Factors related to mortality of patients with COVID-19 who are admitted to the ICU Prognostic mortality factors of COVID-19 patients

During the severe acute respiratory syndrome coronavirus 2 pandemic, hospital resources, particularly critical care units, were overburdened and this had a significant impact on both the therapies and the prognosis of these patients. This study aimed to identify factors and therapies that may improve prognosis and other factors associated with increased mortality. A secondary objective was to evaluate the impact that obesity had on these patients. An observational study was conducted on 482 patients aged 18 years or older who were diagnosed with SARS-CoV-2 pneumonia and admitted to the Intensive Care Units of 3 national hospitals registered in the CIBERESUCICOVID database between September 2020 and March 2021. After identifying the sample profile, risk factors were analyzed, the predictive model was constructed, and crude odd ratios were calculated for each factor. Additionally, logistic regression was used to build the multivariate model adjusting for potential confounders. The final model included only the variables selected using the Backward method. A sample of 335 men (69.5%) and 145 women (30.08%) aged 61.94 ± 12.75 years with a body mass index (BMI) of 28.05 (25.7; 31.2) was obtained. A total of 113 patients received noninvasive mechanical ventilation. The most common comorbidities were: high blood pressure (51.04%), obesity (28%), diabetes mellitus (23.44%), other metabolic diseases (21.16%), chronic heart failure (18.05%), chronic obstructive pulmonary disease (11.62%), and chronic kidney disease (10.16%). In-hospital, 3-month and 6-month post-discharge mortality in patients with BMI > 30 (n = 135) versus BMI ≤ 30 (n = 347) was significantly different (P = .06). Noninvasive mechanical ventilation failed in 42.4% of patients with BMI > 30 compared to 55% of patients with BMI ≤ 30. This study identified the factors associated with failure of mechanical ventilation. The most common comorbidities were congestive heart failure, high blood pressure, chronic kidney disease, severe liver disease, diabetes mellitus, and solid organ transplantation. In terms of ventilatory support, patients who received high-flow nasal oxygen therapy on admission had lower mortality rates. The use of renal replacement therapy was also significantly associated with higher mortality.Departamento de Biología Ambiental y Salud Públic

Asignatura "Género y salud" en el Grado Universitario de Enfermería : minimizar creencias sexistas

La formación universitaria representa un importante papel en el cambio de actitudes en pro de la igualdad. Atendiendo a este compromiso, se ha implementado en la titulación de Enfermería una asignatura obligatoria en “Género y Salud” con el objetivo de capacitar al alumnado para trabajar la Violencia de Género potenciando las buenas prácticas en Igualdad. Tras dos años de aplicación de la materia hemos realizado un estudio para identificar su influencia en la minimización de las creencias sexistas Para ello hemos realizado un estudio cuasi experimental con un Grupo Estudio (GE) al cual se le ha impartido la asignatura “Género y Salud” y un Grupo Control (GC) equivalente que no ha recibido esa materia, sin embargo, han tenido asignaturas optativas o de libre configuración con perspectiva de género. En el análisis hemos tomado medidas repetidas (Antes y Después) de la intervención mediante la escala Ambivalent Sexism Inventory (Glick y Fiske, 1996) versión española de Expósito (1998) que nos ha permitido medir dos dimensiones del sexismo el Hostil o Tradicional y el Benevolente o Sutil. Los resultados obtenidos reflejan que la materia educativa influye minimizando las creencias Sexistas, especialmente las creencias sexistas Benevolente

Living, working conditions and mental health: a study with Brazilian and Spanish workers who work in hospital cleaning services

O objetivo deste artigo é comparar as condições de vida, trabalho e saúde, com ênfase na saúde mental, de trabalhadores do serviço de limpeza (SL) hospitalar terceirizados da Espanha e do Brasil. Pesquisa quantitativa, transversal realizada em dois hospitais gerais, públicos, sendo um numa cidade no centro-oeste paulista e o outro em uma a sudoeste da Península Ibérica. Foram entrevistados 78 trabalhadores do hospital brasileiro e 39 do espanhol, utilizando-se de um roteiro com dados das condições de vida, de saúde e de trabalho, incluindo alguns questionários já validados como Job Content Questionnaire e o Self Reporting Questionnaire (SRQ-20). Os trabalhadores espanhóis são mais velhos, de cor branca e com renda familiar maior, apresentam escores do SRQ-20 menores em todas as dimensões. Eles fumam mais, têm maior déficit de visão e alergias, trabalham há mais tempo na mesma atividade, com carga horária menor e não contam com dois empregos. Além disso, quase quarenta por cento deles consideram ter autonomia no trabalho. Trabalhadores brasileiros se encontram em condições de vida, trabalho e saúde mental mais precarizadas. Alguns aspectos das condições de saúde foram piores entre os espanhóis, o que provavelmente pode ter ocorrido devido a idade mais avançada dos mesmos.To compare living, work and health conditions, with a particular interest in the mental health of Brazilian and Spanish outsourced hospital cleaning workers. Method: This is a cross-sectional, quantitative investigation carried out in two public general hospitals, one in the Brazilian Midwest region of São Paulo and the other in the Southwest region of the Iberian Peninsula. In total, 78 Brazilian hospital workers and 39 Spanish hospital workers were interviewed using a script with data on the living conditions, including some validated questionnaires such as the Job Content Questionnaire (JCQ) and Self-Reporting Questionnaire (SRQ-20). Results: Spanish workers are older, white and with a higher household income, with lower SRQ scores in all realms. Also, they smoke more, have a higher level of visual impairment and allergies, have been working in the same activity longer, with a lower workload and do not hold two jobs. Besides, almost 40% of them consider that their work is autonomous. Conclusions: Brazilian workers are subject to more impoverished living, working and mental health conditions than Spanish workers. Only a few aspects of health conditions were worse among Spanish workers, which may probably be related to their advanced age

Assessment of reliability and validity of the Spanish version of the Nursing Students’ Perception of Instructor Caring (S-NSPIC)

The care that clinical instructors demonstrate to students is essential for their education, considering the strong impact it has on their future relationships with patients, relatives, and other health professionals. Nursing Students’ Perceptions of Instructor Caring (NSPIC) is an instrument designed to assess nursing students’ perceptions of instructor’s caring behaviors. A trans-cultural, conceptual, and psychometric validation study was conducted with 315 nursing students at the University of Seville during their clinical practices in three regional hospitals. The NSPIC was translated and adapted to Spanish. The content validity was established by a panel of experts. To assess concurrent validity the culturally adapted Spanish version of the Clinical Placement Evaluation Tool (CPET) was used as a gold standard. The construct validity was determined by an exploratory factor analysis to identify the internal structure of the NSPIC-S. The internal consistency was established by Cronbach’s α and the intra-observer reliability for each item was established by test-retest. The content validity index varied between 0.53 and 0.93 and the correlation to the CPET was moderate. The factor analysis revealed a structure of five factors, one of which differed from the original scale. The value of Cronbach’s α was 0.95 and intraclass correlation coefficients varied between 0.5 and 0.89. Our study provided a culturally adapted version of the NSPIC, valid and reliable to be used in the Spanish context, the NSPIC-S

Discursos del alumnado de Ciencias de la Salud de la Universidad de Sevilla vinculados con el género

La formación en género en el ámbito de los estudios universitarios ha demostrado ser no sólo necesaria si no un indicativo de calidad. Esta investigación se centra en el análisis del aprendizaje y la enseñanza en materia de género en la Facultad de Enfermería, Fisioterapia y Podología y sus centros adscritos de la Universidad de Sevilla. Se ha realizado un estudio con metodología cualitativa basado en la Teoría Fundamentada, en el que se han examinado los discursos del alumnado vinculados con el género. Los alumnos y alumnas que habían cursado la asignatura “Género y Salud” en Enfermería, entendían el género como un constructo cultural; el alumnado de Fisioterapia y Podología confundían sexo y género. En cuanto a su primer contacto con el género manifiestan que ha sido en la Universidad. La formación en género es una categoría transversal que produce un cuestionamiento personal, una deconstrucción social con una fundamentación teórica.Gender training in the field of university studies has proved to be not only necessary but also an indication of quality. This research focuses on the analysis of learning and teaching on gender in the Faculty of Nursing, Physiotherapy and Podiatry and its affiliated centers of the University of Seville. A study with qualitative methodology based on Grounded Theory has been carried out, in which discourses of students linked to gender have been examined. The students who had studied the subject "Gender and Health" in Nursing, understood gender as a cultural construct; Physiotherapy and Podology students confused sex and gender. Regarding his first contact with the genre, they state that he has been at the University. Gender training is a transversal category that produces a personal questioning, a social deconstruction with a theoretical foundation

Relação enfermeiro-paciente: Identidade histórica, metodológica e terapêutica no cuidado de enfermagem

Introducción: La relación enfermera-paciente permite desarrollar el cuidado enfermero, siendo el contexto en el que se da una interacción entre ambos con el objetivo de ejecutar un plan de cuidados y conseguir resultados en salud. Objetivo: Reflexionar acerca de a la identidad e importancia de la relación enfermera-paciente en los cuidados de enfermería. Método: Análisis teórico reflexivo acerca de la identidad de la relación enfermera-paciente desde una perspectiva fundamental, metodológica y clínica en los cuidados de enfermería.Resultado: La discusión argumenta el interés de la relación enfermera-paciente como objeto de estudio desde los inicios de la disciplina, así como su importancia en todos los procesos metodológicos que subyacen a los cuidados enfermeros, y las consecuencias terapéuticas de la misma sobre la situación de salud del paciente. Conclusión: La relación enfermera-paciente permite desarrollar el cuidado enfermero, y su importancia y presencia en los cuidados enfermeros la identifican como un pilar básico para el desarrollo del mismo en todas sus dimensiones.Introduction: The nurse-patient relationship allows the development of the nursing care, being the context in which there is an interaction between nurse and patient, executing a care plan by nurse to achieve health results. Objective: Reflect about the identity and importance of the nurse-patient relationship in nursing care. Method: Reflective and theoretical analysis about the fundamental, methodological and clinical identity of the nurse-patient relationship in nursing care. Result: The discussion argues the interest of the nurse-patient relationship as an object of study from the beginning of the discipline, as well as its importance in all the methodological processes that underlie nursing care, and its therapeutic consequences on the patient's health situation. Conclusion: The importance and presence of the nurse-patient relationship identify it as a basic pillar of the nursing cares comprehensive development.Introdução: A relação enfermeiro-paciente permite desenvolver o cuidado de enfermagem, sendo o contexto em que há interação entre ambos com o objetivo de executar um plano de cuidados e alcançar resultados de saúde. Objetivo: Refletir sobre a identidade e importância da relação enfermeiro-paciente na assistência de enfermagem. Método: Análise teórico-reflexivo sobre a identidade da relação enfermeiro-paciente a partir de uma perspectiva fundamental, metodológica e clínica no cuidado de enfermagem. Resultado: A discussão discute o interesse da relação enfermeiro-paciente como objeto de estudo desde o início da disciplina, bem como sua importância em todos os processos metodológicos que fundamentam a assistência de enfermagem, bem como as conseqüências terapêuticas da mesma na situação de saúde do paciente. Conclusão: A relação enfermeiro-paciente permite o desenvolvimento do cuidado de enfermagem, e sua importância e presença na assistência de enfermagem o identifica como pilar básico para desenvolvimento do cuidado em todas as suas dimensões

Medios audiovisuales en el trabajo de campo de los alumnos en la asignatura Género y Salud, Universidad de Sevilla

Presentamos los resultados de los trabajos de campo realizados por las y los estudiantes de la asignatura “Género y Salud”, que comenzó a impartirse en el curso 2009-10, en el Grado de Enfermería. En estos trabajos de campo el alumnado ha trabajado sobre temas relacionados con los contenidos de la asignatura. Han realizado montajes utilizando contenidos multimedia obtenidos en la red, canciones, películas y videos que previamente habían sido utilizados para detectar metamensajes sexistas y por otra parte han realizado videos performativos realizados por ellos y ellas. Tanto la utilización de la imagen como texto, como el manejo de los elemento técnicos del montaje, la interacción grupal y con las profesoras que tutorizaban los grupos de práctica ha sido una experiencia enriquecedora y satisfactoria. La creatividad en la búsqueda y presentación de los temas elegidos, así como la calidad de los videos finales, ha superado las expectativas que nos habíamos planteado al comienzo en la andadura de esta nueva asignatura. Se ha conseguido el objetivo propuesto que era que los alumnos interiorizaran los contenidos de la asignatura Género y Salud y lo expresaran desde su propia óptica y códigos culturales, utilizando para ello tanto su propia expresividad como materiales multimedias que les resultan culturalmente significativos

Primary healthcare nurses' experiences of addressing intimate partner violence in supportive legal and health system contexts

Aim To explore the experiences of primary healthcare (PHC) nurses caring for women experiencing intimate partner violence (IPV) in a context of institutional support for the management of this health issue. Design Secondary qualitative analysis. Methods A purposeful sample (n = 19) of registered nurses, working in a PHC setting, with experience providing care to women who had disclosed intimate partner violence completed an in-depth interview. Thematic analysis was used to code, categorize and synthesize the data. Results Four themes were developed from the analysis of the interview transcripts. The first two themes address the characteristics of the type of violence most frequently encountered by participants, and how these characteristics shape the needs of women and the care nurses provide them. The third theme encompasses uncertainties and strategies developed to deal with the aggressor during the consultations as the woman's companion or as the patient himself. Finally, the fourth theme reflects the positive and negative consequences of caring for women exposed to intimate partner violence. Conclusion When there is a supportive legal framework and health system to address IPV, nurses are able to implement evidence-based best practices in caring for women experiencing intimate partner violence. The predominant type of violence experienced by women at the time they enter the healthcare system shapes their needs and the service/unit they reach. These varying needs should be considered in the development of training programmes for nurses and should be adapted for different healthcare services. Caring for women experiencing intimate partner violence implies an emotional burden even in an institutional supportive context. Therefore, actions to prevent nurses' burnout should be considered and implemented. Impact Lack of institutional support usually hinders the potential role nurses can play in the care provided to women who have experienced intimate partner violence. Findings from this study demonstrated that primary healthcare nurses are able to implement evidence-based best practices in the care for women experiencing intimate partner violence when there is a supportive legal framework and the health system context is openly favourable to addressing intimate partner violence. Findings from this study could inform the design and implementation of programmes and/or policies to improve nurses' responses to intimate partner violence in primary healthcare services.This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors

A perspectiva de gênero nas opiniões e discursos das mulheres sobre o cuidado

Objective: To investigate the meanings given by women caregivers to their care practices and to analyze the relationship between such practices and their work history. Method: This was a phenomenological qualitative cohort study conducted in Seville, Spain, with family caregivers. Data were collected using semi-structured interviews and submitted to content analysis, using Atlas-ti GmbH software version 5.0®. The following categories emerged: caregiving history and work history, and the meaning of care in their lives. Results: Twenty caregivers participated in the study. Women caregivers told stories of wide-ranging care, including several individuals in their family at different moments. They performed different forms of care, encompassing physical and social dimensions. Their discourse expressed the contradiction between their caregiving role and entering and/or maintaining their place in the labor market. Conclusion: The women expressed a concept of comprehensive care that includes responsibility, availability, and companionship, as well as emotional states, which greatly impact health. They tailored their participation in the labor market according to their family’s care needs. Thus, the gender perspective must be incorporated by health care providers who work with the health of caregivers

A perspectiva de gênero nas opiniões e discursos das mulheres sobre o cuidado

Objetivo: Explorar el significado que las mujeres cuidadoras dan a sus prácticas de cuidado y analizar la relación de dichas prácticas con las trayectorias laborales. Método: Estudio de corte cualitativo con diseño fenomenológico, realizado en Sevilla, España con cuidadoras familiares. La estrategia de obtención de datos ha sido la entrevista semi-estructurada. Los datos fueron analizados mediante análisis de contenido, se utilizó el software informático Atlas-ti GmbH versión 5.0®. Las categorías definidas son: historia cuidadora e historia laboral y significado del cuidado en sus vidas. Resultados: Participaron del estudio veinte cuidadoras. Las mujeres cuidadoras narran unas historias de cuidados extensas, cuidan a distintas personas de la unidad familiar en distintos momentos temporales. Los cuidados que desempeñan son muy diversos, contemplando la dimensión física y social. Se observa una contradicción entre el trabajo de cuidado y la incorporación y/o mantenimiento en el mercado laboral. Conclusión: Las mujeres expresan un concepto de cuidados integral que contempla la responsabilidad, la disponibilidad, el acompañamiento, así como estados afectivos, que generan un gran impacto en su salud. Las mujeres entrevistadas ajustan la participación en el mercado laboral a las necesidades de cuidados de la familia. Así, la perspectiva de género debe ser incorporada por los profesionales sanitarios que atienden los problemas de salud de las cuidadoras.Objective: To investigate the meanings given by women caregivers to their care practices and to analyze the relationship between such practices and their work history. Method: This was a phenomenological qualitative cohort study conducted in Seville, Spain, with family caregivers. Data were collected using semi-structured interviews and submitted to content analysis, using Atlas-ti GmbH software version 5.0®. The following categories emerged: caregiving history and work history, and the meaning of care in their lives. Results: Twenty caregivers participated in the study. Women caregivers told stories of wide-ranging care, including several individuals in their family at different moments. They performed different forms of care, encompassing physical and social dimensions. Their discourse expressed the contradiction between their caregiving role and entering and/or maintaining their place in the labor market. Conclusion: The women expressed a concept of comprehensive care that includes responsibility, availability, and companionship, as well as emotional states, which greatly impact health. They tailored their participation in the labor market according to their family’s care needs. Thus, the gender perspective must be incorporated by health care providers who work with the health of caregivers.Objetivo: Explorar o significado que as mulheres cuidadoras dão às suas práticas de cuidado e analisar a relação dessas práticas com as trajetórias de trabalho. Método: Estudo qualitativo, com desenho fenomenológico de desígnio, realizado em Sevilha, Espanha com cuidadoras familiares. A estratégia de obtenção de dados foi a entrevista semiestruturada. Os dados foram analisados com a metodologia de análise de conteúdo, por meio do software Atlas-ti GmbH, versão 5.0®. As categorias definidas são: história de cuidados e história laboral e o significado do cuidado em suas vidas. Resultados: Participaram do estudo 20 cuidadoras. As mulheres cuidadoras narram algumas histórias de cuidados extensas e cuidam de diferentes pessoas da unidade familiar em diferentes momentos temporais. Os cuidados que desempenham são muito diversos, contemplando a dimensão física e social. Observa-se uma contradição entre o trabalho de cuidado e a incorporação e/ou manutenção no mercado de trabalho. Conclusão: As mulheres expressam um conceito integrante de cuidados que abarca a responsabilidade, a disponibilidade, o acompanhamento, como também estados afetivos que geram um grande impacto em sua saúde. As mulheres entrevistadas ajustam a participação no mercado de trabalho com as necessidades de cuidados da família. Deste modo, a perspectiva de gênero deve ser incorporada pelos profissionais da saúde que atendem aos problemas de saúde das cuidadoras