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Obstructive sleep apnoea (OSA) affects 1–5% of the paediatric population, including 55–90% of children with Down syndrome (DS), and has been associated with negative effects on neurocognitive development, cardiovascular health, immune development and quality of life. In-lab attended polysomnography (PSG) is currently the gold standard for the diagnosis of OSA in children, but it poses challenges due to the burden on families and limited testing facilities. Home sleep apnoea testing (HSAT), an unattended sleep test done at home, is an accepted alternative for adults but lacks sufficient evidence to be used clinically for the evaluation of OSA in children. HSAT may be especially beneficial for children with DS or others with sensory issues or those who struggle with sleeping in a laboratory setting overnight.
This single-centre trial compares HSAT to PSG for the diagnosis of OSA in children, including those with DS. The trial will enrol 317 children 5–12 years old, including approximately 100 with DS. The primary outcome is the diagnostic accuracy of HSAT compared with PSG for OSA evaluated through ROC. Secondary outcomes include the agreement between HSAT and PSG for therapeutic decision-making and comparison of preference and acceptability of HSAT versus PSG. This trial seeks to evaluate HSAT as an alternative diagnostic tool for paediatric OSA, potentially expanding testing options for clinicians and families.
This study has been approved by the Institutional Review Board at Children’s Hospital of Philadelphia (#21–0 19 533). Informed consent will be obtained from all participants, and no identifiable data will be reported.
Few studies have investigated the prevalence of chronic wounds and the clinical and sociodemographic characteristics of hospitalised patients affected by them. Understanding these characteristics within the inpatient setting can support improved follow-up, inform care strategies, enhance quality and safety and reduce associated healthcare costs. This study aimed to determine the prevalence and the sociodemographic profile of adult inpatients with chronic wounds admitted to the eight hospitals of the Catalan Institute of Health between 2016 and 2020.
A descriptive, observational, cross-sectional and retrospective multicentre study was conducted using routinely collected clinical data from 1 January 2016 to 31 December 2020. The study encompassed hospital wards, step-down units and home hospitalisation services across eight public hospitals managed by the Catalan Institute of Health, the main public healthcare provider in Catalonia, Spain. The study included all patients aged 18 years or older who were hospitalised with chronic wounds during the study period. The main variables were nursing diagnoses of chronic wound types: pressure injuries (PIs), arterial ulcers (AUs), venous ulcers (VUs), mixed ulcers and diabetic foot ulcers (DFUs), as recorded in nursing electronic health records. Secondary variables included age, sex, reason for admission, unit of admission, hospital type, source of admission and discharge destination. A descriptive and comparative analysis was performed.
Among 796 698 hospitalised patients, 16 935 (2.1%) presented with at least one chronic wound. The most common types of chronic wounds were PIs and AUs. A slight decline in the prevalence of chronic wounds was observed over the study period. Cardiovascular and respiratory conditions were the leading causes of admission among these patients. AUs and DFUs were more prevalent in men, whereas VUs were more frequently observed in women. Patients with PIs had longer hospital stays, higher rates of intensive care unit admissions and increased in-hospital mortality. In contrast, patients with vascular ulcers more often required continued care after discharge (p
Chronic wounds continue to represent a significant healthcare challenge. It is essential to consider the clinical characteristics and health outcomes of hospitalised patients with chronic wounds in order to improve care quality and safety. Further research is warranted to explore the relationship between patient care complexity and the type of chronic wounds present.
Introducción: El uso de la gamificación en el contexto universitario es una alternativa a las prácticas tradicionales, favorece el aprendizaje reflexivo y motiva al cambio, pero existen escasos estudios cualitativos.
Objetivo: Describir el uso de la gamificación en la mejora de su actitud ambiental y los estilos de vida saludables en estudiantes universitarios de enfermería.
Método: La metodología fue cualitativa abordaje fenomenológico. La muestra estuvo constituida por 12 estudiantes matriculados en el curso de Enfermería de Salud Ambiental. Los datos se recolectaron mediante entrevistas semiestructuradas. Se realizó un análisis ideográfico y nomotético.
Resultados: a) Significado de la gamificación y beneficios: didáctico y dinámico que genera entretenimiento, relajación y aprendizaje, b) Gamificación y la práctica del cuidado ambiental que se extrapola a la familia y comunidad, c) Evidenciando cambios en los estilos de vida saludables como actividad física, sueño, alimentación a través de la gamificación, d) Sugerencias para mejorar, implementar y replicar la gamificación.
Conclusiones: El uso de la gamificación genera experiencias trascendentales en la práctica del cuidado ambiental y los estilos de vida de los estudiantes con repercusiones positivas en el proceso de formación y desempeño profesional a futuro, pudiendo motivar cambios en su familia y comunidad.
Los pacientes con cáncer de laringe sometidos a laringectomía total deben estar acompañados por un profesional de enfermería experto, con capacidad de adoptar decisiones complejas y que proporcione una atención de calidad. En España la figura de la enfermera de práctica avanzada (EPA) es poco reconocida y no tiene regulación normativa, aunque es importante incluirla dentro del equipo asistencial para mejorar los cuidados del paciente oncológico complejo debido a su liderazgo clínico y transformacional. Objetivo principal. Evaluar el impacto de la enfermera de práctica avanzada en el proceso asistencial del paciente con cáncer de laringe y tratamiento quirúrgico de laringectomía total. Diseño y ámbito de estudio. Estudio cuasiexperimental pre-post longitudinal prospectivo a un solo grupo de pacientes no aleatorizado, en el servicio de Otorrinolaringología del Hospital Universitario la Paz, desde el año 2021 hasta el 2023. Variables del estudio. Se recogerán variables relacionadas con indicadores clínicos, además de variables como la ansiedad, calidad de vida, grado de satisfacción entre otras. Intervención. La EPA realizará 13 sesiones individuales de forma coordinada con el equipo asistencial desde el diagnóstico hasta el alta hospitalaria, estas abordarán aspectos tanto a nivel educativo como asistencial del paciente. La aparición de la figura de la EPA responde a la cambiante demanda de los servicios sanitarios, al aumento del coste asistencial y al continuo desarrollo profesional, por tanto, es necesario valorar la posibilidad de introducir nuevos modelos profesionales dentro de la práctica clínica, para adaptar el sistema de salud a los cuidados que la sociedad necesita.
ABSTRACT
Patients with laryngeal cancer undergoing total laryngectomy must be accompanied by an expert nursing professional, who must be able to take complex decisions and to provide quality care. In Spain, the advanced practice nurse (APN) figure is little recognized and it has not a formal regulation; although it is important to include it within the care team to improve the care of complex cancer patients due to its clinical and transformational leadership. Main objective: to evaluate the impact of the advanced practice nurse in the care process of patients with laryngeal cancer and total laryngectomy surgical treatment. Study design and scope: a prospective longitudinal pre-post quasi-experimental study of a single non-randomized group of patients, in the Otorhinolaryngology service of the la Paz University Hospital, from 2021 to 2023. Study variables: variables related to clinical indicators, in addition to variables such as anxiety, quality of life, degree of satisfaction, among others. Intervention: the EPA will carry out 13 individual sessions in coordination with the care team from diagnosis to hospital discharge, these will address both educational and patient care aspects.
The appearance of the figure of the EPA responds to the changing demand for health services, the increase in the cost of care and the continuous professional development, therefore, it is necessary to assess the possibility of introducing new professional models within clinical practice, to adapt the health system to the care that society needs.
Las enfermeras nos planteamos las diferentes formas con las que podemos comunicarnos con nuestros pacientes, pero quizás deberíamos pro-fundizar cuántas veces somos nosotras mismas las que, prejuzgamos situaciones, y acabamos siendo las que ponemos barreras a la comunica-ción. El relato que a continuación describimos es una historia real, donde su protagonista, tras el seudónimo de Serafín, nos muestra cómo en las últimas horas de su vida, ni su mudez ni la gravedad de su enfermedad limitaron su comunicación con la persona que lo cuidaba y que a su vez era quien realmente lo conocía. En una residencia de mayores cuando las personas precisan cuidados paliativos, se trabaja con las ventajas de poder ejercer un cuidado que va más allá del confort y del alivio de síntomas. En este tipo de instituciones los profesionales han convivido durante años con sus pacientes y en muchas ocasiones, tan solo una mirada puede hacer que la persona muera en paz.
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