Diferencias en los factores de riesgo entre la población que consulta por un intento de suicidio y la que acude por otros motivos en un servicio de urgencias de una unidad de salud mental

Els principals objectius del present estudi són: 1.-Avaluar les diferències en les característiques sociodemográfiques, clíniques y en els factors de temporalitat entre les persones que van acudir a urgències per un intent de suïcidi i les persones que van acudir per altres motius. 2.Conèixer si existeixen diferències entre sexes en les característiques sociodemográfiques, clíniques i en els factors de temporalitat de les persones que van acudir a urgències per un intent de suïcidi. 3. Conèixer si existeixen diferències entre sexes en les característiques sociodemogàfiques, clíniques i en els factors de temporalitat de les persones que van acudir a urgències per altres motius diferentes a l'intent de suïcidi. 4.Esbrinar si hi ha diferències entre sexes i les característiques de l'intent de suïcidi. S'ha seguit una metodologia quantitativa, concretament s'ha portat a terme un estudi trasnversal analític, degut a que tant la tentativa de suïcidi (efecte) com tota la informació de l'estudi, es van recollir de les fulles d'urgències com a possibles variables associades a l'intent (causa). Per a això, es van seleccionar dos mostres, les persones que van acudir a un servei d'urgències el motiu del qual fou un intent de suiïcidi (498 persones) i la resta de persones ateses per altres motius de consulta (502 persones) durant el mateix periode de temps, de l'1 de gener del 2007 al 31 de juliol del 2014. Als resultats s'han obtingut diferències estadísitcament significatives en múltiples variables entre els grups. Les principals són: major percentatge de dones, major número de persones que estaven casades o en parella, major número de persones incatives laboralment, amb més dificultats econòmiques, major percentatge de persones amb problemes de relació amb la parella, amb menys antecedents de malaltia mental, inferior consum de tòxics, menys ingressos psiquiàtrics previs i menor presència de símptomes psicòtics al moment de l'atenció.Los principales objetivos del presente estudio son: 1. Evaluar las diferencias en las características sociodemográficas, clínicas y en los factores de temporalidad entre las personas que acudieron a urgencias por un intento de suicidio y las personas que acudieron por otros motivos. 2.Conocer si existen diferencias entre sexos en las características sociodemográficas, clínicas y en los factores de temporalidad de las personas que acudieron a urgencias por un intento de suicidio. 3.Conocer si existen diferencias entre sexos en las características sociodemográficas, clínicas y en los factores de temporalidad de las personas que acudieron a urgencias por otros motivos diferentes al intento de suicidio. 4.Averiguar si hay diferencias entre sexos y las características del intento de suicidio. Se ha seguido una metodología cuantitativa, se ha llevado a cabo un estudio transversal analítico, debido a que tanto la tentativa de suicidio (efecto) como toda la información del estudio, se recogió de las hojas de urgencias como posibles variables asociadas al intento de suicidio (causa). Para ello, se seleccionaron dos muestras, las personas que acudieron un servicio de urgencias cuyo motivo de consulta fue un intento de suicidio (498 personas) y el resto de personas atendidas por otros motivos de consulta (502 personas) durante el mismo periodo de tiempo, del 1 de enero del 2007 al 31 de julio del 2014. En los resultados se han obtenido diferencias estadísticamente significativas en múltiples variables entre los grupos. Las principales son: mayor porcentaje de mujeres, mayor número de personas que estaban casadas o en pareja, mayor número de personas inactivas laboralmente, con más dificultades económicas, mayor porcentaje de personas con problemas de relación con la pareja, con menos antecedentes de enfermedad mental, inferior consumo de tóxicos, menos ingresos psiquiátricos previos y menor presencia de síntomas psicóticos en el momento de la atención.The main objectives of this study are: 1.Assess the differences in the sociodemographic and clinical characteristics and in the temporary factors among the people who went to the emergency department for a suicide attempt and those who went for other reasons. 2.Know whether there are sex differences in the sociodemographic and clinical characteristics and in the temporary factors of the people who went to the emergency department for a suicide attempt. 3.Know whether there are sex differences in the sociodemographic and clinical characteristics and in the temporary factors of people who went to the emergency department for reasons other than suicide attempt. 4.Find out whether there are differences between the sexes and the characteristics of the suicide attempt. A quantitative methodology has been followed, specifically a cross-sectional study, since both the attempted suicides (effect) and all the study information were collected from the emergency department documents as potential variables associated with suicide attempt (cause).To do so, two samples were selected, the people who came to the emergency department whose consultation reason was a suicide attempt (498 people) and the rest of people attended for other consultation reasons (502 people) during the same time period, from 1 January 2007 to 31 July 2014. Significant statistically differences in multiple variables have been obtained in the results among the groups. The main are: higher percentage of women, greater number of people who were married or in pairs, greater number of unemployed people, with more economic difficulties, higher percentage of people with couple problems, with minor history of mental health, lower consumption of substances, less previous psychiatric admissions and lower presence of psychotic symptoms when they were assisted

Implementing evidence-based practices on the therapeutic relationship in inpatient psychiatric care: a participatory action research

Aims and objectives: to produce changes in the therapeutic relationship between clinical practice nurses and patients in psychiatric units by implementing evidence-based practices through participatory action research. Background: the therapeutic relationship is the cornerstone of nursing care in psychiatric units. The literature suggests that theoretical knowledge alone is insufficient to establish the therapeutic relationship in practice. Therefore, strategies are needed to adequately establish the therapeutic relationship in psychiatric units. Design: participatory action research. Methods: participants consisted of nurses from two psychiatric units of a university hospital. Data were collected through focus groups and reflective diaries, which were analysed using the content analysis method. The COREQ guidelines were followed to ensure rigour. Results: nurses conceptualised the therapeutic relationship in their practice, identifying facilitating elements and limitations. They were able to compare their clinical practice with the recommendations of scientific evidence and constructed three evidence-based proposals to improve the therapeutic relationship: (a) a customised nurse intervention space, (b) knowledge updating and (c) reflective groups, which they subsequently implemented and evaluated. Conclusions: this study shows that nurses in psychiatric units can generate changes and improvements in the therapeutic relationship. The process of implementing evidence-based practice enhanced participants' awareness of their clinical practice and allowed them to make changes and improvements. Relevance to clinical practice: the process confirmed that the implementation of evidence-based practice through participatory methods, such as participatory action research, is valid and produces lasting changes. This study also reveals the need to rethink nurses' functions and competencies in current psychiatric units

Examining the association between evidence-based practice and the nurse-patient therapeutic relationship in mental health units: a cross-sectional study

Aims: to examine the relationship between the dimensions of evidence-based practice and the therapeutic relationship and to predict the quality of the therapeutic relationship from these dimensions among nurses working in mental health units. Design: a cross-sectional design. Methods: data were collected between February-April 2018 via an online form completed by nurses working at 18 mental health units. Multiple linear regressions were used to examine the relationship between the dimensions of evidence-based practice and therapeutic relationship. Questionnaires were completed by 198 nurses. Results: higher levels of evidence-based practice were a significant predictor of a higher-quality therapeutic relationship (β: 2.276; 95% CI: 1.30-3.25). The evidence-based practice factor which most influenced an improved therapeutic relationship was the nurses' attitude (β: 2.047; 95% CI: 0.88-3.21). The therapeutic relationship dimension which was most conditioned by evidence-based practice dimensions was agreement on tasks, which was most favourable with a better attitude (β: 0.625; 95% CI: 0.09-1.16) and greater knowledge and skills for evidence-based practice (β: 0.500; 95% CI: 0.08-0.93). Conclusion: in mental health settings, the therapeutic nurse-patient relationship is positively enhanced by evidenced-based practice and the nurse's level of experience, with a great influence on shared decision-making. Impact: this research sought to examine the relationship between the evidence-based practice and the therapeutic relationship in mental health nursing. This study demonstrates that an improved attitude and knowledge of evidence-based practices of mental health nurses increases shared decision-making with patients, which is a basic requirement for person-centred care. Because the therapeutic relationship is considered the backbone of nursing practice in mental health units, this research will have an impact on both mental health nurses and mental health unit managers

Actitudes y percepciones de las enfermeras hacia la conducta suicida: Revisión sistemática de estudios cualitativos

Objetivo principal: Conocer las percepciones y actitudes hacia la conducta suicida por parte de las enfermeras, así como su influencia en la evaluación y abordaje de esta. Metodología: Revisión sistemática de estudios cualitativos que sigue el modelo de metasíntesis para el análisis de los resultados. Resultados: El total de artículos incluidos en el trabajo han sido trece, a través de los cuales, se han obtenido cuatro categorías temáticas que sintetizan los resultados de los estudios evaluados. Conclusiones: El trabajo aporta una visión del camino que se está recorriendo, desde una postura moralista hacia la conducta suicida, a la comprensión de la patología que se ha de evaluar, tratar y preveni

Factores de riesgo asociados a los intentos de suicidio en un servicio de urgencias psiquiátricas de una zona rural

CONTEXTO: El suicidio es considerado un problema de salud pública debido a su alcance y magnitud. OBJETIVOS: Determinar las variables sociodemográficas y clínicas asociadas a los intentos de suicidio entre la población atendida en un servicio de urgencias de un hospital psiquiátrico, y comparar las consultas por un intento de suicidio con las consultas por otros motivos. METODOLOGÍA: Estudio observacional de corte retrospectivo realizado en un servicio de urgencia psiquiátricas en el que se estudiaron los datos de 498 personas que habían acudido por un intento de suicido y 502 que habían acudido por otros motivos de consulta, durante un periodo de 7 años. RESULTADOS: En el grupo de pacientes con un intento de suicidio había un porcentaje más alto de mujeres, con una media de edad ligeramente mayor que el otro grupo, estaban casadas, de nacionalidad española, con el diagnóstico de trastorno del humor y los trastornos por abuso de sustancias como los más predominantes, con un menor porcentaje de ingresos psiquiátricos previos, sin antecedentes familiares de enfermedad mental y sin síntomas psicóticos. CONCLUSIONES: Teniendo en cuenta la estructura y funcionamiento de los servicios de salud mental de la zona y la particularidad del entorno, subrayamos la necesidad de tener en cuenta los presentes resultados tanto para la atención directa como para el diseño de estrategias de prevención específicas

As várias faces da enfermagem durante o nacional-socialismo (1933-1945): uma revisão narrativa

En un determinado período de la historia de la enfermería, los cuidados característicos de la profesión convivieron junto la ignorancia y la crueldad de una sociedad corrompida por la tragedia, el miedo y el odio. Objetivo: dar a conocer tanto el papel de las enfermeras simpatizantes del partido nazi como el de las enfermeras del bando aliado y de la resistencia durante el Nacional-socialismo en Europa y exponer las diferencias entre los cuidados que prestaron. Metodología: revisión narrativa desarrollada a través de la búsqueda bibliográfica de libros y de artículos en diversas bases de datos, seleccionados a partir de unos criterios de inclusión y exclusión. Resultados: la atención enfermera de la época estuvo fuertemente diferenciada entre los dos bandos, dónde la empatía y el afecto se substituyeron por el maltrato y la barbarie. Además, se ha descubierto un tipo de enfermería la cual se vio obligada a ayudar al régimen nacionalsocialista en contra de su voluntad. Conclusión: se han plasmado las actuaciones de aquellas enfermeras que trabajaron durante la época del nazismo, para que la enfermería actual pueda conocer lo que ocurrió en el pasado y mejorar de cara al futuro.In a certain period in the history of nursing, the care and attention characteristic of the profession coexisted with the ignorance and cruelty of a society corrupted by tragedy and hatred towards the human being. Objective: to make known the role of the supporters of the Nazi party as nurses of the Allied side and of the resistance during National Socialism in Europe and expose the differences between the care they provided. Methodology: narrative review developed through the bibliographic search of books and articles in various databases, selected based on inclusion and exclusion criteria. Results: the nursing care of the time was strongly differentiated between two sides, where empathy and affection were replaced by abuse and barbarism. In addition, a type of nursing has been discovered which was forced to help the National Socialist regime against its will. Conclusion: the actions of those nurses who worked during the time of Nazism have been reflected, for the current nursing can know what happened in the past to learn and improve for the future.Num determinado período da história da enfermagem, o cuidado e a atenção característica da profissão coexistiam com a ignorância e a crueldade de uma sociedade corrompida pela tragédia e pelo ódio ao ser humano. Objectivo: dar a conhecer o papel dos apoiantes do partido nazi como enfermeiros do lado aliado e da resistência durante o nacional-socialismo na Europa o expor as diferenças entre os cuidados que prestaram. Metodologia: revisão narrativa desenvolvida através da busca bibliográfica de artigos em várias bases de dados, selecionados com base em critérios de inclusão e exclusão. Resultados: o cuidado de enfermagem do tempo foi fortemente diferenciado entre os dois lados, onde a empatia e o afeto foram substituídos por abuso e barbárie. Além disso, foi descoberto um tipo de enfermagem que foi forçada a ajudar o regime nacional-socialista contra sua vontade. Conclusão: as ações das enfermeiras que trabalharam na época do nazismo foram reflectidas, para que a enfermagem atual possa saber o que aconteceu no passado para aprender e melhorar para o futuro

The therapeutic relationship at the heart of nursing care: A participatory action research in acute mental health units

Data de publicació electrònica: 24-12-2022Aims and objectives: To explore the process of change within the clinical practice of nurses in mental health inpatient units in the context of a participatory process to improve the nurse-patient therapeutic relationship. Design: Participatory Action Research. Methods: Ninety-six nurses from 18 mental health units participated. Data were collected through focus groups and reflective diaries between March 2018 and January 2020. Data were analysed using inductive content analysis. The COREQ guidelines were used. Results: The research process was carried out through two cycles of four stages each in which the nurses were able to identify the facilitating and limiting elements of their practice in relation to the therapeutic relationship. They then proposed two consensual improvement strategies for all the units, which they called reserved therapeutic space and postincident analysis. Finally, they implemented and evaluated the two strategies for change. Conclusions: This study has shown that, despite the different cultural and structural realities of the participating units, it is possible to implement a collaborative process of change, provided the needs and expectations of both the participants and the organisations are similar. Relevance to clinical practice: The results obtained through Participatory Action Research were directly transferred to clinical practice, thus having an impact on individual nurses and patients, as well as on the collective dynamics of the teams and aspects related to the management of the units. No patient or public contribution: Patient or public input is not directly applicable to this study. Patients were recipients of the changes that were occurring in the nurses as part of their daily clinical practice

Exploring the therapeutic relationship through the reflective practice of nurses in acute mental health units: a qualitative study

Aims and objectives: To explore the therapeutic relationship through the reflective practice of nurses in acute mental health units. Background: In mental health units, the therapeutic relationship is specially relevant for increasing the effectiveness of nursing interventions. Reflective practice is considered an essential aspect for improving nursing care. Design: Action and observation stages of a participatory action research project. Methods: Data were collected through reflective diaries designed for the guided description and reflection of practice interactions related to the therapeutic relationship and content analysis was applied. A total of 152 nurses from 18 acute mental health units participated. The COREQ guidelines were used. Results: The results were classified into three categories as follows: (i) Nursing attitude as a core of the therapeutic relationship. For the nurses, the attitudinal component was key in the therapeutic relationship. (ii) Nursing practices that are essential to the therapeutic relationship. Nurses identified practices such as creating a conducive environment, using an appropriate verbal approach, offering help and working together with the patient as essential for establishing a therapeutic relationship in practice. (iii) Contextual factors affecting the therapeutic relationship. The nurses considered the patient's condition, the care dynamics of the unit and its regulations, as well as the structure and environment of the unit, as contextual factors involved the establishment of an adequate therapeutic relationship in daily clinical practice. Conclusions: This study has provided knowledge of the importance and role of the nurses' attitude in the context of the nurse-patient therapeutic relationship based on the reflections of nurses in mental health units regarding their own practice

The therapeutic relationship at the heart of nursing care: a participatory action research in acute mental health units

Aims and Objectives: To explore the process of change within the clinical practice of nurses in mental health inpatient units in the context of a participatory process to improve the nurse-patient therapeutic relationship. Design: Participatory Action Research. Methods: Ninety-six nurses from 18 mental health units participated. Data were collected through focus groups and eflective diaries between March 2018 and January 2020. Data were analysed using inductive content analysis. The COREQ guidelines were used. Results: The research process was carried out through two cycles of four stages each in which the nurses were able to identify the facilitating and limiting elements of their practice in relation to the therapeutic relationship. They then proposed two consensual improvement strategies for all the units, which they called reserved therapeutic space and postincident analysis. Finally, they implemented and evaluated the two strategies for change. Conclusions: This study has shown that, despite the different cultural and structural realities of the participating units, it is possible to implement a collaborative process of change, provided the needs and expectations of both the participants and the organisations are similar. Relevance to Clinical Practice: The results obtained through Participatory Action Research were directly transferred to clinical practice, thus having an impact on individual nurses and patients, as well as on the collective dynamics of the teams and aspects related to the management of the units

Influence of Pain and Discomfort in Stroke Patients on Coping Strategies and Changes in Behavior and Lifestyle

The implementation of prevention strategies can reduce the risk of having a stroke. This prospective, longitudinal, multicenter observational study of 82 patients describes health habits, quality of life, coping strategies, and physical and neurological status at 3 months and 1 year after stroke. The EuroQoL-5D quality of life scale (EQ-5D) and the coping strategy measurement scale (COPE-28) were used to assess pain and discomfort, and behavioral and lifestyle changes. Significant differences were observed in the pain or discomfort levels of those patients with behavioral and lifestyle changes. Correlation was also found between pain or discomfort and the coping strategies associated with active emotional support at 1 year after stroke. The results of the pain or discomfort dimension were not, however, associated with better adherence to treatment. Pain and discomfort could have a predictive value in changes in lifestyles and behaviors but not for treatment adherence in patients who have had a stroke, which is significant at 1 year. In addition to important active coping strategies such as social support, these changes in behavior and lifestyle following a stroke are long-term and should therefore be assessed during the initial examination