[Rate of episiotomy in the University Clinical Hospital of Arrixaca and factors that influence in its practice.] / Tasa de episiotomía en el Hospital Clínico Universitario de La Arrixaca y factores que influyen en su práctica.

OBJECTIVE: The conduction of episiotomy is a questioned practice given the strong scientific evidence on its adverse effects. The study objectives were to know the episiotomy rate and its adaptation to the recommendations of the Ministry of Health, Consumption and Social Welfare and assess the associated factors. METHODS: It has been made a Observational, descriptive and transversal quantitative study, it was carried out in the university clinical hospital arrixaca. Data were collected from deliveries attended between January 1, 2016 and October 30, 2017, obtaining a sample of 10,630 women, registered in the SELENE computer program which is the clinical database of said hospital. To perform the data analysis, were used the SPSS statistical program and an Excel database. At the first level, it was carried out a descriptive analysis of the obstetric variables and, at a second level, the data were compared with the Ministry of Health indicators by means of a comparison of two proportions and the chi-square test. In order to estimate the Effect Size, the Cramer V was used for qualitative variables and the relative risk was calculated for each pair of qualitative variablesas a relative measure of the effect, to determine the strength of association between the variables. RESULTS: The episiotomy rate was 36.5%. When the birth started spontaneously, the percentage was 35.5%, when it was induced 47.2% and stimulated rate was 42.3%. The rate in eutocic deliveries was 20.6% and in instrumented was 95.25%. In primiparas, the episiotomy was 49.64% and in multiparas the conduction was 15.55%. Was observed a tendency of second-degree tears (43.40%), followed by first-degree (35.61%) and third-degree (19.81%) with episiotomy. CONCLUSIONS: The episiotomy rate in our study exceeds current recommendations. The variables associated with the performance of the episiotomy are induced or stimulated delivery, instrumentation and primiparity. There is a significant relationship between the practice of episiotomy and the greater degree of tear.

OBJETIVO: La realización de episiotomías es una práctica cuestionada dada la fuerte evidencia científica existente sobre sus efectos adversos. Los objetivos de este estudio fueron conocer la tasa de episiotomías y su adecuación a las recomendaciones del Ministerio de Sanidad, Consumo y Bienestar Social y valorar los factores asociados. METODOS: Se realizó un estudio cuantitativo observacional, descriptivo y transversal, que fue llevado a cabo en el Hospital Clinico Universitario Arrixaca. Se recogieron datos De los partos atendidos entre el 1 de enero de 2016 y el 30 de octubre de 2017, obteniendo una muestra de 10.630 mujeres, a través del programa informático SELENE, que es la base de datos clínicos de dicho hospital. Para realizar el análisis de datos se utilizó el programa estadístico SPSS y una base de datos Excel. En un primer nivel, se efectuó un análisis descriptivo de las variables obstétricas y, en un segundo nivel, se contrastaron los datos con los indicadores del Ministerio de Sanidad, Consumo y Bienestar Social mediante una comparación de dos proporciones y el test de la ji al cuadrado. Para poder estimar el Tamaño del Efecto se utilizó la V de Cramer para variables cualitativas, y se calculó el riesgo relativo para cada par de variables cualitativas como medida relativa del efecto, para determinar así la fuerza de asociación entre las variables. RESULTADOS: La tasa de episiotomías fue del 36,5%. Cuando el parto comenzó espontáneamente el porcentaje fue del 35,5%; cuando fue inducido, la tasa fue del 47,2% y cuando fue estimulado, el porcentaje fue del 42,3%. La tasa en partos eutócicos fue del 20,6% y en instrumentados fue del 95,25%. En primíparas, la realización de episiotomía fue del 49,64% y en multíparas la realización fue del 15,55%. Se observó una tendencia a desgarros de segundo grado (43,40%), seguidos de primer grado (35,61%) y de tercer grado (19,81%) con episiotomía. CONCLUSIONES: La tasa de episiotomía de nuestro estudio supera las actuales recomendaciones. Las variables asociadas a la realización de la episiotomía son el parto inducido o estimulado, la instrumentación y la primiparidad. Se evidencia una relación significativa entre la práctica de episiotomia y el mayor grado de desgarro.

Tasa de episiotomía en el Hospital Clínico Universitario de La Arrixaca y factores que influyen en su práctica / Rate of episiotomy in the University Clinical Hospital of Arrixaca and factors that influence in its practice

OBJETIVO: La realización de episiotomías es una práctica cuestionada dada la fuerte evidencia científica existente sobre sus efectos adversos. Los objetivos de este estudio fueron conocer la tasa de episiotomías y su adecuación a las recomendaciones del Ministerio de Sanidad, Consumo y Bienestar Social y valorar los factores asociados. MÉTODOS: Se realizó un estudio cuantitativo observacional, descriptivo y transversal, que fue llevado a cabo en el Hospital Clinico Universitario Arrixaca. Se recogieron datos De los partos atendidos entre el 1 de enero de 2016 y el 30 de octubre de 2017, obteniendo una muestra de 10.630 mujeres, a través del programa informático SELENE, que es la base de datos clínicos de dicho hospital. Para realizar el análisis de datos se utilizó el programa estadístico SPSS y una base de datos Excel. En un primer nivel, se efectuó un análisis descriptivo de las variables obstétricas y, en un segundo nivel, se contrastaron los datos con los indicadores del Ministerio de Sanidad, Consumo y Bienestar Social mediante una comparación de dos proporciones y el test de la ji al cuadrado. Para poder estimar el Tamaño del Efecto se utilizó la V de Cramer para variables cualitativas, y se calculó el riesgo relativo para cada par de variables cualitativas como medida relativa del efecto, para determinar así la fuerza de asociación entre las variables. RESULTADOS: La tasa de episiotomías fue del 36,5%. Cuando el parto comenzó espontáneamente el porcentaje fue del 35,5%; cuando fue inducido, la tasa fue del 47,2% y cuando fue estimulado, el porcentaje fue del 42,3%. La tasa en partos eutócicos fue del 20,6% y en instrumentados fue del 95,25%. En primíparas, la realización de episiotomía fue del 49,64% y en multíparas la realización fue del 15,55%. Se observó una tendencia a desgarros de segundo grado (43,40%), seguidos de primer grado (35,61%) y de tercer grado (19,81%) con episiotomía. CONCLUSIONES: La tasa de episiotomía de nuestro estudio supera las actuales recomendaciones. Las variables asociadas a la realización de la episiotomía son el parto inducido o estimulado, la instrumentación y la primiparidad. Se evidencia una relación significativa entre la práctica de episiotomia y el mayor grado de desgarro

OBJECTIVE: The conduction of episiotomy is a questioned practice given the strong scientific evidence on its adverse effects. The study objectives were to know the episiotomy rate and its adaptation to the recommendations of the Ministry of Health, Consumption and Social Welfare and assess the associated factors. METHODS: It has been made a Observational, descriptive and transversal quantitative study, it was carried out in the university clinical hospital arrixaca. Data were collected from deliveries attended between January 1, 2016 and October 30, 2017, obtaining a sample of 10,630 women, registered in the SELENE computer program which is the clinical database of said hospital. To perform the data analysis, were used the SPSS statistical program and an Excel database. At the first level, it was carried out a descriptive analysis of the obstetric variables and, at a second level, the data were compared with the Ministry of Health indicators by means of a comparison of two proportions and the chi-square test. In order to estimate the Effect Size, the Cramer V was used for qualitative variables and the relative risk was calculated for each pair of qualitative variablesas a relative measure of the effect, to determine the strength of association between the variables. RESULTS: The episiotomy rate was 36.5%. When the birth started spontaneously, the percentage was 35.5%, when it was induced 47.2% and stimulated rate was 42.3%. The rate in eutocic deliveries was 20.6% and in instrumented was 95.25%. In primiparas, the episiotomy was 49.64% and in multiparas the conduction was 15.55%. Was observed a tendency of second-degree tears (43.40%), followed by first-degree (35.61%) and third-degree (19.81%) with episiotomy. CONCLUSIONS: The episiotomy rate in our study exceeds current recommendations. The variables associated with the performance of the episiotomy are induced or stimulated delivery, instrumentation and primiparity. There is a significant relationship between the practice of episiotomy and the greater degree of tear

El contexto del nacimiento en los años cuarenta en una zona rural del sur de España / Birth context in the forties in a rural area of southern Spain / Contexto do nascimento em quarenta anos em uma área rural do sul da Espanha

En este estudio nos planteamos como objetivos conocer el contexto del nacimiento en un pueblo rural de España en un período de posguerra, 1945-1950; determinar cómo influyeron los roles de género en la vivencia de estos acontecimientos; identificar qué valores y creencias influyeron en el proceso del nacimiento de sus hijos y descubrir qué actitudes promovieron cambios. Desde el enfoque cualitativo hemos escogido el método etnográfico. La información se obtuvo a través de historias de vida y entrevistas semiestructuradas durante 2009. El estudio se llevó a cabo en un pueblo rural del sureste de España (Abarán-Murcia). Se realizaron 11 historias de vida a mujeres que fueron madres entre 1945 y 1950 y 5 entrevistas semiestructuradas para la triangulación y ampliación de la información. Tras la trascripción y fragmentación de las entrevistas y mediante análisis temático del contenido surgieron tres categorías: trabajo/economía doméstica, matrimonio/familia y nacimiento. Los roles de género se han impuesto en la vida de los hombres y las mujeres. El modelo social relaciona a la mujer con las actividades dentro del hogar, sin embargo, la mujer trabajaba duro fuera de casa en labores agrícolas. Las creencias transmitidas provocaban que las mujeres no conocieran su propio cuerpo incluso en el momento del parto, la matrona es el personal de referencia para este acontecimiento

In this study we set objectives to define the birth context of a rural town in Spain in the post-war period 1945-1950; to define what influence gender roles had on experience of these events; to identify what values and beliefs had influence on the childbirth process and to investigate which attitudes promoted change. Taking a qualitative approach, we chose an ethnographic method. The information was obtained through life story reports and semi-structured interviews during 2009. The study was carried out in a rural town in southern Spain: Abarán, in the Region of Murcia. Eleven life stories were collected from women who became mothers between 1945 and 1950 and five semi-structured interviews were also carried out to enable triangulation and information expansion.After transcription of the interviews, the information was fragmented and, after thematic analysis of the content, three categories were defined: household work/ economy, marriage/family and childbirth. Despite the way that gender roles defined the lives of men and women. Even though the social model of the time links women to activities at home, these women also worked hard at agricultural labour outside the home. The prevailing beliefs meant that many of the women were ignorant of their own bodies, even up until the moment of giving birth. Midwives were the reference professionals for this event

Este estudo tem como objectivos conhecer o contexto do nascimento numa vila rural de Espanha no período de pós-guerra, 1945- 1950; determinar como o papel de género influiu na vivência desses eventos; identificar quais valores e crenças influíram no processo do nascimento dos filhos e descobrir quais actitudes promoveram as mudanças. A partir da abordagem qualitativa foi escolhido o método etnográfico. As informações foram obtidas através das histórias de vida e entrevistas semi-estruturadas ao longo de 2009. O estudo desenvolveu-se numa vila rural no sudeste da Espanha (Abarán, Murcia). Foram realizadas onze histórias de vida a mulheres que foram mães entre 1945 e 1950, e cinco entrevistas semi-estruturadas para a triangulação e ampliação da informação. Após a transcrição e fragmentação das entrevistas e da análise temática do conteúdo, surgiram três categorias: trabalho/economia doméstica, casamento/ família e nascimento. O papel do género tem-se imposto na vida dos homens e das mulheres. O modelo social relaciona à mulher com as actividades dentro de casa, no entanto, a mulher trabalhava duramente fora de casa na agricultura. As crenças transmitidas fizeram com que as mulheres não conhecessem o seu próprio corpo, mesmo no momento do parto, sendo a parteira a pessoa de referência para este acontecimento

Factores de estrés laboral en el personal de enfermería hospitalario del equipo volante según el modelo de demanda-control-apoyo / Factors of work-related stress in hospital nursing bureau according to the demand-control-support model

Objetivos: Analizar la presencia de estrés laboral en el equipo volante de enfermería de un Hospital General Universitario tomando como referencia el modelo demandas-control-apoyo de Karasek. Método: Estudio observacional de corte transversal. La muestra estuvo constituida por 38 profesionales de enfermería del equipo volante de un Hospital General Universitario. Instrumentos de evaluación: para conocer la percepción de los profesionales de enfermería sobre el contenido de su trabajo y determinar los estresores laborales, se empleó el cuestionario Job Content Questionnaire (JCQ) traducido y validado para enfermería hospitalaria. Resultados: La tasa de participación fue del 90,47% (N=38). Se registró una media para la dimensión de apoyo social de 2,59±0,47, para la dimensión de demandas psicológicas en el trabajo de 3,26±0,47, y para la dimensión de control sobre el trabajo se obtuvo una media de 2,87±0,40. El análisis de datos puso de manifiesto un nivel moderado de estresores, destacando un déficit de apoyo social por parte de los superiores, que resultó ser más acusado en el grupo de profesionales adscritos a la dirección de enfermería (2,89 vs 2,49; p<0,05). Ninguna de las tres dimensiones se mostró asociada a las variables socio-laborales de sexo, edad, turno, adscripción y tipo de vinculación al hospital. Conclusiones: Existe una percepción moderada de estresores laborales, resaltando el escaso apoyo social por parte de los superiores, siendo este aspecto una área de mejora sobre la que intervenir

Objectives: To analyse the presence of work-related stress in the nursing bureau of a University General Hospital taking as reference Karasek's demand-control-support model. Methods: Cross-sectional observational study. The sample included 38 nursing professionals from the nursing bureau of a University General Hospital. Assessment tools: the Job Content Questionnaire (JQC), translated and validated for hospital nursing, was used to know the perception of nursing professionals concernins their work, and to determine the presence of any work-related stressors. Results: The participation rate was 90.47% (N=38). The average for the social support dimension was 2.59±0.47, for the psychological demands of 3.26±0.47, and for control over their own work of 2.87±0.40. Data analysis pointed to a moderate level of stress, reflecting a deficit in the social support provided by superiors, particulary in the group of professionals assigned to nursery management (2.89 vs 2.49; p<0.05). None of the three dimensions showed a link of any kind with socio-occupational variables of gender, age, shift, assignment or type of connection to the hospital. Conclusion: Improvement is needed in this area on the part of human resources management in order to lessen the effect of work-related stress, psychological demands and lack of control over these

Impact of support networks for breastfeeding: A multicentre study.

BACKGROUND: The rates of breastfeeding worldwide are slowly improving since 1996. Europe is still trailing behind the global breastfeeding incidence and prevalence rates. Thus, breastfeeding promotion, protection, prolongation and support have become an important challenge as breastfeeding sharply decreases in the first six months of life. OBJECTIVES: The aim of this project is to determine, assess and identify the real impact of breastfeeding support networks in Murcia (Spain). METHODS: After searching unsuccessfully for a validated questionnaire, a specific one was developed and validated for measuring the impact of formal and informal support networks through five dimensions: satisfaction, consultation, experience, problems and support. The questionnaire was provided to 500 mothers with experience in breastfeeding, who brought their children to baby paediatricians between 2 June and 27 November 2014. Upon completion of the survey and fieldwork, a detailed statistical analysis was conducted. RESULTS: The degree of satisfaction perceived by the users of the services of support breastfeeding networks is remarkable. In addition, mothers who clarified their doubts and discussed their problems with health professionals and/or breastfeeding support networks were more likely to breastfeed for a longer duration compared to those who did not (p=0.005). Furthermore, mothers who sought support in breastfeeding are more likely to breastfeed for more than 6 months (p<0.0005). CONCLUSION: Based on this information, we conclude that breastfeeding support networks have a positive influence in the duration of a women's decision to breastfeed.

An exploratory study of the relationship between resilience, academic burnout and psychological health in nursing students.

OBJECTIVES: The purpose of this study was to examine the relationship between resilience, academic burnout and psychological health in a sample of nursing students. METHOD/DESIGN: A descriptive and cross-sectional design was applied, with questionnaires as tools. PARTICIPANTS: The convenience sample consisted of 113 nursing students in their final academic year, who voluntarily participated in the study. RESULTS: The results indicated a statistically significant relationship between resilience and both emotional exhaustion (r = -.55; p < .01) and psychological health (r = -.62; p < .01), as well as between all three dimensions of burnout and psychological health. Hierarchical multiple regression analysis indicated that high scores for resilience and low scores for emotional exhaustion predict better perceived psychological health [F(2.96) = 17.75; p < .001]. CONCLUSIONS: Resilience was associated with lower levels of psychological discomfort and academic burnout. These findings highlight the importance of developing resilience and integrating it as an element in the nursing educational programme.

El concepto del Baby Café como red internacional de apoyo a la lactancia materna / O conceito do Baby Café como rede internacional de apoio à amamentação materna / The Baby Café concept as an international network of support to breastfeeding

El objetivo general de este trabajo consiste, en reflexionar sobre el fenómeno del Baby Café como recurso novedoso y conveniente dentro del mundo de la promoción, protección y apoyo a la lactancia materna a nivel internacional. El Baby Café es una iniciativa de apoyo a la lactancia materna, que coordina una red internacional de centros en los que se combina el apoyo formal proveniente de los profesionales sanitarios especializados en lactancia y el apoyo informal propio de los grupos o redes de apoyo a la lactancia. Con el fin último de promover proteger y apoyar a la lactancia materna, adentrándonos en la iniciativa del Baby Café y animando a que se realicen más estudios que avalen el verdadero impacto que éste tipo de iniciativas tienen sobre la sociedad; hemos desarrollado, mediante el estado de la cuestión y un diario de campo, un estudio cualitativo, que nos ha permitido explorar el fenómeno del Baby Café en el distrito 10 de Singapur, durante el mes de marzo de 2015 (AU)

O objetivo geral deste trabalho consiste em refletir sobre o fenômeno do bebe café como novo e conveniente recurso dentro do mundo da promoção, proteção e apoio a amamentação materna a nível internacional. O bebe café é uma iniciativa de apoio a amamentação materna que coordena uma rede internacional de centros nos quais se combina o apoio formal proveniente dos profissionais sanitários especializados em amamentação, e no apoio informal próprio dos grupos o redes de apoio a amamentação. Com o fim de promover, proteger e apoiar a amamentação materna aprofundando a iniciativa do bebe café e incentivando a que se realizem mais estudos que avaliem o verdadeiro impacto que este tipo de iniciativa tem sobre a sociedade; temos desenvolvido, mediante o estado da questão e um diário de campo, um estudo qualitativo, que nos permitiu explorar o fenômeno do bebe café no distrito de Singapura durante o mês de Março 2015 (AU)

The general objective of this work is to reflect on the phenomenon of The Baby Café as a novel and convenient concept in a world of promotion, protection and support of breastfeeding worldwide. The Baby Café is an initiative to support breastfeeding that coordinates an international network of centers that combines formal support from health professionals who specialize in lactation with informal support groups or networks of breastfeeding. With the ultimate goal of the promotion, protection and support of breastfeeding, the introduction of The Baby Café initiative encourages more studies of such nature to be conducted, eventually demonstrating the true impact of such initiatives on society; we have developed, through the theoretical framework and a field diary, a qualitative study, which has allowed us to explore the phenomenon of the Baby Cafe in the 10th district of Singapore, during the month of March 2015 (AU)

La satisfacción de la vida laboral de los enfermeros de las unidades móviles de emergencias de la Región de Murcia / Working life satisfaction in the nursing staff of the emergency mobile units of the Región of Murcia

El análisis de la satisfacción laboral es un indicador de la calidad del servicio prestado, convirtiéndose de forma indirecta, en un instrumento para mejorar la calidad de la atención sanitaria. Objetivo: Analizar la satisfacción laboral de los profesionales de enfermería de las Unidades Móviles de Emergencias de la Región de Murcia. Metodología: Estudio cuantitativo de corte transversal, con una muestra de conveniencia de 77 profesionales de enfermería de las Unidades Móviles de Emergencias, realizado en febrero/abril de 2013. Se utilizó la escala NTP 394: Satisfacción Laboral: escala general de satisfacción. Se procedió al análisis descriptivo y estadístico de asociación de variables con el programa estadístico SPSS (v.15). Resultados: La participación fue del 90,58%. Los resultados del estudio reflejan una satisfacción general media (M=72.12; DT=13,97), los 'compañeros de trabajo' y el 'horario de trabajo' son los aspectos mejor evaluados. Conclusiones: Este estudio mostró un elevado nivel de satisfacción laboral de los profesionales de enfermería de las Unidades Móviles de Emergencias de la Región de Murcia. No obstante, la detección de facetas laborales que producen insatisfacción constituye una herramienta importante para el establecimiento de acciones de mejora por parte de los gestores de las organizaciones de salud (AU)

The analysis of the job satisfaction is an indicator of the quality of the service provided, becoming in an indirect way, an instrument for improving the quality of health care. Objective: analyze the job satisfaction of nursing professionals of the Mobile Units of Emergencies in the Region of Murcia. Methodology: Quantitative cross-sectional study with a convenience sample of 77 nurses from the Emergency Mobile Units. The study was conducted from February to April 2013. Overall level of satisfaction: the NTP 394 scale: Job Satisfaction was used to measure satisfaction. We proceeded to the descriptive and statistical analysis of association of variables with the statistical program SPSS (V.15). Results: The response rate was 90.58%. The study results reflect an average overall satisfaction (M=72.12; SD=13.97); the 'colleagues' and 'working shift' are the best evaluated aspects. Conclusions: This study showed a high level of job satisfaction of nurses in the Emergency Mobile Units of the Region of Murcia. However, the detection of occupational aspects that produce dissatisfaction is an important tool concerning the establishment of improvement actions from managers of health organizations (AU)

Use and influence of Delivery and Birth Plans in the humanizing delivery process.

OBJECTIVES: get to know, analyze and describe the current situation of the Delivery and Birth Plans in our context, comparing the delivery and birth process between women who presented a Delivery and Birth Plan and those who did not. METHOD: quantitative and cross-sectional, observational, descriptive and comparative cohort study, carried out over two years. All women who gave birth during the study period were selected, including 9303 women in the study. RESULTS: 132 Delivery and Birth Plans were presented during the first year of study and 108 during the second. Among the variables analyzed, a significant difference was found in "skin to skin contact", "choice of dilation and delivery posture", "use of enema", "intake of foods or fluids", "eutocic deliveries", "late clamping of the umbilical cord" and "perineal shaving". CONCLUSIONS: the Delivery and Birth Plans positively influence the delivery process and its outcome. Health policies are needed to increase the number of Delivery and Birth Plans in our hospitals.

El estudiante como protagonista de su aprendizaje: La necesidad del uso del portafolio en enfermería dentro del contexto de Educación Superior / The student as protagonists of their learning: the need to use the portfolio in nursing within the context of higher education

Las reformas promovidas por el proceso Bolonia han implicado cambios en las formas de enseñar y aprender dentro del marco del Espacio Europeo de Educación Superior. Esta amplia remodelación trae consigo por un lado un cambio estructural y, por otro, una reconceptualización del proceso de aprendizaje apoyada en las teorías constructivistas, a través de estrategias metodológicas de construcción del conocimiento desarrolladas por los estudiantes. El objetivo del presente artículo es presentar una reflexión teórica acerca del uso del portafolio como recurso didáctico para la enseñanza y aprendizaje dentro de este contexto. Se ha observado que la implicación de los estudiantes en la identificación de los problemas a través del portafolio, facilita a los docentes una mayor comprensión de los procesos de aprendizaje de los estudiantes, así como una oportunidad para éstos de efectuar un aprendizaje más reflexivo, autónomo y participativo, tan importante en disciplinas eminentemente prácticas como la Enfermería

The reforms promoted by the Bologna process have led to changes in the forms of teaching and learning within the framework of European Higher Education. This brings extensive remodeling on the one hand a structural change and on the other, a re-conceptualization of the learning process supported by constructivist theories, through methodological strategies developed knowledge construction by students. The aim of this paper is to present a theoretical reflection on using the portfolio as a teaching resource for teaching and learning in this context. It has been observed that the involvement of students in identifying problems through the portfolio, provides teachers with a greater understanding of the learning processes of students as well as an opportunity for them to make a more reflective learning, independent and participatory practices eminently important in disciplines such as Nursing

Use and influence of Delivery and Birth Plans in the humanizing delivery process / Uso e influência dos Planos de Parto e Nascimento no processo de parto humanizado / Uso e influencia de los Planes de Parto y Nacimiento en el proceso de parto humanizado

get to know, analyze and describe the current situation of the Delivery and Birth Plans in our context, comparing the delivery and birth process between women who presented a Delivery and Birth Plan and those who did not.

conhecer, analisar e descrever a situação atual dos Planos de Parto e Nascimento no contexto estudado, comparando o processo de parto e sua finalização entre as mulheres que apresentaram e as que não apresentaram um Plano de Parto e Nascimento.

conocer, analizar y describir la situación actual de los Planes de Parto y Nacimiento en nuestro entorno, comparando el proceso de parto y la finalización del mismo entre las mujeres que han presentado un Plan de Parto y Nacimiento y las que no lo han hecho.

Satisfacción laboral de los profesionales sanitarios de un Hospital Universitario: análisis general y categorías laborales / Job satisfaction of health professionals in a University Hospital: General analysis and job categories

La satisfacción laboral en los servicios de salud está implicada en la calidad asistencial, de ahí la importancia de su medición en los trabajadores de las instituciones sanitarias. El objetivo fue explorar y analizar el fenómeno de la satisfacción laboral en una muestra constituida por 546 profesionales sanitarios pertenecientes a un Hospital Universitario público. Se administró un cuestionario general que contenía un conjunto de preguntas de contenido sociodemográfico y se utilizó la Escala General de Satisfacción (Overall Job Satisfacción) adaptada y validada al castellano. Los resultados del estudio reflejan una satisfacción general media (M = 71.37; DT = 14.03), los “compañeros de trabajo” y el “superior inmediato” son los aspectos mejor evaluados. Los principales hallazgos reflejan diferencias importantes en los distintos niveles de satisfacción atendiendo a la categoría profesional, siendo los grupos de gestión y los médicos residentes lo más satisfechos, mientras que los facultativos especialistas de área, profesionales de enfermería y auxiliares de enfermería manifiestan niveles de satisfacción más reducidos

Job satisfaction in health services is measured by the quality of care provided, hence the importance of surveying the workers of health institutions. The objective was to explore and analyze the phenomenon of the satisfaction of working in a sample made up of 546 health professionals belonging to a public University Hospital. Both a socio-demographic questionnaire and General Scale of Satisfaction (Overall Job Satisfacción) that were both validated in Spanish were given to the participants. The results of general satisfaction showed a mean of 71.37 (SD = 14.03). The subscales with better results were: colleagues and immediate superior. There were important differences in satisfaction scores between the different professional categories. The higher levels of general satisfaction were found in hospital management groups and resident doctors, while the lower levels of general satisfaction were found in medical area specialists, nurses and auxiliary nurses

Desarrollo y validación de un instrumento diseñado para medir el impacto de las redes de apoyo a la lactancia materna / Development and validation of an instrument designed to measure the impact of networks of support for breastfeeding

Antecedentes: partimos de la hipótesis de que no existen suficientes cuestionarios validados que midan el impacto de las redes de apoyo a la lactancia materna para población hispano hablante. Objetivo: Por ese motivo, nos planteamos como objetivo general de este trabajo, elaborar y validar (a nivel de contenido y constructo) un instrumento de medida cuantitativa. Método: Se evaluó la validez de contenido sometiendo el cuestionario a un juicio de expertos en lactancia materna de la Región de Murcia. La prueba piloto se llevó a cabo entre los meses de marzo y abril de 2014. Las encuestas fueron realizadas directamente por las usuarias que acudían al grupo de apoyo a la lactancia «Lactando». Para la validez de constructo se realizó un análisis factorial con el que se determinaron las distintas dimensiones que el cuestionario podría medir. Se realizó una estadística descriptiva de cada uno de los ítems. A través del análisis de componentes principales, se obtuvo la varianza total explicada, determinando así, los factores con los elementos que los definían. Resultados: A través del análisis factorial, el cuestionario obtuvo una alta consistencia interna para sus cinco componentes (satisfacción, consultas, experiencia, problemas y apoyo), consiguiendo valores de 0,942 a 0,632. Y un porcentaje de varianza total explicada elevado (11,157%-5,093%). Conclusión: Este estudio ha servido para crear un instrumento pertinente y válido a nivel de contenido y de constructo, capaz de medir el impacto de las redes de apoyo a la lactancia a través de 5 dimensiones (AU)

Background: the hypothesis of this study is that there are not enough validated questionnaires that measure the impact of networks to support breastfeeding for the Spanish speaking population. Objective: For this reason, we ask as a general objective of this study, to develop and validate (in terms of content and construct) a quantitative instrument of measure. Method: We evaluated the content validity, subjecting the survey to a breastfeeding expert's opinion in the Region of Murcia. The pilot test was conducted between the months of March and April 2014. Surveys were carried out directly by users who attended the breast-feeding support group «Lactando». For construction validity, a factor analysis was conducted, which determined the different dimensions that the survey could measure. A description of each of the items on the statistics was conducted. Through principal component analysis, the total variance explained was obtained, determining the factors that define the elements. Results: Through factor analysis, the questionnaire has a high internal consistency for its five components (satisfaction, consultations, experience, problems and support), obtaining values from 0.942 to 0.632. And a high percentage of total variance explained (11,157%-5,093%). Conclusion: This study has served to create a relevant and valid in terms of content and construction, instrument, capable of measuring the impact of networks of support for breastfeeding through 5 dimensions (AU)

[Development and validation of an instrument designed to measure the impact of networks of support for breastfeeding]. / Desarrollo y validación de un instrumento diseñado para medir el impacto de las redes de apoyo a la lactancia materna.

BACKGROUND: the hypothesis of this study is that there are not enough validated questionnaires that measure the impact of networks to support breastfeeding for the Spanish speaking population. OBJECTIVE: For this reason, we ask as a general objective of this study, to develop and validate (in terms of content and construct) a quantitative instrument of measure. METHOD: We evaluated the content validity, subjecting the survey to a breastfeeding expert's opinion in the Region of Murcia. The pilot test was conducted between the months of March and April 2014. Surveys were carried out directly by users who attended the breast-feeding support group "Lactando". For construction validity, a factor analysis was conducted, which determined the different dimensions that the survey could measure. A description of each of the items on the statistics was conducted. Through principal component analysis, the total variance explained was obtained, determining the factors that define the elements. RESULTS: Through factor analysis, the questionnaire has a high internal consistency for its five components (satisfaction, consultations, experience, problems and support), obtaining values from 0.942 to 0.632. And a high percentage of total variance explained (11,157% - 5,093%). CONCLUSION: This study has served to create a relevant and valid in terms of content and construction, instrument, capable of measuring the impact of networks of support for breastfeeding through 5 dimensions.

Antecedentes: partimos de la hipótesis de que no existen suficientes cuestionarios validados que midan el impacto de las redes de apoyo a la lactancia materna para población hispano hablante. Objetivo: Por ese motivo, nos planteamos como objetivo general de este trabajo, elaborar y validar (a nivel de contenido y constructo) un instrumento de medida cuantitativa. Método: Se evaluó la validez de contenido sometiendo el cuestionario a un juicio de expertos en lactancia materna de la Región de Murcia. La prueba piloto se llevó a cabo entre los meses de marzo y abril de 2014. Las encuestas fueron realizadas directamente por las usuarias que acudían al grupo de apoyo a la lactancia "Lactando". Para la validez de constructo se realizó un análisis factorial con el que se determinaron las distintas dimensiones que el cuestionario podría medir. Se realizó una estadística descriptiva de cada uno de los ítems. A través del análisis de componentes principales, se obtuvo la varianza total explicada, determinando así, los factores con los elementos que los definían. Resultados: A través del análisis factorial, el cuestionario obtuvo una alta consistencia interna para sus cinco componentes (satisfacción, consultas, experiencia, problemas y apoyo), consiguiendo valores de 0,942 a 0,632. Y un porcentaje de varianza total explicada elevado (11,157% - 5,093%). Conclusión: Este estudio ha servido para crear un instrumento pertinente y válido a nivel de contenido y de constructo, capaz de medir el impacto de las redes de apoyo a la lactancia a través de 5 dimensiones.

Adecuación entre la práctica clínica obstétrica en el Hospital Clínico Universitario Virgen de la Arrixaca (Murcia) y las recomendaciones de la Estrategia de Atención al Parto Normal / Adaptation between the obstetric clinical practise at the University Hospital Virgen de la Arrixaca (Murcia) and the recommendations of the Strategy Normal Birth Care

OBJETIVO: Comprobar el grado de adecuación de la práctica clínica obstétrica a las recomendaciones de la Estrategia de Atención al Parto Normal. Personas, material y método: Estudio descriptivo, transversal, de la actividad obstétrica de 12.093 mujeres durante el proceso de parto (en los años 2011 y 2012) en el Hospital Clínico Universitario Virgen de la Arrixaca (Murcia). Las variables estudiadas fueron: paridad, edad gestacional, inicio del parto, utilización de analgesia epidural, uso de oxitocina, posición durante la etapa de expulsión fetal, peso del recién nacido y finalización del parto. RESULTADOS: Se observa una adecuación de la práctica clínica a las recomendaciones de la Estrategia de Atención al Parto Normal en la tendencia a disminuir las siguientes practicas: el rasurado perineal (13%), el uso de enemas (7%) y el número de cesáreas urgentes (11,38%). Asimismo, se constata una tendencia a aumentar el acompañamiento al parto (88,7%), la monitorización continua (99%), la ingesta de líquidos intraparto (34,8%), el número de partos vaginales tras cesárea previa (93,1%) y el porcentaje de epidural (77%). El resto de variables estudiadas (realización de amniotomia y partos instrumentados) se mantienen sin cambios. CONCLUSIONES: Las recomendaciones de la Estrategia no se siguen en su totalidad. Se han identificado puntos de mejora. Es necesario desarrollar políticas que permitan reducir los procedimientos desaconsejados por el Ministerio de Sanidad, así como reforzar la formación del equipo interdisciplinar

OBJECTIVE: The aim is to check the adaption of the obstetric clinical practise and the recommendations of the Strategy Normal Birth Care. Persons, material and methods: This has been a descriptive, transversal and analytical study of the obstetrical activity of 12,093 childbirths which took place between 2011 and 2012 in the Clinical University Hospital Virgen de la Arrixaca (Murcia). The studied variables were: parity, gestational age, onset of labor, use of epidural analgesia, use of oxytocin, stage position during fetal expulsion, new-born weight and type of delivery (eutocic, implemented or cesarean). RESULTS: The clinical appropriateness of the recommendations of the Strategy Normal Birth Care presents a tendency to decrease in the following practises: perineal saving (13%), the use of enemas (7%) and the number of emergency caesareans (11.38%). Likewise, some practices have also had a tendency to increase: accompaniment of childbirth (88.7%), continuous monitoring (99%), intrapartum fluid intake (34.8%), the number of vaginal births after cesarean (93.1%) and the number of women with epidural (77%). There has not been any variation in the remaining studied variables (amniotomy and performing instrumental births). CONCLUSIONS: The recommendations of the Strategy are not followed entirely. Some points of improvement have been identified. It will be necessary to develop some reduction policies of procedure advised against by the Ministry, and to reinforce the interdisciplinary team training

Seguridad del paciente y competencia enfermera en el almacenamiento y conservación de los botiquines de las unidades de hospitalización de un hospital universitario / Patients safety and nursing competences regarding drug storage in hospital units at a University Hospital

Resumen:

La seguridad del paciente es un tema actual e importante y son muchas las campañas, planes y estrategias en estudios e investigaciones de diversos países, dirigidas a minimizar los errores de medicación. Objetivo: evaluar el correcto almacenamiento y conservación de la medicación termolábil, fotosensible y la identificación de los medicamentos de alto riesgo. Material y método: estudio cuantitativo y transversal. Se evaluaron todos los botiquines en abril de 2013. Resultados: de las 16 unidades estudiadas, 14 (87,5%) mostraron algunos medicamentos fotosensibles incorrectamente protegidos de la luz. Igualmente, 14 unidades (87,5%) no tenían la totalidad de sus medicamentos de alto riesgo identificados como tal. Respecto a los termolábiles el 100% presentó un correcto almacenamiento y conservación.

Conclusiones: el correcto almacenamiento y conservación de los medicamentos es vital para garantizar su calidad, eficacia y seguridad, por lo que resulta imprescindible su conocimiento por parte de los y las enfermeras dada su competencia en la administración de los mismos.

Abstract:

Patients safety is a contemporary and significant issue, with many campaigns, plans and strategies aimed at minimizing drug mistakes being now investigated in several countries. Purpose: To asses correct storage for heat-sensitive, photosensitive drugs and to identify drugs at a high risk. Material and methods: A quantitative cross-sectional study. All medicine cabinets were evaluated in April 2013. Results: Among 16 hospital units, 14 (87.5%) had some photosensitive drugs inadequately protected from light. Furthermore, 14 units (87.5%) did not store all such medicines adequately identified as high-risk drugs. Regarding heat-sensitive drugs, all of them were correctly stored. Conclusions: Appropriate drug storage is essential to ensure drug quality, efficacy and safety. Thus, adequate understanding by nursing staff is needed because nurses are responsible for drug administration.

A segurança do paciente é um tema atual e importante e são muitas as campanhas, os planos e as estratégias em estudos e pesquisas de diversos países, destinadas a minimizar os erros de medicação. Objetivo: avaliar o adequado armazenamento e conservação de medicamentos termolábeis, fotossensíveis e a identificação dos que são de alto risco. Material e Método: estudo quantitativo e transversal. Foram avaliados todos os kits de medicamentos em abril de 2013. Resultados: das 16 unidades estudadas, 14 (87,5%) apresentaram alguns medicamentos fotossensíveis indevidamente protegidos da luz. Da mesma forma, 14 unidades (87,5%), não tinham todos os seus medicamentos de alto risco identificados como tal. Quanto aos termolábeis, 100% apresentaram um armazenamento e uma conservação adequada. Conclusões: o armazenamento e a conservação adequada dos medicamentos é vital para garantir a sua qualidade, eficácia e segurança, por isso, é essencial o conhecimento de enfermagem devido à sua competência na administração dos mesmo.

Job satisfaction among health care workers: the role of gender and age / Influência do gênero e da idade: satisfação no trabalho de profissionais da saúde / Influencia del género y edad: satisfacción laboral de profesionales sanitarios

OBJECTIVE: to analyze the influence of gender and age on the quality of the professional lives of health care professionals at a university hospital. METHOD: a total of 546 professionals completed a general questionnaire that measured sociodemographic variables and evaluated job satisfaction using a scale adopted from the NTP 394 Job Satisfaction scale and translated into Spanish. RESULTS: overall, 77.2% of the professionals surveyed were satisfied with the work they perform. With regards to gender, we found overwhelming evidence of the feminization of practically all health care professions included in the study, with higher levels of job satisfaction among women than men. Regarding age, 20-30-year-olds and professionals over 61 years old showed higher satisfaction levels than did middle-aged professionals. Higher levels of dissatisfaction were reported by professionals between 41 and 50 years old. CONCLUSIONS: we were able to detect the influence of gender and age on the level of job satisfaction, finding significant associations between job satisfaction and both of these variables. Generally, women expressed more satisfaction than men, and elderly professionals showed higher satisfaction compared to younger professionals. Management policies should focus on taking action to correct the conditions that produce dissatisfaction among certain groups of employees. .

OBJETIVO: analisar a influência do gênero e da idade na satisfação no trabalho de profissionais da saúde num hospital universitário. MÉTODO: a amostra foi constituída por 546 profissionais, aos quais foi administrado um questionário genérico, contendo variáveis sociodemográficas e um questionário específico, o NTP 394: Satisfação no Trabalho: Escala de Satisfação Global adaptada e validada para o castelhano. RESULTADOS: de modo geral, 77,2% da amostra manifestou estar satisfeita com o trabalho que realiza. Quanto ao gênero, foi evidenciada a feminização de praticamente todas as profissões em saúde, sem exceções, sendo que as mulheres manifestaram níveis mais elevados de satisfação. Com relação à idade, as faixas etárias que manifestaram os níveis mais elevados de satisfação foram entre 20 e 30 anos e acima de 61 anos. Em contrapartida, os profissionais entre 41 e 50 anos de idade apresentaram níveis de insatisfação. CONCLUSÕES: pode-se estabelecer a influência do gênero e da idade nos níveis de satisfação no trabalho da amostra estudada, visto que foram identificadas associações significativas. Em relação ao gênero, as mulheres manifestaram estar mais satisfeitas e, com respeito à idade, os maiores níveis de satisfação foram manifestos pelos participantes mais idosos. Sendo assim, as políticas de gestão devem focar na implantação de ações destinadas a melhorar as variáveis que se associam à insatisfação. .

OBJETIVO: analizar la influencia del género y edad en la satisfacción de la vida laboral en los profesionales sanitarios de un Hospital Universitario. MÉTODO: la muestra quedó constituida por 546 profesionales, administrándose un cuestionario general con variables sociodemográficas y otro específico, el NTP 394 Satisfacción Laboral: escala general de satisfacción adaptada y validada al castellano. RESULTADOS: en general un 77,2% se encuentra satisfecho con el trabajo que desempeña. En relación al género, se evidencia la feminización de prácticamente todas las profesiones sanitarias sin excepción, quedando patente niveles de satisfacción superior en las mujeres. La edad, presenta niveles más elevados de satisfacción en profesionales de edades entre 20 y 30 años y en los mayores de 61; en contrapartida los niveles de insatisfacción se presentan en los profesionales de edades comprendidas entre 41 y 50 años. CONCLUSIONES: podemos delimitar la influencia del género y la edad en los niveles de satisfacción laboral, obteniéndose asociaciones significativas en ambas variables; respecto al género, las mujeres se muestran más satisfechas y en cuanto a la edad los profesionales de mayor edad muestran mayor satisfacción. Así, las líneas de gestión deben orientarse al establecimiento de acciones de mejora en aquellas variables que producen insatisfacción. .

Job satisfaction among health care workers: the role of gender and age.

OBJECTIVE: to analyze the influence of gender and age on the quality of the professional lives of health care professionals at a university hospital. METHOD: a total of 546 professionals completed a general questionnaire that measured sociodemographic variables and evaluated job satisfaction using a scale adopted from the NTP 394 Job Satisfaction scale and translated into Spanish. RESULTS: overall, 77.2% of the professionals surveyed were satisfied with the work they perform. With regards to gender, we found overwhelming evidence of the feminization of practically all health care professions included in the study, with higher levels of job satisfaction among women than men. Regarding age, 20-30-year-olds and professionals over 61 years old showed higher satisfaction levels than did middle-aged professionals. Higher levels of dissatisfaction were reported by professionals between 41 and 50 years old. CONCLUSIONS: we were able to detect the influence of gender and age on the level of job satisfaction, finding significant associations between job satisfaction and both of these variables. Generally, women expressed more satisfaction than men, and elderly professionals showed higher satisfaction compared to younger professionals. Management policies should focus on taking action to correct the conditions that produce dissatisfaction among certain groups of employees.

Figura del padre en relación a la crianza: pasado, presente y futuro / A figura do pai em matéria de educação: passado, presente e futuro / Figure of the father in relating to the upbringing: past, present and future

La situación actual en el mundo occidental refleja un cambio gradual de la figura del padre en la crianza de su descendencia; según refleja Madeleine Leininger en su teoría, debemos conocer las características de este fenómeno para aplicar cuidados culturalmente congruentes. Basándonos en el concepto de Mercer «los roles no están fijados; por tanto, carece de importancia qué persona se encarga de realizar los distintos roles» (Marriner, 2007) podemos asemejar el vínculo materno-filial al paterno-filial. Proponemos una investigación de corte cualitativo basada en la entrevista en profundidad al objeto de estudio: padres (hombres) noveles; y grupos de discusión a matronas como figura profesional más representativa y que está directamente implicada con la salud reproductiva de la mujer y del cuidado del recién nacido. Así podemos afirmar que la idea de familia típica tal y como es aceptada entra en crisis entorno a los años noventa, emergiendo así la figura de los Nuevos Padres, concepto introducido por Bonino (2003). Nos encontramos con un padre cuya presencia en el cuidado de los hijos tiene una gran importancia en el buen desarrollo de los mismos (Alberdi Escario, 2007). Por tanto debemos trabajar sobre el modelo de Nuevos Padres para definir la implicación de éste en la crianza. La matrona es la profesional más cualificada para servir como agente impulsor de cambio (AU)

A situação atual no Ocidente reflete uma mudança gradual do pai na educação dos seus filhos, como refletido na sua teoria Madeleine Leininger, é preciso conhecer as características deste fenômeno para implementar cuidados culturalmente congruentes. Baseado no conceito de Mercer «papéis não são fixos, então não importa onde a pessoa é responsável por executar os diferentes papéis» (Marriner, 2007) podem imitar a subsidiária maternopaterno-filial. Propomos uma pesquisa qualitativa com base em entrevistas em profundidade a fim de estudar: os pais (homens) novato, e grupos de discussão parteiras profissionais como a figura mais representativa e está diretamente envolvido com a saúde reprodutiva das mulheres e cuidados o recém-nascido. Assim, podemos dizer que a idéia típica família é aceito como está em crise em torno da década de noventa, emerge a figura de os novos pais, um conceito introduzido por Bonino (2003). Encontramos um pai cuja presença no cuidado das crianças é de grande importância no desenvolvimento adequado desses (Alberdi & Escario, 2007). Portanto, devemos trabalhar com o modelo para definir o envolvimento dos pais em Nova elevando-o. A parteira é o profissional mais qualificado para servir como agentes de mudança (AU)

The current situation in the West reflects a gradual change of the father in the upbringing of their offspring, as reflected in its theory Madeleine Leininger, one must know the characteristics of this phenomenon to implement culturally congruent care. Based on the concept of Mercer «roles are not fixed, so no matter which person is responsible for performing the different roles» (Marriner, 2007) can mimic the maternal-paternal-filial subsidiary. We propose a qualitative research based on in-depth interview in order to study: parents (men) novice, and discussion groups professional midwives as the most representative figure and is directly involved with women’s reproductive health and care the newborn. Thus we can say that the typical family idea is accepted as is in crisis around the nineties, there emerges the figure of the new parents, a concept introduced by Bonino (2003). We met a father whose presence in the care of children is of great importance in the proper development of these (Alberdi & Escario, 2007). Therefore we must work on the model to define the New Parent involvement in raising it. The midwife is the professional most qualified to serve as agents of change (AU)