Estrategias que modulan el síndrome de Burnout en enfermeros (as): una revisión bibliográfica

Introduction: the Burnout syndrome is the feeling of exhaustion and loss of interest in the work  that emerges in professionals that maintain daily contact with other people. Methodology: A review  of articles that report strategies to modulate the Burnout in nursing professionals was performed in  the following databases: Scielo, ProQuest, ScienceDirect, Ovid Nursing, EBSCO, Medline, Pubmed  and Wiley Online Library. The descriptors used in Spanish, English and Portuguese were: Burnout,  nurses, interventions. 1833 articles were found, in which 17 met the criteria of selection. Results: the effects of pre and post interventions for the Burnout was measured with the Maslach Burnout  Inventory and the Hospital Anxiety and Depression Scale, among others. The interventions most  reported were social support, psychoeducation, problem solving training and communication skills.  16 articles reported the decrease or absence of Burnout after the interventions, with changes in the  variables proposed by Maslach and Jackson or in the sustainability over time. Conclusion: strategies  for the Burnout are reported without distinction of the variables; however, differences are evidenced  on the results regarding positive changes in emotional tiredness, compared to other variables. Keywords: adaptation psychological, Burnout professional, nurses, depersonalization.Introducción: el síndrome de Burnout es la sensación de agotamiento y pérdida de interés por el trabajo que surge en profesionales que mantienen contacto diario con otras personas. Metodología: se realizó una revisión de artículos que reportan estrategias para modular el Burnout en profesionales de enfermería, en las siguientes bases de datos: Scielo, ProQuest, Sciencie Direct, Ovid Nursing, EBSCO, Medline, Pubmed y Wiley Online Library. Los descriptores en español, inglés y portugués utilizados fueron: Burnout, enfermeras, intervenciones. Se encontraron 1.833 artículos, de los cuales 17 cumplieron con los criterios de selección. Resultados: el efecto de las intervenciones pre y post para el Burnout fue medido con el Maslach Burnout Inventory y la Escala de Depresión y Ansiedad Hospitalaria, entre otros. Las intervenciones más reportadas fueron apoyo social, psico-educación, entrenamiento en la solución de problemas y en habilidades de comunicación. 16 artículos reportaron disminución o ausencia del Burnout después de las intervenciones, con cambios en las variables propuestas por Maslach y Jackson o en la sostenibilidad en el tiempo. Conclusión: se reportan estrategias para el Burnout sin distinción de las variables del mismo; sin embargo, se evidencian diferencias en los resultados frente a cambios positivos en cansancio emocional, en comparación con las otras variables Palabras clave:  adaptación  psicológica,  agotamiento  profesional,  enfermeros,  despersonalización. Strategies that modulate the Burnout syndrome in nurses: a bibliographic review Abstract Introduction: the Burnout syndrome is the feeling of exhaustion and loss of interest in the work  that emerges in professionals that maintain daily contact with other people. Methodology: A review  of articles that report strategies to modulate the Burnout in nursing professionals was performed in  the following databases: Scielo, ProQuest, ScienceDirect, Ovid Nursing, EBSCO, Medline, Pubmed  and Wiley Online Library. The descriptors used in Spanish, English and Portuguese were: Burnout,  nurses, interventions. 1833 articles were found, in which 17 met the criteria of selection. Results: the effects of pre and post interventions for the Burnout was measured with the Maslach Burnout  Inventory and the Hospital Anxiety and Depression Scale, among others. The interventions most  reported were social support, psychoeducation, problem solving training and communication skills.  16 articles reported the decrease or absence of Burnout after the interventions, with changes in the  variables proposed by Maslach and Jackson or in the sustainability over time. Conclusion: strategies  for the Burnout are reported without distinction of the variables; however, differences are evidenced  on the results regarding positive changes in emotional tiredness, compared to other variables. Keywords: adaptation psychological, Burnout professional, nurses, depersonalization. Estratégias que modulam a síndrome de Burnout em enfermeiros (as): uma revisão de literatura Resumo Introdução: a síndrome de Burnout é um transtorno adaptativo crônico associado às demandas e exigências laborais, cujo desenvolvimento é insidioso e frequentemente não reconhecido pelo indivíduo, que gera cansaço emocional, sensação de esgotamento e perda de interesse pelo trabalho, principalmente apresentando-se em professionais que mantem contato diário com outras pessoas. Metodologia: realizou-se uma revisão de artigos que reportam estratégias para modular o Burnout em professionais de enfermagem, nas seguintes bases de dados: Scielo, ProQuest, Sciencie Direct, Ovid Nursing, EBSCO, Medline, Pubmed e Wiley Online Library. Os descritores utilizados em espanhol, inglês e português foram: Burnout, enfermeiras, intervenções. Encontraram-se 1.833 artigos, dos quais 17 cumpriram com os critérios de seleção. Resultados: o efeito das intervenções pré e pós para o Burnout foi medido com o Maslach Burnout Inventory e a Escala de Depressão e Ansiedade Hospitalar, entre outros. As intervenções mais reportadas foram apoio social, psico-educação, treinamento na solução de problemas e em habilidades de comunicação. 16 artigos reportaram diminuição ou ausência do Burnout depois das intervenções, com mudanças nas variáveis propostas por Maslach e Jackson ou na sustentabilidade no tempo. Conclusão: se reportam estratégias para o Burnout sim distinção das variáveis do mesmo; porém, se evidenciam diferenças nos resultados frente a mudanças positivas em cansaço emocional, em comparação com as outras variáveis Palavras-chave: adaptação psicológica, esgotamento professional, enfermeiras e enfermeiros,  despersonalização. &nbsp

Noncollinear magnetic order in two-dimensional NiBr2 films grown on Au(111)

Metal halides are a class of layered materials with promising electronic and magnetic properties persisting down to the two-dimensional limit. While most recent studies focused on the trihalide components of this family, the rather unexplored metal dihalides are also van der Waals layered systems with distinctive magnetic properties. Here we show that the dihalide NiBr2 grows epitaxially on a Au(111) substrate and exhibits semiconducting and magnetic behavior starting from a single layer. Through a combination of a low-temperature scanning-tunneling microscopy, low-energy electron diffraction, X-ray photoelectron spectroscopy, and photoemission electron microscopy, we identify two competing layer structures of NiBr2 coexisting at the interface and a stoichiometrically pure layer-by-layer growth beyond. Interestingly, X-ray absorption spectroscopy measurements revealed a magnetically ordered state below 27 K with in-plane magnetic anisotropy and zero-remanence in the single layer of NiBr2/Au(111), which we attribute to a noncollinear magnetic structure. The combination of such two-dimensional magnetic order with the semiconducting behavior down to the 2D limit offers the attractive perspective of using these films as ultrathin crystalline barriers in tunneling junctions and low-dimensional devices.D.B. acknowledges funding from the Austrian Science Fund (FWF) under the Erwin Schrödinger fellowship agreement (project number: J4395-N). C.G.-O. and M.P.-D. acknowledge funding of the Ph.D. fellowship from the MPC Foundation. We gratefully acknowledge financial support from Spanish AEI (Grant Nos. PID2019-107338RB-C6, RTI-2018-095303-C53, and the Maria de Maeztu Units of Excellence Programme MDM-2016-0618) and from the European Union (EU) through Horizon 2020 (SUPERTED Grant No. 800923), from Interred POCTEFA V-A Spain/France/Andorra Program (EFA 194/16/TNSI), the Basque Government (GV/EJ) under grants IT-1255-19, and the European Regional Development Fund. P.G. acknowledges funding from MINECO Grant No. FIS2016-78591-C3-2-R and FLAG-ERA Grant No. PCI2019-111908-2.Peer reviewe

Epitaxial monolayers of the magnetic 2D semiconductor FeBr2 grown on Au(111)

Magnetic two-dimensional (2D) semiconductors have attracted a lot of attention because modern preparation techniques are capable of providing single-crystal films of these materials with precise control of thickness down to the single-layer limit. It opens up a way to study a rich variety of electronic and magnetic phenomena with promising routes toward potential applications. We have investigated the initial stages of epitaxial growth of the magnetic van der Waals semiconductor FeBr2 on a single-crystal Au(111) substrate by means of low-temperature scanning tunneling microscopy (STM), low-energy electron diffraction (LEED), X-ray photoemission spectroscopy (XPS), low-energy electron emission microscopy (LEEM), and X-ray photoemission electron microscopy (XPEEM). Magnetic properties of the one- and two-layer thick films were measured via X-ray absorption spectroscopy (XAS) and X-ray magnetic circular dichroism (XMCD). Our findings show a striking difference in the magnetic behavior of the single layer of FeBr2 and its bulk counterpart, which can be attributed to the modifications in the crystal structure due to the interaction with the substrate.C.G.-O. and M.P.-D. acknowledge funding of the Ph.D. fellowship from the MPC Foundation. S.E.H. thanks the whole AG Kuch and in particular J. Gördes for help during the BESSY measurements and also the local IT/electronics workshop/fine mechanics workshop teams for their continuous support. In particular, he is very thankful for the possibility to perform some last STM measurements at the PEARL beamline at SLS thanks Dr. Matthias Muntwiler. J.N. thanks the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) for his funding under project 277101999 - CRC 183. S.T. acknowledges financial support by BMBF through project VEKMAG (BMBF 05K19KEA). P.G. acknowledges funding from PID2020-116181RB-C32 and FlagEraSOgraphMEM PCI2019-111908-2 (AEI/FEDER). D.G.O. acknowledges funding by the Spanish MCIN/AEI/10.13039/501100011033 and by the European Union “NextGenerationEU”/PRTR (PID2019-107338RB-C63 and TED2021-132388B–C43). C.R., M.I., C.G.-O., and M.P.-D. acknowledge funding by the European Union’s Horizon 2020 research and innovation program (grant agreement No 800923), the Spanish MCIN/AEI/10.13039/501100011033 (PID2020-114252GB-I00, PID2019-107338RB-C63, TED2021-130292B–C42), the Basque Goverment IT1591-22, and by the IKUR Strategy under the collaboration agreement between Ikerbasque Foundation and MPC on behalf of the Department of Education of the Basque Government. C.R., M.I., C.G.-O., and S.E.H. are very thankful for the help during the XMCD and STM measurements of Samuel Kerschbaumer, Andrea Aguirre Baños, and Amitayush Jha Thakur.Peer reviewe

Consensus on diagnosis and treatment of Chronic Myeloid Leukemia in Colombia.

Objetivo: Unificar criterios para agilizar el diagnóstico de la Leucemia Mieloide Crónica (LMC) y racionalizar el uso de nuevos medicamentos para su tratamiento. Métodos: Se realizó una búsqueda estructurada de la literatura médica en la bases de datos Medline, en el Registro de Estudios Clínicos (CCTR) de la Biblioteca Cochrane y en EMBASE, usando la plataforma OVID. Todos los artículos fueron revisados por un comité central y los resultados fueron validados por hematólogos, oncólogos y otros especialistas en una reunión de consenso. Resultados: Se generaron 11 recomendaciones sobre diagnóstico (criterios definitorios), tratamiento (fase crónica, fase acelerada, crisis blástica, transplante alogénico), y seguimiento según fase y tratamiento base (remisión hematológica, respuesta citogenética, respuesta molecular, evolución clonal, etc). Conclusiones: Los esquemas de tratamiento disponibles permiten mejorar la supervivencia y calidad de vida de los pacientes. Todo paciente con LMC requiere confirmación histológica y citogenética de su enfermedad. El inicio temprano del tratamiento con inhibidores de la tirosina-quinasa y el seguimiento estricto de las respuestas hematológica, citogenética y molecular permitirán adecuar o modificar la terapia de manera oportuna en pacientes resistentes primarios o secundarios.Objective: To harmonize criteria for an effective diagnosis of Chronic Myeloid Leukemia (CML), and to promote a rational use of available molecules for treatment. Methods: A structured search in Medline, Cochrane Controlled Trials Register, and EMBASE data bases was done through the OVID platform. All scientific papers were reviewed by a central committee and the results were validated in a national consensus panel. Results: Eleven recommendations were done on diagnostic criteria, treatment (chronic phase, accelerated phase, blastic phase, bone marrow transplantation), and follow-up according to disease phase and treatment (hematological response, cytogenetic response, molecular response, clonal evolution, etc). Conclusions: available treatments allow for better survival rates and quality of life. Every CML patient requires histological and cytogenetic verification. Early treatment with tyrosine-kinase inhibitors and strict follow-up of hematological, cytogenetic, and molecular responses will allow a timely adaptation of treatment in primary or secondary resistanc

MANEJO DE MEDICAMENTOS EN CASA, EN PERSONAS CON ENFERMEDAD CRÓNICA NO TRANSMISIBLE (ECNT) Y CUIDADORES

La enfermedad crónica no trasmisible (ECNT) es la principal causa de morbilidad, a nivel mundial y es un problema de salud pública, que amenaza el desarrollo económico y social de los países. El manejo de la ECNT requiere un régimen terapéutico y farmacológico eficaz para su control. La administración segura de medicamentos en casa es fundamental para prevenir el deterioro de la calidad de vida de las personas y los reingresos hospitalarios, que aumentan los costos para las instituciones y las familias. El objetivo del estudio fue evaluar el manejo de medicamentos en casa, en un grupo de personas con ECNT y en cuidadores. Se empleó un diseño descriptivo transversal. La recolección de la información, se realizó a través de un instrumento de caracterización sociodemográfica y una guía de observación semiestructurada, previamente evaluados por expertos; se aplicó una prueba piloto. El estudio, se practicó con una muestra de 35 personas, quienes cumplieron con los criterios de inclusión, a partir de una población de 71 individuos, que asisten a un Programa de apoyo a la persona mayor, en una Localidad de Bogotá. Se efectuó un análisis descriptivo. La edad de las personas con ECNT fue de 71 a 90 años y la de los cuidadores, de 56 a 70 años. En su mayoría, los dos grupos pertenecían al género femenino, con bajo nivel de escolaridad y en estrato socioeconómico II. Los medicamentos más utilizados son antihipertensivos; las personas almacenan medicamentos vencidos y tienen dificultad para leer la etiqueta

Home care medication in people with nontransferable chronic disease (NTCD) and caregivers

La enfermedad crónica no trasmisible (ECNT) es la principal causa de morbilidad, a nivel mundial y es un problema de salud pública, que amenaza el desarrollo económico y social de los países. El manejo de la ECNT requiere un régimen terapéutico y farmacológico eficaz para su control. La administración segura de medicamentos en casa es fundamental para prevenir el deterioro de la calidad de vida de las personas y los reingresos hospitalarios, que aumentan los costos para las instituciones y las familias. El objetivo del estudio fue evaluar el manejo de medicamentos en casa, en un grupo de personas con ECNT y en cuidadores. Se empleó un diseño descriptivo transversal. La recolección de la información, se realizó a través de un instrumento de caracterización sociodemográfica y una guía de observación semiestructurada, previamente evaluados por expertos; se aplicó una prueba piloto. El estudio, se practicó con una muestra de 35 personas, quienes cumplieron con los criterios de inclusión, a partir de una población de 71 individuos, que asisten a un Programa de apoyo a la persona mayor, en una Localidad de Bogotá. Se efectuó un análisis descriptivo. La edad de las personas con ECNT fue de 71 a 90 años y la de los cuidadores, de 56 a 70 años. En su mayoría, los dos grupos pertenecían al género femenino, con bajo nivel de escolaridad y en estrato socioeconómico II. Los medicamentos más utilizados son antihipertensivos; las personas almacenan medicamentos vencidos y tienen dificultad para leer la etiqueta.Nontransferable chronic diseases (NTCD) are the leading cause of morbidity worldwide; they are considered a public health problem that threatens economic and social development of many countries. Management of NTCD requires an effective therapeutic and drug regimen to control it. Safe administration of medications at home constitutes the base to prevent life quality weakening of people and hospital readmissions, both increasing costs for institutions and families. The aim of the study was to evaluate medication management at home in a group of people with NTCD and in caregivers. The study used-design was cross sectional descriptive. Data collection was performed using a socio-demographic instrument and semi-structured observation guide previously evaluated by experts and pilot test was applied. Sample for the study corresponded to 35 people, who met the inclusion criteria, from a preliminary 71 people characterized population who attended a Program to support the older person in a district of Bogotá. Data analysis was descriptive. Age of people with NTCD was 71 - 90 years, and caregivers 56 - 70 years. Women were prevalent in two groups, with low levels of education and socioeconomic level II. More used drugs were antihypertensive; people used to stored expired medicines and have difficulty for reading the label.Incluye refencias bibliográfica

Carga mental en enfermeros(As) que laboran en diferentes unidades de un hospital

Introduction: The mental workload is the set of psychophysical requirements the worker is under throughout his/her working day. If high and long-standing, it can lead to staff fatigue. This represents a risk both for the nurse and for the patients under his/her care. Objective: To analyze the mental workload in nurses who work in different units of a hospital in Bogotá, Colombia. Methods: Quantitative study of descriptive type. For the collection of sociodemographic and occupational information from healthcare nurses, an instrument proposed by the authors was applied, while the tasks evaluation was carried out using the instrument NASA-TLX. Results: The tasks that generate mental workload were administration of the medication (with a score of 58.20), and managerial tasks (54.90). Internal medicine presented serious mental workload (68.15). The morning shift presented serious mental workload (69.61). Conclusions: The most evaluated dimension was time-related demand. The tasks that most generate mental load are administration of the medication, managerial tasks, patient and family education, laboratory tests analysis, and attention code blue

The timing and circadian rhythm of pain: new concepts for timely and opportune nursing care

En la actualidad el dolor crónico o agudo es considerado una situación que requiere un manejo adecuado porque interfiere con la calidad de vida de quien lo experimenta, por sus efectos en la salud física, mental, social y familiar, en algunos casos por el impacto sobre quienes lo rodean; sin embargo, poco se conoce sobre las variaciones en su intensidad a lo largo del día y su asociación con enfermedades específicas, así como su respuesta al tratamiento farmacológico. El personal de enfermería es una pieza fundamental en el manejo integral de quienes presentan dolor puesto que es el eslabón que comunica al paciente y familia con el médico; por lo tanto, es prioritario que conozca las variaciones del dolor durante el día con el fin de administrar de manera oportuna los medicamentos analgésicos. El presente artículo pretende proporcionar al profesional en Enfermería una nueva visión para el manejo oportuno del dolor, mejorar la eficacia y disminuir la dosis de medicamentos analgésicos requeridos por el paciente, así como recomendar mejores horarios de administración.Relief of chronic or acute pain requires patient good management. Chronic pain interferes with the quality of life of patients and those around the patient. In addition, it can affect physical and mental health and family and social relationships. Nevertheless, little is known about the behavior of its intensity during the day, its association with certain specific diseases or its response to pharmacological treatment. This aim of this paper is to improve the efficiency of necessary drugs, to diminish their dosages, and to establish the best treatment schedules. For nursing personnel, who are the key in integral management of patients suffering pain because they are the links between doctors and patients, understanding variations in the intensity of pain throughout the day must be a priority in order to program accurate analgesic treatment schedule.Incluye referencias bibliográfica

COMORBILIDAD DEL PACIENTE HOSPITALIZADO EN EL SERVICIO DE GERIATRÍA EN LA FUNDACIÓN HOSPITAL SAN CARLOS

La comorbilidad es la existencia de una entidad clínica adicional a una enfermedad bajo estudio, que ocurre durante la hospitalización de un paciente. Genera prolongación en la estancia hospitalaria, impactando sobre la terapéutica, el pronóstico de la enfermedad a mediano y largo plazo y la demanda del servicio en salud. Se realizó un estudio cuantitativo de tipo analítico, retrospectivo. Se revisaron 93 historias clínicas y se aplicó un análisis de varianza, utilizando el lenguaje de programación R, para determinar la prevalencia de diagnósticos de comorbilidad en la población evaluada. Se identificaron 151 diagnósticos de egresos. Las más representativas fueron: Hipertensión Arterial: 10,4%; Enfermedad Pulmonar Obstructiva Crónica: 6,1%; Diabetes Mellitus Tipo II: 4,1%; Infección de Vías Urinarias: 3,6%. El análisis de la prevalencia mostró la presencia de 32 diagnósticos que prolongaron la estancia hospitalaria, principalmente: Enfermedad Renal Crónica, Neumonía Asociada al Cuidado de la Salud, Fístula Recto Vaginal, Hipoalbuminemia y Obstrucción Urinaria. La comorbilidad encontrada en pacientes geriátricos hospitalizados en la Fundación Hospital San Carlos corresponde a enfermedades agudas y crónicas de aparición repentina durante la estancia hospitalaria. Su vínculo con los estados de salud iniciales se debe aún establecer