Juan Gómez-Salgado

The effects of massage therapy in hospitalized preterm neonates: A systematic review

OBJECTIVE The aim of this study was to perform a systematic review to identify, evaluate and summarise studies on the administration of therapeutic massage to preterm neonates during their stay in the NICU, and to assess their methodological quality. DESIGN systematic review following PRISMA statements guidelines. DATA SOURCES A comprehensive search was performed including relevant articles between January 2004 and December 2013, using the following electronic databases: Medline, PEDro, Web of Science and Scopus. REVIEW METHODS Two reviewers conducted a review of the selected articles: one evaluated the methodological quality of the studies and performed data extraction and the other performed a cross-check. Divergences of opinion were resolved by discussion with a third reviewer. The studies reviewed implemented a wide variety of interventions and evaluation methods, and therefore it was not possible to perform a meta-analysis. The following data were extracted from each article: year of publication, study design, participants and main measurements of outcomes obtained through the intervention. A non-quantitative synthesis of the extracted data was performed. Level of evidence was graded using the Jadad Scale. RESULTS A total of 23 articles met the inclusion criteria and were thus included in the review; these presented a methodological quality ranging from 1 to 5 points (with a mean of 3 points). Most studies reported that the administration of various forms of therapeutic massage exerted a beneficial effect on factors related to the growth of preterm infants. The causes indicated by the researchers for these anthropometric benefits included increased vagal activity, increased gastric activity and increased serum insulin levels. Other demonstrated benefits of massage therapy when administered to hospitalised preterm infants included better neurodevelopment, a positive effect on brain development, a reduced risk of neonatal sepsis, a reduction in length of hospital stay and reduced neonatal stress. CONCLUSIONS Although based on a qualitative analysis of heterogeneous data, the present review suggests that a clear benefit is obtained from the administration of massage therapy in hospitalised preterm infants, a finding which should encourage the more generalised use of massotherapy in NICU clinical practice.

Preanalytical errors: a preliminary approach to the point of view of primary health care givers.

Abstract Background: The presence of errors in the preanalytical phase is a widely studied topic. However, information regarding the perspective of those professionals involved is rather scant. Methods: Two focus groups of professionals from Primary Care involved in the preanalytical phase (general practitioners [GP], community nurses [CN], and other auxiliary health workers, including administrative personnel [AHW]) were convened. A qualitative analysis with a phenomenological approach was performed by using the structure of SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis as a guide, and results were categorized by grouping the resultant dimensions according to this structure. Results: Overall, 12 professionals (3 GP, 6 CN, and 3 AHW) were distributed in two groups. Age and gender distribution were similar between groups. The most commented strengths were organizational capability and teamwork. The main weakness was the workload increase (compared to the short time spent on sample collection). Opportunities were related to workload optimization through on-line analytical requests. Threats were related to the long time elapsed between sample drawing at Primary Care and delivery to the Central Laboratory. Conclusions: The phenomenological approach allows revealing those aspects that cannot be entirely elucidated by objective data measurement. Attitudes considered as positive can be exploited by the institution, whereas those considered as negative alert us to possible future problems. Primary Care professionals offered a different point of view to laboratory staff, but both recognized high workload as the main threat and on-line analytical request as the best opportunity. These perspectives may help to improve detection and decrease the number of errors.

Preanalytical errors: the professionals’ perspective

This study was partially supported by project Fondo de Investigaciones Sanitarias (FIS) grant PIFIS 1099/12 from “Instituto de Salud Carlos III” Ministerio de Sanidad y Politica Social. Gobierno de Espana. (Health Ministry, Spanish Government).

EditorialInvestigación, innovación y originalidad: la contribución enfermera al conocimiento científicoResearch, innovation and originality: Nursing contribution to scientific knowledge

Es indudable el crecimiento exponencial de la investigación enfermera en los últimos años, fiel reflejo del desarrollo académico que posibilita y potencia la formación de posgrado a nivel de máster y doctorado, así como la participación de enfermeras en grupos de investigación interdisciplinares. Estas nuevas coordenadas nos sitúan en una situación privilegiada, donde tenemos la posibilidad de seguir contribuyendo al cuerpo de conocimientos de la disciplina. En este sentido, no podemos olvidar que el fin último de toda investigación en salud no culmina hasta la difusión de los resultados y su integración en la práctica clínica. Actualmente, además, la investigación constituye uno de los pilares fundamentales a nivel curricular para la acreditación académica y profesional, por lo que es uno de nuestros motores de desarrollo disciplinar. Desde el mundo editorial donde nos movemos, las revistas científicas en enfermería, y como prioridad específica en Enfermería Clínica, tenemos como objetivo contribuir a la difusión de los resultados, haciendo visible la investigación enfermera, sin olvidar la responsabilidad que supone velar por la calidad y la rigurosidad de las publicaciones. Es de vital importancia confiar en la originalidad de los artículos de investigación publicados en los diferentes soportes de referencia como base ética de la difusión de la información en el campo de la investigación. La honestidad

Investigación, innovación y originalidad: la contribución enfermera al conocimiento científico

Es indudable el crecimiento exponencial de la investigación enfermera en los últimos años, fiel reflejo del desarrollo académico que posibilita y potencia la formación de posgrado a nivel de máster y doctorado, así como la participación de enfermeras en grupos de investigación interdisciplinares. Estas nuevas coordenadas nos sitúan en una situación privilegiada, donde tenemos la posibilidad de seguir contribuyendo al cuerpo de conocimientos de la disciplina. En este sentido, no podemos olvidar que el fin último de toda investigación en salud no culmina hasta la difusión de los resultados y su integración en la práctica clínica. Actualmente, además, la investigación constituye uno de los pilares fundamentales a nivel curricular para la acreditación académica y profesional, por lo que es uno de nuestros motores de desarrollo disciplinar. Desde el mundo editorial donde nos movemos, las revistas científicas en enfermería, y como prioridad específica en Enfermería Clínica, tenemos como objetivo contribuir a la difusión de los resultados, haciendo visible la investigación enfermera, sin olvidar la responsabilidad que supone velar por la calidad y la rigurosidad de las publicaciones. Es de vital importancia confiar en la originalidad de los artículos de investigación publicados en los diferentes soportes de referencia como base ética de la difusión de la información en el campo de la investigación. La honestidad

Integrating Research Techniques to Improve Quality and Safety in the Preanalytical Phase

Background Reducing errors in the preanalytical phase is difficult, which suggests the issue may be multidimensional. As such, qualitative research may be truly innovative in this context. Method We carried out a descriptive study using a qualitative method incorporating 4 focus groups. Data analysis followed the principles of Grounded Theory. Results We queried in each of the 4 focus groups collectively to identify weaknesses in the system. Those weaknesses that were most cited were logistics, coupled with uneven compliance with regulations. Conclusion All 4 focus groups mapped out directives for future work, so that regulatory aspects, process management, communication and resources could be identified as key areas where error reduction is critical.

Rehabilitation and early mobilization in the critical patient: systematic review

[Purpose] To review the literature that examines rehabilitation and early mobilization and that involves different practices (effects of interventions) for the critically ill patient. [Materials and Methods] A PRISMA-Systematic review has been conducted based on different data sources: Biblioteca Virtual en Salud, CINHAL, Pubmed, Scopus, and Web of Science were used to identify randomized controlled trials, crossover trials, and case-control studies. [Results] Eleven studies were included. Early rehabilitation had no significant effect on the length of stay and number of cases of Intensive Care Unit Acquired Weaknesses. However, early rehabilitation had a significant effect on the functional status, muscle strength, mechanical ventilation duration, walking ability at discharge, and health quality of life. [Conclusion] Rehabilitation and early mobilization are associated with an increased probability of walking more distance at discharge. Early rehabilitation is associated with an increase in functional capacity and muscle strength, an improvement in walking distance and better perception of the health-related quality of life. Cycloergometer and electrical stimulation can be used to maintain muscle strength. Further research is needed to establish stronger evidences.

Examination of the Brain-Dead Organ Donor Management Process at a Spanish Hospital

The number of donors and organs available has not increased at the same rate as the inclusion of new patients in the waiting lists. The aim of the present study was to analyze the quality of the detection process of potential brain-dead organ donors at the Hospital of León. For this, a cross-sectional prospective study was developed on a retrospective cohort of patients who were admitted or died by catastrophic brain damage with the potential for organs donation. Data were collected for six months using hospital records of admissions and exitus. For the statistical analysis, the free distribution software Epi Info 3.5.4 was employed. A total of 627 patients were studied: 550 were discharged and 77 died as potential donors. Of the potential donors, 65 died in asystole, but 60 of them had an absolute contraindication to donation and 20 died after limitation of life support therapy. Five cases with donor criteria in controlled asystole were detected. The analysis found that the detection process conformed to the regulatory framework stablished by the National Transplant Organization. However, population aging leads to a high rate of absolute contraindications among detected potential donors. The donation capacity of the hospital could therefore be increased with the implementation of a donor protocol in controlled asystole.

Job Satisfaction and Perceived Health in Spanish Construction Workers during the Economic Crisis

The attitude towards work, either satisfaction or dissatisfaction, could influence the way in which workers perceive their health status. To check this hypothesis, this study analyses job satisfaction and its relationship with occupational health perception of Spanish construction workers. A descriptive, cross-sectional, observational study was carried out through a socio-demographic data questionnaire, the General Scale of Job Satisfaction and the SF-36 Health Survey. The study was conducted from January 2014 to June 2015, on a sample of 302 individuals belonging to Andalusian companies using the stratified random method to access companies from different provinces and sizes. The findings indicate that work experience in the sector increases general satisfaction: workers above 55 years of age are more satisfied with their work than those between 36 and 45. Likewise, workers with an experience of 2–5 years show higher levels of overall satisfaction, in opposition to workers with 6 months and 2 years of experience. On the other hand, workers without a contract and interns are the most dissatisfied in job terms. Also, there is a positive correlation between job satisfaction and the positive dimensions of health perception (physical functioning and physical and social role functioning), as well as a negative correlation between job satisfaction and bodily pain and general health perceived.

Factors Affecting Sick Leave Duration for Non-Work-Related Temporary Disabilities in Brazilian University Public Servants

Sickness absenteeism in public institutions compromises the execution of services, and may also generate direct impacts on the population that receives coverage. To determine if sick leave duration for temporary disabilities is associated with non-work-related illnesses (NWRI), a historical cohort study was carried out of workers at a Brazilian University. The Charlson Comorbidity Index (CCI) was obtained from the most prevalent diagnoses in each expert examination and from the corresponding days of sick leave per episode, adjusting simple and multiple Cox regression models. As a result, 70% of the NWRI temporary disabilities were due to depressive disorders, convalescence, and dorsalgia with a sick leave duration between 4 and 320 days. The factors of protection for sick leave durations until the rehabilitation were non-insulin-dependent diabetes mellitus and hypertension. Long-term sick leaves were observed in the cases that required rehabilitation of those workers diagnosed with recurrent depressive disorders, conjunctivitis, acute sinusitis, skin disorders, calculus of kidney and ureter, abdominal and pelvic pain, and same-level fall accidents. It is also worth noting that even in a disease that can justify long-term sick leaves, such as breast cancer, the duration may be shorter according to the worker’s capacity and self-efficacy.