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Typologies of common maternal mental disorders and associated factors: a quantitative life course study applied to cohort data in a resource-constrained setting in Northeastern Brazil

Objectives

We aim to identify trajectories of probable maternal common mental disorders (CMD), as well as risk and protective factors associated with maternal mental health among postpartum women during the pandemic using life course theory approach.

Design

Prospective individual level cohort study from the Iracema-COVID Study.

Population

Mothers (n=335) at postpartum period who delivered during the COVID-19 pandemic in the fourth largest city in Brazil.

Methods

Probable CMDs were accessed using validated instruments in five cohort waves at postpartum period. Sequence analyses (SA) were employed to extract CMD trajectories, and a set of generalised binomial logistic and log-Poisson multivariable regression models with robust variance were employed to assess risk and protective factors for probable CMDs diagnosis.

Outcome measures

Trajectories patterns of probable maternal common mental disorders.

Results

Fit indices demonstrated a two-cluster-SA solution of probable CMD. The patterns of probable CMDs indicated that 335 mothers were clustered into occasional/transitory (n=240, 71.64%) and mostly/persistent (n=95, 28.36%) CMD trajectories. We found that mothers with low education (OR: 2.44; 95% CI 1.13 to 5.23), single (OR: 1.97; 95% CI 1.03 to 3.75) or in a stable union (OR: 2.00; 95% CI 1.02 to 3.90) and travel time spent to access the nearest primary healthcare unit (OR: 1.02; 95% CI 1.006 to 1.04) were associated with increased OR of belonging to the mostly/persistent CMD trajectory. Deprived green areas acted as a risk factor to maternal CMDs prevalence (OR: 1.37; 95% CI 1.002 to 1.87).

Conclusions

This study provides evidence that individual vulnerabilities and neighbourhood deprivation play an important role in understanding maternal mental health, beyond the patterns and trajectories of probable maternal CMD due to issues confronted during the COVID-19 outbreak in the northeastern region of Brazil. Policies to prevent and treat maternal mental health issues and improvement in neighbourhood deprivation need to be developed and addressed to avoid exacerbation of probable maternal CMDs.

Hospital‐Acquired Pressure Injuries: Application of Preventive and Reactive Measures in Real Practice

ABSTRACT

Aims

To determine the application rate of the preventive measures, alternate air anti-decubitus mattress and postural changes in patients who develop hospital-acquired pressure injury (HAPI) on the basis of their preventive or reactive temporality.

Design

This is an ambispective observational study that included adult patients without pressure injuries admitted to Mancha Centro Hospital (Spain) who developed at least one HAPI during hospitalisation (August 2022 to March 2023).

Method

The main variables were the implementation of preventive measures and the time of their application. Other variables were comorbidities, sociodemographic and clinical variables, Braden and Barthel scale, variables related to the application of preventive measures and information to characterise HAPI.

Results

180 patients who developed 276 HAPI during their admission were included; 73.9% of the patients received a risk assessment upon admission, and 53.9% were re-evaluated. At some point during admission, an anti-decubitus mattress was placed in 73.3% of the patients, and 76.1% received postural changes.

Among the patients at risk at the time of HAPI onset, 49.4% had received anti-decubitus mattress preventively, 23.9% had received it reactively, and 26.7% did not receive it. Among the patients without contraindication for postural changes, 51.4% received them before the lesions appeared, 33.6% received them after the lesions appeared, and 13.6% did not receive them.

We detected a significant association between the preventive application of anti-decubitus mattress and postural changes with the Braden reassessment; admission to the intensive care unit; mechanical ventilation, vasopressors, nasogastric tube; mental state confused; hospital isolation; low Barthel and Braden scores; impaired mobility; inability to perform postural changes; diaper; urinary/faecal incontinence; and sedatives.

Conclusions

Only approximately half of the patients received preventive measures. Although patients with a more unfavourable clinical profile were more likely to receive these measures, increased awareness and training among healthcare professionals are necessary to ensure broader and more consistent implementation of preventive strategies.

Implications for the Profession and/or Patient Care

This study explores the real-world use of preventive measures in hospitalized patients who develop HAPI. In half of the patients, these measures were applied reactively, highlighting the need to introduce strategies that facilitate the implementation of evidence-based practices.

Reporting Method

This study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.

No Patient or Public Contribution

In the present study, data from patients have been obtained, but the patients or caregivers have not contributed to the development of the manuscript.

Intensive Care Unit Nurses' Perceptions of Work Environments: A Cross‐Sectional Study From Five European Counties

ABSTRACT

Aim

To explore intensive care nurses' perceptions of their work environments at the unit and organisational levels according to the American Association of Critical Care Nurses standards, their impact on care quality, national differences, and demographic associations.

Design

Cross-sectional study using a survey design.

Methods

Study conducted between January 2021 and April 2022, using a convenience sample of intensive care unit nurses across Cyprus, Spain, Croatia, and Poland, Romania. The Critical Elements of a Healthy Work Environment Scale (CEHWES) developed by the American Association of Critical Care Nurses and cross-culturally adapted by the authors was used, which included four sections, including sociodemographic data and a total of 50 questions. The core section of the tool comprised 16 questions using Likert-type response (1—strongly disagree—4 strongly agree). Perception of fulfilment of healthy work environment standards was calculated using the aforementioned Likert-type scale.

Results

A total of 1183 nurses participated reporting moderate perception of fulfilment of the standards, with mean scores ranging from 2.6 to 2.8. Skilled communication and effective decision making were the highest rated. 56% (n = 662) reported awareness of some standards and while 25.8% (n = 305) reported full or significant implementation in their unit. Significant differences related to the perception of all standards were observed across countries. Implementation of the standards was significantly associated with higher quality of care having better perception when standards were fully implemented.

Conclusions

This study shows moderate perception of healthy work environment standards among intensive care nurses. Country differences highlight the need for more awareness, training, and further implementation of the standards, which is linked to better care quality.

Implications for the Profession

Work environment still need to improve and needs to be prioritised by organisations, considering local and national particularities. Having a measuring tool available in multiple languages facilitates comparisons and getting a global picture.

Impact

The questionnaire used is validated in different languages, allowing results to be compared with other countries. Novel data from countries that were poorly investigated is now available. More evidence points out the need to prioritise work environment for maintaining quality in patient care.

Reporting Method

The study has been reported following the STROBE checklist.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.

Microbes and ageing beyond the gut: the oral microbiome and frailty, sarcopenia and neurocognitive disorders in the elderly - a scoping review protocol

Introduction

Population ageing is a global phenomenon that has resulted in an increase in the number of patients with chronic diseases and geriatric syndromes. Frailty, sarcopenia and neurocognitive disorders are among the most prevalent conditions affecting older adults and have a direct effect on their quality of life, and can impact the burden and budgets of health systems. Recently, the oral microbiome has gained attention as it may be a factor that potentially influences the onset and progression of these syndromes. However, this is still a new line of research that has not been deeply explored. This scoping review protocol aims to explore how the oral microbiome may be associated with the onset of prevalent geriatric syndromes, frailty, sarcopenia and neurocognitive disorders, providing a picture of the current evidence and potential gaps for future research.

Methods and analysis

The scoping review will follow the Johanna Briggs Institute (JBI) methodology and will be reported accordit to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines (PRISMA-ScR). Searches will be conducted in Medline, Embase, Cochrane Central, CINAHL, LILACS and Epistemonikos from inception to December 2025. Independent reviewers will perform the study selection and data extraction. A descriptive analysis of information will be conducted, highlighting oral microorganisms associated with these syndromes and emerging trends in the evidence. Original research studies in any language will be included. We will include randomised controlled trials, cohort studies, case–control studies and other relevant designs if they investigate the oral microbiome and its relation to geriatric syndromes in adults aged 65 or older, regardless of geographic location or setting.

Ethics and dissemination

Ethics approval is not required.

Effects of stimulus emotional content on gaze pattern: An eye-tracking study

by Andrés Castellanos-Chacón, Daniela Arias-Otero, Valeria Uribe-Jaramillo, Juan David Leongómez, Milena Vásquez-Amézquita

The attentional system tends to prioritize negative stimuli in the early stages of processing, favoring threat detection. However, it is unclear whether this bias is maintained or reversed toward positive stimuli at later stages. In this study, we used a free-viewing paradigm with eye tracking to examine early and late attentional biases toward negative, positive, and neutral stimuli (humans in emotionally unloaded activities) versus control stimuli (inanimate objects) in 122 participants without affective disorders (64 men, 58 women). We fitted generalized linear mixed models with random intercepts for stimuli and random intercepts and slopes for participants, and used non-parametric bootstrap resampling to obtain robust estimates and confidence intervals. Additionally, the number of first fixations was analyzed with a COM-Poisson. Results showed that participants fixated faster (χ2(3) = 97.55, p 2(3) = 337.45, p χ2(3) = 200.24, p χ2(3) = 207.02, p

Rationale and design of the REMECHOQUE multicentre registry protocol: evaluating therapeutic trends in cardiogenic shock

Introduction

Cardiogenic shock (CS) is a complex syndrome characterised by primary cardiac dysfunction. Despite advances in therapeutic options such as mechanical cardiac support, it remains associated with high mortality. Although previous registries have described heterogeneous populations and outcomes across different centres, contemporary real-world data on management practices remain limited. This gap is particularly evident in low- and middle-income countries, where there is no robust registry that clearly defines the current state of CS management. Therefore, a multicentre registry is needed to better characterise current practices and outcomes. Our study aims to gain insight into current therapeutic trends in Mexico, a low- to middle-income country with a significant cardiovascular disease burden.

Methods and analysis

The Mexican Registry of Cardiogenic Shock is a quality initiative that aims to identify therapeutic trends, demographic characteristics and clinical presentations. It also aims to evaluate outcomes, including mortality and cognitive function at in-hospital and 1-year follow-ups, and to identify areas for improvement in the care process across the broad spectrum of CS.

Ethics and dissemination

Ethical approval for this multicentre study was obtained from the local research ethics committees of all participating institutions. The study results will be disseminated to all participating institutions in the form of summary reports and presentations on completion of the analysis.

Protocol for the development of the WHO gestational weight gain charts

Por: Rangel Bousquet Carrilho · T. · Oladapo · O. T. · Hutcheon · J. A. · Gatica-Dominguez · G. · Rasmussen · K. M. · Flores-Urrutia · M. C. · Kumapley · R. · Tuncalp · O. · Bahya-Batinda · D. · Fayed · A. A. · Bogaerts · A. · Papageorghiou · A. T. · Munoz-Manrique · C. · Farias · D. R
Introduction

Gestational weight gain (GWG) is an important indicator of maternal nutrition to be monitored during pregnancy. However, there is no evidence-based tool that can be used to monitor it across all geographic locations and pre-pregnancy body mass index (BMI) categories. The WHO is undertaking a project to develop GWG charts by pre-pregnancy BMI category, and to identify GWG ranges associated with the lowest risks of adverse maternal and infant outcomes. This protocol describes all the steps that will be used to accomplish the development of these GWG charts.

Methods and analysis

This project will involve the analysis of individual participant data (researcher-collected or administrative). To identify eligible datasets with GWG data, a literature review will be conducted and a global call for data will be launched by the WHO. Eligible individual datasets obtained from multiple sources will be harmonised into a pooled database. The database will undergo steps of cleaning, data quality assessment and application of individual-level inclusion criteria. Heterogeneity of maternal weight and GWG will be assessed to verify the possibility of combining datasets from multiple sources and regions into a single database. Generalized Additive Models for Location, Scale and Shape will be applied for the construction of the centile curves. Diagnostic measures, internal and external validation procedures will also be performed.

Ethics and dissemination

This project will include an analysis of existing study de-identified data. To be included in the pooled database, each included study should have received ethics approvals from relevant committees. Manuscripts will be submitted to open-access journals and a WHO document will be published, including the GWG charts and cut-offs for application in antenatal care.

Human emotional odours influence horses’ behaviour and physiology

by Plotine Jardat, Alexandra Destrez, Fabrice Damon, Noa Tanguy-Guillo, Anne-Lyse Lainé, Céline Parias, Fabrice Reigner, Vitor H. B. Ferreira, Ludovic Calandreau, Léa Lansade

Olfaction is the most widespread sensory modality animals use to communicate, yet much remains to be discovered about its role. While most studies focused on intraspecific interactions and reproduction, new evidence suggests chemosignals may influence interspecific interactions and emotional communication. This study explores this possibility, investigating the potential role of olfactory signals in human-horse interactions. Cotton pads carrying human odours from fear and joy contexts, or unused pads (control odour) were applied to 43 horses’ nostrils during fear tests (suddenness and novelty tests) and human interaction tests (grooming and approach tests). Principal component analysis showed that overall, when exposed to fear-related human odours, horses exhibited significantly heightened fear responses and reduced interaction with humans compared to joy-related and control odours. More precisely, when exposed to fear-related odours, horses touched the human less in the human approach test (effect size: Rate Ratio(RR)=0.60 ± 0.24), gazed more at the novel object (RR = 1.32 ± 0.14), and were more startled (startle intensity – Cohen’s d = −0.88 ± 0.39; and maximum heart rate – Cohen’s d = 1.16 ± 0.47) by a sudden event. These results highlight the significance of chemosignals in interspecific interactions and provide insights into questions about the impact of domestication on emotional communication. Moreover, these findings have practical implications regarding the significance of handlers’ emotional states and its transmission through odours during human-horse interactions.

Influence of Social Determinants of Health on Adherence to Lifestyle Modifications in Individuals With Prediabetes: A Mixed Methods Study

ABSTRACT

Aim

To explore the relationship between social determinants of health and adherence to lifestyle recommendations, and how these determinants can help explain contextual and interpersonal factors contributing to adherence among individuals with prediabetes.

Design

Explanatory sequential mixed methods study integrating a cross-sectional quantitative analysis with an ethnomethodological qualitative approach grounded in critical social paradigm.

Methods

The quantitative phase used data from the intervention arm (n = 86) of the PREDIPHONE trial, a randomised controlled study evaluating the effectiveness of a nurse-led telephone intervention for lifestyle changes in glycaemic control. Adherence was measured using a composite index, analysed as both a continuous and categorical variable. Correlation analysis examined adherence and age. Chi-square and ANOVA tests were used to analyse differences in participant characteristics across adherence quartiles. The qualitative phase included individual semi-structured interviews and a focus group with participants showing high or low adherence. Thematic content and discourse analysis were employed, ensuring validity through triangulation, reflexivity and discourse saturation.

Results

Employment status was identified as a significant factor, with unemployed or retired participants showing better adherence. Although no statistical differences in adherence were found by social class or gender, lower social class participants reported financial barriers to healthy eating and time constraints limiting physical activity (PA). Women reported facing greater challenges due to caregiving responsibilities, whereas men benefited from household support.

Conclusions

Employment status emerged as a determinant of time availability for self-care, alongside social class and gender in adherence to lifestyle modifications. Women, especially those from lower social classes, experienced heightened barriers to adherence, underscoring the need for tailored, gender-sensitive and equity-focused interventions.

Implications

Addressing social determinants is essential for effective lifestyle advice among individuals with prediabetes.

Impact

The study highlights the role of social class and gender in adherence.

Reporting Method

STROBE and COREQ guidelines.

Patient Contribution

Through interviews and focus group.

International evaluation of the SEIZUre Risk in Encephalitis (SEIZURE) score for predicting acute seizure risk

Por: Hughes · T. · Venkatesan · A. · Hetherington · C. · Egbe · F. N. · Netravathi · M. · Thakur · K. T. · Baykan · B. · Hui Jan · T. · Arias · S. · Garcia-de Soto · J. · Kahwagi · J. · Vogrig · A. · Versace · S. · Habis · R. · Sowmitran · S. · Husari · K. S. · Probasco · J. · Hasbun · R. · Bea
Objective

Encephalitis is brain parenchyma inflammation, frequently resulting in seizures which worsens outcomes. Early anti-seizure medication could improve outcomes but requires identifying patients at greatest risk of acute seizures. The SEIZURE (SEIZUre Risk in Encephalitis) score was developed in UK cohorts to stratify patients by acute seizure risk. A ‘basic score’ used Glasgow Coma Scale (GCS), fever and age; the ‘advanced score’ added aetiology. This study aimed to evaluate the score internationally to determine its global applicability.

Design

Patients were retrospectively analysed regionally, and by country, in this international evaluation study. Univariate analysis was conducted between patients who did and did not have inpatient seizures, followed by multivariable logistic regression, hierarchical clustering and analysis of the area under the receiver operating curves (AUROC) with 95% CIs.

Participants and setting

2032 patients across 13 countries were identified, among whom 1324 were included in SEIZURE score calculations and 970 were included in regression modelling. The involved countries comprised 19 organisations spanning all WHO regions.

Outcome measures

The primary outcome was measuring inpatient seizure rates.

Results

Autoantibody-associated encephalitis, low GCS and presenting with a seizure were frequently associated with inpatient seizures; fever showed no association. Globally, the score had limited discriminatory ability (basic AUROC 0.58 (95% CI 0.55 to 0.62), advanced AUROC 0.63 (95% CI 0.60 to 0.66)). The scoring system performed acceptably in western Europe, excluding Spain, with the best performance in Portugal (basic AUROC 0.82 (95% CI 0.69 to 0.94), advanced AUROC 0.83 (95% CI 0.72 to 0.95)).

Conclusions

The SEIZURE score performed best in several countries in Western Europe but performed poorly elsewhere, partly due to differing and unknown aetiologies. In most regions, the score did not reach a threshold to be clinically useful. The Western European results could aid in designing clinical trials assessing primary anti-seizure prophylaxis in encephalitis following further prospective trials. Beyond Western Europe, there is a need for tailored, localised scoring systems and future large-scale prospective studies with optimised aetiological testing to accurately identify high-risk patients.

Evaluación del grado de ansiedad y depresión en pacientes oncológicos ante la perspectiva de alta médica

Introducción. La transición del hospital al domicilio en pacientes oncológicos es un momento crítico que puede generar ansiedad y depresión debido a la autogestión de cuidados. Objetivo. evaluar el impacto emocional de los pacientes oncológicos al recibir el alta de enfermería. Metodología. Estudio observacional descriptivo. Se utilizará el cuestionario HADS para medir los niveles de ansiedad y depresión en una muestra de pacientes hospitalizados próximos a recibir el alta. Los resultados permitirán diseñar estrategias de apoyo emocional y educación sanitaria para mejorar la adherencia terapéutica y la calidad de vida post hospitalaria.

ABSTRACT

Introduction. The transition from hospital to home for oncology patients is a critical moment that may generate anxiety and depression due to self-management of care. Objective. To assess the emotional impact of oncology patients upon receiving nursing discharge. Methodology. Descriptive observational study The HADS questionnaire will be used to measure anxiety and depression levels in a sample of hospitalized patients close to discharge. The results will guide the development of emotional support strategies and health education to improve post-hospital therapeutic adherence and quality of life.

Evaluación del grado de ansiedad y depresión en pacientes oncológicos ante la perspectiva de alta médica

Introducción. La transición del hospital al domicilio en pacientes oncológicos es un momento crítico que puede generar ansiedad y depresión debido a la autogestión de cuidados. Objetivo. evaluar el impacto emocional de los pacientes oncológicos al recibir el alta de enfermería. Metodología. Estudio observacional descriptivo. Se utilizará el cuestionario HADS para medir los niveles de ansiedad y depresión en una muestra de pacientes hospitalizados próximos a recibir el alta. Los resultados permitirán diseñar estrategias de apoyo emocional y educación sanitaria para mejorar la adherencia terapéutica y la calidad de vida post hospitalaria.

ABSTRACT

Introduction. The transition from hospital to home for oncology patients is a critical moment that may generate anxiety and depression due to self-management of care. Objective. To assess the emotional impact of oncology patients upon receiving nursing discharge. Methodology. Descriptive observational study The HADS questionnaire will be used to measure anxiety and depression levels in a sample of hospitalized patients close to discharge. The results will guide the development of emotional support strategies and health education to improve post-hospital therapeutic adherence and quality of life.

Social Representations of Bedside Milk Expression Among Mothers of Preterm Newborns in Neonatal Intensive Care Units

ABSTRACT

Aim

To understand the social representations of bedside milk expression (BME) among mothers of preterm newborns in neonatal intensive care units (NICUs).

Design

Qualitative descriptive study.

Methods

The study was conducted from July to August 2024 in two NICUs of a referral maternity hospital in Fortaleza, Brazil. Nineteen mothers of hospitalised premature newborns participated. Semi-structured interviews were conducted and subjected to thematic content analysis.

Results

Mothers perceived BME as a meaningful act of protection and bonding, though some were unfamiliar with the practice. Emotional ambivalence was common, shaped by prior breastfeeding experiences and the context of prematurity. Discomfort related to privacy and shared spaces was noted. Support from healthcare professionals was essential to promote understanding and adherence.

Conclusion

Social representations of BME are shaped by emotional, social and institutional experiences. Anchored in prior breastfeeding experiences and cultural meanings of maternal care, the practice is objectified through both gestures of affection and tangible barriers.

Implications for the Profession and/or Patient Care

Healthcare professionals, particularly nurses, should receive training to support mothers in BME. Structural improvements, privacy and emotional support are essential for fostering maternal autonomy and confidence.

Impact

This study highlights the barriers to BME, emphasising the role of healthcare support and the need for better infrastructure, privacy and training to enhance maternal confidence and breastfeeding.

Reporting Method

The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.

Patient or Public Contribution

None.

What Does This Paper Contribute to the Wider Global Clinical Community?

This paper highlights the pivotal role of healthcare professional support in overcoming barriers to BME and promoting breastfeeding practices.

What Already Is Known?

Fresh breast milk is considered the gold standard for reducing complications and improving survival in preterm infants. BME is recommended as an effective strategy to ensure the availability of fresh breast milk. Mothers' social representations of this practice remain underexplored within the neonatal intensive care context.

What This Paper Adds?

Explores mothers' social representations of BME in NICUs, addressing a significant gap in qualitative research. Reveals how emotional, social and institutional factors shape mothers' perceptions, motivations and challenges related to BME. Highlights the need for targeted professional support, improved infrastructure and privacy to enhance maternal autonomy and adherence to milk expression practices.

Implications for Practice

Healthcare professionals, particularly nurses, should receive specialised training to provide technical guidance and emotional support, enhancing mothers' confidence and autonomy in BME. Improving infrastructure and ensuring privacy in NICUs are crucial to creating supportive environments that facilitate milk expression and strengthen maternal–infant bonding. Institutional policies should integrate maternal-centred strategies to support breastfeeding continuity and promote humanised neonatal care.

Safety and effectiveness of opioid use in adult patients presenting to emergency services with suspected acute appendicitis: a protocol for a systematic review of the literature and network meta-analysis

Introduction

Acute abdominal pain is a chief complaint in emergency departments and represents 7%–10% of emergency room (ER) visits. Acute appendicitis represents 15% of the causes of abdominal pain and 62% of the causes that require surgical treatment. Opioid analgesia has been evaluated in clinical trials, and they have determined it does not impact diagnostic accuracy. Despite evidence, withholding analgesia is still a common practice. Pain severely impacts quality of life and analgesia has become essential in humanised medicine. We aim to determine the safety and effectiveness of different opioid regimens for adult patients that present to the ER with acute suspected appendicitis.

Methods and analysis

We will search MEDLINE and Embase via Ovid, and the Cochrane Central Register of Controlled Trials without restrictions on the study publication date. Screening, extraction and risk of bias assessment will be performed in duplicate. We will use the Cochrane Risk of Bias Assessment Tool. We will perform both pairwise meta-analysis and network meta-analysis (NMA) if transitivity and coherence principles are met. Heterogeneity will be evaluated using the I² and ² and using the thresholds recommended by Cochrane. We will perform sensitivity analysis based on the pre-established potential effect modifiers, risk of bias and data that required transformation or imputation. Publication bias will be addressed by using funnel plots on a pairwise level. We will assess the strength of the body of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE) per outcome, and evidence from the NMA will be assessed using the GRADE approach for NMA.

Ethics and dissemination

Approval by an ethics committee is not required for this study since no personal information will be handled. Information will be disseminated by publication on a peer-reviewed journal.

PROSPERO registration number

CRD42024583804.

¿Qué importancia y justificación tiene para enfermería la competencia cultural en lactancia materna? Una revisión narrativa de estudios cualitativos

Introducción: en el mundo contemporáneo donde cada vez se dan más oleadas de migraciones de un país a otro, se hace más necesaria una enfermería competente culturalmente. La mujer en su embarazo, en su maternidad y en la lactancia materna necesita ser apoyada con sensibilidad cultural por parte del profesional sanitario. Objetivo: revisar y reflexionar sobre la importancia y justificación que tiene la competencia cultural para enfermería en lactancia materna a través de estudios de metodología cualitativa. Material y método: se plantea una revisión narrativa en castellano e inglés en los recursos bibliográficos Pubmed, Scopus, Dialnet y Scielo teniendo en cuenta el objetivo de la revisión y los objetivos de inclusión. Los trabajos han de ser de metodología cualitativa y tener como temática de estudio la maternidad y/o la lactancia materna teniendo en cuenta la competencia cultural. Resultados: finalmente son seleccionados 6 artículos por cumplir los criterios de inclusión. En síntesis, en todos los estudios seleccionados se muestra la justificación e importancia que tiene la competencia cultural en todo lo concerniente a la maternidad y a la lactancia materna a nivel internacional entre grupos de mujeres diversamente culturales. Conclusiones y reflexiones finales: continúan existiendo márgenes de mejora en cuanto a la formación enfermera en competencia cultural en el cuidado de la mujer en el embarazo, en el puerperio y en lo que respecta a la lactancia materna internacionalmente.

Assessing the experimental EuroQol toddler and infant populations (EQ-TIPS) descriptive system: a protocol integrating discrete choice experiment (DCE) surveys in instrument development

Por: Craig · B. M. · Rivero-Arias · O. · Devlin · N. · Verstraete · J.
Introduction

The experimental EuroQol Toddler and Infant Populations (EQ-TIPS) instrument is currently under development as a health-related quality of life (HRQoL) measure for toddlers and infants aged 0–36 months. Using this protocol, researchers can conduct surveys with discrete choice experiments (DCEs) that examine the key properties of HRQoL instruments, specifically whether severity aligns with preferences across each attribute and the extent to which attributes influence choices. To demonstrate this protocol, we will conduct two waves of DCE surveys using different choice tasks and a common scenario (a 1-month health episode for a 1-year-old child).

Methods and analysis

In the first wave (a general population sample of 400 Australian adults; 14 kaizen tasks each), respondents will view a single EQ-TIPS-five-level (v3.0) profile for each task and be asked to make a series of choices that sequentially alleviate the child’s health problems. Using this exploratory evidence, we will assess whether EQ-TIPS severity aligns with preferences and the extent to which each attribute level influences choices (ie, main effects). In the second wave (1000 Australian adults; 28 paired comparisons), respondents will see two EQ-TIPS profiles for each task and be asked to choose between them. Using this confirmatory evidence, we will compare the main effects and their uncertainty by wave. For each DCE, we will estimate a main-effects conditional logit model and test for differences in effects using cluster bootstrap techniques. As sensitivity analyses, we will evaluate the effects of task sequence, attribute order and sample size on uncertainty in each wave.

Ethics and dissemination

The independent review board at Includovate evaluated the application for ethical clearance and approved the study on 19 February 2025. To disseminate our findings, we will prepare multiple manuscripts for publication in peer-reviewed journals and present highlights at scientific meetings, such as the EuroQol Plenary Meeting and the International Academy of Health Preference Research.

Competências profissionais do enfermeiro: Revisão Integrativa de literatura

Objetivo: identificar, nas produções científicas, os fatores relacionados à construção da identidade
profissional do enfermeiro. Métodos: Trata-se de revisão integrativa realizada nas bases de dados
SCIELO, BDENF e LILACS disponíveis na Biblioteca virtual em saúde no intervalo temporal de
2015 a 2019 a partir dos descritores “Papel do profissional de enfermagem” AND “Cuidados de
enfermagem” OR “Competência profissional”. Resultados: A identificação profissional do
enfermeiro está relacionada à sua atuação no serviço de saúde com estratégias de atendimento
domiciliar, empreendedorismo, gerenciamento do cuidado e da equipe, educação em saúde,
consultas de enfermagem, procedimentos técnicos, articulação da rede de atenção, organização do
serviço e qualificação da equipe mas que sofrem algumas limitações individuais, organizacionais,
institucionais e sociais. Conclusão: A identificação dos fatores que caracterizam o enfermeiro e
fomentam sua identidade profissional exerce grande influência no empoderamento da categoria e
melhor autonomia nos diversos campos de atuação.
Descritores: Papel do profissional de enfermagem; Cuidados de enfermagem; Competência
profissional.

Adaptación cultural de la intervención Un Estilo de Vida Saludable para la reducción de riesgo de diabetes mellitus tipo 2

Objetivo. Plantear el proceso de adaptación cultural de la intervención educativa en salud Un EVS utilizando la metodología ADAPT-ITT. Se consideran los determinantes sociales y culturales de la población adulta de la comunidad González Ortega en Mexicali, México para asistir a la población en la reducción de riesgo de Diabetes Mellitus tipo 2 (DMT2). Metodología. Se utiliza el marco ADAPT-ITT que consta de ocho fases divididas en dos etapas. La primera etapa comprende las fases de 1) evaluación, 2) decisión, 3) adaptación, 4) producción, 5) expertos temáticos e 6) integración de fases previas. La segunda etapa comprende la 7) capacitación y 8) ejecución de la intervención. Se plantea el uso de grupos focales y encuestas semiestructuradas con respuestas abiertas y cerradas para el análisis de los aportes de la población participante y expertos involucrados. La evaluación de la aceptabilidad y factibilidad de la intervención educativa se realiza utilizando encuestas adaptadas al contexto. Relevancia. México presenta un incremento en la incidencia y prevalencia de DMT2. Se estima que los casos asciendan un 46% para el 2045 (1). Intervenciones educativas en salud han demostrado que la mejora en la nutrición y actividad física (AF) pueden reducir la incidencia de DMT2 (2). No obstante, la implementación de una intervención puede ser truncada si no existe la aceptación social. Por lo tanto, realizar la adaptación cultural resulta crucial para abordar de manera más precisa los determinantes sociales y culturales de salud y así atender de manera más favorable a una población específica.

ABSTRACT

Objective. Present an approach to perform the cultural adaptation of the educational health intervention “Un EVS” using the ADAPT-ITT methodology. The social and cultural determinants from the adult population in the Gonzalez Ortega community in Mexicali, Mexico, are considered to assist in the risk reduction of DMT2. Methodology. The ADAPT-ITT framework that consists of eight stages is used and divided in two steps. The first step comprises the stages 1) assessment, 2) decision, 3) adaptation, 4) production, 5) subject matter experts, and 6) integration of the previous stages. The second stage covers 7) training and 8) implementation. The use of focus groups and semi-structured surveys with open and closed questions is considered to study the contributions of both experts and participants. Additionally, the feasibility and acceptance of the intervention are evaluated through surveys adapted to the specific context. Relevance. The incidence and prevalence of DMT2 is exacerbated within the Mexican population. It is estimated that DMT2 will grow to 46% by 2045 (1). Educational health interventions that improve nutrition and physical activity within the population have proved to reduce the incidence of DMT2 (2). However, poor social acceptance can prevent its positive impact. Therefore, implementing a cultural adaption is essential to deal with the social and cultural determinants and address more favorably the specific population.

Percepción del liderazgo enfermero ejercido en instituciones de tercer nivel de atención en Armenia (Colombia)

Objetivo principal: conocer la percepción sobre el liderazgo de enfermería desarrollado durante el ejercicio profesional en un grupo de enfermeros vinculados a instituciones de salud públicas y privadas de tercer nivel de atención en un municipio de Colombia. Metodología: investigación cualitativa del tipo de estudio de casos; se realizó entrevistas semiestructuradas a enfermeros del área asistencial con dedicación exclusiva de tiempo completo. Para el análisis de los datos, se utilizó la técnica de análisis de contenido, mediante el Software IRaMuTeQ. Resultados principales: En total participaron 13 enfermeros, los datos analizados fueron clasificados en dos categorías temáticas, a saber: (a) Significados y características del liderazgo en enfermería, y (b) Roles y ámbitos del liderazgo. Conclusión principal: El concepto de liderazgo se relaciona con dinámicas de trabajo en equipo desde relaciones jerárquicas. Es necesario reflexionar sobre el objeto disciplinar, para el caso el acto de cuidado de enfermería para el desarrollo del liderazgo requerido y en congruencia con las visiones epistémicas actuales.

Cuidados populares de las enfermedades crónicas entre indígenas Pijao durante la pandemia por Covid-19

Justificación: la pandemia por Covid-19 ocasionó interrupción de los servicios dirigidos a atender las enfermedades crónicas provocando reajustes en el cuidado de los pacientes. Objetivo: Describir los cuidados populares empleados por los indígenas Pijao para el tratamiento y control de enfermedades crónicas, en contexto de pandemia, en Bogotá (Colombia). Metodología: Estudio cualitativo de tipo micro–etnográfico. Participaron 16 indígenas Pijao. Los datos, recolectados por medio de entrevistas y observación, fueron analizados temáticamente. Resultados: emergieron tres categorías, (1) del territorio de origen a la ciudad: cuidados populares para el tratamiento de las de enfermedades, (2) viviendo con la enfermedad: signos y síntomas de las de enfermedades, y (3) procura de otros recursos para el cuidado: autoatención y apoyo familiar. Conclusión: la trayectoria de cuidado de los Pijao con enfermedades crónicas fue permeada por la pandemia, convirtiendo los cuidados populares, caracterizados por un sincretismo de saberes, en parte fundamental de su rutina de cuidados.

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