality of the studies was assessed using the critical reading guides of the Joanna Briggs Institute and an adaptation of the STROBE guide for ecological studies. A total of 58 articles out of 811 articles were included. Most of the articles were (77.59%, n = 45) cross-sectional studies, followed by ecological studies (13.8%, n = 8). The population group used was uneven, while the main geographical area under investigation was the whole state (51.7%, n = 30) compared to other territorial distributions (48.3%, n = 28). The studies used a multitude of health and socioeconomic indicators, highlighting self-perception of health (31.03%, n = 19) and social class (50%, n = 29). The relationship between better health and better socioeconomic status is evident. However, there is variability in the populations, methods, and indicators used to study health equity in Spain. Future health research and policies require greater systematization by public institutions and greater cooperation among researchers from disciplines such as sociology, economics, and health.

Nomophobia and Its Relationship with Social Anxiety and Procrastination in Nursing Students: An Observational Study.

Nomophobia is a phenomenon that describes the fear of not having one's mobile phone accessible. This study aimed to evaluate the presence of nomophobia among nursing students as well as its relationship with procrastination and social anxiety. METHODS: An observational, descriptive, cross-sectional study was conducted in a sample of 308 nursing students. Data were collected using the Nomophobia Questionnaire, Academic Procrastination Scale-Short Form, and Social Anxiety Questionnaire for Adults. Additionally, sociodemographic variables related to academic performance and smartphone use were collected. We performed a descriptive, bivariate, and multivariate analysis of the Nomophobia Questionnaire score. RESULTS: 19.5% (n = 60) of the students presented with or were at high risk of nomophobic behaviour. Moreover, nomophobic behaviour was positively correlated with high levels of social anxiety (p < 0.001), longer daily smartphone usage time (p < 0.001), and a high frequency of smartphone checking in class (p < 0.001). The predictive variables for nomophobic behaviour included age, variables related to smartphone use, social anxiety levels, work, procrastination tendency, sex, and self-reported average grade. CONCLUSION: One out of five students in the sample studied presented with or were at high risk of nomophobic behaviour. Additionally, nomophobic behaviour was associated with social anxiety and variables related to smartphone use. This study was not registered.

Impact of hospitalization on nutritional status in persons aged 65 years and over (NUTRIFRAG Study): Protocol for a prospective observational study.

BACKGROUND: Malnutrition is a recurring problem that has become more relevant in recent years. The aim of this study is to assess the risk of malnutrition and nutritional status on admission and its evolution until discharge in patients aged 65 and over admitted to medical and surgical hospitalization units in hospitals of the Spanish National Health System. METHODS: Prospective observational study to be carried out in the medical-surgical hospitalization units of 9 public hospitals between 01/09/2022 and 31/12/2024. Using consecutive sampling, a total of 4077 patients will be included (453 in each hospital). Variables included are related to the care process, functionality, cognition and comorbidity, risk profile, nutritional status and dysphagia; as well as frailty, dietary quality and contextual variables. The incidence of risk of malnutrition, undernutrition and dysphagia during the care process and at discharge will be calculated. The association with risk factors will be studied with logistic regression models and multivariate Cox regression models. In addition, an analysis of participants' satisfaction with food services will be carried out. The study was approved by the Ethics and Research Committee on 30/09/2020, approved for funding on 02/12/2021 and with registration number RBR-5jnbyhk in the Brazilian clinical trials database (ReBEC) for observational studies. DISCUSSION: Some studies address nutritional status or dysphagia in older people in various care settings. However, there is a lack of large sample studies including both processes of the impact of hospitalization. The results of the project will provide information on the incidence and prevalence of both pathologies in the study subjects, their associated factors and their relationship with the average length of stay, mortality and early readmission. In addition, early detection of a problem such as malnutrition related to the disease and/or dysphagia during a hospital stay will favor the action of professionals to resolve both pathologies and improve the health status of patients.

Diagnostic accuracy study of the VALENF instrument in hospitalization units for adults: a study protocol.

Recently, the VALENF instrument, Nursing Assessment by its acronym in Spanish, was developed as a meta-tool composed of only seven items with a more parsimonious approach for nursing assessment in adult hospitalization units. This meta-tool integrates the assessment of functional capacity, the risk of pressure injuries and the risk of falls. The general objective of this project is to validate the VALENF instrument by studying its diagnostic accuracy against the instruments commonly used in nursing to assess functional capacity, the risk of pressure injuries and the risk of falls. An observational, longitudinal, prospective study is presented, with recruitment and random selection based on admissions to six adult hospitalization units of the Hospital Universitario de La Plana. The study population will be made up of patients hospitalized in these units. The inclusion criteria will be patients over 18 years of age with a nursing assessment within the first 24 h of admission and an expected length of stay greater than 48 h and who sign the informed consent form. The exclusion criteria will be transfers from other units or centers. A sample of 521 participants is estimated as necessary. The evaluation test will be the VALENF instrument, and the reference tests will be the Barthel, Braden and Downton indices. Sociodemographic variables related to the care process and results such as functional loss, falls or pressure injuries will be collected. The evolution of functional capacity, the risk of falls and the risk of pressure injuries will be analyzed. The sensitivity, specificity and positive predictive values of the VALENF instrument will be calculated and compared to those of the usual instruments. A survival analysis will be performed for pressure injuries, falls and patients with functional loss. The VALENF instrument is expected to have at least the same diagnostic validity as the original instruments.Trial registration The study will be retrospectively registered (ISRCTN 17699562, 25/07/2023).

Explorando la validez de constructo del índice de Barthel en una muestra de pacientes hospitalizados españoles / Exploring the construct validity of the Barthel index in a sample of Spanish hospitalised patients

Objetivo: Examinar la validez de constructo del índice de Barthel en unidades de hospitalización de adultos. Métodos: Se realizó un análisis secundario en una muestra de 1.342 pacientes adultos ingresados en unidades de hospitalización. El análisis factorial confirmatorio del índice de Barthel no confirma su estructura unidimensional (CFA-1). Se exploraron dos métodos para encontrar una solución con un mejor ajuste. Se realizó la secuencia de los métodos clásicos de análisis factorial exploratorio y confirmatorio (CFA-2). Se realizó un modelo gráfico gaussiano y un análisis factorial confirmatorio (CFA-3). Se compararon tres modelos sobre una base de varios indicadores de bondad de ajuste. Resultados: Los resultados del CFA-1 (χ2 = 161.616; p < 0,001; RMSEA = 0,183) indicaron un mal ajuste entre el modelo y los datos obtenidos. El análisis factorial exploratorio proporcionó un modelo con dos dimensiones que explicaba 86% de la varianza y mejoró el indicador de bondad de ajuste en CFA-2 (χ2 = 846; p < 0,001; RMSEA = 0,133). El modelo gráfico gaussiano ofreció una solución con tres dimensiones que mejoró la bondad de ajuste con respecto a los modelos anteriores al eliminar el ítem continencia vesical (χ2 = 493; p < 0,001; RMSEA = 0,09). Conclusiones: El índice de Barthel no es una medida unidimensional de la capacidad funcional cuando se aplica en unidades de hospitalización de adultos. El modelo que mejor se ajusta tiene una estructura tridimensional (higiene, alimentación y eliminación, movilidad) que se relaciona con los dominios de los cuidados básicos.(AU)

Objective: Examine the construct validity of the Barthel Index in adult inpatient units. Methods: A secondary analysis was performed on a sample of 1342 adult patients admitted to inpatient units. A confirmatory factor analysis of the Barthel Index did not confirm its unidimensional structure (CFA-1). Therefore, two methods were explored to find a solution with a better fit. The sequence of the classical exploratory and confirmatory factor analysis methods was carried out (CFA-2). In contrast, a Gaussian graphical model and confirmatory factor analysis (CFA-3) were performed. Three models were compared on the basis of several goodness-of-fit indicators. Results: CFA-1 results (χ2 = 161616; P < .001; RMSEA = .183) indicated a poor fit between the model and the data. Exploratory factor analysis provided a model with two dimensions that explained 86% of the variance and improved the goodness-of-fit in CFA-2 (χ2 = 846; P < .001; RMSEA = .133). The Gaussian graphical model, by removing the item ‘Bladder’, offered a solution with three dimensions that improved the goodness-of-fit compared to the previous models (χ2 = 492; P < .001; RMSEA = .09). Conclusions: The Barthel Index is not a unidimensional measure of functional capacity when applied to adult inpatient units. The best-fitting model has a three-dimensional structure (Hygiene; Feeding and disposal; Mobility) that relates to the domains of care needs.

Exploring the construct validity of the Barthel index in a sample of Spanish hospitalised patients.

OBJECTIVE: Examine the construct validity of the Barthel Index in adult inpatient units. METHOD: A secondary analysis was performed on a sample of 1342 adult patients admitted to inpatient units. A confirmatory factor analysis of the Barthel Index did not confirm its unidimensional structure (CFA-1). Therefore, two methods were explored to find a solution with a better fit. The sequence of the classical exploratory and confirmatory factor analysis methods was carried out (CFA-2). In contrast, a Gaussian graphical model and confirmatory factor analysis (CFA-3) were performed. Three models were compared on the basis of several goodness-of-fit indicators. RESULTS: CFA-1 results (χ2 = 161,616; P < .001; RMSEA = .183) indicated a poor fit between the model and the data. Exploratory factor analysis provided a model with two dimensions that explained 86% of the variance and improved the goodness-of-fit in CFA-2 (χ2 = 846; P < .001; RMSEA = .133). The Gaussian graphical model, by removing the item 'Bladder', offered a solution with three dimensions that improved the goodness-of-fit compared to the previous models (χ2 = 492; P < .001; RMSEA = .09). CONCLUSION: The Barthel Index is not a unidimensional measure of functional capacity when applied to adult inpatient units. The best-fitting model has a three-dimensional structure (Hygiene; Feeding and disposal; Mobility) that relates to the domains of care needs.

Improving Nursing Assessment in Adult Hospitalization Units: A Secondary Analysis.

The main objective of this study was to analyze the impact of a multifaceted strategy to improve the assessment of functional capacity, risk of pressure injuries, and risk of falls at the time of admission of patients in adult hospitalization units. This was a secondary analysis of the VALENF project databases during two periods (October-December 2020, before the strategy, and October-December 2021, after the strategy). The quantity and quality of nursing assessments performed on patients admitted to adult hospitalization units were evaluated using the Barthel index, Braden index, and Downton scale. The number of assessments completed before the implementation of the new strategy was n = 686 (28.01%), versus n = 1445 (58.73%) in 2021 (p < 0.001). The strategy improved the completion of the evaluations of the three instruments from 63.4% (n = 435) to 71.8% (n = 1038) (p < 0.001). There were significant differences depending on the hospitalization unit and the assessment instrument (p < 0.05). The strategy employed was, therefore, successful. The nursing assessments show a substantial improvement in both quantity and quality, representing a noticeable improvement in nursing practice. This study was not registered.

Development and Validation of a Meta-Instrument for the Assessment of Functional Capacity, the Risk of Falls and Pressure Injuries in Adult Hospitalization Units (VALENF Instrument) (Part II).

The nursing assessment is the first step of the nursing process and fundamental to detecting patients' care needs and at-risk situations. This article presents the psychometric properties of the VALENF Instrument, a recently developed meta-instrument with only seven items that integrates the assessment of functional capacity, risk of pressure injuries and risk of falls with a more parsimonious approach to nursing assessment in adult hospitalization units. A cross-sectional study based on recorded data in a sample of 1352 nursing assessments was conducted. Sociodemographic variables and assessments of the Barthel, Braden and Downton instruments were included at the time of admission through the electronic health history. Thus, the VALENF Instrument obtained high content validity (S-CVI = 0.961), construct validity (RMSEA = 0.072; TLI = 0.968) and internal consistency (Ω = 0.864). However, the inter-observer reliability results were not conclusive, with Kappa values ranging between 0.213 and 0.902 points. The VALENF Instrument has adequate psychometric properties (content validity, construct validity, internal consistency and inter-observer reliability) for assessing the level of functional capacity, risk of pressure injuries and risk of falls. Future studies are necessary to establish its diagnostic accuracy.

Development and Validation of the Breastfeeding Literacy Assessment Instrument (BLAI) for Obstetric Women.

BACKGROUND: Despite international efforts to protect and promote exclusive breastfeeding (EBF) for infants up to six months of age, global rates of EBF continue to fall short of the targets proposed by the WHO for 2025. Previous studies have shown a relationship between the level of health literacy and the duration of EBF, although this relationship was not determinant, probably due to the use of a generic health literacy questionnaire. Therefore, this study aims to design and validate the first specific breastfeeding literacy instrument. METHODS: A Breastfeeding Literacy instrument was developed. Content validation was carried out by a group of 10 experts in health literacy, breastfeeding or instrument validation, obtaining a Content Validity index in Scale (S-CVI/Ave) of 0.912. A multicentre cross-sectional study was carried out in three Spanish hospitals to determine the psychometric properties (construct validity and internal consistency). The questionnaire was administered to 204 women during the clinical puerperium. RESULTS: The Kaiser-Meier-Oklin Test (KMO = 0.924) and Bartlett's Test of Sphericity (X2 = 3119.861; p ≤ 0.001) confirmed the feasibility of the Exploratory Factor Analysis, which explained 60.54% of the variance with four factors. CONCLUSIONS: The Breastfeeding Literacy Assessment Instrument (BLAI) consisting of 26 items was validated.

Developing and validating an integrated instrument for nursing assessments in adult hospitalization units: Study protocol.

AIMS: To develop and validate an instrument that integrates functional capacity, risk of pressure ulcers and risk of falling with a more parsimonious approach towards nursing assessments in hospitalization units. DESIGN: Cross-sectional validation multicentre study. METHODS: Socio-demographic variables and assessments of Barthel Index, Braden Index and Downton Scale are included via electronic health records. Instrument's development process will include: (i) conceptual assessments; (ii) content validity; (iii) construct validity; (iv) internal consistency and (v) interobserver reliability. The analysis will consider possible differences in medical and surgical hospitalization units, hospitalization type or being a COVID-19 patient. This study was accepted for funding in November 2020 and approved by the Ethics and Research Committee in January 2021. RESULTS: An integrated instrument that lowers the administrative load of nursing assessments and allows at-risk patients to be detected with at least the same validity and reliability as the original instruments is expected to be obtained.

Experiences with obstetric violence among healthcare professionals and students in Spain: A constructivist grounded theory study.

BACKGROUND: Obstetric violence appears to be a worldwide concern and is defined as a type of gender-based violence perpetrated by health professionals. This violence undermines and harms women's autonomy. In Spain, 38.3 % of women have identified themselves as victims of this type of violence. AIM: To explore current information and knowledge about obstetric violence within the Spanish healthcare context, as well as to develop a theoretical model to explain the concept of obstetric violence, based on the experiences of healthcare professionals (midwives, registered nurses, gynaecologists and paediatricians) and nursing students. METHODS: A constructivist grounded theory study was conducted at Jaume I University in Spain between May and July 2021, including concurrent data collection and interpretation through constant comparison analysis. An inductive analysis was carried out using the ATLAS.ti 9.0 software to organise and analyse the data. RESULTS: Twenty in-depth interviews were conducted, which revealed that healthcare professionals and students considered obstetric violence a violation of human rights and a serious public health issue. The interviews allowed them to describe certain characteristics and propose preventive strategies. Three main categories were identified from the data analysis: (i) characteristics of obstetric violence in the daily routine, (ii) defining the problem of obstetric violence and (iii) strategies for addressing obstetric violence. Participants identified obstetric violence as structural gender-based violence and emphasised the importance of understanding its characteristics. Our results indicate how participants' experiences influence their process of connecting new information to prior knowledge, and they provide a connection to specific micro- and macro-level strategic plans. DISCUSSION: Despite the lack of consensus, this study resonates with the established principles of women and childbirth care, but also generates a new theoretical model for healthcare students and professionals to identify and manage obstetric violence based on contextual factors. The term 'obstetric violence' offers a distinct contribution to the growing awareness of violence against women, helps to regulate it through national policy and legislation, and involves both structural and interpersonal gender-based abuse, rather than assigning blame only to care providers. CONCLUSIONS: Obstetric violence is the most accurate term to describe disrespect and mistreatment as forms of interpersonal and structural violence that contribute to gender and social inequality, and the definition of this term contributes to the ongoing awareness of violence against women, which may help to regulate it through national policy and legislation.

Análisis de tendencia del indicador infección del torrente sanguíneo en chile

Objetivo: Analizar la tendencia de las infecciones del torrente sanguíneo asociadas a la instalación de catéter venoso central en el sistema sanitario de Chile. Material y Método: Estudio ecológico, con análisis de tendencia de la prevalencia anual de las infecciones de torrente sanguíneo asociadas a instalación de catéter venoso central en los hospitales chilenos desde el año 2001 a 2019. Para el análisis univariado se utilizaron frecuencias, porcentajes, media y desviación estándar. En el análisis bivariado se utilizó la prueba de X 2 y T de Student en función de la naturaleza de las variables, con un nivel de significación de p=0,0034/0,0039), con un 5% de crecimiento promedio interanual de la tasa. El análisis por regiones muestra, en general, una tendencia estática. Conclusión: La infección del torrente sanguíneo por catéter venoso central es una complicación creciente en Chile, por lo que se hace necesario desarrollar programas e intervenciones que permitan controlar el avance de esta complicación.

Objective: To analyze the trend of bloodstream infections associated with central venous catheter insertion in the Chilean healthcare system. Materials and Methods: Ecological study with trend analysis of the annual prevalence of bloodstream infections associated with central venous catheter insertion in Chilean hospitals from 2001 to 2019. For univariate analysis, frequencies, percentages, mean and standard deviation were used. For bivariate analysis, the X 2 test and Student's t-test were used, according to the nature of the variables, with a significance level of p<0.01. For the trend analysis, a linear trend analysis of the annual prevalence was performed using the Prais-Winsten autoregression method, which allows the estimation of a global trend of a series of data of a quantitative indicator. The annual percent change (APC) and its 95% confidence intervals (CI-95%) were calculated. Results: A total of 27,197,232 cases were analyzed. An overall increasing and significant trend was observed throughout Chile (APC=0.00370; 95% CI=0.0034 / 0.0039), with an average interannual growth rate of 5%. In general, the analysis by region shows a static trend. Conclusion: Central venous catheter-related bloodstream infection is a growing complication in Chile. Therefore, it is necessary to develop programs and interventions to control the progression of this complication.

Objetivo: Analisar a tendência das infecções da corrente sanguínea associadas à instalação de cateter venoso central no sistema de saúde chileno. Material e Método: Estudo ecológico, com análise de tendência da prevalência anual de infecções da corrente sanguínea associadas à instalação de cateter venoso central em hospitais chilenos de 2001 a 2019. Para a análise univariada foram utilizadas frequências, porcentagens, média e desvio padrão. A análise bivariada utilizou o teste X 2 e o teste t de Student de acordo com a natureza das variáveis, com um nível de significância de p<0,01. Para a análise de tendência, foi realizada uma análise de tendência linear da prevalência anual com o método de autoregressão de Prais-Winsten, que permite estimar uma tendência global de uma série de dados de um indicador quantitativo. Foi calculada a variação percentual anual (APC sigla em inglês) e os respectivos intervalos de confiança a 95% (IC-95%). Resultados: Foram analisados 27.197.232 casos. Observou-se uma tendência global crescente e significativa em todo o Chile (APC=0,00370; IC 95%=0,0034/0,0039), com uma taxa média de crescimento anual de 5%. A análise por região mostra, em geral, uma tendência estática. Conclusão: A infecção da corrente sanguínea por cateter venoso central é uma complicação crescente no Chile. Portanto, é necessário desenvolver programas e intervenções para controlar a progressão desta complicação.

Prevalencia de las úlceras por presión al egreso hospitalario en chile: tendencia del indicador 2001 al 2019

Objetivo: Analizar la tendencia de la prevalencia de úlceras por presión en Chile y sus regiones de acuerdo con los egresos hospitalarios. Material y Método: Estudio ecológico de series temporales, que analizó la prevalencia de úlceras por presión entre 2001 y 2019. Se realizó un análisis descriptivo, bivariante y lineal de tendencias. Este último con método de autorregresión Prais Winsten, calculando el cambio porcentual anual (APC) y sus intervalos de confianza al 95% (IC-95%). Resultados: La muestra fue de 11.060 casos. El 55,2% (6.103) fueron hombres, la media de edad fue 60 años (± 27.5) y la estancia hospitalaria fue 21,80 (± 35,084) días, siendo significativamente mayor en quienes presentaban lesiones por presión (p< 0,001). Existe una tendencia creciente y significativa en la prevalencia de úlceras por presión en Chile y todas sus regiones, teniendo promedio de un 11,33% de crecimiento interanual (APC= 0,0019; IC:95%= 0,0016-0,0022). Conclusión: Los resultados no son alentadores a pesar del aumento de la notificación de medidas de prevención y estandarización en los cuidados.

Objective: To analyze the trend in the prevalence of pressure ulcers in Chile and its regions according to hospital discharges. Material and Method: Ecological time series study, which analyzed the prevalence of pressure ulcers between 2001 and 2019. A descriptive, bivariate and linear analysis of trends was carried out. The latter with the Prais Winsten auto-regression method, calculating the annual percentage change (APC) and its 95% confidence intervals (95% CI). Results: The sample was 11,060 cases. 55.2% (6,103) were men, the average age was 60 years (± 27.5) and the hospital stay was 21.80 (± 35,084) days, being significantly longer in those with pressure injuries (p< 0.001). There is a growing and significant trend in the prevalence of pressure ulcers in Chile and all its regions, with an average of 11.33% interannual growth (APC= 0.0019; 95% CI= 0.0016-0.0022). Conclusion: The results are not encouraging despite the increase in notification of prevention measures and standardization of care.

Objetivo: Analisar a tendência da prevalência de úlceras por pressão no Chile e suas regiões de acordo com as altas hospitalares. Material e Método: Estudo ecológico de série temporal, que analisou a prevalência de úlceras por pressão entre 2001 e 2019. Foi realizada análise descritiva, bivariada e linear de tendências. Este último com o método de autorregressão de Prais Winsten, calculando a variação percentual anual (APC) e seus intervalos de confiança de 95% (IC 95%). Resultados: A amostra foi de 11.060 casos. 55,2% (6.103) eram homens, a idade média foi de 60 anos (± 27,5) e o tempo de internação foi de 21,80 (± 35.084) dias, sendo significativamente maior naqueles com lesão por pressão (p< 0,001). Há uma tendência crescente e significativa na prevalência de úlceras por pressão no Chile e em todas as suas regiões, com uma média de crescimento interanual de 11,33% (APC= 0,0019; IC 95%= 0,0016-0,0022). Conclusão: Os resultados não são animadores apesar do aumento da notificação de medidas de prevenção e da padronização dos cuidados.

Breastfeeding and Obstetric Violence during the SARS-CoV-2 Pandemic in Spain: Maternal Perceptions.

Catalan legislation, a pioneer in Europe, has defined obstetric violence (OV) as "preventing or hindering access to truthful information, necessary for autonomous and informed decision-making". The definition also states that OV can affect physical and mental health, as well as sexual and reproductive health. Some authors have expressed concern about an increase in OV during the SARS-CoV-2 pandemic. During the pandemic, recommendations were also openly offered on the non-establishment and/or early abandonment of breastfeeding without scientific evidence to support them. Experiencing a traumatic childbirth can influence breastfeeding outcomes. Here, we conducted a cross-sectional study using a self-administered online questionnaire. The sample consisted of women who gave birth in Spain between March 2020 and April 2021. The mean age was 34.41 (±4.23) years. Of the women, 73% were employed, 78.2% had a university education, and almost all were Caucasian. Among the subjects, 3.3% were diagnosed with SARS-CoV-2 during pregnancy and 1% were diagnosed during delivery. Some of the women (1.6%) were advised to stop breastfeeding in order to be vaccinated. Women diagnosed with SARS-CoV-2 during delivery (p = 0.048), belonging to a low social class (p = 0.031), with secondary education (p = 0.029), or who suffered obstetric violence (p < 0.001) perceived less support and that the health care providers were less inclined to resolve doubts and difficulties about breastfeeding. Breastfeeding has been significantly challenged during the pandemic. In addition to all the variables to be considered that make breastfeeding support difficult, we now probably need to add SARS-CoV-2 diagnosis and OV.

Development and Validation of a Meta-Instrument for Nursing Assessment in Adult Hospitalization Units (VALENF Instrument) (Part I).

Nursing assessment is the basis for performing interventions that match patient needs, but nurses perceive it as an administrative load. This research aims to develop and validate a meta-instrument that integrates the assessment of functional capacity, risk of pressure ulcers and risk of falling with a more parsimonious approach to nursing assessment in adult hospitalization units. Specifically, this manuscript presents the results of the development of this meta-instrument (VALENF instrument). A cross-sectional study based on recorded data was carried out in a sample of 1352 nursing assessments. Socio-demographic variables and assessments of Barthel, Braden and Downton indices at the time of admission were included. The meta-instrument's development process includes: (i) nominal group; (ii) correlation analysis; (iii) multiple linear regressions models; (iv) reliability analysis. A seven-item solution showed a high predictive capacity with Barthel (R2adj = 0.938), Braden (R2adj = 0.926) and Downton (R2adj = 0.921) indices. Likewise, reliability was significant (p < 0.001) for Barthel (ICC = 0.969; τ-b = 0.850), Braden (ICC = 0.943; τ-b = 0.842) and Downton (ICC = 0.905; κ = 7.17) indices. VALENF instrument has an adequate predictive capacity and reliability to assess the level of functional capacity, risk of pressure injuries and risk of falls.