La enfermería en el proceso de duelo por la pérdida de un ser querido en los campos de refugiados

La muerte de un ser querido representa un cambio vital que para muchas personas es difícil de afrontar. Para la población refugiada constituye un añadido al que hacer frente. El duelo suele ser un proceso doloroso en respuesta a dicha muerte. El sufrimiento que genera esta pérdida puede verse incrementado cuando dicho proceso se complica y se prolonga en el tiempo dando lugar al denominado duelo patológico. Objetivo: conocer, en base a la experiencia de profesionales expertos en el proceso de duelo y en trabajo en campos de refugiados, el papel que puede desempeñar la enfermería en el afrontamiento del duelo ante la pérdida de un ser querido. Material y método: se utilizó un análisis cualitativo con diseño narrativo. Participaron dos expertas en la materia a las que se les realizó una entrevista individual en profundidad. Resultados: ambas participantes pusieron de manifiesto la importancia de la figura enfermera para los cuidados de la población refugiada, así como la necesidad de capacitar a dichos profesionales en salud mental y apoyo psicosocial. Discusión: es recomendable diseñar un plan de actuación y trabajo de la enfermera para apoyar, dentro de un equipo multidisciplinar, el proceso de duelo en personas refugiadas. Conclusiones: el personal de enfermería no solo detecta mayor cantidad de problemas psicosociales durante su evaluación, sino que también observa las relaciones familiares y facilita un primer acompañamiento.A loved one ́s death represents a significant change, which is quite tricky for many people to be faced. For the refugee population, it constitutes an addition to cope with. Grief is often a painful process in response to such death. The suffering generated by this loss can be increased when this process gets complicated and prolonged over time, giving rise to the so-called pathological grief. Objective: get to know, based on the experience of experts in the grieving process and working in refugee camps, the role that nursing can play in coping with grief in the face of losing a loved one in these camps. Material and method: a qualitative analysis with the narrative design was used. Two experts in the field participated, whereby individual in-depth interviews were conducted. Results: Both participants highlighted the importance of the nurse figure to take care of the refugee population and train said professionals in mental health and psychosocial support. Discussion: it is advisable to design an action/work plan for the nurse to support, within a multidisciplinary team, the grieving process in refugees. Conclusions: nursing personnel not only detect a more significant number of psychosocial problems during their evaluation, but also observe family relationships and facilitate the first follow-up

Reliability of the Spanish Version of the Movement Imagery Questionnaire-3 (MIQ-3) and Characteristics of Motor Imagery in Institutionalized Elderly People

Motor imagery (MI) training is increasingly used to improve the performance of specific motor skills. The Movement Imagery Questionnaire-3 (MIQ-3) is an instrument for assessing MI ability validated in Spanish although its reliability has not yet been studied in the elderly population. The main objective of this study was to test its reliability in institutionalized elderly people. Secondarily, we studied whether there are differences according to gender and age in MI ability (measured by the MIQ-3) and in temporal congruency (measured by mental chronometry of elbow and knee flexion-extension and getting up and sitting down from chair movements). The subjects were 60 elderly, institutionalized, Spanish-speaking individuals without cognitive impairment or dementia, and aged between 70 and 100 years. Cronbach?s alpha showed high internal consistency in the internal visual and external visual subscales and moderate in the kinesthetic subscale. The intraclass correlation coefficient showed good test-retest reliability for all three subscales. Mixed factorial analysis of variances (ANOVAs) showed that MI ability decreased with increasing age range, the imagery time decreased concerning the execution of the same movement, and there were no gender differences in either IM ability or temporal congruence. The Spanish version of the MIQ-3 is a reliable instrument for measuring MI ability in institutionalized elderl

Diaphragmatic activation correlated with lumbar multifidus muscles and thoracolumbar fascia by B-mode and M-mode ultrasonography in subjects with and without non-specific low back pain: a pilot study.

Background and Objectives: The diaphragm, the lumbar multifidus muscles, and the thoracolumbar fascia (TLF) execute an important role in the stability of the lumbar spine and their morphology has been modified in subjects with non-specific low back pain (NS-LBP). While it is true that three structures correlate anatomically, the possible functional correlation between them has not been investigated previously in healthy subjects nor in subjects with NS-LBP. The aim of the present study was to examine this functional nexus by means of a comparison based on ultrasonographic parameters of the diaphragm, the lumbar multifidus muscles, and the TLF in subjects with and without NS-LBP. Materials and Methods: A sample of 54 (23 NS-LBP and 31 healthy) subjects were included in the study. The thickness and diaphragmatic excursion at tidal volume (TV) and force volume (FV), the lumbar multifidus muscles thickness at contraction and at rest, and the TLF thickness were evaluated using rehabilitative ultrasound imaging (RUSI) by B-mode and M-mode ultrasonography. The diaphragm thickening capacity was also calculated by thickening fraction (TF) at tidal volume and force volume. Results: There were no significant differences recorded between the activation of the diaphragm and the activation of the lumbar multifidus muscles and TLF for each variable, within both groups. However, there were significant differences recorded between both groups in diaphragm thickness and diaphragm thickening capacity at tidal volume and force volume. Conclusions: Diaphragmatic activation had no functional correlation with the activation of lumbar multifidus muscles and TLF for both groups. Nevertheless, subjects with NS-LBP showed a reduced diaphragm thickness and a lower diaphragm thickening capacity at tidal volume and force volume, compared to healthy subjects

Psychological flexibility, mindfulness and acceptance, an innovative model and techniques for psychosocial management of chronic pain: Implications for physical therapy

Psychological Flexibility (PF) model is a new development from a biopsychosocial perspective. Acceptance and Commitment Therapy (ACT) is a form of cognitive-behavioral therapy based on PF which is considered a well-established psychological treatment for chronic pain. A growing evidence in chronic pain field shows accepting pain and discomfort instead of trying to avoid it, or to disconnect from or suppress pain experience or related thoughts, combined with engaging in goal-directed actions in the presence of ongoing pain, can be more effective in the long run and can increase quality of life. Mindfulness-based approaches and other acceptance techniques can help to increase PF. Studies have showed brief training based on PF can help physiotherapists working with complex patients presenting emotional distress and pain-related disability, and point at potential barriers and facilitators to embedding an ACT philosophy within a physiotherapy setting.Sin financiación0.121 SJR (2016) Q4, 152/169 Physical Therapy, Sports Therapy and RehabilitationUE

Exoesqueletos portables en personas con lesión medular. Revisión sistemática

1) Antecedentes: existe gran cantidad de dispositivos para facilitar la bipedestación y la marcha. Cada exoesqueleto tiene características propias, beneficios y limitaciones. Esta revisión compendia y ordena el conocimiento disponible sobre los diferentes tipos de exoesqueletos portables para personas con lesión medular.2) Métodos: se realizó una búsqueda sistemática en Pubmed, Cochrane Libraryy Physiotherapy Evidence Database, sin limitación de tipo de artículo. Además,se analizaron los artículos que figuraban en su bibliografía y se consultaron páginas web relacionadas.3) Resultados: de un total de 128 estudios se seleccionaron 28. Se recogieron datos sobre el nombre del dispositivo y empresa distribuidora, población diana, articulaciones diana, nivel lesional, uso indicado, tipo de terapia, necesidad de ayudas técnicas, autonomía y comercialización.4) Conclusiones: se han encontrado20 exoesqueletos portables que se utilizan por personas con lesión medular.La mayor parte de articulaciones diana son la cadera y la rodilla. La mayoría se emplean con fines rehabilitadores y necesitan un producto deapoyo complementario1) Background: there are many devices to facilitate standing and walking. Each exoskeleton has its characteristics, benefits, and limitations. This review summarizes and orders the available knowledge about the different types of portable exoskeletons for people with spinal cord injury. 2) Methods: a systematic search was conducted in Pubmed, Cochrane Library, and Physiotherapy Evidence Database, without limitation of the type of article. Also, the articles in their bibliography were analyzed, and related web pages were consulted. 3) Results: from a total of 128 studies, 28 were selected. Data were collected on the name of the device and distribution company, target population, target joints, injury level, indicated use, type of therapy, need for technical assistance, autonomy, and commercialization. 4) Conclusions: 20 portable exoskeletons have been found that are used by people with spinal cord injury. Most of the target joints are the hip and the knee. Most are used for rehabilitation purposes and need a complementary support product

Dual-task and risk of falls in elderly people: A cross-sectional study

Older adult population has been increasing in the last decades. The Time Up and Go (TUG) is used in the exploration of elders and can discriminate the risk of falls. The aim of the study is to understand if aging people have more risk of falls while performing a dual-task in their daily life activities. A cross-sectional study with older people of the general community between 60-85 years was done. Participants were instructed to perform the TUG without Dual Task (DT), and with a cognitive and a motor secondary task. TUG with and without DT (motor and cognitive) presented shows statistical significance. There is an increase in time to perform TUG associated with a second task in elderly people. TUG tests can help in the multifactorial assessment of risk of fallingSin financiaciónNo data 2019UE

El fisioterapeuta como facilitador de la inclusión social en personas adultas con pluridiscapacidad

La intervención sobre personas con pluridiscapacidad se realiza en el seno de un equipo\ud interdisciplinar cuya finalidad es abordar al individuo desde un punto de vista holístico. La\ud Fisioterapia forma parte de las intervenciones que se incluyen dentro de este equipo, y aunque su\ud labor es principalmente la rehabilitación física y funcional del individuo, también tiene una\ud repercusión psicosocial. Con este estudio se pretende mostrar el papel del fisioterapeuta en la\ud integración social y en la vida emocional de las personas adultas con pluridiscapacidad. Se diseñó\ud un cuestionario dirigido a familiares y/o tutores de este colectivo y tras su posterior análisis se llegó\ud a la conclusión de que el fisioterapeuta influye de forma positiva sobre los aspectos sociales y\ud emocionales de la persona con pluridiscapacidad. Sería necesaria una exploración más profunda\ud para seguir identificando los aspectos que ejercen una influencia positiva sobre el estado de salud y\ud calidad de vida de estas personas.The intervention on people with multiple disabilities is done within an interdisciplinar\ud team from a holistic point of view. Physiotherapy takes part in the interventions that are included\ud within this team, and although the work is mainly physical and functional rehabilitation of the\ud individual, also has a psychological impact. This study aims to show the role of the physiotherapist\ud in social integration and emotional life of adults with multiple disabilities. A questionnaire was\ud addressed to the family and/or guardians of this group and after further analysis it was concluded\ud that the physiotherapist has a positive influence on the social and emotional aspects of the person\ud with multiple disabilities. It would require deeper research to identify the aspects that have a\ud positive influence on the health and quality of life of these people

Relationship between Forward Head Posture and Tissue Mechanosensitivity: A Cross-Sectional Study

The relationship between forward head posture (FHP) and neck pain is not clear. FHP could possibly increase the mechanosensitivity of cervical tissues, which could lead to the development of pain depending on the adaptation capability of the central nervous system. The purpose of this study was to analyse the influence of FHP in the mechanosensitivity of articular, muscular, and neural tissues related to the cervical spine. The pressure pain threshold was bilaterally measured in different muscles and nerves and the second cervical vertebrae. The cervical spine’s range of movement was also examined. The measurements were obtained from people with (n = 32) and without (n = 64) FHP. The analyses included a 2-by-2 mixed analysis of variance (ANOVA), pairwise comparisons with Bonferroni correction, and point-biserial correlation coefficients. Subjects with FHP showed a less pressure pain threshold (PPT) in all locations except for the upper trapezius and scalenus medius muscles. They also showed less extension and right-rotation range of motion. There was no association between FHP, neck pain, disability, and headache. Nevertheless, more research is needed to evaluate the relationship between FHP, tissue mechanosensitivity, and neck pain.Sin financiación4.241 JCR (2020) Q1, 39/169 Medicine, General & InternalNo data SJR 2020No data IDR 2019UE