Pub Date : 2024-01-01DOI: 10.1016/j.enfcle.2023.08.001
Antonius Ngadiran , Amin Husni , Dian Ratna Sawitri , Blacius Dedi , Maria Suryani
Objective
Many older adults in Indonesia decide to live in nursing homes. Living in a nursing home has been associated with the incidence of cognitive decline in older adult that leads to decreasing ability to perform daily activity. This study aimed to determine the association between demographic and clinical characteristics with cognitive functions in older adults living in nursing homes in Indonesia.
Methods
This study used a cross-sectional design and involved 60 older adults in a nursing home. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) instrument. Demographic and clinical characteristics such as age, education level, length of stay in the nursing home, as well as serum levels of brain-derived neurotrophic factor (BDNF) and dopamine were studied. Spearman-Rank test was used for data analysis.
Results
Cognitive function of attention had a positive correlation with age (r = 0.314, P = .015), length of stay in the nursing home (r = 0.268, P = .038), and negative correlation with dopamine serum levels (r = −0.425, P = .001). The cognitive function of naming has a positive correlation with age (r = 0.263, P = .042).
Conclusions
Age, length of stay, and dopamine levels associated with cognitive function in older adult living in nursing homes. The older adult should be assessed in term of factors associated with cognitive function to make the cognitive improvement programs in nursing homes.
{"title":"Associated factors to the cognitive function among indonesian older adult living in nursing home","authors":"Antonius Ngadiran , Amin Husni , Dian Ratna Sawitri , Blacius Dedi , Maria Suryani","doi":"10.1016/j.enfcle.2023.08.001","DOIUrl":"10.1016/j.enfcle.2023.08.001","url":null,"abstract":"<div><h3>Objective</h3><p>Many older adults in Indonesia decide to live in nursing homes. Living in a nursing home has been associated with the incidence of cognitive decline in older adult that leads to decreasing ability to perform daily activity. This study aimed to determine the association between demographic and clinical characteristics with cognitive functions in older adults living in nursing homes in Indonesia.</p></div><div><h3>Methods</h3><p>This study used a cross-sectional design and involved 60 older adults in a nursing home. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) instrument. Demographic and clinical characteristics such as age, education level, length of stay in the nursing home, as well as serum levels of brain-derived neurotrophic factor (BDNF) and dopamine were studied. Spearman-Rank test was used for data analysis.</p></div><div><h3>Results</h3><p>Cognitive function of attention had a positive correlation with age (r<!--> <!-->=<!--> <!-->0.314, <em>P</em> <!-->=<!--> <!-->.015), length of stay in the nursing home (r<!--> <!-->=<!--> <!-->0.268, <em>P</em> <!-->=<!--> <!-->.038), and negative correlation with dopamine serum levels (r<!--> <!-->=<!--> <!-->−0.425, <em>P</em> <!-->=<!--> <!-->.001). The cognitive function of naming has a positive correlation with age (r<!--> <!-->=<!--> <!-->0.263, <em>P</em> <!-->=<!--> <!-->.042).</p></div><div><h3>Conclusions</h3><p>Age, length of stay, and dopamine levels associated with cognitive function in older adult living in nursing homes. The older adult should be assessed in term of factors associated with cognitive function to make the cognitive improvement programs in nursing homes.</p></div>","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"34 1","pages":"Pages 56-60"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378935","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}
Pub Date : 2024-01-01DOI: 10.1016/j.enfcle.2024.01.001
María Isabel Orts-Cortés , María José Cabañero-Martínez , Cristóbal Meseguer-Liza , Claudia P. Arredondo-González , Carmen de la Cuesta-Benjumea , Eva Abad-Corpa
Objective
To estimate the effectiveness of fall prevention programs in people aged 65 years and older involving nursing professionals.
Methods
We included available full-text randomized clinical trials on nurse-led prevention of falls in the community in people over 65 years of age and reporting the incidence of such falls. An extensive search was performed in 14 databases covering the period 2016–2018 for publications in English, French, Portuguese and Spanish.
The quality of the papers was assessed independently and blindly by reviewers working in pairs using the risk of bias dominios of the Cochrane Collaboration.
The hazard ratio was used as a measure of the effect size of the incidence of falls. A random-effects model was assumed for statistical analyses. The influence of moderator variables of the studies on the effect sizes was performed using ANOVAs and its 95% CI for each moderator category.
Results
A total of 31 randomized clinical trials were selected with 25,551 participants. The most frequent type of intervention was education (57.1%), followed by multifactorial models (37.1%). The probability of falling was significantly reduced by 13% in the intervention groups compared to the control groups (RR+ = 0.87). Multifactorial (RR+ = 0.89) and education-based (RR = +0.84) interventions significantly reduced the probability of falls by 11% and 16%, respectively.
Conclusions
Discarding publication bias prevention programs carried out by nurses produce a significant 10% reduction in falls. Education-based and multifactorial interventions are the most effective when conducted by nurses.
{"title":"Effectiveness of nursing interventions in the prevention of falls in older adults in the community and in health care settings: A systematic review and meta-analysis of RCT","authors":"María Isabel Orts-Cortés , María José Cabañero-Martínez , Cristóbal Meseguer-Liza , Claudia P. Arredondo-González , Carmen de la Cuesta-Benjumea , Eva Abad-Corpa","doi":"10.1016/j.enfcle.2024.01.001","DOIUrl":"10.1016/j.enfcle.2024.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate the effectiveness of fall prevention programs in people aged 65 years and older involving nursing professionals.</p></div><div><h3>Methods</h3><p>We included available full-text randomized clinical trials on nurse-led prevention of falls in the community in people over 65 years of age and reporting the incidence of such falls. An extensive search was performed in 14 databases covering the period 2016–2018 for publications in English, French, Portuguese and Spanish.</p><p>The quality of the papers was assessed independently and blindly by reviewers working in pairs using the risk of bias dominios of the Cochrane Collaboration.</p><p>The hazard ratio was used as a measure of the effect size of the incidence of falls. A random-effects model was assumed for statistical analyses. The influence of moderator variables of the studies on the effect sizes was performed using ANOVAs and its 95% CI for each moderator category.</p></div><div><h3>Results</h3><p>A total of 31 randomized clinical trials were selected with 25,551 participants. The most frequent type of intervention was education (57.1%), followed by multifactorial models (37.1%). The probability of falling was significantly reduced by 13% in the intervention groups compared to the control groups (RR+<!--> <!-->=<!--> <!-->0.87). Multifactorial (RR+<!--> <!-->=<!--> <!-->0.89) and education-based (RR<!--> <!-->=<!--> <!-->+0.84) interventions significantly reduced the probability of falls by 11% and 16%, respectively.</p></div><div><h3>Conclusions</h3><p>Discarding publication bias prevention programs carried out by nurses produce a significant 10% reduction in falls. Education-based and multifactorial interventions are the most effective when conducted by nurses.</p></div>","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"34 1","pages":"Pages 4-13"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378937","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}
To explore the experiences of primary healthcare (PHC) midwives with the implementation of telemedicine in pregnancy and puerperium care during the Covid-19 pandemic.
Method
Exploratory qualitative study based on an inductive content analysis of 15 semi-structured interviews with intentionally selected PHC midwives in four Spanish Autonomous Regions, during 2021–22.
Results
Five categories were identified: (1) changes in the modality of care in pregnancy and puerperium: prioritization of pregnant women, unprotected puerperium, an increase of home visits and decline of parental education groups, (2) implementation of telemedicine in a changing scenario: the positive and negative side of telemedicine (3) reaction of women to telemedicine (4) strategies implemented by midwives for a humanized care, (5) learning for the future.
Conclusions
The use of telemedicine by primary healthcare midwives enabled the care of pregnant and postpartum women during the pandemic in Spain. The positive aspects of the implementation of this type of care raise possibilities for change towards a hybrid format of healthcare.
{"title":"Primary health care midwives’ perceptions on the use of telemedicine during the COVID-19 pandemic in Spain","authors":"Mariana Loezar-Hernández , Erica Briones-Vozmediano , Montserrat Gea-Sánchez , Juana Robledo-Martin , Laura Otero-García","doi":"10.1016/j.enfcle.2023.10.002","DOIUrl":"10.1016/j.enfcle.2023.10.002","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the experiences of primary healthcare (PHC) midwives with the implementation of telemedicine in pregnancy and puerperium care during the Covid-19 pandemic.</p></div><div><h3>Method</h3><p>Exploratory qualitative study based on an inductive content analysis of 15 semi-structured interviews with intentionally selected PHC midwives in four Spanish Autonomous Regions, during 2021–22.</p></div><div><h3>Results</h3><p>Five categories were identified: (1) changes in the modality of care in pregnancy and puerperium: prioritization of pregnant women, unprotected puerperium, an increase of home visits and decline of parental education groups, (2) implementation of telemedicine in a changing scenario: the positive and negative side of telemedicine (3) reaction of women to telemedicine (4) strategies implemented by midwives for a humanized care, (5) learning for the future.</p></div><div><h3>Conclusions</h3><p>The use of telemedicine by primary healthcare midwives enabled the care of pregnant and postpartum women during the pandemic in Spain. The positive aspects of the implementation of this type of care raise possibilities for change towards a hybrid format of healthcare.</p></div>","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"33 6","pages":"Pages 380-390"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2445147923000632/pdfft?md5=6d93e0e020a75135401b7d1868165f8b&pid=1-s2.0-S2445147923000632-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1016/j.enfcle.2023.10.001
Victor Fernandez-Alonso , Ana Maria Hernandez-Matias , Manuela Perez-Gomez , Maria Nieves Moro-Tejedor
Aim
To study the health status of a group of patients with liver transplantation by alcohol-related disease vs another etiology before and after the transplantation.
Method
Longitudinal cohort study of liver transplant patients from November 2019 to July 2022. Adult patients attended in the unit of transplantation of a hospital for a first liver transplant, both elective and urgent, were included. Patients who already had a transplanted organ and those who required liver re-transplantation in the first month after the first transplant were excluded. Sociodemographic and clinical variables, MELDNa, liver frailty index, emotional–behavioral effects of transplantation, level of anxiety and depression were collected. Pearson’s chi-square, Student’s t, Mann–Whitney U, and Wilcoxon sign tests were used for statistical analysis.
Results
The sample was n = 67 liver transplant patients with a mean age of 56.37 years, 67.2% being men and 39% due to alcohol-related liver disease. 9% of all included patients were urgent transplants. Alcohol consumption was associated with older age, a high rate of liver frailty, and a non-active work situation. Alcoholic etiology correlated with increased concern during the first six months after liver transplantation.
Conclusion
There are differences in the health status between liver transplant patients for alcohol-related liver disease vs other etiology. Nurses must consider the etiology of liver disease to guide care and interventions throughout the transplant process.
{"title":"Health status of patients with liver transplantation by alcohol-related disease vs another etiology: A cohort study","authors":"Victor Fernandez-Alonso , Ana Maria Hernandez-Matias , Manuela Perez-Gomez , Maria Nieves Moro-Tejedor","doi":"10.1016/j.enfcle.2023.10.001","DOIUrl":"10.1016/j.enfcle.2023.10.001","url":null,"abstract":"<div><h3>Aim</h3><p>To study the health status of a group of patients with liver transplantation by alcohol-related disease vs another etiology before and after the transplantation.</p></div><div><h3>Method</h3><p><span>Longitudinal cohort study of </span>liver transplant patients from November 2019 to July 2022. Adult patients attended in the unit of transplantation of a hospital for a first liver transplant, both elective and urgent, were included. Patients who already had a transplanted organ and those who required liver re-transplantation in the first month after the first transplant were excluded. Sociodemographic and clinical variables, MELDNa, liver frailty index, emotional–behavioral effects of transplantation, level of anxiety and depression were collected. Pearson’s chi-square, Student’s t, Mann–Whitney U, and Wilcoxon sign tests were used for statistical analysis.</p></div><div><h3>Results</h3><p>The sample was n = 67 liver transplant patients with a mean age of 56.37 years, 67.2% being men and 39% due to alcohol-related liver disease. 9% of all included patients were urgent transplants. Alcohol consumption was associated with older age, a high rate of liver frailty, and a non-active work situation. Alcoholic etiology correlated with increased concern during the first six months after liver transplantation.</p></div><div><h3>Conclusion</h3><p>There are differences in the health status between liver transplant patients for alcohol-related liver disease vs other etiology. Nurses must consider the etiology of liver disease to guide care and interventions throughout the transplant process.</p></div>","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"33 6","pages":"Pages 391-400"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685731","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}
Pub Date : 2023-11-01DOI: 10.1016/j.enfcle.2023.09.004
Carmen Ferrer-Arnedo , Aintzane Orkaizagirre-Gómara
{"title":"Redefining Primary Care through the nurse’s perspective and action","authors":"Carmen Ferrer-Arnedo , Aintzane Orkaizagirre-Gómara","doi":"10.1016/j.enfcle.2023.09.004","DOIUrl":"10.1016/j.enfcle.2023.09.004","url":null,"abstract":"","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"33 6","pages":"Pages 377-379"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2445147923000644/pdfft?md5=40e61a037c22b45a503d666fbb4fd261&pid=1-s2.0-S2445147923000644-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1016/j.enfcle.2023.09.003
Nguyen Tram Thi Bich , Riksa Wibawa Resna
{"title":"Impact of attrition rate and exodus of nursing students on the nursing shortage","authors":"Nguyen Tram Thi Bich , Riksa Wibawa Resna","doi":"10.1016/j.enfcle.2023.09.003","DOIUrl":"10.1016/j.enfcle.2023.09.003","url":null,"abstract":"","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"33 6","pages":"Pages 445-447"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694736","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}
Pub Date : 2023-11-01DOI: 10.1016/j.enfcle.2023.10.003
Eva Abad-Corpa , Juan Francisco Guillén-Ríos , María del Mar Pastor-Bravo , Ismael Jiménez-Ruiz
Objective
The most effective training methods are experiential, including those focused on experiences and emotions. Clinical simulation, especially high-fidelity simulation, is one of the most effective methodologies for the acquisition of competencies in care like palliative care. The simulation with actors can train future healthcare science professionals: in technical, intellectual, or interpersonal skills. The objective is to evaluate high-fidelity simulation with actors as a tool in palliative care training for nursing students.
Method
Over three years, the study was conducted in a Faculty of Nursing of the south of Spain with nursing students. A mixed methods study with sequential explanatory design in three moments was conducted: (1) Quasi-experimental study in a single group (n = 12) before and after attending the palliative care course with Clinical Simulation with actors to assess the communication skills (CICAA scale), (2) Qualitative study with phenomenological perspective after Clinical Simulation (174 reflective students’ narratives), (3) Cross-sectional observational study, one year later, to assess the transfer of knowledge and skills to the clinical practice (71 students).
Results
Students who interacted with actors in Clinical Simulation improved their communication skills and the ability to establish an effective helping relationship with both end-of-life patients and their families. The students perceived the Clinical Simulation as an innovative learning methodology that is useful to encourage reflection and transfer of learning during their clinical internship.
Conclusions
Standardization of the use of active learning methodologies is recommended for a better acquisition of transversal skills such as communication skills in palliative care.
{"title":"Assessment of high fidelity simulation with actors in palliative care in nursing students: a mixed methods study","authors":"Eva Abad-Corpa , Juan Francisco Guillén-Ríos , María del Mar Pastor-Bravo , Ismael Jiménez-Ruiz","doi":"10.1016/j.enfcle.2023.10.003","DOIUrl":"10.1016/j.enfcle.2023.10.003","url":null,"abstract":"<div><h3>Objective</h3><p>The most effective training methods are experiential, including those focused on experiences and emotions. Clinical simulation, especially high-fidelity simulation, is one of the most effective methodologies for the acquisition of competencies in care like palliative care. The simulation with actors can train future healthcare science professionals: in technical, intellectual, or interpersonal skills. The objective is to evaluate high-fidelity simulation with actors as a tool in palliative care training for nursing students.</p></div><div><h3>Method</h3><p>Over three years, the study was conducted in a Faculty of Nursing of the south of Spain with nursing students. A mixed methods study with sequential explanatory design in three moments was conducted: (1) Quasi-experimental study in a single group (n = 12) before and after attending the palliative care course with Clinical Simulation with actors to assess the communication skills (CICAA scale), (2) Qualitative study with phenomenological perspective after Clinical Simulation (174 reflective students’ narratives), (3) Cross-sectional observational study, one year later, to assess the transfer of knowledge and skills to the clinical practice (71 students).</p></div><div><h3>Results</h3><p>Students who interacted with actors in Clinical Simulation improved their communication skills and the ability to establish an effective helping relationship with both end-of-life patients and their families. The students perceived the Clinical Simulation as an innovative learning methodology that is useful to encourage reflection and transfer of learning during their clinical internship.</p></div><div><h3>Conclusions</h3><p>Standardization of the use of active learning methodologies is recommended for a better acquisition of transversal skills such as communication skills in palliative care.</p></div>","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"33 6","pages":"Pages 401-411"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784744","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}
Pub Date : 2023-11-01DOI: 10.1016/j.enfcle.2023.10.005
Josefa Valls-Matarín, Rosa María Peradejordi-Torres, Mercedes del Cotillo-Fuente
Objective
To determine the incidence of dependence-related skin lesions (DRSL) in patients in prone position (PP) and to identify the predisposing factors.
Method
Follow-up study in two polyvalent intensive care units. Patients undergoing invasive mechanical ventilation and PP with no skin lesions on admission were included. We recorded the 3 types of DRSL: (pressure ulcers [PU], moisture-associated skin damage [MASD] and friction injuries [FI]), demographic variables, diagnosis, length of stay, PP episodes, postural changes, APACHE II (Acute Physiology and Chronic Health Disease Classification System), prealbumin level on admission, body mass index (BMI), diabetes, hypertension, smoking, peripheral vascular disease (PVD), vasoactive drugs, Braden scale and mortality. Bivariate analysis: chi-square test, t-test or Mann–Whitney U test. Multivariate analysis: logistic regression.
Results
Forty nine patients were included and 170 PP were performed.Forty-one DRSL appeared in 22 patients with a cumulative incidence of 44.9% (95%CI: 31.6–58.7). PU accounted for 63.4% (73.1% facial; 76.9% stage II), 12.2% were MASD (60% inguinal; 60% stage II) and 24.4% were FI (50% thoracic; 70% stage III).
The median age of the lesion group (LG) was 66.5 [61.8−71.3] vs. 64 [43−71] years old in the non-lesion group (NLG), p = 0.04. Eighty percent of the LG had PVD vs. 20% of the NLG, p = 0.03. The median total hours on PP of the LG was 96.9 [56.1−149.4] vs. 38.2 [18.8−57] of the NIG, p < 0.001. Multivariate analysis selected total PP hours (OR = 1.03; 95%CI:1.01–1.05) and PVD (OR = 8.9; 95%CI:1.3–58.9) as predisposing factors for developing DRSL.
Conclusions
There is a high incidence of skin lesions related to prone decubitus dependence, mostly pressure lesions, although of low severity.The accumulated hours in probe position and peripheral vascular disease favor their development.
{"title":"Dependency-related skin lesions in the prone critical patient. Incidence study","authors":"Josefa Valls-Matarín, Rosa María Peradejordi-Torres, Mercedes del Cotillo-Fuente","doi":"10.1016/j.enfcle.2023.10.005","DOIUrl":"10.1016/j.enfcle.2023.10.005","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the incidence of dependence-related skin lesions<span> (DRSL) in patients in prone position (PP) and to identify the predisposing factors.</span></p></div><div><h3>Method</h3><p><span><span>Follow-up study in two polyvalent intensive care units. Patients undergoing invasive </span>mechanical ventilation<span><span><span> and PP with no skin lesions on admission were included. We recorded the 3 types of DRSL: (pressure ulcers [PU], moisture-associated skin damage [MASD] and friction injuries [FI]), demographic variables, diagnosis, length of stay, PP episodes, postural changes, APACHE II (Acute Physiology and Chronic Health Disease Classification System), prealbumin level on admission, body mass index (BMI), diabetes, hypertension, smoking, </span>peripheral vascular disease<span> (PVD), vasoactive drugs, </span></span>Braden scale and mortality. </span></span>Bivariate analysis<span>: chi-square test, t-test or Mann–Whitney U test. Multivariate analysis: logistic regression.</span></p></div><div><h3>Results</h3><p>Forty nine patients were included and 170<!--> <!-->PP were performed.Forty-one DRSL appeared in 22 patients with a cumulative incidence of 44.9% (95%CI: 31.6–58.7). PU accounted for 63.4% (73.1% facial; 76.9% stage II), 12.2% were MASD (60% inguinal; 60% stage II) and 24.4% were FI (50% thoracic; 70% stage III).</p><p>The median age of the lesion group (LG) was 66.5 [61.8−71.3] vs. 64 [43−71] years old in the non-lesion group (NLG), p<!--> <!-->=<!--> <!-->0.04. Eighty percent of the LG had PVD vs. 20% of the NLG, p<!--> <!-->=<!--> <!-->0.03. The median total hours on PP of the LG was 96.9 [56.1−149.4] vs. 38.2 [18.8−57] of the NIG, p<!--> <!--><<!--> <!-->0.001. Multivariate analysis selected total PP hours (OR<!--> <!-->=<!--> <!-->1.03; 95%CI:1.01–1.05) and PVD (OR<!--> <!-->=<!--> <!-->8.9; 95%CI:1.3–58.9) as predisposing factors for developing DRSL.</p></div><div><h3>Conclusions</h3><p>There is a high incidence of skin lesions related to prone decubitus dependence, mostly pressure lesions, although of low severity.The accumulated hours in probe position and peripheral vascular disease favor their development.</p></div>","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"33 6","pages":"Pages 424-431"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784745","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}
Pub Date : 2023-11-01DOI: 10.1016/j.enfcle.2023.10.004
Núria Babot-Pereña , Joan Blanco-Blanco
Objectives
To summarize the existing evidence and provide recommendations for the most effective management of partial-thickness graft donor sites in adults, with the goals of enhancing re-epithelialization, reducing pain, and preventing infection.
Methodology
Umbrella review. A systematic search was conducted encompassing databases such as Pubmed, CUIDEN, Cochrane Library, CINHAL Plus, SCOPUS, and LILACS. The search targeted systematic reviews published since 2011 that focused on examining the effectiveness of different approaches for the treatment of partial-thickness graft donor sites. Reviews with a low critical appraisal score according to AMSTAR 2 were excluded. The included reviews were evaluated using the SIGN scale to assess the level of evidence and grade the recommendations.
Results
Five systematic reviews with meta-analysis were incorporated in the analysis. Platelet-rich plasma and human amniotic membrane demonstrated statistically significant improvements in re-epithelialization and pain reduction when compared to the control group. Moreover, platelet-rich plasma also exhibited a decrease in wound infection rates. Recombinant human growth hormone was found to expedite the re-epithelialization process.
Conclusions
Based on the findings, the use of platelet-rich plasma is recommended to enhance re-epithelialization, alleviate pain, and reduce infection in partial-thickness graft donor sites among adults. Application of human amniotic membrane is recommended to accelerate re-epithelialization and alleviate pain, while recombinant human growth hormone is suggested to expedite the overall healing time of these wounds.
{"title":"Healing techniques for split-thickness skin grafts donor sites. Umbrella review","authors":"Núria Babot-Pereña , Joan Blanco-Blanco","doi":"10.1016/j.enfcle.2023.10.004","DOIUrl":"10.1016/j.enfcle.2023.10.004","url":null,"abstract":"<div><h3>Objectives</h3><p>To summarize the existing evidence and provide recommendations for the most effective management of partial-thickness graft donor sites in adults, with the goals of enhancing re-epithelialization, reducing pain, and preventing infection.</p></div><div><h3>Methodology</h3><p>Umbrella review. A systematic search was conducted encompassing databases such as Pubmed, CUIDEN, Cochrane Library, CINHAL Plus, SCOPUS, and LILACS. The search targeted systematic reviews published since 2011 that focused on examining the effectiveness of different approaches for the treatment of partial-thickness graft donor sites. Reviews with a low critical appraisal score according to AMSTAR 2 were excluded. The included reviews were evaluated using the SIGN scale to assess the level of evidence and grade the recommendations.</p></div><div><h3>Results</h3><p>Five systematic reviews with meta-analysis were incorporated in the analysis. Platelet-rich plasma and human amniotic membrane demonstrated statistically significant improvements in re-epithelialization and pain reduction when compared to the control group. Moreover, platelet-rich plasma also exhibited a decrease in wound infection rates. Recombinant human growth hormone was found to expedite the re-epithelialization process.</p></div><div><h3>Conclusions</h3><p>Based on the findings, the use of platelet-rich plasma is recommended to enhance re-epithelialization, alleviate pain, and reduce infection in partial-thickness graft donor sites among adults. Application of human amniotic membrane is recommended to accelerate re-epithelialization and alleviate pain, while recombinant human growth hormone is suggested to expedite the overall healing time of these wounds.</p></div>","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"33 6","pages":"Pages 432-437"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784746","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}
Pub Date : 2023-11-01DOI: 10.1016/j.enfcle.2023.09.002
Lidia Sanz Durán
At the beginning of breastfeeding, difficulties such as rusty-pipe syndrome may appear. Very little known, it presents with colostrum that is brown in color, rusty or bloody in appearance bilaterally. Despite having a spontaneous resolution and being painless, it requires education and training in its approach by health personnel.
This syndrome generates stress and maternal concern. The clinical case of a postpartum woman who wishes to breastfeed is presented, the situation experienced during the first postpartum week and the care plan that is designed and applied in the midwife's primary care consultation to achieve the initial objective are reported. and maintenance of breastfeeding.
Resolution is spontaneous during the first days, it is recommended to assess the newborn's tolerance to colostrum and not suspend breastfeeding in general for this reason. More research is required to publicize this syndrome and improve the advice and counselling of breastfeeding professionals.
{"title":"Nursing care for women with rusty-pipe syndrome: About a case","authors":"Lidia Sanz Durán","doi":"10.1016/j.enfcle.2023.09.002","DOIUrl":"10.1016/j.enfcle.2023.09.002","url":null,"abstract":"<div><p>At the beginning of breastfeeding, difficulties such as rusty-pipe syndrome may appear. Very little known, it presents with colostrum that is brown in color, rusty or bloody in appearance bilaterally. Despite having a spontaneous resolution and being painless, it requires education and training in its approach by health personnel.</p><p>This syndrome generates stress and maternal concern. The clinical case of a postpartum woman who wishes to breastfeed is presented, the situation experienced during the first postpartum week and the care plan that is designed and applied in the midwife's primary care consultation to achieve the initial objective are reported. and maintenance of breastfeeding.</p><p>Resolution is spontaneous during the first days, it is recommended to assess the newborn's tolerance to colostrum and not suspend breastfeeding in general for this reason. More research is required to publicize this syndrome and improve the advice and counselling of breastfeeding professionals.</p></div>","PeriodicalId":72917,"journal":{"name":"Enfermeria clinica (English Edition)","volume":"33 6","pages":"Pages 438-444"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286408","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}