Análisis de la relevancia percibida del trabajo de planificación compartida de la atención a través de la instrumentalización con cartas / Analysis of the perceived relevance of the work of advance directives through instrumentalization with cards

Objetivo: Desarrollo y evaluación de un instrumento capaz de medir la relevancia percibida del trabajo con cartas para el diálogo acerca de las preferencias en el proceso final de la vida.Método: Se ha construido la escala de la pertinencia percibida acerca del trabajo con cartas para las preferencias al final de la vida la cual ha sido evaluada mediante juicio de expertos y análisis factorial confirmatorio en una muestra de 320 estudiantes de Grado en Enfermería y 68 personas mayores de 40 años.Resultado: Se llega a una solución de 21 ítems, los cuales se ajustan en las 4 dimensiones teórica propuestas de manera óptima (CFI: 0,912; 0,842; 0,816; 0,995; RMSA: 0,170; 0,198; 0,187; 0,076).Conclusiones: La escala de medición de la pertinencia del trabajo con cartas es fiable y válida. Está compuesta por 4 dimensiones: Pertinencia percibida para la formación; Pertinencia percibida para el autoconocimiento; Pertinencia percibida para la aplicación en pacientes; e Iatrogenia percibida del instrumento). (AU)

Objective: Development and evaluation of an instrument capable of measuring the perceived relevance of working with cards for the dialogue about preferences at the end stages of life.Method: A scale to measure the perceived relevance of working with cards for the conversation about preferences at the end of life was developed and evaluated through expert judgment and confirmatory factor analysis in a sample of 320 nursing degree students and 68 people older than 40 years.Result: A solution with 21 items was reached, which optimally fitted the four proposed theoretical dimensions (CFI: 0.912; 0.842; 0.816; 0.995; RMSA: 0.170; 0.198; 0.187; 0.076).Conclusions: The scale for measuring the relevance of working with cards is reliable and valid. It is made up of four dimensions: Perceived relevance for training; Perceived relevance for self-knowledge; Perceived relevance for application in patients; and Perceived iatrogenicity of the instrument). (AU)

Perceived Competence in the Face of Death before and after Nursing Studies: An Intrasubject Longitudinal Study.

Perceived competence is a subject's perception of being able to interact effectively with the environment. Perceived Competence in the face of death in Nursing degree programs in which the presence of the subject of death and bereavement is key becomes more topical and relevant. The objective of this study is to determine whether this competence is improved through Nursing Studies. This study was designed as paired repeated intrasubject measures, initial measurement at the beginning of the first year and second measurement in the fourth year of the Nursing degree. One hundred and seventeen nursing students were assessed. Significant improvement is evidenced in three of the four dimensions of Perceived Competence in the face of death (Accompaniment and Communication: 25.70/29.34; Self-Confidence: 9.64/12.78; Management of Self-Fear: 13.18/14.66). These results show notable differences with their cross-sectional predecessors, suggesting the need for further studies in this field to consolidate a still developing body of knowledge.

Health-Related Quality of Life in Community-Dwelling Older People with Cognitive Impairment: EQ-5D-3L Measurement Properties.

BACKGROUND: Assessing quality of life (QoL) in older people with cognitive impairment is a challenge. There is no consensus on the best tool, but a short, user-friendly scale is advised. OBJECTIVE: This study aimed to assess the psychometric properties of the self-reported and generic EQ-5D (including the EQ index and EQ visual analog scale [VAS]) in community-dwelling older adults with cognitive impairment. METHODS: Cross-sectional study analyzing the feasibility, acceptability, reliability, and validity of the EQ-5D based on 188 self-administered questionnaires in a sample of community-dwelling older adults with Mini-Mental State Examination (MMSE) scores of 10 to 24 points. RESULTS: The EQ index was 0.69 (±0.27) and the EQ VAS was 63.8 (±28.54). Adequate measurement properties were found in acceptability and feasibility. Cronbach's alpha was 0.69. Good validity was observed in the correlation of each dimension of the EQ-5D with geriatric assessment scales. Higher validity was observed for the EQ index compared to the EQ VAS. CONCLUSION: The EQ-5D scale could be a good tool for assessing health-related QoL in community-dwelling older adults with cognitive impairment, though it is necessary to assess the dimensions and the EQ index.

Understanding illnesses through a film festival: An observational study.

Audio-visual materials play a fundamental role in the context of education, care and clinical treatment, as they seem to have a high impact on public awareness. This study aims to describe what messages are perceived by the society at an International Festival of Short Films and Art on Diseases that may help to understand difficult topics, such as illness, dying and suffering. Through an observational, descriptive, cross-sectional study, using full participant observation and an open, self-administered questionnaire, 32 short films were analysed during a healthcare art festival. Categories were developed using inductive content analysis. The message perceived by the participants, after the viewing of the shorts and reflection of the debates among the attendees, were considered in four categories: i) creative and positive education is possible; ii) awareness of preconception and practical duties; iii) meaning of life changes the experience of illness; iv) family and caregivers also experienced suffering. The short films are considered as an excellent tool to generate social dialogue and debate. Public events can be understood as an opportunity to acquire, in an emotional and critical manner, other competencies for public awareness. Together, they are capable of communicating difficult messages through a fast, positive, and creative way.

Malignant Bowel Obstruction in Relapsed Ovarian Cancer With Peritoneal Carcinomatosis: An Occlusive State.

OBJECTIVE: The aim of this study was to describe the clinical and oncological outcomes of women with malignant bowel obstruction (MBO) for relapsed ovarian cancer and peritoneal carcinomatosis. METHODS: A retrospective cohort study was performed in all consecutive patients admitted at Instituto Valenciano de Oncología, Valencia, Spain, between July 2013 and July 2016 with MBO for relapsed ovarian cancer and peritoneal carcinomatosis. All patients underwent the same protocol of conservative management. Surgical treatment was indicated only in selected cases. RESULTS: There were a total of 22 patients presenting 59 episodes of MBO; 17 (77.2%) of those patients presented more than 1 episode of MBO. All patients had serous epithelial ovarian cancer; 18 (81.8%) were high grade, and 4 (18.2%) low-grade tumors. The median (range) number of episodes per patient was 3 (range, 1-7) with a mean length of hospitalization of 13 (SD, 13.6) days. The median time interval between episodes of MBO (54 episodes in 17 patients) was 17 days (range, 1-727 days). Twenty of 22 patients died with a median overall survival time from the first episode of MBO of 95 days (95% confidence interval, 49-124 days). CONCLUSIONS: Patients with MBO due to relapsed epithelial ovarian cancer in the peritoneal carcinomatosis setting have a short life expectancy, presenting a median of 3 episodes of MBO until death, with a short time interval between episodes. These findings show that bowel obstruction can represent a constant status over time until death.

Recurrencias en infecciones por Clostridium difficile en pacientes con cáncer / Recurrences in Clostridium difficile infections in cancer patients

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