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We analysed whether immediate skin-to-skin contact between the healthy newborn and the mother after a caesarean section has a modulatory role on postpartum haemorrhage and uterine contraction. Unblinded, randomized clinical trial, simple random sampling, conducted in women undergoing caesarean sections. Of the population identified, the caesarean section total (N = 359), 23.2% (N = 83) met the inclusion criteria: scheduled caesarean section, accepting skin-to-skin contact, good level of consciousness. They were randomly allocated to the intervention group, skin-to-skin contact (N = 40), and to the control group, usual procedure (N = 40). There were three losses. Clinical variables: plasma haemoglobin, uterine contraction, breastfeeding, postoperative pain, were measured, and subjective variables: maternal satisfaction, comfort, comparison with previous caesarean section and newborn crying. Women with skin-to-skin contact had greater uterine contraction after caesarean section. The maternal plasma haemoglobin levels at discharge were significantly higher. It was associated with higher breastfeeding rate, satisfaction, comfort levels and with less maternal pain and less crying in the newborn.

Resumen La agresion laboral a profesionales sanitarios por parte de los usuarios del sistema es un fenomeno multidimensional en alza, motivo de preocupacion para aquellos que velan por la seguridad y salud de dichos profesionales. Aunque diferentes estudios senalan altos porcentajes de personal sanitario agredido, las estadisticas de declaraciones realizadas revelan datos muy inferiores. La infradeclaracion de las agresiones laborales a sanitarios es un hecho conocido y referido en multitud de estudios y se presenta como un gran escollo a la hora de poder proponer medidas preventivas adecuadas, ya que las estadisticas en las que estas pueden basarse no corresponden a la verdadera casuistica de todas las agresiones que se producen. Asi mismo, dificulta el poder valorar correctamente la utilidad de las medidas preventivas adoptadas. El siguiente articulo hace un recorrido por los ultimos estudios realizados sobre el tema, presentando una panoramica general sobre los factores que acompanan a las agresiones, asi como de los motivos principales involucrados en que la infradeclaracion se produzca. Destaca, ademas, en la literatura, la falta de instrumentos que hayan sido sometidos a un proceso de validacion para medir esta infradeclaracion. Por todo ello, es necesario seguir investigando en esta problematica con herramientas validadas que permitan conocer los motivos y circunstancias que acompanan y fomentan la infradeclaracion de las agresiones a profesionales sanitarios. Conocer estos motivos es un paso previo para luchar contra la misma y poder conocer la verdadera magnitud del problema, de modo que los servicios de salud laboral puedan contar con datos precisos y desarrollar y evaluar medidas preventivas implementadas.

To evaluate the effectiveness of telemedicine psychoeducational interventions (PIs) in adult patients on the clinical management of chronic non-oncological diseases compared with another therapeutic option or no treatment.Systematic review of randomized controlled trials.Six databases were searched between January 2011 and August 2021.A systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study selection, quality appraisal and data extraction were conducted independently by two reviewers. A third arbiter was available if discrepancies.A total of 719 articles were reviewed and 17 studies met the inclusion and quality criteria. The included studies related to smoking, chronic pain, obesity and mental illness. Most interventions were based on cognitive behavioural theory. Most of the included studies (12/17, 70.5%) showed improvements in health and significant reductions in anxiety, pain and depression with variable effect sizes. Patients reported a high satisfaction rate and indicated lectures or self-report writings as helpful in their recovery compared with more interactive items. Only financial incentives demonstrated greater adherence. A specific intervention format or complementary professional support was not associated with health outcomes.Telemedicine PIs are a safe and effective option for the clinical management of adults with chronic diseases. Future longitudinal studies are needed to assess the impact of these interventions on chronic physical and mental disease, evaluating the quality of life, morbidity and mortality.The results reinforce the telemedicine PIs with effects on clinical management similar to those of the face-to-face modality and can be carried out in a safe environment for patients at a lower cost to the health system. These conditions make them suitable for comprehensive care in the epidemiological COVID-19 context with the highest safety conditions for the patients and professionals.

AIM To build and preliminarily validate a Spanish-language instrument to assess the impact that CNCP has on the daily lives of people who suffer from it. BACKGROUND The experience of pain is multifactorial and a correct assessment of it helps to control the intensity of pain. Although there are instruments that evaluate areas on which Chronic Non-Cancer Pain impacts, it would be necessary to include other aspects that scientific literature identifies as relevant. DESIGN Instrument and construct cross-sectional study for psychometric validation. METHODS A total of 157 items based on items from validated questionnaires were evaluated by a group of 21 chronic pain experts using Delphi methodology in three evaluation rounds. A final questionnaire of 55 items with a 5-point Likert-type scale was formed. This questionnaire was piloted on a total of 30 patients to assess their understanding of the items and the psychometric validation process was carried out (January to March 2020) on a subsequent sample of 395 people, all of whom attended Pain Units and Primary Care Centres of the Public Health System in Spain. RESULTS The PAIN_Integral Scale© showed acceptable internal consistency scores measured by Cronbach's alpha. Exploratory Factor Analysis indicated a structure of nine factors that explain 71.02% of the total variance, from 157 to a final total of 36 items. Confirmatory Factor Analysis showing adequate values confirmed this structure. The effect size was used to calculate the cut-off points for the overall scale, setting them at scores of 130 and 135. CONCLUSION This instrument would allow to assess other constructs and dimensions not included in the instruments previously available such as treatment compliance, proactivity, resilience, hopelessness due to pain and pain catastrophizing. However, despite the fact that the preliminary analysis shows good results, it is necessary to continue with its validation process in subsequent studies. IMPACT The PAIN_Integral Scale© , once the validation process is finished, could be a complete enough instrument to allow a comprehensive healthcare assessment of Chronic Non-Cancer Pain's impact on daily nursing clinical practice and other healthcare professionals.