Effectiveness of a telephone intervention based on motivational health coaching for improving the mental health of caregivers of people with dementia: A randomised controlled trial

Objectives: Caring for a family member with dementia is considered one of the activities with the greatest negative impact on a person's mental health. Developing long-lasting and effective strategies is a challenge for caregivers. This study sought to evaluate the impact of an intervention based on a programme of motivational coaching delivered by telephone in a group of caregivers of patients with dementia compared to a control group. Methods: A randomised controlled trial with a control group and an intervention group. (CONSORT guidelines were used). Telephone calls were made during six weeks, involving a process of coaching and motivational interviews. The following variables were measured in caregivers: self-efficacy of caring, depression, perceived stress, frequency of problematic behaviours and dysfunctional thoughts. Assessments were conducted at three time points: baseline, post-intervention and three months? post-intervention. Results: In total, 106 caregivers participated (53 subjects in the control group and 53 in the intervention group). Statistically significant differences (ANCOVA) were found between both groups for the self-efficacy and stress variables, with improved results in the intervention group (p < .01). Furthermore, statistically significant differences were found in the intervention group between the baseline and post-intervention assessments, with improvements in self-efficacy, decreased stress and decreased dysfunctional thoughts (p < .05). The results were maintained over time for both groups. Conclusions: An intervention based on telephone calls using a health coaching approach with motivational interviewing appears to be effective for the improvement of self-efficacy and mental health of caregivers of people with moderate dementia. Furthermore, these effects appear to be maintained over time

Case report: Nursing methodology in hemodynamics: Patient undergoing coronary angioplasty via the radial access

En los últimos años, el acceso radial ha surgido como una alternativa al acceso femoral, en la mayoría de pacientes que acuden para realizarse una angioplastia coronaria, para el tratamiento del síndrome coronario agudo con elevación del ST. La vía radial como acceso en el abordaje de procedimientos como cateterismos, angioplastia e implantación de stents permite tratar el mismo tipo de lesiones que por la vía femoral. Además, la vía radial disminuye la morbilidad relacionada con el punto de punción y permite una mayor comodidad para el paciente. Se presenta el caso clínico de un paciente de 55 años que ingresa procedente de urgencias con el diagnóstico de síndrome coronario agudo con elevación del ST, utilizando como vía de elección la arteria radial. Para ello, elaboramos el plan de cuidados del paciente siguiendo los pasos del método científico y apoyándonos en la taxonomía de la North American Nursing Diagnosis Association (NANDA), así como en la Nursing Outcomes Classification (NOC) y Nursing Interventions Classification (NIC) para delimitar objetivos e intervenciones enfermeras, respectivamente.In recent years, the radial access has emerged as an alternative to the femoral access in most patients who are to be subjected to a coronary angioplasty as a treatment for ST-elevation acute coronary syndrome. The radial access in approaching such procedures as catheterization, angioplasty and stent implantation allows the treatment of the same types of lesions as the femoral access. In addition, the radial access reduces puncture site-related morbidity and allows the patient to have a greater comfort. We present herein the case of a 55-year-old patient who is admitted from the emergency room with a diagnosis of STEACS, using the radial artery as the elective approach. With that aim, we developed the patient?s care plan following the scientific method steps and relying on the North American Nursing Diagnosis Association (NANDA) taxonomy, as well as on the Nursing Outcomes Classification (NOC) and the Nursing Interventions Classification (NIC), to define the objectives and the nursing interventions, respectively

The patient with Austrian syndrome: regarding a case

En la actualidad, la endocarditis infecciosa es una enfermedad poco frecuente, con una incidencia estimada entre 3,1 y 3,7 episodios cada 100.000 habitantes/año. Pese a los progresos en el tratamiento médico-quirúrgico, la mortalidad hospitalaria de los pacientes con endocarditis es alta. La endocarditis infecciosa es un proceso que se debe a una infección microbiana localizada en el endocardio. La zona afectada con más frecuencia es la superficie de las válvulas y, en la mayor parte de los casos, es de origen bacteriano. Un tipo de endocarditis es el denominado síndrome de Austrian, esta afección tiene un mecanismo diferente a otros tipos de endocarditis y destaca por la agresividad con la que se destruye la región valvular izquierda del corazón. El nombre que da título al caso se debe al médico que publicó la triada de neumonía, endocarditis y meningitis neumocócica. Se presenta el caso clínico de una mujer de 68 años diagnosticada de síndrome de Austrian que ingresó en una Unidad de Cuidados Críticos Cardiológicos con gran inestabilidad hemodinámica, sedoanalgesiada y en tratamiento con ventilación mecánica por una insuficiencia respiratoria. Dada la gravedad del caso está justificado establecer un plan de cuidados basado en el modelo bifocal de Carpenito para resolver las necesidades de salud reales y potenciales en un paciente diagnosticado de síndrome de Austrian, apoyándonos en la taxonomía North American Nursing Diagnosis Association, así como en la Nursing Outcomes Classification y Nursing Interventions Classification para delimitar objetivos e intervenciones enfermeras, respectivamente.Infective endocarditis is currently an uncommon disease, with an estimated incidence of between 3.1 and 3.7 episodes per 100,000 inhabitants/year. Despite the progress in medical-surgical treatment, hospital mortality of patients with endocarditis is high. Infective endocarditis is a process that is due to a microbial infection localized in the endocardium. The area most often affected is the surface of the valves and in most cases it has a bacterial origin. A type of endocarditis is the so-called Austrian syndrome; this condition has a different mechanism from other types of endocarditis and stands out for the aggressiveness with which the left valvular region of the heart is destroyed. The name that entitles the case is due to the doctor who published the triad of pneumonia, endocarditis and pneumococcal meningitis. We present the case of a 68-year-old woman, diagnosed with Austrian syndrome, who was admitted into a Cardiac Intensive Care Unit with a serious hemodynamic instability, under sedation and analgesia and on treatment with mechanical ventilation due to respiratory failure. Considering the seriousness of the case, there is a justification for establishing a care plan based on Carpenito?s bifocal model so as to meet the real and potential health needs in a patient diagnosed with Austrian Syndrome, relying on the North American Nursing Diagnosis Association taxonomy, as well as on the Nursing Outcomes Classification and the Nursing Interventions Classification, in order to define objectives and nursing interventions, respectively

Nursing students´ satisfaction: a comparison between medium- and high-fidelity simulation training

Training based on clinical simulation is an effective method of teaching in nursing. Nevertheless, there is no clear evidence about if it is better to use high- or medium-fidelity simulation. The aim is to analyse if students are more satisfied when their clinical simulation practices are based on high-fidelity simulation (HFS) or medium-fidelity simulation (MFS). Students´ satisfaction was assessed using the Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation. The sample is composed of 393 students from two Spanish Universities. Satisfaction with simulation in nursing students is significantly greater in MFS than HFS. Simulation is beneficial for learning in all its forms, but for the acquisition of basic skills, and at a lower cost, MFS proves to be effective. However, high-fidelity is not always better than medium-fidelity as this depends on the student?s level of knowledge and clinical experienc

Transcultural adaptation of the revised caregiving appraisal scale (RCAS) in the Spanish population

Aim To develop a transcultural adaptation of the Revised Caregiving Appraisal Scale among Spanish caregivers of dependent older people and to test the psychometric properties of the scale. Design Cross-sectional study. Methods The Revised Caregiving Appraisal Scale was transculturally adapted to the Spanish population following the methodology of direct and back translation. The Spanish version of the Revised Caregiving Appraisal Scale was administered to a total of 182 family caregivers of older dependent people. The study began in January 2016 and ended in December of the same year. The construct validity was studied by means of the scree plot and parallel analysis. The exploratory factorial analysis was carried out, and the correlation between factors was studied. To verify the reliability of the process, Cronbach's alpha and homogeneity were calculated by the corrected total item correlation. The validity of the convergent criterion was studied by means of the Pearson correlation coefficient, using the Zarit Caregiver Load Interview and the Family Satisfaction Scale as the gold standard. Results The construct validity revealed three factors: ?Subjective Burden? (15 items), ?Satisfaction? (7 items) and ?Competence? (3 items). The Cronbach alpha was .86 for ?Subjective Burden?, .74 for ?Satisfaction? and .74 for ?Competence?. The corrected total item correlation was greater than .25. The validity of the convergent criterion of the ?Subjective Burden? and ?Competence? factors with the ?Zarit Caregiver's Load Interview? presented a very high statistically significant correlation, unlike ?Satisfaction? which presented a low positive correlation with the ?Family Satisfaction Scale?. Conclusion The Spanish version of the Revised Caregiving Appraisal Scale is a valid and reliable scale according to the tests performed on a random sample of family caregivers of older dependent people in Spain. Impact This scale will enable the simultaneous assessment of negative (?Subjective Burden? and ?Competence?) and positive (?Satisfaction?) perceptions among family caregivers of older dependent people

Association among presence of cancer pain, inadequate pain control, and psychotropic drug use

Introduction Pain is a common symptom in cancer patients, and its control and management are complex. Despite the high concomitant use of psychotropic drugs among such patients, the association among pain, inadequate pain control, and psychotropic drug use has not been fully determined. This study examined the prevalence of cancer pain and inadequate pain control and the association with psychotropic drug use. Materials and methods In this cross-sectional study, we investigated 402 medical records obtained by simple random sampling of oncology patients at a hospital in northern Spain from July 2012 to July 2014. Adjusted odds ratios (ORs) were estimated together with their 95% confidence intervals (95% CIs) by unconditional logistic regression for each type of psychotropic drug (anxiolytics, hypnotics, and antidepressants). Results The mean patient age was 61.17 (standard deviation ± 13.14) years; 57.5% were women, 42.5% men. Pain was present in 18.4% of patients and inadequate pain control in 54.2%. We found a statistically significant association between the presence of cancer pain and anxiolytic use (adjusted OR, 3.15; 95% CI, 1.49±6.68) and hypnotic use (adjusted OR, 5.19; 95% CI, 1.77±15.25). Inadequate pain control was associated to a greater extent with the use of those drugs: adjusted OR for anxiolytic use, 4.74 (95% CI, 1.91±11.80); adjusted OR for hypnotic use, 6.09 (95% CI, 1.74±21.32). By contrast, no association was found between pain and antidepressant use (adjusted OR, 0.99). Conclusion The presence of pain and (to a greater extent) poor pain control were associated with increased use of certain psychotropic drugs, such as anxiolytics and hypnotics. There appeared to be no association between pain and antidepressant use

Checklist implementation in catheterization laboratory

-Introducción: El Checklist (CL) ha demostrado ser una herramienta que permite resumir información, disminuir los errores y mejorar los estándares de calidad, tanto en los procedimientos quirúrgicos como en la práctica clínica. -Objetivos: evaluar el cumplimiento de un CL adaptao a una sala de hemodinámica en los pacientes sometidos a procedimientos de cardiología intervencionista. -Materiales y métodos: diseño descriptivo transversal realizado en un hospital terciario. Se incluyeron consecutivamente a 400 pacientes sometidos a un procedimiento intervencionista desde noviembre del 2014 a febrero de 2015 y se llevó a cabo utilizando un cuestionario adaptado de la Organización Mundial de la Salud. -Resultado: el 70% fueron hombres con una media inferior a las mujeres. El diagnóstico de cardiopatía isquémica fue el más frecuente (64%), con una mayor prevalencia en varones (71% vs. 29%; p<0,0001) y en trasplantados cardiacos (92% vs. 8%; p=0,02). El acceso vascular de elección fue la vía femoral (64,5%). En más de un cuarto de los CL faltaban 4 o más ítems sin rellenar. El CL se cumplimentó íntegramente en un 18,5%. - Conclusiones: el CL es un registro útil para la consecucion de los acontecimientos; permite identificar situaciones de riesgo y eventos adversos. Los ítems del CL no registrados pueden deberse a la falta de conocimientos y de motivación, por lo que es necesario implementar estrategias para mejorar el cumplimiento de las prácticas recomendadas y para la seguridad de los pacientes.-Introduction: the checklist (CL) has proven to be a tool that allows to summarize information, reduce errors and improve quality standards both in surgical procedures and in clinical practice. -Objectives: to evaluate compliance with a CL adapted to a catheterazation laboratory in patients undergoing interventional cardiology procedures. - Material and methods: cross-sectional descriptive design conducted at a tertirary care hospital. Four hundrer patients who had underwent an interventional procedure from November 2014 to February 2015 were consecutively included therein, and it was carried out with the use of an adapted questionnaire from the World Health Organization (WHO). -Results: 70% were men with a mean age lower thanh women. Ischemic heart disease was the most frequent diagnosis (64%), with a higher prevalence in males (71% vs. 29%; p<0.0001) and in heart-transplanted patients (92% vs. 8%; p=0.02). The vascular approach of choice was the femoral one (64.5%). In more than a quarter of the CLs, 4 or more items remained uncompleted. The CL was completely complied with in a 18.5%. -Conclusion: the CL is a useful recording system for the achievement of the procedures; it allows to identify risk situations and adverse events. Unrecorded CL items may be due to the lack of knowledge and motivation, whereby approaches should be implemented in order to improve the compliance with the recommended practices and for patients' safety

Experiences of geriatric nurses in nursing home settings across four countries in the face of the COVID-19 pandemic

Aim: To explore the emotional impact and experiences of geriatric nurses working in nursing homes and caring for patients with coronavirus 2019 disease (COVID-19). Design: This is a qualitative study with phenomenological method and data were gathered through in-depth interview. Methods: The experiences and expectations that nurses are facing during their care duties were explored via video conference, using a semi-structured interview guide. We have followed the Consolidated criteria for reporting qualitative research COREQ. Results: Interviews (N=24) were conducted with nurses from four countries (Spain, Italy, Peru, and Mexico) during April 2020. Three main categories were extracted: fear of the pandemic situation, the sense of duty and professional commitment, and emotional exhaustion. Conclusions: Regardless of the country and situation, in the face of the pandemic, dramatic situations have been experienced in nursing homes worldwide, with nursing staff feeling exhausted and overwhelmed, and reflection is urged on a global level to consider the most appropriate model of care in nursing homes

The Influence of the COVID-19 Pandemic on the Clinical Application of Evidence-Based Practice in Health Science Professionals

(1) Background: Evidence-based practice (EBP) informs daily clinical interventions with the purpose of seeking changes to traditional practice through scientific evidence that justifies the reasons for our actions. The objectives were to describe the barriers, beliefs, and attitudes in the application of EBP among university health professionals (not doctors) and to evaluate the influence of the COVID-19 pandemic among them. (2) Methods: This prospective study is both descriptive and observational. The individuals under study were university health professionals (not doctors) from various autonomous regions within Spain, in both public and private spheres. Sociodemographic and labor-related variables linked to the research and its completion were studied. Likewise, the survey instrument Health Sciences Evidence-Based Practice questionnaire (HS-EBP) was administered to evaluate the barriers to, beliefs in, and attitudes towards evidence-based practice. (3) Results: A total of 716 responses were gathered, of which 387 were collected during the period of confinement, and 343 in the COVID-19 post-confinement period. Possible associations that might help respond to the objectives were explored through a correlational study between the sociodemographic variables and each sub-scale of the HS-EBP 30 questionnaire (n = 716). (4) Conclusions: Barriers to, beliefs in, and attitudes towards evidence-based practice are described. There is a leadership gap where line management provides insufficient motivation to follow work routines. The COVID-19 pandemic has caused immense stress among health professionals. The post-confinement group showed a significant change in the variables "beliefs and attitudes", and likewise in the "evaluation" block, justified by the need to update knowledge and to apply evidence.This project has been financed with the help of IDIVAL, Project number NVAL 19/04 through the Marqués de Valdecilla Research Institute, IDIVAL, Spain