"Perinatal loss, a devastating cyclone": A situation-specific nursing theory.

PURPOSE: The aim of this paper is to develop a preliminary theory that explores in depth into understanding the experiences of women who have suffered a spontaneous perinatal loss during any trimester of their pregnancy regarding their emotional response to this loss. DESIGN: A grounded theory approach was used, and 25 in-depth interviews were conducted with Spanish women who suffered a spontaneous perinatal loss. METHODS: Theoretical sampling and constant comparative analysis were used to reach theoretical saturation. EQUATOR guidelines were followed, using the COREQ checklist. RESULTS: The "Perinatal loss, a devastating cyclone," a situation-specific nursing theory, explains the process that a woman experiences when she loses her baby at any stage of pregnancy, drawing an analogy with tropical cyclones as natural disasters that destroy everything in their path. This situation-specific theory includes three dimensions, explaining the phases identified in the perinatal loss process (phase prior to impact [before the perinatal loss], impact phase [diagnostic moment], emergency phase [hospital care], relief or honeymoon phase [return home], disillusionment or stock-taking phase [after the first postloss days at home], reconstruction and recovery phase [grief construction process] and consequences [with an eye to the future]). Three intervention areas were described around the perinatal loss process: "rescue area" (partner, grandparents, and siblings of the deceased baby), "relief area" (healthcare professionals), and "base camp" (society). CONCLUSION: The situation-specific nursing theory "Perinatal loss, a devastating cyclone" is the final product of a grounded theory study that provided an in-depth analysis of women's experiences when they suffer a spontaneous perinatal loss at any point in their pregnancy. CLINICAL RELEVANCE: The situation-specific theory "Perinatal loss, a devastating cyclone" with the seven identified phases and the three areas of intervention could be used as a framework for healthcare professionals in their clinical practice as a guide to support women in this disfranchised grief.

Extended and Long-term Cancer Survivorship of Childhood Survivors: A Scoping Review of Nursing Evidence With Bibliometric Analysis.

BACKGROUND: With the increasing survival rates of childhood cancer, nurses' familiarity with published evidence has become crucial to care for this population and their families throughout the survival process. OBJECTIVE: To systematically identify and conduct a bibliometric analysis of nursing-related evidence concerning extended and long-term survival of childhood survivors. METHODS: A scoping review was conducted using bibliometric analysis with searches performed in the PubMed, CINAHL, SCOPUS, and Web of Science databases. A total of 300 studies on childhood cancer survival within the nursing field were included. RESULTS: The first study on this topic was published in 1975. American and Chinese researchers lead study publications, primarily publishing in nursing journals such as Cancer Nursing. Quantitative designs were prevalent, and the majority of the studies focused on physical late effects, overall quality of life, and survivor follow-up care. CONCLUSIONS: This study has allowed us to map and synthesize the bibliometric evidence pertaining to the extended and long-term survivorship of childhood cancer survivors in the nursing field. Consequently, it identifies gaps in knowledge, research trends, and areas necessitating further exploration. IMPLICATIONS FOR PRACTICE: The evidence presented in this review can facilitate academic and clinical discussions, offering a comprehensive synthesis of the published knowledge. More research needs to be developed on the topic, particularly in Central and Latin America, Africa, Southern and Eastern Europe, and in some regions of Asia. Furthermore, the scope of studies should extend beyond late effects and quality of life, encompassing the experience of surviving childhood cancer, including psychosocial and spiritual dimensions.

Use of Online Communities among People with Type 2 Diabetes: A Scoping Review.

PURPOSE OF REVIEW: People with diabetes require continuous self-monitoring and face numerous decisions in their day-to-day lives. Therefore, on many occasions, they need more support than that provided by health professionals. In this context, peer support in online diabetes communities could be a useful tool. The purpose of the review is to describe, analyze and synthesize the available evidence on the use and health out-comes of online communities for people with type 2 diabetes mellitus. A scoping review was conducted in accordance with the Joanna Briggs Institute guidelines. Searches were performed PubMed, Web of Science, CINHAL, Scopus and Cochrane databases. RECENT FINDINGS: From 1821 identified documents, 6 articles were included. These studies explored the characteristics of diabetes online communities and the population features. Besides, the results were classified according to whether they were clinical, psychosocial, or addressed people's experiences with the online community. The analysis underscores their value in facilitating communication, improving diabetes management, and enhancing psychosocial well-being. Future investigations should prioritize longitudinal assessments to elucidate the sustained impact of community engagement and optimize user participation for enhanced patient outcomes. The growing relevance of new technologies has led to a significant number of individuals with chronic illnesses seeking peer support. Online health communities have emerged as virtual spaces where individuals with shared health interests interact and form relationships. Within these digital spaces, individuals can engage in peer interaction, observe behaviors, and mutually benefit, potentially leading to improved attitudes toward the disease.

Efficacy of educational interventions in adolescent population with feeding and eating disorders: a systematic review.

BACKGROUND: Educational interventions are a key element in the care of young patients with feeding and eating disorders, forming part of the majority of therapeutic approaches. The aim of this review is to evaluate the impact of educational interventions in adolescents with feeding and eating disorders. METHODS: Following the PRISMA recommendations electronic databases were searched up to 29 June 2023. Studies related to educational interventions in young population diagnosed with feeding and eating disorders (anorexia nervosa, avoidant/restrictive food intake disorder, bulimia nervosa, pica and ruminative disorders and binge- eating disorder) in Spanish and English language, without temporal limitation, were located in the databases: PubMed, Scopus, CINAHL, Cochrane Library, PsycINFO, CUIDEN, DIALNET, and ENFISPO. A search in the databases of grey literature was performed in OpenGrey and Teseo. The review protocol was registered in PROSPERO (CRD42020167736). RESULTS: A total of 191 articles were selected from the 9744 citations screened. Ten publications were included. The results indicated variability between educational programs, including individual and group interventions, learning techniques and various research methodologies. Variables such as learning, attitudinal and perceptual changes, anthropometric parameters, symptom improvement, normalization of eating patterns, evaluation of the program and cognitive flexibility were identified. The risk of bias was high due to the low methodological quality of a large number of studies analyzed. CONCLUSION: The results indicate that educational interventions can influence the improvement of knowledge level and have a positive effect on health outcomes. Although education is a common practice in the treatment of these pathologies, high-quality studies were not identified. Thus, this review concludes that additional evidence is needed to evaluate the effectiveness of educational programs, with further research studies, especially randomized controlled trials, to confirm these results. LEVEL OF EVIDENCE: Level I: Systematic review.

Proposal of nursing diagnosis "adult disuse syndrome": A conceptual derivation and integrative review.

PURPOSE: To develop a nursing diagnosis proposal derived from the concept of "disuse syndrome" based on an integrative review. METHODS: The conceptual derivation technique, proposed by Walker and Avant, was used in the following phases: an integrative review of the literature was carried out, applying the parameters of Whitermore and Knalf, where 43 articles were selected that covered the existence of the concept in the nursing discipline and other health sciences, the concepts were subsequently analyzed, and the new concept was redefined following the middle-range theory of causality and validation of nursing diagnoses proposed by Oliveira-Lopes et al. FINDINGS: The proposal of the new nursing diagnosis was developed, including the following elements: diagnostic label adult disuse syndrome, the corresponding definition, 25 defining characteristics, eight related factors, eight risk populations, and 14 associated problems. CONCLUSIONS: The concept of the proposed new diagnosis describes adult disuse syndrome as a phenomenon that transcends the physiological component and should be viewed from a multidimensional view, expressing a clinical judgment related to a series of nursing diagnoses that appear together. IMPLICATIONS FOR NURSING PRACTICE: The results of this study will help nursing professionals to identify the phenomenon of adult disuse syndrome in any setting and in turn guide optimal care interventions that decrease the consequences of adult disuse syndrome.

Effectiveness of Digital Health on the Quality of Life of Long-Term Breast Cancer Survivors: A Systematic Review.

OBJECTIVES: To identify, critically appraise, and synthesize the available evidence on the effectiveness of digital health interventions to improve the quality of life or any of its four dimensions (physical, psychological, social, and spiritual) in women survivors of breast cancer who are in the extended or permanent survival stage. DATA SOURCES: Systematic review-Four databases were searched: PubMed, CINAHL, PsycINFO, and Web of Science. CONCLUSION: The clinical evidence shows a positive relationship or association between eHealth use and improved quality of life in breast cancer survivors at extended or permanent survival stage. However, the findings point to a deficit in the assessment of the social and spiritual domains that play a fundamental role in the quality of life of survivors. IMPLICATION FOR NURSING PRACTICE: The findings found reflect implications of great value for nursing practice because these professionals are the main users of digital health tools to provide them to patients. Using these digital tools contributes to improving evidence-based practice and providing greater efficiency and effectiveness in the care of long-term cancer survivors.

Assessing the Reliability and Validity of the Spanish Version of the Actual Scope of Nursing Practice Scale.

Nursing workforce shortage is one of the main challenges for healthcare organizations and it is important to determine if nurses are fulfilling their full scope of practice. There is a questionnaire that measures the activities carried out by nurses, but there is no version available for the Spanish context. The purpose of this study was to develop a cross-cultural adaptation of the "Actual Scope of Nursing Practice" questionnaire by D'Amour et al., and to assess the psychometric characteristics of the Spanish version. An exploratory sequential research design was used. The cross-cultural adaptation was performed using translation, back-translation, review, and pre-testing. Psychometric properties were assessed to determine its construct validity and internal consistency. Among the 501 eligible nurses from the three main hospitals in the region, the first 310 nurses to respond to an online questionnaire were included in our study. The response rate was 61.9%. They were invited via email and completed the survey using the SurveyMonkey platform. The Spanish version of the questionnaire was obtained. A final scale with twenty items and two factors was confirmed with an adequate fit, with the item scores demonstrating that all items were optimally related to their respective latent construct. The alpha coefficients for the Spanish ASCOP scale were robust and revealed good internal consistency. This study showed that the Spanish version of the scale, "Scope of Nursing Practice", has a good degree of validity and reliability. This questionnaire can support nurse managers in realising nursing activities within their organisations and in promoting desirable work outcomes among nurses.

Use of Telehealth Among Cancer Survivors: A Scoping Review.

Background: Long-term cancer survivors have specific needs that are frequently neglected. Telehealth, as a new form of health care, can benefit this growing population. Objective: To identify, analyze, and synthesize the existing evidence on the use of telehealth in the care of cancer survivors after the end of treatment. Methods: A scoping review was conducted in the databases PubMed, CINAHL, COCHRANE, SCIELO, DIALNET, and LILACS and reference institutions in cancer. Results: The initial search yielded 406 publications with 59 articles meeting the eligibility criteria. There are different types of telehealth (video calls, phone calls, websites, mobile applications, and short message services) used for the care of cancer survivors. Most telehealth interventions focus on improving the physical and mental spheres of quality of life in the extended survival phase (from 1 to 3 years postdiagnosis), with only two articles (3%) on long-term cancer survivors (>5 years postdiagnosis). Survivors are satisfied with telehealth interventions, noting the importance of improving comprehensibility, personalization of the platforms, and the lack of excessive information included. Conclusions: Telehealth is a feasible modality for cancer survival care. The scarcity of interventions aimed at long-term survivors stands out, as does the general neglect of the social and spiritual spheres of quality of life. Implications for Practice: Telehealth platforms must adapt their content, format, and items to the preferences reported by the survivors.

Analysis of mental health effects among nurses working during the COVID-19 pandemic: A systematic review.

WHAT IS KNOWN ON THE SUBJECT?: Working on the frontline during the pandemic has had a negative impact on the mental health of health professionals. A significant proportion experienced anxiety, insomnia, posttraumatic stress or depression. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Analysis and synthesis of the evidence of the impact of the COVID-19 pandemic on the mental health of nurses based on their work context. There exists a gap in the literature as no studies were found that analysed the effects on nurses' mental health according to the level of care they worked in (hospital-primary care-nursing home). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is an urgent need to assess and respond to the impact of COVID-19 on the physical and mental well-being of nurses, and to monitor international policies for the improvement of nurses' working conditions. ABSTRACT: Introduction Health professionals have suffered negative consequences during the COVID-19 pandemic. No review has specifically addressed the impact of the pandemic on the mental health of nurses exclusively according to the work context. Aim To analyse the impact of the COVID-19 pandemic on the mental health of nurses who have worked in hospitals, primary care centres and social health centres. Method PubMed, CINAHL, PsychINFO and Cochrane databases were searched (Prospero number: CRD42021249513). Out of 706 papers, 31 studies (2020-2021) were included in the systematic review. A qualitative synthesis method was used to analyse the data. Results Most studies were conducted in hospitals or frontline settings. The prevalence of moderate-to-severe symptoms was for anxiety 29.55%, depression 38.79%, posttraumatic stress disorder 29.8%, and insomnia 40.66%. Discussion This review highlights the mental health effects among nurses working in acute hospital settings. It also evidences a data gap on mental health effects among nurses working in primary health care and in nursing homes. Implications for practice In the post phase of the pandemic, there is an urgent need to assess and respond to the impact on the mental well-being of nurses, and to monitor international policies for the improvement of nurses' working conditions.

Web-Based Personalized Intervention to Improve Quality of Life and Self-Efficacy of Long-Term Breast Cancer Survivors: Study Protocol for a Randomized Controlled Trial.

Long-term breast cancer survivors (>5 years free of disease) may suffer late sequelae of cancer that impact on their quality of life. The use of telehealth for cancer care is recommended but little is known about the effectiveness of digital interventions for long-term cancer survivors. This study aims to evaluate the effectiveness of a web-based personalized intervention based on artificial intelligence instead of usual primary health care to improve the quality of life of long-term survivors of breast cancer and self-efficacy for the management of late sequelae. A randomized controlled trial will be conducted. The sample will consist of long-term breast cancer survivors recruited from primary health centers. Women will be randomly assigned to the intervention group to receive a web-based personalized intervention or to the control group to receive standard primary health care by nurses. Data on quality of life of cancer survivors and self-efficacy for the management of late sequelae of cancer will be collected and assessed at preintervention, and at 3, 6, and 9 months. It is expected that, at the end of the programme, the experimental group will have improved quality of life and improved self-efficacy for the management of late sequelae of cancer.

Salud familiar en tiempos de pandemia / Family health in times of pandemic

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Continuity of Care Challenges for Professional Nursing Practice / Desafíos en la continuidad de cuidados para la práctica profesional de enfermería / Desafios na continuidade de cuidados para a prática profissional de enfermagem

The transformation of health systems to meet the needs of chronic and multi-pathological patients has turned continuity of care into one of the mainstays of care programs and the design of new resources to care for these patients and their families. In this context, nurses' professional practice poses challenges for the three dimensions of continuity of care: relational, informational, and managerial. Faced with these challenges, nursing research is essential for the profession and necessary to promote innovative quality care.

La transformación de los sistemas sanitarios para dar respuesta a las necesidades del paciente crónico y pluripatológico ha situado la continuidad de cuidados como uno de los pilares en los que se basan los programas de atención y el diseño de nuevos recursos para atender a estos pacientes y a sus familias. En este contexto, la práctica profesional de las enfermeras presenta retos y desafíos en las tres dimensiones de la continuidad de cuidados: relacional, informativa y de gestión. Ante estos desafíos, la investigación en enfermería es fundamental para la profesión y necesaria para promover unos cuidados innovadores y de calidad.

A transformação dos sistemas sanitários para atender às necessidades do paciente crônico e pluripatológico situa a continuidade de cuidados como um dos pilares nos quais os programas de atenção e a criação de recursos para assistir esses pacientes e suas famílias estão baseados. Nesse contexto, a prática profissional dos enfermeiros apresenta desafios e obstáculos nas três dimensões da continuidade de cuidados: relacional, informativa e de gestão. Diante desses desafios, a pesquisa em enfermagem é fundamental para a profissão e necessária para promover cuidados inovadores e de qualidade.

Density of nurses and midwives in sub-Saharan Africa: Trends analysis over the period 2004-2016.

AIM: To analyse the trends of density rates of nurses and midwives per population in sub-Saharan Africa over the period from 2004 to 2016. BACKGROUND: Nursing, the largest health care workforce, is actively contributing to the achievement of the Sustainable Development Goals. The African continent is one of the most affected areas by the differences in the density of nurses and midwives indicator. METHODS: Joinpoint regression analysis was applied to identify significant changes in trends of the density of nurses and midwives from the 50 countries of sub-Saharan Africa. RESULTS: From 2004 to 2013, the density of nurses and midwives in sub-Saharan Africa increased significantly from 5.6 to 12.44 per 10,000 population, although it exhibited a increasing trend of a magnitude of 8.3% until 2013 that does not continue from that year. CONCLUSIONS: Only seven countries show an increasing trend, although in the case of the rest, they do not present any trend that suggests a change in this indicator in the short term. IMPLICATIONS FOR NURSING MANAGEMENT: From a macrolevel nursing management point of view, our study shows the importance of implementing actions that contribute to the increase of the nursing workforce in Africa, essential to achieve the Sustainable Development Goals.

HIV Incidence Among Women in Sub-Saharan Africa: A Time Trend Analysis of the 2000-2017 Period.

ABSTRACT: The aim of this study was to use data from the United Nations Global Indicators Database to analyze the trends in the HIV incidence rate among women in sub-Saharan African countries between 2000 and 2017. The HIV incidence rate is defined as the number of new HIV infections per 1,000 uninfected population, aged 15 to 49 years old. Joinpoint regression analysis was applied to identify periods when there were significant changes in the HIV incidence rate. The results show that there was a global decrease trend in the HIV incidence rates among women in sub-Saharan Africa, decreasing in all sub-Saharan African countries, except in Angola, Equatorial Guinea, and Sudan, which have remained the same, and Madagascar, where the overall trend is increasing. The joinpoint regression statistical method offers an in-depth analysis of the incidence of HIV among women in sub-Saharan Africa.

Construction and validation of the CAPA questionnaire of Nutritional Knowledge among Adolescents diagnosed with Feeading and Eting disorders.

Feeding and eating disorders represent a serious problem especially in young population. Nutritional education is essential in its treatment and prevention.

Construcción y validación delcuestionario C.A.P.A. Conocimientosen Alimentación de PersonasAdolescentes diagnosticadas detrastornos alimentarios / Construction and validation of the C.A.P.A. questionnaire in Nutrition of Adolescents diagnosed with Adolescents diagnosed with eating disorders

Introducción. Los trastornos de la conducta alimentariarepresentan un grave, problema especialmente en poblaciónjoven. La educación nutricional es fundamental en su tratamiento y prevención.Entre las acciones desarrolladas, en España destaca la estrategia NAOS, que enmarca el programa educativo Perseodestinado a escolares. Sin embargo, existen escasos instrumentos que evalúen los conocimientos tras la realización deeste tipo de acciones. El objetivo del estudio ha sido elaborar y validar un cuestionario que permita evaluar los conocimientos tras realizar el programa Perseo en población juvenil diagnosticada de trastornos alimentarios.Metodología. Se implementó la técnica e-Delphi modificada online, en la que participaron 26 expertos de saludmental y nutrición. Evaluándose el grado de consenso enadecuación y relevancia a través de una escala Likert decuatro puntos y un campo para comentarios. Los criteriosbásicos y suplementarios del desarrollo de la técnica se establecieron previamente.Resultados. Tomando como base el programa Perseo yel cuestionario General Nutrition Knowledge Questionnaire(GNKQ) en su versión adaptada a adolescentes portugueses,se desarrolló una versión inicial del cuestionario de 30 ítemsy 4 posibles respuestas. Tras tres fases, 26 ítems alcanzaron elconsenso requerido tanto en adecuación como en relevancia.Finalmente, se obtuvo un nuevo cuestionario compuesto por26 ítems con un alto grado de consenso en opinión de losexpertos.Conclusiones. El cuestionario ha demostrado una sólidavalidez de contenido. Permitiendo evaluar una intervencióneducativa sobre nutrición, basada en el programa Perseo, enpoblación juvenil con trastornos alimentarios. (AU)

Introduction. Feeding and eating disorders represent aserious problem especially in young population. Nutritionaleducation is essential in its treatment and prevention.Among the actions developed in Spain the NAOS strategyhighlights, which frames the Perseo educational program forschoolchildren. However, there are few tools to evaluate theknowledge after these programs are implemented. The aimof the study was to create and to validate a questionnairethat allows the evaluation of the acquired knowledge onyoung population diagnosed of eating disorders after participating on Perseo program.Methodology. The on-line modified e-Delphi techniquewas applied, 26 mental health and nutrition experts tookpart, evaluating the consensus level on adequacy and relevance through a 4-points Likert scale and a field for comments. Basic and supplementary criteria for the developmentof the technique were previously established.Results. On the basis of the Perseo program and theadapted version of GNKQ for Portuguese teenagers, an initial version of the questionnaire was developed with 30 items and 4 possible answers. After three rounds 26 of theitems reached the required consensus both in adequacyand relevance.Eventually a new questionnaire of 26 items was obtainedwith a high degree of general agreement according to theexperts.Conclusions. The questionnaire has demonstrated astrong validity of content that allows to evaluate an educational intervention on nutrition based on the Perseo program, among young population with eating disorders. (AU)

Conceptual development and validation of the nursing diagnosis "Disturbed thought process".

PURPOSE: To validate the content of the nursing diagnosis proposal Disturbed thought process. METHODS: With an exploratory and descriptive design, the content validation for each component of the diagnosis proposal was pursued, based on a previous broad conceptual work, through consulting experts, applying Fehring's Diagnosis Content Validation Model. The modified Delphi technique was used by sending out three rounds of questionnaires electronically to seek consensus among the experts. FINDINGS: The nursing diagnosis version validated in this study includes the diagnosis label Disturbed thought process, the corresponding definition, 15 defining characteristics, and 13 related factors. The resulting diagnosis total Diagnosis Content Validation score was 0.99, implying its content validation. CONCLUSIONS: The validated diagnosis proposal describes a human response for which nursing professionals can autonomously assess and prescribe interventions leading to improvement of this health problem and/or alleviate its consequences, preserving the patient's autonomy and helping them to address their situation. It will be included in the next edition of the nursing diagnosis classification NANDA-I 2021-2023. IMPLICATIONS FOR NURSING PRACTICE: The results of this study will help nursing professionals reduce the potential impact among patients who suffer from an alteration in cognitive functioning in its executive function dimension, as the validated diagnosis proposal will make it possible to identify and report this problem precisely.

OBJETIVO: Llevar a cabo la validación de contenido de la propuesta de diagnóstico enfermero Trastorno del proceso de pensamiento. METODOLOGÍA: Con un diseño exploratorio y descriptivo, se procedió a la validación de contenido de cada uno de los componentes de la propuesta de diagnóstico, desarrollado en base a un amplio trabajo conceptual previo, a través de la consulta de expertos y la búsqueda de consenso, aplicando el Modelo de Validación de Contenido Diagnóstico de Fehring. Se empleó la técnica Delphi modificada mediante la que se enviaron tres rondas de cuestionarios de forma electrónica para buscar el consenso entre los panelistas. RESULTADOS: La versión del diagnóstico enfermero validada en este estudio incluye la etiqueta diagnóstica Trastorno del proceso de pensamiento, la correspondiente definición, 15 características definitorias y 13 factores relacionados. El índice total de validación de contenido del diagnóstico resultante fue de 0,99, implicando su validación de contenido. CONCLUSIONES: La propuesta de diagnóstico validada describe una respuesta humana sobre la que los profesionales de enfermería de manera autónoma, pueden valorar y prescribir intervenciones encaminadas a la mejoría de este problema de salud y/o paliar sus consecuencias, preservando la autonomía del paciente y facilitando su afrontamiento. Será incluido en la próxima edición de la clasificación de diagnósticos enfermeros NANDA-I 2021-2023. IMPLICACIONES PARA LA PRÁCTICA ENFERMERA: Los resultados de este estudio ayudarán a los profesionales de enfermería a disminuir el impacto potencial en los pacientes que sufren una alteración del funcionamiento cognitivo en su dimensión función ejecutiva, ya que la propuesta de diagnóstico validada les permitirá identificar y comunicar dicho problema con precisión.