Dpto. Enfermería y Fisioterapia

Objetivo: Conocer el impacto de la intervención educativa realizada sobre los profesionales de una zona básica de salud y su grupo de participación comunitaria, que conforman el grupo intervención (GI), y analizar su repercusión en la cobertura vacunal alcanzada para gripe en el grupo de riesgo (gestantes y puérperas) comparándola con su zona básica vecina, que conforma el grupo control (GC), durante la temporada vacunal 2019/20. Dise˜no: Estudio cuasiexperimental de intervención comunitaria. Emplazamiento: Dos zonas básicas de salud pertenecientes al departamento de salud Elche- Crevillente, Espa˜na. Participantes: Gestantes y puérperas de 2 zonas básicas de salud y el grupo de participación comunitaria. Los profesionales de salud directamente relacionados con la campa˜na vacunal de gripe. Intervenciones: Sesión formativa al GI previa a la campa˜na de gripe 2019/20. Mediciones principales: Actitudes hacia la vacunación de gripe en profesionales sanitarios mediante el cuestionario validado CAPSVA y la cobertura vacunal de las gestantes y puérperas a través del Registro de Vacunas Nominal y su aceptación a la vacuna en la consulta de la matrona. Resultados: Los datos de cobertura vacunal en gripe registrados en el Registro de VacunasNominal para las mujeres gestantes y puérperas fue del 26,4% (n = 207) en el GI y del 19,7%(n = 144) en el GC (p = 0,001), con una razón de incidencia del 1,34, lográndose así un 34% másde vacunación en el GI. La aceptación para la vacunación en las consultas de la matrona tambiénfue elevada, inmunizándose en el GI el 96,5% vs. el 89,0% en el GC, con un RR = 1,09 (IC 95%1,01-1,62).Conclusiones: Estrategias de formación conjunta a profesionales y activos de la comunidadmejoran los resultados de cobertura vacunal.

Objective: To evaluate the effect on the satisfaction of nursing students and the participants of Service-Learning methodology in the development of Health Education workshops. Materials and methods: Service-Learning project was designed in four stages: 1) students training in knowledge about Community Nursing and Health Education; 2) development of healthy workshops for its implementation in associations; 3) implementation of the workshops; 4) reflection on Service-Learning impact. An ad hoc questionnaire was developed to assess students’ satisfaction. It was also evaluated the workshops’ participant’s satisfaction. Results: students reported having a very high level of satisfaction by increasing their scores after improving Service-Learning methodology in the subject. In addition, participants who received health promotion workshops developed by nursing students reported a positive impact on their health. Conclusion: development of Service-Learning methodology associated with health education implies high level of satisfaction in nursing students and a social impact for the community.

Caso clínico de un paciente varón de 94 años, que presentaba pérdida de la integridad cutánea (úlcera por presión) en el maléolo lateral externo de su pierna derecha. La resolución del caso supuso un periodo de cuidados de once meses hasta su resolución definitiva, con una variabilidad en los tratamientos tópicos de cura en ambiente húmedo con terapia de presión negativa, según necesidades evolutivas debidas al proceso crónico y tórpido de la úlcera.

Accurate evaluation of physical function in patients undergoing haemodialysis is crucial in the analysis of the impact of exercise programs in this population. The aim of this study was to evaluate the reproducibility of several physical functional tests, depending on the timing of their implementation (before the HD session vs. non-HD days). This is a prospective, non-experimental, descriptive study. Thirty patients in haemodialysis were evaluated twice, 1 week apart. The test session was performed before the haemodialysis session started and a retest was performed in non-dialysis day. The testing battery included the short physical performance battery, sit-to-stand tests, 6 min walk test, one-leg stand test, timed up and go, and handgrip strength with and without forearm support. The intrarater reproducibility was determined by the intraclass correlation coefficients and the agreement was assessed by Bland–Altman analysis. The intraclass correlation coefficients values ranged from 0.86 to 0.96, so that all tests showed good to very good relative reliability. The mean differences between trials of sit to stand 10 and 60, timed up and go and all the handgrip tests were close to zero, indicating no systematic differences between trials. Large range of values between trials was observed for the 6 min walk test, gait speed, one-leg stand test and short physical performance battery, indicating a systematic bias for these four tests. In conclusion, the sit to stand 10 and 60, timed up and go and handgrip tests had good to excellent test–retest reliability in measuring physical function in different dialysis days of patients undertaking haemodialysis. The minimal detectable change values are provided for this population. Bias were found for the 6 min walk test, gait speed, Short physical performance battery or one-leg stand test when the testing day changed.

Background: The central component of person-centred care is in having a therapeutic realtionship. Furthermore, the empathy of the physiotherapist is one of the most important attributes in achieving a successful therapeutic alliance. Objective: The aim of the research was to determine the association between the constructs of empathy and therapeutic alliance in Spanish physical therapists and the possible influence of socio-professional variables on them. Design: Cross-sectional research. Methods: An electronic survey including the Working Alliance Inventory-Short Form, the Interpersonal Reactivity Index and sociodemographic data with 473 Spanish physiotherapists. A descriptive, bivariate and simple lineal regression analysis was carried out. Results: Work experience has a positive influence on bonding and the agreement on objectives and tasks (0.04 < B > 0.06; p < 0.01). The perspective taking dimensions and empathic concern positively influence the agreement on achievement (0.14 < B > 0.19; p < 0.001). Personal distress inversely influences bonding and the agreement on achievements and tasks (􀀀 0.13 < B > 􀀀 0.09; p < 0.01). Conclusions: The dimensions of perspective taking and empathic concern seem to facilitate successful shared decision making in terms of treating objectives. Furthermore, the physiotherapist’s personal distress acts as an obstacle to the development of the three subcomponents of the therapeutic alliance analysed.

The biopsychosocial paradigm contemplates the patient’s personality traits in physiotherapy treatments for chronic pain. Among these traits, the locus of control has a direct relationship with the person’s coping strategies in the face of their health problems. The objective of this systematic review was to assess the influence of locus of control on the efficacy of physiotherapy treatments in patients with chronic pain. A systematic review of the publications of the last ten years in Pubmed, Scopus, Science Direct and Web of Science databases was conducting with the terms physical therapy modalities, chronic pain, internal-external control, self-management, physical therapy and physiotherapy. The inclusion criteria were participants with chronic pain lasting at least three months who have received at least one session of physical therapy; the studies should have collected the patient’s locus of control as a prognostic factor at the beginning of physiotherapy treatment; the variables studied should include the pain intensity or clinical variables related to pain. A total of 13 articles were found, of which three were experimental studies and ten were observational studies. The included samples had chronic knee pain, nonspecific back pain, low back pain or neck pain; were people over 65 years of age or patients who had undergone hand surgery. In patients with chronic pain for more than three months, the locus of control construct participates as a predictor of the results of physiotherapy treatment. The presence of an internal locus of control favors better results. The personality traits of the subjects represent an important factor to take into account when planning physiotherapy treatments.

Due to the COVID-19 pandemic, physical therapists have had to adopt a set of specific protection measures, which have had an impact on their clinical activity and economy. The objective was to evaluate the impact of the COVID-19 pandemic on the work of Spanish physical therapists, as well as their attitudes and predisposition to vaccination. An online questionnaire was divided into five sections: (1) demographic and professional data; (2) labor impact; (3) precautions and infection-control measures; (4) economic impact; and (5) vaccine acceptance and adverse effects. Of the 666 participants, 62.1% showed a reduction in their working hours motivated by: fear of infection (p = 0.007), financial issues (p = 0.002) and being in quarantine or isolation (p < 0.001). Of these, 36.4% were forced to close the clinic, 62.7% requested help from the government, but only 12.04% mentioned that it was adequate. The main prevention measures adopted were the use of gels and masks and, in the private sector, disinfection with ozone or ultraviolet light (p < 0.05). The acceptance of the vaccine was high, 87.5%, being lower among the group over 40 years of age, self-employed, widowed or separated. More adverse effects were mentioned after receiving the AstraZeneca-Oxford vaccine, compared to Pfizer-BioNTech or Moderna. In conclusion, this study assessed for the first time that the COVID-19 pandemic in Spain had a negative impact on work and finances of physical therapists. The vaccine was widely accepted, in part by the economic impact that an infection in the work setting could signify.

Objectives: To analyse the relationship between spirometric parameters measured with a face mask versus a mouthpiece, as well as the feasibility of face mask spirometric evaluation in a head and neck surgery (HNS) decannulation context. Furthermore, we examine peak inspiratory flow (PIF) cut-off values before and after decannulation. Design: Prospective cohort study. Setting: Otolaryngology HNS Department of a university teaching hospital. Participants: Twenty-four patients were selected. A maximal flow-volume loop was conducted before (with mouthpiece) and after (with mouthpiece and face mask) decannulation. Main outcome measures: Recorded outcomes were forced vital capacity (FVC), forced expiratory volume in the first second, peak expiratory flow, PIF, forced expiratory flow at 50% of FVC and forced inspiratory flow at 50% of FVC. Spearman correlation coefficients between spirometric parameters measured with a face mask versus a mouthpiece were calculated. Wilcoxon test was used to check differences between mouthpiece and face mask values. Results: Correlation between mouthpiece and face mask spirometric values was moderate to high (r = 0.46–0.95). All parameters measured by spirometry were significantly lower with a face mask than those obtained with a mouthpiece (p < 0.05). Before decannulation, the lowest PIF value (tested with mouthpiece) that allowed successful decannulation was 1 L/s. After decannulation, the lowest PIF value tested with mouthpiece and face mask for successful completion of the decannulation process were 0.77 and 0.56 L/s, respectively. Conclusion: Face mask is a feasible option to perform a spirometry when face diseases hinder spirometric evaluation through a mouthpiece in an HNC surgery context.

This study analyses the obstetric–neonatal outcomes of women in labour with symptomatic and asymptomatic COVID-19. A retrospective, multicenter, observational study was carried out between 1 March 2020 and 28 February 2021 in eight public hospitals in the Valencian community (Spain). The chi-squared test compared the obstetric–neonatal outcomes and general care for symptomatic and asymptomatic women. In total, 11,883 births were assisted in participating centers, with 10.9 per 1000 maternities (n = 130) infected with SARS-CoV-2. The 20.8% were symptomatic and had more complications both upon admission (p = 0.042) and during puerperium (p = 0.042), as well as transfer to the intensive care unit (ICU). The percentage of admission to the Neonatal Intensive Care Unit (NICU) was greater among offspring of symptomatic women compared to infants born of asymptomatic women (p < 0.001). Compared with asymptomatic women, those with symptoms underwent less labour companionship (p = 0.028), less early skin-to-skin contact (p = 0.029) and greater mother–infant separation (p = 0.005). The overall maternal mortality rate was 0.8%. No vertical transmission was recorded. In conclusion, symptomatic infected women are at increased risk of lack of labour companionship, mother–infant separation, and admission to the ICU, as well as to have preterm births and for NICU admissions.

Anxiety, depressive symptoms and stress have a significant influence on chronic musculoskeletal pain. Behavioral modification techniques have proven to be effective to manage these variables; however, the COVID-19 pandemic has highlighted the need for an alternative to face-to-face treatment. We conducted a search of PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL),Web of Science, APA PsychInfo, and Psychological and Behavioural Collections. The aim was to assess the effectiveness of telematic behavioral modification techniques (e-BMT) on psychological variables in patients with chronic musculoskeletal pain through a systematic review with meta-analysis. We used a conventional pairwise meta-analysis and a random-effects model. We calculated the standardized mean difference (SMD) with the corresponding 95% confidence interval (CI). Forty-one randomized controlled trials were included, with a total of 5018 participants. We found a statistically significant small effect size in favor of e-BMT in depressive symptoms (n = 3531; SMD = 􀀀0.35; 95% CI 􀀀0.46, 􀀀0.24) and anxiety (n = 2578; SMD = 􀀀0.32; 95% CI 􀀀0.42, 􀀀0.21) with low to moderate strength of evidence. However, there was no statistically significant effect on stress symptoms with moderate strength of evidence. In conclusion, e-BMT is an effective option for the management of anxiety and depressive symptoms in patients with chronic musculoskeletal pain. However, it does not seem effective to improve stress symptoms.