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Aim: To obtain consensus on barriers and facilitators to nurse prescribing following its recent introduction in Spain. Design: A three round online Delphi survey and focus group. Methods: An exploratory method was used with three consecutive rounds of questionnaires based on anonymity and feedback, and a focus group. The study was carried out with primary care, specialized care, socio‐health care and manager nurses. Results: On the basis of the Delphi study that was conducted, a list of 15 barriers and 18 facilitators of nurse prescribing was obtained. However, no general consensus was found with respect to the prioritization of these barriers/facilitators. The analysis of the results of the focus group confirmed the information obtained from the Delphi study. The main barriers highlighted were dependence on the figure of the physician, insufficient training in pharmacology, a lack of institutional support and the limited list of products that could be prescribed. The key facilitators were academic knowledge and ongoing training and education, independence in the functions and responsibilities of the nursing profession, adaptation to new roles and autonomy in the case of chronic care processes. Conclusion: Nurses were generally positive about the introduction of nurse prescribing. The commitment of nurses to training and their accreditation as prescribers (internal forces) and health policy and nursing management (external forces) play a fundamental role in supporting the basis of nurse prescribing and ensuring that it is developed with the identified support resources, such as staff training and the provision of the materials necessary for its proper implementation, all with the aim of guaranteeing quality healthcare. Implications for the Profession and/or Patient Care: Strong models of nurse prescribing are being considered globally to address population needs. The results can help the future implementation of non‐medical independent prescribing and provide guidance to the government and society on the interventions that can be used to consolidate it. Impact: What problem did the study address? By 2027, the world's population will receive more than 4.5 trillion doses of medicine each year. However, the WHO estimates a projected shortfall of 10 million health workers by 2030. Inadequacies with traditional physician‐led care systems mean that new approaches are imperative to maintain patient access to prescription medicines, with NP being a key element in this regard. In Catalonia (Spain), the accreditation process for nurses as prescribers was implemented in 2021. It is therefore of vital importance to question and consult the nurses themselves, the main promoters of the process, to find out their perceptions and thus be able to take them into consideration in the implementation process.What were the main findings? A total of 15 barriers and 17 facilitators were identified. The main perceived barriers are dependence on the figure of the physician, insufficient training in pharmacology during undergraduate studies and a lack of institutional support. The main perceived facilitators are academic knowledge and ongoing education and training, independence in nursing functions and responsibilities, and adaptation to new roles and tasks.Where and on whom will the research have an impact? These results can contribute to improving NP implementation in Spain and serve as a reference for other countries, especially where NP education and training have only recently been instigated or are in the planning process. Reporting Method: Standards for reporting qualitative research: a synthesis of recommendations. SRQR. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Docosahexaenoic acid (DHA) is a polyunsaturated essential fatty acid from the omega-3 series that appears to be key to perinatal mental health. For this, the aim of this review is to evaluate the effect of DHA on maternal mental health during pregnancy and lactation with respect to depression and anxiety. The present scoping review was carried out following the methodology of Arksey and O'Malley (2005). The selection of studies was carried out in accordance with PRISMA by means of systematic searches in the PubMed, Scopus, PsycINFO and Medline databases. The results classified according to the effectiveness of DHA. In most (n = 9) of the 14 studies finally included, DHA plasma levels with or without other polyunsaturated omega-3 fatty acids were significantly lower in pregnant women with depressive and anxiety symptoms. However, no study reported a beneficial effect of DHA on mental health during the postpartum period. The majority used detection method was the Edinburgh Postpartum Depression Scale (n = 11). The prevalence of depressive symptoms ranged between 5.9 % and 50 %. As a conclusion, although more research is needed in this area, these exploratory results suggest that DHA could play an important role in preventing the pathogenesis of depression and anxiety during gestation. [ABSTRACT FROM AUTHOR]

Background: Given the beneficial effects of exercise in different populations and the close relationship between healthy ageing and sleep quality, our objective was to determine if physical exercise delivered through a structured program improves sleep quality in older adults. Methods: Embase, PubMed/MEDLINE, Web of Science, and Cochrane Register of Clinical Trials (CENTRAL) were searched to 15 January 2023. Studies that applied physical exercise programs in older adults were reviewed. Two independent reviewers analysed the studies, extracted the data, and assessed the quality of evidence. Results: Of the 2599 reports returned by the initial search, 13 articles reporting on 2612 patients were included in the data synthesis. The articles used interventions based on yoga (n = 5), multicomponent exercise (n = 3), walking (n = 2), cycling (n = 1), pilates (n = 1), elastic bands (n = 1), and healthy beat acupunch (n = 1). In the intervention group, we found significant improvement in Pittsburgh sleep quality index of −2.49 points (95% CI −3.84 to −1.14) in comparison to the control group (p = 0.0003) and sleep efficiency measured with objective instruments (MD 1.18%, 95% CI 0.86 to 1.50%, p < 0.0001). Conclusion: Our results found that physical exercise programs in older adults improve sleep quality and efficiency measured with objective instruments. [ABSTRACT FROM AUTHOR]

Objective: To identify and analyse topical treatments for peripheral venous catheter (PVC)‐related phlebitis. Design: The methodological framework used to make this scoping review was developed by Arksey and O'Malley (2005; (International Journal of Social Research Methodology, 8, 2005 and 19)). Data sources: A literature search was performed in various databases such as PubMed, Scopus, CINAHL, Cochrane, Cuiden, Web of Science, WorldWideScience and Joanna Briggs. Additionally, articles from informal sources were incorporated. Review methods: A search and selection were made of experimental, quasi‐experimental and pre‐experimental studies published between January 2015 and September 2020 that consider the use of topical products for the treatment of hospital in‐patients with PVC‐related phlebitis. Appraisal of the methodological quality of the study was performed independently by pairs of reviewers on the basis of the Cochrane Collaboration tool. The review was based on the guidelines in the PRISMA‐ScR statement. Results: Twenty‐two articles were selected (8 randomised controlled trials (RCTs), 12 quasi‐RCTs and 2 pre‐experimental studies) which considered treatments applied to a total of 2042 adult patients. The topical treatments described were classified into physical measures and phytotherapeutic and pharmacological treatments. The physical measures are easy to apply, but their effectiveness is limited. The main limitation of the phytotherapeutic treatments is their marketing and use in eastern culture. The best performing pharmacological treatment is the application of magnesium sulphate either with or without glycerine. These products can be presented in different pharmaceutical formulas: ointment, solution and oil. Conclusions and relevance to clinical practice: The evidence currently available on this issue is limited and often of dubious methodological rigour. Further studies are required on the treatment and follow‐up of intravenous therapy‐related phlebitis in different national and international contexts. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this study was to determine the prevalence of low fluid intake in institutionalized older residents and the associated factors. Design This was a cross-sectional study. Setting and Participants The study was carried out at a nursing home with a capacity for 156 residents, all of whom were older than 65 years. Measures Data were collected on the fluids consumed by each resident over a period of 1 week. Information relating to sociodemographic variables and to residents' health, nutrition, and hydration status was also collected. Results Of 53 residents, 34% ingested less than 1500 mL/d. The factors with the greatest correlation associated with low fluid intake were cognitive and functional impairment, the risk of suffering pressure ulcers, being undernourished, a texture-modified diet, dysphagia, impaired swallowing safety, and BUN:creatinine ratio. Conclusions/Implications The results obtained highlight the scale of low fluid intake in nursing homes and also aid to identify and understand the factors associated with this problem. The findings could help us to develop specific strategies to promote the intake of liquids and thereby reduce the incidence of dehydration in nursing homes. [ABSTRACT FROM AUTHOR]

Background: residents are vulnerable to suffer of dehydration due to physiological changes and the physical and cognitive limitations.Aim: to handle this situation, it has been decided to evaluate the interventions which are carried out for the management of dehydration and low fluid intake in older people living in nursing homes.Methods: the revised scientific literature review methodology of PRISMA was applied. An electronic database search was performed in PubMed, Scopus, CINAHL and other sources databases. The literature search was carried out between October 2016 and January 2017. Out of a total of 3,379 articles extracted, eleven studies were selected for analysis. In addition, their quality was assessed through Cochrane and the Newcastle-Ottawa Scale.Results: the risk of bias in the studies was mostly medium. Regarding the results, the interventions were classified according to whether they were invasive or non-invasive. Invasive interventions were intravenous and/or subcutaneous fluid therapy. Their effectiveness was related to the clinical improvement of dehydration. However, local reactions appeared. Non-invasive interventions focused on the individualized assistance, the stimulation to drink more and the consideration of the preferences of each resident, producing an increase in fluid intake and an improvement in analytical parameters.Conclusions: given the peculiarities of the institutionalized elderly population, both types of intervention have been shown to have a positive effect on improving hydration. Nonetheless, non-invasive interventions have confirmed to be more efficient given their simplicity of application and cause fewer adverse effects. [ABSTRACT FROM AUTHOR]

Background Dehydration in the older people is a prevalent problem that is often associated with physiological changes, physical limitations and environmental conditions. Objectives The scoping review was carried out to identify risk factors associated with dehydration in older people living in nursing homes. Design The revised scoping methodology framework of Arksey and O’Malley (2005) was applied. Study selection was carried out in accordance with Davis et al. (2009) and focused on the inclusion criteria (people over 65 years old and living in nursing homes). Risk factors were classified using the geriatric assessment. Data sources An electronic database search was performed in PubMed, Scopus and CINAHL. The literature search was carried out between October 2016 and January 2017. Review methods Thematic reporting was performed and study findings were validated through interdisciplinary meetings of experts. The quality of the papers consulted was also evaluated using the Newcastle-Ottawa Scale adapted for cross-sectional, cohort and case-control studies. Results In all, 16 papers were analysed, all of which were observational studies. The risk of bias ranged from very low (n = 1), to medium (n = 13) and high (n = 2). The risk factors were classified in line with the different components of the geriatric assessment. In the socio-demographic characteristics age and gender were identified. In the clinical component, infections, renal and cardiovascular diseases and end-of-life situations were the most common factors highlighted in the papers analysed. With reference to the functional component, its limitation was associated with dehydration, while for factors of mental origin, it was related to dementia and behavioural disorders. Finally, the factors relating to the social component were institutionalisation, requiring a skilled level of care and it being winter. Conclusions The most commonly repeated factors highlighted in the review were age, gender, infections, end of life and dementia, with it being important to highlight the large number of factors in the clinical component. Even so, the great majority of the factors were unmodifiable conditions associated typically associated with the physiology of ageing. [ABSTRACT FROM AUTHOR]

Introduction. During the COVID-19 pandemic, there was a need to promote the most adequate behaviors. It is essential to know what aspects were implemented and what needs to be re-enforced. Objectives. (a) To identify the knowledge and behaviors related with preventive measures, lifestyle habits, sources of information, vaccination, and emotions generated and coping strategies and (b) to explore the personal experiences with respect to the knowledge, attitudes, and practices when facing COVID-19. Design. A convergent mixed method design. Setting and Participants. This study was conducted in the Segrià region (Catalonia, Spain) during the months of January and February 2022, with individuals 18 years old or older. Methods. Based on variables proposed by the WHO and a bibliographic review, an ad hoc electronic survey was utilized for the quantitative part, analyzed through frequency distribution or central tendency and dispersion measurements. For the qualitative part, two focus groups were analyzed through content analysis. Results. The participants (n QUAN = 1,559; n QUAL = 19) were aware about and applied the prevention measures, but when delving into it, deficiencies were detected especially when referring to hand-washing; lifestyles remained healthy; the population trusted the information from professionals (78.8%), but excess of information led to saturation; protection (75.3%) and herd immunity (47.2%) were recognized with vaccination; and the psychological impact (69.5%) was buffered with the activation of positive coping measures (99.1%), although it was maintained in more than half of them. Conclusions. This study showed that prevention measures must be re-enforced, especially hand-washing. Another revealing aspect was psychological impact, which, although coping measures were utilized, was maintained for another two years in most of them. This evidences the need for an intervention centered on this to guarantee the mental health of the population. Implications for Nursing Management. The detection of the current needs of the population provides the information necessary for the design of an adapted intervention and for promoting health education programs to address COVID-19 or other future health situations. [ABSTRACT FROM AUTHOR]

The COVID‐19 crisis in Spain has exacerbated the shortage of nursing staff to respond to increasing healthcare demands. For this reason, nursing students were requested to collaborate voluntarily as auxiliary health staff. This emergency has led to mental health problems in health professionals, hence the relevance of coping techniques. The objectives of this study were to explore the experiences and emotional responses of final‐year nursing students who volunteered to carry out healthcare relief tasks during the peak of the COVID‐19 pandemic, and to identify the coping strategies they adopted to deal with this situation. A qualitative study was conducted in the constructivist paradigm. Purposive sampling was used, and twenty‐two students participated in semi‐structured interviews, which were then content‐analysed. The study is reported using the COREQ checklist. Five themes emerged in the 'Experiences and emotional response' dimension (context, patients, emotions and feelings, risk of contagion, and personal satisfaction), and three themes emerged in the 'Coping strategies' dimension strategies in the work environment, in daily life and personal life. Although the students expressed negative emotions due to the highly complex context and lack of professional experience, they evaluated the experience positively in terms of learning and usefulness. Most notably, the students employed adaptive coping strategies to deal with the pandemic. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has had an important impact on the academic world. It is known that university studies can influence the mental health of students, and especially those studying health sciences. In this study, we therefore sought to analyse whether the current pandemic has affected the mental well‐being of final‐year nursing students. This was a multi‐centre study, with a descriptive, longitudinal, and prospective design. Mental well‐being was evaluated using the General Health Questionnaire. A total of 305 participants were included in the study, of whom 52.1% had experienced the COVID‐19 pandemic. Statistically significant differences were found between the two groups analysed in terms of age, access to university, average marks, mental well‐being self‐esteem, emotional exhaustion, and sense of coherence. In the case of mental well‐being, a direct association was found with both the pandemic situation (OR = 2.32, P = 0.010) and emotional exhaustion scores (OR = 1.20, P < 0.001), while an inverse association was found with sense of coherence scores (OR = 0.45, P < 0.001). This study shows that the mental health of students is a significant factor and one that must be taken into consideration when training nursing staff at university. There is a need to promote healthy habits and provide appropriate coping strategies. It is also important to train and prepare students for pandemic situations as these can have an important impact on the mental health of both the members of the public who will be treated by these future nursing professionals and the students themselves. [ABSTRACT FROM AUTHOR]

Introduction: Background: dehydration in institutionalized elderly people has not been extensively studied. There are not clear data on the Spanish context. Aim: to estimate the prevalence of dehydration and to identify the associated factors in institutionalized older people in a nursing home. Methods: a cross-sectional study was carried out. Dehydration was measured through the colour of urine. For the identification of the associated factors, sociodemographic, clinical, functional, and mental variables were selected. Results: the total sample studied was comprised of 96 individuals with a mean age of 86.6 years (± 7.1), of whom 80.2 % were women. The prevalence of dehydration was 31.3% (95 % CI, 22.0 to 40.6). The factors that were independently associated with dehydration were the presence of sunken eyes (OR = 8.67; p = 0.004), low fluid intake (OR = 3.96; p = 0.041), and both functional (OR = 0.97; p = 0.012) and cognitive (OR = 1.10; p = 0.009) impairment. Conclusions: this study highlights the problem of dehydration in institutionalized older people in Spain. An urine colour table may be used routinely, non-invasively, and cheaply. So, it may well be the best simple method for detecting dehydration in this population. Taking into account that chronic dehydration is most prevalent in elderly people, the identification of associated factors is a key factor for a successful approach. [ABSTRACT FROM AUTHOR]

Background: Despite technological advances and specialist training of neonatal teams, perinatal deaths still occur. Such events are traumatic experiences for the parents and increase the risk of pathological grieving. Nursing is one of the main sources of support. However, the important work of nurses in these situations is made more difficult by the lack of recognized strategies that can be implemented to assist parents and family members in the bereavement process. Aim: Identify nursing interventions to help parents of neonates admitted to neonatal intensive care units cope with perinatal loss. Methods: A scoping review based on the methodological framework established by Arksey and O'Malley was used. A total of 327 relevant studies were identified through a bibliographic search in Pubmed, CINAHL Plus, APA PsycNET and Scopus between 2000 and 2019. The screening process included an initial analysis of the relevance of the abstract and, when required, an extensive review of the full paper. Results: A total of 9 papers were finally selected which responded to the research question. All nine papers are from the USA and have different methodological characteristics. A number of effective interventions were identified, including legacy creation, support groups, family‐centred accompaniment and follow‐up, parental involvement in pre‐mortem care, intergenerational bereavement programmes, and the use of technological and spiritual resources. Conclusion: In general, the scant evidence that is available about nursing interventions around perinatal bereavement care underlines the requirement to thoroughly assess the effectiveness of those that have already been designed and implemented. Implications for nursing practice and policy: This scoping review contributes to the potential implementation of effective interventions to deal with and help parents and family members cope with perinatal bereavement, with nursing staff as the main source of support and leading interventions which have family members in the care team. This review also makes a substantial contribution to the development of a practical and evidence‐based clinical guide for nursing, with recommendations that can be adapted to effective quality care criteria. It is additionally intended to encourage visibility in health policies of care and attention to perinatal grief in neonatal intensive care units. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare fitness levels in women aged 60 and over participating in a supervised exercise program (involving tai chi, recreational gymnastics, and/or aquatic fitness) with those in a sedentary group. An observational, descriptive, cross-sectional study was performed on a total of 171 women aged from 60 to 92 who attended public community clubs for older adults. The instruments used included the Senior Fitness Test, the Tinetti Balance Assessment Tool, the Katz Index, and the Lawton & Brody Activities of Daily Living Scale. Significant differences in fitness levels were observed when we compared the exercise groups with the sedentary group. Women with better fitness levels had a lower risk of suffering falls and greater autonomy in performing activities of daily living and instrumental activities of daily living. Agility and gait control were found to be independently associated with exercise groups. [ABSTRACT FROM AUTHOR]

Background: Despite the number of studies that have tried to demonstrate that there is an association between previous falls and the fear of falling, the relationship between these two variables remains a matter of controversy. Objectives: Our objective was to investigate whether the fear of falling is a cause of falls, a consequence, or both in community-dwelling adults aged ≥ 75 years old. Methods: A descriptive, longitudinal, prospective study was performed. A total of 640 individuals were interviewed between 2009 and 2011. Sociodemographic data, health status, history of falls and fear of falling were assessed at baseline and at 24 months. Results: The prevalence of falls at baseline was 25% as opposed to 35.2% at 24 months. The prevalence of the fear of falling was 41.5% at baseline. Logistic regression analysis showed a significant association between a history of falls and the fear of falling. Other factors associated with the fear of falling were female gender, comorbidity, depressive symptoms, and disability. In total, 41.7% of the subjects who had reported a fear of falling at baseline had suffered at least one fall 24 months later. Unadjusted Cox regression analysis revealed that the fear of falling was a risk factor for falls. According to the final model adjusted for other covariates, the only reliable predictor was female gender. The Cox model stratified by gender failed to show a crude association between fear of falling and falls. Conclusion: A previous history of falls in the previous year was a good predictor of the fear of falling; but the fear of falling was a predictor of falls during follow-up only in the unadjusted model, pointing to strong gender turns out as an effect modifier of the association of FOF and subsequent falls. Nursing staff working in elderly care should not only routinely assess patients’ previous history of falls, but also evaluate their fear of falling and its associated factors. [ABSTRACT FROM AUTHOR]