Promoting dignified end-of-life care in the emergency department: a qualitative study

Background: Preservation of a dying person’s dignity in the emergency department (ED) is fundamental for the patient, his/her relatives and healthcare professionals. The aim of this study was to explore and interpret physicians’ and nurses’ experiences regarding conservation of dignity in end-of-life care in dying patients in the ED. Methods: A qualitative study based on the hermeneutic phenomenological approach, was carried out in the emergency department of two general hospitals. A total of 16 nurses and 10 physicians participated in the study. Data collection included 12 individual in-depth interviews and 2 focus groups. Results: The findings revealed that two themes represent the practices and proposals for the conservation of dignity in the emergency department: dignified care in hostile surroundings and the design of a system focused on the person’s dignity. Conclusion: Dignifying treatment, redesigning environmental conditions, and reorienting the healthcare system can contribute to maintaining dignity in end-of-life care in the ED

Perceptions about the sexuality of women with fibromyalgia syndrome: a phenomenological study

Aims: The aim of this study was to explore and understand the perceptions and experiences of women with fibromyalgia syndrome regarding their sexuality. Background: Fibromyalgia syndrome is a chronic pathology, which compromises a woman’s physical, mental and emotional health. Although concerns related to sexuality are commonly reported, research has tended to focus on the physical symptoms. Design: An interpretive qualitative research methodology using Gadamer’s philosophical hermeneutics was carried out. Methods: This qualitative study explores the sexuality of women with fibromyalgia syndrome. A focus group and semi-structured interviews were conducted with 13 women with fibromyalgia syndrome. Data were collected between April - June 2014. Participants were recruited until findings reached saturation. Findings: Three themes define the perception of sexuality for these women: (i) Physical impact: don’t touch, don’t look; (ii) Sexuality and identity: fighting against their loss; (iii) Impact on the relationship: sexuality as a way of connecting the couple. Conclusion: Despite limitations, sexuality is important for the identity and quality of life of women with fibromyalgia syndrome. Together with the physical symptomology, guilt, fear and a lack of understanding compromise the coping process. Women need the support of their partner, their socio-family environment and health professionals. Nurses can aid the successful adjustment to sexual problems related to fibromyalgia syndrome

Psychometric evaluation and cultural adaptation of the Spanish version of the “Scale for End-of Life Caregiving Appraisal”

Objective: To translate, culturally adapt and psychometrically evaluate the Spanish version of the ‘Scale for End-of Life Caregiving Appraisal’ (SEOLCAS). Methods: Observational cross-sectional study. Convenience sample of 201 informal end-of-life caregivers recruited in a southern Spanish hospital. The reliability of the questionnaire was assessed through its internal consistency (Cronbach’s α) and temporal stability (Pearson’s correlation coefficient (r) between test-retest). The content validity index of the items (I-CVI) and the scale (S-CVI/Ave) was calculated. Its criterion validity was explored through performing a linear regression analysis to evaluate the SEOLCAS’ predictive validity. Exploratory factor analysis was used to examine its construct validity. Results: The SEOLCAS’s reliability was very high (Cronbach’s α=0.92). Its content validity was excellent (all items’ content validity index=0.8–1; scale’s validity index=0.88). Evidence of the SEOLCAS’ criterion validity showed that the participants’ scores on the SEOLCAS explained approximately 79.3% of the between-subject variation of their results on the Zarit Burden Interview. Exploratory factor analysis provided evidence of the SEOLCAS’ construct validity. This analysis revealed that two factors (‘internal contingencies’ and ‘external contingencies’) explained 53.77% of the total variance found and reflected the stoic Hispanic attitude towards adversity. Significance of the results: The Spanish version of the ‘Scale for End-of Life Caregiving Appraisal’ has shown to be an easily-applicable, valid, reliable and culturally-appropriate tool to measure the impact of end-of-life care provision on Hispanic informal caregivers. This tool offers healthcare professionals the opportunity to easily explore Hispanic informal end-of-life caregivers’ experiences and discover the type of support they may need (instrumental or emotional) even when there are communicational and organisational constraints

Design and psychometric evaluation of the 'Clinical Communication Self-Efficacy Toolkit'

Nursing students experience difficulties when communicating in clinical practice. Their self-efficacy in clinical communication should be explored as part of their competence assessment before they are exposed to real human interactions in the clinical setting. The aim of this study was to design and psychometrically evaluate a toolkit to comprehensively assess nursing students’ self-efficacy in clinical communication. The study followed an observational cross-sectional design. A sample of 365 nursing students participated in the study. The ‘Clinical Communication Self-Efficacy Toolkit’ (CC-SET) was comprised of three tools: the ‘Patient-Centered Communication Self-efficacy Scale’ (PCC-SES), the ‘Patient clinical Information Exchange and interprofessional communication Self-Efficacy Scale’ (PIE-SES), and the ‘Intrapersonal communication and Self-Reflection Self-Efficacy Scale’ (ISR-SES). The tools’ reliability, validity (content, criterion, and construct) and usability were rigorously tested. The Cronbach’s alpha coefficient of the three tools comprising the CC-SET was very high and demonstrated their excellent reliability (PCC-SES = 0.93; PIE-SES = 0.87; ISR-SES = 0.86). The three tools evidenced to have excellent content validity (scales’ content validity index > 0.95) and very good criterion validity. Construct validity analysis demonstrated that the PCC-SES, PIE-SES, and ISR-SES have a clear and theoretically-congruent structure. The CC-SET is a comprehensive toolkit that allows the assessment of nursing students’ self-efficacy in interpersonal, interprofessional, and intrapersonal communication

Transferencia de pacientes de cuidados paliativos desde el hospital hasta atención primaria: un estudio cualitativo = Transferring palliative-care patients from hospital to community care: a qualitative study

Aim: To know the experience of case-manager nurses with regard to transferring palliative-care patients from the hospital to their homes. Design: Qualitative phenomenological study carried out in 2014 2015. Setting: Poniente and Almería health districts, which referral hospitals are Poniente Hospital and Torrecárdenas Hospital, respectively. Participants: A purposive sample comprised of 12 case-manager nurses was recruited from the aforementioned setting. Method: Theoretical data saturation was achieved after performing 7 in-depth individual interviews and 1 focus group. Data analysis was performed following Colaizzi’s method. Results: Three themes emerged: (1) ‘Case-management nursing as a quality, patient-centred service’ (2) ‘Failures of the information systems’, with the subthemes ‘‘patients’’ insufficient and inadequate previous information’’ and ‘‘ineffective between levels communication channels for advanced nursing’’; (3) ‘Deficiencies in discharge planning’, with the subthemes ‘‘deficient management of resources on admission’’, ‘‘uncertainty about discharge’’ and ‘‘insufficient human resources to coordinate the transfer’’. Conclusions: Case-manager nurses consider themselves a good-quality service. However, they think there are issues with coordination, information and discharge planning of palliative patients from hospital. It would be useful to review the communication pathways of both care and discharge reports, so that resources needed by palliative patients are effectively managed at the point of being transferred home

Design and psychometric analysis of the COVID-19 prevention, recognition and home-management self-efficacy scale

In order to control the spread of COVID-19, people must adopt preventive behaviours that can affect their day-to-day life. People’s self-efficacy to adopt preventive behaviours to avoid COVID-19 contagion and spread should be studied. The aim of this study was to develop and psychometrically test the COVID-19 prevention, detection, and home-management self-efficacy scale (COVID-19-SES). We conducted an observational cross-sectional study. Six-hundred and seventy-eight people participated in the study. Data were collected between March and May 2020. The COVID-19-SES’ validity (content, criterion, and construct), reliability (internal consistency and test-retest reliability), and legibility were studied. The COVID-19-SES’ reliability was high (Cronbach’s alpha = 0.906; intraclass correlation coefficient = 0.754). The COVID-19-SES showed good content validity (scale’s content validity index = 0.92) and good criterion validity when the participants’ results on the COVID-19-SES were compared to their general self-efficacy (r = 0.38; p 0.001). Construct validity analysis revealed that the COVID-19-SES’ three-factor structure explained 52.12% of the variance found and it was congruent with the World Health Organisation’s recommendations to prevent COVID-19 contagion and spread. Legibility analysis showed that the COVID-19-SES is easy to read and understand by laypeople. The COVID-19-SES is a psychometrically robust instrument that allows for a valid and reliable assessment of people’s self-efficacy in preventing, detecting symptoms, and home-managing COVID-19

Kinetic study of the reaction of leuco methylene blue with 2,6-dimethyl-p-benzoquinone in a reverse micellar system

The kinetics of the reaction of leuco methylene blue (MBH) with 2,6-dimethyl-p-benzoquinone (DMBQ) were studied in a heptane/bis(2-ethylhexyl)-sulfosuccinate (AOT)/water reverse micellar system. The pseudo-first-order rate constant (k (obsd)) obtained in the presence of excess of DMBQ was found to be proportional to the initial concentration of DMBQ for W (0)=3, 5, 10, 15 and 20 (W (0)=[H2O]/[AOT]). The second-order rate constant (k (2)=k (obsd)/[DMBQ](0)) increased with an increase in the W (0) value, but was almost independent of the concentration of the water pool. A mechanism involving the distribution of DMBQ between the reverse micellar interface and bulk organic solvent was proposed to explain these findings.</p

Cognitive Performance and Heart Rate Variability: The Influence of Fitness Level

In the present study, we investigated the relation between cognitive performance and heart rate variability as a function of fitness level. We measured the effect of three cognitive tasks (the psychomotor vigilance task, a temporal orienting task, and a duration discrimination task) on the heart rate variability of two groups of participants: a high-fit group and a low-fit group. Two major novel findings emerged from this study. First, the lowest values of heart rate variability were found during performance of the duration discrimination task, compared to the other two tasks. Second, the results showed a decrement in heart rate variability as a function of the time on task, although only in the low-fit group. Moreover, the high-fit group showed overall faster reaction times than the low-fit group in the psychomotor vigilance task, while there were not significant differences in performance between the two groups of participants in the other two cognitive tasks. In sum, our results highlighted the influence of cognitive processing on heart rate variability. Importantly, both behavioral and physiological results suggested that the main benefit obtained as a result of fitness level appeared to be associated with processes involving sustained attention.This research was supported by the Spanish Ministerio de Educación y Cultura with a predoctoral grant (FPU-AP2010-3630) to the first author, Spanish grants SEJ2007-63645 from the Junta de Andalucía to Daniel Sanabria, Mikel Zabala and Esther Morales, and the CSD2008-00048 CONSOLIDER INGENIO (Dirección General de Investigación) to Daniel Sanabria

Social acceptance of death and its implication for end‐of‐life care

Aims To understand how the social patterns about death influence end‐of‐life care from the perspective of healthcare professionals. Design A qualitative study according to the theory of Glaser and Strauss. Methods A purposeful sample of 47 participants with different roles (nurses, physicians and clinical psychologists) were involved in four focus groups and 17 interviews in 2017–2019. Responses were audio‐recorded, transcribed verbatim and analysed using computer‐assisted qualitative data. Results A core category ‘the theory of social patterns about death’ emerged, which is explained by three categories: the culture of concealment and stubbornness towards death, the effort and internal work to make death a part of existence, and the influence of the social patterns of coping with death on end‐of life care and healthcare professionals. Our results suggest that social coping with death is affected by a network of concealment and obstinacy towards death. Conclusion Recognizing death as part of life and thinking about death itself are social coping strategies. Although healthcare professionals occupy a privileged place in this process, the culture of concealment of death influences end‐of‐life care. Impact The social process that leads to the loneliness of the dying in our days has been theorized. However, social acceptance of death also influences healthcare professionals’ attitudes towards death. Thus, healthcare professionals’ own attitudes may affect the end‐of‐life care given to dying individuals and their families. The social patterns of death may contribute to the healthcare professionals’ negative attitudes towards death. The concept of dignified death has been linked to the notion of humanization of healthcare. Death should be approached from a more naturalistic perspective by healthcare professionals, healthcare and academic institutions

Assessment of Pablo de Olavide University's Alignment with the 2030 Agenda. A Diagnosis from Seville, Spain

Document compiled by staff from Pablo de Olavide University of Seville (UPO), with technical assistance from Periferia Consultoría Social. This project has been funded with support from the European Commission.Versión española del documento en: https://dx.doi.org/10.46661/rio.20230630_1Recognizing the crucial role of universities in implementing the 2030 Agenda, the Pablo de Olavide University (UPO) has conducted a comprehensive assessment to evaluate its alignment and contribution towards achieving the Targets defined within the 17 Sustainable Development Goals (SDGs). The 2030 Agenda presents a dual mandate for universities. Firstly, they are tasked with integrating the SDGs into their educational and research programs. Secondly, they are expected to act as catalysts for societal transformation and promote a governance model in higher education that aligns with the Agenda's objectives. In light of these responsibilities, UPO has recognized the need to equip itself with the necessary tools to effectively assess the fulfillment of these mandates. This accountability is crucial for demonstrating UPO's commitment to the SDGs and for enhancing the effectiveness of its actions within the framework of the Agenda. This document provides a summary of the process undertaken by UPO, in collaboration with Periferia Social Consulting, between November 2022 and May 2023. The objective was to design a set of indicators that can measure UPO's contribution to the 2030 Agenda. The first section describes the methodology and various phases involved in the process. Following that, the document presents the system of indicators developed and provides information on UPO's contribution to the 2030 Agenda for the academic year 2021-2022. In the annexes, two posters are included, displaying the complete set of indicators and the measurements made for the 2021-2022 academic year.Universidad Pablo de Olavid