Agresiones externas hacia los profesionales del Servicio Aragonés de Salud en los servicios de Atención Primaria y Especializada durante el año 2018

Objetivo: El riesgo que tiene el personal sanitario de sufrir una agresión en el lugar de trabajo no es homogéneo. Factores como la categoría profesional, el nivel asistencial o el servicio modulan su probabilidad. El objetivo del presente trabajo fue analizar las agresiones registradas por los profesionales del Servicio Aragonés de Salud, comparando las características de aquellas que sucedieron en Atención Primaria con las que tuvieron lugar en Atención Especializada durante el año 2018. Metodos: Se realizó un estudio descriptivo transversal, llevado a cabo a través de la información disponible en la base de datos del registro de agresiones aragonés durante el año 2018. Las variables del estudio incluyeron características sociodemográficas de las personas agredidas, tipo de agresión, nivel de asistencia y baja laboral. Se calcularon frecuencias y porcentajes para las variables cualitativas, y media y desviación típica para las cuantitativas. La relación entre las variables se realizó mediante las pruebas de Mann-Whitney y Chi-Cuadrado. Resultados: Se registraron 236 agresiones, de las que el 75, 4% tuvieron lugar en Atención Especializada. La edad media se situó en 45 años. Los médicos fueron más agredidos en Atención Primaria, mientras que el personal de enfermería lo fue más en especializada. En primaria se produjeron más agresiones verbales, mientras que en especializada se registraron más agresiones físicas. Conclusiones: La violencia laboral que sufren los profesionales sanitarios varía en función del nivel asistencial, donde se observa una mayor incidencia de agresiones en Atención Especializada. Es necesario establecer mejoras en el registro de agresiones de Aragón, para perfeccionar la prevención y seguridad de los trabajadores. Objective: The risk that health personnel have of being assaulted in the workplace is not homogeneous. Factors such as professional category, level of care or service, modulate their probability. The objective of this work was to analyze the aggressions registered by the Servicio Aragonés de Salud professionals, comparing the characteristics of those that occurred in primary care with those that took place in specialized care during 2018. Methods: A cross-sectional descriptive study was made, carried out using the information available in the Aragon aggression registry database, during the year 2018. The study variables included sociodemographic characteristics of the people attacked, type of aggression, level of assistance and sick leave. Frequencies and percentages were calculated for the qualitative variables and mean and standard deviation for the quantitative ones; the relationship between the variables was made using the Mann-Whitney and Chi-Square tests. Results: 236 assaults were registered, of which 75.4% took place in AE. The average age was 45 years. Doctors were more attacked in primary care, while nursing staff was more attacked in specialized care. In primary there were more verbal attacks, while in specialized there were more physical attacks. Conclusions: Occupational violence suffered by health professionals change depending on the level of care, where a higher incidence of assaults is observed in specialized care. It is necessary to establish improvements in the registry of aggressions in Aragón, to improve the prevention and safety of workers

Adapting and validating the Hospital Survey on Patient Safety Culture (HSOPS) for nursing students (HSOPS-NS): A new measure of Patient Safety Climate

Background: Patient Safety Culture and Patient Safety Climate (PSC) are different factors. PSC is the shared perception that is held within a hospital''s area or unit at a specific moment in time. This measure is necessary for designing activities for promoting and improving safety. It must include the perception of all the agents involved, including future nurses throughout their patient safety education. Objectives: The aim was to adapt and validate a new version of the Hospital Survey on Patient Safety Culture (HSOPS), targeted specifically at nursing students. It provides a new comprehensive and more complete measure of PSC that contributes to improving patient safety. Methods: Data were obtained from 654 undergraduate and postgraduate nursing students. PSC was tested using factor analyses and structural equation modeling. In order to facilitate the improvement of PSC, we examined differences in climate strength across different academic groups using the Rwg(j) and ICC measures of inter-rater agreement. Results: Factor analyses confirmed a five-factor solution that explained between 52.45% and 54.75% of the variance. The model was found to have adequate fit ¿ 2 (5) = 14.333, p =.014; CFI = 0.99; RMSEA = 0.05. Cronbach''s alphas for PSC were between 0.74 and 0.77. “Teamwork within units” was the highest rated dimension, and “Staffing” the lowest rated. Medium-to-high scores were obtained for PSC. The median of Rwg (j) was high in the five dimensions of the PSC survey, supporting the idea of shared climate perceptions (0.81–0.96) among undergraduate and postgraduate nursing students. Conclusions: HSOPS-NS is a useful and versatile tool for measuring the level and strength of PSC. It screens knowledge regarding patient safety in clinical practice placements and compares nursing students’ perceptions of the strength of PSC. Weaknesses perceived in relation to PSC help implement changes in patient safety learning

Impact of reducing sitting time in women with fibromyalgia and obesity: a randomized controlled trial

Background: Sitting time has negative effects on health, increasing the risk of obesity, osteoporosis, diabetes, and cancer. Thus, primary health care education interventions aimed to reduce sitting time and sedentary behavior could have beneficial effects on people’s health and wellbeing. The purpose of this study was to assess the effectiveness of an intervention based on reducing sitting time to decrease cardiometabolic risk on a sample of women diagnosed with fibromyalgia and moderate obesity. Methods: Randomized controlled trial to evaluate the effectiveness of an intervention to decrease cardiometabolic risk in 84 participants. Sedentary behavior was monitored using an accelerometer before and at 3-month follow-up. Results: Compared with the control group, body mass index decreased, and the number of steps taken increased, in the intervention group 3 months after the intervention. No significant differences were found in the rest of the variables measured. Conclusion: The intervention group decreased sitting time after the intervention. Group activities and support from primary care may be useful to improve treatment adherence

Identificación en aguas recreativas de bacterias patógenas en amebas de vida libre, que actúan como nicho ecológico, mediante técnicas de biología molecular.

Las amebas de vida libre (AVL) son protozoos que se encuentran ampliamente distribuidos en la naturaleza, siendo algunas de ellas patógenos oportunistas. Existe una interacción en el medio ambiente entre AVL y bacterias, siendo estas su sustrato alimenticio, aunque se ha demostrado la capacidad de algunas especies para sobrevivir en el interior de la ameba1. Este hecho supone que bacterias consideradas patógenas para el ser humano, permanezcan protegidas en el interior de las amebas cuya forma quística es altamente resistente y cuando las condiciones que hacían adverso el medio desaparecen, sean liberadas persistiendo en lugares como torres de refrigeración, piscinas, fuentes ornamentales, lo que supone un riesgo para la salud pública1-2. Se estudió la presencia de bacterias patóge

La escala CIBISA: herramienta para la autoevaluación del aprendizaje práctico de estudiantes de enfermería

Objetivo principal: Elaborar y validar un cuestionario para medir el aprendizaje de los cuidados enfermeros durante las prácticas en el grado de enfermería. Metodología: Elaboración de la escala inicial de 45 ítems, pilotaje de la herramienta con alumnado de la Universidad de Zaragoza y Universidad del País Vasco, mediante análisis de la fiabilidad y de estructura. Posterior consulta a expertos para validación de contenido. Resultados principales: El resultado del pilotaje reportó que el global de la herramienta presentaba buena fiabilidad (alfa=0,888), con una estructura unidimensional que explica el 66% de la varianza. El grupo de expertos confirmó la estructura unidimensional de la escala, y propuso la eliminación de 17 ítems por considerarlos redundantes. Conclusión principal: La herramienta presentada resulta útil para la evaluación del aprendizaje del alumnado. Resultaría necesario ampliar el estudio con muestras de otras universidades, e incluir herramientas que aporten validez convergente o divergente. Objective: Development and validation of a questionnaire to measure the learning of nursing care during Nurse Degree clinical practices. Methods: Elaboration of a 45-item initial scale, pilot study with students from University of Zaragoza and University of Pais Vasco, through reliability and structural analysis. Content validation through experts consulting. Results: Pilot-study result a good reliability (alpha=0,888) in the global tool, with a unidimensional structure accounting for variance 66%. The expert panel confirmed that unidimensional structure for the scale, and considered 17 items redundant, proposing its elimination. Conclusions: Presented tool is useful for students learning assessment. It would be necessary to Include samples from other universities and tools that provide convergent and divergent validity in further studies

Ageism and nursing students, past or reality?: a systematic review

Objective: This systematic review aimed to summarise and update existing knowledge about ageism among nursing students through the following research question: what is the perception and attitudes of ageism among student nurses? Design: A systematic review of longitudinal and cross-sectional studies of ageism in nursing students was carried out. Data sources: The literature search was conducted in the scientific databases Pubmed and Scopus in February 2021. Review methods: After the screening process, 22 studies meeting the selection criteria were selected; 8 more were identified after manually searching the selected paper' reference lists. A total of 30 studies were included in the review. The JBI Critical Appraisal Checklists for Analytical Cross-Sectional studies and for Cohort Studies were used to appraise the articles' quality. Results: There was large variability in the manifestation of ageism among student nurses, as well as in the instruments used for assessment. Most of the articles analysed attitudes towards old age, the majority of which were positive. Being a female student, being on the final year of study and having regular contact or cohabitation with an older adult were three of the main determinants in the expression of positive attitudes towards the elderly. Conclusions: Our findings suggest that student nurses generally have positive attitudes towards old age, although ageist beliefs and discriminatory behaviours were identified and should be studied in greater depth. Training programs for future care professionals have a responsibility to educate from a non-stereotypical perspective based on current societal needs

The TELE-DD project on treatment nonadherence in the population with type 2 diabetes and comorbid depression

Diabetic patients have increased depression rates, diminished quality of life, and higher death rates due to depression comorbidity or diabetes complications. Treatment adherence (TA) and the maintenance of an adequate and competent self-care are crucial factors to reach optimal glycaemic control and stable quality of life in these patients. In this report, we present the baseline population analyses in phase I of the TELE-DD project, a three-phased population-based study in 23 Health Centres from the Aragonian Health Service Sector II in Zaragoza, Spain. The objectives of the present report are: (1) to determine the point prevalence of T2D and clinical depression comorbidity and treatment nonadherence; (2) to test if HbA1c and LDL-C, as primary DM outcomes, are related to TA in this population; and (3) to test if these DM primary outcomes are associated with TA independently of shared risk factors for DM and depression, and patients’ health behaviours. A population of 7,271 patients with type-2 diabetes and comorbid clinical depression was investigated for inclusion. Individuals with confirmed diagnoses and drug treatment for both illnesses (n = 3340) were included in the current phase I. A point prevalence of 1.9% was found for the T2D-depression comorbidity. The prevalence of patients nonadherent to treatment for these diseases was 35.4%. Multivariate analyses confirmed that lower diabetes duration, increased yearly PCS visits, HbA1c and LDL-C levels were independently related to treatment nonadherence. These findings informed the development of a telephonic monitoring platform for treatment of nonadherence for people with diabetes and comorbid depression and further trial, cost-effectiveness, and prognostic studies (phases II and III)

Clinical and epidemiological approach to delirium in an acute care unit: a cross-sectional study

During hospital admissions, the union of various factors, those related to acute pathology, dependency conditions, cognitive impairment, change of habitual environment, and others, can cause delirium. Acute delirium in the elderly (ADE) occurs in around a third of patients over 70 years of age. The syndrome generates serious complications that increase hospital morbidity and mortality and a high cost for the health administration. This study aimed to determine the clinical and epidemiological profile of ADE in an internal medicine unit. A descriptive cross-sectional study was carried out using a convenience test. A total of 356 patients participated between September and November 2021. Sociodemographic variables, predisposing and precipitating factors of ADE, methods of action against ADE, and the impact on functional and cognitive deterioration were analyzed. A total of 35.1% of the patients developed ADE, mostly of the hyperactive type and of nocturnal appearance. ADE was mainly treated with psychoactive drugs and 22% required mechanical restraint, with non-pharmacological preventive strategies, support, and caregiver training being the main tools for controlling ADE during hospital admission

An evaluation of undergraduate student nurses' gameful experience while playing an escape room game as part of a community health nursing course

Background: The integration of innovative strategies to teaching and learning in higher education, such as escape room games, can enhance the acquisition of key professional competencies including communication, teamwork and critical thinking. Objectives: This study aimed to evaluate undergraduate student nurses' gameful experience while playing an escape room game as part of a nursing course. Design: Cross-sectional descriptive study. Participants: A total of 126 third year student nurses enrolled in the “Community Health Nursing II” course. Method: The escape room game took place in a classroom at the Faculty of Health Ciences. The measures included the GAMEX scale in its Spanish version and a self-reported questionnaire to evaluate the student's outcome of scape room game immediately after the end of the activity. Results: The vast majority (99.21%) considered the escape room game to be an appropriate and an innovative teaching and learning strategy. The mean score for each of the GAMEX dimensions was over 3, with the exception of Absence of negative effects. Our results suggest that the students enjoyed playing the game (mean = 4.40; SD = 0.71), that escape room games should be integrated in nursing courses (mean = 4.54; SD = 0.74) and that playing the game increased their motivation for learning (mean = 3.06; SD = 1.09). Gender differences were observed in the GAMEX Dominance dimension (p < 0.005). Conclusion Gamification in general, and escape rooms in particular, have proven to be a valid tool for the acquisition of professional competencies in higher education

Translation and validation of the Mind-Wandering Test for Spanish adolescents

Abstract Background Working memory capacity and fluent intelligence influence cognitive capacity as a predictive value of success. In line with this, one matter appears, that of mind wandering, which partly explains the variability in the results obtained from the subjects who do these tests. A recently developed measure to evaluate this phenomenon is the Mind-Wandering Questionnaire (MWQ). Objective The objective of this work was to translate into Spanish the MWQ for its use with adolescents and to validate it and to analyze its relation with these values: self-esteem, dispositional mindfulness, satisfaction with life, happiness, and positive and negative affects. Methods A sample of 543 secondary students: 270 males (49.72%) and 273 females (50.28%) were used, who completed the questionnaire, and also did tests of self-esteem, dispositional mindfulness, satisfaction with life, happiness, and positive and negative effects. The transcultural adaptation process followed these steps: translation, back translation, evaluation of translations by a panel of judges, and testing the final version. Results Validity analyses were done of the construct (% explained variance = 52.1), and internal consistency was high (α = .766). The coefficients of correlation with the self-esteem, MASS, satisfaction with life, happiness, and affects scales confirmed the questionnaire’s validity, and a multiple regression analysis (R 2  = 34.1; model F = 24.19. p < 0.001) was run. Conclusions The Spanish version of the questionnaire obtained good reliability coefficients and its factorial structure reliably replicated that obtained by the original measure. The results indicate that the Spanish version of the MWQ is a suitably valid measure to evaluate the mind-wandering phenomenon