Revistas UDEA (Universidad de Antioquia)
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Prevalência e fatores associados ao Burnout Acadêmico em estudantes de ciências da saúde no contexto do COVID-19
No full textIntroduction: The COVID-19 pandemic has had a significant impact not only on the infected population, but also on education and, above all, on the health of students. Factors such as quarantine, virtual classes and workload may be predisposing to pathologies such as Academic burnout syndrome.Objective: The objective of this study is to identify the prevalence of Academic burnout Syndrome (ABS) and the factors associated with its occurrence in surgical instrumentation students in the context of the COVID-19 pandemic. Methods: A cross-sectional study was conducted in surgical instrumentation students of a private institution in the city of Bogota. The MBI - SS (Maslach Burnout Inventory – Student Survey) and variables of interest were used. Descriptive statistics, OR (Odds Ratios) and a logistic regression model were calculated, as well as Spearman correlations. Results: A prevalence of SBOA of 75.1% was identified, physical activity is presented as a protective factor OR=0.22 CI 95% (0.064 - 0.784) p = 0.007, a negative correlation was also found between exercise and dimensions such as burnout (p = -0.294; p<0.001) and cynicism (p = -0.253; p<0.001). A significant limitation was the scarce literature of analytical studies in the context of surgical instrumentation. Conclusions: This study presents a main finding due to; it demonstrates the influence of physical activity on the occurrence of SBOA in a pandemic context.Introducción: la pandemia por COVID-19 ha generado un impacto signi-ficativo no solo en la población contagiada, sino también en la educación y sobre todo en la salud de los estudiantes. Factores como las cuarentenas, las clases virtuales y la carga de trabajo pueden ser predisponentes para padecer síndrome de burnout académico.
Objetivo: identificar la prevalencia de síndrome de burnout académico (SBOA) y factores asociados a su ocurrencia en estudiantes de instrumenta-ción quirúrgica en contexto de la pandemia por COVID-19. Métodos: se realizó un estudio de corte transversal en estudiantes de Instrumentación Quirúrgica de una institución privada de la ciudad de Bogotá. Se empleó el MBI – SS (Maslach Burnout Inventory – Student Survey) y variables de interés. Se calcularon estadísticos descriptivos, OR (Odds Ratio) y se realizó un modelo de regresión logística, también se calcularon correlaciones de Spearman.
Resultados: se identificó una prevalencia de SBOA de 75,1%, la actividad física se presenta como factor protector OR=0,22 IC95% (0,064 – 0,784) p = 0,007, también se encontró una correlación negativa entre el ejerci-cio y dimensiones como el agotamiento (ρ=-0,294; p<0,001) y el cinismo (ρ=-0,253; p<0,001). Una limitación significativa fue la escasa bibliografía de estudios analíticos en el contexto de instrumentación quirúrgica.
Conclusiones: este estudio presenta un hallazgo relevante puesto que demuestra la influencia de la actividad física en la ocurrencia de SBOA en un contexto de pandemia.Introdução: A pandemia da COVID-19 teve um impacto significativo não apenas na população infectada, mas também na educação e, acima de tudo, na saúde dos estudantes. Fatores como a exposição à quarentena, aulas virtuais e carga de trabalho podem ser predisponentes a patologias como a Síndrome de Burnout Acadêmico.Objetivo: O objetivo deste estudo é identificar a prevalência da Síndrome de Burnout Acadêmico (ABS) e os fatores associados à sua ocorrência em estudantes de instrumentação cirúrgica no contexto da pandemia da COVID-19. Métodos: Foi realizado um estudo transversal em estudantes de instrumentação cirúrgica de uma instituição privada na cidade de Bogotá. Foram utilizados o MBI - SS e variáveis de interesse. Estatísticas descritivas, OR e um modelo de regressão logística foram calculados, assim como correlações Spearman. Resultados: Foi identificada uma prevalência de SBOA de 75,1%, a atividade física é apresentada como um fator protetor OR=0,22 CI 95% (0,064 - 0,784) p=0,007, também foi encontrada uma correlação negativa entre exercício e dimensões como burnout (ρ=-0,294; p<0,001) e cinismo (ρ=-0,253; p<0,001). Uma limitação significativa foi a escassa literatura de estudos analíticos no contexto da instrumentação cirúrgica. Conclusões: Este estudo apresenta uma externalidade já que; demonstra a influência da atividade física na ocorrência da SBOA em um contexto pandêmico
Efectos inmunológicos de los inhibidores de integrasa como parte de la terapia de inicio en personas viviendo con VIH: revisión sistemática de la literatura
No full textIntroduction: The use of integrase inhibitors within highly active antire-troviral therapy (HAART) has demonstrated benefits for individuals living with HIV. However, most comparisons are based on effectiveness against viral replication, with limited information on their impact on the immune system.Objective: To identify immunological outcomes in studies comparing in- tegrase inhibitors (INSTIs) with other drugs used as third agents in HAART.Methods: Systematic review of studies reporting patients treated with INS- TIs versus non-nucleoside reverse transcriptase inhibitors (NNRTIs) or pro-tease inhibitors (PIs) as the third drug in HAART. Immunological reconstitution outcomes were assessed, including CD4+ T lymphocyte count, CD4/ CD8 ratio, serum concentration of sCD14, D-dimer, and C-reactive protein, as well as the frequency and phenotype of T cells, functional capacity of T cells, and proviral DNA.Results: A total of 2804 studies were screened, 59 were evaluated in full text and four were included in the synthesis. A cohort study reported normalization of the CD4/CD8 ratio in patients initiating treatment with INSTIs compared to PIs or NNRTIs. However, this finding was not consistently replicated in other studies, and in one of them, this ratio was higher in those receiving efavirenz vs. dolutegravir. No evidence was found for other outcomes.Conclusions: The analyzed studies are inconclusive regarding differences in immunological reconstitution between INSTIs vs. PIs and NNRTIs.Introducción: el uso de fármacos inhibidores de integrasa dentro de la terapia antirretroviral altamente activa (TARAA) ha mostrado beneficios en personas viviendo con el VIH. Sin embargo, la mayoría de las comparaciones se basan en la efectividad sobre la replicación viral, pero existe información limitada acerca de su efecto sobre el sistema inmune.Objetivo: identificar los desenlaces inmunológicos en estudios que comparan inhibidores de integrasa con otros medicamentos utilizados como tercer fármaco en la TARAA.Métodos: revisión sistemática de estudios que reportaban pacientes tratados con inhibidores de integrasa (INSTI) vs. inhibidores de transcriptasa reversa no análogos de nucleósido (ITRNN) o inhibidores de proteasa (IP) como tercer fármaco de la TARAA. Se evaluaron desenlaces de reconstitución inmunológica incluyendo recuento de linfocitos T CD4+; índice CD4/ CD8; concentración sérica de sCD14, dímero D y proteína C reactiva; frecuencia y fenotipo de las células T; capacidad funcional de las células T y ADN proviral.Resultados: en total fueron tamizados 2804 estudios, se evaluaron 59 en texto completo y cuatro fueron incluidos en la síntesis. Una investigación de cohorte reportó normalización del índice CD4/CD8 en pacientes que iniciaron con INSTI vs. IP o ITRNN. Sin embargo, este hallazgo no fue replicado en los demás estudios, e incluso, en uno de ellos este índice fue mayor en quienes recibieron efavirenz vs. dolutegravir. No se encontró evidencia para los demás desenlaces.Conclusiones: los estudios analizados no son concluyentes sobre las diferencias en la reconstitución inmunológica de los INSTI vs. los IP y los ITRNN
Perfil epidemiológico, clínico y complicaciones de pacientes con quemaduras eléctricas en una unidad de quemados
No full textIntroduction: Electrical burns are a frequent cause of complications, including infections, the need for grafts and amputations that affect functionality.Objective: To identify the sociodemographic and clinical characteristics and complications in patients with electrical burns and their compromised functionality.Methods: Analytical cross-sectional study in patients with electrical burns hospitalized in the years 2018 to 2020. Demographic and clinical variables, CPK levels, need for graft, amputation, functionality and mortality were analyzed.Results: The average age was 33 years (SD: 16 years), 88.4% were of legal age and 91.6% were male, with a median hospital stay of 21 days, 17.5% required ICU. 29.9% had infection, 5.8% sepsis and 20.1% had amputation. Differences were sought between patients with and without amputation, finding in the Barthel scale a higher percentage of patients with independence in the group without amputation (17.6%) compared to the group of amputated patients, who had some degree of dependency. CPK levels were higher in amputees compared to non-amputees (7,356 mcg/L vs. 611 mcg/L, p<0.001), and longer hospital stays (32 days vs. 12 days, respectively, p<0.001). Hospital mortality was 3.2%.Conclusion: Electrical burns occur in all age groups, but more frequently in persons 18 years of age or older, male, occupationally active, in the workplace. The increase in total CPK should alert the clinician to the risk of amputation, which causes varying degrees of dependence in affected individuals.Introducción: las quemaduras eléctricas son causa frecuente de complicaciones entre ellas infecciones, necesidad de injertos y amputaciones que afectan la funcionalidad Objetivo: identificar las características sociodemográficas, clínicas y complicaciones en pacientes con quemaduras por electricidad y su efecto en la funcionalidadMétodos: estudio transversal analítico en pacientes con quemadura por electricidad hospitalizados en los años 2018 a 2020. Se analizaron variables demográficas, clínicas, niveles CPK, necesidad de injerto, amputación, funcionalidad y mortalidad.Resultados: la edad promedio fue de 33 años (DE: 16 años), 88,4% eran de 18 años en adelante y 91,6% de género masculino con una mediana en la hospitalización de 21 días, 17,5% requirieron UCI. El 29,9% presentaron infección, 5,8% sepsis y 20,1% tuvieron amputación. Se buscaron diferencias entre los pacientes con y sin amputación encontrando en la escala de Barthel mayor porcentaje de pacientes con independencia en el grupo sin amputación (17,6%) en comparación con el grupo de pacientes amputados, los cuales tenían algún grado de dependencia. Los valores de la CPK estuvieron más elevados en las personas amputadas comparadas con las no amputadas (7.356 mcg/L vs. 611 mcg/L, p<0,001); así mismo el tiempo de hospitalización fue mayor en los pacientes amputados (32 días vs. 12 días respectivamente, p<0,001). La mortalidad hospitalaria fue del 3,2%. Conclusión: las quemaduras eléctricas se presentan en todas las edades, pero con mayor frecuencia en personas de 18 años o más, sexo masculino, laboralmente activos, en el lugar trabajo. El incremento en la CPK total debe alertar al clínico sobre el riesgo de amputación, lo que ocasiona diversos grados de dependencia en las personas afectadas
Experimentar cáncer de mama confronta con la muerte, pero reconcilia con la vida. Estudio cualitativo con el método de la Teoría Fundamentada
No full textIntroduction: Breast cancer is the most common oncological diagnosis in women, and experiencing it generates physical, psychological, and social demands.Objectives: To describe the meaning women construct around breast cancer and their coping strategies.Materials and Methods: A hermeneutic study with a constructivist/interpretive paradigmatic approach, based on Grounded Theory. Twenty semistructured interviews were conducted with women diagnosed with breast cancer at Hospital Pablo Tobón Uribe. The analysis utilized open and axial coding characteristic of the methodology.Results: The primary emergent meanings of breast cancer were the imminence of death and forced awareness of life's finitude. The diagnosis news generates profound uncertainty, fear of death, and the devastating effects of treatment. Some women face it alone to protect their families from suffering. Cancer highlights pre-existing life burdens: fears, situations, unresolved interpersonal relationships, or emotions difficult to manage. Cancer, as an extreme experience, improves self-relationship, enables recognition of life's essentials, and re-evaluates relationships with others. Humanized and empathetic treatment from healthcare personnel helps alleviate suffering and distress. Cancer catalyzes thoughts about the meaning of life.Conclusions: The breast cancer experience confronts death but reconciles with life, as the proximity to death triggers the necessary coping mechanisms to produce changes that allow for a more fulfilling life.Introducción: el cáncer de mama es el diagnóstico oncológico más común en las mujeres y padecerlo genera demandas físicas, psicológicas y sociales.Objetivos: describir el significado que las mujeres construyen alrededor del cáncer de mama y su afrontamiento.Materiales y métodos: estudio hermenéutico con enfoque paradigmático constructivista/interpretativo, basado en la Teoría Fundamentada. Se realizaron 20 entrevistas semiestructuradas a mujeres con diagnóstico de cáncer de mama del Hospital Pablo Tobón Uribe. El análisis utilizó codificación abierta y axial propia de la metodología.Resultados: los principales significados emergidos sobre el cáncer de mama fueron inminencia de muerte y toma de conciencia forzada de la finitud de la vida. La noticia del diagnóstico genera una profunda incertidumbre, miedo ante la posibilidad de morir y los nefastos efectos de tratamiento.Algunas lo afrontan en soledad para proteger del sufrimiento a la familia. El cáncer hace evidente las cargas previas que pesan en la vida: miedos, situaciones, relaciones interpersonales o emociones no resueltas y difíciles de gestionar. El cáncer como experiencia extrema mejora la relación consigo mismo, posibilita reconocer lo esencial en la vida y reevalúa las relaciones con las personas. El trato humanizado y empático del personal de salud ayuda a aliviar el sufrimiento y la angustia. El cáncer cataliza los pensamientos alrededor del sentido de la vida.Conclusiones: la experiencia del cáncer de mama confronta con la muerte, pero reconcilia con la vida, pues la proximidad de la muerte detona el afrontamiento necesario para producir cambios que permiten vivir una vida más gratificante
Emergency Care for Suicidal Behavior Before and During the COVID-19 Pandemic in Two Hospitals in Bogotá: a Longitudinal Analysis
No full textIntroduction: The impact of the COVID-19 pandemic and confinement measures on the pattern of admissions for suicidal behavior in emergency departments is unknown.
Methods: A retrospective longitudinal cohort study was conducted, collecting monthly data from January 2015 to June 2022 from the mental health program of two reference institutions in Bogota. All patients were assessed by psychiatrists and psychologists in the emergency department and their demographic, clinical and specific attributes of suicidal behavior were characterized. An interrupted time series analysis was performed to evaluate the trend and impact on the pattern of care before and during the pandemic.
Results: A total of 884 individuals were admitted for suicidal behavior during the study period (67% women, 66% young adults, 55% students, and 1.6% LGBTQ+ population). There was an increase in the number of cases attended (mean of 5 additional cases per month) compared to the prepandemic period (p < 0.000). Suicidal ideation was the most documented typology during the pandemic (p <0.001), and the prevalence of suicidal behavior among children and adolescents (≤18 years) increased from 29% to 33%.
Conclusions: Theresults suggest that the pandemic catalyzed the number of admissions for suicidal behavior in the general population after the implementation of containment measures or contagion prevention restrictions. The need to integrate emergency departments in the prevention, detection, management, and follow-up of suicidal behavior, especially in the current mental health epidemic, is underscored.Introduction: The impact of the COVID-19 pandemic and confinement measures on the pattern of admissions for suicidal behavior in emergency departments is unknown.
Methods: A retrospective longitudinal cohort study was conducted, collecting monthly data from January 2015 to June 2022 from the mental health program of two reference institutions in Bogota. All patients were assessed by psychiatrists and psychologists in the emergency department and their demographic, clinical and specific attributes of suicidal behavior were characterized. An interrupted time series analysis was performed to evaluate the trend and impact on the pattern of care before and during the pandemic.
Results: A total of 884 individuals were admitted for suicidal behavior during the study period (67% women, 66% young adults, 55% students, and 1.6% LGBTQ+ population). There was an increase in the number of cases attended (mean of 5 additional cases per month) compared to the prepandemic period (p < 0.000). Suicidal ideation was the most documented typology during the pandemic (p <0.001), and the prevalence of suicidal behavior among children and adolescents (≤18 years) increased from 29% to 33%.
Conclusions: Theresults suggest that the pandemic catalyzed the number of admissions for suicidal behavior in the general population after the implementation of containment measures or contagion prevention restrictions. The need to integrate emergency departments in the prevention, detection, management, and follow-up of suicidal behavior, especially in the current mental health epidemic, is underscored
Sarcopenia and Frailty in Older Adults in Medellin. SABE Colombia 2015 Survey
No full textIntroduction: Sarcopenia and frailty are important medical syndromes affecting the health of older adults.Objectives: To determine the prevalence of sarcopenia and frailty in older adults in Medellín by conducting a secondary analysis of data from the 2015 National Survey on Health, Well-being, and Aging in Colombia (known as SABE Colombia 2015).Methods: Sociodemographic, anthropometric, and health variables in adults ≥60 years were analyzed using the SABE Colombia 2015 data. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), while frailty was defined using Fried et al.'s phenotype. Binary logistic regression was used to identify factors associated with sarcopenia and frailty.Results: A total of 496 individuals were studied for sarcopenia and 451 for frailty. Sarcopenia was present in 41 older adults (8.3%), while 48 were frail (11.6%). Logistic regression analysis showed that increasing age, lack of formal education, and lower BMI values increase the likelihood of sarcopenia: age (OR 1.08), no formal education (OR 4.4), and BMI (OR 0.66). The factors associated with frailty included age (OR 1.06), no formal education (OR 5.04), and primary education level (OR 4.56).Conclusions: The prevalence of sarcopenia was lower than that of frailty, and both conditions increase with age and lack of formal education. Early detection of these syndromes and timely management will help reduce morbidity and mortality, contributing to healthier aging.Introduction: Sarcopenia and frailty are important medical syndromes affecting the health of older adults.Objectives: To determine the prevalence of sarcopenia and frailty in older adults in Medellín by conducting a secondary analysis of data from the 2015 National Survey on Health, Well-being, and Aging in Colombia (known as SABE Colombia 2015).Methods: Sociodemographic, anthropometric, and health variables in adults ≥60 years were analyzed using the SABE Colombia 2015 data. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), while frailty was defined using Fried et al.'s phenotype. Binary logistic regression was used to identify factors associated with sarcopenia and frailty.Results: A total of 496 individuals were studied for sarcopenia and 451 for frailty. Sarcopenia was present in 41 older adults (8.3%), while 48 were frail (11.6%). Logistic regression analysis showed that increasing age, lack of formal education, and lower BMI values increase the likelihood of sarcopenia: age (OR 1.08), no formal education (OR 4.4), and BMI (OR 0.66). The factors associated with frailty included age (OR 1.06), no formal education (OR 5.04), and primary education level (OR 4.56).Conclusions: The prevalence of sarcopenia was lower than that of frailty, and both conditions increase with age and lack of formal education. Early detection of these syndromes and timely management will help reduce morbidity and mortality, contributing to healthier aging
Dual Clinical Collaborator: A Pragmatic Role of nurses from developing countries
No full textCollaboration is crucial in Professional nursing practice. Nurses act as a liaison between physicians and patients and their family members. Thus, it is vital to define the collaborative role of nurses in developing countries. The authors discuss pragmatic nurses’ role by adopting the Dual Clinical Collaborator model to ensure offering the quality of care to their clients. Nursing is a healthcare profession that focuses on the care of individuals and their families to help them recover from illness and maintain optimal health and quality of life. Health Care Professionals (HCPs) work together to provide quality health care and accomplish common goals. As healthcare delivery is becoming more complex, collaboration among healthcare workers and the patient can be a path to improve the quality of healthcare services
Development and Validation of the Companion's Satisfaction Questionnaire of Patient's Hospitalized in Intensive Care Units
No full textObjective. The current study aimed to develop and validate of companions’ satisfaction questionnaire of patients hospitalized in ICUs.
Methods. This is a methodological study that was performed in three phases: In the first phase, the concept of companion's satisfaction of patients hospitalized in ICUs was defined through qualitative content analysis method. In the second phase, early items of questionnaire were generated based on findings of the first phase. In the third and final phase, validation of the questionnaire was evaluated using face, content and construct validity as well as reliability.
Results. In exploratory factor analysis, three subscales including: satisfaction with nursing staff communication (5 items), satisfaction with nursing care (12 items), and satisfaction with decision making (5 items) were extracted by Eigen value above one and factor load above 0.5. Internal consistency and stability of the developed questionnaire confirmed with 0.94 and 0.95 respectively that indicated acceptable reliability.
Conclusion. The 22-item developed questionnaire is valid and reliable for measurement of levels of companion's satisfaction of Iranian patients hospitalized in ICUs