Identificación de posibles necesidades emocionales de la mujer con pérdida fetal tardía mediante revisión documental

La atención en crisis es un momento decisivo ante una situación inesperada como es el caso de la pérdida fetal, que afecta no solo la parte física sino también la emocional y psicológica y que obliga a una pronta respuesta por parte del profesional de enfermería identificando las necesidades emocionales y así poder ser abordado dicha atención, teniendo en cuenta que no se potencializa y entrena dicha habilidad desde la academia, la cual va dirigida a apoyar de forma directa a la mujer cuando entra en choque emocional desde el instante de conocer la noticia sabiendo que toda mujer es diferente y asume su proceso de duelo de acuerdo a su situación. Por otro lado se analizaron 15 artículos, en los cuales se identificaron las necesidades emocionales que tiene las mujeres que presentan muerte fetal tardía y de que forma el profesional de enfermería logra realizar una intervención a estas mujeres en estado de crisis emocional, además se encontró que no se cuentan con guías de manejo para dicha problemática. Se utilizó la técnica de revisión documental, teniendo en cuenta que es la forma más significativa de consolidar información de forma resumida, ordenada y coherente proporcionando un alto nivel de evidencia, permitiendo la comprensión y profundización desde diferentes perspectivas del fenómeno estudiado, desarrollada en tres fases definidas así: búsqueda de documentos, selección de artículos y análisis de artículos.The attention under crises is a decisive moment due to an unexpected situation like the fetal lose which affects not only the physical side, but the emotional and psychological part where a quick response of a professional is demanded taking into account that these skills are not currently worked under academic environments and which focuses the attention on the direct help these women under emotional shock need as soon as they realize they have experienced a loss and every one faces it differently. On the other hand, we analyzed 15 articles where we identified the emotional needs of women who have experienced late fetal death and the way the First Aid personnel are able to assist these women under emotional shock state, we also found that there is no information about the procedure o follow under those circumstances. We used the Documental Revision Technique, taking into account that this is the most significant way to gather information in a short way, orderly and coherently giving a high level of evidence, which permits to understand and go deeply from different points of view regarding the studied phenomenon. We develop it in three stages defined as follows: Documentary search, selection of articles and analysis of articles.Enfermero (a)Pregrad

Early Tracheostomy for Managing ICU Capacity During the COVID-19 Outbreak: A Propensity-Matched Cohort Study

10 p.Background: During the first wave of the COVID-19 pandemic, shortages of ventilators and ICU beds overwhelmed health care systems. Whether early tracheostomy reduces the duration of mechanical ventilation and ICU stay is controversial. Research question: Can failure-free day outcomes focused on ICU resources help to decide the optimal timing of tracheostomy in overburdened health care systems during viral epidemics? Study design and methods: This retrospective cohort study included consecutive patients with COVID-19 pneumonia who had undergone tracheostomy in 15 Spanish ICUs during the surge, when ICU occupancy modified clinician criteria to perform tracheostomy in Patients with COVID-19. We compared ventilator-free days at 28 and 60 days and ICU- and hospital bed-free days at 28 and 60 days in propensity score-matched cohorts who underwent tracheostomy at different timings (≤ 7 days, 8-10 days, and 11-14 days after intubation). Results: Of 1,939 patients admitted with COVID-19 pneumonia, 682 (35.2%) underwent tracheostomy, 382 (56%) within 14 days. Earlier tracheostomy was associated with more ventilator-free days at 28 days (≤ 7 days vs > 7 days [116 patients included in the analysis]: median, 9 days [interquartile range (IQR), 0-15 days] vs 3 days [IQR, 0-7 days]; difference between groups, 4.5 days; 95% CI, 2.3-6.7 days; 8-10 days vs > 10 days [222 patients analyzed]: 6 days [IQR, 0-10 days] vs 0 days [IQR, 0-6 days]; difference, 3.1 days; 95% CI, 1.7-4.5 days; 11-14 days vs > 14 days [318 patients analyzed]: 4 days [IQR, 0-9 days] vs 0 days [IQR, 0-2 days]; difference, 3 days; 95% CI, 2.1-3.9 days). Except hospital bed-free days at 28 days, all other end points were better with early tracheostomy. Interpretation: Optimal timing of tracheostomy may improve patient outcomes and may alleviate ICU capacity strain during the COVID-19 pandemic without increasing mortality. Tracheostomy within the first work on a ventilator in particular may improve ICU availability

Propuesta de intervención para un problema de salud publica.

Esta investigación se desarrolló en el municipio de Riohacha la Guajira, en los barrios más vulnerables de este municipio, con base a las condiciones alimentarias que afectan a los niños y niñas de 0 a 5 años afectando su crecimiento y desarrollo cerebral en los primeros años de vida. Esta investigación tuvo como objetivo general: Diseñar estrategias para el mejoramiento de las condiciones alimentarias de la población infantil e identificar las características socio económicas de las personas, y factores de riesgo a los que están asociados y mejorar sus condiciones de alimentarias. Con este estudio se trató de identificar que la desnutrición infantil es el resultante de múltiples factores asociados: económicos, políticos y sociales, y es a la vez, la causante de muchos problemas de salud, como la susceptibilidad a las infecciones recurrentes, escases de alimentos, falta de agua potable que contribuyen a las altas tasas de mortalidad en esta población.This research was carried out in the municipality of Riohacha la Guajira, in the most vulnerable neighborhoods of this municipality, based on the food conditions that affect children from 0 to 5 years affecting their growth and brain development in the first years of lifetime. This research had as a general objective: Design strategies for the improvement of the food conditions of the child population and identify the socio-economic characteristics of the people, and risk factors to which they are associated and improve their food conditions. This study tried to identify that child malnutrition is the result of multiple associated factors: economic, political and social, and is at the same time the cause of many health problems, such as susceptibility to recurrent infections, food shortages , lack of drinking water that contribute to the high mortality rates in this population

Effective and Ineffective Elements of Community-based Treatment for Delinquents: An Interview Survey of Volunteer Probation Officers

Additional file 1. Digital Content

Cross-cultural adaptation of the FRAIL scale for critically ill patients in Spain.

AIM: To translate and culturally adapt the FRAIL scale into Spanish and perform a preliminary test of diagnostic accuracy in patients admitted to intensive care units. DESIGN: Cross-sectional diagnostic study. METHODS: Five intensive care units (ICU) in Spain were participated. Stage 1: Three native Spanish-speaking bilingual translators familiar with the field of critical care translated the scale from English into Spanish. Stage 2: Three native English-speaking bilingual translators familiar with critical care medicine. Stage 3: Authors of the original scale compared the English original and back-translated versions of the scale. Stage 4: Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the comprehension and relevance of each of the items of the Spanish version in 30 patients of 3 different age ranges (<50, 50-65 and >65 years). RESULTS: The FRAIL scale was translated and adapted cross-culturally for patients admitted to intensive care units in Spain. The process consisted of four stages: translation, back translation, comparison and pilot test. There was good correspondence between the original scale and the Spanish version in 100% of the items. The participating patients assessed the relevance (content validity) and comprehensibility (face validity) of each of the items of the first Spanish version. The relevance of some of the items scored low when the scale was used in patients younger than 65 years. CONCLUSIONS: We have cross-culturally adapted the FRAIL scale, originally in English, to Spanish for its use in the critical care medical setting in Spanish-speaking countries. IMPLICATIONS FOR PROFESSIONALS: Physicians and nurses can apply the new scale to all patients admitted to the intensive care units. Nursing care can be adapted according to frailty, trying to reduce the side effects of admission to these units for the most fragile patients. REPORTING METHOD: The manuscripts authors have adhered to the EQUATOR guidelines, using the COSMIN reporting guideline for studies on the measurement properties of patient-reported outcome measures. PATIENT OR PUBLIC CONTRIBUTION: In a pilot clinical study, we applied the first version of the FRAIL-Spain scale to intensive care unit (ICU) patients. Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the relevance (content validity) and comprehensibility (face validity) of the five items of the first Spanish version. Relevance was assessed using a 4-point Likert scale ranging from 1 (no relevance) to 4 (high relevance), and comprehensibility was assessed as poor, acceptable or good. Each health professional applied the scale to three patients (total number of patients = 30) of three different age ranges (<50, 50-65 and >65 years) and recorded the time of application of the scale to each patient. Although the frailty scales were initially created by geriatricians to be applied to the elders, there is little experience with their application in critically ill patients of any age. Therefore, more information is needed to determine the relevance of using this scale in critical care patients. In this pilot study, we considered that nurses and critical care physicians should evaluate frailty using this adapted scale in adult patients admitted to the Intensive Care Units

Cross‐cultural adaptation of the FRAIL scale for critically ill patients in Spain

Abstract Aim To translate and culturally adapt the FRAIL scale into Spanish and perform a preliminary test of diagnostic accuracy in patients admitted to intensive care units. Design Cross‐sectional diagnostic study. Methods Five intensive care units (ICU) in Spain were participated. Stage 1: Three native Spanish‐speaking bilingual translators familiar with the field of critical care translated the scale from English into Spanish. Stage 2: Three native English‐speaking bilingual translators familiar with critical care medicine. Stage 3: Authors of the original scale compared the English original and back‐translated versions of the scale. Stage 4: Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the comprehension and relevance of each of the items of the Spanish version in 30 patients of 3 different age ranges (65 years). Results The FRAIL scale was translated and adapted cross‐culturally for patients admitted to intensive care units in Spain. The process consisted of four stages: translation, back translation, comparison and pilot test. There was good correspondence between the original scale and the Spanish version in 100% of the items. The participating patients assessed the relevance (content validity) and comprehensibility (face validity) of each of the items of the first Spanish version. The relevance of some of the items scored low when the scale was used in patients younger than 65 years. Conclusions We have cross‐culturally adapted the FRAIL scale, originally in English, to Spanish for its use in the critical care medical setting in Spanish‐speaking countries. Implications for Professionals Physicians and nurses can apply the new scale to all patients admitted to the intensive care units. Nursing care can be adapted according to frailty, trying to reduce the side effects of admission to these units for the most fragile patients. Reporting Method The manuscript's authors have adhered to the EQUATOR guidelines, using the COSMIN reporting guideline for studies on the measurement properties of patient‐reported outcome measures. Patient or Public Contribution In a pilot clinical study, we applied the first version of the FRAIL‐Spain scale to intensive care unit (ICU) patients. Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the relevance (content validity) and comprehensibility (face validity) of the five items of the first Spanish version. Relevance was assessed using a 4‐point Likert scale ranging from 1 (no relevance) to 4 (high relevance), and comprehensibility was assessed as poor, acceptable or good. Each health professional applied the scale to three patients (total number of patients = 30) of three different age ranges (65 years) and recorded the time of application of the scale to each patient. Although the frailty scales were initially created by geriatricians to be applied to the elders, there is little experience with their application in critically ill patients of any age. Therefore, more information is needed to determine the relevance of using this scale in critical care patients. In this pilot study, we considered that nurses and critical care physicians should evaluate frailty using this adapted scale in adult patients admitted to the Intensive Care Units