Psychological Resilience and Suicide Attempt in Patients With Bipolar Disorder: An Exploratory Study.

BACKGROUND: Patients with bipolar affective disorder (BPAD) have a suicide risk of up to 30 times higher than the general population. There is increasing interest in analyzing the effects of resilience in psychiatric diseases and its relationship to other factors such as suicide risk. AIM: The main objective of this study was to analyze the relationship between psychological resilience and suicide attempts, along with other relevant clinical and sociodemographic variables in euthymic patients with BPAD. METHODS: Eighty six outpatients, more than 18 years old, mostly men (60.5%) with BPAD type 1, 2, mixed, and unspecified, in euthymic phase receiving antidepressant and/or euthimizing treatment, participated in the study. Sociodemographic and clinical variables were assessed by means of a questionnaire and psychological resilience by means of Connor-Davidson's 10-item Resilience Scale. RESULTS: Patients with previous autolytic attempts scored significantly lower in resilience than those who had not attempted suicide (T = 3.30; p ≤ .001; 20.61 ± 6.58 vs. 26.52 ± 7.29). Patients diagnosed with BPAD scored significantly lower than other samples of university participants, workers, and the unemployed. The number of depressive episodes experienced was negatively and significantly associated with resilience scores (r = -.28; p < .01). CONCLUSIONS: Patients diagnosed with BPAD who had made autolytic attempts had lower resilience scores than those who had not made them and lower scores than other general nonpsychiatric samples. The promotion of resilience in patients diagnosed with BPAD would facilitate a more adaptive and positive coping with the disease and their recovery process.

Airborne acquisition of Pneumocystis in bronchoscopy units: a hidden danger to healthcare workers.

The possible presence of Pneumocystis in a bronchoscopy unit of a tertiary-hospital was examined by detecting Pneumocystis-specific DNA by polymerase chain reaction in prospectively obtained samples of oropharyngeal wash from seven healthcare workers (HCWs) and air from three areas of the unit at different time points (baseline, days +15,+30,+60,+90 after initiation of the study). Positive samples were genotyped at two genetic loci: the mitochondrial large subunit ribosomal RNA (mtLSUrRNA) fragment by direct sequencing and the gene for dihydropteroate synthase (DHPS) by restriction fragment-length polymorphism. Pneumocystis DNA was identified in 13/24 samples from HCWs, in 4/14 air samples and also in two patients with Pneumocystis pneumonia (PcP) and another with a Pneumocystis-associated disease subjected to bronchoscopy on days +15 and +60 after initiation of the study. The HCWs harbored a high rate of mtLSU-rRNA genotypes 1 and 3 and samples from air and patients with only genotype 3. DHPS mutations related to sulpha resistance were detected in three samples from HCWs and in one from air; 65% of the positive samples showed genotypic concordance. The study demonstrates that HCWs of bronchoscopy units represent a new dynamic reservoir and a possible source of infection for human Pneumocystis species, including DHPS genotypes related to sulpha resistance that could be transmitted within hospitals to immunosuppressed hosts in whom a PcP can develop. The results provide the first evidence of the risk of Pneumocystis transmission in the bronchoscopy units and arguments to improve prevention and control of this infection in nosocomial setting.

Factores de estrés laboral en el personal de enfermería hospitalario del equipo volante según el modelo de demanda-control-apoyo / Factors of work-related stress in hospital nursing bureau according to the demand-control-support model

Objetivos: Analizar la presencia de estrés laboral en el equipo volante de enfermería de un Hospital General Universitario tomando como referencia el modelo demandas-control-apoyo de Karasek. Método: Estudio observacional de corte transversal. La muestra estuvo constituida por 38 profesionales de enfermería del equipo volante de un Hospital General Universitario. Instrumentos de evaluación: para conocer la percepción de los profesionales de enfermería sobre el contenido de su trabajo y determinar los estresores laborales, se empleó el cuestionario Job Content Questionnaire (JCQ) traducido y validado para enfermería hospitalaria. Resultados: La tasa de participación fue del 90,47% (N=38). Se registró una media para la dimensión de apoyo social de 2,59±0,47, para la dimensión de demandas psicológicas en el trabajo de 3,26±0,47, y para la dimensión de control sobre el trabajo se obtuvo una media de 2,87±0,40. El análisis de datos puso de manifiesto un nivel moderado de estresores, destacando un déficit de apoyo social por parte de los superiores, que resultó ser más acusado en el grupo de profesionales adscritos a la dirección de enfermería (2,89 vs 2,49; p<0,05). Ninguna de las tres dimensiones se mostró asociada a las variables socio-laborales de sexo, edad, turno, adscripción y tipo de vinculación al hospital. Conclusiones: Existe una percepción moderada de estresores laborales, resaltando el escaso apoyo social por parte de los superiores, siendo este aspecto una área de mejora sobre la que intervenir

Objectives: To analyse the presence of work-related stress in the nursing bureau of a University General Hospital taking as reference Karasek's demand-control-support model. Methods: Cross-sectional observational study. The sample included 38 nursing professionals from the nursing bureau of a University General Hospital. Assessment tools: the Job Content Questionnaire (JQC), translated and validated for hospital nursing, was used to know the perception of nursing professionals concernins their work, and to determine the presence of any work-related stressors. Results: The participation rate was 90.47% (N=38). The average for the social support dimension was 2.59±0.47, for the psychological demands of 3.26±0.47, and for control over their own work of 2.87±0.40. Data analysis pointed to a moderate level of stress, reflecting a deficit in the social support provided by superiors, particulary in the group of professionals assigned to nursery management (2.89 vs 2.49; p<0.05). None of the three dimensions showed a link of any kind with socio-occupational variables of gender, age, shift, assignment or type of connection to the hospital. Conclusion: Improvement is needed in this area on the part of human resources management in order to lessen the effect of work-related stress, psychological demands and lack of control over these

La satisfacción de la vida laboral de los enfermeros de las unidades móviles de emergencias de la Región de Murcia / Working life satisfaction in the nursing staff of the emergency mobile units of the Región of Murcia

El análisis de la satisfacción laboral es un indicador de la calidad del servicio prestado, convirtiéndose de forma indirecta, en un instrumento para mejorar la calidad de la atención sanitaria. Objetivo: Analizar la satisfacción laboral de los profesionales de enfermería de las Unidades Móviles de Emergencias de la Región de Murcia. Metodología: Estudio cuantitativo de corte transversal, con una muestra de conveniencia de 77 profesionales de enfermería de las Unidades Móviles de Emergencias, realizado en febrero/abril de 2013. Se utilizó la escala NTP 394: Satisfacción Laboral: escala general de satisfacción. Se procedió al análisis descriptivo y estadístico de asociación de variables con el programa estadístico SPSS (v.15). Resultados: La participación fue del 90,58%. Los resultados del estudio reflejan una satisfacción general media (M=72.12; DT=13,97), los 'compañeros de trabajo' y el 'horario de trabajo' son los aspectos mejor evaluados. Conclusiones: Este estudio mostró un elevado nivel de satisfacción laboral de los profesionales de enfermería de las Unidades Móviles de Emergencias de la Región de Murcia. No obstante, la detección de facetas laborales que producen insatisfacción constituye una herramienta importante para el establecimiento de acciones de mejora por parte de los gestores de las organizaciones de salud (AU)

The analysis of the job satisfaction is an indicator of the quality of the service provided, becoming in an indirect way, an instrument for improving the quality of health care. Objective: analyze the job satisfaction of nursing professionals of the Mobile Units of Emergencies in the Region of Murcia. Methodology: Quantitative cross-sectional study with a convenience sample of 77 nurses from the Emergency Mobile Units. The study was conducted from February to April 2013. Overall level of satisfaction: the NTP 394 scale: Job Satisfaction was used to measure satisfaction. We proceeded to the descriptive and statistical analysis of association of variables with the statistical program SPSS (V.15). Results: The response rate was 90.58%. The study results reflect an average overall satisfaction (M=72.12; SD=13.97); the 'colleagues' and 'working shift' are the best evaluated aspects. Conclusions: This study showed a high level of job satisfaction of nurses in the Emergency Mobile Units of the Region of Murcia. However, the detection of occupational aspects that produce dissatisfaction is an important tool concerning the establishment of improvement actions from managers of health organizations (AU)

Hepatitis crónicas virales B y C en población inmigrante en España / Chronic viral hepatitis B and C in immigrant population, Spain

Fundamentos: En España la prevalencia de la hepatitis crónicas de origen viral puede variar a causa de los inmigrantes procedentes de áreas de elevada prevalencia de infección por virus B y C de la hepatitis. La infección por estos virus es un problema importante de salud pública global por los procesos crónicos que originan. El objetivo del estudio fue conocer el impacto de la inmigración en la prevalencia de las hepatitis crónicas virales en España. Métodos: Revisión bibliográfica cualitativa de la literatura científica sobre el tema publicada entre enero de 1998 y diciembre de 2012 utilizando las bases Medline y MEDES-MEDicina. Resultados: Se analizaron los datos procedentes de 19 artículos originales. En conjunto la prevalencia de infección por los virus B y C de la hepatitis fue mayor en la población emigrante que la descrita para la población general española. Los emigrantes de África y Europa del Este presentaron las mayores prevalencias y los inmigrantes iberoamericanos las menores. Conclusiones: La prevalencia de las infecciones por virus B y C de la hepatitis en inmigrantes sugiere que podrían tener un importante impacto en la salud pública en España (AU)

Background: the prevalence of chronic viral hepatitis in Spain could vary because of the immigrants coming from countries having an elevated with a higher endemicity of hepatitis B and C virus. Hepatitis B and hepatitis C virus infections are an important health problem worldwide taking into account their chronic consequences. The aim of this study was to know the impact of immigration in the prevalence of chronic viral hepatitis in Spain. Methods: qualitative of scientific papers searching in Medline and MEDES-MEDicina, with date limit January 1998- December 2012 and only papers in English and Spanish. Results: data from19 original articleswere analyzed. The prevalences of hepatitis B and C virus infections in the immigrant population, on the whole, are higher than Spanish population. Immigrants from Africa and East European countries presented the higher prevalence of Hepatitis B and Hepatitis C virus infection, whereas the Latin American-origin population displayed the lowest one. Conclusion: the prevalences of hepatitis B and C virus infections in the immigrant population suggest they could have a substantial public health impact in Spain (AU)

[Chronic viral hepatitis B and C in immigrant population, Spain]. / Hepatitis crónicas virales B y C en población inmigrante en España.

BACKGROUND: the prevalence of chronic viral hepatitis in Spain could vary because of the immigrants coming from countries having an elevated with a higher endemicity of hepatitis B and C virus. Hepatitis B and hepatitis C virus infections are an important health problem worldwide taking into account their chronic consequences. The aim of this study was to know the impact of immigration in the prevalence of chronic viral hepatitis in Spain. METHODS: qualitative of scientific papers searching in Medline and MEDES-MEDicina, with date limit January 1998- December 2012 and only papers in English and Spanish. RESULTS: data from 19 original articles were analyzed. The prevalences of hepatitis B and C virus infections in the immigrant population, on the whole, are higher than Spanish population. Immigrants from Africa and East European countries presented the higher prevalence of Hepatitis B and Hepatitis C virus infection, whereas the Latin American-origin population displayed the lowest one. CONCLUSION: the prevalences of hepatitis B and C virus infections in the immigrant population suggest they could have a substantial public health impact in Spain.

Estudio exploratorio de satisfacción laboral de los profesionales de enfermería generalistas y especialistas (matrona) / Estudo exploratório da satisfação no trabalho dos enfermeiros generalistas e especialistas em obstetrícia e ginecologia (parteiras) / Exploratory study on the general and specialist nursing professionals (midwife) laboral satisfaction

Partimos de la importancia de la satisfacción laboral y su repercusión en el desarrollo de la actividad de los Profesionales Sanitarios así como su impacto en la calidad de los servicios que prestan. El objetivo es conocer, analizar y describir las expectativas, necesidades, valores y percepciones de los profesionales de enfermería generalistas y especialistas (matrona) de tres Hospitales Universitarios en relación a la satisfacción de la salud laboral como factor influyente en su calidad de vida. El diseño se plantea desde un enfoque cualitativo bajo la orientación teórico-metodológica de la antropología social, utilizando un muestreo teórico hasta alcanzar la saturación de los datos. Se usarán como técnicas de recogida de datos cualitativos los grupos de discusión con profesionales de enfermería generalistas y especialistas. Los resultados de un estudio cuantitativo sobre la satisfacción de la vida laboral en un Hospital Universitario y los distintos aspectos que producen la misma en los profesionales, nos hacen plantearnos el inicio de este estudio. Como conclusión, un estudio de estas características, nos permitiría indagar en los porqués de la satisfacción e insatisfacción de los profesionales de enfermería, ya que la calidad de salud laboral de los mismos influye directamente en la calidad del servicio prestado (AU)

Starting from the importance of the laboral satisfaction and its repercussion in the development of the Health Professional activity as well as its impact in the quality of the services rendered.The aim of this study is to know, analyze and describe the expectations, needs, values and perceptions of the general and specialist nursing professionals (midwife) of three University Hospitals in relation to the satisfactionof safety at work as an influential factor in their life quality.The design is considered from a qualitative perspective under the theoretical and methodological guidance of the social anthropology, using a theoretical sampling until reach the data saturation. The discussion groups with general and specialist nursing professionals will be used as data collection techniques. The results of a quantitative study on the working life satisfaction at an University Hospital and the different aspects which produce the same in professionals, raise the issue of the start of the study. As a conclusion, this kind of study will allow us to investigate reasons for the satisfaction or dissatisfaction of the nursing professionals, inasmuch as the quality of their laboral health affects directly the quality of the services rendered (AU)

Assumimos a importância da satisfação no trabalho e o seu impacto sobre o desenvolvimento da actividade dos Profissionais da Saúde, bem como seu impacto sobre a qualidade dos serviços prestados.O objetivo é compreender, analisar e descrever as expectativas, necessidades, valores e percepções dos Profissionais de Enfermagem generalistas e especialistas (parteiras) de três Hospitais Universitários em relação a satisfação da saúde ocupacional como um fator que influencia a sua qualidade de vida. O designsurge a partir de uma abordagem qualitativa, sob a orientação teórico-metodológica da Antropologia Social, utilizando uma amostragem teórica até a saturação de dados. Serám usados como técnicas de recolha de dados qualitativos os Grupos de Discusso com Profissionais de Enfermagem generalistas e especialistas. Os resultados de um estudo quantitativo sobre a satisfação da vida de trabalho em um Hospital Universitário e os vários aspectos que produze a mesma nos profissionais, faz-nos pensar sobre o início deste estudo. Em conclusão, um estudo desta natureza, nós permitiria investigar os porquês da satisfação e insatisfação dos Profissionais de Enfermagem, uma vez que a qualidade da saúde ocupacional deles tem uma influência directa sobre a qualidade do serviço prestado (AU)

Guía de práctica clínica sobre terapia intravenosa con dispositivos no permanentes en adultos / Clinical practice guideline on intravenous therapy with temporary devices in adults

El objetivo principal de la guía es proporcionar a los profesionales sanitarios una herramienta que les permita tomar decisiones basadas en evidencia sobre aspectos de la atención al paciente adulto con indicación de terapia intravenosa con dispositivos no permanentes. Además, se señalan los objetivos secundarios siguientes: aumentar la calidad de las intervenciones, evitar complicaciones relacionadas con la terapia intravenosa y reducir la variabilidad existente entre los profesionales sanitarios.

The guideline includes recommendations for taking care of adult patients with intravenous therapy who are at primary care centres, hospitals and homes.

Agotamiento emocional y síntomas de malestar psíquico en alumnos de enfermería / Emotional exhaustion and symptoms of psychic distress in nursing students

Resumen:

Objetivos: estimar el nivel de agotamiento emocional y conocer el estado de malestar psicológico en una muestra de estudiantes de enfermería. Analizar la relación entre el agotamiento emocional y el estado de malestar psicológico percibido. Método: estudio descriptivo transversal. En una muestra de 113 estudiantes de enfermería de cuarto de grado se administraron dos cuestionarios validados: la escala del agotamiento emocional en la adaptación española del Inventario de Burnout de Maslach (MBI-GS), y la validación española del cuestionario de bienestar psicológico GHQ-12. Resultados: un 27,4% de la muestra experimentó niveles altos de agotamiento emocional. Se obtuvo una puntuación media de 9,43 (SD=7,26) en la escala de bienestar psicológico. El agotamiento emocional se asoció a la edad (r=0,252; p<0,01) y a una mayor frecuencia de malestar psíquico (r=0,494, p≤0,000). Ni el género ni el estado civil se asociaron al agotamiento emocional y al estado de bienestar psíquico.Conclusiones: un amplio porcentaje de la muestra reflejó altos niveles de agotamiento emocional, asociados a una mayor presencia de sintomatología psíquica. Por tanto, se requieren medidas a nivel formativo que permitan prevenir el desarrollo del síndrome de burnout y de sus consecuencias sobre el bienestar psicológico de los estudiantes.

The relationship between psychosocial job stress and burnout in emergency departments: an exploratory study.

BACKGROUND: The purpose of this study was to examine the relationship and predictive power of various psychosocial job stressors for the 3 dimensions of burnout in emergency departments. METHODS: This study was structured as a cross-sectional design, with a questionnaire as the tool. The data were gathered using an anonymous questionnaire in 3 hospitals in Spain. The sample consisted of 191 emergency departments. Burnout was evaluated by the Maslach Burnout Inventory and the job stressors by the Nursing Stress Scale. FINDINGS: The Burnout Model in this study consisted of 3 dimensions: emotional exhaustion, cynicism, and reduced professional efficacy. The model that predicted the emotional exhaustion dimension was formed by 2 variables: Excessive workload and lack of emotional support. These 2 variables explained 19.4% of variance in emotional exhaustion. Cynicism had 4 predictors that explained 25.8% of variance: Interpersonal conflicts, lack of social support, excessive workload, and type of contract. Finally, variability in reduced professional efficacy was predicted by 3 variables: Interpersonal conflicts, lack of social support, and the type of shift worked, which explained 10.4% of variance. DISCUSSION: From the point of view of nurse leaders, organizational interventions, and the management of human resources, this analysis of the principal causes of burnout is particularly useful to select, prioritize, and implement preventive measures that will improve the quality of care offered to patients and the well-being of personnel.

[Hardy personality, self-efficacy, and general health in nursing professionals of intensive and emergency services]. / Personalidad resistente, autoeficacia y estado general de salud en profesionales de Enfermería de Cuidados Intensivos y Urgencias.

In this study, the predictive power of hardy personality and generalized self-efficacy on general health perception was investigated in a sample of nursing personnel working in emergency and intensive care services. A cross-sectional retrospective design was used, and the following measurement instruments were applied: a sociodemographic and work questionnaire, Goldberg's GHQ-28 Health Questionnaire, the Baessler and Schwarzer General Self-efficacy Questionnaire, and the Hardy Personality Subscale of Moreno's Nursing Burnout Questionnaire (CDPE). The results revealed a positive and statistically significant relationship between the individual variables of generalized self-efficacy and hardy personality. A canonical correlation analysis carried out on the psychological distress symptoms with self-efficacy and hardy personality as predictor variables, led us to emphasize the relevance of the construct total hardy personality as a predictor and, consequently, as a protective factor against the onset of psychological distress symptoms in the sample of professionals studied. Lastly, the implications of the results for clinical practice are discussed.

Personalidad resistente, autoeficacia y estado general de salud en profesionales de Enfermería de cuidados intensivos y urgencias / Hardy personality, self-efficacy, and general health in nursing professionals of Intensive and Emergency Services

En este estudio se analiza la capacidad predictiva de la personalidad resistente y la autoeficacia generalizada sobre la percepción del estado general de salud en una muestra de profesionales de enfermería de Urgencias y Cuidados Intensivos. Se utilizó un diseño retrospectivo de corte transversal, empleando como instrumentos de medida un cuestionario de variables sociodemográficas y laborales, el cuestionario de salud GHQ-28 de Goldberg, la escala de autoeficacia generalizada de Baessler y Schwarzer, y la subescala de personalidad resistente del cuestionario de desgaste profesional en enfermería (CDPE) de Moreno. Los resultados ponen de manifiesto que las variables individuales de autoeficacia generalizada y personalidad resistente están estadísticamente relacionadas y en sentido positivo. El análisis de correlación canónica realizado sobre los síntomas de malestar psíquico tomando como predictores la autoeficacia y la personalidad resistente permite destacar la relevancia del constructo de personalidad resistente global como predictor y, por tanto, como factor protector frente a la aparición de malestar psíquico en la muestra de profesionales estudiados. Finalmente, se discuten las implicaciones clínicas de los resultados (AU)

In this study, the predictive power of hardy personality and generalized self-efficacy on general health perception was investigated in a sample of nursing personnel working in emergency and intensive care services. A cross-sectional retrospective design was used, and the following measurement instruments were applied: a sociodemographic and work questionnaire, Goldberg’s GHQ- 28 Health Questionnaire, the Baessler and Schwarzer General Self-efficacy Questionnaire, and the Hardy Personality Subscale of Moreno’s Nursing Burnout Questionnaire (CDPE). The results revealed a positive and statistically significant relationship between the individual variables of generalized self-efficacy and hardy personality. A canonical correlation analysis carried out on the psychological distress symptoms with self-efficacy and hardy personality as predictor variables, led us to emphasize the relevance of the construct total hardy personality as a predictor and, consequently, as a protective factor against the onset of psychological distress symptoms in the sample of professionals studied. Lastly, the implications of the results for clinical practice are discussed (AU)

La migración de la burbuja de aire postransferencia embrionaria es un evento al azar / Air bubble migration post embrionary tranferir is a random event

Demostrar que la migración de la burbuja de aire postransferencia embrionaria es un evento al azar que no depende de la posición del paciente. Estudio prospectivo multicéntrico. Se practicó transferencia embrionaria a 69 pacientes bajo guía ultrasonográfica. Se cargó el catéter de transferencia con una o dos burbujas junto con el medio conteniendo los embriones usando catéter de Frydman o catéter de Wallace y luego se les hizo seguimiento ecográfico en posición horizontal, 20-25 minutos más tarde y luego a los 90 minutos postransferencia en posición vertical para verificar movimiento y configuración de las burbujas. Centro Médico Docente La Trinidad, Caracas. Nortwestern University Feimberg School of medicine, Chicago, IL. EE.UU. En 50 (72,46 por ciento) de las pacientes se observó movimiento de las burbujas. En posición de pie se demostró una distribución al azar sin efecto visible de la gravedad. Las burbujas de aire se mueven y dividen frecuentemente posterior a la transferencia con la paciente en posición horizontal y de pie, lo que sugiere actividad contráctil uterina. No fue común observar movimiento de burbujas relacionada con la gravedad, lo que sugiere que el descanso horizontal postransferencia embrionaria puede ser innecesario.

To demonstrate that air bubble migration is a random event after embryo transfer regardless of the position of patient. Multicenter prospective study. Sixty nine embryo transfers were performed under ultrasound guidance. Transfer catheter was loaded with one or two air bubbles and medium containing embryos, either Wallace catheter or Frydman catheter were used, ultrasound tracking of air bubble was performed to verify movement and configuration inmediately, 20-25 minutes in horizontal position and 90 minutes on standing position after embryo transfer. Centro Medico Docente La Trinidad, Caracas. Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Movement was observed in 50 (72,46 percent) of the patients. Movement was not observed related to gravity while standing up. Air bubbles move and split frequently after embryo transfer with the patient in the horizontal position and on standing, suggestive of active uterine contractions. Gravity related bubble motion was uncommon, suggesting that horizontal rest post embryo transfer may be unnecessary.

Estudio clínico de la hipertensión arterial en 170 ancianos / Clinical study of arterial hypertension in 170 elderly patients

Se presentan los resultados de un estudio retrospectivo descriptivo realizado en 170 ancianos (An: 58 varones y 112 hembras) con hiper tensión arterial (HTA) egresados de un Servicio de Medicina Interna durante la década 1980-1989. Los An hipertensos representaron el 36,1 por ciento del total de egresados durante ese lapso. Los 170 An presentaron una edad promedio de 73 ñ 6,2 años (Amplitud: 65-96), con un tiempo de evolución aparente de la enfermedad de 121,9 meses (Amplitud: 3-480). La mayoría adultos mayores, hembras, ingresados por causas inherentes a la HTA. Forma usual de presentación: HTA sistodiastólica, siendo raras (2 por ciento ) las formas aceleradas o malignas. La variedad arterioesclerótica fue la más frecuente (81,5 por ciento ) y el compromiso cardiovásculocerebral y renal (CVC-R) la complicación y causa de muerte dominante. Se concluye en que la HTA no es un fenómeno normal en el paciente An y que debe ser tratada precozmente para reducir la alta morbiletalidad en este grupo etario