Search

Marta Mellides González,1 Marta Elena Losa Iglesias,2 Inmaculada Corral-Liria,2 Ricardo Becerro-de-Bengoa-Vallejo,3 Eva Maria Martinez-Jimenez,3 Sandra Fares-Medina,2 Sara González-Martín,2 Marta San-Antolín,4 Raquel Jiménez-Fernández2 1Hospital Universitario 12 de Octubre, Usera, Madrid, 28041, Spain; 2Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, 28922, Spain; 3Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, 28040, Spain; 4Department of Psychology, Universidad de Valladolid, Valladolid, 47002, SpainCorrespondence: Inmaculada Corral-Liria, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, 28922, Spain, Email inmaculada.corral.liria@urjc.esObjective: To evaluate the moral distress (MD)in health professionals of pediatric and adult units to show how the complexity of care in the pediatric field causes the professionals who carry out their activity in these units to present a higher level of moral distress and a worse climate ethical.Design: Observational study with health professionals who currently work in Spanish Hospitals.Methods: A 58-item questionnaire was electronically distributed which included sociodemographic and employment characteristics, the Spanish version of the Measure of Moral Unrest for Healthcare Professionals (MMD-HP-SPA) and the Hospital Ethical Climate Survey (HECS).Results: A total of 169 health professionals completed the questionnaire. The moral distress was significantly higher among nurses than among physicians and nursing assistant care technicians. Focusing on the type of unit, moral distress it was only significantly higher for those physicians treating adult patients compared to those treating pediatric patients. Regarding the total score of the HECS survey, the medical group shows higher scores compared to the nursing group.Conclusion: Statistically significant differences have been found only in the medical group that treats adult patients, presenting a higher level of moral unrests than the pediatrician group. The MMD-HP-SPA questionnaire is a valid and useful instrument to detect MD in our hospital units in order to be able to implement strategies/interventions that improve the ethical climate and other factors that can mitigate and prevent this MD.Keywords: moral unrest, ethical climate, surveys, questionnaires, pediatrics

Background: This research evaluated whether the relationships between factors of resilience, self-esteem, depression, and anxiety in dental students with changes in teaching and learning methods. We also studied the psychological impact of face-to-face lectures during the COVID-19 pandemic., Methods: This cross-sectional descriptive study used Google Forms to collect data with the Rosenberg Self-Esteem Scale (RSE), Connor-Davidson Risk Resilience Scale (CD-RISC), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI and BDI-II). An open-ended question was also asked about important learning difficulties., Results: The analysis revealed very high levels of resilience (30.23 ± 5.84), self-esteem in the normal range (29.08 ± 4.03), minimal depression levels (12.32 ± 8.05), and low anxiety levels (17.20 ± 12.41). There were no significant differences between sociodemographic variables ranges in regard to all psychological questionnaires. No high levels of depression and anxiety were found., Conclusions: The levels were low compared to other studies in which online teaching was used, which is explained by the fact that the students retained adequate resilience and self-esteem thanks to being able to contact teachers and, above all, their own peers., (© 2024. The Author(s).)

Introduction: The aim of this systematic review is to assess the relationship between patient empowerment and other empowerment-related constructs, and affective symptoms and quality of life in patients with type 2 diabetes., Methods: A systematic review of the literature was conducted, according to the PRISMA guidelines. Studies addressing adult patients with type 2 diabetes and reporting the association between empowerment-related constructs and subjective measures of anxiety, depression and distress, as well as self-reported quality of life were included. The following electronic databases were consulted from inception to July 2022: Medline, Embase, PsycINFO, and Cochrane Library. The methodological quality of the included studies was analyzed using validated tools adapted to each study design. Meta-analyses of correlations were performed using an inverse variance restricted maximum likelihood random-effects., Results: The initial search yielded 2463 references and seventy-one studies were finally included. We found a weak-to-moderate inverse association between patient empowerment-related constructs and both anxiety ( r = -0.22) and depression ( r = -0.29). Moreover, empowerment-related constructs were moderately negatively correlated with distress ( r = -0.31) and moderately positively correlated with general quality of life ( r = 0.32). Small associations between empowerment-related constructs and both mental ( r = 0.23) and physical quality of life ( r = 0.13) were also reported., Discussion: This evidence is mostly from cross-sectional studies. High-quality prospective studies are needed not only to better understand the role of patient empowerment but to assess causal associations. The results of the study highlight the importance of patient empowerment and other empowerment-related constructs such as self-efficacy or perceived control in diabetes care. Thus, they should be considered in the design, development and implementation of effective interventions and policies aimed at improving psychosocial outcomes in patients with type 2 diabetes., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192429, identifier CRD42020192429., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Duarte-Díaz, Perestelo-Pérez, Rivero-Santana, Peñate, Álvarez-Pérez, Ramos-García, González-Pacheco, Goya-Arteaga, de Bonis-Braun, González-Martín, Ramallo-Fariña, Carrion and Serrano-Aguilar.)

Background: Intensive care units (ICUs) may produce stress on the relatives of patients that have long-term physiological and psychological implications., Objectives: This study aimed to evaluate the effects of the relatives´ visit prior to hospital admission(s) on the patient's scheduled cardiac surgery regarding depression, anxiety, and satisfaction of the patient's family in an ICU., Methods: A randomized clinical trial [NCT03605420] was carried out according to the CONSORT criteria. Thirty-eight relatives of ICU patients were recruited at an ICU and randomized into study groups. Experimental group participants ( n  = 19) consisted of relatives who received 1 ICU visit prior to the patient's admission. Control group participants ( n  = 19) consisted of patients' relatives who received standard care alone. A self-report test battery, including the Impact of Event Scale-Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS), was completed by the patient's relative prior to the patient's ICU admission and again three and 90 days after ICU discharge. Furthermore, the Family Satisfaction with Care in the Intensive Care Unit (FS-ICU) and Critical Care Family Needs Inventory (CCFNI) were administered to help determine the respondents' satisfaction three days after the patient's ICU discharge., Results: Statistically significant differences in FS-ICU results were found between control and experimental groups; no statistically significant differences were found in IES-R, HADS, and CCFNI results. Thus, members in the control group were more satisfied with the time elapsed to raise their concerns ( p =0.005), emotional support provided ( p =0.020), quality of care ( p =0.035), opportunities to express concerns and ask questions ( p =0.005), and general satisfaction with the ICU's decision-making ( p =0.003)., Conclusions: Relatives' satisfaction during patients' ICU admission may be impaired after their prior visit to the hospital admission. Relative's anxiety and depression scores did not seem to be significantly affected. Relatives´ visit prior to elective cardiac surgery hospital admission impaired their satisfaction in an ICU and may not be advisable for healthcare practice., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Sara González-Martín et al.)

Background: There are no studies on long-term bilateral calf stretching in relation to balance and plantar pressure., Objectives: To demonstrate that there is better control of posture and pressures after continuous stretching of the posterior calf muscles., Design and Setting: Pre and post-intervention study conducted in a private clinic., Methods: We measured static footprints and stabilometry before and after continuous passive plantar flexor stretching of duration 120 seconds, among 24 healthy subjects., Results: We found differences in Y displacement with eyes closed (P = 0.010), but not among other variables with eyes closed: X displacement (P = 0.263); surface (P = 0.940); laterolateral speed displacement (P = 0.279); and anteroposterior speed displacement (P = 0.914). There were also no differences in eyes-open variables: X displacement (P = 0.341); Y displacement (P = 0.491); surface (P = 0.167); laterolateral speed displacement (P = 0.852); and anteroposterior speed displacement (P = 0.079). The plantar pressures in the heel (maximum pressure, P = 0.048; mean pressure, P = 0.001) and in the midfoot (maximum pressure, P = 0.004; mean pressure, P = 0.004) were reduced, but not in the forefoot (maximum pressure, P = 0.391; mean pressure, P = 0.225). The surface became larger in the forefoot (P = 0.000) and midfoot (P = 0.021)., Conclusions: Continuous static stretching of plantar flexors for 120 seconds improved stance balance and reduced plantar pressures (maximum and mean) in the rearfoot and midfoot. It also increased the surface in the midfoot and forefoot., Trial Registration: at clinicaltrials.gov, under the number NTC03743168.

Orthodontic extrusion (OE) is an orthodontic tooth movement in a coronal direction to modify the tooth position and/or induce changes on the surrounding bone and soft tissue with a therapeutic purpose. Evidence emanating from clinical reports and case series studies indicates that OE is a predictable treatment option to manage a variety of clinical situations. Common indications include traction of impacted teeth, exposure of teeth presenting structural damage to facilitate restorative therapy, treatment of periodontal bony and papillary defects, and implant site development. Unfortunately, there is a paucity of established protocols and guidelines for its application in clinical practice. Controversy exists in regard to the definition of rapid and slow OE, use of circumferential supracrestal fiberotomy, and tooth stabilization protocols during and upon completion of orthodontic movement. This article provides a concise perspective on the topic of OE by discussing key biologic principles and technical aspects that are translated into guidelines for the management of different clinical scenarios.

Objectives: To assess the effects of a vists prior to hospital admission on anxiety, depression and satisfaction of patients admitted electively to an intensive care unit (ICU)., Design: A randomised clinical trial [NCT03605407]., Setting: A sample of 38 patients was recruited who were to be electively admiited to ICU divided into experimental (n = 19 patients receiving one visit prior to hospital ICU admission for surgery) and control (n = 19 patients not receiving a visit prior to hospital ICU admission for surgery) groups., Main Outcome Measurements: Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale-Revised (IES-R) were self-reported by patients before ICU admission, at 3-days and 90-days after ICU discharge. Critical Care Family Needs Inventory (CCFNI) and Family Satisfaction with Care in the Intensive Care Unit (FS-ICU) were used to measure the users' satisfaction before ICU admission and 3-days after ICU discharge., Results: There were statistically significant differences between experimental and control groups for FS-ICU, but not for HADS, IES-R and CCFNI. Indeed, control group patients were more satisfied with regard to emotional support, ease of getting information, control feeling, concerns and questions expression ability and overall score for decision-making satisfaction., Conclusions: The visit prior to hospital admission did not seem to modify anxiety or depression, but may impair satisfaction of ICU patients., (Copyright © 2019 Elsevier Ltd. All rights reserved.)