The experiences of family members of persons with intellectual disabilities who used residential care homes during the COVID-19 pandemic.

BACKGROUND: The global COVID-19 pandemic has shown the vulnerability of some population groups, including persons with intellectual and developmental disabilities (IDD). AIM: The present paper will provide more clarity and understanding of the experiences of family members of persons with IDD housed in residential facilities in Catalonia within the period of maximum restrictions during the COVID-19 pandemic. METHODS AND PROCEDURES: Semi-structured interviews were conducted using an interpretive phenomenological qualitative approach. Study participants consisted of 14 relatives of IDD individuals who were institutionalized in residence facilities or homes. The guiding questions emerged from group discussions with relatives of those with IDD who did not participate in the subsequent interviews. Drawing from this group, the factors that were identified to have had the greatest impact on their lives were later used to guide the interviews. Data collection was carried out in face-to-face individual interviews that were recorded together with the observations of two researchers between February and October 2022. RESULTS: Our analysis identified 4 main themes that developed into additional factors: the decision to stay at home or in the residence, fear, illness, and protocol. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. CONCLUSION: The results of this study allow for a better understanding of the experiences of families of persons with IDD in residential centres during the lockdown by identifying their needs and how to better support them in the future. OUTCOMES AND RESULTS: Knowledge and understanding of these events should allow for better management of similar situations in the future.

This study contributes to a growing body of research that examines the experiences of IDD individuals and their families during the early months of the COVID-19 pandemic. A qualitative phenomenological interpretative approach was used following the recommendations of qualitative research practices in health care. Our findings reveal that relatives of persons with IDD who lived in residential care homes felt that the residents were not adequately cared for by the staff, who applied measures for containment and contagion prevention that were disproportionate, resulting in their needs not being considered; these recommended measures had been developed for elderly care homes. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. The present findings show that residential care homes for persons with IDD require specific action protocols in crisis situations that are adapted to the needs and characteristics of each centre,thus adopting a model of care based on human rights.

Análisis de las complicaciones del acceso vascular en hemodiálisis. Una revisión sistemática / Analysis of complications of vascular access in hemodialysis: A systematic review

Introducción:El acceso vascular sigue siendo uno de los retos más importantes en todas las unidades de diálisis, por todas las complicaciones derivadas de su uso y el gran impacto en la mor-bimortalidad del enfermo renal. Los tres tipos de acceso vascu-lar más utilizados son la fístula arteriovenosa nativa, el injerto o fístula arteriovenosa protésica y el catéter venoso central. Objetivo: Analizar y evaluar la situación actual y la incidencia de las complicaciones relacionadas con los diferentes accesos vasculares en hemodiálisis. Metodología: Se realizó una revisión sistemática en las bases de datos PubMed, CINAHL, SCOPUS y SciELO. Se incluyeron todos los artículos originales de menos de 5 años de antigüe-dad en los que uno de sus objetivos fuera analizar la preva-lencia o incidencia de las complicaciones de cualquier acceso vascular en hemodiálisis en población adulta. Resultados: El número de artículos para el análisis fueron 15. De ellos, 14 fueron estudios observacionales y uno, un ensa-yo clínico multicéntrico. Se analizaron datos demográficos de los pacientes, la prevalencia de complicaciones entre todos los accesos vasculares y la incidencia de complicaciones se-gún fístula nativa/protésica/catéter venoso central.Conclusiones: La fístula arteriovenosa nativa es el acceso vas-cular de elección ya que tiene tasas de complicaciones muy bajas. De entre ellas, la trombosis, es la complicación con más incidencia. El uso de catéter venoso central todavía es muy habitual, pese a ser el acceso vascular que presenta mayores tasas de complicaciones como las infecciones y la bacteriemia, produciéndose en un 10%-17% de los pacientes portadores.(AU)

Introduction: Vascular access remains one of the most important challenges in all dialysis units due to the complications associated with its use and its significant impact on the morbidity and mortality of renal patients. The three most used types of vascular access are native arteriovenous fistula, graft or prosthetic arteriovenous fistula, and central venous catheter. Objective: To analyze and evaluate the current situation and incidence of complications related to different vascular accesses in hemodialysis. Methodology : A systematic review was conducted using the PubMed, CINAHL, SCOPUS, and SciELO databases. All original articles published within the last 5 years that aimed to analyze the prevalence or incidence of complications related to any vascular access in hemodialysis in the adult population were included. Results: A total of 15 articles were included for analysis. Among them, 14 were observational studies, and one was a multicenter clinical trial. Demographic data of the patients, the prevalence of complications across all vascular accesses, and the incidence of complications for native fistula/prosthetic fistula/central venous catheter were analyzed. Conclusions: Native arteriovenous fistula is the preferred vascular access due to its very low complication rates. Among the complications, thrombosis has the highest incidence. The use of central venous catheters is still common, despite having higher rates of complications such as infections and bacteremia, occurring in 10%-17% of the patients.(AU)

mHealth to Improve Experience, Adherence to Pharmacological Treatment, and Positive Mental Health in Patients Diagnosed With Femur Fractures: Protocol for a Quasi-Experimental Study.

BACKGROUND: Considering the prognosis of femur fractures worldwide, the ageing of our society, and the problems in adherence to treatment found in these patients, it is believed that mobile health can have a positive impact on the process and quality of care. OBJECTIVE: We aim to evaluate the effectiveness of a pharmacological educational nurse intervention with Myplan app with regard to knowledge, adherence to pharmacological treatment, and positive mental health of patients with femur fractures. METHODS: A nonrandomized, quasi-experimental study will be carried out with a pretest-posttest control group. It will include 278 older patients diagnosed with femur fractures, with a Glasgow Coma Scale of 15 and access to mobile devices. Patients with psychological pathologies and cognitive impairment or patients treated in isolation will be excluded. Study variables are as follows: sociodemographic variables (AdHoc Form), patient experience (Patient Experience Questionnaire-15), adherence to pharmacological treatment (Morisky-Green questionnaire), and positive mental health (Positive Mental Health questionnaire). The measurements will be taken 24 hours after admission, upon discharge, and 25 days after discharge. RESULTS: Enrollment commenced in October 2022. Data collection will be completed in April 2023. CONCLUSIONS: The results of this study will offer evidence of the effectiveness of a pharmacological educational nurse intervention by means of a free smartphone app. If its efficacy is demonstrated and the results are acceptable, it could mean an improvement in the care of patients with femur fractures, and this technology could be used to guide other training interventions in patients with other pathologies. TRIAL REGISTRATION: ClinicalTrials.gov NCTT05669040; https://clinicaltrials.gov/ct2/show/NCTT05669040. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/45856.

Diseño y validación de una aplicación móvil para fomentar la salud mental positiva de los cuidadores no profesionales / Design and validation of a mobile application to promote positive mental health in non-professional caregivers

Objetivo: Diseñar y validar una aplicación móvil para fomentar la salud mental positiva y reducir la sobrecarga de los cuidadores no profesionales de personas con enfermedades crónicas.Métodos: Estudio realizado en dos fases. Fase I: Elaboración e implementación del programa de salud móvil “TIVA” en la app “Cuidadoras crónicos” con la participación de un equipo multidisciplinar. Fase II: Validación de contenido de la app con 26 cuidadores no profesionales de las provincias de Tarragona y Barcelona. En la fase I se calculó el Índice de Validez de Contenido según MR Lynn y en la fase II los cuestionarios de usabilidad y satisfacción auto administrados después de la intervención.Resultados: Se diseñaron 20 actividades generadoras de salud mental positiva, el personaje de la app, un sistema de recompensa mediante puntuaciones y se incluyeron 28 frases motivadoras. En usabilidad destacó que la app está bien adaptada a la mayoría de dispositivos móviles (88,5%), todos los cuidadores afirmaron que la app es de navegación rápida y los colores, el tamaño del texto y botones facilitaron su uso. Y en satisfacción, el 61,5% declararon que las actividades eran fáciles, el 92,3% que el personaje de la app facilitó la adherencia al programa y el 61,5% ampliarían el tiempo de la intervención.Conclusiones: Promover la investigación de intervenciones mHealth en el ámbito de la atención primaria para los cuidadores, ayudará a generar nuevos recursos que podrán tener un impacto significativo en mejorar la salud emocional y reducir la sobrecarga de este colectivo. (AU)

Objective: Design and validate a mobile application to promote positive mental health and reduce the burden of non-professional caregivers of people with chronic diseasesMethods: Study carried out in two phases. Phase I: Preparation and implementation of the mobile health program «TIVA» in the app «Chronic Caregivers» with the participation of a multidisciplinary team. Phase II: Validation of the content of the app with 26 non-professional caregivers from the provinces of Tarragona and Barcelona. In phase I the Content Validity Index was calculated according to MR Lynn and in phase II the self-administered usability and satisfaction questionnaires after the intervention.Results: 20 positive mental health generating activities were designed, the character of the app, a reward system through scores and 28 motivational phrases were included. In terms of usability, he highlighted that the app is well adapted to the majority of mobile devices (88.5%), all the caregivers affirmed that the app is fast navigating and the colors, the size of the text and buttons facilitated its use. And in satisfaction, 61.5% declared that the activities were easy, 92.3% that the character of the app facilitated adherence to the program and 61.5% would extend the time of the intervention.Conclusions: Promoting research on mHealth interventions in the primary care setting, aimed at caregivers, will help generate new resources that may have a significant impact on improving emotional health and reducing the burden on this group. (AU)

Nursing Intervention to Improve Positive Mental Health and Self-Care Skills in People with Chronic Physical Health Conditions.

The exponential increase in the number of people suffering chronic illness has become a problem for which healthcare services need a response. The inclusion of self-care and positive mental health as part of a strategy to promote health offers an opportunity for a reorganization oriented towards community spaces and group interventions. This study undertook the assessment of an intervention designed to optimize the agency of and capacity for self-care and positive mental health by utilizing activities drawn from the Nursing Intervention Classification (NIC), specifically from Field 3 (Behavioral), and organized as a program called PIPsE. A quasi-experimental design was prepared with an intervention group (n = 22) and a control group (n = 22), in a primary care center in the Barcelona metropolitan area. The instruments used were two ad hoc questionnaires to collect sociodemographic and satisfaction information and two scales: the Appraisal of Self-care Agency Scale (ASA) and the Positive Mental Health Questionnaire (PMHQ). The results obtained showed a significant increase in self-care capacity and both overall positive mental health and mental health by factors in the intervention group.

Effectiveness of the Online "Dialogue Circles" Nursing Intervention to Increase Positive Mental Health and Reduce the Burden of Caregivers of Patients with Complex Chronic Conditions. Randomized Clinical Trial.

The personal demands involved in caring for a chronically ill person can lead to emotional and physical exhaustion in caregivers. The aim of this study was to evaluate the effectiveness of an online nursing intervention called "dialogue circles" designed to reduce caregiver overload and enhance positive mental health (PMH) in family caregivers. We used a pre-post design. The sample consisted of 86 family caregivers of patients with complex chronic conditions, randomly assigned to the intervention group (n = 43) or the control group (n = 43). All participants completed the Zarit scale and the Positive Mental Health Questionnaire 15 days before starting the intervention and 30 days after its completion. Comparison of the post-test changes revealed statistically significant differences between the two groups in PMH and overload, with the intervention group showing greater positive changes in all dimensions of PMH after the intervention and lower scores on overload. In conclusion, the results suggest that incorporating dialogue circles as an online nursing intervention in the caregivers of patients with complex chronic conditions can enhance PMH and decrease caregiver overload, especially in settings where face-to-face encounters are not possible.