DigitalUM :: Browsing by browse.metadata.contributordepartment "Enfermería"

Browsing by browse.metadata.contributordepartment "Enfermería"

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Open Access
A New Tool to Study Parkinsonism in the Context of Aging: MPTP Intoxication in a Natural Model of Multimorbidity
(MDPI, ) Cuenca, Lorena; Pizzichini, Elisa; Gonçalves, Valeria C.; Guillén Díaz, María; Aguilar Moñino, Elena; Sánchez Rodrigo, Consuelo; González Cuello, Ana María; Fernández Villalba, Emiliano; Herrero Ezquerro, María Trinidad; Enfermería
The diurnal rodent Octodon degus (O. degus) is considered an attractive natural model for Alzheimer’s disease and other human age-related features. However, it has not been explored so far if the O. degus could be used as a model to study Parkinson’s disease. To test this idea, 10 adult male O. degus were divided into control group and MPTP-intoxicated animals. Motor condition and cognition were examined. Dopaminergic degeneration was studied in the ventral mesencephalon and in the striatum. Neuroinflammation was also evaluated in the ventral mesencephalon, in the striatum and in the dorsal hippocampus. MPTP animals showed significant alterations in motor activity and in visuospatial memory. Postmortem analysis revealed a significant decrease in the number of dopaminergic neurons in the ventral mesencephalon of MPTP animals, although no differences were found in their striatal terminals. We observed a significant increase in neuroinflammatory responses in the mesencephalon, in the striatum and in the hippocampus of MPTP-intoxicated animals. Additionally, changes in the subcellular expression of the calcium-binding protein S100 were found in the astrocytes in the nigrostriatal pathway. These findings prove for the first time that O. degus are sensitive to MPTP intoxication and, therefore, is a suitable model for experimental Parkinsonism in the context of aging.
Open Access
Access to healthcare among transgender and non-binary youth in Sweden and Spain: a qualitative analysis and comparison
(Public Library of Science, 2024-05-14) Pastor Bravo, María del Mar; Linander, Ida; Enfermería; Facultad de Enfermería
Background: Transgender and non-binary (TGNB) people tend to report worse health than cis people, however, despite an increased need for care, they face several barriers when trying to access healthcare. These barriers might be exacerbated when young age intersects with a trans identity, and so there is a need for studies highlighting the experiences of TGNB youth. Aims: To explore and compare how TGNB youth (15–26 years old) in Sweden and Spain experienced their access to healthcare, in order to shed light on the strengths and limitations of different kinds of healthcare systems and improve healthcare provision and policy development. Methods: This study was based on a qualitative analysis of semi-structured interviews with TGNB youth living in Sweden (n = 16) and Spain (n = 18). Of these, 22 identified as male or transmasculine, six as non-binary, and six as women or transfeminine; 25 had undergone some type of gender-affirming care, and the rest were on the waiting list or undergoing preparatory visits and had not started hormonal treatment. The interviews were analyzed using reflexive thematic analysis. An abductive approach was applied, and the Levesque conceptual framework was used to compare the analyses of each set of materials. Results: We present our findings using the structure of the accessibility framework, focusing on approachability, acceptability, availability, affordability, and appropriateness. The conceptualization of accessibility in combination with the concept of cisnormativity illustrates how specific ideals and normative expectations affect access to healthcare for TGNB people across contexts, with most barriers arising from the appropriateness of the services. Discussion: Young TGNB people experience barriers to accessing healthcare both in the Spanish and the Swedish contexts. Strategies to reduce these barriers should be framed within the critique of and resistance to cisnormativity and should focus on users with intersecting marginalized identities to promote health equity.
Open Access
Actitudes de médicos y enfermeras ante las actividades preventivas y de promoción en atención primaria
(Elsevier, 2014-04-25) Ramos Morcillo, Antonio Jesús; Ruzafa Martínez, Maria; Fernández Salazar, Serafín; del Pino Casado, Rafael; Armero Barranco, David; Enfermería
Objetivo Conocer la actitud de los profesionales de medicina y enfermería del sistema sanitario público andaluz ante las intervenciones preventivas y de promoción de salud (PPS) en el contexto de la atención primaria y la relación con las variables sociolaborales y con las competencias autodeclaradas en PPS. Diseño Estudio multicéntrico, observacional, descriptivo transversal. Emplazamiento Atención primaria, comunidad autónoma de Andalucía, España. Participantes Se incluyeron los 282 profesionales (médicos y enfermeras) que participaron en la validación del cuestionario sobre las actitudes ante PPS en atención primaria (CAPPAP). Pertenecían a 22 centros de salud del sistema sanitario público andaluz. Mediciones principales Actitud de los profesionales ante las actividades de PPS, compuesta por las dimensiones: necesidad de mejora, percepción de la actitud de otros compañeros, importancia, oportunidades de mejora y obstáculos. Se utilizó el cuestionario validado CAPPAP. Se incluyeron variables sociolaborales y preguntas sobre las competencias autodeclaradas en PPS. Resultados Todas las dimensiones del CAPPAP superan el punto medio de la escala (2,5), oscilando sus valores entre 3,06 (DT: 0,76) en «necesidad de mejora» y 4,39 (DT: 0,49) en «importancia». Las variables sociolaborales y de competencias autodeclaradas presentan una relación estadísticamente significativa con las dimensiones de la actitud de los profesionales, excepto: años en atención primaria, formación y realización de actividades programadas de PPS. Conclusiones Las actitudes de los profesionales ante las actividades de PPS son aceptables y se debe trabajar en su mantenimiento. Las organizaciones sanitarias deberían implementar intervenciones adaptadas a distintos perfiles profesionales así como intervenciones que pongan en valor dichas actividades y mejoren la pericia y la seguridad en su realización.
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Adaptación y validación de un instrumento de evaluación de la competencia del consejo breve para dejar de fumar. BTI-Prof©
(Elsevier, 2022-09-30) Ramos Morcillo, Antonio Jesús; García Moralb, Ana Teresa; Fernández Salazaf, Serafín; Leal Costa, César; Ruzafa Martínez, María; Granero Moya, Nani; Enfermería
Objetivo: Adaptación y validación del BTI-St© para evaluar el nivel de competencia en consejo breve para dejar de fumar en profesionales de medicina y enfermería de Atención Primaria. Diseño: estudio transversal, de adaptación y validación psicométrica de un test referido a criterio. Emplazamiento: Atención Primaria. Participantes: Ciento cincuenta y cinco profesionales de medicina y enfermería de Atención Primaria en activo. Intervenciones: Se disenaron ˜ 3 escenarios clínicos. A través de una plataforma online, los participantes en primer lugar visualizaban cada escenario donde se desarrollaba un consejo breve para dejar de fumar y posteriormente debían valorar si se había realizado de acuerdo con el modelo de las 5A + 5R. Mediciones principales: Competencia en el consejo breve para dejar de fumar medida a través del BTI-Prof©. Resultados: Los resultados vinculados a la fiabilidad se obtuvieron mediante el coeficiente Kuder-Richardson y fueron para el escenario 1: 0,880, para el escenario 2: 0,829 y para el escenario 3: 0,826. El test-retest muestra una adecuada estabilidad temporal, con unos coeficientes de correlación intraclase de 0,857 (IC 95%: 0,734-0,923), p < 0,0001 para el escenario 1, 0,829 (IC 95%: 0,676-0,909), p < 0,001 para el escenario 2 y 0,869 (IC 95%: 0,76-0,928), p < 0,0001 para el escenario 3. Conclusiones: El BTI-Prof© es una herramienta robusta, con adecuadas propiedades psicométricas para evaluar la competencia en consejo breve para dejar de fumar en profesionales de medicina y enfermería de Atención Primaria.
Open Access
Adecuación entre la práctica clínica obstétrica en el Hospital Clínico Universitario Virgen de la Arrixaca (Murcia) y las recomendaciones de la Estrategia de Atención al Parto Normal
(2015) Carrillo García, César; Martínez Roche, M. E.; Enfermería
Open Access
La alimentación del lactante: la nodriza y el examen probatorio de la leche en la obra de Oribasio
(2025-07-01) López Pérez, Mercedes; Enfermería
El presente trabajo tiene como objetivo principal analizar el examen probatorio de la leche de Mnesites de Cízico, que conocemos gracias a la obra de Oribasio, incluyo también la comparación con un capítulo que versa sobre el mismo tema en la obra de Sorano de Éfeso. Estos textos están impregnados de «irracionalidades», que son mas propios de los conocimientos populares que de lo que entendemos como conocimiento científico. El cuerpo femenino continua siendo un gran desconocido en ésta época y sus cuidados están sobre todo relacionados con la salud doméstica.
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Amuletos con imagen del lagarto en la glíptica greco-romana y su aplicación en las patologías infantiles
(Signifer Libros, 2021) López Pérez, Mercedes; Enfermería; Perea Yébenes, Sabino; Facultades de la UMU::Enfermería
El simbolismo y la iconografía del lagarto en las gemas grecorromanas es el ob- jetivo principal de este análisis. El lagarto es un animal empleado en recetas mágicas como se pone de manifiesto en los Papiros Griegos Mágicos, y en el libro de Kyranides, pero también en numerosas recetas recopiladas en la enciclopedia del Plinio. Estos remedios y la naturaleza de las gemas han llevado a la mayoría de estudiosos a señalar la utilidad de las mismas para la higiene ocular. Nuestro análisis parte de la teoría de Nock que mantenía que la idea de que el lagarto es un animal perverso y odiado por los dioses es casi con toda probabilidad una leyenda inventada ad hoc. El análisis de las recetas infantiles en la obra de Plinio, las indicaciones para la realización de una estatua a Hécate en los Oráculos Caldeos con un tipo de lagarto doméstico, la evolución de la iconografía de este animal en los vasos griegos y en los relieves sepulcrales infantiles, así como la sustitución de este animal en la triaca galénica, son datos que nos permiten profundizar en una faceta más doméstica y menos trascendental de este animal.
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Análisis de dos gemas fusiformes y su función como amuletos femeninos
(Signifer Libros, 2022) López Pérez, Mercedes; Enfermería; Perea Yébenes, Sabino; Facultades de la UMU::Enfermería
Se analizan a continuación dos1 hematites fusiformes cuya simbología y caracteres permite identificarlos como amuletos para la protección de la salud femenina. La utilización de la piedra hematites, su aspecto alargado en forma de huso y las referencias simbólicas al cuerpo femenino nos permiten relacionarlas con el resto de gemas que denominamos uterinas. Las imágenes representadas en estas gemas aluden al mito de Isis y Osiris, el símbolo del útero en ellas y el estudio de los textos médicos grecorromanos en materia ginecológica, nos permiten completar la función y utilización de estas gemas.
Open Access
Analysis of Anxiety Levels of Nursing Students Because of e- Learning during the COVID-19 Pandemic. Healthcare 2021,9, 252.
(2021) Garcia-Gonzalez, J.; Ruqiong, Wei; Alarcon-Rodriguez, Raquel; Requena-Mullor, Mar; Ding, Can; Ventura-Miranda, Maria Isabel; Enfermería
Open Access
Aproximación al estudio de la salud mental en mujeres que han realizado una interrupción voluntaria del embarazo.
(Universidad de Murcia. EDITUM, 2014) Martínez Mellado, Carmen María; González Cuello, Ana María; Enfermería
Open Access
Assessing Evidence-Based Practice Competence in Nurse Leadership Roles in Spain
(Wiley, 2026) Pedro Simón Cayuela-Fuentes; César Leál-Costa; Serafín Fernández-Salazar; José Antonio Vera-Pérez; Antonio Jesús Ramos-Morcillo; María Ruzafa-Martínez; Segura López, Gabriel; Cayuela Fuentes, Pedro Simón; Leal Costa, César; Vera Pérez, José Antonio; Ramos Morcillo, Antonio Jesús; Ruzafa Martínez, María; Enfermería; Facultades de la UMU
ABSTRACT Objective: This study evaluated the competency of nursing leaders and managers in Spain regarding evidence-based practice (EBP) and identified factors that affect its implementation in clinical environments. Background: EBP is essential for enhancing healthcare quality; however, there are still gaps between theoretical knowledge and its practical application. Nursing leaders are crucial in promoting EBP, yet their competence levels and obstacles have not been thoroughly examined in Spain. Material and methods: A cross-sectional study surveyed 159 nurse managers across 16 autonomous communities in Spain, utilizing the validated EBP-COQ Prof tool. The questionnaire assessed four competency domains—attitude, knowledge, skills, and utilization—using a 1 to 5 Likert scale. Predictors of EBP competency, including training, mentorship, and organizational afiliation, were analyzed using multivariate linear regression. Results: Participants demonstrated a strong overall EBP competence, with an average total score of 143.77 out of 175. The highest scores were in the attitude domain (36.26/40) and knowledge (43.09/55), whereas utilization scores were relatively lower (37.57/ 50). This indicates that applying EBP in practice still lags behind positive attitudes and knowledge. Key factors predicting higher EBP competence included EBP training, consistent reading of scientific literature, mentoring nursing students, and working in a BPSO center. These results also imply that organizational constraints may continue to impede the integration of EBP competence into routine managerial practice. Conclusions: Spanish nurse managers possess strong EBP knowledge but continue to encounter difficulties in applying it clinically. The study highlights four adjustable factors of EBP competency that could guide focused interventions. Implications for Nursing Management: Healthcare institutions should implement (1) training programs for addressing knowledge-to-practice gaps, especially for nonspecialist managers; (2) mentorship systems pairing EBP-competent leaders with novices; (3) protected time for EBP activities; and (4) expanded BPSO accreditation to institutionalize evidence-based care. Future initiatives should include EBP metrics in performance evaluations, and research should explore factors such as leadership styles and the impact of resource allocation on patient outcomes through longitudinal designs.
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Assessing sexual function in middle-aged sexually active Spanish women: a community-based study focusing on the intimate partner.
(2021-03) Martinez Madrid, María M.; Arnau Sánchez, José; González Cuello, Ana María; Enfermería
Objective: This study evaluated sexual function, the influence of the relationship with the intimate partner, and the factors related to sexual function in middle-aged Spanish women. Methods: The methodology entailed a cross-sectional study of 187 sexually active women aged 40-59 years. The participants were randomly recruited from primary public health care. They completed the 6-item Female Sexual Function Index (FSFI-6), the short-form Woman Abuse Screening Tool (WAST), and a sociodemographic questionnaire. Descriptive and inferential analysis was performed. Results: The participants’ median age was 49 years, 90.4% had a steady intimate partner, 54.5% were postmenopausal, 43.3% had chronic diseases, 12.3% reported alcohol abuse, and 35.8% smoked. The prevalence of low sexual function was 33.16% in all the women, and 44.12% in the postmenopausal women (an FSFI-6 total score 19 reflects low sexual function). WAST screening detected 17.65% cases of intimate partner violence (WAST total score 1), with low sexual function in 87.9%. Multiple linear regression analysis models revealed that the lowest total FSFI-6 scores (worst sexual function) were negatively associated with intimate partner violence (IPV), depression, hysterectomy, and associated female issues. The scores in the FSFI-6 domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were linked to IPV (P < 0.001), except for lubrication (P < 0.001postmenopausal).
Open Access
Barriers Perceived by Managers and Clinical Professionals Related to the Implementation of Clinical Practice Guidelines for Breastfeeding through the Best Practice Spotlight Organization Program
(MDPI, 2020-08-27) Ramos Morcillo, Antonio Jesús; Armero Barranco, David; Leal Costa, César; Moral García, José Enrique; Ruzafa Martínez, María; Harillo Acevedo, Francisco David; Enfermería
: International institutions facilitate the contact of health professionals to evidence-based recommendations for promoting exclusive breast feeding (BF). However, the achievement of good rates of exclusive BF is still far from the optimum. The intention of the present work is to determine the barriers identified by managers and health professionals involved in the implementation and sustainability of Clinical Practice Guidelines (CPG) for breastfeeding under the auspices of the Best Practice Spotlight Organization program. A qualitative research study was carried out. The participants were managers, healthcare assistants, nurses, midwives, pediatricians and gynecologists. Semi-structured interviews were conducted which were transcribed and analyzed using the six steps of thematic analysis. Twenty interviews were conducted, which defined four major themes: (1) Lack of resources and their adaptation; (2) Where, Who and How; (3) Dissemination and reach of the project to the professionals; and (4) The mother and her surroundings. This research identifies the barriers perceived by the health professionals involved in the implementation, with the addition of the managers as well. Novel barriers appeared such as the ambivalent role of the midwives and the fact that this CPG is about promoting health. The efforts for promoting the implementation program should be continuous, and the services should be extended to primary care.
Open Access
Benefits of a community physical exercise program prescribed from primary care for perimenopausal/menopausal women
(2021) Aviles - Martinez, M. A.; Lopez Roman, F. J.; Galiana Gómez de Cádiz, María José; Arnau Sánchez, José; Martinez Ros, M. T.; Fernandez Lopez, L.; Garcia Sanchez, E.; Menárguez Puche, Juan Francisco; Enfermería
Objetivo: Medir los beneficios de un programa comunitario de ejercicio físico, a través de las modificaciones que se producen en calidad de vida, y condición física de mujeres perimenopáusicas-menopáusicas. Emplazamiento: Las participantes fueron reclutadas en consultas de Atención Primaria (AP) de dos centros de Salud de Molina de Segura (Murcia). Participantes: Mujeres de entre 40 y 70 anos ˜ o menores de 40 diagnosticadas de menopausia precoz. Diseno: ˜ Estudio cuasiexperimental, no aleatorizado, controlado, abierto y unicéntrico con dos ramas paralelas a estudio. Intervención: Grupo experimental: programa de ejercicio ACTIVA-Salud Ósea durante seis meses. Control: Inactivos. Mediciones principales: Calidad de vida mediante cuestionario SF36. Condición física: Condición aeróbica, flexibilidad, equilibrio y fuerza, medida con los test de la milla, flamenco y el cajón, así como lanzamiento del balón medicinal, respectivamente. Nivel de actividad física a través del General practice physical activity questionnaire (GPPAQ). Se recogieron variables sociodemográficas y se midió la adherencia al programa. Resultados: La calidad de vida mejoró en el grupo intervención vs. control, salvo la dimensión «dolor corporal» (p = 0,412). A nivel intragrupo, presentan mejoría significativa todas las dimensiones, a excepción de «función física» (p = 0,263) y «dolor corporal» (p = 0,136). Las capacidades físicas que más se beneficiaron fueron la condición aeróbica, fuerza y equilibrio. Conclusiones: El pilotaje del Programa de ejercicio físico Activa Salud Ósea demostró beneficios sobre la calidad de vida física y mental de las participantes. Además, se constata que la realización de un ejercicio específico para mujeres premenopáusicas-menopáusicas mejora su condición física
Open Access
Burnout and job satisfaction among nurses in three Spanish regions
(Wiley, 2021-05-17) Acea-López, Lorena; Pastor Bravo, María del Mar; Rubinat-Arnaldo, Esther; Bellon, Filip; Blanco-Blanco, Joan; Gea-Sánchez, Montserrat; Briones-Vozmediano, Erica; Enfermería; Facultad de Enfermería
Aims: To determine the levels of job satisfaction and burnout syndrome and related factors among nurses in three Spanish regions. Background: The nursing profession involves high work stress due to emotional involvement, workload and available resources. Methods: Descriptive multicentric cross-sectional study. Sociodemographic and migration data were collected and participants completed the Job Satisfaction Questionnaire S20/23 and Maslach Burnout Inventory. The data were analysed using descriptive statistical methods using the program SPSS. Results: The sample included 228 nurses (187 women and 41 men), with a mean age of 37.11 ± 10.87. Reported job satisfaction was medium to high. Overall, values were low in emotional fatigue and medium in depersonalization and personal fulfilment. In terms of migration, 21.59% of the participants had already moved to other Spanish regions or another country, while 18.58% had the intention of doing so. Conclusion: Nurses with a temporary contract showed a high burnout rate, and high levels of emotional fatigue, depersonalization and lack of personal fulfilment. Implications for Nursing Management: Strategies are needed to improve working and contractual conditions such as enhancing teamwork, management and leadership skills in nurses; achieving internal promotion; and having higher participation in decision-making and a better balance of power between health institution managers and health professionals.
Open Access
Cardiac Changes in Parkinson’s Disease: Lessons from Clinical and Experimental Evidence
(MDPI, 2021-12) Herrero Ezquerro, María Trinidad; Laorden Carrasco, María Luisa; Cuenca Bermejo, Lorena; Almela Rojo, Pilar; Navarro Zaragoza, Javier; González Cuello, Ana María; Fernández Villalba, Emiliano; Enfermería
Dysautonomia is a common non-motor symptom in Parkinson’s disease (PD). Most dysautonomic symptoms appear due to alterations in the peripheral nerves of the autonomic nervous system, including both the sympathetic and parasympathetic nervous systems. The degeneration of sympathetic nerve fibers and neurons leads to cardiovascular dysfunction, which is highly prevalent in PD patients. Cardiac alterations such as orthostatic hypotension, heart rate variability, modifications in cardiogram parameters and baroreflex dysfunction can appear in both the early and late stages of PD, worsening as the disease progresses. In PD patients it is generally found that parasympathetic activity is decreased, while sympathetic activity is increased. This situation gives rise to an imbalance of both tonicities which might, in turn, promote a higher risk of cardiac damage through tachycardia and vasoconstriction. Cardiovascular abnormalities can also appear as a side effect of PD treatment: L-DOPA can decrease blood pressure and aggravate orthostatic hypotension as a result of a negative inotropic effect on the heart. This unwanted side effect limits the therapeutic use of L-DOPA in geriatric patients with PD and can contribute to the number of hospital admissions. Therefore, it is essential to define the cardiac features related to PD for the monitorization of the heart condition in parkinsonian individuals. This information can allow the application of intervention strategies to improve the course of the disease and the proposition of new alternatives for its treatment to eliminate or reverse the motor and non-motor symptoms, especially in geriatric patients.
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Cessation of oral anticoagulation is an important risk factor for stroke and mortality in atrial fibrillation patients
(2017) Rivera Caravaca, José Miguel; Roldán Schilling, Vanessa; Esteve Pastor, María Asunción; Valdés Chávarri, Mariano; Vicente García, Vicente; Lip, Gregory YH; Marín Ortuño, Francisco; Enfermería
Oral anticoagulation (OAC) is highly effective preventing stroke and mortality in AF, but withdrawal is common in the elderly, when high bleeding risk and when are difficulties achieving an optimal time in therapeutic range (TTR). We analysed the rate of OAC cessation, predisposing factors to cessation and the relation to clinical outcomes in a large ‘real world’ cohort of AF patients over a long follow-up period. Consecutive non-valvular AF outpatients clinically stables for six months were recruited. Rates of cardiovascular events, major bleeding and mortality were recorded and related to OAC cessation. We included 1361 patients (48.7 % male; aged 76, IQR 71–81), followed-up for a median of 6.5 years. During follow-up, 244 patients suffered thrombotic events, 250 suffered from major bleeding and 551 patients died. 10 % of patients stopped OAC. After OAC withdrawal, there were 36 thromboembolic events (22 strokes), 10 major bleedings and 75 deaths. OAC cessation was independently associated with adverse cardiovascular events (HR 1.45; 95 % CI 1.01–2.08), stroke/TIA (HR 1.85; 1.17–2.94) and all-cause mortality (HR 1.30; 1.02–1.67). Independent predictors of OAC cessation were age 80 (HR 2.29; 1.60–3.29), previous coronary artery disease (HR 0.32; 0.15–0.71), major bleeding (HR 5.00; 3.49–7.15), heart failure (HR 2.38; 1.26-4.47), cancer (HR 5.24; 3.25–8.44) and renal impairment developed during follow-up (HR 2.70; 1.26–5.75). In conclusion, in non-valvular AF patients, cessation of OAC was independently associated with the risk of stroke, adverse cardiovascular events and mortality. Bleeding events and some variables associated with higher bleeding risk are responsible for OAC cessation.
Open Access
CFAE-Visual Cuestionario autoadministrable para familias de personas con enfermedades raras en el ámbito educativo
(Universidad de murcia, 2025) Gómez Navarro, Carmen María; Cascales Martínez, Antonia; Peñalver García, Dolores María; López Mellado, José; García Recover, Pedro; Trabajo Social y Servicios Sociales; Métodos de Investigación y Diagnóstico en Educación; Enfermería
Encuesta autoadministrada a familias con hijos con enfermedad rara que afecta a la visión y que se encuentren escolarizados en educación infantil, primaria, secundaria, FP o bachillerato. Este instrumento de investigación y apoyo para la educación inclusiva en el ámbito de la discapacidad visual está diseñado para recoger información de las familias y guiar a los profesionales en intervenciones educativas adecuadas basadas en la evidencia.
Open Access
Changes in nurse job outcomes after 4 years of a Best Practice Spotlight Organization® programme implementation in the Spanish National Health Context
(2021-05) Ruzafa Martinez, Maria; Garcia Gonzalez, Jessica; Leal Costa, Cesar; Martínez González, Miguel Ángel; Ramos Morcillo, Antonio Jesús; Hernández Méndez, Solanger; Enfermería
Aim: To evaluate the changes produced after the application of the Best Practice Spotlight Organization® (BPSO® ) Program on the attitude towards the evidence-based practice, the nurses' perception of the organisational climate and nurse outcomes in a health area of the Spanish National Health System. Background: There is limited research that associates strategies of evidence-based practice implementation with changes on the work environment and nurse outcomes. Methods: Cross-sectional study that compared data on the nurses' perception of the work environment. Five guidelines were implemented between 2012 and 2015 in a health area. Data were collected in 2012 and 2016/2017, using a questionnaire consisting of five previously validated tools. X2 , t test, ANOVA and multivariate analysis were carried out. Results: A total of 451 nurses participated. Compared with the baseline evaluation in 2012, several outcomes changed significantly (p < .001), nurses were younger and were more satisfied with "salary", "annual leaves" and "sick leave". The rest of the nurse outcomes were not modified. Conclusions: Nurses' perception of the work environment is favourable, although the application of the BPSO® Program has not produced any major changes. Implications for nursing management: Measures are suggested that are oriented towards the planning of staffing and the increase in the participation of the nursing staff in programmes of implementation of guidelines.
Open Access
Clinical profile and prognosis in patients on oral anticoagulation before admission for COVID-19
(Wiley, 2020) Rivera-Caravaca, José Miguel; Núñez-Gil, Iván J.; Vivas, David; Viana-Llamas, María C.; Uribarri, Aitor; Becerra-Muñoz, Víctor Manuel; Trabattoni, Daniela; Fernández Rozas, Inmaculada; Feltes, Gisela; López-Pais, Javier; El-Battrawy, Ibrahim; Macaya, Carlos; Fernández-Ortiz, Antonio; Estrada, Vicente; Marín Ortuño, Francisco; Enfermería
Background: The coronavirus disease 2019 (COVID-19) shows high morbidity and mortality, particularly in patients with concomitant cardiovascular diseases. Some of these patients are under oral anticoagulation (OAC) at admission, but to date, there are no data on the clinical profile, prognosis and risk factors of such patients during hospitalization for COVID-19. Design: Subanalysis of the international ‘real-world’ HOPE COVID-19 registry. All patients with prior OAC at hospital admission for COVID-19 were suitable for the study. All-cause mortality was the primary endpoint. Results: From 1002 patients included, 110 (60.9% male, median age of 81.5 [IQR 75-87] years, median Short-Form Charlson Comorbidity Index [CCI] of 1 [IQR 1-3]) were on OAC at admission, mainly for atrial fibrillation and venous thromboembolism. After propensity score matching, 67.9% of these patients died during hospitalization, which translated into a significantly higher mortality risk compared to patients without prior OAC (HR 1.53, 95% CI 1.08-2.16). After multivariate Cox regression analysis, respiratory insufficiency during hospitalization (HR 6.02, 95% CI 2.18-16.62), systemic inflammatory response syndrome (SIRS) during hospitalization (HR 2.29, 95% CI 1.34-3.91) and the Short-Form CCI (HR 1.24, 95% CI 1.03-1.49) were the main risk factors for mortality in patients on prior OAC. Conclusions: Compared to patients without prior OAC, COVID-19 patients on OAC therapy at hospital admission showed lower survival and higher mortality risk. In these patients on OAC therapy, the prevalence of several comorbidities is high. Respiratory insufficiency and SIRS during hospitalization, as well as higher comorbidity, pointed out those anticoagulated patients with increased mortality risk.

Browsing by browse.metadata.contributordepartment "Enfermería"

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