Efecto de un programa educativo para cuidadores de personas ancianas: una perspectiva cultural

Objetivo Determinar el efecto de la aplicación de un programa educativo con perspectiva cultural para cuidadores de personas ancianas en situación de discapacidad y pobreza en un sector de Bogotá - Colombia, sobre las variables: auto percepción de salud, funcionalidad familiar, carga del cuidador y depresión. Métodos Estudio cuasiexperimental con pre-prueba y pos-prueba. Participaron 56 cuidadores familiares, 37 en el grupo experimental (ge) y 19 en el grupo control (gc).El programa educativo aplicado al grupo experimental constaba de seis sesiones grupales con intervalo de 30 días. Cada sesión tiene  cinco fases: sensibilización, información culturalmente adaptada, toma de decisiones, compromisos de acción y cierre. Fue aplicado por una enfermera experta en geronto-geriatría y enfermería transcultural. Se aplicaron las escalas de Autopercepción de Salud,  Apgar familiar, Carga del cuidador y Escala de Depresión. Resultados El programa educativo con enfoque cultural tuvo efectos significativos, sobre las variables: funcionalidad familiar (T=2,506; p=0,015) y carga del cuidador (T=-2,149; p=0,036). La autopercepción en salud y depresión no presentaron diferencias significativas. Discusión Las acciones en educación en salud abordadas desde la perspectiva cultural abren una puerta a co-crear diversidad de terapéuticas derivadas del diálogo y la mediación entre los saberes populares y profesionales. Podría ser una clave frente al escaso éxito en la adherencia de los usuarios a las instituciones de salud y a los tratamientos

The importance of being a compassionate leader: the views of nursing and midwifery managers from around the world

Introduction: Despite the importance of compassionate leadership in health care, many of the existing publications do not account for the effect of culture. The aim of this study is to explore the views of nursing and midwifery managers from different countries in relation to the definition, advantages, and importance of compassion. Methodology: A cross-sectional, descriptive, exploratory online survey was conducted across 17 countries, containing both closed and open-ended questions. Data from N = 1,217 respondents were analyzed using a directed hybrid approach focusing only on qualitative questions related to compassion-giving. Results: Four overarching themes capture the study’s results: (1) definition of compassion, (2) advantages and importance of compassion for managers, (3) advantages and importance of compassion for staff and the workplace, and (4) culturally competent and compassionate leadership. Discussion: Innovative research agendas should pursue further local qualitative empirical research to inform models of culturally competent and compassionate leadership helping mangers navigate multiple pressures and be able to transculturally resonate with their staff and patients

Exploring nurses' meaning and experiences of compassion: an international online survey involving 15 countries

Purpose: In recent years, there has been much focus on compassion in nursing care, and concern has been raised in a number of reports and media stories regarding decreased compassion. The aim of this study was to explore similarities and differences in the understanding and demonstration of compassion in nursing practice across 15 countries. Design: A total of 1,323 nurses from 15 countries responded to questions in relation to compassion, via an international online survey. Results: The data revealed the impact of sociopolitical influences on perceptions of compassion, and the conscious and intentional nature of compassion. Discussion and Conclusion: The study demonstrated shared understandings of the importance of compassion as well as some common perceptions of the attributes of compassionate care. The differences reported were not as significant as had been expected. Implications for Practice: Further research is needed to explore the country and culture differences in the enactment of compassion

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

Background: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX). Methods: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung–Knapp–Sidik–Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Conclusions: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care