Identifying undergraduate nurses´ learning requirements and teaching strategies in dementia care education: A nominal group technique.

AIM: Identify priorities and reach a consensus on student nurses´ learning requirements and the best-suited teaching strategies in dementia care. BACKGROUND: Dementia has become a global health priority. Nurses are primary service providers for people with dementia, but they may fall short on professional training. Nursing curricula still lacks a clear educational framework for dementia, meaning that nurse educators must make decisions amidst uncertainty. DESIGN: Nominal group technique based on the conceptual framework proposed by Van de Ven and Delbecq (1972). METHODS: A structured face-to-face meeting convened in November 2021 involved nine participants who were directly involved in dementia care. The steps in the technique were (a) idea generation, (b) round-robin recording, (c) discussion, (d) voting and ranking, (e) discussion on the vote and (f) re-ranking. Participants answered two nominal questions. Consent, anonymity, feedback and iteration were guaranteed throughout the process. RESULTS: The nominal group prioritized theoretical understanding of dementia, communication, caregivers´ needs, comprehensive assessment and ethical practice as learning requirements for nursing students. The outstanding teaching strategy discussed included various approaches to experiential learning. CONCLUSIONS: The nominal group technique process explored learning requirement priorities for student nurses within a specific context. Participants discussed experiential learning as the best-suited teaching strategy. Findings could support nurse educators to design and deliver better dementia education.

Content, implementation strategies and knowledge assessment tool on venous leg ulcers: An e-Delphi study.

AIM: To get consensus on the knowledge and skills that nursing students need to acquire regarding venous leg ulcer care, the strategies that can be applied during education and to design a first draft of a questionnaire to assess knowledge to be validated. BACKGROUND: Venous leg ulcers' care is included on undergraduate nursing education programmes but without specifying the content and training implementation strategies. Different tools have been validated to assess knowledge, but have been found inadequate. DESIGN: An e-Delphi study. METHODS: The participants were Chronic Wound Care expert nurses. Two questions were constructed and agreed on by the research team to define the problem. To answer the third question, a search was conducted for publications on venous leg ulcers, to help design the questionnaire. A 2-round e-Delphi study was conducted from January to March 2022. A panel of 17 experts participated in both rounds. The data were analysed using statistical and qualitative analysis. RESULTS: Content must fulfil knowledge-skill areas: epidemiology, venous pathophysiology and aetiology, classification scales, knowing how to determine a differential diagnosis, treatment, measures for prevention and care of the venous return circuit, quality-of-life scales. As implementation strategies, proposals were made in four areas: subject profile where training is to be acquired, theoretical teaching, practical teaching in the classroom and clinical practice. The average consensus of the questionnaire proposal was high (>86 %) both in relevance and clarity in both rounds. We thereby obtained a questionnaire with 72 items. CONCLUSIONS: Seven categories and eight subcategories were created regarding knowledge/skills that nursing students should acquire. Four categories were recognised as strategies that can be implemented during education. A high level of consensus was reached on the items in the initial versions of the questionnaire.

Efecto de una asignatura optativa de heridas crónicas, en el grado de enfermería, sobre el conocimiento respecto a úlceras de etiología venosa. Proyecto de investigación / Effect of an optional subject about chronic wounds care in the nursing degree: evaluating knowledge regarding venous etiology ulcers. A research project

Objetivo: Evaluar la mejora del conocimiento respecto a úlceras de etiología venosa en estudiantes de grado de enfermería matriculados en una asignatura optativa específica sobre heridas crónicas. Metodología:Se realizará un estudio analítico cuasiexperimental. Asimismo, se efectuará un cuestionario ad hoc pre-post- postintervención con grupo control. La muestra estará compuesta por 365 estudiantes que hayan recibido la misma formación teórica y práctica de enfermería ajustada al curso en el que se encuentran. Como grupo control se encuentra el alumnado matriculado en el grado de enfermería de las sedes Donostia, Leioa y Vitoria de la Universidad del País Vasco/Euskal Herriko Unibertsitatea no matriculado en una asignatura específica en heridas crónicas. Como grupo intervención se encuentra el alumnado que esté matriculado en una asignatura optativa específica de heridas crónicas que incluye, entre sus contenidos teoricoprácticos, úlceras de etiología venosa. Se realizará un análisis descriptivo de las variables sociodemográficas, asociándolas mediante c2. Para valorar las diferencias observadas en el nivel de conocimientos se utilizará la prueba ANOVA de medidas repetidas si la variable tiene distribución normal, y el test de Friedman en caso contrario tras ser contrastada mediante la prueba Kolmogórov-Smirnov. Resultados: El diseño de este plan de investigación como trabajo fin de máster tiene su continuidad con la matriculación en un programa de doctorado en ciencias de la salud en la Universidad de Alicante (AU)

Objective: To evaluate the improvement of knowledge regarding ulcers of venous etiology in nursing students enrolled in an optional subject specific to chronic wound care. Methods:A quasi-experimental analytical study will be carried out. An ad hoc pre-post-post intervention questionnaire with a control group will be carried out. The sample will be made up of 365 students who have received the same theoretical and practical nursing training adjusted to the course they are in. The control group is made up of students enrolled in the nursing degree at the Donostia, Leioa and Vitoria campuses of the University of the Basque Country who are not enrolled in a specific subject on chronic wounds. The intervention group includes students enrolled in a specific elective course on chronic wounds that includes among its theoretical and practical content, venous leg ulcers. A descriptive analysis of the socio-demographic variables will be carried out, associating them by means of c2. To assess the differences observed in the level of knowledge, the repeated measures ANOVA test will be used if the variable has a normal distribution and the Friedman test otherwise after being contrasted by the Kolmogórov-Smirnov test (K-S). Results: The design of this research plan as a final master's degree project has its continuity with the enrolment in a doctoral programme in health sciences at the University of Alicante (AU)

Knowledge and teaching-learning methods regarding venous leg ulcers in nursing professionals and students: A scoping review.

AIM: According to our scoping review questions, three aims were formulated to synthesize the evidence published on: (1) the content (2) the best or most appropriate teaching-learning methods for training nurses and undergraduate nursing students in venous leg ulcer care, and (3) to identify the level of knowledge in nurses and undergraduate nursing students about venous leg ulcer care. BACKGROUND: A venous leg ulcer can be defined as a skin lesion on the leg or foot that occurs in an area affected by ambulatory venous hypertension. Hence, nurse visits are the main driver of Venous Leg Ulcer-related healthcare costs. Optimal levels of knowledge obtained with appropriate methodologies tend to improve care. Nonetheless, the time devoted to chronic wound education in undergraduate nursing curricula has been considered insufficient and inadequate. METHODS: For this scoping review, a search was performed in January 2021. To identify sources of evidence, a systematic search was conducted in MEDLINE, Embase, CINAHL, Web of Science, Scopus, Cuiden, ERIC and ScienceDirect. All types of evidence associated with knowledge, teaching and/or learning methods regarding venous leg ulcers in nursing were included. RESULTS: Finally, 19 documents were included. In these articles, the content mostly widely included in teaching-learning methods was compression therapy (14/19), anatomy, physiology, aetiology and/or pathophysiology (10/19) and topical treatment and care (8/19); various other topics were mentioned but less frequently. Teaching/learning methods and interventions were heterogeneous in modality, content, and duration but the majority showed better results after implementation. When looking at knowledge level, studies mainly focused on nursing staff. In general, it seems that there is a lack of knowledge and skills. CONCLUSIONS: Regarding our three pivotal questions: (1) There is no uniform type of content over the studies analysed and the most referred was compression therapy. (2) The educational interventions studied have demonstrated effectiveness, but there is insufficient data to determine which is the most effective. (3) This scoping review has highlighted the lack of knowledge among nurses and nursing students about venous leg ulcer care. Additionally, we felt that there is no ideal assessment tool to quantify knowledge, skills, attitude, confidence, and commitment in this context. TWEETABLE ABSTRACT: A scoping review that synthesise the evidence on the level of knowledge and teaching-learning methods in nursing regarding of people with venous leg ulcers shows lack of knowledge and variability in programs.

Osteo-Proliferative Lesions of the Phalanges on Radiography: Associations with Sex, Age, and Osteoarthritis.

Objectives: The effects of aging such as osteophyte formation, acral shape changes, cortical tunneling, and bone porosity as well as enthesophytes can be studied in the X-rays of hands. However, during the interpretation of radiographs of the hands, misinterpretation and false-positive findings for psoriatic arthritis often occur because periosteal proliferations of the phalanges are overinterpreted and too little is known about enthesophytes of the phalanges in this area. Method: It included a total of 1153 patients (577 men, 576 women) who presented themselves to the emergency department and received a radiography of their right hand to exclude fractures. The Osseographic Scoring System was used in a modified form to record osteophytes and enthesophytes. A linear regression model for periosteal lesions was computed with age, sex, osteophytes, and global diagnosis as covariables. The inter-reader agreement was assessed using ICC (two-way mixed model) on the sum scores of osteophytes and periosteal lesions. Results: Overall, men exhibited more periosteal lesions, demonstrated by a higher mean sum score of 4.14 vs. 3.21 in women (p = 0.008). In both sexes, the second and third proximal phalanx were most frequently affected by periosteal lesions, but the frequencies were significantly higher in men. The female sex was negatively associated with an extent of periosteal lesions with a standardized beta of −0.082 (p = 0.003), while age and osteophytes were positively associated with betas of 0.347 (p < 0.001) and 0.156 (p < 0.001), respectively. The distribution of osteophytes per location did not differ between men and women (p > 0.05). The inter-reader agreement was excellent for periosteal lesions with ICC of 0.982 (95%CI 0.973−0.989, p < 0.001). Conclusions: Special care should be taken not to confuse normal periosteal changes in aging with periosteal apposition in psoriatic arthritis.

Percutaneous Lateral Collateral Ligament Release for Arthroscopic Procedures of the Knee: The "Lateral Pie-Crusting".

Arthroscopy of the knee is among the most frequent procedures worldwide in orthopaedic surgery. To avoid iatrogenic cartilage injury, adequate visualization and working space are mandatory to perform complex procedures. Narrow femorotibial joint space is often encountered, and it is challenging to obtain consistent satisfactory results. Medial collateral ligament release is safe and reliable for facilitating medial joint widening. Current clinical studies support lateral collateral ligament (LCL) healing capacity in isolated injuries. This article describes a simple, safe, and reproducible technique of LCL release through a multiple-puncture method to facilitate lateral compartment visualization and instrumentation, the so-called lateral pie-crusting.

Conocimiento, actitud y práctica sobre pie diabético en pacientes o sus cuidadores en cirugía vascular / Knowledge, attitude and practice about diabetic foot in patients or their caregivers in Vascular Surgery

OBJETIVOS: Identificar el nivel de conocimiento, actitud y práctica orientada a la prevención del pie diabético en personas ingresadas o sus cuidadores principales en la Unidad de Cirugía Vascular. METODOLOGÍA: Se realizó un análisis estadístico descriptivo transversal. Las variables analizadas fueron: conocimiento, actitud y comportamientos relacionados con el cuidado del pie diabético. Desde diciembre de 2016 a diciembre de 2017, un equipo de enfermeras facilitó un cuestionario durante el ingreso de los pacientes en la Unidad de Cirugía Vascular, el cual no se había utilizado anteriormente con población española. RESULTADOS: El tamaño de la muestra se calculó con el objetivo de conseguir 189 personas. Un total de 172 respondió el cuestionario. En la dimensión de conocimiento, la media fue de 6,56 sobre 10 (DE = 2,05). El nivel de conocimiento de un 58,2% fue medio. En la dimensión de actitud, la media fue de 4,42 sobre 5 (DE = 0,95). Un 93% declaró tener actitud favorable hacia el autocuidado de sus pies. En la dimensión de práctica orientada a la prevención, la media fue de 5,45 (DE = 2,55). El 51,5% realizó una práctica media de autocuidado del pie diabético. CONCLUSIONES: Las personas poseían conocimientos medios de los cuidados del pie diabético. Al preguntarles por su actitud, esta fue favorable. Contrasta con el nivel de comportamiento en la práctica de autocuidado, que en la mitad de la muestra fue de carácter medio, repartiendo en partes iguales la buena práctica con la escasa práctica de autocuidado

BACKGROUND: To identify the level of knowledge, attitude and practice oriented to the prevention of diabetic foot in hospitalized persons or their main caregivers in the Vascular Surgery Unit. METHODS: A transversal descriptive statistical analysis was carried out. The variables analyzed were: knowledge, attitude and behavior related to the care of the diabetic foot. A team of six nurses, provided a questionnaire during the period of admission of patients from December 2016 to December 2017, which had not previously been used with Spanish population. RESULTS: The sample size was calculated in order to get 189 people. A total of 172 people answered the questionnaire. In the Knowledge Dimension, the mean was (6.56) out of 10 (SD = 2.05). The level of knowledge of 58.2% was medium. In Attitude, the average was 4.42 out of 5 (SD = 0.95). 93% say they are favorable towards self-care of their feet. In Practice oriented to prevention, the average was 5.45 (SD = 2.55). 51.5% perform an average self-care practice of diabetic foot. CONCLUSIONS: The people in the study had average knowledge of diabetic foot care. When asked about their attitude, this was favorable. It contrasts with the level of behavior in the practice of self-care, which in the middle of the sample was of average character, distributing in equal parts the good practice with the scarce practice of self-care

The anatomy of the navicular and periarticular structures.

The navicular bone, located in the midfoot, articulates with the head of the talus, cuboid, and the three cuneiform bones that are involved in the acetabulum pedis. It gives attachment to the spring ligament (superomedial and inferior calcaneonavicular ligament)that can be injured in a failure of the posterior tibialis tendon and cause an adult acquired flatfoot deformity. The navicular bone provides insertion for the posterior tibialis tendon. Some pathologies can be related to the presence of an accessory navicular bone. Osteonecrosis or stress fractures can affect the navicular bone because of its poor vascularization, especially in its central portion.