Percepción sobre la autonomía personal y la calidad de vida en personas mayores institucionalizadas en un centro libre de sujeciones

[Resumen] Antecedentes: En la actualidad existe un debate sobre el uso de las sujeciones físicas ya que constituyen un tema muy controvertido, debido a sus consecuencias éticas, sociales y jurídicas. El uso de éstas tiene efectos como consecuencia de su uso rutinario, efectos físicos y psicológicos, además de que pueden atentar contra los derechos de las personas mayores. Cuando una persona es sometida a una sujeción física está perdiendo su autonomía para decidir participar en ocupaciones en su entorno y, por lo tanto, podría ser una forma de injusticia ocupacional. Además esta falta de participación puede poner en riesgo la salud de la persona y su calidad de vida. La terapia ocupacional debe identificar posibles barreras en la participación, entre las que se encuentran las sujeciones físicas. El terapeuta ocupacional, integrado dentro de un equipo interdisciplinar, debe buscar con los diferentes profesionales las posibles alternativas a esa sujeción, estableciendo unos objetivos comunes e interviniendo desde las diferentes disciplinas para lograr esas metas. Objetivos: El objetivo general de este estudio es describir el cambio percibido sobre la autonomía personal y la calidad de vida de personas mayores institucionalizadas que han tenido sujeciones físicas y actualmente se encuentran libres de sujeciones. Metodología: La metodología empleada para esta investigación se trata de la metodología cualitativa, en concreto la fenomenología y las técnicas de recogida de datos utilizadas serán la entrevista semi-estructurada y un cuaderno del investigador. Se utilizará un muestreo intencional, seleccionando tres perfiles de informantes, las personas mayores, sus familiares y/o cuidadores y profesionales del centro.[Abstract] Background: There is currently a debate on the use of pshysical restraints as they constitute a very controversial subject, because of their ethical, social and legal consequences. The use of these has effects from rutine use, physical and psychological effects, besides they can infrige the rigths of the elderly. When a person is subjected to a phsysical restraint he is losing his autonomy to decide to participate in occupations in his environment and, therefore, could be a form of occupational injustice. In adittion this lack of participation can put in risk the health of the person and his quality of life. Occupational therapy must identify potential barriers to participation, including pshysical restraints. Occupational therapist, integrated within an interdisciplinary team, should look to different proffesionals possibles alternatives to this restraint, establishing common objetives and intervening from differents disciplines to achieve these goals. Objective: The general objective of this study is to describe the change perceived on personal autonomy and quality of life of institutionalized elderly who have had physical restraints and are currently free of restraitns. Methodology: The metodology used in this research is qualitative methodology, specifically the phenomenology and data collection thechniques are semi-structured interview and a notebook of the investigator. Intentional sampling is used, selecting three profiles informants, elderly, their families and/or caregivers and center professionals.Traballo fin de grao (UDC.FCS). Terapia ocupacional. Curso 2014/2015

Cultivating learning in vitro: a meta-ethnography of learning experiences of nursing students regarding high-fidelity simulation

Review[Abstract] Objectives: To synthesise the experience of nursing students in their final years regarding high-fidelity simulation in acute and critical care. Background: For the complex and changing healthcare environment, new tools are required to help health students, educational staff and managers to design and present rewarding educational simulations. Due to the complexity and limited learning opportunities in real settings, high-fidelity simulation enables students to acquire skills for the provision of acute and critical care in a controlled environment that closely imitates reality; however, the literature on students' learning experiences with this education methodology is still limited. Design: This study followed Noblit and Hare's interpretive meta-ethnography, which was written and reviewed for reporting clarity against the EQUATOR checklist using the eMERGe. Data sources: A comprehensive systematic search strategy was carried out in five databases: PubMed, Scopus, CINAHL, Web of Science and PsycINFO. Review methods: Ten studies met the research objective and inclusion criteria. Results: The metaphor 'Cultivating learning in vitro' and four themes were developed to describe the learning experiences of nursing students regarding high-fidelity simulation in acute and critical care. The themes were as follows: Learning roots-Ways to learn during high-fidelity simulation; Learning stimulants-Elements that favour learning; Learning impairments-Elements that hinder learning; and Learning flourishing-Results after high-fidelity simulation. Conclusions: Seeing, doing and reflecting constituted the main sources of learning. Students identified the stimulating and debilitating aspects of learning which could help in the design of simulation sessions and promote their incorporation into nursing curricula. Finally, 'the flowering of the plant' represents the learning outcomes developed in a controlled and safe environment. Relevance to clinical practice: The results of this meta-ethnography provide keys to promote change in teaching planning in relation to acute and critical care

Correction to: Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: a multicentric and nation-wide retrospective analysis.

An amendment to this paper has been published and can be accessed via a link at the top of the paper

Permanent postoperative hypoparathyroidism: an analysis of prevalence and predictive factors for adequacy of control in a cohort of 260 patients.

Recent guidelines for the treatment of hypoparathyroidism emphasize the need for long-term disease control, avoiding symptoms and hypocalcaemia. Our aim has been to analyze the prevalence of poor disease control in a national cohort of patients with hypoparathyroidism, as well as to evaluate predictive variables of inadequate disease control. From a nation-wide observational study including a cohort of 1792 patients undergoing total thyroidectomy, we selected 260 subjects [207 women and 53 men, aged (mean ± SD) 47.2±14.8 years] diagnosed with permanent hypoparathyroidism. In every patient demographic data and details on surgical procedure, histopathology, calcium (Ca) metabolism, and therapy with Ca and calcitriol were retrospectively collected. A patient was considered not adequately controlled (NAC) if presented symptoms of hypocalcemia or biochemical data showing low serum Ca levels or high urinary Ca excretion. Two hundred and twenty-one (85.0%) patients were adequately controlled (AC) and 39 (15.0%) were NAC. Comparison between AC and NAC patients did not show any significant difference in demographic, surgical, and pathological features. Rate of hospitalization during follow-up was significantly higher among NAC patients in comparison with AC patients (35.9% vs. 10.9%, P In a nation-wide cohort of 260 subjects with definitive hypoparathyroidism, 15% of them had poor disease control. These patients required higher doses of oral Ca and calcitriol, had higher rate of hospitalization during follow-up and showed lower PTH concentrations in the postoperative period

Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: a multicentric and nation-wide retrospective analysis

[Purpose]: The prevalence of postoperative hypoparathyroidism has been studied in registries and in surgical series with highly variable and imprecise results. However, the frequency of this hormonal deficiency in the clinical practice of endocrinologists is not known with accuracy. We aimed to assess the prevalence and risk factors of hypoparathyroidism in patients undergoing total thyroidectomy in Spain. [Methods]: We designed a retrospective, multicentre and nation-wide protocol including all patients with total thyroidectomy who were seen in the endocrinology clinic of the participant centers from January to March 2018. Prevalence of hypoparathyroidism was evaluated at discharge of surgery, 3–6 months after surgery, 12 months after surgery and at last visit. Twenty hospitals participated in the study. [Results]: Of 1792 patients undergoing total thyroidectomy, 866 (48.3%) developed postoperative hypoparathyroidism at discharge of surgery. Most of them recover parathyroid function over time. Prevalence of hypoparathyroidism at 3–6 months, 12 months and at last visit was 22.9%, 16.7% and 14.5%, respectively. The risk of developing definitive hypoparathyroidism was related to the presence of parathyroid tissue at histology, lymph node dissection, and two-stage thyroidectomy. Patients with thyroid cancer, with higher postoperative calcium levels and treated by expert surgical teams exhibited lower risk of developing permanent hypoparathyroidism. [Conclusions]: Although most patients with postsurgical hypoparathyroidism recover parathyroid function, the prevalence of permanent disease in clinical practice is non negligible (14.5%). Postoperative calcium, extent and timing of surgery, the presence of cancer, expert surgical team, and parathyroid tissue at histology are predictors of permanent hypoparathyroidism