Detección y atención a la violencia de género en el embarazo. Una asignatura pendiente

Aims: to determine the number of cases of gender violence (GV) that health personnel in charge of pregnancy control were aware they had attended to; to identify whether resources were available to the personnel to address this problem; to ascertain the priority these personnel assign to GV within the health system.Method: descriptive, observational study. Subjects were health personnel working in pregnancy control. A questionnaire developed by the researchers was used. Descriptive analysis of the data was made.Results: 93.10% (81) believed that they attended fewer than ten such cases a year. 95.40% (83) stated that they did not have the necessary resources to enable them to act. A mean score of 8,14 + 1,45 out of 10 was awarded regarding prioritization.Conclusion: The personnel seemed to be aware of the problem but did not consider themselves prepared to address it.Objetivos: Determinar el número de casos de violencia de género (VG) que el personal sanitario encargado del control de embarazo era consciente que se habia atendido. Identificar la existencia o no de recursos de los que dispone este personal para abordar este problema. Conocer la prioridad que este personal asigna a la VG dentro del sistema sanitario.Método: estudio observacional descriptivo, sujetos de estudio: personal sanitario con funciones en el control del embarazo. Se utilizó un cuestionario de elaboración propia. Se realizó un análisis descriptivo de los datos. Resultados: El 93,10% (81) creen que son menos de diez al año las mujeres atendidas El 95,40% (83) afirma que no tiene los recursos necesarios para poder actuar Se otorga una media de 8,14 + 1,45 sobre 10 en el orden de priorización.Conclusión: El personal parece estar sensibilizado aunque no se considera preparado para abordar el problema

Commitment, perception and evidence-based practice training in Spanish nursing students: A multicentre cross-sectional study in 2020

Aims and objectives: To evaluate the commitment and level of self-perceived training in evidence-based practice among students of the Nursing degree of five Spanish universities. Background: In university Health Sciences degrees, evidence-based clinical practice can directly or indirectly impact the quality of care, the cost of the service provided and the safety of clinical practice. Design: Multicentre cross-sectional observational study according to STROBE guidelines. Methods: The evidence-based skills in Practice questionnaire (CACH-PBE, for its acronym in Spanish) and the Utrecht Work Engagement Student Scale (UWES-9S) were used. The study was performed in five Spanish universities (Alicante, Castilla La Mancha, Jaen, Huelva and Seville) from October to December 2020, with 755 participants (Nursing students). Results: A total mean score of 91.9 points (SD = 11.81) was observed for the CACH-PBE questionnaire and of 36.8 points (SD = 8.48 points) for the UWES-9S. In addition, the multivariate analysis predicted that variables such as sex, academia, university, intention to do a Master or Doctorate degree, the level of work engagement, and the previous training in evidence-based clinical practice were associated with a greater perception of evidence-based practice. Conclusion: The sample of Nursing degree students has intermediate-high levels of knowledge, skills and attitudes regarding evidence-based practice and work commitment, with differences observed between each of the universities. Relevance to clinical practice: Nursing students should develop from intermediate to high levels of knowledge, skills and attitudes regarding evidence-based practice and work commitment. There are various actions to promote EBP, such as the incorporation of a specific course covering the subject into the nursing curriculum, and the selection, for clinical practices, of care units that implemented evidence-based care

Association between Non-Competitive Physical Exercise and Menstrual Disorders

No Abstract

Anorexia nerviosa en el embarazo: cuidados en la enfermería obstétrico-ginecológica

The anorexia nervosa is a food psychosomatic, complex disorder, that primarily affects girls and young women. Disorders in food conduct can happen at any age and in certain situations (especially of change) can precipitate the appearance of symptoms. Pregnancy and the maternity are such situations. It is a rare situation, but the anorexic woman needs special care by matrons and nurses involved in the pregnancy, childbirth and puerperio of the woman. These care plans should be of a standard form and adapted to each clinical case, for an efficient, effective and  quality assistance. Aims: To increase the quality of nursing care in patients with anorexia nervosa during the pregnancy. To avoid relapses during the evolution of the disease. To promote the suitable utilization of NANDA, NIC, NOC to record nursing work. Development: After a Marjory Gordon valuation functional health patterns, the following diagnostic nurses are standardized for the care plan: nutritional imbalance by default corporal appearance disorder, chronic low self-esteem, anxiety and interruption of the family processes. Conclusions: The treatment must be multidisciplinary, and nursing cares are of special importance, since the follow-up of these patients is practically for life. The application of care plans and the use of nursing diagnoses of infirmary(nursing) has repercussions on the profession, the patient and on the nurse; professionally, the nursing process defines the field of the professional exercise and includes the quality procedure; the patient is benefited, since by means of this process the nursing care quality is guaranteed; for the professional nurse there is an increase of satisfaction and professionalism.La anorexia nerviosa es un desorden alimentario psicosomático, complejo, que primariamente afecta a niñas y mujeres jóvenes. Los trastornos de la conducta alimentaria pueden ocurrir a cualquier edad y en determinadas situaciones (en particular, de cambio), pueden precipitar la aparición de síntomas. El embarazo y la maternidad son una de estas situaciones. Es una situación rara, pero la mujer anoréxica necesita unos cuidados especiales por parte de matronas y enfermeras implicadas en el embarazo, parto y puerperio de la mujer. Estos planes de cuidados deberían  ser protocolizados de una forma estándar y adaptarlos en cada caso clínico, para una asistencia de calidad, eficaz y eficiente. Objetivos: Aumentar la calidad de los cuidados de enfermería en pacientes con anorexia nerviosa durante el embarazo. Evitar recaídas durante la evolución de la enfermedad. Promover la adecuada utilización de: NANDA, NIC, NOC,  para registrar el trabajo de enfermería.   Desarrollo: Tras una valoración por patrones funcionales de salud de Marjory Gordon, se estandarizan los siguientes diagnósticos enfermeros para el plan de cuidados: Desequilibrio nutricional por defecto, trastorno de la imagen corporal, baja autoestima crónica, ansiedad e interrupción de los procesos familiares. Conclusiones: El tratamiento debe ser multidisciplinario, y los cuidados de enfermería son de especial relevancia, puesto que el seguimiento de estas pacientes es prácticamente de por vida. La aplicación de planes de cuidados y la utilización de los diagnósticos de enfermería tienen repercusiones sobre la profesión, la paciente y sobre la enfermera; profesionalmente, el proceso enfermero define el campo del ejercicio profesional y contiene las normas de calidad; la paciente es beneficiada, ya que mediante este proceso se garantiza la calidad de los cuidados de enfermería; para el profesional enfermero se produce un aumento de la satisfacción, así como de la profesionalidad

Prevalence of Intimate Partner Violence in Pregnancy: An Umbrella Review

Background: Intimate partner violence (IPV) is a public health concern, especially during pregnancy, and needs to be urgently addressed. In order to establish effective actions for the prevention of IPV during pregnancy, authorities must be aware of the real burden of IPV. This review aimed to summarize the existing evidence about IPV prevalence during pregnancy worldwide. Methods: A review of reviews was carried out. All published systematic reviews and meta-analyses published until October 2020 were identified through PubMed, Scopus, and Web of Science. The main outcome was the IPV prevalence during pregnancy. Results: A total of 12 systematic reviews were included in the review, 5 of them including meta-analysis. The quality of the reviews was variable. Physical IPV during pregnancy showed a wide range (1.6–78%), as did psychological IPV (1.8–67.4%). Conclusions: Available data about IPV prevalence during pregnancy were of low quality and showed high figures for physical and psychological IPV. The existing evidence syntheses do not capture the totality of the worldwide disease burden of IPV in pregnancy.Ministry of Science, Innovation, and Universities of the Spanish Governmen

Types of Carbohydrates Intake during Pregnancy and Frequency of a Small for Gestational Age Newborn: A Case-Control Study

The objective of this study was to assess the relationship between consumption of different types of carbohydrates (CHO) during pregnancy and the risk of having a small for gestational age (SGA) newborn. A retrospective matched case–control design was carried out with a total of 518 mother-offspring pairs. A total of 137 validated items were included in the food frequency questionnaire (FFQ). Conditional logistic regression models were used to calculate crude odds ratios (cORs) and adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Having more than 75 g/day of brown bread showed an inverse association with SGA (aOR = 0.64, CI 0.43–0.96). In contrast, an intake of industrial sweets more than once a day (aOR = 2.70, CI 1.42–5.13), or even 2–6 times a week (aOR = 1.84, CI 1.20–2.82), increased the odds of having a SGA newborn. During pregnancy, the higher the increase of wholegrain cereal and bread, the lower the possibility of having a SGA newborn, but the opposite occurred with refined sugar products—just consuming industrial bakery products or pastries twice a week increased the odds of having an SGA infant. Case–control studies cannot verify causality and only show associations, which may reflect residual confusion due to the presence of unknown factors. It is possible that a high consumption of sugary foods is a marker of a generally poor lifestyle.This work was supported by a grant from the National Institute of Health Carlos III (PI11/02199). Finally, N.C-I. would like to acknowledge support from the Ministry of Education of Spain (FPU14/03630)

Maternal seafood intake and the risk of small for gestational age newborns: a case–control study in Spanish women

Objective To investigate the relationship between seafood consumption during pregnancy and the risk of delivering a small for gestational age (SGA) newborn. Design This case–control study included women with SGA newborns and controls matched 1:1 for maternal age (±2 years) and hospital. Setting Five hospitals in Eastern Andalusia, Spain. Participants 518 pairs of pregnant Spanish women. The SGA group included women who delivered SGA newborns: SGA was defined as a birth weight below the 10th percentile of infants at a given gestational age. Controls were women who delivered newborns with adequate birth weights. Interventions We collected data on demographic characteristics, socioeconomic status, toxic habits and diet. Midwives administered a 137-item Food Frequency Questionnaire. Outcome measures We calculated quintiles of seafood intake and applied conditional logistic regression to estimate ORs and 95% CIs. Results Shellfish intake more than once/week yielded a significant protective effect against an SGA newborn (OR 0.25, 95% CI 0.08 to 0.76, after adjusting for energy, educational level, smoking, prepregnancy body mass index, weight and a history of preterm or low birthweight newborn). The risk of an SGA newborn was lower among women who consumed >29 g/day fish compared with women who consumed ≤8 g (adjusted OR 0.63, 95% CI 0.41 to 0.98; p=0.025 for a trend). Similarly, the risk of an SGA newborn was lower among women who consumed >1 g/day of marine n-3 polyunsaturated fatty acids compared with those who consumed ≤0.4 g/day (adjusted OR 0.58, 95% CI 0.38 to 0.90; p=0.025 for a trend). Conclusion An average seafood intake of at least 29 g/ day during pregnancy, equivalent to 2–3 servings/week, reduced the risk of an SGA newborn, compared with an average seafood intake of less than 8 g/day.The National Institute of Health Carlos III (PI11/02199) supported this work

Consumo de carne y productos cárnicos durante el embarazo y riesgo de tener un recién nacido pequeño para su edad gestacional. Un estudio de casos y controles

Introduction: different diets during pregnancy might have an impact on the health as reflected by the birth weight of the newborn. The consumption of meat and meat products during pregnancy and its relationship with the newborn health status have been studied by several authors. The studies carried out show inconsistent results Objective: to analyse the association between maternal dietary intake of meat and meat products and the risk of small for gestational age (SGA) newborn. Methods: a matched case-control study of 518 cases and controls of pregnant women was performed in Spain. Cases were women with a SGA newborn. Data about demographic characteristics and diet were collected. Meat consumption was gathered through a validated food frequency questionnaire. Meat and meat products intakes were categorized in quintiles (Q1-Q5).The association between maternal meat and meat product intakes and SGA was assessed by logistic regression models with adjustment for confounding factors. Results: an intake of meat products above 6.8 g/day was associated with a lower risk of SGA delivery (OR = 0.7; 95% CI, 0.53-0.93) after adjusting for smoking, body mass index, previous preterm-low birth weight, newborn gender and adherence to Mediterranean diet. Conclusions: meat consumption was not associated with SGA, whereas meat products showed a moderate protective relationship.Introducción: la ingesta dietética durante el embarazo es un factor clave en la salud maternal y fetal, pudiendo tener un impacto en el peso al nacer del recién nacido. El consumo de carne y productos cárnicos durante el embarazo y su asociación con el estado de salud del neonato ha sido estudiado, sin embargo los hallazgos encontrados muestran resultados contradictorios. Objetivo: analizar la asociación entre la ingesta dietética materna de carne y productos cárnicos durante el embarazo y el riesgo de tener un bebé pequeño para la edad gestacional (PEG). Metodología: se realizó un estudio de casos y controles emparejados en mujeres españolas embarazadas (518 casos y 518 controles). Los casos fueron mujeres con un recién nacido PEG. El consumo de carne se obtuvo a través de un cuestionario de frecuencia de alimentos validado. La carne y la ingesta de productos cárnicos fueron categorizados en quintiles (Q1-Q5). La asociación entre la ingesta materna cárnica durante el embarazo y el riesgo de tener un recién nacido PEG se evaluó mediante modelos de regresión logística ajustados por factores confusores. Resultados: una ingesta de productos cárnicos ≥ 6,8 g/día se asoció significativamente con un menor riesgo de tener un recién nacido PEG (OR = 0,7; IC 95%, 0,53-0,93) después de ajustar el modelo por factores confusores: fumar, índice de masa corporal, embarazos previos con bajo peso al nacer, sexo del recién nacido y adherencia materna a la dieta mediterránea. Conclusiones: el consumo materno de carne no se asoció con recién nacidos PEG, sin embargo el consumo de productos cárnicos mostró una moderada asociación protectora. Estos hallazgos respaldan el consejo de una dieta variada para mujeres embarazadas, que proporciona ingesta de proteínas y otros micronutrientes de diferentes fuentes alimentarias

Autocontrol de las complicaciones asociadas con el tratamiento de quimioterapia: una scoping review

Objetivo: explorar o estado atual do conhecimento científico relacionado com o fenômeno da autogestão da doença e dos efeitos secundários associados ao tratamento de quimioterapia. Método: realizou-se uma scoping review, para mapeamento dos estudos publicados nos últimos 10 anos, recorrendo a bases de dados eletrônicas MEDLINE, CINAHL e Psychology and Behavioral Sciences Collection. Resultados: foram incluídos 88 estudos. Identificou um primeiro grupo de estudos (15 artigos), de natureza qualitativa, que maioritariamente analisam as percepções e vivências dos doentes relativamente ao fenômeno. Outro conjunto de estudos (32 artigos) analisam as variáveis ou fatores que interferem na autogestão da doença. E o último, com 39 estudos que apresenta intervenções direcionadas para a promoção da autogestão durante o tratamento de quimioterapia, nos quais prevalecem as intervenções que recorrem ao uso de tecnologia, nomeadamente os equipamentos móveis. Conclusão: as intervenções neste âmbito deverão abordar determinantes importantes, tais como autocuidado, autocontrole, autoeficácia, crenças e estratégias de coping. O uso das tecnologias de informação, poderão ser efetivamente um caminho profícuo a seguir nesta era da comunicação e representar uma nova forma de “cuidar” em oncologia.Objective: to explore the current state of scientific knowledge related to the phenomenon of self-management of the disease and the side effects associated with chemotherapy treatment. Method: a scoping review was carried out to map the studies published in the last 10 years using the electronic databases MEDLINE, CINAHL and Psychology and Behavioral Sciences Collection. Results: 88 studies were included. A first group of studies (15 articles), of qualitative nature, which mostly analyze the perceptions and experiences of patients regarding the phenomenon was identified. Another set of studies (32 articles) analyze the variables or factors that interfere with self-management of the disease. And lastly, 39 studies that present interventions aimed at promoting self-management during chemotherapy treatment, in which interventions that use technology, such as mobile equipment, prevail. Conclusion: interventions in this area should address important determinants such as self-care, selfcontrol, self-efficacy, beliefs and coping strategies. The use of information technologies could effectively be a useful way forward in this age of communication and represent a new way of “caring” in oncology.Objetivo: explorar el estado actual del conocimiento científico relacionado con el fenómeno del autocontrol de los efectos secundarios asociados con el tratamiento con quimioterapia. Método: se realizó una scoping review para mapear los estudios publicados en los últimos 10 años (1, enero de 2007 al 28, febrero de 2017), recorriendo a las bases de datos electrónicas MEDLINE, CINAHL e Psychology and Behavioral Sciences Collection. Resultados: se incluyeron 88 estudios. Identificado un primer grupo de estudios (15 artículos), de naturaleza cualitativa, que analizan ampliamente las percepciones y vivencias de los pacientes con el fenómeno. Otro conjunto de estudios (32 artículos) analizan las variables o factores que interfieren en la autogestión. Y un último, con 39 estudios que presenta intervenciones dirigidas a la promoción de la autogestión durante el tratamiento de quimioterapia, en las que prevalecen las intervenciones que recurren al uso de tecnología, en particular los equipos móviles. Conclusión: las intervenciones deben abordar determinantes importantes como el autocuidado, autocontrol, autoeficacia, creencias y estrategias de afrontamiento. El uso de las tecnologías de información podría ser una forma útil de avanzar en esta era de comunicación y representar una nueva forma de "cuidado" en oncología.info:eu-repo/semantics/publishedVersio

Maternal Dietary Patterns during Pregnancy and Their Association with Gestational Weight Gain and Nutrient Adequacy.

Several epidemiologic studies have shown an association between Gestational Weight Gain (GWG) and offspring complications. The GWG is directly linked to maternal dietary intake and women's nutritional status during pregnancy. The aim of this study was (1) to assess, in a sample of Spanish pregnant women, the association between maternal dietary patterns and GWG and (2) to assess maternal dietary patterns and nutrient adequate intake according to GWG. A retrospective study was conducted in a sample of 503 adult pregnant women in five hospitals in Eastern Andalusia (Spain). Data on demographic characteristics, anthropometric values, and dietary intake were collected from clinical records by trained midwives. Usual food intake was gathered through a validated Food Frequency Questionnaire (FFQ), and dietary patterns were obtained by principal component analysis. Nutrient adequacy was defined according to European dietary intake recommendations for pregnant women. Regression models adjusted by confounding factors were constructed to study the association between maternal dietary pattern and GWG, and maternal dietary patterns and nutritional adequacy. A negative association was found between GWG and the Mediterranean dietary pattern (crude β = -0.06, 95% CI: -0.11, -0.04). Independent of maternal dietary pattern, nutrient adequacy of dietary fiber, vitamin B9, D, E, and iodine was related to a Mediterranean dietary pattern (p < 0.05). A Mediterranean dietary pattern is related to lower GWG and better nutrient adequacy. The promotion of healthy dietary behavior consistent with the general advice promoted by the Mediterranean Diet (based on legumes, vegetables, nuts, olive oil, and whole cereals) will offer healthful, sustainable, and practical strategies to control GWG and ensure adequate nutrient intake during pregnancy