Perceived stress in relation to quality of life and resilience in patients with advanced chronic kidney disease undergoing hemodialysis

Patients with chronic kidney disease undergo various stages of therapeutic adaptation which involve lifestyle modifications, physical changes, and adjustment to renal replacement therapy. This process produces adaptive stress. Objective: To identify how resilience, healthrelated quality of life, and sociodemographic, clinical, and hemodialysis routine-related variables are related to perceived stress in patients with chronic kidney disease receiving hemodialysis for more than six months. Methods: This was a multicenter and cross-sectional study involving 144 patients from the Valencian Community (Spain). The assessment scales used for the study were the Perceived Stress Scale 10, the Kidney Disease Quality of Life 36, and the Connors–Davidson Resilience Scale. To identify variables with predictive power over Perceived Stress Scale 10 scores, multiple regression analyses were performed. Results: Employment status (p = 0.003), resilience (p < 0.001), and quality of life (p < 0.001) were shown to be significantly related to perceived stress. The regression models determined that health-related quality of life and resilience explained up to 27.1% of the variance of total PSS10 scores. Conclusions: Resilience was identified as one of the most important predictors of Perceived Stress Scale 10 scores. Thus, the development of interventions to promote resilience may have a positive impact on perceived stress in patients with chronic kidney disease

Divulgación científica: aprender haciendo y coevaluando

[EN] Objective/s: To assess the process of acquiring competence in scientific dissemination among students at the La Fe School of Nursing in Valencia. Development of the innovation: Four cycles of group work were implemented. Each group creates scientific dissemination documents focused on a work topic related to the subject of Physical Activity and Health Promotion in Nursing. Each work is co-evaluated by peers using an analytical rubric, with 10 learning domains, and this evaluation is returned before the creation of the next document. At the end of the 4 work cycles, 8 teachers external to the activity assessed the dissemination papers using the same co-assessment rubric, anonymously and blinded. Results: Acquisition of competence in the domains studied showed significant improvements with repetition of the tasks. The study differentiated by groups shows that learning becomes uniform in 6 of the 10 competencies, showing significant differences in learning between groups in 4 of the domains. Conclusions: Repetition of the task and co-assessment improves the acquisition of competences in science popularisation. The moment of greatest evolution occurs between the second and third repetition of the task, slowing down this benefit between the third and fourth repetition.[ES] Objetivo: Valorar el proceso de adquisición de la competencia en divulgación científica del alumnado de la Escuela de Enfermería de la Fe de Valencia. Desarrollo de la innovación: Se implementaron cuatro ciclos de trabajo grupal. Cada grupo crea documentos de divulgación científica centrados en una temática de trabajo relacionada con la asignatura de Actividad física y Promoción de la salud en Enfermería. Cada trabajo es coevaluado por pares mediante rúbrica analítica, con 10 dominios de aprendizaje, y se devuelve esta evaluación antes de la creación del siguiente documento. Finalizados los 4 ciclos de trabajo, 8 docentes externos a la actividad valoraron los documentos de divulgación utilizando la misma rúbrica de coevaluación, de forma anónima y cegada. Resultados: La adquisición de competencia en los dominios estudiados mostraron mejoras significativas con la repetición de las tareas. En el estudio diferenciado por grupos se muestra que el aprendizaje se vuelve uniformen en 6 de las 10 competencias, mostrando diferencias significativas de aprendizaje entre grupos en 4 de los dominios. Conclusiones: La repetición de la tarea y la coevaluación mejora la adquisición de competencias en divulgación científica. El momento de mayor evolución se produce entre la segunda y tercera repetición de la tarea, ralentizando este beneficio entre la tercera y cuarta repetición.García-Martinez, P.; Saus-Ortega, C.; García-Molina, P.; Balaguer-López, E.; Celda-Belinchón, L.; Sosa-Palanca, E.; Buck Sainz-Rozas, P.... (2022). Divulgación científica: aprender haciendo y coevaluando. Editorial Universitat Politècnica de València. 161-172. https://doi.org/10.4995/INRED2022.2022.1583516117

Impacto de una intervención educativa sobre seguridad del paciente en enfemeras de unidades de hospitalización de adultos

INTRODUCCIÓN: La seguridad del paciente es un componente esencial de la calidad asistencial y sigue siendo un reto para las organizaciones sanitarias. Gran parte de las estrategias diseñadas para fomentarla van dirigidas a mejorar la cultura de seguridad y a disminuir los eventos adversos. OBJETIVO: Analizar el impacto de una intervención educativa sobre seguridad del paciente dirigida a enfermeras de unidades de hospitalización de adultos. MÉTODO: Estudio de intervención comunitaria cuasi experimental antes-después, con grupo comparación, mediante intervención educativa. La intervención consistió en varias acciones formativas dirigidas a enfermeras y mandos intermedios enfermeros de unidades de hospitalización de adultos en un hospital terciario. La cultura de seguridad se evaluó utilizando la versión española del cuestionario Hospital Survey on Patient Safety Culture y la incidencia de eventos adversos mediante rondas de seguridad. RESULTADOS: En la fase pre intervención no se encontraron diferencias significativas entre los grupos a estudio. Tras la intervención la cultura de seguridad mejoró significativamente en siete dimensiones (notificación de eventos relacionados con la seguridad, percepción de seguridad, expectativas y acciones de la dirección/supervisión en la unidad/servicio en apoyo a la seguridad, aprendizaje organizacional/mejora continua, franqueza en la comunicación, feed-back y comunicación sobre errores, y respuesta no punitiva a los errores). La percepción del grado de seguridad aumentó significativamente tras la intervención (p=0.000). No se registró disminución de la incidencia de eventos adversos respecto a la fase pre intervención, pero si se observó un aumento de la notificación de eventos en el grupo intervención (p=0.043). CONCLUSIÓN: La intervención educativa dirigida a enfermeras de unidades de hospitalización de adultos de un hospital terciario sobre seguridad del paciente es efectiva para mejorar la cultura de seguridad y la notificación de eventos adversos, pero no mostró mejora en la incidencia de eventos adversosINTRODUCTION: Patient safety is an essential component of quality of care and remains a challenge for healthcare organisations. Many of the strategies designed to promote it are aimed at improving safety culture and reducing adverse events. OBJECTIVE: To analyse the impact of an educational intervention on patient safety aimed at nurses in adult hospitalisation units. METHOD: Quasi-experimental before-after community intervention study, with a comparison group, using an educational intervention. The intervention consisted of several training actions aimed at nurses and middle management nurses in adult inpatient units in a tertiary hospital. Safety culture was assessed using the Spanish version of the Hospital Survey on Patient Safety Culture questionnaire and the incidence of adverse events was assessed by safety rounds. RESULTS: In the pre-intervention phase no significant differences were found between the study groups. After the intervention, safety culture significantly improved in seven dimensions (reporting of safety-related events, perception of safety, expectations and actions of management/supervision in the unit/service in support of safety, organisational learning/continuous improvement, openness in communication, feedback and communication about errors, and non-punitive response to errors). Perceived safety significantly increased after the intervention (p=0.000). There was no decrease in the incidence of adverse events compared to the pre-intervention phase, but there was an increase in event reporting in the intervention group (p=0.043). CONCLUSION: Patient safety education intervention for nurses in adult inpatient units of a tertiary hospital is effective in improving safety culture and adverse event reporting, but did not show improvement in the incidence of adverse eventsEnfermeríaCiencias de la Salu

Leisure Programmes in Hospitalised People: A Systematic Review

Nurses carry out holistic assessments of patients during hospital admission. This assessment includes the need for leisure and recreation. Different intervention programmes have been developed to meet this need. The aim of this study was to investigate hospital leisure intervention programmes described in the literature in order to determine their effects on patient health and highlight the strengths and weaknesses of the programmes as reported by health professionals. A systematic review of articles in English or Spanish published between 2016 and 2022 was carried out. A search was performed in the following databases: CINAHL COMPLETE, PubMed, Cochrane Library and Dialnet and the Virtual Health Library and Web of Science resources. A total of 327 articles were obtained, of which 18 were included in the review. The methodological quality of the articles was assessed using the PRISMA, CASPe and STROBE scales. A total of six hospital-based leisure programmes were identified, including a total of 14 leisure interventions. The activities developed in most of the interventions effectively reduced the levels of anxiety, stress, fear and pain in patients. They also improved factors such as mood, humour, communication, wellbeing, satisfaction and hospital adaptation. Among the main barriers to implementing hospital leisure activities is the need for more training, time and adequate spaces for them develop. Health professionals consider it beneficial for the patient to develop leisure interventions in the hospital

Health Inequities in LGBT People and Nursing Interventions to Reduce Them: A Systematic Review

Background: Lesbian, gay, bisexual, and transgender (LGBT) people present poorer mental and physical health results compared to the heterosexual and cisgender population. There are barriers in the healthcare system that increase these health inequities. Objective: To synthesise the available evidence on how nurses can intervene in reducing health inequities in LGBT people, identifying their specific health needs and describing their experiences and perceptions of the barriers they face in the healthcare system. Methods: Systematic review. Between March and April 2021, a bibliographic search was carried out in the Cuiden, LILACS, PubMed, Dialnet, SciELO, Trip Database, and Web of Science databases and metasearch engines. Inclusion criteria: Articles published in the last 5 years that address the specific health needs of LGBT people, their experiences and perceptions, or interventions in this group in which nurses may engage. Results: A total of 16 articles were selected. Health disparities were detected in the LGBT community, which exhibited higher rates of mental health problems, substance abuse, risky sexual behaviours, self-harm, and suicide. These inequalities were related to minority stress, and each of them differently impacted individual populations within the broader LGBT community depending on their sexual orientations and gender identities. The impact of these factors was, in turn, modified by the intersections of race/ethnicity, geographic region, and socioeconomic factors. LGBT people described discriminatory experiences by health professionals, as well as their distrust and fear in this setting. Nurses can carry out interventions such as inclusive education about sex and sexual and gender diversity and bullying and suicide prevention programmes, and can provide gender-affirming and family-centred care. Conclusions: LGBT people experience health inequities and discrimination in the healthcare system. Nurses can implement diverse interventions to reduce these problems and, moreover, these health professionals are obliged to acquire cultural competence regarding LGBT health

Estrés percibido por el alumnado de enfermería. Estrategias de sensibilización en la comunidad educativa

[EN] The emotional discomfort perceived by the students needs to be identified and evaluated as a way to improve the emotional well-being and health of the university community. The objective of this experience was to sensitize the university community about the need to promote the emotional well-being of our students, as well as to identify the level of stress perceived in the students of the Escuela Universitaria de Enfermería de la Fe (Valencia) and to analyze the relationship between stress with the sense of coherence, manageability, comprehensibility and significance among the students. The experience has focused on participation in a descriptive and analytical research project on the stress perceived by the students and its relationship with the sense of coherence, with a subsequent return of the results to the educational community. The results identified a greater perceived stress in the first and second years and a sense of coherence that did not increase significantly with the years of teaching experience. Lastly, the creation of a space for participation made it possible to learn about the reality of the emotional well-being of the students, to sensitize the entire community about this problem and to jointly seek solutions with the participation of the entire educational community.[ES] El malestar emocional percibido por el alumnado requiere ser identificado y evaluado como una vía para mejorar el bienestar emocional y la salud de la comunidad universitaria. El objetivo de esta experiencia era sensibilizar a la comunidad universitaria sobre la necesidad de promover el bienestar emocional de nuestro alumnado, así como identificar el nivel de estrés percibido en el estudiantado de la Escuela de Enfermería de la Fe (Valencia) y analizar la relación del estrés con el sentido de coherencia, manejabilidad, comprensibilidad y significancia entre el alumnado. La experiencia se ha centrado en la participación en un proyecto de investigación descriptivo y analítico sobre el estrés percibido por el alumnado y su relación con el sentido de coherencia, con una posterior devolución de los resultados a la comunidad educativa. En los resultados se identificaba un mayor estrés percibido en primer y segundo curso y un sentido de coherencia que no aumentaba significativamente con los años de experiencia docente. Por último, la creación de un espacio de participación permitió conocer la realidad del bienestar emocional del alumnado, sensibilizar a toda la comunidad sobre este problema y buscar de forma conjunta soluciones participadas por toda la comunidad educativa.García-Martínez, P.; Sosa Palanca, E.; García Molina, P.; Buck Sainz-Rozas, P.; González Blázquez, F.; Trujillo Barbera, S.; Castro Calvo, J. (2023). Estrés percibido por el alumnado de enfermería. Estrategias de sensibilización en la comunidad educativa. Editorial Universitat Politècnica de València. 1291-1299. https://doi.org/10.4995/INRED2023.2023.165571291129