Enfermeria clinica (English Edition)最新文献

Objective

To evaluate the cost-effectiveness and cost-utility of a psychoeducational group intervention led by primary care (PC) nurses in relation to customary care to prevent the depression and improve quality of life in patients with physical comorbidity.

Design

Economic evaluation based on data from randomized, multicenter clinical trial with blind response variables and a one-year follow-up, carried in the context of the PSICODEP study.

Location

7 PC teams from Catalonia.

Participants

>50 year-old patients with depression and some physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma.

Intervention

12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training.

Measurements

Effectiveness: depression-free days (DFD) calculated from the BDI-II and quality-adjusted life years (QALYs) from the Euroqol-5D. Direct costs: PC visits, mental health, emergencies and hospitalizations, drugs. Indirect costs: days of temporary disability (TD). The incremental cost-effectiveness ratios (ICER), cost-effectiveness (ΔCost/ΔDLD) and cost-utility (ΔCost/ΔQALY) were estimated.

Results

The study includes 380 patients (intervention group [IG] = 204; control group [CG] = 176). 81.6% women; mean age 68.4 (SD = 8.8). The IG had a higher mean cost of visits, less of hospitalizations and less TD than the CG. The difference in costs between the IG and the CG was −357.95€ (95% CI: −2026.96 to 1311.06) at one year of follow-up. There was a mean of 11.95 (95% CI: −15.98 to 39.88) more DFD in the IG than in the CG. QALYs were similar (difference −0.01, 95% CI −0.04 to 0.05). The ICERs were 29.95€/DLD and 35,795€/QALY.

Conclusions

Psychoeducational intervention is associated with an improvement in DFD, as well as a reduction in costs at 12 months, although not significantly. QALYs were very similar between groups.

Objective

To perform a literature review aimed to analyze if acupoint stimulation increases lactation quantity.

Method

Studies were collected from five electronic databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Eligibility criteria were full-text articles in English or Spanish with clinical trial design and observational studies, with no restriction on time of publication, in which the effect of acupoint stimulation on improving the quantity of lactation by conventional acupuncture, electroacupuncture, laser, fire needling, manual stimulation, tuina or catgut had been evaluated. Two authors independently extracted data for the characteristics and main outcomes of the studies selected for inclusion. The risk of bias (RoB 2 and Robins-I) and the quality assessments (GRADE) were performed. For the quantitative synthesis, the standardized mean difference was calculated for each individual study selected and then the data were combined using a random-effects meta-analysis.

Results

A total of 14 studies were included in the present review. Most of the included studies exhibited some concerns in the risk of bias assessment. The quality of the studies was moderate. The meta-analysis showed that manual acupoint stimulation improves the lactation quantity (SMD 95% CI = 1.63 [1.13–2.13]; p < 0.0001).

Conclusion

The literature suggests that manual stimulation of acupuncture points improves the amount of milk produced during lactation.

Objective

To evaluate the effectiveness a group intervention based on Mindfulness in patients with anxiety and depression treated in a community mental health center. Secondarily, evaluate quality of life and adherence to the intervention.

Methods

Quasi-experimental study with evaluations pre-post intervention in people over 18 years of age treated at the Les Corts Adult Mental Health Center (AMHC), Barcelona, between March 2015 and December 2019.

Inclusion criteria

(1) anxiety symptoms (Hamilton Anxiety Rating Scale >10 points); (2) sign informed consent. Variables collected: (1) anxiety; (2) depression (Beck Depression Inventory); (3) quality of life (EuroQoL) and (4) adherence to the intervention. The intervention (9 weekly sessions; 75 min) was carried out by two nurses. Each group consisted of 10–15 patients.

Results

128 patients were included, of which 103 were women with a mean age of 52.23 years (SD 12.78). Comparisons pre and post measures, its showed improvements in relation to anxiety, depressive symptoms and general quality of life (p < 0.001) and in its dimensions of anxiety-depression (p = 0.003). The mean number of sessions attended was 6.17 (SD 2.31), and they were statistically significant and positively correlated with an improvement in anxiety (p < 0.001) and depressive symptoms (EQ-5D) (p = 0.021). There were no differences between age groups.

Conclusion

The group intervention based on Mindfulness improves anxiety and depressive symptoms, as well as the quality of life. This improvement in the symptomatology is associated to greater adherence to the intervention.

Objective

The objective of this paper is to explore the influence of Web 2.0 as a complementary support network to traditional networks for the promotion of breastfeeding (BF).

Method

Qualitative and exploratory study carried out from September 8 to December 31, 2022, at the Las Vegas Health Centre (Corvera), Health Service of the Principality of Asturias (SESPA). The participants were 5 professional experts in BF and 7 breastfeeding mothers, who made up two focus groups, selected by convenience sampling. The analysis consisted of transcription of data, in-depth reading, analysis by grouping concepts and classification of the information into categories.

Results

After the final analysis, seven categories were identified, organised according to the proximity of the topic and the proposed objective, based on the most significant discourses of the study: difficulties during BF, importance of receiving help: first support networks, other support networks, A health system with deficiencies, pandemic and BF 2.0, Health 2.0 and apps in BF: new form of support and characteristics of an “ideal” app on BF.

Conclusions

Web 2.0 has revolutionised the way mothers access information and support on BF, creating an online support network connecting mothers and professionals around the world, providing up-to-date information and enabling a source of emotional support through the creation of peer groups.

This positive influence of Web 2.0 has had a significant impact on promoting BF and empowering mothers to make informed decisions about their breastfeeding process.

Objective

To assess the association between age, parity, nationality, educational level, employment and partner support with depression and anxiety during pregnancy. To determine the impact of the evolution of the COVID-19 pandemic on the anxiety and depression levels of the participants.

Method

Cross-sectional descriptive correlational study carried out in the Osakidetza/Basque Health Service, Primary Care, Bizkaia (Spain). A total of 295 pregnant women between 8 and 41 weeks participated. The association between age, parity, nationality, educational level, employment, partner support and COVID-19 incidence rates during the study period and depression (measured with the Edinburgh Postnatal Depression Scale) and anxiety (measured with the State-Anxiety Inventory/STAI-S subscale) scores during pregnancy was measured. A logistic regression model was constructed and odds ratios and their 95% confidence intervals were estimated.

Results

The mean score was 18.75 points for anxiety (SD = 8.69) and 6.45 points for depression (SD = 4.32). Women expecting their second or later child had higher scores for depression (OR 2.51[95%IC: 1.26–5.01)) and anxiety (OR 1.98 [95%IC: 1.01–3.89]). Having completed university studies was associated with lower scores in depression (OR 0.28 [95%IC: 0.11−0.77]) and in anxiety (OR 0,2 [95%IC: 0.08−0.54]). A good relationship with the partner was associated with lower levels of anxiety (OR 0.45 [95%IC: 0.24−0.81]). The mean anxiety and depression scores are related to the incidence of COVID-19 cases; the anxiety score was significantly higher in periods of higher incidence.

Conclusions

Greater emotional care for pregnant women with low educational level, multiparous and with weak support from their partner, would reduce anxiety and depression in pregnancy. Health emergency situations affect mental health during gestation.

Purpose

The study aimed to determine body image and levels after surgery in cornea transplant patients.

Materials and methods

The population of this cross-sectional study was composed of 383 patients presented to the Eye Bank unit of a University Hospital after corneal transplantation. Sample size of 193 patients was calculated with 0.5 power, a margin of error of 5%, representing 95% of the universe. The data were collected through face-to-face interviews with the patients by the researcher and the study was completed with 178 patients in September–November 2022. The data were collected using a Patient Information Form, the Body Image Scale, and the General Self-Efficacy Scale. Parametric tests, Pearson Correlation, Student’s t-test, and One-Way Analysis of Variance tests were performed were used in the data analysis.

Results

It was determined that the mean Body Image Scale score of the transplant patients participating in the study was 159.41 ± 36.99 and the mean Self-Efficacy Scale score was 30.37 ± 8.31. When the comparison of the mean scores was examined, the difference between the mean scores of gender, marital status, occupation, and body image scale was statistically significant (p < .05), while the difference between the self-efficacy mean scores was not statistically significant (p > .05). There was a positive, moderately strong significant relationship between body image and the self-efficacy of the patients (p < .01) (r = .57).

Conclusion

It was found that the patient's body image and self-efficacy levels were high, and self-efficacy increased as the body image increased.