Maria Flores Vizcaya-Moreno

Percepción de la transición a la maternidad: estudio fenomenológico en la provincia de Barcelona

OBJECTIVES To describe needs and experiences of mothers with children under one year old, to identify the factors that hinder the transition to motherhood, and to design the content of a health promotion program to develop motherhood support group sessions. DESIGN A qualitative study with a phenomenological approach. LOCATION Eight Primary Care Centres in the province of Barcelona, between July 2011 and July 2012. PARTICIPANTS A total of 21 mothers participating in group dynamics maternity support: All of them participated in interviews and 8 in focus group. METHOD Semi-structured interviews were used in a purposive sample. The transcriptions were analysed by structure (latent content analysis) and content (manifest content analysis), with different categories being obtained. RESULTS The participants in the study defined the construct of motherhood around three categories: Changes in lifestyle, feelings and perceptions. They identified as the most stressful times; «the new role», «changes in the partner relationship», «feelings», «experiences of pregnancy and childbirth», «idealisation», «lack of support», «crying», «colic», «read the signs of the child», «bath», «rest», «contradictory opinions», «learning», and «acquisition of new skills». They highlighted, as key topics for group dynamics, feeding, development, affective relationship, maternal confidence, fathers participation, family role, emotional, rest, massage, bath, accident prevention, colic, first aid, childcare, resources, and vaccines. CONCLUSION Dynamic groups should be contextualised according to the perceived needs of the mothers, and other family members should be allowed to participate.

Reasons for delaying surgery following hip fractures and its impact on one year mortality

PurposeThe purposes of this study were to identify the reasons for delayed surgery following hip fractures and analyze the impact of these reasons on 1-year mortality.MethodsA prospective cohort study of 1234 patients with mean age of 83.1 (range 65–92, SD 8.0) who underwent hip fracture surgery compared three subgroups: (1) surgery within two days from admission (609 patients); (2) delayed surgery for medical reasons (286); and (3) delayed surgery for organizational causes (339). Medical reason was defined as the need of medical optimization of the patient prior to surgery. Pre-operative assessment was performed by the American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), Hodkinson mental status, Katz index for activities of daily living, and Short-Form (SF-12) questionnaire. Univariate analyses were used (chi-square and Fisher exact or Mantel-Haenszel tests for categorical data, and variance analysis, Student t test, or Mann-Whitney U test for continuous data). Logistic regression models were used for influence of variables on complications and one year mortality.ResultsThere were no significant differences in complications or one year mortality rates between patients with surgery within two days and those with delayed surgery for medical reasons. However, the patients with delayed surgery for organizational causes had significant higher rates of both complications and one year mortality compared to the other two groups (p = 0.001).ConclusionsThis study suggests that waiting time for hip fracture surgery more than two days was not associated with higher complication or mortality rate if waiting was to stabilize patients with active comorbidities at admission, compared to stable patients at admission with early surgery. Although early surgery within two days from admission is desirable for stable patients at admission, in patients with complex comorbidities, the surgery should be performed once they are optimized. However, the patients with delayed surgery for organizational reasons had a significant higher rate of post-operative complications and one year mortality compared to the other two groups.

Country Validation of the CLES-Scale: Linguistic and Cultural Perspectives

In the field of health sciences, cross-cultural research is enabling researchers to test, modify and disseminate theories in an international context. This practice entails the need to translate both measurement instruments and their application and correction instructions, usually from English into other languages. In this chapter, we describe the concepts of linguistic equivalence, functional equivalence, cultural equivalence and metric equivalence, along with some examples.

Comparison of Functional Outcomes Between the First and Second Knee in Staged Bilateral Total Knee Arthroplasty With Diverse Intervals Between Stages

BACKGROUND The objective of the study was to analyze if the length of interval time between stages influenced functional and quality of life outcomes in patients with staged bilateral primary total knee arthroplasty (TKA). METHODS This is a retrospective comparative study between 93 patients with an interval between stages of 6-8 months (6-month group), 112 of 12-14 months (1-year group), and 108 of 24-26 months (2-year group). Outcome variables were Knee Society scores, Western Ontario and McMaster Universities, Short Form, and patient satisfaction. RESULTS Overall, the mean follow-up for the first TKA was 8.2 (range, 7-10) years, and for the second TKA, 6.7 (range, 5-10) years. At last follow-up, functional and patient-related outcomes were similar for both knees, regardless of the interval. However, mental score and patient satisfaction were significantly better for the second than for the first TKA in the 2-year group. Age did not correlate significantly with the functional scores but was significantly correlated with the mental score. CONCLUSION The performing staged bilateral TKA with a wide interval between surgeries provided equivalent functional outcomes and quality of life for both knees. Postoperative outcomes were not affected by the length of the time interval between procedures or age. Our results can help the surgeon to inform the patients reliably about what they can expect in the delay of a second knee replaced. Thus, patients could make an informed decision.

Cruciate-Retaining vs Posterior-Stabilized Primary Total Arthroplasty. Clinical Outcome Comparison With a Minimum Follow-Up of 10 Years

BACKGROUND Controversy continues regarding whether the posterior cruciate ligament should be retained or removed during total knee arthroplasty (TKA) procedure. The objective was to compare the clinical outcomes with a minimum follow-up of 10 years between patients who received contemporary cruciate-retaining or posterior-stabilized primary TKA. METHODS Case-control study of 268 patients who underwent cruciate-retaining TKA vs 211 to posterior-stabilized design, with the same arthroplasty system, and a minimum follow-up of 10 years. Clinical assessment was performed by Knee Society scores, Western Ontario and MacMasters Universities and Short-Form 12 questionnaires, range of motion, and patient satisfaction. RESULTS Successful outcomes were found for both designs. No significant differences in functional scores, range of motion, patient-related scores, or patient satisfaction. Between the 5-year and last postoperative follow-up, there were a significant decrease of all clinical scores in both groups. In addition, complication rate and implant survival were similar between groups. CONCLUSION The superiority of one design over the other was not found. Both designs can be used expecting long-term successful outcomes and high survival. The choice of the design depended on the status of the posterior cruciate ligament and surgeon preference.