Domingo Palacios-Ceña

Identification of intervention categories for aquatic physical therapy in pediatrics using the International Classification of Functioning, Disability and Health-Children and Youth: a global expert survey

Highlights • Due to the unique properties of the water-based environment, a range of categories may be treated.• This study reveals the areas of functioning and disability most commonly targeted by aquatic physical therapists.• Prior authors have performed Delphi studies to determine the categories related to specific diagnoses, not categorizing interventions.• This guide could be included in goal setting for a given condition.• This may enable aquatic physical therapists to develop treatment-based classification systems and competencies for entry-level practice.

Individual and institutional factors associated with functional disability in nursing home residents: An observational study with multilevel analysis

Background High prevalence of functional limitations has been previously observed in nursing homes. Disability may depend not only on the characteristics of the residents but also on the facility characteristics. The aims of this study were: 1, to describe the prevalence of functional disability in older people living in Spanish nursing homes; and 2, to analyze the relationships between individual and nursing home characteristics and residents’ functional disability. Methods A cross-sectional study with data collected from 895 residents in 34 nursing homes in the province of Albacete (Spain) was conducted. Functional status was assessed by the Barthel Index. Taking into account both levels of data (individual and institutional characteristics) we resorted to a multilevel analysis in order to take different sources of variability in the data. Results The prevalence of functional disability of the total sample was 79.8%. The best fitting multilevel model showed that female gender, older age, negative self-perception of health, and living in private nursing homes were factors significantly associated with functional disability. After separating individual and institutional effects, the institutions showed significant differences. Conclusions In line with previous findings, our study found high levels of functional dependence among institutionalized elders. Gender, age, self-perception of health, and institution ownership were associated with functional status. Disentangling individual and institutional effects by means of multilevel models can help evaluate the quality of the residences.

Living with chronic migraine: a qualitative study on female patients' perspectives from a specialised headache clinic in Spain

Objectives The aim of this study was to explore the views and experiences of a group of Spanish women suffering from chronic migraine (CM). Setting Headache clinic at a university hospital in Madrid (Spain). Participants Purposeful sampling of patients that attended a specialised headache clinic for the first time between June 2016 and February 2017 was performed. The patients included were females aged 18–65 and with positive diagnoses of CM according to the International Classification of Headache disorders (third edition, beta version), with or without medication overuse. Accordingly, 20 patients participated in the study with a mean age of 38.65 years (SD 13.85). Design Qualitative phenomenological study. Methods Data were collected through in-depth interviews, researchers’ field notes and patients’ drawings. A thematic analysis was performed following appropriate guidelines for qualitative research. Results Five main themes describing the significance of suffering emerged: (a) the shame of suffering from an invisible condition; (b) treatment: between need, scepticism and fear; (c) looking for physicians’ support and sincerity and fighting misconceptions; (d) limiting the impact on daily life through self-control; and (e) family and work: between understanding and disbelief. The disease is experienced as an invisible process, and the journey to diagnosis can be a long and tortuous one. Drug prescription by the physician is greeted with distrust and scepticism. Patients expect sincerity, support and the involvement of their doctors in relation to their disease. Pain becomes the main focus of the patient’s life, and it requires considerable self-control. The disease has a strong impact in the work and family environment, where the patient may feel misunderstood. Conclusions Qualitative research offers insight into the way patients with CM experience their disease and it may be helpful in establishing a more fruitful relationship with these patients.

Balance deficiencies in women with fibromyalgia assessed using computerised dynamic posturography: a cross-sectional study in Spain

Objectives Our aims were (1) to compare the sensory organisation of balance control and balance strategies between women with fibromyalgia (FM) and healthy women; (2) to investigate which sensory component, that is, vestibular, visual or somato-sensory, is the most affected in FM and (3) to determine the associations between the functional independence measure (FIM) and balance responses in FM. Design Cross-sectional observational study. Setting Urban regional hospital and university (Universidad Rey Juan Carlos, Madrid, Spain). Participants Twenty women with FM and 20 matched healthy women. Primary/secondary outcome measures The sensory organisation test (SOT) was used to determine postural sway and balance during six different conditions with subjects in a standing position. The FIM was used to determine the level of functional independence in daily life activities (ADL). Between-group differences were analysed with analysis of covariance, and the Spearmans test was used for correlations. Results Significant differences between-groups and between-conditions were found for all SOT conditions (all, p<0.001): women with FM showed lower scores being the vestibular score the most affected. Different correlations between SOT conditions and some specific ADL were observed in the FM group: bathing activity and balance condition 6 (rs=0.541; p<0.001), bed transfers activity and conditions 2 (rs=0.491; p<0.001) and 3 (rs=0.510; p<0.001), positioning strategy six and dressing the upper (rs=0.530; p<0.001) or lower (rs=0.562; p<0.001) body, and toileting (rs=0.521; p<0.001): the greater the loss of balance, the greater the interference on some daily life activities. Conclusions Women with FM exhibited balance deficiencies and used different strategies for maintaining their balance in standing, which was associated with a negative impact on functional independence.

Supplemental nursing staff´s experiences at a Spanish hospital: Qualitative phenomenology research.

The objective of this study was to describe the Supplemental Nursing Staff´s experiences at different hospital units. A qualitative phenomenological approach was conducted; a purposeful and theoretical sampling was implemented with supplemental nursing staff at Santa Barbara Hospital of Soria (Spain), to gain a more in-depth understanding of the Supplemental Nursing Staff ´s experience. Data were collected by in-depth interviews and through a field notebook. Data were analyzed using the Giorgi proposal. Twenty-one nurses with a mean age of 46 years were included. Three main topics emerged from the data analysis: building the first contact, carving out a niche and establishing interprofessional/interpersonal relationships. We conclude that the experience of hosting the supplemental nursing staff in changing clinical environments is conditioned by various factors. It is necessary for nurses and hospital managers to establish clear objectives with regard to the supplemental nursing staff´s role in the units.O proposito deste estudo e descrever a experiencia das enfermeiras de turno nas diferentes unidades hospitalares. Seguiu- -se um enfoque fenomenologico e qua...

A experiência das enfermeiras de turno num hospital espanhol: estudo qualitativo-fenomenológico.

The objective of this study was to describe the Supplemental Nursing Staff´s experiences at different hospital units. A qualitative phenomenological approach was conducted; a purposeful and theoretical sampling was implemented with supplemental nursing staff at Santa Barbara Hospital of Soria (Spain), to gain a more in-depth understanding of the Supplemental Nursing Staff ´s experience. Data were collected by in-depth interviews and through a field notebook. Data were analyzed using the Giorgi proposal. Twenty-one nurses with a mean age of 46 years were included. Three main topics emerged from the data analysis: building the first contact, carving out a niche and establishing interprofessional/interpersonal relationships. We conclude that the experience of hosting the supplemental nursing staff in changing clinical environments is conditioned by various factors. It is necessary for nurses and hospital managers to establish clear objectives with regard to the supplemental nursing staff´s role in the units.O proposito deste estudo e descrever a experiencia das enfermeiras de turno nas diferentes unidades hospitalares. Seguiu- -se um enfoque fenomenologico e qua...

La experiencia de las enfermeras "de apoyo" en un hospital español: estudio cualitativo fenomenológico

The objective of this study was to describe the Supplemental Nursing Staff´s experiences at different hospital units. A qualitative phenomenological approach was conducted; a purposeful and theoretical sampling was implemented with supplemental nursing staff at Santa Barbara Hospital of Soria (Spain), to gain a more in-depth understanding of the Supplemental Nursing Staff ´s experience. Data were collected by in-depth interviews and through a field notebook. Data were analyzed using the Giorgi proposal. Twenty-one nurses with a mean age of 46 years were included. Three main topics emerged from the data analysis: building the first contact, carving out a niche and establishing interprofessional/interpersonal relationships. We conclude that the experience of hosting the supplemental nursing staff in changing clinical environments is conditioned by various factors. It is necessary for nurses and hospital managers to establish clear objectives with regard to the supplemental nursing staff´s role in the units.O proposito deste estudo e descrever a experiencia das enfermeiras de turno nas diferentes unidades hospitalares. Seguiu- -se um enfoque fenomenologico e qua...