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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.

Work-related violence against healthcare workers inflicted by healthcare users is a rising multidimensional phenomenon, a cause of concern among those who ensure the safety and health of these professionals. Although different studies indicate high percentages of attacks against healthcare workers, statistics from reports reveal much lower data. Underreporting of occupational violence against healthcare workers is a well-known fact reported in many studies. It is presented as a major obstacle when it comes to proposing adequate preventive measures, because the data on which to base these measures do not correspond to the true incidence of all the assaults that take place. Underreporting also makes it difficult to correctly assess the usefulness of preventive measures implemented. The following article looks at the latest studies carried out on the subject, presenting an overview of the factors accompanying these assaults, as well as the main reasons for this underreporting. It also highlights the lack in the literature of instruments designed to measure underreporting that have undergone a validation process. For all these reasons, this problem requires further study with validated tools to determine the reasons and circumstances that accompany and promote the underreporting of violence against healthcare workers. Knowing these reasons is a preliminary step in the fight against workplace violence and to measure the true magnitude of the problem, to provide the occupational health services with precise data and develop and assess the preventive measures implemented.

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.

Background: The inflammatory bowel disease nurse plays a key role in the multidisciplinary team. The aim of the study was to evaluate the inflammatory bowel disease knowledge before and after the educational intervention with nurses. Methods: A cross-sectional, descriptive and comparative study was performed from June to August 2016. The sample consisted of 26 nurses from the nursing staff of a public university hospital in Sao Paulo State, Brazil. The study was divided into three phases: pre-educational intervention, educational intervention and post-educational intervention (test application). A p-value < 0.05 was considered to indicate statistically significance. Results: The study included 26 general nurses with an average of 9.20 ± 5.78 years of experience. There was an increase in safety in administering biological therapy after the course (from 33.34% to 78.26%), and an increase in knowledge about the main inflammatory bowel disease symptoms (64.29% vs 96.30%, p = 0.0224), and about infliximab infusion (35.71% vs 74.07%, p = 0.0404). Conclusion: The educational intervention effectively contributed to the increase of knowledge of the nursing staff.

Giovana Signorelli Astolfi Cury,1 Debora Mayumi Takamune,1 Giedre Soares Prates Herrerias,1 Adriana Rivera-Sequeiros,2 Jaqueline Ribeiro de Barros,1 Julio Pinheiro Baima,1 Rogerio Saad-Hossne,1 Ligia Yukie Sassaki1 1São Paulo State University (Unesp), Medical School, Botucatu, Brazil; 2Department of Internal Medicine, San Juan de Dios del Aljarafe Hospital, Seville, SpainCorrespondence: Giovana Signorelli Astolfi Cury, Tel +5514 38801171, Fax +55 14 38801667, Email curygigi@gmail.comBackground: Inflammatory bowel diseases are chronic conditions characterized by incapacitating symptoms, which can compromise patient’s quality of life and social interaction. As social media use is continuously increasing and Facebook is one of the most accessed social media worldwide, this study aimed to evaluate the use of Facebook and identify clinical and psychological factors associated with addiction and compensatory use among patients.Methods: This case-control study enrolled 100 outpatients and 100 healthy individuals, who were classified into the patient and control groups, respectively. Facebook use was evaluated using the questionnaire Psycho-Social Aspects of Facebook Use (PSAFU). The IBD Questionnaire and the 36-Item Short-Form Health Survey (SF-36) were used to measure Health-related quality of life. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale; self-esteem, using the Rosenberg Self-Esteem scale.Results: The patient group included 54 patients with Crohn’s disease and 46 with ulcerative colitis. Facebook use was similar between the patient and control groups in all evaluated aspects (p=0.21). In the patient and the control groups, the compensatory use of Facebook was directly related to the symptoms of depression (patients: R = 0.22; p = 0.03; controls: R = 0.34; p = 0.0006) and inversely related to self-esteem scale (patients: R = − 0.27; p = 0.006; controls: R = − 0.37; p = 0.0001). Facebook addiction showed an inverse correlation with self-esteem (patients: R = − 0.32; p = 0.001; controls: R = − 0.24; p = 0.02) and quality of life (patients: IBDQ score, R = − 0.30; p = 0.003; controls: SF-36 score, R = − 0.29; p = 0.004).Conclusion: The use of Facebook was not different between study groups. Psychological aspects such as depression and low self-esteem were associated with the compensatory use of Facebook in both groups, which may be related to unsatisfactory personal aspects of social interaction.Keywords: Facebook, addiction, compensatory use, inflammatory bowel disease

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.

To face the COVID-19 pandemic, our intensive care and hospitalization units were expanded, surgical activity was limited to urgent and non-delayed procedures and teleconsultations were increased in order to minimize face-to-face consultations. The objective of this work was to learn users' satisfaction with teleconsultations performed during the pandemic as well as its benefits, applications and areas for improvement.Cross-sectional study through a questionnaire with 26 closed questions and 5 open ones, grouped in 9 dimensions: patient characteristics; the query; treatment; utility; resolution; security; satisfaction; face-to-face modality and opportunities for improvement. Necessary sample size: 307 (confidence: 95%; error: 3%; expected satisfaction: 92%). Definitive sample: 352. Stratified random sampling by specialty. Period: March 16th-May 25th 2020. The statistical analysis was done with the statistical program SPSS vs.27.0. 95% confidence intervals were calculated.Statistical significance was established at p0.05.Patient profile: age 54 (SD: 18.6) years; 213 (60.5%) women. Calls made by doctors (298; 84.7%) and nurses (15; 4.3%); 342 (97.2%) attended at home. Reasons: follow-up (223; 63.4%); first consultation (45; 12.8%); result's report (23; 6.5%) and manage an appointment (50; 14.2%). 29 (8.62%) were directed to another center. 335 (95.44%; 95% CI: 93.26%-97.62%) patients were satisfied and 309 (91.96%; 95% CI: 89.06%-94.87%) would recommend them. 351 (99.72%; 95% CI: 99.16%-99.99%) felt they were treated with kindness; 336 (95.96%; 95% CI: 93.81%-98.11%) considered sufficient care; 309 (95.96%; 95% CI: 93.81%-98.11%) were able to solve doubts; 311 (96.58%; 95% CI: 94.60%-98.57%) calmed down; for 245 (69.6%; 95% CI: 65.98%-74.67%) it was as useful as the face-to-face session; equally safe (240; 69.57%; 95% CI: 64.71%-74.42%) and beneficial (338; 96.02%; 95% CI: 94.25%-98.26%).The high satisfaction expressed by users, the benefits verified and the high resolution of the teleconsultations, makes us consider expanding these services after the pandemic.Para afrontar la pandemia por COVID-19, ampliamos la unidad de cuidados intensivos y hospitalización, limitando la actividad quirúrgica a las urgentes y no-demorables, minimizando las consultas presenciales y aumentando las teleconsultas. El objetivo de este trabajo fue conocer la satisfacción de nuestros usuarios con las teleconsultas realizadas durante la pandemia, beneficios, aplicaciones y áreas de mejora.Estudio transversal con un cuestionario con 26 preguntas cerradas y 5 abiertas, agrupadas en 9 dimensiones: características del paciente, la consulta, trato, utilidad, resolución, seguridad, satisfacción, modalidad presencial y oportunidades de mejora. Tamaño muestral necesario: 307 (confianza: 95%; error: 3%; satisfacción esperada: 92%). Muestra definitiva: 352. Muestreo aleatorio estratificado por especialidad, entre el 16 marzo a 25 mayo. El análisis estadístico se hizo con el programa estadístico SPSS vs. 27.0. Se calcularon los intervalos de confianza al 95%. La significación estadística se estableció en p0,05.Perfil del paciente: edad 54,0 (SD: 18,6) años; 213 (60,5%) mujeres. Llamadas realizadas por médicos (298; 84,7%) y enfermeros (15; 4,3%); 342 (97,2%) atendidas en el hogar. Motivos: seguimiento (223; 63,4%); primera consulta (45; 12,8%); informar resultado (23; 6,5%) y gestionar cita (50; 14,2%). Fueron direccionados a otro centro 29 (8,62%). Estaban satisfechos 335 (95,44%; IC95%: 93,26%-97,62%) pacientes y 309 (91,96%; IC95%: 89,06%-94,87%) las recomendarían. Se sintieron tratados con amabilidad 351 (99,72%; IC95%: 99,16%-99,99%); 336 (95,96%; IC95%: 93,81%-98,11%) consideraron la atención suficiente; 309 (95,96%; IC95%: 93,81%-98,11%) pudieron resolver dudas; 311 (96,58%; IC95%: 94,60%-98,57%) se tranquilizaron; para 245 (69,6%; IC 95%: 65,98%-74,67%) fue tan útil como la presencial; igual de segura (240; 69,57%; IC95%: 64,71%-74,42%) y beneficiosa (338; 96,02%; IC 95%: 94,25%-98,26%).La alta satisfacción manifestada por los usuarios, los beneficios constatados y la gran resolución de las teleconsultas, nos hace plantearnos ampliar estos servicios tras la pandemia.