Search

Resumen Fundamento y objetivos Comparar el estado nutricional de una poblacion de pacientes hospitalizados distribuidos en 2 grupos diferentes, tanto al ingreso como al alta hospitalaria y evaluar la influencia de la alteracion nutricional en la estancia hospitalaria. Material y metodos Estudio cuasiexperimental formado por 2 grupos de pacientes (N = 581): un grupo de intervencion (n = 303), en el que las enfermeras responsables recibieron formacion especifica en metodologia de cuidados y otro de control (n = 278), en el que las enfermeras siguieron su dinamica habitual. Cada grupo estaba compuesto por 2 unidades de cuidados con pacientes tanto de especialidades medicas como quirurgicas. Criterios de inclusion: pacientes ingresados en las unidades elegidas con una estancia minima de 5 dias. La seleccion de la muestra se realizo de manera prospectiva y consecutivamente tras realizar la accion formativa. Resultados De los 581 pacientes estudiados, el 49,4% eran mujeres y el 50,6% hombres, con una edad media de 68,29 (DT 16,23) anos. En el grupo intervencion, la odds ratio (OR) asociada a un buen estado nutricional se multiplicaba por 1,7 veces (OR = 1,67) respecto al grupo control en la primera evaluacion y por 1,4 veces (OR = 1,43) al alta. La estancia media en dias resulto mayor en el grupo control (13,71, DT 10,19) que en el grupo intervencion (10,89, DT 7,49) (p Conclusion La intervencion basada en metodologia sistematizada en las unidades intervenidas resulto positiva. Los pacientes ingresados en ellas presentaron una menor alteracion nutricional y una menor estancia hospitalaria que los ingresados en las unidades control.

Background and objectives To compare the nutritional status of a population of hospitalized patients, divided into 2 different groups, both at admission and hospital discharge, and to assess the influence of nutritional alteration during the hospital stay. Material and methods Quasi-experimental study comprising 2 groups of patients (N = 581): an intervention group (n = 303), in which nurses received specific training on managing care methodology, and a control group (n = 278), in which nurses continued their usual dynamics. Each group was made up of 2 care units with patients from both surgical and medical specialties. Inclusion criteria: patients admitted to the selected units with a minimum stay of 5 days. The sample selection was performed prospectively and consecutively after implementing the training. Results Of the 581 patients studied, 49.4% were women and 50.6% were men. Mean patient age was 68.29 (SD 16.23) years. In the intervention group, the odds ratio (OR) associated with good nutritional status was multiplied by 1.7 (OR = 1.67) compared to the control group in the first evaluation and by 1.4 times (OR = 1.43) at hospital discharge. The average stay in days was higher in the control group (13.71, SD 10.19) than in the intervention group (10.89, SD 7.49) ( p Conclusion The systematic methodology-based intervention in the chosen units was positive. Patients admitted to the intervention units had a lower nutritional alteration and a shorter hospital stay than those admitted to the control units.

BACKGROUND: Most studies address the health impact of violence by an intimate partner; therefore, violence exerted by someone other than a partner in university students and its health effects are less known. PURPOSE: This study aims to analyze the effect of different forms of interpersonal violence on female university students' health. DESIGN: Women 18 to 25 years of age enrolled at two schools of the University of Valencia in the academic year 2013-2014 (N = 540) were selected, with a participation rate of 82%. Students were grouped as follows: no lifetime violence, violence by an intimate partner (IPV), other personal violence (OPV), and by both (IPV and OPV). Adjusted logistical regression analysis was performed to assess the effects of the different forms of violence on students' health. RESULTS: As many as 92 students (20.6%) experienced violence at least once in their lives: 46 (10.3%) by an intimate partner, 24 (5.4%) by someone other than a partner, and 22 (4.9%) by both. Abused students are more likely to suffer psychological distress and poor health perception, and more regularly used psychoactive drugs than nonabused students, although the use of medication is higher for those abused by a partner and others. Women who experienced only IPV are more likely to suffer psychological distress (adjusted odds ratio [aOR] = 1.78, p CONCLUSIONS: The high prevalence of violence and its consistent association with a wide range of female university students' health problems suggest that violence seriously compromises women's health. CLINICAL RELEVANCE: Prevention programs that promote harmonious social relationships among university students should be implemented.© 2016 Sigma Theta Tau International. Language: en

Objective: To explore the association between violence and suicidal behavior in female university students. Method: A convenience sample of 540 female students enrolled in the Nursing and Teacher Training Faculties at the University of Valencia was selected. Violence by partners, nonpartners, and both was compared with suicidal thoughts and suicide attempts. An adjusted logistic regression and the Wald Test were performed to explore whether the effect on student's suicidal behavior differed if a partner or others committed violence. Results: 18.1% reported suicidal thoughts in the last month and 2.4% had attempted suicide in the past five years. Suicidal behavior was significantly higher in abused than in nonabused students, although the magnitude was higher when committed by a nonpartner. Conclusions: All forms of violence are strongly associated with suicidal behavior. Understanding the relationship between violence and suicidal thoughts and attempts is a priority for reducing suicide behavior in young women.

Background Studies reported an excess of health services utilization among women with violence by an intimate partner (IPV). However, little is known about health utilization by women victims of other forms of interpersonal violence than IPV. This study aimed to determine the effect of violence from different relationship contexts on health care utilization. Methods A cross-sectional study following a multistage cluster sampling scheme was conducted. Women aged 18 to 70 years were randomly selected according to their scheduled health care visit. The number of women invited to participate was 16,419 and 73% accepted. After exclusion, the final sample consisted of 10,815 women. The outcome variables were health care utilization (primary care, specialty services, emergency rooms, and hospital admissions) and the predictor variable was interpersonal violence from different relationship contexts. Multivariable adjusted logistic regression models were conducted to assess the independent effect of each violence relationship context on health care utilization. Main Findings Compared with never abused women, use of health services was significantly higher for abused women, although the rates varied depending on the violence relationship context. The greatest probability of service use was among women whose abuse was perpetrated by both a partner and others. Comparing the magnitude of effect of each violence category by perpetrators other than a partner, this effect was stronger for violence in a social context in the case of emergency rooms only. Conclusion Regardless of the perpetrator, lifetime violence increased health services utilization. Violence affects women’s behavior in terms of how they use health services.

The health impact of violence against women by perpetrators other than intimate partners has received little attention. This study aims to analyze the effect of different forms of interpersonal violence on women's health.Adult women (10,815) randomly sampled from primary healthcare services around Spain were included. Women were grouped as follows: (1) no history of violence, (2) history of intimate partner violence only (IPV), (3) history of non-IPV only, and (4) history of both IPV and non-IPV. Lifetime prevalence of violence by IPV, non-IPV, and both was calculated. Adjusted multivariable regression analysis was performed to assess the effects of the different forms of violence on women's health status.Of the women, 32.7% experienced lifetime violence. Poor self-perceived health, psychological distress, co-occurring somatic complaints, and use of antidepressant or tranquilizer medication were significantly higher for women with a history of violence than for women with no history of violence. Women who reported both types of violence, IPV and non-IPV, were almost five times more likely to suffer psychological distress and co-occurring somatic complaints andsix times more likely to use medication than women with no history of violence.The high prevalence of violence and its consistent association with a wide range of women's health problems suggest that violence seriously compromises women's health. Health providers should ask their female patients specifically about their history of violence, both IPV and non-IPV. Including this in patient's assessment would lead to more informed clinical decisions and more integrated care.

Objective: To assess the reliability, accuracy, and construct validity of the Spanish Abuse Assessment Screen (AAS) among pregnant women using the Spanish version of Index of Spouse Abuse (ISA) as a reference standard. Design and Sample: Cross-sectional survey. A total of 1,329 pregnant women were selected in nine primary care centers during 2008-2009. Measures: The Spanish ISA was self-administered first, followed by the AAS, administered by the midwife. Sensitivity, specificity, and predictive values of the Spanish AAS were compared with the Spanish version of the ISA as a reference standard. Results: Percentage of agreement between initial and retest administration of the Spanish AAS was high, from 96.4% to 100%. Specificity was for all types of abuse above 97%, but sensitivity values were much lower (33.3%, 22.9%, 6.9%, for severe physical abuse, minor psychological abuse, and minor physical abuse, respectively). The sensitivity of severe psychological abuse was perfect. Construct validity was good. Conclusion: The Spanish AAS has good test-retest reliability, specificity, and construct validity. The sensitivity was good for severe psychological abuse and moderate for severe physical abuse. Further formal psychometric evaluations, in other languages from countries with low prevalence of abuse, remains a priority for clinical and research efforts in pregnancy domestic violence screening.

The purpose of this study is to estimate the prevalence of lifetime intimate partner violence (IPV) in older women and to analyze its effect on women"s health and Healthcare Services utilization. Women aged 55 years and over (1,676) randomly sampled from Primary Healthcare Services around Spain were included. Lifetime IPV prevalence, types, and duration were calculated. Descriptive and multivariate procedures using logistic and multiple lineal regression models were used. Of the women studied, 29.4% experienced IPV with an average duration of 21 years. Regardless of the type of IPV experienced, abused women showed significantly poorer health and higher healthcare services utilization compared to women who had never been abused. The high prevalence detected long standing duration, negative health impact, and high healthcare services utilization, calling attention to a need for increased efforts aimed at addressing IPV in older women.

Purpose: This pilot study aims to identify factors associated to roofless own health self-perception.Design: Cross-sectional study with a sample of homeless people (n=68) who come for help to one of the homeless service centers founded by a non-profit organization. Socio-demographic characteristics, years living on streets, unhealthy habits, chronic morbidity, basic needs and self-reported physical and mental health were described. To identify factors related to mental and physical health from roofless own perspective, a binary logistic analysis was held. Findings: The majority of participants were under 40 years, male and Spanish, alcohol or drug consumers, 80% have lived in the street for one to five years with high levels of pain and poor mental health conditions. Living on the street over a year, exposure to violence, lack of hygiene and female gender, affect negatively the own perception of physical and mental health conditions.Conclusions: Our results show the different and complex homeless health needs. Given the duration of homelessness affected their health condition, recent roofless homeless should be identified as soon as possible.Clinical relevance and further research: Those providing care for homeless people must promote a more coordinated care, maximizing flexibility and fostering relationships to better response to the multiple and different needs of this one vulnerable population. Further study is needed to allow identify the different experiences of homeless women and men.

Objective To describe the incidence and risk factors of psychological intimate partner violence (IPV) during pregnancy and the first year after childbirth. Design Longitudinal cohort study. Setting Nine primary care centers in the Valencia Region (Spain). Population A consecutive sample of 1400 women in the first trimester of pregnancy, attending the prenatal programme in the Valencia Region of Spain in 2008, with follow-up in the third trimester of pregnancy, and at 5 and 12 months postpartum. A total of 888 women (66.5%) participated in all four phases. Methods A logistic regression model was fitted using generalised estimating equations to assess the effects of previous partner violence, consumption of alcohol or illicit drugs and social support on subsequent psychological partner violence. Main outcome measure Psychological IPV during follow-up. Results We observed an increase in the incidence of psychological IPV after birth, particularly at 5 months postpartum. The strongest predictor of psychological IPV was having experienced abuse 12 months before pregnancy (OR 10.46, 95%CI 2.40–45.61). Other predictors were consumption of alcohol or illicit drugs by the partner or a family member (OR3.50, 95%CI 1.38–8.85) and lack of affective social support (OR2.83, 95%CI 1.31–6.11). Conclusions Previous abuse and psychosocial risk factors predict partner psychological abuse after birth. Monitoring psychological IPV and effective interventions are needed not only during pregnancy but also during the postpartum period.

Background Research on women99s responses to intimate partner violence (IPV) has largely been limited to women who have been exposed to severe physical violence with scarce generalisation. This study aimed to analyse how Spanish abused women from different backgrounds and with different IPV characteristics respond to violence. Method Women experiencing IPV before the previous year (1469) were selected from a large cross-sectional national survey of adult women recruited during 2006–7 among female patients seeking medical care for whatever reason in primary healthcare services. The outcome variables were women9s responses to IPV and the predictor variables were personal and social resources profiles and characteristics of the abuse (type, duration and women9s age at onset). Stepwise logistic regression models were fitted. Results 87.5% of abused women took some kind of action to overcome IPV. Significant differences on personal and social profile and type and duration of the abuse were detected between the three strategic responses: distancing, in process and inhibition. The probability of a woman responding with a distancing strategy (seeking outside help or leaving temporarily) is almost three times greater if she is employed, was young when the abuse began, had experienced physical and psychological abuse and when the abuse was under 5 years. Conclusions The results of this study show that personal and social resources and the specific circumstances of the abuse should be taken into account to understand women9s responses to IPV. Well-validated interventions targeted at abused women9s needs and the circumstances of IPV remain a priority.

Objectives: To determine the effect of two kinds of intimate partner violence (IPV) (physical and psychological) in the previous 12 months (current) and before the previous 12 months (past) on psychological well-being among women aged 18 to 70 years who attend primary healthcare centers in Spain; and to analyze the effect of the duration of lifetime IPV and social support on psychological well-being. Methods: A cross-sectional survey was carried out among 10,322 women randomly recruited in primary healthcare centers in Spain. Outcome variables were three indicators of psychological well-being (psychological distress, psychotropic drug use, and self-perceived health). Predictor variables were the different types of IPV, IPV timing (current and past), duration of lifetime IPV, and social support. Logistic regression models were fitted. Results: Both types of IPV increased the probability of worse psychological well-being in both IPV timings (current and past). Longer duration of lifetime IPV, friends network size, and tangible support were independently associated with worse psychological well-being. However, an interaction between current IPV and family network size was found. The probability of poor self-perceived health status was reduced by 29% among women exposed to current IPV who had a large family network (odds ratio, 0.71; 95% confidence interval, 0.54-0.94). Conclusions: Psychological well-being was independently affected by IPV (types and duration) and social support (friends network size, tangible support). Only family network size mitigates the negative consequences of IPV on self-perceived health status. Language: en

To describe the prevalence of intimate partner violence and non-partner violence against women in Spain overall and by autonomous regions, as well as the characteristics of this violence, and to study the association between the prevalence of intimate partner violence and the frequency of formal complaints and deaths.A cross-sectional survey was performed through a self-administered questionnaire in 11,475 women attending primary care from 2006 to 2007. Multistage stratified sampling was carried out in a representative sample in each autonomous region. Data on intimate partner and non-intimate partner violence, formal complaints to the police and deaths due to intimate partner violence were gathered. A descriptive analysis was conducted. Correlations between the prevalence of intimate partner violence and police reports and deaths from this cause were determined through Pearson's correlation coefficient.A total of 24.8% (23.4%-26.3%) of the sample reported having experienced intimate partner violence at some time. The highest prevalence of intimate partner violence was found in Ceuta and Melilla (40.2%) and the Balearic Islands (32.5%) and the lowest in Cantabria (18%). Fifteen percent of the sample reported having experienced non-partner violence at some time, and the most frequent type was that committed by a relative. Again, the highest prevalence of non-partner violence was found in Ceuta and Melilla and the Balearic Islands and the lowest in Cantabria. A significant positive linear correlation was found between intimate partner violence in the previous year and the rate of reports of intimate partner violence in the autonomous regions (r=0.398; p=0.005).The prevalence of intimate partner violence varies from one autonomous region to another. The reasons for this variation should be further explored in future studies.

Background. There are a significant number of studies assessing the negative health consequences of violence against women. However, a limited number of studies analyse the health consequences of violence committed against young women by different types of aggressors. Objectives. The goal of this study is to assess the prevalence of interpersonal violence against young women in Spain and analyse its impact on the physical and mental health of the victims. Methods. A total of 1076 women aged 18–25 years attending Spanish primary care services were selected. We estimated the prevalence of interpersonal violence and compared the health data and demographic characteristics of abused and non-abused young women, multi-logistic regression models were fitted. The Wald test was used to assess whether there were differences in the negative health consequences of intimate partner (IPV) versus non-IPV. Results. As many as 27.6% young women reported a history of abuse, of whom 42.7% had been assaulted by their partner, 41.1% by someone other than their partner and 16.2% both by their partner and another person. The distribution of social and demographic characteristics was similar for IPV and non-IPV victims. Young abused women were three times more likely to suffer psychological distress and have somatic complaints, and they were four times more likely to use medication as compared to non-abused women. Conclusion. Our results suggest that all forms of violence compromise young women’s health seriously. Including patients’ history of abuse in their health record may help make more informed clinical decisions and provide a more integrated care. This study was partially supported by the Institute of Carlos III (1/06-36) (Ministry of Health, Spain) and CIBERESP (AE08018).