Intervención psicoterapéutica grupal intensiva realizada en un entorno natural para el tratamiento del burnout en un equipo de enfermería oncológica

This pilot study aims to test the influence of a group psychotherapeutic intervention on stress and burnout in an oncology nursing team. The psychological intervention consisted of implementing a package for stress inoculation, mainly using cognitive-behavioral techniques. The intervention is carried out intensively, through the coexistence of the group for three days in an accommodation located in a natural mountain environment. We used a quasi-experimental design of two groups (experimental and control) with pre and post-treatment measures. The experimental group was composed of nine members of the nursing team that received the psychological treatment and the control group was composed of eleven professionals from other teams of oncology nursing. The dependent variables considered were, on one hand anxiety and depression (evaluated by the Hospital Anxiety and Depression Scale) and, on the other hand, emotional exhaustion, depersonalization, and personal fulfilment (evaluated by the Maslach Burnout Inventory). The experimental group improved significantly in anxiety (Z = -2.44, P = 0.015, d = 0.71), personal fulfilment (Z =-2.54, P= 0.011, d=-1.29) and emotional exhaustion (Z=-2.08; p=0.037; d=0.94) one month post -treatment. In the pre-treatment, The experimental group showed burnout levels higher than the control group, particularly with regard to the lack of personal personal fulfilment (U=14, P = 0.006, d = -1.61), mainly regarding the lack of personal fulfillment (U=14; p=0.006; d=-1.61). in fact the experimental group had requested psychological intervention. In fact, the experimental group had requested psychological intervention. After the therapeutic experience, the values of the dependent variables were equal in both groups. One year after the intervention, the treated group is still having a significant positive effect on the personal fulfilment (Z=-2.24; p=0.025; d=-1.15) and on the depersonalization (Z=-2.23; p=0.026; d=0.52). We conclude that an intensive program of group cognitive behavioral therapy in a natural setting outside the hospital can be an effective strategy of burnout treatment in oncology nurses.Este estudio piloto tiene como objetivo valorar la influencia que tiene la intervención psicoterapéutica grupal sobre el estrés y el burnout en un equipo de enfermería oncológica. La intervención psicológica consistió en la aplicación de un paquete para la inoculación al estrés, utilizando principalmente técnicas cognitivo-conductuales, llevándose a cabo de forma intensiva, a través de la convivencia del grupo durante tres días en un alojamiento situado en un entorno natural de montaña. Utilizamos un diseño cuasi-experimental de dos grupos (experimental y control) con medidas pre y post-tratamiento. El grupo experimental estaba compuesto por los nueve miembros del equipo de enfermería que recibió el tratamiento psicológico y el grupo control estuvo compuesto por once profesionales de otros equipos de enfermería oncológica. Las variables dependientes consideradas fueron, de un lado, ansiedad y depresión (evaluadas con la Escala Hospitalaria de Ansiedad y Depresión) y, de otro lado, cansancio emocional, despersonalización y realización personal (evaluadas con el Maslach Burnout Inventory). Los resultados muestran que transcurrido un mes de la intervención psicoterapéutica grupal, en el grupo de tratamiento se había producido una mejoría significativa de la ansiedad (Z=-2,44; p=0,015; d=0,71) y de la realización personal (Z=-2,54; p=0,011; d=-1,29), igualmente se produjo en este período un gran efecto positivo sobre el cansancio emocional (Z=-2,08; p=0,037; d=0,94). En el pre-tratamiento el grupo experimental manifestaba mayores signos de desgaste profesional que el grupo control, principalmente en lo referido a la falta de realización personal (U=14; p= 0,006; d=-1,61), de hecho había demandado la intervención psicológica. Tras la experiencia terapéutica se produjo una equiparación en los valores de las variables dependientes consideradas entre los grupos, respecto a la situación pre-tratamiento. Al año de la intervención, en el grupo tratado sigue habiendo un efecto positivo importante sobre la realización personal (Z=-2,24; p=0,025; d=-1,15) y sobre la despersonalización (Z=-2,23; p=0,026; d=0,52). Concluimos que el tratamiento cognitivo-conductual grupal, intensivo realizado en un medio natural, ajeno al hospital, puede tener notables ventajas para el tratamiento del desgaste profesional en personal de enfermería oncológica

Intensive group psychotherapy intervention in a natural environment for the treatment of burnout in an oncology nursing team

This pilot study aims to test the influence of a group psychotherapeutic intervention on stress and burnout in an oncology nursing team. The psychological intervention consisted of implementing a package for stress inoculation, mainly using cognitive-behavioral techniques. The intervention is carried out intensively, through the coexistence of the group for three days in an accommodation located in a natural mountain environment. We used a quasi-experimental design of two groups (experimental and control) with pre and post-treatment measures. The experimental group was composed of nine members of the nursing team that received the psychological treatment and the control group was composed of eleven professionals from other teams of oncology nursing. The dependent variables considered were, on one hand anxiety and depression (evaluated by the Hospital Anxiety and Depression Scale) and, on the other hand, emotional exhaustion, depersonalization, and personal fulfilment (evaluated by the Maslach Burnout Inventory). The experimental group improved significantly in anxiety (Z = -2.44, P = 0.015, d = 0.71), personal fulfilment (Z =-2.54, P= 0.011, d=-1.29) and emotional exhaustion (Z=-2.08; p=0.037; d=0.94) one month post -treatment. In the pre-treatment, The experimental group showed burnout levels higher than the control group, particularly with regard to the lack of personal personal fulfilment (U=14, P = 0.006, d = -1.61), mainly regarding the lack of personal fulfillment (U=14; p=0.006; d=-1.61). in fact the experimental group had requested psychological intervention. In fact, the experimental group had requested psychological intervention. After the therapeutic experience, the values of the dependent variables were equal in both groups. One year after the intervention, the treated group is still having a significant positive effect on the personal fulfilment (Z=-2.24; p=0.025; d=-1.15) and on the depersonalization (Z=-2.23; p=0.026; d=0.52). We conclude that an intensive program of group cognitive behavioral therapy in a natural setting outside the hospital can be an effective strategy of burnout treatment in oncology nurses

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Puesta en marcha del Doble Grado Internacional en Derecho UCM - Sorbona en el marco de la alianza europea de universidades UNA EUROPA

Implementación de mejoras que potencien el Doble Grado Internacional en Derecho impartido conjuntamente entre la UCM y la Universidad de la Sorbona y que esta doble titulación internacional refuerce el papel de la UCM en la alianza europea UNA EUROP

Manual de atención sanitaria a inmigrantes : guía para profesionales de la salud

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales: www.juntadeandalucia.es/salud (Consejería de Igualdad, Salud y Políticas Sociales / Profesionales / Salud Pública / Promoción de la Salud / Material Publicado para Inmigrantes)YesEsta publicación enmarcada en el II Plan Integral para la Inmigración de Andalucía (2006-2009), tiene como objetivo servir de instrumento de apoyo a la labor que en este ámbito realizan los profesionales sanitarios. Al objetivo de la integración se suma ahora la necesidad de potenciar la convivencia intercultural de las personas inmigrantes, lo que requiere la puesta en marcha de actuaciones desde una vertiente socio-sanitaria que posibiliten ofrecer una asistencia integral en distintos ámbitos: la familia, la salud reproductiva de la mujer, la salud de los niños, niñas, adolescentes y jóvenes, las situaciones especiales de la segunda generación, la atención a los problemas de salud mental derivados de la adaptación cultural, etc

Implementación y ordenación de las relaciones internacionales e institucionales y de las medidas de aseguramiento de la calidad del Doble Grado en Derecho y Estudios Jurídico Militares

DecanatoFac. de DerechoFALSEsubmitte

Role of age and comorbidities in mortality of patients with infective endocarditis.

The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups: A total of 3120 patients with IE (1327  There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in th

Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis—The ESCAPE Study

International audienceBackground: Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.Methods: We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.Results: Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients <66 years old and without cardiac failure were more likely to undergo cardiac surgery (adjusted odds ratios [aORs], 6.80 [95% confidence interval [CI], 1.59-29.13] and 10.92 [1.15-104.06], respectively). Surgery was not associated with better survival rates at 6 months. Patients who received L-amB alone had a better 6-month survival rate than those who received an echinocandin alone (aOR, 13.52; 95% CI, 1.03-838.10). "Maintenance" fluconazole therapy, prescribed in 21 patients for a median duration of 13 months (range, 2-84 months), led to minor adverse effects.Conclusion: L-amB induction treatment improves survival in patients with PVE-C. Medical treatment followed by long-term maintenance fluconazole may be the best treatment option for frail patients

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective