RESUMO
BACKGROUND: Advances in health have highlighted the need to implement technologies as a fundamental part of the diagnosis, treatment, and recovery of patients at risk of or with health alterations. For this purpose, digital platforms have demonstrated their applicability in the identification of care needs. Nursing is a fundamental component in the care of patients with cardiovascular disorders and plays a crucial role in diagnosing human responses to these health conditions. Consequently, the validation of nursing diagnoses through ongoing research processes has become a necessity that can significantly impact both patients and health care professionals. OBJECTIVE: We aimed to describe the process of developing a mobile app to validate the nursing diagnosis "intolerance to physical activity" in patients with acute myocardial infarction. METHODS: We describe the development and pilot-testing of a mobile system to support data collection for validating the nursing diagnosis of activity intolerance. This was a descriptive study conducted with 11 adults (aged ≥18 years) who attended a health institution for highly complex needs with a suspected diagnosis of coronary syndrome between August and September 2019 in Floridablanca, Colombia. An app for the clinical validation of activity intolerance (North American Nursing Diagnosis Association [NANDA] code 00092) in patients with acute coronary syndrome was developed in two steps: (1) operationalization of the nursing diagnosis and (2) the app development process, which included an evaluation of the initial requirements, development and digitization of the forms, and a pilot test. The agreement level between the 2 evaluating nurses was evaluated with the κ index. RESULTS: We developed a form that included sociodemographic data, hospital admission data, medical history, current pharmacological treatment, and thrombolysis in myocardial infarction risk score (TIMI-RS) and GRACE (Global Registry of Acute Coronary Events) scores. To identify the defining characteristics, we included official guidelines, physiological measurements, and scales such as the Piper fatigue scale and Borg scale. Participants in the pilot test (n=11) had an average age of 63.2 (SD 4.0) years and were 82% (9/11) men; 18% (2/11) had incomplete primary schooling. The agreement between the evaluators was approximately 80% for most of the defining characteristics. The most prevalent characteristics were exercise discomfort (10/11, 91%), weakness (7/11, 64%), dyspnea (3/11, 27%), abnormal heart rate in response to exercise (2/10, 20%), electrocardiogram abnormalities (1/10, 9%), and abnormal blood pressure in response to activity (1/10, 10%). CONCLUSIONS: We developed a mobile app for validating the diagnosis of "activity intolerance." Its use will guarantee not only optimal data collection, minimizing errors to perform validation, but will also allow the identification of individual care needs.
RESUMO
Introduction: Different physical, social, affective, and sexual changes take place during adolescence, such as the sexual debut. Objective: To explore the factors associated with the onset of sexual activity in adolescents attending school (1216 years) in Bucaramanga. Materials and Methods: This analytical cross-sectional study included 440 adolescents from a public school. An instrument developed by Latin American Center for Perinatology - History of Adolescents was applied, and descriptive and bivariate analyses were conducted using a binomial regression model adjusted by age and sex, with sexual activity onset as the outcome and possible associated factors as exposures. Results: The prevalence of the onset of sexual activity was 22.27% (95% CI: 18.5626.46). Factors associated with greater prevalence of sexual activity onset were having a criminal record and partner PR=3.24, (95%CI: 2.604.05) and PR=2.00, (95%CI: 1.422.82), respectively. Male gender PR=1.19, (95% CI: 0.841.67), using tobacco PR=1.23 (95% CI: 0.732.06), alcohol consumption PR=1.23, (95% CI: 0.732.06), and other psychoactive substance use PR=1.78, (95% CI: 0.993.19) were risk factors; meanwhile, socializing with friends was a protective factor PR=0.27, (95% CI: 0.200.36). Discussion: Follow-up by parents and school support decrease the risk of adolescent sexual activity onset. Furthermore, interventions in the family and school settings are important. Conclusion: There are conditions that could promote the beginning of sexual activity in adolescence such as being male, having a partner, having a criminal record, smoking, and consuming alcohol or other substances could promote adolescent sexual activity onset, while socializing with friends was found to be a protective factor.
Introducción: En la adolescencia se producen cambios físicos, sociales, afectivos, sexuales, entre otros; sobre los cambios sexuales, el debut sexual. Objetivo: Explorar factores asociados al inicio de actividad sexual en adolescentes escolarizados (12 - 16 años) en Bucaramanga. Materiales y métodos: Estudio de corte trasversal analítico, incluyó 440 adolescentes de un colegio público. Se aplicó el instrumento Centro Latinoamericano de Perinatología - Historia del adolescente. Se realizó un análisis descriptivo de la información y análisis bivariado, empleando un modelo de regresión binomial ajustadas por edad y sexo empleando como desenlace el inicio de actividad sexual, y como exposiciones los posibles factores asociados. Resultados: La prevalencia del inicio de actividad sexual fue 22,27% (IC 95%: 18,56-26,46). Tener antecedentes judiciales y tener pareja, estaban asociados a mayor prevalencia de inicio de actividad sexual, RP=3,24, (IC 95%: 2,60-4,05) y RP=2,00 (IC 95%: 1,42-2,82), respectivamente. El ser hombre RP=1,19, (IC 95%: 0,84-1,67), consumir tabaco RP=1,23, (IC 95%: 0,73-2,06), alcohol RP= 1,23, (IC 95%: 0,73-2,06) y otras sustancias RP=1,78, (IC 95%: 0,99-3,19) se comportan como factores de riesgo; relacionarse con amigos fue un factor protector RP=0,27, (IC 95%: 0,20-0,36). Discusión: El acompañamiento de los padres y el apoyo del colegio, disminuyen el riesgo de inicio de actividad sexual en la adolescencia; intervenciones familiares y en el colegio son importantes. Conclusiones: Existen condiciones que podrían promover el inicio de actividad sexual en la adolescencia tales como, ser hombre, tener pareja, antecedentes personales judiciales, fumar, consumir alcohol y otras sustancias, mientras que, el relacionarse con amigos es un factor protector.
Introdução: Durante a adolescência ocorrem alterações físicas, sociais, emocionais e sexuais, entre outras; sobre mudanças sexuais, estreia sexual. Objetivo: Explorar fatores associados ao início da atividade sexual em adolescentes escolares (12 - 16 anos) em Bucaramanga. Materiais e métodos: Estudo transversal analítico que incluiu 440 adolescentes de uma escola pública. Foi aplicado o instrumento Centro Latino-Americano de Perinatologia - História do adolescente. Foi realizada análise descritiva das informações e análise bivariada, utilizando modelo de regressão binomial ajustado por idade e sexo, tendo como desfecho o início da atividade sexual e como exposições os possíveis fatores associados. Resultados: A prevalência de início da atividade sexual foi de 22,27% (IC 95%: 18,56-26,46). Ter antecedentes judiciais e ter companheiro estiveram associados a maior prevalência de início da atividade sexual, RP=3,24, (IC 95%: 2,60-4,05) e RP=2,00 (IC 95%: 1,42-2,82), respectivamente. Ser homem RP= 1,19, (IC 95%: 0,84-1,67), consumir tabaco RP=1,23, (IC 95%: 0,73-2,06), álcool RP= 1,23, (IC 95%: 0,73-2,06) e outros substâncias RP=1,78, (IC 95%: 0,99-3,19) comportam-se como fatores de risco; interagir com amigos foi fator de proteção RP=0,27; (IC 95%: 0,20-0,36). Discussão: O acompanhamento parental e o apoio escolar reduzem o risco de início da atividade sexual na adolescência; as intervenções familiares e escolares são importantes. Conclusões: Existem condições que podem favorecer o início da atividade sexual na adolescência como ser homem, ter companheiro, antecedentes criminais pessoais, fumar, consumir álcool e outras substâncias, sendo o relacionamento com amigos um fator de proteção.
Assuntos
Comportamento Sexual , Fatores de Risco , AdolescenteRESUMO
Visceral leishmaniasis (VL) is a disease caused by species of the Leishmania donovani complex that is mainly transmitted through the urban cycle involving dogs as the primary reservoir. In Colombia, the incidence of VL is increasing, along with the spread of potential vectors. This study aims to investigate the eco-epidemiological factors associated with Leishmania spp. infection in dogs from the Metropolitan Area of Bucaramanga (MAB), Santander, eastern Colombia, which is a region at risk for VL. We conducted molecular and serological surveillance of Leishmania spp. in 207 dogs from MAB to determine the epidemiological factors associated with infection. Subsequently, we carried out a molecular and serological analysis of phlebotomine and humans, respectively, in areas with a higher prevalence of infection, aiming to describe the main features associated with the transmission cycle. Out of the 207 dogs tested, 37 (17.8%, 95% CI = 12.6-23.1%) were positive for the presence of Leishmania antibodies by the IFAT test, and only 9 (4.3%, 95% CI = 1.55-7.15%) were positive for L. infantum by PCR. Multivariate analyses indicated that canine shelters and dogs with clinical signs commonly associated with canine VL had a higher prevalence of infection (P < 0.05). In the entomological survey, 69 blood-fed female phlebotomine of the genus Lutzomyia were captured in canine shelters, among them, 55% were identified as Lutzomyia camposi, 29% as Lu. ovallesi, 7% as Lu. dubitans, 6% as Lu. torvida, and 3% as Lu. cayennensis. The identified meal sources of the phlebotomine included human, pig, avian, cattle, and porcupine (Coendou quichua) blood. However, no phlebotomine positive for Leishmania spp. were detected by molecular analyses. Finally, 14 humans who had frequent contact with L. infantum-positive dogs were analyzed through rK39 test, but none tested was positive for IgG/IgM antibodies. The molecular and serological analyses indicate the circulation of L. infantum in dogs from MAB, with canine shelters having the highest prevalence of infection. The entomological survey of canine shelters showed a significant diversity of phlebotomine without potential vectors of L. infantum, suggesting the presence of infection in dogs from these areas could take place in other locations or through other transmission routes. The circulation of L. infantum in multiple dogs from MAB suggests a latent risk of zoonotic transmission of VL in these cities.
RESUMO
En Santander existen importantes instituciones prestadoras de salud de alto nivel de complejidad. En dichas instituciones, Enfermería tiene una representación y organización profesional a través de las subgerencias, unidades o departamentos de dirección asistencial. En casi todas estas entidades, se desarrollan procesos docentes asistenciales que buscan mejorar la calidad en la gestión del cuidado a través de diferentes estrategias. Sin embargo, aún se evidencia la adherencia a prácticas administrativas propias de otras disciplinas para implementar y evaluar las funciones desarrolladas por los profesionales de enfermería. Se han descrito algunos acercamientos en la aplicación del conocimiento propio de enfermería a nivel asistencial como lo son la enfermería basada en la evidencia y el proceso de enfermería. Sin embargo, es importante resaltar que son pocas las experiencias publicadas y que muchas de las publicaciones tienen más de 10 años, por lo que surge la necesidad de conocer el panorama actual de la gestión del cuidado en Santander. Es necesario un fortalecimiento de la definición, ejecución y evaluación de la gestión del cuidado de enfermería, la cual, desde las diferentes experiencias encontradas, tiene limitantes como el tiempo, la baja adherencia por parte de algunos profesionales, entre otros, lo cual conduciría a fortalecer el liderazgo en enfermería.
In Santander, there are important healthcare institutions with a high level of complexity. Nursing is professionally represented and organized in these institutions through care management sub-directorates, units, or departments. In almost all these entities, teaching and care processes are developed to improve the quality of management of care through different strategies. However, there is still evidence of adherence to administrative practices of other disciplines to implement and evaluate the functions performed by nursing professionals. Some approaches to applying nursing knowledge at the level of care have been reported, such as evidence-based nursing and the nursing process. However, it is important to point out that there are few published experiences, and many of the publications are more than 10 years old, so there is a need to know the current panorama of care management in Santander. It is necessary to strengthen the definition, implementation, and evaluation of care management, which, according to the different experiences found, has limitations such as time and low adherence of some professionals, among others, which would lead to strengthening nursing leadership.
Em Santander, há importantes instituições de saúde com alto nível de complexidade. Nessas instituições, a enfermagem está representada e organizada profissionalmente por meio de subgerências, unidades de gestão de cuidados ou departamentos. Em quase todas essas instituições, são desenvolvidos processos de ensino e assistência que buscam melhorar a qualidade da gestão do cuidado por meio de diferentes estratégias. Entretanto, ainda há evidências de adesão às práticas administrativas de outras disciplinas para a implementação e avaliação das funções desempenhadas pelos profissionais de enfermagem. Foram descritas algumas abordagens para a aplicação do conhecimento de enfermagem em nível assistencial, como a enfermagem baseada em evidências e o processo de enfermagem. No entanto, é importante destacar que poucas experiências foram publicadas e que muitas das publicações têm mais de 10 anos, razão pela qual é necessário conhecer o panorama atual da gestão do cuidado em Santander. É necessário fortalecer a definição, a implementação e a avaliação do gerenciamento do cuidado de enfermagem, que, a partir das diferentes experiências encontradas, apresenta limitações como tempo, baixa adesão por parte de alguns profissionais, entre outras, o que levaria ao fortalecimento da liderança de enfermagem.
Assuntos
Teoria de Enfermagem , Gestão em Saúde , Cuidados de EnfermagemRESUMO
Introducción: La carga de trabajo de Enfermería en unidades de cuidado intensivo está relacionada con la eficiencia y calidad de la atención, sin embargo, no existen métodos para cuantificar las enfermeras necesarias por turno en UCI. Objetivo: Identificar las herramientas más utilizadas para medir la carga de trabajo de Enfermería en UCIs. Materiales y métodos: Se realizó una revisión de literatura tipo integradora, utilizando artículos originales en inglés, español o portugués, publicados entre 1991 hasta 2017 en las bases de datos: Science@direct, BVS, Socupus y Embase, empleando la estrategia de búsqueda: Nursing and workload and intensive critical or ICU unit and measure, se excluyeron artículos duplicados y/o desarrollados en UCIs de cuidado intermedio, la calidad de los artículos fue valorada usando la lista de chequeo Strobe. Resultados: Se incluyeron 36 artículos con un total de 19.036 pacientes; el 50% (n=18) empleo el NAS, 27.7%(n=10) utilizó una combinación de métodos como el NAS, NEMS, TISS-28 o el VACTE, el 13.8%(n=5) empleo el TISS-28, el 5.6%(n=2) empleo registro de cámaras de video y un 2.7%(n=1) empleo el NEMS para cuantificar el tiempo empleado por enfermería en el cuidado. Discusión: actualmente no existe un consenso sobre métodos de medición de carga de trabajo en enfermería, en este sentido, es necesario realizar más estudios de validación y comparación que permitan mejorar la gestión del cuidado de enfermería en UCI. Conclusión: La herramienta más utilizada para cuantificar la carga de trabajo en enfermería es el Nursing Activities Score (NAS), otras herramientas identificadas fueron: NEMS, TISS-28 y VACTE.
Introduction: Nursing workload in intensive care units (ICUs) is related to efficiency and quality of care; however, there are no methods to quantify the nurses needed per shift in ICUs. Objective: To identify the most used tools to measure ICU nursing workload. Methods: An integrative literature review was performed using original articles in English, Spanish or Portuguese, published between 1991 and 2017 in the databases ScienceDirect, BVS, Scopus, and Embase. The search strategy was "nursing and workload and intensive critical or ICU and measure." Duplicate articles or articles about intermediate care units were excluded. The quality of the articles was assessed using the Strobe checklist. Results: Thirty-six articles with a total of 19,036 patients were included; 50% (n=18) used NAS, 27.7% (n=10) used a combination of methods such as NAS, NEMS, TISS-28 or VACTE; 13.8% (n=5) used TISS-28, 5.6% (n=2) used video camera recording, and 2.7% (n=1) used NEMS to quantify the time spent by nurses in care. Discussion: There is currently no consensus on workload measurement methods in nursing. In this sense, more validation and comparison studies are needed to improve nursing care management in the ICUs. Conclusion: The most used tool to quantify workload in nursing is the Nursing Activities Score (NAS). Other tools identified were NEMS, TISS-28, and VACTE.
Introdução: A carga de trabalho de enfermagem em unidades de terapia intensiva está relacionada à eficiência e qualidade da assistência, entretanto, não existem métodos para quantificar o número de enfermeiros necessários por turno na UTI. Objetivo: Identificar os instrumentos mais utilizados para mensurar a carga de trabalho de Enfermagem nas UTIs. Metodologia: Foi realizada uma revisão integrativa da literatura, utilizando artigos originais em inglês, espanhol ou português, publicados entre 1991 e 2017 nas bases de dados: Science@direct, BVS, Socupus e Embase, utilizando a estratégia de busca: Nursing and workload and intensivo critical ou unidade e medida de UTI, artigos duplicados e/ou desenvolvidos nas UTIs de cuidados intermediários foram excluídos, a qualidade dos artigos foi avaliada por meio do Strobe checklist. Resultados: foram incluídos 36 artigos com um total de 19.036 pacientes; 50% (n=18) utilizaram o NAS, 27,7%(n=10) utilizaram uma combinação de métodos como NAS, NEMS, TISS-28 ou VACTE, 13,8%(n=5) utilizaram o TISS-28, 5,6% (n=2) utilizaram registros de câmeras de vídeo e 2,7%(n=1) utilizaram o NEMS para quantificar o tempo gasto pela enfermagem no cuidado. Discussão: atualmente não há consenso sobre métodos de mensuração da carga de trabalho em enfermagem, nesse sentido, faz-se necessária a realização de mais estudos de validação e comparação para melhorar o gerenciamento do cuidado de enfermagem em UTI. Conclusão: O instrumento mais utilizado para quantificar a carga de trabalho de enfermagem é o Nursing Activities Score (NAS), outros instrumentos identificados foram: NEMS, TISS-28 e VACTE.
Assuntos
Enfermagem , Carga de Trabalho , Medição de Risco , Unidades de Terapia Intensiva , Cuidados de EnfermagemRESUMO
The Palpada genus, which belongs to the Diptera order (family, Syrphidae), has been rarely reported to cause accidental myiasis in humans. Herein, we report the first case of genitourinary myiasis caused by a larva of the Palpada genus in a 9-year-old girl from Colombia. The girl, who resided in a rural area in the municipality of Floridablanca, Santander, near Bucaramanga city, in eastern Colombia, presented with lower abdominal pain accompanied by oliguria, followed by the subsequent elimination of a larva through the urine. The next day, the patient visited a primary healthcare centre, and no signs or symptoms were observed on clinical examination. Haematological analysis showed high plateletcrit levels and platelet large cell counts. The results of the urine test revealed a decrease in specific gravity and a slight increase in bacterial content and mucus. DNA barcoding analyses showed that the etiological agent corresponded to a third instar larva of the Palpada scutellaris species. This is the first case to report genitourinary myiasis caused by larvae of the genus Palpada in humans. However, we believe that additional cases might be accurately detected if adequate tests are performed to confirm the clinical and molecular features associated with this infection.
Assuntos
Dípteros , Miíase/parasitologia , Doenças Urogenitais/parasitologia , Dor Abdominal , Animais , Criança , Colômbia , Código de Barras de DNA Taxonômico , Dípteros/classificação , Dípteros/genética , Feminino , Humanos , Larva , Miíase/diagnóstico , Oligúria/parasitologia , População Rural , Doenças Urogenitais/diagnósticoRESUMO
BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality worldwide, with a prevalence of approximately 100 million patients. There is evidence that antiplatelet agents and antihypertensive medications could reduce the risk of new vascular events in this population; however, treatment adherence is very low. An SMS text messaging intervention was recently developed based on behavior change techniques to increase adherence to pharmacological treatment among patients with a history of ASCVD. OBJECTIVE: This study aims to evaluate the efficacy and safety of an SMS text messaging intervention to improve adherence to cardiovascular medications in patients with ASCVD. METHODS: A randomized controlled clinical trial for patients with a prior diagnosis of cardiovascular events, such as acute myocardial infarction, unstable angina, cerebrovascular disease, or peripheral artery disease, in one center in Colombia was conducted. Patients randomized to the intervention arm were assigned to receive SMS text messages daily for the first 4 weeks, 5 SMS text messages on week 5, 3 SMS text messages each in weeks 6 and 7, and 1 SMS text message weekly from week 8 until week 52. In contrast, patients in the control arm received a monthly SMS text message reminding them of the next study appointment and the importance of the study, requesting information about changes in their phone number, and thanking them for participating in the study. The primary endpoint was the change in low-density lipoprotein cholesterol (LDL-C) levels, whereas the secondary endpoints were the changes in thromboxane B2 levels, heart rate, systolic and diastolic blood pressure, medication adherence, cardiac and noncardiac mortality, and hospitalization. Linear regression analyses and bivariate tests were performed. RESULTS: Of the 930 randomized patients, 805 (86.5%) completed follow-up and were analyzed for the primary endpoint. There was no evidence that the intervention changed the primary outcome (LDL-C levels; P=.41) or any of the secondary outcomes evaluated (all P>.05). There was also no evidence that the intervention was associated with adverse events. CONCLUSIONS: In this study, there was no evidence that a behavior modification intervention delivered by SMS text messaging improved LDL-C levels, blood pressure levels, or adherence at 12 months. More research is needed to evaluate whether different SMS text messaging strategies, including personalized messages and different timings, are effective; future studies should include mixed methods to better understand why, for whom, and in which context (eg, health system or social environment) SMS text messaging interventions work (or not) to improve adherence in patients with ASCVD. TRIAL REGISTRATION: ClinicalTrials.gov NCT03098186; https://clinicaltrials.gov/ct2/show/NCT03098186. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2018-028017.
Assuntos
Telefone Celular , Envio de Mensagens de Texto , Pressão Sanguínea , Colômbia/epidemiologia , Humanos , Adesão à MedicaçãoRESUMO
Objetivo: Determinar los niveles de fatiga por compasión y sus factores relacionados en profesionales de enfermería de tres Unidades de Cuidado Intensivo de la ciudad de Bucaramanga. Material y métodos: Estudio correlacional de corte transversal realizado entre febrero del 2018 y febrero del 2020. Se utilizó un muestreo a conveniencia. Se aplicó el cuestionario de Calidad de vida para profesionales ProQOL (Professional Quality of Life Scale). Resultados: En general se encontró según las pautas de la escala niveles inferiores al promedio de satisfacción por compasión 45.71% (n=32), niveles medios de Burnout: 56.34% (n=40) y niveles medios de trauma por compasión: 49.30% (n=35). No se encontraron diferencias significativas en relación a factores sociodemográficos. Conclusiones: Se encontraron bajos niveles de satisfacción por compasión lo que incrementa el riesgo de fatiga por compasión. No se hallaron diferencias significativas en relación a los años de experiencia laboral, la edad, el género, los años de experiencia o el estado civil (AU)
Objective: To determine the levels of compassion fatigue and its Related factors in nursing professionals from three Units Intensive Care. Material and methods: Cross-sectional correlational study carried out between February 2018 and February 2020. A sampling at convenience. The Quality of life questionnaire for professionals ProQOL (Professional Quality of Life Scale) was applied. Results: In general, it was found according to the scale guidelines lower than average levels of compassion satisfaction 45.71% (n = 32), mean levels of Burnout: 56.34% (n = 40) and mean levels of compassion trauma: 49.30% (n = 35). Significant differences were not found in relation to sociodemographic factors. Conclusions: Low levels of satisfaction were found for compassion, which increases the risk of compassion fatigue. No significant differences were found in relation to the years of work experience, age, gender, years of experience, or civil status (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Enfermeiros Clínicos/psicologia , Esgotamento Profissional , Esgotamento Profissional , Satisfação no Emprego , Unidades de Terapia Intensiva , Fadiga , Estudos TransversaisRESUMO
Objetivo principal: Diseñar y validar un instrumento de valoración focalizada de enfermería para el sistema cardiopulmonar para su uso en el entorno clínico. Metodología: Estudio descriptivo de validación de aspecto y de contenido de un instrumento de valoración focalizada de las respuestas cardiopulmonares en el adulto para el entorno clínico. Resultados principales: Se creó un instrumento de valoración, de acuerdo a los siguientes componentes: generalidades, anamnesis, examen físico y ayudas diagnósticas. La evaluación de la validez aspecto y de contenido se revisaron aquellos ítems que obtuvieron un porcentaje inferior al 80 % en cada uno de los ítems evaluados. De esta manera se realizaron algunos cambios para obtener el instrumento final. Conclusión principal: El instrumento de valoración focalizada de las respuestas cardiopulmonares en el adulto muestra una adecuada validez de aspecto y de contenido. Este instrumento podrá ser utilizado en entorno clínico o académico. (AU)
Objective: Design and validate a nursing assessment instrument for cardiopulmonary system in the clinical setting. Methods: Descriptive study to validate the appearance and content of a cardiopulmonary responses assessment instrument for nursing in adults for clinical environment. Results: An assessment instrument was created, according to the following components: Generalities, anamnesis, physical examination and diagnostic aids. The evaluation of the aspect and content validity were reviewed those items that obtained a percentage lower than 80 % in each of the items evaluated. In this way, some changes were made to obtain the final instrument. Conclusions: The instrument of focused assessment of cardiopulmonary responses in adults shows adequate appearance and content validity. This instrument may be used in a clinical or academic setting. (AU)
Assuntos
Humanos , Enfermagem , Doença Cardiopulmonar , Epidemiologia Descritiva , Inquéritos e Questionários , Avaliação em Enfermagem , ColômbiaRESUMO
RESUMEN: Las venas superficiales de la fosa cubital se han estudiado con varios fines, venopunciones, cateterismos, fístulas, entre otros. Se han descrito varios patrones venosos en esta región en diferentes poblaciones. En uno de estos la vena cefálica termina en la vena basílica a nivel del antebrazo generando posibles riesgos de lesiones durante la canalización. En el presente estudio se evaluaron 200 miembros superiores de 100 personas colombianas, 50 mujeres y 50 hombres, 70 de ellas nacidas en la ciudad de Bucaramanga y 30 en la ciudad de Villavicencio. Se registró el número de venas cefálicas y su sitio de terminación, en el brazo o antebrazo. El patrón venoso que predominó en ambos miembros superiores fue el tipo I. El patrón IV en el cual la vena cefálica termina en la vena basílica se presentó en 12 casos (6 %) en el miembro superior derecho y en 17 casos (8,5 %) en el miembro superior izquierdo. Se encontró dos venas cefálicas entre el 13 % y 13,5 % dependiendo del lado y tres venas cefálicas entre el 1 % y 2 %. Conocer esta particularidad de los patrones venosos podría disminuir el riesgo de complicaciones durante la venopunción.
SUMMARY: The superficial veins of the ulnar fossa have been studied for various purposes, venipuncture, catheterization, fistulae, among others. Various venous patterns have been described in this region in different populations. In one of these, the cephalic vein ends in the basilic vein at the level of the forearm, generating possible risks of injury during cannulation. In the present study, 200 upper limbs of 100 Colombians, 50 women and 50 men, were evaluated, 70 of them born in the city of Bucaramanga and 30 in the city of Villavicencio. The number of cephalic veins and their termination site, on the arm or forearm, were recorded. The venous pattern that predominated in both upper limbs was type I. Pattern IV in which the cephalic vein ends in the basilic vein occurred in 12 cases (6 %) in the right upper limb and in 17 cases (8.5 %) in the left upper limb. Two cephalic veins were found between 13 % and 13.5 % depending on the side and three cephalic veins between 1 % and 2 %. Knowing this particularity of venous patterns could reduce the risk of complications during venipuncture.
Assuntos
Humanos , Masculino , Feminino , Veias/anatomia & histologia , Antebraço/irrigação sanguínea , ColômbiaRESUMO
La actual pandemia por COVID-19 ha significado para los profesio-nales de la enfermería un escenario en el que se ha hecho evidente el impacto que el ejercicio profesional puede tener sobre su cali-dad de vida. Justo cuando el 2020 fue escogido por la Organización Mundial de Salud como el año de la enfermería, se ha evidenciado un panorama poco favorecedor para el ejercicio del cuidado, en el que no sólo se han visto afectados pacientes, familias, sistemas de salud, sino también los propios profesionales que prestan atención a pacientes diagnosticados con el nuevo virus. En el presente artículo de reflexión se realizó un análisis de uno de los efectos de las con-diciones actuales de trabajo de los profesionales de enfermería: la fatiga por compasión, la cual constituye una afectación de la calidad de vida; también se presentan las recomendaciones actuales disponi-bles, para hacer frente a este fenómeno en Colombia
The current COVID-19 pandemic has meant for nursing professio-nals a scenario in which the impact that professional practice can have on their quality of life has become evident. Just when 2020 was chosen by the WHO (World Health Organization) as the year of nursing, an unflattering panorama has been evidenced for the exercise of care in which not only patients, families, health systems have been affected, but also the professionals who care for patients diagnosed with the new virus. In this reflection article, an analysis of one of the effects of the current working conditions of nursing professionals was carried out: compassion fatigue, which constitutes an impairment of the quality of life, as well as the current recommendations available to make faced with this phenomenon in Colombia
A atual pandemia pela COVID-19 tem significado para os enfermeiros profissionais um senário que evidenciou o impacto do exercício profissional pode ter sobre a qualidade de vida. Justo quando o 2020 foi escolhido pela Organização Mundial da Saúde como o ano da enfermagem, tem se evidenciado um panorama pouco favorecedor para o exercício de prestar cuidados, onde não só os pacientes, famílias e sistemas de saúde têm sido os afetados, como também os profissionais que prestam atenção aos diagnosticados com o novo vírus. No presente artigo de reflexão realizou-se uma análise dos efeitos das condições atuais de trabalho dos profissionais de enfermagem: a fadiga por compaixão, constituindo uma afetação da qualidade de vida; tam-bém se apresentam as recomendações atuais disponíveis, para fazer frente a esse fenômeno em Colômbia.
Assuntos
Esgotamento Profissional , Estresse Ocupacional , Pandemias , Satisfação no Emprego , Enfermeiros Clínicos , Cuidados de EnfermagemRESUMO
INTRODUCTION: Anti-platelet therapy, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, beta-blockers and statins are cost-effective in patients with atherosclerotic cardiovascular diseases (ASCVD) for reducing the risk of ASCVD events. Unfortunately, there is abundant evidence that adherence to these cardiovascular medications is far from ideal. A recent Cochrane review showed a potential beneficial effect of Short Message Service (SMS) interventions on adherence to medication in ASCVD patients. METHODS AND ANALYSIS: The txt2heart study is a pragmatic randomised single-blind controlled trial. The objective is to evaluate the efficacy and safety of an intervention with SMS messages delivered by mobile phones to improve adherence to cardiovascular medications in patients with ASCVD. The intervention consists of behavioural techniques delivered via SMS. The primary outcome is change in blood serum low-density lipoprotein cholesterol levels as an indicator of adherence to statins. Secondary outcomes will include systolic blood pressure as an indicator of adherence to blood-lowering therapies and heart rate as an indicator of adherence to beta-blockers, urine levels of 11-dehydrothromboxane B2, self-reported adherence to cardiovascular medications and rates of cardiovascular death or hospitalisation due to cardiovascular disease. ETHICS AND DISSEMINATION: The study will be performed in compliance with the protocol, regulatory requirements, Good Clinical Practice and ethical principles of the Declaration of Helsinki. The Ethics Committee of Fundación Cardiovascular de Colombia evaluated and approved the trial. The txt2heart Colombia trial aims to provide robust evidence to evaluate whether SMS messages delivered through mobile telephones change the behaviour of Colombian patients who have suffered a cardiovascular event. Trial results will be presented to the local health authorities, and if the intervention is effective and safe, we hope this strategy will be implemented quickly because of its low cost and wide-reaching impact on the population. TRIAL REGISTRATION NUMBER: NCT03098186.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Adesão à Medicação/estatística & dados numéricos , Sistemas de Alerta , Prevenção Secundária/métodos , Envio de Mensagens de Texto , Telefone Celular , Colômbia , Humanos , Ensaios Clínicos Pragmáticos como Assunto , Método Simples-CegoRESUMO
Resumen Introducción: En las unidades de cuidado intensivo (UCI) es frecuente el contacto con la muerte a la que se expone el profesional de enfermería. Este tema ha sido poco estudiado en nuestro país. El objetivo de este estudio fue describir las actitudes hacia la muerte en un grupo de enfermeras que laboraban en una uci de alta complejidad. Materiales y métodos: Estudio descriptivo en el que se incluyeron 17 profesionales de enfermería que trabajan en una unidad de cuidados intensivos de alta complejidad. Se aplicó el perfil revisado de actitudes hacia la muerte. Las variables continuas fueron reportadas como promedio acompañadas de desviación estándar, dado que tenían una distribución normal según la prueba de Shapiro-Wilk y demás pruebas gráficas. Las variables categóricas fueron expresadas como frecuencias absolutas o relativas. Resultados: El promedio general de la escala de actitud hacia la muerte fue 133,53 ± 21,50. La actitud con mayor promedio fue la de aceptación de acercamiento con 48,17 ± 12,64, seguida por la actitud de aceptación neutral con 28,94 ± 4,62 y miedo a la muerte con 23,0 ± 7,42. Existe una correlación moderada y directa entre el promedio general de la escala de actitudes hacia la muerte y los años de trabajo en el servicio, rho = 0,59, p = 0,016. Conclusiones: Dentro de las actitudes hacia la muerte de los participantes del presente estudio, la que más predominó fue la de aceptación de acercamiento. Adicionalmente, se pudo establecer que existe una correlación moderada y directa entre el promedio general de la escala de actitudes hacia la muerte y los años de trabajo en UCI.
Abstract Introduction: In intensive care units (ICU), contact with death is frequent for nurses who work there. In our country, this issue has been little studied. The objective of this study was to describe attitudes towards death in a group of nurses who work in a highly complex ICU. Materials and methods: This descriptive study included 17 nursing professionals working in a highly complex ICU. The revised profile of attitudes toward death was applied. Continuous variables were reported as average accompanied by standard deviation, given that they had a normal distribution according to the Shapiro-Wilk test and other graphic ones. Categorical variables were expressed as absolute or relative frequencies. Results: The overall average of the attitude towards death scale was 133.53 ± 21.50. The attitude with the highest average was the acceptance approach with 48.17 ± 12.64, followed by neutral acceptance with 28.94 ± 4.62, and fear of death with 23.0 ± 7.42. There is a moderate and direct correlation between the general average of the scale of attitudes toward death and years of work in the service, rho = 0.59, p = 0.016. Conclusions: Among the participants' attitudes towards death, the one that prevailed most was acceptance approach. Additionally, it was established that there is a moderate and direct correlation between the general average of the scale of attitudes towards death and the years of work in the ICU.
Resumo Introdução: Nas unidades de cuidado intensivo (UCI) é frequente o contacto com a morte à que se expõe o profissional de enfermagem. Este tema tem sido pouco estudado em nosso país. O objetivo deste estudo foi descrever as atitudes à morte em um grupo de enfermeiras que trabalha em uma uci de alta complexidade. Materiais e métodos: estudo descritivo no que se incluíram 17 profissionais de enfermagem que trabalham em uma unidade de cuidados intensivos de alta complexidade. Se aplicou o perfil revisado de atitudes à morte. As variáveis contínuas foram reportadas como média acompanhadas de desvio-padrão, dado que tinham uma distribuição normal segundo a prova de Shapiro-Wilk e demais provas gráficas. As variáveis categóricas foram expressadas como frequências absolutas ou relativas. Resultados: A média geral da escala de atitude à morte foi 133,53 ± 21,50. A atitude com maior média foi a de aceitação aproximação com 48,17 ± 12,64, seguida pela atitude de aceitação neutral com 28,94 ± 4,62 e medo à morte com 23,0 ± 7,42. Existe uma correlação moderada e direta entre a média geral da escala de atitudes à morte e os anos de trabalho no serviço, rho = 0,59, p = 0,016. Conclusões: Dentro das atitudes à norte dos participantes do presente estudo, a que mais predominou foi a de abordagem de aceitação. Adicionalmente, se conseguiu estabelecer que existe uma correlação moderada e direta entre a média geral da escala de atitudes à morte e os anos de trabalho em UCI.
Assuntos
Humanos , Atitude Frente a Morte , Relatório de Pesquisa , Unidades de Terapia Intensiva , EnfermeirosRESUMO
Resumen Introducción: Las bombas de infusión inteligentes, constituyen una herramienta útil para la administración segura de medicamentos endovenosos dado que permiten prevenir potenciales eventos adversos. Objetivo: Evaluar la adherencia y los potenciales eventos adversos prevenidos, durante la administración de medicamentos endovenosos empleando bombas de infusión inteligentes. Metodología: Estudio observacional, realizado en cuatro unidades de cuidados intensivos usando datos del software Hospira MedNetTM. Un análisis descriptivo fue llevado a cabo junto con un análisis bivariado empleando una prueba U de Mann-Whitney, una prueba de Kruskal-Wallis y un test de Bonferroni para evaluar la adherencia y los potenciales eventos adversos prevenidos por año y servicio. Resultados: La adherencia fue del 74,0%, se presentaron 78.299 alertas de seguridad y se previnieron 4,54% (n=16.288) potenciales eventos adversos. Se encontraron diferencias entre el primer y segundo año en la adherencia [Mediana: 69,15 (Q1:64,2-Q3:75,5) Vs Mediana: 84,2(Q1:72,15-Q3:89,05), p<0.001], adherencia a la seguridad [Mediana: 87,1% (Q1:83,05-Q3:91,2) Vs Mediana: 94,05 (Q1:89,95-Q3:96,2), p<0.001] y las ediciones de alertas de limite relativo [Mediana:17,0 (Q1:8,5-Q3:24,5) Vs Mediana: 12,0 (Q1:7,0-Q3:17,5), p=0.013]. La solución salina, la norepinefrina, el lactato de ringer, la piperacilina-tazobactam, la nitroglicerina y la heparina presentaron el mayor número de alertas de seguridad. Conclusión: Se encontró una buena adherencia (uso de la farmacoteca) y adherencia a la seguridad (indicador de uso de la bomba), con una reducción de los potenciales eventos adversos; así el uso de bombas inteligentes podría contribuir en la prevención de potenciales errores durante la administración de medicamentos endovenosos en la unidad de cuidados intensivos.
Abstract Introduction: Smart infusion pumps have become a useful tool for the safe administration of intravenous medications, since they allow the prevention of potential adverse events. Objetive: To assess adherence and potential adverse events prevented during intravenous medication administration using smart infusion pumps. Methods: Observational study, conducted in four intensive care units using data from Hospira MedNetTM software. A descriptive analysis was carried out together with a bivariate analysis using a Mann-Whitney U test, a KruskalWallis test and a Bonferroni test to assess adherence and potential adverse events prevented by year and service. Results: Adherence was 74.0%, 78,299 safety alerts were presented and 4.54% (n = 16,288) potential adverse events were prevented. Differences were found between the first and second year in adherence [Median: 69.15 (Q1: 64.2-Q3:75.5) versus Median: 84.2 (Q1: 72.15-Q3: 89.05), p<0.001]. Likewise safety adherence [Median: 87.1% (Q1: 83.05-Q3: 91.2) versus Median: 94.05 (Q1: 89.95-Q3: 96.2), p<0.001] and the relative limit alert editions [Median: 17.0 (Q1: 8.5-Q3: 24.5) versus Median: 12.0 (Q1: 7.0-Q3: 17.5), p=0.013]. The saline solution, norepinephrine, ringer's lactate, piperacillin-tazobactam, nitroglycerin and heparin presented the highest number of safety alerts. Conclusions: Adequate adherence (use of the drug library) and safety adherence (indicator of pump use) were found, with a reduction in potential adverse events; thus, the use of smart pumps could contribute to the prevention of potential errors during the administration of intravenous medications in the intensive care unit.
Assuntos
Humanos , Erros de Medicação , Bombas de Infusão , Gestão da Segurança , Administração IntravenosaRESUMO
Introducción: Laenfermedad pulmonar obstructiva crónica es una importante causa de mortalidad y morbilidad a nivel mundial y tiene efectos psicosociales y fisiopatológicos que repercuten de manera significativa en la calidad de vida de quienes la padecen. Objetivo:Evaluar la calidad de vida de pacientes con enfermedad pulmonar obstructiva crónica a través del instrumento SF-36, versión en español para Colombia (SF-36 v2), en un servicio de consulta externa de Floridablanca, Colombia, durante el año 2015. Metodología: Estudio de corte transversal descriptivo realizado en 40 pacientes con diagnóstico de enfermedad pulmonar obstructiva crónica que asistieron al servicio de consulta externa por Neumología entre los meses de febrero y noviembre de 2015. El cuestionario SF-36 v2 fue diligenciado por todos los participantes; previamente, se firmó el consentimiento informado. La base de datos fue digitada, bajo licencia, en QualityMetric Health Outcomes™ Scoring Software 4.0. Resultados: Participaron 40 pacientes, con una edad media de 73 (DE ± 8.4) años. En las dimensiones de funcionamiento físico se encontraron valores inferiores a 50; por otra parte, las dimensiones Funcionamiento Social y Rol Emocional presentaron valores superiores y cercanos a los reportados por población sana. Conclusiones:Los pacientes con enfermedad pulmonar obstructiva crónica mostraron una disminución en la calidad de vida comparado con los valores de referencia en población en general en sus dos componentes: físico y mental. Se ratifica el impacto que tiene esta enfermedad en todas las subescalas que componen este constructo, especialmente en el componente físico
Introduction: Chronic obstructive pulmonary disease is one the most significant causes of mortality and morbidity worldwide. It has psychosocial and pathophysiological effects that impact in a significant way to those who suffer from it. Objective: To evaluate quality of life from patients suffering from chronic obstructive pulmonary disease through the SF-36 survey (Spanish version for Colombia (SF-36 v2)) made during an external medical appointment made in Floridablanca, Colombia in 2015. Methodology:Descriptive cross sectional study performed to 40 patients diagnosed with chronic obstructive pulmonary disease. These patients attended to external pulmonology medical appointments between February and November of 2015 and filled out the short form SF-36 v2 after signing informed consent. The database was created under license using QualityMetric Health Outcomes™ Scoring Software 4.0. Results: 40 patients, with an average age of 73 years (DE ± 8.4), participated in this study. When analyzing data, it was found that the physical functioning dimensions were values lower than 50. On the other hand, it was found that dimensions related to social functioning and emotional role had higher values and close to the ones reported by healthy population. Conclusions: Patients diagnosed with chronic obstructive pulmonary disease showed a decrease in quality of life, in both of its dimensions: physical and mental, compared to healthy population's reference values. It is ratified that this disease impacts all sub-scales of this construct, specially the ones related to the physical component
Introdução: Adoença pulmonar obstrutiva crônica é uma importante causa de mortalidade e morbidade em todo o mundo e tem efeitos psicossociais e fisiopatológicos que têm um impacto significativo na qualidade de vida daqueles que sofrem com ela. Objetivo: Avaliar a qualidade de vida de pacientes com doença pulmonar obstrutiva crônica através do instrumento SF-36, versão em espanhol para a Colômbia (SF-36 v2), em um serviço ambulatorial de Floridablanca, Colômbia, durante 2015. Metodologia:Estudo descritivo de corte transversal feito em 40 pacientes com diagnóstico de doença pulmonar obstrutiva crônica que compareceram ao ambulatório de Pneumologia entre os meses de fevereiro e novembro de 2015. O questionário SF-36 v2 foi preenchido por todos os participantes; anteriormente, o consentimento informado foi assinado. O banco de dados foi digitado, sob licença, em Quality Metric Health Outcomes™ Scoring Software 4.0. Resultados:Participaram 40 pacientes, com média de idade de 73 (DE ± 8.4) anos. Nas dimensões do funcionamento físico, valores menores que 50 foram encontrados; por outro lado, as dimensões do Funcionamento Social e do Papel Emocional apresentaram valores superiores e próximos aos relatados pela população saudável. Conclusões: Os pacientes com doença pulmonar obstrutiva crônica apresentaram diminuição da qualidade de vida em relação aos valores de referência na população geral em seus dois componentes: físico e mental. O impacto desta doença em todas as subescalas que compõem este construto, especialmente no componente físico, é confirmado