No abstract

The decentralization of health systems can have direct repercussions on maternity care. Some inequalities can be noted in outcomes, like neonatal and child mortality in Spain. This study aimed to make the presence of obstetric violence in Spain visible as an interterritorial equity criterion. A descriptive, restrospective and cross-sectional study was conducted between January 2018 and June 2019. The sample comprised 17,541 questionnaires, which represented all Spanish Autonomous Communities. Of our sample, 38.3% perceived having suffered obstetric violence; 44.4% perceived that they had undergone unnecessary and/or painful procedures, of whom 83.4% were not requested to provide informed consent. The mean satisfaction with the attention women received obtained 6.94 points in the general sample and 4.85 points for those women who viewed themselves as victims of obstetric violence. Spain seems to have a serious problem with public health and respecting human rights in obstetric violence. Offering information to women and requesting their informed consent are barely practiced in the healthcare system, so it is necessary to profoundly reflect on obstetric practices with, and request informed consent from, women in Spain.

Objectives:to evaluate the effectiveness of an educational intervention on the knowledge, skills and attitudes of evidence-based practice among second-year nursing students. Method:a quasi-experimental before-and-after study. The study population consisted of 120 students enrolled in the Nursing Care in Healthcare Processes course. The educational intervention was based on theoretical and practical classes about the evidence-based practice process and the use of the critical incident technique during the clinical clerkship. Effectiveness was measured with the Evidence-Based Practice Competence Questionnaire in three paired measures using repeated-measures analysis of variance. Results:the mean scores of the Evidence-Based Practice Competence Questionnaire were 79.83 (CI 95% 78.63-81.03) for the basal measurement, 84.53 (CI 95% 83.23-85.83) for the intermediate measurement, and 84.91 (CI 95% 83.26-86.55) for the final measurement, with a statistically significant difference among the three paired measurements (p<0.001). There were statistically significant differences in Attitudes (p = 0.034) and Knowledge (p <0.001) but not in Skills (p = 0.137). Conclusion:this educational intervention based on theoretical and practical classes about the evidence-based practice process and the use of the critical incident technique during the clinical clerkship enhances evidence-based practice competence among second-year nursing degree students.

Background: Despite scientific recommendations for exclusive breastfeeding until 6 months of age and complementary breastfeeding to 2 years of age, breastfeeding abandonment rates increase with time, and one of the main reasons is that women go back to work. Aim: To analyze the perception of support of breastfeeding workers to continue breastfeeding at two Spanish universities, and associated factors. Methods: A multicenter retrospective cross-sectional comparative study conducted in a population of 777 female workers at the Universidad de Sevilla (US) and the Universitat Jaume I (UJI) in Spain using an online questionnaire. Results: The response rate was 38.74% (n = 301). Of all the participants, 57.8% continued breastfeeding after returning to work. The factors associated with continuing breastfeeding for longer were the university having a breastfeeding support policy and special accommodation (p < 0.001); participating in breastfeeding support groups (p < 0.001); intending to continue breastfeeding after returning to work (p < 0.001); knowing the occupational legislation in force (p = 0.009); having a female supervisor (p = 0.04). Conclusion: Breastfeeding support initiatives and having special accommodation to pump and preserve breast milk after returning to work are associated with a longer duration of female workers’ breastfeeding.

Objetivo Desarrollar un modelo SIR pronóstico de la pandemia de COVID-19 en el territorio colombiano.Métodos Se utilizó un modelo SIR con enfoque determinístico para pronosticar el desarrollo de la pandemia de COVID-19 en Colombia. Los estados considerados fueron susceptibles (S), infecciosos (i) y recuperados o fallecidos (R). Los datos poblacionales se obtuvieron del Departamento Administrativo Nacional de estadística Proyecciones de Población 2018-2020, difundida en enero de 2020) y los datos sobre casos diarios confirmados de COVID-19 del Instituto Nacional de Salud. Se plantearon diferentes modelos variando el número básico de reproducción (R0).Resultados A partir de los casos reportados por el Ministerio de Salud se crearon cuatro ambientes o escenarios simulados en un modelo SIR epidemiológico, se extendieron las series de tiempo hasta el 30 de mayo, fecha probable del 99% de infección poblacional. Un R0 de 2 es la aproximación más cercana al comportamiento de la pandemia durante los primeros 15 días desde el reporte del caso 0, el peor escenario se daría en la primera semana de abril con un R0 igual a 3.Conclusiones Se hacen necesarias nuevas medidas de mitigación y supresión en las fases de contención y transmisión sostenida, como aumento de la capacidad diagnostica por pruebas y desinfección de zonas pobladas y hogares de aislamiento.

Background: El burnout académico aparece por la aproximación de los estudiantes a las sobrecargas de las esferas laboral y académica, y puede repercutir negativamente en el aprendizaje y la calidad de los cuidados durante las prácticas clínicas. Objectives: Evaluar la presencia del síndrome de burnout en estudiantes de enfermería y detectar los principales factores estresores durante las prácticas clínicas. Design: Estudio observacional, descriptivo y transversal llevado a cabo entre enero y julio de 2017. Settings and participants: Estudiantes de segundo, tercero y cuarto curso del Grado en Enfermería de la Universitat Jaume I (España) (n=126). Methods: Se utilizaron los cuestionarios KEZKAK y Maslach Burnout Inventory Student Survey para llevar a cabo la recogida de datos, así como variables sociodemográficas y relacionadas con las prácticas clínicas. Se realizó un análisis descriptivo y bivariante de los cuestionaros respecto a las variables sociodemográficas y relacionadas con las prácticas clínicas. Results: Ningún estudiante presentó un alto percentil en despersonalización, ni un percentil bajo en realización personal. Asimismo, se observó cómo la despersonalización aumentó conforme se avanza de curso académico (p=0,027). Los factores más estresantes fueron impotencia e incertidumbre (m=3,61; ds=0,345) y confundirse de medicación (m=2,50; ds=0,754). El colectivo femenino reflejó mayores niveles de estrés ante múltiples factores como la falta de competencia (p=0,001) o tener que dar malas noticias (p=0,01). Conclusion: El estudio llevado a cabo pone de manifiesto que la muestra sujeta a estudio no cumple los criterios para el establecimiento del Síndrome de Burnout. Además, se han identificado los principales estresores en los estudiantes de grado de enfermería durante las prácticas clínicas.

Objective:to identify and classify the most important occupational stressors affecting nursing professionals in the medical units within a hospital. Method:quantitative-qualitative, descriptive and prospective study performed with Delphi technique in the medical units of a general university hospital, with a sample of 30 nursing professionals. Results:the stressors were work overload, frequent interruptions in the accomplishment of their tasks, night working, simultaneity of performing different tasks, not having enough time to give emotional support to the patient or lack of time for some patients who need it, among others. Conclusion:the most consensual stressors were ranked as work overload, frequent interruptions in the accomplishment of their tasks, night working and, finally, simultaneity of performing different tasks. These results can be used as a tool in the clinical management of hospital units, aiming to improve the quality of life of nursing professionals, organizational models and, in addition, continuous improvement in clinical treatment.

Background: Obstetric violence could be defined as the dehumanized treatment or abuse of health professionals towards the body or reproductive process of women. Some practices associated with obstetric violence have been routinely standardized and do not include the woman in decision making. This type of violence has consequences for the health of both the mother and the baby and that of the professionals who practice or observed it. Methods: A questionnaire consisting of 33 items that measured perception through a Likert scale was developed. Some sociodemographic variables were collected. The instrument was applied to a sample of nursing, medicine and midwifery students to determine its psychometric properties. Results: The final sample consisted of 153 students. The Kaiser-Meyer-Olkin (p = 0.918) and Barlett tests (p ≤ 0.001) allowed for factor analysis, which explained 54.47% of the variance in two factors called protocolized-visible obstetric violence and non-protocolized-invisible obstetric violence. Conclusions: The PercOV-S (Perception of Obstetric Violence in Students) instrument was validated. The distribution and content of the two factors are closely related to obstetric violence against women. The existence of statistically significant relationships between the sociodemographic variables collected and the global measurements, domains and items of the PercOV-S scale highlight the normalization of obstetric violence as a central factor for future studies.