NECESIDADES Y PROBLEMAS DE LAS PERSONAS CUIDADORAS FAMILIARES DE MAYORES CON DEMENCIA/ENFERMEDAD DE ALZHEIMER: UN ESTUDIO CUALITATIVO

Objetivos: Identificar, clasificar y analizar las necesidades y problemas percibidos por las personas cuidadoras familiares de mayores con demencia durante el proceso del cuidado. Metodología: Estudio cualitativo de teoría fundamentada constructivista. Se realizaron siete grupos focales. Participaron 82 personas cuidadoras principales familiares de mayores con demencia, seleccionadas por muestreo propositivo de máxima variación y teórico. Resultados: Se identificaron necesidades percibidas por las personas cuidadoras relacionadas con el manejo de los cuidados del familiar con demencia y con el manejo de su propia vida. Se constató que la persona cuidadora desempeña su rol en una realidad caracterizada por el cambio; el reto adaptativo está en el balance entre los problemas que dificultan la adaptación a los cambios de la persona cuidadora y los factores que facilitan su labor cuidadora. Conclusión: Las necesidades percibidas por las personas cuidadoras familiares son complejas, cambiantes y están interrelacionadas. Además, el proceso de adaptación de las personas cuidadoras de familiares con demencia podría mejorar mediante un mayor apoyo formal en las primeras fases del cuidado y con la adaptación de las intervenciones a cada fase de la evolución del rol cuidador.Aim: To identify, classify and analyse caregivers’ of elderly people with dementia perceived needs and problems among the care process. Methods: Qualitative study based on constructivist grounded theory. Seven focus groups were conducted. Eighty-two primary family caregivers of relatives with dementia participated by purposeful maximum variation sampling and theoretical sampling. Results: It was identified needs perceived by family caregivers related to the management in caring for the relative with dementia and related to the management of the caregivers’ own cares. Family caregivers perform their role in a context characterized by personal change; the challenge of adaptation lies in the balance between the problems that hamper adaptation to the changes of the caregiver and the factors that facilitate the caregiver role Conclusion: The needs perceived by family caregivers are complex, changable, and interrelated. In addition, the adaptation of family caregivers to caring for a person with dementia could be improved by strengthening formal support in the early stages of care and by interventions adapted to each phase in the development of the caregiver role.Tesis Univ. Jaén. Departamento de Enfermería. Leída el 13 de junio de 2017

Problemas en el proceso de adaptación a los cambios en personas cuidadoras familiares de mayores con demencia

ResumenObjetivoIdentificar y analizar los problemas que surgen en el proceso de adaptación de la persona cuidadora a los cambios durante el cuidado familiar a una persona afectada por demencia.MétodoEstudio cualitativo basado en la metodología de la teoría fundamentada constructivista de Charmaz. Se realizaron siete grupos focales en diferentes centros de atención primaria de salud en la provincia de Jaén (España). Participaron 82 personas cuidadoras principales familiares de mayores con demencia, seleccionadas por muestreo propositivo de máxima variación y teórico. Se llevó a cabo una triangulación del análisis para favorecer la validez interna del estudio.ResultadosSe obtuvieron tres categorías centrales, que fueron «Cuidados cambiantes», «Problemas en el proceso de adaptación a los cambios» y «Factores facilitadores del proceso de adaptación a los cambios». La persona cuidadora desempeña su rol en una realidad caracterizada por el cambio, tanto personal como de la persona a la que cuida y su contexto social y cultural. El reto adaptativo está en el balance entre los problemas que dificultan la adaptación a los cambios de la persona cuidadora a las nuevas situaciones de cuidado y los factores que facilitan su labor cuidadora.ConclusionesLa escasez de apoyo formal y el infradiagnóstico de la demencia dificultan la adaptación de la persona cuidadora al cuidado de una persona afectada por demencia. El proceso de adaptación podría mejorar reforzando el apoyo formal en las primeras fases del cuidado para reducir el estrés del proceso de aprendizaje autodidacta de las familias cuidadoras, así como adaptando las intervenciones a cada fase de la evolución del rol cuidador.AbstractObjectiveTo identify and analyse problems in adapting to change among the family caregivers of relatives with dementia.MethodQualitative study based on the methodology of Charmaz's Constructivist Grounded Theory. Seven focus groups were conducted in different primary health care centres in the province of Jaen (Spain). Eighty-two primary family caregivers of relatives with dementia participated by purposeful maximum variation sampling and theoretical sampling. Triangulation analysis was carried out to increase internal validity.ResultsWe obtained three main categories: ‘Changing Care’, ‘Problems in the process of adapting to change’ and ‘Facilitators of the process of adapting to change’. Family caregivers perform their role in a context characterized by personal change, both in the person receiving the care and in the social and cultural context. The challenge of adaptation lies in the balance between the problems that hamper adaptation of the caregiver to new situations of care and the factors that facilitate the caregiver role.ConclusionsThe adaptation of family caregivers to caring for a person with dementia is hindered by the lack of formal support and under-diagnosis of dementia. The adaptation process could be improved by strengthening formal support in the early stages of care to reduce the stress of family caregivers who must teach themselves about their task and by interventions adapted to each phase in the development of the caregiver role

Implicación de la matriz extracelular de Bacillus subtilis en la interacción beneficiosa con la planta

Bacillus subtilis es una bacteria Gram-positiva comúnmente presente en los suelos. Algunos aislados de esta especie son capaces de promover el crecimiento en plantas (actividad PGPR, del inglés plant growth promoting rhizobacteria) y de contribuir al control de diferentes enfermedades microbianas mediante la producción de una amplia batería de metabolitos secundarios con actividad antimicrobiana y la inducción de los mecanismos de defensa de la planta. Todo ello ocurre en el contexto de una eficiente colonización y persistencia sobre la raíz, la cual se cree estar asociada a la formación de biofilms: comunidades bacterianas donde las células están englobadas en una matriz extracelular de producción propia y compuesta principalmente por proteínas y exopolisacáridos. Estudios previos han demostrado que la surfactina, uno de los metabolitos secundarios producidos por esta bacteria, está involucrada en la cascada de señalización que dispara la formación del biofilm así como en la comunicación con la planta. Esta observación conduce a plantear la hipótesis de que alguno de los metabolitos secundarios u otros componentes estructurales de la matriz extracelular pueden ser mediadores de la comunicación bacteria-semilla y tener relevancia en la actividad PGPR. En este trabajo se evalúa el papel que los distintos componentes estructurales y metabolitos secundarios presentes en la matriz extracelular de B. subtilis puedan tener en la promoción de la germinación de semillas. Valiéndonos de una batería de mutantes en dichos elementos, realizamos ensayos de bacterización de semillas para estudiar posteriormente los patrones de colonización y persistencia bacteriana en la rizosfera y el efecto sobre la actividad PGPR. Los resultados obtenidos hasta la fecha sugieren que la molécula fengicina y la proteína TasA pueden ser claves en esta función de B. subtilis

Risk thresholds for alcohol consumption : combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

Background Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease. Methods We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose-response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12.5 units per week) across 83 prospective studies, adjusting at least for study or centre, age, sex, smoking, and diabetes. To be eligible for the analysis, participants had to have information recorded about their alcohol consumption amount and status (ie, non-drinker vs current drinker), plus age, sex, history of diabetes and smoking status, at least 1 year of follow-up after baseline, and no baseline history of cardiovascular disease. The main analyses focused on current drinkers, whose baseline alcohol consumption was categorised into eight predefined groups according to the amount in grams consumed per week. We assessed alcohol consumption in relation to all-cause mortality, total cardiovascular disease, and several cardiovascular disease subtypes. We corrected HRs for estimated long-term variability in alcohol consumption using 152 640 serial alcohol assessments obtained some years apart (median interval 5.6 years [5th-95th percentile 1.04-13.5]) from 71 011 participants from 37 studies. Findings In the 599 912 current drinkers included in the analysis, we recorded 40 310 deaths and 39 018 incident cardiovascular disease events during 5.4 million person-years of follow-up. For all-cause mortality, we recorded a positive and curvilinear association with the level of alcohol consumption, with the minimum mortality risk around or below 100 g per week. Alcohol consumption was roughly linearly associated with a higher risk of stroke (HR per 100 g per week higher consumption 1.14, 95% CI, 1.10-1.17), coronary disease excluding myocardial infarction (1.06, 1.00-1.11), heart failure (1.09, 1.03-1.15), fatal hypertensive disease (1.24, 1.15-1.33); and fatal aortic aneurysm (1.15, 1.03-1.28). By contrast, increased alcohol consumption was loglinearly associated with a lower risk of myocardial infarction (HR 0.94, 0.91-0.97). In comparison to those who reported drinking >0-100-200-350 g per week had lower life expectancy at age 40 years of approximately 6 months, 1-2 years, or 4-5 years, respectively. Interpretation In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data support limits for alcohol consumption that are lower than those recommended in most current guidelines. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Evaluating Satisfaction and Self-Confidence among Nursing Students in Clinical Simulation Learning

Background: Clinical simulation is effective in nursing student education, fostering autonomous learning and critical skill development in safe environments. This method is adaptable to dynamic educational approaches and integrates technology. Satisfaction and self-confidence are key elements in its evaluation. The general objective of this research was to describe the levels of satisfaction and self-confidence among undergraduate nursing students regarding the use of clinical simulation in the field of family and community nursing. Methods: A cross-sectional descriptive study was conducted at the University of Jaén, Spain, during the 2023/2024 academic year. Data on sociodemographic aspects, satisfaction, and self-confidence were collected using a validated instrument. The statistical analysis included central measures, dispersion, and frequencies, with confidence intervals. Results: The study involved 96 students in scenario 1 (family assessment) and 97 in scenario 2 (family intervention), with the majority being women. In scenario 1, the mean satisfaction score was 4.38 out of 5, and self-confidence was scored 4.44 out of 5. Prior preparation time correlated significantly with higher levels of satisfaction and self-confidence. In scenario 2, the mean scores were slightly higher but not statistically significant. Conclusions: Our study demonstrated high levels of satisfaction and self-confidence among nursing students following clinical simulations. Prior preparation was associated with better outcomes, and the quality of the simulation positively impacted the results

Association between Sense of Coherence Associated with Mental Health in Caregivers of Older Adults.

The purpose of this study was to analyze association between sense of coherence and perceived burden, anxiety, depression, and quality of life in caregivers of older adults. A cross-sectional study was carried out with a probabilistic sample of 132 caregivers of older relatives from the regions of Jaén, Spain. The measures assessed were sense of coherence (Life Orientation Questionnaire), subjective burden (Caregiver Strain Index of Robinson), anxiety and depression (Goldberg Scale), and quality of life (Health Questionnaire SF-12). The main analyses included bivariate analysis using Pearson's correlation coefficient and multivariate analysis through canonical correlation analysis. Our findings show that the sense of coherence explained 50.8% of the variance shared between subjective burden, anxiety, depression, and quality of life. We highlighted manageability as the variable within the dimensions of the sense of coherence with the greatest participation in the model. The sense of coherence may be an important protective factor for the mental health of the caregiver of dependent elderly relatives

Coping and Anxiety in Caregivers of Dependent Older Adult Relatives

The aim of this study was to analyze the relationship between coping and anxiety in caregivers of dependent older adult relatives. A cross-sectional study was carried out in the province of Jaén (Andalusia, Spain). The convenience sample consisted of 198 family caregivers of dependent older adults. The main measurements were anxiety (Hamilton scale), coping (Brief COPE), subjective burden (Caregiver Strain Index), objective burden and sex of the caregiver. The main analyses were bivariate analysis using the Pearson correlation coefficient, and multivariate analysis using multiple linear regression. An independent regression model was developed for anxiety and each type of coping, adjusting for sex, subjective burden and objective burden. Our results demonstrate that anxiety was negatively associated with planning (partial r = −0.18), acceptance (partial r = −0.22) and humor (partial r = −0.20), and it was positively associated with self-distraction (partial r = 0.19), venting (partial r = 0.22), denial (partial r = 0.27) and self-blame (partial r = 0.25). Planning, acceptance and humor coping strategies may be protective factors of anxiety. Strategies such self-management, relief, denial and self-blame may be risk factors for anxiety

Burden and Anxiety in Family Caregivers in the Hospital That Debut in Caregiving.

This cross-sectional study aims to determine the level of subjective burden and anxiety of caregivers of dependent older relatives that start providing care in the hospital and to analyse the relationship between objective burden, subjective burden and anxiety in these caregivers. Seventy-two caregivers of dependent older relatives were recruited in a medium-long stay hospital. Sociodemographic variables, number of basic activities of daily living (ADLs) attended, hours of surveillance, burden, and anxiety were collected from caregivers. A trajectory analysis was used to analyse the relationship between variables. Of the caregivers, 36.1% had subjective burden and 14.9% had anxiety. Subjective burden was positively associated with the number of basic ADLs attended, the hours of surveillance, and the cognitive impairment of the care recipient. Anxiety was also positively associated with subjective burden. Subjective burden mediated the effects of the number of basic ADLs attended, hours of surveillance and the cognitive impairment of the care recipient on anxiety. The levels of subjective burden and anxiety in caregivers debuting in hospital care are elevated, showing the need for these caregivers to be cared for. Subjective burden is a possible risk factor for anxiety, independent of the objective burden; it may buffer the effects of objective burden on anxiety