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Background: Delirium or an acute confusional state (ACS) is characterised as being a frequent and complex hospital complication in older adult patients, which can affect their level of independence and increase patient morbidity and mortality. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium, leading to longer hospital and ICU stays, increased mortality and long-term impairment., Objectives: This review aims to assess existing evidence of interventions that can be considered effective for the management and prevention of delirium in ICUs, reducing short-term morbidity and mortality, ICU and hospital admission times and the occurrence of other long-term complications., Methodology: For this systematic review, we searched Medline, PubMed, Cochrane Library, CINHAL, LILACS, SciELO and Dialnet from January 2018 to August 2024, in English, Spanish and French. MeSH descriptors were adjusted to search the different databases. We also checked Prospero for ongoing systematic reviews., Main Results: The electronic search yielded a total of 2656 studies, of which 14 trials met the eligibility criteria, with a total of 14,711 participants. We included eight randomised clinical trial (RCTs), four cohort analyses, one systematic review and one observational trial, including participants over 65 years admitted to the ICU. Ten of these studies were based on pharmacological interventions, three of them examined non-pharmacological interventions and the remaining study examined mixed (pharmacological and non-pharmacological) interventions. Six placebo RCTs were included, plus four reported comparisons between different drugs. Regarding non-pharmacological interventions, nursing programmes focused on optimising modifiable risk factors or the use of therapies such as bright light are emerging. Regarding mixed interventions, we found the combination of invasive techniques and with sedoanalgesia., Conclusions: Due to its satisfactory level of sedation, dexmedetomidine is presented as a viable option because, although olanzapine offers safer results, postoperative administration angiotensin inhibitor systems significantly reduced the incidence of delirium. As for propofol, no significant differences were found. Among the non-pharmacological and mixed therapies, bright light therapy was able to reduce the incidence of delirium, and the combination of epidural/general anaesthesia was effective in all subtypes of delirium. Concerning the remaining interventions, the scientific evidence is still insufficient to provide a definitive recommendation.

Objective: to evaluate the level of cultural competence of an undergraduate nursing students' population from four European higher education institutions., Method: a total of 168 nursing students from four different countries were included in our study. The study methodology involved a cross-sectional assessment of cultural competence among undergraduate nursing students from four European universities. Data collection included sociodemographic variables, as well as the following validated tools: the Intercultural Sensitivity Scale, the Cultural Competence Assessment Tool (student version) and the Cultural Awareness Scale., Results: our results indicated that students demonstrated a high level of intercultural sensitivity but a moderate level of cultural competence and cultural awareness. Variations existed among students from different countries, suggesting potential differences in educational approaches. Despite expectations that higher-level students would exhibit greater cultural competence, no significant differences were found by year of study, indicating a lack of effective integration of cultural competence into nursing curricula., Conclusion: nurse educators should consider the students' cultural competence before designing related study programmes. Training programmes related to cultural competence should include elements which have been associated with enhanced cultural competence, including language skills, cultural encounter, and opportunities for internationalisation.

Purpose: To know the discontinuation rate and characterize predictors and reasons of contraceptive implant removal within 12 months of insertion in our community setting., Methods: This prospective cohort study included women receiving the etonogestrel contraceptive implant at sexual and reproductive health centers between September 2019 and September 2020. The variables collected were implanted insertion timing, reproductive and demographic characteristics, medical conditions, sexual activity and counseling. Our primary outcome was implant discontinuation. Kaplan-Meier survival curves were used to show the cumulative discontinuation rate of implants contraceptive within the first year of insertion. We also identified factors that increased the risk of implant removal using the log-rank test and the Cox regression model. Reasons for discontinuation were documented., Results: 199 women were followed up. Implant discontinuation was documented in 17.1% of implant users prior to 12 months. Factors that increase the risk of implant removal are living with a partner, being aged 25-34 years and not receiving comprehensive and structured counseling from the midwife. The main reason for removal was unsatisfactory bleeding (97.1%), but this was combined with other reasons such as cessation of sexual intercourse (58.8%), worsening mood (58.8%), weight gain (55.9%) or decreased libido (50.0%)., Conclusion: The rate of discontinuous implant uses in the first year is relevant in relation to cost-effectiveness, there is room for improvement that should not be overlooked. Comprehensive and structured midwife-led counseling can reduce early implant abandonment removal. The development in different countries of the role of midwives in the management of contraceptives can contribute to the economic benefit of health services and the satisfaction of women., 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 © 2024 Ruiz de Viñaspre-Hernández, Garrido-Santamaria, Urra-Martínez, Sáenz-Cabredo, Garrido-Rivas, Juárez-Vela, Sánchez-González, Lafuente-Jimenez, Ramón-Arbués, Navas-Echazarreta and Santolalla-Arnedo.)

Background: Symptoms of anxiety and depression are prevalent among young adults and are a significant public health issue. College students are at a higher risk of experiencing poor mental health than other young people due to several factors, including moving away from home, financial pressures, heavy workload, poor time management skills, competitivity, new processes of socialization and insufficient coping mechanisms, among others. In addition, nursing students' mental and physical health may also be affected by unhealthy lifestyle habits and health-related behaviors., Aim: To determine the prevalence of symptoms of depression and anxiety, and the association between these symptoms and health-related behaviors, in a population of Spanish student nurses., Methods: Cross-sectional study on a sample of 339 nursing students. We used the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire-Short form, the Spanish Healthy Eating Index and an " ad hoc " questionnaire for sociodemographic variables. The association between psychological symptoms and health-related behaviors was analyzed through binary logistic regression models., Results: The prevalence of symptoms of depression and anxiety was 3.8% and 24.5%, respectively. Negative health-related behaviors were frequent, namely tobacco and alcohol consumption, suboptimal physical activity and diet. Moderate physical activity was associated with a lower probability of experiencing depressive symptoms. Symptoms of anxiety were related to a low level of physical activity, an unhealthy diet and alcohol consumption ≥2 times a week., Conclusion: Student nurses could benefit from the implementation of both physical and mental health promotion initiatives., 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 Ramón-Arbués, Sagarra-Romero, Echániz-Serrano, Granada-López, Cobos-Rincón, Juárez-Vela, Navas-Echazarreta and Antón-Solanas.)

Objective: to determine the prevalence of anxiety and depression symptoms, as well as their association with screen time, diet and physical activity, in a cohort comprised by nursing students., Method: a descriptive and cross-sectional study conducted with a sample of 648 Nursing students. The instruments used were the Hospital Anxiety and Depression Scale, the short version of the International Physical Activity Questionnaire and the Spanish Healthy Eating Index (Índice de Alimentación Saludable Español, IASE). Different multiple linear regression models were performed to analyze the association between anxiety/depression symptoms and screen time, diet and physical activity., Results: the prevalence values for anxiety and depression symptoms were 24.1% and 3.7%, respectively. Prolonged screen times (>6 hours a day), low levels of physical activity and inadequate diet were independently and significantly associated with deeper psychological symptoms., Conclusion: Nursing students' mental health might benefit from the implementation of initiatives promoting healthy lifestyles.

Background: Research shows that many mental disorders begin in childhood but are sometimes not diagnosed until later years. School-age children spend much of their time in schools and have daily interactions with school teachers., Aim: Examine school teachers' experiences of mental disorders in school going children and adolescents and their associated mental health training needs., Method and Sample: A descriptive cross-sectional study was carried out with teachers in Infant-Primary and Secondary Education-Baccalaureate schools., Results: A convenience sample of 685 teachers responded to the online survey. Participants worked in both urban and rural areas and in Infant-Primary and Secondary Education-Baccalaureate schools. Over half of participants reported classroom experiences of learner mental disorders such as ADHD, anxiety, conduct disorders or autism. Most participants acknowledged a training need, both in recognition of symptoms of mental disorders and in care resources and processes. However, 80% of respondents reported having not received any training in this regard. Participant preferences for training included face-to-face or hybrid - combined online learning. Participants also considered the management of their own mental health to be deficient, therefore any training should incorporate personal mental health awareness and self-help strategies., Conclusion: In Aragón (Spain), teachers of children and adolescents with mental disorders, recognize a need for training in the identification of symptoms and other aspects of mental healthcare, such as availability and access to services. Protocols for early identification and referral would promote mentally healthy school environments and reduce stigma which could be a barrier to timely intervention. In addition, any training should include mental health self-care for teachers., 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 Granada-López, Ramón-Arbués, Echániz-Serrano, Juárez-Vela, Cobos-Rincón, Satustégui-Dordá, Navas-Echazarreta, Santolalla-Arnedo and Nash.)

Background: Nursing professionals have a crucial role in promoting health literacy in health services, so it is necessary to ensure health literacy skills in future health professionals., Objective: The objective of the study was to examine the health literacy of nursing students and its associated factors., Methods: A cross-sectional descriptive study was carried out on 460 nursing students. For data collection, a semi-structured questionnaire was obtained on sociodemographic characteristics, perception and health care, use of the health system and lifestyles. In addition, health literacy was assessed using the European Health Literacy Questionnaire., Results: 6.1% of the participants had an inadequate level of health literacy and 36.5% problematic. The probability of having sufficient health literacy is directly associated with age; and inversely with smoking, prolonged screen time and living alone ( p  < 0.05)., Conclusion: A large percentage of nursing students need to improve their health literacy skills. It is necessary to integrate a greater number of contents in health literacy in the curriculum of nursing students., 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 Ramón-Arbués, Granada-López, Antón-Solanas, Cobos-Rincón, Rodríguez-Calvo, Gea-Caballero, Juárez-Vela, Tejada-Garrido and Echániz-Serrano.)

Objective: to describe the physical activity patterns of a cohort comprised by pregnant women from our environment and to explore its association with weight gain in each of the trimesters of pregnancy., Methods: a descriptive and longitudinal study conducted with a sample of 151 women. The International Physical Activity Questionnaire was used to assess physical activity during pregnancy based on volume, intensity and setting where it is performed. Different multiple linear regression models were performed to analyze the association between physical activity and gestational weight gain., Results: physical activity decreased during pregnancy, both in terms of time and intensity. Pre-gestational Body Mass Index was the main factor associated with lower weight gain throughout pregnancy. The influence of physical activity on gestational weight gain was limited to the third trimester of pregnancy, where an inverse association was observed between both variables., Conclusion: the results of this study show an important reduction in physical activity during pregnancy and suggest that it exerts a limited influence on gestational weight gain.

Quality of life (QOL) is a complex and multifaceted concept that has been used to study different aspects of people's lives, including physical and psychological wellbeing, financial independence, social relationships, personal beliefs and living situation. In this study, we aimed to assess the QOL of a group of Spanish university students and identify associated factors., Method: We completed a cross-sectional study of the QOL of 868 university students using the WHOQOL-BREF questionnaire. In addition, data regarding sociodemographic information and self-esteem (Rosenberg Self-Esteem Scale), physical activity (International Physical Activity Questionnaire-Short version), diet (Spanish Index of Healthy Eating), alcohol consumption (CAGE questionnaire) and sleep quality (Pittsburgh Sleep Quality Index) were collected., Results: A total of 66.2% of participants assessed their QOL positively, while 58.8% favorably evaluated their overall health. Students reported the highest scores for the physical health domain of QOL, whereas they gave the lowest scores for the psychological health domain. Age was inversely associated with QOL. Higher self-esteem and satisfaction with academic performance, as well as sleep and diet quality, were directly associated with higher QOL. The physical health domain of QOL was scored more highly by participants who had a healthy body weight or those who reported moderate levels of physical activity. Higher scores in the social relationships domain of QOL were directly linked to alcohol intake, smoking and low body weight in addition to being inversely associated with screen time. The psychological domain of QOL was lower for those who were overweight or lived alone., Conclusion: Many sociodemographic, academic and behavioral variables are associated with university students' QOL. The present findings underscore the need to direct further initiatives toward identifying and overcoming barriers to increased QOL for university students.

Objective: To analyze the perception of culture and experience of working in European health services of a purposive sample of qualified migrant and ethnic minority nurses currently living in Belgium, Portugal, Spain and Turkey., Method: A qualitative phenomenological method was chosen. Individual interviews took place with 8 qualified migrant and ethnic minority nurses currently living in four European countries. Thematic analysis was conducted using Braun and Clark's stages after qualitative data had been verbatim transcribed, translated into English, and analyzed., Results: Four themes and 4 subthemes emerged from thematic analysis of the transcripts., Conclusion: Migrant and ethnic minority nurses working in the European Union experience and witness discrimination and prejudice from patients and colleagues due to cultural differences. European health services should closely monitor and address discrimination and prejudice towards migrant and ethnic minority staff and patients, and take initiatives to reduce and, eventually, eradicate them.

While it has long been recognized that diet is a leading behavioral risk factor for human health, recent scientific findings have also suggested that diet and sleep quality may be connected. The purpose of the present study is to evaluate the association between diet and sleep quality among a group of Spanish university students. To do so, a cross-sectional study of 868 students was carried out. Sleep quality was assessed using the Spanish version of the Pittsburgh Sleep Quality Index (PSQI), while diet was assessed using the Spanish Healthy Eating Index (SHEI). The study revealed a noteworthy rate of bad sleepers (51.6%) and students whose diet needed modifications (82.2%). Unhealthy eaters were more likely to have poor sleep quality (aOR = 4.20; CI 95%: 2.07-8.52). The unbalanced intake of vegetables (aOR = 1.63; CI 95%: 1.14-2.34), fruits (aOR = 4.08; CI 95%: 2.90-5.74), dairy products (aOR = 1.96; CI 95%: 1.41-2.72), lean meats (aOR = 1.82; CI 95%: 1.19-2.78), legumes (aOR = 1.43; CI 95%: 1.00-2.02), sweets (aOR = 1.60; CI 95%: 1.13-2.25) and sugary soft drinks (aOR = 1.46; CI 95%: 1.07-1.99) was associated with lower sleep quality., Competing Interests: The authors declare no conflict of interest.

Given that there is only a limited body of evidence available concerning the dietary habits of Spanish university students, the present study assesses the quality of this group's diet, their adherence to the National Food-Based Dietary Guidelines, and the predictive factors of their diet quality. To do so, a cross-sectional study was performed on a sample of 1055 students. The quality of the participants' diets was then analysed by using the Spanish Healthy Eating Index, and then their level of compliance was assessed in light of the dietary recommendations put forth by the Spanish Society for Community Nutrition. According to these standards, only 17.4% of the participants had a healthy diet. The level of compliance with the recommendations was poor, highlighting especially the low levels of "fruit" and "vegetables" that they consumed as well as high levels of "cold meats and cuts" and "sweets". The factors that predicted a worse diet are being male, living alone, low levels of physical activity, smoking, high alcohol intake, leading a sedentary lifestyle, psychological distress, and insomnia ( p < 0.005). Furthermore, participants with low or high body weights showed signs of a higher quality diet ( p < 0.001). The present findings suggest that a significant proportion of university students ought to change their dietary habits; these also attest to the importance of developing strategies that are directly targeted at university students in order to promote a healthy diet.

(1) Background: To examine the prevalence, and associated factors of, problematic Internet use in a sample of Spanish university students. (2) Methods: Cross-sectional descriptive study of a convenience sample of 698 university students. Self-esteem, alcohol consumption, perceived social support, depression, anxiety, stress and problematic Internet use were evaluated using the Rosenberg, CAGE, DUKE-UNC-11, DASS-21 and Young's Internet Addiction Test, respectively. (3) Results: Problematic internet use was reported by 21% of respondents. Risk of problematic Internet use was independently associated with the preferred use of the smartphone, time of exposure to the Internet, less perceived social support, problematic alcohol consumption and symptoms of stress and anxiety. We found significant association between problematic internet use and time of exposure to the Internet, residential status, alcohol consumption, self-esteem, perceived social support and psychological distress, after bivariate analysis. (4) Conclusions: A considerable prevalence of problematic Internet use was found; in our sample problematic Internet use was associated with stress, alcohol consumption, anxiety and perceived social support. Strategies aimed at the early identification of problematic Internet use may lead to an improvement in the psychosocial health of the university student population.

Cultural competence is an essential component in providing effective and culturally responsive healthcare services, reducing health inequalities, challenging racism in health care and improving patient safety, satisfaction and health outcomes. It is thus reasonable that undergraduate nursing students can develop cultural competency through education and training. The aim of this paper was to investigate nursing lecturers' perception and experience of teaching cultural competence in four undergraduate nursing programs. A phenomenological approach was selected to illicit nursing lecturers' perception of culture and experience of teaching cultural competence. Semi-structured personal interviews were held with a sample of 24 lecturers from four European universities. The anonymized transcripts were analyzed qualitatively following Braun and Clark's phases for thematic analysis. Six themes and fifteen subthemes emerged from thematic analysis of the transcripts. Cultural competence was not explicitly integrated in the nursing curricula. Instead, the lecturers used mainly examples and case studies to illustrate the theory. The integration of cultural content in the modules was unplanned and not based on a specific model. Nursing programs should be examined to establish how cultural content is integrated in the curricula; clear guidelines and standards for a systematic integration of cultural content in the nursing curriculum should be developed.

Visible nursing work is usually associated with formal work and physician-delegated tasks which are protocolised and usually well documented. Nevertheless, nurses carry out many actions and display specific attitudes and behaviours which, despite contributing to the well-being, recovery of patients and satisfaction with the attention received, are not as visible. Previous studies have been conducted in order to define 'invisible nursing interventions', but no quantitative instruments focused on measuring invisible nursing interventions have been found in the literature., Purpose: To test the psychometric properties of the Perception of Invisible Nursing Care-Hospitalisation (PINC-H) questionnaire., Methods: Cross-sectional survey design. A self-administered questionnaire was completed by 381 participants recruited consecutively after discharge from a Spanish hospital. Data were collected from 2012 to 2020., Results: Three factors were identified from exploratory factor analysis, namely 'Caring for the person', 'Caring for the environment and the family' and 'Caring presence'. Criterion Validity Coefficient was highly significant (p < 0.001) with values ranging between 0.63 and 0.71. Cronbach's alpha was 0.96. Test-retest reliability was estimated in a subsample of 187 participants; in all the items, correlation coefficients were highly significant (p < 0.001) and within range (0.532-0.811) with a mean value of 0.680. Also, correlations between each dimension and the complete questionnaire indicated good temporal stability between measurements., Conclusions: The instrument had satisfactory validity and reliability. PINC-H can contribute to highlight nursing interventions and behaviours which are often unseen and, thus, less valued. We argue that PINC-H will also be useful to evaluate the quality of invisible nursing care to oncology inpatients., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: To estimate the prevalence of symptoms of depression, anxiety, stress and associated factors in a population of college students., Method: Cross-sectional study of psychological distress measured through the Depression, Anxiety and Stress Scale (DASS-21) in a sample of 1074 college students., Results: We found a moderate prevalence of depression (18.4%), anxiety (23.6%) and stress (34.5%) symptoms in our study population. Being <21, having problematic Internet use behavior, smoking, presenting insomnia and having a low self-esteem were independently associated with symptoms of depression, anxiety and stress. Being a woman, living with their family, having a stable partner, consuming alcohol frequently and having poor nutritional habits were significantly associated with symptoms of stress; lacking a stable partner was significantly associated with depressive symptoms; and frequent consumption of alcohol was significantly associated with symptoms of anxiety., Conclusion: We found a moderate prevalence of depression, anxiety and stress symptoms in our population. Interventions aimed at promoting mental health among college students should be implemented.

Falls in the elderly are one of the main geriatric syndromes and a clear indicator of fragility in the older adult population. This has serious consequences, leading to an increase in disability, institutionalization and death. The purpose of this cross-sectional study was to analyze the prevalence of risk of falling and associated factors in a population of 213 non-institutionalised, able older adults with a history of falling in the previous year. We used the following assessment tools: Questionnaire of the WHO for the study of falls in the elderly, Geriatric Depression Scale and Tinetti's Gait and Balance Assessment Tool. Age, using ambulatory assistive devices, polymedication, hospital admission following a fall and depression were significantly associated with risk of falling. In order to prevent fall reoccurrence, community-based fall prevention programs should be implemented.

Objective: to determine the prevalence of cardiovascular risk factors in a cohort of workers and to quantify its association with compliance with the Mediterranean diet follow-up., Method: a cross-sectional descriptive study was carried out on a cohort of 23,729 workers. Clinical data from annual medical examinations and the Mediterranean Diet Adherence Screener were used to assess adherence to the Mediterranean diet., Results: 51.3% of the participants showed good adherence to the Mediterranean diet. The multivariate analysis showed an inverse and significant association between the follow-up of the Mediterranean diet and the prevalence of abdominal obesity (Odds Ratio = 0.64, 95% CI 0.56; 0.73), dyslipidemia (Odds Ratio = 0.55, 95% CI 0.42; 0.73), and metabolic syndrome (Odds Ratio = 0.76, 95% CI 0.67; 0.86)., Conclusions: our results suggest that the Mediterranean diet is potentially effective in promoting cardiovascular health. Implementing the interventions promoting the Mediterranean diet in the working population seems justified.

Introduction: Introduction: there is growing evidence linking food consumption with psychological health of adult people. This association has not been well explored among university students. Objectives: the aims of this study were to analyze the diet quality in a university population, and to assess its association with prevalence of anxiety, stress, depression, and insomnia. Methods: cross-sectional study of a sample of 1055 university students. Three validated questionnaires were used: the Healthy Eating Index (HEI), the Depression Anxiety Stress Scales (DASS 21), and the Insomnia Severity Index. Results: The average HEI score was 68,57±12,17. Prevalence of unhealthy eating was 82,3%, higher in women (84,8% vs. 76,4%). Unhealthy eating was significantly associated with prevalence of anxiety, depression, and stress. Excessive intake of sweets and low of dairy products were associated with higher prevalence of psychological and sleep disturbances. Conclusions: unhealthy eating patterns are common in university population and are related to anxiety, stress, and depression. Educational interventions to reduce unhealthy food consumption in university students can also result in psychological health improvements and/or vice versa.

Introduction: Objectives: to estimate the prevalence of overweight and obesity in a sample of workers in Aragón (Spain) and to assess its associations with diabetes, dyslipidemia, hypertension and metabolic syndrome. Methods: cross-sectional study of a sample of 23,729 workers. Data from routine medical check-ups (physical examination, blood analysis and structured questionnaire) practiced by MAS Sociedad de Prevención were used. Results: prevalence of overweight and obesity was 38.6% and 18.4%, respectively (higher in males). Prevalence of diabetes mellitus, hypertension, dyslipidemia and metabolic syndrome was 7.6%, 20.1%, 31.3% and 7.5%, respectively. There was a significant association between overweight and obesity and prevalence of diabetes, dyslipidemia, hypertension and metabolic syndrome. Conclusions: states of overweight and obesity are common in the working population and are related to a significant increase in the prevalence of cardiovascular risk factors. It is necessary to promote strategies for prevention and management of body weight in the working population.

Objectives: To describe gestational weight gain and postpartum weight retention in women classified by pre-pregnancy body mass index BMI)., Methods: Prospective cohort study with a sample of 301 women. Weight was evaluated throughout pregnancy and puerperium. Multilinear regression models were performed to assess determinants of gestational weight gain and postpartum weight retention by pre-gestationalBMI categories., Results: During pregnancy, 36.5% of the participants gained more weight than recommended, and 90% retained weight at six months after childbirth. Slim women had greater weight gain during pregnancy and retained more postpartum weight. Age, parity, miscarriage history, pre-gestational BMI, origin and place of residence were independently associated with gestational weight gain. Postpartum weight retention was directly related to gestational weight gain and inversely with breastfeeding duration., Conclusions: Pre-gestational BMI is a predictor of gestational weight gain. Also, gestational weight gain is a predictor of postpartum weight retention. Educational programs focused on promoting healthy behaviors are needed both in pregnancy and postpartum.

Palliative care is a group of actions performed by nurses in order to increase the comfort and well-being of patients with terminal illnesses. The World Health Organization (WHO) defines this term as: An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual [1]. Cicely Mary Strode Saunders is considered as the precursor of the palliative care, who explained the need to change the Palliative Care Units in order to improve the quality of life of patients with terminal illnesses. Palliative care is necessary for patients with a terminal illness. In such cases, the life expectancy is less than six months. Human being is considered a biopsychosocial model. For this reason, the nurse must take into account all the requirements arising from these three dimensions of the human being. In this essay, we deal with palliative care in patients with terminal illnesses, considering the role of the nurse as an important reference when teaching palliative care to the main carer.

Objective: To estimate the prevalence of falls in people over 65 years old institutionalized and to know the elderly profile of those who suffered falls in the last 12 months., Method: It was performed a transversal-descriptive study. The instruments used were the Mini-Mental State Examination (MMSE-35 Lobo, 1979) and the Questionnaire (1989) for the study of falls in the elderly. It was collected the following variables: age, sex, BMI, weight, height, assistive devices for ambulation, fear of falling, falling place, difficulty in actions, sort of footwear, fall time, lighting at the fall time, objects that could favour the fall, type of fall and contact with the health system., Results: All of the participants in this study were 51 valid elderly and institutionalized. In the last 12 months, 21 individuals suffered a fall. This is equivalent to 41,17% in both sexes, being a 61,91% for women and 38,09% for men. The BMI average in all of the study participants amounts to 26,6 kg/m2. By the MCA, it was observed how the overweight variable is, without any doubt, linked with suffering a fall. In the Mantel-Haenszel test, it was obtained that women between 85-90 years old had a 42% more probability of falling. The places with the highest prevalence of falls were inside the nursing home with 71,4%. The women reported a fear sensation in order to suffer a second fall by 84,6% and the men by 75% over the total falls which were produced in both sexes. From the elderly who suffered falls, 52,38% used technical assistance to ambulate, compared to the 47,61% who didn't use. The footwear, which was used the most at the time of the fall, was slippers with 38,1%. Most falls took place in the morning with a percentage of 47,6% and the 90,5% of the falls occurred with an optimal lighting and in the 71,4% of the falls, there wasn't anything that favoured them. The 66,7% of the falls didn't need health care after them and the 52,4% of the falls had no physical consequences. The main difficulties that arise in our elderly are run and roam., Conclusions: The record of the falls has allowed to know the falls prevalence which corresponds to 41,17% in both sexes. It's usually a woman aged between 85 and 90 years old with a MMSE-35 of 31,4 points and a BMI of 26,6 kg/m2 on average. The falls occur inside the nursing home and showed a high fear of faIling. The footwear used was slippers without technical assistance to ambulate. Most of the falls took place in the morning with optimal lighting conditions and without any object that had favoured the fall. The majority of the falls didn't present immediate consequences after them and they didn't seek healthcare. Therefore, it can be assumed that the falls could be influenced by intrinsic factors, maybe the elderly comorbidity could influence. It's clear that the furniture of the institution is not a decisive factor, although the highest prevalence appears inside the nursing home, but it was found that the elderly spend most of their time inside the nursing home. We're facing a public health problem, for our country's health system doesn't have an accurate estimate referring to the falls prevalence in the elderly population.

Aging is a stage with various changes and physiological modifications. It's a progressive, dynamic and irreversible process. Elderly people are beings fragile, multipathological, and polimedicated. 40 Of the world's population has indigestion. They are the most common digestive disorders: constipation, dysphagia, and dyspepsia, reaching levels of prevalence around the 25, 30 and 25 respectively. The main activity of the nursing professional lies in making a proper assessment of the patient and offer a health education regarding habits hygiene and dietetics, in order to reduce the intake of drugs and increase the quality of life of our elders. We should not forget that the family plays a fundamental role for the treatment of these disorders.