Nurses' perceptions of the performance of nurse managers and senior hospital management during the COVID-19 pandemic.

BACKGROUND: The first waves of the COVID-19 pandemic had a negative impact on health systems and health professionals, due to the high number of cases and a lack of preparation. The aim of this study was to understand how nurses working in hospital units and in intensive care perceived the performance of nurse managers and senior hospital management during the first two waves of the pandemic. METHODS: The phenomenological approach proposed by Giorgi was used to investigate perceptions of the performance of nurse managers and senior hospital management during the first two waves of the COVID-19 pandemic in Spain. Fourteen clinical nurses who worked on the front line in inpatient units or intensive care units of the Health Services of Extremadura and Madrid in the first (March-April 2020) and second (October-November 2020) waves of the COVID-19 pandemic participated in this study. The data was collected through semi-structured interviews, following a script of themes, in a theoretical sample of nurses who were worked during the pandemic. RESULTS: Two main themes emerged from the analysis of the data: (1) perceptions about the performance of nurse managers and senior hospital managers during the first and second waves of the pandemic (health system failure; belief that senior hospital management professionals could have managed the pandemic better; recognizing the efforts of middle management (nursing supervisors); insufficient institutional support) and (2) strategies employed by nurses to compensate for the weaknesses in pandemic management. CONCLUSIONS: The clinical nurses perceived that the nurse managers demonstrated better management of the pandemic than the hospital's senior management, which they attribute to their proximity, empathy, accessibility, and ability to mediate between them and the senior management. The nurses also believe that the senior management of the hospitals was to blame for organisational failures and the poor management of the pandemic.

Competencias de cuidados domiciliarios en niños oncológicos durante la pandemia por COVID-19

Objetivos: determinar la relación entre la competencia para el cuidado domiciliario y sus dimensiones con la presencia de infecciones respiratorias en menores con Leucemia Linfoblástica Aguda y tratamiento oncológico en el contexto de la pandemia por COVID-19. Métodos: cuantitativo, correlacional, transversal la muestra se integró de 75 díadas, la población de estudio: menores con diagnóstico de Leucemia Linfoblástica Aguda en tratamiento con quimioterapia antineoplásica, se aplicó muestreo probabilístico aleatorio sistemático, se utilizó el instrumento CUIDAR. Resultados: la prevalencia de infecciones respiratorias fue del 4% para los menores con cuidadores con un nivel alto de competencia para el cuidado domiciliario, 12% para el nivel medio y 21,3% para el nivel bajo (p=0,001), se determinó una r=-0,439, p<0,001, entre las variables de estudio, la dimensión Relación e Interacción mostró asociación lineal negativa moderada muy significativa (r=-0,492, p<0,01), y la dimensión Respiratoria asociación lineal negativa débil estadísticamente significativa(r=-0,253, p=0,02). Conclusiones: a mayor competencia para el cuidado menor la prevalencia de infecciones respiratorias, se encontró una asociación lineal moderada estadísticamente muy significativa entre la competencia para el cuidado domiciliario y la presencia de infección respiratoria en niños con leucemia y tratamiento oncológico en el contexto de la pandemia por COVID-19.

Objective: to determine the relationship between the competence for home care and its dimensions with the presence of respiratory infections in minors with Acute Lymphoblastic Leukemia and cancer treatment in the context of the COVID-19 pandemic. Methods: quantitative, correlational, cross-sectional, the sample was made up of 75 dyads, the study population: minors diagnosed with Acute Lymphoblastic Leukemia undergoing treatment with antineoplastic chemotherapy, systematic random probabilistic sampling was applied, the CUIDAR instrument was used. Results: the prevalence of respiratory infections was 4% for minors with caregivers with a high level of competence for home care, 12% for the medium level and 21.3% for the low level (p=.001), a r=-.439, p<.001, among the study variables, the Relationship and Interaction dimension showed a very significant moderate negative linear association (r=-0.492, p<0.01), and the Respiratory dimension statistically significant weak negative linear association (r=-0.253, p=0.02). Conclusions: the higher the competence for care, the lower the prevalence of respiratory infections, a statistically highly significant moderate linear association was found between the competence for home care and the presence of respiratory infection in children with leukemia and cancer treatment in the context of the pandemic. by COVID-19.

La experiencia de los géneros de vivir con colostomía por cáncer de colon

Objetivo: Analizar la experiencia de los géneros de vivir con colostomía por cáncer de colon. El estudio de las diferencias en las relaciones sociales entre hombres y mujeres y los espacios vividos durante la enfermedad son trascendentales para la intervención en el cuidado. La teoría del feminismo da soporte teórico para analizar los trazos de diferencias y similitudes desde el significado de ser mujer u hombre con colostomía. Materiales y métodos: Cualitativo-fenomenológico, 8 sujetos participantes, se realizaron entrevistas a profundidad en su domicilio, observación no participante y notas de campo Resultados: La mujer vive la enfermedad en el espacio privado; mientras que el hombre lucha y vive en el espacio público y poco tiempo en el privado. La mujer hace narrativa de LA subjetividad en que vive la colostomía, la acepta y continúa su vida; el hombre lucha por la representación de su rol de fortaleza en el espacio público y el privado. Conclusiones: Los estándares de masculinidad se ven afectados por portar una colostomía y existen experiencias de vida que deben resolver en lo público y padecer en lo privado. Mientras que las mujeres o la femineidad se desarrollan con un rol de compromiso y responsabilidad de no enfermar o de permanecer activas cuidando a su familia.

Objective: Analyze the gender experience of living with colon cancer colostomy, the study of the differences in social relations between men and women and the spaces lived during the disease are transcendental for intervention in care, the theory of feminism gives theoretical support to analyze the traces of differences and similarities from the meaning of being a woman or man with colostomy. Material and methods: A qualitative phenomenological study was conducted with eight participated subjects, in- depth interviews were conducted at their home, non-participating observation and field notes. Results: Women live the disease in private space, while men fight and live-in public space and little time in the private. The woman makes narrative to her subjectivity in which she lives the colostomy, accepts and continues her life, the man fights for the representation of her role of strength in public and private space. Conclusions: Male standards are affected by carrying a colostomy and there are life experiences that must be solved in the public and in the private. While women or femineity develop with a role of commitment and responsibility not to get sick or stay active caring for their family.

The Psychological Impact of COVID-19 on Front Line Nurses: A Synthesis of Qualitative Evidence.

Caring for people with COVID-19 on the front line has psychological impacts for healthcare professionals. Despite the important psychological impacts of the pandemic on nurses, the qualitative evidence on this topic has not been synthesized. Our objective: To analyze and synthesize qualitative studies that investigate the perceptions of nurses about the psychological impacts of treating hospitalized people with COVID-19 on the front line. A systematic review of qualitative studies published in English or Spanish up to March 2021 was carried out in the following databases: The Cochrane Library, Medline (Pubmed), PsycINFO, Web of Science (WOS), Scopus, and CINHAL. The PRISMA statement and the Cochrane recommendations for qualitative evidence synthesis were followed. Results: The main psychological impacts of caring for people with COVID-19 perceived by nurses working on the front line were fear, anxiety, stress, social isolation, depressive symptoms, uncertainty, and frustration. The fear of infecting family members or being infected was the main repercussion perceived by the nurses. Other negative impacts that this review added and that nurses suffer as the COVID-19 pandemic progress were anger, obsessive thoughts, compulsivity, introversion, apprehension, impotence, alteration of space-time perception, somatization, and feeling of betrayal. Resilience was a coping tool used by nurses. Conclusions: Front line care for people with COVID-19 causes fear, anxiety, stress, social isolation, depressive symptoms, uncertainty, frustration, anger, obsessive thoughts, compulsivity, introversion, apprehension, impotence, alteration of space-time perception, somatization, and feeling of betrayal in nurses. It is necessary to provide front line nurses with the necessary support to reduce the psychological impact derived from caring for people with COVID-19, improve training programs for future pandemics, and analyze the long-term impacts.

Health-Related Quality of Life in Spanish Women with Eating Disorders.

People with eating disorders show impaired health-related quality of life (HRQoL). We aimed to investigate the relative role of physical and mental factors and stage of change as possible predictors of HRQoL in a group of Spanish women (n = 124) with eating disorders. For this purpose, initial and follow-up data were obtained after 6 months from patients attending an outpatient treatment unit for eating disorders. The determinants of the physical and mental domains of the Medical Outcomes Survey Short-form Health Survey (SF-36) questionnaire were investigated in the total sample and separately based on the eating disorder diagnosis by multiple linear regression. Lower scores in the physical component of the SF-36 questionnaire were associated with the presence of a higher body mass index (BMI) at follow-up as well as a higher score in the "action" component of the Attitudes towards Change in Eating Disorders Questionnaire (ACTA). Conversely, a higher index in the EuroQoL-5D overall quality of life questionnaire (EQ-5D) and the presence of obsessive compulsive disorder were associated with a higher score in the physical dimension. The instrument used demonstrated the ability to assess changes associated with the physical component of these patients over the period studied, and the analysis provided more information and specific data on different aspects of HRQoL, thus allowing a more detailed analysis of the information.

Qualification of nursing potential in maternal mortality in Mexico.

OBJECTIVES: To develop a method that measures nursing potential through the factor analysis of relevant nursing data and social context by taking maternal mortality as the study problem. METHODS: A Cross-sectional and analytical study, a multivariate analysis was performed. The Nursing Coverage Index, the Human Development Index, population density and the proportion of nurses with a bachelor's degree or upper degree, are studied by federative entity, only data from government sources are used. The Index of Nursing Qualification in Mexico (INQM) was constructed through principal component analysis. RESULTS: The highest correlation was between the INQM and the Nursing Coverage Prioritization Index (NCPI), which was 0.849 (P < 0.01) and showed a strong positive linear relationship. The Population Density Prioritization Index (PDPI) shows a strong positive correlation with the INQM (0.716, P < 0.01). Three factors were extracted by principal component analysis and the INQM was generated with the three main components in a model. There is very low correlation between INQM and maternal mortality rate (MMR) and no statistical significance was found. CONCLUSIONS: This study shows that nursing qualification must include economic, geographic and social variables. The INQM is an indicator that summarises the potential of each federative entity. Given these results, a contribution is provided for the application of these indices, which can help determine nursing potential in a specific geographical region.

Impacto de la fractura de cadera intervenida quirúrgicamente sobre la calidad de vida, el estado funcional y el estado de ánimo del anciano / Impact of surgically operated hip fracture on the quality of life, functional status and mood of the elderly

OBJETIVO: Determinar la calidad de vida relacionada con la salud, la capacidad funcional y el estado de ánimo previo a la fractura de cadera y al mes de la intervención quirúrgica. MÉTODO: Estudio descriptivo prospectivo desarrollado desde enero de 2015 a enero de 2016 en el Hospital Campo Arañuelo (Navalmoral de la Mata, Cáceres). Se recogieron variables sociodemográficas, capacidad funcional (índice de Barthel), dependencia (escala de Lawton y Brody), calidad de vida relacionada con la salud (cuestionario Euroqol-5D) y estado de ánimo (escala de depresión geriátrica de Yesavage) con anterioridad a la fractura de cadera y al mes de la intervención. RESULTADOS: En 96 pacientes mayores de 65años se produjo un descenso significativo de la capacidad funcional: la media fue de 86,66 antes de la fractura frente a 58,72 al mes de la intervención (p < 0,001). La dependencia media fue de 4,95, y al mes, de 2,24 (p < 0,001). Las puntuaciones medias sobre calidad de vida basal y posterior a la intervención en EQ-5D fue de 72,95 vs 59,45, respectivamente (p = 0,004). Aunque antes de la fractura el 94,10% no tenían alteración del estado de ánimo, al mes de la intervención presentaban probable depresión el 20,50% y depresión establecida el 11%. CONCLUSIONES: La fractura de cadera afecta a la funcionalidad de los ancianos y provoca dependencia para las actividades básicas e instrumentales de la vida diaria. También afecta a la calidad de vida, y esta disminuye de forma significativa al mes de la intervención quirúrgica. El estado de ánimo depresivo está inversamente relacionado con la calidad de vida percibida

OBJECTIVES: To determine the quality of life related to health, functional capacity and mood to hip fracture and one month after surgery. METHOD: Prospective and descriptive study developed from January 2015 to January 2016 in Campo Arañuelo Hospital (Navalmoral de la Mata, Cáceres, Spain). Sociodemographic variables, functional capacity (Barthel Index), dependence (Lawton and Brody Scale), quality of life related to health (Questionnaire Euroqol-5D) and on mood (Yesavage geriatric depression scale GDS15) were collected, prior to the hip fracture and one month after the intervention. RESULTS: Significant decrease in functional capacity (Barthel), the mean score was 86.66 before the fracture, compared to 58.72 at the month after surgery (P<.001). Regarding the Lawton and Brody Scale, the mean was 4.95 and at 2.24months (P<.001). The mean scores on health related quality of life, baseline and post-intervention in the analog visual scale of the EQ-5D questionnaire were 72.95 vs 59.45 respectively (P=.004). Although before the fracture, 94.10% had no alteration in mood, one month after the intervention there was a possible depression of 20.50% and an established depression of 11%. CONCLUSIONS: The fracture of the head affects the functionality of the elderly, causing dependence for the basic and instrumental activities of daily life. It also affects the quality of life related to health and this decreases significantly in the month after surgery. Depressive mood is inversely related to perceived perceived quality of life

Impact of surgically operated hip fracture on the quality of life, functional status and mood of the elderly. / Impacto de la fractura de cadera intervenida quirúrgicamente sobre la calidad de vida, el estado funcional y el estado de ánimo del anciano.

OBJECTIVES: To determine the quality of life related to health, functional capacity and mood to hip fracture and one month after surgery. METHOD: Prospective and descriptive study developed from January 2015 to January 2016 in Campo Arañuelo Hospital (Navalmoral de la Mata, Cáceres, Spain). Sociodemographic variables, functional capacity (Barthel Index), dependence (Lawton and Brody Scale), quality of life related to health (Questionnaire Euroqol-5D) and on mood (Yesavage geriatric depression scale GDS15) were collected, prior to the hip fracture and one month after the intervention. RESULTS: Significant decrease in functional capacity (Barthel), the mean score was 86.66 before the fracture, compared to 58.72 at the month after surgery (P<.001). Regarding the Lawton and Brody Scale, the mean was 4.95 and at 2.24months (P<.001). The mean scores on health related quality of life, baseline and post-intervention in the analog visual scale of the EQ-5D questionnaire were 72.95 vs 59.45 respectively (P=.004). Although before the fracture, 94.10% had no alteration in mood, one month after the intervention there was a possible depression of 20.50% and an established depression of 11%. CONCLUSIONS: The fracture of the head affects the functionality of the elderly, causing dependence for the basic and instrumental activities of daily life. It also affects the quality of life related to health and this decreases significantly in the month after surgery. Depressive mood is inversely related to perceived perceived quality of life.

Tener una colostomía: transformación de la corporalidad / Tendo uma colostomia: Transformação da corporeidade / To have a colostomy: transformation corporality

Justificación: La persona con cáncer de colon con una colostomía requiere de reconocer su cuerpo físico transformado y su corporalidad sentida vivida. Objetivos: Describir procesos y significados transformativos de corporalidad, y significado atribuido a una colostomía. Metodología: Estudio fenomenológico de 8 participantes, análisis de contenido hasta la saturación. Referentes teóricos Henri Lefebvre y Martin Heidegger. Resultados: El producto es la categoría central "transformación sentida de la corporalidad de la persona con cáncer de colon". Los cambios en la corporalidad adquieren una resignificación de adaptación a su cuerpo, vivencia de la corporalidad. Conclusiones: Los cambios en el cuerpo y en la corporalidad por tener una colostomía, y la falta de control en su vida desencadenan una crisis personal y social. La resignificación de la salud puede adquirirse mediante cuidados de enfermería empáticos, solidarios y comprensivos que permiten a la persona adaptarse en una forma más pronta y eficaz (AU)

Justification: The person with colon cancer with a colostomy required to recognize your physical body felt transformed and lived corporeality. Objectives: Describe transformative processes and meanings of corporeality, and meaning attributed to a colostomy. Methodology: Phenomenological study of 8 participants, content analysis to saturation. Henri Lefebvre y Martin Heidegger theoreticals references. Results: The product is the central category "felt transformation of the corporeality of the person with colon cancer". Changes in corporeality acquire a new meaning to adapt to your body, experience of corporeality. Conclusions: Changes in the body and corporeality to have a colostomy, and lack of control in your life triggered a personal and social crisis. Redefining health can be acquired through nursing empathetic, caring and understanding that enable people to adapt in a more timely and effective manner (AU)

Justificativa: A pessoa com cancro do cólon com uma colostomia exige para reconhecer o seu corpo físico se sentiu transformado e viveu corporalidade. Para descrever os processos e significados transformadoras de físico, e o significado atribuído a uma colostomia. Metodologia: Estudo fenomenológico de 8 participantes, análise de conteúdo para a saturação. Henri Lefebvre enquadramento teórico e Martin Heidegger. Resultados: O produto é a categoria núcleo "sentida transformação do corporeality da pessoa com cancro do cólon". Mudanças na corporalidade adquirir um novo significado para se adaptar ao seu corpo, a experiência da corporalidade. Conclusões: As mudanças no corpo e corporeidade ter uma colostomia, e falta de controle em sua vida desencadeia uma crise pessoal e social. saúde ressignificação pode ser adquirido através de cuidados de enfermagem empatia, carinho e compreensão que permitem que as pessoas se adaptem de forma mais atempada e eficaz (AU)

Cobertura de atención de enfermería y su impacto en la mortalidad por enfermedades crónicas no transmisibles en México, 2013 / Nursing care coverage and its impact on mortality from chronic non communicable diseases in Mexico, 2013

Introducción: el análisis de los índices, cobertura de enfermería y mortalidad por enfermedades crónicas no transmisibles aporta a los tomadores de decisiones información basada en evidencia. Objetivo: identificar el impacto que tiene la cobertura de atención de enfermería en la mortalidad por enfermedades crónicas no trasmisibles en México. Metodología: Estudio transversal analítico que utilizó información oficial de 2013 del Sistema Nacional de Salud sobre recursos humanos y daños a la salud. Resultados: se encontró que existe significancia estadística entre el índice de cobertura y la mortalidad, interpretándose que por cada punto porcentual que se incrementa la cobertura de enfermería disminuye la mortalidad en -.472. Conclusiones: el ejercicio de regresión lineal simple a nivel nacional demostró que existe significancia estadística entre cobertura y mortalidad ya que cuando se incrementa el primero, disminuye el segundo

Introduction: the analysis of the rates, nursing coverage and mortality from chronic non communicable diseases gives decision makers evidence-based information. Objective: to identify the impact of nursing care coverage in mortality from chronic non-communicable diseases in Mexico. Methodology: cross-sectional study using official data from the National Health System of human resources and damage to health of 2013. Results: it was found that there is statistical significance between the coverage ratio and mortality, interpreted that for every percentage point that nursing coverage increases mortality reduces in -.472. Conclusions: the simple linear regression exercise nationwide showed that there is statistical significance between coverage and mortality because when the first increases, the second diminishes

Enfermería: la Némesis de la ciencia y filosofía del cuidado / Nursing: the Nemesis of science and philosophy of care

En la cultura griega, para proteger el equilibrio universal la diosa Némesis castigaba la desmesura. A partir de esta metáfora se realizó un ejercicio crítico desde la concepción teórica, epistemológica y práctica de la enfermería, centrándose en explorar el concepto de cuidado en las dimensiones de interacción, participación y significado. A partir de este análisis, se concluyó que existe un distanciamiento entre los aspectos teóricos y filosóficos con la práctica cotidiana de la profesión.

In Greek culture, to protect the universal balance the goddess Nemesis punished excess. From this metaphor a critical exercise was made of the theoretical, epistemological and practical conception of nursing, focusing on exploring the concept of care in the dimensions of interaction, participation and meaning. From this analysis, it was concluded that there is a critical distance between theoretical and philosophical aspects with the daily practice of the profession.