Enfermeria clinica (English Edition)最新文献_第8页

Effect of pregnancy and childbirth on perineal musculature in women with obesity. A longitudinal cohort study 妊娠和分娩对肥胖妇女会阴肌肉组织的影响。纵向队列研究

Enfermeria clinica (English Edition)

Pub Date : 2023-11-01 DOI: 10.1016/j.enfcle.2023.10.006

Manuel Martín Pineda , Felipe Santiago Fernández Méndez , Juan de Dios Gutiérrez Henares , Beatriz Rodríguez Villegas , Nieves Luisa González González , Erika Padrón Pérez

Objective

Evaluating the changes of the perineal muscles in primigravid women with obesity (BMI ≥ 30) and to compare the progress with primigravid women in normal BMI range.

Methods

A prospective longitudinal cohort study was carried out. The pregnant women were studied at three moments: at 12 weeks' gestation, at 34 weeks' gestation and at 12 weeks after delivery. During the ckeck-up, perinometric measurements were taken to determine basal tone (BT), maximum contractile force (FMax) and applied forced (AF). In addition, the Oxford test (MOS) was used. General statistical mixed models were used for the statistical study.

Results

Fifty nulliparous pregnant women (25 with BMI ≥ 30 and 25 with BMI < 25) were recruited at the beginning of the study and 39 completed the entire study. Basal tone (BT) was 4.62 ± 0.24 Nw at the beginning of pregnancy and decreased to 4.18 ± 0.26 Nw after delivery. Contractile capacity was 5.56 ± 0.79 Nw at week 12 and increased to 6.34 ± 1.24 Nw after delivery. When comparing the FCMax at week 12 in obese VS normal weight pregnant women, values of 5.51 ± 87 Nw vs. 5.61 ± 0.71 Nw were observed (P = .941). Postpartum values were 6.72 ± 1.17 Nw vs 5.95 ± 1.21 Nw (P = .024), higher in the obese population.

Conclusions

There is an increase in contractile strength (Fmax) at 12 weeks postpartum in order to counteract the significant decrease in basal tone (BT). The body has compensatory mechanisms that allow recovery after 3 months postpartum, with greater muscle strength in obese patients.

评估肥胖(BMI≥30)初潮女性会阴肌肉的变化，并与正常BMI范围的初潮女性进行比较。进行了一项前瞻性纵向队列研究。研究人员分别在怀孕12周、34周和分娩后12周对孕妇进行了研究。在检查期间，采用围周测量来确定基底张力(BT)、最大收缩力(FMax)和施加力(AF)。此外，采用牛津测验(MOS)。采用一般统计混合模型进行统计研究。在研究开始时招募50名未分娩孕妇(25名BMI≥30,25名BMI < 25)，其中39名完成了整个研究。妊娠初基底压(BT)为4.62±0.24 Nw，分娩后降至4.18±0.26 Nw。第12周收缩能力为5.56±0.79 Nw，分娩后增加到6.34±1.24 Nw。肥胖孕妇与正常体重孕妇第12周的FCMax比较，分别为5.51±87 Nw和5.61±0.71 Nw (p = 0.941)。产后值为6.72±1.17 Nw vs 5.95±1.21 Nw (p = 0.024)，肥胖人群较高。产后12周收缩强度(Fmax)增加，以抵消基底张力(BT)的显著下降。身体有代偿机制，产后3个月后恢复，肥胖患者肌肉力量更大。通过与evolución会阴肌瘤与IMC在正常情况下的比较，评价evolución会阴肌瘤对肥胖(IMC≥30)的影响。Se realizó unestudio队列纵向前瞻性研究了Se estudió在3个时刻的妊娠:en semana 12 de gestación, la semana 34 de gestación, y a las 12 semana tras el parto。En estas consultas se realizó medición mediante perinometría para determinar el Tono basal (TB)， la Fuerza máxima Contráctil (FMax);(e)。Además，参见utilizó el test de Oxford (MOS)。Para el estudio estadístico se utilitzaron modelos estadísticos generales mixtos。随访50例孕妇nulíparas(25例妊娠期IMC≥30例，25例妊娠期IMC < 25例)，术后随访39例。会阴部基底部基底部为4,62±0,24 Nw; descendió为4,18±0,26 Nw;La capacidad contráctil fue de 5,56±0,79 Nw, La semana 12, y aumento 6,34±1,24 Nw trel parto。结果表明:肥胖组与正常组的FCMax值分别为5.51±87 Nw和5.61±0.71 Nw (p = 0.941)。6、72±1,17 Nw vs 5、95±1,21 Nw (p = 0,024)，均优于población。存在一个disminución显著的基础模型，与此相对立的是，在未来的研究中contráctil可获得12个语义。1 .组织排解机制补偿机制与许可机制之间的关系(recuperación):一个人在患肥胖症后的3个小时内的存在。

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引用次数: 0

The symbolic framework of obstetric violence 产科暴力的象征性框架。

Enfermeria clinica (English Edition)

Pub Date : 2023-09-01 DOI: 10.1016/j.enfcle.2023.07.003

Rosario Pérez García , Manuela Pérez García , Dolores Pérez García

引用次数: 0

Older person’s experience of PT4Ageing—A programme on self-management «support» in chronic illness 老年人在PT4Ageing-A慢性病自我管理“支持”计划中的经验。

Enfermeria clinica (English Edition)

Pub Date : 2023-09-01 DOI: 10.1016/j.enfcle.2023.09.001

Célia Santos , Carla Silvia Fernandes , Celeste Bastos , Márcia Antonieta Cruz , Sandra Costa , Lígia Lima

Objective

This study sought to describe the experience of a group of older adults who participated in a chronic illness self-management program.

Methods

The study employed a qualitative phenomenological approach. Participants were eight elders and data collected using semi-structured interviews Data was analysed using thematic analysis.

Results

Five themes emerged from the analysis: (1) Tips to improve our daily lives, (2) I was always motivated, (3) Sharing and mutual help, (4) They made us believe we were capable (5). It would be great if it did not end here. Globally, the participants of the program described their experience as very positive. They identified gains from participating in the program, such as learning strategies to help them cope with their health problems, improving their ability to manage their illnesses more autonomously and building social support, that even persisted after the conclusion of the intervention.

Conclusion

The findings of this study provide insight into how older adults experience a program for the self-management of chronic illness. For the development of future programs, support building must be considered. Older adults who participate in self-management programmes exhibit improved self-efficacy in relation to the management their chronic illnesses and greater autonomy in self-care.

目的：本研究旨在描述一组参加慢性病自我管理计划的老年人的经历。方法：采用定性现象学方法。参与者为八名老年人，数据采用半结构化访谈收集。数据采用主题分析进行分析。结果：分析得出了五个主题：（1）改善我们日常生活的技巧，（2）我总是有动力，（3）分享和互助，（4）它们让我们相信我们有能力（5）。如果它没有在这里结束，那就太好了。在全球范围内，该项目的参与者称他们的经历非常积极。他们确定了参与该项目的收获，例如帮助他们应对健康问题的学习策略，提高他们更自主地管理疾病的能力，以及建立社会支持，这些在干预结束后仍然存在。结论：这项研究的结果为老年人如何体验慢性病自我管理计划提供了见解。对于未来项目的发展，必须考虑支持建设。参与自我管理计划的老年人在管理慢性病方面表现出更好的自我效能感，并在自我护理方面表现出更大的自主权。

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引用次数: 0

Evolution of end-of-life care from the nursing perspective: training, research and professional commitment 从护理角度看临终关怀的演变：培训、研究和专业承诺。

Enfermeria clinica (English Edition)

Pub Date : 2023-09-01 DOI: 10.1016/j.enfcle.2023.07.007

Alfonso Miguel García Hernández

引用次数: 0

Leadership in a hospital of the Andalusian Public Health System 安达卢西亚公共卫生系统一家医院的领导。

Enfermeria clinica (English Edition)

Pub Date : 2023-09-01 DOI: 10.1016/j.enfcle.2023.06.004

Daniel Bárcenas-Villegas , María Soledad Vázquez-Santiago

Objective

To analyse, from a gender perspective, the characteristics and perception of the effects of leadership of nurses in a hospital of the Andalusian Public Health System.

Methodology

Qualitative study with a phenomenological approach. The participants were nurses in care and intermediate positions with a contract of more than 6 months. A qualitative content analysis was carried out. Four phases were established for data analysis, from which 5 categories resulted. NVivo 11 software was used to analyse the dialogues.

Results

The participants’ discourses endow the leader with characteristics that define him as a reference person. The contribution of middle management is necessary for the achievement of the objectives of the care units and the cohesion of the group, although this group perceives it only in relation to the management of resources. Access to management positions is not linked to gender.

Conclusions

The participants’ discourses endow the leader with characteristics that define him as a reference person. The contribution of middle management is necessary for the achievement of the objectives of the care units and the cohesion of the group, although this group perceives it only in relation to the management of resources. Access to management positions is not linked to gender.

目的：从性别角度分析安达卢西亚公共卫生系统某医院护士领导作用的特点和感知。方法：采用现象学方法进行定性研究。参与者是护理和中级职位的护士，合同期超过6个月。进行了定性内容分析。为数据分析建立了四个阶段，其中产生了5个类别。使用NVivo 11软件对对话进行分析。结果：参与者的话语赋予了领导者作为参照人的特征。中层管理人员的贡献对于实现护理单位的目标和团队的凝聚力是必要的，尽管该团队只认为这与资源管理有关。获得管理职位与性别无关。结论：参与者的话语赋予了领导者作为参照人的特征。中层管理人员的贡献对于实现护理单位的目标和团队的凝聚力是必要的，尽管该团队只认为这与资源管理有关。获得管理职位与性别无关。

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引用次数: 0

The post-surgical transition in adolescents who have idiopathic scoliosis. A qualitative study 青少年特发性脊柱侧弯的术后过渡。定性研究。

Enfermeria clinica (English Edition)

Pub Date : 2023-09-01 DOI: 10.1016/j.enfcle.2023.07.004

María Dolores Navarrete-Zampaña , Nicomedes Fernández-Baillo , Javier Pizones , José Miguel Sánchez-Márquez , María Carmen Sellán-Soto

Objective

To know the process experienced by adolescents suffering from idiopathic scoliosis when undergoing surgery to correct the physical deformity.

Method

Qualitative study with a symbolic interactionism approach. 22 semi-structured interviews were conducted with adolescents who underwent posterior spinal fusion in a third-level hospital in Madrid between May 2019 and January 2021. Taylor and Bogdan’s analysis in progress was carried out.

Results

Patients with adolescent idiopathic scoliosis present with a complex simultaneous health/illness and developmental transition. The main inhibitory conditions of the transition are the meanings about: their identity, social, beliefs about surgery, ignorance about the pathology, the surgical process, and their recovery. As facilitating conditions, we find: a positive attitude towards physical, aesthetic, and social change, socioeconomic level, and family support.

Conclusions

The informants of this study refer that aesthetic affectation and physical limitations are the main elements that cause them discomfort. Surgical intervention is presented as the solution to this situation. Recovery is a critical point in the transition process mainly due to pain. They accept the discomfort suffered during the recovery because they hope to obtain an improvement in the image and physical limitations. The changes and differences they experience during the transition make them think that they will be able to lead a «normal life» to which they constantly refer in their speeches.

目的：了解青少年特发性脊柱侧弯在接受矫正身体畸形手术时所经历的过程。方法：采用符号互动法进行定性研究。2019年5月至2021年1月，对在马德里一家三级医院接受脊柱后融合术的青少年进行了22次半结构化访谈。泰勒和博格丹的分析正在进行中。结果：青少年特发性脊柱侧弯患者同时存在复杂的健康/疾病和发育过渡。转变的主要抑制条件是意义：他们的身份、社会、对手术的信念、对病理学的无知、手术过程以及他们的康复。作为促进条件，我们发现：对身体、审美和社会变化、社会经济水平和家庭支持持积极态度。结论：本研究的知情者认为，审美矫揉造作和身体限制是导致他们不适的主要因素。手术干预是解决这种情况的方法。恢复是过渡过程中的一个关键点，主要是由于疼痛。他们接受康复过程中所遭受的不适，因为他们希望在形象和身体限制方面有所改善。他们在过渡期间经历的变化和差异使他们认为自己将能够过上他们在演讲中不断提及的“正常生活”。

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引用次数: 0

Exploring the construct validity of the Barthel index in a sample of Spanish hospitalised patients 探讨Barthel指数在西班牙住院患者样本中的结构有效性。

Enfermeria clinica (English Edition)

Pub Date : 2023-09-01 DOI: 10.1016/j.enfcle.2023.06.005

María Jesús Valero-Chillerón , Irene Llagostera-Reverter , David Luna-Aleixós , Mayte Moreno-Casbas , Laura Andreu-Pejó , Víctor M. González-Chordá

Objective

Examine the construct validity of the Barthel Index in adult inpatient units.

Method

A secondary analysis was performed on a sample of 1342 adult patients admitted to inpatient units. A confirmatory factor analysis of the Barthel Index did not confirm its unidimensional structure (CFA-1). Therefore, two methods were explored to find a solution with a better fit. The sequence of the classical exploratory and confirmatory factor analysis methods was carried out (CFA-2). In contrast, a Gaussian graphical model and confirmatory factor analysis (CFA-3) were performed. Three models were compared on the basis of several goodness-of-fit indicators.

Results

CFA-1 results (χ2 = 161,616; P < .001; RMSEA = .183) indicated a poor fit between the model and the data. Exploratory factor analysis provided a model with two dimensions that explained 86% of the variance and improved the goodness-of-fit in CFA-2 (χ2 = 846; P < .001; RMSEA = .133). The Gaussian graphical model, by removing the item ‘Bladder’, offered a solution with three dimensions that improved the goodness-of-fit compared to the previous models (χ2 = 492; P < .001; RMSEA = .09).

Conclusion

The Barthel Index is not a unidimensional measure of functional capacity when applied to adult inpatient units. The best-fitting model has a three-dimensional structure (Hygiene; Feeding and disposal; Mobility) that relates to the domains of care needs.

目的：检验Barthel指数在成人住院病人中的结构有效性。方法：对住院的1342名成年患者进行二次分析。Barthel指数的验证性因素分析没有证实其一维结构（CFA-1）。因此，探索了两种方法来找到更适合的解决方案。采用经典的探索性和验证性因素分析方法（CFA-2）。相反，进行了高斯图形模型和验证性因素分析（CFA-3）。基于几个拟合优度指标对三个模型进行了比较。结果：CFA-1结果（χ2 = 161616；P 结论：Barthel指数应用于成人住院单位时，并不是一个单一维度的功能能力衡量标准。最合适的模型有一个与护理需求领域相关的三维结构（卫生；喂养和处理；流动性）。

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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提州医疗机构助产士亲密伴侣暴力（IPV）知识和管理实践的影响。

Enfermeria clinica (English Edition)

Pub Date : 2023-09-01 DOI: 10.1016/j.enfcle.2023.07.002

Theresa Olaitan Bamigboye , Omolola Oladunni Irinoye , Emmanuel Olufemi Ayandiran , Adekemi Eunice Olowokere , Opeyemi Adeniyi Adedeji , Deborah Tolulope Esan

Objective

To assess the influence of an educational intervention on midwives' knowledge, detection and management of intimate partner violence (IPV).

Methods

A quasi-experimental study involving 158 midwives from two districts in Ekiti State, Nigeria. The sample was divided into experimental and control groups (79 midwives per group). Data were collected using a questionnaire and an observation checklist. A customized educational training program on IPV detection and management was conducted in the experimental group. Measurement was performed before the intervention, immediately after and 6 weeks later. Data were analyzed using descriptive and inferential statistics (Chi-square and binary logistic regression) with a level of significance set at p < 0.05.

Results

Prior knowledge regarding IPV detection and management among midwives in both groups was poor, with only 16.5 % of the experimental group and 17.7 % of the control group having good knowledge in the pre-intervention phase. The experimental group had a significant improvement in knowledge of IPV screening and management, with 82.1 % having good knowledge immediately after the intervention and 92.0 % at 6 weeks after the intervention (p = 0.001). Observed practice of IPV detection and management improved significantly from 21.9 % satisfactory practice before the intervention to 63.5 % after the intervention (p = 0.001) in the experimental group, with no appreciable improvement in practice detected in the control group (21.9% versus 36.5%; p = 0.682).

Conclusion

The use of a customized educational training program improved midwives' knowledge and practice in the detection and management of intimate partner violence.

目的：评估教育干预对助产士了解、发现和管理亲密伴侣暴力（IPV）的影响。方法：一项准实验研究，涉及尼日利亚埃基提州两个地区的158名助产士。将样本分为实验组和对照组（每组79名助产士）。使用问卷和观察检查表收集数据。在实验组中进行了关于IPV检测和管理的定制教育培训计划。在干预前、干预后立即和干预后6周进行测量。使用描述性和推断统计学（卡方和二元逻辑回归）对数据进行分析，显著性水平设置为p 结果：两组助产士对IPV检测和管理的先验知识都很差，只有16.5%的实验组和17.7%的对照组在干预前阶段有良好的知识。实验组在IPV筛查和管理方面的知识有显著提高，82.1%的患者在干预后立即掌握了良好的知识，92.0%的患者在介入后6周掌握了良好知识（p = 0.001）。观察到的IPV检测和管理实践从干预前的21.9%的满意实践显著改善到干预后的63.5%（p = 0.001），而对照组在实践中没有发现明显的改善（21.9%对36.5%；p = 0.682）。结论：使用定制的教育培训计划提高了助产士在发现和管理亲密伴侣暴力方面的知识和实践。

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引用次数: 0

Professional competencies of oncology nurses: Recognizing advanced practice in nursing 肿瘤科护士的专业能力：认可高级护理实践。

Enfermeria clinica (English Edition)

Pub Date : 2023-09-01 DOI: 10.1016/j.enfcle.2023.07.006

Sergio Muñoz-Villaverde , María Martínez-García , Leticia Serrano-Oviedo , Ana María Sobrado-Sobrado , María Ángeles Cidoncha-Moreno , Paloma Garcimartin

Objective

To identify the competency profile of advanced practice nurses involved in the care process of cancer patients.

Methods

Cross-sectional and descriptive study. The study included all nurses involved in the cancer patient care process in a tertiary hospital in Barcelona. Competence profile data were collected using the instrument for defining the role of the advanced practice nurse (APRD), as well as sociodemographic and occupational variables. Sociodemographic and occupational data were compared against the performance of advanced practice activities.

Results

A total of 29 (82.9%) nurses participated with a mean age of 42.6 ± 12.54 years. 9 (31%) nurses were identified as meeting the standard in all 6 domains on the APRD scale to be considered advanced practice nurses. Of these 9 (31%) nurses, 7 (24.1%) met the training standards required by the International Council of Nurses (ICN) with an official master’s degree and 2 (6.9%) with a PhD.

Conclusions

There are nurses who carry out their activity in the oncology field of the hospital analyzed with the EPA profile. The identification of advanced practice nurses (APNs) in our health system is essential to be able to recognize the competencies of these professionals and create specific positions that help to address chronicity, patients' quality of life, their survival, and the optimization of health resources. Our study highlights the importance of chronicity and cancer as areas for the development of the APNs.

目的：确定参与癌症患者护理过程的高级实践护士的能力概况。方法：横断面和描述性研究。这项研究包括了巴塞罗那一家三级医院参与癌症患者护理过程的所有护士。使用该工具收集能力档案数据，以确定高级实习护士（APRD）的角色，以及社会人口统计和职业变量。将社会形态和职业数据与高级实践活动的表现进行了比较。结果：共有29名（82.9%）护士参加，平均年龄42.6±12.54岁。9名（31%）护士在APRD量表的所有6个领域都符合标准，被认为是高级实习护士。在这9名（31%）护士中，7名（24.1%）达到了国际护士理事会（ICN）要求的培训标准，拥有正式硕士学位，2名（6.9%）拥有博士学位。在我们的卫生系统中识别高级执业护士（APN）对于能够认识到这些专业人员的能力并创建有助于解决慢性病、患者生活质量、生存和卫生资源优化问题的特定职位至关重要。我们的研究强调了慢性和癌症作为APN发展领域的重要性。

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引用次数: 0

Nursing care in perinatal grief. A systematic and critical review of attitudes and knowledge in clinical practice 围产期悲痛的护理。对临床实践中的态度和知识进行系统和批判性的回顾。

Enfermeria clinica (English Edition)

Pub Date : 2023-09-01 DOI: 10.1016/j.enfcle.2023.07.005

Pablo Santiago Moreno Tirado , Eugenia Gil García , Lorena Tarriño Concejero

Aim

To review and synthesize the available evidence on the attitudes and knowledge of nurses regarding the perinatal grief of the parents.

Methods

A systematic review of original articles published from January 2016 to February 2023 without language limit in the Scopus, PubMed, Cinahl, PsycINFO, ScienceDirect and Web Of Science databases was carried out. The Prisma Statement methodological framework was used for systematic reviews and meta-analyses. The entire process was carried out in pairs, with discrepancies being resolved by a third reviewer. The quality of the articles was evaluated following the CASPe criteria (Critical Appraisal Skills Program Spanish).

Results

Twelve articles were obtained in this review after applying the inclusion criteria, of which. Except for one cross-sectional quantitative study (8.33%), the rest were qualitative studies carried out through interviews (75%) or discussion groups (16.66%). It is highlighted that there are different biopsychosocial problems related to the care needs demanded by the family and that, due to poor training or culture of the health professional, are not adequately addressed.

Discussion

The studies found show various resources to adequately attend to perinatal grief, there being discrepancies in relation to allowing or not allowing the body of the deceased baby to be shown and/or taken; There are also disagreements regarding whether the healthcare team should base its practice on protocols or theories such as the Kubler-Ross theory of grief. Most of the studies (75%) consider that more training and awareness is necessary, contemplating the biopsychosocial nature of the user.

目的：回顾和综合护士对父母围产期悲痛的态度和知识的现有证据。方法：对2016年1月至2023年2月在Scopus、PubMed、Cinahl、PsycINFO、ScienceDirect和Web of Science数据库中发表的无语言限制的原创文章进行系统综述。Prisma Statement方法框架用于系统审查和荟萃分析。整个过程是成对进行的，差异由第三位评审员解决。文章的质量按照CASPe标准（西班牙语批判性评估技能计划）进行评估。结果：在应用纳入标准后，本次审查获得了12篇文章，其中。除了一项横断面定量研究（8.33%）外，其余均为通过访谈（75%）或讨论小组（16.66%）进行的定性研究。值得强调的是，与家庭所需的护理需求有关的生物-心理-社会问题各不相同，由于卫生专业人员的培训或文化较差，这些问题没有得到充分解决。讨论：研究表明，有各种资源可以充分照顾围产期的悲痛，在允许或不允许展示和/或取下已故婴儿的尸体方面存在差异；对于医疗团队是否应该将其实践建立在协议或Kubler-Ross悲伤理论等理论的基础上，也存在分歧。大多数研究（75%）认为需要更多的培训和意识，考虑到用户的生物心理社会性质。

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引用次数: 0