Políticas alimentarias en las comunidades y ciudades autónomas españolas. Periodo 2006-2018 / Food policies in the spanish autonomous communities and cities: period 2006-2018

Objetivo: identificar y conocer las políticas alimentarias elaboradas por las comunidades y ciudades autónomas en el territorio español. Método: se realizó una investigación documental. La población de estudio fueron las políticas alimentarias de las comunidades autónomas (CC.AA.), Ceuta y Melilla. Se incluyeron planes de salud y programas nutricionales (integrales o infanto-juveniles) publicados en las páginas web de las administraciones públicas regionales (periodo 2006-2018). Se efectuaron diferentes estrategias de búsqueda para identificar los planes y programas procedentes de administraciones públicas a través de las URL descritas. Se elaboró un checklist ad hoc en función del instrumento TREND para valorar la presencia de seis ítems: objetivos, población, descripción de acciones, método, evaluación de las acciones y difusión de los resultados. Resultados: se obtuvieron 38 planes y programas relacionados con las políticas alimentarias, correspondientes a las 17 CC.AA. y a la ciudad autónoma de Ceuta. El 47,4% (n= 18) fueron planes de salud, uno por CC.AA., incluida Ceuta; el 36,8% (n= 14) fueron programas nutricionales integrales y el 15,8% (n= 6) se trataba de programas de obesidad infanto-juvenil. Todos cumplían los cuatro primeros criterios valorados. Sin embargo, no estaban presentes los criterios cinco y seis en algunos programas. Conclusión: todas las CC.AA. tenían plan de salud y también la ciudad autónoma de Ceuta. Andalucía es la región que más políticas ha desarrollado para afrontar la obesidad como problema de salud. País Vasco, Aragón, Canarias, Castilla-La Mancha, Cataluña y Galicia también han elaborado varios programas para tratar este problema. El abordaje de la alimentación saludable y la obesidad en España es heterogéneo en el ámbito regional

Objective: to identify and understand the food policies conducted by the autonomous communities and cities in the Spanish territory. Method: a documentary research was conducted. The study population was the food policies by the autonomous communities (AACC), Ceuta and Melilla; it included the healthcare plans and nutrition programs (comprehensive or child and youth) published in the websites of regional authorities (period 2006-2018). Different search strategies were used to identify the plans and programs from public authorities through the URLs described. An ad hoc checklist was created based on the TREND tool to assess the presence of six items: objectives, population, description of actions, method, evaluation of actions, and dissemination of results. Results: thirty-eight (38) plans and programs associated with food policies were retrieved, corresponding to the 17 AACCs and the autonomous city of Ceuta; 47.4% (n=18) of these were healthcare plans, one per AACC, including Ceuta; 36.8% (n= 14) were comprehensive nutrition programs, and 15.8% (n= 6) were programs on child-youth obesity. All of them met the first four criteria assessed; however, criteria five and six were not present in some programs. Conclusion: all AACCs have healthcare plans, as well as the autonomous city of Ceuta. Andalusia is the region that has developed more policies to address obesity as a health problem. The Basque Country, Aragon, the Canary Islands, Castille-La Mancha, Catalonia and Galicia have also prepared some programs to deal with this problem. In Spain, healthy eating and obesity are addressed heterogeneously in the regional setting

Benefits of Advanced Practice Nursing for Its Expansion in the Spanish Context.

The objective of this study is to describe the impact of the Advanced Practice Nurse role on the clinical practice and patient benefit, as well as to provide reasons for its implementation and expansion in Spain. Through the scoping review method, this study has been carried out according to five thematic blocks: life quality, cost-effectiveness, health results, satisfaction, and accessibility. The critical appraisal was performed with the Critical Appraisal Skills Programme (CASP) tool and the level of evidence and strength of recommendation have been analysed following the Oxford Centre for Evidence-Based Medicine (OCEBM) system. The results show that it is possible to formally implement advanced practice nursing in the Spanish context. The analysis of the Spanish regulatory framework reveals that the generalisation of the Case Manager Nurse is the starting point for the development of advanced practice nursing in Spain. This implementation would have a positive impact on patients in terms of health results, satisfaction, and life quality, given that the advanced practice nurse performs a more effective follow-up of chronic patients with a better control of risk factors, symptoms and health outcomes, and an earlier detection of complications. Considering these results, regional governments should promote the role of the Advanced Practice Nurse to contribute to its expansion.

Impacto de un programa formative en Atención Primaria sobre la actitud ante los diagnósticos enfermeros y los conocimientos en metodología / Attitude towards nursing diagnosis and knowledge of nursing methodology. Impact of a training program in primary health care

Introducción. El proceso enfermero facilita la identificación de necesidades biopsicosociales y el registro de cuidados en historias electrónicas, mediante el empleo de lenguajes estandarizados. La formación debe favorecer un uso coherente incidiendo favorablemente en la salud de las personas. Nuestro objetivo es analizar el impacto de un programa formativo sobre la actitud ante diagnósticos enfermeros (DE) y el nivel de conocimientos en metodología de un grupo de enfermeras de Atención Primaria (AP). Material y métodos. Estudio cuasiexperimental con medición antes-después para evaluar impacto de programa formativo de veinte horas sobre actitud y conocimientos. Se incluyeron variables sociodemográficas y profesionales. Participaron enfermeras de diez zonas de salud de Tenerife, excluyendo cuadernos incompletos. La actitud se evaluó con escala de posicionamiento ante el DE, EPADE-7, y los conocimientos con test evaluativo de respuestas alternativas. Resultados. Se recogieron 83 cuadernos de campo completos. Un 68 % eran mujeres, con 44.7(8.3)años y 20.8(8.4) de experiencia. Nivel bajo de competencia para DE en 88 % de participantes. Se observaron diferencias significativas entre los momentos pre-post para actitud ante DE y nivel de conocimientos, siendo los más jóvenes y los más expertos quienes puntuaron mejor. La satisfacción fue alta. Discusión. Los participantes respondieron a un perfil tipo de enfermeras de AP. Se comprueba que, a mayor contacto con lenguajes de cuidados, mejor integración y comprensión para su uso en la práctica asistencial real. Conclusiones. La fórmula docente, que combina talleres grupales y asesoramiento en consulta, resultó adecuada para mejorar la actitud ante DE y los conocimientos de enfermeras de AP en metodología

Introduction. The nursing process helps to identify bio-psycho-social needs of patients and helps register care plans in electronic health records, with the advantage of using standardized language. A consistent use of language supported with adequate training should ease the nursing process, finally resulting in a positive impact on health. Our aim is to analyze the impact that a training program had on the attitude towards nursing diagnoses (ND), and the level of methodology knowledge among a group of primary healthcare nurses (PHN). Material and methods. Quasi-experimental design with before-and-after measurement to evaluate the impact of a 20-hour training program on attitudes and knowledge. Socio-demographic and professional variables were included. Nurses from 10 health care areas in Tenerife took part in the study; incomplete field notebooks were excluded. Attitude was verified using the Position on Nursing Diagnosis Scale (EPADE-7), and knowledge was measured with an evaluative test with alternative answers. Results. 83 complete field notebooks were collected. 68 % participants were women, 44.7 (8.3) years old and with 20.8 (8.4) years of experience. There was a low level of ND expertise in 88 % of participants. Significant differences were observed between the pre and post evaluation for attitude towards ND and level of knowledge, finding the highest scores among the youngest nurses. The level of satisfaction among participants was high. Discussion. Participants met the standard profile for PHN. It has been proved that the greater the contact with care language, the better the integration and understanding for its use in healthcare settings. Conclusions. The teaching formula that combines group workshops and coaching in nurses’ office is suitable to improve the attitude towards ND and the knowledge of nursing methodology among PHN