Bioethical knowledge in students and health professionals: a systematic review.

Introduction: Bioethics training is essential for healthcare professionals as it enables them to address ethical dilemmas in their clinical practice. However, there is still a lack of rigorous teaching programs, and assessing bioethical knowledge poses challenges. Methodology: Systematic review using the PRISMA method. Results: Analysis of 27 studies reveals a lack of ethical knowledge and skills among healthcare professionals and students. Specific training in bioethics is effective in developing bioethical competencies. Different approaches have been employed, including integrated training in academic curricula and intensive or ongoing programs. The results demonstrate improvements in knowledge, attitudes, and ethical values, although regularly updating these courses is recommended. Conclusion: Specific training, institutional support, and considering regional and disciplinary differences are necessary to enhance ethics in the practice of healthcare professionals. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023437146, identifier CRD42023437146.

Predictors of physical activity in older adults 65 years and older: findings in health survey of the Valencian Community.

Background: Physical activity is part of a healthy lifestyle in the older adult and is related to multiple variables that promote this behavior. Objective: To identify the relationship and predictive power of sociodemographic variables, multimorbidity, severity index, risk of poor mental health, social support, affective support and confidential support with the time devoted to physical activity in the population over 65 years of age in the Valencian Community. Methods: Cross-sectional descriptive analytical study of the data collected in the Health Survey of the Valencian Community on a total of 3,199 people over 65 years of age. The study variables were age, sex, educational level, marital status, social class, multimorbidity, severity index collected with the EQ-5D-5L tool, risk of poor mental health collected with the Goldberg general health questionnaire (GHQ-12), and perceived social, affective and confidential support collected with the Duke-Unc social support scale (Duke-UNC-11). Results: All variables, except affective support, are significantly related to the time of physical activity performed by people older than 65 years. The severity index has a predictive capacity of 13.7% of physical activity performed and age is able to predict 1.2% of this variable. Conclusion: Sex, age, education, social class, marital status, multimorbidity, risk of poor mental health or social support and confidentiality are related to the physical activity time of the Valencian population over 65 years of age. On the other hand, the variables severity index and age have been identified as variables capable of predicting up to 14.8% of the variance of the physical activity time variable in our study population.

The Promotion of Mental Health and Prevention of First-Episode Psychosis: A Pilot and Feasibility Non-Randomised Clinical Trial.

BACKGROUND: Mental-health-related stigma prevents active help seeking and therefore early therapeutic approaches and the recovery of functionality. National and international agencies recommend the implementation of prevention and mental health promotion programs that support the elimination of stigma in the classroom, since most mental health problems usually start in the adolescent stage. In view of the evidence that teachers present stigmatizing attitudes towards mental health, it has been considered as convenient to carry out an anti-stigma program with the main objective of evaluating the impact of an intervention based on the education and promotion of mental health, aimed at teachers and counsellors of a secondary school. The specific objectives were to get to know which were the most stigmatising attitudes that prevailed in the sample before and after the intervention; to evaluate the knowledge of the teaching staff and counsellors on psychosis before the intervention; to analyse correlations between clinically relevant variables; and assess whether this programme was beneficial and feasible for alphabetising counsellors/teachers of educational centres on stigma and FEP. METHODS: This was a non-randomised clinical trial in which a nursing intervention was performed. TOOLS: a psychosis test (pre), Stigma Attribution Questionnaire (AQ-27) (pre-post), and satisfaction survey (post) were used. The inferential analysis included the Wilcoxon and the Pearson Correlation Test. RESULTS: In the sample (n = 22), the predominant stigmatising attitude was "Help". The p-values obtained in the Wilcoxon Test were statistically significant, except for "Responsibility" and "Pity". The following constructs of interest were faced: "Fear"-"Age" and "Professional experience"; and "Help"-"Psychosis test". CONCLUSIONS: Despite the scores obtained in "Responsibility" and "Pity", the intervention was useful for reducing stigma in the sample. Implications for the profession: There are adolescents who have suffered stigma from their teachers, and consequently have minimized their symptoms and not asked for help. For this reason, we implemented a nursing intervention based on the education and promotion of mental health, with the aim of expanding knowledge and reducing stigma. In fact, this intervention, which we carried out on high school teachers, managed to reduce the majority of stigmatizing attitudes measured on the stigma attribution scale.

The Effect of Craniofacial Manual Lymphatic Drainage after Moderate Traumatic Brain Injury.

Previous studies suggest that craniofacial manual lymphatic drainage (MLD) facilitates brain fluids clearance, reducing intracranial pressure and reabsorbing chronic subdural hematoma. This study aimed to explore the effect of craniofacial MLD in combination with pharmacological treatment for improving cranial pain intensity, vital signs, and cerebral edema (Hounsfield units, HUs) in moderate traumatic brain injury (mTBI). Patient 1 received pharmacological therapy, while patient 2 received both pharmacological and craniocervical MLD treatment. Patient 2 showed decreased cranial pain intensity and systolic blood pressure (66%-11.11%, respectively) after two 30 min daily sessions of treatment for three days. HUs in the caudate nucleus of both hemispheres (left 24.64%-right 28.72%) and in the left temporal cortical gray matter increased (17.8%). An increase in HU suggests a reduction in cerebral edema and vice versa. For patient 1, there were no changes in cranial pain intensity, but a slight increase in the systolic blood pressure was observed (0%-3.27%, respectively). HUs decreased in the temporal cortical (14.98%) and caudate nucleus gray matter (9.77%) of the left and right cerebral hemispheres (11.96%-16.74%, respectively). This case study suggests that craniofacial MLD combined with pharmacological treatment could reduce cerebral edema, decrease head pain intensity, and maintain vital signs in normal physiologic values in patients with mTBI.

Modulating Elements of Nurse Resilience in Population Care during the COVID-19 Pandemic.

COVID-19 has significantly affected the work environment of nurses. In the face of the challenges posed by stressors in clinical practice, some nurses adapt and prove to be resilient. In the face of the COVID-19 pandemic, the nature of care itself and the new ways of working are potentially very stressful. We aim to analyze the resilience of care nurses to the psychological impact of the COVID-19 pandemic. This study is a systematic review of nurse caregiver resilience to the COVID-19 pandemic in 2021. Our search was conducted in the WOS, Medline/PubMed, Cochrane, BVS/LILACS, and Cuiden databases. The inclusion criteria were: studies published in Spanish or English; carried out from March 2020 to May 2021 on nurses caring for patients with COVID-19; and investigating the factors influencing the psychological impact, resilience, strategies to develop it, and interventions to promote it during this pandemic and others, such as SARS, MERS, or ebola. The quality of the studies and the risk of bias were evaluated following ICROMS, STROBE and AMSTAR-2 criteria. Twenty-two studies were selected. Most of the studies highlighted the presence of stressors in nurses, emphasizing those of the environment, which converged in dysfunctional responses that hurt their resilience. The most persuasive factors were social and organizational support. Coping strategies developed by nurses and especially interventions by organizations were detected as instruments to foster resilience, but have not been well researched. Resilience has a key moderating role in mitigating the psychological impact of nurses in the face of the COVID-19 pandemic.

Impact of Nurses' Intervention in the Prevention of Falls in Hospitalized Patients.

BACKGROUND: Clinical safety is a crucial component of healthcare quality, focused on identifying and avoiding the risks to which patients are exposed. Among the adverse events that occur in a hospital environment, falls have a large impact (1.9-10% of annual income in acute care hospitals); they can cause pain, damage, costs, and mistrust in the health system. Our objective was to assess the effect of an educational intervention aimed at hospital nurses (systematic assessment of the risk of falls) in reducing the incidence of falls. METHODS: this was a quasi-experimental study based on a sample of 581 patients in a third level hospital (Comunitat Valenciana, Spain). An educational program was given to the intervention group (n = 303), and a control group was included for comparison (n = 278). In the intervention group, the nurses participated in a training activity on the systematized assessment of the risk of falls. Analysis was undertaken using the Bayesian logistic regression model. RESULTS: a total of 581 patients were studied (50.6% male, 49.4% female), with an average age of 68.3 (DT = 9) years. The overall incidence of falls was 1.2% (0.3% in the intervention group and 2.2% in the control group). Most of the falls occurred in people ≥65 years old (85.7%). The intervention group had a lower probability of falling than the control group (OR: 0.127; IC95%: 0.013-0.821). Neither the length of hospital stay, nor the age of the participants, had any relevant effect. CONCLUSIONS: the systematic assessment of the risk of a patient falling during hospital processes is an effective intervention to reduce the incidence of falls.

Evaluación de la video-simulación como metodología docente para la entrevista motivacional en estudiantes de enfermería / Evaluation of the video-simulation as a teaching methodology for the motivational interview in nursing students / Avaliação de um vídeo-simulação como metodologia de ensino para a entrevista motivacional em estudantes de enfermagem

INTRODUCCIÓN: La Video-Simulación como herramienta pedagógica ha sido escasamente utilizada. Pretendemos evaluar la utilidad y la satisfacción con la metodología utilizada en el aprendizaje de entrevista motivacionales mediante VS. METODOLOGÍA: Estudio observacional descriptivo transversal (2015) con estudiantes de enfermería de 4. º curso de la Escuela de Enfermería La Fe (Valencia, España). Se diseñó un cuestionario Likert de 12 ítems. Se midieron las puntuaciones obtenidas, la fiabilidad, y se realizó un análisis factorial. RESULTADOS: La edad media fue 23,6 ± 4,5 años. Alfa de Cronbach de 0,91. El análisis factorial identificó dos dimensiones que explican el 32,4% y el 32,1% de la varianza (64,5% varianza total). El 70,6% de los estudiantes están bastante o totalmente de acuerdo con que la videosimulación les permite mejorar sustancialmente el aprendizaje CONCLUSIONES: Los estudiantes mostraron un alto nivel de satisfacción con este método de aprendizaje, que consideran útil para mejorar las habilidades en entrevista motivacional

INTRODUCTION: The Video-Simulation how a new pedagogical method has been scarcely used. We pretend to evaluate the utility and satisfaction with methodology used in the learning of the motivational interview technique through video-simulation. METHOD: A descriptive cross-sectional study (2015) in students of 4 th nursing course of Nursing School La Fe (Valencia, España). The scores obtained were measured, and the reliability of the questionnaire (Cronbach Alfa), through a factorial analysis. RESULTS: Average age=23.6 ± 4.5 years. Cronbach Alpha = 0.91. The factorial analysis identified two dimensions explaining 32.4% and 32.1% of the variance (64.5% total variance).70.6% of the students are quite or totally in agreement with the fact that the video-simulation allows them to improve substantially the learning. CONCLUSIONS: Students showed a high level of satisfaction with the learning methodology implemented. It is an effective learning method, that they consider useful to improve the skills in motivational interviewing

INTRODUÇÃO: A Vídeo-Simulação como método e ferramenta pedagógica tem sido pouco utilizada. Pretendemos avaliar a utilitário, satisfação e metodología utilizada na aprendizagem da entrevista motivacional a través da video-simulação. METODOLOGIA: Estudo descritivo de corte transversal (2015) em escolares do 4. º curso enfermagem do Escola Enfermagem La Fe (Valencia, España). Realizou-se um questionário de Likert de 12 itens. Os resultados obtidos foram mensurados assim como a confiabilidade do questionário (Cronbach Alfa), através de uma análise fatorial. RESULTADOS: A idade média foi de 23,6 ± 4,5 anos. Alfa de Cronbach de 0,91. A análise fatorial identificou duas dimensões que explicam 32,4% e 32,1% da variância (64,5% da variância total).70,6% dos alunos estão totalmente ou totalmente de acordo com o fato de que a videoimulação permite que eles melhorem substancialmente sua aprendizagem. CONCLUSÕES: Os estudantes mostraram um alto nível de satisfação com o método de aprendizagem implementado, que eles consideram útil para melhorar as habilidades em entrevistas motivacionais

La importancia del desarrollo académico de postgrado en la mejora profesional enfermera: Másteres y doctorados / The importance of academic development for nurses' professional advancement: masters and phd

Los aspectos formativos son esenciales para el desarrollo de cualquier disciplina. La ciencia enfermera ha vivido cambios profundos y positivos en su historia más reciente, que han culminado con su conversión académica en título de grado y la posibilidad de acceder a estudios superiores de segundo y tercer ciclos (másteres y doctorados). Analizamos en nuestro estudio la situación actual de la formación superior en Enfermería reflexionando sobre los antecedentes. El nivel académico y formativo de las enfermeras se ha mostrado como un elemento clave en aspectos básicos para los servicios sanitarios, como son la mejora de la seguridad del paciente y los resultados en salud (disminución de la mortalidad hospitalaria, menos eventos no deseados como errores de medicación, caídas, úlceras por presión...), y una mejora global de la calidad del cuidado. Además, ello está repercutiendo en el protagonismo social que las enfermeras están adquiriendo. Por ello, el acceso al desarrollo académico superior de las enfermeras a través de másteres (profesionalizantes o investigadores) o programas de doctorado, además de contribuir a desarrollar la disciplina, mejora el cuidado y permite la asunción de nuevas responsabilidades y roles avanzados, que son no solo de mayor calidad, sino también más eficientes para el sistema, que debe fomentar y facilitar la formación de sus enfermeras

Training aspects are essential for the development of any discipline. The nursing science has undergone profound and positive changes in its most recent history, which have culminated with its academic development into a Bachelor's degree, with the possibility of accessing Nursing Master's and PhD's. In our study, we analyzed the real situation of higher Nursing education, reflecting on its background. It's proven that the academic and training level of nurses is key for the success of Health Services, including: the improvement of patient safety and health outcomes (decrease in hospital mortality, less unwanted events such as medication errors, falls, pressure ulcers), and a global improvement in the quality of care. This has a double-pronged impact, reflected on nurses' acquired social role and recognition. Access to higher academic development through Masters (focused both on specialization or research) and/or PhD programs, in addition to contributing to the discipline's development, improves care and allows for the unfolding of new responsibilities and advanced roles. Highly trained nurses don't only display a higher professional quality, but are also more efficient for the system, which should in return encourage and facilitate the training of its nurses

[Population impact of nurses in care interventions chronicity in Spain. Systematic review]. / Impacto de las intervenciones enfermeras en la atención a la cronicidad en España. Revisión sistemática.

BACKGROUND: Epidemiological projections for the coming decades suggest that most chronic diseases will increase its prevalence. Different models of care have been developed to meet the challenge of chronicity; all implemented initiatives point to primary health care and especially the community nurse as the guarantors of chronic patient care, family and community. However, health policies do not endorse facts. The objective of this review was to evaluate the impact of different nursing interventions in the care strategy to chronicity in Spain. METHODS: Systematic review of the literature on the nurse contribution to address the chronicity in adult patients in Spain. The search was carried out in Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME and CUIDEN, databases. Inclusion criteria: written articles in Castilian and English published between 2007 and 2016 involving patients with chronic disease in all their life stages. The quality of the studies was assessed following Prisma criteria and the CEBM levels of evidence and recommendation. RESULTS: The Nursing interventions with the highest impact on the strategy of chronicity care in Spain were cases management and advanced nursing practice (50%), the home-care program offered from Primary Care (41,7%) and Telemonitoring intervention (8,3%). CONCLUSIONS: Nurses interventions have shown favorable results in effectiveness and satisfaction more studies that demonstrate the efficiency of the nurse contribution to the chronicity are needed.

OBJETIVO: Las proyecciones epidemiológicas para las próximas décadas sugieren que la mayor parte de las patologías crónicas incrementarán su prevalencia. Se han desarrollado diferentes modelos de atención para afrontar el reto que supone la cronicidad; todas las iniciativas implementadas señalan a la atención primaria de salud y especialmente a la enfermera comunitaria como los garantes de la atención al paciente crónico, su familia y la comunidad, si bien las políticas sanitarias no lo refrendan. El objetivo de esta revisión fue evaluar el impacto de las distintas intervenciones enfermeras incluidas en la estrategia de atención a la cronicidad en España. METODOS: Revisión sistemática de la literatura sobre la aportación enfermera en la atención a la cronicidad en pacientes adultos en España. La búsqueda se realizó en las bases de datos Medline / Pubmed, Cochrane, EMBASE, LILACS, CINAHL, IME y CUIDEN. Criterios de inclusión: artículos escritos en castellano e inglés publicados entre 2007-2016, que incluyesen pacientes con enfermedad crónica en todas las etapas del ciclo vital. Se evaluó la calidad de los estudios siguiendo los criterios Prisma y los niveles de evidencia y recomendación CEBM. RESULTADOS: Las intervenciones enfermeras de mayor impacto en la estrategia de atención a la cronicidad en España fueron la gestión de casos y la práctica avanzada (50%), los programas de atención domiciliaria desde atención primaria (41,7%) y la telemonitorización (8,3%). CONCLUSIONES: Las intervenciones enfermeras demuestran resultados favorables en efectividad y satisfacción. Se necesitan más estudios que evidencien la eficiencia de la aportación enfermera en la cronicidad.

A propósito de la ética, la mala conducta científica y la honestidad en las publicaciones científicas / Speaking of ethics, scientific misconduct and honesty in the scientific literature

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[Evaluation of a new infusion kit. A study of cases and controls]. / Evaluación de un nuevo equipo de infusión. Un estudio de casos y controles.

Since prevention and control of hospital-generated infections comprises one of the priorities in today's hospitals, the authors analyze how two infusion kits function; one kit is the classical version normally used in the hospital where this study took place and the other is a new kit which incorporates a security system. After carrying out a statistical and cost analysis, the authors conclude that the new perfusion system is cost effective, providing, among other factors, a savings of 62.083 Euro per hospitalized patient.

Evaluación de un nuevo equipo de infusión. Un estudio de casos y controles / Evaluation of a new infusion kit: a study of cases and controls

Puesto que la prevención y control de la infección hospitalaria constituye una de las prioridades de los hospitales actuales, se analiza el funcionamiento de dos tipos de equipos de infusión: el clásico, utilizado normalmente en el hospital donde se desarrolla el estudio, y uno nuevo que incorpora un sistema de seguridad. Tras efectuar un análisis estadístico y de costes se concluye que el nuevo sistema de perfusión resulta coste-efectivo, consiguiendo -entre otros elementos- un ahorro por paciente hospitalizado de 62,083 €(AU)

Since prevention and control of hospital-generated infections comprises one of the priorities in today's hospitals, the authors analyze how two infusion kits function; one kit is the classical version normally used in the hospital where this study took place and the other is a new kit which incorporates a security system. After carrying out a statistical and cost analysis, the authors conclude that the new perfusion system is cost effective, providing, among other factors, a savings of 62.083 € per hospitalized patient(AU)

Reflexiones acerca de la informatización del proceso de atención de enfermería / Reflections on the computerization of the nursing care process

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Enfermería en Atención Primaria: nuestra responsabilidad con la población (experiencia del área 9) / Nursing in Primary Health Care: our responsability with the population (Experience of area 9)

La incorporación de distintos profesionales en los equipos de Atención Primaria de salud en España hace necesaria la definición de la aportación específica de cada uno en la mejora de los servicios a la población. Esta definición en enfermería no ha sido homogénea, encontrándonos distintas situaciones dependiendo del equipo o área de salud. En el área 9 de Atención Primaria de Madrid se inició una experiencia de Gestión por procesos como forma de conseguir la mejora en los servicios ofrecidos por las enfermeras. Tras una autoevaluación se definió la misión, visión y valores de la organización para enfermería. Posteriormente, y compatible con la cartera de servicios del INSALUD, se ha elaborado un listado de procesos/responsabilidades de enfermería agrupados en 4 niveles de intervención: procedimientos técnicos básicos, conductas generadoras de salud/actividades preventivas, promoción del autocuidado y seguimiento y control de problemas de afrontamiento y adaptación. Estos niveles de intervención y procesos de enfermería se relacionan, mediante un esquema, con los servicios del EAP y con las clasificaciones NANDA, NIC y NOC de diagnósticos, intervenciones y resultados de enfermería. Para el conjunto de procesos se han establecido unos diagramas de flujo que muestran las relaciones entre cada uno de los distintos niveles de intervención. Además cada proceso tiene definidos sus criterios de inclusión, lo que permite la medición. El modelo propuesto permite definir la responsabilidad propia de enfermería, desarrollar un sistema de medición del desempeño, lo que redunda en una mejor rentabilidad para el conjunto de la organización. Para su puesta en marcha es necesario el esfuerzo de médicos, directivos, universidades y de las propias enfermeras y enfermeros