Enfermeria Clinica最新文献_第8页

Cuidados enfermeros frente al reto planetario de la crisis climática: si no ahora, ¿cuándo? 护理面对全球气候危机的挑战:如果不是现在，什么时候?

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-07-01 DOI: 10.1016/j.enfcli.2023.05.001

Enrique Castro-Sánchez

引用次数: 0

Resultados neonatales tras parto en el agua: Estudio de cohortes retrospectivo 水中分娩后新生儿结局的回顾性队列研究

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-07-01 DOI: 10.1016/j.enfcli.2023.05.005

Susana Iglesias-Casas , María Reyes Pérez-Fernández , María Sol Montenegro-Alonso , María Esther Parada-Cabaleiro , Lorena Sanmartín-Freitas , Desirée Mena-Tudela

Objective

To compare neonatal outcomes between water births, births with immersion only during labour, and births in which immersion was never used.

Methods

A retrospective cohort study was performed including mother-baby dyads attended between 2009 and 2019 at the Hospital do Salnés regional hospital (Pontevedra, Spain). These women were categorised into 3 groups: water birth; immersion only during dilation; and women who never used immersion. Several sociodemographic-obstetric variables were studied and the main outcome was the admission of the neonate to the intensive care unit (NICU). Permission was obtained from the responsible provincial ethics committee. Descriptive statistics were used and between-group comparisons were performed using variance for continuous variables and chi-square for categorical variables. Multivariate analysis was performed with backward stepwise logistic regression and incidence risk ratios with 95%CI were calculated for each independent variable. Data were analysed using IBM SPSS® statistical software.

Results

A total of 1,191 cases were included. 404 births without immersions; 397 immersions only during the first stage of labor; and 390 waterbirths were included. No differences were found in the need to transfer new-borns to a NICU (P = .735). In the waterbirth cohort, neonatal resuscitation (P < .001, OR: 0,1), as well as respiratory distress (P = .005 OR: 0,2) or neonatal problems during admission (P < .001, OR: 0,2), were lower. In the immersion only during labor cohort, less neonatal resuscitation (P =.003; OR: 0,4) and respiratory distress (P = .019; OR: 0,4) were found. The probability of not breastfeeding upon discharge was higher for the land birth cohort (P < .001, OR: 0,4;).

Conclusions

The results of this study indicated that water birth did not influence the need for NICU admission, but was associated with fewer adverse neonatal outcomes, such as resuscitation, respiratory distress, or problems during admission.

目的比较水中分娩、产程中仅浸泡分娩和未浸泡分娩的新生儿结局。方法回顾性队列研究包括2009年至2019年在西班牙Pontevedra的saln地区医院就诊的母婴。这些妇女被分为三组:水中分娩;仅在扩张时浸泡;还有从不浸泡的女性。研究了几个社会人口统计学-产科变量，主要结果是新生儿入住重症监护病房(NICU)。获得了省级伦理委员会的许可。采用描述性统计，连续变量采用方差，分类变量采用卡方进行组间比较。采用后向逐步logistic回归进行多变量分析，计算每个自变量95%CI的发病率风险比。采用IBM SPSS®统计软件对数据进行分析。结果共纳入1191例。404例未浸泡分娩;仅在产程第一阶段进行397次浸泡;其中包括390例水中分娩。在需要将新生儿转移到NICU方面没有发现差异(P = .735)。在水中分娩队列中，新生儿复苏(P <.001, OR: 0,1)，以及入院时呼吸窘迫(P = 0.005 OR: 0,2)或新生儿问题(P <.001, OR: 0,2)，较低。在仅浸泡分娩队列中，新生儿复苏较少(P = 0.003;OR: 0,4)和呼吸窘迫(P = 0.019;OR: 0,4)被发现。在陆地出生队列中，出院后不母乳喂养的概率更高(P <.001，或:0,4;)。结论:本研究结果表明，水中分娩不影响新生儿入住NICU的需要，但与较少的新生儿不良结局相关，如复苏、呼吸窘迫或入院时出现的问题。

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引用次数: 0

Influence of educational intervention on nurse-midwives' knowledge and management practices of Intimate Partner Violence (IPV) in healthcare Facilities in Ekiti-State, Nigeria. 教育干预对尼日利亚埃基蒂州医疗机构中护士-助产士关于亲密伴侣暴力(IPV)的知识和管理做法的影响

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-07-01 DOI: 10.1016/j.enfcli.2023.05.006

T. O. Bamigboye, O. Irinoye, E. O. Ayandiran, A. Olowokere, O. Adedeji, D. Esan

引用次数: 0

¿Restricción, rutina o personalización de los fluidos? Una perspectiva para enfermería 流体的限制、常规或个性化？护理展望

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-07-01 DOI: 10.1016/j.enfcli.2023.05.002

Raquel Ferrero-Franco , Alejandro González-Castro , Carmen Blanco Huelga

引用次数: 0

Valoración clínica y funcional de pacientes ingresados pluripatológicos con disfagia según el modo de alimentación: a través de una sonda de gastrostomía o vía oral 根据进食方式入院的多病性吞咽困难患者的临床和功能评估:通过胃造口管或口服

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-07-01 DOI: 10.1016/j.enfcli.2023.05.003

Cristina López-Muñoz , Marta Aranda-Gallardo , Francisco Rivas-Ruiz , Ana Belén Moya-Suárez , José Miguel Morales-Asencio , José Carlos Canca-Sanchez

Introduction

Multipathological patients are a vulnerable population with high comorbidity, functional impairment, and nutritional risk. Almost 50% of these hospitalized patients have dysphagia. There is no consensus on whether placement of a percutaneous endoscopic gastrostomy (PEG) tube provides greater clinical benefit. The purpose of this study was to know and compare 2 groups of multipathological patients with dysphagia according to the mode of feeding: PEG vs. oral.

Method

Retrospective descriptive study with hospitalized patients (2016-19), pluripathological, with dysphagia, nutritional risk, over 50 years with diagnoses of: dementia, cerebrovascular accident (CVA), neurological disease, or oropharyngeal neoplasia. Terminally ill patients with jejunostomy tube or parenteral nutrition were excluded. Sociodemographic variables, clinical situation, and comorbidities were evaluated. Bivariate analysis was performed to compare both groups according to their diet, establishing a significance level of P<.05.

Results

1928 multipathological patients. The PEG group consisted of 84 patients (n=122). A total of 84 were randomly selected to form the non-PEG group (n_434). This group had less history of bronchoaspiration/pneumonia (P=.008), its main diagnosis was stroke versus dementia in the PEG group (P<.001). Both groups had more than a 45% risk of comorbidity (P=.77).

Conclusions

Multipathological patients with dysphagia with PEG usually have dementia as their main diagnosis, however, stroke is the most relevant pathology in those fed orally. Both groups have associated risk factors, high comorbidity, and dependence. This causes their vital prognosis to be limited regardless of the mode of feeding.

多病理患者是易患人群，具有较高的合并症、功能障碍和营养风险。几乎50%的住院患者有吞咽困难。关于放置经皮内镜胃造口术(PEG)管是否能提供更大的临床效益尚无共识。本研究的目的是了解并比较两组多病理吞咽困难患者的喂养方式:PEG与口服。方法回顾性描述性研究2016- 2019年住院的多病理、吞咽困难、营养风险、50岁以上诊断为痴呆、脑血管意外(CVA)、神经系统疾病或口咽肿瘤的患者。绝症患者排除空肠造口管或肠外营养。评估社会人口学变量、临床情况和合并症。采用双因素分析比较各组的饮食差异，显著性水平为P< 0.05。结果1928例多病理患者。PEG组84例(n=122)。随机抽取84只，组成非peg组(n_434)。该组支气管吸入性肺炎病史较少(P= 0.008)， PEG组的主要诊断为卒中而非痴呆(P= 0.008)。两组共病风险均大于45% (P= 0.77)。结论多病理合并PEG的吞咽困难患者多以痴呆为主要诊断，而口服吞咽困难患者以卒中为最相关病理。两组都有相关的危险因素，高合并症和依赖性。这导致它们的生命预后受到限制，无论喂养方式如何。

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引用次数: 0

Perfil sociodemográfico y descripción del síntoma de presentación en mujeres con cáncer de mama en un estudio de base poblacional: implicaciones y papel de las enfermeras 在一项基于人群的研究中，乳腺癌妇女的社会人口概况和症状描述：护士的含义和作用

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-07-01 DOI: 10.1016/j.enfcli.2023.02.004

Maria Angustias Diaz-Santos , Alba Marcos-Delgado , Pilar Amiano , Eva Ardanaz , Marina Pollán , Juan Alguacil , en nombre del equipo de investigadores del estudio MCC-SPAIN

Objective

To describe the frequency and typology of the presenting symptom of women diagnosed of breast cancer in Spain and their socio-demographic profile.

Methods

Descriptive study nested in a population epidemiological study (MCC-SPAIN) in 10 Spanish provinces. Between 2008 and 2012, 836 histologically confirmed incident cases of breast cancer were recruited who reported some symptom prior to diagnosis in a direct computerized interview. For the comparison of 2 discrete variables, the Pearson Chi square test was used.

Results

The most frequent presenting symptom among women who reported at least one symptom was noticing a «lump in the breast» (73%), followed far behind by noticing «changes in the breast» (11%). The frequency of the presenting symptom showed some geographic heterogeneity as well as with menopausal status. No association was observed between the type of presenting symptom and the rest of the sociodemographic variables explored, except for the educational level in which women with a higher educational level tended to proportionally report other symptoms different from the «lump in the breast» more frequently than less educated. Postmenopausal women reported noticing changes in the breast (13%) more frequently than premenopausal women (8%), although without reaching statistical significance (P = .056).

Conclusions

The most frequent presenting symptom is «breast lump», followed by «breast changes». There could be sociodemographic heterogeneity in the type of presenting symptom to be taken into account by nurses in their socio-sanitary interventions.

目的了解西班牙女性乳腺癌的发病频率和类型，以及她们的社会人口特征。方法采用西班牙10个省的人口流行病学调查(MCC-SPAIN)进行描述性研究。在2008年至2012年期间，836例组织学证实的乳腺癌病例被招募，这些病例在诊断前通过直接计算机访问报告了一些症状。对于两个离散变量的比较，使用皮尔逊卡方检验。结果在报告至少一种症状的女性中，最常见的症状是“乳房肿块”(73%)，其次是“乳房变化”(11%)。出现症状的频率表现出一定的地理异质性以及绝经状态。除了受教育程度外，未观察到出现症状的类型与所探索的其他社会人口学变量之间存在关联，受教育程度较高的妇女比受教育程度较低的妇女更倾向于按比例报告与“乳房肿块”不同的其他症状。绝经后妇女报告注意到乳房的变化(13%)比绝经前妇女(8%)更频繁，尽管没有达到统计学意义(P = 0.056)。结论最常见的临床表现是“乳房肿块”，其次是“乳房变化”。在护士的社会卫生干预措施中，可能会考虑到出现症状类型的社会人口统计学异质性。

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引用次数: 0

Ansiedad y miedo ante la muerte en los profesionales sanitarios de los servicios de urgencias hospitalarios en Aragón 阿拉贡医院急诊服务的卫生专业人员对死亡的焦虑和恐惧

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-07-01 DOI: 10.1016/j.enfcli.2023.03.002

Daniel Vázquez-García , Marisa de-la-Rica-Escuín , Concepción Germán-Bes , Ana-Luisa Caballero-Navarro

Objectives

To describe the levels of anxiety in the face of death in professionals from emergency hospital services of Aragon. To analyze its association with sociodemographic, perception and labor variables.

Methodology

Observational, descriptive and cross-sectional study. Population and context of the study were health professionals of the hospital emergency services of Aragon. A non-probabilistic sampling selection was applied (n = 230 participants). The “Collet-Lester-Fear-of-Death-Scale” instrument was introduced to measure death anxiety. The data was collected with a self-applied telematic questionnaire. Descriptive and inferential statistics were performed to analyze the association between the study variables.

Results

Anxiety in the face of death mean values of 94,58 ± 21,66 with 95% CI: (91,76-97,39) (scale range: 28-140 points) were obtained. A significant association was obtained with the variables professional category (physicians, medical residents, nurses, and nursing assistants) (p: 0,006), sex (p: 0,001), level of training in emotional self-management (p: 0,03), self-perceived level of mental health (p: 0,07) and perception of lack of support from palliative care/mental health professionals (p: 0,006). This association was not obtained with the variables age (Sig.: 0.558), total professional experience (p: 0.762) and in emergencies (p: 0.191).

Conclusion

The levels of anxiety in the face of death in the emergency hospital services are lower than those presented in other hospital units. Variables such as professional category, degree of training in emotional self-management and self-perceived level of mental health are related to levels of anxiety in the face of death and their study requires further work.

目的了解阿拉贡急救医院专业人员面对死亡时的焦虑程度。分析其与社会人口学、认知和劳动变量的关系。方法:观察性、描述性和横断面研究。研究对象为阿拉贡医院急诊服务的卫生专业人员。采用非概率抽样选择(n = 230名参与者)。采用“Collet-Lester-Fear-of-Death-Scale”量表测量死亡焦虑。数据是通过自行应用的远程信息处理问卷收集的。采用描述性统计和推理统计来分析研究变量之间的相关性。结果获得的死亡焦虑均值为94,58±21,66,95% CI为(91,76 ~ 97,39)(量表范围:28 ~ 140分)。与专业类别(医生、住院医师、护士和护理助理)(p: 0,006)、性别(p: 0,001)、情绪自我管理培训水平(p: 0,03)、自我感知的心理健康水平(p: 0,07)和对缺乏姑息治疗/心理健康专业人员支持的感知(p: 0,006)存在显著关联。这种关联与年龄(Sig.: 0.558)、总专业经验(p: 0.762)和紧急情况(p: 0.191)等变量无关。结论急诊病人面对死亡时的焦虑水平低于其他医院单位。职业类别、情绪自我管理训练程度和自我认知的心理健康水平等变量与面对死亡时的焦虑程度有关，需要进一步研究。

{"title":"Ansiedad y miedo ante la muerte en los profesionales sanitarios de los servicios de urgencias hospitalarios en Aragón","authors":"Daniel Vázquez-García , Marisa de-la-Rica-Escuín , Concepción Germán-Bes , Ana-Luisa Caballero-Navarro","doi":"10.1016/j.enfcli.2023.03.002","DOIUrl":"10.1016/j.enfcli.2023.03.002","url":null,"abstract":"<div><h3>Objectives</h3><p>To describe the levels of anxiety in the face of death in professionals from emergency hospital services of Aragon. To analyze its association with sociodemographic, perception and labor variables.</p></div><div><h3>Methodology</h3><p>Observational, descriptive and cross-sectional study. Population and context of the study were health professionals of the hospital emergency services of Aragon. A non-probabilistic sampling selection was applied (n=230 participants). The “Collet-Lester-Fear-of-Death-Scale” instrument was introduced to measure death anxiety. The data was collected with a self-applied telematic questionnaire. Descriptive and inferential statistics were performed to analyze the association between the study variables.</p></div><div><h3>Results</h3><p>Anxiety in the face of death mean values of 94,58±21,66 with 95% CI: (91,76-97,39) (scale range: 28-140 points) were obtained. A significant association was obtained with the variables professional category (physicians, medical residents, nurses, and nursing assistants) (p: 0,006), sex (p: 0,001), level of training in emotional self-management (p: 0,03), self-perceived level of mental health (p: 0,07) and perception of lack of support from palliative care/mental health professionals (p: 0,006). This association was not obtained with the variables age (Sig.: 0.558), total professional experience (p: 0.762) and in emergencies (p: 0.191).</p></div><div><h3>Conclusion</h3><p>The levels of anxiety in the face of death in the emergency hospital services are lower than those presented in other hospital units. Variables such as professional category, degree of training in emotional self-management and self-perceived level of mental health are related to levels of anxiety in the face of death and their study requires further work.</p></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44005637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Actitudes, capacidades y barreras percibidas en investigación de las enfermeras del Servicio Canario de la Salud 研究金丝雀保健服务护士的态度、能力和障碍

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-07-01 DOI: 10.1016/j.enfcli.2023.05.004

Héctor González-de la Torre , David Díaz-Pérez , Ricardo José Pinto-Plasencia , Begoña Reyero-Ortega , Elizabeth Hernández-González , Conrado Domínguez-Trujillo

Objective

To evaluate the attitudes, capacities and perceived barriers associated with research among nurses and midwives of the Canary Health Service (SCS).

Methods

Descriptive observational cross-sectional study with an analytical component carried out in the different SCS departments by means of an online survey in which sociodemographic and specific variables, the Spanish version of the Attitudes towards Research and Development within Nursing Questionnaire (ATRDNQ-e) instrument and the BARRIERS scale were collected. Authorisation was obtained from the two provincial ethics committees. A descriptive and inferential analysis (Mann-Whitney U test and Kruskal-Wallis test, post hoc contrast by Dwass-Steel-Critchlow-Fligne test) was performed with JAMOVI® v.2.3.24 software.

Results

A total of 512 nurses and midwives with a mean age of 41.82 years participated in the study. Regarding the scores with the ATRDNQ-e instrument, the dimension with the lowest score was «Language of research» (Mean = 3.55/SD = 0.84) and the highest «Assessment of nursing research and development of the nursing discipline» (Mean = 4.54/SD = 0.52). The total mean score with the BARRIERS scale was 54.33 (SD = 16.52), with «Organizational characteristics» being the highest scoring subscale (Mean = 17.25/SD = 5.90). The two highest perceived barriers were «Not enough time at work to implement new ideas» (Mean = 2.55/SD = 1.11) and «Nursing does not have time to read research» (Mean = 2.46/ SD = 1.11).

Conclusions

SCS nurses have a positive attitude towards research, although there are some barriers where improvement actions for nursing research should be implemented.

目的了解加纳利卫生服务中心(SCS)护士和助产士对研究的态度、能力和感知障碍。方法通过收集社会人口学和特定变量、西班牙语版护理人员对研究和发展的态度问卷(ATRDNQ-e)和障碍量表的在线调查，在不同SCS科室进行描述性观察性横断面研究，并辅以分析成分。获得了两个省级伦理委员会的授权。采用JAMOVI®v.2.3.24软件进行描述性和推理分析(Mann-Whitney U检验和Kruskal-Wallis检验，事后对比采用Dwass-Steel-Critchlow-Fligne检验)。结果共512名护士和助产士参与研究，平均年龄41.82岁。在ATRDNQ-e量表得分方面，得分最低的维度是“研究语言”(Mean = 3.55/SD = 0.84)，得分最高的维度是“护理学科研究与发展评估”(Mean = 4.54/SD = 0.52)。障碍量表的总平均得分为54.33 (SD = 16.52)，“组织特征”是得分最高的子量表(mean = 17.25/SD = 5.90)。两个最高的障碍是“没有足够的工作时间来实施新想法”(平均= 2.55/SD = 1.11)和“护理人员没有时间阅读研究”(平均= 2.46/ SD = 1.11)。结论scs护士对护理研究的态度是积极的，但仍存在一些障碍，需要采取改进措施。

{"title":"Actitudes, capacidades y barreras percibidas en investigación de las enfermeras del Servicio Canario de la Salud","authors":"Héctor González-de la Torre , David Díaz-Pérez , Ricardo José Pinto-Plasencia , Begoña Reyero-Ortega , Elizabeth Hernández-González , Conrado Domínguez-Trujillo","doi":"10.1016/j.enfcli.2023.05.004","DOIUrl":"10.1016/j.enfcli.2023.05.004","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the attitudes, capacities and perceived barriers associated with research among nurses and midwives of the Canary Health Service (SCS).</p></div><div><h3>Methods</h3><p>Descriptive observational cross-sectional study with an analytical component carried out in the different SCS departments by means of an online survey in which sociodemographic and specific variables, the Spanish version of the Attitudes towards Research and Development within Nursing Questionnaire (ATRDNQ-e) instrument and the BARRIERS scale were collected. Authorisation was obtained from the two provincial ethics committees. A descriptive and inferential analysis (Mann-Whitney U test and Kruskal-Wallis test, post hoc contrast by Dwass-Steel-Critchlow-Fligne test) was performed with JAMOVI® v.2.3.24 software.</p></div><div><h3>Results</h3><p>A total of 512 nurses and midwives with a mean age of 41.82 years participated in the study. Regarding the scores with the ATRDNQ-e instrument, the dimension with the lowest score was «Language of research» (Mean = 3.55/SD = 0.84) and the highest «Assessment of nursing research and development of the nursing discipline» (Mean = 4.54/SD = 0.52). The total mean score with the BARRIERS scale was 54.33 (SD = 16.52), with «Organizational characteristics» being the highest scoring subscale (Mean = 17.25/SD = 5.90). The two highest perceived barriers were «Not enough time at work to implement new ideas» (Mean = 2.55/SD = 1.11) and «Nursing does not have time to read research» (Mean = 2.46/ SD = 1.11).</p></div><div><h3>Conclusions</h3><p>SCS nurses have a positive attitude towards research, although there are some barriers where improvement actions for nursing research should be implemented.</p></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47081882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Análisis de las necesidades de atención paliativa en pacientes hospitalizados 住院患者姑息治疗需求分析

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-07-01 DOI: 10.1016/j.enfcli.2023.04.002

Joana Maria Julià-Móra , Ian Blanco-Mavillard , Araceli Prieto-Alomar , Enriqueta Márquez-Villaverde , Margalida Terrassa-Solé , Juan Pablo Leiva-Santos , Miguel Ángel Rodríguez-Calero

Aim

To determine the prevalence of palliative care needs in patients in an acute care hospital and to analyze the profile of these patients.

Design

We conducted a prospective cross-sectional study in an acute care hospital, in April 2018. The study population consisted of all patients over 18 years of age admitted to hospital wards and intensive care units. Variables were collected on a single day by six micro-teams using the NECPAL CCOMS-ICO© instrument. The descriptive analysis, on patient mortality and length of stay, was performed at a one-month follow-up.

Results

We assessed 153 patients, of whom 65 (42.5%) were female, with a mean age of 68.17 ± 17.03 years. A total of 45 patients (29.4%) were found to be SQ+, of which 42 were NECPAL+ (27.5%), with a mean age of 76.64 ± 12.70 years. According to the disease indicators, 33.35% had cancer, 28.6% had heart disease, and 19% had COPD, resulting in a ratio of 1:3 between patients with cancer and non-cancer disease. Half of the inpatients in need of palliative care were in the Internal Medicine Unit.

Conclusions

Almost 28% of patients were identified as NECPAL+, most of them not identified as under palliative care in clinical records. Greater awareness and knowledge from healthcare professionals would facilitate the early identification of these patients and avoid overlooking palliative care needs.

目的了解某急症医院患者对姑息治疗需求的流行情况，并分析这些患者的概况。2018年4月，我们在一家急症护理医院进行了一项前瞻性横断面研究。研究人群包括所有18岁以上住院病房和重症监护病房的患者。6个微型团队使用NECPAL CCOMS-ICO©仪器在一天内收集变量。在一个月的随访中，对患者死亡率和住院时间进行描述性分析。结果153例患者中，女性65例(42.5%)，平均年龄68.17±17.03岁。SQ+ 45例(29.4%)，NECPAL+ 42例(27.5%)，平均年龄76.64±12.70岁。根据疾病指标，33.35%的患者患有癌症，28.6%的患者患有心脏病，19%的患者患有慢性阻塞性肺病，癌症与非癌症疾病的比例为1:3。需要姑息治疗的住院病人有一半在内科。结论28%的患者被诊断为NECPAL+，大部分患者在临床记录中未被诊断为姑息治疗。医护专业人员提高认识和知识，有助于及早发现这些病人，避免忽视缓和医疗的需要。

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引用次数: 0

Debilidad muscular en pacientes críticos: efectos de un programa de rehabilitación sistematizado de enfermería 危重病人肌肉无力:系统化护理康复计划的影响

IF 0.5 Q3 Nursing

Enfermeria Clinica

Pub Date : 2023-05-01 DOI: 10.1016/j.enfcli.2022.11.001

Paulo Azevedo , Bárbara Gomes , José Macedo , Soraia Ferreira , José Pereira , Ana Pires

Objective

Intensive care unit-acquired muscle weakness (ICUAW) in critically ill patients is frequent and associated with negative outcomes. Early rehabilitation is a strategy to improve outcomes. The aim was to assess the effects of a rehabilitation nursing programme at discharge from intensive care unit.

Methods

Quasi-experimental study with the comparison between two groups: one enrolled in a systematized nursing rehabilitation program and the other with usual nursing rehabilitation care. A non-probabilistic sample, sequential, of 42 critically ill ventilated patients, 21 patients in the control group and 21 patients the intervention group (June 2017 to June 2019), in three intensive care units of one large Portuguese teaching hospital. Mann-Whitney test was performed to compare Medical Research Council Sum Score (MRC-SS) values between groups.

Results

Patients undergoing the rehabilitation program had a decrease in ICUAW (at ICU discharge mean MRC-SS = 38 vs. mean MRC-SS = 42.7; p = 0.043; U = 152.5). There was a decrease in severe muscle weakness (9.5% vs. 28.6%) and significant muscle weakness (42.9% vs. 52.4%) and an increase without muscle weakness (47,6% vs. 19%).

Conclusions

The systematic rehabilitation nursing program can improve muscle strength and reduce functional disability at the time of discharge from intensive care.

重症监护病房获得性肌无力(ICUAW)在危重患者中很常见，并与不良预后相关。早期康复是改善结果的一种策略。目的是评估康复护理方案在重症监护室出院时的效果。方法采用系统护理康复方案组与常规护理康复方案组进行对比研究。2017年6月至2019年6月，在一家大型葡萄牙语教学医院的三个重症监护室，对42名危重通气患者进行非概率序列抽样，其中21名患者为对照组，21名患者为干预组。采用Mann-Whitney检验比较两组间医学研究委员会总评分(MRC-SS)值。结果接受康复治疗的患者ICUAW明显降低(ICU出院时MRC-SS = 38 vs. MRC-SS = 42.7;p = 0.043;u = 152.5)。严重肌无力(9.5% vs. 28.6%)和明显肌无力(42.9% vs. 52.4%)减少，无肌无力增加(47.6% vs. 19%)。结论系统的康复护理方案可提高重症患者出院时的肌力，减少功能障碍。

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引用次数: 0