Análisis de las complicaciones del acceso vascular en hemodiálisis. Una revisión sistemática.

Introducción: El acceso vascular sigue siendo uno de los retos más importantes en todas las unidades de diálisis, por todas las complicaciones derivadas de su uso y el gran impacto en la morbimortalidad del enfermo renal. Los tres tipos de acceso vascular más utilizados son la fístula arteriovenosa nativa, el injerto o fístula arteriovenosa protésica y el catéter venoso central. Objetivo: Analizar y evaluar la situación actual y la incidencia de las complicaciones relacionadas con los diferentes accesos vasculares en hemodiálisis. Metodología: Se realizó una revisión sistemática en las bases de datos PubMed, CINAHL, SCOPUS y SciELO. Se incluyeron todos los artículos originales de menos de 5 años de antigüedad en los que uno de sus objetivos fuera analizar la prevalencia o incidencia de las complicaciones de cualquier acceso vascular en hemodiálisis en población adulta. Resultados: El número de artículos para el análisis fueron 15. De ellos, 14 fueron estudios observacionales y uno, un ensayo clínico multicéntrico. Se analizaron datos demográficos de los pacientes, la prevalencia de complicaciones entre todos los accesos vasculares y la incidencia de complicaciones según fístula nativa/protésica/catéter venoso central. Conclusiones: La fístula arteriovenosa nativa es el acceso vascular de elección ya que tiene tasas de complicaciones muy bajas. De entre ellas, la trombosis, es la complicación con más incidencia. El uso de catéter venoso central todavía es muy habitual, pese a ser el acceso vascular que presenta mayores tasas de complicaciones como las infecciones y la bacteriemia, produciéndose en un 10%-17% de los pacientes portadores

Nursing intervention to improve positive mental health and self-care skills in people with chronic physical health conditions

The exponential increase in the number of people suffering chronic illness has become a problem for which healthcare services need a response. The inclusion of self-care and positive mental health as part of a strategy to promote health offers an opportunity for a reorganization oriented towards community spaces and group interventions. This study undertook the assessment of an intervention designed to optimize the agency of and capacity for self-care and positive mental health by utilizing activities drawn from the Nursing Intervention Classification (NIC), specifically from Field 3 (Behavioral), and organized as a program called PIPsE. A quasi-experimental design was prepared with an intervention group (n = 22) and a control group (n = 22), in a primary care center in the Barcelona metropolitan area. The instruments used were two ad hoc questionnaires to collect sociodemographic and satisfaction information and two scales: the Appraisal of Self-care Agency Scale (ASA) and the Positive Mental Health Questionnaire (PMHQ). The results obtained showed a significant increase in self-care capacity and both overall positive mental health and mental health by factors in the intervention group

Effectiveness of the online 'Dialogue Circles' nursing intervention to increase positive mental health and reduce the burden of caregivers of patients with complex chronic conditions. Randomized clinical trial

The personal demands involved in caring for a chronically ill person can lead to emotional and physical exhaustion in caregivers. The aim of this study was to evaluate the effectiveness of an online nursing intervention called 'dialogue circles' designed to reduce caregiver overload and enhance positive mental health (PMH) in family caregivers. We used a pre-post design. The sample consisted of 86 family caregivers of patients with complex chronic conditions, randomly assigned to the intervention group (n = 43) or the control group (n = 43). All participants completed the Zarit scale and the Positive Mental Health Questionnaire 15 days before starting the intervention and 30 days after its completion. Comparison of the post-test changes revealed statistically significant differences between the two groups in PMH and overload, with the intervention group showing greater positive changes in all dimensions of PMH after the intervention and lower scores on overload. In conclusion, the results suggest that incorporating dialogue circles as an online nursing intervention in the caregivers of patients with complex chronic conditions can enhance PMH and decrease caregiver overload, especially in settings where face-to-face encounters are not possible

Rúbrica d’avaluació de l’activitat Pla d’Autocures

La rúbrica que es presenta és l’instrument per avaluar la pràctica del Pla d’Autocures que es realitza com activitat d’avaluació continuada en l’assignatura de Ciències Psicosocials Aplicades a la Salut, en el primer curs del Grau d’Infermeria

The experiences of family members of persons with intellectual disabilities who used residential care homes during the COVID-19 pandemic

Background: The global COVID-19 pandemic has shown the vulnerability of some population groups, including persons with intellectual and developmental disabilities (IDD). Aim: The present paper will provide more clarity and understanding of the experiences of family members of persons with IDD housed in residential facilities in Catalonia within the period of maximum restrictions during the COVID-19 pandemic. Methods and procedures: Semi-structured interviews were conducted using an interpretive phenomenological qualitative approach. Study participants consisted of 14 relatives of IDD individuals who were institutionalized in residence facilities or homes. The guiding questions emerged from group discussions with relatives of those with IDD who did not participate in the subsequent interviews. Drawing from this group, the factors that were identified to have had the greatest impact on their lives were later used to guide the interviews. Data collection was carried out in face-to-face individual interviews that were recorded together with the observations of two researchers between February and October 2022. Results: Our analysis identified 4 main themes that developed into additional factors: the decision to stay at home or in the residence, fear, illness, and protocol. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. Conclusion: The results of this study allow for a better understanding of the experiences of families of persons with IDD in residential centres during the lockdown by identifying their needs and how to better support them in the future. Outcomes and results: Knowledge and understanding of these events should allow for better management of similar situations in the future

Assessing positive mental health in people with chronic physical health problems: correlations with socio-demographic variables and physical health status

Background: A holistic perspective on health implies giving careful consideration to the relationship between physical and mental health. In this regard the present study sought to determine the level of Positive Mental Health (PMH) among people with chronic physical health problems, and to examine the relationship between the observed levels of PMH and both physical health status and socio-demographic variables. Methods: The study was based on the Multifactor Model of Positive Mental Health (Lluch, 1999), which comprises six factors: Personal Satisfaction (F1), Prosocial Attitude (F2), Self-control (F3), Autonomy (F4), Problem-solving and Self-actualization (F5), and Interpersonal Relationship Skills (F6). The sample comprised 259 adults with chronic physical health problems who were recruited through a primary care center in the province of Barcelona (Spain). Positive mental health was assessed by means of the Positive Mental Health Questionnaire (Lluch, 1999). Results: Levels of PMH differed, either on the global scale or on specific factors, in relation to the following variables: age: global PMH scores decreased with age (r=-0.129; p=0.038); b) gender: men scored higher on F1 (t=2.203; p=0.028) and F4 (t=3.182; p=0.002), while women scored higher on F2 (t -3.086; p=0.002) and F6 (t=-2.744; p=0.007); c) number of health conditions: the fewer the number of health problems the higher the PMH score on F5 (r=-0.146; p=0.019); d) daily medication: polymedication patients had lower PMH scores, both globally and on various factors; e) use of analgesics: occasional use of painkillers was associated with higher PMH scores on F1 (t=-2.811; p=0.006). There were no significant differences in global PMH scores according to the type of chronic health condition. The only significant difference in the analysis by factors was that patients with hypertension obtained lower PMH scores on the factor Autonomy (t=2.165; p=0.032). Conclusions: Most people with chronic physical health problems have medium or high levels of PMH. The variables that adversely affect PMH are old age, polypharmacy and frequent consumption of analgesics. The type of health problem does not influence the levels of PMH. Much more extensive studies with samples without chronic pathology are now required in order to be able to draw more robust conclusions

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Assessing positive mental health in people with chronic physical health problems: correlations with socio-demographic variables and physical health status

Background: A holistic perspective on health implies giving careful consideration to the relationship between physical and mental health. In this regard the present study sought to determine the level of Positive Mental Health (PMH) among people with chronic physical health problems, and to examine the relationship between the observed levels of PMH and both physical health status and socio-demographic variables. Methods: The study was based on the Multifactor Model of Positive Mental Health (Lluch, 1999), which comprises six factors: Personal Satisfaction (F1), Prosocial Attitude (F2), Self-control (F3), Autonomy (F4), Problem-solving and Self-actualization (F5), and Interpersonal Relationship Skills (F6). The sample comprised 259 adults with chronic physical health problems who were recruited through a primary care center in the province of Barcelona (Spain). Positive mental health was assessed by means of the Positive Mental Health Questionnaire (Lluch, 1999). Results: Levels of PMH differed, either on the global scale or on specific factors, in relation to the following variables: age: global PMH scores decreased with age (r=-0.129; p=0.038); b) gender: men scored higher on F1 (t=2.203; p=0.028) and F4 (t=3.182; p=0.002), while women scored higher on F2 (t -3.086; p=0.002) and F6 (t=-2.744; p=0.007); c) number of health conditions: the fewer the number of health problems the higher the PMH score on F5 (r=-0.146; p=0.019); d) daily medication: polymedication patients had lower PMH scores, both globally and on various factors; e) use of analgesics: occasional use of painkillers was associated with higher PMH scores on F1 (t=-2.811; p=0.006). There were no significant differences in global PMH scores according to the type of chronic health condition. The only significant difference in the analysis by factors was that patients with hypertension obtained lower PMH scores on the factor Autonomy (t=2.165; p=0.032). Conclusions: Most people with chronic physical health problems have medium or high levels of PMH. The variables that adversely affect PMH are old age, polypharmacy and frequent consumption of analgesics. The type of health problem does not influence the levels of PMH. Much more extensive studies with samples without chronic pathology are now required in order to be able to draw more robust conclusions