Enfermeria clinica (English Edition)最新文献

Quality of life and spiritual needs of patients diagnosed with cancer in a tertiary hospital in southwestern Nigeria 尼日利亚西南部一家三甲医院确诊癌症患者的生活质量和精神需求。

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.001

Deborah Tolulope Esan , Falilat Idowu Bolarinwa , Blessed Obem Oyama , Oluwaseyi Isaiah Olabisi , Joel Adeleke Afolayan , Carlos Guillermo Ramos , Oladimeji Akeem Bolarinwa

Objective

In Africa, cancer is considered a death sentence. Its impact can be debilitating for the patient and those who care for them. This study therefore assessed the spiritual needs and Quality of life of Cancer patients in a tertiary hospital in Nigeria.

Methods

This study utilized a cross-sectional descriptive design. We systematically recruited 302 cancer patients who visited the cancer registry and outpatient departments. A standardized and validated Spiritual needs questionnaire (SpNQ) and WHO Quality of Life (WHOQL) were used to collect data. Data was analyzed with SPSS version 23 with a significance level set at p < 0.05.

Results

The preponderance cancer among respondents was breast cancer 146 (48.4%) followed by prostate cancer 41 (13.6%). Most of the respondents admitted having “strong” spiritual needs. Categorization of the spiritual need score was below average in 20% of the respondents which indicated those with low spiritual needs and the majority 241 (79.8%) of the patients had high spiritual needs. Most respondents had poor quality of life in all four domains. The spiritual care needs of respondents were significantly associated with the quality of life of the respondents particularly in the psychological domain (p = 0.040) and social domain (p = 0.005).

Conclusion

This study revealed high spiritual needs and poor quality of life among cancer patients. Healthcare practitioners should provide for the spiritual needs of cancer patients to enhance their quality of life.

目的：在非洲，癌症被视为死刑。癌症对患者和护理人员的影响可能会使人衰弱。因此，本研究对尼日利亚一家三级医院癌症患者的精神需求和生活质量进行了评估：本研究采用横断面描述性设计。我们系统地招募了 302 名癌症患者，他们都曾在癌症登记处和门诊部就诊。收集数据时使用了经过验证的标准化精神需求问卷（SpNQ）和世界卫生组织生活质量标准（WHOQL）。数据采用 SPSS 23 版进行分析，显著性水平设为 p：受访者主要罹患的癌症是乳腺癌，占 146 人（48.4%），其次是前列腺癌，占 41 人（13.6%）。大多数受访者承认有 "强烈 "的精神需求。20%的受访者的精神需求分类得分低于平均分，这表明他们的精神需求较低，而大多数患者的精神需求较高，有 241 人（79.8%）。大多数受访者在所有四个方面的生活质量都较差。受访者的精神护理需求与受访者的生活质量有显著相关性，尤其是在心理领域（p = 0.040）和社会领域（p = 0.005）：本研究显示，癌症患者的精神需求高，生活质量低。医护人员应满足癌症患者的精神需求，以提高他们的生活质量。

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引用次数: 0

Descriptive study on the overload of the main caregiver of cancer patients with tumour asthenia in Salamanca 关于萨拉曼卡市肿瘤气喘癌症患者主要照顾者超负荷工作的描述性研究。

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.007

Samuel Jiménez-Sánchez , Eduardo José Fernández-Rodríguez , Alberto García-Martín , Celia Sánchez-Gómez , María Isabel Rihuete-Galve

Introduction

The incidence of oncology patients is increasing due to the ageing of the population and advances in research leading to early diagnoses. This has resulted in an increase in the care required for patients at all stages of their illness. To describe the current situation of the overload of informal caregivers of cancer patients with tumour asthenia belonging to the Medical Oncology Service of the University Health Care Complex of Salamanca and the Palliative Care Unit of the Hospital de los Montalvos, we employed the following.

Methods

This is a cross-sectional descriptive observational study conducted at the Complejo Asistencial Universitario de Salamanca and the Palliative Care Unit of the Hospital de los Montalvos from February to May 2023. The study involved 75 informal caregivers of oncology patients with tumour asthenia. Data was collected through interviews, which included sociodemographic information and measurement scales. The study employed the Barthel Scale, PERFORM questionnaire, and Reduced Zarit Caregiver Overload Scale to assess the informal caregivers' ability to care for cancer patients with tumour asthenia.

Results

Of the caregivers, 58.7% were female, and the mean age was 60.0 years (±14.10). Over half (50.7%) of the caregivers experienced high levels of overload, making it impossible to care for the patient. Among patients with tumour asthenia, 37.3% were totally dependent, and 8.0% were moderately dependent. Of these caregivers, 58.7% had no prior caregiving experience, 80.7% had no training, and 77.3% never received help in caring for the patient.

Conclusions

In the Medical Oncology service of the Complejo Asistencial Universitario de Salamanca (CAUSA) and the Palliative Care Unit of the Hospital de los Montalvos, over one third of caregivers of oncology patients with tumour asthenia experienced caregiver overload. Variables such as the patient's age, the caregiver's age, the number of care hours, and the willingness to seek help can influence the perception of overload. This can worsen the effective care of the patient. It is important to consider these factors when providing care.

导言：由于人口老龄化和早期诊断研究的进展，肿瘤患者的发病率不断上升。这导致患者在各个疾病阶段所需的护理工作都在增加。为了描述萨拉曼卡大学医疗保健中心肿瘤内科和蒙塔尔沃斯医院姑息治疗科的肿瘤气喘患者的非正式护理人员超负荷工作的现状，我们采用了以下方法：这是一项横断面描述性观察研究，于2023年2月至5月在萨拉曼卡大学综合医疗中心和蒙塔尔沃斯医院姑息治疗科进行。这项研究涉及 75 名肿瘤患者的非正规护理人员。数据通过访谈收集，其中包括社会人口学信息和测量量表。研究采用了巴特尔量表（Barthel Scale）、PERFORM问卷和Reduced Zarit照顾者超负荷量表来评估非正规照顾者照顾肿瘤气喘患者的能力：在护理人员中，58.7% 为女性，平均年龄为 60.0 岁（± 14.10）岁。半数以上（50.7%）的护理人员感到工作负担过重，无法照顾病人。在肿瘤气喘患者中，37.3%为完全依赖型，8.0%为中度依赖型。在这些护理人员中，58.7%的人没有护理经验，80.7%的人没有接受过培训，77.3%的人在护理病人时从未得到过帮助：在萨拉曼卡大学辅助综合医院（CAUSA）肿瘤内科和蒙塔尔沃斯医院姑息治疗科，超过三分之一的肿瘤患者护理人员都经历过护理人员超负荷工作的情况。病人的年龄、护理者的年龄、护理时数和寻求帮助的意愿等变量都会影响对超负荷的感知。这可能会恶化对患者的有效护理。在提供护理时考虑这些因素非常重要。

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引用次数: 0

Effectiveness of implementing a Best Practice Guideline recommendations to manage pain in oncological hospitalized patients 实施《最佳实践指南》建议以控制肿瘤住院患者疼痛的效果。

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.002

Ana-Isabel Alcañiz-Mesas , María-Victoria Ruiz-García , María-Pilar Córcoles-Jiménez , María-José Caballero-García , María Teresa González Álvarez

Objective

To evaluate the effectiveness of implementing the Clinical Best Practice Guideline (BPG) “Assessment and Management of Pain” recommendations for pain control in oncological/oncohaematological hospitalized patients.

Methods

Ambispective cohort study. Sample and Setting: Adults admitted to oncological unit in Hospital of Albacete.

Intervention

Implementation of GBP recommendations. Variables: 1) Demographic data. 2)On implementation of GBP recommendations. 3) Outcome in patients: pain intensity in the first 24 h after admission and maximum intensity during admission Tools: Numeric and Visual Scales. Data collection: indicators exported from clinical history for evaluation of the BPSO® program. Ethical aspects: anonymous data. Data analysis (SPSS®): Descriptive during periods: baseline (T0 = December 2015); initial (T1 = 2017); consolidation (T2 = 2018–2019); sustainability (T3 = 2021–2022). Measurements of central tendency and dispersion, absolute and relative frequencies. Comparison of proportions (Chi-Square) and averages (Student t-test, ANOVA). Statistical significance: p < 0.05.

Results

Included 572 patients, 61.5% (352) men. Daily intervention of pain detection was performed in 94.6% (538) of patients (20%–T0; 98.3%–T1; 98.4%–T2; 91.2%–T3; p < 0.001), pain assessment using an appropriate scale in 97.6% (558) (0%–T0; 98.3%–T1; 99.2%–T2; 100%–T3; p < 0.001); 93.7% (535) had a care plan for assessment and management of pain (0%–T0; 98.3%–T1; 96.3%–T2; 92.3%–T3; p < 0.001). The percentage of patients who had severe pain (6–10) during the first 24 hours was reduced from T1 to T3 (5.1%–T1; 6.6%–T2; 2.1%–T3; p = 0.145), but throughout hospitalization increased from T1 to T3 (19.2%–T1; 17%–T2; 22.5%–T3; p = 0.21).

Conclusions

Implementation of recommendations has led to a statistically significant improvement over the periods in the study; however, no effectiveness has been shown to reduce pain intensity.

目的评估《临床最佳实践指南》（BPG）"疼痛的评估和管理 "建议对肿瘤/血液病住院患者疼痛控制的实施效果：方法：前瞻性队列研究：干预措施：实施 GBP 建议：变量：1）人口统计学数据。2）GBP建议的实施情况。3）患者的结果：入院后 24 小时内的疼痛强度和入院期间的最大疼痛强度：数据收集：从临床病历中导出指标，用于评估 BPSO® 程序。伦理方面：匿名数据。数据分析（SPSS®）：描述性期间：基线（T0 = 2015 年 12 月）；初始（T1 = 2017 年）；巩固（T2 = 2018-2019 年）；持续（T3 = 2021-2022 年）。中心倾向和离散度、绝对频率和相对频率的测量。比例（Chi-Square）和平均数（学生 t 检验、方差分析）的比较。统计学意义：P 结果：共纳入 572 名患者，61.5%（352 名）为男性。94.6%（538 人）的患者进行了疼痛检测的日常干预（20%-T0；98.3%-T1；98.4%-T2；91.2%-T3；P 结论：在研究期间，建议的实施带来了统计学意义上的显著改善；然而，并没有显示出降低疼痛强度的效果。

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引用次数: 0

Rasch analysis implementation in nursing research: A methodological approach Rasch 分析在护理研究中的应用：方法介绍。

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.009

José Verdú-Soriano , Héctor González-de la Torre

The design and validation of tools constitutes a fundamental pillar of nursing research, where it is essential to incorporate the most current methodologies and analyses in order to guarantee validity and reliability in their clinical application.

The aim of this paper is to describe the characteristics of the Rasch analysis and the methodology for its development as well as to discuss its relevance and applicability in nursing research, highlighting its potential contribution to the improvement of the quality and accuracy of measurement instruments in the discipline.

Through a narrative synthesis, the theoretical foundations of Rasch analysis are described and the characteristics and assumptions that must be fulfilled to carry out this type of analysis are presented. Subsequently, the implementation methodology is presented in 11 steps: definition of objectives and preparation, instrument design, data collection, initial and unidimensionality analysis, goodness-of-fit assessment (infit-outfit, reliability and separation), item local independence assessment (Yen's Q3 coefficient), item calibration and estimation of skills, measurement invariance analysis (DIF analysis), review and modification of the instrument, final analysis and validation, interpretation of results. Examples of use are presented, as well as the advantages and limitations of the method. In conclusion, the Rasch analysis provides a valuable methodology for the evaluation of clinical competencies and skills, as well as for the development and validation of measurement instruments of great utility for research in care, although it would be necessary to promote training and standardization in its use.

工具的设计和验证是护理研究的一个基本支柱，必须采用最先进的方法和分析，以保证其在临床应用中的有效性和可靠性。本文旨在介绍 RASCH 分析法的特点及其开发方法，并讨论其在护理研究中的相关性和适用性，强调其对提高该学科测量工具的质量和准确性的潜在贡献。通过叙事综述，介绍了 RASCH 分析法的理论基础，以及进行此类分析所必须满足的特征和假设。随后，介绍了 11 个步骤的实施方法：确定目标和准备工作、工具设计、数据收集、初始分析和单维分析、拟合度评估（infit-outfit、可靠性和分离度）、项目局部独立性评估（Yen's Q3 系数）、项目校准和技能估计、测量不变性分析（DIF 分析）、工具审查和修改、最终分析和验证、结果解释。介绍了使用实例以及该方法的优势和局限性。总之，RASCH 分析法为评估临床能力和技能以及开发和验证测量工具提供了一种宝贵的方法，对护理研究非常有用，但有必要促进其使用方面的培训和标准化。

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引用次数: 0

Proposed therapeutic and care approach in a patient with chronic prurigo: Clinical case 慢性瘙痒症患者的拟议治疗和护理方法：临床病例。

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.005

Sara Chiquero Valenzuela , Francisco Pedro García-Fernández , María Piedad García Ruíz , María Dolores López Franco

We present the clinical case of an 87-year-old man who presents with chronic prurigo without skin treatment.

The aim is to apply an individualized care plan that allows, based on the latest evidence, to achieve skin integrity, which is deteriorated, and improve its quality of life due to the current failure toad dress the pathology.

Several NANDA International diagnostic labels were identified using the NNNConsult online tool and the expected outcomes were plan along with the planned nursing interventions.

The care plan shows the intrinsic difficulty of a multifactorial pathology that is little known and rare but that entails a notable impact on the quality of life and skin integrity, especially when new treatment approaches are currently emerging that are un explored by patients and professionals. This situation makes it necessary to expose and train cases like the one presented, update treatment path ways, real involvement of professionals for adaptation, individualization and continuous search to meet the needs and problems suffered by the people we care for, as well as the need to know new skin approaches.

This work outlines a line of skin care that respects skin integrity, following the latest evidence and points out the therapeutic medical approach without going into depth as it is not the aim of the work or nursing competence.

我们介绍了一位 87 岁老人的临床病例，他患有慢性瘙痒症，但未进行皮肤治疗。该病例的目的是根据最新证据制定个性化护理计划，以实现皮肤完整性（由于目前未能对病症进行治疗，皮肤完整性已经恶化）并改善其生活质量。使用 NNNConsult 在线工具确定了几个 NANDA 国际诊断标签，并计划了预期结果和护理干预措施。该护理计划显示了一种多因素病理的内在困难，这种病理鲜为人知且罕见，但对生活质量和皮肤完整性有显著影响，尤其是在目前新的治疗方法不断涌现，而患者和专业人员尚未进行探索的情况下。在这种情况下，有必要对类似的病例进行揭露和培训，更新治疗方法，让专业人员真正参与其中，以适应、个性化和不断探索，满足我们所照顾的人的需求和问题，同时也有必要了解新的皮肤治疗方法。本著作概述了一种尊重皮肤完整性、遵循最新证据的皮肤护理方法，并指出了治疗性医疗方法，但没有深入探讨，因为这不是本著作的目的，也不是护理能力的目的。

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引用次数: 0

Artificial intelligence as a tool for error prevention in clinical care 人工智能作为临床护理防错工具。

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.004

Claudia Patricia Cañadas-Aragón , Angela Andrea González Orjuela

引用次数: 0

Development and validation of a proposal for a Charter of Citizens' Rights and Commitments regarding eHealth 制定和论证有关电子健康的公民权利和承诺宪章提案。

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.008

Fernando Campaña-Castillo , Olga Paloma-Castro , José Manuel Romero-Sánchez

Background

There is a new technological paradigm in health care which has been reinforced following the outbreak of the Covid-19 pandemic. Technological innovations create both challenges and opportunities to which citizens, healthcare professionals, and healthcare organisations must adapt to this reality. Although most health services have charters of citizens’ general rights and commitments, there is no specific charter concerning eHealth.

Objectives

To develop and validate a proposal of a minimum set of citizens’ rights and commitments to e-Health.

Methods

Experts in a discussion group developed a charter composed of twenty items, ten rights and ten commitments to e-Health. Two rounds of consensus were necessary to obtain a final version of the charter. The twenty items were validated for content and assessed for appropriateness, relevance, and understandability using an internet-based 2-round Delphi approach in which 134 experts, patients and healthcare professionals participated. They rated the assessed attributes for each item on a 5-point Likert scale for consensus. The content validity index was calculated with kappa statistic, a consensus measure of inter-rater agreement.

Results

In the first round, 18 items were validated, leaving only two commitments with unacceptable indices. Both were modified using the experts’ contributions and entered a second round of evaluation, after which the indices met the established requirements.

Conclusions

A proposal for a chart of patient rights and commitments to eHealth was developed and showed adequate content validity and inter-observer reliability. This chart is expected to become a starting point for the debate on the role of technology in the way patients, professionals, and health services interact in the current context.

背景：随着 Covid-19 大流行病的爆发，医疗保健领域出现了一种新的技术模式。技术创新带来了挑战和机遇，公民、医疗保健专业人员和医疗保健组织必须适应这一现实。尽管大多数医疗服务机构都有关于公民一般权利和承诺的章程，但却没有关于电子医疗的具体章程：方法：专家们在讨论小组中制定了一份关于电子健康的最低公民权利和承诺的宪章：方法：专家们在一个讨论小组中制定了一份由二十个项目组成的宪章，其中包括十项权利和十项对电子健康的承诺。宪章的最终版本需要经过两轮协商一致。134 名专家、患者和医护人员参与了这两轮德尔菲法，对这 20 个项目的内容进行了验证，并对其适当性、相关性和可理解性进行了评估。他们采用 5 点李克特量表对每个项目的评估属性进行评分，以达成共识。内容有效性指数通过卡帕统计量（一种衡量评分者之间一致性的共识指标）计算得出：结果：第一轮共有 18 个项目通过验证，只有两项承诺的指数无法接受。这两项承诺都根据专家的意见进行了修改，并进入了第二轮评估，之后，这两项承诺的指数都达到了既定要求：结论：我们提出了一份关于电子医疗患者权利和承诺表的建议，该表显示了足够的内容有效性和观察者之间的可靠性。在当前情况下，该图表有望成为讨论技术在患者、专业人员和医疗服务互动方式中的作用的起点。

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引用次数: 0

Men’s mourning experiences for the death of a loved one: An integrative review 男性对亲人去世的哀悼体验：综合评述。

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.006

Daniel Martínez-Esquivel , Maureen Araya-Solís , Alfonso Miguel García-Hernández

Objective

To analyze the current state of knowledge regarding men's mourning experiences following the death of a loved one.

Method

An integrative review was conducted using quantitative, qualitative, and mixed-methods studies published in English or Spanish between 2017 and 2022 that investigated men’s mourning experiences. Studies focused on grief in participants with different sexes or gender identities, maladaptive grief, persistent complex bereavement disorder, prolonged grief disorder, bereavement over pets, or losses other than a human death were excluded. Additionally, reviews, books, theses, editorials, and opinion pieces were not included. The search was conducted in CINAHL, PubMed, and Scopus in 2023. JBI tools were used for quality appraisal, and the analysis employed the constant comparative method.

Results

Our analysis of eight English-language documents with evidence levels IV-VI, informed by the Socioecological Model of Men’s Grief, revealed that factors at individual, interpersonal, community, and public policy sublevels interact significantly to shape men's grief experiences. Themes emerged along a continuum of intuitive and instrumental coping responses, including adaptive and maladaptive coping strategies, loneliness and social support needs, the influence of societal constructions of masculinity and the grieving process in men.

Conclusions

Men’s mourning experiences are complex and multifaceted, influenced by diverse expressions of masculinity and the interaction of various contextual factors. The Mental Health Nursing Process should prioritize understanding and addressing the unique experiences of bereaved men.

目的分析有关男性在亲人去世后的哀悼经历的知识现状：利用 2017 年至 2022 年间以英语或西班牙语发表的调查男性哀悼经历的定量、定性和混合方法研究进行了综合综述。重点关注不同性别或性别认同的参与者的哀悼、适应不良的哀悼、持续复杂的丧亲障碍、延长的哀悼障碍、宠物丧亲或人类死亡以外的损失的研究被排除在外。此外，还不包括评论、书籍、论文、社论和观点文章。检索在 2023 年的 CINAHL、PubMed 和 Scopus 中进行。使用 JBI 工具进行质量评估，并采用恒定比较法进行分析：我们根据男性悲伤的社会生态学模型，对证据等级为 IV-VI 级的 8 篇英文文献进行了分析，结果显示，个人、人际、社区和公共政策等子层面的因素在很大程度上相互作用，形成了男性的悲伤经历。在直觉性和工具性应对反应的连续统一体中出现了一些主题，包括适应性和不适应性应对策略、孤独感和社会支持需求、男性的社会建构的影响以及男性的哀悼过程：男性的哀悼经历是复杂和多方面的，受到男性气质的不同表现形式以及各种环境因素相互作用的影响。心理健康护理过程应优先考虑了解和处理丧亲男性的独特经历。

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引用次数: 0

Analysis of the therapeutic effort and economic cost of the care provided to a group of hospitalized end-of-life patients 分析为一组住院临终病人提供护理的治疗努力和经济成本。

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.003

Estela Hernández-Bello , Raquel Sánchez-Recio , Ángel Gasch-Gallén

Aim

There are social inequalities in access to health care that affect therapeutic effort. The aim of the present study was to determine whether there are differences in expenditure according to days of admission and tests performed by age, sex and population of origin in patients at the end of life.

Methods

Cross-sectional descriptive study, with review of clinical histories of terminally ill patients admitted to a hospital, recruited on the basis of the administration of transfusions, who underwent numerous tests and interventions during their last admission before death. Sociodemographic and clinical variables were studied, as well as the cost of admission and tests.

Results

The 140 patients were hospitalized for an average of 17.41 days (SD: 14.323), with an average cost of 8,264.19 euros (SD: 6,799.8788) per stay. They underwent 59 tests, which amounted to €532,209.68. Being male, of advanced age and of rural origin saw an increase in the number of days of admission. Older people and women received more tests. No relationship was found between days of hospitalization and expenditure with sociodemographic and clinical variables. There was a relationship between surgical interventions and sex (p = 0.047); between age and receiving oncological treatments (p < 0), other techniques (p < 0), nuclear medicine tests (p = 0.02) and electrocardiograms (p = 0.052).

Conclusions

Many palliative patients die in hospitals receiving numerous tests that increase the number of days of hospitalization and costs. Advanced age determines hospital admissions, but not sex or population of origin.

目的：在获得医疗服务方面存在着社会不平等，从而影响了治疗效果。本研究的目的是确定生命末期患者的入院天数和所做检查的支出是否存在年龄、性别和原籍人口的差异：方法：横断面描述性研究，对一家医院收治的临终病人的临床病史进行回顾，这些病人是在输血的基础上入院的，在临终前的最后一次入院期间接受了多项检查和干预。对社会人口学和临床变量以及入院和检查费用进行了研究：结果：140 名患者平均住院 17.41 天（标准差：14.323），每次住院平均花费 8264.19 欧元（标准差：6799.8788）。他们接受了 59 项检查，总费用达 532 209.68 欧元。男性、高龄和农村人口的入院天数有所增加。老年人和女性接受的检查更多。住院天数和支出与社会人口学和临床变量之间没有关系。手术干预与性别（P 0.047）、年龄与接受肿瘤治疗（P 结论）之间存在关系：许多姑息治疗患者死于医院，接受了大量检查，增加了住院天数和费用。高龄决定了入院情况，但与性别或原籍人口无关。

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引用次数: 0

Professional identity and performance: The complex imbalance between effort and recognition

Enfermeria clinica (English Edition)

Pub Date : 2024-11-01 DOI: 10.1016/j.enfcle.2024.11.011

Esther Arimon-Pagès

引用次数: 0