Socio-demographic characteristics, indicators of risk and health care in relation to sexual transmission infections in migrant population of Granada

Fundamentos: El objetivo de este estudio fue describir el perfil sociodemográfico, las características de la atención clínica recibida, los indicadores de riesgo y la prevalencia de Infecciones de Transmisión Sexual (ITS) en la población inmigrante que acude a un centro especializado en ITS de la provincia de Granada, así como analizar la asociación entre la presencia o no de ITS con variables sociodemográficas e indicadores de riesgo. Métodos: Se realizó un estudio observacional, transversal y analítico, elaborado en el Centro de Orientación y Enfermedades de Transmisión Sexual de Granada. Se revisaron las historias clínicas de 374 inmigrantes, extraídas de una muestra de 1.455 historias de sujetos con sospecha de padecer una ITS, correspondientes al periodo 2000-2014. Se realizó análisis univariante, bivariante mediante U de Mann-Whitney y test de chi cuadrado, además de regresión logística múltiple. Resultados: La edad media de los sujetos fue de 28,28 años (Dt=7,54). El 69,3% eran mujeres y el 30,7% hombres, procedentes del Mercado Común del Sur (39%) y Unión Europea (35,6%), fundamentalmente. Un 36,1% eran profesionales o ex profesionales del sexo, un 34,5% tenía estudios superiores y un 79,9% eran solteros. Un 70% de los casos tuvo un diagnóstico positivo de ITS, siendo la más prevalente el Virus del Papiloma Humano. El número de parejas en el último año (OR=1,39; IC 95%=1,12-1,74; p=0,002) se asoció significativamente a la presencia de ITS. Conclusiones: En la muestra, que es principalmente de mujeres, profesionales o ex profesiona- les del sexo, jóvenes, procedentes de Sudamérica y Europa, hay una prevalencia alta de ITS y un mayor riesgo a medida que aumenta el número de parejas en el último año.Background: The objective of this paper was to describe the sociodemographic profile, the characteristics of clinical care received, the risk indicators and the prevalence of Sexually Transmitted Infections (STI) in an immigrant population attending a specialized center in Granada, as well as to analyse the asso- ciation between the presence or absence of STI with the sociodemographic variables and risk indicators. Methods: A cross-sectional observational and analytical study was conducted at the at the Center for Sexually Transmitted Diseases and Sexual Orientation in Granada, by reviewing the clinical records of 374 immigrants extracted from a sample of 1.455 records of subjects with a suspected of STI, corresponding to the period 2000-2014. Univariate analyses was conducted, bivariate analyses was conducted by using Mann-Whitney U and chi-square test, in addition to multiple logistic regression. Results: The mean age of individuals was 28,28 years (Dt=7,54). 69,3% were women and 30,7% were men, mainly from the Southern Common Market (39%) and the European Union (35.6%). 36.1% were professionals or former sex professionals, 34,5% had higher education and 79,9% were single. 70% of the cases had a positive diagnosis of STI, Human Papilloma Virus was the most prevalent infection. The number of partners in the last year (OR = 1,39; IC 95% = 1,12 - 1,74; p = 0,002) was significantly associated with the presence of STI. Conclusions: The sample, mainly women, sex workers or former sex workers, young people, from South America and Europe, has a high prevalence of infections and an increased risk as the number of partners increases in the last year

Experiences and Attitudes of People with HIV/AIDS: A Systematic Review of Qualitative Studies

The aim of this article was to explore the experiences and attitudes of people with HIV/AIDS. A systematic review of qualitative studies was carried out. Twenty-seven articles were included, with sample sizes ranging from 3 to 78. Articles from North America, South America, Central America, Europe, and Africa were included. Five topics emerged from the synthesis: feelings about the diagnosis of HIV/AIDS; stigma and HIV/AIDS; changes in sexual behavior after becoming infected; living with the virus; and pregnancy and motherhood in seropositive women. The moment of diagnosis is of vital importance for these people due to feelings such as disappointment, sadness, fear, despair, lack of awareness, and pain. Social support is highly valued among these people and is linked to an improvement in these peoples’ quality of life. Different kinds of stigma accompany people with HIV/AIDS throughout their life, like social stigma, self-stigma, and health professionals’ stigma. Seropositive women who decide to become mothers can feel frustration because they cannot breastfeed. Spirituality helps some people to deal with the fact of being a virus or disease carrier

Good practices in perinatal bereavement care in public maternity hospitals in Southern Spain

Funding sources The Department of Nursing from University of Granada pro- vided infrastructure and funding for the realization of the study (documents, material, software, web platforms etc.). Funding for open access charge: Universidad de Granada/CBUA. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.midw.2023.103749Objective To assess the attitudes and care practices of midwives and nurses in the province of Granada in relation to death care and perinatal bereavement, to determine their degree of adaptation to international standards and to identify possible differences in personal factors among those who best adapt to international recommendations. Design A local survey of 117 nurses and midwives from the five maternity hospitals in the province was conducted using the Lucina questionnaire developed to explore professionals' emotions, opinions, and knowledge during perinatal bereavement care. Adaptation of practices to international recommendations was assessed using the CiaoLapo Stillbirth Support (CLASS) checklist. Socio-demographic data were collected to establish their association with increased compliance with recommendations. Findings The response rate was 75.4%, the majority were women (88.9%), with a mean age of 40.9 (SD=1.4) and 17.4 (SD= 10.58) years of work experience. Midwives were the most represented (67.5%) and reported having attended more cases of perinatal death (p = 0.010) and having more specific training (p<0.001.) Of these, 57.3% would recommend immediate delivery, 26.5% would recommend the use of pharmacological sedation during delivery and 47% would take the baby immediately if the parents expressed their wish not to watch them. On the other hand, only 58% would be in favour of taking photos for the creation of memories, 47% would bathe and dress the baby in all cases, and 33.3% would allow the company of other family members. The percentage that matched each recommendation on memory-making was 58%, 41.9% matched the recommendations on respect for the baby and parents, and 23% and 10.3% matched the appropriate delivery and follow-up options, respectively. The factors associated with 100% of the recommendations, according to the care sector, were being a woman, a midwife, having specific training and having personally experienced the situation. Key conclusions Although the levels of adaptation observed are more favourable than in other nearby contexts, serious deficiencies are identified in the province of Granada with respect to internationally agreed recommendations on perinatal bereavement care. More training and awareness-raising of midwives and nurses is needed, which also considers factors related to better compliance. Implication for practice This is the first study to quantify the degree of adaptation to international recommendations in Spain reported by midwives and nurses, as well as the individual factors associated with a higher level of compliance. Areas for improvement and explanatory variables of adaptation are identified, which allow support for possible training and awareness-raising programmes aimed at improving the quality of care provided to bereaved families.Funding for open access charge: Universidad de Granada/CBU

Sexually Transmitted Infections and Associated Factors in Homosexuals and Bisexuals in Granada (Spain) during the Period 2000–2015

Sexually transmitted infections (STIs) are a major public health issue. Previous research shows the vulnerability of the homosexual and bisexual population, as well as the influence of economic, political, and cultural determinants. The aim of this study was to describe the socio-demographic healthcare profile and the main risk factors associated with STIs in homosexuals and bisexuals seen at the STI clinic in Granada (Spain) during the years 2000–2015. Infection prevalences were compared between the economic crisis period (2008–2014) and the rest of the years analysed. A cross-sectional observational and analytical study was conducted by reviewing 261 clinical records of individuals with suspected or present infection. Univariate, bivariate, and multivariate analyses were performed. 91.2% of the individuals were men, and 8.8% were women, with the mean age being 28.61 (SD = 9.35, Range = 17–74) years old. The prevailing sexual orientation identity was homosexual. 94.2% were single. The main reason for consultation was HIV. Differences in prevalence were found between crisis and non-crisis years (OR = 3.91; 95% CI = 1.73–9.19). In conclusion, their profile was that of a young, single man suspecting possible HIV infection. STI prevalence was significantly higher in the years of economic recession in comparison to the rest of the years

Spanish Nursing Students’ Attitudes toward People Living with HIV/AIDS: A Cross-Sectional Survey

Human immunodeficiency virus (HIV) infection is still a public health issue. Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) creates, in society, stigmatizing attitudes, fear, and discrimination against infected people; even health professionals do not feel trained enough to adequately take care of these patients, which a ects the quality of care provided to such patients. The purpose of this study was to explore nursing students’ attitudes and other related factors toward people with HIV/AIDS, as well as their evolution in subsequent academic years. A cross-sectional study was performed with students in four academic years from four Spanish health sciences institutions (n = 384). Data were collected voluntarily and on an anonymous basis, utilizing the “Nursing students’ attitudes toward AIDS” (EASE) validated scale. The students’ attitudes toward people with HIV/AIDS were relatively positive, with a total mean EASE value of 85.25 9.80. Statistically significant di erences were observed according to the academic year (p = 0.041), in 4 out of 21 items of the scale and among students with no religious beliefs. By adjusting every variable, only the weak association with religion was maintained (p = 0.045)

Economic Crisis, Social Policies and Health Inequalities

In recent years, the European Public Health Systems have been mired in the worst financial crisis in its history, pointing to the welfare state as the main responsible for it. The objective of this work has been to analyze the extent to which the economic crisis that began in 2008 has affected the social policies and inequalities in health, specifying the effects of this on the health of the population. To properly analyze the current situation, it is important to know to what extent the economic crisis has affected the health of populations and in particular, certain vulnerable groups (children, elderly, women, others). Contrary to the recent UN resolution urging governments to provide universal access and quality of health services, the tendency has been to prioritize the reduction in the deficit through austerity measures focused on health and education. The effects of this health crisis depends on the social protection policies undertaken, and its extension of services to the most vulnerable groups, as these crises have been associated with an increase in most diseases, mainly mental, as well as an increase in suicide mortality.En estos últimos años los Sistemas Públicos de Salud europeos se han visto sumidos en la peor crisis financiera de su historia, señalándose al Estado de Bienestar como principal responsable de la misma. El objetivo de este trabajo ha sido analizar en qué medida ha afectado la crisis económica iniciada en 2008, a las políticas sociales y a las desigualdades en salud, concretando los efectos de la misma sobre la salud de la población.Para analizar correctamente la actual situación habría que conocer en qué medida influyen las crisis económicas en la salud de las poblaciones y más aún sobre ciertos grupos vulnerables (niños, ancianos, mujeres,…). En contra de la reciente resolución de la ONU instando a los gobiernos hacia un acceso universal y de calidad de sus servicios sanitarios, se ha priorizado la reducción del déficit mediante programas de austeridad en sanidad y educación principalmente. Los efectos de esta crisis sobre la salud van a depender fundamentalmente de las políticas de protección social, y de su extensión a los grupos más vulnerables, ya que estas crisis se han asociado a un aumento de la mayoría de las enfermedades, fundamentalmente mentales, además, de un incremento de la mortalidad por suicidio

Sexually Transmitted Infections in 2000–2018 in a Specialised Centre: Comparison between Pre-Crisis, Crisis, and Post-Crisis Period

Background: Sexually Transmitted Infections (STIs) are a major public health problem due to their consequences in sexual and reproductive health. There is a close link between the crisis and the increase in communicable diseases. The objective of this study was to analyse the evolution of Sexually Transmitted Infections during the period 2000–2018 in the population attending the Centre for Sexually Transmitted Diseases and Sexual Orientation in Granada (Spain), specifically comparing the pre-crisis, crisis, and post-crisis periods. (2) Methods: A retrospective, observational, and analytical study was conducted by reviewing medical records. The sample analysed comprised 1666 cases. (3) Results: During the pre-crisis period (2000–2007), the percentage of diagnoses was 41.6% (n = 126) compared to 58.4% (n = 177) of negative results; during the crisis, the percentages were 63.5% (n = 183) and 36.5% (n = 105), respectively; and during the post-crisis period, the percentages were 42.9% (n = 157) and 57.1% (n = 209), respectively. The variables that were significantly associated with STI diagnosis were the time periods analysed, sexual orientation, occupation, and age at first intercourse. The evolution of the number of positive diagnoses during the entire study period showed a trend of progressive increase in Sexually Transmitted Infections from 2000 to 2018. (4) Conclusions: The period of economic crisis presented a higher risk of infection, although this is a finding with certain limitations due to the lack of homogeneity between the periods analyse

Evaluation of interventions in people with digestive stoma through the Nursing Interventions Classification

This manuscript is part of the project "The experience of having an intestinal stoma and its relations to nursing practice. Qualitative metasynthesis and implementation of qualitative evidence through clinical pathways." This project was funded by the Ministry of Health, Junta de Andalucia, Spain (Expt: PI-2011-0564).Purpose: To determine which nursing interventions are used in individuals with a digestive stoma and the relationships between nursing interventions used and sociodemographic and clinical variables. Methods: The present study is an observational, cross-sectional, descriptive. Data from 102 individuals in the general surgery unit of a first-level hospital (University Hospital Complex of Granada, Spain) were analyzed. Data on the use of nursing interventions and sociodemographic and clinical variables were collected. Univariate, bivariate, and multivariate data analyses were conducted. Findings: Interventions: Decision-Making Support (5250) and Ostomy Care (0480) were the most prevalent interventions in the sample. The period of care (postoperative and follow-up) was the most common significant variable (p < 0.05) among the interventions observed. Anxiety Reduction (5820), Nutritional Counseling (5246), Self-Esteem Enhancement (5400), and Body Image Enhancement (5220) were also relevant findings. Conclusions: The present study contributes to determining which nursing interventions are used in individuals with a digestive stoma. Implications for nursing practice: This study could be useful in planning nursing interventions in individuals with a digestive stoma.Ministry of Health, Junta de Andalucia, Spain PI-2011-056

Validation of the Women’s Views of Birth Labor Satisfaction Questionnaire (WOMBLSQ4) in the Spanish Population

The satisfaction of women with the birth experience has implications for the health and wellness of the women themselves and also of their newborn baby. The objectives of this study were to determine the factor structure of the Women’s Views of Birth Labor Satisfaction Questionnaire (WOMBLSQ4) questionnaire on satisfaction with the attention received during birth delivery in Spanish women and to compare the level of satisfaction of pregnant women during the birth process with that in other studies that validated this instrument. A cross-sectional study using a self-completed questionnaire of 385 Spanish-speaking puerperal women who gave birth in the Public University Hospitals of Granada (Spain) was conducted. An exploratory factor analysis of the WOMBLSQ4 questionnaire was performed to identify the best fit model. Those items that showed commonalities higher than 0.50 were kept in the questionnaire. Using the principal components method, nine factors with eigenvalues greater than one were extracted after merging pain-related factors into a single item. These factors explain 90% of the global variance, indicating the high internal consistency of the full scale. In the model resulting from the WOMBLSQ4 questionnaire, its nine dimensions measure the levels of satisfaction of puerperal women with childbirth care. Average scores somewhat higher than those of the original questionnaire and close to those achieved in the study carried out in Madrid (Spain) were obtained. In clinical practice, this scale may be relevant for measuring the levels of satisfaction during childbirth of Spanish-speaking women

Influencia del contexto social sobre la salud de la población: Análisis de factores de riesgo asociados a infecciones de transmisión sexual en el periodo 2000-2014

El propósito de esta tesis se ha centrado en analizar cómo el contexto social (entendido como la situación económica, cultural y política) de los últimos años estaría afectando al ámbito de la Salud Pública y más concretamente al de la incidencia de Infecciones de Transmisión Sexual. El periodo de tiempo en el que se acota este estudio ha sido el intervalo 2000- 2014, ya que durante el mismo se produjeron cambios sociales y políticos significativos en España, además de por ser el periodo en el que se sitúa el comienzo de la crisis económica y la consiguiente repercusión que ha tenido en el ámbito de la salud. En el contexto de globalización y crisis económica resurgen algunas Infecciones de Transmisión Sexual de las que se consideraban ya prácticamente erradicadas en países del primer mundo, como Sífilis o Gonorrea y por otro lado, destaca el avance de otras como Síndrome de Inmunodeficiencia Adquirida (SIDA), Hepatitis, Chlamydias, Herpes genital, Virus del papiloma humano, Moluscum contagiosum, etc., enfermedades cuyo control parecía haberse logrado no sólo en el diagnóstico y tipificación de las mismas, sino también respecto al tratamiento farmacológico e implementación de políticas de salud efectivas en materia de prevención. Estas infecciones suponen un grave problema de Salud Pública, tanto por la proporción de personas afectadas, como por las complicaciones y secuelas que llevan aparejadas si no se tratan a tiempo, de ahí el interés que despierta tanto desde políticas de salud como estrategias de investigación, dentro de las cuales se situaría esta investigación. Se parte de la premisa de que para controlar la aparición de nuevos casos de infecciones de este tipo hay que contar con fuentes de información que aporten datos sobre cómo se distribuyen y comportan en periodos de tiempo determinados y en contextos sociales determinados. El objetivo general de esta esta tesis ha sido analizar la evolución de indicadoresde riesgo y control de Infecciones de Transmisión Sexual durante el periodo 2000-2014 a través de la información recogida en un centro específico de atención a estas infecciones.Tesis Univ. Granada. Programa Oficial de Doctorado en: Ciencias Sociale