Assessment of Nursing Care and Teaching: A Qualitative Approach Martínez-Linares, Jose Manuel; Martínez-Yébenes, Rocío; Andújar-Afán, Francisco Antonio ...
International journal of environmental research and public health,
08/2019, Letnik:
16, Številka:
15
Journal Article
Recenzirano
Odprti dostop
The reform of the Spanish higher education to adapt to the European Higher Education Area involves, among other issues, the students' participation in the curriculum assessment. The aim is to ...understand the insights of both nursing professionals and current undergraduate students of nursing on the connection between the knowledge acquired throughout the degree and the professional healthcare practice.
An exploratory, descriptive qualitative study was carried out at a Spanish University. By convenience sampling, twelve nursing professionals and twelve 4th-year students of the Degree in Nursing were included. In two phases, twelve semi-structured interviews and two focus groups were conducted in order to triangulate data. A thematic analysis of data was carried out, later to be coded by two researchers.
Two main themes were identified: Evidence-based nursing vs. experience-based nursing, and a theory-practice gap. The topics that were specifically highlighted were the coexistence between professionals who work according to evidence and those whose work is based on experience, and the lack of connection between the training received during the degree and actual healthcare practice.
Nursing care work varies in terms of the implementation of evidence-based care. Nursing training is perceived as being affected by a theory-practice gap. To achieve the linking between nursing theory and practice, a great effort on stakeholders would be needed.
Longevity and population growth generate an increase in the number of people with dependency, who require homecare assistance to meet their health needs. Homecare support workers provide this care in ...Spain, and they may have unique insights into the unmet health needs of those receiving homecare assistance. The aim of this study was to determine the unmet health needs of people with dependency based on the perspective of homecare support workers.
Qualitative exploratory-descriptive study. Through convenience sampling, homecare support workers from a Spanish province were selected, following inclusion and exclusion criteria. Four focus groups, transcription and thematic analyses were performed using Atlas.ti. Coding triangulation was carried out, applying criteria for scientific rigour.
The six themes obtained were classified into the material, psychoemotional, socioeconomical and psychosocial needs of people with dependency from the point of view of homecare support workers, along with the contributions of improvements and the need of these professionals for continuous training.
People with dependency need complex technical assistance, materials, psychological attention due to their situation, and more effective assessments of their health and disability status. Homecare support workers perceive themselves to be essential in these assessments. They ask for psychological assistance, due to the emotional burden of their work, and believe this help would contribute to improving the quality of their service. Homecare support workers perceive that they are capable of performing their job, although they believe that some delegated activities are beyond their levels of competency.
Increased body weight is a major factor that interferes with smoking cessation. Nicotine, the main bioactive compound in tobacco, has been demonstrated to have an impact on energy balance, since it ...affects both feeding and energy expenditure at the central level. Among the central actions of nicotine on body weight, much attention has been focused on its effect on brown adipose tissue (BAT) thermogenesis, though its effect on browning of white adipose tissue (WAT) is unclear. Here, we show that nicotine induces the browning of WAT through a central mechanism and that this effect is dependent on the κ opioid receptor (KOR), specifically in the lateral hypothalamic area (LHA). Consistent with these findings, smokers show higher levels of uncoupling protein 1 (UCP1) expression in WAT, which correlates with smoking status. These data demonstrate that central nicotine-induced modulation of WAT browning may be a target against human obesity.
Common variable immunodeficiency (CVID) constitutes a heterogenic group of primary immunodeficiency disorders with a wide-ranging clinical spectrum. CVID-associated non-infectious morbidity ...constitutes a major challenge requiring a full understanding of its pathophysiology and its clinical importance and global variability, especially considering the broad clinical, genetic, and regional heterogeneity of CVID disorders. This work aimed to develop a nationwide, multicenter, retrospective study over a 3-year period describing epidemiological, clinical, laboratory, therapeutic, and prognostic features of 250 CVID patients in Spain. The mean diagnostic delay was around 10 years and most patients initially presented with infectious complications followed by non-infectious immune disorders. However, infectious diseases were not the main cause of morbimortality. Non-infectious lung disease was extraordinarily frequent in our registry affecting approximately 60% of the patients. More than one-third of the patients in our cohort showed lymphadenopathies and splenomegaly in their follow-up, and more than 33% presented immune cytopenias, especially Evans’ syndrome. Gastrointestinal disease was observed in more than 40% of the patients. Among biopsied organs in our cohort, benign lymphoproliferation was the principal histopathological alteration. Reaching 15.26%, the global prevalence of cancer in our registry was one of the highest reported to date, with non-Hodgkin B lymphoma being the most frequent. These data emphasize the importance of basic and translational research delving into the pathophysiological pathways involved in immune dysregulation and diffuse lymphocytic infiltration. This would reveal new tailored strategies to reduce immune complications, and the associated healthcare burden, and ensure a better quality of life for CVID patients.
: The reform of the Spanish higher education studies from the Bologna Declaration did not entail the necessary changes in the teaching methodologies used. The clinical preceptor emerged as the main ...guiding professional in the practical training of nursing students. The aim of this qualitative study was to understand fourth-year nursing students' and newly qualified nurses' (NQNs) perception on their lecturers' and clinical preceptors' effectiveness.
: Exploratory, descriptive qualitative study was carried out at a Spanish University. By convenience sampling and according to defined inclusion and exclusion criteria, twelve newly qualified nurses and twelve fourth-year students of the Degree in Nursing were included in order to contrast the results. A thematic analysis of data was carried out, to later be coded by two researchers.
: Two main themes were identified: the good lecturer and the good clinical preceptor, with several subthemes in each. These included the characteristics that both should have, both in teaching, nursing and interpersonal-relation skills.
: The need of preceptorship training programs has been highlighted in our context. Educators all over the world should be properly qualified in order to train and educate competent nurses for the future.
Assuring quality training for future nursing professionals is essential to preserving population health and socio-economic development. Quality assurance in the European Higher Education Area places ...students in a leading role to transform and improve higher education programs. Therefore, an innovative way of reviewing strengths and weaknesses of the nursing education program of a Spanish university has been developed.
The aim of this paper was to explore the perceptions and opinions of nursing students and newly-qualified nurses regarding the contents of the nursing curriculum in order to improve its quality.
Descriptive and exploratory qualitative research was carried out involving 12 newly-qualified nurses and 12 student nurses. Semi-structured interviews and focus groups were performed.
Based on the thematic analysis, two themes emerged: improving clinical practices and reviewing the theoretical curriculum.
Among the improvements suggested by the participants, the most relevant ones were establishing a clear structure of learning contents in the practicum, and redistributing the European Credit Transfer and Accumulation System ECTS credits in various courses of the study program. However, additional evidence is needed prior to proceeding with any changes.
: After implementing the Tuning Educational Structures in Europe Project, numerous efforts have been made to define, establish, and evaluate nursing competences. The European Federation of Nurses ...Association played a key role in enacting the nursing competences included in Directive 2013/55/EU. Nevertheless, assessing competences remains elusive, and there is little research into nurses' perceptions of the competency training provided by their universities. The purpose of the study was to explore the perceptions and experiences of newly qualified nurses about the competences they acquired during their university education.
: A qualitative research study was developed in a Spanish university. Twelve semi-structured interviews with newly qualified nurses were conducted, and two focus groups made up of twelve students were carried out in order to triangulate the results. Participants were recruited through email contact. Interviews focused on clinical training, theoretical content, and the reality of healthcare. Data was analyzed thematically.
: Two main themes emerged: (1) improving theoretical content and (2) rethinking practical lessons and clinical training. A lack of knowledge about mental health, pharmacology, or critical care has been found; in addition, it was highlighted, among others, the need to improve communication skills in difficult and conflictive situations.
: Considering the participants' perception of deficiency in some aspects of most of the competences established by the European Federation of Nurses Association, further research has been suggested to include other stakeholders' views.
A multidisciplinary approach and Doppler ultrasound (DU) assessment for the creation and maintenance of arteriovenous fistulas (AVF) for haemodialysis can improve prevalence and patency. The aim of ...this study was to analyse the impact of a new multidisciplinary vascular access (VA) clinic with routine DU.
We analysed the VA clinic results from 2014 and 2015, before and after the implementation of a multidisciplinary team protocol (vascular surgeon/nephrologist) with routine DU in preoperative mapping and prevalent AVF.
We analysed 345 and 364 patients from 2014 and 2015 respectively. The number of surgical interventions was similar in both periods (p=.289), with a trend towards an increase in preventive surgical repair of AVF in 2015 (17 vs. 29, p=.098). 155 vs. 169 new AVF were performed in 2014 and 2015, with a significantly lower primary failure rate in 2015 (26.4 vs. 15.3%, p=.015), and a non-significant increase in radiocephalic AVF, 25.8 vs. 33.2% (n=40 vs. 56), p=.159. The concordance between the indication at the clinic and the surgery performed also increased (81.3 vs. 93.5%, p=.001). Throughout 2015 fewer complementary imaging test were requested from the clinic (78 vs. 35, p <.001), with a corresponding reduction in costs (€87,716 vs. €59,445).
Multidisciplinary approach with routine DU can improve VA results, with a decrease in primary failure rate, higher likelihood of radiocephalic AVF, better management of dis-functioning AVF and lower radiological test costs.
Heat Adaptation among the Elderly in Spain (1983-2018) Navas-Martín, Miguel Ángel; López-Bueno, José Antonio; Ascaso-Sánchez, María Soledad ...
International journal of environmental research and public health,
01/2023, Letnik:
20, Številka:
2
Journal Article
Recenzirano
Odprti dostop
The capacity for adaptation to climate change is limited, and the elderly rank high among the most exposed population groups. To date, few studies have addressed the issue of heat adaptation, and ...little is known about the long-term effects of exposure to heat. One indicator that allows the ascertainment of a population's level of adaptation to heat is the minimum mortality temperature (MMT), which links temperature and daily mortality. The aim of this study was to ascertain, firstly, adaptation to heat among persons aged ≥ 65 years across the period 1983 to 2018 through analysis of the MMT; and secondly, the trend in such adaptation to heat over time with respect to the total population. A retrospective longitudinal ecological time series study was conducted, using data on daily mortality and maximum daily temperature across the study period. Over time, the MMT was highest among elderly people, with a value of 28.6 °C (95%CI 28.3-28.9) versus 28.2 °C (95%CI 27.83-28.51) for the total population, though this difference was not statistically significant. A total of 62% of Spanish provinces included populations of elderly people that had adapted to heat during the study period. In general, elderly persons' level of adaptation registered an average value of 0.11 (°C/decade).
The continuous increase of people with chronic diseases is one of the greatest challenges for healthcare systems worldwide. Population growth and life expectancy means that an increasing number of ...people with chronic diseases and dependency need some kind of assistance to meet their needs. Determining these subjective unmet needs helps to understand the situation of these people. The aim of this study was to explore the perceptions of chronic patients over 65 years of age from the day-care center toward subjective health needs that are not being met by the socio-health system.
Qualitative exploratory-descriptive study. Through convenience sampling, we selected people with chronic diseases and dependency who used day-care centers and met the inclusion criteria. Focus groups were performed. The data were transcribed and a thematic analysis was carried out using Atlas.ti software.
The topics resulting from the analysis were classified into dissatisfaction of biological/physiological needs, psychological needs, social needs, and other issues that arose in both groups of participants which referred to the types of needs previously indicated. The issues related to social and psycho-social needs stood out.
People with chronic diseases and dependency have their physiological needs covered with the help they receive, but their situation of dependency generates additional costs that worsen their economic situation. However, their greatest need is due to the loneliness they feel and the feeling they have of "being a burden" on their families.
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