Working Environment in Nursing: Needs Improvement?

Background: Knowing the quality of life of professionals is important because it is related to job performance, better results, and greater productivity, which results in better patient care. Objective: To know the Professional Quality of Life perceived by the nurses at the Geriatric Hospital of Toledo (Spain). Method: A descriptive cross-section study was employed to measure the Professional Quality of Life of all healthcare nurses (69 in total) at the Geriatric Hospital of Toledo. The questionnaire used as a measuring instrument was the Professional Quality of Life - 35. The data obtained was analyzed by means of: descriptive statistics, single-factor ANOVA variance analysis, T Student tests, and simple and multiple regression analysis. The study was approved by both the research commission and the ethics commission at the Hospital Complex of Toledo. Participation in the study on behalf of the nursing staff was voluntary. Results: In total, 45 responses were obtained (65.2%). The overall mean score measured the perceived Professional Quality of Life to be low. In relation to the three dimensions evaluated in the study, the highest average found was in “intrinsic motivation,” followed by “workload”, and then “management support.” In the multivariate analysis, “management support” was shown as the most influential factor in the Professional Quality of Life with a 23% influence (P<0.001), followed by workload with 9% (P = 0.01). Conclusions: The professionals at the participating center perceive their workplace as having an elevated degree of responsibility, a large quantity of work, a high occurrence of rushes and fatigue, and all this with little support on behalf of management. Promotions are scarce or the policies for receiving a promotion are inadequate. The perception of Professional Quality of Life in nursing is low. The obtained results indicate a need for an organizing cultural change based on participation, motivation, and increased management support

Effects of commercial enrichment diets on the nutritional value of the rotifer (Brachionus plicatilis)

12 páginas, 4 tablasThe rotifer, Brachionusplicatifis, pre-fed on baker’s yeast, was enriched for 6 h with three commercial products from Artemia Systems S.A., namely Protein Selco (microcapsules), Dry Selco (microparticles) and Super Selco (an emulsion containing high levels of n-3 HUFA). The biochemical composition (protein, carbohydrate, total lipid, lipid classes and fatty acids) and dry weight ofthe rotifers before and after the enrichment experiments were studied. Two of the enrichers, Dry Selco and Super Selco, are rich in lipid but poor in protein and carbohydrate. Protein Selco contains lipid as well as protein and carbohydrate. The biochemical composition and the dry weight of the rotifers were changed after 6 h of enrichment. The percentage of protein and lipid increased with all of the three enrichers and the percentage of carbohydrate decreased slightly. Rotifer dry weight increased in rotifers enriched on Protein Selco. Phospholipids, sterol esters+ waxes, triacylglycerols and free fatty acids increased after the enrichment with the three enrichers while sterols slightly decreased when the rotifers were fed on Protein Selco. The fatty acid content of the rotifers increased after the enrichment with all ofthe enrichers and this increase was particularly apparent in the case of n-3 HUFAs (20: Sn-3 and 22 : 6n-3).This work was supported by the contract-project “ Larval Nutrition of Turbot” with the fish farm Cultivo de Peces S.A. (CULTIPECSA).Peer reviewe

Tratamiento de las fracturas abiertas conminutas del primer metatarsiano con fijador externo: a propósito de 1 caso

Se presenta 1 caso de fractura abierta grado III de Gustilo conminuta de primer metatarsiano del pie derecho resuelta mediante la utilización de un fijador externo como método de osteosíntesis ósea. Se hace especial mención a la necesidad del tratamiento simultáneo de ls partes blandas y del hueso, manteniendo los requerimientos biomecánicos del pie como objetivo del tratamiento.We present a case of conminutcd open fracture of the first metatarsal bone of the right foot treated by using an external fixator as a method of osteosynthesis. Simultaneous treatment of bone and soft tissues is recomended. The aim of the treatment should be to restore biomechanical requirements of the foot

Tratamiento de la gonartrosis con osteotomía tibial de penetración y fijación con grapas

La osteotomía metafisaria proximal de tibia ha sido utilizada en el tratamiento de 96 gonartrosis con desviación axil en varo (87 casos) o en valgo (nueve casos), con componente de flexo en la mitad de los casos y con cierto grado de laxitud ligamentosa en 1/3 de los casos. Se utilizó un cálculo angular preoperatorio en bipedestación con contraste opaco del eje mecánico de la extremidad y Rx-TV. La osteotomía fue cuneiforme de penetración, se estabilizó con grapas y se aplicó calza de yeso para facilitar el apoyo precoz. Proporcionó un efecto antiálgico en el 94 % de los casos, pero la valoración funcional deja el resultado en 25 % de casos excelentes y 51% de casos buenos. Destacan la necesidad de operar ambas rodillas, la bondad del resultado con independencia del grado de angulación, la compensación de las laxitudes moderadas ya referidas y la repercusión favorable del realineamiento axil sobre la artrosis femoropatelar presente en el 75 % de los casos

Estudio comparativo del tratamiento quirúrgico de las fracturas diafisarias de húmero mediante enclavado endomedular de Hackethal y placa atornillada

Se revisan comparativamente 160 fracturas diafisarias humerales tratadas quirúrgicamente en nuestro servicio mediante 2 técnicas distintas: placa atornillada a comprensión y enclavado endomedular en haz de Hackethal. Siguiendo la clasificación de la AO, se comparan los resultados de ambos métodos en cuanto al tiempo de consolidación según la localización y trazo de fractura, así como las complicaciones de cada método. El tiempo de consolidación fue menor en las fracturas tratadas con haz de Hackethal (3.9 meses) que en las tratadas con placa (4 meses), mientras que en las fracturas complejas (tipo C) tratadas con placa, el tiempo de consolidación disminuyó (4.1 meses) en relación a las tratadas con haz de Hackethal (4.9 meses). Destaca un alto porcentaje de pseudoartrosis (9.7) y la peor recuperación funcional en las fracturas tratadas mediante haz de Hackethal frente al 0% de pseudoartrosis de los casos tratados con placa, así como la ausencia de infecciones en ambas series.A total of 160 humeral shaft fractures surgically treated were retrospectively assessed. Surgical technique was performed by means of two different methods: compression plate and closed intramedullary nailing. Fractures were grouped following AO criteria. Outcome assessment was carried out analyzing complications rate and time period for fracture healing according to type and level of the fracture. No instances of infections were observed. Fractures treated with flexible intramedullary nailing showed an average time period of healing lower than those treated with compression plate (3.9 and 4 months respectively). However this difference was increased and reverse in the more complex fractures (type C fractures) being 4.1 months for plating technique and 4.9 months for intramedullary nailing. Regarding complication rate, 9.7% of pseudoarthrosis and worse functional outcome were found with intramedullary nailing. There were no cases of pseudoarthrosis with plating technique

La relación médico-paciente en el tratamiento de la diabetes tipo 1. Un estudio cualitativo

ObjetivosConocer las experiencias y las expectativas de pacientes con diabetes tipo 1 (DM1) y sus familiares sobre la relación que establecen con sus médicos y su influencia en la forma de afrontar la enfermedad y el tratamiento.DiseñoDiseño cualitativo a través de grupos focales realizado en 2001.EmplazamientoDistintos centros sanitarios de Granada y Sevilla.ParticipantesPacientes con DM1, familiars y/o cuidadores.MétodoMuestreo teórico con representación de los perfiles más característicos. Procedimiento de análisis cualitativo: asignación de códigos al texto, triangulación e interpretación de resultados.ResultadosLa relación médico-paciente influye decisivamente en la vivencia emocional de la enfermedad y en la manera en que los pacientes asumen el control. Los pacientes entrevistados aseguran que la relación con sus médicos está centrada en los signos y los síntomas de la enfermedad, y que el aspecto emocional se deja de lado. Es frecuente que los profesionales basen su comunicación en la reprimenda y en la amenaza. Los tratamientos se imponen más que se consensúan, y las posibilidades de participación en las decisiones clínicas son escasas. En consecuencia, los pacientes desarrollan estrategias para tomar sus propias decisiones sobre el tratamiento adaptándolo a su vida.ConclusionesDesean un modelo de relación con sus médicos en el que les escuchen, empaticen con su situación, comprendan los problemas que enfrentan para seguir el tratamiento, les transmitan ánimos y adapten sus recomendaciones a las circunstancias vitales y emocionales de cada paciente. Se prefiere a los profesionales que combinan la competencia técnica (incluida la dimensión relacional) con la humanidad y la amabilidad, y que asumen su corresponsabilidad en el éxito del tratamiento.ObjectivesTo know the experiences and expectations of diabetes mellitus type 1 (DM1) patients and their relatives as regards the relationships established with doctors, and the impact of such relationships on their strategies to cope with the disease and treatment.DesignQualitative design based on focus groups conducted in 2001.LocationSeveral health care centres in Granada and Seville, Spain.ParticipantsDM1 patients and their relatives and/or carers.MethodTheory-based sampling including the most representative profiles. Qualitative analysis procedure: text coding, triangulation and interpretation of results.ResultsDoctor/patient relationship highly influences the emotional experience of disease and the way patients gain control over it. Interviewed patients said that the relationship with doctors is focused on disease signs and symptoms, leaving emotional aspects aside. Very often, provider communication is built on recrimination and threat. Treatment is imposed rather than agreed, with scarce opportunities for participating in clinical decisions. Patients develop strategies to take their own decisions and adapting treatment to their daily life.ConclusionsPatients value a relationship model whereby providers listen and empathise with their situation, understand their difficulties in treatment compliance, encourage them, and adapt recommendations to the personal and emotional circumstances of each patient. They prefer doctors combining professional competence-including relational skills-with humanity and kindness, as well as being capable of assuming their co-responsibility in treatment success

Ortesis para la prevención de la subluxación y luxación de rodilla en alargamientos femorales complejos

Se describe una ortesis para uso en la prevención de la subluxación y luxación de rodilla en los casos de alargamientos femorales en los que se considera posible la presentación de este problemaWe present an orthesis to prevent dislocation of the knee during femoral lengtheing when this problem can presumably occur

Utilización de fijadores externos como tratamiento de urgencias en las fracturas pélvicas del politraumatizado

La importancia de la inestabilidad pélvica en el pronóstico vital del paciente politraumatizado obliga a actuar con rapidez sobre estas lesiones. Presentamos nuestra casuística de 10 pacientes politraumatizados con fracturas inestables de pelvis tratados de urgencia mediante fijación externa. Los buenos resultados obtenidos confirman la utilidad de este sistema como tratamiento inicial en un servicio de urgencias, que en la gran mayoría de los casos será el tratamiento definitivo.The importance of pelvis instability for life prognosis in multiple trauma patients implies a rapid treatment action in these lesions. We report 10 patients with multiple trauma and unstable pelvis fractures treated as emergency by external fixation. The good results obtained confirm the utility of this method as both the initial and definitive treatment of pelvis fractures in cases of emergency