Abstract
Health-care workers (HCWs) are at the frontline of response to coronavirus disease 2019 (COVID-19), being at a higher risk of acquiring the disease and, subsequently, exposing patients and ...others. Searches of 8 bibliographic databases were performed to systematically review the evidence on the prevalence, risk factors, clinical characteristics, and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among HCWs. A total of 97 studies (all published in 2020) met the inclusion criteria. The estimated prevalence of SARS-CoV-2 infection from HCWs’ samples, using reverse transcription–polymerase chain reaction and the presence of antibodies, was 11% (95% confidence interval (CI): 7, 15) and 7% (95% CI: 4, 11), respectively. The most frequently affected personnel were nurses (48%, 95% CI: 41, 56), whereas most of the COVID-19–positive medical personnel were working in hospital nonemergency wards during screening (43%, 95% CI: 28, 59). Anosmia, fever, and myalgia were the only symptoms associated with HCW SARS-CoV-2 positivity. Among HCWs positive for COVID-19 by reverse transcription–polymerase chain reaction, 40% (95% CI: 17, 65) were asymptomatic at time of diagnosis. Finally, severe clinical complications developed in 5% (95% CI: 3, 8) of the COVID-19–positive HCWs, and 0.5% (95% CI: 0.02, 1.3) died. Health-care workers suffer a significant burden from COVID-19, with those working in hospital nonemergency wards and nurses being the most commonly infected personnel.
Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to evaluate ...biomarkers of anemia and iron metabolism (hemoglobin, ferritin, transferrin, soluble transferrin receptor, hepcidin, haptoglobin, unsaturated iron-binding capacity, erythropoietin, free erythrocyte protoporphyrine, and erythrocyte indices) in patients diagnosed with COVID-19, and explored their prognostic value. Six bibliographic databases were searched up to August 3rd 2020. We included 189 unique studies, with data from 57,563 COVID-19 patients. Pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 129.7 g/L (95% Confidence Interval (CI), 128.51; 130.88) and 777.33 ng/mL (95% CI, 701.33; 852.77), respectively. Hemoglobin levels were lower with older age, higher percentage of subjects with diabetes, hypertension and overall comorbidities, and admitted to intensive care. Ferritin level increased with older age, increasing proportion of hypertensive study participants, and increasing proportion of mortality. Compared to moderate cases, severe COVID-19 cases had lower hemoglobin weighted mean difference (WMD), − 4.08 g/L (95% CI − 5.12; − 3.05) and red blood cell count WMD, − 0.16 × 10
12
/L (95% CI − 0.31; − 0.014), and higher ferritin WMD, − 473.25 ng/mL (95% CI 382.52; 563.98) and red cell distribution width WMD, 1.82% (95% CI 0.10; 3.55). A significant difference in mean ferritin levels of 606.37 ng/mL (95% CI 461.86; 750.88) was found between survivors and non-survivors, but not in hemoglobin levels. Future studies should explore the impact of iron metabolism and anemia in the pathophysiology, prognosis, and treatment of COVID-19.
ObjectiveTo compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries.DesignA realist ...review.Data sourcesEmbase, PubMed, Dimensions ai and Google Scholar.SettingHigh-income countries.DefinitionsWe defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021.ResultsWe included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited.ConclusionOur review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.
The aim of the study is to evaluate the cross-sectional and longitudinal association of early natural menopause with changes in cardiovascular risk factors (CVRFs).
Postmenopausal women from the ...Swiss CoLaus study, reporting age at natural menopause (ANM) and having CVRFs measurements (blood lipids, blood pressure, glucose, homeostatic model assessment for insulin resistance HOMA-IR, and inflammatory markers) at baseline (2003-2006) and first follow-up (2009-2012) were eligible for analysis. Age at natural menopause was analyzed as a continuous variable and in categories (ANM <45 and ≥45 y old). Linear regression analysis and linear mixed models were used to assess whether ANM is associated cross-sectionally and longitudinally with changes in CVRFs. Models were adjusted for demographic characteristics, lifestyle-related factors, time since menopause, medication, and clinical conditions.
We analyzed 981 postmenopausal women. The cross-sectional analysis showed that women with ANM younger than 45 years had lower diastolic blood pressure (β = -3.76 mm Hg; 95% confidence interval CI = -5.86 to -1.65) compared with women whose ANM was 45 years or older. In the longitudinal analysis, ANM younger than 45 years was associated with changes in log insulin (β = 0.26; 95% CI = 0.08 to 0.45) and log homeostatic model assessment for insulin resistance levels (β = 0.28; 95% CI = 0.08 to 0.48). No associations were found between ANM and other CVRFs.
Early menopause may be associated with changes in glucose metabolism, while it may have little to no impact on other CVRFs. Larger longitudinal studies are needed to replicate our findings.
Introducción: La hipertensión y la diabetes mellitus son enfermedades crónicas que representan una importante carga tanto económica como social. El manejo de estas patologías requiere de estrategias ...que involucran cambios en el estilo de vida, cumplimiento del tratamiento farmacológico y monitoreo eficaz de la enfermedad. Usualmente, la medición del cumplimiento se enfoca en el tratamiento farmacológico, dejando de lado el enfoque integral que involucra diferentes recomendaciones que son clave para el adecuado control de estas enfermedades. Objetivo: Determinar la validez de constructo y reproducibilidad de la etiqueta de resultado de enfermería “Conducta terapéutica: enfermedad o lesión (1609)” para medir la adherencia al régimen terapéutico en personas con hipertensión arterial y diabetes mellitus tipo 2. Materiales y Métodos: Estudio de corte transversal realizado en 500 usuarios de programas de riesgo cardiovascular en Bucaramanga-Colombia. Se diseñó un instrumento para medir la adherencia al tratamiento con base en la taxonomía Clasificación de Resultados de Enfermería, recomendaciones vigentes de la literatura científica y la experiencia de los investigadores. La validez de constructo fue evaluada a través de un análisis factorial de componentes principales y bajo la metodología Rasch. La reproducibilidad por medio del coeficiente de correlación intraclase en 100 usuarios. Resultados: Se obtuvo un instrumento de 13 ítems que representan 5 indicadores de la etiqueta de resultado de enfermería 1609, los cuales explicaron el 67.62% de la variación total y se ajustaron al modelo Rasch (unidimensionalidad del constructo adherencia). La reproducibilidad fue del 0.63 (IC 95% 0.46 - 0.75). Discusión y Conclusiones: Se encontró evidencia de la validez de constructo del instrumento que operacionaliza la etiqueta de resultado de enfermería (1609) para la medición de la adherencia al régimen terapéutico en pacientes con hipertensión y diabetes.
Objective. To determine the face, content, constructvalidity, and reliability of the functional social supportdomain of Perinatal Infant Care Social Support (PICSS)translated into Spanish and adapted ...for first-time mothersof term babies.
Methods. Validation study of the functionalsocial support domain of PICSS, which has 22 itemswith response options from 1 to 4; higher scores indicategreater social support. A translation, back-translation, andcultural adaptation process took place along with an expertreview to evaluate face and content validity. In total, 210mothers participated to establish construct validity andthe reliability of the domain. The content validity index andfactor analysis were used to identify the structure of thedomain. Reliability was estimated using Cronbach’s alphacoefficient.
Results. Linguistic and cultural adaptationswere performed, along with validation and reliability. Face validity for mothers was the following: high comprehension (94%); and forexperts: high comprehension (95.83%), high clarity (96.53%), and high precision(92.82%). In relevance and pertinence, the content validity index was high (0.97).Construct validation identified two factors that explained 76% of the variance of thedomain evaluated: factor 1 “Supporting presence -emotional and appraisal support”(13 items, 39%) and factor 2 “Practical support -informational and instrumentalsupport-” (9 items, 37%). Cronbach’s alpha value was 0.97.
Conclusion. Given the robust psychometric properties of the Spanish version of the functional socialsupport domain of PICSS, this may be used to identify the functional social supportin the mothers.
Objective
The objective of this study was to determine the validity and the reliability of the Perceived Maternal Parenting Self-Efficacy tool translated into Spanish and adapted to be used among ...primiparous women of term babies.
Methods
Validation study. A total of 210 women participated in the survey to establish construct validity and reliability. The questionnaire has 20 items and four subscales. The higher the score, the higher the self-efficacy. A process of translation/back-translation and cultural adaptation in accordance with international standards and an expert review were conducted to test face and content validity. The Validity Content Index and an exploratory factor analysis were used to identify the structure of the questionnaire. Reliability was estimated using Cronbach’s alpha coefficient.
Results
Linguistic and cultural adaptation, validation and reliability were performed. Face validity for women was as follows: high comprehension (99%); and for experts: medium comprehension (84.1%), medium clarity (83.9%) and medium precision (80%). Concerning pertinence, the content validity index was 0.93 (i.e., highly pertinent). Concerning relevance, the content validity index was 0.96 (i.e., highly relevant). Factor validation identified four factors that accounted for 91% of the variance. Overall Cronbach’s alpha value was 0.98 (IC 95 0.97–0.98).
Conclusions for Practice
Given the robust properties of the Spanish version of the Perceived Maternal Parenting Self-efficacy, it may be used to identify women with low self-efficacy and to assess the effectiveness of health-based interventions.
Objective: Determine factors related to the intention of dropping out of nursing students in public universities in Colombia. Materials and Methods: Cross-sectional analytic study. The sample ...corresponded to 162 students of different academic levels. To identify the risk factors a questionnaire with 54 items was created which was subject to facial validity and included a question to establish the intention of dropping out in the last month. A descriptive analysis was made, and a model of logistic regression was made to identify the factors related to the intention of dropping out. The statistical analysis was made with the program software Statav12. Results: The average age of the participants was 21, 85% were females; 20% (n=32) declared having thought about dropping out from the nursing program in the last month, 78% of these (25/32) were in the sixth semester or earlier in the career. The risk factors for dropping out were: depressive symptoms of anxiety and depression; lack of interest in the classes offered by the program related to absence of vocational identity; regular interaction with the professors and belonging to a low socioeconomic population. Conclusions: The interest in classes and the interaction with the professors are related with the intention of dropping out, as well as the mental health component and the socioeconomic status. Longitudinal studies are required to corroborate these findings.
Objetivo: Determinar os fatores relacionados com a intenção de desertar em estudantes de enfermagem de uma universidade pública na Colômbia. Materiais e Métodos: estudo de corte transversal
analítico. A amostra correspondeu a 162 estudantes dos diferentes níveis acadêmicos. Para identificar os fatores de risco se criou um questionário com 54 itens que se someteu a validade facial, e
incluiu uma pergunta para estabelecer a intenção de desertar do curso no último mês. Realizou-se
uma análise descritiva e se construiu um modelo de regressão logística que identificou os fatores
relacionados com a presença de intenção de desertar do curso de enfermagem. A análise estadística se realizou no programa Stata v12 software. Resultados: A média de idade dos participantes
foi de 21 anos, o 85% pertenceram ao género feminino; o 20% (n=32) declarou haver considerado desertar do programa de enfermagem no último mês, destes 78% (25/32) cursavam sexto ou
níveis inferiores. Os fatores de risco para a intenção de desertar foram: sintomas depressivos de
ansiedade e depressão; falta de interesse nas disciplinas do programa relacionado com ausência
de identidade vocacional; relacionamento regular com os professores e pertencer a baixo estrato
socioeconómico. Conclusões: O interesse pelas disciplinas e o relacionamento com os professores estão relacionados com a intenção de desertar, assim como, o componente de saúde mental e
o estrato socioeconômico. Requerem-se estudos longitudinais para corroborar estas descobertas.
Objetivo: Determinar los factores relacionados con la intención de desertar en estudiantes de enfermería de una universidad pública en Colombia. Materiales y Métodos: estudio de corte transversal analítico. La muestra correspondió a 162 estudiantes de los diferentes niveles académicos. Para identificar los factores de riesgo se creó un cuestionario con 54 ítems que se sometió a validez facial, e incluyó una pregunta para establecer la intención de desertar de la carrera en el último mes. Se realizó un análisis descriptivo y se construyó un modelo de regresión logística que identificó los factores relacionados con la presencia de intención de desertar de la carrera. El análisis estadístico se realizó en el programa Stata v12 software. Resultados: Promedio de edad de los participantes fue 21 años, el 85% pertenecen al género femenino; el 20% (n=32) declaró haber considerado desertar del programa de enfermería en el último mes, de estos 78% (25/32) cursaban sexto o niveles inferiores. Los factores de riesgo para la intención de desertar fueron: síntomas depresivos de ansiedad y depresión; falta de interés en las asignaturas del programa relacionado con ausencia de identidad vocacional; relación regular con los profesores y pertenecer a estrato socioeconómico bajo. Conclusiones: El interés por las asignaturas y la relación con los profesores están relacionados con la intención de desertar, así como el componente de salud mental y el estrato socioeconómico. Se requieren estudios longitudinales para corroborar estos hallazgos.
OBJECTIVE
To determine the clinical and construct validity of the nursing diagnosis “decreased cardiac output” (DCO) in patients with chronic heart failure.
METHODS
Cross‐sectional study.
RESULTS
A ...total of 200 people were studied. The defining characteristics with the highest prevalence were as follows: arrhythmia (62.5%) and fatigue (61.5%). Adjustment measures such as infit and outfit were maintained between 0.50 and 1.56 and the total variance explained by the measures was 29.3%.
CONCLUSIONS
This study determined the clinical validity of the nursing diagnosis DCO. Regarding construct validity, adjustment of the defining characteristics to the Rasch model was observed.
IMPLICATIONS FOR NURSING PRACTICE
This study improves the evidence‐based practice of nursing and strengthened the role of the nurse who leads care to this population.
OBJETIVO
Determinar la validez clínica y de constructo del diagnóstico de enfermería “Disminución del Gasto Cardíaco” en pacientes con falla cardíaca crónica.
MÉTODOS
Estudio de corte transversal.
RESULTADOS
Un total de 200 pacientes fueron estudiados. Las características definitorias con las mayores prevalencias fueron: arritmia (62.5%) y fatiga (61.5%). Medidas de ajuste como el infit y outfit se mantuvieron entre 0.50 y 1.56. El total de la varianza explicada por las medidas fue de 29.3%.
CONCLUSIONES
Este estudio determinó la validez clínica del diagnóstico de enfermería “Disminución del Gasto Cardíaco”. En cuanto a la validez de constructo, se observó que 19 de las 21 características definitorias se ajustaron al modelo Rasch.
IMPLICACIONES PARA LA PRÁCTICA DE ENFERMERÍA
Este estudio mejora la práctica basada en la evidencia de enfermería y fortalece el rol de las enfermeras que lideran el cuidado en esta población.
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