[Sleep and academic performance in university students: a systematic review]. / Sueño y rendimiento académico en estudiantes universitarios: revisión sistemática.

INTRODUCTION: University students tend to suffer from problems of sleep regularity, quantity and quality, which can affect their academic performance. These problems are related to changes typical of the phase of the life cycle in which they find themselves due to maturational, psychosocial development (associated with the processes of individuation and socialisation) and academic factors. The study of the relationship between sleep and academic performance in university students is an area of research of growing interest, which has started to be studied over the last two decades. AIM: To conduct a systematic review of the existing literature on the relationship between sleep and academic performance in university students. SUBJECTS AND METHODS: The articles included in the PubMed database were selected, following the PRISMA guidelines. Studies evaluating samples of subjects with an average age between 18 and 26 years, published in English or Spanish during the period 2000-2019 were included. Subsequently, the quality of the selected articles was evaluated according to the STROBE standard. RESULTS: Thirty studies were identified, which were grouped according to different aspects of sleep: drowsiness, duration, experience of total sleep deprivation, sleep quality, chronotype, regularity and sleep disorders. CONCLUSION: The results of these studies suggest that inadequate sleep has a negative effect on the academic performance of university students.

TITLE: Sueño y rendimiento académico en estudiantes universitarios: revisión sistemática.Introducción. Los estudiantes universitarios tienden a padecer problemas de regularidad, cantidad y calidad de sueño, que pueden afectar a su rendimiento académico. Estos problemas se relacionan con cambios propios de la fase del ciclo vital en la que se encuentran debido a diversos factores: madurativos, del desarrollo psicosocial (asociados con los procesos de individuación y socialización) y académicos. El estudio de la relación entre el sueño y el rendimiento académico en estudiantes universitarios es un área de investigación de interés creciente, que ha empezado a ser objeto de estudio en las últimas dos décadas. Objetivo. Revisión sistemática de la bibliografía existente sobre la relación del sueño y el rendimiento académico en los estudiantes universitarios. Sujetos y métodos. Se seleccionaron los artículos recogidos en la base de datos PubMed, siguiendo las directrices PRISMA. Se incluyeron los estudios que valoraban muestras de sujetos con una edad media entre 18 y 26 años, publicados en inglés o castellano, durante el período 2000-2019. Posteriormente, se evaluó la calidad de los artículos seleccionados siguiendo la normativa STROBE. Resultados. Se identificaron 30 estudios, que fueron agrupados según distintos aspectos del sueño: somnolencia, duración, experiencia de privación total de sueño, calidad de sueño, cronotipo, regularidad y trastornos del sueño. Conclusión. Los resultados de estos estudios sugieren que un sueño inadecuado afecta negativamente al rendimiento académico de los estudiantes universitarios.

Barreras y facilitadores para la implementación de la toma de decisiones compartidas en oncología: percepciones de los pacientes / Barriers and facilitators to implementing shared decision-making in oncology: patient perceptions

Objetivo. Conocer, desde el punto de vista del paciente oncológico, quién tomó la decisión sobre su tratamiento, así como las principales barreras y facilitadores que permiten la implementación de la toma de decisiones compartidas (TDC). Material y métodos. Estudio transversal y de asociación a partir de un cuestionario autoadministrado a pacientes oncológicos seleccionados mediante muestreo casual en diferentes consultas oncológicas y periodos aleatorios. Ciento ocho pacientes proporcionaron datos analizables. La información recogida fue sobre variables sociodemográficas y clínicas, sobre quién tomó la decisión sobre el tratamiento y el grado de acuerdo o desacuerdo con diferentes barreras y facilitadores. Resultados. El 38,1% de los pacientes afirmó haber tomado la decisión de manera compartida con su médico. Barreras como el tiempo, la dificultad de comprensión, el paternalismo, la falta de comunicación fluida y el disponer de información previa y frecuentemente errónea influyeron en la implicación en la toma de decisiones. Sin embargo, disponer o no de instrumentos suficientes de ayuda a la decisión o el interés del paciente por participar no influyeron. En lo referente a los facilitadores, la motivación del médico, su percepción de mejora y el interés del enfermo tuvieron una influencia positiva. La excepción la constituyó la posibilidad de incentivar económicamente a los médicos. Conclusiones. La nula o escasa participación percibida por los pacientes oncológicos en las decisiones sobre su salud hace necesario introducir mejoras en el modelo de atención sanitaria que permitan superar barreras y promover una actitud más participativa en el paciente (AU)

Objective. To determine, from the point of view of the oncological patient, who made the decision about their treatment, as well as the major barriers and facilitators that enabled Shared Decision Making to be implemented. Material and methods. A cross-sectional, descriptive, sand association study using a self-report questionnaire to selected cancer patients, with casual sampling in different oncology clinics and random time periods. A total of 108 patients provided analysable data. The information was collected on sociodemographic and clinical variables, who made the decision about treatment, and level of agreement or disagreement with various barriers and facilitators. Results. More than one-third (38.1%) of patients claimed to have participated in shared decision making with their doctor. Barriers such as, time, the difficulty of understanding, the paternalism, lack of fluid communication, and having preliminary and often erroneous information influenced the involvement in decision-making. However, to have or not have sufficient tools to aid decision making or the patient's interest to participate had no effect. As regards facilitators, physician motivation, their perception of improvement, and the interest of the patient had a positive influence. The exception was the possibility of financial incentives to doctors. Conclusions. The little, or no participation perceived by cancer patients in decisions about their health makes it necessary to introduce improvements in the health care model to overcome barriers and promote a more participatory attitude in the patient (AU)

[Shared decision making from the perspective of the cancer patient: participatory roles and evaluation of the process]. / La toma de decisiones compartidas desde la perspectiva del paciente oncológico: roles de participación y valoración del proceso.

BACKGROUND: In Spain there is no clear knowledge about the degree to which Shared Decision Making (SDM) is carried out in the normal practice of oncology. Our article analyses the preferred role and the perceived role of oncological patients and measures the SDM process from their perspective. MATERIAL AND METHODS: Descriptive transversal study using a self-conducted questionnaire with patients with different types of cancer. To evaluate the role preferred and perceived by the patient we used The Control Preference Scales (CPS) and to measure SDM we used The nine-item Shared Decision Making Questionnaire (SDM-Q-9). RESULTS: Out of the 132 patients surveyed, only 118 provided analysable data. No evidence was found that sex, age, educational level or type of tumour affected the preferred role or the perceived role. Only 59.3% was in agreement with the role exercised. All of those who preferred a passive role achieved this (21.2%), while out of those who wanted a shared role (78.8%), this was achieved by only 48.39% while the remaining 51.61% played a passive role. None preferred or played an active role. The set of patients evaluated the SDM process with a score of 41.07±5.94, on a scale of 0 to 100, with the highest score of 61.39 ± 13.24 reached by urological patients. CONCLUSIONS: Our study found no evidence that, from the point of view of the oncological patient, the SDM model is being implemented in practice.

La toma de decisiones compartidas desde la perspectiva del paciente oncológico: roles de participación y valoración del proceso / Shared decision making from the perspective of the cancer patient: participatory roles and evaluation of the process

Fundamento: En España no existe un claro conocimiento sobre el grado en que la Toma de Decisiones Compartidas (TDC) es llevada a la práctica habitual en oncología. Nuestro trabajo analiza el rol preferido y el rol percibido de los pacientes oncológicos y mide el proceso de TDC desde su perspectiva. Material y métodos: Estudio descriptivo transversal mediante cuestionario autoadministrado a pacientes con distintos tipos de cáncer. Para evaluar el rol preferido y percibido por el paciente utilizamos The Control Preference Scales (CPS) y para medir la TDC se utilizó The nine-item Shared Decision Making Questionnaire (SDM-Q-9). Resultados: De los 132 pacientes encuestados, solo 118 proporcionaron datos analizables. No se encontraron evidencias de que el sexo, edad, nivel educativo o tipo de tumor afectaran al rol preferido o al percibido. Solo el 59,3% estaba de acuerdo con el rol ejercido. Todos los que preferían un rol pasivo lo alcanzaban (21,2%), mientras que de los que deseaban uno compartido (78,8%), solo el 48,39% lo lograba y el 51,61% restante desempeñaba uno pasivo. Ninguno prefirió ni ejerció un rol activo. El conjunto de pacientes valoró el proceso de TDC con una puntuación de 41,07±5,94, en una escala de 0 a 100, alcanzando los pacientes urológicos una puntuación máxima de 61,39 ± 13,24. Conclusiones: Nuestro estudio no encuentra evidencias de que, desde el punto de vista del paciente oncológico, el modelo de TDC esté implementado en la práctica (AU)

Background: In Spain there is no clear knowledge about the degree to which Shared Decision Making (SDM) is carried out in the normal practice of oncology. Our article analyses the preferred role and the perceived role of oncological patients and measures the SDM process from their perspective. Material and methods: Descriptive transversal study using a self-conducted questionnaire with patients with different types of cancer. To evaluate the role preferred and perceived by the patient we used The Control Preference Scales (CPS) and to measure SDM we used The nine-item Shared Decision Making Questionnaire (SDM-Q-9). Results: Out of the 132 patients surveyed, only 118 provided analysable data. No evidence was found that sex, age, educational level or type of tumour affected the preferred role or the perceived role. Only 59.3% was in agreement with the role exercised. All of those who preferred a passive role achieved this (21.2%), while out of those who wanted a shared role (78.8%), this was achieved by only 48.39% while the remaining 51.61% played a passive role. None preferred or played an active role. The set of patients evaluated the SDM process with a score of 41.07±5.94, on a scale of 0 to 100, with the highest score of 61.39 ± 13.24 reached by urological patients. Conclusions: Our study found no evidence that, from the point of view of the oncological patient, the SDM model is being implemented in practice (AU)

[Barriers and facilitators to implementing shared decision-making in oncology: Patient perceptions]. / Barreras y facilitadores para la implementación de la toma de decisiones compartidas en oncología: percepciones de los pacientes.

OBJECTIVE: To determine, from the point of view of the oncological patient, who made the decision about their treatment, as well as the major barriers and facilitators that enabled Shared Decision Making to be implemented. MATERIAL AND METHODS: A cross-sectional, descriptive, sand association study using a self-report questionnaire to selected cancer patients, with casual sampling in different oncology clinics and random time periods. A total of 108 patients provided analysable data. The information was collected on sociodemographic and clinical variables, who made the decision about treatment, and level of agreement or disagreement with various barriers and facilitators. RESULTS: More than one-third (38.1%) of patients claimed to have participated in shared decision making with their doctor. Barriers such as, time, the difficulty of understanding, the paternalism, lack of fluid communication, and having preliminary and often erroneous information influenced the involvement in decision-making. However, to have or not have sufficient tools to aid decision making or the patient's interest to participate had no effect. As regards facilitators, physician motivation, their perception of improvement, and the interest of the patient had a positive influence. The exception was the possibility of financial incentives to doctors. CONCLUSIONS: The little, or no participation perceived by cancer patients in decisions about their health makes it necessary to introduce improvements in the health care model to overcome barriers and promote a more participatory attitude in the patient.

Análisis comparativo de los sellos de calidad de páginas web sanitarias / Comparative analysis of quality labels of health websites

Introducción. La búsqueda de información sanitaria en Internet es un fenómeno creciente, siendo su principal inconveniente el desconocimiento de la fiabilidad de las páginas consultadas. El objetivo de nuestro trabajo fue analizar y comparar los principales sellos vigentes de calidad de páginas web sanitarias. Material y métodos. Se realizó un estudio observacional transversal mediante una búsqueda en Medline, IBECS, Google y Yahoo realizado los días 8 y 9 de marzo de 2015 tanto en inglés como español. Se utilizaron diferentes palabras clave en función de si la búsqueda se realizaba en bases de datos médicas o en buscadores genéricos. Los sellos se clasificaron en función de su origen, analizando su carácter, año de implantación, existencia de proceso de acreditación, número de categorías, criterios y estándares, posibilidad de autoevaluación, número de niveles de certificación, ámbito de certificación, vigencia, análisis de la calidad de contenidos, cuota, resultados del proceso de acreditación o solicitud, número de webs con sello concedido y sellos obtenidos por el organismo acreditador. Resultados. Se analizaron siete sellos, cinco de origen nacional (WMA, PAWS, WIS, SEAFORMEC y M21) y dos internacional (HONcode y Health Web Site Accreditation). Existía disparidad en la forma de llevar a cabo el proceso de acreditación, llegando algunos a no detallar aspectos fundamentales de dicho proceso o proporcionar información incompleta, desactualizada e incluso inexacta. Los más rigurosos garantizaban el nivel de confianza que las páginas web poseían en relación con los contenidos de información, pero ninguno revisaba la calidad de los mismos. Conclusiones. Aunque los sellos de calidad rigurosos pueden llegar a ser útiles, las deficiencias detectadas en algunos de ellos pueden hacer dudar de su finalidad (AU)

Background. The search for health related information on the Internet is a growing phenomenon, buts its main drawback is the lack of reliability of information consulted. The aim of this study was to analyse and compare existing quality labels of health websites. Material and methods. A cross-sectional study was performed by searching Medline, IBECS, Google, and Yahoo, in both English and Spanish, between 8 and 9 March, 2015. Different keywords were used depending on whether the search was conducted in medical databases or generic search engines. The quality labels were classified according to their origin, analysing their character, year of implementation, the existence of the accreditation process, number of categories, criteria and standards, possibility of self-assessment, number of levels of certification, certification scope, validity, analytical quality of content, fee, results of the accreditation process, application and number of websites granted the seal, and quality labels obtained by the accrediting organisation. Results. Seven quality labels, five of Spanish origin (WMA, PAWS, WIS, SEAFORMEC and M21) and two international ones (HONcode and Health Web Site Accreditation), were analysed. There was disparity in carrying out the accreditation process, with some not detailing key aspects of the process, or providing incomplete, outdated, or even inaccurate information. The most rigorous guaranteed the level of confidence that the websites had in relation to the content of information, but none checked the quality of them. Conclusions. Although rigorous quality labels may become useful, the deficiencies in some of them cast doubt on their current usefulness (AU)

[Comparative analysis of quality labels of health websites]. / Análisis comparativo de los sellos de calidad de páginas web sanitarias.

BACKGROUND: The search for health related information on the Internet is a growing phenomenon, buts its main drawback is the lack of reliability of information consulted. The aim of this study was to analyse and compare existing quality labels of health websites. MATERIAL AND METHODS: A cross-sectional study was performed by searching Medline, IBECS, Google, and Yahoo, in both English and Spanish, between 8 and 9 March, 2015. Different keywords were used depending on whether the search was conducted in medical databases or generic search engines. The quality labels were classified according to their origin, analysing their character, year of implementation, the existence of the accreditation process, number of categories, criteria and standards, possibility of self-assessment, number of levels of certification, certification scope, validity, analytical quality of content, fee, results of the accreditation process, application and number of websites granted the seal, and quality labels obtained by the accrediting organisation. RESULTS: Seven quality labels, five of Spanish origin (WMA, PAWS, WIS, SEAFORMEC and M21) and two international ones (HONcode and Health Web Site Accreditation), were analysed. There was disparity in carrying out the accreditation process, with some not detailing key aspects of the process, or providing incomplete, outdated, or even inaccurate information. The most rigorous guaranteed the level of confidence that the websites had in relation to the content of information, but none checked the quality of them. CONCLUSIONS: Although rigorous quality labels may become useful, the deficiencies in some of them cast doubt on their current usefulness.