El acto de cuidado de enfermería como fundamentación del quehacer profesional e investigativo

El objetivo de este artículo de reflexión fue analizar los elementos de discusión que se presentan durante la praxis del quehacer en los diferentes campos en los cuales se puede desempeñar el profesional de la salud, considerando el acto de cuidar e involucrando la conciencia, el conocimiento, el razonamiento, la ética y el respeto por la cultura del individuo inmerso en una comunidad. El análisis se obtuvo mediante la combinación de la práctica, la teoría y la experiencia, así como también de la búsqueda de literatura con el abordaje conceptual del cuidado de la salud. Para esto se consultaron diversos autores a través de la exploración bibliográfica actualizada en las bases de datos SciELO y PubMed, en relación con los conocimientos y experiencias a partir del acto de cuidar.Como  conclusión, se afirma que el recurso humano en salud está comprometido con el acto de cuidar, en el cual no sólo se calma el dolor ocasionado por un desorden fisiológico, sino también el dolor ocasionado por el desorden social, la indiferencia, la soledad y el silencio espiritual, evidencia del estado de la sociedad del consumo y la superficialidad. De aquí que sea importante como formadores de recurso humano en salud insistir en el “cuidado” con  sentido ético, humano, mediante una adecuada comunicación con el paciente y su familia,  desarrollando actitudes y prácticas durante su formación, acorde a la misión y visión institucional. Como  conclusión, se afirma que el recurso humano en salud está comprometido con el acto de cuidar, en el cual no sólo se calma el dolor ocasionado por un desorden fisiológico, sino también el dolor ocasionado por el desorden social, la indiferencia, la soledad y el silencio espiritual, evidencia del estado de la sociedad del consumo y la superficialidad. De aquí que sea importante como formadores de recurso humano en salud insistir en el “cuidado” con  sentido ético, humano, mediante una adecuada comunicación con el paciente y su familia,  desarrollando actitudes y prácticas durante su formación, acorde a la misión y visión institucional.The aim of this reflection article was to analize discussion topics of the praxis of work in different fields in which health professional can perform, reflecting upon care act and involving awareness, knowledge, reasoning, ethics, and respect for the culture of the individual within a community. The analysis was obtained by combining the practice, theory, and experience, as well as the literature search with the conceptual approach to health care. For this purpose, several authors were consulted, scanning bibliographic databases as scielo, and pubmed, as far as knowledge and experience, starting from care act. In conclusion, it can be asserted that human health resources are committed to the care act, wherein not only the pain caused by a physiological disorder is relieved, but also the pain caused by social disorder, indifference, loneliness, and spiritual silence, evidence of the state of the consumer society and superficiality. Hence it is important, as trainers of human resources in health, to emphasize the “care” with ethical, human sense, through adequate communication with the patient and family, developing attitudes and practices during training according to the institutional mission and vision.O objetivo deste artigo de reflexão foi inserir argumentos de discussão durante a práxis do trabalho nos diferentes campos em que pode se desempenhar o profissional de saúde, refletindo sobre o ato de cuidar e envolvendo consciência, conhecimento, raciocínio, ética e respeito pela cultura do indivíduo dentro de uma comunidade. A análise foi realizada através da combina- ção da prática, teoria e experiência e a busca de literatura com a abordagem conceptual do cuidado de saúde. Para isso, consultaram-se vários autores, mediante a revisão bibliográfica atualizada nas bases de dados SciELO e PubMed, em relação com os conhecimentos e experiências obtidas a partir do ato de cuidar. Em conclusão, pode-se afirmar que os recursos humanos comprometidos com o ato de cuidado de saúde, no qual, além de aliviar a dor causada por um distúrbio fisiológico, também se alivia a dor causada pela desordem social, a indiferença, a solidão e o silêncio espiritual, como evidência o estado da sociedade de consumo e da superficialidade. Portanto, é importante como formadores de recursos humanos em saúde, enfatizar no “cuidado” com ética e sentido humano, através de uma adequada comunicação com o paciente e a família, desenvolvendo atitudes e práticas durante o treinamento e a formação, de acordo com a missão e visão institucional

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Objetivo: identificar los factores que se relacionan con mortalidad perinatal de la población afiliada a una  EPS del departamento de Nariño durante 2007. Materiales y Métodos: la investigación fue de tipo  cuantitativo, descriptivo, retrospectivo-evaluativo, dado que los datos corresponden a la revisión documental  realizada a las historias clínicas de las gestantes con eventos de mortalidad en el año 2007. Se tomó el 100%  de los casos de mortalidad perinatal, lo cual representó el total de la población. Se estudiaron las variables  socio-demográficas; se realizó análisis de casos (manejo de protocolo de atención, diligenciamiento de ficha  de notificación, cumplimiento de las normas técnicas y guías de atención). Se estudiaron 34 eventos, de los  cuales 61,8% murieron en el ante-parto, 20,6% en el intraparto y 17,6% en la pre-alta. Se diseñó una ficha de  verificación, se aplicó a los eventos, los datos se consolidaron en el sistema estadístico de información  EPIINFO versión 2000, y se realizó el cruce de variables existentes. Una vez identificados los hallazgos en  cuanto a las causas de riesgo, se aplicó el chi2 y determinando el valor de P, se levantó la línea de base con el fin de priorizar planes o proyectos enfocados a la reducción del indicador de mortalidad perinatal para la  EPS. Resultados: de la población total las madres con edades comprendidas entre 23 y 26 años de edad,  registran el mayor número de casos, procedentes el 56% de cabecera municipal quienes tenían un grado de  escolaridad de primaria completa, el 23% con cónyuge, el 26% presentaban antecedentes de multiparidad;  durante el embarazo asistieron a cuatro controles realizados por médico general en el primer nivel de  atención, de ellas el 67% no utilizaban método de planificación familiar. Con relación a los riesgos que tenían  las madres se encontraron 3 casos con hipertensión crónica; infecciones urinarias 3 casos; tabaquismo,  alcoholismo y alteraciones sicológicas, así como retardo en el crecimiento intrauterino fue reportado un  caso; los cuales fueron clasificados como embarazo de alto riesgo; 6 embarazos no se clasificaron, los cuales  sí tenían aspectos relevantes a tener en cuenta. El estudio demostró la omisión al momento de escribir o  consignar aspectos en la historia clínica. En el proceso de parto y puerperio se identificaron las semanas de  gestación entre las 28 y 40 semanas, de las cuales el 71% tuvo parto vaginal; 26,57% cesárea, de las cuales la  mitad fueron atendidas por médico obstetra y el restante por médico general; el 11% no registra datos y el  5% corresponde a otros. El nivel de atención fue el nivel 1 en un 70%. Entre las causas más frecuentes de  complicaciones en el momento del parto están la retención de restos placentarios, partos pretermino,  sufrimiento fetal, shock hipovolémico, hemorragias de tercer trimestre. Con respecto a la notificación  obligatoria de casos de mortalidad perinatal reportados al Sistema de Vigilancia Epidemiológica (Sivigila), en  ninguno de los eventos se realizó investigación de campo; igualmente no hubo comités de análisis de las  muertes perinatales. La ficha perinatal se lleva en un 100%, pero al hacer el análisis de la confrontación de los datos con la historia clínica no concuerdan, posiblemente debido a que lo diligencian diferentes  profesionales de la salud.Introduction: the presence of perinatal mortality events requires actions of health institutions, which must  implement strategies, in order to improve conditions and health status taking into account the causes of  events. Objective: identify factors associated with perinatal mortality of the population of health care  affiliates of the department of Nariño in 2007. Materials and Methods: this is a quantitative, descriptive,  retrospective-evaluative research, since the data correspond to the documentary revision of the medical  records of pregnant women with mortality events in 2007. 100% of cases of perinatal mortality were taken,  representing the total population. Socio-demographic variables, case studies (protocol handling care,  completion of the notification sheet, compliance with technical norms and practice guides) were considered.  34 events were studied, of which 61.8% died in the antepartum, 20.6% in the intrapartum and 17.6% at pre- discharge. A verification guide was applied to each event, while the data was consolidated in the statistical  information system EPIINFO version 2000, and the crossing of existing variables was carried out. Once the  findings were identified regarding the causes of risk, the chi2 was applied in order to determine the value of  P, raising the base line in order to prioritize plans and projects aimed at reducing perinatal mortality rate for  the health care provider. Results:of the total population of mothers between the ages of 23 and 26, present  the highest number of cases, 56% came from towns and had complete primary schooling, 23% have a  spouse, 26% have a history of multiparity. During their pregnancy, these women attended four general  medical checks-ups carried out by the primary care level, of which 67% did not use birth control. Regarding  the risks the mothers have, there were three cases with chronic hypertension, 3 cases of urinary tract  infections, tobacco and alcohol usage, psychological disorders; intrauterine growth retardation was reported  in 1 case, which were classified as high-risk pregnancy; 6 pregnancies were not classified, which had relevant  aspects to consider. The study demonstrated the failure to record aspects on the medical history. In the  childbirth  and puerperium process, the gestation period ranged from 28 to 40 weeks, of which 71% had a  vaginal delivery, 26.57% C-section, half of which were attended by obstetricians and the remainder by a  general physician; 11% did not register any data and 5% corresponds to other patients. The first attention  level was used in 70% of the cases. The most frequent causes of complications during childbirth include the  retention of placental remains, preterm delivery, fetal distress, hypovolemic shock, third trimester  hemorrhage. As far as the mandatory notifications of perinatal mortality cases, these were reported to  Epidemiological Surveillance System (Sivigila), in none of the events was field research conducted, no analysis  committees were carried out to examine perinatal deaths. The perinatal form was carried out in  100% of the cases, but in the analysis of the data confrontation with the medical records, these two do not  agree, possibly due to the fact that they were filled-out by different health care professionals.&nbsp

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Objetivo: analizar las tendencias de la actividad de investigación en los Programas de Salud de los  programas de postgrado y pregrado en la Universidad Mariana de Pasto, Nariño, Colombia. Metodología:  las investigaciones fueron tomadas de la biblioteca “Elizabeth Guerrero” desde el año 2004 hasta 2007.  Mediante análisis de contenido, los datos fueron recolectados para cada investigación teniendo en cuenta las siguientes variables: identificación del proyecto, problema que se va a investigar, teorías y modelos teóricos,  metodología e innovación. Resultados: el 39,4% de los proyectos están enfocados hacia la sublínea estilo de  vida saludable. Los paradigmas más frecuentemente utilizados en los programas de los postgrados en salud  y el programa de enfermería fueron de tipo cuantitativo en 76 trabajos de investigación (69,7%), es  importante señalar que 14 reportes (12,8%) tuvieron los dos paradigmas simultáneamente. Sólo el 32,1% del  total de las investigaciones utiliza el formulario de consentimiento, y no hubo aprobaciones por Comité de  Ética. Los proyectos no tienen impacto debido a que no hay publicaciones de los mismos, ni acciones  definidas desde proyectos de acción. De acuerdo con el problema de investigación, se presentó un tipo que  conduce a la investigación aplicada. Conclusión: se requiere hacer un mayor balance entre los problemas de  investigación teóricos con relación a los prácticos. No se incluyeron referentes teóricos basados en modelos  o teorías.Objective: the aim of this study was to analyze trends in research activity in the Undergraduate and  Graduate Health Programs at Universidad Mariana from Pasto, Nariño, Colombia. Methodology: the  research was taken from the “Elizabeth Guerrero” library from 2004 to 2007. Through content analysis, data  was collected for each investigation taking into account the following variables: Identification of the project,  the research problem statement, theories and theoretical models, methodology and innovation. Results:  39.4% of the projects are focused on the sub-line healthy lifestyle. The paradigms most frequently used in the graduate programs in the health and nursing programs were quantitative research in 76 (69.7%)  research  works. It is important to note that 14 reports (12.8%) included both paradigms simultaneously. Only 32.1%  out of the total investigation works uses the consent form, and there was no Ethics Committee approval. The  projects have no impact because there are no publications available or any defined actions from actions  projects. According to the research problem statement it was presented one type that leads to applied  research. Conclusion: A major balance between the theoretical research in relation to the practical ones is  required. Theoretical referents based on models and theories were not included.&nbsp

Percepciones de un grupo de epidemiólogos en formación acerca de su propia vejez

Objetivo Explorar desde la mirada de un grupo de epidemiólogos en formación, las percepciones sobre su propia vejez.Material y Métodos Estudio exploratorio, cualitativo - descriptivo, en el cual se hizo aplicación de herramientas etnográficas: observación, diario de campo y entrevista grupal (GF).Resultados El grupo consensuo que programarse para llegar a una vejez funcional y digna es importante, a pesar de las desfavorables y adversas condiciones actuales, reconociendo que no todos lograrán llegar a ella, y que es menos común en los jóvenes pensar y planear su propia vejez, y menos trabajar con y para los viejos. Los significados sobre vejez más frecuentemente referidos por el grupo contienen la palabra “etapa”, en cuyo concepto y cuidados se reflejan los altos estándares deseados a nivel individual. Se puso de manifiesto que los hogares para ancianos son necesarios, pero que los servicios prestados son diferenciados pues “la economía determina la atención para el anciano”.Conclusión La reflexión acerca de la percepción de la propia vejez, para el grupo de epidemiólogos en formación, ayudó a visualizar sus inquietudes, miedos, expectativas y a reflexionar acerca de su responsabilidad y posibilidades en el aporte de evidencia científica que permita planear y tomar decisiones acertadas para un envejecimiento y vejez dignas de la población nariñense.Objective Exploring, from the perspective of a group of epidemiologists in training, the perceptions about their own old age.Material and Methods Exploratory, qualitative-descriptive study, in which ethnographic tools were applied: observation, field diary and group interview (GF).Resultados Explored from the perspective of a group of epidemiologists in training. The group agreed that to plan to reach a functional and decent old is important, despite the current unfavorable and adverse conditions, recognizing that not all will reach there, and it is less common for young people to think and plan their own old age, and even less work with and for the elderly. The meaning of aging most often mentioned by the group contain the word “phase”, in which concept and care reflect the high standards desired individually. It became clear, that nursing homes for old age people are necessary, but the services provided are differentiated since “the economy determines the care for the elderly”.Conclusion Reflecting on the perception of old age itself, for the group of epidemiologists in training, helped visualize their concerns, fears, expectations, and to reflect on their responsibilities and possibilities in providing scientific evidence to plan and make sound decisions for a dignified old age and aging of the population from Nariño

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat