Regular physical activity is related to many factors in a university student's environment. The coronavirus pandemic and the resulting lockdown have restricted many elements of our environment. The ...aim of this study was to evaluate students' physical activity and sedentary behaviour at two points in time: before and during the coronavirus lockdown. As a secondary aim, we also wanted to look at changes resulting from other factors (alcohol, tobacco, diet, stages of change, symptoms of anxiety/depression and sociodemographic characteristics). We conducted an observational, cross-sectional, pre-post study with two cut-off points. Two hundred and thirteen students took part in the study. The main dependent variables were physical activity and sitting time, measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Parametric and non-parametric tests were used for paired and unpaired data, as well as group-stratified analysis. During lockdown, both weekly physical activity (MD: -159.87; CI: -100.44, -219.31) and weekly sitting time increased (MD: -106.76; CI: -71.85, -141.67). In the group analysis, differences were observed in relation to gender, year of study, BMI, alcohol consumption, tobacco use, symptoms of anxiety/depression, Mediterranean diet, living situation and stage of change. The results showed an increase in both physical activity and sitting time globally and by group.
•PTSD may be a significant mental health concern for pregnant and postpartum women. Onset of PTSD can precede pregnancy or occur during the perinatal period.•There is a relationship between PTSD and ...quality of life (QoL) as to the negative influence of PTSD on QoL. This fact implies the need to consider PTSD as a real problem that affects women's health and their surroundings.•We aimed to know the prevalence of PTSD at postpartum weeks 4–6, and its relation with not only perinatal practices and interventions, but also with QoL.•PTSD prevalence at postpartum weeks 4–6 is presented in 1 in every 10 women, and these women suffer a worse QoL.•The protective factors include: maternal age ≥35 years, multiparity, having a respected birth plan, using epidural analgesia and performing skin-to-skin contact with the newborn.
The relationship between obstetric variables and postpartum post-traumatic stress disorder (PTSD), and its influence on quality of life (QoL), have scarcely been studied.
Determine the prevalence of PTSD at postpartum weeks 4 and 6, and its relation with perinatal variables and quality of life
A cross-sectional study with 2990 Spanish puerperal women in Spain. Data were collected on socio-demographic and obstetric variables, and on newborns. An online ad hoc questionnaire was used, including the Perinatal Post-traumatic Stress Disorder Questionnaire (PPQ) and SF-36. The crude and adjusted odds ratios were estimated by binary logistic regression.
10.6% (318) of the women appeared at risk for PTSD symptoms. Factors like having a respected birth plan (aOR: 0.52; 95%CI: 0.34, 0.80), using epidural analgesia (aOR: 0.64; 95%CI: 0.44, 0.92) and performing skin-to-skin contact (aOR: 0.37; 95%CI: 0.28, 0.50) were protective factors against PTSD, among others. Instrumental birth (aOR: 2.50; 95%CI: 1.70, 3.69) and caesarean section (aOR: 3.79; 95%CI: 2.43, 5.92) were found to be risk factors, among others. The area under the ROC curve in this model was 0.79 (95%CI: 0.76, 0.81). The women with PTSD presented a mean difference for QoL of −13.37 points less than those without PTSD (95%CI: −11.08, −15.65).
The women with PTSD symptoms had a worse quality of life at postpartum weeks 4–6. Birth type, analgesia methods and humanising practices, like skin-to-skin contact and using respected birth plans, were related with presence of the postpartum PTSD risk.
Background
This study aimed to determine whether there is an association between clinical practices carried out during spontaneous vaginal birth (SVB), or clinical situations that arise during ...vaginal birth, and the incidence of post‐traumatic stress disorder (PTSD).
Methods
A cross‐sectional study with 839 puerperal women in Spain was conducted. The Perinatal Post‐traumatic Stress Disorder Questionnaire (PPQ) was administered online. The relationship between the risk of postpartum PTSD and various intrapartum complications was studied in addition to practices or procedures performed during the intrapartum period.
Results
PTSD (PPQ scores ≥19) was identified in 8.1% (68) of the women who participated. Among the risk factors for PTSD was a concerning intrapartum FHR tracing (adjusted OR: 2.24, 95% CI: 1.07‐4.66). Other intrapartum practices also put women at risk of PTSD, including the administration of an enema (aOR: 7.01, 95% CI: 2.14‐23.01), being required to stay lying down throughout the labor and birth (aOR: 5.75, 95% CI: 3.25‐10.19), artificial amniorrhexis without consent (aOR: 2.28, 95% CI: 1.31‐3.97), administration of synthetic oxytocin without consent (aOR: 2.18, 95% CI: 1.26‐3.77), fundal pressure during pushing (aOR: 3.14, 95% CI: 1.72‐5.73), repeated vaginal examinations performed by different people (aOR: 4.84, 95% CI: 2.77‐8.47), and manual removal of the placenta without anesthesia (aOR: 3.45, 95% CI: 1.81‐6.58).
Conclusions
Various intrapartum clinical practices, all related to dehumanized treatment, and intrapartum complications, were associated with an increased risk of PTSD. There is a need to eradicate obstetric mistreatment and to increase access to evidence‐informed, respectful care in Spain. Care practitioners need to better appreciate their roles in preventing PTSD.
We exploit the high versatility of the solvent ethylene glycol (eg = CH2OH-CH2OH) acting as a ligand with three different coordination modes: terminal (κO), chelate (κ2 O,O′), and bridge (1κO,2κO′) ...to prepare a novel family of six different coordination polymers with DyIII and three different anilato ligands (3,6-disubstituted-2,5-dihydroxy-1,4-benzoquinone dianion = C6O4X2 2–, with X = H, Cl, and Br). With the X = H derivative (dhbq2–), we have prepared Dy2(dhbq)3(eg)2(μ-eg)·4eg·2H2O (1), a 3D diamond-like network with a chelate and bridging eg molecules. With the X = Cl derivative (chloranilato), we have prepared Dy2(C6O4Cl2)3(eg)4·2eg·H2O (2) and Dy2(C6O4Cl2)3(μ-eg)(H2O)4·2eg·7H2O (3). Compound 2 has a 2D (6,3)-gon brick-wall lattice and contains a chelate and a terminal eg molecule. Compound 3 has a 3D diamond-like topology as 1, although now the chelate eg has been replaced by two water molecules. Finally, with the X = Br derivative (bromanilato), we have obtained Dy2(C6O4Br2)3(eg)2(CH3OH)2·2eg·4CH3OH (4), Dy2(C6O4Br2)3(eg)4·4eg (5), and Dy2(C6O4Br2)3(eg)3(H2O)·2eg·H2O (6). Compound 4 has a 2D (6,3)-gon herringbone topology and contains a chelate eg and a MeOH molecule. Compounds 5 and 6 have a 2D (6,3)-gon brick-wall topology with a chelate and a terminal eg molecules (in 5 and in one of the two independent Dy centers of 6). The other Dy center in 6 has a chelate eg and a water molecule. All the compounds show slow relaxation of the magnetization at low temperatures (in compounds 1, 2, and 5 with no applied DC field). The magnetization of compounds 1–6 relaxes through Orbach and direct mechanisms when a DC field is applied and through an Orbach and/or quantum tunneling mechanism when no DC field is applied.
Aim
To examine women's evaluations of quality of care from their perspectives.
Background
Assessing women's satisfaction with the quality of care they receive during childbirth is an important ...component of care quality that should be analysed. Evidence suggests that childbirth experience has an important impact on women's health. Therefore, taking into account the perceptions of women about quality is a means to improve care. However, studies examining care quality in this setting remain scarce.
Design
Mixed‐methods explanatory sequential design.
Methods
A national survey with a sample of 1082 participants, and 15 semi‐structured interviews. Data collection occurred between January 2017 and January 2019. Quantitative data were obtained through a validated scale, the Quality from the Patient's Perspective‐Intrapartal questionnaire, whose score can range from 1 (minimum satisfaction) to 4 (maximum satisfaction). Semi‐structured interviews were conducted for qualitative data. Descriptive statistics, group comparison and qualitative content analysis were included in data analysis.
Results
The mean score on the QPP‐I tool was high (3.13; SD 0.74). Variables that had the most influence on the experience were type of birth, type of perineal trauma, admission of the baby, time since birth, home‐birth, parity and duration of labour. Data from the qualitative interviews identified five themes that explained women's experiences with the quality of care. Previous expectations influence the emotions they have regarding the experience. Relationships with professionals and their social skills are fundamental for the evaluation of quality. The separation of the newborn appears as a factor that worsens the appreciation of women. Good pain management and continuity of care by specialists are also named as key elements of the quality of care.
Conclusion
Findings demonstrate that experience with childbirth care is of utmost importance for women. They also show the indisputable need to listen to their opinions and assessments when lines of improvement of quality are identified.
Impact
This study provides information that can improve the care that women receive during their childbirths. Using their opinions will make them feel an active part of the system and in this way, we will be closer to achieve excellence in our services.
The prevalence of poor sleep quality among students is very high and, in nursing students, has been associated with reduced performance, behavioral changes, dietary changes, and even aggressive ...behavior due to changes in sleep patterns. The lockdown in response to COVID-19 may have resulted in lifestyle changes that affected sleep quality. For this reason, the objective of this study is to determine the difference in nursing students' sleep quality before and during the lockdown, put in place in response to the coronavirus (COVID-19) pandemic. To meet this objective, we conducted a longitudinal observational study on 207 nursing students, with two cut-off points (February and April). The main dependent variable was sleep quality, measured using the Pittsburgh sleep quality index (PSQI) and its seven components. Parametric and nonparametric tests were used for paired and unpaired data, as well as group-stratified analysis. The mean time students spent in bed was 7.6 h (standard deviation (SD) = 1.1 h) before lockdown and 8.5 h (SD = 1.2 h) during lockdown. The PSQI score got 0.91 points worse during lockdown (95% CI, -0.51, -1.31). Of the five components, five were statistically significantly affected (
≤ 0.05), and of these, the most changed were sleep latency, sleep duration, and sleep efficiency. When stratified by group, we observed differences in women, first-year students, second-year students, alcohol consumers, those of normal weight, and those that live with family. The main conclusion is that although students spent more time in bed, overall sleep quality was worse during lockdown, as well as being worse in five of the seven components.
Aims and objectives
To investigate health‐related quality of life in a representative sample of adults with diabetes mellitus in Spain, as well as its clinical and sociodemographic determinants.
...Background
Diabetes mellitus is a chronic disease causing considerable morbidity and mortality worldwide, resulting in an impaired quality of life in affected people.
Design
A nationwide cross‐sectional study, based on an online survey and carried out between February–March 2016, was performed on diabetic subjects recruited through diabetic patients’ organisations.
Methods
A validated Spanish‐language version of the self‐administered Diabetes Quality of Life questionnaire was used, with 0 being the worst and 100 the best QoL level. Determinant factors of health‐related quality of life were assessed with the aid of multivariate analysis to control for confounding factors.
Results
The responses provided by 456 patients (52.4% being women) revealed an overall mean score of 66.4 ± 13.3. Social/vocational worries and diabetes‐related worries were the dimensions with the highest (74.3 ± 20.1) and lowest (61.1 ± 20.6) scores, respectively. Younger age, female gender, having no studies and poor glycaemic control were all independent determinants for an impaired overall health‐related quality of life, with most of these factors having a higher impact than the dimensions negative impact of therapy on daily life, satisfaction with therapy and diabetes‐related worries. Married (or equivalent) subjects had better scores in the diabetes‐related worries dimension. The perception of health‐related quality of life progressively worsens as glycaemic control deteriorates and with an increased number of disease complications. Most of the associations did not vary significantly with the type of diabetes mellitus.
Conclusion
Overall health‐related quality of life perception in the Spanish diabetic population is moderate and depends on several sociodemographic factors. Adequate glycaemic control to avoid disease complications improves perception.
Relevance to clinical practice
The results can help health professionals to develop strategies to promote diabetic patient self‐care, in order to improve the metabolic control of the disease and avoid its complications, as a therapeutic goal towards an improvement in health‐related quality of life perception.
Abstract
Background
Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain ...syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions.
Objective
Determine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women.
Material and methods
This observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated.
Results
One thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia.
Conclusions
The prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.
Influence of pelvic floor disorders on sexuality in women Martínez‐Galiano, Juan Miguel; Peinado‐Molina, Rocío Adriana; Martínez‐Vazquez, Sergio ...
International journal of gynaecology and obstetrics,
March 2024, 2024-Mar, 2024-03-00, 20240301, Letnik:
164, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Objective
To determine the association between different pelvic floor disorders and the presence of sexual dysfunction in women.
Method
An observational study of non‐pregnant women was carried out in ...Spain in 2021 and 2022. To assess the presence of pelvic floor problems, the Pelvic Floor Distress Inventory (PFDI‐20) was used, consisting of the subscales Pelvic Organ Prolapse Distress Inventory‐6 (POPDI‐6; prolapse symptoms), Colorectal‐Anal Distress Inventory (CRADI‐8; colorectal symptoms), and Urinary Distress Inventory‐6 (UDI‐6; urinary symptoms). The validated tool, Female Sexual Function (FSF), was used to evaluate female sexual function.
Results
In total, 1008 women participated. Of these, 288 (28.6%) had some type of sexual dysfunction. Regarding symptoms, 52 (5.2%) stated that they do not reach orgasm and 172 (17.1%) said they had never or occasionally felt sexual desire in the last month. Women with sexual dysfunctions had higher mean scores on the POPDI‐6, CRADI‐8, and UDI‐6 subscales than those who did not have sexual dysfunction (P ≤ 0.005). Risk factors identified included being postmenopausal, with an adjusted odds ratio (aOR) of 2.98 (95% confidence interval CI 2.12–4.18), and a greater impact of the symptoms of pelvic floor problems as assessed by the PFDI‐20 scale, in such a way that for each point increase the probability of sexual dysfunction increases with an aOR of 1.008 (95% CI 1.005–1.011).
Conclusion
Women with pelvic floor disorders and postmenopausal women present sexual dysfunction more frequently.
Synopsis
The high prevalence of sexual dysfunction in women associated with pelvic floor disorders is an important public health problem.
During the COVID-19 pandemic health crisis, in some countries such as Spain, nursing students have offered to provide health assistance, but the role they have played, their degree of preparedness to ...face the situation, and what must be improved in their training to be ready for these situations is unknown.
Describe the experience and perceptions of students of the Nursing university degree during their participation as health support in the COVID-19 health crisis in Spain.
We conducted a cross-sectional survey study.
503 students enrolled in the 4th course of the Nursing degree in Spain during the months of March and April 2020. An online questionnaire was developed, based on a pilot study and distributed through the Nursing Association, students' unions and students' associations. Variables were used to describe their participation, degree of preparedness and training needs to determine how to improve training through descriptive statistics, as well as nonparametric tests to analyse the relationship between training and degree of preparedness nursing students. Results are reported according to the STROBE Statement.
73.2% (368) of students offered to participate in healthcare aid, of which 225 were actively involved. 27.8% carried out nursing tasks without supervision, and 47.7% assisted COVID-19 patients as any other nurse. Only 3.4% felt very prepared to work in the field of intensive care, finding that those students who perceived a higher degree of preparedness had received previous training in personal protective equipment and mechanical ventilation (p < 0.005). The highest scores for training activities that may improve their preparedness were simulations to improve levels of anxiety and stress when managing critical patients, simulation in ventilatory support and mandatory practices in services where ventilators are used.
Although three out of four students were willing to provide health assistance, they recognise that they were not specially prepared in the field of intensive care and demand training with simulation to improve anxiety and stress levels in the management of critical patients and simulation in ventilatory support.
Students have been vital resources for our health system and society when they have been needed. It is now up to us, both teachers and health authorities, to share their efforts by implementing the necessary improvements in training and safety measures not only because these affects the health and safety of the patient, but because they will be essential parts in future pandemics.
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