Calidad del sueño y somnolencia diurna en estudiantes de enfermería: estudio de prevalencia

Introducción. El sueño es un fenómeno fisiológico restaurativo y esencial que ocupa un tercio de la vida del ser humano y cuyos mecanismos y función todavía hoy no son bien conocidos. A pesar de ser uno de los grupos de patologías más frecuentes en el hombre, las referencias al sueño y a sus patologías en medicina occidental han sido escasas hasta el S.XIX. El estudio del sueño como actividad fisiológica no comenzó hasta 1929 con el descubrimiento de la electroencefalografía por el neuropsiquiatra alemán Hans Berger, desterrando definitivamente la idea del sueño como un estado unitario y homogéneo. En este sentido, podemos afirmar que el aporte más relevante para la praxis clínica de la medicina del sueño vino de la electrofisilogía que se convirtió, con el desarrollo de la polisomnografía, en la abanderada de las pruebas para el sueño. La calidad del sueño constituye un aspecto clínico de gran importancia no sólo como factor determinante de la salud, sino como elemento propiciador de una buena calidad de vida. El 60% de los adolescentes manifiestan sentirse cansados por falta de sueño o dificultad para dormir, del 30-40% de la población padece insomnio y el 60% de los trabajadores por turnos informa de alteraciones en el ritmo circadiano. Dormir poco o mal merma las funciones mentales, debilita la memoria, altera el juicio crítico y aumenta la tendencia a quedarse dormido. En España son pocos los trabajos que estudian los hábitos de sueño en los jóvenes universitarios. Nos parece importante abordar su estudio en la población universitaria de nuestra facultad, junto con otros aspectos como: calidad del sueño, tipología circadiana, patrón de sueño, somnolencia diurna y hábitos de sueño. Objetivos: Para ello, nos planteamos como objetivo principal conocer la prevalencia del deterioro del patrón del sueño en los alumnos de enfermería de la Universidad Católica San Antonio y su relación con los hábitos de sueño, aspectos sociofamiliares y rendimiento académico. Material y método: Para dar respuesta a los objetivos propuestos en nuestro trabajo se ha utilizado metodología cuantitativa, diseñando un estudio observacional, descriptivo y prospectivo, de secuencia transversal. La población de estudio quedó compuesta por los alumnos de 1º, 2º y 3º de grado en enfermería que cumplieran los siguientes requisitos: Ser alumno de la Facultad de enfermería y acudir a clase en el momento de entrega del cuestionario en la fase de recogida de datos. Quedaron excluidos del estudio aquellos alumnos que padecían algún trastorno del sueño previo, o bien que estuviesen en tratamiento con fármacos psicotrópicos. Se ha utilizado una técnica de muestreo no probabilístico, realizando el cuestionario todos los alumnos que asistieron a clase en el momento de la encuesta. Para el cálculo del tamaño de la muestra hemos utilizado el programa de cálculo de tamaños muestrales Ene 2.0 (Laboratorios Glaso W), y se ha realizado en base a la estimación de que la proporción de alumnos universitarios con ESD obtenido de la prueba piloto es del 68%, con una precisión de ±5 y un error alfa del 5% para una población finita de 950 alumnos. Resultó una muestra necesaria de 248 sujetos, siendo la muestra final de 401 sujetos. Como variables dependientes se han utilizado 4 escalas: La Escala de Edpworth, Índice de Calidad del sueño de Pittsburg, Escala de Matutinos Vespertinos Adan y Almiral y la Escala de Hábitos de Sueño, de elaboración propia. Las variables independientes son: sexo, edad, estado civil, hábitos de vida, curso académico y rendimiento académico. Conclusiones: La Escala de Somnolencia y el Índice de Calidad del Sueño, describen a los estudiantes universitarios de la Facultad de Enfermería como malos dormidores, con una alta prevalencia de somnolencia diurna, una latencia de sueño prolongada, superior a treinta minutos, un sueño poco reparador y un importante déficit de sueño. El cronotipo intermedio es el más común entre los alumnos de enfermería si bien, puede apreciarse una clara tendencia a la vespertinidad. Los estudiantes prefieren la actividad nocturna antes que desarrollar sus tareas durante el día. Los alumnos que ostentan un mayor número de asignaturas suspensas son también los que peor calidad del sueño tienen, presentan un ritmo circadiano vespertino, poseen malos hábitos de sueño, duermen menos horas al día, tienen un IMC más elevado y fuman un mayor número de cigarrillos al día.MedicinaEnfermerí

Romani Women and Health: The Need for a Cultural-Safety Based Approach

The Romani are the main European ethnic minority. The Romani people’s situation of social vulnerability and their difficulties accessing the health system make their health indicators worse than those of the non-Romani population. The present study will delve into health beliefs, and experiences with health services and professionals, through the perspectives of Romani women. In this qualitative study, 16 women of different ages were interviewed in a city located in the South of Spain. Four themes emerged from the analysis of the data: the construction of the identity of Romani women, difficulties in life, health and disease beliefs and barriers to accessing the health system. We conclude that every project for the improvement of the health of the Romani community must take into account the active participation of Romani women and must consider the principles of Cultural Safety, by delving into the intercultural training of health professionals and addressing the social determinants of health which affect the Romani collective

Occupational Therapy in Severe Mental Disorder—A Self-Controlled Quasi-Experimental Study

Severe mental disorder (SMD) produces a significant functional limitation that affects the performance of daily activities. The occupational therapist intervenes on this limitation by seeking greater autonomy of these patients through specific activities. This study aims to identify the main limitations of people with SMD and to examine whether an occupational intervention has any effect in helping to overcome or ameliorate these limitations. A quasi-experimental study including 103 participants was carried out. An evaluation using the World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaire was performed before and after the intervention. Within the activity program, those with a higher attendance rating during cognitive stimulation, cooking workshop, therapeutic walks, relaxation, and creative activities were mainly men. Both patients and professionals indicated that Understanding and Communicating, Participation in Society, and Activities of Daily Living were the main perceived limitations. Upon discharge, patients and professionals reported positive outcomes. The intervention programs carried out by occupational therapy, along with the other aspects of the treatment that SMD patients received, played an important part in improving the performance and occupational interests of these patients

Reliability and Validity of a Stress Scale in Public Employees from Murcia (Spain)

Stress is common in all work environments. Technostress and the difficulty of separating the family arena from the work environment are some of the new and emerging risks faced by companies, employees and society in general. Most of the available instruments for measuring stress in workers have been focused on education professionals and healthcare workers. Therefore, it is necessary to validate simple and friendly-use tools to detect stress levels in public workers. The aim of this study was to determine the internal consistency of an adapted version of the Student Stress Inventory-Stress Manifestations (SSI-SM) for public employees and to determine if high-stress levels are related to personal and work-related factors. A cross-sectional and descriptive study was conducted from October 2016 to February 2019 including 468 Spanish public workers based in Murcia. An adapted version of the SSI-SM was administered and data on personal and work-related factors were collected. Results showed that all of the factors had Cronbach’s α over 0.700, and no items need to be deleted due to correlations with the factor exceeding 0.300. Factor 1, “Self-concept”, has a Cronbach’s α of 0.868, with values of 15.62 ± 4.99; factor 2, “Sociability”, Cronbach’s α: 0.853, with mean values of 13.33 ± 4.17; factor 3, “Somatization”, Cronbach’s α: 0.704, mean value of 5.35 ± 1.90 and: factor 4, “Uncertainty”, Cronbach’s α: 0.746, with a mean value of 8.19 ± 2.51. In conclusion, the internal consistency of the adapted SSI-SM for public employees with different work positions and shifts has been validated and determined. This study provides a useful tool for the early detection of stress in public employees and may be potentially useful for preventing the harmful consequences of stres

The COVID-19 Pandemic and Its Impact on Homebound Nursing Students

University students are predisposed to stress, which could be even higher in Nursing students since they are directly related to the COVID-19 pandemic given their health training and area of knowledge. Our purpose was to assess the stress levels of Nursing students before and during lockdown due to the COVID-19 pandemic in Murcia (Spain), its influence on taking an online exam and how it was affected by physical exercise. This was an observational and prospective study including Nursing students from the second year of the Nursing Degree from 3 February to 23 April 2020. Three measurements were performed: one before lockdown and two during lockdown. Stress increased substantially during lockdown. Financial, family or emotional problems, as well as physical exercise, also increased. Indeed, at 40 days of lockdown, those students with financial, family or emotional problems, and less physical exercise reported significantly higher stress levels. In addition, those who passed the online exam had lower stress levels compared to those who failed. In conclusion, during lockdown, stress in Nursing students increased. This could be triggered by students’ personal problems, and physical exercise may be used as a way to reduce stress. Academic performance was better in those students reporting less stress

Rompiendo el estigma en enfermería de salud mental a través del entrenamiento con simulación de alta fidelidad

The social stigma toward individuals with mental health problems is habitual among nursing students, which can lead to poor quality of health care services for patients with mental illnesses. The purpose of the present study was to learn about nursing students’ perceptions of providing care to patients with severe mental disorders before and after participating in a simulated student clinical case. A descriptive qualitative study was conducted through 39 interviews. The difficulties expected by the students and their perceptions about patients were explored before the simulation training. Their perceptions about the use of clinical simulation for learning about the adequate management of these patients were analyzed afterwards. Results: Before the simulation training, the students assessed the case as being complicated, expressed their lack of specific training, and felt fear and insecurity, thus reproducing the stigma towards mental health patients. After this training, they positively valued the usefulness of the clinical simulation for gaining confidence and overcoming the stigma. Discussion: The use of high-fidelity simulation offers nursing students the opportunity to approach patients with mental health conditions, overcoming their fears and normalizing mental disorders. Simulation training allows nursing students to analyze the reasoning of clinical judgment and to detect the influence of previous prejudices about mental illness in their clinical decision. This study was not registered.Depto. de EnfermeríaFac. de Enfermería, Fisioterapia y PodologíaTRUEpu

Use of high-fidelity clinical simulation for the development of cultural competence of nursing students

CRUE-CSIC (Acuerdos Transformativos 2022)Background: The increasing growth of migrant populations in Spain has changed the cultural profile of healthcare system users. Cultural competence in health care settings has become an increasing worry for health professionals, specifically for nurses. Therefore, the training in cultural competency of nursing students is indispensable. Objective: To explore the views on the use of high-fidelity simulation in fourth-year nursing students to improve their cultural competence. Methods: A qualitative descriptive study was conducted with an interpretative phenomenological approach. Before and after taking part in simulated scenarios, 56 semi-structured interviews were conducted. We explored the perceptions of the nursing students when addressing a simulated clinical case with a patient who is a migrant, including the training deficiencies in cultural competences perceived before the simulation, the benefits perceived, and the improvement suggestions. We also analyzed their views on the skills and knowledge developed during the simulation experience. Results: Before entering the simulation scenario, we found the existence of insecurity, uncertainty, and cultural differences in the nursing students, with the main worry being the language barrier. They also mentioned the need to improve their intercultural communication and cultural adaptation of the care in their training. After finishing the simulation, they indicated positive aspects, aspects to be improved, learning acquired, and learning to be strengthened, highlighting the existing cultural differences and asking for training on cultural competence. Conclusions: The use of high-fidelity simulation provides a positive learning experience, which increases a student's comfort when working with patients of varied cultural origins. Its usefulness in teaching is found in its capacity to develop communication skills and interpersonal skills, such as empathy, in the students. This study provides evidence on the importance of specific training on cultural competence in the Nursing Degree, and the usefulness of high-fidelity clinical simulation to achieve this.Depto. de EnfermeríaFac. de Enfermería, Fisioterapia y PodologíaTRUEpu

Las mujeres gitanas y la salud: la necesidad de un enfoque cultural basado en la seguridad

The Romani are the main European ethnic minority. The Romani people’s situation of social vulnerability and their difficulties accessing the health system make their health indicators worse than those of the non-Romani population. The present study will delve into health beliefs, and experiences with health services and professionals, through the perspectives of Romani women. In this qualitative study, 16 women of different ages were interviewed in a city located in the South of Spain. Four themes emerged from the analysis of the data: the construction of the identity of Romani women, difficulties in life, health and disease beliefs and barriers to accessing the health system. We conclude that every project for the improvement of the health of the Romani community must take into account the active participation of Romani women and must consider the principles of Cultural Safety, by delving into the intercultural training of health professionals and addressing the social determinants of health which affect the Romani collective.Depto. de EnfermeríaFac. de Enfermería, Fisioterapia y PodologíaTRUEpu