Sistematización y cuidados de enfermería a pacientes con problemas respiratorios

Breve descripción de la valoración que debe de realizar una enfermera que preste cuidados desde la prevención, diagnóstico, tratamiento y rehabilitación de las personas que precisan cuidados respiratorios

Crohn’s disease: The experience of living with a chronic illness

Objetivo. Explorar las experiencias de personas con enfermedad de Crohn (EC), aquellos acontecimientos que modificaron sus vidas, el impacto y las estrategias utilizadas para sobrellevar la enfermedad. Material y métodos. Estudio cualitativo. Se realizaron 10 entrevistas a profundidad a afectados de la provincia de Alicante (España). La recolección de datos, procesamiento y análisis de los mismos se realizó a través de algunos elementos que recoge la fenomenología. Resultados. Las experiencias de los afectados se pueden clasificar en cuatro grandes temas: reconocimiento de enfermar, consecuencias percibidas por los afectados por EC de la propia enfermedad, gestión de la enfermedad y búsqueda de apoyo. Conclusiones. El conocimiento de la experiencia de vida de las personas afectadas por EC parece una herramienta indispensable para conseguir una gestión eficaz del proceso de cronicidad al momento de planificar programas sanitarios específicos de tratamiento.Objective. To explore the experiences of people with Crohn disease (CD), their life-changing events, the impact on their lives and the strategies used to cope with it. Materials and Methods. Qualitative study. In-depth interviews were carried out on 10 people affected by the disease in the province of Alicante (Spain). The collection, processing and analysis of data was performed using some phenomenological elements. Results. The experiences of those affected can be classified into four main areas: recognition of the illness; perceived consequences of the disease itself by CD affected patients; disease management, and the search for support. Conclusions. Knowledge of the life experience of people affected by CD appears to be essential for the effective management of chronic illnesses when planning specific health treatment programs.Esta investigación es apoyada por la Beca Vali+D (ACIF/2013/141García-SanjuánSofía), Consellería de Educación, Cultura y Deporte. Generalitat. Valenciana. España

Crohn’s disease, chronic and nurse role: literature review and state of affairs

Objetivo: Conocer las experiencias de vida y la percepción del apoyo social en las personas afectadas por la Enfermedad de Crohn (EC), así como el rol que desempeñan las enfermeras/os en dicho proceso. Método: La búsqueda se realizó en PUBMED, CUIDEN, CINHAL, CSIC, SCIELO, TESEO. También se utilizó la búsqueda sensible, REDICS (Red de investigación cualitativa en salud) y RUA (Repositorio Institucional de la Universidad de Alicante). Resultados: Tras aplicar los criterios de exclusión, se identificaron 20 artículos que por su título y resumen se consideraron pertinentes para un examen más detallado (texto completo). Las posibles discrepancias se resolvieron por consenso entre el investigador principal y dos investigadores más del estudio. La revisión se llevó a cabo entre enero de 2011 y diciembre de 2011. Conclusiones: Son pocos los estudios que se ocupan de conocer la experiencia de vivir con la EC. La poca literatura recuperada que se encarga de estos temas muestra las luchas y afrontamientos que realizan los afectados. La enfermera/o suele ser la persona de referencia como único apoyo para manejar el afrontamiento de dicha enfermedad. Las funciones de la enfermera/o como apoyo de los afectados, muestran un rol amplio que puede cubrir todas las necesidades de las personas con EC.Objective: to know the experiences of life and perception of social support for people affected by Crohn's disease (CD), and the role played by nurses in the process. Methods: The PubMed search was conducted, CUIDEN, CINAHL, CSIC, SCIELO, Theseus. Also used sensitive search, REDICS (Red qualitative health research) and RUA (Institutional Repository of the University of Alicante). Results: After applying the exclusion criteria, 20 articles were identified by title and summary were considered relevant for further scrutiny (full text). The discrepancies were resolved by consensus between the principal investigator and two researchers of the study. The review was carried out between January 2011 and December 2011. Conclusions: there are few studies that deal with knowing the experience of living with the EC. The recovered little literature that deals with these issues shows the struggles and confrontations that perform those affected. The nurse / or the person is often referred to as sole support to handle coping with the disease. The functions of the nurse / or support of those affected, showing a role can I expand to cover all the needs of people with CD.Esta investigación es apoyada por la Beca VALI + D (ACIF/2013/141García-SanjuánSofía). Consellería de Educación, Cultura y Deporte. Generalitat Valenciana. España

Dietary habits and feeding beliefs of people with Crohn’s disease

Introducción: la enfermedad de Crohn es una enfermedad crónica de etiopatogenia desconocida. Las consecuencias que esta enfermedad provoca a nivel nutricional dependen de varios factores. Sin embargo, poco se sabe sobre las prácticas nutricionales que adoptan estos pacientes una vez diagnosticados. Objetivo: explorar la experiencia de los afectados en relación con la ingesta alimentaria, con el objetivo futuro de comprender dichas experiencias y diseñar intervenciones eficaces y adecuadas. Metodología y sujetos: se empleó un diseño cualitativo basado en el enfoque etnográfico. Se realizaron 19 entrevistas semiestructuradas, hasta conseguir la saturación de la información, a afectados por la enfermedad de Crohn, en la provincia de Alicante y, posteriormente, se realizó el análisis temático. Resultados: cinco categorías con sus respectivas subcategorías de análisis fueron identificadas a partir de los datos sobre la experiencia de alimentación de las personas entrevistadas. 1) Creencias sobre nutrición y EC, 2) Modificación de los hábitos alimentarios, 3) Búsqueda de información sobre alimentación y EC, 4) El papel de los profesionales, 5) Autogestión. Conclusiones: el conocimiento de los hábitos dietéticos de la persona con EC en una población en la que su dieta se presupone que culturalmente es reconocida como saludable, nos puede dar pautas de abordaje o apoyo profesional tanto en materia de prevención, promoción y educación para la salud, así como sobre su nivel organizativo en las instituciones sanitarias, cosas que actualmente no se tienen en cuenta, puesto que el abordaje de la EC es meramente clínico y con enfoque patológico, pero no desde una perspectiva de salud, fomentando hábitos saludables desde la multidisciplinariedad.Introduction: Crohn’s disease (CD) is a chronic illness of unknown etiology. The consequences that CD causes nutritionally depend on several factors. However, little is known about the nutritional practices that CD affected people adopt once diagnosed. Objective: to explore the experience of those affected in relation to food intake, with the future goal of understanding those experiences and design effective and appropriate interventions. Subjects and methods: a qualitative design based on ethnographic approach was used. 19 semi-structured interviews were conducted in Alicante, until data saturation was reached and later the analysis of categories and subcategories was developed. Results: 5 categories with their subcategories were identified from the data collected on the experience of feeding: 1) Beliefs about nutrition and CD, 2) Changing eating habits, 3) Finding information about food and CD, 4) The role of professionals, 5) Self-management. Conclusions: knowledge of the dietary habits of the person with CD, may provide professional workforce with the appropriate information for management and support in terms of prevention, health promotion and health education, useful for the organization of health institutions, where those things are not usually taken into account since the CD approach is purely based on clinical and pathological aspects. Consequently, it appears a need of a new CD perspective based on health, focused on promoting healthy habits and from a multidisciplinary approach

Nursing clinical tutoring

En la docencia y el aprendizaje clínico, la tutorización universitaria se comparte con la que las enfermeras y los enfermeros de los distintos puestos de prácticas llevan a cabo en instituciones sociosanitarias (centros de atención familiar y comunitaria, hospitales, instituciones geriátricas, centros de atención a la diversidad funcional y a la salud mental, colegios, comunidades de vecinos, etc.). Sus funciones son coordinadas e interdependientes y ambas deben confluir en el aprendizaje en competencias del alumnado. Sin embargo, la tutoría clínica se diferencia de aquella que el alumnado realiza con el profesorado a nivel teórico en la universidad, ya sea de forma online o presencial, individual o grupal. Esta diferencia se basa fundamentalmente en que la tutorización clínica siempre se realiza de forma presencial en cada uno de los centros de prácticas y a través de la instrucción y el modelaje. El tutor clínico está satisfecho con la función docente que realiza y reclama mayor formación, acreditación y participación en la planificación de objetivos de aprendizaje conjuntamente con el profesorado de la universidad.When it comes to teaching and clinical learning, university tutoring is shared with nurses from different disciplines in public health institutions (Family and Community Care Centers, Hospitals, Geriatric Institutions, Mental Health Centers, schools, neighboring communities, etc...). Their activities are coordinated and interdependent; both must coalesce in students’ competency-based learning process. However, clinical tutoring differs substantially from the university tutoring that students receive at a theoretical level, either online or face to face, individually or in groups. The difference is fundamentally based on the fact that clinical tutoring is always carried out in person at each of the practice centers and is based on instruction and modeling. The clinical tutor, satisfied with the teaching function he performs, logically demands greater training, accreditation and participation in the planning of learning objectives jointly with the university faculty

The impact of volunteering in mental health settings on nursing students' attitudes

Nursing faculties are working to improve students’ attitudes towards mental illness and people with severe mental illness, given the repercussions a lack of knowledge and negative attitudes may have on the quality of care. Complementing undergraduate programmes with volunteering activities affords students the opportunity to interact with people with a severe mental illness, and allow them to develop positive attitudes and overcome prejudice. Aim: to explore and deepen in nursing students attitudes prior to and following volunteering on an Acute Mental Health Inpatient Unit. By means of mixed methods approach, students were assessed at two time points by questionnaires including “Community Attitudes to Mental Illness” and “Semantic Differential”, and by testimonies gathered from interviews. Positives changes in attitudes were identified and monitored over time capturing a destigmatizing tendency. The participation in educational strategies such as volunteering in Acute Mental Health Inpatient Unit, complementary to undergraduate programmes and clinical placements in mental health, allows nursing students to develop more diversified and positive attitudes towards mental illness and people with severe mental illness. The impact of an interventional education strategy is not as powerful in nursing students as it might be in students of other non-healthcare oriented university degrees due to their baseline attitudes.The present study received financial assistance via the ‘Programa de Redes-I 3CE’ research program for university training from the ‘Instituto de Ciencias de la Educación’ at the University of Alicante (2016-17); Reference No: 3720

Understanding life experiences of people affected by Crohn's disease in Spain. A phenomenological approach

Background and objectives: People affected by Crohn's disease must adapt their lives to their new chronic condition, and therefore, understanding such experience can be helpful in planning effective interventions for the affected ones. The aim of this study was to gain an insight into such experience and how they adapted in different areas of their lives, particularly in a family-centred culture such as the Spanish one. Method: A descriptive phenomenological study was conducted through in-depth interviews to 19 people diagnosed of Crohn's disease in the province of Alicante (Spain). Once the interviews were transcribed, data were analysed using Colaizzi's seven-step method. Results: Five emergent themes were identified: self-protection against the unknown cause; self-training; learning to live with Crohn's disease; perceived losses associated to Crohn's disease; and relationship with others. The results portrayed a chronically ill patient who is unconscious about the chronicity and consequently must develop strategies to keep living a similar life like the one lived before. Conclusions: This study revealed that people affected by Crohn's disease struggle with the fact of being a chronic patient with uncertainty about the illness and need to learn living with a chronic condition that limits their daily lives. Furthermore, the lack of Crohn's disease a professional in charge of these people's Cares such as the specific nursing role existing in other countries support in the Spanish Health System determines the loneliness those diagnosed experience to cope with the new situation.This study was funded by project ‘Diseño de una vía clínica de patologías crónicas como la hipertensión arterial y la enfermedad de Crohn. Orientación a la gestión de procesos’ (704753085-53085-45-514) integrated into the State plan I+D+I 2013-2016 Ministerio de Economía y Competitividad orientada a los Retos de la Sociedad and cofunded by ISCIII-Subdirección General de Evaluación y Fomento de la investigación el Fondo Europeo de Desarrollo Regional (FEDER)

Healthcare professionals’ views of the experiences of individuals living with Crohn’s Disease in Spain. A qualitative study

Crohn’s Disease (CD) in Spain lacks of a unified National Clinical Pathway and not even any early detection program and professional follow-up outpatient attention once it has been diagnosed. Little is known about the Spanish health professionals’ views of the experiences of individuals living with Crohn’s Disease nationwide and also about how the Spanish Health System faces this situation. A qualitative research method was conducted to explore this topic through in-depth interviews with eleven healthcare professionals, who represented different clinics treating people with CD from the province of Alicante (Spain). Three topics and seven sub-topics were derived from the analysis of the content emerging from the interviews. The three main topics were: the healthcare system as a hindrance for ongoing treatment of CD, the impact of the disease, support networks. The knowledge of CD gained by healthcare professionals, in the contexts studied here within, with regards to the psychosocial aspects and the experience of those living with the disease and their immediate circles, is poor, if not null on an academic level, becoming experiential on their incorporation into the professional field. Additionally, a priori, they lack the tools to address the doubts and concerns of patients from the moment of diagnosis through the ongoing care of the patient. Organizational hindrances, such as the lack of time and consensual guidelines for adequately monitoring CD patients in Alicante (Spain), further restrict the patient-professional relationship. Due to the consensus established by the National Agency regulating the contents of the Health Professions’ Education and Training across the country, we are assuming that the phenomenon highlighted may be similar in other parts of Spain. Therefore, it can be said that healthcare professionals have a limited understanding of the impact of CD on the day-to-day life of those affected, not being considered a part of the CD patients’ formal support network. Nonetheless, they are conscious of this limitation and advocate for multidisciplinary teams as the best means of attending to people living with CD. Our study outcomes may represent the first step onto identifying strategies and best practices for establishing an effective therapeutic relationship, as well as any hindering factors.This study was funded by project “Diseño de una vía clínica de patologías crónicas como la hipertensión arterial y la enfermedad de Crohn. Orientación a la gestión de procesos” (704753085-53085-45-514) integrated into the State plan I+D+I 2013-2016 Ministerio de Economía y Competittividad orientada a los Retos de la Sociedad and co-funded by ISCIII-Subdirección General de Evaluación y Fomento de la investigación el Fondo Europeo de Desarrollo Regional (FEDER)

The experiences of older individuals providing care to older dependents: A phenomenological study in Spain

Objective: Non-professional care provided in domestic settings by a family member or someone from the close environment and without a connection to a professional care service, is increasingly assumed by older people, mainly the spouses of those requiring care. The aim of this study was to describe the experience of older people providing care at home to older dependents. Methods: A qualitative study was carried out to describe and explore the experience of older people, caregivers of dependent older people in the home. Results: Four themes emerged as a result of the analysis: interpersonal relationships established in the caregivers’ immediate environment; the need and request for public and private resources; consequences of providing care during old age; and adaptation to the circumstance of being a caregiver during old age. Older people who provide home-based care, experience their situation as stressful, feel that it limits their daily life, deprives them of their freedom, and affects their interpersonal relationships and social activities. Discussion: Older caregivers learn quickly and can manage the skills issues. The volume of work is their challenge. Interpersonal relationships are altered depending on the length of time spent together and the demand for care. Public services and benefits are not adapted to the demands of caregivers or dependent persons

Affective Impact on Informal Caregivers over 70 Years of Age: A Qualitative Study

Given today’s rapidly ageing society, family members providing informal care to dependent older adults face ever-increasing challenges. The aim of this study was to describe the affective impact on older adults over 70 years of age caring for a dependent older person at home. A qualitative study was designed from a phenomenological perspective. Thirteen in-depth interviews were conducted with caregivers aged 70 or older. A content analysis of the interviews was carried out in five stages. Three themes were identified: “Emotions”, “Feelings”, and “Looking to the future”. Caregivers express negative emotions (sadness, anger, and fear) and feelings of social and emotional isolation, and they feel abandoned by health professionals, family, and friends. In conclusion, prolonged caregiving by older adults has a negative affective impact and creates uncertainty about the future. There is a need to devise social and healthcare policies and actions, creating social support networks to improve their health and emotional wellbeing