Efficacy of nonpharmacologic interventions in preoperative anxiety: a systematic review of systematic reviews

Aims and objectives: Evidence suggests that preparing patients for surgery using nonpharmacological strategies reduces their anxiety. However, there is no consensus on what the best practices are. This study aims to answer the question: Are interventions using nonpharmacological therapies effective in reducing preoperative anxiety? Background: Preoperative anxiety causes physiological and psychological adverse effects, with a negative effect on postoperative recovery. Introduction: According to the World Health Organization, between 266 and 360 million surgical procedures are performed annually worldwide, and it is estimated that more than 50% of patients will experience some degree of preoperative anxiety. Design: Systematic review of systematic reviews with results of interventions aimed at mitigating preoperative anxiety. Methods: A search was conducted for systematic reviews with meta-analyses published between 2012 and 2021 in Medline, Scopus, Web of Science and Cochrane Library. Quality was assessed using the AMSTAR-2 scale. The protocol was registered in PROSPERO. Results: A total of 1016 studies were examined, of which 17 systematic reviews were selected, yielding 188 controlled trials with 16,884 participants. In adults, the most common intervention included music, followed by massage, in children virtual reality and clowns. Almost all controlled trials reported a reduction in preoperative anxiety after the intervention, of which almost half had statistically significant results. Conclusion: Interventions that include music, massage and virtual reality reduce preoperative anxiety and have shown that they are cost-effective, minimally invasive and with a low risk of adverse effects. Preoperative anxiety can be reduced through a short-term intervention involving nursing professionals as an alternative or complement to drugs.FUNDING INFORMATION: This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. Journal Pre-proof. ACKNOWLEDGEMENTS: The authors would like to thank Roberto Martin Melón for his contribution to the literature search

Knee Kinematics During Landing: Is It Really a Predictor of Acute Noncontact Knee Injuries in Athletes? A Systematic Review and Meta-analysis

Background: Although knee kinematics during landing tasks has traditionally been considered to predict noncontact knee injuries, the predictive association between noncontact knee injuries and kinematic and kinetic variables remains unclear. Purpose: To systematically review the association between kinematic and kinetic variables from biomechanical evaluation during landing tasks and subsequent acute noncontact knee injuries in athletes. Study Design: Systematic review; Level of evidence, 2. Methods: Databases used for searches were MEDLINE, LILACS, IBECS, CINAHL, SPORTDiscus, SCIELO, IME, ScienceDirect, and Cochrane from database inception to May 2020. Manual reference checks, articles published online ahead of print, and citation tracking were also considered. Eligibility criteria included prospective studies evaluating frontal and sagittal plane kinematics and kinetics of landing tasks and their association with subsequent acute noncontact knee injuries in athletes. Results: A total of 13 studies met the eligibility criteria, capturing 333 acute noncontact knee injuries in 8689 participants. A metaanalysis revealed no significant effects for any kinematic and kinetic variable with regard to subsequent noncontact knee injuries. Conclusion: No kinetic or kinematic variables from landing tasks had a significant association with acute noncontact knee injuries. Therefore, the role and application of the landing assessment for predicting acute noncontact knee injuries are limited and unclear, particularly given the heterogeneity and risk of bias of studies to date

The use of social network analysis in social support and care: a systematic scoping review protocol

Background: In recent decades, the literature on Social Network Analysis and health has experienced a significant increase. Disease transmission, health behavior, organizational networks, social capital, and social support are among the different health areas where Social Network Analysis has been applied. The current epidemiological trend is characterized by a progressive increase in the population's ageing and the incidence of long-term conditions. Thus, it seems relevant to highlight the importance of social support and care systems to guarantee the coverage of health and social needs within the context of acute illness, chronic disease, and disability for patients and their carers. Thus, the main aim is to identify, categorize, summarize, synthesize, and map existing knowledge, literature, and evidence about the use of Social Network Analysis to study social support and care in the context of illness and disability. Methods: This scoping review will be conducted following Arksey and O'Malley's framework with adaptations from Levac et al. and Joanna Briggs Institute's methodological guidance for conducting scoping reviews. We will search the following databases (from January 2000 onwards): PubMed, MEDLINE, Web of Science Core Collection, SCOPUS, CINAHL, PsycINFO, Cochrane Database of Systematic Reviews, PROSPERO, and DARE. Complementary searches will be conducted in selected relevant journals. Only articles related to social support or care in patients or caregivers in the context of acute illnesses, disabilities or long-term conditions will be considered eligible for inclusion. Two reviewers will screen all the citations, full-text articles, and abstract the data independently. A narrative synthesis will be provided with information presented in the main text and tables. Discussion: The knowledge about the scientific evidence available in the literature, the methodological characteristics of the studies identified based on Social Network Analysis, and its main contributions will highlight the importance of health-related research's social and relational dimensions. These results will shed light on the importance of the structure and composition of social networks to provide social support and care and their impact on other health outcomes. It is anticipated that results may guide future research on network-based interventions that might be considered drivers to provide further knowledge in social support and care from a relational approach at the individual and community levels

Implementing a Care Pathway for Complex Chronic Patients from a Nursing Perspective: A Qualitative Study

A care pathway constitutes a complex care strategy for decision-making and the organization of processes in the care of complex chronic patients, avoiding the fragmentation of care. Health professionals play a decisive role in the implementation, development, and evaluation of care pathways. This study sought to explore nurses' opinions on the care pathway for complex chronic patients three years after its implementation. The study participants were thirteen nurses with different roles who were involved in the care pathway. Thematic content analysis of the semi-structured interviews resulted in four major themes: (a) the strengths of the route; (b) the impact of the route on caregivers; (c) the weaknesses of the route; and (d) the future of the route. Overall, the pathway was positively valued for the benefits it provides to patients, the caregiver, and the administration of professional health care. Participants voiced their concerns regarding: communication and coordination difficulties among professionals across the different levels of care, the need for improved teamwork and consensus among professionals at the same center, and human and material resources. The ongoing evaluation and monitoring of facilitators and barriers is necessary throughout the implementation process, to ensure continuity and quality of care in the health system

Characteristics of Nursing Interventions That Improve the Quality of Life of People With Chronic Diseases. A Systematic Review With Meta-Analysis

Purpose The objective of this systematic review was to determine the characteristics of the interventions conducted by nurses that attempt to improve the health related quality of life (HRQoL) of people over 18 years of age with chronic diseases. Methods This systematic review with meta-analysis summarizes 24 studies, conducted in 10 countries, that evaluated HRQoL through the Short-Form Health Survey (SF). Five databases were accessed to find the available studies from December 31st, 2000 to May 22sd, 2017. Selected studies were coded according to the characteristics of the sample and the intervention. A model of random effects was adopted for the overall estimation and to explain the heterogeneity. Results Twenty-four studies were included in the systematic review and meta-analysis providing a sample of 4324 chronic patients aged 63.4 years. Among the 8 subscales and two summary measures that comprise the SF-36, only an overall significant effect size (ES) index was found in the Mental Health Component summary score (ES = 0.14; 95% CI:0.03 ? 0.26; I2 = 44.6, p = 0.042) and the Mental Health subscale. This improvement on HRQoL was associated to interventions on ?Case Management? and ?Treatments and Procedures?, which were based on a theory, were of shorter duration, and had a follow-up period. Conclusions Interventions targeting people with chronic diseases resulted in a slight increase in the HRQoL that was not always significant, which suggests that there is a need for their continuous improvement.Funding: This project was funded by the University of Cantabria (Spain). Budget implementation 28.VU08.64662

Experiences of Nursing Students Participating in End-Of-Life Education Programs: A Systematic Review and Qualitative Metasynthesis

Objective: The aim of this review was to explore the experiences of nursing students participating in end-of-life education programs. Design: A systematic review. Data sources: Exhaustive literature searches were performed using seven electronic databases: Medline, Scopus, Web of Science, CINAHL Plus, Dialnet Plus, Eric and Cuiden Plus. Review methods: In total, 6572 studies published from 2008 until 2018 were examined. The Critical Appraisal Skills Program was used to assess the quality of the studies included in the review. The findings were synthesized using meta-aggregation. Results: Seventeen studies were included in this systematic review, representing a sample of 606 nursing students. Simulation methods were most common among the educational programs analyzed. The analysis of qualitative data allowed us to identify 260 illustrations which were grouped into 14 categories and three themes: feelings and emotions during the performance of the pedagogical activity, end-of-life education among nursing students and competencies acquired on death and end-of-life. The most highlighted communication skills were learning to listen and building confidence to speak with the patient, family and the general public. Conclusions: End-of-life programs generally helped students acquire communication skills, learn concepts and improve the administration of this type of care. In addition, they perceived the experience as an opportunity to learn more about oneself, gain trust and support critical thinking. Nonetheless, the evidence available in this field is limited due to the small number of studies, plus the limited data reported. Thus, further studies on this subject are necessary

Comparison of injury severity scores (ISS) obtained by manual coding versus ?Two-step conversion? from ICD-9-CM

Background: The International Classification of Diseases (ICD) is the standard diagnostic tool for classifying and coding diseases and injuries. The Abbreviated Injury Scale (AIS) is the most widely used injury severity scoring system. Although manual coding is considered the gold standard, it is sometimes unavailable or impractical. There have been many prior attempts to develop programs for the automated conversion of ICD rubrics into AIS codes. Objective: To convert ICD, Ninth Revision, Clinical Modification (ICD-9-CM) codes into AIS 2005 (update 2008) codes via a derived map using a two-step process and, subsequently, to compare Injury Severity Score (ISS) resulting from said conversion with manually coded ISS values. Methods: A cross-sectional retrospective study was designed in which medical records at the Hospital Universitario Marqués de Valdecilla of Cantabria (HUMV) and the Complejo Hospitalario of Navarra (CHN), both in Spain, were reviewed. Coding of injuries using AIS 2005 (update 2008) version was done manually by a certified AIS specialist and ISS values were calculated. ICD-9-CM codes were automatically converted into ISS values by another certified AIS specialist in a two-step process. ISS scores obtained from manual coding were compared to those obtained through this conversion process. Results: The comparison of obtained through conversion versus manual ISS resulted in 396 concordant pairs (70.2%); the analysis of values according to ISS categories (ISS24) showed 493 concordant pairs (87.4%). Regarding the criterion of ?major trauma? patient (i.e., ISS> 15), 538 matching pairs (95.2%) were obtained. The conversion process resulted in underestimation of ISS in 112 cases (19.9%) and conversion was not possible in 136 cases (19%) for different reasons. Conclusions: The process used in this study has proven to be a useful tool for selecting patients who meet the ISS>15 criterion for ?major trauma?. Further research is needed to improve the conversion process

El impacto de la COVID-19 en el enfoque pedagógico y seguimiento de una asignatura del Grado de Enfermería

RESUMEN: La situación provocada por la COVID-19 impulsó la aplicación de la metodología del Aula Invertida en una asignatura del Grado de Enfermería. El objetivo de este estudio fue analizar el impacto de dicha metodología en las calificaciones de la asignatura. Los resultados mostraron un incremento de la puntuación en el examen final; además el alumnado percibe que la metodología empleada favorece llevar al día la asignatura y adaptarla a su propio ritmo de aprendizaje.ABSTRACT: The situation caused by COVID-19 prompted the application of the Flipped Classroom methodology in a subject of the Nursing Degree. The aim of this study was to analyze the impact of such methodology on the ratings of the subject. The results showed an increase in the qualification in the final exam, in addition the students perceive that their use favored keeping the subject up to date and adapting it to their own learning pace

Using High-Fidelity Simulation to Introduce Communication Skills about End-of-Life to Novice Nursing Students

Background: High-fidelity simulation is being considered as a suitable environment for imparting the skills needed to deal with end-of-life (EOL) situations. The objective was to evaluate an EOL simulation project that introduced communication skills to nursing students who had not yet begun their training in real healthcare environments. Methods: A sequential approach was used. The ?questionnaire for the evaluation of the end-of-life project? was employed. Results: A total of130 students participated. Increasing the time spent in high-fidelity simulation significantly favored the exploration of feelings and fears regarding EOL (t = ?2.37, p = 0.019), encouraged dialogue (t = ?2.23, p = 0.028) and increased the acquisition of communication skills (t = ?2.32, p = 0.022).Conclusions: High-fidelity simulation promotes communication skills related to EOL in novice nursing studentsThis research was funded by the University of Cantabria (Spain). Grant number 28.0000.229

A critical review of superfoods from a holistic nutritional and environmental approach

n a global arena in which the identification of healthier and cleaner nutrient sources is practically mandatory, superfoods, known as foods of high nutritional and biological value with satisfactory bioavailability and bioactivity within the body due to extraordinary concentrations of nutrients and bioactive ingredients, can play a key role. These products are highly connected with sustainability, which is composed of an economic, envi- ronmental, and social balance, mainly translated in meeting nutritional needs. Focusing on the two latter aspects, this article is intended to provide a breakthrough in the knowledge by assessing the nutritional characteristics and environmental performance of superfoods. Firstly, a selection is made by revising the nutritional profile of different products. Secondly, a review of life cycle assessment (LCA) studies aims to establish guidelines for future analyses, based on the current state-of-art and possible recommendations, as well as to provide infor- mation on the impacts of these novel products. 40 superfoods are identified, of which only 15 have environ- mental analysis. The LCA revision enable to recognize methodological vulnerabilities based on the lack of definition of the function, allocations, uncertainty and quality assessments, as well as a weak justification on the selection of data sources and impact categories. Other recommendations include the possibility of using nutrient- based functional unit, extending system boundaries up to retailer, applying high quality primary data and standardized databases, and analyzing a wider range of indicators. Finally, this scientific field is still little explored, so the suitability of superfoods from an environmental perspective cannot be concluded, thus encouraging the use of LCA to fill this scientific gap.This work was supported by the Spanish Ministry of Science and Innovation through the KAIROS-BIOCIR project (PID2019-104925RB) (AEO/FEDER, UE). Ana Fern ́andez-Ríos thanks the Ministry of Economy and Competitiveness of Spanish Government for their financial support via the research fellowship RE2020-094029